Meena V, Meena DS, Rathore PS, et al. - Researchers conducted this randomized prospective study to compare the safety and effectiveness of ibuprofen, indomethacin, and paracetamol in the closure of patent ductus arteriosus (PDA) in preterm neonates. This investigation was carried out in the Division of Pediatric Cardiology, M. D. M and Umaid Hospital, Jodhpur. A total of 105 preterm neonates with gestational age < 37 weeks and hemodynamically significant PDA (hs-PDA) who were clinically diagnosed and echocardiographically validated have been registered. Study participants were assigned randomly in a ratio of 1:1:1 to oral indomethacin (Group A, 3 doses at an interval of 12 h with a starting dose of 0.2 mg/kg), oral ibuprofen (Group B, 10 mg/kg ibuprofen followed by 5 mg/kg/day for 2 days), or IV paracetamol (Group C, 15 mg/kg every 6 hourly for 3 consecutive days). After the completion of two courses of treatment, no significant difference was noted in PDA closure among all the three treatment groups. No major differences were observed in Hb, platelet, blood urea nitrogen (BUN), creatinine, and liver enzymes after treatment in the paracetamol group. BUN and serum creatinine levels in indomethacin and ibuprofen groups were significantly increased following treatment. The outcomes reveal that IV paracetamol is just as effective in supporting the closure of hs-PDA in premature infants with a better safety profile as indomethacin and ibuprofen.