Storage of human breast milk is unavoidable especially among working mothers who need to report back to work soon after delivery. The aim of this study was to describe the effects of storage process on the bacterial growth-inhibiting activity of expressed human breast milk on common neonatal pathogens. Methods: This was an experimental study performed at the Ospital ng Makati on the breast milk of mothers who were without infection prior to delivery, did not take any medications, and spontaneously delivered their babies full term. Fifteen mothers expressed breast milk within the first seven days up to one month, postpartum. Each milk sample was stored and tested with the following time series: immediately after expression; thawed after being frozen for 24; and thawed after being frozen for 72 hours. Each of the broth medium containing Staphylococcus aureus, Escherichia coli or Klebsiella pneumonia was added to 1 ml of expressed breast milk. Tenfold dilutions were made. Each dilution was plated at zero and four hours and colony-forming units (CFU) were counted after 24 hours incubation. Same procedure was performed on a negative control. Results: The number of CFU for the three tested organisms (had lower nominal counts with the breast milk solution when compared to control solutions both at zero-hour and four-hour test samples. Breast milk exhibited bacteriostatic properties against most pathogens except for Escherichia coli after being frozen for 24 hours. For the breast milk that was frozen for 72 hours, most tests did not show significant lower counts when compared to control solutions, except still for Staphylococcus aureus and Escherichia coli both at 0 hour. Conclusion: Breast milk has bacterial inhibiting property against common neonatal pathogens. Bacteriostatic property of breast milk started to diminish after being frozen for 72 hours, but still exerted its inhibiting property.
Human ; Animal ; Female ; Adult ; Young Adult ; MILK, HUMAN ; STAPHYLOCOCCUS AUREUS ; ESCHERICHIA COLI ; KLEBSIELLA PNEUMONIAE

Objectives: The World Health Organization recently revised their recommendations and considered healthy children and adolescents as low priority group for COVID-19 vaccine. This review comprehensively assessed existing clinical evidence on COVID-19 vaccine in 12-17 years old. Methods: Included in this review were any type of study that investigated the efficacy, immunogenicity, safety, and effectiveness of COVID-19 vaccine on protection against SARS-COV-2 infection in 12-17 years old. Various electronic databases were searched up to March 15, 2023. Studies were screened, data extracted, risk of bias appraised, and certainty of evidence was judged using GRADE. Review Manager 5.4 was used to estimate pooled effects. Difference between the two groups was described as mean difference for continuous variables and as relative risk or odds ratio for categorical variables. Results: There were six randomized controlled trials and 16 effectiveness studies (8 cohorts and 8 case control). Low certainty evidence showed that BNT162b2 (Pfizer) was effective, immunogenic, and safe in healthy adolescents. There were 15 effectiveness studies on BNT162b2 (Pfizer) in healthy adolescent and one on immunocompromised patients. It was protective against infection with any of the variants, with higher protection against Delta than Omicron. BNT162b2 is protective against hospitalization and emergency and urgent care (high certainty); and critical care and MIS-C (low). Very low certainty evidence noted that BNT 162b2 was also immunogenic in 12-21 years old with rheumatic diseases while on immunomodulatory treatment but with possible increased exacerbation of illness. Low certainty evidence demonstrated that mRNA-1273 (Moderna) was effective, immunogenic, and safe. Low to very low certainty evidence were noted on the safety and immunogenicity of two vector base vaccines (ChAdOx1-19 and Ad5 vector COVID vaccine) and two inactivated vaccines (CoronaVac and BBIBP CorV). Conclusion There is presently low certainty evidence on the use of RNA vaccines in 12-17 years old. The recommendation on its use is weak. There is presently insufficient evidence for the use of inactivated and vector-based COVID-19 vaccines. Different countries should consider whether to vaccinate healthy adolescent without comprising the other recommended immunization and health priorities that are crucial for this age group. Other factors including cost-effectiveness of vaccination and disease burden should be accounted.
mRNA Vaccines ; Vaccines, Inactivated

Executive Summary Leptospirosis is a disease prevalent mostly in tropical and subtropical countries. Its potential to be a concerning problem emerges with the onset of the rainy season, as flooding and heavy rainfall facilitate disease epidemics. Among those at risk of contracting the disease are field workers, veterinarians, sewer workers, military personnel and those who swim or wade in contaminated waters. In the absence of an existing evidence-based guideline for the pediatric age group, this first edition hopes to standardize approach to diagnosis, antibiotic management, and prevention of leptospirosis. The intended users are primary care physicians, family medicine physicians, pediatricians, and other healthcare workers involved in the management of leptospirosis in children. Ten priority questions were identified by a group of experts composed of an oversight committee, a guideline writing panel, and a technical review committee. The GRADE methodology was used to determine the quality of evidence of each recommendation. The draft recommendations (summarized below) were finalized after these were presented to and voted on by a panel of stakeholders.

Introduction: Teaching is considered to be a high-risk occupation for developing burnout, a phenomenon where chronic workplace stress is unsuccessfully managed. Despite studies on burnout in high- and upper-middle income countries, there is limited evidence for lower-middle-income (LMIC) countries and in the context of the COVID-19 pandemic. Objective: This study aimed to determine the prevalence and factors associated with burnout under worker’s health, working environment, and working culture among junior high school teachers. Methods: Data were collected through a six-part, self-administered questionnaire that measured sociodemographics and teacher characteristics, musculoskeletal pain, comorbidities, job insecurity, workplace social support, and burnout from 16 public high schools in Quezon City. Bivariate and multivariate analyses were used to assess significant factors associated with burnout. Results: Of the 171 JHS teachers in the study, the prevalence of burnout was 5.3%. Teachers who were more likely to have burnout were males, younger age, lower teaching positions, fewer working hours and teaching experience, blended work setup, with musculoskeletal pain and mental comorbidities, job insecurity, and low workplace social support. Bivariate analysis found that mental comorbidities and job insecurity were significant, however, these were not significant in the multivariate analysis. Conclusion This study presents alternative findings for the factors associated with burnout when contextualized in an LMIC setting. Despite not finding significance when adjusted for other variables, descriptive statistics have shown the characteristics of teachers who are more likely to have burnout. Efforts to detect, manage, and prevent burnout should take these into consideration to identify teacher with burnout.
Burnout, Psychological ; Occupational Health