Yafteh

---

Introduction: Bacterial meningitis is still one of the most dangerous infectious diseases and causes serious complications and mortalities in children. The aim of this study was to identify the most common of bacterial agents causing meningitis in children under 10 years old and to detect their resistance to antibiotics in patients who referred to the educational hospital of Hamadan. Materials and Methods: Overall 582 children suspected to meningitis were investigated for CSF cultures, frequency of age groups, sex and seasons and antibiogram patterns from 1998 to 2000. Data were gathered through a questionnaire and analyzed using Epi6 software. The species were identified by biochemical and serological methods. Antibiogram tests were also performed by Gel- diffusion method of Kirby- Bauer. Findings: Out of 582 children suspected to meningitis, 46 cases (7.9%) had positive bacterial culture that 58.9% were gram positive and 41.1% were also gram negative bacteria. The most common species were S. pneumonia 23.9%, S. aureus 13.1%, E. coli 10.9%, N. meningitis and P. aeroginosa each 6.5% respectively. The most positive cases were observed in children 0-2 age group (28.3%), male (54.4%) and during Autumn (43.7%). The results of antibiogram showed that the most effective antibiotics were ceftizoxime, kanamycin and gentamycin for both gram positive and gram negative bacteria, but they showed high resistance to amoxicilin, ampicillin and chloramphenicol. Conclusion: The present study showed that gram positive bacteria in particular, Streptococcus pneumonia and Staphilococcus aureus are predominant causes of bacterial meningitis in children under 10 years old in these regions. Most species showed high resistance to routine antibiotics such as amoxicillin, ampicillin and choramphenicol.

---

Introduction: Urinary tract infection is a common bacterial infection in childhood . Approximately 3-5% of girls and 1% of boys acquire a urinary tract infection (UTI). The management of UTI is complicated by the increasing prevalence of antibiotic- resistant strains and over the - counter antibiotics empiric therapy with antibiotics such as ampicillin , amoxicillin and cotrimoxazole world cost more and lead to widespread antibiotic resistance . Materials and Methods: In this study we aimed at assessment of prevalence of antibiotic resistance in 127 patients with positive urine culture based on antibiogram results. This cross- sectional study was performed in Khorramabad Madani hospital during 2001-2002. 62/2% of the patients were female and 37.8% were male. Findings: Culture results were : Ecoli (73.3%), proteus (12.6%) , klebsiela(9/4%), Entrobacter(3.1%) , Citerobacter (0.8%), Yersinia (0.8%). Overall antibiotic resistance was 96.9% and resistance to antibiotics, were: Ampicillin(88.2%), Amoxicillin (86.6%), Cotrimoxazole (75.6%), Nitrofurantoin (18.9%), Nalidixic acid (10.2%), Cefixim (4.7%) , Ceftriaxon (3.1%) Gentamicin (11.8%), Amikacin (3.1%). Conclusion: Results showed that antibiotic resistance for over- the counter antibiotics was significant .

---

Introduction: Measles is a contagious disease which is passed on easily from a person to the other. Today, although, the number of measles cases have been decreased dramatically, but it is still a common disease. The aim of this research is to study the patients with measles in Khorramabad city. Materials and Methods: This cross – sectional study was carried out on 124 patients who were admitted with diagnosis of measles in Khorramabad Shahid Madani hospital. The method of sampling was simple. The studied variables include age, sex and the season of admission. Data was collected by questionnaire and analyzed using SPSS software. Findings: From 124 patients who completed the study , 78(62.9%)were boys and 46(27.1%) were girls .59(47.6%) were <9 months old,2(1.6%) were 9 months to 1.5 years old, 16(12.9%) were 1.5 – 6 years old and 47(37.9%) were 6-13 years old. The correlation between measles and age and also, measles and sex with p<0.05 was significant . Of patients who were hospitalized, 31 (25%)were in March to February, 2002 and 93(75%) were in March to July, 2003. Conclusion: In this study the most outbreak rate of measles was under the age of 9 months and after the age of 6 years, while according to the ministry of health and treatment program, inoculation of measles is done during 2 doses, the first one at the age of 9 months and the other at the age of 15 months. So changing vaccination time is recommended, provided the results of this study are confirmed in the other cities.

---

Background: Children’s malnutrition has an important effects on the level of well being in the society and anthropometrical indictors in children represent the ultimate results of nutritional status. Materials and methods: In this study nutritional status of 480 children of 6-12 years old (260 boys, 220 girls) has been evaluated base on nutritional stratification indices such as height, age (H/A) and weighty and height (W/H). They divided based on point z in three groups of hypoalimentation, normal children and polyphagia. Determined in three classifications in several classes (slight, middle, sever). Results: Statistical analysis showed that under nutrition in term of (H/A) was 15 percent in both sex, and weight/height for girls was higher than boys (34.58%. vs. 32.6%, respectively). Also over nutrition in term of W/H index for girls was higher than boys (8.41% vs. 6.61%, respectively). However, H/A index was higher in boys.(16.74% vs. 20% respectively). In Conclusion: The results of present investigation show that in 40.42% of children based on index of weight to height and 33.23% based on index of height to age are malnutrition. So that the main nutritional problem in this population is oligotrophia.

---

Background: Febrile convulsion is one of the most common types of seizure in childhood (9 month to 5 years of age). Its pathogenesis is unknown, so studying its causes is valuable. The purpose of this study was to determine the serum level of magnesium in children with FC (9 months to 5 years of age). Materials and Methods: In this analytical study, serum level of magnesium in 102 children with febrile convulsion in Shahid Madani hospital of Khorram Abad was determined. The control group was composed of 102 febrile children with no seizure. All of the children in both groups were 9 months to 5 years of age. The children in the case group had a history of episodes of documented febrile convulsion in the past years and had no underlying disease or infection in other parts of their body. In contrast, control group included febrile children with no history of episodes of documented seizure. Serum level of magnesium was determined by biochemical methods in all of the children in both groups. Finally, the data were analyzed by Chi-square and T tests. Findings: In both groups (case and control), 57% were male and 43% were female. The mean serum level of magnesium in case group, was lower than the mean serum level of magnesium in control group (P<0.0001). There was a relationship between serum level of magnesium and presence of febrile convulsion in children (P<0.0001). There was no relationship between sex and serum level of magnesium in children in both groups (P>0.05). Conclusion: There is a relationship between serum level of magnesium and the presence of febrile convulsion in children. It can be said that the deficiency of magnesium may be one of causes of FC in children. So, it is suggested to use supplements of magnesium in diet of affected children.

---

Background: Micronutrients deficiency is one of the most health problems in the world. Iron and zinc deficiency and their interaction with vitamin A are important, too. The aim of this study was to investigate the effects of supplementation of iron and zinc, alone or combined, on vitamin A status of primary school children. Material and methods: The study was a randomized double-blind clinical trial in which 81 primary school children, 11 y of age, were randomly supplemented for 4 months with iron (20 mg/d), zinc (20 mg/d), or iron+ zinc (20 mg of each/d). Plasma retinol was measured at beginning and after 4 months by HPLC method. SPSS version 11.5 software was used. Data were analyzed by ANOVA, and paired t test. Results: Plasma retinol changes in Iron, zinc, and iron +zinc groups were: -0.1±0.2, -0.1±0.1, -0.1±0.1 µmol/L, respectively. These changes in female and male were, respectively: -0.18±0.2, -0.03±0.1 for iron group, -0.1±0.1, -0.08±0.09 for zinc group, and -0.14±0.2, -0.06±0.1 for iron + zinc group retinol decreased in all supplemented groups. Deficient or non-deficient basal serum zinc had no effect on result. Conclusion: Plasma retinol was decreased in all supplemented groups. As, decrease in plasma retinol results from the supplementation, more studies should be carried out on this subject.

---

Background: Zinc is essential for nucleic acid metabolism, protein synthesis and tissue healing. Zinc deficiency has detrimental effects on child health and increases mortality rate of pneumonia and gastroenteritis. By improving absorptive function of villous cells and by reducing pathogenic enterobacteriaceae in lumen, Zinc improves diarrhea outcome in children. Previous studies in developing countries are available regarding zinc efficacy in acute and persistent diarrhea. We tried effectiveness of zinc treatment in acute diarrhea of children in Lorestan province. Materials and methods: A triple blinded randomized controlled trial was planned over test and control groups. Each group contained 36 children aged 12 to 60 months with acute watery diarrhea whom weight for height was below -2SD under median according to Waterlow's classification. Test group took 1mg/kg/day zinc (in the form of 1% zinc sulfate solution). Then, diarrhea duration, daily times of bowel movement and weight gain were recorded. Data were analyzed by SPSS Version 13. Results: T-test showed that daily diarrhea in test and control group was 3.30.99 times and 4.91.1 times respectively. Duration of diarrhea in them was 4.93.2 days and 7.83.9 days. Weight gain was 223.05110.8 grams and 95.8106.4 grams. The results were significantly different between two groups at p<0.05. No child in zinc group suffered persistent diarrhea or weight loss. Conclusion: Zinc sulfate could be a part of acute gastroenteritis treatment plan in children besides other nutritional and hygienic orders especially in malnourished children in developing countries.

---

Khalilzadeh S¹, Baghaei N², Bolorsaz MR¹, Masjedi MR³

1. Associate professor, Department of pediatrics, Education, research and treatment center of tuberculosis and long diseases, Shahid Beheshti University of medical sciences

2. Assistant professor, Department of pediatrics, Education, research and treatment center of tuberculosis and long diseases, Shahid Beheshti University of medical sciences

3. professor, Department of internal, Education, research and treatment center of tuberculosis and long diseases, Shahid Beheshti University of medical sciences

Abstract

Background: Idiopathic Pulmonary Fibrosis (IPF) is a chronic rare disease with unknown etiology which is usually fatal and occurs mostly in adults. This disease is extremely rare in children and infants.

Case presentation: Eight children with IPF who were examined in the pediatric department of Masih Daneshvari Hospital during 2001-2004 have been reported.

There were 5 boys and 3 girls at the age range of 7 to 13 years (mean age 10.2 yrs). Clinical symptoms were cough and dyspnea in all patients which were progressive and exacerbated by recurrent respiratory infections. In clinical examination, crackles were found in both lungs of all patients while cyanosis and clubbing were detected in 5 subjects. Chest x ray showed reticulonodular and bullocystic patterns in 6 and 2 cases respectively. Pulmonary function tests in all patients were in concord with those of pulmonary restrictive diseases.

To make a definite diagnosis, lung biopsy was performed in all patients which showed histologic changes in accord with IPF. Patients were mostly treated with steroids. In the present study, the prognosis of disease has been good in our patients and only one death occurred due to respiratory failure.

Conclusion: To our knowledge, this study is the first report of P.I.P.F (Pediatric Idiopathic Pulmonary Fibrosis) in Iran. Other cases of this disease may be found in other medical centers which should be collected and evaluated by the researchers.

---

Namdari P¹, Nazari H²

1. Instructor, Department of Social Medicine, Faculty of Medicine, Lorestan University of Medical Sciences

2. Assistant Professor, Department of Psychiatry, Faculty of Medicine, Lorestan University of Medical Sciences, Iran

Abstract

Background: Disruptive Behavior Disorder (DBD) is one of the most prevalent psychiatric disorders starting from childhood and is considered an important mental health problem of the society. DBDs may have distractive effects on the social, educational, personality, and behavioral relationships of people in their childhood and adulthood. The present research was done to determine the prevalence of Disruptive Behavior Disorders in elementary school students of Khorramabad in 2005.

Materials and methods: This research was a cross-sectional study. Its statistical community includes all the students studying in grades one to five at elementary schools in Khorramabad (N = 943). Sixteen state and private schools (8 for girls and 8 for boys) were selected in a cluster and multi–stage sampling method. The standardized questionnaire of Child Symptoms Inventories (CSI-4) was used to collect data on the prevalence of children’s psychiatric disorders. The results ware analyzed using descriptive statistic and Chi-square test.

Results: The total sample included 943 children. There was 21.4% DBD behavior (17.7% oppositional defiant disorder and, 3.7% conduct disorder). The number of the boys was twice as that of the girls (28.7% vs. 14.4%). The students in grade 2 showed the lowest, and those in grade 3, 4 and 5 the highest prevalence rate of DBD. There was also a significant relationship between children’s grade (P= 0.02), parent’s education (P=0.005, P=0.006), Mother’s job (P= 0.03), income (P = 0.005) and DBD. However no significant relationship between father’s job, educational level of the students and parent’s mental problems and Disruptive Behavior Disorders was found.

Conclusion: Due to the high prevalence of the disorder including DBD, and lack of enough attention to their consequences in children and adolescents, it seems necessary to identify these disorders so that they may be dealt with on time.

---

Qasemi F1, Valizadeh F1, Toulabi T2, Saki M3 1. Instructor, Department of Children, Faculty of Nursing and Midwifery, Lorestan University of Medical Sciences 2. Instructor, Department of Internal Surgery, Faculty of Nursing and Midwifery, Lorestan University of Medical Sciences 3. Instructor, Department of Nursing, Faculty of Nursing and Midwifery, Lorestan University of Medical Sciences Abstract Background: Family has an important role on childrens personality and preparing them for future. Corporal punishment involves the application of some forms of physical pain in response to undesirable behavior for the purpose of correction or control of the childs behavior. Corporal punishment constitutes a human-rights violation and has physical and mental health consequences for children. Materials and methods: This survey was conducted to detect and compare some behavioral disorders due to parental corporal punishment in school age children. This case-control trial deals with 240, primary school children aged 7-12 years old. These subjects were selected through cluster randomized sampling in Korramabad and divided into two (case and control) groups. Instruments for measuring data consisted of three components: 1) a questionnaire on demographic information, 2) a questionnaire on corporal punishment and, 3) a rating scale about behavioral disorder such as verbal and behavioral aggression, withdrawal, and cooperation in school. Data were analyzed by SPSS ver11. Results: Results indicated that in 92.6% of cases the corporal punishment method was slapping. Significant differences were found between the two groups in terms of mothers educational level (p=0.001), mothers job (p=0.004), mothers child-birth number (p=0.024), verbal aggression (p=0.001), behavioral aggression (p=0.001), withdrawal (p=0.05), and cooperation (p=0.001). Conclusion: Results indicated that housekeeper mothers and mothers with low educational level use more corporal punishment and behavioral disorders were more in school age children who had suffered parental corporal punishment. Based on the results of this study, educating parents and families about results of corporal punishment in young children is suggested. Public health actions including training programs on alternative methods of discipline are also suggested.

---

Malekshahi F1, Farhadi A2 1. Instructor, Department of Society Health, Faculty of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran 2. Instructor, Department of Psychology, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran Abstract Background: Childhood period it one of the most important stages of life in which individuals personality is formed. The majority of behavioral problems are due to attention deficit to the sensitive periods of childhood. This attention deficit leads to lack of agreement with environment and causes behavioural problems in children. Behavioural problem is attributed to a persons behaviour that his IQ isn lowered, but his or her mental and behavioural equilibrium is deviated from social norm and has severity, repetition and continuance in numerous times and places, so that his educational performance and behaviour will be frustrated and his efficiency is reduced. Such children are always rejected by others and in school there are a lot of grievances against them. Therefore, to pay attention children common behavioural problems is one of the most important topics and it prompt detection makes its treatment possible. So this study designed to determine prevalence of behavioural problems of Khorramabad pre-school children. Materials and methods: This descriptive-cross sectional study was carried out on 600 rural and urban pre-school children selected using random one stage sampling method. Data gathering tool was a two-part questionnaire including demographic and behavioural disorders signs obtained from DSM IV. Reability and validity of the questionnaire was confirmed by the university teaching members and retest method with a correlation coefficient 98%. Data were analyzed using SPSS software (ver 11) and Ch-square test. Results: Results of the study showed that 79% of the rural, and 68% of the urban children were at least involved in one of the behavioural problems. Anxiety, withdrawal and social isolation, too much irrelevant peevishing and crying were higher in urban children, and behavioural problems such as, urinary incontinence, night fear, teeth gnashing, hitting the head against the wall, sleep disorders were higher in rural children. Some of the children behavioural problems such as urinary incontinence, stammering, onychophagia and … had a significant relation with sex, as well as between age, job, educational level of the parents, birth rank, and some behavioural problems a significant relation was observed. Conclusion: These findings showed that most of the pre-school children somehow suffer from behavioural problems, they need more attention and support in the area of mental health which require an accurate and comprehensive planning. So study of children mental health level in the stations of measurement and mental health services in the schools, and education to teachers and parents in order to prevent behavioural disorders, and ontime diagnosis and treatment are necessary.

---

Background: Attention Deficit Hyperactivity Disorder (ADHD) is one of the most prevalent psychiadric disorders starting from Childhood and is considered as an important mental health problem of a society. Behavioral disorders including ADHD may have distractive effects on peoples social, educational, personality, and behavioral relationship in their childhood and adulthood. Therefore, we decided to conduct the present research for ADHD in elementary school students of Khoramabad year 2004. Materials and methods: This research was a cross-sectional study. Its statistical community includes all the students studing in grades one to five at elementary school in Khorramabad (N=945). Some 16 state and private schools (8 girls and 8 boys schools) were selected in a cluster and multi-stage method. The standardized questionnaire Child symptom inventories – 4 (CSI4) has been used to collect data, which was a means for the prevalens of children’s psychiatric disorders. Owing to their scoring. The cases which showed ADHD were undergone clinical examination by psychiatrist. Then, the results were analyzed using descriptive statistic and X2 test. Results: The total sample was 945 children There were 50.7% and 49.3% girls and boys respectively. Some 3.17 per cent of them were reported to suffer from ADHD the most percentages of which were of inattention (40%), overactivens (33.3%), and mixed type (26.6%). ADHD was reported to be more prevalent in boys than girls (4.9% VS. 1.5%). The students in grade 5 showed the lowest, and those in grade 2 and 3 showed the highest prevalence rate of suffering from ADHD. There was also a significant relationship between children’s sex and ADHD (P<0.005). However, there seemed no significant relationship between parents age, education, job, income, grade, and the family psychiatric problems. Conclusion: Due to the high prevalence of the disorder including ADHD, and lack of enough attention to their consequences in children and adolescent age group. It seems necessary to identify these disorders so that they may be considered in time. Since our population is stepping to word growth and development, understanding children’s problems is very worthy. Because they play an important role in our society future. On the other hand, providing mental health for children and teenagers half them to play better their social, mental and physical role in society.

---

The most important consequence of sleep disorders in children is cognitive dysfunction that leads to study, family and social disturbances. This study was carried out to evaluate the prevalence of sleep disorders in Khorramabad 7-12 year old elementary school children in school year 2006-2007. Materials and Methods: In this cross sectional study, 364 students were selected randomly in both sexes male and female with equal numbers. Data were collected using TUCASA questionnaire. Results: Results showed the revalence of sleep disorders as follows: mouth breathing 35/7%, sleep talking 24/7%, habitual snoring 20/3%, nightmare 19/8%, sleep teeth grinding 15/9%, secondary enuresis 8/2%, primary nocturnal enuresis 7/1%, sleep apnea 6/6%, sleep walking 6/6% and excessive daytime sleepiness 10%. Statistical tests showed that there is a significant relation between primary and secondary nocturnal enuresis and male sex, and both disorders were more in boys (p-value=0. 004). Between other disorders, and sex and age there was not significant relation. In this study between teeth grinding and snoring, sleep apnea and snoring, open mouth breathing and snoring, excessive daytime sleepiness and sleep apnea, sleep duration and time of sleep of parents, there was significant relation (p-value<0. 001). Conclusion: According to findings, mouth breathing was the most common sleep disorder in our subjects and had a significant relation with sleep snoring. So due to treating ability of nonmedical therapy in sleep disorders, it is recommended to increase parents information about necessity of medication and its effect on children cognition.

---

Many hospitalized children are suffered from medical errors that may cause serious injuries. The aim of this study was to evaluate medical errors in hospitalized children in khorramabad Madani hospital in the first half of 2008. Materials and Methods: This study was a cross sectional that was performed for all medical errors in hospitalized children in khorramabad Madani hospital from 21/3/2008 to 21/9/2008. The sampling method was census. Studied variables included: age, sex, weight, kinds of errers, education of parents, job of parents. Data was collected by questionnaire and analyzed by SPSS software. Results: In this study out of 2250 records, 151 (6/3%) had medical errors. 53%were girls and 47% were boys that there was a significant relation between sex and medical errors. 46/4%were related to age group lower than 2 years old. Most of the errors were occurred in weight group of 6kg. Types of medical errors included drug ordering 46/3% (involved incorrect dosage of drug (37%), frequency 28%, rout 19% and others 16%), transcribing10%, administering32/4%, dispensing11/3%. Most errors related to liquid therapy 76/2% and intravenous rout 85/4%. Most errors were occurred during night 47% and during weekend 56/6%. Conclusion: Medical errors are common in hospitalized patients, and in our study the rate of medical errors was 6/3%. So further efforts are needed to reduce them.

---

Hypothyroidism is one of the problems that can cause severe growth and developmental defects in children and infants. By using anticonvulsive drugs (Phenobarbital, Carbamazepine, Navalproate , and Phenytoin), liver microsomal enzymes will be increased and will lead to hypothyroidism in infants because of increasing metabolism of T3, and T4 by liver. The purpose of this study was to evaluate the prevalence of hypothyroidism in children referring to the clinic of Shahid Madani hospital in Khrorramabad with anticonvulsive drug treatment during Fall, 2008, and Winter, 2009. Materials and Methods: In this study, the samples were collected from the children referring to the clinic of Shahid Madani hospital in Fall, 2008, and Winter, 2009. The patients were taking anticonvulsive drugs and had the acceptance criteria including the age range of 3 months to 13 years old, using anticonvulsive drugs at least for 2 months, having abnormal EEG, etc. The data gathering instrument was a questionnaire containing the demographic information including age, gender, type of drug, duration of using drugs, etc. The lab data (T3UR, T4, and TSH) were analyzed after they were collected. Results: Among 38 referring epileptic children taking anticonvulsive drugs, 4 (10.5%) patients had hypothyroid so that 2 (5.25%) of them were clinical hypothyroid, and 2 (5.25%) were subclinical hypothyroid. Moreover, 2 out of the 4 patients(50%) were girls and 2 (50%) were boys, and the mean age was 6.5 2 years with the median of 6.5 years. Conclusion: The prevalence of hypothyroidism in patients with anticonvulsive drugs treatment in the clinic of Shahid Madani hospital during Fall, 2008, and Winter, 2009 was 10.5%. So, there was no significant relationship between age and gender. A significant relationship was found between duration of using anticonvulsive drugs and hypothyroidism in children.

---

Regarding to the importance of food habits and the probable role of obesity in dental caries, this study was done to assess the relationship between teeth decay index in children and body mass index, and food habits in dentistry clinic of Tabriz university of medical sciences. Materials and Methods: In this cross-sectional analytic study 202 children aged 3-12 years old were selected randomly. For assessing dental caries, decayed, missed, and filled teeth index and for evaluating food habits, semi quantitative food frequency questionnaire were used. Data were analyzed using Correlation test and Regression analysis. Results: The overall mean of decayed, missed, and filled teeth index in the children of this study was 7.61±3.80. There were significant reverse correlations between this index and age (r = -0.176), and fruit consumption (r = -0.155) (P<0.05). There was no significant correlation between dental caries and body mass index (P>0.05). Considering the last regression model, age, mother job, and frequency of nuts consumption were significant predictors for decayed teeth number. Conclusion: The results of this study indicated that high fruit consumption was associated with less dental caries and among foods which were evaluated, consumption of nuts was significant predictor for decayed teeth number.

---

Proper nutrition is among the most important needs to provide physical and mental health and in other words,it is the essential principle of the society good health.Offering healthy eating to children, the suitable preservation and distribution of foodstuff, and the control of the different sites of the maintenance and allotment of the nutritive substances at the schools are considered to be of foremost importance.So the present study is intended to specify the extent of the control and supervision of the allotment and distribution of the foodstuff to the students and the amount of the nutritional and hygienic knowledge of the parents and educators at the primary schools in 2007. Material and Methods: This descriptive cross sectional study conducted on 5695 male and female students studying at 39 primary schools of Khorramabad (district one). In order to scrutinize the status of the supervision of supply and distribution of the nutritive substances to the students and the measurement of the amount of the nutritional and hygienic knowledge of the parents and educators, a census was carried out. It suffices to say that the parents’ samples were selected apropos the arrangement of the classificatory sampling,cluster sampling, the two-stage sampling, and finally systematic sampling.The data gathering tool was a two self-made questionnaire completed by the interviewees themselves. Subsequently, the data were described with respect to the frequency distribution tables, the x2 independence tests and SPSS,V.15 saftware. Results: It was considered that 29.7% of the primary schools possessed buffets. Besides, 40.5% of them had hygiene educators. The amount of the attentiveness of the parents and educators to the control and supervision of the nutritive substances at the buffets was 61.5%, which is considered as a relatively good estimate. In this way, it is posited that, there exists a significant relationship between the existences of buffets at the primary schools and the scope of the acquaintance of the parents and educators with the control and supervision of the supply and distribution of foodstuff. (P=0/025) Nevertheless, the extent of the hygiene experts’ supervision on the supply of nutritive substances at the buffets was 14.5%, which is conceived to be rather poor. Conclusion: This study showed that, having a suitable place to present and distribute foodstuff in schools is necessary. Due to students needs to healthy snack in school, the surveillance of teachers and health experts is more important.

---

Regarding of the well-documented relationship of overweight and obesity with disorders of the biliary system among adults, in this study the ultrasonographic findings of biliary system were compared in children and adolescents with or without overweight. Materials and Methods: This cross-sectional study was conducted on 372 children and adolescents, aged 6-18 years in Isfahan.They were divided into two groups of normal and overweight , based on their body mass index. Sonographic findings of the biliary system were compared in the both groups. Results: The mean age of participants was 12.6 ± 3.2 years . The mean diameter of biliary ducts was 2.7±1.1mm in the normal-weight group and 3 ± 1.3 mm in high body mass index group. There was a significant correlation between biliary ducts diameter and body mass index (p = 0.04) . There existed a significant direct correlation (0.13)between the age of the samples and biliary ducts diameter (p=0.01) . The gallbladder was normal in all samples . There was no significant correlation between body mass index and gallbladder wall thickness. Conclusion: Early diagnosis of biliary disease which is associated with overweight and obesity in children and adolescents, can prevent from disease progression ,and reduce their future complications.

---

Background : Obesity predisposes individuals to cardiovascular diseases.The aim of this research is to study CRP as a prognostic inflamatory factor in children with obesity and overweight in comparison with non obese ones. Materials and Methods: We investigated 80 children aged 8- 10 years assessing obesity as case group and 80 non-obese children as control group. Serum level of Cholesterol , triglycerides , low-density lipoproteins (LDL), high-density lipoproteins (HDL) and C-reactive protein were measured . Finally the data were analysed using SPSS software, X2,t and fisher tests. Results: The results showed that there were significant correlations between CRP in obese children than non-obese children. 31% of the case group had positive CRP (PV=0.000001). Lipid analysis showed significant correlations between mean Cholesterol level and CRP in obese and non-obese children. Mean Cholesterol level in posetive CRP group was 201.9 mg/dl but mean Cholesterol level in control group was 183.1 mg/dl . (P=0.04,T=-2.1) Conclusion: This study showed significant correlations between CRP and obesity in 8-10 years old children.

---

Background : Children's diarrhea is one of the major health problems worldwide, especially in developing countries, accounting for nearly 4-5 million deaths per year.Campylobacter jejuni is a common human bacterial pathogen, which plays at least the same leading role to Salmonella and Shigella as the causative agent of infectious diarrhea. Regarding limited studies on different epidemiologic aspects of this bacterium in Iran, this research carried out to determine infectious enteritis caused by Campylobacter Jejuni in children with diarrhea in Khorramabad city. Materials and Methods: In this study the descriptive survey of the diarrhea caused by Campylobacter jejuni in children less than 12 years of age in Khorramabad city was conducted between September 2004 and September 2005. Stool specimens were collected from patients referred to medical laboratory of Shahid Madani children’s hospital and the correspondent laboratories with clinical symptoms of acute diarrhea. The specimens were transferred to microbiological laboratory of the veterinary faculty of Lorestan university in an attempt to isolate and identify Campylobacter jejuni species. Results:One hundred-thirty out of the total 321 collected specimens (40.5%) were concerned to the female and 191 specimens (59.5%) to the male patients. Campylobacter jejuni species were isolated from 19 (5.92%) of the total collected specimens from which 11(3.43%) and 8 (2.49%) were associated to the female and the male children, respectively. Maximum of the positive cases were reported in the children aged less than 1 year (1.87%) and 1-3 years old (1.87%) that difference based on age groups was significant. Conclusion: According to the findings of the present investigation, the prevalence rate of Campylobacter enteritis in children less than 12 in Khorramabad in 2007 was 5.92 % which is same as the findings of similar studies in Zahedan (6%), Tehran (5%), Sari (4.8%) and Shiraz (5%).