Tehran University Medical Journal

Background: Many of hospital acquired infections that cause so much morbidity and mortality and have great economical burden are transmitted via contaminated hands of health care workers (HCW).Prevalence of these infections can decrease up to 30% with hygienic measures. In this study we assessed the prevalence of careers and microbial spectrum of HCW,s hand and relation between detergent used for washing and reduction of microbial load of HCW, s hand.

Materials and Methods: This study was done in two part: Descriptive part (cross sectional) and analytical part (before –after). Cases were Consist of all staff Working in wards of center of pediatrics hospital (Including attends, residents, interns, nurses and workers). In first part ,we assess hand microbial spectrum and contamination load of 72 staff and in second part, we assessed and compared hand microbial spectrum and load before and after of washing with four detergent : plain soap (60 staff ), liquid soap (60 staff ) , betadin scrub in ward (60 staff ) and betadin scrub in operating room manner (26 staff).

Results: %87.5 of personnel had positive cultures-.The most prevalent bacteria were staph. epidermidis (%79.4), staph. oreus (%42.9), klebsiella (%12.7), E-coli (%12.7). The rate of reduction or negative cultures in groups used betadin were greater than the first two group (P-value <0/05).Thirty staff (10 with plain soap,10 with liquid soap and 10 with operating room betadin scrub ) dried their hands after washing. Forty percent of first, fifty percent of second and ninety percent of third group have negative culture after drying. Also 11 samples were drawn from faucets that all of them were positive.

Conclusion: Prevalence of careers is high among HCWS and drying of hands can an important role in hospital infection rate. Faucets have heavy contamination and can transmit bacteria to hands after washing. For theses reasons education and of staff to correct hand washing and drying before every contact with patients and used of faucets without direct hand touching can play a great role in lowering hospital infections.

Background: Chronic renal failure defines as progressive and irreversible dysfunction of kidneys that could eventually terminated to end stage renal disease (GFR< 10% NL). Because of therapeutic problem and high mortality and morbidity and it &aposs implication quality of life , ESRD is one of the important dilemma of pediatric medicine .

Materials and Methods: In our study 216 patients evaluated .

Results: Male to female ratio was 1.1 . The peak of the presenting age of ESRD was 10 years old (8-12 y). Congenital urological malformation (30%) , glomerulopathies (20%) , hereditary nephropathies (14.3%) , multisystem diseases (7%) and nephrolithiasis (6.2%) are the most common etiologies of ESRD . VUR in 21% and congenital obstructive disease in 8.5% are the etiology of ESRD. In patients with age five years old and lesser common causes of ESRD are congenital urologic malformation and glomerulopathies. In other age groups , urologic malformation is the most common cause of ESRD. In etiologic assessment of two separate 7 years interval , (1988-1993) and (1996-2003) , there was not any significant change in frequency of etiologies but frequency of congenital obstructive uropathy decreased from 10 % to 5.7%. Total amount of VUR (VUR ± Neuropathic bladder) has not any change but frequency of primary reflux nephropathy decreased from 14.2% to 8%. In this study , in 145 patients hemodialysis continued and 28 cases had unsuccessful renal transplant (13.8%) . 7.4 % of patients had successful renal replacement therapy (RRT) and mortality rate was 7.4% . B

Conclusion: Based on that the most common cause of ESRD is all ages in congenital urologic malformations , early diagnosis and appropriate management of these cases are effective in decreasing incidence of ESRD and with respect to few cases of renal transplant and unsuccessful results in 65% of RRT , the approach of this problem should be revised.