مجله دانشکده پزشکی اصفهان
پیاپی 102 (بهمن 1388)

The assessment method of result of surgeries has changed to self-evaluation. Health outcome should be measured by valid and standardized tools. The aim of this study was to evaluate the effect of total hip arthroplasty (THA) on the quality of life of Iranian patients. In this cross sectional study, the obtained data of 220 patients underwent total hip arthroplasty because of hip joint osteoarthritis in Baqhiatallah University hospitals, Tehran and Kashani hospital, Isfahan from 1995 to 2005 with 220 patients of the same age group admitted in hospitals and orthopedic clinics because of hip joint osteoarthritis without arthroplasty were compared. The tools of obtaining data were “Short form of general health status” (SF-36), “The disease specific symptom (WOMAC)” Questionnaire, and the “Arthritis patient preference disability” Questionnaire. Respectively, mean scores of SF-36 and WOMAC questionnaires were 53.07 ± 18.43 and 63.02 ± 17.42 for case group and 81.3 ± 16.31 and 42.53 ± 18.73, for control group. The scores obtained from these two questionnaires showed 23.3% improvement in general health status and 18.1% improvement in specific symptom of the disease in case group. The two groups had a significant difference considering these two parameters (P < 0.001). The SF-36 questionnaire showed improvement in life quality in eight aspects of physical performance, physical limitation, physical pain, general health, liveliness, social performance, psychological problems, and psychological health. Total hip arthroplasty improve general health, social performance and physical function and decrease pain and physical limitation of Iranian patients.

Tuberculosis (TB) is in the 7th grade according to Disability Adjusted Life Years (DALY) and will stay in this grade until 2020. In the developing countries, 25% of preventable deaths are due to tuberculosis, 75% of them occurs in producing people. The main reason of this outcome is ineffective national programs for tuberculosis surveillance in the countries. Therefore, periodic program evaluation of tuberculosis surveillance would be essential. This was a Health system research (program evaluation) study that has been conducted in Isfahan 1 district, according to Health Providing System deviding (2005-2006). Data were collected from epidemiologic forms sent to Isfahan provincial health center. All samples were analyzed. Data were analyzed using SPSS 11.5 software. The outcome and process indices were computed and compared with standards. The computed indices in 2005 and 2006 were as case detection rate (CDR) 90% and 77%, incidence of smear-positive cases per 100000 population 2.28 and 1.11, conversion rate 87.5% and 81%, cure rate 77.5% and 56%, completion rate 2.5% and 2%, success rate 80% and 58%, failure rate 2.5% and 4%, respectively. This study revealed that there is a gap between new–case incidence of smear positive lung tuberculosis, cure rate, success rate and the standards. This reveals a problem in accomplishment of tuberculosis surveillance program and continuous monitoring of this program will lead to improvement the indices.

Miscarriage was estimated 20% of all pregnancy every year, approximately. There are different modalities, medical or surgical, to treat incomplete abortion. One of the procedures is manual vacuum aspiration (MVA). It is a new method in Iran. The aim of this study was to evaluate the efficacy of this method in Iran. This randomized clinical trial was designed to compare MVA against sharp curettage in incomplete abortion treatment. The two universities related medical centers with obstetric department were engaged. The 316 cases were elected by inclusion criteria and then allocated into MVA (156 cases) or curettage (160 cases) treatment group. They were followed up for three weeks and blood pressure, pain with visual analogue scale; patient satisfaction and bleeding were evaluated in every subject by gynecologist. At the end, data were analyzed using by SPSS15 software. Duration of surgery was significantly shorter in MVA than curettage group. Although there were no difference in pain score at admission but patients had less pain during surgery and one hour after surgery in MVA group. Patients in curettage group had more bleeding during surgery. Satisfaction score were significantly more in MVA group at discharge (96.2% against 83.3 %) but this difference was not significant between two groups, 1 and 3 weeks after surgery. Our findings showed that MVA was effective to treat incomplete abortion. It has less complication and bleeding. In addition, satisfaction is high and it consider cost effective.

Spinal column is the main axis of the body and plays an important role in maitaining a proper posture. The purpose of this study was to investigate the rates of spinal abnormal curvatures in University of Isfahan students and the correlation of them with body mass index (BMI) and low back pain (LBP). In a cross-sectional study, 730 female and 718 male students of University of Isfahan (1448 cases), aged 18 to 24 years participated in a voluntary screening testing program between 2006 and 2008. First, age, antropometric measures and low back pain were measured with a standard clinical scale and Quebec back pain disability standard questionnaire, respectively. Then, spinal curvature and degree of lumbar lordosis and thoracic kyphosis were measured using flexible ruler (non-invasive tools). During five subsequent semesters all participants were tested. Data were analyzed using t-test for independent means, χ2 and correlation coefficient. The mean anthropometric measurements including the mean of hight, weight measurements, percentage of body fat, body mass index, and waist-hip ratio differed significantly between the groups for both men and women (P < 0.05). The mean angle of kyphosis and lordosis was 28.20 ± 12.78 and 29.07 ± 9.71 in women group and 31.87 ± 10.70 and 24.00 ± 10.50 in men group, respectively. The overall incidence and rate of degrees for kyphosis and lordosis differed significantly among the groups by gender (P < 0.05). No significant relationship was found between thoracic kyphosis and BMI among the groups by gender (P > 0.05). However, a significant relationship was seen between lumbar lordosis and body mass index among the groups by gender (P < 0.05). There was significant differences in low back pain by gender in subjects with severe lordosis (P > 0.05). The results showed that although the flexibility ruler has a relatively high corrilation with radiologic, it is a reliable and valid instrument and can effectively be used for measuring the spinal curvatures in screeing testing programs and many populations accordingly.

The problem of bone defects during treatments of bone lesions, especially cranial trauma, and also during craniotomy operations indicates isolation of osteoblasts and culturing them for filling these bone effects. Bone tissue specimens were obtained from 6 patients’ carvaria undergoing craniotomy surgery operations in Al-zahra teaching hospital and transferred to lab. These specimens were cut into small pieces measuring 1 × 1 mm and put in Petri dishes having culture medium and then transferred to the incubator. The mean interval of observed cellular outgrowth was 9-10 days. After 2 weeks, the cells in cultures reached confluencey. First passage cells were detached from Petri dishes, using Trypsin EDTA, and were divided in two portions. One portion was used for monolayer osteoblast culture, and the other, was added to alginate gel. The activity of these cells was tested by Alkalin phosphatase, Von kossa and Azan staining. Cell viability was also tested by Trypan blue staining. The morphology of osteoblasts in monolayer cultures appeared fusiform and fibroblastic, while in the alginate beads, cells appearance was round. Alkaline phosphatase staining method confirmed the presence of osteoblasts. Von kossa and Azan staining demonstrated, mineralized and organised matrix in both groups. The number of harvested cells in day 1 and day 21 were significantly different in each group (P < 0.001). In addition, there was significant difference in the mean of cells number and viability between monolayer cultures and alginate beads in day 21 (P < 0.001). This study showed that osteoblasts can come out from bones in dish culture without using any enzyme; and sodium Alginate gel supports cell viability and proliferation of osteoblasts cells significantly in comparison with the monolayer culture.

Millions of children around the world live on the street. They are at higher risk of viral diseases (eg. hepatitis B virus) because of physical, sexual and drug abuse. The aim of this study was to evaluate the prevalence of hepatitis B virus (HBV) and its risk factors in Isfahan street children. In a cross-sectional study, we selected 399 street children. After getting information and performing the tests for HBs Ag, HBs Ab and HBc Ab, data were analyzed by SPSS software version 15 used t-test, χ2, Mann-Whitney and logistic regression. We studied 271 (68%) boys and 128 (32%) girls. Their mean age was 12.74 ± 3.27 years. In our study, poverty was the main motivation for street children (68% of participants). 91.7%, 94.7% and 96.7% of the participants had no history of smoking, drinking alcoholic beverages or drug abuse, respectively. 34.4% of girls and 4.4% of boys (P = 0.001) were sexually abused and 68% of girls and 17.3% of boys (P = 0.001) were involved in physical fighting. HBs Ag, HBs Ab and HBc Ab seroprevalence were 3.3%, 14.4% and 2.1% respectively. No significant statistical difference was between HBV-seroprevalence and its probable risk factors. KEducational programs for safer behaviors, training them to improve their quality of life, and hepatitis B vaccination in those who are non-immune should be performed.

The word wide concern for safety has created a need for new and effective methods to improve safety in the workplace. The aim of this study was to promote safe behavior in Isfahan Steel Company workers by theory-based intervention. This randomized control trial consisted of two case and control groups. The case group received intervention based on Health Action Model. Control group did not receive any intervention except participating in the current safety courses of company. The sample size was 270 worker who were randomly selected and divided into two equal groups (n = 135). Data was collected using a questionnaire and a checklist after and before the intervention and were analyzed based on distribution of variables, parametric (t-test, paired t-test) or nonparametric (chi-square, Wilcoxon) tests. The mean scores of knowledge, attitude and behaviors of safe behaviors in case group increased statistically significant and the observed difference in control group was not significant. The results also indicated that unsafe behaviors in the case group decreased, following the educational intervention. The difference, again, was not statistically significant in the control group. The results showed that application of Health Action Model has an acceptable and positive influence on promoting safe behaviors of workers in Isfahan steel Company. It is, therefore, recommended that same theory based intervention can be useful for other and similar industries.