Prompt action is needed to reduce the unacceptably high rate of unwarranted cesarean deliveries. Improving women's knowledge about the risks and benefits of different modes of delivery can lead to a positive maternal attitude towards vaginal delivery.

With the aim of studying the feeding patterns in infants under 6 months of age, 451 mothers attending the children's clinic in two university hospitals in the north of Tehran were interviewed. All babies had been born in hospital and > 98 per cent had been breastfed during the first few hours of birth. The rate of full breastfeeding at 6 months of age, with no introduction of the bottle, was 83 per cent; approximately 6.5 per cent of infants were fed on breast and bottle concomitantly, and in about 10.5 per cent breastfeeding had been discontinued before 6 months and the babies were fed on bottle only. About 60 per cent of mothers who stopped breastfeeding, did so during the first postnatal month and another 20 per cent during the 2nd and 3rd month after the babies' birth. The mother's age, education or parity, did not affect the rate of breastfeeding. Low birthweight, especially birthweight less than 2 kg, was a risk factor for early termination of breastfeeding. Caesarean delivery and hospitalization of the infant during the neonatal period was also associated with a higher rate of bottlefeeding compared with newborns who had been delivered normally, discharged early, and nursed at home. Although breastfeeding rates are high, the finding that the majority of mothers who give up breastfeeding do so in the early weeks, calls for better support to all mothers by committed health personnel during the period when breastfeeding is being established, and for extra assistance to women whose infants are hospitalized or have a low birthweight.

The purpose of this study was to determine the presence of integrons in Escherichia coli, which cause urinary tract infections, and to define the association between integrons and antimicrobial susceptibility. Susceptibility of 200 isolates from urine samples of patients suffering from urinary tract infections to 13 antibiotics was determined by the Kirby-Bauer disk diffusion method. The existence of class1 and 2 integrons in resistant isolates was assessed by polymerase chain reaction-restriction fragment length polymorphism and sequencing. Antibiotic resistance patterns were observed as follows: amoxicillin 78%, tetracycline 76.1%, co-trimoxazole 67.7%, cephalotin 60%, nalidixic acid 57.4%, chloramphenicol 49%, gentamicin 46.4%, ceftazidim 38.1%, ciprofloxacin 36.2%, nitrofurantoin 33.5%, amikacin 32.1%, norfloxacin 36.1%, and imipenem 27.1%. Of 200 isolates, 155 (77.5%) were multidrug resistant (MDR). The existence of integrons was confirmed in 50.3% of isolates. Three class 1 integron types, aadA2 being the most frequently found, and four class 2 integron types are described. Significant association between resistance to gentamicin, co-trimoxazole, cephalotin, ceftazidim, imipenem, chloramphenicol, and nalidixic acid with the existence of integrons was observed. Multidrug resistance suggests that the strategy for treatment of patients with E.coli infections needs to be revised. Furthermore, it was shown that integrons may be partly responsible for multidrug resistance. Imipenem and norfloxacin were the most effective antibiotics against isolates.

Niemann-Pick disease type C is a rare neurodegenerative disorder with autosomal recessive inheritance that can be broadly categorized into different forms dependent on age at disease onset: pre-/perinatal, early infantile, late infantile, juvenile, and adolescent/adult. This study was conducted to define the age at onset, clinical manifestations, neuroimaging findings and response to treatment in 21 patients diagnosed with Niemann-Pick disease type C and managed in the neurology departments of hospitals in Tehran, Iran. The effects of miglustat on patient ambulation, fine and gross motor function, swallowing, hearing, speech, seizures, psychomotor development, and ocular movements were evaluated for up to 26 months of treatment. Ambulation, fine and gross motor movements, swallowing, speech, and supranuclear gaze palsy were generally stabilized during therapy, and psychomotor delay appeared to be improved in early- and late-infantile onset patients. However, miglustat had no effect on organomegaly or other systemic manifestations of the disease. Miglustat was well tolerated.

Aim: To observe the effects of fathers' smoking on respiratory symptoms in children between the ages of 6 mo and 5 y living in Tehran during the period January to December 2001. Methods: The caregivers of 622 children attending resident‐based clinics in two university hospitals were interviewed about the respiratory illnesses incurred by the child during the previous 12 mo and the smoking habits of those living with the child. Children who lived in households in which any person, other than the father, smoked were excluded. Results: The analysis included 595 children, 40.6% of whom were living in homes where fathers smoked cigarettes. About 35% of smokers admitted to unrestricted smoking at home. In children not living with a smoker, 81.6% had experienced at least one episode of upper respiratory tract infection (URTI) during the previous year and the rate increased to 95.2% in passive smokers whose fathers were not restricted from smoking in front of the children, (p‐value <0.01). A similar pattern was found for otitis media and asthma (p‐value <0.05 and <0.01, respectively). The average number of URTI episodes during the previous year was significantly higher in children exposed to unrestricted smoking (p < 0.01). Conclusion: The study outlines the detrimental effects of paternal smoking on the respiratory health of children from a part of world in which this problem has not been studied previously, and highlights the importance of educating fathers to alter their smoking habits so that even if they do not stop smoking altogether, they should discontinue smoking indoors.