We conducted this single blind randomized clinical trial to compare the efficacy and safety of oral chloral hydrate and intranasal midazolam for induction of sedation for computerized tomography scan of brain in children. Participants aged 1-10 years (n=60) were randomized to receive 100 mg/kg chloral hydrate orally with intra nasal normal saline OR intranasal midazolam 0.2 mg/kg with oral normal saline. Adequate sedation (Ramsay sedation score of four) was obtained and CT scan completed successfully in 76.7% of chloral hydrate group and in 40% of midazolam group (P=0.004). No significant difference was seen for side effects frequency between the two drugs (10% in chloral hydrate, 3.3% in midazolam group; P=0.34). We conclude that oral chloral hydrate can be considered as a safe and effective drug for sedation in children undergoing CT scan of brain.

Background: Transient tachypnea of the newborn (TTN) is one of the most frequent causes of respiratory distress in neonates. A relationship has been shown between vitamin D deficiency and respiratory disorders in neonates. This research was carried out to evaluate the serum level of vitamin D in TTN newborns and their mothers compared to the control group. Methods: This case-control research was conducted during 2016-2019 in a general hospital affiliated with Mashhad University of Medical Sciences, Iran. Thirty-four infants with TTN and 82 neonates in the control group as well as their mothers were investigated. The levels of umbilical cord serum vitamin D in infants with TTN and also their mothers were compared to the control group. Results: The mean levels of serum vitamin D in infants with TTN and their mothers were 8.11 ± 4.32 and 12.6 ± 10.12 ng/mL, respectively (P<0.001), whereas they were 19.21 ± 12.71 and 25.96 ± 16.6 ng/mL in the newborns of the control group and their mothers, respectively (P<0.001). The mean differences (95% CI) of neonatal and maternal vitamin D level between the two groups were 11.10 (7.92–14.28) and 13.36 (7.90–18.08), respectively. In the TTN group, 100% of the infants had vitamin D levels less than 30 ng/mL (79.4% had severe, 17.6% had moderate and 2.9% showed mild deficiency). However, vitamin D levels lower than 30 ng/mL were observed in 76.4% of the neonates in the control group (28.8% had severe, 31.1% showed moderate and 16.3% had a mild deficiency) (P<0.001). Conclusion: The serum vitamin D levels of infants with TTN and their mothers were significantly lower than the control group. Therefore, TTN in infants may be reduced through the treatment of vitamin D deficiency in mothers.

BackgroundVitamin D deficiencies have been suggested as one of the risk factors for neonatal respiratory distress syndrome (RDS). The present study aimed to evaluate the effect of 25-hydroxyvitamin D [25(OH)D] administration in pregnant women at risk of preterm delivery on the incidence of RDS in their preterm neonates.MethodsA single-blinded randomized controlled clinical trial was conducted on pregnant mothers with a gestational age of less than 34 weeks at risk of preterm delivery. Subjects were randomly assigned into two groups by the corresponding author, including intervention (intramuscular injection of 50,000 units of 25(OH) D three days before delivery) and control (with no injection of 25(OH) D). Serum concentrations of 25(OH) D were measured after offspring, including RDS, were collected and recorded in a checklist. Short-term outcomes and the need for respiratory support were assessed by the principal investigator who was unaware of the type of intervention. Data were analyzed by independent t-test, paired sample t-test, and chi-square test.ResultsDespite the homogeneity of neonates in the two groups in terms of gestational age, birth weight and the delivery method, 45% of neonates in the control group and 20% in the intervention group developed respiratory distress syndrome (P < 0.05). The mean 25(OH) D level in neonates was 17.7 ± 10.5 and 23.7 ± 13.5 ng/mL in the intervention and control groups, respectively.ConclusionsAccording to this study, a single dose of 50,000 units of intramuscular 25(OH) D in pregnant women at risk of preterm delivery can reduce the incidence of RDS in the newborn.Trial RegistrationIranian Registry of Clinical Trials, IRCT20190814044529N1. Registered 21st Jan. 2020, https://fa.irct.ir/user/trial/41515/view

Background: Vitamin D deficiency is associated with respiratory problems in neonates. The late preterm or near-term neonates who have been admitted for tachypnea and fully recovered before 12 h are called non-specific respiratory distress syndrome (NRDS) cases. The present study aimed to evaluate the effect of 25-hydroxy vitamin D administration in pregnant women at risk of preterm delivery on the incidence of NRDS in their newborns. Methods: This single-blind clinical trial was performed on mothers and neonates with a gestational age of 32–37 weeks who were referred with labor pains from February 20, 2021 to June 29, 2021 to the Obstetrics and Gynecology Department and intensive care unit of Ghaem Hospital, affiliated to Mashhad University of Medical Sciences, Iran. Within 72 h before premature delivery, a dose of 50,000 units of 25 hydroxyvitamin D was injected intramuscularly to pregnant women in the intervention group. A sample containing 1.5 mL of whole blood was collected from the umbilical cord of the infant and mother to assess the level of 25-hydroxy vitamin D. Results: In the present study, there was a significant difference between the two groups of control and intervention in terms of infant’s weight (p = 001), 1-minute (p = 0.027) and 5-minute Apgar scores (p = 0.001), the incidence of NRDS (p = 0.001), and the maternal age (p = 0.004). However, the results showed no statistically significant difference between the two groups in terms of gender (p = 0.673), type of delivery (p = 0.299), level of 25-hydroxy(OH) vitamin D of the mother (p = 0.053), and infant (p = 0.805). Conclusions: A single injection of vitamin D into the mother prone to preterm birth over 31 weeks of gestation reduces transient respiratory problems in their newborns. Clinical Trial Registration: The study was also registered in the Iranian Clinical Trial Registration Center (IRCT20110807007244N7).

Coronavirus disease 2019 (COVID-19) infection, which was initially reported in Wuhan, China, in December 2019, had a rapid spread throughout the world becoming a new global crisis. Today, very little is known about neonatal COVID-19 infection. Herein, we tried to define the clinical and demographic characteristics, risk factors, and laboratory and imagining findings of neonates who tested positive for COVID-19 and were admitted to the NICU (neonatal intensive care unit) of Ali Ibn Abi Taleb Hospital, Zahedan, Iran, from June 2021 to July 2021. All full-term and premature neonates diagnosed with COVID-19 were included in the study. Their ages ranged from 1 to 21 days at admission, including 6 boys and 4 girls. The medical records of mother-baby dyads were reviewed. All mothers, except for one, were negative for COVID-19 infection. The most frequent findings in the neonates were fever, poor feeding, respiratory distress, cough, hypoxemia, and drooling. Broad-spectrum antibiotics were administered as routine. All neonates, except for one, needed respiratory support, and intratracheal surfactant was administered for three newborns. Three neonates with severe disorders died during the study period.