[Different doses of ibuprofen in the treatment of patent ductus arteriosus: a randomized clinical trial]

Patent ductus arteriosus [PDA] is a common finding among premature or low-birth-weight infants and it often does not close. Nowadays, drugs used for its treatment include indomethacin and more commonly ibuprofen. Oral ibuprofen was recently shown to be as effective and have several important advantages in preterm infants. Studies performed to find the best dose of ibuprofen for PDA treatment are limited; hence, we compared the effects of two different doses of ibuprofen in this interventional study. In this randomized controlled clinical trial, we randomly divided 60 patients with echocardiographically confirmed PDA into two groups of 30. This study was done in NICU of Valiasr hospital in 1387-89 years. In the first group, we administered a loading dose of 10 mg/kg ibuprofen on the first day, followed by two doses of 5 mg/kg in the next two days. In the second group, we administered a loading dose of 15 mg/kg ibuprofen on the first day followed by two doses of 7.5 mg/kg in next two days. Eventually, we compared PDA closure rates and complications of therapy between the two groups. Thirty [100%] patients in 15-mg/kg group and 23 [76.7%] patients in 10 mg/kg group had successful PDA closure with no need for surgery. The two groups had a statistically significant difference [P=0.011] and the highest response to treatment was seen within the first 24 hours of treatment. We may conclude that higher doses of ibuprofen [15 and 2x7.5 mg/kg] would offer better outcomes for PDA closure without gastrointestinal or renal complications and less need for surgery.

[Clinical, epidemiological, and molecular evaluation of SMA type I in Iran [a pilot study]]

Spinal muscular atropies are common [genetically determined] disorders. They are heterogeneous both in genetic and phenotypic characteristics. Prevalence of disease was reported between 1 in 6000 to 1 in 25000 in different populations. So, carrier frequency should be 1 in 40 to 1 in 80 in those people. Deletion of both copies of SMA, gene was detected in more than%90 of SMA patients. According to present data there were not any epidemiological study and data in Iran regarding SMAs. So, we do not have accurate information about prevalence, incidence of disease and its carrier frequency. Because of high rate of consanguinity it should be high. With this background, we decided to carry this pilot study out, to determine prevalence, incidence, carrier rate, along with consanguinity rate, clinical spectrum, and molecular abnormality in the affected cases. In a 2 years period, 30734 live-born babies followed, 4 patient affected to SMA type I were detected. Prevalence of SMA I in this population was 1 in 7683, and carrier frequency was 1 in 43. At least 2 third of the newborn babies were product of consanguineous marriages