Prognostic factors of concomitant hyperglycemia and hypocalcemia in pediatric intensive care units

Hyperglycemia and hypocalcemia have separately been attributed to adverse outcomes in critically ill patients. This study aimed to investigate the simultaneous effects of the two conditions on mortality and morbidity in a pediatric intensive care unit. All children aged 1 month to 18 years, admitted for at least 24 hours to medical pediatric intensive care unit [PICU], Nemazee Hospital, Shiraz, Iran were reviewed over one year period. Those with a history of diabetes mellitus and any calcium disorders were excluded. Data on blood glucose and calcium during the first 6 hours of admission, in-PICU length of stay, need for mechanical ventilation, vassopressor drugs administration, and mortality were assessed. The incidence of hyperglycemia [>/= 150 mg/dl [8.3mmol/L]] and hypocalcemia [serum calcium<8.5 mg/dl [2.12mmol/L]] were 26.5% and 43.9%, respectively. Hyperglycemia and hypocalcemia were associated with increased mortality. Among the survivors, hyperglycemia and hypocalcemia had no significant effect on PICU length of stay. The interaction of hyperglycemia and hypocalcemia did not intensify their separate effects on mortality, the need for mechanical ventilation and vasopressor infusion. Although hyperglycemia and hypocalcemia separately increase the mortality rate, their simultaneous presence is not associated with poorer outcomes in critically ill patients

Evaluation of the growth parameters in major thalassemic patients

Thalassemia major is the most severe identified hemolytic anemia and the most common single gene abnormality. This disease is very common in Iran and that is why there should be a careful investigation into it. Not treated properly, growth faliure is one of the most important complications of this disease. This study was designed to evaluate the growth parameters in thalassemic children and to compare the obtained data with normal children. This cross-sectional, descriptive and analytical study was carried out on 121 thalassemic patients who received blood transfusion therapy in Yasuj, with respect to the physical growth parameters such as height, weight, sitting height, and arm circumference. Collected data were compared with data from normal children [who were chosen from the same sex, age and socioeconomic groups]. According to statistical analysis, weight of 53.7% of thalassemics and 17.1% of non-thalassemics, for the same age group, was under 5 percentile [p<0.0001]. These measurements for height and mid arm circumference were 66.9% v/s 17.1%, and 72.7% v/s 32.5% under percentile respectively [p<0.0001]. Considering the growth retardation of thalassemic patients, we recommend regular follow-up for confirming the blood transfusion and desferal injection with exact interval