Most of septicaemias begin with invasion of transcutaneous insersion tract by microorganisms from the patient skin flora. Disinfection of insertion site with chemical antiseptics such as ethanol, Betadine, Cetrimide - chlorhexidine gluconate is regarded as one the most Important measures for prevention of intravascular device related infection especially in NICU, ICU and immunocompromised patient. Phlebitis, local abscess, bacteremia, osteomy elitis, arthritis and endocarditis are the most common serious complication of improper use of antiseptics. To asses the efficacy of three cutaneous antiseptics, Ceuimide-c, 10% Betadine and 96% Ethyl alcohol, Phenol coefficient of them against S.aureus (PTCC 1113), E.coli (PTCC 1338) and K.pneumoniae (PTCC 1053) were determined by AOAC methods. Phenol coefficient of Cetrimide-C were 66,47,51 on S,aureus, E.coli and K.pneumoniae respectively. Phenol coefficients of 10% Betadine were 30,16 and 12 and Phenol Coefficients of Ethyl alcohol were 0.04, 0.03 and 0.03. There were a significant differences among Cetrimide-C, 10% Betadine and Ethyl alcohol (P=0.00). Our finding suggests that Cetrimide-c and Betadine should be considered as a, first-line antiseptics against 3 bacterial strains. We also encourage other investigators to examine these common antiseptics in clinical trials studies.      

We have evaluated 45 episodes of fever and severe Neutrogena, with ANC (Absolute Neutrophil Count) of 92/mm3 and range of 500/mm3-10/mm3 in 38 children with immunocompromising underling diseases, generally post chemotherapy, in a period of 18 months. Their underlying diseases were mainly ALL (Acude Lymphoblastic Leukemia) 62.5% and AML (Acute Myeloblastic Leukaemia) 13.5%. Blood cultures were positive in 24% of episodes, and cultures of localized infectious sites in 7%. The infection was diagnosed clinically and/or radiographically in 37%, but there was no apparent cause for fever in 32%. Gram negative enteric microorganisms were isolated in 61.5% and gram positives in 38.5% of positive cultures, E.coli 22.5%, Staph. epidermidis 16.5%, Staph. aureus 16.5%, Pseudomonas aeruginosa 11% , Klebsiella pneumonia 11% , Providencia spp 11%, polygroup Salmonella 5.5%, and P hemolytic Strep. 5.5%. Herpes Zoster virus and Candida were main non bacterial pathogenes. The main localized infections were: pneumonias 23%, gingivostomatitis 23%, I.V. line infection 11.5%, perianal abscess 7.5%, septic arthrtis 4%, G.I. infection 4%, periorbital cellulitis 4%, surgical wound infections 4%, subcutaneous abscess 4%, esophagitis 4% and vulvovaginitis 4%. There was very good response to the first line antibiotics (Amikacine+ Ceftizoxime) in 77% of episodes. In 7% of episodes recovery came after adding another antibiotic(s), and in another 7% after complete change of antibiotics. Four patients (9%) died due to polymicrobial sepsis (3) and disseminated H.Z.V infection (1).

The assessment to bacterial epidemiology in large hospitals helps the management of the febrile patients and prescribing the correct kind of antibiotics, before receiving the laboratory results. In a descriptive study during (1996-97) in different hospital departments. The samples were transferred to the laboratory and common bacterias were isolated. In this study, cultural mediums of stool, blood, wound, were used as source the samples the results indicate that, the most common bacteria was E.coli with 30.6%, Staphylococci 14.2% and common infection sites were, urinary 33.3%, blood 21.7% respiratory tracts 14% respectively. The results from this investigation show that frequency and distribution pattern agrees with those reported by other researchers. The susceptibility of isolated bacteria to Ciprofloxacin and amino glycosides were quiet high.

1315 boold specimens from children (0-12 years old) were examined for value of cytoplasmic vocalization of neutuophils in septicemia.Concerning vacuolization and septicemia and occurrence of Gram-positive or negative organisms in the studied age group meaningful statistical findings were obtained (p<0.005).Comparison of septicemia and some parameters such as vacuolization, toxic granulation and WBC showed sensitivity, specificity and predictive value of 72%, 96.6% and 68.8% for vacuolization, 77%, 85% and 43% for toxic granulation and 55%, 72% and 12% for WBC, respectively.

Invasive Salmonellosis is common in tropical areas. This study examines the performance of a clinical definition for its recognition among children ages 1 to 14 years admitting to a referral pediatric hospital in Tehran.60 Children were enrolled into the study during a period of 51 months. To facilitate analysis, cases were divided into 5 categories according to the likelihood of invasive salmonellosis with category A representing microbiologically confirmed salmonella bacteremia 17 (28.3%) and 6 (10%) with positive bone marrow cultures. And Category D representing those cases .in which an alternative diagnosis was firmly established. Salmonella serology supported invasive salmonellosis as the diagnosis in 17 (28%) of the nonbacteremic children (Category B and C).Salmonella serology suggested that invasive salmonellosis without detectable bacteremia was common. Blood culture proved and serologically diagnosed cases shows that the definition has a specificity of at least 60%.

Introduction: One of the most important causes in mortality and morbidity and outcome of liver transplantation is the method used for anastomosis of the bile duct to the intestine. Several methods have been used for restoring a normal bile flow to the intestine; among which, the most important are choledochojejunostomy and choledochocholedochostomy. The most common complications confronted with after these operations include anastomosis site leakage and stenosis. For this reason, widespread research projects are underway to find an easier and more optimal method for bile duct anastomosis in the intestine. In this research, following the choledochal edges inside and passing them through an intestinal intramural channel (the Roux-en- Y anastomosis method), have been studied as a method to decrease the incidence of the two common prementioned complications. Materials and Methods: the common bile ducts were found in 6 sheeps, and with the help of two 180 degrees sutures, their edges were folded back on. The intestine, pulled through an 'intestinal intramural channel and with the same two sutures, werte anastomosed internally to all of the intestinal layers. Results: 8 months after teloscopic anastomosis of the bile duct to the intestine, no sign of stenosis, cholangitis or bacteremia were found in 3 cases, a prominent papillary - shaped fold was seen in the jejunum. In one case, a leakage site from the anasomosis was detected; no leakage was detected on the 3rd day in the laparatomy. The anastomosis was found in another case on the 14th day for the purpose of histological examinations; both macroscopic and microscopic repair process was normal. Conclusion: The results of the study suggest that in the Roux-en- Y choledochojejunostomy method, fewer numbers of bacteria reach the common bile duct (C.B.D); however, the direct anastomosis of CBD to the jejunum is associated with a higher incidence of bacteremia and stenosis. Folding the CBD edges inside-out, associated with decreased number of sutures joining the duct to the intestine. Introduction of the duct to intestine through an intestinal intramural channel and finally, formation of a papillary fold or prominence, all could be seen? promising approaches to overcome the difficulties encountered in a classic bile duct anastomosis.      

In order to determine the incidence and kinds of adverse events attributable to exchange transfusion in high risk neonates including ill and prematures, we have reviewed the medical records of neonates who underwent ET, and the following results obtained: Of 129 neonates, in this study 162 time exchange transfusion were done. 69.8% were premature and 30.2% were fullterm. There were low APGAR score in 39% of these patients. 72% had birth weight less than 2500gr. The main causes of jaundice in fullterm was Rh and ABO incompatibility, idiopathic, septicemia, while in prematures was idiopothic, Rh incompatibility and septicemia. 18.6% had more than one exchange transfusion.Adverse events due to ET was more common in preterm than fullterm infants, (P<0.05). The main complications was apnea, bradycardia, hypocalcemia, thrombocytopenia, bactremia, NEC and hemorrhage (Cerebral & pulmonary).One patient died during the procedure and 7 patients died 72 hr after ET due to septicemia, seizure, IVH, and pulmonary hemorrhage. In conclusion adverse events in premature is higher than fullterm and for prevention of these complications we suggest that total serum billirubin level as a determinant of exchange doing should be reevaluated.

Predisposing factors (bacteremia, endothelial damage, ...) are important for development of endocarditis in cattle. A dairy cow was referred to Teaching hospital of veterinary faculty. Clinical examination revealed cardiac murmur on auscultation and a chronic abscess on thorax. There was a constant neutrophilia and progressive anemia in cell blood count (CBC). Endocarditic was diagnosed clinically. Because of poor prognosis the cow was slaughtered and vegetative valvular endocanditis accompany by one hydatid cysts on right atrium were found. Actinomyces pyogenes was isolated from lesions. This is the first report of concurrent hydatid cysts and endocarditic in dairy cattle.