Comparison of Phototherapy Effect with and without Phenobarbital on the Newborns with Hyperbilirubinemia.

Objectives: Jaundice occurs in 60% of full-term and 80% of pre-term newborns. This study compared the effect of phototherapy with and without phenobarbital on icteric newborns. Materials & Methods: This study is a randomized clinical trial conducted from July until March 2018 at Imam Reza Hospital, Mashhad University of Medical Science, Iran. Full-term and near-term neonates with more than 2000 grams who were hospitalized in the mentioned period for jaundice were entered into the study. The newborns were divided into two groups using block randomization. Data were analyzed by SPSS version 19. Results: The average gestational age was 36.4 weeks (SD 2.39) in the intervention group and 36.9 weeks (SD 2.16) in the control group, with no significant difference between them. The mean hospital stay for the intervention group was 72 hours (SD 1.66), compared to 55 hours (SD 1.88) for the control group. At discharge, the serum bilirubin level in the intervention group was 11.53 mg/dL (SD 0.77), while it was 10.80 mg/dL (SD 1.09) in the control group, a statistically significant difference. Conclusion: According to this study, phototherapy with phenobarbital is not more effective than phototherapy alone in neonatal hyperbilirubinemia.

An Evaluation of the Relationship between Mental Disorders and Driving Accidents among Truck Drivers.

INTRODUCTION: A review of the existing literature shows the importance of mental health in preventing traffic accidents. Therefore, the current study aims to determine the mentioned mental disorders in relation with the history of accidents among truck drivers. METHODS: This cross-sectional study was done with two groups of truck drivers (with and without a history of accidents) in Iran. 56 people with a history of accidents and 410 people without a history of accidents participated in this study. At first, using questionnaires, the demographic information of the participants including age, education level, cigarette use, and addiction to drug was collected. Then, the mental disorders of the participants were evaluated by a 71-question, short form of the multidimensional Minnesota Multiphasic Personality Inventory (MMPI). The evaluated disorders are the HS or hypochondria, D or depression, HY or hysteria, Pd or social mental deviation, Pa or paranoia, Pt or mental weakness, Sc or schizophrenia, and Ma or hypomania. The tests used for data analysis include descriptive tests and Chi square. RESULTS: Man-Whitney U test showed that status of mental disorders, as revealed by the MMPI questionnaire, had a significant difference between the two groups with and without history of driving accidents (P < 0.001). The results showed that mental disorders of depression, hysteria, social mental deviation, paranoia, schizophrenia, and hypomania in individuals with history of driving accidents led to meaningful differences from individuals without history of driving accidents (P < 0.048). CONCLUSION: The results of the current study showed that generally, individuals with history of driving accidents had significantly more mental disorders than people without history of driving accidents.

Evaluation of the effect of fatigue on the coping behavior of international truck drivers.

BACKGROUND: Fatigue can affect the behavior of drivers. While the driver must be able to respond and cope appropriately to the critical situations, which is known as the ability to cope with a crisis. It is likely that the fatigue can change the people's coping style and thereby increase the chance of the crashes. Therefore, the present study aimed to investigate the effects of fatigue on the coping behavior of international truck drivers. METHODS: This study was conducted on 239 of international truck drivers employed in Iran. The Endler and Parker coping strategies questionnaire (CISS) and Persian version of the Fatigue Multidimensional Fatigue Inventory (MFI) were used to evaluate the coping styles of the drivers and the drivers' fatigue, respectively. RESULTS: The mean values of the total fatigue before and after traveling were 36.77 and 76.13, respectively. The mean values of coping styles of the problem-oriented, emotion-oriented, and avoidance before traveling were 53.66, 40.91, and 38.17, respectively, and those after traveling were 45.59, 51.18, and 36.45, respectively. The chi-square test demonstrated that there was a significant difference in the coping style of drivers before and after the trip (P <  0.001), and the percent of individuals with emotion-oriented increased. CONCLUSIONS: In general, the results showed that fatigue due to traveling could change the coping styles of subjects from problem-oriented to emotion-oriented and avoidance. This can increase the statistics of driving accidents.

Prevalence hearing loss of truck and bus drivers in a cross-sectional study of 65533 subjects.

BACKGROUND: Noise pollution is one of the most important occupational pollutants in heavy-vehicle drivers. Therefore, this epidemiological research was conducted with the aim of determining the prevalence of hearing loss in heavy-vehicle drivers in Iran. METHODS: This cross-sectional research was conducted on 65,533 heavy-vehicle drivers including truck and intercity bus drivers from February 2006 to March 2016. The air and bone threshold of pure tone was measured for each ear at 0.5, 1, 2, 3, 4, 6, and 8 kHz by a skillful radiology expert. The obtained data from this research was analyzed in SPSS software using statistical tests such as descriptive analysis and paired t test. RESULTS: Mean (standard deviation) of hearing loss in left and right ears of all people was 23.02 (8.25) and 22.48 (7.86), respectively. Paired t test showed that hearing loss difference in left and right ears was significant (P < 0.001). Mean and standard deviation of paired t test showed that hearing loss difference in left and right ears was significant in all frequencies except 1000 Hz (P < 0.001). CONCLUSION: The findings of this research generally showed that 26.8% of the studied drivers have hearing loss. Hearing loss in the left ear was more than right ear.

Driving Behavior among Different Groups of Iranian Drivers Based on Driver Coping Styles.

BACKGROUND: This study aimed to assess driving behavior of Iranian drivers based on their coping styles (problem-oriented, emotion-oriented, and avoiding). METHODS: This study was conducted on 610 drivers divided into four different groups. The drivers' behaviors and coping styles were evaluated using driver behavior questionnaire (DBQ) and coping inventory for stressful situations. RESULTS: The results showed a significant difference among the three coping styles regarding the mean scores of DBQ dimensions (P < 0.001). In addition, the emotion-oriented drivers obtained higher mean scores compared to those with other coping styles. CONCLUSIONS: It can be concluded that emotion-oriented drivers were more susceptible to crashes compared to those with problem-solving and avoidance coping styles.

Single dose of 50 mg/kg clofibrate in jaundice of healthy term neonates: randomised clinical trial of efficacy and safety.

OBJECTIVE: To evaluate the effect of single oral dose of 50 mg/kg clofibrate in hyperbilirubinemia of term healthy neonates in Yazd, Iran. METHODS: A parallel single- blinded randomized clinical trial, conducted on 60 healthy term neonates admitted between July and December 2007 to Shahid Sadoughi Hospital. Inclusion criteria were neonates with gestation age of 38-42 wk, birth weight of 2500-4000 g, product of normal vaginal delivery, breast-fed and total serum bilirubin (TSB) level of 17-29.9 mg/dL. Neonates with sepsis, anemia, severe asphyxia, hemolytic diseases, major congenital anomalies, indirect hyperbilirubinemia and underlying hepatic disorders were excluded. Selection of patients was based on random allocation via table of random numbers and the patients distributed into two groups. In group one, 30 neonates were treated with phototherapy alone and in 30 of other group treatment done with single dose of 50 mg/kg clofibrate and phototherapy. The primary endpoint with respect to efficacy in reducing of TSB was achieving TSB to less than 14 mg/dL as measured at the beginning, 12, 24 and 48 h after the start of phototherapy. Secondary outcomes were hospital stay days, duration of phototherapy and side effects of treatments during hospital stay and on the second day after discharge. RESULTS: No significant differences were seen from the viewpoint of rout of delivery, gender, gestational age, birth weight, hemoglobin and bilirubin level at time of admission and weight in discharge time in the two groups. After 48 h of intervention, 27 (90%) neonates in clofibrate group and 15 (56.7%) in control group had TSB of less than 14 mg/dL (p 0.02). Mean TSB 12 h after treatment (mean ± SD: 14.82 ± 1.7 mg/dL vs. 16.67 ± 1.77 mg/dL, P 0.001), 24 h after treatment (mean ± SD: 11.97 ± 2.92 mg/dL vs. 14.61 ± 2.52 mg/dL, P 0.001) and 48 h after treatment (mean ± SD: 7.91 ± 2.45 mg/dL vs. 12.74 ± 2.21 mg/dL, P 0.0001), mean of hospital stay days (mean ± SD: 1.7 ± 0.7 days vs. 3.2 ± 1.2 days, P 0.03) and duration of phototherapy (mean ± SD: 30.2 ± 13.99 h vs. 46.2 ± 15.58 h, P 0.001] were significantly lower in clofibrate group. Only loose stool was seen in two patients of clofibrate group and no significant difference was seen from view of safety of the treatments. CONCLUSIONS: A single dose of 50 mg/kg clofibrate in treatment of neonatal hyperbilirubinemia is effective, safe and cost effective in view of reducing hospital stay days.