BACKGROUND: Liver injury associated with antiepileptic drugs accounts for a large proportion of drug-induced liver injuries (DILI) in children. Although withdrawal of the causative agent is the only proved treatmen...BACKGROUND: Liver injury associated with antiepileptic drugs accounts for a large proportion of drug-induced liver injuries (DILI) in children. Although withdrawal of the causative agent is the only proved treatment for DILI, in some dinical situations it is not possible. Recent studies have reported promising results of using hepatoprotective drugs with antioxidant actions for the management of DILl. This study aimed to evaluate the efficacy of folic acid versus silymarin treatment in relation to decreasing liver enzymes in patients with DILI due to antiepileptic therapy. METHODS: This randomized, open-label, clinical trial evalu- ated 55 children with epilepsy who were on antiepileptic treat- ment and experienced DILL The children were randomized to receive either silymarin (5 mg/kg per day) or folic acid (1 mg per day) for one month and were followed up for three months. RESULTS: Liver enzymes significantly decreased in both groups. The decrease trend in alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were stronger in the folic acid group compared to silymarin group (P=0.04 and P=0.007, respectively). At the end of the study patients in the folic acid group had significantly lower ALT (P=0.04), AST (P=0.02), and gamma-glntamyl transferase (GGT) (P〈0.001) levels and also higher percentage of normal ALT (30.7% vs 3.4%, P=0.009) and AST (42.3% vs 0%, P〈0.001), and GGT (23.1% vs 0%, P=0.008) values compared to the patients in the silymarin group. No rebound elevations in ALT, AST and GGT levels or adverse reactions were noted in neither of the study groups.CONCLUSION: Although both treatments were safe and effective in decreasing liver enzymes, folic acid seems to be superior to silymarin in the management of DILl.展开更多
Purpose: Some topics such as women’s life style and nutrition and using some special medicines during pregnancy have been discussed and demonstrated as effective factors on infant’ health. Based on recommendations i...Purpose: Some topics such as women’s life style and nutrition and using some special medicines during pregnancy have been discussed and demonstrated as effective factors on infant’ health. Based on recommendations in Iranian traditional medicine, we aimed to evaluate the efficacy of pomegranate paste consumed by women during their pregnancy on the neonatal jaundice incidence. Methods: In this single-blinded controlled clinical trial, 80 healthy pregnant women were randomly divided into 2 groups, as treatment and control. The treatment group members added pomegranate paste to their daily diet from the 34th week of the pregnancy to birth, as administered. The levels of neonates’ bilirubin were checked in the 5th day of the delivery. Results: Both the need of phototherapy and the mean level of neonates’ bilirubin in the group fed with pomegranate paste were significantly lesser compared to control group. The number of neonates who were undergone phototherapy in the pomegranate paste receiving group was significantly lesser than that in the control group (P value = 0.029). By measuring the total bilirubin, statically significant difference between the treatment group and the control group was seen (P value = 0.021). Conclusion: The results of this study suggest the possible effect of adding pomegranate paste to pregnant women’s diet on the incidence of neonatal jaundice.展开更多
The aim of this study was to assess the Breastfeeding status among children aged 21 - 27 moths. A cross sectional study was carried out in South Health Center (Tehran-Iran) in 2010. Four hundred 21 - 27 month breastfe...The aim of this study was to assess the Breastfeeding status among children aged 21 - 27 moths. A cross sectional study was carried out in South Health Center (Tehran-Iran) in 2010. Four hundred 21 - 27 month breastfed infants entered the study. This study compared some variables in 2 groups;weaning before and after 22 months. The level of significance was considered P < 0.05. Mean breastfeeding duration and median (either exclusive or combined) were 19.66 ± 6.40 and 22 months. Among all reasons were cited by mothers, some reasons like insufficient breast milk supply (77.9%), infant restless (77.1%), and Mother’s reluctance (75.6%) were the most common causes of exclusive breastfeeding cessation. A significant relation was seen between breastfeeding duration and gestational age or birth trauma (P Value = 0.031, P Value = 0.04). Breastfeeding training and First mother-infant skin to skin contact had significant roles on breastfeeding duration (P Value < 0.05, P Value = 0.001, respectively). It seems lots of public health efforts and policy are needed to improve breastfeeding rate in our country.展开更多
基金supported by a grant from the research deputy of Tehran University of Medical Sciences
文摘BACKGROUND: Liver injury associated with antiepileptic drugs accounts for a large proportion of drug-induced liver injuries (DILI) in children. Although withdrawal of the causative agent is the only proved treatment for DILI, in some dinical situations it is not possible. Recent studies have reported promising results of using hepatoprotective drugs with antioxidant actions for the management of DILl. This study aimed to evaluate the efficacy of folic acid versus silymarin treatment in relation to decreasing liver enzymes in patients with DILI due to antiepileptic therapy. METHODS: This randomized, open-label, clinical trial evalu- ated 55 children with epilepsy who were on antiepileptic treat- ment and experienced DILL The children were randomized to receive either silymarin (5 mg/kg per day) or folic acid (1 mg per day) for one month and were followed up for three months. RESULTS: Liver enzymes significantly decreased in both groups. The decrease trend in alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were stronger in the folic acid group compared to silymarin group (P=0.04 and P=0.007, respectively). At the end of the study patients in the folic acid group had significantly lower ALT (P=0.04), AST (P=0.02), and gamma-glntamyl transferase (GGT) (P〈0.001) levels and also higher percentage of normal ALT (30.7% vs 3.4%, P=0.009) and AST (42.3% vs 0%, P〈0.001), and GGT (23.1% vs 0%, P=0.008) values compared to the patients in the silymarin group. No rebound elevations in ALT, AST and GGT levels or adverse reactions were noted in neither of the study groups.CONCLUSION: Although both treatments were safe and effective in decreasing liver enzymes, folic acid seems to be superior to silymarin in the management of DILl.
文摘Purpose: Some topics such as women’s life style and nutrition and using some special medicines during pregnancy have been discussed and demonstrated as effective factors on infant’ health. Based on recommendations in Iranian traditional medicine, we aimed to evaluate the efficacy of pomegranate paste consumed by women during their pregnancy on the neonatal jaundice incidence. Methods: In this single-blinded controlled clinical trial, 80 healthy pregnant women were randomly divided into 2 groups, as treatment and control. The treatment group members added pomegranate paste to their daily diet from the 34th week of the pregnancy to birth, as administered. The levels of neonates’ bilirubin were checked in the 5th day of the delivery. Results: Both the need of phototherapy and the mean level of neonates’ bilirubin in the group fed with pomegranate paste were significantly lesser compared to control group. The number of neonates who were undergone phototherapy in the pomegranate paste receiving group was significantly lesser than that in the control group (P value = 0.029). By measuring the total bilirubin, statically significant difference between the treatment group and the control group was seen (P value = 0.021). Conclusion: The results of this study suggest the possible effect of adding pomegranate paste to pregnant women’s diet on the incidence of neonatal jaundice.
文摘The aim of this study was to assess the Breastfeeding status among children aged 21 - 27 moths. A cross sectional study was carried out in South Health Center (Tehran-Iran) in 2010. Four hundred 21 - 27 month breastfed infants entered the study. This study compared some variables in 2 groups;weaning before and after 22 months. The level of significance was considered P < 0.05. Mean breastfeeding duration and median (either exclusive or combined) were 19.66 ± 6.40 and 22 months. Among all reasons were cited by mothers, some reasons like insufficient breast milk supply (77.9%), infant restless (77.1%), and Mother’s reluctance (75.6%) were the most common causes of exclusive breastfeeding cessation. A significant relation was seen between breastfeeding duration and gestational age or birth trauma (P Value = 0.031, P Value = 0.04). Breastfeeding training and First mother-infant skin to skin contact had significant roles on breastfeeding duration (P Value < 0.05, P Value = 0.001, respectively). It seems lots of public health efforts and policy are needed to improve breastfeeding rate in our country.