The Effects of Sildenafil on the Treatment of Neonatal Chronic Lung Disease

Background: Bronchopulmonary dysplasia is one of the most common disorders in premature infants and this study aimed to investigate the role of sildenafil in the treatment of neonatal chronic lung diseases. Methods: In a placebo-controlled clinical trial study, a total of 40 neonates were included and randomly divided into control and intervention groups; sildenafil tablets were used at a dose of 2mg per kg for 8 hours in the intervention group and placebo with the same characteristics in the control group. After a period of 10 days, oxygen demand, type of respiratory support, changes in pulmonary artery pressure, Length of hospital stay, and systemic blood pressure changes were measured. Results: Duration of admission significantly decreased in the intervention group (P value = 0.006). For the neonates in the control group from approximately 11 days after the start of treatment (11/47±9/19) and for those in the intervention group from approximately 8 days after the start of treatment (8/21±3/84), respiratory support with positive pressure was changed to respiratory support with free flow oxygen. No severe systolic or diastolic blood pressure change was observed in any of the groups. Decrease in pulmonary pressure was significantly higher in the intervention group than that in the control group (21/1% and 68/4%, respectively) (P value: 0.003). Conclusion: The results of the study showed that sildenafil significantly reduced the length of hospital stay, the duration of the need for respiratory support and oxygen administration, and corrected the pulmonary pressure. No specific side effects were foun

Prevalence of positive findings of brain computed tomography scans in pediatric population

  Objectives Computed tomography (CT) scans are used more frequently in medical centers, increasing unnecessary requests for it as a first-line evaluation. This study aimed to investigate the rate and prevalence of abnormal findings in a brain CT scan in children at the Children’s Hospital of Tabriz, Iran. Materials &Methods This study was a cross-sectional descriptive-analytical study that included all children under 15 years old undergoing a brain CT scan at the Children’s Hospital of Tabriz, Iran. All patients who fulfilled the inclusion criteria and were referred to the Children’s Hospital of Tabriz during the spring of 2018 entered the study. Age, gender, patient history, and clinical findings were examined. In the next step, the results of each patient’s CT scan were evaluated. Results In this study, 108 patients were studied with a median age of 18.0 months. CT scan results were normal in seventy-four cases (68.5%), hydrocephalus was seen in 15 (13.9%), and benign infantile hydrocephalus was seen in eight (7.4%). The study revealed a statistically significant relationship between patient history and CT scan results (p=0.017). A statistically significant relationship was observed between the clinical findings and CT scan results (p=0.042). Conclusion Brain CT scans have more abnormal findings in patients with positive clinical findings. Although a CT scan is a highly sensitive and specifimodality in diagnosing central nervous system (CNS) abnormalities, its value depends on the underlying medical history and physical exam

Determination of valproic acid and 3-heptanone in plasma using air-assisted liquid-liquid microextraction with the assistance of vortex: Application in the real samples

Introduction: Valproic acid (VPA) is an antiepileptic drug used to treat epilepsy and bipolar disorder. Adverse effects of VPA were studied in many reports, however, a dose-response relationship between VPA and its metabolites in epilepsy patients are extremely limited. In this paper, a high efficient method was developed for the preconcentration and determination of VPA and its main metabolite in plasma. Methods: For the extraction and preconcentration of the selected analytes, a volume of an extractant was placed at the bottom of the microtube containing pretreated plasma. The mixture was repeatedly withdrawn from the microtube and pushed-out into it using a 1.0-mL glass syringe and resulted in a cloudy mixture. For further turbidity, the mixture was shaken on a vortex agitator. This procedure was used to analyze the plasma samples of patients with epilepsy (n = 70). Results: The results revealed that in most patients with a low level of VPA relative to its expected level, 3-heptanone concentrations were high. The limits of quantification of 3-heptanone and VPA were 0.04 mg L–1 and 0.2 mg L–1, respectively. A suitable precision at a concentration of 2 mg L-1 for each analyte was obtained (relative standard deviation ≤ 9%). Conclusion: The obtained results indicated that this procedure is easy, sensitive, and reliable, and can be used for the analysis of the selected analytes in the plasma samples of patients with epilepsy

Evaluation of brain CT scan, sonography and EEG findings in neonates with seizure

AbstractObjectivesThis study aimed to determine the frequency of different types, causes, and abnormal findings of brain computed tomography scan (CT scan) and ultrasonography (US) and multichannel- electroencephalography(EEG) in neonates with seizure. The ability of brain CT scan was also compared with US in terms of detecting the underlying causes of neonatal seizures.Materials & MethodsIn this cross-sectional retrospective study, the medical records of 90 neonates younger than 28 days with the definite diagnosis of seizure were reviewed. The ability of brain CT scan was also compared with US in terms of detecting the underlying causes of neonatal seizures.ResultsTotally, 90 newborns (M: F = 1.5:1) with mean age of 63.11 ± 32.8 days were enrolled. 35.5% of newborns were born before the 37th week of pregnancy. In this study, 45.6% of EEG findings, 22% of brain CT scan findings, and 12.5% of US findings were abnormal. The automatisms (38.9%) and benign idiopathic neonatal seizure (70.7%) were the most common seizure type and cause respectively. The hypoxic Ischemic encephalopathy was the most common abnormal finding (30%) in brain CT scan. ConclusionsGiven the accuracy of EEG in detection of brain pathologies, where available, all neonatal seizures should be initially confirmed using EEG. Radiologic investigations (CT scan, US) off the head/ craniumshould be done to detect the cause of neonatal seizure. The capacity of brain CT scan to detect underlying causes of neonatal seizures is more than US &nbsp

Findings of Brain CT Scan in Patients Hospitalized with Meningitis in Tabriz Children's Hospital and Its Association with Prognosis

Background. Children's meningitis is associated with many complications and deaths. Therefore, it is critical to develop reliable and available methods to predict these complications, diagnose them in a timely manner, and prevent the progression of complications. This study aimed to investigate the findings of computed tomography (CT) scan in patients with meningitis and evaluate its association with prognosis. Methods. In this cross-sectional analytical study, we investigated the clinical files of 100 patients with meningitis (preferably bacterial meningitis) in Tabriz Children's Hospital, Iran between 2013-2017. The results of CT scan and disease complications were recorded and analyzed by statistical software. Results. Common symptoms identified in the patients included fever (88%), nausea and vomiting (36%), headache (27%), and convulsions (25%). Also, the results of CT scan included cerebral effusion (16%), hydrocephalus (7%), diffuse cerebral edema (7%), and cerebral atrophy (4%). Statistical analysis indicated a statistically significant association between the complications of meningitis (learning disorder, epilepsy, and hearing disorder) and the results of CT scan (cerebral effusion, diffuse cerebral edema, and hydrocephalus). Conclusion. CT scan can be used as an early diagnostic and prognostic method in children with meningitis. Practical Implications. Meningitis is associated with many complications and deaths, and the lack of diagnostic methods and accurate prognosis is one of the important challenges in this field. Therefore, identifying and introducing accurate and cheap methods for predicting these complications and taking early measures to prevent the development of complications and treatment can be beneficial. The results of the present study showed that CT scan can be used as an early diagnostic and prognostic method in children with meningitis

The Effects of Vitamin B-Complex Supplementation on Serum Homocysteine Levels and Migraine Severity in Children A Randomized Controlled Trial: The Effects of Vitamin B-Complex Supplementation on Serum Homocysteine Levels and Migraine Severity in Children A Randomized Controlled Trial

ObjectivesGiven that deficiency in B vitamins can lead to the accumulation of homocysteine (Hcy), and hyperhomocysteinemia may have a role in migraine pathogenesis, the present prospective randomized doubleblinded placebo-controlled trial aimed to evaluate the effect of vitamin B-complex supplementation on the alleviation of migraine in children through a possible reduction in Hcy levels.Materials & MethodsNinety children under 15 years of age suffering from typical migraine were included in the present trial. They were randomly assigned into two groups (forty-five patients in each group) to receive either vitamin B-complex or a matching placebo for six months. Serum Homocysteine levels and headache characteristics were evaluated and compared before and after administering vitamin B-complex or placebo. ResultsUnlike the placebo group, the monthly headache frequency, severity of headache, headache disability, and serum Hcy levels were significantly decreased after the vitamin administration. The headache duration was not significantly different before and after the treatment. In the vitamin group, there were significant positive correlations between the frequency and severity, frequency and disability, and severity and disability of headaches. Hcy also had significant positive correlations with the frequency and disability of headaches. In the placebo group, the only found significant correlation was between headache frequency and disability ConclusionThe administration of vitamin B-complex might effectively relieve migraine severity in children by reducing serum Hcy. However, further studies are needed to confirm the results. &nbsp