Which is Better for Pain Reduction before Venipuncture: Glucose, Lidocaine or Expressed Breast Milk? Introduction and Aim

Abstract Aim: The aim of this study was to compare effects of 2 cc oral glucose (50%), topical application of lidocaine, 2 cc of expressed breast milk (EBM), and nothing per oral for reducing of pain before painful procedures. Patients and methods: In this case-control study, 121 term neonates were included. There were 3 groups of cases and one control group. Inclusion criteria were: term neonates (38-42 weeks); stable condition; per oral feeding; five minutes APGAR>7; and no history of narcotic usage. Neonates were randomly divided in 4 groups. Two milliliter of glucose solution (50%), topical application of lidocaine, and 2 cc of expressed breast milk via syringe were used for group I, II, and III respectively. Group IV is the control group. For control group, no additional measure was done. Data analysis was performed using SPSS ver 11.0 (SPSS Inc, Chicago, IL, USA). Chi-square, t-test, and ANOVA were used for analysis. P<0.05 was considered significant. Results: Score of Douleur Aiguë Nouveau-né was significantly lower in group III compared to other group (P<0.05, Tukey). Crying time in group III was significantly lower than group IV. Respiratory rate in group II was significantly lower than group IV (P=0.018). Pulse rate was significantly lower in group III compared to other group. Conclusion: Expressed breast milk is the safe and natural agents for reducing pain of neonates. Another clinical trial study with more samples is recommended

Association of Benign Joint Hypermobility Syndrome with Mitral Valve Prolapse in Iranian Children Benign Joint Hypermobility with MVP 116

Abstract Aim and purpose: The aim of this study was to determine the association of benign joint hypermobility syndrome (BJHS) with mitral valve prolapse. Subjects and methods: This is a case-control study. Sixtythree children with benign joint hypermobility syndrome were included in case group and 63 without any rheumatologic disease were placed in control group. We used Carter-Wilkinson and Beighton criteria for diagnosing of benign joint hypermobility syndrome. Mitral valve prolapse was evaluated by echocardiography in both groups. The mitral leaflet displacement >2 mm considered as cut off for diagnosis of mitral valve prolapse. Cardiologist did not have any information about patients group during echocardiography. Data was analysed using SPSS ver. 13.0. Chi-square used for comparison. Results: In this study, 32 girls and 31 boys were included. Mean of age in case group was 7.1±2.67 and for control was 6.9±3.25 years. Mitral valve prolapse was discovered in 54% of cases and 12.7% of control groups (P=0.001). Mitral valve prolapse was significantly higher among cases with BJHS aged >7 (58.8%) year compared to 3-7 (41.2%) year of age (P=0.027). Heart murmur and palpitation was more common among children with benign joint hypermobility syndrome with mitral valve prolapse compared to children without mitral valve prolapse (P<0.05). Conclusion: The incidence of mitral valve prolapse among children with benign joint hypermobility was significantly higher than control group