[Comparing the antipyretic effectiveness of oral and rectal acetaminophen in children]

Introduction: Acetaminophen is the most commonly used drug for temperature reduction in febrile children, which is used orally or rectally. The effectiveness of rectal versus oral Acetaminophen is not well established

Objective: This study is designed to compare the antipyretic effectiveness of rectal acetaminophen dose 15mg/kg to the standard oral dose of 15mg/kg

Materials and Methods: A randomized clinical trial was performed on 60 patients aged 6 months to 6 years with fever>/=39 rectally. The patients were randomly assigned in one of two groups. First 39[degree]c group received 15mg/kg Acetaminophen rectally and the second group received same dose orally and their body temperature was measured one and three hours after Acetaminophen administration

Results: The mean temperature reduction, 60 and 180 minutes after use of acetaminophen were 1.07 +/- 0.16 and 1.74 +/- 0.25

Conclusion: Effectiveness of oral and rectal Acetaminophen with 15mg/kg dose is similar in decreasing children's fever. Standard [15mg/kg] oral and [15mg/kg] rectal acetaminophen has similar antipyretic effectiveness

[Hirschsprung disease with VSD-PUL.atresia and PDA]

A four month old male infant was referred to the pediatric clinic of Afshar Hospital in Yazd city because of cyanosis. On physical examination, patient had central cyanosis, single second heart sound, A grade III/VI continuous murmur in left clavicular area, abdominal distension and large sized smooth and movable abdominal mass in right upper quadrant of abdomen. Transthoracic echocardiography showed VSD pulmonary atresia and small patent ductus arteriosis. Plain abdominal X Ray showed right sided abdominal mass. Ultra sonography showed a mass lesion in RT upper quadrant of abdomen with diameters of 5cmX12cm that was suggestive of fecaloma. Soap enema was performed and after that abdominal mass disappeared and abdominal distension was improved. Rectal biopsy 5cm from anal verge showed absence of ganglion cells in the intramural and sub mucosal plexuses. Ten day later, barium enema was performed. Barium enema showed dilated descending, transverse ascending colon and transition zone in recto sigmoid area. Therefore, definite diagnosis of the case was Hirschsprung disease with VSD- Pul. Atresia and small PDA. At first the patient underwent Right modified Blalock Taussig shunt [systemic to pulmonary shunt] and one month later underwent temporary colostomy. As no case of Hirschsprung disease with pulmonary Atresia- VSD and PDA has been reported to date, the above case has been reported