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Diarrhea and malnutrition are important health problems in human societies, especially in developing countries, leading to a huge number of deaths annually. Numerous studies have death with the relationship between malnutrition as a predisposing factor and acute diarrhea, but they have yielded conflicted results. In a cross-sectional controlled study, we examined 398 infants 1-24 month-old referred to the diarrhea-training unit (DTU) of hospital. After treating dehydration, height, weight were measured and compared with an age-matched control group. In cases with acute diarrhea, 3.2% had severe, 14.8% had moderate, 48.8% had light malnutrition, 33.2% had no malnutrition according to Gomez scale. In the control group, the percentage of subjects with severe, moderate, light, and with out malnutrition were 0.5%, 2.2%, 32.4%, and 64.8%, respectively. Average weight for age and weight for height scores were significantly lower in cases with acute diarrhea than in control subjects. However, average for age score was not statistically different in the 2 groups. Patients with acute diarrhea suffered a higher prevalence of malnutrition compared with those from the control group. There was not statistically significant relationship between growth indices and socioeconomic class of the family. A lower percentage of infants with acute diarrhea compared with control group enjoyed breast-feeding as the primary feeding routine. The period of breast-feeding was shorter in infants with acute diarrhea. Nevertheless, breast-feeding neither have significant effects on malnutrition nor on weight and height growth indices. Overall, we concluded that malnutrition and decreased weight growth index might be important predisposing factors for acute diarrhea. Early diagnosis and treatment of malnutrition (Especially moderate and light degrees) are very important measures to be taken in order to decrease diarrhea and its complications.

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Diarrhea is one of the main reasons of mortality among children in the developed countries and half of all death is due to persisted diarrhea. This research is a cross-sectional and analytical study done on 708 children with acute diarrhea in village around Gorgan, to find out the effective factors on having persisted diarrhea in children under 5 years old. Face to face interview and determining the variable factors and examining health center records on children with acute diarrhea were the basis for filling the corresponding questionnaires. 14 days after the start of acute diarrhea, which was the second part of this research, the above questionnaires were fully completed by calling on the patient’s home. According to our investigation the risk factors related to the persisted diarrhea were as follow: Age, ethnicity, children length of breast feeding, chlorinated water, children consumed food at the time of acute diarrhea. The results from this investigation indicate that with 95% about probability 10.7%-11.3% of patients with acute diarrhea end-up with persisted diarrhea, which means diarrhea, was continued for more than 14 days. Therefore by controlling the above risk factors the mortality rate due to acute diarrhea could be reduced.

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Background and Objective: Zinc is one of the micronutrient with many roles in health, especially among the growing children. It has been thought that Zinc deficiency cause diarrhea, and Zinc supplementation can prevent it in children. Materials and Methods: This study was carried out to determine the effect of Zinc sulphat on 4-24 month old children dirrahea. This clinical trial study was done double blind, the sample were study 4-24 month old afflicted with acute diarrhea in pediatric ward of Besat Hospital in Sanandaj, Iran during 2006. The sample size was 40 and mached by Blocks Randomization. The children in case group (intervention) received Zinc sulfate (9mg/kg/day) during ten days. In the Control groups they there given distilled water instead. The data was analyzed, using t-test and manwitney test. Results: During ten days of monitoring there was not significant differences between two groups. Duration of diarrhea in case and control groups was 5.72±3.15 and 5.32±2.58 days respectivley this diffence was not significant. Conclusion: This study showed that Zinc sulfate has no benefit on acute diarrhea in childhood

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Background and Objective: Gastroenteritis due to Salmonella is common in human and considered as a global dilemma of public health. This study was done to determine the Pattern of serotyping and antibiotic resistance of Salmonella in children with diarrhea in Iran. Methods: In this laboratory study, 306 stool samples were collected from children with diarrhea in public health centers in Robat-karim, Tehran province, Iran. The specimens were enriched in Selenite F medium and then cultured on Hekton agar. The identification of Salmonella was carried out by conventional method and antimicrobial susceptibility testing was performed according to CLSI procedures. Results: Out of 306 stool samples, 7.2 % were identified as Salmonella species, as follow: 7 Salmonella typhi, 6 Salmonella paratyphi B, 3 Salmonella paratyphi C, 2 Salmonella paratyphi A and 4 samples were not identifiable. There was a significant relation between presence of WBC in fecal and salmonellosis (P<0.05). In drug sensitivity trends, 92.3% of Salmonella species were sensitive to chloramphenicol, ceftizoxime, Nalidixic acid and Amikacin. Conclusion: This study showed that Salmonella was the cause of children diarrhea in 7.2% in this region.

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Background and Objective: Yersinia enterocolitica is a worldwide pathogen belong to genus Yersinia. The association between acute childhood diarrhea and other diseases caused by Yersinia enterocolitica has been established by several researchers. Due to the lack of sufficient information on other pathogenic Yersinia species, this study was done to determine the prevalence and the pattern of antibiotic susceptibility of atypical Yersinia spp isolated from children, less than 14 years old. Methods: This descriptive cross - sectional study was carried on 384 children with diarrhea whom referred to the Tehran children medical center, Tehran, Iran during August 2011 to August 2012. 384 fecal specimens of children were transferd to the laboratory and cold enrichment in alkaline buffer with pH of 7.2 for 21 days. The samples were cultured in Cefsulodin-Irgasan-Novobiocin Agar (CIN) differential media in 7, 14, and 21 days. The identification of Yersinia species were carried out by conventional procedure. Antibiotic susceptibility test to Ciprofloxacin, Co-trimoxazole, Tetracycline, Chloramphenicol, Erythromycin, Ampicillin, Gentamicin, Penicillin were determined by standard disk diffusion method. Results: Out of 384 fecal samples, 3 (0.7%) were infected with Yersinia. Three species of Yersinia were Y.enterocolitica, Y.Kristensenii and Y.frederiksenii. All three strains were sensitive to Cotrimoxazole, Tetracycline, Chloramphenicol, Ciprofloxacin and Gentamicin. Conclusion: This study showed that atypical Yersinia play important role in diarrhea. Therefore, more attention should be noticed to atypical Yersinia species in addition to Yersinia enterocolitica.

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Background and Objective: Yersinia is a gram-negative bacillus that cause diarrhea through consumption of contaminated food and water.  This study was performed to identify the atypical Yersinia virulence markers isolated from children with diarrhea.

Methods: This descriptive cross -sectional study was done on 384 fecal samples of 0- 14 years old children admitted at children medical center from August 2011 to August of 2012. Fecal samples, for the enrichment, after 21 days of incubation in alkaline buffer with pH=7.2 at 4degree C, on days 7, 14 and 21 samples were cultured on CIN agar and Mac agar and then confirm the differentiation atypical Yersinia from other typical Yersinia species from fermentation of different sugars. Isolates were tested for marker of virulence including calcium dependence, auto agglutination, Congo red uptake and binding of crystal violet.

Results: Out of 384 stool samples, 4 (1.04%) were infected with Yersinia (Yersinia frederikseni, Yersinia kristensenii and Yersinia enterocolitica). Out of these three, only two samples in association was positive with virulence markers.

Conclusion: Phenotypic markers can be used to study the properties of phenotypic strains of Yersinia.

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Background and Objective: Ferula assa foetida (Ferula assa-foetida L.) is an herbaceous wild plant native to Iran which is used in the traditional medicine for treating stomach and intestinal disorders. This study was done to determine the antidiarrheal effect of hydroalcoholic extract of Ferula assa foetida in rat.

Methods: In this experimental study, Wistar adult male rats randomly allocated into negative control, positive control and interventional groups. Animals in negative control groups were recived normal salin orally. Animals in positive control groups were recived Atropine (0.1 mg/kg/bw) for evaluation of intestinal propulsive movement and Loperamide (3 mg/kg/bw) for evaluation of diarrhea. In interventional group 1, 2 and 3 animals were received hydroalcoholic extract of Ferula assa foetida 100, 200 and 400 mg/kg/bw, resepectively. One hour after administration of extracts and medicine diarrhea induced using castor oil in animals. Induced diarrhea, intestinal propulsive movement and intestinal fluid accumulation were evaluated in rats.

Results: Gavage of the extract (5 g/kg) did not produce any toxic effect in rats. The mean peristaltic index in Gavage for doses of 100, 200 and 400 mg/kg/bw, control and atropine groups was 97.00%, 65.88%, 62.23%, 86.19% and 52.86%, respectively. The extract at the lowest dose in combination with atropine was significantly reduced peristaltic index rather than of the atropin alone (P<0.05). The extract produced a non-significant reduction in the volume of intestinal fluid accumulation and propulsive movement in the castor oil-induced intestinal transit in rats. In a dose-dependent manner, the extract delayed the onset of diarrhea. Loperamide and highest dose of extract (400 mg/kg/bw) produced a significant reduction in the frequency of defecation and severity of diarrhea (P<0.05).

Conclusion: The hydroalcoholic extract of F. assa foetida showed anti-diarrheal activity due to its inhibitory effect on intestinal fluid accumulation.

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Background and Objective: Campylobacter is one of the most important pathogens causing bacterial gastroenteritis, which is usually transmitted through the food of animal origin. This study was done to evaluate the status of Campylobacter in diarrheal food outbreaks compared to other microbial agents.
Methods: This descriptive study was performed on 305 diarrheal swab samples from 102 food outbreaks during six months from spring to the end of summer 2018. Presence of Campylobacter species were assessed according to the protocol of the General Directorate of Laboratory Affairs.
Results: Out of 305 samples, 8 (2.6%) were identified as Campylobacter species, 3 (37.5%) Campylobacter and 5 (62.5%) Campylobacter coli. The epidemiology of the outbreaks showed that female (54.5%), average age of 16-30 years (28.2%), consumption of salads and vegetables (16.1%) and living in the cities (59.7%) were the most cases.
Conclusion: This study showed that in addition to classic pathogens such as Salmonella, Shigella, Escherichia coli, attention also should be paid to Campylobacter bacteria. In addition, recognizing epidemiological factors can play an important role in preventing and controlling food outbreaks.

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Background and Objective: Yersinia is water and foodborne organism that cause human gastroenteritis. This study was done to evaluate the frequency of Yersinia species isolated from children diarrheal samples and chicken meat in Tehran, Iran.
Methods: In this descriptive study 250 sample of diarrhea of children referred to the Children's Medical Center, Tehran, Iran and 250 samples of chicken were collected and examined for Yersinia infection during July 2016 to March 2017. Isolation method was performed based on initial enrichment in phosphate buffer for 3 weeks in refrigerator (cooling in c4 +) and then using KOH as secondary enrichment and culture on CIN agar medium. Biotyping method was used to determine pathogenic strains.
Results: In this study, 5(2%) isolates from pediatric diarrhea samples and 20 isolates (8%) from chicken meat samples were obtained from Yersiniaenterocolitica. Biotyping of human Yersiniaenterocolitica isolates identified 3 cases of biotype 1A, one case of biotype 1B, one case of biotype 2 and from chicken meat isolates, 16 isolates belonged to biotype 1A and 4 isolates belonged to biotype 1B.
Conclusion: Presence of common pathogenic 1B and non-pathogenic 1A biotypes in pediatric diarrhea samples and chicken meat can indicate the cause of diarrhea in children.