Abstract:After elapsing more than a decade since the beginning of hepatitis B vaccination program in Iran, this study was designed to investigate the level of hepatitis B vaccination coverage in medical students and nursing staff of Kerman teaching hospitals and to explore the main barriers to vaccination. This cross-sectional study was performed on 493 randomly selected medical students and hospital staff working in different wards of the four teaching hospitals of Kerman, Iran (I.R.). Data gathering was done by using a questionnaire including items related to vaccination history and the main barriers to vaccination. Although 86.8% of the health care workers (HCWs) had been vaccinated against hepatitis B, complete vaccination had been performed in only 71.7% of them. Barriers to complete vaccination, in spite of good knowledge of subjects in this regard (93.6%), were negligence (44.6%), unavailability of vaccine (27.7%), fear of complications (9.2%) and lack of knowledge (6.2%). There was significant difference between the students and nurses in regard to their vaccination coverage level (p<0.02) and barriers to complete vaccination (p<0.001). From 83 subjects who had tested their HBSAg prior to the vaccination, 8 ones (9.6%) were positive HBSAg. There was also significant difference between the two groups in the rate of performing vaccination before entering the hospital (76.2% of students vs. 32.5% of nurses, p<0.001). Considering high rate of positive HBSAg among hospital staff, insufficient knowledge about the necessity of complete vaccination against hepatitis B and high risk of exposure in the studied groups, enhancing the uptake of the vaccine by this target population should be a priority to the health policy experts in Kerman and possibly Iran.

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Problem statement: Considering high prevalence of gastrointestinal complaints in children and the important role of endoscopy in the diagnosis of such complaints, this study was designed to characterize the clinical, endoscopic and pathologic features of Iranian children undergoing upper Gastrointestinal (GI) endoscopy. Approach: This prospective study was performed in an office-based setting in a private medical centre in Kerman, Iran, between December 2004 to January 2008. Three hundred forty pediatric patients who underwent upper endoscopy for dyspeptic symptoms or other reasons were enrolled into this study and data were gathered concerning age, sex, reason of endoscopy, endoscopy report and pathologic report. Upper GI endoscopy was performed using Pentax video endoscope. Results: The most prevalent reason of performing endoscopy (43.1%) was abdominal pain. More than half of the cases with abdominal pain (54%) were in the age range of 5-10 year old of whom 80% had an abnormal pathologic finding such as esophgitis and active chronic gastritis associated with helicobacter pylori. The most common endoscopic finding (31.2%) and pathologic finding (40.3%) was esophagitis. More than half of the children with esophagitis (56.6%) had some degrees of hiatal hernia. In 35.5% of children with nodular gastritis, simultaneous esophagitis was observed. The rate of normal endoscopies and pathologies were respectively 10.8 and 19.4%. Conclusion: Considering low rate of normal endoscopic and pathologic reports in the studied subjects and also the variety of gastrointestinal complaints in them, it seems that proper selection of patients for undergoing upper GI endoscopy can have a significant directive role in the diagnosis of pediatric problems.

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Objective-Foreign body ingestion is common in children due to playing with everything. This study was done to identify type, site, and complication, as well as knowledge about the state of foreign body ingestion in children in Kerman/Iran. Methods-In this prospective study, during 4 years, 85 children less than 14 years old presented to the Emergency Department of Afzalipour Hospital in Kerman were studied. All children, regardless of their clinical symptoms, underwent total radiography (from neck to Pelvic) within the first hour of admission. In symptomatic patients, or sharp, long objects, and narcotic substances ingestion, prompt endoscopy was performed and in the case of foreign body lodging in the subglottic area, the patient was being referred to an ear, nose and throat specialist. For asymptomatic patients or far-access foreign body; lactulose, polyethylene glycol solution and high-fiber substances (for ingestion of diskette batteries, heroine and sharp objects respectively) were administered as medical treatments. Asymptomatic subjects who had ingested sharp objects or narcotic substances were hospitalized and observed, but other cases were followed out patiently (by phone call or face to face observation). Results-Mean age of subjects was 3.7 years with no significant difference between the two sexes. Mean age was 3.7 year. The most frequent ingested foreign body was diskette battery (28.2%) followed by coin (21.2%). The majority of subjects had no symptom (67%). the most frequent endoscopic location (21.8%) was subglot. Most complications occurred after battery ingestion. Endoscopic intervention was required in 31.8% that mostly in cases with ingestion of organic substances (77.8%) and coin (61.1%). There was a significant relationship between age and the type of foreign body (p=0.033) and its location (p= 0.012). Medical treatment was completely successful in 68.2%. There was no mortality. Conclusion-Manufacturing clockwork toys instead of operated toys, minting smaller coins and applying medical treatment in the cases that foreign body is not in the access of endoscope are recommended.