Aim This study aimed to investigate the effect of adding ursodeoxycholic acid (UDCA) to phototherapy in neonates with glucose‐6‐phosphate dehydrogenase (G6PD) deficiency and hyperbilirubinaemia. G6PD deficiency is a common cause of severe hyperbilirubinaemia in neonates. Methods This study was a triple blind, clinical trial study of 40 neonates with G6PD deficiency and hyperbilirubinaemia who admitted for phototherapy in hospitals affiliated to the University of Medical Sciences. The treatment group (n = 20) received UDCA 10 mg/kg (2 cc/kg) daily divided into 2 doses every 12 h. The control group (n = 20) received the same volume of placebo syrup. The drug and placebo treatments were continued until the bilirubin level dropped below 171 μmol/L. Both the control and treatment group received continuous phototherapy. Independent sample t‐test, survival analysis and logrank test were used to statistically analyse the results. Results The mean total bilirubin level was 231.9 ± 18.8 μmol/L and 184.3 ± 18.6 μmol/L in the control and intervention group respectively, 24 h after drug administration and 209.7 ± 19.3 μmol/L and 157.4 ± 16.4 μmol/L, respectively, 48 h after intervention (P < 0.05). The median length of hospitalisation in the treatment group was approximately 1 day lower than the control group (logrank test P value: <0.001). Conclusion The study showed that the addition of UDCA to phototherapy accelerates the reduction of total bilirubin level in neonates with G6PD deficiency and can reduce the duration of hospitalisation.
Objective: It has been shown that clinical practice may be a risk factor for job burnout. On the other hand, annual income may have a protective effect on job burnout. Clinical faculty in contrast to basic sciences faculty members have higher income but are involve in clinical practice. Comparison between these two groups can clarify which factors have greater influence on burnout. As a second aim for this study, reliability and validity of the Persian version of Maslach burnout inventory general survey (MBI-GS) were evaluated as well. Method: This cross-sectional study was conducted at Shiraz Medical School in Iran and a total of 241 faculty members were randomly selected and burnout was measured by the Persian version of the Maslach burnout inventory general survey (MBI-GS). Results: Comparison of burnout between the two groups indicated that clinical faculty showed significantly higher scores in the exhaustion dimension compared to the basic sciences faculty (p value = 0.017) but no significant differences were found between the two groups in other dimensions. Job satisfaction and income satisfaction were negatively correlated with exhaustion and cynicism dimensions, and job satisfaction was positively associated with professional efficacy (p value > 0.05). Internal consistency of the questionnaire was acceptable (α=0.77). Scaling success rate for discrimination and convergent validity were 100% except for convergent validity in the cynicism subscale. Correlation of all questions with their dimensions was equal to or more than 0.4 with the exception of item 13 in the cynicism subscale. Conclusion: Clinical faculty had higher burnout than basic sciences faculty especially in the exhaustion dimension. It has also been shown that income and job satisfaction are the most important factors which can predict professional burnout in medical faculty members. It is important for administrative and organizational decision makers to improve job engagement and decrease job abandonment. This study largely confirmed the 3-dimensional structure of the Persian version of MBI-GS.
Background The high prevalence of diabetes and the importance of long-term follow-up of these patients encourage finding an inexpensive and applicable educational method to control the disease. Distance education based on mobile technology and Short message service (SMS) can be an effective way to manage this disease by eliminating time and place limitations. Due to the world’s high penetration rate, SMS is one of the best ways to transfer information and health education. Objective This study aimed to compare the effect of SMS- and group-based education in managing diabetes type 2 and compare them with a control group. Method A total of 168 patients with diabetes type 2 under the coverage of three family physician clinics were randomly allocated into three groups. The education was conducted in 12 one-hour sessions once a week in the group-based arm, and a daily short message was sent to the participants in the SMS group. The control group also underwent routine care at the family physician clinic. The duration of the education was 3 months. At baseline and 3 months later, fasting blood sugar (FBS), 2 hours postprandial sugar (2hppBS), and HBA1c, as well as diabetes self-management questionnaire score (DSMQ), were measured. Results The comparison of the three groups in terms of changes in FBS (P-value: 0.001), 2hppBS (8 P-value: < 0.001) and HbA1c (P-value: < 0.001) were significantly different after 3 months. In pairwise analysis, 2hppBS was the only significantly different parameter between the group- and SMS-based education (P-value: 0.035). Conclusion Although the effect of both educational methods via SMS or group education was better than the control group in controlling diabetes, these two methods were not statistically different. Due to spending a lot of time and money on group-based education, it is better to replace it with education by SMS.
Background:Patent ductus arteriosus (PDA) is an important risk for heart failure due to left to right shunt in term neonates.Objectives:In this study, we evaluated the effect of high dose ibuprofen in closure of PDA in term neonates.Patients and Methods:We used double dose ibuprofen (20 mg/kg, 10 mg/kg, and 10 mg/kg) for 3 - 30 day old term neonates with PDA who were admitted in the neonatal wards of Shiraz University of Medical Sciences. The results of this study were compared to the data of the previous study in our center which used the low dose of ibuprofen (10 mg/kg, 5 mg/kg, and 5 mg/kg).Results:29 full term neonates received high-dose ibuprofen, in 18 neonates, PDA was closed after 4 days (62.1% versus 43.3% for the standard dose and 4.7% for the control group in the previous study) (P = 0.001). The results showed no significant correlation between the closure rate and gestational age, postnatal age, sex, and weight. In the 4th day of treatment, size of the pulmonic end of ductus arteriosus decreased from 2.09 mm to 0.77 mm compared to 1.68 mm to 0.81 mm in the standard dose of oral ibuprofen and 2.1 mm to 1.4 mm in the control group (P = 0.046).Conclusions:This study indicated that high-dose oral ibuprofen was more effective in closing or decreasing the size of PDA.
Introduction: In recent decades, there are multiple reports of lead poisoning in drug abusers in Iran and other Middle East countries. The lead in the mother's blood can cause many dangerous, harmful effects on the mother and the fetus. Therefore, in this study, we evaluated the blood lead level (BLL) in pregnant women who were an illegal drug user and compared it with pregnant women who did not use these agents. Method: A cross-sectional study was conducted among 60 pregnant women referred to Shiraz Hazrat Zinab and Hafez Hospitals. All pregnant women with a history of any drug abuse were sampled. Two pregnant women without any history of drug abuse were sampled for each pregnant mother with a history of drug abuse on the same day. To check BLL, 5 cc blood sample of all participants sent to a reference laboratory. BLLs have been assessed by atomic absorption spectrophotometry with GBC Avanta, and all reports were confirmed by a specific pathologist. The data were completed with maternal demographic information and infants’ anthropometric indices. Data analysis was performed using SPSS software version 24, and the significance was 0.05. Results: There was a significant difference in BLL among pregnant women with and without drug abuse history (9.91 ± 26.2 and 2.95 ± 0.7, respectively) (P-value: 0.001). The prevalence of lead levels of more than 5 μg/dl in mothers with and without substance abuse was 20% and 7.5%, respectively. Anthropometric indices, Apgar score, and gestational age in the mothers with a history of drug abuse were significantly lower than the control group (a significant level less than 0.05). Conclusion: The level of lead in pregnant women taking illegal drugs is higher than that of the control group who do not have a history of illegal drug abuse. On the other hand, it is likely that increased serum levels of lead with fetal complications and maternal health threats childbirth and clinical outcomes during childbirth.
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