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Preoperative severe renal impairment is included in the risk scores to predict out-come after open cardiac surgery. The purpose of this study was to assess the impact of pre-operative mild renal impairment on the early postoperative mortality after open heart surgery. Data of all cases of open cardiac surgery performed from January 2005 to June 2006 were collec-ted. Cases with preoperative creatinine clearance below 60 mL/min were excluded from the study. Data were retrospectively analyzed to find the impact of renal impairment on short-term outcome. Of the 500 cases studied, 47 had preoperative creatinine clearance between 89-60 mL/min. The overall mortality in the study cases was 6.8%. The mortality was 28.7% in those who developed postoperative ARF, 33.3% in those who required dialysis and 40.8% in those with preoperative mild renal impairment. Binary logistic regression analysis showed that female gender (P = 0.01), preoperative mild renal impairment (P = 0.007) as well as occurrence of multi organ failure (P < 0.001) were the only independent variables determining the early postoperative mortality after cardiac surgeries. Among them, preoperative mild renal impairment was the most significant and the best predictor for early postoperative mortality after cardiac surgery. Our study suggests that renal impairment remains a strong predictor of early mortality even after adjustment for several confounders.

Obstructive sleep apnoea (OSA) is a prevalent underdiagnosed disorder whose incidence increases with age and weight. Uniquely characterised by frequent breathing interruptions during sleep-known as intermittent hypoxia (IH)-OSA disrupts the circadian rhythm. Patients with OSA have repeated episodes of hypoxia and reoxygenation, leading to systemic consequences. OSA consequences range from apparent symptoms like excessive daytime sleepiness, neurocognitive deterioration and decreased quality of life to pathological complications characterised by elevated biomarkers linked to endocrine-metabolic and cardiovascular changes. OSA is a well-recognized risk factor for cardiovascular and cerebrovascular diseases. Furthermore, OSA is linked to other conditions that worsen cardiovascular outcomes, such as obesity. The relationship between OSA and obesity is complex and reciprocal, involving interaction between biological and lifestyle factors. The pathogenesis of both OSA and obesity involve oxidative stress, inflammation and metabolic dysregulation. The current medical practice uses continuous positive airway pressure (CPAP) as the gold standard tool to manage OSA. It has been shown to improve symptoms and cardiac function, reduce cardiovascular risk and normalise biomarkers. Nonetheless, a full understanding of the factors involved in the deleterious effects of OSA and the best methods to eliminate their occurrence are still poorly understood. In this review, we present the factors and evidence linking OSA to increased risk of cardiovascular conditions.

Background: Weight-loss surgery is one of the recommended methods for treating obstructive sleep apnea (OSA) in obese patients. While weight reduction is critical to relieve symptoms of OSA, the biochemical factors involved in post-surgery improvement are still unknown. We aimed to explore the link between ANGPTL7 and OSA in patients with different OSA severity. Furthermore, we examined the effect of treating OSA with bariatric surgery on ANGPTL7 level., Methods: We quantified levels of circulating ANGPTL7 in fasting plasma and adipose tissue samples of 88 participants before and after bariatric surgery. Confocal microscopy analyses were also performed to assess the ANGPTL7 expression in subcutaneous white adipose tissue biopsies obtained from people with moderate-to-severe OSA compared to those with none or mild OSA. The study involved 57 individuals with none or mild OSA and 31 patients with moderate-to-severe OSA., Results: Levels of circulating ANGPTL7 were significantly higher in people with moderate-to-severe OSA (1440 ± 1310 pg/ml) compared to the none or mild OSA group (734 ± 904 pg/ml, p = 0.01). The increase in ANGPTL7 correlated significantly and positively with the apnea-hypopnea index (AHI, r = .226, p = .037), and AHI-supine (r = .266, p = .019) in participants with moderate-to-severe OSA. Multivariate logistic regression analysis demonstrated an association between ANGPTL7 and OSA severity (log 2 ANGPTL7; OR =1.24, p = 0.024). ANGPTL7 levels exhibited significant positive correlations with the levels of TG and oxLDL (p-value = 0.002 and 0.01 respectively). Bariatric surgery reduced the levels of both ANGPTL7 and AHI significantly., Conclusion: Here we report significantly increased levels of ANGPTL7 both in the circulation and in adipose tissue of patients with OSA, which concurred with increased inflammation and OSA severity. Levels of ANGPTL7 decreased significantly as OSA showed a significant improvement post-surgery supporting a potential role for ANGPTL7 in either OSA progression or a role in an OSA-related mechanism., Competing Interests: NV is a member of the Medical Advisory Board of NightBalance, consultant of Philips Healthcare, Inspire Medical Systems and Nyxoah. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Leentjens, Alterki, Abu-Farha, Bosschieter, de Raaff, de Vries, Al Shawaf, Thanaraj, Al-Khairi, Cherian, Channanath, Kavalakatt, van Wagensveld, de Vries and Abubaker.)

IGFBP4 is the smallest member of the insulin-like growth factor binding protein family (IGFBP). It is a hepatic protein that plays a role in modulating the activity and bioavailability of IGF-I. The expression of IGFBP4 was found to increase under conditions of hypoxia. Obstructive sleep apnea (OSA) is a common disorder, characterized by cyclic episodes of intermittent hypoxia and fragmented sleep. Our aim was to quantify levels of circulating IGFBP1, IGFBP2, IGFBP3, IGFBP4, and IGFBP7 in fasting plasma samples of 69 Kuwaiti participants and explore its correlation with indices of OSA. The quantification was performed using multiplexing assay. The study involved 28 controls and 41 patients with OSA. Levels of circulating IGFBP4 were significantly higher in people with OSA (289.74 ± 23.30 ng/ml) compared to the control group (217.60 ± 21.74 ng/ml, p = 0.028). The increase in IGFBP4 correlated significantly and positively with AHI ( r = .574, p = .01) and AI ( r = .794, p = .001) in people with moderate and severe OSA. There was a significant decline in circulating IGFBP4 after 3 months of surgery (225.89 ± 18.16 ng/ml, p = 0.012). This was accompanied by a prominent improvement in OSA (AHI 8.97 ± 2.37 events/h, p = 0.001). In this study, our data showed a significant increase in circulating IGFBP4 in people with OSA. We also report a significant positive correlation between IGFBP4 and indices of OSA at baseline, which suggests IGFBP4 as a potential diagnostic biomarker for OSA. There was a significant improvement in OSA after 3 months of surgical intervention, which concurred with a significant decline in IGFBP4 levels. Altogether, the detected change suggests a potential link between IGFBP4 and OSA or an OSA-related factor, whereby OSA might play a role in triggering the induction of IGFBP4 expression., Competing Interests: The authors declare that there is no conflict of interest regarding the publication of this paper., (Copyright © 2021 Abdulmohsen Alterki et al.)

Predictive indices like the atherogenic index of plasma (AIP) have been developed to estimate the risk of cardiovascular disease (CVD). Metabolic surgery is the most effective treatment for a rapid improvement of morbid obesity and its comorbidities such as type 2 diabetes (T2D) and CVD. A decreased reoccurrence of CVD after metabolic surgery has been reported by several studies. However, studies utilizing predictive indices for CVD risk in CVD-free morbid-obese patients who undertook laparoscopic sleeve gastrectomy (LSG) are lacking. Here, we use AIP as a tool to evaluate the improvement in CVD risk post-LSG in morbid-obese people who had no history of CVD. Method. We compared baseline, 6- and 12-month post-LSG score of AIP, vascular age, circulating biochemical markers related to CVD in two groups of BMI and age-matched morbid-obese participants with and without T2D. Results. At baseline, people with T2D had significantly higher AIP both, with morbid obesity (0.23 ± 0.06, p < 0.001) and normal weight (0.022 ± 0.05, p < 0.001) compared to their BMI-matched without T2D group. People with morbid obesity had low AIP (-0.083 ± 0.06). Vascular age was significantly higher in people with morbid obesity and T2D (65.8 ± 3.7year, p < 0.0001) compared to morbid obesity (37.9 ± 2.6 year). After one year, AIP was significantly reduced compared to baseline score in people with morbid obesity with/without T2D, respectively (-0.135 ± 0.07, p = 0.003; and -0.36 ± 0.04, p = 0.0002). Conclusion . Our data illuminates AIP as a reliable predictive index for CVD risk in morbid-obese people who had no history of CVD. Moreover, AIP accurately distinguishes between morbid obesity with T2D and morbid obesity and showed a rapid and significant reduction in CVD risk after LSG in people who had no history of CVD. This is a ClinicalTrials.gov registered trial (Reference NCT03038373)., Competing Interests: The authors declare that there are no Potential Conflicts of interest associated with this manuscript., (Copyright © 2020 Eman Al Shawaf et al.)

Background: ANGPTL4 is a glycoprotein that is involved in regulating triglyceride metabolism by inhibiting LPL activity under fasting conditions. Additionally, ANGPTL4 has been suggested as a link between hypertriglyceridemia and albuminuria in the nephrotic syndrome. In this study, we examined levels of circulating ANGPTL4 in people with diabetic nephropathy (DN) and its association with established DN-associated proteins such as IGFBP1 and IGFBP4., Methods: We quantified circulating ANGPTL4, IGFBP1, IGFBP3, and IGFBP4 in fasting plasma samples of 122 Kuwaiti participants using a multiplexing assay. The study involved 36 controls, as well as 86 people with type 2 diabetes (T2D) including 37 people with normal kidney function and 49 people with DN., Results: ANGPTL4 level was increased in people with DN (241.56 ± 14.1  μ g/ml) compared to the control group (178.43 ± 24.09  μ g/ml). The increase in ANGPTL4 correlated with clinical parameters of DN including albumin-to-creatinine ratio ( r = 0.271, P = 0.002), serum creatinine ( r = 0.381, P = 0.0001), and eGFR ( r = -0.349, P < 0.0001). Furthermore, ANGPTL4 correlated positively with both IGFBP1 ( r = 0.202, P = 0.026) and IGFBP4 ( r = 0.364, P < 0.0001). Multiple regression analysis showed increased IGFBP1 and TG as predictors of higher ANGPTL4 in people with DN. In people with T2D, only IGFBP1 acted as a positive predictor of a rise in ANGPTL4., Conclusion: In this study, our data showed a significant increase in circulating ANGPTL4, IGFBP1, and IGFBP4 in patients with DN. The elevation in ANGPTL4 correlated significantly with clinical markers of DN such as ACR, serum creatinine, and eGFR, as well as IGFBP1 and IGFBP4. Altogether, this suggests a potential role for ANGPTL4 in DN perhaps through its role in inhibiting LPL activity and promotes ANGPTL4 as a biochemical marker for the detection of a diabetic kidney disease in patients with T2D., Competing Interests: The authors declare that there are no potential conflicts of interest associated with this manuscript., (Copyright © 2019 Eman Al Shawaf et al.)

Background: Angiopoietin-like 8 (ANGPTL8) a hepatic protein, is implicated by several studies with a role in promoting pancreatic β-cell proliferation and improving glucose tolerance. Although a matter of controversy, a growing number of reports support ANGPTL8's potential, yet unclear, role in type 2 diabetes (T2D)., Objectives: To examine changes in fasting ANGPTL8 level in people with morbid obesity, with or without diabetes after laparoscopic sleeve gastrectomy (LSG) in a 1-year prospective study., Setting: Dasman Diabetes Institute, government, and private hospitals, Kuwait., Methods: Fasting serum ANGPTL8 was measured by enzyme-linked immunosorbent assay at baseline in participants with morbid obesity, 17 with diabetes and 23 without diabetes, and in healthy weight participants, 19 with and 15 without diabetes, during 1 year post-LSG in participants with morbid obesity., Results: At baseline, people with T2D had higher ANGPTL8 level, (morbid obese, mean ± standard error of the mean; 1415 ± 196.4 pg/mL, and healthy weight, 2231 ± 328.1 pg/mL), compared with individuals without T2D (morbid obese, 876 ± 155.0 pg/mL, and healthy weight controls 868.9 ± 218.7 pg/mL). In participants with diabetes and morbid obesity, T2D remission occurred 15 days post-LSG, defined by a sustained reduced fasting blood glucose levels <6.9 mmol/L. In this group, the 1-year post-LSG measurement of ANGPTL8 showed unique biphasic changes, first a prominent elevation (day 60, 3336 ± 916.5 pg/mL, P < .01), followed by a gradual decrease to reach almost the baseline level (day 360, 1184 ± 119.3 pg/mL)., Conclusion: Elevated baseline ANGPTL8 in participants with diabetes at baseline reflected a link to T2D. Interestingly, the unique biphasic pattern of change in fasting ANGPTL8 post-LSG, occurred only in people with diabetes, suggesting ANGPTL8's potential role in T2D remission., (Copyright © 2018 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.)

The Transient Receptor Potential Canonical 5 (TRPC5) protein forms calcium-permeable cationic channels that are stimulated by G protein-coupled receptor agonists. The signaling pathways of such agonist effects are poorly understood. Here we investigated the potential for involvement of lysophosphatidylcholine (LPC) and arachidonic acid generated by group 6 (GVI) phospholipase A2 (PLA2) enzymes, focusing on stimulation of TRPC5 by sphingosine-1-phosphate (S1P) which acts via a pertussis toxin-sensitive (Gi/o protein) pathway without Ca2+-release. Experiments were on HEK 293 cells containing conditional expression of human TRPC5. Channel activity was recorded using an intracellular calcium indicator or whole-cell patch-clamp and PLA2 activity was detected using 3H-arachidonic acid. S1P stimulated PLA2 and TRPC5 activities. Both effects were suppressed by the GVI PLA2 inhibitor bromoenol lactone. Knock-down of GVI PLA2 by RNA interference suppressed channel activity evoked by S1P whereas activity evoked by the direct channel stimulator LPC was unaffected. Arachidonic acid did not stimulate the channels. Prior exposure of channels to LPC but not arachidonic acid suppressed channel activity evoked by S1P but not gadolinium, a putative direct stimulator of the channels. The data suggest roles of LPC and GVI PLA2 in S1P-evoked TRPC5 activity., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Transient receptor potential canonical 5 (TRPC5) forms cationic channels that are polymodal sensors of factors including oxidized phospholipids, hydrogen peroxide, and reduced thioredoxin. The aim of this study was to expand knowledge of the chemical-sensing capabilities of TRPC5 by investigating dietary antioxidants. Human TRPC5 channels were expressed in HEK 293 cells and studied by patch clamp and intracellular Ca(2+) recording. GFP- and HA-tagged channels were used to quantify plasma membrane localization. Gallic acid and vitamin C suppressed TRPC5 activity if it was evoked by exogenous hydrogen peroxide or lanthanide ions but not by lysophosphatidylcholine or carbachol. Catalase mimicked the effects, suggesting that lanthanide-evoked activity depended on endogenous hydrogen peroxide. Trans-resveratrol, by contrast, inhibited all modes of TRPC5, and its effect was additive with that of vitamin C, suggesting antioxidant-independent action. The IC(50) was ∼10 μM. Diethylstilbestrol, a related hydroxylated stilbene, inhibited TRPC5 with a similar IC(50), but its action contrasted sharply with that of resveratrol in outside-out membrane patches where diethylstilbestrol caused strong and reversible inhibition and resveratrol had no effect, suggesting indirect modulation by resveratrol. Resveratrol did not affect channel surface density, but its effect was calcium-sensitive, indicating an action via a calcium-dependent intermediate. The data suggest previously unrecognized chemical-sensing properties of TRPC5 through multiple mechanisms: (i) inhibition by scavengers of reactive oxygen species because a mode of TRPC5 activity depends on endogenous hydrogen peroxide; (ii) direct channel blockade by diethylstilbestrol; and (iii) indirect, antioxidant-independent inhibition by resveratrol.

Introduction: Prosthetic valve thrombosis is a rare but life-threatening condition that requires careful evaluation and prompt treatment. While surgical intervention remains the gold standard, thrombolytic therapy is now emerging as a potential substitute. Various thrombolytic treatments including streptokinase, urokinase and recombinant tissue plasminogen activators have been reported with variable success rates. However, the data on the use of tenecteplase (a synthetic tissue plasminogen activator) is limited., Case Presentation: A 44-year-old Middle Eastern man with a previously implanted prosthetic mitral valve presented with exertional dyspnea and orthopnea. Investigations revealed a thrombosed prosthetic mitral valve. Successful thrombolysis was achieved using tenecteplase which lead to the complete restoration of valve function with no risk to the patient., Conclusion: Prosthetic valve thrombosis is a rare but life threatening condition, the diagnosis of which requires a high index of suspicion. Tenecteplase can be used successfully in the management of such cases. It has proved to be useful with no extra risk to the patient.

Objective: To determine whether calcium-permeable channels are targets for the oxidized phospholipids: 1-palmitoyl-2-glutaroyl-phosphatidylcholine (PGPC) and 1-palmitoyl-2-oxovaleroyl-phosphatidylcholine (POVPC)., Methods and Results: Oxidized phospholipids are key factors in inflammation and associated diseases, including atherosclerosis; however, the initial reception mechanisms for cellular responses to the factors are poorly understood. Low micromolar concentrations of PGPC and POVPC evoked increases in intracellular calcium in human embryonic kidney 293 cells that overexpressed human transient receptor potential canonical 5 (TRPC5) but not human TRP melastatin (TRPM) 2 or 3. The results of electrophysiological experiments confirmed stimulation of TRPC5. To investigate relevance to endogenous channels, we studied proliferating vascular smooth muscle cells from patients undergoing coronary artery bypass surgery. PGPC and POVPC elicited calcium entry that was inhibited by anti-TRPC5 or anti-TRPC1 antibodies or dominant-negative mutant TRPC5. Calcium release did not occur. The effect was functionally relevant because it enhanced cell migration. The actions of PGPC and POVPC depended on G(i/o) proteins but not on previously identified G protein-coupled receptors for oxidized phospholipids., Conclusions: Stimulation of calcium-permeable TRPC5-containing channels may be an early event in cellular responses to oxidized phospholipids that couples to cell migration and requires an unidentified G protein-coupled receptor.

TRPC channels are a subset of the transient receptor potential (TRP) proteins widely expressed in mammalian cells. They are thought to be primarily involved in determining calcium or sodium entry and have broad-ranging functions that include regulation of cell proliferation, motility and contraction. The channels do not respond to a single stimulator but rather are activated or modulated by a multiplicity of factors, potentially existing as integrators at the plasma membrane. This review considers the sensitivity of TRPCs to lipid factors, with focus on sensitivities to diacylglycerols, lysophospholipids, arachidonic acid and its metabolites, sphingosine-1-phosphate (S1P), cholesterol and derivatives, and other lipid factors such as gangliosides. Promiscuous and selective lipid-sensing are apparent. In many cases the lipids stimulate channel function or increase insertion of channels in the membrane. Both direct and indirect (receptor-dependent) lipid effects are evident. Although information is limited, the lipid profiles are consistent with TRPCs having close working relationships with phospholipase C and A2 enzymes. We need much more information about lipid-sensing by TRPCs if we are to fully appreciate its significance, but the available data suggest that lipid-sensing is a key, but not exclusive, aspect of TRPC biology.

Mammalian homologues of Drosophila melanogaster transient receptor potential (TRP) are a large family of multimeric cation channels that act, or putatively act, as sensors of one or more chemical factor. Major research objectives are the identification of endogenous activators and the determination of cellular and tissue functions of these channels. Here we show the activation of TRPC5 (canonical TRP 5) homomultimeric and TRPC5-TRPC1 heteromultimeric channels by extracellular reduced thioredoxin, which acts by breaking a disulphide bridge in the predicted extracellular loop adjacent to the ion-selectivity filter of TRPC5. Thioredoxin is an endogenous redox protein with established intracellular functions, but it is also secreted and its extracellular targets are largely unknown. Particularly high extracellular concentrations of thioredoxin are apparent in rheumatoid arthritis, an inflammatory joint disease that disables millions of people worldwide. We show that TRPC5 and TRPC1 are expressed in secretory fibroblast-like synoviocytes from patients with rheumatoid arthritis, that endogenous TRPC5-TRPC1 channels of the cells are activated by reduced thioredoxin, and that blockade of the channels enhances secretory activity and prevents the suppression of secretion by thioredoxin. The data indicate the presence of a previously unrecognized ion-channel activation mechanism that couples extracellular thioredoxin to cell function.

Objectives: The purpose of this study was to compare the hemodynamic profiles and the postoperative insulin requirements in 2 groups of type 2 diabetic patients with depressed myocardial function who underwent elective surgery for coronary artery disease and who received levosimendan or milrinone for postcardiopulmonary bypass low-output syndrome., Design: Randomized controlled trial., Setting: The Chest Diseases Hospital, Safat, Kuwait., Participants: Type 2 diabetic patients undergoing elective surgery for coronary artery disease., Interventions: Fourteen patients and 16 patients received levosimendan and milrinone infusions, respectively, for treatment of the low-output syndrome., Measurements and Main Results: The hemodynamic, mixed venous oxygen saturation, oxygen extraction ratios, arterial lactate concentrations, and postoperative insulin infusion rates were serially documented for the first 48 hours after the diagnosis. The cardiac index and mixed venous oxygen saturation were significantly higher in the levosimendan group. The pulmonary capillary wedge pressure, systemic vascular resistance, and oxygen extraction ratios were significantly higher in the milrinone treatment group. The insulin requirements were similar for both of the treatment groups., Conclusions: Levosimendan was more efficient than milrinone for treating the hemodynamic manifestations of the postcardiopulmonary bypass low-output syndrome. However, all the values in the milrinone treatment group were normalized. In this small population, both treatment groups had similar postoperative insulin requirements.

Unlabelled: The purpose of this study was to review our experience with intrathoracic major bronchial disruptions due to trauma and to describe the diagnosis and treatment., Methods: A retrospective review was performed of major bronchial injuries managed in Kuwait (1995-2001), n=12. Clinical presentation, diagnostic evaluation, surgical management, and outcome were reviewed., Results: The mechanism of injury involved blunt trauma in seven patients and penetrating trauma in five. Tachypnea and subcutaneous emphysema (occurring in 10, 9 of the patients, respectively) are common. Nine patients had pneumothorax and air leak after tube thoracostomy. The diagnosis was confirmed by bronchoscopy in all patients. The majority of the injuries were repaired primarily. Lung resection was necessary in two patients. Four patients sustained complications including death (two patients), atelectasis (one patient), and pneumonia (one patient). Follow-up bronchoscopy revealed no evidence of granulation tissue or stenosis at the site of repair., Conclusion: The diagnosis of intrathoracic major bronchial disruptions required a high index of suspicion and liberal use of bronchoscopy. The majority were repaired primarily with good outcome.

Objective: To review our experience of indications, technique, and complications as they relate to video-assisted thoracoscopic surgery (VATS) in the diagnosis and management of intrathoracic diseases., Subjects and Methods: One hundred and fifty consecutive VATS procedures, which were performed over a 3-year period, were retrospectively evaluated. Indications included recurrent or persistent primary spontaneous pneumothorax (n = 73 patients), lung biopsies for diagnosis of diffuse lung disease (n = 33), pleural biopsies (n = 18), wedge resections of pulmonary nodules (n = 8), bilateral thoracic sympathectomy (n = 6), decortication (n = 5), mediastinal tumor biopsies (n = 5), excision of bullous emphysema (n = 1), and removal of a foreign body from the pleural cavity (n = 1). An alternative method of manipulating thoracoscopic instruments without using a trocar is described., Results: Of the 150 VATS procedures, 127 (85%) were successfully performed, 6 (4%) were converted to thoracotomy and 17 (11%) had complications. The most common complication was prolonged air leak, which occurred in 9 patients. The average postoperative hospital stay was 4 days (range: 2-17). Diagnostic procedures were considered successful in 32 out of 33 lung biopsies and in all 18 patients with pleural diseases, 8 lung nodules, or 5 mediastinal tumor biopsies. The other 86 therapeutic VATS procedures were effective in 82 (95%) patients. Four (5%) patients had a recurrence of the pneumothorax after VATS., Conclusion: Thoracoscopy and the use of a nontrocar technique is a safe and effective method for the diagnosis and treatment of intrathoracic diseases., (Copyright 2004 S. Karger AG, Basel)

Objective: The objective of this study was to determine the effect of indomethacin on reducing the incidence of intraventricular hemorrhage in premature infants treated in our units at King Faisal Specialist Hospital and Research Centre., Methods: This historical cohort study included 45 infants born with birth weights of 1250g or less and received indomethacin in the first 12 hours of life for intraventricular hemorrhage prevention. The treated infants were compared to 33 other infants with birth weights of 1250g or less who did not receive indomethacin for intraventricular hemorrhage prevention. Data collected included demographic, complications of prematurity, renal function and maternal data., Results: Mean birth weight (grams) and gestational age (week) were 928.4+/-34, 1066.2+/-38.9, 27.2+/-0.37 and 29+/-0.42 for the treated and the control infants. Overall incidence of intraventricular hemorrhage decreased significantly in the treated infants in comparison to the controls (P=0.0169). There was no infant with Grade 3-4 intraventricular hemorrhage found in the treated group while 2 developed grade 3-4 intraventricular in the control group which was insignificant. There were no statistically significant differences between the groups in terms of the complications of prematurity, Apgar scores at 5 minutes, airleak syndrome and the use of umbilical catheters. The total fluid intake in the first 4 days after starting the treatment was comparable between the groups. There were no significant differences between the groups in urine output in day 1, 3 and 4. However the urine output decreased significantly in day 2 in the treated group (P = 0.0349). There were no statistically significant differences in serum urea and creatinine between the groups, Conclusion: Low dose indomethacin given in the first 12 hours of life was shown to be associated with a decrease in intraventricular hemorrhage in premature infants and it was not associated with significant adverse effect.