Journal of Arak University Medical Sciences
Year:2022 | Volume:25 | Issue:2 (156)|Papers Count:12

Background and Aim Coronavirus disease 2019 (COVID-19) is a respiratory disorder that can affect many body systems, including the hemostatic system. In this study, we aim to investigate the role of hemostatic system and the blood coagulation in COVID-19. Methods & Materials In this review study, the articles were searched using the keywords COVID-19, Respiratory infection, and Coagulopathy in Google Scholar, PubMed, Google Springer and Science Direct databases. Ethical Considerations Ethical principles in writing this article were observed in accordance with the guidelines of the National Ethics Committee and the Committee on Publication Ethics (COPE). Results Many changes in the coagulation profile of infected patients were reported, including changes in the platelet count, fibrinogen/fibrin degradation product, D-Dimer, fibrinogen, prothrombin time, and activated partial thromboplastin time. With the increase in the number of patients with COVID-19, several studies found out the occurrence of thrombosis and coagulopathy in patients. Conclusion Due to the increase in the occurrence of coagulation disorders in patients with COVID-19, the administration of anticoagulants is needed for their treatment,it can play an effective role in improving the prognosis of patients.

Background and Aim Adropin is a new hormone plays an important role in improving lipid metabolism and vascular protection. The current study aims to determine the effect of eight weeks of high-intensity interval training (HIIT) on Adropin level and nitric oxide (NO) metabolites in overweight men. Methods & Materials This is a quasi-experimental study with a pre-test/post-test design. Participants were 32 overweight men (Mean±, SD age: 30. 5±, 3. 07 years, BMI: 27. 93±, 4. 2 kg/m2). They were randomly divided into two groups of HIIT (n=16) and control (n=16). The VO2max test was first conducted. Then, the HIIT group performed 8 weeks of HIIT (3 days per week) at 20 sessions of 30 seconds with a 13-s interval between each session. Body composition was measured using a bioelectrical impedance analyzer and the blood sampling was done for measuring Adropin and NO metabolites by ELISA kits in pre-test and post-test phases. The data analysis was done by repeated-measures ANOVA. The significance level was set at P<0. 05. Ethical Considerations This study was approved by the ethics committee of the University of Tehran (Code: IR. UT. REC. 1395007). All procedures were in accordance with guidelines of the declaration of Helsinki. Results There was a significant difference in Adropin between HIIT and control groups (0. 88±, 0. 256,95% CI: 0. 26-1. 5 ng/mL). There was also a significant difference in NO metabolites between the two groups (7. 5±, 3. 03,95% CI: 0. 85-14. 15 ng/ml). Moreover, there was a positive relationship between Adropin and NO metabolites in overweight men (r=0. 498, P=0. 0001). Conclusion It seems that HIIT can attenuate cardiovascular diseases by increasing Adropin and NO and can improve cardiovascular fitness (VO2max) and body composition of men with overweight.

Background and Aim Evidence shows that vitamin D deficiency and obesity are associated with impaired physical and mental health. This study aims to investigate the effect of Pilates and vitamin D supplementation on quality of life and mental health of overweight men. Methods & Materials This is a randomized clinical trial with a pre-test/post-test design. Fifty overweight men were selected by a convenience sampling method and were randomly divided into four groups of control, exercise, supplementation, and exercise+supplementation. The exercise and combined groups performed 8 weeks of Pilates at an intensity of 50-75% of heart rate reserve, three sessions per week. The supplementation and combined groups received 50, 000 IU vitamin D capsule once per week. Assessment tools were the 36-item Short Form survey (SF-36) and the General Health Questionnaire (GHQ). The data were analyzed by paired t-test, one-way ANOVA and Kruskal-Wallis test. P˂, 0. 05 was statistically significant. Ethical Considerations This study was approved by the research ethics committee of Islamic Azad University, Babol Branch, Iran (Code: IR. IAU. BABOL. REC. 1398. 088). Results Vitamin D status in subjects was lower than normal (<30 ng/mL) at baseline. Eight weeks of Pilates alone, vitamin D intake alone, and the combined intervention led to a significant increase in SF-36 (10. 57%, 9. 26% and 15. 75%, respectively) and GHQ (12. 66%, 10. 72% and 17. 90%, respectively). However, the effect of combined intervention was higher on the SF-36 (P<0. 001) and GHQ (P<0. 001) scores compared to two other interventions. Conclusion It seems Pilates alone, vitamin D supplementation alone, and their combination can improve the quality of life and mental health in overweight people with vitamin D deficiency, where the combined intervention is more effective.

Background and Aim Recently, a myokine called irisin has been discovered that affects glucose level, obesity, metabolism and glucose homeostasis by browning of white adipose tissue and heat production. This study aims to evaluate the effect of four weeks of ginger supplementation followed by acute eccentric and concentric training on irisin and insulin levels, insulin resistance index, and lipid profile of young women with obesity. Methods & Materials This is a randomized clinical trial. Participants were 50 young women (BMI >30 kg/m2, age: 24. 86±, 2. 87 years, height: 159. 66±, 4. 20 cm, and weight: 87. 42±, 4. 61 kg). After measuring their maximum oxygen consumption, they were randomly divided into five groups, two groups of supplementation, two groups of placebo, and one control group. The training protocol consisted of two sessions of acute eccentric and concentric activity. The supplementation groups consumed 2 g of ginger powder daily for 4 weeks. Blood samples were collected before and immediately after each activity. Data were analyzed using dependent t-test and one-way analysis of variance (ANOVA). Ethical Considerations This study was registered by Iranian Registry of Clinical Trials (Code: IRCT201104246178N1) and was approved by the ethics committee of Ilam University of Medical Sciences (Code: IR. MEDILAM. REC. 1395. 192). Results The irisin and insulin levels between increased and the glucose level decreased significantly in the supplementation groups (P<0. 05). The change in insulin resistance index was not significantly different among the study groups (P>0. 05). Based on the results of one-way ANOVA, triglyceride and low-density lipoprotein levels decreased significantly (P<0. 05), but the high-density lipoprotein level showed no significant difference (P<0. 05). The total cholesterol level was not significantly different in terms of exercise type (P> 0. 05) but was significantly different in terms of supplementation type (P<0. 05). Conclusion Long-term consumption of ginger along with regular exercise can be an effective method for lowering glucose level and causing favorable changes in irisin level, insulin resistance, and lipid profile in young women with obesity.

Background and Aim Most heart diseases show symptoms on ECG, but diagnosing heart disease with ECG requires the knowledge and experience of medical specialized. Because these specialists may not always be available, it is necessary to design tools to diagnose heart disease in these situations. In this paper, a two-stage approach based on artificial neural networks is designed to diagnose heart disease using ECG information. In this study, we aim to propose a two-stage approach using artificial neural network (ANN) to diagnose heart disease based ECG data. Methods & Materials To design the proposed approach, first the ECG data of 861 patients referred to medical centers in Arak, Iran were collected. The data were examined based on the opinions of specialists. Then, 154 features from ECG were used as inputs to the proposed model. In the first stage, an ANN was used to detect the ECG status (usable and unusable). In the second stage, using the usable ECG data, an ANN was used to diagnose the presence or absence of heart disease. Finally, the performance of the two-stage approach was evaluated and its accuracy and precision in determining the ECG quality and heart disease diagnosis were determined. Ethical Considerations This study was approved by the ethics committee of Arak University of Medical Sciences (Code: IR. ARAKMU. REC. 1400. 138). Results In the proposed approach, the ANN used for the determining the ECG status had a precision of 97. 1% and an accuracy of 97. 3%. The ANN used for the diagnosis of heart disease had a precision of 95. 8% and an accuracy of 95. 4%. Conclusion Considering the high efficiency of the proposed approach in determining of ECG status and diagnosing heart disease, it is possible to use this approach to help the treatment staff.

Background and Aim Emotional/social problems in childhood are associated with delinquency in adolescence, violence in adulthood, and anxiety disorders. This study aims to investigate the role of parents’,stress and perceived social support in predicting children’, s emotional/social problems. Methods & Materials This is a descriptive-correlational study. The study population includes all parents and their children referred to health centers in Pardis, Tehran, Iran in 2020 who had children under 5 years of age. Of these, 230 parents were selected by a convenience sampling method. Data collection tools were the Parental Stress index, the multidimensional scale of perceived social support and the child behaviour questionnaire-parent form. For data analysis, multiple regression analysis was used in SPSS software, version 25. Results Among participants, 42. 6% were employed and 57. 4% were housekeeper. The mean age of participants was 28. 42±, 12. 5 years. The results showed that parents’,stress and perceived social support had a significant role in predicting children’, s emotional/social problems such that they explained 44. 7% and 8. 9% of the variance in children’, s emotional/social problems. Conclusion Parents’,stress and support from friends can be effective in predicting emotional/social problems of their children.

Background and Aim Old age is a critical period in life. Due to advances in technologies and improvement in healthy conditions, the number of aged population is increasing. Hence, it is necessary to pay attention to their life satisfaction and attitudes towards aging. The present study aims to assess the effectiveness of a psychological empowerment program on life satisfaction and attitude towards aging in older women living in Tehran, Iran. Methods & Materials The study population consists of all women aged 60-70 years referred to a charity foundation in Tehran, Iran in 2020. Of these, 24 women were selected by a convenience sampling method. They were randomly assigned to the intervention (n=12) and control (n=12) groups. Using a pre-test/post-test design, the elderly first completed the life satisfaction index-Z and the attitude towards aging questionnaire. Then, the experimental group received the psychological empowerment program at 8 sessions. After the intervention, the questionnaires were completed again by both groups. Multivariate analysis of covariance was used to analyze the collected data in SPSS software, version 19. Ethical Considerations This study was approved by the Research Ethics Committee of Islamic Azad University of Arak Branch (Code: IR. IAU. ARAK. REC. 1400. 027). Results There was a significant difference in life satisfaction (F=9. 673, P=0. 006) and attitudes towards aging (F=8. 385, P=0. 009) between the two groups. The psychological empowerment program significantly improved life satisfaction and attitudes towards aging in older women. Conclusion The psychological empowerment program is effective in improving life satisfaction and attitude towards aging in older women living in Tehran. It can be used by experts in the fields of counseling, geriatrics, psychology, and health.

Background and Aim The high use of pesticides has increased the concern about its possible harm to individual and environment health. Chronic exposure to pesticides has serious effects on different body organs even before the onset of clinical symptoms. In this study, we aim to evaluate clinical and biochemical characteristics of male workers in a pesticide production factory in Guilan province, Iran. Methods & Materials This cross-sectional study was conducted on 99 male workers exposed to pesticide and 107 people without exposure who were employed in a pesticide production factory in Guilan and selected using a convenience sampling method in 2020. Their demographical data as well as clinical characteristics such as respiratory symptoms (cough, shortness of breath, etc. ), neurological symptoms (fatigue, tremors, cramps, muscle weakness, etc. ), psychological symptoms (sleep disorders, anxiety, etc. ) and skin symptoms (redness, itching, etc. ) were collected from the occupational health records of the workers. Finally, the biochemical parameters were compared between the two groups. Statistical analysis was performed in SPSS software, version 16. Ethical Considerations This study was approved by the Research Ethics committee of Guilan University of Medical Science, Rasht, Iran (Code: IR. GUMS. REC. 1399. 632). Informed consent was obtained from all participants in this study. Results The frequency of symptoms such as headache, itchy skin, cough, and sleep disorders was higher in the exposed group (P<0. 05). Based on the biochemical findings, blood urea level, creatinine level, alkaline phosphatase, and fasting blood sugar level were significantly higher in the exposed group (P<0. 05). Thrombocytosis was observed in 9. 09% of exposed workers, which was higher in those with more than 11 years of work experience. Conclusion Chronic exposure to pesticide can cause thrombosis, changes in biochemical parameters, and clinical symptoms. It is recommended that biological monitoring should be conducted in exposed workers at a shorter interval.

Background and Aim This study aims to investigate the effect of nurses’,autonomy on the quality of patient care based on Kramer and Schmalenberg’, s model Methods & Materials This is a causal-comparative study. Participants were 101 nurses of Imam Khomeini Hospital in Arak, Iran from the intensive care unit and internal medicine, surgery, pediatrics, gynecology, orthopedics, and emergency departments. The data collection tools were Moghimi and Ramazan’, s patent care quality questionnaire and an autonomy assessment questionnaire based on Kramer and Schmalenberg’, s autonomy model. The data were analyzed in SPSS software. Ethical Considerations This study was approved by the ethics committee of Islamic Azad University of Arak Branch (Code: IR. IAU. ARAK. REC. 1397. 66). Results The mean autonomy score of nurses was 3. 16 ±, 0. 35, indicating a desirable level. Nurses of all departments had limited autonomy. In the internal department, nurses had unsanctioned autonomy, while in the surgical department, they had autonomous nursing care action. The regression models were significant for all departments except for the internal department. With an increase of one unit in limited autonomy in the intensive care unit, autonomous nursing care in the surgical department, and limited autonomy in pediatrics, gynecology, orthopedics, and emergency departments among the nurses, the quality of care can be increased by 0. 253, 0. 187, 0. 522, 0. 205, 0. 466 and 0. 129, respectively. Conclusion Nurses’,autonomy can increase the quality of patient care. The nursing managers need to empower nurses and provide an environment for them to apply their knowledge in practicing autonomy.

Background and Aim The internationalization of higher education is an effective strategy to meet the diverse needs of a society. One of the factors determining the failure or success of internationalization is the organizational culture of universities. The present study aims to investigate the role of organizational culture-related factors in the internationalization of Iranian universities. Methods & Materials This is a quantitative-quantitative study. Participants were 124 Iranian experts in higher education and those involved in internationalization of universities. A researcher-made questionnaire was used as a self-report tool with close-ended questions. In the quantitative stage, structural equation modeling and first-and second-order factor analysis were performed in SPSS and AMOS software. Ethical Considerations This study was approved by the ethics committee of Islamic Azad University, Rasht Branch (Code: IR. IAU. RASHT. REC. 1400. 035) Results The ranking of factors affecting the internationalization of Iranian universities showed that the factor with the highest factor loading was “, communication & interaction”,(1. 03) and the factor with the lowest factor loading was “, human/physical/financial resources”,(0. 87). Conclusion Communicat, ion/interaction of universities with other education centers, as an organizational culture-related factor, plays an important role in the internationalization of Iranian universities.

Background and Aim Sciatica is one of the most common diseases of the peripheral nervous system and may be caused by pressure on the sciatic nerve. Due to the fact that piriformis muscle located near the sciatic nerve, piriformis muscle spasm may put pressure on the nerve and cause sciatica and consequently piriformis syndrome. The present study aims to investigate the effect of core stability exercises on pain and inflammation of patients with piriformis syndrome. Methods & Materials This is a randomized clinical trial. The study population consists of all patients with piriformis syndrome referred to medical centers in Arak, Iran from. Of these, 20 were purposefully selected and randomly divided into two groups of control (n=10) and exercise (n=10). The exercise group performed core stability exercises for 6 weeks, while the control group continued their normal life during this period. To examine the differences between the study groups, t-test, Chi-Square test, and McNemar’, s test were used. The significance level was set at 0. 05. Ethical Considerations This study was approved by the Ethics Committee of Arak University of Medical Sciences (Code: IR. ARAKMU. REC. 1400. 157) and was registered by Iranian Registry of Clinical Trials (ID: IRCT20211003052662N1). Informed consent was obtained from all participants. Results The Mean pain score in the control group decreased from 95. 2 to 90. 7 after the exercise, which was not statistically significant (P=0. 562). In the exercise group, the mean pain score decreased from 91. 7 to 33. 4, and this decrease was statistically significant (P=0. 0),Therefore, at 95% confidence interval, we can say that core stability exercises had a significant effect on the pain of patients with piriformis syndrome (P<0. 05). The number of patients with inflamed nerve in the control group decreased from 10 in the pre-test phase to 8 in the post-test phase, but this decrease was not statistically significant (P=0. 5). In the exercise group, it was reduced from 10 to 2, and this decrease was statistically significant (P=0. 008),Therefore, we can say that core stability exercises had a significant effect on the inflammation of patients with piriformis syndrome (P<0. 05). Conclusion Core stability exercises can reduce pain and inflammation in patients with piriformis syndrome. These exercises can be used in the treatment of these patients.

Background and Aim Crisis management is an important field of management, especially in the field of health. This study aims to investigate the factors affecting the development of disaster management mechanisms in hospitals of Arak, Iran. Methods & Materials In this regard, 240 questionnaires were distributed among hospital and nursing managers in Arak. The questionnaire had acceptable reliability with Cronbach’,alpha value of 0. 897. Ethical Considerations This study was approved by the ethics committee of Arak University of Medical Sciences (code: 1274. 1401. REC. ARAKMU. IR). Results Then, by using structural equation modeling in LISREL software, the designed model was analyzed. Finally, by using statistical tests, the research hypotheses were examined. Conclusion The results showed the significant effect of three factors of “, lack of stability in business environment”, , “, risk taking”, , and “, organizational culture”,on the development of the mechanism of crisis management.