Correlation between anthropometric indices at birth and developmental delay in children aged 4-60 months in Isfahan, Iran.

BACKGROUND: Advances in medical knowledge and treatment modalities have resulted in an increased survival rate for high-risk infants. This increased number of survivors enables study of the future development of these children. Other than infection and trauma, developmental and behavioral problems are the most common medical problems among such children. This study sought correlations between anthropometric indices at birth and developmental delay in children aged 4-60 months who visited health service centers affiliated with the Isfahan University of Medical Sciences in 2010. METHODS: In this descriptive, correlational study, 401 children aged 4-60 months and visiting health service centers were selected using a multistage method. Anthropometric indices at birth were collected from their health care records, and developmental status was measured using the Ages and Stages Questionnaire, the validity (0.84) and reliability (0.94) of which were obtained from a previous study. RESULTS: The mean age of the children in the normal group was 17.33 ± 13.18 months and that in the developmental delay group was 29.92 ± 19.19 months. Most children in the normal group were female (56%) and in the developmental delay group were male (55.2%). No correlation was found between height and head circumference at birth and developmental delay. However, the birth weight of children with developmental delay was four times lower than that of children with normal development (P = 0.004, odds ratio 4). CONCLUSION: Birth weight and male gender were factors that strongly correlated with developmental delay in this study.

The Effects of Health Education through Face To Face Teaching and Educational Movies, on Suburban Women in Childbearing Age.

BACKGROUND: The aim of the study was to compare the effects of 'face-to-face education' and 'educational movies' on 'knowledge' and 'practice' of women of child-bearing-age, in terms of health-care during pregnancy and during infancy in a suburban region near Tehran City, Iran. METHODS: In this quasi-experimental study, the sample included 873 married women. Questionnaires for knowledge and practice assessment were designed. The women were assigned to three groups: control (group I), face-to-face education (group II), and educational movie (group III). Knowledge questionnaires were completed before and immediately after intervention. Practice questionnaires were completed before and three months after intervention. Both questionnaires consisted of two types of questions: type A (concerning infant care issues) and type B (concerning prenatal health care). RESULTS: There was a significant difference in post-test knowledge between groups I and II and between groups I and III, but not between groups II and III. In terms of post-test practice, the changes were determined for every individual question, and significantly, better results were seen in group II, especially concerning type B questions. CONCLUSION: Face to face education lead to better practice than educational movies. In addition, significantly better practice occurred regarding child health care issues rather than prenatal issues in both groups. Realistic and tangible issues, those easy to practice, and with little or no economical burden imposed on the family, progressed from the knowledge state to the practice state more successfully in both groups.

Validity and reliability of Infant Neurological International Battery for detection of gross motor developmental delay in Iran.

BACKGROUND: Child development screening is important issue for early detection of developmental delay and disability. Children in different environment acquire developmental abilities at different age. In this paper we report the examination of Infant Neurological International Battery (INFANIB) as a screening tool for early detection of gross motor developmental delay in Iran. METHODS: In this study, we reported the result of a study which was conducted on 6150 consecutive 4- to 18-month infants who were referred form Karaj Health Network (Tehran Province) over a 12-month period. A questionnaire was filled for each child, and an evaluation was carried out with INFANIB by occupational therapists. Assessed infants had been classified in three categories: normal, transiently abnormal and abnormal neuro-development. The transient group infants were divided to normal and abnormal group after 3 months' follow-up. The abnormal group was referred to developmental centre for neuro-developmental examination. For depicting validity of the test, some of the normal, transient and abnormal group was evaluated randomly by paediatrician for neuro-developmental exam and for reliability of test between paediatrician and occupational therapist 54 infants scored randomly by both of them. RESULTS: The INFANIB was valid for normal and abnormal group with 90% sensitivity, 83% specificity, 79% positive predictive value and 93% negative predictive value (NPV). Also the reliability coefficient between the examiners (paediatrician and occupational therapists) was calculated, and the intraclass correlation coefficient was 0.90. CONCLUSIONS: Results indicate that INFANIB is proposed as an appropriate screening test in developing countries such as Iran as a reliable measurement of gross motor developmental delay and short time of performing.

Intralesional autotherapy of cutaneous leishmaniasis with buffy coat cells: cytological findings.

The skin lesions of five patient volunteers with dry-type cutaneous leishmaniasis were treated by intralesional injection of auto-leukocytes prepared from buffy coat of the patient's own blood. Giemsa stained, air-dried cytological smear preparations were prepared from scrapings taken from the margins of the lesions. The cellular interaction between the organism and the inflammatory response of the host was studied. All lesions showed clinical evidence of regression. The cytological findings suggested progressive degradation of the Leishman donovan (LD) bodies within the parasitophorous vacuoles of the activated macrophages. The parasiticidal effect appeared to be induced by synergistic action of the injected neutrophils and lymphocytes. Due to lack of placebo controls in this study the possibility that, healing might not be related to therapy can not be excluded. This study illustrates the potential for intralesional autotherapy with buffy coat in dry-type cutaneous leishmaniasis.

Cytologic features of "dry-type" cutaneous leishmaniasis.

Exfoliative cytology smears from the lesions of 179 patients with cutaneous leishmaniasis due to Leishmania tropica were studied with specific reference to cellular reactions and their effect on the parasite. Aggregates of the parasite (so-called Leishmania Donovan bodies) were present within macrophages and in some fibroblasts. The nature of the inflammatory reaction to the disease was studied by performing differential counts of the inflammatory cells present in the smears. These were correlated with the number of Leishman Donovan bodies. There was an inverse relationship between the number of Leishman Donovan bodies and the percentage of small lymphocytes, neutrophils, and type I macrophages. It is postulated that aggregates of activated macrophages (designated types II and III) and the Leishmanian milieu (sticky matrix) protect the amastigote Leishmania parasites from being eradicated by the inflammatory and immune reaction. The cytoplasmic blebbing of the parasitophorous vacuoles and cell to cell connection of the activated histiocytes could be shown by the CD-68 immunostaining of the tissue biopsy.