Surgical procedures of morbid obesity

Surgical intervention has been recently advocated in the treatment of morbid obesity. The objective of this study was to review surgery as an alternative in the treatment of morbidly obese adolescents. This research was conducted by searching English websites such as PubMed, Up to Date, and Google Scholar, as well as some Persian websites including SID, Iranmedex, and Magiran. Articles published from 2000 to 2010 on interventional and clinical trials were reviewed for treatment of morbid obesity in adolescents. Keywords used in internet searches include obesity; adolescence; and surgery. The results obtained from the studies indicated that 4% of American adolescents suffer from morbid obesity. So far, pharmacological treatment and other approaches toward this type of obesity have been inefficient. Hence, surgery was employed as one of the new approaches to the treatment of this disorder. According to the National Health Institute criteria, in the treatment of adolescent candidates for surgery, anthropometric measurements are performed together with the measurement of other co-morbidities of obesity. Adolescents whose percentiles are >/=99 are considered as morbidly obese patients. The results of the studies suggested that for the extremely obese adolescents, who do not respond to other types of medical interventions within 6 months, surgery can be performed. Adolescents with BMI of >/=40 kg/m[2] and skeletal maturity, or those with co morbidities of obesity, or 13-year-old girls and boys >/=15 years of age can be candidates for surgery. However, the side effects of obesity should not be neglected. Therefore, before the adolescent obesity become morbid obesity, preventive measures should be taken through changes in lifestyle

Drug therapy in obese adolescents

The behavior and dietary treatments are not so successful for extremely obese adolescents. Therefore, using drugs to treat extremely obese children and adolescents are among the modern approaches. This research aims to study the pharmaceutical interventions performed for treatment of obese children. The strategy of research was using of key words 'obesity', 'adolescence', 'treatment' and 'anti-obesity drugs' were searched in websites of PubMed, Iranian Medical Digital Library, SID, Iran Medex, Magiran. This study reviewed all the available published papers in English and Farsi languages during 2000-2010. The Criteria for exclusion was The papers that had been published on interventions and treatment of eating disorders, type II diabetes or the obesity caused by the secondary syndromes. Twelve papers were found as short-term clinical trials and/or long-term follow-ups. In these studies, the positive effects of 'sibutramine' in some studies are shown; although some other side effects are reported as well. A significant weight-loss had been reported on 'orlistat' medicine, but digestive complications had been observed as well. None of the studies had followed up patients for more than one year. Apparently, 'Metformin' requires further studies. The FDA has only approved 'sibutramine' and 'orlistat' drugs. But side effects of long-term these drugs have already been unknown. However, it seems that 'orlistat' is applied for >/=12-year-old children and 'sibutramine' for >/= 16-year-old children

Prevalence of obesity and metabolic syndrome in adolescent girls in south east of Iran

Obesity is the most common cause of insulin resistance and metabolic syndrome [MetS]. These are the most important risk factors for Coronary Heart Disease [CHD]. The objective of the present study was to evaluate the prevalence of obesity and metabolic syndrome [Mets] in adolescent girls in Rafsanjan, Iran. In this cross sectional study 1221 respondents were randomly selected using a multiphase sampling method. The individual questionnaire was completed after receiving a written informed consent. The weight, height, Waist Circumference [WC] and blood pressure were measured using standard equipments. Five milliliters blood were taken for measuring TG, HDL CHO and FBS of the obese volunteers after detecting obesity [n=76]. We determined metabolic syndrome according to the earlier Adult Treatment Panel III [ATPIII] criteria. Mean age of respondents was 14.3 +/- 1.7 years and 11.2% [95% CI = 9.4% -12.9%] and 2.4% [95% Cl = 1.5% - 3.3%] of subjects were overweight and obese respectively. Based on our finding about 1.2% [95% CI= 0.6% - 1.8%] respondents had abdominal obesity. According to ATPIII criteria 3.9% [C195% = 2.8% - 5%] of respondents had metabolic syndrome. This study showed high prevalence of obesity and metabolic syndrome among girls studying in secondary and high schools of Rafsanjan. We suggest screening programme for children aged 6-11 years as the result will help in planning to control obesity and metabolic syndrome

comparison of serum ferritin concentration between healthy people with and without history of family diabetes

This study aims to compare serum ferritin of the first degree relatives of diabetic patients with the control group. This is a case control study. Thirty five adults in each group of case and control group were chosen by random technique. For each individual a questionnaire was completed and serum ferritin and fasting blood sugar concentration of the subjects were measured. Parametric and non parametric tests were used for comparing groups were appropriate. About 74.2% of subjects were female and 25.8% were males in each group. Mean frittin concentration in case group was higher than this mean among respondents in control group [63 +/- 58.73ng/dl versus 58.07 +/- 54.57ng/dl]. The fasting blood sugar concentration in the case group was also higher than the control group [100.6 +/- 37.38mg/dl versus 95.9 +/- 17.02mg/dl]. However these differences were not significant between the two groups. There was a significant correlation between the ferritin concentration and fasting sugar in case group. Although there wasn't a significant difference in mean ferritin concentration between the two groups, the higher ferritin concentration among respondents in the case group comparing to it's concentration among respondents in control group is very important. More investigation of this type recruiting larger groups as case and control is suggested

[Prevalence of obesity and metabolic syndrome among adolescent girls in Rafsanjan, 2007]

Obesity is the most common cause of insulin resistance and metabolic syndrome [MS]. These are the most important risk factors for CHD. The present study aims to evaluate the prevalence of obesity and metabolic syndrome, the two most important risk factors for CHD, in adolescent girls in Rafsanjan. In this cross sectional study 1221 respondents were randomly selected using a multiphase sampling method. The individual questionnaire was completed after receiving a written consent form. The weight, height, waist circumference [WC] and blood pressure were measured using standard equipments. Five ml blood sample were taken for measuring TG, HDL-C and FBS of the obese volunteer after detecting obese subjects [n=76]. We determined MS according to the latest ATP3 criteria. Mean age of respondents was 14.3 + 1.7 years, and 11.2% [95% CI = 9.4% -12.9% and 2.4% [95% CI = 1.5% -3.3%] of subjects were overweight and obese respectively. Based on our findings about 1.2% [95% CI= 0.6%-1.8%] of respondents counted as abdominal obesity. According to ATPIII criteria 3.9% [CI 95% = 2.8% -5%] of respondents encounter with MS. This study showed high prevalence obesity and metabolic syndrome among adolescent girls of Rafsanjan. Therefore researchers suggest screening test also for children aged 6-11 years .The results will help with planning to control the problem in the future

Prevalence of obesity and abdominal obesity in a sample of urban adult population within south east of Iran

Obesity is now considered as a major health challenges in the both developed and developing countries. The prevalence of this phenomenon has been reported up to 36.7% in some of the urban regions of Iran. Since, there has been no previous study regarding prevalence of obesity in the adult population within South East of Iran, this study was carried out in the year 2002 to estimate the prevalence of obesity and abdominal obesity in adults 30 years and older in Rafsanjan. This survey was a cross sectional study in which a random sample of adults [n=756, age>30] were selected. For each individual a questionnaire was completed, in which height, weight, waist circumference and demographic characteristics were recorded. The overweight and obesity were defined by BMI=25-29.9 and BMI >30, respectively. The abdominal obesity was defined for women and men by waist circumference >88cm and >102cm,respectively. The prevalence of obesity [type 1 and 2] and overweight were 11.6% and 38.2%, respectively. In addition 164 [37.5%] of women and 118 [36.9%] of men were overweight. Seventy eight [18.2%] of women and 15 [4.7%] of men were obese, 248 [56.9%] of women and 52 [16.6%] of men suffered from abdominal obesity. The results of this study showed that the obesity and abdominal obesity are among the most important health problems within South East of Iran. Therefore, it can be suggested that an interventional approach is needed in order to change people's lifestyle, which by itself may also have an important effect in reducing morbidity and mortality from other chronic diseases

[Critical appraisal of the submitted theses by medical students of Rafsanjan medical school during 1993- 2003]

Submitting thesis is one of the most important tasks of medical students. Moreover medical theses can be considered as a basic source for improving the health statues of the society. The aim of this study was critical appraisal of the submitted theses by medical students of Rafsanjan Medical School during 1993- 2003.In the present cross- sectional study, 332 Medical theses were evaluated by using a questionnaire. Data analysis was done by using simple descriptive methods and Chi- square test.According to the results, 258 theses [77.7%] have been well written. Theses submitted during the recent years had better quality comparing to others [92.4% versus 73.9%]. Theses supervised by more than one leader were better in comparison to those with only one leader [91.5% versus 73.9%, P= 0.002]. Moreover theses with at least one advisor had a better quality than those conducted without any advisor [88.4% versus 39.7%, P= 0.0001].Better quality of theses submitted during the recent years can show the beneficial effect of participation of both medical students and their supervisors in Research Methodology Workshops held in the recent years. This fact has also been reported in other studiesSubmitting thesis is one of the most important tasks of medical students. Moreover medical theses can be considered as a basic source for improving the health statues of the society. The aim of this study was critical appraisal of the submitted theses by medical students of Rafsanjan Medical School during 1993- 2003.In the present cross- sectional study, 332 Medical theses were evaluated by using a questionnaire. Data analysis was done by using simple descriptive methods and Chi- square test.According to the results, 258 theses [77.7%] have been well written. Theses submitted during the recent years had better quality comparing to others [92.4% versus 73.9%]. Theses supervised by more than one leader were better in comparison to those with only one leader [91.5% versus 73.9%, P= 0.002]. Moreover theses with at least one advisor had a better quality than those conducted without any advisor [88.4% versus 39.7%, P= 0.0001].Better quality of theses submitted during the recent years can show the beneficial effect of participation of both medical students and their supervisors in Research Methodology Workshops held in the recent years. This fact has also been reported in other studies