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Objective: Preventive therapy in migraine must be started with frequent or disabling headaches in children, while, no drugs have been approved for migraine preventive therapy of them up to now. The aim of the present research was to investigate safety and efficacy of melatonin in pediatric migraine prophylaxis. Methods: In a quasi- experimental study, monthly frequency, severity and duration of headache, migraine disability and clinical side effects in sixty migraineur referred children to Pediatric Neurology Clinic of Shahid Sadoughi Medical Sciences University, Yazd, Iran from January to June 2013 whom were treated with single dose of 0.3 mg/kg melatonin for three months, were evaluated. Results: Thirty two (53.3%) girls and 28(46.7%) boys with mean age of 10.31 ± 2.39 years were evaluated, 38 of whom (63.3%) had migraine without aura. Clinical adverse events were seen in 23.3% (N=14) of children including sleepiness in seven, vomiting in four, mild hypotension in two and constipation in one child. Excessive daytime sleepiness as a serious side effect was seen in three children which caused the drug use to be stopped. Monthly frequency, severity and duration of headache reduced from 15.63±7.64 to 7.07±4.42 attacks, from 6.20±1.67 to 3.55± 2.11 scores, and from 2.26±1.34 to 1.11±0.55 hours, respectively. Pediatric Migraine Disability Assessment score decreased from 31.72 ±8.82 to 17.78 ±10.64. (All p < 0.05). Conclusion: Melatonin might be considered as an effective and without life-threatening side effects drug in prophylaxis of migraine in children.

Objective: The aim of the present study was to investigate safety and efficacy of billinaster drop and glycerin suppository in hyperbilirubinemia of healthy term newborns who had passage of first meconium. Methods: In a randomized clinical trial, 90 neonates with total plasma bilirubin(TPB) level of 15–20mg/dL, were randomly assigned to be treated with alone phototherapy (control) or 5drop/kg of bilinaster drop every eight hours and phototherapy(B) or half of glycerin suppository every twelve hours and phototherapy(G). The primary outcomes were safety of drugs and efficacy in obtaining TPB of less than 14 mg/dL as measured at the beginning, 12, 24 and 48 hours after intervention. Secondary endpoint was hospitalization days. Results: After 48 hours of intervention, achieving TPB of less than 14 mg/dL was seen in 50 %( N=15) in control group, 73.3 %( N=22) in B group and 86.7 %( N=26 neonates) in G group (P= 0.01). Watery stool was seen in two neonates of glycerin group and safety of the treatments was not significantly different. Mean of TPB 12 hours after beginning of phototherapy(mean±SD:14.38±2.27mg/dL in G, 15.97±1.96mg/dL in B and 16.67±1.77mg/dL in control), 24 hours after intervention(mean±SD:12.56 ±1.59mg/dL in G, 12.57±2.05mg/dL in B and 14.36±2.26mg/dL in control), 48 hours after intervention (mean±SD: 9.34 ± 1.6mg/dL in G, 9.96 ± 2.95mg/dL in B and 12.27 ± 2.4mg/dL in control) and mean of hospitalization days (mean± SD: 1.5 ± 0.4days in G, 1.7 ± 0.4days in B and 2.9 ± 1.1days in control) were significantly lower in glycerin and billinaster groups. Conclusion: Bilinaster drop and glycerin suppository can be used as hazardless, efficient and cost effective drugs in treatment of neonatal hyperbilirubinemia.

AbstractBackground:Migraine is the most frequent acute recurrent primary headache in childhood. Hypothyroidism may be an exacerbating factor for some primary headaches. The purpose of this study was to determine the frequency of subclinical hypothyroidism in children with migraine headache.Methods:In a cross-sectional analytic study, the thyroid function tests of 5- to 15-year-old migraineurs who were referred to the Pediatric Neurology Clinic of Shahid Sadoughi University of Medical Sciences from January 2010 to February 2011 in Yazd, Iran, were measured based on the second edition of the International Classification of Headache Disorders.Results:Forty-eight girls (46.2%) and 56 boys (53.8%) with mean age of 10.46±2.72 years were evaluated. Twenty-five (24%) children had hypothyroidism. The monthly frequency of headache (mean±SD, 14.75±8.9 vs. 20.12±9.49, p=0.04) and the duration of headache (mean±SD, 1.96±1.08 vs. 3.75±2.71 h, p=0.03) were more statistically significant in migraineur children with hypothyroidism, but the mean age, mean of onset age of migraine, sex distribution, and severity of headache were not statistically different in both groups.Conclusion:Based on the results of this study, subclinical hypothyroidism was as an exacerbating factor for migraine headache. Therefore, it is logical to check the thyroid function tests in migraineur children.