Alternating ibuprofen and acetaminophen in the treatment of febrile hospitalized children aged 9-24 months

Recently, studies reported the emergence and increasing popularity of the alternate use of acetaminophen and ibuprofen. The aim of the present study was to compare the clinical effectiveness of acetaminophen alone with an alternative regimen of acetaminophen and ibuprofen in hospitalized infants aged 9-24 months with fever of non bacterial origin. The study was performed between March 2006 and December 2007, in pediatric center of two hospitals in Urmia. Patients were randomly separated into two groups. Eligible cases were febrile hospitalized patients aged between 9 and 24 months; whose rectal temperature was ?38.5oC. Infants of case group received 10 mg/kg ibuprofen alternating with 15 mg/kg acetaminophen every four hours. Infants of control group received 15 mg/kg acetaminophen every four hours. Temperature of patients in the two groups was registered 2, 4, 5, 7, and 8 hours after drug administration. The study was completed when each group received 35 cases. Seventy infants were divided into two groups. The case group consisted of 19 males and 16 females, in control group there were 18 males and 17 females. The results revealed significant difference between the two groups in lowering fever at 4, 5, 7 and 8 hours after treatment was initiated, but there was no significant difference at 2 hours after drug administration. An alternating treatment of acetaminophen [15 mg/kg] and ibuprofen [10mg/kg] 4 hours later is more effective than acetaminophen in lowering fever in 9 to 24 month old infants

Urinary tract infection in term neonates with prolonged Jaundice

The aim of this study was to evaluate the frequency of urinary tract infection [UTI] in neonates with prolonged jaundice. Newborn infants with jaundice lasted more than 2 weeks were included in this study. Patients who had other signs or symptoms were excluded. Workup of prolonged hyperbilirubinemia was performed, including direct Coomb's test, blood group of the neonate and the mother, complete blood count, blood smear, glucose-6-phosphate dehydrogenase [G6PD], reticulocyte count, serum level of bilirubin [ unconjugated and conjugated], thyroid function tests [serum thyroxine [T4] and thyroid-stimulating hormone], urinalysis, and suprapubic urine culture. Pediatric nephrologists carried out further investigation including kidney function tests, renal ultrasonography, voiding cystourethrography, and Technetium Tc 99m dimercaptosuccinic acid renal scintigraphy for patients with positive urine culture for microorganisms. Of 100 neonates who were evaluated, 43 were boys and 57 were girls. All of the neonates were breastfed. Six suffered from UTI [4 boys and 2 girls]. Reflux was detected on voiding cystourethrography in 1 and cortical defect in the kidney of renal scan in 2 boys. In our region, with a high rate of breastfeeding, UTI remains as an important cause of prolonged jaundice. Despite the high rate of urogenital system abnormality accompanied by neonatal UTI, there was not a significant difference between the signs and symptoms of jaundice in patients with and without UTI. Performing urine cultures should be considered as a routine procedure in the evaluation of every infant with prolonged jaundice