Razi Journal of Medical Sciences
Year:2020 | Volume:27 | Issue:5|Papers Count:25

Background: Acquired immune deficiency syndrome is an epidemic in various communities caused by the Human Immuno deficiency Virus (HIV) and exposes people to opportunistic infections and various malignancies. Studies show increase in neurological disorders in people with AIDS. Brain-derived neurotrophic factor (BDNF) is a member of the neurotrophin family that plays an important role in survival, differentiation and cognitive function. Serum BDNF levels have been shown to decrease in HIV patients. Therefore, decreased BDNF levels may be a risk factor for exacerbating neurological disorders in people with AIDS. In addition, studies show that people living with HIV have more psychological disorders that affect their quality of life. Exercise is a treatment strategy performed by people living with HIV as well as rehabilitation professionals to reduce disorders and improve or maintain the health of people living with HIV. Several studies have examined the effect of exercise on quality of life in patients with human immunodeficiency virus infection HIV. Some studies have reported significant positive changes in the quality of life of people with HIV after exercise therapy. Also have been reported increased BDNF levels following exercise in patients with cognitive impairment and neurological disease. Considering the important role of exercise training in health and prevention and treatment of diseases, especially HIV, it seems that the study of the effects of exercise in these patients is of great importance, Therefore, the aim of this study was to investigate the effect of training on level of BDNF level and quality of life in HIV-infected patients. Methods: This is a semi-experimental study. The statistical population of this study consisted of all patients with human immunodeficiency virus infection in the Public health department in Islamshahr, Iran who were invited to participate in this study. 30 AIDS patients were targeted and accessible selected and randomly divided into two groups; combined training and control. The combined training program was run for 12 weeks and 3 sessions per week. Aerobic training involves walking or jogging on the treadmill with a rising intensity and duration of 40% to 65% of maximum heart rate and a duration of 30-60 minutes. Also, Strength training includes 2 to 4 sets and 12 to 20 repetitions per isotonic device in the range of 40% to 60% 1RM. Serum BDNF levels were measured using the ELISA kit, also Quality of life was measured by SF36 health questionnaires. Data were analyzed by independent and dependent t-test at the p<0. 05. Results: The results showed that after 12 weeks of combined exercise the level of BDNF in acquired immunodeficiency (AIDS) patients decreased non-significantly (p=0. 451), also combined exercise significantly improved the quality of life in patients with acquired immunodeficiency (p=0. 037). Conclusion: The findings of the present study show that regular combination exercise can prevent further reduction of BDNF levels in HIV patients, so it may play an important role in reducing central nervous system disorders in these patients. The findings of this study were consistent with the results of Previous research. Various mechanisms that alter BDNF levels are the production of IGF1, neurochemicals such as corticosteroids, intensity of training, age, increased neural activity, or altered activity patterns during exercise. HIV is associated with increased stress, and these patients are exposed to increased levels of stress hormones, so it is possible that increased stress hormones reduce BDNF levels. One of the important reasons for improving the quality of life is increasing patients' self-confidence and ability to overcome special circumstances as a result of comprehensive patient support in the exercise program. Also, exercise can increase the quality of life by increasing exercise capacity and improving mood. Exercise is effective in the mental health of HIV patients and increases confidence, health, feelings of intimacy and happiness, with reducing depression and anxiety and overall increases the quality of life of patients. There were some limitations in the present study, such as the lack of measurement of other cognitive factors. Measurement of endocrine factors, catecholamines, and the internal opioid system after exercise can also help to better explain and interpret the results in HIV-infected patients. According to the results, it seems that regular combined exercise can prevent further decrease of BDNF levels in HIV patients and as a behavioral intervention and complementary therapy play an important role in improving the quality of life of patients. Therefore, it is recommended that HIV patients benefit of regular combination training.

Background: The development of health among different sections of society is the main concern of researchers in todaychr('39')s world. In this regard, it is one of the useful ways to develop the health of sports and physical activity. So that physical activity causes psychological and social development of young people and the elderly, personal growth and development. Finally, those who exercise have a higher quality of life than non-athletes, and through exercise, knowledge of nutrition, exercise and health can be developed. For this reason, over the years, the role of exercise and physical activity in society has become increasingly important not only for the individual but also for public health. What is vital and very important in this regard is the issue of continuing physical activity and exercise, because maintaining health benefits requires continuous participation in physical activity and sports. In this regard, research has shown that regular physical activity and exercise provide numerous health benefits. However, the benefits of physical activity and exercise are not achieved by cross-sectional, occasional, and sporadic presence, although having minimal physical activity is better than no physical activity at all. To this end, physical activity guidelines recently recommend regular and continuous participation in physical activity. However, in all parts of the world, a large number of people in the community have not yet taken the impact of physical activity and sports seriously. For this reason, different countries are trying to adopt solutions to combat inactivity, as well as to encourage people to participate regularly and continuously in physical activity and sports and to gain health, vitality and vitality. One of these approaches is public sports or sports for all, which tries to create equal opportunities for people with any cultural, racial, economic, gender or other differences to participate in cheap and fun sports activities. Public sport is necessarily a philosophy, a message to motivate citizens to participate in sports and ultimately health. The tendency of people towards public sports and its positive effect on the physical and mental health of managers and officials leads them to study methods that increase the number of participants in public sports. Certainly, the coherent view of these groups will lead to progress in this regard; As these perspectives differ, the lack of coordination between the perspectives challenges the planning work for the development of grassroots sports. Therefore, it is necessary to coordinate between policy makers and planners in each country. Methods: The present study is a descriptive-correlational study that was conducted with the structural equation model approach. The statistical population of this study included 354 people including the Director General of Sports and Youth of Khuzestan Province, Deputy Chiefs of Staff of the General Directorate, Deputy of Women Affairs of the General Directorate, Heads of Sports Departments of the General Directorate, Sports Experts of the General Directorate, Heads of Sports Boards, Vice Chairman of Sports Boards, Secretaries of Sports Boards And sports management experts in Khuzestan province. According to Schumacher and Lumex, for structural modeling equation studies, the minimum sample size is 200 to 600 people. Given that there were no questionnaires or standard scales for measuring research variables, the researcher reviewed the sources and documents and articles related to the research topic; Also, asking for opinions from professors, experts and managers of physical education and sports in the country, a researcher-made questionnaire was prepared, which included 56 questions and a five-point Likert scale. This questionnaire consisted of two main parts: personal information and managerial background. After analyzing the questions of the researcher-made questionnaire using tests of degree of difficulty, discrimination coefficient and loop method, we used exploratory and confirmatory factor analysis to determine the validity of this questionnaire. Descriptive statistics (frequency, frequency percentage, mean and standard deviation), skewness and elongation test were used to evaluate the normality of the data and the measurement model was used to evaluate each of the factors affecting the development of public sports to promote health as inferential statistics. All analyzes were performed at 95% confidence level using SPSS 19 and AMOS 22 software. Results: The results of the present study showed that the managerial factor with a factor load of 0. 743, the resource factor with a factor load of 0. 761, the behavioral factor with a factor load of 0. 716 and the environmental factor with a factor load of 0. 785 have effect on health development. In addition, the hypothetical model of research on health development in Khuzestan province with a public sports approach has a favorable fit. The results of the research showed that the environmental factor of public sports was the most important factor in the development of health in Khuzestan province, followed by resource, managerial and behavioral factors, respectively. Each factor or variable in institutionalizing an action or behavior has three functions: regulatory, normative, and cognitive functions. Regulatory factors seem to be an important and fundamental behavior in the early stages of institutionalization. Because public sports in the country is at the beginning of its path and is not so developed, it requires more structure and framework for expansion and development. Therefore, environmental factors can cause the structuring and framing of public sports and ultimately institutionalize health and vitality in society, because it seems that the regulatory function of environmental factors is greater than other functions. Conclusion: In general, the results of this study show that public sports is one of the factors affecting the level of health in Khuzestan province and public sports is also affected by managerial factors with managerial, resource, behavioral and environmental subscales. The role of behavioral factors in institutionalizing health behavior in public sports is very important and fundamental, because these factors provide the ground for acceptance and continuation of physical activity and sports behavior in individuals. However, a set of behavioral factors were ranked last in the factors affecting the institutionalization of health through public sports in Khuzestan province. Perhaps the reason is that the functioning and effectiveness of behavioral factors depend on the good performance of other factors, and until other factors do not work well, these factors can not have a good performance and impact, therefore, in terms of respondents are in the last place. Such a priority seems logical since public sports are in the early stages of formation and growth and requires focusing on other factors, especially environmental factors to shape and frame public sports in society. This is because the proper functioning of the set of environmental factors may results in structuring and framing of the public sports. In addition, resource and managerial factors play an important role in promoting and properly guiding environmental factors. It is possible that the respondents are of the opinion that first public sports will find a special place, structure and system in Khuzestan province and then its institutionalization in the existence of each individual in the society will be on the agenda. This framework can institutionalize public sports as an activity. Facilitate a body that promotes health and vitality in the existence of each individual in the society.

Background: Ectopic pregnancy (EP) is the most common cause of death in pregnant women in the first trimester of pregnancy and causes 10% of maternal mortality. It is a common complication in the world and its prevalence varies in different countries. Only one-third of women, who have had an ectopic pregnancy with tubal rupture, can have live birth in the future. Ectopic pregnancy treatment depends on the patientchr('39')s clinical condition and desire to maintain fertility in the future. Early diagnosis and treatment of Ectopic pregnancy has been associated with a reduction in female mortality and has shifted treatment to conservative methods. In vitro evaluation, low levels of BHCG are the cornerstone of the diagnosis of EP. Immunological examination of HCG with a sensitivity of 25 mIU/ml is an accurate test for ectopic pregnancy. The standard treatment for EP is laparoscopic surgery and in cases of hemodynamic instability or in cases where the laparoscopic method is difficult, laparotomy is performed. The most widely used drug for medical treatment is methotrexate, which is used in a single-dose or multi-dose method with specific criteria. For the first time, Tanka et al. Introduced EP treatment using methotrexate (a folic acid analog). Methotrexate is a folic acid analog that inhibits the function of dihydrofolate reductase and inhibits DNA production. Methotrexate actively affects growing cells such as trophoblastic tissue, malignant cells, bone marrow, intestinal mucosa, and respiratory epithelium. This drug is widely used in the treatment of trophoblastic diseases. Initially, methotrexate was applied topically to residual trophoblastic tissue following ectopic pregnancy. About 35% of patients with ectopic pregnancies are candidates for initial treatment with methotrexate. In cases of stable ectopic pregnancy after surgery, the use of this drug is also indicated. Medical treatment is considered due to less damage to the tube, lower cost, increasing in fertility, elimination of surgical complications and anesthesia. Medical treatment for ectopic pregnancy with methotrexate is both harmless and effective; But it cannot be used in all patients. According to the recommendations of the American School of Midwifery and Gynecology, methotrexate can be prescribed in patients with proven ectopic pregnancy or, most likely, in patients with stable hemodynamic conditions and in the absence of evidence of rupture. Patients who cannot complete the follow-up period after drug administration should not be a candidate for medical treatment. Due to the relatively high prevalence of ectopic pregnancy and its potential side effects, in this study we aimed to evaluate the efficacy of methotrexate in ectopic pregnancy patients. Methods: In this descriptive-analytical-cross-sectional study, all pregnant women with ectopic pregnancies admitted to the gynecology ward of Ali Ibn-e Abitaleb Hospital of Zahedan in 2017 according to IR. ZAUMS. REC. 1397. 2120 ethics code were examined. Inclusion criteria included, diagnosis of ectopic pregnancy based on transvaginal ultrasound and B HCG titration and treatment with methotrexate for ectopic pregnancy and exclusion criteria included receiving surgical as the first step in treatment of ectopic pregnancy. 169 cases that were performed during a one-year period with easy and accessible sampling to review patientschr('39') medical records. In this study, the aim of this study was to evaluate the efficacy of single-dose methotrexate in patients with ectopic pregnancies, response to treatment with methotrexate and the need for surgery. 169 patients who were initially treated with single-dose methotrexate ampoules at a dose of 50-100 mg based on the patientchr('39')s weight with a diagnosis of ectopic pregnancy in the gynecology ward and were followed on days 4, 7, 11of methotrexate injection by BHCG test (the decision for the next doses of methotrexate was made based on the test results) was extracted from the archive of Ali Ibn-e Abitaleb hospital and the necessary data were recorded in the information form. Finally, the obtained data were entered into SPSS software for statistical analysis. To describe the data, descriptive statistics including statistical tables and graphs, frequency in percentages and central index such as middle and view were used. Results: The total number of reviewed cases was 169, of which 114 (67. 5%) responded to methotrexate treatment and 55 (32. 5%) did not respond to treatment. According to the test results, there is a significant difference between these two groups (p<0. 001). The mean gestational age in patients who responded to methotrexate at the time of diagnosis of ectopic pregnancy was (5. 91± 2. 55 weeks) also the mean gestational age in patients who did not respond to treatment (8. 89± 2. 63 weeks). According to the test results, a significant difference (p<0. 001) was observed between the two groups, which indicates that the younger gestational age response to the treatment. The mean mass volume in patients who responded to methotrexate treatment was (1. 76± 0. 60), also the mean mass volume in patients who did not respond to treatment (2. 73± 1. 12), there is a significant difference between the two groups p<0. 001. Also, according to the result of Spearman test (R=-0. 40), this relationship is inversely and significantly with moderate correlation. The initial BHCG value in the group that responded to treatment was 10341. 49± 25848. 08 while in the non-response group, was 19895. 73± 40235. 31. The result of the statistical test din not showed a significant difference. In these two groups (p=0. 11). The final BHCG in the responsed group was equal to (850. 68± 957), and in the non-responder group was equal (31959. 12± 49380. 37). The test results show a statistically significant difference (p<0. 001) between the two groups. Due to the higher BHCG in the non-responder group and the low BHCG in the treated group, the numbers will be predictable. This study also showed that there is a direct and potential relationship between the final BHCG value and the therapeutic response to methotrexate. Conclusion: In general, in the present study, methotrexate therapy shows a significant and logical response. Also, the factors of gestational age at the time of diagnosis, the initial and final HCG β values, as well as the volume of the observed mass able to affect the treatment in the study.

Background: Accidents and emergencies associated with natural or human-made environment have been occurring on the earth in recent years. There should be precise and effective reactions against critical incidents and urgent conditions. Firefighters are the first group attending in the place where important urgent accidents occur in order to cope with such incidents. They are responsible for citizens’ safety and some functions such as firefighting, rescue people, preventive measures by evaluating risks against life and properties of people, and medical aids. On the other hand, accidents may negatively affect the people involved in the incidents as well as their quality of life and social relationships. World Health Organization (WHO) defines quality of life as individuals’ perception of their position in life in the context of the culture and value systems in which they live and in the relation to their goals, expectations, standards and concerns. Furthermore, rescue team may tackle with emotions, irritability and frustration in accidents associated with immediate rescue conditions. Irritability is defined as the tendency to respond to aggressive feelings, impulsivity, hostility, and failure behaviors in disagreement. Moreover, the concept of distress tolerance covers a multidimensional nature including tolerance, assessment and acceptance of emotional state, emotional regulation method, and influence of negative affections and their impact on dysfunction. Distress tolerance represents itself in two forms: first, the individual’ s ability to tolerate negative emotions and second, behavioral presentations of tolerating unpleasant inner states caused by various stressors. A study was conducted on 643 firefighters in Kaohsiung City, Taiwan, 2006 and results indicated that 16. 7-19. 3% of rescue members experienced psychological diseases. A longitudinal study on rescuers attending in a warehouse explosion in residential area in Netherlands indicated an increase from 2. 9% (6 months ago) to 5. 3% (after the disaster) in number of rescuers who visited occupational physician because of psychological problems. These results are in line with previous findings indicating that exposure to disasters and catastrophes may cause health problems in rescuers so that they are at the risk of psychological problems. In addition, another relevant study proved that quality of life of people has effect on the inter-organizational relationships and professional tasks. Therefore, it is essential to examine quality of life, distress tolerance and irritability occurring in hard jobs, in particular firefighters who are at the risk of physical and mental harms. Hence, this study was conducted to investigate the quality of life, distress tolerance, and irritability among firefighters and comparing them with normal people. Methods: This was a descriptive study and its statistical population comprised some of firefighters involved in Plasco Building Incident and normal adults working in different professions during 2017. Sample size included 116 firefighters who were involved in Plasco Building Incident and 101 normal people. Random Cluster Sampling method was used. Inclusion criteria were as follows: firefighter involved in Plasco Building Incident, normal adults working in other professions and interest in participation; exclusion criteria included absence of firefighters in Plasco incident, those normal people who were not firefighters and lack of interest in participation in research. Data collecting tools included Quality of Life Questionnaire (SF-12), Distress Tolerance Scale, and Irritability Questionnaire (RIQ), which were filled out by participants based on self-report method. The collected data were analyzed through SPSS22 Software using mean and standard deviation at descriptive statistics as well as independent t test and multivariate (MANOVA) at inferential statistics. Results: MANOVA and independent t test were used to compare quality of life, distress tolerance and irritability among firefighters and normal individuals. Statistical presumptions of normal distribution of scores, homogeneity of variances and homogeneity of covariance matrixes were assessed before the abovementioned tests using Kolmogorov– Smirnov test, Levin Tests and Mbox test, respectively. These tests could be used due to unbiased assumptions. The Obtained results indicated no significant difference between quality of lives of firefighters and normal individuals; however, there was a significant difference between firefighters and normal individuals in terms of at least one of subscales of distress tolerance. Comparison between mean scores of groups indicated higher irritability among normal people relative to firefighters. Conclusion: Physical and mental health is considered as a key factor for productivity and progress in any profession or job so it is essential to any cause threating this health. Quality of life, irritability and distress tolerance are some of important psychological variables that improve performance and productivity of individuals in many of professions such as firefighting, which highly makes the person at the risk of physical or mental harms. As the quality of life, irritability and distress tolerance are the most substantial psychological variables in hard jobs such as firefighting, firefighters need a high physical and mental capacity in coping with critical and dangerous situations, which may lead to any physical or psychological harm. In fact, the obtained results indicate that some of significant psychological factors such as quality of life, irritability and distress tolerance should be considered to identify and employ workers of hazardous jobs such as firefighting. Therefore, research findings of this study indicate the importance of the case so that these findings can be used as a scientific evidence to make preventive and professional programs regarding optimal psychological performance of firefighters. In the end, it should be said that the present study had some limitations, including the fact that this study is a descriptive study and it is not possible to draw conclusions about cause and effect. Another limitation of this study was that this study was conducted in connection with firefighters involved in the Plasco accident and adults working in other occupations in Tehran. Therefore, the possibility of generalizing the results is limited; Therefore, it is suggested that a similar study be conducted with the present study in other communities. In addition, it is suggested that future studies examine qualitative and causal comparisons of psychological factors such as quality of life, irritability, and distress tolerance between firefighters and other occupations. Also, considering the important role of quality of life, irritability and tolerance of anxiety in the psychological state of firefighters and, consequently, the quality of their performance in critical situations, further studies can be sessions on the effectiveness of treatments related to quality of life, irritability and Examine the tolerance of distress.

Background: High-intensity interval training can improve aerobic power especially if they have active recovery periods. So that the athlete will be able to perform endurance activities at a higher speed. Immune, oxidative and inflammatory markers are factors that may appear with exercise and if there is no proper recovery period, they will have negative effects. One of these factors is Monocyte chemotactic protein-1, also known as factor 1, a chemical adsorbent for monocytes, and is produced by monocytes, endothelial cells, fibroblasts, and T cells. This factor increases the migration of monocytes from the bloodstream to the tissue and converts them into macrophages, and by inducing phagocytosis, it eliminates the infection from the body. Cell adhesion molecule is another factor. These molecules are glycoprotein receptors that are present on the outer surfaces of the cell membrane and can pass through the membrane and enter the cytoplasm. Adhesive molecules are important in directing the movement of white blood cells as well as their exit from the bloodstream to the lymphatic tissues, etc., especially areas of infection and inflammation. Some of these molecules are soluble in plasma and their presence indicates the degree of vascular endothelial dysfunction. Methods: The research method was experimental with an applied purpose. The study population was male Sprague-Dawley rats. Among them, sixty rats were selected for the study and randomly divided into four groups (interval training, interval training + supplement, resveratrol supplement and control). The training program was performed for eight weeks and five sessions per week. Resveratrol supplementation was done daily in the supplement and supplement + exercise groups. Resveratrol supplementation was given orally with a gavage syringe once a day for eight weeks in the supplement and supplement + exercise groups. In exercise and resveratrol groups, physiological serum was used to equalize gavage stress. The supplement and control groups had no exercise. Blood samples were taken 48 hours after the last training session and 10-12 hours of fasting in different stages and with similar conditions. Rats were profoundly anesthetized by a skilled veterinarian in accordance with ethical principles by intra peritoneal injection of a combination of ketamine and xylazine. At the end of the period, 5 ml of blood were taken from rats to measure the biochemical factors of Intercellular Adhesion Molecule-1 index. Blood samples were taken directly from the left ventricle of their hearts. The serum of the samples were then separated and kept at-70 ° C until the measurement of serum samples. Serum samples were separated by centrifugation for 15 minutes at 30 ° C and transferred to the laboratory to evaluate and evaluate changes. Visceral adipose tissue was also sampled to measure Monocyte chemotactic protein-1 protein concentration. An incision was made in the abdomen of the rats and the white visceral fat tissue were removed. White subcutaneous fat tissue were obtained from the groin just above the thigh. The resulting fat samples were immediately frozen in nitrogen and stored in the refrigerator at-80 ° C for subsequent measurements. At the end of the study period, the rats were facilitated. Blood samples were then transferred to a reference laboratory for analyzes. First the normality of the distribution of the main variables was checked using Shapiro-Wilk test and the homogeneity of variances was checked by Leven test. Mean, standard deviation statistical tests and one-way analysis of variance were used to determine changes. Then, Bonferroni post hoc test was used to analyze the data. All results were analyzed using SPSS and excel statistical software. Results: The highest mean for Monocyte chemotactic protein-1 and Intercellular Adhesion Molecule-1belonged to the interval intensity training group. The results showed that interval training had the highest increase on Monocyte chemotactic protein-1 and Intercellular Adhesion Molecule-1 and the largest decrease is in the resveratrol group. Changes Monocyte chemotactic protein-1 and Intercellular Adhesion Molecule-1 are significantly. There was a statistically significant difference between resveratrol supplementation, resveratrol supplementation and resveratrol supplementation + intense interval training groups with the control group. There was a statistically significant difference in the groups of interval intensity training, resveratrol supplementation and resveratrol supplementation + interval intensity training with the control group. Monocyte chemotactic protein-1 and Intercellular Adhesion Molecule-1 between the control group and the interval intensity training group with resveratrol supplementation were confirmed by Bonferroni test post hock (p≤ 0. 05). Conclusion: Monocyte chemotactic protein-1 of changes, showed that resveratrol + intensity interval training had a significant effect and reduced monocyte chemotactic protein-1. It is possible that the reduction in fat volume due to the training protocol was effective in reducing Monocyte chemotactic protein-1, and the anaerobic exercises designed in the protocol cause the production of free radicals and increased oxidative stress. Oxidative damage plays an important role in the production of inflammatory factors and mediators and strengthens the immune system and exercise training induced indicators inflammations including Monocyte chemotactic protein-1. Resveratrol supplementation with antioxidant properties has been able to enhances a wide range of biological functions focused on regulating oxidation and inflammation, and reduce pro-inflammatory cytokine levels and inflammatory responses. Resveratrol probably protects cells through its high antioxidant properties. The balance of oxidants and antioxidants is an important indicator of immune system function, and any disturbance in this balance causes oxidative stress. Therefore, the concentration of food antioxidants in immune cells is higher than other cells, and a lack of antioxidants disrupts the immune response. The protocol exercise considered in the study may have caused infection and pathogenic and harmful factors in the research samples. Which is activated and strengthened by the effect of resveratrol on the immune system and the intrinsic part of the acquisition, followed by a decrease in Monocyte chemotactic protein-1. The role of monocytes in the release of proteases from lysosomes and the destruction of oxygen and nitrous oxide free radicals is also debatable. Because it eliminates infectious factors and pathogens, it produces IL-8 and Monocyte chemotactic protein-1 cytokines. They activate lymphocytes and stimulate the inflammatory process to improve. The results showed that interval training with resveratrol decreased Intercellular Adhesion Molecule-1 and less adhesive molecules than the training group from endothelial secretion and adequate safety is provided. It is possible that the selected exercise was also involved in the study to reduce the weight and fatty tissue of the samples and helped to reduce Intercellular Adhesion Molecule-1. Exercise reduces inflammation and adhesion of leukocytes and platelets to the endothelium. Another effect of the training protocol could be the reduction of cell adhesion molecule synthesis agonists in adipose tissue. The role of resveratrol as a compound that improves and strengthens the immune system in the production of cytokines and anti-inflammatory agents and strengthens the production of immune cells is also significant. Improving the antioxidant status and increasing the oxidative capacity and counteracting free radicals has led to the development of the immune system and a decrease in the Intercellular Adhesion Molecule-1 index in the endothelium. It is recommended to use less intensity interval training and reduce the negative effects by using resveratrol if you use this type of training. Protocol exercise and resveratrol can reduce or prevent inflammation and strengthen the immune system. The natural and non-synthetic resveratrol is another factor that will develop the use of this compound among patients and athletes. Resveratrol supplementation improves the performance of beginner and professional athletes as well as cardiovascular, diabetic and morbidly obese patients on various parts of the body with metabolic effects, protection of the immune system and counteracting the effects of exercise and the side effects of vascular disease and obesity can work well. It is also recommended to use fruits and vegetables containing resveratrol such as grapes, chard and raspberries. The use of resveratrol supplementation and its effect on immune factors such as CRP, interleukins and HSPs may also be useful for future research.

Background: Patients with breast cancer feel helpless due to the type of disease and the treatment process and show a sharp decline in mental health. The purpose of the study was to develop an educational package to overcome learned helplessness (LH) and its effectiveness on mental health in women with breast cancer. Breast cancer is one of the most common types of cancer in women, which has more severe psychological and emotional effects than other types of cancer. Breast cancer accounts for about 30 percent of cancers in women which this number will increase to 11 million in 2030. There are many challenges during the treatment period include changes in medical care, fear of relapse, changing life roles, long-term effects of treatment (can be physical or psychological), loss of supports, lack of family and friends emotional support, can all be one of the main reasons for the decline in mental health in these patients. Diagnosing breast cancer is a very unpleasant and unbelievable experience for any person that can disrupt family life. Fear of death, severe stress and financial anxiety lead to the onset and increase in the severity of disorders such as depression. And physical health directly affects mental health status and overall quality of life. In this regard, identify and investigate the causes of mental health decline to provide therapeutic intervention not only affects the quality of life of individuals but also effects on their survival rate and increases their ability to fight disease. Examination of mental health factors in these patients shows that learned helplessness is an important factor that can weak the protection of a person’ s mental system against severe stress. Learned helplessness is an important and fundamental factor that makes people with cancer feel incapable of this problem and cannot properly use strategies and support resources. Methods: The purpose was to develop a training package to overcome helplessness of women with breast cancer in two stages. This study was a Simi-experimental pretest-posttest with control group. The study sample was selected by purposive sampling method and consist of 30 women with breast cancer who randomly assigned to experimental (15 subjects) and control (15 subjects) groups. Then, the participants in the experimental group participated in 12 sessions of 90 min of educational package to overcome learned helplessness. Then, the data were analyzed using statistical tests such as MANCOVA and ANCOVA. In the qualitative part of the study, the population of the experienced experts in sciences, managers and experts in the field of psychological intervention is positive. In the quantitative section, the population of the present study was the woman with breast cancer admitted to the Cancer Research Center and patients of Vali Aasr Clinic in Imam Khomeini Hospital. In the qualitative section of sampling method, the number of interviews, in other words, the sample size, depends on the theoretical saturation of the questions in question, so that if the investigator concludes that the answers given or the interviews conducted, they are closely resembled with informed individuals, leading to duplication of responses or interviews, and there are no new data, the interviews are enough and thus stop. In the quantitative section, 30 people were selected based on inclusion (age of the participants should be 20 to 50 years, being literate, lack of participation in other psychological periods in the past and present, at least 2 months past from the diagnosis and lack of disability or physical and mental illness preventing the presence of the patients) and exclusion criteria (absence of more than 2 sessions of participation in the sessions, any incapacity associated with the attendance of participants, and lack of willingness to continue receiving interventions) were selected purposefully. Instruments for gathering data were General Health Questionnaire (GHQ-28). This questionnaire has been developed to identify non-psychiatric disorders. It is used to diagnose mild mental disorders and to screen for non-psychotic psychological disorders in different societies and different situation, The text of the questionnaire is about boredom, discomfort and general health. This questionnaire with emphasis on psychological, physical and social issues at the present time and in this way, the person’ s symptoms and health conditions are evaluated. Results: The results of MANCOVA indicated that training to overcome learned helplessness improved mental health (F=56. 191, p=0. 000) in women with breast cancer. In addition, the results showed that the study intervention have significant impact on the components of mental health such as, physical function (F=6. 906, p=0. 000), anxiety (F=10. 307, p=0. 004), disruption in social functioning (F=11. 678, p=0. 002) and major depression (F=32. 378, p=0. 000). Conclusion: Based on research findings, using of educational package to overcome learned helplessness could have important role in improving the mental health of women with breast cancer. By concerning the explanation of effectiveness of the skills of overcoming learned helplessness and effectiveness on helplessness in women with breast cancer could reduce physical function and anxiety and disruption in social functioning and major depression. In deed by practicing on this skills, these kind of people will not have an inferiority style of depression that will activated when dealing with a negative life event and will not believe that the result is a negative event, and they will not do anything to change it. Since these patients are tired of the treatment process and the disease progresses more, they could learn how they will get out of feeling afraid. These studies often carried out in the context of positive psychotherapy, all show the effect and effectiveness of this approach on reducing helplessness and increasing mental health in a variety of ways. In general, despite the limitations of the study, the results showed that if the patients are helped to learn for accepting their feelings at the beginning of the illness and also learn to be aware of their mental awareness and thoughts and behavior in the present moment, and be able to separate himself from mental experiences (mind reading, catastrophizing, extreme generalization) and recognize their values and adopt an adaptive attributional style, they will be very resilient against the stresses of cancer in the way of improving mental health.

What is known about obesity Obesity occurs for many reasons, including heredity, poor nutrition, hormonal problems and the environment (inactivity). For this reason, after obesity or overweight, people decide to return to their previous ideal weight by using fat-burning supplements. Primarily, green tea has been ranked as a fat burner and supplement for many years. Of course, it is not possible to use sports supplements without doing sports activities. For this reason, the use of sports supplements along with sports activities with appropriate intensity and duration can cause very significant changes in body composition. There are many fat burning supplements that have a long-term negative effect on the body due to their chemical nature. For this reason, obese people are looking for natural fat burning supplements. In recent years, plants have been able to have significant effects on fat oxidation. Meanwhile, tea after water is one of the most widely consumed natural plants in the market, which has very few negative effects. Tea consumption in the world is typically 120 ml per day. The mechanisms of action of tea in relation to obesity include: increased hepatic metabolism, caffeine synergy, decreased appetite, exothermic stimulation and increased enzymes associated with fat burning. Among teas, green tea is one of the most popular natural herbal supplements in fat burning that most people around the world use this tea to increase fat oxidation. The main ingredients of most teas are epicatechin, epigallocatechin, epicatechin gallate and epigallocatechin gallate. There are four main types of tea that are produced depending on the type of processing, which include green, white, black and oolong tea. Studies have shown that oolong tea and black tea can both increase fat oxidation in obese and overweight people. But this fat burning effect is less than green tea. For this reason, extensive research has been done on green tea and its effect on fat oxidation, and researchers have been able to conclusively report that this tea can be a beneficial fat supplement. Meanwhile, several studies have been able to prove that white tea has more fat-burning substances than green tea. For this reason, it is possible that white tea is much more useful than most fat-burning teas. The naming of white tea by this name is due to the white silver villi of the immature buds of the tea plant, which gives it a white appearance, although its brew is pale yellow. In very limited research on laboratory mice, researchers have reported that white tea affects adipose tissue lipolysis. But so far, no research has been done on humans that in Iran for the first time the effect of white tea on fat oxidation in obese people was discussed. In this study, subjects poured 10 grams of white tea in 500 ml of boiling water and brewed it one hour before exercise. Finally, the researchers reported that consuming white tea one hour before exercise could increase fat oxidation in obese people. Therefore, according to the only current research on humans and similar animal research, this study examines the effects and compounds of white tea. In this review study, articles with the keyword’ s green tea, obesity, green tea and fat oxidation, green tea compounds, effects of green tea compounds, white tea, white tea and fat oxidation, white tea and weight loss, white tea compounds were selected. 120 articles related to the present study were found. Then, out of 120 articles, 43 articles did not correspond to the present study, so they were removed from the study. Finally, 77 articles in this review study were discussed by researchers. Discussion: Obesity is on the rise and the search for a beneficial supplement to improve fat oxidation is becoming increasingly important. The present study showed that tea can be prescribed as a plant and a healthy beverage for obese people to reduce body fat percentage. Also, in this specialized study, it was found that the ingredients of white tea are the same as green tea, with the difference that in some compounds, the amount of substances that affect fat oxidation is higher. This factor may raise the question of whether white tea can be superior to fat tea and other teas in fat oxidation. The necessity of this study is that due to the unfamiliarity of white tea and the anonymity of its ingredients, by doing this study, a new way will be opened for future researchers and researchers will show significant results with initial studies. Researchers can compare the effects of green and white tea on fat oxidation in both the short and long term to provide the results of this valuable tea. It is also possible to study the effects of this tea compared to other fat burners such as caffeine or other supplements at different times such as morning and evening and determine the best time to consume it. The strength of this review study was that it was able to first examine the importance of green tea through short-term and long-term research tables and then focus on past research on white tea, breaking down the ingredients of this tea. One of the weaknesses of this article was that due to the extensive search; The authors were able to find very little research on white tea. For this reason, it cannot be said with certainty that white tea can be 100% superior to green tea. But based on the study of its ingredients, it can be concluded that it can probably be superior to other teas in fat oxidation. Finally, this study states that white tea as a natural fat burner can be useful in the process of fat oxidation. But the consumption of this tea should be influenced by exercise in order to have significant effects on fat oxidation. Long-term exercise and consumption of green tea could play an important role in increasing oxidation. It is therefore probable; White tea can be used in long-term sports activities and have better effects. Therefore, these results can play a decisive role in directing future selective strategies to improve body composition and weight loss.

Background: In recent decades, the role of genetic factors in both secretion of insulin from the pancreas and insulin resistance in target tissues has got particular importance. Some genetic factors such as TCF7L2 and its polymorphisms or GLP-1 severely affect the synthesis and secretion of insulin from beta cells (2, 3). On the other hand, some other genetic components, such as FOXO1, PPARy, and FTO, also affect the energy homeostasis and metabolism of glucose and fat in target tissues such as skeletal muscles and fatty tissue. Membrane glucose transport is one of the most important determinants of hyperglycemia in type 2 diabetics. The purpose of this study was to determine the effect of aerobic training on the expression of 4-glucose transporter (GLUT4) in expression in gastrocnemius muscle in type 2 diabetic rats (T2D). Methods: In this experimental-applied study, eighteen 10-weeks-old male Wistar rats (220 ± 20 g), procured from the institutional animal house facility were used for all the experiments and after induction of T2D were randomly divided into exercise (aerobic training / 12 weeks, n = 8) and control (no training, n = 8) groups aimed to determine the effect of aerobic training on GLUT4 expression in gastrocnemius muscle. Sample size and the number of rats in each groups designed according to the same previous studies that assessed gene expression in diabetes rats in response to exercise training. Animals were maintained under standardized conditions (12-h light/dark cycle, 25 ± 2 ° C & humidity 45-55 %). The rats were left for 1 week for acclimatization prior to the commencement of the experiment. The study was approved by department of Exercise physiology of Amirkabir University of Technology, Iran and carried out in accordance with CPCSEA (Committee for the Purpose of Control and Supervision of Experiment on Animal) guidelines. T2D induced by STZ and Nicotinamide injection (dissolved in citrate buffer, pH 4. 5). Hyperglycemia was confirmed by elevated blood glucose levels on day 7 after diabetes induction and only animals with fasting blood glucose level between 150-400 mg/dl were selected for were served as T2D rats and used in the study. The exercise group participated in a 12-week aerobic exercise (5 days/weekly) in the form of running on the treadmill. Finally, 48 hours after the lasted exercise session, the fasting rats in both groups (with 10-12 hours overnight fast) were anesthetized through intraperitoneal injection of 10% ketamine at a dose of 50 mg/kg along with 2% xylosine at a dose of 10 mg/kg, after which they were underwent dissection. After the rats were anesthetized, blood samples were collected through cardiac puncture. Then, subcutaneous fatty tissue was removed and immersed in RNA later until biochemical analysis was performed for determine GLUT4 expression. The blood samples were used to analyze the blood glucose and serum insulin. The serum was separated by centrifugation (5 min, 3, 000 rpm) and was analyzed for glucose by glucose using a Cobas 6000 Analyzer (Roche, Germany). Glucose was determined by the oxidase method (Pars Azmoon kit, Tehran). The remaining serum samples were then stored at − 20 ◦ C until the insulin determination was made by ELISA method (Demeditec, Germany) and the intra-assay and inter-assay coefficient of variation of the method were 2. 6% and 2. 88 respectively. The RNA was extracted by Rneasy protect mini kit (QIAGEN) from subcutaneous fatty tissue according to manufactures instructions (19). RT-Real time PCR quantification of FTO mRNA was performed with Rotor gene 6000 system using One Step SYBR PrimeScript RT PCR kit (Takara co. ) according to manufactures instructions. Melting curve analysis was performed at the end of PCR cycles in order to validate the specificity of the expected PCR product. We used RNA Polymrasell as a normalizer. Data were analyzed by computer using the Statistical Package for Social Sciences (SPSS) for Windows, version 16. 0. Normal distribution of data was analyzed by the Kolmogorov-Smirnov normality test. Independent student t test was used for comparison of variables between two groups. A p-value of less than 0. 05 was considered to be statistically significant Results: Compare to control rats, Fasting glucose level decreased significant in response to aerobic training (p = 0. 001). Aerobic training also resulted in significant increase in GLUT4 expression in Gastrocnemius muscle (p = 0. 029). Conclusion: Based on the available evidence, a decrease in glucose levels in response to aerobic training in T2D rats can be attributed to an increase in GLUT4 expression in twin muscle. However, further studies are needed to identify other effective mechanisms on glucose levels in response to exercise training in diabetes rats.

Background: One of the most common chronic childhood disorders that have a significant impact on childchr('39')s health is functional abdominal pain. Children with functional abdominal pain often provide increased parental stress due to their disorder. Parental stress, which reflects the perception of tension and stress in the parent-child communication system, is one of the factors associated with abdominal pain in children. Long-term restrictive conditions, especially for children, lead to stress for the individual and his family, which is why parents of children with different disorders experience different levels of stress. Numerous studies have shown that the levels of anxiety and depression in mothers of children with chronic abdominal pain are higher than in mothers who do not have such children. Researchers believe that parental stress has many negative consequences and in addition to endangering the proper functioning of the family, it leads to a decrease in mental health and well-being of parents. In addition, parental stress has many negative effects on the child. Evidence from previous studies suggests that one of the treatments that can be used to control pain is play therapy. There are different approaches to play therapy. One of these approaches is cognitive-behavioral play therapy which integrates behavioral and cognitive interventions in the play therapy model. In this method of play therapy, contradictory thoughts related to cognitive and behavioral problems in children are identified and replaced with more adaptive thoughts and behaviors. Numerous studies have shown that cognitive-behavioral therapy reduces parental stress in children with chronic illness and improves childrenchr('39')s anxiety. On the other hand, creating resilience as a relatively new perspective on improving health is a valuable topic. Resilient people use effective coping strategies to deal with life issues and see problems as opportunities for learning and growth. Over the past 15 years, research has been conducted to identify strengths and protective processes that promote resilience related to childrenchr('39')s health status. Resilience programs can also be used as stress prevention and control interventions. Based on the findings of various studies, resilience promotion programs increase resilience and reduce the level of stress and anxiety of parents. The aim of this study was to determine the effects of resiliency based play therapy and cognitive-behavioral play therapy on parenting stress in children with functional abdominal pain. Methods: The research method was quasi-experimental with three-group research design consisted of a resilience-based play therapy group, a cognitive-behavioral play therapy group and a control group alongside three stages of pre-test, post-test and follow-up. The statistical population of the study included all children aged 5 to 10 years with their mothers who had functional abdominal pain and referred to the specialized clinic of Amin Hospital for Pediatric Gastroenterology in Isfahan, Iran. Among these children, 24 were selected by purposive sampling according to the inclusion and exclusion criteria and randomly assigned to three groups of 8 children with their mothers. Complete confidentiality, having complete freedom to withdraw from the research, informing about the research, obtaining written consent and using the data only for the purposes of the research were among the ethical considerations that were observed. At the end of the research period, the control group underwent one of the two types of play therapy freely and intensively. Barry and Jones (1995) parenting stress questionnaire was used to measure the dependent variable in the pretest, posttest and follow-up stages. Two experimental groups received a treatment course on cognitive-behavioral play therapy and resiliency-based play therapy in 8 sessions and the control group did not receive any treatment. In the statistical analysis of the data, at the descriptive level, the mean and standard deviation and at the inferential level, the repeated measures analysis of variance and Bonferroni post hoc test was used. The normality of data distribution was assessed by Shapiro-Wilk test, the equality of error variances was assessed by Levene test, and the Sphericity assumption of repeated-measures ANOVA was assessed by Mauchly test. Results: Comparison of age, number of siblings, fatherchr('39')s education and motherchr('39')s education through Chi-square test showed that there was no significant difference between the three groups (p>0. 05). The results of repeated measure analysis of variance revealed that there is a significant difference on parental stress between pre-test, post-test and follow-up (F=5. 50, df=2 and p<0. 01) and also there is a significant difference in the interaction of time with the group (including control group, resilience-based play therapy group and cognitive-behavioral play therapy group) (F=4. 74, df=4 and p<0. 01). This means that there is a significant difference between pre-test, post-test and follow-up in the two experimental groups (two treatments) and the control group (p<0. 01). The results of Bonferroni post hoc test showed that in the parental stress variable, there is only a significant difference between resilience-based play therapy with the control group (p<0. 05), but there is no significant difference between cognitive-behavioral play therapy with the control group and between the two treatments with each other (p<0. 05). Conclusion: Based on the results of the present study, resilience-based play therapy reduced parental stress in children with functional abdominal pain. Therefore, in addition to educating mothers with functional abdominal pain for effective use of this play therapy at home, to reduce parental stress in children with abdominal pain, it is recommended that this type of play therapy have been use in medical centers by psychologists. Limitations of the present study include the limitation of the research sample group to children with functional abdominal pain and their parental stress, along with a small sample of eight children for each of the three research groups due to the limited research time. In line with the above mentioned limitations, it is recommended that a resilience-based play therapy package be used with sample groups beyond children with abdominal pain to determine the effectiveness of this therapy package for other groups as well. In addition, it is suggested that in future studies, by increasing the length of the research, it will be possible to use larger samples for experimental and control groups.

Background: In December 2019, an acute respiratory illness with symptoms of pneumonia broke out in Wuhan, China, caused by a new coronavirus called SARS COV2. This highly contagious disease has been able to infect many people in most parts of the world in a short period of time. This situation continued to become an international threat (1, 2). The causative of this acute respiratory illness identified as a new type of coronaviruses called COVID-19 by WHO, and there is currently no specific treatment or vaccine. This disease has high transmission rate and at the beginning of the disease has symptoms such as fever, fatigue and cold-like symptoms and will gradually cause respiratory problems and sometimes progress rapidly which it can lead to death. Currently, due to the lack of a specific treatment, the best way to overcome the disease is to control and preventing of new cases (2, 3). The number of cases and death rates in some countries, including Iran, the United States, China, Italy, and Germany, is shown in Figure 1. Reports from the World Health Organization (WHO) regarding the spread of the virus as of 30th April 2020 shows 3090445 infected and 217769 deaths worldwide. In addition, in Iran, the disease has affected 93, 657 people so far and 5957 deaths, which shows the importance of this issue and the importance of preventive measures (4). In this review, considering the necessity of using preventive measures to control the disease, first the characteristics of the virus and the disease are discussed and then the methods of prevention and control of the disease and Chinachr('39')s experiences in this field are examined. Methods: In this review, the aim was to disease prevention and control methods and Chinachr('39')s experiences in this field. For these purposes, keywords such as coronavirus, novel coronavirus, SARS-CoV-2, acute respiratory syndrome, 2019-nCoV, prevention and control were searched in popular databases including PubMed, Google Scholar, Science Direct and Scopus. Databases related to COVID-19 to access new articles have also been used by some of the top journals in the field, including JAMA, Lancet, Cell, Nature, BMJ and medRxiv. Results: Coronaviruses history: Coronavirus is a single-stranded RNA virus with a positive sense and contains an enolope coat which belongs to the coronaviridae family and the order nidoviral (1). These viruses can cause infections in humans and a wide range of animals. The coronavirus family has 4 subfamilies Alpha, Beta, Gamma and Delta. Alpha and beta belong to mammals and especially bats and gamma and delta belong to pigs and birds. Among the 7 genera of coronaviruses that can infect humans, the beta subtype causes serious and deadly disease in humans, while the alpha type causes a mild and usually asymptomatic infections (2). The coronavirus was first isolated from the respiratory secretions of a cold patient by Tyrell and Bynoe in the 1960s. In 2002, the virus caused Acute Respiratory Syndrome (SARS) in China and caused a contagious respiratory illness. About 10 years later, another disease called Middle East Respiratory Syndrome (MERS), which was caused by a Coronavirus, spread to Middle Eastern countries (3, 5). In December 2019, another acute respiratory illness caused by a new coronavirus called SARS-CoV-2 broke out in Wuhan, China. The disease spread rapidly in the cities of China and other countries. The disease continued to worsen, with the World Health Organization (WHO) declaring an international state of emergency in connection with the disease on January 30, 2020, and on February 12, 2020, renaming the new coronavirus disease Cronavirus 2019, or COVID-19. (6). Pathogenicity and etiology: Phylogenetic studies and data review so far suggest that the probable host of this virus is the bat. The virus was transmitted to humans by ant-eaters, and the infection may have spread to the seafood market and transmitted from person to person (6). Bioinformatics studies have shown that SARS-CoV-2 belongs to the beta-coronavirus group and the genome of this virus is at least 70% similar to the SARS-CoV genome. The new coronavirus has four majorstructural proteins on its capsid. One of these proteins is the Spike protein, which binds to the angiotensin-converting enzyme receptor 2 (ACE-2) and the virus enters its genome into the host cell and then begins to amplify its RNA (1, 6). Spike protein of SARS-CoV-2 virus has undergone many changes compared to SARS-CoV virus. Both of these viruses target the ACE-2 receptor. Reports have shown that SARS-CoV-2 binds to this receptor with a much higher affinity than SARS-CoV, so the spread of the virus will be faster (6, 7). Diagnosis and clinical signs: The initial diagnosis of the disease is based on clinical signs as well as the patientchr('39')s history, for example, such as traveling to infected areas or being in contact with infected patients (8). Clinical signs of the disease are often non-specific symptoms such as fever, cough, fatigue and myalgia. In some patients, symptoms such as headache or hemoptysis are also observed. Patients may experience nausea and diarrhea at the onset of the disease. Fever is an important sign of the disease, but it is not a definite and specific symptom. Symptoms are more severe in people with underlying diseases and the elderly and can cause severe damage (9). The incubation period of the disease is 3 to 14 days. The patient develops shortness of breath after the onset of the disease and in severe cases can quickly cause dysfunction of some organs. Symptoms of acute respiratory distress syndrome (ARDS), septic shock, acute heart and kidney damage, blood clotting disorders, and even death are some of the symptoms that may occur in a patient (10).

Background: In recent years, the relationship between the complications due to diabetes along with an increase in glucose levels, blood lipid profile, decreased antioxidant defenses and subsequently, an increase in oxidative reactions in the body has been investigated. The results of extensive studies show that increasing the formation of free radicals, as a result of hyperglycemia, plays a important role in the pathogenesis and progression of complications diabetes (1). The combination of using herbal medicines and performing various physical activities to inhibit oxidative reactions has been considered by many researchers, as well. In this regard, the researchers found that Resveratrol, whit chemical formula: trans 3, 4 and 5-trihydroxyethylene, is a natural polyphenol and phytoalexin that protects plants against fungi in nature (10). As animal studies progressed, the effects of Resveratrol on various diseases were investigated, and some researchers reported the prophylactic effects of this chemical on cancer, cardiovascular disease, ischemic injury, and Alzheimerchr('39')s (10). On the other hand, it is also a factor in improving plasma markers related to type 2 diabetes (11). In adition, botanical studies show that Resveratrol contains important anti-inflammatory and antioxidant elements such as flavonoids and saponins (12). Therefore, the aim of current study was to evaluate the effect of interval and continuous exercise with Resveratrol on selected oxidative indicator in the heart tissue of mice with type 2 diabetes. Methods: The present study was experimental. For this purpose, 56 male rats (mean age 40 to 50 weeks and weight average 250 to 300 g) were divided into eight groups including: control-healthy, control-diabetes, diabetes-saline, diabetes-supplement, diabetes-continuse, diabetes-interval, diabetes-continuous-supplement, diabetes-interval-supplement. Rats became diabetic by injecting a single dose of 50 ml / kg streptozotocin intraperitoneally. Continuous training consisted of 8 weeks, five sessions per week, which started with a speed of 15 meters per minute and a duration of 5 minutes, and got to 28 meters per minute, finally. Interval training included 10 sets of 1-minute activity with an intensity of 50% and 2 minutes of rest between sets. Resveratrol was injected intraperitoneally into the supplement group at a dose of 20 ml / kg and with daily program. The rats were slaughtered 48 hours after the last training session, and then their heart muscle tissue was removed and transferred to the laboratory for measuring the desired indicators. Results: One-way analysis of variance related to Catalase levels demonstrated a significant difference between the groups (p<0. 001). The report of Tukeychr('39')s post hoc test was as follows: Significant difference among healthy-control group with control-diabetes (p=0. 001) and diabetes-saline (p=0. 001) groups, diabetes-control group with continuous-diabetes (P = 0. 020) groups, Diabetes-continuous-supplement (p=0. 004) and diabetes-interval-supplement (p=0. 043), diabetic saline group with groups of continuous-diabetes (p=0. 014), diabetes-continuous-supplement (p=0. 003) and diabetes-interval-supplement (p=0. 030). The assessment of intergroup changes of data related to MDA variable also showed a significant difference among groups (p<0. 001). Tukey post hoc test indicated a considerable difference among healthy control with control – diabetes groups (p=0. 001) and diabetes-saline (p=0. 001), diabetes control with continuous-diabetes groups (p=0. 020), diabetes-continuous-supplement (p=0. 004) and diabetes-interval-supplement (p=0. 043), saline group with continuous diabetes (p=0. 001), interval diabetes (p=0. 021), diabetes-continuous-supplement (p=0. 001) and diabetes-interval-supplement (p=0. 006). Tukey post hoc test reported there is a significant difference in SOD among healthy-control group with control-diabetes (p=0. 001), diabetes-saline (p=0. 001) and supplement-diabetes (p=0. 046) groups, diabetes control group with continuous-diabetes groups (p=0. 010), diabetes-Continuous-Supplement (p=0. 002) and diabetes-interval-Supplement groups (p=0. 033), saline diabetes group with continuous diabetes group (p=0. 015), diabetes-Continuous-Supplement (p=0. 003) and diabetes-interval-Supplement groups (p=0. 049). Finally, Tukey post hoc test showed that insulin levels in the study groups increased significantly (p=0. 001) and glucose levels decreased significantly (p=0. 001) compared to the control-diabetes and diabetes-saline groups. Discussion: The results of the present study showed that eight weeks of interval and continuous training can decrease blood sugar levels and increase insulin levels along with increasing SOD and Catalase levels and decreasing MDA levels in the heart tissue of diabetic rats. SOD exerts its function when the intensity of training is such that it does not require high excretion of hydrogen peroxide, howeverat high training intensities the release of Catalase is stimulated (23). The past evidence has shown that increasing the concentration of hydrogen peroxide prevents the function of insulin in glucose transport. Hydrogen peroxide, as well as other exercise-generated free radicals, regulate several cellular functions and act as a secondary messenger; they, also, activate factors sensitive to hydrogen products such as AP-1 and NF-κ B. The combination of these two factors and the other factors sensitive to hydrogen products can determine the release of the type of antioxidants (24). In line with this theory, a study reported that the expression of SOD and catalase antioxidants is inhibited by the use of a specific inhibitor NF-κ B (25). Besides, the increase in VO2max after a period of aerobic exercise is another reason for the improvement in antioxidant indices. The assessment of effect of the training intensity and duration on changes in antioxidant indices, especially SOD and catalase showes the amount of oxygen consumption during exercise is one of the reasons for the difference in the effects of different exercises (23). In high-intensity interval training, the production of oxidative anions increases, and at low-intensities, oxidation anions are neutralized by the greater release of antioxidants (26). Regarding the positive effects of this type of exercise in reducing lipid peroxidation in diabetics, a research has been done that indicates a decrease in MDA levels following exercise. It has been suggested that at low training intensities, increased SOD production may cause MDA uptake, and at high training intensities through GPX production, the antioxidant system is activated (27). In the present study, Resveratrol intake decreased blood glucose levels and increased insulin levels in rats with type 2 diabetes. Studies have shown that Resveratrol can help treat diabetes by lowering blood glucose levels, protecting the beta cells of the of Langerhans island, and improving insulin function. It has been shown Resveratrol increases the rate of glucose reabsorption, even in the absence of insulin, by increasing the expression of genes involved in glucose transporters in plasma membranes such as GLUT4, by various cells derived from diabetic rats (28). These results suggest that Resveratrol and exercise can strengthen the heart tissuechr('39')s antioxidant defense system against oxidative stress. Conclusion: In general, the results of the present study showed that exercise by lowering blood glucose and increasing insulin levels in diabetic rats causes increasing of the levels of SOD and catalase, as antioxidant enzymes and decreasin of the levels of MDA in the heart tissue of diabetic rats as an oxidative enzyme. These positive changes, when it comes to Resveratrol consumption was higher.

Background: Cognitive impairment is a common progressive disease in the elderly and is one of the worldwide leading causes of their disability. What makes it worse that there are currently no treatments to reverse cognitive impairment. Therefore, early intervention would be the best issue to prevent cognitive impairment. Moreover, early detection of asymptomatic cognitive impairment can prevent Alzheimerchr('39')s disease. Improvement in cognitive impairment could be related to the amount of physical activity. Recently, the effects of serum lipid profiles, including total cholesterol, triglycerides, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol, have been studied on cognitive impairment in the elderly. The results of these researches on how lipid profile levels can affect cognitive function have been controversial. On the other hand, the effects of various types of exercise, including the intensity and duration of these exercises on serum lipid profile and also its relationship with cognitive function in the elderly are unknown. Furthermore, most studies are focused on aerobic exercise and hence investigation on the effect of various types of exercise, including resistance and combination exercises on serum lipid profiles and cognitive status, and the relationship between them in the elderly patients with mild cognitive impairment have been neglected so far. Therefore, the main purpose of this study was to compare the effect of different types of exercise, and not only aerobic exercise, on serum lipid profile in one hand, and also its relationship with cognitive function in the elderly with mild cognitive impairment on the other hand. Methods: The present study is a pilot study with a small population to be effective in future investigations with more subjects and longer duration. For this study, thirty elderly (men and women) patients in the age range of 50 to 70 years old which diagnosed with mild cognitive impairment were selected from the 1223 patients who referred to the Cardiovascular clinic of Imam Reza subspecialty Clinic which is under supervision of Shiraz University of Medical Sciences, as the study population. In selecting this population, in addition to mild cognitive impairment, three other parameters also were considered for the research samples. First, they should not have been regularly exercising for past six months before the start of the study. Second, they should not have any respiratory or cardiac disease; Finally, in a case that they have had surgery, at least 6 months must be passed since it. The samples were randomly divided into three groups: aerobic exercise group (n = 10), resistance exercise group (n = 10) and combined (aerobic and resistance) exercise group (n = 10). Twelve weeks of the resistance, aerobic and combined exercise programs consisted of 90-minute sessions in length, three days per week with moderate intensity for each mentioned group. In the present study, exercise programs were designed according to the physical condition of the subjects and based on the recommended physical activity instructions for the elderly. Evaluations including Lipid profiles levels and the cognitive performance of the samples were made at baseline and at the end of the twelfth week. Lipid profiles including total cholesterol, triglycerides, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol were tested in the laboratory of Shiraz Hafez Hospital which is under the auspices of Shiraz University of Medical Sciences, using an auto-analyzer and Pars Azmoon kits (made in Iran). Also, the cognitive performance of the samples was assessed by a short mental status test, which includes a cognitive status questionnaire by Folstein et al. The Shapiro Wilk test was used to found the normality of distribution and also knowing that whether parametric tests could be used or not. The results reported as mean and standard deviation and a one-way analysis of variance (ANOVA) was utilized to determine the differences between variables. The paired t-tests were performed to detect differences between time points (pre and post). Also, in order to understand the relationship between the variables, the Pearson’ s single correlation test was used and statistical significance was set at p≤ 0. 05. Statistical Package for the Social Sciences (SPSS) ver. 22 (SPSS Inc, Chicago, IL, USA) was used for statistical analysis. To do so, the differences of all variables between groups, their relationship, and changes between pre-test and post-test were evaluated. Results: The results showed that except for the low-density lipoprotein cholesterol marker, which was significantly reduced in the resistance group, in other serum lipid profiles, there was no significant difference observed between the groups results after three months of aerobic, resistance, and combined exercise. However, total cholesterol, triglycerides, and low-density lipoprotein cholesterol decreased in the aerobic and combined groups and increased in the resistance group, which none of them were significant. Also, after three months of exercise, high-density lipoprotein decreased in the aerobic group and on the other hand increased in the combination and resistance groups. Therefore, in the resistance group, despite the increase in total cholesterol, triglycerides, and low-density lipoprotein cholesterol to a low extent, low-density lipoprotein cholesterol levels decreased significantly. Hence, resistance exercise is able to optimally reduce the concentration of low-density lipoprotein cholesterol and increase high-density lipoprotein cholesterol. On the other hand, cognitive function in all the three groups increased significantly after 12 weeks (p≤ 0. 05). Finally, it should be mentioned that despite the simultaneous improvement of some of the serum lipid profiles and cognitive function, no significant relationship in the elderly was found between lipid profiles and cognitive function. Conclusion: According to the results of this study, the resistance and the aerobic exercise are able to improve one or two serum lipid profiles in the elderly with mild cognitive impairment; But, the combined exercise improves all serum lipid profile markers, which (should be mentioned) was much less effective than other two types of exercise. Overall, it seems that the resistance exercise can improve the serum lipid profile in the elderly more effectively. On the other hand, the results indicate that the aerobic, resistance, and combination exercises are able to improve cognitive function in the elderly with mild cognitive impairment. However, more comprehensive studies with larger sample sizes should be done in this regard.

Background: The emergence of stimulants is a challenge in the field of addiction. Abuse of stimuli is associated with behavioral and psychological damage. From a biological point of view, methamphetamine use is associated with changes in plasma cortisol levels and subsequent psychological changes. Given the importance of the issue, many researchers have considered the need for psychological interventions to improve the quality of life of patients with substance abuse. Although in recent years we have witnessed the emergence of various therapies in the field of addiction; but we still see the failure of some patients in treatment programs, continuous abuse and high recurrence rates. Studies show that the condition of most addicts recurred after stopping treatment and generally about 50 to 60 percent of patients improved within 6 months and 80 percent of patients with a gap of 1 year after the end of treatment, began re-use of drugs again. One of the important components in the treatment of addiction is psychotherapy, which increases the consequences of treatment. One of the types of psychotherapy that can play an important role in the field of addiction is therapies focused on positive psychology, including wellbeing therapy, which originates from cognitive-behavioral therapy. Considering what has been said and contradictory findings on the effectiveness of wellbeing therapy, and considering the significant prevalence of stimulant use and its destructive effects on the individual, family and society, as well as considering the promising effects of positive therapies, including wellbeing therapy in the treatment of mood disorders and addictive indicators, the present study was conducted aimed to investigate the effectiveness of wellbeing therapy on psychological well-being index, optimist and life expectancy in Iranian men dependent on methamphetamine in the abstinence from use phase. Methods: The present study was conducted in the form of a single-center randomized clinical trial (clinical trial registration code: TCTR20190506001). The data of the present study were collected during October to March 2013, using clinical interviews and self-report questionnaires. The statistical population of this study consisted of all men taking methamphetamine in the abstinence from use phase and living in Tehran, and they were in Verdich Camp for doing detoxification process. In this study, considering the one-sidedness of the test and taking the base of 𝚣 = 1. 645, α = 0. 05 and also the test power 1-β = 0. 84, the sample size in each group was estimated to be 25 people. From the mentioned community, 50 participants were selected using random sampling and randomly assigned into two experimental and control groups (25 people in each group) using Excel Office software. In order to ensure the subjects' commitment to abstinence from use, participants' urine was randomly taken twice a week for one month and then once every 15 days and based on the assumed threshold of five hundred ng / ml and was analyzed using chromatographic method. Wellbeing therapy protocol was presented to the experimental group as a group for 12 sessions and each session lasted 50 minutes and the control group was placed on a waiting list. The two groups were evaluated in two rounds of pre-test and post-test by Ryff's Well-being therapy, shierer's optimist Questionnaire and snyder's hope Questionnaire. Data were analyzed by parametric t-test and analysis of covariance. All stages of the research were carried out after obtaining informed consent and based on the latest version of the Helsinki Declaration. Results: In terms of cognitive demographic distribution, the subjects often had a education level above diploma (wellbeing therapy: 64%, control: 72%). In the age index, most of the subjects had an age index of less than 25 years (wellbeing therapy: 68%, control: 60%). In terms of job status component, the majority of participants in the treatment and control groups were unemployed (wellbeing therapy: 56%, control: 60%). In the financial status index, the majority of participants in both groups had an income of less than one million tomans per month (wellbeing therapy: 60%, control: 68%). The results showed that wellbeing therapy had a significant effect on improving psychological wellbeing indices with a confidence interval of 24. 3 (16. 75-31. 85), optimist with a confidence interval of 19. 71 (14. 68-24. 74) and hope with a confidence interval of 17. 02 (11. 56-22. 48) (all p's < 0. 01). Conclusion: The present study was formed in order to change the view from the problem-oriented approach or psychological damage to the ability-building approach. The findings of this study confirm the research background on the effectiveness of positive therapies as an effective component in the process of recovery and abstinence from drug use. The findings of this study are consistent with a wide range of research backgrounds that have confirmed the effectiveness of wellbeing therapy in the treatment of emotional and mood disorders and increasing psychological wellbeing. Although similar to this study was not observed in terms of research dependent variables, but studies based on wellbeing therapy intervention have been conducted that indicate the effectiveness of this therapy. The most important limitation of the present study can be considered the different records of hospitalization of patients in the camp. According to the research background, the transition from substance use to abstinence takes place through stages that can affect the mental processes and behavioral patterns of patients. It is suggested that in future studies, the criterion of time of abstinence should be considered as one of the entry criteria. Also, the mere use of self-report tools such as questionnaires, especially in certain areas such as addiction can be associated with the respondent bias, so it is suggested that biological markers be used in the evaluation of psychological indicators in the future studies. Conducting a randomized clinical trial to assess the effectiveness of wellbeing therapy in cocaine users could be a good route for future studies. Findings of this study can be associated with clinical applications in the context of prevention and treatment of stimulant addiction.

Background: Complications and mortality after pediatric heart surgery have declined dramatically in recent decades, low cardiac output syndrome (LCOS) remains one of the most common complications of pediatric heart surgery, occurring in 25% of children undergoing Heart surgery. The most important complications of LCOS include prolonged intubation, prolonged hospital stay, and increased risk of infection and death. Factors that predict the development of LCOS after open heart surgery include: 1) factors before heart surgery for example the presence of ventricular dysfunction and heart failure, … 2) factors during surgery including the use of cardiopulmonary pump (CPB), hypothermia, type of Heart surgery, Use of cardioplegia, Myocardial ischemia during aortic clamp, Myocardial reperfusion injury, Acute systemic inflammatory syndrome (SIRS) and changes in systemic and pulmonary vascular resistance. Low cardiac output syndrome (LCOS) presents with symptoms of tachycardia, decreased diuresis, decreased systemic perfusion and metabolic acidosis. Therefore, early prevention and treatment of LCOS is very important. The general principles of treatment in LCOS are: Proper control of preload of heart, control of mechanical ventilation with the use of drugs that simultaneously have positive inotropic effects and reduce systemic and pulmonary vascular resistance, Drugs with this property are called inodilators Inodilators have positive inotropic effects (stronger myocardial contraction), Lusitropic effects (relaxation or better expansion of the heart) as well as vasodilatory effects on systemic-pulmonary and coronary arteries simultaneously. Therefore, these drugs are the basis of prevention and treatment (LCOS) after heart surgery. Milrinone (phosphodiesterase inhibitor type 3) and Levosimendan (calcium myocyte sensitizers) are the two main Inodilators drugs currently available for LCOS are used after heart surgery. Methods: We have reviewed several studies on the effects of heart medications on LCOS, especially after pediatric heart surgery. Results: Levosimendan is a new drug that has been used to treat heart failure since 2000. The effects of this drug are through two main mechanisms on cardiomyocyt: Cardiomyocyte sensitizer to calcium, Opening potassium-dependent channels also Levosimendan has three simultaneous effects on the cardiovascular system through these two mechanisms: Positive inotropic effect (stronger myocardial contraction), Lusitropic effect (Relaxation or better expansion of the heart), Vasodilatory effect on systemic-pulmonary and coronary arteries. The usefulness of Levosimendan in the treatment (LCOS) after heart surgery has been proven in adults and children. However, the use of this drug as a first-line treatment (LCOS) after heart surgery is expensive because of this reason limited. Levosimendan is well tolerated by patients and its most common side effects are headache (7-8%), hypotension (5-6%), hypokalemia (5%) and tachycardia. Hypotension and tachycardia can be controlled by giving proper fluid volume or prescribing vasopressors such as norepinephrine. Studies on the effect of Levosimendan on increasing the risk of atrial fibrillation are contraverse It should be noted that Hypotension, tachycardia and hypokalemia are more common in children than adults. Levosimendan has a better effect on heart function in adults undergoing heart surgery than traditional inotropic drugs, improving the patient's hemodynamic function, reducing myocardial damage, and shortening the length of hospital stay. Despite the high prevalence of LCOS after pediatric heart surgery, but we have no consensus on the choice of inotropic drug for the treatment of LCOS. Traditional LCOS therapy is the use of catecholamines. Side effects of catecholamines include increased oxygen consumption in the heart, increased ventricular after load, Down-regulation of beta-adrenergic receptors, reduces the efficacy of these drugs. Due to these side effects, Inodilator such as Milrinone are used to treat LCOS after heart surgery. In Europe, Milrinone is present in 70. 7% of LCOS treatment regimens after heart surgery, and the combination of this drug with other inotropes is present in 64% of treatment regimens. The mechanism of Milrinone is inhibition of phosphodiesterase type 3 (PDE3), which increases the intracellular concentration of CAMP. CAMP activates protein kinase, increases the entry of extracellular calcium into the heart cell, and ultimately these effects Increases the activity of contractile proteins and improves the contractile power of the heart. The effect of Milrinone on peripheral and coronary arteries is secondary to the increase in CGMP in vascular wall smooth muscle cells. These effects of Milrinone improve heart function without increasing myocardial oxygen consumption and without increasing ventricular loading. These effects are also independent of alpha and beta adrenergic receptors. More common complication of Milrinone is hypotension. The next complication is tachycardia, although there is controversy about of tachycardia as a side effect of milrinone. We have no evidence that Milrinone causes tachyarrhythmias. The next complication of Milrinone is thrombocytopenia. Therefore, the patient's platelets should be monitored during treatment with Milrinone. Although Milrinone-induced thrombocytopenia cannot be distinguished from thrombocytopenia due to cardiovascular bypass pump (CPB). Other side effects of milrinone include seizures, oral intolerance, and delayed in PDA closure of preterm infants. Conclusion: Milrinone and Levosimenda are both effective drugs in treatmen of LCOS in children, however, due to the availability and lower price of Milrinon, the use of Milrinon is more common.

Background: Human beings face various events in their lives from birth to death, and these events challenge their lives, and each in turn affects people's lives. One of these events that has a lasting effect on people due to permanent loss is the loss of loved ones, which is referred to as bereavement. Death is an undeniable phenomenon, human beings face the death of their loved ones during their lifetime, which causes them to grieve due to the loss of loved ones in their lives. Bereavement has harmful effects on people and affects all different levels and aspects of life and consequently the quality of life. When a person faces the loss of a loved one, the correct passage of this crisis affects his well-being and quality of life. Appropriate endurance conditions and proper management of behavior and the use of appropriate strategies and methods to deal with loss are related to various factors and how to deal with these conditions in the later stages of life will have a great impact and not going through the process of endurance, well-being and It affects the mental health and quality of life of people in general. Spiritual intelligence can curb the negative effects of Bereavement on quality of life and help people get through these difficult situations. In addition, having a personal resilience can act as a protective factor against the negative effects of Bereavement and on quality. Involve the lives of bereaved people. Therefore, identifying the factors that improve the quality of life in bereavement conditions is very important to maintain the health and well-being of individuals. Therefore, the present study was conducted with the aim of predicting the quality of life of bereaved people based on spiritual intelligence with respect to the mediating role of resilience. Methods: The present study was a descriptive-correlational study. The statistical population of this study included bereaved people in Qazvin who passed 1-6 months after the death of their loved ones. The sampling method in this study was that 109 people from the statistical population of the study were selected to participate in the study using cluster random sampling method and the tools used in the study including Connor-Davidson Resilience Questionnaire, King Spiritual Intelligence Questionnaire and The World Health Organization quality of life questionnaire was answered. The collected data were analyzed using descriptive statistics methods including frequency and central tendency indices and dispersion of variables and inferential statistics (path analysis model). Results: The results of the present study showed that the component of critical existential thinking, the component of developing the state of consciousness and the component of transcendent consciousness could directly and meaningfully predict the quality of life, but the component of personal meaning could not directly predict the quality of life. The resilience variable was able to directly and meaningfully predict the quality of life. Predict the quality of life. The set of predictor variables in model 55/30 explained the variance in quality of life. Conclusion: Using the results of the study, which showed that the components of spiritual intelligence could predict the quality of life of bereaved people, it can be stated that attention to spiritual intelligence and efforts to strengthen it in people and the need to pay attention to its importance when faced with Challenges and crises and life events and its training can help improve the quality of life of bereaved people by increasing their resilience. On the other hand, considering the mediating role of resilience in predicting the quality of life of bereaved people based on spiritual intelligence and that increasing resilience leads to the use of coping strategies in stressful life conditions and increases the quality of life and causes when people with They face various problems, crises and challenges during their lives. They react appropriately and manage difficult situations better and can behave properly in any situation to be safe from the negative consequences of crises and situations such as burnout. Therefore, by providing appropriate solutions such as the implementation of effective educational programs and psychological counseling to increase resilience and quality of life of bereaved people can improve and improve the quality of life of these people to the effects and problems that burnout has on the quality of life. By reducing these problems and complications, it helped to improve the level of mental health and quality of life of the bereaved people, and thus, by increasing the quality of life of the bereaved people, it prevented many problems caused by bereavement and improved the quality of life of the people.

Background: Bacteriophages are viruses that can kill bacteria with the least adverse effect on human or animal host cells). Phage therapy is the use of bacterial viruses (phage) to treat bacterial infections, a medical intervention that has long been abandoned in the West but is now experiencing resurgence. At present, therapeutic phages are often selected based on limited criteria, which are sometimes simple as the ability to bind to pathogenic bacteria. Therefore, the use of therapeutic methods and antibacterial properties of phages is known as phage therapy, especially in clinical or veterinary fields. More widely, phages have been used as biological control agents to reduce the amount of bacteria in food. In addition, modified phages can be used as tools of transmitting DNA, protein or medicine. Various problems in the treatment of many life-threatening bacterial infections have led scientists to review phages. Numerous studies on the use of phage in vitro, in laboratory animals, and in humans have been performed in the United States and Europe. For this reason, phages can be used alone or in combination with antibiotics to treat bacterial infections. This article reviews a number of aspects of the use of phages and their products in the medical and especially antibacterial fields. Methods: In this review study, all studies to date have been reviewed and searched through databases such as Irandoc, Scopus, Google scholar, PubMed and other reputable scientific databases with keyword searches such as bacteriophage, phage therapy, Biological treatment, infection, bacterial and the latest information has been obtained. Results: Due to the high prevalence of antibiotic resistance in different bacterial infections, the use of bacteriophages is one of the best options for the treatment of bacterial diseases. Therefore, different aspects of therapeutic use in patients at different levels have been studied and the advantages of using phages over antibiotics have been determined in all cases. Bacteriophages invade biofilms and in these cases they can be an alternative treatment to antibiotics. Most of studies are on using phages for the topical treatment of bacterial skin infections. Some chronic skin infections, such as acne, may require long-term antibiotic treatment, although they are not life-threatening. The immunosuppressive activity of pure bacteriophages may be an argument for the safety of phage therapy, especially in allograft recipients. Excessive levels of immunosuppression due to the concomitant activity of immunosuppressive drugs and phages can increase the risk of other infections. Obviously, cancer patients and people with immunodeficiency will be at greater risk for infections following phage therapy. The use of bacteriophages, in addition to its benefits for the treatment of bacterial infections, has disadvantages such as the narrow range of bacterial hosts for phage, insufficient purity of phage, difficulty in removing integrase genes, phage resistance, Antibiotic resistance, decreased phage function due to neutralizing immune system involvement, pre-prepared phage instability, lack of understanding of phage heterogeneity and function, exaggerated claims about the effectiveness of commercial phage preparation, and Lack of scientific evidence for the effectiveness of phage treatment. Conclusion: Despite the apparent need for new and safe antibacterial drugs, the use of phages as biological therapies by most physicians has not yet been addressed, and this is probably due to a lack of familiarity with phage therapy, as well as another reason for the lack of regulatory approval. We believe that, given the widespread crisis of antibiotics, this approach requires serious attention. Because despite the many restrictions on the use of phages, these biological tools still have many unique applications in medicine.

Background: A sedentary lifestyle is associated with the spread of dangerous clinical events in middle-aged people. The most serious health problems of sedentary lifestyle are obesity, type 2 diabetes and cardiovascular diseases. In the cardiovascular system, cellular responses to various stimuli are mediated through coordinated signaling pathways. Mitogen-activated protein kinases (MAPKs) are a family of known proteins that play an important role in these signaling events. However, this family also has good and bad members who can protect or damage the heart. P38 is expressed in heart cells. In cultured cells of heart tissue, P38 activity induces myocyte hypertrophy and apoptosis, as well as increased cytokine production. Also, in the cardiovascular system, special emphasis has been placed on the role of phosphoinositide-3 kinase (PI3K) in health and disease. Studies have shown that the PI3K-Akt signaling cascade is associated with cardiac hypertrophy. Resistance training improves strength and muscle mass and cardiovascular function in middle-aged and elderly people. However, many inactive people are reluctant to exercise at moderate or high intensity, and high intensity training may not be appropriate for these people and may be associated with injury. Therefore, the effectiveness of alternative training methods has been investigated. Among these methods is low intensity resistance training with blood flow restriction (BFR). Research has reported an increase in cardiovascular function after resistance training with BFR. it may be possible to achieve an optimal training method for inactive middle-aged people, for treatment and to prevent the effects of aging, by determining the effect of blood flow restriction with low intensity resistance training on cardiovascular parameters. However, the effects of intermittent and continuous blood flow restriction on inactive cardiovascular parameters are not known, Therefore, the aim of this study was to evaluate the effect of low intensity resistance training with intermittent and continuous blood flow restriction (BFR) on P38 and PI3K in inactive middle-aged men. Methods: This is a semi-experimental study. This research was conducted on inactive healthy middle-aged men. 45 inactive healthy middle-aged men (40-65 years) were randomly divided into three groups include resistance training with intermittent BFR, resistance training with continuous BFR, Resistance training without BFR. Low-intensity resistance training groups with intermittent and continuous BFR performed 3 sessions per week blood flow restriction with a cuff pressure of 110 mm Hg in the thigh area for 8 weeks. also, the resistance training group performed the exercise, 3 sessions per week without BFR. At the end of the intervention, blood was taken. The p38 and PI3kinase levels were measured by ELISA kit. Data were analyzed by dependent t test, One-way ANOVA and Tukey post hoc test at the p<0. 05. Results: Data analysis showed that there was a difference between changes of p38 and PI3kinase levels in middle-aged men in different research groups (p=0. 001). The results showed that low-intensity resistance training with intermittent and continuous BFR led to significant decrease in p38 (p=0. 001), as well as significant increase in PI3kinase levels compared to the resistance training group without BFR in middle-aged men (p=0. 001). There was no significant difference between the effect of two methods training with BFR (p<0. 05). Conclusion: The results of our study suggest that both low-intensity resistance training with intermittent and continuous BFR may have greater cardiac benefits for middle-aged people than low-intensity resistance training. The findings of this study were consistent with the results of Previous research [31-29]. Regarding the mechanisms of change of MAPKs following exercise with BFR, it seems that part of the activation of this pathway is due to increased GH secretion, fluid exchange between blood and active muscle tissue, and BFR-induced hypoxia [26-28]. Regarding the mechanisms affecting PI3K changes, it has been reported that high expression of IGF-1 or IGF receptors activates PI3K (p110α ) and induces physiological hypertrophy of the heart and myocardial infarction. Therefore, it is possible that low-intensity resistance training with intermittent and continuous BFR and low-intensity resistance training without BFR in the present study led to an increase in PI3K by affecting IGF-1 levels. There were some limitations in the present study, such as the lack of measurement of other cardiovascular indicators in inactive middle-aged men. Also, Measurement of cardiac function indices can more clearly show the effects of resistance training with BFR on the cardiovascular system in inactive middle-aged people. According to the results, it seems that low intensity resistance training with intermittent and continuous blood flow restriction (BFR) can help improve cardiovascular performance in inactive middle-aged men, and there is no difference between the two methods.

Background: Acinetobacter baumannii (A. baumanni) is one of the most important pathogens of Ventilator-associated Pneumonia in hospitals. Ventilator-associated pneumonia usually develops after more than 48 hours of tracheal intubation and mechanical ventilation. Prevalence of Multidrug-resistant (MDR) in Acinetobacter baumannii species is increasing. This organism can cause severe infections in hospital settings, especially in the ICU. In the past, carbapenems such as meropenem and imipenem have been used as the drug of choice in the treatment of multidrug-resistant Acinetobacter infections. Carbapenem resistance is currently increasing. Despite numerous studies to treat ventilator-associated pneumonia caused by Carbapenem-resistant A. baumanni, the best drug choice for the treatment of this pneumonia remains unclear. Although some studies suggest Colistin as a first-line drug choice for critically ill patients with ventilator-associated pneumonia, the results of a systematic review study in 2017 showed that monotherapy with sulbactam in the treatment of pneumonia caused by drug-resistant Acinetobacter is preferable to treatment with intravenous colistin. Researchers have recommended clinical trials to confirm the findings in this pneumonia. Therefore, the purpose of this study was to compare colistin based vs. Ampicillin-Sulbactam based therapy in carbapenem-resistant A. baumanni ventilator-associated pneumonia. Methods: In this double-blind clinical trial study, 43 patients with ventilator-associated pneumonia who were admitted to the ICU of Valiasr Hospital in Arak, Iran, were included in the study and were assessed in two groups: colistin based vs. Ampicillin-Sulbactam based. Patients were evaluated at baseline and at the end of treatment for white blood cell count, ESR, and sputum culture and mortality. Inclusion criteria included age over 16 years and ventilator-induced pneumonia with carbapenem-resistant A. baumanni. Exclusion criteria included discontinuation of treatment and patient dissatisfaction to continue the study. Lower Respiratory Secretion was collected from these patients and sent to the laboratory. Isolation of bacteria was performed according to the standard bacteriological method and then using isolated biochemical methods, the isolated bacteria were identified up to the species. E-test was used to determine the lowest growth inhibitory concentration (MIC) to colistin and ampicillin sulbactam. The sample size was 33 patients in each group. There were 33 patients in the Colistin group. In the ampicillin-sulbactam group, 10 patients and 20 laboratory samples with ampicillin-sulbactam discs were also performed by antibiogram method. Laboratory sputum culture was used because antibiotic resistance was observed in the first 10 patients in the ampicillin-sulbactam group and there was no complete recovery and therefore due to concern for the lives of patients; The rest of the samples were performed in vitro. Patients were evaluated at the beginning and end of treatment on day 14. It should be noted that in order to double-blinded study, the patient and the data analyzer did not know about grouping. Data were analyzed by SPSS 20 software using descriptive statistics, t-test and chi-square. The normality of quantitative data distribution was checked by Kolmogorov-Smirnov test. The code of ethics of this dissertation was IR. ARAKMU. REC. 1397. 89. The registration code in Iran Clinical Trial Center for the above dissertation was IRCT20141209020258N126. Results: In this double-blind clinical trial study, 33 patients in the colistin group and 10 patients and 20 sputum culture samples in the ampicillin-sulbactam group were studied. The mean ± standard deviation of age of 43 patients was 48. 23± 16. 85 years. The minimum age was 19 years and the maximum age was 85 years. In the cholistin + carbapenem group, out of 33 patients who were initially admitted to the study, 3 died before the end of the study and in the ampicillin-sulbactam group, out of 10 patients admitted to the study, 2 died before the end of the study. The number of WBC and the rate of ESR in the colistin + carbapenem group were decreased significantly (p<0. 05) and 23 cases of sputum culture were negative for acinetobacter at the end of the study. in the colistin based group on day 14 of treatment, only 2 patients had higher than normal WBC counts and 24 cases had normalized chest X-rays. In the ampi-sulbactam+carbapenem group, at the end of treatment, 3 patients had normal WBC counts. Only one sputum culture was negative and 1 case had normal chest x-ray at the end of study. In 20 sputum culture samples that were examined in vitro, only two samples were sensitive to ampicillin-sulbactam and 18 cases were resistant to ampicillin-sulbactam. Conclusion: The use of colistin+carbapenem improves clinical and laboratory response of patients. Therefore colistin-based therapy for the treatment of Carbapenem-resistant A. baumanni ventilator-associated pneumonia is recommended.

Background: Oral cancer is the sixth most common cancer in the world and the second deadliest cancer. One of the main ways to treat this cancer is chemotherapy and immunotherapy. However, some tumors may recur after being treated with chemotherapy. Many scientists believe that using antioxidants at the same time as chemotherapy may counteract the effects of drugs. Therefore, this study aimed to investigate the effect of saffron crocin on the anticancer function of doxorubicin on the cellular signaling pathway genes (PTEN / AKT1) on Human Epidermoid Cancer Cells (KB). Materials and Methods: In this case-control study, the KB cell was cultured in RPMI 1640 culture medium. Cell proliferation or death of cells treated with crocin and doxorubicin were evaluated using MTT assay. DAPI and DNA-ladder assays were also performed to demonstrate the cell apoptosis. After total RNA extraction and cDNA synthesis, the expression changes of PTEN / AKT1-associated growth and apoptotic genes were assessed using real-time PCR. Results: Our finding revealed that doxorubicin has an inhibitory effect on oral cancer cells, and it is capable of inducing proapoptotic gene (PTEN) as well as inhibiting AKT1 gene expression. The use of crocin had no significant effect on doxorubicin inhibition. The results also showed that combined use of this natural antioxidant with drug chemistry significantly increased the effects of the drug. Conclusion: Saffron Crocin as a natural antioxidant can have both antioxidant and anti-cancer effects synergistically with doxorubicin on on Human Epidermoid Cancer Cells (KB).

Background: Epidemiological evidence has supported the increase in oxidative stress in the presence of obesity. Low levels of physical activity and extra calorie intake are considered as the main cause of obesity and related metabolic disorders. Obesity is associated with an increase in oxygen-derived free radicals and a decrease in antioxidants. Overweight and obesity predispose to many diseases including cardiovascular disease, diabetes, hypertension, high cholesterol and blood triglycerides, arthritis, asthma and certain types of cancer. Oxidative stress is an imbalance between the body's antioxidant defense system and the production of pre-oxidants such as free radicals and reactive oxygen species due to the overproduction of free radicals and oxidants such as malondialdehyde, damage to many macromolecules Weakness leads to the body's defense system. Although hydrogen peroxide (H2O2) is not considered a free radical, but it is a component of ROS and has a direct and effective role in creating oxidative stress and free radicals. Along with other stimulants such as obesity, H2O2 is strongly affected by sedentary. In another definition, H2O2 is a non-radical compound that readily produces radicals such as hydroxyl radicals under special conditions, and although it is not able to directly oxidize DNA and lipids, it directly inactivates some enzymes. The body's antioxidant system includes enzymatic and non-enzymatic agents, the most important of which is glutathione peroxidase (GPX). GPX is a member of the family of celloprotein antioxidant enzymes that catalyze the reduction of H2O2 and alkyl hydroperoxides in the presence of reduced glutathione, respectively, as electron donors to water and alcohol. In muscle cells, 45% of its activity is in the cytosol and the remaining 55% is in the mitochondria. The uptake of toxic oxygen metabolites under oxidative stress is one of the most prominent features of GPX. On the other hand, physical activity and exercise have been introduced as stimuli for its synthesis, so that endurance training leads to a 20 to 177% increase in GPX in skeletal muscle. The American Sports Medicine Association has identified intermittent exercise with long periods of time as one of the most important training methods to reduce oxidative stress (14). Among these training methods, TRX or whole body resistance training has recently received a lot of attention, so that this unique training method that uses tools such as two straps and handles, uses body weight as resistance and performs it. It is a prominent feature in any place and environment. Sport science researchers have reported a decrease in body fat levels along with an increase in muscle mass in response to TRX. However, although the antioxidant effects of other aerobic and resistance training methods have been reported in athletes and non-athletes or healthy or sick obese populations, studies showing the effect of response or adaptation of antioxidant and oxidative stress indices to TRX as one of the newest training methods, especially in obese women, is less visible. Therefore, the present study aimed to evaluate the effect of 8 weeks of TRX training 3 sessions per week on some oxidative and antioxidant indices such as GPX and H2O2 in inactive obese women. Methods: For this purpose, 28 sedentary middle-aged obese (30 ≤ BMI ≤ 36) women aged 35-45 years were divided into of TRX (8 weeks, 3days/weekly, n= 14) and control (no training, n = 14) groups by simple accidentally. Fasting levels of GPX activity and H2O2 and anthropometric indices were measured before and 48 hours after lasted exercise session in both groups. Independent t test used to compare baseline levels between the groups and paired t-test to determine inter-group changes of variables. Results: TRX training led to a significant decrease in anthropometric indices (p < 0. 05) and a significant increase in GPX (p=0. 023) but H2O2 levels did not change significantly (p=0. 627). None of these variables were changed in the control group (p>0. 05). Conclusion: Increased glutathione peroxidase activity in the absence of H2O2 change in the exercise group in response to TRX exercises is the main finding of the present study. In other words, 8 weeks of TRX training with 3 sessions per week increased GPX activity as one of the most prominent antioxidant indicators in obese middle-aged women who previously had a sedentary lifestyle. However, both variables were not significantly changed in the control group. In this regard, although studies that show the response or compatibility of oxidant and antioxidant components to TRX exercises are not visible, but some findings have been reported in response to other training methods, which are sometimes contradictory and inconsistent. In the present study, despite no change in H2O2, the level of GPX activity in response to TRX training in obese women increased significantly, which alone supports the antioxidant effects of this training method. On the other hand, the insignificant change in H2O2 may be attributed to the small number of samples studied. Because in the present study, the pattern of H2O2 changes indicates a downward but insignificant trend in the TRX group. On the other hand, the inhibitory effect of ROSs or antioxidants in exercise can not be summed up in the measurement of serum or plasma levels alone. This is because it is possible for these effects to appear at the cellular or tissue levels of the samples being studied. On the other hand, the increase in GPX activity may be attributed to weight loss and loss of body fat following exercise. Because obesity and high levels of body fat mass are associated with increased ROS and lipid peroxidation due to increased access to fat substrate). Decreased activity of antioxidants including GPX in obese people has been reported as one of the reasons for the increase in oxidative stress. On the other hand, clinical studies have shown the correlation between high levels of ROS or oxidative stress with obesity and have identified the increase in oxidative stress caused by obesity as the cause of more than 100 different diseases. Therefore, the increase in GPX activity in the present study may be rooted in a decrease in body fat mass in response to TRX training. Scientific evidence shows that TRX or whole body resistance training reduces the percentage of body fat. This evidence suggests a reduction in fat mass in response to TRX or resistance training. Despite this evidence, the antioxidant effects of exercise can not be attributed solely to the measurement of GPX or H2O2. Rather, the improvement in antioxidant profile in response to exercise is rooted in a change in other indicators of oxidative or antioxidant stress, such as superoxidase dismutase, malondialdehyde, total antioxidant capacity, milio peroxidase, or catalase. On the other hand, the lack of measurement of these indicators is one of the limitations of the present study. Performing TRX exercises improves the antioxidant profile of obese middle-aged women. In other words, despite the fact that H2O2 did not change, the increase in glutathione peroxidase activity in the present study and other laboratory evidence in this area support the antioxidant effects of TRX exercise in middle-aged obese women. This improvement may be attributed to a reduction in body fat mass in response to TRX training. However, further studies are needed to identify the mechanisms responsible for the effect of exercise on the antioxidant profile.

Background: Quality of life is a complex concept to be evaluated. Quality of life refers to a person's expectations, goals, concerns, and level of her/his satisfaction with life. In recent decades, especially after the 1990s, quality of life has been considered as an important factor in assessing the health, well-being, social functioning and rehabilitation programs. In ophthalmology, indicators such as visual acuity are used to evaluate the outcome of treatment. This indicator shows the success of the treatment but it can’ t reflect the emotion and perception of patients from their myopia. Myopia can affect people’ s quality of life and can cause problems in driving, reading and using computers, and as a result, these problems can affect the psychological status of people. People use many methods to correct this problem. The use of spectacles and contact lenses has often been the first choice of people to correct their myopia but today, surgery is considered a better option. LASEK is a new method for eye surgery and this method has more advantages than LASIK surgery and PRK. LASEK also has fewer risks than other surgeries. There are several questionnaire and scales for measuring the quality of life in ocular patients. But none of them has addressed the psychological statues, personality traits and the importance of cosmesis in these patients. IER QOL deals with all these factors. The purpose of this study is evaluate of quality of life and depression in patients with high and low myopia that undergone to laser-assisted sub epithelial keratectomy (LASEK). Methods: This study is descriptive. 311 patients are participated before LASEK surgery. 185 patients have high myopia and 126 patients have low myopia. This was done in javad ol’ aeme eye specialist clinic in Qom. Patients in this study ranged in age from 21 to 40 years. Their refractive errors of patients should not be less than 5. Preoperative patients were informed of the secondary evaluation after surgery. For evaluating of quality of life, IER QOL was used. The IER QOL scale was specifically developed to evaluate QOL in patients with myopia and can be administered rapidly and easily in clinics. This multidimensional scale assesses physical status, psychological state, personality traits, and cosmesis, which are dimensions associated with a patient's QOL. The IER QOL scale has the following subscales validated through factor analysis and confirmatory factor analysis: Frequency of disturbing visual and ocular symptoms that assess the patients visual symptoms that patients experience, Tolerance to disturbing visual and ocular symptoms, Health Proneness Psychological Traits Questionnaire that assess the patients how to adjust to different environments and their mental well-being, self-efficacy and compatibility, Personality traits (extraversion/introversion) and Cosmesis assess the patient's belief in the effect of vision correction method on their beauty and attractiveness. In addition, the scale assesses patient satisfaction with the current treatment for correcting myopia. Physical status subscale has 26 questions, psychological status subscale has 10 questions, and personality traits have 3 questions. Internal validity of this Questionnaire with Cronbach's alpha coefficient in cosmesis subscale was 0/77, 0/80 in psychological condition, 0/73 in extroversion and introversion, and 0/88 in frequency of disturbing visual, ocular symptoms and tolerance to disturbing visual and ocular symptoms. The second questionnaire used in this study was Beck Depression Inventory. This questionnaire has 21 questions that range from 0 which shows the no symptoms and 3 which shows high symptoms. In this study patients answer the IER QOL and Beck Depression Inventory before undergone to surgery. 13 patients didn’ t participate in second evaluation. Results: Result showed that quality of life after LASEK surgery was significantly better than before (p<0. 001). Quality of life in low myopia patients was significantly better than other group. Patients with high myopia had a significant improvement in cosmesis (p<0. 001). Patients with low myopia (p<0. 052) and high myopia (p<0. 063) didn’ t have any significant change in depression. But there was a significant difference in depression between high and low myopia groups before and after surgery. Conclusion: The purpose of this study was to evaluate the quality of life and depression in patients who have been candidates for LASEK surgery. According to the results, LASEK surgery has a significant effect on the quality of life of ocular patients. As previous research has shown, LASEK surgery has fewer negative and more positive effects than LASIK surgery. The results of this study are similar with them. In general, the quality of life of patients with high myopia is lower than people with low myopia. According to the results obtained in this study, it can be said that the degree of myopia can have a significant impact on quality of life. In the extroversion / introversion subscale, the increase in extraversion characteristics in these patients showed that myopia can affect their avoidance of extraversion or their self-confidence. They also found greater ability to adapt better to new environments. Cosmesis is another reason that can be important in choosing surgery to correct myopia in patients. As shown in this study, patients' perceptions of their cosmesis changed significantly after surgery. Perception of cosmesis in patients with high myopia is lower than the other group, so it can be said that people with high myopia have to use thicker spectacles and it affects their perception of their cosmesis. In the group with high myopia, psychological status was lower than the other group. But both groups showed significant improvement in this factor after surgery. According to these results, it can be said that psychological status is a valuable variable to be evaluated in these patients and is also an important factor that affects the quality of life. Because the secondary evaluation in this study was two months after surgery, it is better to evaluate these patients after a longer period of time to assess their quality of life after the complete disappearance of symptoms after surgery. Depression in both groups is normal. However, the group with high myopia had a higher mean before and after surgery than the group with low myopia. However, according to the results, both groups did not show a significant change in their depression. It can be stated that depression is not an important factor to motivate these patients to have surgery.

Nowadays, 3D printing technology is used for rapid prototyping of high quality objects, so that this technology plays an important role in the modern fields of medicine, especially in surgery, radiation therapy, radiology and etc. Generally, the process of creating a physical object from a digital model is considered as a simple definition of 3D printing. Compared to conventional printers, 3D printers create a physical 3D model of the desire target. Creation of a model by 3D printer requires a digital 3D model which can be obtained by scanning a set of 3D images or drawing them using CAD design software, as well as using computed tomography (CT) data or magnetic resonance imaging (MRI) imaging. Then, this digital model is sent to the printer and finally, a 3D layer-by-layer model is created. The whole mentioned process is called as fast prototyping or 3D printing. Since, personal radiotherapy is introduced as one of the main modality for the treatment and management of various cancers, requires precise details to improve the performance of the employed modality. Todays, 3D printers are able to produce a realistic model of complex geometries, so 3D printing technology can be a complementary and promising method for treating patients and making specific equipment for them, especially in radiotherapy. The dramatic growth of 3D printing technology in various fields of medicine in recent years, has led to the introduction of new applications of this technology in these fields, so that the importance of this technology in improving the performance of treatment modalities, has been reported in several recent studies. The use of 3D printing technology will reduce the cost of radiation therapy which as a promising method, can enhance the efficacy of employed modality. Performed studies have shown that 3D printing technology is a fast, practical and inexpensive method for delivering a uniform dose to the target volume while protecting healthy tissues in the radiation field. Furthermore, this technology reduces patient discomfort which can provide specific radiotherapy devices to each patient. The employment of 3D printed devices, based on the anatomical features of each patient in radiotherapy, such as bolus and fixed devices can reduce daily uncertainty (in radiotherapy) and also increase the accuracy of treatment. 3D printing technology enables users to employ various materials for better performance of radiotherapy method. So far, several materials have been used and evaluated to produce the desired 3D object via the 3D printing technology, including polylactic acid (PLA), acrylonitrile butadiene styrene (ABS), polyethylene terephthalate glycol (PETG), thermoplastic elastomers (TPE), Polyamide (PA, also called nylon), thermoplastic polyurethane (TPU), and polyvinyl acetate. The accuracy and efficacy of 3D printing technology highly depends on the performed materials for creation of the 3D objects. PLA and ABS have been introduced as the most common performed materials in 3D printing technology. PLA is a type of odorless plastic polymer which can be used in many industries, such as biodegradable implants and food packaging. ABS is more resistant than PLA which can tolerate the high temperatures. PA material is flexible, very cohesive and very resistant as a plastic polymer as well. The most common use of TPE has been introduced in the construction of flexible objects which with the use of this material objects can be created in a short time. PETG materials are a combination of PET and glycols with different concentrations. All the mentioned materials are available in the form of filaments with diameters of 1. 75 mm and 3 mm. Performed investigations in our present work have shown that patient-specific devices can be generated from volumetric CT images or MRI data by 3D printing. In fact, 3D printing technology has great potential for improving the accuracy and efficiency of personal radiotherapy which this technology offers a relatively inexpensive and effective method to produce devices based on individual anatomy in radiotherapy. The practical usage of the 3D printing technology in radiation therapy can improve treatment outcomes and reduce treatment error which the weaknesses of traditional radiotherapy methods can be eliminated. Due to the advantages of this new method, the main aim of present review is to introduce some applications of 3D printing technology in radiotherapy, as a new approach in this therapeutic method, such as bolus, phantoms, brachytherapy applicators, filters, patient fixation devices, compensatory blocks and grid blocks. In most of the performed studies, the advent of 3D printing technology in the field of radiotherapy has been reported as a cost-effective and accessible method so that more practical parts can be produced. Performed studies also showed that the favorable agreement between the printed model in terms of matching the unique body geometry of each patient will reduce the side effects of radiation to healthy tissues.

Peritoneal dialysis is a method of renal replacement therapy in patients with end-stage chronic renal failure. Over time, peritoneal dialysis damages the peritoneal membrane, which can adversely affect peritoneal function, leading to cessation of peritoneal dialysis and the onset of hemodialysis, and even malnutrition and death. Due to the invasive nature of peritoneal biopsy to evaluate peritoneal injury and fibrosis, the structure of the peritoneal membrane is evaluated based on biomarkers that are secreted by the peritoneal membrane and measured in the peritoneal dialysis effluent. Several biomarkers were studied for this purpose, including interleukin-6, hyaluronan, vascular endothelial growth factor and etc. One of these markers is CA125 antigen, which is considered as a measure of the health and mass of mesothelial cells lining the peritoneum, which, unlike other biomarkers named above, is not secreted by any cell other than mesothelial cells. CA125 is a glycoprotein produced by ovarian cancer cells and is widely used for ovarian cancer screening today. This antigen is also secreted by mesothelial cells lining the peritoneal membrane and can be measured in peritoneal dialysis effluent. Its amount is not affected by the type of dialysis solution. Visser et al. (1995) first proposed the theory of measuring CA125 levels of dialysis fluid at the end of a four-hour peritoneal equilibration test (PET) as a diagnostic biomarker for mesothelial cell function in patients undergoing peritoneal dialysis. Therefore, finding a suitable diagnostic biomarker for rapid detection and identification of peritoneal membrane damage as well as peritoneal function at a lower cost is very valuable and will be of great help in patient management. In this review article, 25 studies with a total of 623 patients over 18 years old and 73 patients under 18 years old undergoing peritoneal dialysis were reviewed and summarized. These 25 studies included clinical trials, descriptive studies, and prospective studies to evaluate the relationship between CA125 dialysis effluent and peritoneal function and to evaluate the value of using this biomarker in evaluating mesothelial cell health and dialysis quality and its relationship with peritonitis and demographic characteristics. Patients were evaluated and summarized. Normal baseline values for CA125 dialysis concentration have not yet been determined. To date, numerous studies have been performed on peritoneal dialysis patients in both age groups of children and adults to determine the concentration of CA125 in dialysis effluent. In these studies, the level of CA125 dialysis had a wide distribution range between 0. 5-65 U / ml and values CA125-AR U / min / 1. 73m2 was variable 3. 471-6. Due to the fact that CA125 dialysis levels in patients are significantly different, its serial measurement in each individual may be a more valuable indicator in the follow-up of specific patients, so that deviation from the process of time reduction can be a worrying sign. Significant difference between CA125 and CA125-AR peripheral concentrations (CA-125 Apearrance rate) with patients' demographic information including age, sex, BMI (Body mas index), primary biopsy results and cause of chronic renal failure leading to dialysis Not seen in various studies. Degradation of the mesothelium over time due to contact with high concentrations of peritoneal dialysis solution, toxicity of glucose metabolites, and the occurrence of peritonitis may explain the decrease in CA125 dialysis concentration. Peritoneal biopsy data show loss of mesothelial layer integrity after 5 years in patients undergoing peritoneal dialysis. It is a gradual process, so its changes over time can be an indication of mesothelial cell mass. This can be used in the longitudinal follow-up of rolling patients. Information on the relationship between CA125 concentration and peritoneal transport is somewhat inconsistent. Only in three papers a positive correlation between CA125 dialysis level and peritoneal transport parameters was reported (11, 14, 15) and no similar correlation was seen in other studies. Dialysis levels of CA125 are temporarily increased during peritonitis and return to the level of patients without peritonitis after recovery. Due to the fact that the increase in CA125 concentration in the acute peritonitis episode occurs due to both reversible damage to mesothelial cells and cell death, it can not have a prognostic effect in patients with acute peritonitis. Despite more than 30 years of initial research introducing CA125 as a biomarker of the mesothelial mass of the peritoneal membrane, many of the results are still contradictory and a full understanding of the biological significance of this biomarker has not yet been established. Changes in its level in each person are unique and valuable over time, and further studies are needed in this regard.

Background: The growing obesity and some chronic diseases such as asthma and diabetes have been the focus of many health researchers over the past two decades. Therefore, the present study aimed to determine the effect of a relatively long period of aerobic exercise on serum levels of glucose, insulin and insulin resistance as indicators for determining diabetes in adult men with asthma. Methods: In this quasi-experimental study, the effect of a period of aerobic exercise on fasting levels of glucose, insulin and insulin resistance in a group of men with chronic asthma was investigated (Saveh, Spring 1398). The statistical population consists of adult men (age 36-48 years, weight 105-80 kg, height 176-170 cm) with asthma in Saveh. The statistical sample consists of 28 asthma patients who were invited to participate in the study during a call at the medical centers in the city, who were welcomed to participate in the study in an accessible manner and with the approval of a cardiologist, and then Randomly divided into experimental groups (participation in the quarterly training program) and control (not participating in the training program). Before the study, all patients were informed of the objectives of the study by the administrators and completed the consent form. Sampling and exercise protocol: To measure biochemical variables, 5 cc of blood was drawn from the brachial vein after 10 to 12 hours of night starvation between 8 and 9 am. Subjects were asked to refrain from any strenuous physical activity for 2 days before sampling. Blood samples were taken to measure fasting glucose and insulin levels. Then, the experimental group participated in an aerobic exercise course. Aerobic exercise was performed in the form of 3 sessions per week for three months. Each training session lasted 60 to 80 minutes. Intensity of exercise during the exercise program ranged from 60 to 80% of maximum heart rate. As the intensity or duration of each training session increased compared to previous sessions by observing the principle of overload. The control group was prohibited from exercising during this period. Exercises were performed with warm-up for 10 minutes, then stretching exercises, endurance exercises in the form of running on a flat surface and pedaling on a stationary bike, and special exercises to strengthen the chest muscles and finally cooling down. Finally, 48 hours after the last training session, measurement of anthropometric indices and fasting blood sampling were repeated with the aim of measuring fasting insulin and glucose levels. Blood samples were centrifuged at 2000 rpm for 10 minutes to separate the resulting serum. Fasting glucose was measured enzymatically by glucose oxidase by Kobas autoanalyzer. Insulin was measured by ELISA using a commercial kit made by the German company Demeditec. The coefficients of intragroup and extragroup changes and serum insulin sensitivity were 2. 6, 2. 88% and 1. 76 IU / ml, respectively. Using fasting insulin and glucose measurements, insulin resistance was measured in each patient. Statistical analysis: Raw data were analyzed using SPSS software version 16. Kolmogorov-Smirnov test was used to determine the normality of the data. Descriptive statistics were used to calculate the central indices and dispersion and independent t-test was used to compare the baseline levels of the variables between the experimental and control groups. Dependent t-test was used to compare the changes of each variable in response to the training program compared to baseline levels. Alpha less than 5% was considered as a significant level. Raw data were analyzed using SPSS software version 16. Kolmogorov-Smirnov test was used to determine the normality of the data. Descriptive statistics were used to calculate the central indices and dispersion and independent t-test was used to compare the baseline levels of the variables between the experimental and control groups. Dependent t-test was used to compare the changes of each variable in response to the training program compared to baseline levels. Results: Information on the levels of anthropometric and biochemical markers in baseline and post-exercise conditions is summarized in Table 1. Findings are presented in terms of mean and standard deviation. The results of independent t-test showed that there was no significant difference in the baseline levels of each of the anthropometric indices, spirometry indices and diabetes diagnostic markers between the experimental and control groups. Exercise program was associated with weight loss, body fat percentage and body mass index as well as other anthropometric markers such as abdominal circumference (p<0. 05). On the other hand, aerobic exercise led to a significant increase in FEV1 (p=0. 023), FVC (p=0. 014) and FEV1 / FVC (p=0. 019) in the experimental group, but these variables changed in the control group Were not significant. On the other hand, the results of independent t-test showed a significant decrease in fasting blood glucose levels in response to the quarterly aerobic exercise program in the experimental group (p=0. 028). The aerobic exercise program also led to a significant reduction in insulin resistance in the experimental group compared to baseline levels (p=0. 011). Statistical findings also showed a significant decrease in serum insulin levels in response to quarterly aerobic exercise in the experimental group (p=0. 033). None of the dependent variables in the control group underwent significant changes (p≥ 0. 05). Conclusion: Significant reductions in fasting glucose and insulin resistance in response to three months of aerobic exercise in adult men with asthma are the main findings of the present study. Although the main mechanisms for lowering glucose levels or insulin resistance in response to a variety of exercise programs are less well known in asthma patients, other hormonal changes or changes in body weight appear to be of particular importance in this category. The improvement in diabetes determinants in the present study may also be attributed to the increase in pulmonary function indices in response to aerobic exercise. Because aerobic exercise was associated with improvement in FVC, FEV1 and FEV1 / FVC in the patients studied. Some studies have suggested a significant relationship between decreased spirometry indices and a history of diabetes. Introduced a risk of outbreak of insulin resistance. Based on this evidence, the increase in spirometry indices representing pulmonary function due to aerobic exercise in the present study may be introduced as a possible effective mechanism in improving the diagnostic indices of diabetes in asthma patients studied. Elevated blood glucose levels and insulin resistance in asthma patients have already been observed by some studies as researchers have suggested a link between asthma and insulin resistance. On the other hand, based on the findings of the present study, it is concluded that providing relatively long-term aerobic exercise is associated with improved blood glucose profile and insulin resistance in these patients, although based on the findings of the present study and other previous studies, the improvement of these variables It can be attributed to hormonal changes, increased lung function and changes in body weight, but recognizing and presenting the main mechanisms responsible for these changes requires further studies in this area.