background: As with any drug or medication, vaccines also require special attention because, though they are considered safe and beneficial to control diseases, they can trigger mild or even severe adverse events. Aim: assess nurse's knowledge and practice regarding adverse events of vaccines in expanded program on immunization in health care centers. Research design: A descriptive research design used in the current study. Setting: all available health care centers ( 14) & the only health office in Port Said city. Sample: All available nurses working in vaccination clinic, with total number of 64 nurses. Tools: data collected by two tools: tool one: Nurse's knowledge of vaccination and adverse event Questionnaire, tool two: observational checklists to assess nurse's practice about vaccination. Results: regarding the general knowledge of nurses of vaccines 96.9% of studied nurses had satisfactory knowledge, while 53.1% of studied nurses had satisfactory knowledge about contraindications of vaccines. 40.6% of nurses had unsatisfactory knowledge about adverse events of vaccines, moreover, 57.8% of the studied nurses had inadequate practice before and at the beginning of the vaccination session, while 93.8% of studied nurses had adequate practice during the vaccination session.Conclusion: most nurses had satisfactory score regarding overall knowledge of immunization, more than half of studied nurses had unsatisfactory knowledge regarding adverse event of vaccines. Moreover, more than half of studied nurses had inadequate practice. Recommendations: Establish training programs reinforce knowledge and practice of nurses related to adverse event of vaccines, continues training for nurses to keep them up to date in relation to immunization.

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Background: Jaundice is the most common clinical sign in neonatal medicine. Phototherapy is the most commonly used intervention to treat and prevent severe hyperbilirubinemia. Zinc has a vital role in maintenance of cell functions, protein synthesis, and immune-functions.Objective: To study the effect of phototherapy on zinc status in term neonates with indirect hyperbilirubinemia. Patients and methods:This was a prospective study carried out on 50 term neonates with indirect hyperbilirubinemia in neonatal intensive care unit at Damietta Al-Azhar University Hospital during the period from February 2019 to February 2020. Total serum zinc was measured before and after phototherapy.Results: About 26 (52%) were males and 24 (48%) were females. The mean zinc levels before and after phototherapy showed no statistically significant difference. There were no statistically significant difference in total serum bilirubin (TSB) level at admission and after 12 hrs following admission but there were statistically significant differences after 24 hrs and at discharge. However, the majority of neonates with hyperbilirubinemia were deficient in zinc level. Conclusion:Phototherapy has no effect on serum zinc level. However, zinc supplementation encouraged in cases with neonatal jaundice as they usually have zinc deficiency.

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Background: Neonatal jaundice is considered a major health problem in neonates owing to bilirubin deposition. Recently, zinc demonstrated a high efficiency in reduction of low bilirubin level when administrated in association with phototherapy. Aim of the work: To assess efficiency and safety of oral zinc as a therapy in treatment of indirect hyperbilirubinemia in term neonates during phototherapy. Patients and Methods: A total of 100 term neonates with indirect hyperbilirubinemia were divided into two equal groups: Intervention Group (n=50) received oral zinc sulphate preparation, in a dose of 5 mg twice daily in combination with phototherapy. Control group (n=50) received phototherapy without oral zinc supplementation. In both groups, the total serum bilirubin levels were measured at admission, 12 hours, 24 hours and at discharge. Results: Treatment of full-term neonates with hyperbilirubinemia by oral zinc sulfate at a dose of 5 mg given twice-daily induce a significant reduction of total serum bilirubin [TSB] after 12 hours, 24 hours and at discharge when compared to the control group. The duration of phototherapy in intervention group was markedly decreased with statistically significant difference in comparison to the control group. However, there was no significant differences between groups regarding adverse effects of phototherapy and zinc therapy. Conclusion: Oral zinc could play a major role in the management of neonatal jaundice when administrated at dose of ten mg/day as it can decrease the neonatal TSB with subsequent reduction of phototherapy duration.