---

Background: Pediatricians frequently confront with elevated body temperature in children and subsequent anxious parents. They practice several approaches in management of fever. A recently addressed issue is administration of alternating doses of acetaminophen and Ibuprofen. This method is relatively common , despite lack of sufficient evidence in this field.

Materials and Methods: This study is a randomized clinical trial. A total of 240 children, aged 6 months to 12 years suffering from gastroenteritis was recruited in this research. Children were classified in 3 groups. First group received Acetaminophen, second group received Ibuprofen and third group were treated with acetaminophen – Ibuprofen every other day alternately.

Results: 240 child were taken apart in this research . 112 ones were female (46.66%) and 128 were male (53.33%). The mean time of lowering fever in the first group was 2.07 days. This figure in the second and third groups were 1.82 and 1.87 respectively. Average doses in the first, second and third groups were (in order) 9, 8.17 and 7.13 doses. Medication in the first group minimum effectiveness rather than two other groups.

Conclusion: The alternating regimen of Acetaminophen – Ibuprofen is more effective than monotherapy in reduction of fever in infants and children between 6 months to 12 years.

---

Background and Aim: Patent Ductus Arteriosus (PDA) is a common problem in premature neonates, especially in neonate’s low birth weight (LBW). This study aimed to compare the effectiveness of oral and intravenous ibuprofen in the management of PDA.
Methods & Materials: We enrolled 40 low birth weight neonates (gestational age <37 weeks) with PDA into semi-experimental study. the LBW neonates received ibuprofen as an initial dose of 10 mg/kg, followed by 5 mg/kg at 24 and 48 hours later. The exclusion criteria were congenital chromosome anomalies, congenital heart disease, asphyxia, sepsis. The PDA was initially confirmed by echocardiography. Treatment efficacy was evaluated by echocardiography after the treatment.
Ethical Considerations: This study was approved by the Ethics Committee of Arak University of Medical Sciences (Code: IR.ARAKMU.REC.1396.265).
Results: Of the total participants 37.5% (female 25) were girls. Gestational age ranges from 29 to 36 weeks. The average birth weight was 1639±616 gr and the minimum of weight 750 gr. the mean gestational age was 30.4±4.0 weeks. After the first dose of ibuprofen, closure of PDA was observed in 32 patients (80%), PDA closed in eight patients (20%) with to repeat course ibuprofen. There was no significant relationship between the frequency of ibuprofen use with gestational age (P=0.06), birth weight (P=0.08), type of delivery (P=0.068) and multiple births (P=0.061).
Conclusion: Most LBW neonate with PDA responded to using the first course of ibuprofen. extremely, all LBW infants responded to the second course. it seems that ibuprofen is as effective as ibuprofen for PDA closure even in LBW infants.