ABSTRACT
Glucose-6-phosphate dehydrogenase (G6PD) deficiency is one of the causes of severe hyperbilirubinemia, prolonged jaundice, and bilirubin-induced encephalopathy in neonates. In a randomized controlled trial, we evaluated the effect of oral ursodeoxycholic acid (UDCA) on indirect hyperbilirubinemia in G6PD-deficient neonates requiring phototherapy. Intervention group I (N = 45; received phototherapy and 10 mg/kg/day UDCA), Intervention group II (N = 40; received phototherapy and 20 mg/kg/day UDCA), and a control group (N = 49; received phototherapy and placebo). Levels of total serum bilirubin (TSB) in all 3 groups decreased significantly over time (P = .001) but the level of TSB at different hours after admission and the duration of phototherapy did not differ significantly between the 3 groups. After discharge, the 2 intervention groups had a significantly lower rate of readmission than the control group (P = .001). No significant difference was observed between the 10 and 20 mg/kg/day groups. Further evaluation is recommended, especially in terms of the pharmacokinetics of UDCA in neonates. Trial registration number: IRCT20091201002801N4, prospectively registered on 2019-06-1.
ABSTRACT
Objective: Vaccination is one of the most convenient and safe preventive care measures available for children. The Pentavalent vaccine which protects against five major infections including diphtheria, tetanus, pertussis, hepatitis B(HepB) and Haemophilus influenzae type b(Hib) was added to the Iranian national immunization program in November 2014. This study aimed to determine the Pentavalent vaccine adverse events and immunogenicity in an Iranian children population in Sari, northern Iran. Method: In this descriptive-analytical study, children who were vaccinated with three doses of the Pentavalent vaccine were studied. Two venous blood samples were obtained before the first dose and 4 weeks following the last booster dose. Possible local and systemic complications of the vaccine were recorded until 7 days following vaccination. Antibody titers were measured by quantitative ELISA kits and geometric mean titer(GMT) was calculated for each vaccine component before and after 3 doses of vaccine. Statistical analysis was performed by SPSS 20.0 software and Chi-square and Fisher's exact tests were used for analysis. Results: Immunogenicity of the Pentavalent vaccine for tetanus was 100%(GMT:2.52 Eu/mL, 95%CI: 2.22-2.88), Hib 98.7%(GMT:2.44 Eu/mL, 95%CI: 2.06-2.89), HepB 98.7%(GMT:153.54 Eu/mL, 95%CI: 133.73-176.29), diphtheria 93.1%(GMT:0.43 Eu/mL, 95%CI:0.37-0.51) and pertussis were 63.7% (GMT:19.44 Eu/mL, 95%CI:16.42-23.03). The most common systemic complication after vaccination was fever. Also, one infant cried for more than 3 hours after the second dose. Other serious side effects were not observed. Conclusion: The Pentavalent vaccine used in Iran can cause adequate antibody response against diphtheria, tetanus, pertussis, Hib and hepatitis B in most cases with minimal side effects. The immunogenicity of this vaccine is significantly lower for pertussis. In this study, no severe complication leading to contraindication to subsequent injections was reported. So, the present policy in replacing triple DTP vaccine with Pentavalent vaccine should be continued in Iran.
ABSTRACT
Job satisfaction of healthcare providers is important for their own health and also the quality of care provided to their patients. The aim of our study was to measure the chronotype patterns among healthcare providers and its association with their job satisfaction. Using stratified cluster random sampling, we recruited 210 healthcare providers working permanent morning or evening shifts for a cross-sectional study in Sari, Iran. By in-person interview, we collected data on demographic characteristics and assessed both chronotype, using the Horne-Östberg M-E Questionnaire, and job satisfaction, using the Danet's Job Satisfaction Questionnaire. We grouped job satisfaction scores into four ordinal categories and assessed correlations with study variables by ordinal multivariate logistic regression. The average age of the participants was 39.0 (SD 8.02) years. Most were younger than 45 years of age (74.27%), female (66.67%), married (62.24%), of high income (45.71%), and employed in permanent full-time healthcare work (56.67%). Overall, 63.4% of the participants had moderately high to high job satisfaction. Those who worked the morning shift who were moderate morning and high morning chronotypes, compared to those who were intermediate chronotype, had a statistically significant adjusted odd ratio (AOR), respectively, of 11.36 and 6.53 of higher job satisfaction. Likewise, those who worked the evening shift and were moderate evening and high evening chronotype, compared to intermediate chronotype, had a statistically higher AOR of job satisfaction, respectively, 3.44 and 32.63. We found the match between chronotype and work shift schedule to be linked with increased job satisfaction. If the findings are verified in other investigations, the relatively easy measure of chronotype should be considered to assign people to a work shift to improve job satisfaction of healthcare and perhaps other workers.
