A Survey of Doctors' Awareness of Simultaneous Vaccination

PURPOSE: In this study, doctors were surveyed with a questionnaire to determine whether they performed simultaneous vaccination and whether there were any concerns about safety or anxiety. The purpose of this study was to determine any problems associated with doctors readily performing simultaneous vaccination. METHODS: A trained surveyor visited 241 doctors from every institution registered with the National Immunization Program (NIP) located within six districts (gu) in the City of Busan (Dongnae-gu, Geumjeong-gu, Yeonje-gu, Suyeong-gu, Busanjin-gu, Haeundae-gu); a total of 155 (64%) valid responses were obtained. RESULTS: Of the 155 respondents, 144 (93%) were already performing simultaneous immunizations and 141 (91%) had a positive view of the practice. However, among the 144 doctors performing simultaneous immunizations, 67 (47%) were not confident about its safety; side effects were seen after simultaneous immunization by 86 doctors, 35 (41%) of whom believed that the frequency or possibility of side effects in simultaneous immunizations was higher than that in sequential immunizations. CONCLUSIONS: The use of simultaneous immunization is expanding quickly. However, among the doctors performing simultaneous immunizations, a high percentage had concerns over its unproven safety and potential side effects, indicating the need for academic societies or government institutions to present evidence to address such concerns.

A clinical study on neonatal exchange transfusion

Clinical observation was performed on 81 cases who were received exchange transfusion at Ilsin Christian Hospital from January, 1986 to Decrmber, 1990. The results obtained were as follows: 1) Among 6,388 cases of neonatal jaundice, the exchange transfusion was performed on 81 cases (1.27%). 2) There was no sex predominance (male 40, female 41). The birth weight of 75 cases(92.6%) ranged from 2,500 gm 4,000 gm. 3) The most predominant delivery type was normal vaginal delivery (66 cases, 81.5%). Instrumental delivery was 9 cases (11.1%) that was higher than control group (4.2%). 4) Analysing the exchanged 81 cases, sepsis accounted for 28 cases (34.6%) of the total exchanged group:ABO incompatibility 25 cases (30.9%), complicated causes 13 cases(16.0%), unknown causes 12 cases (14.8%) and Rh incompatibility 1 cases (1.2%). 5) Repeated exchange transfusion was required in 12 cases (16.0%). 6) In 20 cases (24.7%), exchange transfusion was performed on 7 days or more after birth. In 4 cases (4.9%), including 1 cases of Rh incompatibility, exchange transfusion was done within 24 hours after birth. 7) The most common organism of sepsis, which was the most predominant etiology of exchange transfusion was E. coli in 12 cases (31.5%). 8) After exchange transfusion, serum bilirubin, Hb and reticulocyte count were decreased by 24%, 22% and 36%, respectively.

Clinical study on infants of diabetic mothers

A clinical observation was performed on the 80 cases of neonates born from diabetic mothers among the total of 34,936 neonates delivered at II Sin Christian Hospital from January 1985 to December 1989. The results were as follows: 1) The incidence of infants of diabetic mothers was 0.23%, among whom gestational diabetic mothers were 63 cases (78.7%) and overt diabetic mothers were 17 cases (21.3%). 2) Among the complications of pregnancy and delivery, preeclampsia was most frequent as 33.8%, following by urinary tract infection (13.8%), polyhydramnios (1.3%), diabetic ketoacidosis (1.3%). 3) According to the gestational age, prematurity was 11.3%, full term 78.7% and post term 10%. And according to the growth state, small for date infants were 11.3%, appropriate for date infants 53.7% and large for date infants 35%. 4) The incidnece of giant babies (over 4,000 gm) was 30.0% and sex ratio of male to female was 1.1:1 in infants of diabetic mothers. 5) The most frequent clinical manifestation was tachypnea (45.3%), following by poor feeding (20.0%), cyanosis (18.7%). 6) According to the laboratory findings, 53.7% showed hypoglycemia, 36.3% hyperbilirubinemia, 25% hypocalcemia, 15% polycythemia. 7) On the chest X-ray, there were pulmonary infiltration and hyaline membrane disease in 3.2% each other and pulmonary congestion and wet lung in 1.6% each other. 8) The incidence of congenital anomaly was 13.8% in 80 cases of infants of diabetic mothers, and congenital heart disease was most frequent as 3 cases.

Neonatal mortality

A review of all 919 perinatal deaths occurring in II Sin Christian Hospital From 1985 to 1989 was carried out. The results of clinical analysis were as follows: 1) The overall perinatal mortality rate was 26.30 per 1,000 birth. 2) The perinatal mortality rate was lowest in the gestation group between 37~41 week and in the weight group between 2,501~4,000 gm. 3) The perinatal mortality rate was high in the age group under 20 and 40 and more. 4) The perinatal mortality rate was increased with an increasing number of parity. 5) The majority of neonatal deaths occurred within 24 hours of life, and the most common cause of death was prematurity. 6) The most common congesital anomaly was multiple anomaly, and the most common single anomaly was anencephaly. 7) In pregnancy, the most common maternal complication was anemia.