Pattern and extent of off-label and unlicensed drug use in neonatal intensive care units in Iran

Abstract Background Many newborns may need to be hospitalized and receive drugs during the first days of their lives. These drugs are fundamentally prescribed as off-label and unlicensed. This study aimed to investigate the amount of these kinds of drugs administered in the Neonatal Intensive Care Units (NICUs) of Abuzar and Imam Khomeini Teaching Hospitals in Ahvaz, Iran. Methods This was a 3-month descriptive, cross-sectional study with retrospective nature in which 193 hospitalized newborns were studied. Demographic data were extracted from the patients’ files. The drugs were classified as off-label, unlicensed or licensed according to the Pediatric & Neonatal Dosage Handbook (Lexicomp®, 22nd Edition). Results In total, 1049 prescriptions were registered for the 193 hospitalized newborns (term and preterm). For each newborn, the mean numbers of prescriptions and drugs received were 5.4 and 4.5, respectively. The mean numbers of prescriptions and drugs were greater for preterm newborns. Of the total 1049 prescriptions, 38.1% were off-label and 1.9% were unlicensed. Of the 193 newborns, 85% received at least one off-label or unlicensed prescription. Off-label prescriptions were mostly related to dose (44.8%) and dosing interval (36.5%). Most off-label drugs were antibiotics (mainly Gentamicin). Albuterol was used off-label in 100% of the cases. Conclusions The results of the present study show that the prescription of off-label and unlicensed drugs in NICUs is as high in Iran as in other countries. This suggests that it is necessary to provide information to neonatologists to decrease the prescription of off-label and unlicensed drugs

Investigation of metal-nickel oxide contacts used for perovskite solar cell

Perovskite solar cells (PSCs) have been able to raise new hopes for a revolution in solar cell technology. However, there are many challenges which need to be resolved in order to reveal the true potential of this technology. An issue which should be addressed in designing PSCs is the metal-hole transporting material (HTM) contact’s property. One of the most promising inorganic HTMs for PSCs is Nickel oxide. Although NiO has been extensively studied in the literature, to the best of our knowledge metal-NiO junctions have never been studied experimentally. In this work, metal-NiO contacts have been investigated to indicate a novel route to choose proper metals in designing PSCs based on NiO as the HTM. Thus, NiO layers with four various metals have been fabricated and comprehensively explored. The contacts have been characterized using the transmission line method (TLM), and a contact resistivity ranging from about 2052 to 34 mΩ⋅cm2 was observed. I-V characteristics showed ohmic behavior in all metal-NiO cases. These results indicate that Fermi level pinning occurs at the valence band edge of the NiO. Further discussions resulted in suggesting Nickel as the most applicable candidate on NiO have been also included

Comparison between maternal and neonatal serum vitamin D levels in term jaundiced and nonjaundiced cases

Background: Neonatal jaundice is the result of an imbalance between the production and conjugation of bilirubin. Considering the multiple roles of vitamin D, lower levels of vitamin D in these cases may be associated with neonatal jaundice. The present study was undertaken for the purpose of comparing serum vitamin D levels in healthy term jaundiced and nonjaundiced newborns and their mothers. Methods: This case–control study was conducted in 60 term newborns and their mothers from a teaching and referral children’s hospital in the southwestern region of Iran, from December 22, 2013 through March 22, 2014. Neonatal and maternal blood samples were obtained and sent to the laboratory. Results: The mean serum 25-hydroxy vitamin D levels of newborns and their mothers in both the case and the control groups were not significantly associated with their serum bilirubin levels. The mean of laboratory indices (calcium, phosphorus, alkaline phosphates, parathyroid hormone, and 25-hydroxy vitamin D) in mothers and newborns of the case group were nonsignificantly higher than that of the control group, but the mean vitamin D level was significantly lower among newborn cases compared with the controls (p<0.05). Conclusion: Newborn vitamin D levels were significantly lower in jaundiced cases compared with those in the nonjaundiced healthy groups, which may reveal an association between indirect hyperbilirubinemia and serum vitamin D levels. We suggest that more studies should be conducted including follow-up after 15 days of age, when jaundice has typically been resolved, and before starting vitamin D supplementation