Objectives: The aim of this study was to explore the detrimental effects of working a varying pattern of 8-hour shifts on quality of sleep, general health and work performance. Subjects and Methods: The Arabic version of the Pittsburgh Sleep Quality Index (PSQI)and 2 self-administered questionnaires were used to assess quality of sleep, work performance and general health in a sample of 200 males on a schedule of varying 8-hour shifts at the Kuwait Oil Company. A matched sample of an equal number of workers on a fixed daytime shift as a control group was enrolled in the study. Results: Compared with men working on a straight daytime shift schedule, those working on 8-hour variable shifts exhibited higher rates of heavy smoking (p < 0.003), coffee/tea consumption (p < 0.0001), constipation (p < 0.002), job stress (p < 0.0001) and poor sexual performance (p < 0.0001). Variable-shift workers reported persistent sleep disturbances in 3 dimensions of the global score of the PSQI (p < 0.0001). They also had significantly more complaints of fatigue (p < 0.005), poor level of work performance (p < 0.005) and loss of concentration (p < 0.005). Shift workers were significantly more prone to making errors and having accidents at work, and were more likely to report absence from work than the controls (p < 0.0001 and p < 0.005, respectively). Conclusion: These results suggest that the majority of workers on an 8-hour variable-shift schedule experienced various health problems, poor quality of sleep and an increased risk for errors and accidents at work as compared with those workers on a straight daytime shift schedule. There is a need to compare potential benefits of an alternative work shift schedule.
Post-transfusion purpura (PTP) is a rare bleeding disorder of platelet alloimmunization that perhaps occurs as an anamnestic reaction. Most commonly, it is observed in PlA1-negative subjects previously sensitized with PlA1 platelet antigen either through PlA1-positive pregnancy or PlA1-positive transfusion. PTP appears with sudden severe thrombocytopenia, purpura, and often life-threatening hemorrhage within 5-10 days of blood transfusion. It is believed to be self-resolving. Yet inactivity risking dangerous bleeding can be disastrous. Treatment with intravenous immunoglobulin, corticosteroids, exchange transfusion, and plasmapheresis has been reported with variable success. No single modality, however, is effective in all cases. Not more than 150 cases of PTP seem to have been reported. We present two such cases. Both were multiparous PlA1-negative women given a blood transfusion for the first time. Corticosteroid therapy failed in both. One responded to intravenous immunoglobulin, while for the other plasmapheresis was the only life-saving modality. One of them subsequently required a blood transfusion for surgical intervention, which could be given uneventfully.
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