Treating Viral Diarrhea in Children by Probiotic and Zinc Supplements / 대한소아소화기영양학회지

PURPOSE: The aim of this study was to analyze the effects of probiotics and zinc supplements on the mean duration and frequency of acute diarrhea in children aged 6 months to 2 years. METHODS: In this clinical trial of infants aged between 6 months and 2 years, eligible patients were divided into 3 groups: Zinc Receiving Group (ZRG), Probiotic Receiving Group (PRG), and a control group receiving supportive care alone. The frequency of diarrhea was evaluated in the test groups during the first 24 hours and 48–72 hours, along with the duration of hospitalization and diarrhea persistence for 3–7 days. RESULTS: Diarrhea persisted for until the third day of admission in 100% of the infants in PRG compared with only 76.1% in ZRG. The relative risk of diarrhea persistence in the PRG was 1.31 times more than in ZRG until the third day. Also, 80% of diarrhea cases in the PRG persisted until the fourth day of admission, compared with 47.8% in the ZRG group, and this value was significant. The relative incidence of diarrhea persistence in the PRG was 36.4 times greater than in the ZRG until the day 4. Also, the percentage of post-treatment complications was 35.5% in the PRG and 2.6% in the ZRG, which was significant. CONCLUSION: In our study, the effectiveness of zinc at a dose of 20 mg was higher than that of probiotics. The complications associated with zinc supplementation were lower than those of probiotics.

Effect of Synbiotic on the Treatment of Jaundice in Full Term Neonates: A Randomized Clinical Trial / 대한소아소화기영양학회지

PURPOSE: Jaundice accounts for most hospital admissions in the neonatal period. Nowadays, in addition to phototherapy, other auxiliary methods are used to reduce jaundice and the length of hospitalization. This study aimed to investigate the effect of probiotics on the treatment of hyper-bilirubinemia in full-term neonates. METHODS: In this randomized clinical trial, 83 full-term neonates, who were admitted to the hospital to receive phototherapy in the first 6 months of 2015, were randomly divided into two groups: synbiotic (SG, n=40) and control (CG, n=43). Both groups received phototherapy but the SG also received 5 drops/day of synbiotics. Serum bilirubin, urine, stool, feeding frequency, and weight were measured daily until hospital discharge. A p-value<0.05 was considered statistically significant. RESULTS: The mean total serum bilirubin in the SG was lower than that in the CG (9.38±2.37 and 11.17±2.60 mg/dL, respectively). The urine and stool frequency in the SG was significantly higher than that in the CG (p<0.05). The duration of hospitalization in the SG was shorter than that in the CG. CONCLUSION: Use of synbiotics as an adjuvant therapy had a significant treatment effect on jaundice in full-term neonates. Further studies including larger samples with long follow-up periods are essential to confirm the benefits of routine use of synbiotics in neonatal patients with jaundice.

[Errors in medication orders and the nursing staffs reports in medical notes of children]

Medication errors are the most common type of medical error and an avoidable cause of iatrogenic injury in pediatric patients. These errors can occur at any point in the process of ordering, transcribing, dispensing, administering, or monitoring medications. This study was conducted to verify medication errors by analyzing medication orders and the nursing staffs reports in medical notes of children admitted in Madany Pediatric Hospital, Khoramabad, Iran, in the first 6 months of 2004. This is a descriptive cross-sectional and hospital information based study. Samples included 898 medical charts of children selected by random sampling. The data collection instruments were a demographic questionnaire for patients, physicians and nurses, a scale for analyzing medication orders and a scale for analyzing the nursing staff's reports. Data are analyzed by SPSS Ver. 11.5 software. Analysis of the medication orders indicated that in 74.1%, drug administration precautions were not written down, in 47.8%, exact time or intervals of drug administration were not recorded, in 45.5%, drug unit was not stated or it was incomplete or ambiguous, and in 20.5%, orders had at least one drug interaction. Analysis of nursing staffs reports indicated that in 77.5%, drug administration precautions were not indicated, in 14.9%, drug interactions were not noted, in 14.8%, time or intervals of drug administration were not according to orders, and in 6.3%, medication was not administered by nurses. In the busy and complex environment of pediatric units, medication errors can occur frequently. However, most of these errors are trivial and do not harm patients. The types of errors indicate the need for continuous education and the implementation of management tools that allow the promotion of the practice and monitoring results as medication errors are indicators of the quality of the Healthcare provided. Therefore, their detection and systematic analysis of their causes can contribute to their systematic prevention, thus improving the healthcare