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The effect of body status on gastroesophageal reflux after feeding among hospitalized premature infants: a randomized crossover clinical trial
Leila Valizadeh , Golnar Ghahremani , Manizheh Mostafa Gharehbaghi , Mohammad Asghari Jafarabadi Asghari Jafarabadi ,
Volume 75, Issue 8 (11-2017)
Abstract
Background: Gastroesophageal reflux is a common condition among premature infants, which causes problems such as reduced weight gain and prolonged length of hospital stay. Body status is an appropriate way to reduce this condition. However, there have been few studies conducted in this regard. The objective of this study was therefore to investigate the effect of body status on gastroesophageal reflux in premature infants.
Methods: The present research was a crossover study conducted on premature infants with a gestational age of 33-36 weeks in Al-Zahra Hospital in Tabriz, Iran, from January to March 2015. In this clinical trial, thirty-two premature infants hospitalized in this center were selected as the sample. The initial selection of the participants was based on the simple random sampling. Then the participants were allocated to groups using randomized block procedure. Each infant was under study for 4 days. After each feeding and about two hours before the beginning of next feeding, the infants were randomly and not repeatedly put in one of the following four status for 12 hours (8 am -8 pm) every day: facilitated fetal tucking posture in lateral position, free body posture in lateral position, facilitated fetal tucking posture in supine position, and free body posture in supine position. Then, the incidence of gastroesophageal reflux was measured in each of these statuses. SPSS software, version 21 (SPSS Inc., Chicago, IL, USA) was used to analyze the data at significant level of P<0.05.
Results: The results showed that there was a significant difference between facilitated fetal tucking posture in lateral position and other status (P<0.001). The incidence of gastroesophageal reflux in facilitated fetal tucking posture was lower than free body posture, but there was no statistically significant difference in this regard. Moreover, the incidence of reflux in lateral position was significantly less than those in supine position (P=0.04).
Conclusion: The findings of this study revealed that facilitated fetal tucking posture and lateral positioning reduced the incidence of gastroesophageal reflux in hospitalized premature infants.
 

The effect of oral ibuprofen in doctus arteriosus closure in full- term neonates.
Manouchehr Soltani , Bahman Sadeghi Sedeh , Gholamali Fattahi Bayat , Parasto Mollai Tavana , Mojtaba Ahmadlou ,
Volume 80, Issue 3 (6-2022)
Abstract
Background: This study aimed to assess the efficacy and safety of the oral use of ibuprofen suspension in various doses in the treatment of PDA (Patent ductus arteriosus) in mature babies. Mature babies (37-42 weeks) aged more than 3 days who had been diagnosed with PDA were involved in this study. For the measurement of the ratio of left atrial to aortic root diameters (La/Ao) Color, pressure gradient and the internal ductal diameter, Doppler echocardiography (ECHO) was performed. This clinical trial was performed on 60 infants born born between August 2013 to August 2015.
Methods: This clinical trial study was performed on 60 infants were randomly born between August 2013 to August 2015 which Randomly divided into two groups: The first group, received oral ibuprofen in three doses (5, 5, 10 mg/kg at 24-hour intervals) and the second group received an early dose of OIS, in two doses of 10 mg/kg after 24 and 48 hours (totally 20 mg/kg). A follow-up ECHO was performed 48 hours and 2 weeks after treatment by the same pediatric cardiologist who was not aware of the study groups. Evaluation of changes in platelet count, blood urea nitrogen, creatinine and complications of thrombocytopenia, evaluation of elevated serum creatinine, and complications of gastrointestinal bleeding were compared between the two groups using statistical analysis.
Results: Seventy-three percent (73%) patients in the first group and seventy-six (76%) patients in the second group had successful PDA closure in the first 48 hrs. No statistically significant difference between the two groups (P=0.0001) was obtained and the highest response time was observed in the first 48 hours of treatment. After 2 weeks, the PDA closure in both groups was completely successful (100%). No specific side effects were observed between the two groups.
Conclusion: We conclude that higher doses of ibuprofen (20 and 2×510 mg/kg) do not show better results for PDA closure without renal or gastrointestinal complications.

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