[Comparison between breastfeeding in employed and unemployed women]

Numerous studies show that working outside home is the key barrier to breastfeeding. The objective of this study was comparing the pattern of breastfeeding in infants whose mothers were employed in public sectors with unemployed mothers. In this study 630 mothers [254 employed], attending health care centers in northern and western Tehran with 6-30 months infants with the birth weight of at least 2000 g, were interviewed. The results were analyzed by SPSS software. After logistic regression it was revealed that parental education, infant's sex or birth order had no significant effect on rate or duration of breast-feeding. There were no significant differences in the rate of breastfeeding between the two groups at 0 and 2 months, but there were significant differences after returning to work [at 4, 6, 8, 10 and 12 months]. Our results showed that the rate and duration of breast feeding were significantly lower in employed mothers at all infant ages, after 4 months. Figures for breastfeeding at 4, 6, 8, 10, and 12 months in the two groups of employed and unemployed mothers were as follows: 69.7% versus 76.9%, 61.4% versus 73.7%, 57.9% versus 69.9%, 54.7% versus 67.7%,and 52.6% versus 67%, and p-values = 0.044, 0.001, 0.002, 0.001, and 0.0001, respectively. After returning to work the rate and duration of breastfeeding in employed mother are significantly lower than housewives

effect of alterations in processing solution and exposure times on Dentus M2 and Ektaspeed intra-oral films

The processing procedure influences the degree of density and contrast of the resulting radiograph. To determine the effect of changes in processing solution and exposure times on Dentus M2 and Ektaspeed intra-oral films. This was an analytical study in which 44 samples of each type of the films were used. The distance between the source and the film surface was 28 inches. The exposure was performed using 11 different times, vertically, with maximum voltage of 70 and 8 mA. Processing was carried out at days 1, 5, 10 and 15 using an automatic machine. Later, the density of each film was measured by Digital Density Meter. Data were analyzed by T-Test and paired T-Test. Longer exposure time caused an increase in density of both types of the films. The mean density of either type decreased through days 1 to 15. The mean density was 0.92 +/- 0.09 for Dentus M2 and 0.75 +/- 0.09 for Ektaspeed in all processing time. However, a significant difference was found between two groups [p<0.05]. The Dentus M2 is recommended asboth result in a intra-oral film showed to have higher density with lower variability than the Ektaspeed film

[Indication of lumbar puncture in infants with their first febrile convulsion]

It is frequently thought that lumbar puncture [LP], is a mandatory procedure in all children presenting with febrile convulsion since convulsion may be the sole clinical manifestation of bacterial meningitis. The present study was conducted to assess whether meningitis could be recognized using readily available clinical information. During the study period, 254 previously healthy children aged 6 months to 5 years were brought consecutively to the pediatric department of a teaching university hospital after their first febrile convulsion. Lumbar puncture [LP] was performed in all cases. Children with febrile convulsion and meningitis served as cases and those with febrile convulsion in the absence of meningitis, served as controls. The following factors were compared between groups: age, lethargy, irritability, vomiting, nuchal rigidity, bulging fontanel, headache, drowsiness, toxicity, coma, complex seizure, and prior antibiotic use.Of 245 infants, 12[4.7%] had meningitis. The following risk factors were significantly associated with meningitis: lethargy [p<0.0006], irritability [p<0.0008], vomiting [p<0.0001], nuchal rigidity [p<0.0001], bulging fontanel [p<0.05], headache [p<0.006], drowsiness [p<0.0001], toxicity [p<0.0012], coma [p<0.005], complex seizure [p<0.04], and prior antibiotic use [p<0.0002]. All children with meningitis had at least one of the following risk factors: prior antibiotic use, positive clinical manifestations. Our results indicate that clinical manifestations and type of convulsion [simple or complex] could be used to diagnose meningitis, thus, there is no need for routine [LP] in all children who present with fever and seizure. However a lumbar puncture is mandatory in infants younger than 12 months or those who have received prior antibiotics

[Nosocomial sepsis in NICU department in Taleghani Hospital, 2001-2002]

Nosocomial sepsis continues to be a significant cause of mortality in neonatal intensive care unit [NICU]. Various interventional policies have been adopted to reduce its incidence. This study was designed to investigate the role of preventive strategies to bring down the incidence of nosocomial sepsis in the NICU. The NICU was moved to a new location in 2002. This study was conducted in two phases. Data was collected from case note of neonates admitted to NICU in 2001, and compared to data from neonates admitted to the new NICU in 2002, and followed prospectively. Changes in new location included: large space, elbow operated water taps, availability of disposable endotracheal tubes, and insistence on strict hand washing with continuous surveillance. Neonates who had a negative blood culture on admission, and a positive blood culture 48hr later, plus clinical and/or paraclinical signs compatible with sepsis, were selected. The incidence of nosocomial sepsis was compared in babies admitted during 2 study periods. In 2001, nosocomial sepsis developed in 41 out of 285 neonates [14.3%], however, in 2003 it was developed in 24 out of298 admissions [8%] [p<0.02]. Preventive measures including an increase in bed space from 1.5 M[2] to 2.5 M[2], using disposable endotracheal tubes, elbow operated water taps, and strict hand washing, result in a significant decline in nosocomial sepsis

Knowledge of physicians attending CME courses for acute diarrhea in children

Special attention has been paid to the management of acute diarrhea in children during the recent 15 years. Diarrhea-related CME courses have been established in Iran since 1991 [Control of Diarrheal Diseases] in order to improve physicians' knowledge and attitude towards the appropriate management of acute diarrhea. The present study was conducted to assess knowledge of private physicians attending CME courses for acute diarrhea in Tehran. Case group included physicians attending the CME courses and the controls were those not attending these courses. All were requested to reply a 13-question exam. The mean score of pediatrician cases [n=48] and control [n=21] was 10.3 +/- 1.5 and 7.5 +/- 3.1, respectively [p < 0.0001]. However, the mean score of general practitioner cases [n=94] and controls [n=58] was 7.6 +/- 2.5 and 7.0 +/- 3.1, respectively [p < 0.026]. Results have revealed that CME courses have effectively improved the physicians' knowledge