Journal of Research in Pharmacy Practice

Abstract Objective: This study was designed to compare the efficacy and safety of enteral 
supplementation of a prebiotic mixture (SCGOS/LCFOS) on faecal microbiota in very 
premature infants who fed exclusively with human-milk.
Methods: This double‑center randomized control trial was conducted from December 
2012 to November 2013 in the tertiary Neonatal Intensive Care Units of the Isfahan 
University of Medical Sciences. Fifty preterm infants (birth weight ≤1500 g who 
were not fed with formula) were randomly allocated to have enteral (tube feeding) 
supplementation with a prebiotic mixture (SCGOS/LCFOS; 9:1) or receive no prebiotics.
Findings: The primary outcome (e.g., the effect of the prebiotic mixture on fecal 
microbiota pattern) was clearly different between the two groups. Despite greater 
coliforms colony counts in first stool cultures in the prebiotic group (Group P)(P = 0.67), 
coliforms were significantly lower in the third stool cultures in the Group P (P < 0.001). 
Furthermore, despite the much higher Lactobacillus colony counts, in the first 
stool cultures, in the control group (Group C) (P = 0.005); there was a trend toward 
significantly increased Lactobacillus colony counts in the Group P during the study, 
but the difference between Lactobacillus colony counts, in the third stool cultures, 
between two groups was no longer statistically significant(P = 0.11). Interestingly, the 
median length of hospital stay was significantly less in the Group P (16 [12.50–23.50] 
vs. 25 [19.50–33.00] days; P = 0.003).
Conclusion: This suggests that it might have been “the complete removal of formula” which 
manifests a synergistic effect between nonhuman neutral oligosaccharides (prebiotics) 
and human oligosaccharides, which in turn, led to the rapid growth of beneficial 
Lactobacillus colonies in the gut of breast milk‑fed preterm infants, while decreasing 
the number of pathogenic coliforms microorganisms. Therefore, further studies with 
larger sample sizes are recommended to investigate the issue.

Abstract Objective: Any operation leads to body stress and tissue injury that causes pain and 
its complications. Glucocorticoids such as Dexamethasone are strong anti‑inflammatory 
agents, which can be used for a short time post‑operative pain control in various surgeries. 
Main purpose of this study is to evaluate the effect of administration of intravenous (IV) 
Dexamethasone on reducing the pain after cesarean.
Methods: A double‑blind prospective randomized clinical trial was performed on 60 
patients candidate for elective caesarean section. Patients were randomly assigned into 
two groups: A (treatment: 8 mg IV Dexamethasone) and B (control: 2 mL normal saline). 
In both groups, variables such as mean arterial blood pressure (MAP), heart rate (HR), 
respiratory rate (RR), pain and vomiting severity (based on visual analog scale) were 
recorded in different time points during first 24 h after operation. Statistical methods 
using repeated measure analysis of variances and t‑test, Mann‑Whitney and Chi‑square 
tests were used for analyzing data.
Findings: The results indicated that within‑group comparisons including severity of pain, 
MAP, RR and HR have significant differences (P < 0.001 for all variables) during the study 
period. Between group comparisons indicated significant differences in terms of pain 
severity (P < 0.001), MAP (P = 0.048) and HR (P = 0.078; marginally significant), which in 
case group were lower than the control group.
Conclusion: IV Dexamethasone could efficiently reduce post‑operative pain severity and 
the need for analgesic consumption and improve vital signs after cesarean section.