مجله دانشکده پزشکی اصفهان
پیاپی 183 (هفته اول خرداد 1391)

Osteotomy of proximal tibial bone is a surgical treatment for patients with medial compartment osteoarthritis with a 5-year satisfaction rate of 80%. The surgery aims to correct varus deformity and lower limb alignment and reach a 3- to 5-degree overcorrection. Because the most important cause of unsatisfactory results are overcorrection and undercorrection, in this study we tried to evaluate the final results. In a clinical trial in Kashani Hospital (Isfahan, Iran), 20 patients with medial compartment knee osteoarthritis were selected using convenient sampling. Patients were excluded if they did not wish to participate or did not refer for control. Patient's data was collected before the surgery. Radiographs of the lower limbs (alignment view) were also taken before the operation. Radiography was repeated 2 months after the surgery and the results were compared using paired t-test in SPSS. The mean of anatomical angle was 5.1 ± 3.4 degrees (varus angle) before and 11.9 ± 3.4 degrees (valgus angle) after the surgery. The difference between the 2 values was significant according to paired t-test (P < 0.001). Similarly, a significant difference was observed between the mechanical angles before and after the surgery (12.6 ± 3.4 vs. -4.75 ± 3.5 degrees) (P < 0.001). Upper tibial osteotomy can correct the alignment of lower extremity and decrease knee pain.

The relationship between hepatic disorders and Transfusion transmitted virus (TTV) and the significance of parenteral transmission of TTV are controversial. The aim of this study was to compare the prevalence of TTV in injection drug users (IDUs), hemodialysis patients, and healthy blood donors, in Isfahan, Iran, at the year of 2010. In a case-control study, 108 subjects included 36 hemodialysis patients, 36 IDUs, and 36 healthy blood donors (as control group) were studied. Five-mL blood sample was taken from each subject on EDTA-containing tubes. Then DNA extraction was implemented using DNA extraction kit, and DNA reproduction was done using specific primers and probe by Rotor-Gene 6000 real-time PCR instrument. The mean of age in subjects was 38.7 ± 14.7 and 71 (66%) were male. Of 108 cases, 30 (27.8%) were TTV positive and 78 (72.2%) were TTV negative. The prevalence of TTV in IDUs 21 (58%) and hemodialysis patients 6 (17%) was higher than healthy blood donors 3 (8%) that was statistically significant (P < 0.0001). The prevalence of TTV in IDUs and hemodialysis patients is significantly higher than the general population in Isfahan, Iran. It seems necessary to make plans and policies to reduce the risk of TTV transmission to families of hemodialysis patient and IDUs, individuals who have close contact with them and health care workers.

Massage therapy is known as one of the complementary treatments. The present research was performed with the aim of studying the effects of 5 days of massage on weight gain and serum bilirubin levels in term infants with hyperbilirubinemia. This clinical trial research was carried out on 34 full-term infants with hyperbilirubinemia at a hospital in Gonabad, Iran. The infants weighted between 2500-4000 g at birth and had bilirubin levels of 13-24 mg/dl. The 34 infants hospitalized with hyperbilirubinemia were randomly assigned into a massage group comprising of 18 babies and a control group of 16 babies. A total of 25 infants completed the study. The intervention consisted of massage and passive movements carried out on the infants of the massage group in three 15-minute periods at the beginning of three consecutive hours, daily for 5 days. The mean bilirubin levels were monitored and compared with those of the control group. Data was analyzed in SPSS14 using independent t-test and Fisher's exact test. During the 5 days of intervention, the mean of daily weight gain among the infants was 28.8 g in the massage group and 15.83 g in the control group. The difference between the two groups was not statistically significant (P = 0.14). Bilirubin levels at the beginning of the study were 17.89 ± 2.12 mg/dl in the massage group and 17.87 ± 2.46 mg/dl in the control group (P = 0.98). However, the mean bilirubin levels on the 4th day of hospitalization showed a significant difference between the massage and control groups (9.92 ± 1.3 mg/dl vs. 11.97 ± 1.52 mg/dl; P = 0.001). This study showed that 5 days of massage therapy cannot cause significant differences in weight gain. However, massage had a significant effect in decreasing the bilirubin level of infants suffering from hyperbilirubinemia undergoing phototherapy treatment.

The purpose of this study was to determine the effect of aerobic exercise intensity on serum leptin levels in obese/overweight women. A total number of 45 obese/overweight women (body mass index ≥ 25-30 kg/m2) were selected from patients who referred to the Iranian Health Clinic (Isfahan, Iran). Serum leptin levels of patients were evaluated before eating breakfast. Their body fat percentage was also measured. Participants were randomized into 3 groups of moderate aerobic exercise [45-50% maximum heart-rate reserve (HRRMAX)], intense aerobic exercise (70-75% HRRMAX), control group (without training). Training included three 60-minute aerobic exercise sessions a week and lasted for 10 weeks. After 10 weeks, the variables were reassessed. Pre- and post-test data was analyzed by analysis of variance (ANOVA) and Scheffe's test. Our results showed that moderate and intense aerobic exercise had significant effects on body weight (P < 0.001), body fat percentage (P < 0.03), body mass index (P < 0.001), and serum leptin levels (P < 0.001). This research suggests that aerobic exercise training with higher intensity can better reduce serum leptin levels and body fat percentage.

Obesity is a major public issue. According to the World Health Organization (WHO), the prevalence of obesity and overweight would increase to 1.5 million individuals by 2015. Obesity is an important risk factor for many cardiovascular diseases, hypertension, type 2 diabetes, osteoarthritis, some cancers. In addition, obesity and percent of body fat seem to be associated with respiratory problems, although the mechanism of this correlation is not very clear. The purpose of this study was examining the relationship between anthropometric characteristics, body composition, and lung function in obese, overweight, and normal students. In this study, 283 secondary school students in Isfahan, Iran [age: 12.79 ± 0.88 years old, body mass index (BMI): 20 ± 39.9 kg/m2] were selected using cluster random sampling. Subjects were divided into 3 groups of obese (BMI ≥ the 95th percentile; n= 50), overweight (the 85th ≤ BMI ≤ the 95th percentile; n = 62), and normal (the 15th percentile ≤ BMI ≤ the 85th percentile; n = 171). Pulmonary function was assessed using Spirometric methods. In addition, anthropometric characteristics and body composition were measured. Our results showed the three groups of normal, overweight and obese students to be significantly different in terms of the average lung capacity and volume. Moreover, significant negative correlations were observed between anthropometric characteristics and indicators of body composition and lung function. Least significant difference post hoc test results also showed that lung function in normal students was greater than overweight and obese students. In addition, the prevalence of normal weight, overweight, and obesity among the studied students were 60.4, 21.9, and 17.7, respectively. Based on our results, obesity has a specific effect on lung function and reduces lung capacity and volume. However, the exact mechanism has not been well understood. Therefore, further studies in this field are required.