Effects of breast milk on pain severity during muscular injection of hepatitis B vaccine in neonates in a teaching hospital in Iran

Background: The issue of Pain Management finds special significance in infants who are unable to verbally express pain. Studies have shown that the use of non-pharmacological pain control techniques can be effective in reducing neonatal pain. The aim of this study was to compare the effects of olfactory stimulation (with breast milk) and non-nutritive sucking (with a pacifier) on the physiological and behavioral responses in term neonates to the hepatitis B vaccine. Methods: In this clinical trial, which was done in 2015 at the Nohom-e Dey Hospital of Torbat Heidariyeh, 90 eligible infants were randomly selected and divided into two intervention and one control groups. In the breast-milk odor group (n = 30), the neonates were exposed to the mother's odor during vaccination. In the non-nutritive sucking group (n = 30), a standard soft pacifier was used, whereas, in the control group (n = 30), no intervention was carried out. Data collection tools included demographic information forms and the Neonatal Pain Response Scale. Data were edited and analyzed using SPSS 20 software. Results: This study showed that there was a statistically significant difference between the mean scores of neonatal behavioral responses after intervention in the three groups (p <0.05). The mean behavioral response was 0.73 lower in the breast-milk odor group than in the control group, and the mean behavioral response in the non-nutritive sucking group was 0.6 lower than that of the control group. Conclusion: The results of the study showed that both olfactory stimulations with breast milk and non-nutritive sucking have a positive impact on neonatal pain reduction, nearly equally.

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Response of Hepatitis B Vaccine in Children with Celiac Disease – An Experience at Ayub Teaching Hospital, Abbottabad Pakistan

Journal of Islamabad Medical & Dental College ◽

10.35787/jimdc.v10i2.565 ◽

2021 ◽

Vol 10 (2) ◽

pp. 95-100

Author(s):

Bibi Aalia ◽

Syed Sajid Hussain Shah

Keyword(s):

Celiac Disease ◽

Hepatitis B ◽

Teaching Hospital ◽

Intestinal Inflammation ◽

Tissue Transglutaminase ◽

Tertiary Care ◽

Hepatitis B Vaccine ◽

Intestinal Biopsy ◽

P Value ◽

Small Intestinal

Background: Celiac Disease (CD), characterized by chronic small intestinal inflammation, is an immune-mediated disorder, with a strong family history and association with DQ2 HLA haplotype. It has been postulated that children with CD show less response to hepatitis B vaccine due to overexpression of HLA-DQ2 haplotype. This study was done to determine the response of hepatitis B vaccine in children with CD in our tertiary care setting in the Hazara region of eastern Khyber Pakhtunkhwa, Pakistan.Material and Methods: This cross-sectional study was conducted in the Pediatrics outpatient department (OPD) of Ayub Teaching Hospital, Abbottabad Pakistan from April 2018 till March 2020. Children with CD (n=38) aged 1-14 years with completed HBV vaccination, anti-tissue transglutaminase IgA antibody (tTG-IgA) >150 IU/ml and/or typical histological findings of CD on small-bowel biopsy, were included in the study. Hepatitis B surface antibody (HbsAb) titer of ≥10 mIU/ml was taken as antibody positive, while HbsAb levels < 10 mIU/ml were considered as vaccine non-responsive. Data was analyzed using SPSS version 20.0. Chi square test was applied for comparison with P-value < .05 taken as significant.Results: Out of 38 diagnosed cases of CD, 15 (39.5%) were males and 23 (60.5%) were females. Mean age of children was 8.32±3.26 years with an age range of 3-14 years. HbsAb levels ranged from 0.10 to 62.7 mIU/ml with a mean of 11.2+17.42 mIU/ml. HbsAb levels were less than 10.0 IU/ml in 73.7% of children with CD. Small intestinal biopsy was performed in 11 (28.9%) patients. There was a significant relationship between anti tTG-IgA levels and histopathology findings with P-value of .001.Conclusions: In children having celiac disease, there was low rate of protective antibody response to hepatitis B vaccine.

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Awareness regarding hepatitis B and it’s vaccination status among medical students, doctors and paramedics studying & working at DHQ Teaching Hospital, Sahiwal

Journal of Fatima Jinnah Medical University ◽

10.37018/jfjmu.637 ◽

2020 ◽

Vol 13 (4) ◽

pp. 150-154

Author(s):

Rana Aamir Diwan ◽

Khalil Ahmad ◽

Fahad Mukhtar Hashmi ◽

Muhammad Arslan ◽

Muhammad Nabeel Bhatti

Keyword(s):

Medical Students ◽

Hepatitis B ◽

Teaching Hospital ◽

Vaccination Coverage ◽

Hepatitis B Vaccine ◽

Cross Sectional ◽

Care Workers ◽

Increased Risk ◽

Level Of Knowledge ◽

Physical Care

ABSTRACT Introduction: Hepatitis B is a risk factor for Health Care Workers (HCW) and medical students attending wards at hospital. Hepatitis B vaccine has been recommended since 1982 for use by HCWs to prevent HBV infection. The aim of this study was to evaluate the vaccination coverage among HCWs and medical students, their level of knowledge regarding vaccination as well as and their beliefs regarding Hepatitis B vaccine at a Teaching District Headquarter (DHQ) Hospital of Punjab, Pakistan. Subjects and Methods: This cross sectional descriptive study based on a questionnaire-based survey was carried out at DHQ Teaching Hospital, Sahiwal, Pakistan from 01-04-2019 to 31-07-2019. Doctors, medical students and paramedical staff involved in active physical care of the patients were included in the study. Results: A total of 300 participants were provided questionnaire including consent, out of which 285 participants responded. There were 127 doctors (44.56%), 86 medical students (30.18%) and 72 paramedics (25.26%). 132 (46.31%) participants were fully vaccinated, 9.12% had received 2 doses of vaccine, 8.77% received only one dose whereas 35.43% were unvaccinated. Out of unvaccinated individuals, 32.35% reasoned lack of time being the main cause followed by other reasons including lack of need, lack of awareness and accessibility. Conclusion: This study showed that vaccination coverage among HCWs was alarmingly low along with lesser knowledge of vaccination and infection. Therefore, HCWs and medical students are at an increased risk of acquiring Hepatitis B infection.

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