Implications of maternal vitamin D administration for the neonatal respiratory distress syndrome: A randomized clinical trial.

BACKGROUND: Vitamin D deficiency has been suggested to be a risk factor for neonatal respiratory distress syndrome (RDS). This study aimed to evaluate the effect of 25 (OH) D administrations in pregnant women with findings of preterm labor on the incidence of RDS in their preterm neonates. MATERIALS AND METHODS: A randomized controlled clinical trial was conducted on pregnant mothers with gestational age (GA) of less than 34 weeks at risk of preterm delivery. 175 subjects were randomly assigned into two groups, including intervention (intramuscular injection of 50,000 units of 25(OH) D during 72 hours before delivery) and control (no injections). Serum concentrations of 25(OH) D were measured shortly after birth in both mothers and neonates. Then, clinical and laboratory results of mothers and their offspring were recorded (in a checklist). Short-term outcomes and the need for respiratory support were also assessed. Data were analyzed by independent t-test, Mann-Whitney U test, Fisher's exact test, and chi-square test. RESULTS: Even though gestational age, birth weight, delivery method, and serum vitamin D levels are consistent among both groups, 45% of neonates in the control group and 20% in the intervention group developed respiratory distress syndrome (P = 0.05). The mean 25(OH) D level in neonates was 17.7±10.5 and 19.29±9.94 ng/mL in the intervention and control groups, respectively (P > 0.05). CONCLUSION: A single dose of 50,000 units of intramuscular 25(OH)D in pregnant women at risk of preterm labor can lower the risk of RDS in the infant.

Effectiveness of Matricaria chamomilla (chamomile) extract on pain control of cyclic mastalgia: a double-blind randomised controlled trial.

Breast pain (mastalgia) often precedes menstrual period, which is of mild to moderate severity. This study was performed to determine the effectiveness of chamomile on pain control of cyclic mastalgia. This double-blind randomised controlled clinical trial was conducted on 60 patients with mastalgia referred to the breast clinic of an academic hospital, Mashhad University of Medical Sciences. The patients were randomly allocated into two groups: chamomile (n = 30) and placebo (n = 30). Primary outcomes were: (1) assessment of the visual analogue scale (VAS) and (2) assessment of the breast pain chart (BPC) 8 weeks after initial intervention. All the participants were asked to take drops three times a day each time having five drops for two consecutive months. Significant decline was observed in both the groups (chamomile and placebo) after two months (p < .0001 and p = .048, respectively) compared to baseline and between two groups (p = .007). Chamomile was a well-tolerated, secure and effective drug for treating women with mild to moderate mastalgia. Impact statement What is already known on this subject: Breast pain (mastalgia) is a common chief complaint reported by many women. The 'cyclic' type, which usually occurs monthly prior to the onset of menstrual period, is of moderate severity. In 30% of the cases, mastalgia is severe and disturbs normal life, leading to sexual, physical, and social dysfunction as well as depression and anxiety. The cause of cyclical mastalgia is not known, but given the fact that it begins in the luteal phase, it can be caused by hormonal stimulation. A variety of therapies have been recommended. Such therapies include prescription of vitamin B2, B6, E and C, non-steroidal anti-inflammatory drugs (NSAIDs), diuretics, thyroxin, progesterone, Tamoxifen, Danazol, Bromocriptine and plant extracts like vitexagnus castus, evening primrose oil (EPO). However, given the side effects of hormonal treatment, many women have developed a propensity towards the use of herbal medicine. What do the results of this study add: Chamomile presents a safe, well-tolerated and effective treatment for women with moderate mastalgia. What are the implications of these finding for clinical practice and/or further research: Considering that Danazol, Bromocriptine and Tamoxifen are standard treatments for mastalgia, it would be helpful to carry out a trial study to compare the effect of chamomile extract versus standard treatments. The physicians can prescribe chamomile as a safe alternative treatment for mastalgia.

The role of radiation therapy in the treatment of malignant tumors of the paranasal sinuses.

During a 20 year period, 121 patients with malignant tumors of the paranasal sinuses were seen at this institution. Of these cases, 109 patients with carcinomas originating from the mucous or paranasal sinuses were evaluated. Data were analyzed on the basis of 1. primary tumor control and metastatic nodal sterilization, 2. pre and post-therapy incidence and location of neck node metastasis, and 3. overall survival. Data were also analyzed as to survival on the basis of TNM classification and histology. From this retrospective study, the incidence of neck node metastasis prior to treatment appears to be slightly higher than in literature (23/88 or 26%). The incidence of post-treatment metastasis is 9/88 or 10%. No significant correlation was noted between histology and neck node metastasis.