Background: In addition to the benefits of mechanical ventilation, this method is, sometimes, associated with complications, especially in long-term use. The present clinical trial attempted to evaluate the neonatal outcomes of three methods of self-extubation, negative pressure extubation, and positive pressure extubation. Methods: A double-blind, randomized controlled trial was conducted from 2021 to 2023, at Ayatollah Taleghani Hospital, Ilam, Iran. The eligibility criteria included neonates who were connected to a ventilator and ready for extubation by their physician's order. In the positive pressure group, extubation was done with an expandable ambobag, squeezing the ambobag 3–4 times, slowly. Neonates in the negative pressure group were extubated using a negative pressure of 80–100 mmHg. The self-extubation group consisted of neonates who see trachea separated from a ventilator without the intervention. Data was analyzed by SPSS software version 20. A p-value of 0.05 was considered significant. Results: Overall, 101 newborns were included in the study. The results showed non-statistically significant differences between duration of intubation, need for oxygen after extubation, and duration of hospitalization among the neonates (P> 0.05). Re-intubation was performed for one-third of neonates. The need for re-intubation was not significantly different among the groups. Conclusion: Neonatal outcomes were similar in the positive and negative pressure groups. It is recommended that neonatologists consider the use of positive pressure extubation as a useful method -particularly in neonates who are deemed to experience adverse effects, if negative pressure extube is employed.
Background: Knee and ankle joint proprioception plays an important role in balance. Balance can also be influenced by non-environmental conditions such as anthropometric dimensions. The aim of the present study was to investigate the relationship between knee and ankle proprioception and anthropometric indicators in elementary school children. Methods: The present study is a semi-experimental research in correlational design. The statistical population of this research included all male students in the second to fifth grades of elementary schools, in north of Marand city, 160 of whom met the conditions to enter the research. Anthropometric dimensions were measured by calipers and scanners along with a tape measure; and photography was used for the accuracy of proprioception in ankle and knee joints (ICC ≤0.97). Data analysis was done by Pearson correlation test. All statistical calculations were done at a significance level of p≤0.05. Results: Knee joint proprioceptive sense was negatively correlated with the length difference between thumb and third toe (r=-0.240, p=0.030), and with the second and third toe length difference (p=0.022 r=-0.253). Also there was a significant negative correlation between ankle joint proprioception sense and foot width (r=0.363, p=0.001), ankle circumference (r=-0.240, p=0.030) and hip circumference (r=-0.242, p=0.02). Conclusion: The anthropometric dimensions that are subject to heredity and are least affected by the environment, are effective for developable and changeable functions such as proprioception sense.
Background: Inflammatory bowel diseases (IBDs) are complex and multifaceted disorders characterized by recurrent and persistent intestinal inflammation. The incidence of inflammatory bowel disease (IBD) is on the rise among both children and adults worldwide. In this review, we provide an update on genomic studies of IBD, with a particular focus on Very Early-Onset IBD (VEO-IBD), which often presents with a more severe phenotype than IBD at an older age.Methods: The methods used in this systematic review were performed according to the guidelines of the PRISMA checklist. A search was conducted by two independent researchers in international databases (PubMed, Web of Science, Scopus, and Google Scholar) to find relevant studies published in English.Results: Patients with VEO-IBD have rare or novel genes associated with immunodeficiency that may play a role in the pathogenesis of the disease. To date, ten regions for 240 genes, which are usually monogenic, have been identified for this disease, mostly due to mutations. But the most important cause of VEO-IBD is mutation in interleukin 10. It has also been reported that VEO-IBD is associated with increased expression of S100A8 and S100A9 genes in rectal mucosa and serum.Conclusion: Considering the multifactorial nature of IBD, all the changes that cause protein expression and function should be taken into account; so for early diagnosis and timely treatment of this disease, more extensive phenotypic sequencing is needed to discover new gene loci. And these children can be treated with hematopoietic stem cell transplantation, as the most efficient method.
Background: Inflammation has a remarkable role in Acute Respiratory Distress Syndrome (ARDS) pathophysiology. Pentoxifylline is a phosphodiesterase IV inhibitor with anti-inflammatory and anti-thrombotic properties, which has had positive results in rodents with ARDS. Due to the lack of human studies, we designed this clinical trial to evaluate the pentoxifylline effect on ARDS prevention in high-risk pediatric patients. Methods: We included thirty-four children from Akbar hospital’s pediatric intensive care unit (PICU). These patients were highly susceptible to ARDS progression. Using a randomized, double-blind method, 17 patients received pentoxifylline tablets three times a day for a week, while others received placebo tablets at the same interval for seven days. Lung Injury Prediction Score (LIPS), vital signs, pulse oximetry, PaO2, pH, and PaCO2 were measured at baseline and every day for a week period. CRP was assessed at baseline, then on the third and seventh days. Finally, we imported all the data to SPSS software to compare the treatment and placebo groups. Results: Each placebo and treatment group had seventeen patients who had no statistically significant difference in baseline demographic information or lab data. The variations in LIPS score (P=0.475), CRP (P=0.053), pH (P=0.199), PO2 (P=0.077), PCO2 (P=0.528), Heart rate (P=0.086), Respiratory rate (P=0.512), Diastolic blood pressure (P=0.572), Systolic blood pressure (P=0.517), and SPO2 (P=0.260) were compared between the two groups; and no significant difference was observed. Conclusion: The results of this clinical trial suggest that pentoxifylline had no prophylactic effect on pediatric ARDS, but for confirmation, further clinical trials with different designs and larger sample sizes are required.
Background: Factors like low-protein diet may impose Phenylketonuria (PKU) patients to impaired skeletal disease. The present study assessed the status of Bone Mineral Density (BMD) among PKU patients on a low-protein diet. Methods: A cross-sectional study was conducted (Tehran, Iran, 2019). Patients aged ≥ 4 years old with a definite diagnosis of PKU on a low-protein diet were included. BMD values of the lumbar spine and femoral neck were assessed. The primary objective was assessing femoral and lumbar BMD status in PKU patients. Results: Forty-one PKU patients entered the study. The mean BMI was 20.712±4.833 Kg/m2. The mean bone age was significantly lower than chronological age (10.9 vs. 12.4 years; P=0.008). The results showed a bone mass reduction in 23.1% of all patients. A significant correlation was observed between lumbar and femoral BMD values (P=0.001; r=0.516). Most patients (about 77%) had lumbar Z-scores>-1 and 10.3% showed Z-scores in the range of osteoporosis. Age (P=0.004) and age at diagnosis (P=0.002) were the influencing factors on BMD status. The results showed a significantly inverse correlation between BMD lumbar levels with the patient’s chronological age (P=0.016), age of PKU diagnosis (P=0.002), and phenylalanine level (P=0.025) Conclusion: The results delineated impaired skeletal status among PKU patients on a low-protein diet. Lumbar Z-score values inversely correlated with the patient’s chronological age, age at PKU diagnosis, and phenylalanine level. Hence, early PKU diagnosis and treatment during neonatal period, as well as controlling phenylalanine concentration may improve BMD status.
Background: Tuberous Sclerosis Complex is an autosomal dominant heterogeneous disease that mostly affects the skin and nervous system. The goal of this study was to provide a framework for addressing these patients' psychological and behavioral issues, as well as the therapy and management of these aspects. Methods: As a pilot study for this investigation, 25 patients with Tuberous Sclerosis were assessed. The presence of psychological disorders in these patients was assessed using the TAND (Tuberous Sclerosis Associated Neuropsychiatric Disorders) checklist. The checklist was translated into Persian first, then back into English, and finally verified by the designer of the original checklist. Interviews with the patients' parents took place twice a week with the help of a caregiver, and the checklist was used to analyze the data. Results: A high correlation was found between the parents' (or caregivers') evaluations of the checklist during the first and second distributions (with a Pearson value of 0.99 and P-value of 0.001). The coefficient of correlation for question eight was -0.76, indicating an inverse correlation. According to the parents' evaluation, the two-stage distribution of this checklist had a strong and respectable reliability with a Cronbach's alpha of 0.79. Conclusion: Parents and faculty members generally view the reliability and repeatability of all questions in a satisfactory manner as complete and credible from a position of solidarity.
Background: Despite the growing body of research showing the effectiveness of motor interventions for children both physically and cognitively, there is still a lack of sufficient information regarding the effects of different motor programs and finding suitable interventions to improve motor and cognitive skills in early childhood. This study was conducted to investigate and compare the effects of cognitive and metacognitive factors in motor interventions on the motor and cognitive skills of preschool children. Methods: Sixty-six 6-year-old children (32 girls, 34 boys) participated in this study and were randomly assigned to three experimental groups (motor group (7 girls, 10 boys), motor-cognitive group (8 girls, 8 boys), and motor-metacognitive group (7 girls, 9 boys)) along with a control group (10 girls, 7 boys). The participants in all three experimental groups received a motor program specific to their group for 18 sessions. The Bruininks-Oseretsky test of motor proficiency (BOT-2), the Toulouse-Pieron cancellation test (TP), and the Head-Toes-Knees-Shoulders task (HTKS) were used to collect data. Multivariate repeated measures and multivariate analysis of covariance were used for data analysis. Results: The findings showed that, compared to the control group, the improvement of cognitive skills in the motor-cognitive group was more than that in the motor and motor-metacognitive groups (p < 0.05). Also, the improvement of motor skills in the motor-metacognitive group was more than that in the motor and motor-cognitive groups (p < 0.05). Conclusion: According to the results obtained, it seems that if motor interventions are combined with cognitive and metacognitive activities, they can have more cognitive and motor benefits for preschool children.
Background: Attention Deficit/Hyperactivity Disorder (ADHD) is one of the most common psychiatric disorders that cause major complications in children, and it is essential to identify the best treatment method especially during COVID-19 pandemic. Therefore, the aim of this study was to discuss the effects of mindful parenting-based telepsychology on behavioral symptoms of ADHD children during COVID-19 outbreak. Methods: This randomized clinical trial was conducted on parents with ADHD children. All mothers underwent eight 45-min-sessions of mindful parenting-based telepsychology, administered once a week. Child Behavior Checklist (CBCL) was evaluated before, immediately after, and 2 months after the intervention. Results: We did not find significant differences in the following subscales of CBCL: anxious/depressed, depressed, somatic complaints and thought problems, after and 2 months after the intervention between the two groups (P>0.05). While, after the intervention, social problems (11.65 ± 3.03 vs. 14.55 ± 1.93, P=0.001), attention problems (9.65 ± 2 vs. 11.25 ± 1.8, P=0.034), rule-breaking behavior (14.15 ± 2.15 vs17.35 ± 2.85, P=0.002), aggressive behavior (14.25 ± 2.19 vs. 19.75 ± 3.66, P<0.001), and total score of CBCL (90.55 ± 5.56 vs. 106.5 ± 8.81, P<0.001) were found to be significantly lower in the intervention group as compared to the control group; and they remained significantly lower in the intervention group, after a 2-month follow up (P<0.05). Conclusion: Mindful parenting-based telepsychology significantly improves symptoms in children with ADHD from the parents' point of view. This type of training can also lead to an improvement in parent-child relationships, and so can be suggested as necessary for parents.
Background: Since the beginning of COVID-19 pandemic, several studies have reported increased type 1 diabetes (T1D) and severe diabetic ketoacidosis (DKA) in children. Recent studies have linked viruses to T1D due to their autoimmune nature. SARS-CoV-2 infection may cause hyperglycemia and DKA. In this study we aimed to evaluate the incidence of DKA in pediatric patients with T1D during the initial COVID-19 pandemic and the years preceding it.Methods: The present study is a retrospective observational investigation conducted at Minia University Hospital's Pediatric Intensive Care Unit (PICU). Children diagnosed with T1D who recently had SARS-CoV-2, as validated by laboratory testing with the RT-PCR method, were included in the study. The cases referred to during the period from March 2020 to February 2022, which coincided with the pandemic, were compared with those newly diagnosed with diabetes and presented with DKA from March 2018 to February 2020, the pre-pandemic phase. Comparisons were made on the incidence, frequency, and diagnostic criteria.Results: During the pandemic period, we admitted 212 cases of new‐onset T1D. Of these, 159 (75%) patients had DKA, and 53 (25%) had hyperglycemia. Comparing the pre-pandemic with the pandemic period, we noted that the number of children identified with T1D had risen from 4.99/100,000children per year in pre-pandemic periods to 8.46 /100 000 PY in the pandemic period with an incidence rate ratio (IRR) of 6.25 (95% CI 2.90 to 7.83); p<0.0001.Conclusion: COVID-19 pandemic has caused a rise in the number of children with newly diagnosed diabetes, and more people with newly diagnosed diabetes are now presenting with severe DKA.
Background: Gastroesophageal Reflux Disease (GERD) is common in infants and its treatment remains extremely challenging in this age group. Therefore this study aimed to compare the efficacy and safety of omeprazole and esomeprazole in infants, aged 1-11 months old, presented with GERD. Methods: This double-blind randomized controlled trial was conducted on 80 infants. All patients were randomly divided into omeprazole and esomeprazole treatment groups for four weeks. The signs, symptoms, and disease severity based on the Visual Analog Scale (VAS) of GERD were evaluated after treatment in both groups. The data were then analyzed using the SPSS Statistics software (version 21). Results: The results of this study did not show significant differences between the mean disease severity based on VAS of both omeprazole- (81.1±55.7) and esomeprazole-receiving (79.1±77.6) groups (p=0.091). However, in each group, the mean disease severity after one month of treatment was significantly lower as compared to baseline (p<0.01). The recovery rates were similar in both groups (75% and 70% for omeprazole and esomeprazole groups, respectively) (p=0.799). Conclusion: Omeprazole and esomeprazole did not have significant differences in signs, symptoms, and disease severity of GERD, however, we observed a significant reduction in disease severity in both groups indicating that these two drugs could be used interchangeably for the treatment of GERD disorder.
Background: In the process of intubation, inappropriate placement of the endotracheal tube can lead to hypoxemia, aspiration, insufficient ventilation, atelectasis, barotrauma and pneumothorax. The above complications may be difficult for a patient with severe disease to tolerate; especially when inappropriate placement is not detected by the specialist in the initial evaluation and the diagnosis lasts until the confirmatory chest x-ray is performed. This study evaluated the validity of three formulas in measuring the depth of endotracheal intubation in children under mechanical ventilation. Methods: 60 intubated children aged 2 months to 12 years were included in this study. The patients were randomly divided into three study groups. Endotracheal tube length for each patient was calculated on the basis of the endotracheal tube length formulas (12 + age (years) / 2; endotracheal tube diameter * 3; and 5 + height (cm) / 10). The ideal depth of the endotracheal tube based on chest x-ray was measured as the median distance between the first thoracic vertebra (T1) and the carina in cm. The distance between the ideal depth of the endotracheal tube and the end location of the endotracheal tube was also measured and recorded. Results: The mean age of the patients was 42.90 months and 58.3% of them were boys. The most common indication for intubation was pneumonia, along with respiratory distress (33.3%). Considering the difference in endotracheal tube depth between the two values calculated using the formula and chest X-ray equal to± 0.5 cm, formula 12 + (2 / age) in 55% of patients, formula 3 * endotracheal tube length in 70% patients and formula 5 + (10 / height) in 85% of patients, were correctly estimated endotracheal tube length. On the other hand, it was observed that in 15%, 45% and 40% of the patients, the formula predicted the correct length of the endotracheal tube for correct intubation without any difference while compared to the chest X-ray. In evaluating the results obtained from the formula and length of the endotracheal tube measured by chest X-ray, it was also observed that the formulas 12 + (2 / age), 3 * length of the endotracheal tube and 5 + (10 / height) were significantly correlated with CXR. Conclusion: According to the obtained results, it can be concluded that the formulas used to estimate the depth of endotracheal tube placement in children have low accuracies compared to the gold standard of measurement (chest X-ray). Of course, in comparison to the three formulas (height, weight and diameter of the ETT), the height formula was more accurate than others.
Background: This study aimed to report on the case of a child with the manifestation of orbital cellulitis which was finally diagnosed as an orbital hydatid cyst.Case report: The case is a 5-year-old girl with an isolated orbital hydatid cyst presented with slowly progressive proptosis, deterioration of vision, chemosis, periorbital swelling, and palpebral edema. Evaluations for other organ involvements including liver and lung were negative. A cystic orbital mass lesion with enhancing walls was found in orbital Computed Tomography (CT) scanning. The cyst was removed completely through the upper lid crease incision and treatment continued with systemic albendazole. The patient was followed for three months with a favorable outcome.Conclusion: We should consider the diagnosis of a hydatid cyst in a child with the signs and symptoms of orbital cellulitis, specifically in endemic areas.
Diagnosis of the cystic lesion of the neck in pediatric cases is challenging for radiologists. There are different cystic lesions in the neck region that can present themselves in various parts of this area. Some lesions may lie in the middle parts and some in the lateral areas; however, some cystic defects can be present in every part of the neck. Sonography is the first modality for the assessment of the cases, along with history and physical examination. Sonography is nearly accessible and is not expensive; however, it depends on the expertise of the sonographer. We reviewed sonography findings of various cystic lesions in the neck region and reported the findings with this regard.
Background: Fear and anxiety before entering the operating room are significant issues in pediatric anesthesia. Given that the venipuncture process is accompanied by separation anxiety, and the ease of use of intranasal premedication versus intravenous, rectal, or intramuscular methods, and considering the risk of aspiration during oral delivery in children, the purpose of this study was to compare and contrast the anti-anxiety and sedation effects of intranasal midazolam and intranasal ketamine as a premedication in pediatric hernia repair surgery.Methods: This was a double-blind randomized clinical trial involving 36 participants aged 1 to 6 years who underwent hernia repair surgery in Bu Ali Hospital between 2020 and 2021. The child was transferred to the operating room after 30 minutes of evaluating the effects of the drug and recording the related data. In the operating room, data from an electrocardiogram device, arterial oxygen saturation level, and blood pressure were all checked. At 5 minute intervals, the patient's hemodynamics were checked and recorded. The time from the beginning to the end of anesthesia was recorded. Results: This study included 36 patients (18 in each group). The average age and weight of the patients were 37.71 +/- 21.73 months (range = 1-72 months) and 14.60 +/- 4.26 kg (range = 6.5-25 kg), respectively. Independent t-tests showed no significant difference between the two groups. Heart rate and blood pressure were measured in two groups (ketamine and Midazolam) but no significant difference was observed among the three stages (before premedication, before anesthesia, and after intubation) (P>0.05). The relationship between qualitative outcomes was analyzed using Chi-square test but no significant difference was observed.Conclusion: the current study showed that there is no statistically significant difference between intranasal ketamine and midazolam in terms of effectiveness and side effects.
Background: Adolescent mental health needs, particularly among girls, are of utmost importance and encompass social, behavioral, emotional, and cognitive aspects. The objective of this study was, then, to evaluate the impact of mental health education on the happiness of sixth-grade female students. Methods: In this controlled interventional research, the statistical population included 6th-grade female students in Sarakhs City during 2021-2022. 44 female students were selected by the available sampling method and placed into two intervention and control groups with 22 participants in each group. The interventional group underwent 7 sessions of mental health training, while the control group did not intervene. The Oxford Argyle et al. (1989) happiness questionnaire was used and SPSS 25 software was implemented for data analysis using the multivariate covariance analysis (MANCOVA) to measure the desired variables. Results: According to the results, there was a significant difference, in the post-test, between the interventional and control groups in the examined components, indicating that mental health education has a positive impact on students' happiness (f = 37.30). Also, the results showed statistically significant differences, in the post-test, between the two groups in the positive mood component (F37,1= 8.26; P < 0.05), efficiency (F37,1= 12.58; P < 0.05), satisfaction (F37,1= 21.82; P < 0.05), health (F37,1= 12.99; P < 0.05), and self-esteem (F37,1= 6.78; P < 0.05). Conclusion: According to the results, the mental health education program was effective in female students and can potentially improve education and quality of life. Therefore, it is recommended to implement mental health training programs for students at other educational levels and in the form of skills training.
Background: Different drugs with different mechanisms have been used to remove iron overload in thalassemia patients. This study aimed to compare the effects of Nanojade and Deferoxamine in reducing serum ferritin levels. Methods: This randomized clinical trial was conducted on 41 major thalassemia patients. The selected patients were allocated to two groups by the permuted block randomization method. The first group was treated with Deferasirox (Nanojade) and the second group was treated with Deferoxamine (Desferal). All patients received the drugs at 14 mg/kg. Blood samples were collected at baseline, after 3 and 6 months after intervention. Chi-square test, Mann-Whitney U-test, and Friedman test were used for analytical statistics at the significance level of 0.05. Results: 51.9% of patients in the Nanojade group and 40% in the Desferal group were females. Before the intervention, no difference was observed in terms of basic and demographic information. Before the intervention, as well as 3 months, and 6 months after the intervention, none of the blood parameters in the studied groups were significantly different (p> 0.05). The overall mean ferritin levels had a significant decrease, in both groups, 6 months after the intervention (PDeferasirox = 0.001 vs PDeferoxamine = 0.043); However, in the comparison between the two groups, no significant difference was observed between the levels of ferritin and creatinine at any of the time points (p> 0.05). Conclusions: Deferasirox oral tablet (Nanojade®) is as effective as an injectable form (deferoxamine (Desferal®)) in reducing serum ferritin in patients with beta-thalassemia major without causing nephrotoxic effects. Therefore, it can be a suitable alternative to its injectable form.
Background: Cerebral palsy stands as the main cause of mobility disability in childhood, and the accompanying sialorrhea exacerbates health and psychological issues for both the child and the family. We aimed to assess the effect of botulinum toxin type A on reducing sialorrhea in children with cerebral palsy.Methods: This self-controlled clinical trial was executed among children afflicted with cerebral palsy. The Teacher Drooling Scale was used as the data collection tool. The intervention involved the administration of botulinum toxin A, with a dosage ranging from 30 to 50 units in each parotid gland, skillfully guided by a radiologist using ultrasound. Sialorrhea scores were compared before and after the injection.Results: Our study included 21 children with cerebral palsy and sialorrhea. After the two post-injection weeks, a noteworthy drop was observed in the sialorrhea score (4.10±0.831) compared to the pre-injection score (4.71±0.463). The sialorrhea score until the ninth month after injection (1.121±3.43) was still significantly lower than the score before injection.Conclusion: The injection of botulinum toxin A emerges as a potent medication, significantly curtailing the drooling among patients with cerebral palsy. This finding can be used to prevent aspiration pneumonia and reduce social and psychological complications in this population.
Background: The purpose of this retrospective study was to check sonographic hip types according to the Graf technique and to compare the results related to large newborns with those related to the normal and small ones based on their Gestational Age (GA); and to investigate the influence of birth weight on the incidence of Developmental Dysplasia of the Hip (DDH). Methods: Between 1993 and 2003 Ultrasonography (US) of the hips was performed in 7417 consecutive newborns at 34-42 gestational weeks using the Graf method during the first week of life. Results: The US showed pathological findings in 168 hips (2.3%). 139 of these cases were girls (82.7%) and 29 were boys (17.3%). According to Graf types, there were 63 type IIc, 56 type D, 46 type III, and 3 type IV hips. Except for one boy (type III) all were successfully treated by conservative orthopedic methods. Being overweight (large for GA) in association with breech presentation showed the highest risk for pathological hips requiring treatment (15.6%), followed by normal weight and breech presentation (7.6%), and then came the term newborns large for GA (5%). The lowest percentage need of subsequent orthopedic treatment was in 66 in small newborns for GA with breech presentation (1.5%). There were no associations with DDH in 230 small GA newborns at term, and in 174 twins. Conclusion: The results, according to the sonographic types, suggest that high birth weight is a major risk factor of DDH, especially when combined with breech presentation; and an almost 5:1 female preponderance was observed.
Background: This study aimed to assess the frequency of asymptomatic coronavirus disease-2019 (COVID-19) carriers and related oral manifestations in child dental patients.Methods: This cross-sectional study was conducted on 215 asymptomatic pediatric dental patients aged 4-12 years. Clinical examination was performed by one calibrated examiner to determine oral signs and symptoms between October 2021 to July 2022. After completing clinical examination, the participants underwent a COVID-19 polymerase chain reaction (PCR) test. Data were analyzed by Chi-Square, T- test, and Fisher’s exact test (α<0.05).Results: The mean age of the patients was 7.71±1.74 years; 102 (47.4%) were males and 113 (56.6%) were females. Thirty-two patients (14.9%) had a positive PCR result for COVID-19. Out of 32 positive subjects, 7(3.3%) had oral lesions including aphthous and herpetic ulcers. Impairment in the sense of taste was not observed in any of the patients. Association between oral symptoms, and age (P=0.432) or gender (P=0.539) was not significant.Conclusion: The prevalence of COVID-19 asymptomatic carriers in the study population was 14.9%; and 3.3% of them had oral manifestations, which emphasizes the need for personal protective equipment to prevent infection transmission.
neonates. The purpose of this study is to determine the efficacy of prophylactic parenteral acetaminophen as a safer alternative drug for PDA in preterm infants. Methods: In a randomized clinical trial carried out in a one-year period, 60 preterm newborns under 30 weeks of gestational age with birth weights under 1500 grams, admitted in neonatal intensive care unit (NICU) of Emam Reza Hospital, Mashhad were studied. The prophylaxis group received parenteral acetaminophen for 3 days. Echocardiography was performed 96 hours after the last given dose and on the 14th day in both groups. Result: There were 30 newborns in each group. In the 4th-day echocardiography, in 33.3% of the prophylaxis group and 26.7% of the control group, the ductus arteriosus was closed (P=0.106). In the 14th-day echocardiography, the ductus was closed in 63% and 41.4% of the intervention and control group, respectively, which was not statistically significant. In addition there was not a significant difference in the ratio of left atrium to aortic root between the two groups. Conclusion: This study showed that in total, PDA was closed in more cases in the intervention group compared to the control group but the difference was not statistically significant. Acetaminophen is a new medicine for PDA closure, which may be more prevalent in future due to its cost effectiveness and safety.
