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Background and Objective: Stress hyperglycemia (Transient rise of blood sugar during acute physiologic stress) has been reported in adults in conditions such as trauma, burns, stroke, myocardial infraction and patients admitted for any cause in intensive care unit. In pediatric age group stress hyperglycemia occurs in febrile illness and sever gastroenteritis. Prevalence and importance of stress hyperglycemia is not fully appreciated by physicians. This study was designed to find the frequency of stress hyperglycemia in children and infants admitted in Qaem Hospital and comparing it with other studies in Iran and other countries. Physicians’ knowledge about these phenomena prevents unnecessary and sometimes dangerous intervention. Patients with stress hyperglycemia due to acute clinical illness may be at risk of developing diabetes in future and their follow up is important matter. Materials and Methods: This descriptive cross-sectional study was conducted from March 2001 to May 201 on 334 patients admitted in Qaem Hospital who needed blood sampling for diagnostic tests. Known cases of diabetes mellitus and patients who received corticosteroids or beta-agonist agent and dextrose containing intravenous fluids were excluded from study. Blood sugar was determined by glucose oxidas method. On serum samples within 30 minute-1 hour after blood sampling. Hyperglycemia was defined in our study as blood sugar more than 150 mg/dl, fever as 37.5°C auxiliary temperature, and dehydration status defined as criteria of WHO. Results: 334 patients from age 2 days to 14 years had inclusion criteria, of these 59.5% were male and 40.4% were female. 26.3% of patients had variable degrees of dehydration. 23.7% of patients had auxiliary temperature?38.5°C to 40°C. blood sugar were in the range of 37 mg/dl-325 mg/dl and there was stress hyperglycemia in 17 patients (5.1%). Stress hyperglycemia was obviously more observed in patients with higher temperatures, more sever dehydration or clinical deterioration. There was no case of diabetes mellitus throughout 1-year follow up. Conclusion: Stress hyperglycemia is a relatively frequent clinical and laboratory finding in patients admitted in pediatrics and neonatal wards. There is no relation between the stress hyperglycemia and final diagnosis of patients, however the more serious the clinical condition, the higher the temperatures or more sever dehydration rises the likelihood of stress hyperglycemia.

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Background and Objective: Patent ductus arteriosus (PDA) is a common problem in preterm infants which can result in serious hemodynamic changes causing respiratory and cardiac morbidities if not treated in the first week of life. The treatment options available are pharmacological treatment with cyclo-oxygenase (COX) inhibitors and surgical ligation. The cyclo-oxygenase inhibitors approved for use are indomethacin and ibuprofen which have been used with different routes of administration and dosages. This study was conducted to evalute the lower and standard dose of oral ibuprofen in patent ductus arteriosus closure in preterm infants. Materials and Methods: In this clinical trial study, 44 preterm infants (<35 weeks gestational age) were randomly assigned to receive either a low dose (0.2mg/kg/dose for 3 doses, 24 hours apart) ibuprofen or a standard dose (10mg/kg/dose for the first dose, followed if needed, at 24hours interval by one or two additional doses of 5mg/kg each). These premature neonates either had clinical signs of patent ductus arteriosus or were diagnosed by echocardiography before stabilization of clinical signs. Patent ductus arteriosus closure was confirmed by echocardiography. They were under observe for drug's side effects (oliguria/anuria, GI bleeding, serum creatinin, intraventricular hemorrhage) and their clinical course was recorded. Results: The patent ductus arteriosus closure rates were the same with both doses (74% in case group vs.76% in control), 5 infants in the case group (22%) and 3 infants in the control group (14%) did not respond to the first course of therapy and needed a new course. There was a significant more rate of reducing renal output with the standard dose 33% vs. 4% (P<0.05), but the serum creatinin level was not different between two groups. One infant (4%) in the case group and 3 infants (14%) in the control group had GI bleeding. There was not any difference in intraventricular hemorrhage grading between two groups. Conclusion: This study showed that inspit of lower renal side effect, the low dose oral ibuprofen in comparison to standard dosage did not have any meaningful difference in closure of PDA in preterm infant.