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Background and Objective: Patent ductus arteriosus (PDA) is a common problem in preterm infants which can result in serious hemodynamic changes causing respiratory and cardiac morbidities if not treated in the first week of life. The treatment options available are pharmacological treatment with cyclo-oxygenase (COX) inhibitors and surgical ligation. The cyclo-oxygenase inhibitors approved for use are indomethacin and ibuprofen which have been used with different routes of administration and dosages. This study was conducted to evalute the lower and standard dose of oral ibuprofen in patent ductus arteriosus closure in preterm infants. Materials and Methods: In this clinical trial study, 44 preterm infants (<35 weeks gestational age) were randomly assigned to receive either a low dose (0.2mg/kg/dose for 3 doses, 24 hours apart) ibuprofen or a standard dose (10mg/kg/dose for the first dose, followed if needed, at 24hours interval by one or two additional doses of 5mg/kg each). These premature neonates either had clinical signs of patent ductus arteriosus or were diagnosed by echocardiography before stabilization of clinical signs. Patent ductus arteriosus closure was confirmed by echocardiography. They were under observe for drug's side effects (oliguria/anuria, GI bleeding, serum creatinin, intraventricular hemorrhage) and their clinical course was recorded. Results: The patent ductus arteriosus closure rates were the same with both doses (74% in case group vs.76% in control), 5 infants in the case group (22%) and 3 infants in the control group (14%) did not respond to the first course of therapy and needed a new course. There was a significant more rate of reducing renal output with the standard dose 33% vs. 4% (P<0.05), but the serum creatinin level was not different between two groups. One infant (4%) in the case group and 3 infants (14%) in the control group had GI bleeding. There was not any difference in intraventricular hemorrhage grading between two groups. Conclusion: This study showed that inspit of lower renal side effect, the low dose oral ibuprofen in comparison to standard dosage did not have any meaningful difference in closure of PDA in preterm infant.

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Background and Objective: Regarding to probable high frequency of Glucose - 6 - phosphate dehydrogenase (G6PD) deficiency in Iran, screening of all neonates by cord blood is under consideration. This study was conducted to determine the prevalence of G6PD deficiency in newborns and the relation between gender, jaundice, hemolysis, anemia and the G6PD deficiency in neonated born in in Tehran, Iran.

Materials and Methods: In this descriptive study, cord blood of 450 neonates born in Akbarabady hospital in Tehran, Iran during 2008-09 were screened. Demographic information was recorded by questionnaires and the newborns were examined for detection of jaundice till discharge. G6PD level was determined by Fluorescent Spot Test (FST). G6PD deficient neonate were put under close observation for detection of jaundice. Enzyme activity was rechecked by spectrophotometry.

Results: Nine neonates out of 450 were G6PD deficient (8 boys and one girl). Prevalence of G6PD deficiency was 2% (3.3% for boys and 0.5% for girls). Six neonates of nine G6PD deficient neonates (66%) developed pathologic jaundice. Four neonates were managed by phototherapy and two by exchange transfusion.

Conclusion: This study showed that G6PD deficiency is more prevalate among male neonates, therefore, G6PD determination is recommended to prevent the possible neonatal jaundice.