Atropine combined with ortho-k treatment can improve the efficacy of myopia control

A recent study found that atropine combined with orthokeratology (ortho-k) can significantly improve the efficacy of myopia control in children compared with monotherapy. This study’s findings were published in the British Journal of Ophthalmology.

This was an age-stratified randomised controlled trial, including 164 children aged 8-12 years with spherical equivalent refraction of -1.00 to -6.00 D. The participants were stratified into two age subgroups and randomly assigned to receive placebo drops+spectacles (control), 0.01% atropine+spectacles (atropine), ortho-k+placebo (ortho-k) or combined treatment. Measurements of the axial length were taken at the baseline and visits at 6, 12, 18, and 24-months. The primary analysis of this study was done following the criteria of intention to treat, which included all randomised subjects.

After 2-year follow-up, it was demonstrated that axial elongation was significantly reduced in combined treatment than in monotherapies. In the ortho-k group, a significant age-dependent effect was evident when compared to the control group. Similarly, a significant age-dependent effect was observed in the ortho-k group when compared to the atropine group. Based on the findings of the study, it can be concluded that a combination of atropine and ortho-k treatment improves the efficacy of myopia control compared with monotherapy in children aged 8-12 years. Additionally, younger children may experience greater benefits from ortho-k treatment

Role of oral zinc in reducing serum bilirubin in term neonates with hyperbilirubinemia

According to a recent study, oral zinc sulfate supplementation, along with phototherapy significantly reduced serum bilirubin levels and also the duration of phototherapy required in the term neonatal hyperbilirubinemia. This study was published in the journal, Indian Pediatrics.

This study was a double-blind, randomized, placebo-controlled trial that included 106 term neonates with jaundice, who were admitted to a level III neonatal intensive care unit. They were randomized to receive either 5mg/day of oral zinc sulfate or matching placebo for 5 days. Both group neonates received conventional phototherapy as per AAP (American Academy of Pediatrics) guidelines. The primary outcome measured was a reduction in total serum bilirubin levels at 24, 48, 72, and 96 hr post-intervention.

At the end of the study, it was found that mean (SD) total serum bilirubin levels were 15.3 vs. 17.1 mg/dL at 24h, 11.7 vs. 14.62 mg/dL at 48h, 6.7 vs. 9.5 mg/dL at 72h, 5.1 vs. 6.5 mg/dL after 72hr, for the zinc and placebo groups, respectively. The mean (SD) duration of phototherapy was found to be significantly lower in the zinc group when compared to the placebo group.

From the above results, it can be concluded that total and indirect serum bilirubin levels and total duration of phototherapy required in the term neonatal hyperbilirubinemia may be reduced in neonates after taking oral zinc sulfate supplementation at a dose of 5mg once a day, with minimal or no adverse effects.

Optimal intubation conditions with ciprofol and low-dose rocuronium in pediatric patients undergoing daytime adenotonsillectomy

A recent study suggests that combining ciprofol with low-dose rocuronium provides optimal intubation conditions in pediatric patients undergoing daytime adenotonsillectomy. This study was published in the journal, Scientific reports.

This clinical trial included 144 children, aged 3-12 years, ASA I-II, who were undergoing daytime adenotonsillectomy. The participants were randomly divided into three groups and received 0.4 mg/kg (C4), 0.6 mg/kg (C6), or 0.8 mg/kg (C8) of ciprofol for anesthesia induction. The primary outcome of the study was intubation conditions. Also, vital signs and injection pain were recorded.

It was seen that 30.6%, 8.7%, and 8.2% were the rates of unacceptable intubation conditions in the C4, C6, and C8 groups, respectively. The overall incidence of injection pain was 3.5% while the heart rate and mean arterial pressure did not differ between the groups at the same time points.

Hence, it can be concluded that combining 0.6mg/kg of ciprofol with low-dose rocuronium may provide optimal intubation conditions in pediatric patients undergoing daytime adenotonsillectomy.

Relationship between types of treatment for maternal anemia and the effects on fetus and newborn

According to a recent study, maternal treatment with intravenous ferumoxytol results in an increase in neonatal hematologic and iron indices when compared to oral ferrous sulfate. This study was published in The American Journal of Obstetrics & Gynecology.

This randomized controlled trial included 124 participants with anemia who were divided in a 1:1 ratio to receive either 2 infusions of 510 mg of intravenous ferumoxytol or 325 mg oral ferrous sulfate twice daily. Each intravenous iron infusion was followed by fetal monitoring.

While hemoglobin was 15.7 g/dL vs. 15.4 g/dL in the ferumoxytol vs. ferrous sulphate group, hematocrit was 50.5% and 49.2%, respectively. Infants of participants treated with intravenous ferumoxytol revealed higher cord blood ferritin concentrations. Equivalent iron, transferrin, and total iron binding capacity were equivalent in neonates of participants receiving intravenous vs. oral treatment. At the time of admission for delivery, the post hoc analyses showed a statistically significant correlation between neonatal ferritin and maternal hemoglobin and ferritin.

Based on the above results, it may be seen that neonates of participants who were administered intravenous ferumoxytol had higher ferritin concentrations in cord blood, for the same gestation period and the same birthweight. Thus, participants with higher hemoglobin and ferritin indices gave birth to infants with higher ferritin concentrations in the cord blood.