فهرست مطالب

مجله علوم پزشکی رازی
سال بیست و نهم شماره 6 (پیاپی 220، شهریور 1401)

  • تاریخ انتشار: 1401/10/05
  • تعداد عناوین: 19
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  • امین سعیدی، فاطمه جلالی فر، لیلا کریمی، سپیده میرزایی، مهدی راعی، سلمان دانشی* صفحات 1-11
    زمینه و هدف

    با توجه به اهمیت تشخیص زودهنگام این بیماری، تصویربرداری توسط سی تی اسکن قفسه سینه به عنوان یک روش غیر تهاجمی می تواند  ابزاری با دقت بالا برای تشخیص زودهنگام موارد مشکوک باشد.

    روش کار

    در این مطالعه گذشته نگر، داده ها شامل مشخصات دموگرافیک و یافته های سی تی اسکن قفسه سینه از 224 بیمار با تست PCR مثبت برای 19 COVID- از اسفندماه 1398 تا خردادماه 1399 از بیمارستان امام خمینی دانشگاه علوم پزشکی جیرفت جمع آوری شد و در یک پرسشنامه طراحی شده ثبت شد و برای ارزیابی داده ها از نرم افزار SPSS نسخه 18 استفاده شد.

    یافته ها: 

    بیشترین تعداد افراد مبتلا به کووید-19 در رده سنی 30 تا 59 سال و مردان بودند. در بررسی یافته های سی تی اسکن، بیشترین یافته تصویربرداری سی تی اسکن و هم چنین بیشترین میزان مرگ در افراد مبتلا، نمای PGGO و درگیری به صورت Peripheral و Bilateral و کمترین فراوانی مربوط به یافته  Cavitation بود. 

    نتیجه گیری: 

    با شناسایی یافته های شایع در سی تی اسکن قفسه سینه در افراد مبتلا به  کروناویروس، می توان موارد COVID-19 را به موقع شناسایی  نمود و اقدامات پیشگیرانه فوری را انجام داد. بنابراین با توجه به دقت این ابزار تشخیصی و نتایج سریع آن، باید  تصویربرداری CT در خط مقدم ابزارهای غربالگری COVID-19 قرار گیرد  و سهولت دسترسی گسترده  به آن در مناطق مختلف فراهم گردد.

    کلیدواژگان: سی تی اسکن، کووید-19، کرونا ویروس، ایران
  • سجاد علیزاده، مجید باصری صالحی*، نیما بهادر صفحات 12-25
    زمینه و هدف

    اسینتوباکتربومانی یکی از مهم ترین عوامل عفونت های بیمارستانی است. توانایی فوق العاده در کسب مقاومت دارویی در مقابل طیف وسیعی از آنتی بیوتیک ها را دارد. سویه های مقاوم به چند دارو MDR و تولیدکننده بتالاکتاماز AmpC این باکتری، عامل بیماری های عفونی جدی در بخش های مختلف بیمارستانی و در افراد بستری می باشد و درمان این عفونت ها به علت مقاومت گسترده نسبت به داروهای ضد میکروبی با مشکلات جدی مواجه است. هدف از مطالعه تعیین الگوی مقاومت آنتی بیوتیکی اسینتوباکتر بومانی و بررسی احتمال وجود ژن های کروموزومی و پلاسمیدی مقاوم به آنتی بیوتیک ها در جزایر ژنومی این باکتری بود.

    روش کار

    در این مطالعه 60 ایزوله از گونه های اسینتوباکتر بومانی از نمونه های بالینی جمع آوری شد. آزمون حساسیت ضد میکروبی با استفاده از روش دیسک دیفیوژن و روش PCR برای شناسایی ژن های کروموزومی و پلاسمیدی مقاوم به آنتی بیوتیک ها (dha، cit و mox) انجام شد.

    یافته ها

    بیشترین مقاومت در آمپی سیلین (3/98 %) و کمترین مقاومت در کولیستین (%35) بود. مقاومت بیش از 90% در 12 آنتی بیوتیک از 15 آنتی بیوتیک مشاهده شد.60 ایزوله 34/98% نسبت به بیش از 8 آنتی بیوتیک مقاوم بودند و فقط یک نمونه به همه حساس بود. فراوانی ژن های dha، cit و mox به ترتیب 1 (%2)، 7 (%12) و 27 (%46) بود. 24 ایزوله (%40) برای هر سه ژن منفی بودند. فراوانی ایزوله های حاوی ژنهایmox  با مقاومت آنتی بیوتیکی رابطه مستقیم داشت (05/0 ≤p).

    نتیجه گیری

    نتایج نشان دهنده درصد بالای فراوانی ژنهایmox  است که با مقاومت آنتی بیوتیکی رابطه مستقیم دارد، با این حال حضور این ژنها و رابطه آنها با میزان مقاومت آنتی بیوتیکی نیاز به بررسی بیشتری دارد. مقاومت بالای اسینتوباکتر بومانی به آنتی بیوتیکها بسیار نگران کننده بود، زیرا کنترل و درمان این باکتری را مشکل می سازد. تنها آنتی بیوتیک موثر قابل استفاده در درمان عفونت های مرتبط کولیستین می باشد که مقاومت به آنهم در حال افزایش است.

    کلیدواژگان: مقاومت آنتی بیوتیکی، مقاومت چند دارویی، بتالاکتاماز AmpC، اسینتوباکتر بومانی
  • ملیحه نادری، سمیه طالبی، آسیه بایزن، ندا یوسفی نوجوکامبری، سجاد یزدان ستاد* صفحات 25-37
    زمینه و هدف

    بیماری لوکمی/ لنفوم سلول T بزرگسالان (ATLL) نوعی بدخیمی سلول های T تهاجمی می باشد که پس از عفونت مزمن طولانی مدت با ویروس نوع 1 لنفوتروپیک سلول های T (HTLV-1) ایجاد می شود. سالانه 10 تا 20 میلیون نفر در دنیا به این بیماری مبتلا می شوند و علی رغم میزان بالای عفونت، تنها 5-2 درصد افراد آلوده به HTLV-1 به ATLL مبتلا می شوند. سه راه اصلی برای انتقال ویروس اثبات شده است: (الف) انتقال مادر به فرزند از طریق شیر دادن، (ب) انتقال جنسی و عمدتا از مرد به زن و (ج) اجزای سلولی خون. مطالعه حاضر، با هدف بررسی پیشرفت های صورت گرفته در طول 30 سال گذشته در شناخت عفونت HTLV-1، همانندسازی، بیان ژن های بیماریزایی، تغییر شکل سلول متاثر از فعالیت ویروس و نیز روش های درمانی، پیشگیری از عفونت ویروس و لنفوم-لوکمی سلول های T انجام شده است.

    روش کار

    تدوین مطالعه مروری سیستماتیک حاضر، بر اساس استراتژی جستجوی پیشرفته و استاندارد واژگان کلیدی شامل Leukemia، Lymphoma، ATLL، HTLV-1 و لکوموژنسیس در پایگاه های اطلاعاتی PubMed، Springer، Scopus، Medline، Google Scholar،Science Direct  و Web of Science انجام گردید.

    نتیجه گیری

    علی رغم پیشرفت های اخیر در شیمی درمانی، پیوند سلول های بنیادی هماتوپویتیک آلوژنیک (alloHSCT) و درمان های حمایتی، پیش آگاهی بیماران مبتلا به ATLL یکی از ضعیف ترین پیش آگاهی ها در بین بدخیمی های هماتولوژیکی می باشد. غربالگری پیش از تولد برای HTLV-1 باید در نواحی اندمیک با ارایه اطلاعات و مشاوره دقیق به کار گرفته شود و از طرفی توسعه و تکامل یک واکسن ایمن و موثر می تواند یک ابزار مهم در حفاظت ناقلین در برابر ATLL باشد.

    کلیدواژگان: لوکمی، لنفوم، ATLL، HTLV-1، انتقال جنسی
  • عرفانه موحدی نجف آبادی، مهدی صابری پیروز، صدیقه مرادی*، فاطمه گلگیری، جهانبخش خمسه، مهنا اسکندری صفحات 38-47
    زمینه و هدف

    درخواست نامتناسب تست‎های تیروییدی امری مسیله‎ساز است. به جز موارد درخواست نابه‎جای تست‎های عملکرد تیرویید، باید به این نکته توجه کرد که سنجش هورمون TSH (Thyroid stimulating hormone)  به تنهایی حساسیت زیادی برای افتراق موارد کم‎کاری و پرکاری تیرویید از موارد با عملکرد طبیعی این غده را دارد. پژوهش حاضر به بررسی الگوهای درخواست تست‎های عملکردی تیرویید و موارد منطقی درخواست آن‎ها پرداخته است.

    روش کار

    تعداد 488 بیمار که در بازه زمانی مهر تا اسفند سال 1397 در بیمارستان فیروزگر بستری و تست های تیروییدی برای آن ها درخواست شده بود، وارد این مطالعه مقطعی شدند. نمونه‎ها با ارزیابی بالینی و اخذ شرح حال با هدف یافتن ضرورت درخواست تست تیرویید بررسی شدند. در صورت محتمل بودن تشخیص اختلالات عملکرد تیرویید در مرحله بعد آزمایشات درخواستی از نظر انطباق با الگوریتم‎ها و دستورالعمل‎های موجود بررسی شدند. نهایتا در صورت منتهی شدن بررسی‎های آزمایشگاهی به تشخیص نهایی، متناسب بودن تست عملکردی درخواستی با تشخیص نهایی بررسی شد.

    یافته ها:

     میانگین TSH T4 (Thyroxine) و T3 (Triiodothyronine) بیماران به ترتیب برابر  mlU/L58/3،     µg/dL 68/7 و  nmol/L 61/1 بود.
    در مورد فراوانی درخواست های غیرضروری، T3 با 2/99% ، TSH با 6/60% ، و T4 با 4/59 % به ترتیب بیشترین تا کمترین فراوانی را به خود اختصاص دادند. تمامی درخواست های تست های fT3 (Free,Triiodothyronine) و fT4 (Free,Thyroxine) غیرضروری بودند. بیشترین علت های ضروری که آزمایشات تیروییدی درخواست شده بود به ترتیب هیپوتیروییدی، آدنوم هیپوفیز و Congestive heart failure (CHF) جبران نشده بودند. شایع ترین الگوهای درخواست تست های عملکرد تیروییدی به ترتیب TSH،T4وT3با 87/69% و TSH و T4 با 57/15% بودند.

    نتیجه گیری: 

    این مطالعه نشان داد که درخواست هم زمان تمام شاخص های تیروییدی امری شایع است و الگوهای نامتعارف درخواست تست عملکرد تیرویید، موارد متعدد درخواست این تست‎ها و در نظر نگرفتن سطح TSH طبیعی، باعث درخواست غیرضروری تست‎های عملکرد تیرویید می‎شود؛ بنابراین، بر اساس این نتایج پیشنهاد می شود که اندازه گیری تست های عملکردی تیرویید فقط در موارد منطقی و با الگوی مناسب انجام شود و از درخواست هم زمان همه تست های تیروییدی در مرحله اول خودداری شود.

    کلیدواژگان: تست های تیروئیدی، درخواست های غیرضروری تست های تشخیصی، الگوی درخواست تست های تشخیصی، بیماران بستری
  • معصومه نعل چی، مهری دارایی*، ابراهیم پورحسینی صفحات 48-59
    زمینه و هدف

    تعارض و خشم به عنوان جزیی اجتناب ناپذیر و لاینفک از زندگی سازمانی قلمداد می شود که به علل مختلف در سازمان رخ می دهد. راه حل ها و استراتژی های حل تعارض و خشم در سازمان ها، بسیار متنوع بوده و هر یک دارای نقاط قوت و ضعف هستند. لذا، هدف از تحقیق حاضر، تبیین مدل تعارض و کنترل خشم در مدیران دانشگاه های علوم پزشکی ایران به روش کیفی می باشد.

    روش کار

    مطالعه حاضر از نظر ماهیت از نوع تحقیقات توصیفی- پیمایشی است. جامعه آماری در پژوهش حاضر، خبرگان حوزه علوم پزشکی می باشند. نمونه آماری توسط نمونه گیری غیراحتمالی و در سه مرحله بدست آمد. ابزارهای پژوهش شامل مطالعات کتابخانه ای، مصاحبه نیمه ساختار یافته به صورت سوالات باز (15 سوال) و پرسشنامه در طیف لیکرت 5 امتیازی است که از نتایج دو ابزار قبل استخراج گردید. روش تحقیق در این بخش، تکنیک دلفی است.

    یافته ها

    بر اساس نتایج بدست آمده از سه دور دلفی، 9 مولفه اصلی و 72 مولفه فرعی در نهایت به عنوان شاخص های کننترل تعارض و خشم در دانشگاه های علوم پزشکی انتخاب شدند. مولفه های اصلی مدیریت تعارض عبارتند از: مذاکره، همکاری، استفاده از نظام پیشنهادات، اجتناب، رویارویی، نرمش و سازش، کنترل، تطبیقی و تغییر در روابط.

    نتیجه گیری: 

    مدیران سازمان ها به ویژه دانشگاه های علوم پزشکی کشور برای حل تعارض و خشم در سازمان، ابتدا شرایط و موقعیت و همچنین میزان شدت تعارض را سنجیده و از یکی از روش های حل تعارض استفاده نمایند. روش هایی که با سازش و نرمش هستند برای مشکل تعارض بیشتر توصیه می شود.

    کلیدواژگان: تکنیک دلفی، دانشگاه علوم پزشکی، مدیریت تعارض، کنترل خشم
  • سعیده شیردل*، الهام شیرازی، مسعود احمدزاد اصل، کاوه علوی، امیرحسین جلالی، لیلا طهماسبی صفحات 60-72
    زمینه و هدف

    با توجه به شیوع اختلالات رفتاری و هیجانی در کودکان، پرسشنامه های غربالگری متعددی در اقصی نقاط جهان جهت غربالگری از لحاظ مشکلات روانی اجتماعی و هیجانی طراحی شده و روایی و پایایی پرسشنامه ها نیز تایید شده اند. هدف این مطالعه نیز بررسی روایی و پایایی نسخه ترجمه شده به فارسی پرسشنامه سیاهه علایم کودکان PSC می باشد.

    روش کار

    ابتدا پرسشنامه PSC به زبان فارسی ترجمه و توسط 16 تن روان پزشک و روانشناس حیطه اطفال روایی صوری و محتوایی آن تایید شد. در مرحله بعد در اختیار 180 نفر از مادران شاغل در بیمارستان های روان پزشکی ایران، حضرت رسول و انستیتو روان پزشکی تهران قرار گرفت. سه هفته بعد از تکمیل نیز تعداد 30 نفر از مادران جهت بررسی پایایی آزمون، مجددا پرسشنامه را تکمیل کردند. هم زمان با PSC دو پرسشنامه CSI-VI و SDQ (که قبلا روایی و پایایی نسخه فارسی آن ها بررسی و تایید شده است) نیز تکمیل شد و از نتایج آن ها به عنوان استاندارد جهت بررسی نتایج آزمون PSC استفاده شد. پرسشنامه PSC شامل سوالاتی بود که بر روی مشکلات درونی و بیرونی شده و اختلال تمرکز در کودک و نوجوان متمرکز شده است.

    یافته ها:

     نسخه فارسی پرسشنامه PSC از روایی صوری و محتوایی بالایی برخوردار بوده و پایایی آزمون و همسانی درونی بالایی داشت. قدرت غربالگری در سه حیطه مشکلات بیرونی شده، درونی شده و اختلال توجه نیز مناسب بود.

    نتیجه گیری: 

    نسخه فارسی PSC جهت سنجش و غربالگری زودرس اختلالات روان پزشکی در مدارس و کلینیک ها مناسب می باشد.

    کلیدواژگان: سیاهه، روایی، پایایی، کودکان
  • الهه ناز حاجی مطلبی، سمیه اسدیان نارنجی*، رضا گلیجانی مقدم صفحات 73-88
    زمینه و هدف

    پسوریازیس، نوعی بیماری مزمن التهابی پوستی چند عاملی و با زمینه ایمونوژنتیکی است که در بین جمعیت ها و قومیت های مختلف شیوع دارد. اینترلوکین 10 یک سایتوکاین ضد التهابی است که توسط منوسیت ها، لنفوسیت ها و سایر سلول ها تولید می شود. چندین مطالعه که به بررسی ارتباط بین پلی مورفیسم rs1800896 ژن اینترلوکین 10 و حساسیت پذیری به بیماری پسوریازیس پرداخته اند، نتایج ضدو نقیضی را نشان دادند؛ بنابراین هدف مطالعه اخیر، بررسی ارتباط بین پلی مورفیسم -1082G/A ژن IL-10 و پسوریازیس در شمال ایران می باشد.

    روش کار

    در این مطالعه مورد-شاهدی، تعداد 50 نمونه خون تام افراد مبتلا به پسوریازیس در غرب مازندران و شرق گیلان که بیماری آنان توسط پزشک متخصص تایید شده بود و نیز تعداد 35 نمونه خون تام افراد سالم به عنوان گروه کنترل که تمام شرایط گروه کنترل را دارا بودند، از آزمایشگاه های مناطق ذکر شده جمع آوری گردید. بعد از استخراج DNA نمونه ها، به کمک روش ARMS-PCR، ارتباط بین ژنوتیپ های AA، AG و GG در ژن IL-10 با احتمال ابتلا به پسوریازیس تعیین شد. به منظور تایید صحت انجام کار از تکنیک تعیین توالی استفاده شد. معنی دار بودن تفاوت در فراوانی آللی و ژنوتیپی بین دو گروه با آزمون مربع کای دو بررسی گردید. به منظور حذف اثر عوامل مداخله گر احتمالی از آزمون رگرسیون لجیستیک استفاده شد و Odds Ratio در محدوده اطمینان (95%) CI محاسبه گردید. 05/0˂p به عنوان مقدار سطح معنی داری در نظر گرفته شد.

    یافته ها : 

    نتایج حاصله نشان داد تفاوت معناداری در میزان بروز این آلل ها بین دو گروه مورد مطالعه وجود دارد، بطوریکه آلل G در افراد مبتلا به پسوریازیس بیشتر از افراد سالم می باشد و از نظر ژنوتیپی، ژنوتیپ GG در افراد مبتلا به پسوریازیس در مقایسه با افراد سالم بیشتر است؛ بنابراین می توان نتیجه گرفت، ارتباط معناداری بین پلی مورفیسم rs 1800896 ژن اینترلوکین 10 و استعداد ابتلا به بیماری پسوریازیس در غرب مازندران و شرق گیلان وجود دارد.

    نتیجه گیری: 

    پیشنهاد می شود برای حصول اطمینان بیشتر و نتایج قابل تعمیم، بررسی در مناطق مختلف ایران و با جامعه آماری تا حد ممکن بالاتر و نیز بر روی تمام پلی مورفیسم های این ژن انجام شود.

    کلیدواژگان: پسوریازیس، اینترلوکین 10، پلی مورفیسم، ARMS-PCR
  • معین فصیحیان، مریم طاهری، خسرو ابراهیم، مریم نورشاهی* صفحات 89-104
    زمینه و هدف

    بازماندگان پس از سکته مغزی، دچار اختلالات حرکتی، ضعف حافظه و مشکلات شناختی می شوند. ورزش می تواند استراتژی مناسبی برای توان بخشی این بیماران باشد. هدف از این مطالعه مروری، بررسی مطالعات گذشته در خصوص اثر محافظتی و تمایز پذیری عصبی انواع تمرینات ورزشی در دوره توان بخشی پس از سکته مغزی ایسکمیک می باشد.

    روش کار

    جهت یافتن مقالات با محوریت تاثیر انواع تمرینات ورزشی بر روی سلول های عصبی آسیب دیده پس از سکته مغزی، از بانک های اطلاعاتی و وبگاه های متعدد از جمله: Google Scholar، PubMed، Web of Science و Scopus استفاده شد. سپس با در نظر گرفتن معیارهای ورود و خروج، فرآیند مرور، غربالگری و حذف اطلاعات تکراری و غیر مرتبط، کلیه مقالات در بازه زمانی سال های 2005 تا 2021 انتخاب و در نهایت 65 مقاله مرتبط با موضوع، مورد بررسی قرار گرفت.

    یافته ها

    با توجه به بررسی های صورت گرفته در خصوص تاثیر انواع تمرینات ورزشی در بازه های زمانی مختلف پس از سکته مغزی، تمرینات ورزشی مختلف، تغییرات متفاوتی را در سلول های عصبی ایجاد می کنند که این اثرات وابسته به زمان شروع تمرینات پس از سکته مغزی و نوع تمرینات ورزشی، می باشند.

    نتیجه گیری

    بر اساس نتایج به دست آمده در مطالعات، تمرینات ورزشی با شدت کم در فاز حاد تا یک هفته پس از سکته مغزی و تمرینات با شدت بالا در فاز مزمن، بیش از یک هفته پس از سکته مغزی، بیشترین تاثیرات آنابولیک را در سلول های عصبی آسیب دیده خواهند داشت که در این زمینه می توان استراتژی هایی مانند ورزش های با شدت و مدت فزاینده را در نظر گرفت البته نیاز به بررسی های بیشتر در این زمینه وجود دارد.

    کلیدواژگان: سکته مغزی ایسکمیک، توان بخشی، تمرینات استقامتی، تمرینات شناختی، تمایز پذیری عصبی
  • حمید دمیری، آمنه زارع*، امین کریم نیا، محمدحسین شرف زاده صفحات 105-114
    زمینه و هدف

    امروزه مشکلات گفتاری بیماران دستورپریش فارسی زبان به عنوان یک مسیله مهم و جدی مورد توجه محققان قرار گرفته است. این مسیله سبب گردیده است تا تحقیق حاضر با هدف بررسی سطوح اختلالات گفتاری در بیماران دستورپریش فارسی زبان طراحی و اجرا گردد.

    روش کار

    جهت انجام این تحقیق توصیفی و تحلیلی که به صورت میدانی انجام شده است، 6 بیمار دستور پریش که در سال 1398 به بیمارستان شهدای نی ریز در استان فارس مراجعه کرده اند، انتخاب شدند. آزمودنی های بیمار همگی 35-80 ساله، دارای تحصیلات حداقل ابتدایی، تک زبانه و فارسی زبان، راست دست بودند. داده های مورد نظر به وسیله آزمون های زبان پریشی فارسی مطابق با الگوی گرادزینسکی و فرید من (1997) جمع آوری شده اند. به منظور تجزیه و تحلیل داده های تحقیق حاضر از آمار توصیفی و استنباطی استفاده گردید. در بخش آمار توصیفی از فراوانی و درصد استفاده شد. همچنین در بخش آمار استنباطی از آزمون کای اسکویر استفاده گردید. کلیه فرایند تجزیه و تحلیل داده های تحقیق حاضر در نرم افزار SPSS انجام گردید.

    یافته ها:

     یافته های تحقیق نشان داد که بیماران دستور پریش فارسی در درک کلمات و واژگان عملکرد مطلوب تری به نسبت تولید آنان کلمات داشتند. به صورتی که عملکرد این بیماران در بیان کلمات دچار مشکلات اساسی بود.

    نتیجه گیری:

     به صورت کلی بیماران دستور پریش فارسی دچار اختلالات گفتاری در ابعاد مختلف می باشند که این مسیله نشان می دهد که می بایستی روشی شناختی-زبانی جهت بهبود توانایی های گفتاری آنان ایجاد گردد.

    کلیدواژگان: دستور پریشی، درخت نحوی کوتاه شده، کمینه گرایی، مطابقه، زمان
  • ایرج عابدی*، نگار عبدی، مظفر ناصرپور، مسعود ربانی صفحات 115-122
    زمینه و هدف

    روش استاندارد در تشخیص و مرحله بندی سرطان پروستات، نمونه برداری و تعیین مقدار شاخص گلیسون (Gleason Score) می باشد.  در این مطالعه ارتباط بین شاخص گلیسون به عنوان روش استاندارد در بیماران مبتلا به سرطان پروستات با پارامتر های استخراج شده از تصاویر دیفیوژنی تشدید مغناطیسی (Diffusion-Weighted Images) بررسی گردید.

    روش کار

    این مطالعه ی کاربردی بر روی 90 بیمار مبتلا به سرطان پروستات که بر اساس معیار های Mc Donald از اسفند ماه 1398 تا  بهمن ماه 1399 به مرکز تصویربرداری شفای اصفهان ارجاع داده شده بودند، انجام شد. پس از تشخیص اولیه توسط پزشک، ابتدا تصاویر آگزیال دیفیوژن با تنفس آزاد و با استفاده از سیستم Siemens مدل Avanto، با قدرت 5/1 تسلا (با مقادیر b برابر با mm2 / s 0، 1000، 1500 و 2000) از بیماران اخذ گردید. پس از جراحی پروستاتکتومی، نمونه ها به آزمایشگاه پاتولوژی ارجاع داده شدند و شاخص گلیسون در آن ها تعیین گردید. سپس این مقادیر با مقادیر ضریب انتشار ظاهری (Apparent Diffusion Coefficient) مقایسه و نتایج گزارش گردید.

    یافته ها

    آنالیز همبستگی پیرسون همبستگی منفی و معنادار قابل توجهی بین شاخص گلیسون و اندازه گیری های ADC نشان داد (926/0- r =، 01/0p=).

    نتیجه گیری

    عمده ترین محدودیت مطالعات قبلی، غیر قابل اطمینان بودن مقدار GS حاصل از نمونه برداری و مشکلات در تعیین دقیق محل تومور در MRI بود. برای غلبه بر این محدودیت، در این مطالعه از نمونه های پروستاتکتومی برای بررسی ارتباط تصویر دیفیوژنی و مقدار شاخص GS استفاده شد. نتایج مطالعه حاضر نشان داد که استفاده از نمونه های پروستاتکتومی دقت بالاتری در تعیین ارتباط بین شاخص های تصویری و پاتولوژی در مقایسه با نتایج حاصل از نمونه برداری دارد.

    کلیدواژگان: تصویربرداری تشدید مغناطیسی، سرطان پروستات، شاخص گلیسون، مقدار b
  • شادی جلالیان*، فرشاد غزالیان صفحات 122-133
    زمینه و هدف

    مشکلات و مسایل متعددی که به طور فیزیولوژیک در سنین بالا رخ می دهد، در کاهش کیفیت زندگی در طول دوره سالمندی تاثیر دارد. هدف از مطالعه حاضر بررسی تاثیر 12 هفته فعالیت ورزشی به همراه جینکگوبیلوبا بر سطوح سرمی BDNF و کیفیت زندگی در سالمندان شهر تهران بود.

    روش کار

    مطالعه ی حاضر از نوع نیمه تجربی و آزمایشگاهی که با توجه به طول زمان، از نوع مقطعی و به لحاظ استفاده از نتایج، کاربردی میباشد بصورت پیش آزمون و پس آزمون، با 40 سالمند (60-75 سال) که طبق فراخوان در سطح شهر تهران انتخاب شدند و به صورت تصادفی به چهار گروه تمرین (10=N)، گروه مکمل (10=N)، گروه تمرین+ مکمل (10=N) و گروه کنترل (10=N) تقسیم شدند، انجام گردید. پروتکل گروه تمرین شامل هوازی، قدرتی، انعطاف پذیری و تعادل را (12 هفته و 5 جلسه در هر هفته و به مدت 20 دقیقه در هر جلسه) انجام دادند. گروه مکمل نیز 240 میلی گرم کپسول (یک بار در روز و در صبح قبل از تمرین) را به مدت 12 هفته مصرف کردند. قبل و بعد از مداخله نمونه خونی برای سنجش BDNF سرم و از پرسشنامه SF36 برای سنجش کیفیت زندگی در سالمندان استفاده شد. برای تجزیه و تحلیل داده ها از آزمون آماری ANOVA استفاده شد.

    یافته ها:

     نتایج این مطالعه نشان داد که بین سطوح BDNF سالمندان و نیز کیفیت زندگی (QoL) در گروه‏های مورد مطالعه بعد از دوازده هفته تمرین هوازی به همراه مکمل دهی جینکگوبیلوبا تفاوت معناداری وجود دارد (05/0<p). همچنین نتایج بین گروهی نشان داد که بین تمام گروه ها در سطوح سرمی BDNF تفاوت معنا داری وجود دارد (05/0<p). هم چنین نتایج آزمون توکی برای مقایسه بین گروهی شاخص QoL نشان داد که بین تمام گروه ها تفاوت معنا داری وجود دارد (05/0<p) اما بین دو گروه مکمل و گروه کنترل تفاوت معناداری دیده نشد (05/0>p).

    نتیجه گیری: 

    بطور کلی یافته های مطالعه حاضر نشان داد که انجام فعالیت ورزشی منظم به همراه مصرف مکمل جینکگوبیلوبا سبب بهبود عامل نروتروفیک مشتق از مغز و افزایش کیفیت زندگی سالمندان می شود.

    کلیدواژگان: تمرین هوازی، جینکگوبیلوبا، سالمندان، BDNF
  • معصومه راحت دهمرده، ولی مهدی نژاد*، فاطمه صغری کربلایی هرفته صفحات 134-143
    زمینه و هدف

    تنظیم هیجان و روابط اجتماعی از عوامل مهم مرتبط با فعالیت های مشارکتی برای دانش آموزان می باشند؛ لذا هدف مطالعه، نقش آموزش علم و دانش از طریق فعالیت بدنی بر بهبود روابط اجتماعی و تنظیم هیجانی بود.

    روش کار

    در این مطالعه نیمه تجربی، جامعه آماری شامل کلیه دانش آموزان دختر پایه دوم و سوم ابتدایی شهر زاهدان در سال تحصیلی 1399-1398 بود که به دلیل نیمه تجربی بودن مطالعه، تعداد 30 نفر به روش نمونه گیری هدفمند انتخاب شدند و به طور تصادفی در دو گروه تجربی (15 نفر) و کنترل (15 نفر) جایگزین شدند. جهت گردآوری داده ها از پرسشنامه روابط اجتماعی بارتون (1990) و تنظیم هیجانی گراس و جان (2003) استفاده شد. روش اجرای مداخله فعالیت بدنی به صورت 12 جلسه و هر جلسه به مدت یک ساعت برای گروه های تجربی بود. تجزیه و تحلیل داده ها با کمک آزمون تی وابسته و تی مستقل انجام شد.

    یافته ها: 

    نتایج بررسی درون گروهی نشان داد که در گروه تجربی سطح روابط اجتماعی و ارزیابی مجدد افزایش معنی داری داشت (به ترتیب 002/0= P و 002/0= P)، ولی سطح سرکوبی کاهش نشان داد (001/0= P). از طرفی بررسی بین گروهی نشان داد که آموزش از طریق فعالیت بدنی منجر به بهبود روابط اجتماعی، ارزیابی مجدد و سرکوبی در گروه تجربی نسبت به گروه کنترل گردید (به ترتیب 002/0= P، 001/0= P، 003/0= P).

    نتیجه گیری:

     به طور کلی نتایج نشان داد که در مدارس هوشمند، از مداخلات فعالیت بدنی برای یادگیرندگان بهره گرفته شود تا سطح عوامل روانشناختی بهبود یابد.

    کلیدواژگان: فعالیت بدنی، روابط اجتماعی، تنظیم هیجانی، مدارس هوشمند
  • مرتضی چناری، علیرضا رحیمی*، امیر سرشین، فواد فیض الهی صفحات 144-154
    زمینه و هدف

    آسیب بافت قلب در دیابت باعث التهاب و تخریب سلول های قلب و در نتیجه آپوپتوز یا مرگ سلول می شود. هدف مطالعه حاضر مقایسه تاثیر تمرین هوازی و مقاومتی بر شاخص های آپوپتوزی Bax و کاسپاز-3 در بافت قلب رت های دیابتی نر نژاد ویستار بود.

    روش کار

    در این مطالعه تجربی، 24 سر رت نر نژاد ویستار (میانگین وزن 200 - 250 گرم) 10 تا 12 هفته ای به شش گروه، تمرین هوازی، تمرین مقاومتی، شم هوازی، شم مقاومتی، کنترل و سالم تقسیم شدند. القای دیابت با تزریق تک دوز استرپتوزوتوسین به روش درون صفاقی انجام شد. برنامه تمرین هوازی و مقاومتی به مدت شش هفته انجام شد. برای اندازه گیری میزان BAX و کاسپاز 3 از روش وسترن بلات استفاده شد. داده ها به روش آزمون تحلیل واریانس یک طرفه و آزمون تعقیبی توکی در سطح معنی داری P<0.05 تجزیه و تحلیل شد.

    یافته ها

    نتایج نشان داد اختلاف میانگین کاسپاز-3 بین گروه تمرین هوازی با گروه سالم و شم (000/0=P)، گروه تمرین مقاومتی با گروه شم (000/0=P) و گروه تمرین هوازی با گروه تمرین مقاومتی (000/0=P) معنادار بود و میزان کاسپاز 3 در گروه تمرین مقاومتی نسبت به تمرین هوازی کمتر بود. اختلاف میانگین BAX بین گروه تمرین هوازی با گروه سالم و شم (000/0=P)، گروه تمرین مقاومتی با گروه شم (000/0=P) و گروه تمرین هوازی با گروه تمرین مقاومتی (014/0=P) معنادار بود و میزان BAX در گروه تمرین مقاومتی نسبت به تمرین هوازی کمتر بود.

    نتیجه گیری: 

    تمرینات هوازی و مقاومتی می تواند موجب کاهش میزان شاخص های پیش آپوپتوزی Bax و کاسپاز 3، در بافت قلب رت های دیابتی گردد و تمرینات هوازی مزایای بیشتری به همراه داشت.

    کلیدواژگان: دیابت، Bax، کاسپاز 3، تمرین هوازی، تمرین مقاومتی
  • مجتبی رسولیان، جمشید بنایی بروجنی*، پروین فرزانگی صفحات 155-168
    زمینه و هدف

    یکی از شایع ترین مشکلات جسمی در دوران سالمندی بیماری مزمن دیابت است. این مساله از شدت و حساسیت بیشتری برخوردار است؛ بنابراین، پژوهش حاضر با هدف تعیین اثر حفاظتی تمرین تداومی و تناوبی همرا با مصرف آتورواستاتین بر بیان PGC1α و TFAM میوسیت های قلبی رت های سالمند انجام شد.

    روش کار

    در این مطالعه تجربی، 35 سر موش صحرایی نر مسن به 7 گروه مساوی: دیابتی، کنترل سالم، تداومی+ دیابتی، تناوبی+ دیابتی، آتورواستاتین+ دیابتی، تناوبی+آتورواستاتین+دیابتی، تداومی+آتورواستاتین+ دیابتی تقسیم شدند. دیابت نوع دو با استرپتوزوتوسین (STZ) در موش ها القا شد. گروه های تمرینی به مدت هشت هفته برنامه تمرینی دویدن را روی تردمیل انجام دادند. تمرین تداومی هفته اول با سرعت 15 متر بر دقیقه مدت پنج دقیقه سپس هر هفته با افزایش سرعت 1 تا 2 متر بر دقیقه به مدت 1 تا 2 دقیقه به زمان دویدن افزده شد. تمرین تناوبی شامل 29-25 دقیقه دویدن روی تردمیل بدون شیب و با سرعت 15 متر در دقیقه برای هفته اول بود. هر هفته یک متر بر دقیقه اضافه شد تا در هفته هشتم به 22 متر بر دقیقه رسید. به گروه های آتورواستاتین و آتورواستاتین تمرین (2 میلی گرم/کیلوگرم) آتورواستاتین تزریق شد. 48 ساعت پس از آخرین جلسه تمرینی، موش های صحرایی تشریح شدند؛ برای تجزیه و تحلیل آماری از تحلیل واریانس یک راهه و آزمون تعقیبی توکی در سطح معنی داری 05/0 ≤p استفاده شد.

    یافته ها

    نتایج نشان داد القای دیابت نوع دو باعث کاهش بیان PGC1α و TFAM(000/0=p) در گروه های دیابتی، تداومی+دیابتی، تناوبی+دیابتی، آتورواستاتین+دیابتی، تناوبی+آتورواستاتین+دیابتی، تداومی+آتورواستاتین+دیابتی نسبت به گروه سالم شد. تجویز آتورواستاتین به تنهایی و یا همراه با تمرین ورزشی سبب افزایش معنی داری در بیان ژن های PGC1α و TFAM  (000/0=p) میوسیت های قلبی گردید؛ اما اختلاف معنی داری بین گروه های تمرینی با هم و با گروه آترو استاتین مشاهده نشد.

    نتیجه گیری:

    احتمالا ترکیبی از تمرین تناوبی و تداومی و آتورواستاتین ممکن است بیان ژن های مرتبط با بیوژنز میتوکندریایی را در بیماری دیابتی به طور مثبتی تنظیم کند و موجب افزایش ظرفیت متابولیکی در این بیماران شود.

    کلیدواژگان: تمرین، آتورواستاتین، بیوژنز میتوکندریایی، دیابت
  • مریم مهدوی، سیده علیا عمادیان*، رمضان حسن زاده صفحات 169-177
    زمینه و هدف

     بیماری‌های التهابی روده شرایطی مادام‌العمر هستند که بیمار را نه تنها از نظر شکایات جسمی به چالش می‌کشند بلکه بر مسایل روانی– اجتماعی نیز اثر می گذارند. هدف از انجام پژوهش حاضر اثربخشی درمان مبتنی بر پذیرش و تعهد بر حساسیت بین فردی بیماران اولسراتیو کولیتیس بود.

    روش کار

     برای انجام پژوهش نیمه آزمایشی حاضر که با طرح پیش‌آزمون- پس‌آزمون با گروه کنترل انجام شد از بین افراد مبتلا به اولسراتیو کولیتیس در سال 1400 با روش نمونه گیری هدفمند، 24 نفر با رعایت معیارهای ورود و خروج به مطالعه انتخاب و به صورت تصادفی به دو گروه درمان مبتنی بر پذیرش و تعهد و کنترل تقسیم شدند. بعد از تکمیل فرم رضایت نامه و گردآوری داده ها در پیش‌آزمون با استفاده از پرسشنامه بایس و پارکر (1989)، گروه آزمایش 8 جلسه 90 دقیقه ای در معرض درمان مبتنی بر پذیرش و تعهد قرار گرفت اما گروه کنترل درمانی را دریافت نکرد. پس از مداخله و دو ماه بعد مجددا پرسشنامه توزیع و جمع آوری شد. نهایتا داده ها با استفاده از نرم‌افزار SPSS23 و آزمون تحلیل کواریانس چند متغیری و تحلیل واریانس با اندازه گیری مکرر تجزیه و تحلیل شدند.

    یافته‌ها: 

    نتایج نشان داد که درمان مبتنی بر پذیرش و تعهد باعث کاهش حساسیت بین فردی بیماران اولسراتیو کولیتیس شد.

    نتیجه گیری

     با توجه به نتایج استفاده از این مداخلات برای بهبود حساسیت بین فردی این بیماران پیشنهاد می شود.

    کلیدواژگان: درمان مبتنی بر پذیرش و تعهد، حساسیت بین فردی، اولسراتیو کولیتیس
  • بهراد زادافشار، طیبه شریفی*، رضا احمدی، مریم چرامی صفحات 178-187
    زمینه و هدف

    کودک آزاری پیامدهای کوتاه مدت و بلند مدت مخربی بر روی کودک دارد. هدف از انجام تحقیق حاضر مقایسه تاثیر گروه درمانی هیجان مدار و وجودی بر مکانیسم های دفاعی قربانیان آزار جنسی کودکی شهر اصفهان بود.

    روش کار

    برای انجام تحقیق نیمه آزمایشی حاضر که با طرح پیش آزمون- پس آزمون- پیگیری و گروه کنترل انجام شد از بین افرادی با سابقه قربانی شدن توسط هرگونه آزار جنسی در کودکی که به مراکز روانشناسی شهر اصفهان مراجعه کرده بودند تعداد 45 نفر به صورت در دسترس انتخاب شده و به طور تصادفی به سه گروه درمانی هیجان مدار، وجودی و کنترل تقسیم شدند. پس از تکمیل فرم رضایت نامه آزمودنی های گروه های آزمایش 8 جلسه مداخلات مربوط به خود را دریافت کردند. از آمار توصیفی، آزمون شاپیروویلک و تحلیل واریانس با اندازه گیری مکرر جهت تجزیه و تحلیل داده ها استفاده شد.

    یافته ها: 

    نتایج نشان داد هیچ یک از دو روش درمانی بر مکانیسم های دفاعی رشد نیافته، رشد یافته و روان آزرده قربانیان آزار جنسی کودکی شهر اصفهان تاثیر معناداری نداشته اند (05/0<P)؛ اما بین مراحل اندازه گیری تفاوت معناداری وجود دارد که نشان دهنده تاثیر هر دو مداخله بر متغیرهای تحقیق می باشد.

    نتیجه گیری

    با توجه به نتایج تحقیق توصیه می شود قربانیان آزار جنسی کودکی با مشورت درمانگر از دو نوع مداخله استفاده کنند.

    کلیدواژگان: گروه درمانی هیجان مدار، گروه درمانی وجودی، آزار جنسی، مکانیسم های دفاعی
  • هادی کرمی، امین فرزانه حصاری*، پروین فرزانگی صفحات 188-198
    زمینه و هدف

    پرفشارخونی به دلیل ایجاد خطرات قلبی عروقی و بیماری های کلیوی، از مهم ترین معضلات سلامت عمومی است. هدف از انجام تحقیق حاضر تعیین اثر دو شدت مختلف تمرین تناوبی همراه مصرف آلفا لیپوییک اسید بر بیان ژن MFN بافت قلب موش موش های دارای پرفشارخونی بود.

    روش کار

    برای انجام این تحقیق تجربی 35 سر موش نر نژاد ویستار، هشت هفته ای و وزن 190 تا 220 گرم انتخاب و پس از یک هفته آشناسازی، 5 موش به صورت تصادفی به عنوان گروه سالم جدا شده و 30 موش باقیمانده دچار پرفشارخونی شده و بصورت تصادفی در شش گروه: کنترل، تمرین تناوبی متوسط، تمرین تناوبی شدید، مکمل آلفا لیپوییک اسید، مکمل+ تمرین تناوبی شدید، مکمل+ تمرین تناوبی متوسط تقسیم شدند. برای القای پرفشارخونی، محلول ال نیترو آرژنین متیل استر با دوز 40 میلی گرم به ازای هر کیلوگرم وزن بدن در روز و به مدت سه هفته بصورت خوراکی استفاده شد. برنامه تمرینی تناوبی با شدت بالا و متوسط به مدت شش هفته و پنج جلسه در هفته اجرا شد. به منظور مکمل دهی، روزانه میزان 20 میلی گرم به ازای هر کیلوگرم وزن بدن موش ها مکمل آلفالیپوییک اسید لیپوزومال در متیل سلولز حل شده و یک ساعت بعد از تمرین بصورت گاواژ به موش ها داده شد. بیان ژن mfn2 از روش real-time PCR اندازه گیری گردید.

    یافته ها: 

    سطح mfn2 در گروه دیابتی نسبت به گروه سالم کاهش معنی داری داشت (018/0=P). آلفالیپوییک اسید (008/0=P) و تمرین تناوبی شدید+آلفالیپوییک اسید (014/0=P) و تمرین تناوبی شدید+آلفالیپوییک اسید (039/0=P) سطح mfn2 را به طور معنی داری نسبت به گروه دیابت افزایش دادند.

    نتیجه گیری

    فشارخون با کاهش بیان ژن mfn2 بافت قلب همراه است و تمرین تناوبی به همراه مکمل آلفالیپوییک اسید احتمالا مداخله موثر در افزایش mfn2 بافت قلب در فشارخون در نظر گرفته می شود.

    کلیدواژگان: تمرین ورزشی، آلفا لیپوئیک اسید، پویایی میتوکندریایی، پرفشارخونی
  • رحیم سلگی، فریبرز باقری*، حسن احدی صفحات 199-209
    زمینه و هدف

    اختلال نافرمان مقابله‏ای از شایع ترین اختلالات روانشناختی دوران کودکی می باشد که تاثیر بدی در تعاملات خانواده دارد و همچنین دارای پیش آگهی نامناسب همچون ابتلا به اختلالات روانشناختی در بزرگسالی، اعتیاد، مشکلات بین فردی، تحصیلی می شود . لذا هدف از پژوهش حاضر مقایسه اثربخشی آموزش مدیریت والدین (PMT) با آموزش مبتنی بر رابطه والد-کودک  (CPRT) بر کاهش مجموع نشانگان مرضی کودکان دارای اختلال نافرمانی مقابله‏ای می باشد.

    روش کار

    پژوهش حاضر یک کارآزمایی بالینی نیمه تجربی به صورت پیش آزمون - پس آزمون با گروه کنترل بود.  جامعه ی پژوهش حاضر را کلیه والدین کودکان 5-11 ساله مبتلا به اختلال نافرمانی مقابله ای (ODD) مراجعه کننده به درمانگاه‏ها و مراکز روان شناختی و روان پزشکی شهر تهران می‏باشد. نمونه پژوهش شامل 45 والد بود که با نمونه گیری در دسترس انتخاب و به صورت تصادفی در سه گروه آزمایش 15 نفره قرارگرفتند. ابزارهای مورد استفاده در این پژوهش شامل پرسشنامه علایم رفتاری کودکان (CSI-4) و پرسشنامه SNAP-IV بود.

    یافته ها

    نتایج مربوط به آزمون تحلیل کوواریانس برای نمرات نشانگان مرضی کودکان نشان داد که  آماره F برای نمرات مرضی کودکان نافرمان (34/75) در سطح 001/0 معنی‏دار است؛ بین گروه ها در نمرات مرضی کودکان نافرمان تفاوت معنی دار وجود دارد. نتایج مقایسه میانگین‏ها نشان داد که میانگین گروه آزمایش (PMT) 81/7 و میانگین گروه آزمایشی (CPRT) 9/10 می‏باشد که با توجه به نتایج مقایسه زوجی در سطح 001/0 معنی دار است.

    نتیجه گیری

    روش PMT و روش CPRT هر دو بر بهبود نشانگان مرضی کودکان با اختلال نافرمانی مقابله ای موثر هستند. از میان دو رویکرد درمانی روش PMT از روش CPRT در کاهش نشانگان مرضی موثرتر بود.

    کلیدواژگان: آموزش مدیریت والدین، آموزش مبتنی بر رابطه والد - کودک، اختلال نافرمانی مقابله ای
  • احمد آسمار، محمدعلی آذربایجانی*، مقصود پیری صفحات 210-219
    زمینه و هدف

     طبخ غذا با روغن‌های حرارت دیده عمیق (DFO) به دلیل وجود ترکیبات سمی می‌تواند موجب آسیب‌های نورودژنراتیو گردد. با توجه به مصرف روز افزون غذاهای آماده به طبخ ، این مطالعه با هدف تعیین اثر تمرین هوازی و اکتاپامین  بر غلظتPC  و فعالیت آنزیم GPx بافت مخچه در موش صحرایی تغذیه شده با DFO اجرا شد. 

    روش کار

     در یک کارآزمایی تجربی، 30 سر موش صحرایی نر نژاد ویستار با میانگین سنی 20 هفته، وزن 350-300 گرم در 5 گروه: کنترل سالم، دریافت DFO، DFO + تمرین، DFO+ اکتاپامین، DFO + تمرین+اکتاپامین تقسیم شدند. پس از مسمومیت با DFO از طریق گاواژ، اکتاپامین به مدت 4 هفته به صورت درون صفاقی به موش‌ها تزریق شد. تمرین هوازی  روی تردمیل با سرعت 26 متر در دقیقه، 20 دقیقه در روز و 5 جلسه در هفته انجام شد. آنالیزهای شیمیایی به روش الایزا جهت بررسی غلظت پروتیین کربونیل و میزان فعالیت آنزیم گلوتاتیون پراکسیداز بر روی بافت مخچه موش‌ها صورت گرفت. 

    یافته‌ها: 

    نتایج نشان داد غلظت PC در موش دریافت کننده DFO به طور معنا داری افزایش و میزان فعالیت GPx  به طور معنا دار کاهش یافت (05/0 <p). تمرین موجب افزایش معنا دار  فعالیت GPx و کاهش معنا دار  غلظت PC گردید (05/0<p). دریافت اکتاپامین  منجر به افزایش معنا دار فعالیتGPx  و کاهش معنا دار غلظت PC گردید (05/0 <p). اما تعامل اکتاپامین و تمرین بر کاهش سطح PC و افزایش فعالیت GPx  اثر معنا داری  نداشت (05/0 <p).   

    نتیجه‌گیری:

     نتایج این مطالعه نشان داد، انجام تمرین استقامتی و مصرف اکتاپامین می‌تواند آسیب‌های اکسیداتیو ناشی از روغن‌های حرارت دیده عمیق در بافت مغز  موش‌های صحرایی را کاهش دهد.

    کلیدواژگان: گلوتاتیون پراکسیداز، پروتئین کربونیل، تمرین استقامتی، اکتاپامین، DFO
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  • Amin Saeedi, Fatemeh Jalalifar, Leila Karimi, Sepideh Mirzaei, Mehdi Raei, Salman Daneshi* Pages 1-11
    Background & Aims

    Along with laboratory testing, chest CT scans may be helpful to diagnose COVID-19 in individuals with a high clinical suspicion of infection. Due to their availability and rapid turnaround time, the role of chest computed tomography (CT) scan is growing for early diagnosis of patients with COVID-19. However, due to the low efficiency of viral nucleic acid detection as well as low specificity of chest CT scan for detecting COVID-19 pneumonia, this method shows incomplete clinical performance for proper COVID-19 disease diagnosis. Due to the highly contagious nature of the  Coronavirus 2019 and the importance of early detection of the disease, a limited number of nucleic acid test kits, such as rRT-PCR and the possibility of false-negative rRT-PCR results, chest CT scan as a non-invasive method, it can be a highly accurate tool for early detection of suspected COVID-19 cases. The purpose of this study was the Interpretation of chest CT scan of patints with COVID-19 in Imam Khomeini Hospital of Jiroft University of Medical Sciences from December to March 2019

    Methods

    This research is a retrospective study that was conducted with the aim of interpreting CT scans of the chest in patients with covid-19 in Imam Khomeini Hospital, Jiroft University of Medical Sciences from March 2018 to June 2019. After obtaining permission from the ethics committee of the university, the researcher appeared in the research environment according to the pre-determined schedule for sampling. The desired data were extracted from the patients' files and recorded in a questionnaire form that was designed for this purpose. The criteria for entering the study included cases whose demographic information, clinical and laboratory data were complete and the positive PCR test along with chest CT imaging findings were available in the file, the exclusion criterion was the presence of low quality chest images.The data were extracted from the hospital information system based on clinical electronic medical records. including demographic information including age, sex, level of education and data related to the underlying disease, disease symptoms (cough, fever, phlegm, shortness of breath, chest pain, etc.) and the frequency of imaging findings in the chest CT scan that They were examined and evaluated according to age, gender, level of education, clinical symptoms, underlying disease and based on lymphopenia and lymphocytosis. and chest CT scan report of patients with COVID-19, which was available in the PACS system of this hospital, were evaluated. In this way, all the CT images of the chest by a radiologist as well as a lung specialist who were not aware of the clinical and laboratory data of the patients, in terms of the types of findings include, Patchy ground glass opcification, diffuse ground glass opacification, Air space opacity, Consolidation, pleural effusion, Atelectasis, Bronchiectasis, Fibrotic change, Cavitation, Lymphadenopathy. And the distribution of conflict was investigated as peripheral, central, bilateral, and unilateral.

    Results

    The highest number of people with Covid-19 were in the age range of 30 to 59 years and men. In CT scan findings, the highest CT scan imaging findings as well as the highest mortality rate in patients were PGGO view (63.3%) and peripheral and bilateral involvement and the lowest frequency was related to Cavitation findings. In the examination of CT scan findings, PGGO and peripheral and bilateral involvement were the most frequent and Cavitation was the least frequent. Also, the findings of PGGO, Peripheral and Bilateral in the CT scan of the people who died had the highest frequency.In none of the imaging findings of the chest scan, there was no statistically significant relationship with the level of education, the level of education and death of patients due to COVID-19 . There was no significant difference between gender and the findings of PGGO  and Cavitation and peripheral involvement and Bilateral , but between the findings of DGGO and gender and there was a significant relationship between Bronchiectasis and gender. In general, the results showed that there is no significant relationship between gender and death of patients due to COVID-19. In terms of symptoms, the findings showed that there is no significant relationship between the symptoms of myalgia, chest pain, loss of sense of smell and taste, and digestive symptoms and CT scan findings, but between the feeling of weakness and Peripheral involvement, there was a statistically significant difference between the decrease in level of consciousness and the finding of Pleural effusion and the finding of CavitationP, and in general, a statistically significant relationship was observed between the death of patients and myalgia and the decrease in level of consciousness.

    Conclusion

    Among findings of this research, the symptoms of cough, fever, shortness of breath, and headache were present in most of the patients. In line with this finding, Kazemini and colleagues also concluded in their study that fever and cough are two important factors in identifying patients with Covid-19 is high . In this study, CT scan findings in the form of PGGO, Peripheral and Bilateral had the most frequency, which was also reported in a study that at the time of the onset of the disease, the findings of PGGO and Bilateral distribution were the most frequent in CT scans of patients . The reason that the lesions have a marginal distribution and are not limited to certain parts of the lung lobes can probably be due to the small size of the virus, which has a greater tendency to deposit in the peripheral lobes of the lung and thus cause damage to the epi The telium becomes alveolar and affects several adjacent lobules . Also, according to Wei li et al.'s study, GGO is the most common chest CT imaging manifestation in pneumonia caused by the corona virus, which indicates that the pneumonia of COVID-19 mainly includes interstitial secretions. This means that the pathological mechanism of the disease is secondary to the expansion and congestion of alveolar capillaries and interstitial edema in the interlobular septum . unlike COVID-19, in SARS, most cases of lung involvement are unilateral.In the present study, the findings of Air space opacity and Consolidation imaging were also found to be of high frequency compared to other findings, in the study of SONG et al., it was also reported that GGO image is more frequent in young people and Consolidation image is more frequent with increasing age. This issue is also evident in the present study, so that Consolidation was less frequent at ages less than 30 years compared to ages 30-59 years. Consolidation is one of the characteristics of CT in patients with COVID-19, which is a sign of disease progression, Pan et al. found that consolidation is rare in the early stages of the disease. Consolidation begins to appear with the progress of the disease and gradually becomes the main imaging feature. Therefore, the analysis of chest CT imaging can help the doctor in identifying the early stages or the progress of the disease. By identifying the common findings in chest CT scan in people with coronavirus, based on appropriate epidemiological and demographic characteristics, COVID-19 cases can be identified in a timely manner and immediate preventive measures can be taken. Therefore, due to the accuracy of this diagnostic tool and its rapid results, CT imaging should be at the forefront of COVID-19 screening tools and easy access to it in different areas compared to rRT-PCR kits should be provided.

    Keywords: CT scan, COVID-19, Coronavirus, Iran
  • Sajjad Alizadeh, Majid Baserisalehi*, Nima Bahador Pages 12-25
    Background & Aims

    Acinetobacter baumannii is an opportunistic pathogen and a component of gram-negative, aerobic, and non-fermentative gram-negative bacteria, which is found in the form of cocci or coccobacilli. Because these bacteria have few nutrients to grow, they can survive long periods in adverse conditions, on dry surfaces, as well as in aquatic environments. Acinetobacter is probably known as gram-negative bacteria on the surface of the genus. These organisms are difficult to stain and are often mistaken for gram-positive. Among the gram-negative bacteria that cause nosocomial infections (especially in the intensive care unit of the ICU), Acinetobacter species have received a great deal of attention over the last three decades (1-3).Acinetobacter baumannii OmpA binds to the host epithelium and mitochondria, causing mitochondrial dysfunction and swelling that is followed by the release of cytochrome c, leading to the formation of apoptosis, all of which contribute to cell apoptosis. OmpA, the most abundant surface protein in the pathogen, is also involved in complement resistance and biofilm formation. Key stress survival strategies and the potential for important virulence factors help increase bacterial survival inside and outside the host (1, 4). Most chromosomal AmpC beta-lactamases are found in Enterobacter, Serachia, Pseudomonas, Acinetobacter and, Citrobacter species. These enzymes belong to the C ambler classification and include the genes cmy, fox, mox, dha, acc, mic, family / related bil / lat (cit and act, mir (related to the ebc family)). They are (5). It is noteworthy that at tigecycline resistance levels in Acinetobacter baumannii isolates, its efficacy may be increased during treatment with tigecycline if the drug is exposed for a short time. Recently, mutations in the trm gene, encoding methyltransferases, have been associated with decreased tigecycline sensitivity in one Acinetobacter baumannii strain (6). Most strains of Acinetobacter baumannii are resistant to ampicillin, amoxicillin-clavulanic acid, anti-staphylococcal penicillins, broad-spectrum cephalosporins (except ceftazidime and cefepime), tetracycline,and, tetracycline. MDR resistance in Acinetobacter strains has become a global and growing problem. In previous studies in Iran, the rate of multidrug resistance has been more than 60% (7).

    Methods

    A total of 240 clinical samples (including blood, urine, sputum, respiratory secretions, urine, wounds, skin, etc.) were collected from patients admitted to different wards of Dey Hospital in Tehran. Samples were collected from patients who had been hospitalized for at least three days and had acquired the infection in a hospital setting and were transferred to a microbiology laboratory for evaluation. For initial isolation, clinical specimens were cultured linearly in McConkey Agar and Bloodagar media containing 5% sheep blood and incubated at 37 ° C for 24-48 hours (9). After the incubation period, the cultures were examined for macroscopic characteristics (appearance of the colonies) and microscopy using a hot staining technique. Then gram-negative bacilli were analyzed using biochemical tests.In order to extract the plasmid, the extraction kit made by Sina Clone Company, Iran was used. First, a colony of each isolate cultured on Müller-Hinton agar medium (manufactured by Merck, Germany) was inoculated with 5 ml of Luria Bertani Broth culture medium (manufactured by Sigma-Aldrich, USA) and stored for 13 hours in Incubated at 39 ° C. Then, the plasmid extraction steps were performed using the Cinnagen kit protocol. It should be noted that the resulting plasmids were stored at -20 ° C until PCR.

    Results

    According to the results in Table 6, the higher the number of isolates containing mox gene, the more antibiotic resistance is observed. In fact, a significant relationship was found between the presence of this gene and antibiotic resistance. For colistin, which had the lowest resistance ratio of this antibiotic, fewer isolates had this gene. (Significance level 0.563) A semi-sensitive to colistin isolate containing both ox mox. Genes. One of the semi-sensitive isolates containing cefpeme contained only dha and no semi-susceptible isolates contained cit gene (significance level 0.853). With 1, 5 and, 14 isolates containing dha, cit and mox genes (significance level 0.802) (Table 6).

    Conclusion

    Previous studies have shown that resistance to various antibiotics is on the rise. For example, studies by Wang et al. (23) and Esmoliako et al. (24) in recent years have shown that most strains were sensitive to amikacin, ampicillin, sulbactam, ceftazidime, cefpime, gentamicin, imipenem, meropenem, piperacillin, tazobactam. . In contrast to the present study, which found a 98.3% resistance to ampicillin and the highest resistance among all antibiotics studied, Karimi et al. reported a sensitivity of 91.6% to ampicillin in 2020. Consistent with the results of the present study, the results of the study of money changers and colleagues (2019) in Shahrekord have also shown a high prevalence of resistance to carbapenems, impenem 78% and meropenem 44%. In this study, Acinetobacter baumannii had the highest resistance to cefipime and ceftazidime (100%) and the lowest resistance to tobramycin and meropenem (22). In the study of Karimi et al., The resistance to meropenem was 83.3% and to ceftazidime was 93.3%. (19) Salehnia et al. In their study showed 100% resistance to cefpeme (7).According to the antibiogram results of the present study and also the results of the mentioned studies, to date, some strains of Acinetobacter baumannii have become resistant to all common antibiotics used, which greatly limits the treatment of these infections. The only effective antibiotic used to treat infections associated with this bacterium is colistin, which is also increasing its resistance. In general, the findings of the present study indicate an increase in antibiotic resistance compared to previous studies. This high prevalence of resistance is due to the unnecessary prescription of antibiotics and the lack of appropriate infection control tools. This is very important in identifying antibiotic resistance genes. In addition, the selection of appropriate antibiotics based on antibiogram plays an important role in treating and preventing the spread of drug resistance.The results show a high percentage of MOX genes that are directly related to antibiotic resistance, however, the presence of these genes and their relationship with antibiotic resistance need further investigation. The high resistance of Acinetobacter baumannii to antibiotics was very worrying because it is difficult to control and treat this bacterium. The only effective antibiotic used to treat infections associated with this bacterium was colistin, which is also increasingly resistant.

    Keywords: Antibiotic resistance, Multidrug resistance, AmpC beta-lactamases, Acinetobacter baumannii
  • Malihe Naderi, Somayeh Talebi, Asiye Buyzan, Neda Yousefi Nojookambari, Sajjad Yazdansetad* Pages 25-37
    Background & Aims

    Adult T-cell leukemia (ATLL) is a type of invasive T-cell malignancy that develops after a long-term chronic infection with the lymphotropic T-cell virus type 1 (HTLV-1). The disease typically produces skin lesions of variable kinds, some of which can be similar to Sezary lesions; hypercalcemia with lytic lesions of bones; lymphadenopathy; diagnostic morphology of leukemic cells with lobulated nuclei; and an extremely aggressive clinical course. ATLL also almost always involves the mature CD4+ T-cells. Also, HTLV-1 causes other diseases and mild immune deficiency even in the absence of malignancy besides ATLL. These include the fatal neurologic disease tropical spastic paraparesis (now known as HTLV-associated myelopathy), uveitis and iritis, peripheral neuropathies, and arthritis. All of these diseases could be autoimmune, but their exact mechanisms are not yet known. HTLV-1 was the first human retrovirus to be discovered and it was isolated in 1980 from a cell line of a cutaneous T-lymphocyte lymphoma. HTLV-1 has an ancient origin in the form of simian T-cell leukemia virus 1, different strains of which can be found in African and Asian primates. The virus is not found in American primates. The HTLV-1 virus has a single strand of RNA for its genome and primarily targets the T-cells of the immune system. Phylogenetic analyses have led to the naming of four major types of HTLV-1, each with its own geographic focal areas: Cosmopolitan subtype A (endemic in Japan and found in the Caribbean, Central, and South America, North and West Africa, as well as the Middle East); Central African subtype B; Australia-Melanesian subtype C; and Central African/Pygmies subtype D. Subtype C is the most divergent of the four subtypes, likely reflecting the opportunity for evolution in geographically isolated areas of the Pacific. Antibody tests developed to detect the immunological response to infection with HTLV-1 have been used to investigate the population distribution of infection, modes of transmission, and associations with other diseases. As with other human retroviruses, including most notably HIV, the presence of antibodies in a person is understood to be synonymous with infection, and is lifelong. HTLV-1 infection is a neglected disease despite affecting around 15 million people worldwide and it is the causative agent for two diseases such as adult T-cell leukemia and HTLV-1 associated myelopathy / tropical spastic paraparesis. Simultaneous infection by HTLV-I and the etiology of their pathogenic and disease outcomes have become a global health matter over the past 10 years. Three main methods of virus transmission have been confirmed: 1- mother-to-child transmission: Mother-to-child transmission can be produced through the placenta, perinatally that are uncommon, or by breastfeeding. Nonetheless, evidence suggests that most cases of mother-to-child transmission are produced by ingestion of breast milk. Cell-free virions are not usually detected in breast milk, thus transmission by infected cells is much more plausible. In fact, different types of cells that are found in breast milk such as lymphocytes, macrophages, and epithelial cells of mammary glands can be susceptible to HTLV-1 infection. 2- sexual transmission, mainly from man to woman: Few studies are done about the most frequently affected gender. The initial studies suggested that female to male transmission of HTLV-1 was much more frequent than male to female transmission, but later studies have shown that this difference is not as significant as previously thought, and male to the female transmission could play a more important role. Sexual transmission requires entry through a mucosal barrier, the virus could be transmitted through damaged or infected mucosa or transcytosis across epithelial cells. Consequently, male to female transmission is more efficient in cases of men with a history of penile sores or ulcers. However, the semen also contains several cells that could be infected by HTLV-1, such as CD4+ T-cells, macrophages, and dendritic cells that can have a role in sexual transmission. Regarding female to male transmission, in women infected by HTLV-1, infected cells have been frequently detected in cervical inflammatory secretions and cervix carcinoma. Some of the data obtained studying other retroviruses have been extrapolated to HTLV-1. However, not all this information can be faithfully extrapolated to HTLV, and therefore, further investigations are needed to achieve more accurate data. 3- blood cell components: Blood transmission can occur by transfusion of whole blood or cellular blood products and in the context of needle sharing among intravenous drug users. In the case of blood transmission, passing across a mucosal barrier is not needed, and infected cells can transmit the virus directly by cell-to-cell transmission or by cell-free transmission to dendritic cells. As we saw previously with other routes of transmission, cell to cell transmission is also the most effective way to transmit the virus by blood. A study that compared viral transmission following transfusion of plasma from individuals with different human retroviruses showed that seroconversion occurred in 89% of the individuals who received plasma from HIV-1 infected individuals, but in none of those who received plasma from HTLV-1 or HTLV-2 infected individuals. Several studies suggest that individuals who acquire HTLV-1 by blood are more prone to develop inflammatory disorders, while individuals who acquire the virus during breastfeeding are more likely to develop T cell malignancies. In addition to some factors that can modify this likelihood, such as the age of infection, amount of virus, and immune response, this implies that the mechanism of infection could affect different cell populations and it could be a determinant to develop an inflammatory disease or cancer. A person can be infected with HTLV-I by direct contact with certain body fluids from an infected person. Its prevalence greatly varies in different regions of the world and even in different communities within one restricted region. The virus tends to remain in families due to its routes of transmission. Therefore, the vertical mitotic transmission plays an important role in the persistence of HTLV-I infection. Complex retroviruses such as the HTLVs have an extra gene or several extra genes, but these genes are not oncogenes and cannot be found in normal cellular DNA. The extra gene or genes may cause growth promotion and/or increase of genetic instability. In HTLV-1, the Tax causes growth promotion and increases genetic instability. Mathematical modeling of within-host viral infection has witnessed significant development. Tax-expressing HTLV-infected cells proliferate faster than susceptible CD4+ T cells and silent HTLV-infected cells. This leads to an increase in proviral load. In HTLV-I infection, CTLs also play an effective role in controlling the infection. CTLs can recognize and kill the Tax-expressing HTLV-infected cells moreover, they can reduce the proviral load. Since there is no available antiviral, treatments that can completely eliminate HTLV-I from the body, then this virus, can lead to fatal diseases. HTLV-I is a retrovirus that infects the susceptible CD4+ T cell and destroys its functions. The aim of this study was to evaluate the progress made over the last 30 years in the recognition of HTLV-1 infection, cloning, gene expression, and its resulting cell transformation, as well as methods to prevent human T-cell lymphotropic virus infection and cellular lymphoma/leukemia T cells.

    Methods

    Systematically, we searched PubMed, Google Scholar, Scopus, and Science Direct databases using the following keywords: Leukemia, Lymphoma, ATLL, HTLV-1, and transmission.

    Conclusion

    HTLV- infections are considered a neglected disease nowadays, and despite recent advances in chemotherapy, allogeneic hematopoietic stem cell transplantation (alloHSCT), and supportive care, the prognosis of patients with ATLL is one of the weakest among hematologic malignancies. Prenatal screening for HTLV-1 should be performed in endemic areas with accurate information and advice. The development of a safe and effective vaccine can be an important tool in protecting vectors against ATLL. As a result, research to avoid infection and associated diseases focused on the development of effective treatments or vaccines against the virus is needed. In this article, we provide a comprehensive overview of recently uncovered information on the molecular basis of leukemogenesis in ATLL and HTLV diseases.

    Keywords: Leukemia, Lymphoma, ATLL, HTLV-1, Sexual Transmission
  • Erfaneh Movahedi, Mahdi Saberipirouz, Sedigheh Moradi*, Fatemeh Golgiri, Jahanbakhsh Khamseh, Mohana Eskandari Pages 38-47
    Background & Aims

    Thyroid disorders including hypothyroidism and hyperthyroidism are common condition in the world and the right diagnosis and treatment are important. Now a days screening for thyroid dysfunction recommend only in a specific situation, thus unnecessary tests could have undesirable outcomes such as improper sampling and costs related to long-term follow-up which could affect patients and health system. (5-10. Except for cases of inappropriate doing thyroid function tests, it should be noted that TSH measurement alone has a high sensitivity for the initial investigation and diagnosis of thyroid diseases (7, 10) so, in context of abnormal TSH it is necessary to measure other thyroid hormones. It is worth mentioning that in the case of hospitalized patients, thyroid laboratory disorders are more common without the presence of thyroid gland homeostasis disorder (11), which shows the necessity of paying more attention to the target population in requested examinations. Therefore, according to the importance of the subject, the present study investigated the request patterns of thyroid function tests and the logical cases of their request in Tehran's Firouzgar Hospital affiliated to Iran University of Medical Sciences, during the second 6 months of 2017. In this cross-sectional study, 484 inpatients for whom each of the Thyroid function tests was requested selected as a sample by census and included in the study. The samples included in the study were evaluated by clinical evaluation and history taking with the aim of finding the indications for thyroid test request, and if it is possible to diagnose thyroid function disorders in the next stage of the requested tests in terms of compliance with the algorithms and instructions The existing one was checked. Finally, if the laboratory tests lead to the final diagnosis, the proportionality of the requested functional test with the final diagnosis is checked.

    Methods

    In this study, the definition of essential thyroid tests included the patients who have a known thyroid disease based on previous history or hospital records and clinical examinations, or there is a high clinical suspicion for their thyroid disease, it is reasonable to perform TSH & T4 & T3RU or TSH & FT4 tests. SPSS version 24 software was used for statistical analysis of data.

    Results

    The average age of the participants in the study was 54.2 years with a standard deviation of 17 years and 59.4% were female. In total requested tests the most patients 101 (20.7%) were hospitalized in the neurology department and the least patients 2 (0.4%) were from the toxicology ward. Out of a total of 488 patients for whom thyroid tests were requested, only 259 patients were found to have a specific reason for requesting these types of tests based on the clinical records, history or clinical examination, and 99 patients (38.2%) were hypothyroid. TSH was requested for 477 patients, and the mean TSH was 3.583. Out of a total of 69 patients whose treatment status changed, 27 patients (39.1%) had an increase in the treatment dose. The most patients whom TSH was requested without indication, most cases (26.3%) were admitted to the neurology department. The most common pattern of requesting thyroid tests in people participating in our study was the combination of TSH, T3, T4. In this study, 69 patients out of 488 patients for whom thyroid tests were performed treatment was changed. Out of 194 patients who had a logical reason to request thyroid tests based on their previous history of thyroid diseases or current examination and history, only 54 patients, equivalent to 27.83%, have undergone treatment change.

    Conclusion

    The purpose of this study was to examine the patterns of requests for thyroid function tests and to determine the logical cases of their requests in Firozgar Hospital in a period of 6 months. Considering that hypothyroidism and hyperthyroidism have a significant prevalence in the world and also due to the high prevalence of iodine deficiency in our country, thyroid diseases are also common. Since the symptoms of thyroid diseases are mostly non-specific and shared with other diseases, it is better to avoid unnecessary sampling and related problems, including high cost, the need for long follow-up and the patient's and family's concern about the results. As a result of the tests, the measurement of thyroid function tests should be used only in reasonable cases and with a suitable pattern. There is no need to check thyroid tests in all hospitalized patients who are unrelated to thyroid diseases. In general, it seems that the measurement of thyroid tests in logical cases and with the correct pattern has positive results for the patient and health system. In the current study, thyroid tests were requested for 488 patients, compared to the study of Small et al., it can be said that the sample size of our study was slightly smaller than that study. (11) About 60% of the studied patients were women, which can indicate that thyroid tests are more common in women than in men, regardless of whether the request is reasonable or unreasonable. In terms of average age, it can be stated that thyroid tests are performed at different ages of people, although the average age in this study was 54 years, but a wide standard deviation of 17 years was also observed among patients. Regarding the frequency of unnecessary requests, T3 with 99.2%, TSH with 60.6%, and T4 with 59.4%, T3RU with 59%, and Anti TPO Ab with 38% had the highest to lowest amount respectively. It should be noted that all requests for fT3 and fT4 tests were unnecessary. In our study, the most number of cases for whom thyroid tests were requested were hospitalized in the departments of neurology, endocrinology, neurosurgery, and neurology ICU, respectively. It seems that this amount can be reduced if endocrinologists are consulted about the indication of requesting thyroid tests. The most common request patterns for thyroid function tests were TSH&T4&T3 with 69.87% and TSH&T4 with 15.57% respectively. In the study of Roti et al., the most common requested pattern with 56% was the combination of TSH, T3, T4, and for this reason, the two studies are similar (10). was requested, 27.83% of them had a change in their treatment procedure, which is higher compared to the study of Mr. Small et al., where only 2% of patients had a change in treatment (11). In our study, among the patients whose test results were in favor of changing the treatment or starting of thyroid medication or increasing the dose of drugs was the most common case with 39.1%. In this study, among patients who had a history of thyroid problems, TSH and T4 tests were reported as the most frequently performed tests among these people.In general, based on the obtained results, it seems that requesting all thyroid indicators at the same time is a common finding. It can also be added that the unusual patterns of requesting thyroid function tests, multiple cases of requesting thyroid function tests, and the non-optimal contractual TSH threshold level cause unnecessary requests for thyroid function tests. One of the most important limitations of this type of study is that the algorithms and instructions are different in different field of medicine and the way of requesting thyroid function tests may be different between two medical specialties. Another limitation of this study is the lack of sufficient previous studies. One of the final suggestions can be the point that cases of inappropriate requests for thyroid hormones in free hormones are taken at the same time as taking total hormone levels, which are the most suitable places for intervention to reduce cases of inappropriate requests for thyroid function tests. It is also suggested that studies with a larger sample size and a longer follow-up period be conducted in the future.

    Keywords: Thyroid Tests, Unnecessary requests for diagnostic tests, Request template for diagnostic tests, Hospitalized patients
  • Masoumeh Nalchi, Mehri Daraei*, Ebrahim Pourhosseini Pages 48-59
    Background & Aims

    Conflict is considered as an inevitable and integral part of organizational life that occurs in the organization for various reasons. Conflict resolution solutions and strategies in organizations are very diverse and each has its strengths and weaknesses. Therefore, the best solution to resolve the conflict of any organization is the solution that is designed according to the characteristics of the organization at the required time and place. Anger control and conflict resolution are communication skills that most people lack. One of the most important reasons for people's unhappiness and dissatisfaction with life is that they do not have a good relationship with each other and cannot manage their conflicts. Anger is one of the main emotions of human beings and sometimes it is a cover for other emotions. In fact, part of the anger that people experience is secondary excitement. Anger, if it is the primary emotion, can be rooted in frustrations, deprivations, punishments, and childhood threats. Therefore, it can be said that anger is one of the human emotions that can be expressed verbally or non-verbally. By controlling anger, you can solve problems and misfortunes with a better feeling and build stronger relationships with others. Anger can only turn into a destructive feeling if left unchecked and have dire consequences in one's life. Conflict resolution strategies and strategies in organizations are very diverse and each has its strengths and weaknesses. Therefore, the best solution to resolve the conflict of any organization is the solution that is designed according to the characteristics of the organization at the required time and place. Universities of medical sciences as an organization and institution consisting of a set of vice chancellors, departments, and employees and pursuing a variety of goals are no exception to this and may be subject to organizational conflicts at any time. Considering the effect of conflict on the quantity and quality of medical universities performance, staff efficiency, achievement of university goals and success, conduct this study to identify the causes of conflict, types and levels of conflict in medical universities in order to design a model. Comprehensive and integrated in resolving these conflicts is essential so that the university management can resolve its organizational conflicts based on this model, improve the performance of the organization and ensure the sustainable life of the organization. A review of studies on conflict and anger management shows that this issue is less discussed in medical universities. Also, because medical universities are one of the most important government organizations in the country, the existence of anger and conflict can have devastating effects on the performance of the organization and the university process in general, this research is important. Therefore, the present study was conducted to investigate the components of conflict control and anger of medical university administrators.

    Methods

    The present study is objective in terms of purpose; and in terms of nature, it is a descriptive-survey research that was done using a mixed exploratory approach. The statistical population in the present study is experts in the field of medical sciences. Statistical sample was obtained by non-probability sampling in three steps. The research tools consist of three parts: 1. The first research tools are library studies by which the indicators of conflict management of the directors of medical universities were identified. 2- The second tool of the research is a semi-structured interview in the form of open-ended questions (15 questions) which were completed by 15 experts in the field of medical sciences, conflict management indicators of the managers of medical universities. 3- The third research tool is a 5-point Likert scale questionnaire that was extracted from the results of the previous two tools. The research method in this section is the Delphi technique.

    Results

    Based on the results obtained from three Delphi rounds, 9 main components and 72 sub-components were finally selected as indicators of conflict management in medical universities. The main components of conflict management are: negotiation, cooperation, use of the suggestion system, avoidance, confrontation, flexibility and compromise, control, adaptation and change in relationships.

    Conclusion

    Managers of organizations, especially medical universities in the country to resolve conflict in the organization, first assess the conditions and situation as well as the severity of the conflict and use one of the conflict resolution methods. Compromise and flexible methods are recommended for further conflict problem. Based on the obtained results, it is suggested that the managers of organizations, especially the medical universities of the country, to resolve the conflict and anger in the organization, first assess the situation and also the severity of the conflict and anger and use one of the methods to solve Use conflict and anger. Methods that are compromising and flexible are recommended for more conflict problems, and other methods such as dominating or firing employees are best used if compromise is not possible.

    Keywords: Delphi Technique, University of Medical Sciences, Conflict Management, Anger Control
  • Saeedeh Shirdel*, Elham Shirazi, Masoud Ahmadzad, Kaveh Alavi, Amirhossein Jalali, Leila Tahmasbi Pages 60-72
    Background & Aims

    Most of the emotional disorders and behavioral problems due to the unbalanced and changing situation of the family and social life have affected different groups of children and adolescents. Family  Health problems and deficiencies, displacement of social groups and pressures caused by them, unreasonable population growth, rampant migration and displacement, widespread poverty and addiction, depression, aggression, and the glories of the absence of a guardian in many families, as well as the long-term ignorance of children's parents about the problems they face, Experience and do not update and Lack of sufficient knowledge  about how to manage these issues and many other important issues, have caused the emotional and behavioral disorders of children in this century to reach an unprecedented extent. Therefore, several screening questionnaires around the world have been designed to Screen children in terms of psychosocial and emotional problems and the validity and reliability of the questionnaires have been confirmed.

    Methods

    This study was a test (questionnaire) in which the questionnaires were completed by mothers of children aged 4-11 years, one of whose parents worked in the centers of Tehran Psychiatric Institute, Iran Psychiatric Hospital, and HazratRasoul Hospital. Sampling was selected by a simple non-random sampling method (sample available). Samples were selected from mothers who themselves or their spouses working in Tehran Psychiatric Institute, Iran Psychiatric Hospital, and Hazrat Rasoul Akram Hospital. According to the number of questions in the questionnaire (18 questions), 180 samples were needed to examine the factor structure of the questionnaire. Also, 30 samples were selected from 180 samples to check the reliability of the retest according to the mother's desire and the possibility of attending the retest (which also requires identification of the individual).The PSC questionnaire included questions that focused on internal and external problems and impaired concentration in children and adolescents.The questionnaire has 17 items that are scored under the three headings of "never", "sometimes" and "often". A question has also been added to the questionnaire that includes suicidal ideation and previous suicide attempts. A value of zero was considered for the title "never", a value of one was considered for the title "sometimes" and a value of two was considered for the title "always". By adding the total points, the total score was calculated. Items by the questioner A blank was considered equal to zero. If three or more questions in the questionnaire were not answered, the questionnaire would be removed from the study. The total score was calculated from 0-36. Scores were categorized into three categories: internalized problems, externalized problems, and concentration disorders. The positive items of each category included the total score of each item, which was more than 7.7.5, respectively. Simultaneously with the above questionnaire, SDQ and CSI-IV questionnaires were given to mothers to complete. SDQ Questionnaire is a screening questionnaire of abilities and problems among children and adolescents aged 4-16 years, which is completed by parents and completed by adolescents for the age group of 11-16 years. The questionnaire also provides information on whether the child has problems in these areas and if so, what functional impairments have led to them. This questionnaire was prepared by psychiatrists in the United Kingdom for early screening of psychiatric problems as well as the abilities of children and adolescents. SDQ questionnaire is available on websites and has been translated into 80 living languages of the world. The duration of the questionnaire is about 5-10 minutes and includes 25 questions. All versions of this questionnaire ask about 25 attributes, some positive and some negative. These 25 items are divided into 5 scales. Emotional symptoms (5 items), Behavior problems (5 items), Hyperactivity / Attention Deficit Disorder (5 items), Communication problems related to peers (5 items), Homosexual friendly behaviors (5 items). Another questionnaire used to identify psychiatric disorders in the world is the CSI-IV questionnaire.it was the gold standard test for comparing the results. The parent form of this questionnaire has 98 questions and the teacher form has 87 questions. The disorders that are screened are as follows: Child coping disorder, Behavioral disorder Generalized anxiety disorder, Social phobia, Separation anxiety disorder, Major depressive disorder and Depression, Schizophrenia is a pervasive growth disorder, asperger's, vocal and motor tics.  The time to complete the questionnaire is about 10 minutes.

    Results

    After translating the questionnaire into Persian and reviewing its content and face validity by 16 psychiatrists and clinical psychologists working in the field of children and adolescents, the results were as follows: They had 94%. Face validity was also checked by the relevant team, which obtained a total of more than 95% of the total face validity questions. In the face validity assessment conducted by ten mothers participating in the project, a total of more than 87% validity was obtained. The reliability indices of the questionnaire and its dimensions were also analyzed and internal consistency or Cronbach's alpha was calculated, which was suitable for all questions and each area separately and more than 0.7. The reliability of the quantitative retest test for 30 participants using the coefficient Spearman correlation was analyzed, which in all cases showed a high correlation. The similarity between the diagnosis was assessed by PSCA tool with SDQ and CSI-VI tools separately using Kappa statistical test, which had diagnostic similarity in ADHD. The similarities between the diagnosis of mood disorders and anxiety by PSCI tool with SDQ and CSI-VI were also examined, according to which PSC was significantly successful in distinguishing SAD (Social anxiety disorder) from CSI-VI questionnaire and emotion disorder from SDQ. There was a significant similarity between the diagnosis of externalizing disorder of PSC with ODD of CSI-VI and the conduct of SDQ. Finally, the similarity between the diagnosis of psychiatric disorders was examined. Due to the lack of a total score in the CSI-VI questionnaire, this study was performed only on PSC and SDQ. Based on this, PSC was able to identify disorders as much as SDQ.

    Conclusion

    The Persian version of PSC is suitable for early assessment and screening of psychiatric disorders in schools, clinics, and primary health care.

    Keywords: Validity, Reliability, lLst, Symptoms, Children
  • Elahenaz Haji Motalebi, Somayeh Assadian Narenji*, Reza Goleyjani Moghadam Pages 73-88
    Background & Aims

    Psoriasis is a chronic inflammatory skin disease with an immunogenetic background that is prevalent among ethnic groups. The prevalence of this disease varies from region to region; and it is reported to affect 2-4% of the population in Western countries. While in Asian and some African countries, the lowest prevalence rate (between 0.3 to 1.2% in China) has been reported. On the other hand, in the Scandinavian and Caucasian populations, this rate reaches 11%. In Iran, its prevalence is between 1.3% to 2.5% (1-3, 5, 7). IL-10 is a cytokine produced primarily by monocytes and lymphocytes. The gene encoding IL-10 is located on the long arm of chromosome 1. The promoter region is highly polymorphic, with 3-point mutations including: single nucleotide polymorphisms (SNPs) at positions: –1082 (G/A), –819 (C/T) and –592 (C/A) (4, 12, 13, 14). The association between interleukin-10 gene rs1800896 polymorphism and susceptibility to psoriasis has been investigated in several studies, but with contradictory findings. Therefore, the aim of the present study was to investigate the possible links between –1082(G/A) polymorphism of the IL-10 gene and psoriasis in cases from the north of Iran. The results of this study can be used to find biomarkers that are used in personal medical science for the early diagnosis of diseases and are highly regarded by the scientific community today.

    Methods

    This case-control study was performed on 50 patients and 35 healthy individuals in the west of Mazandaran and east of Guilan province. Genomic DNA was extracted from the blood samples and genotyping was performed by means of the amplification refractory mutation system polymerase chain reaction (ARMS-PCR) method. This method is based on the design of specific pairs of allele primers and the amplification of the desired allele. To amplify the region containing the mutation, two primer pairs can be used, designed for mutated alleles and natural alleles, respectively. All primers used were designed using Gene Runner and Oligo7 software based on the IL-10 gene sequence on chromosome 1. After selecting the primers, their sequences were compared with the sequences of the human genome in the Gene Bank database. In the primer design, in addition to the 3′ terminal mismatch, at the third end of 3′ primers, a base was changed to ensure that the primer did not bind to the opposite allele.The results were validated using the DNA sequencing method. To perform this reaction, a vial containing 25 µl of Master Mix, 2µl of each primer; and 5 µl of DNA was used and reached to 50µl by adding 16µl of distilled water. The mix was then placed in a thermocycler with a annealing binding temperature of 61.5 ° C to perform the polymerase chain reaction. After PCR, qualitative analysis was performed using 2.5% agarose gel; and the rest of the PCR products with Reverse primer were sent to taq-Copenhagen (Denmark) for PCR Sequencing. The submitted sequence analysis was performed using Chromas software and the known mutations in the samples were confirmed. Data were analyzed using the chi-squared test. A logistic regression test was used to eliminate the effect of possible interfering factors and odd ratios (OR) and their respective 95% confidence intervals were calculated.

    Results

    AA, AG, and GG genotypes and A and G alleles were examined in patients with psoriasis. The genotypic distribution of the patient and control groups was in Hardy-Weinberg equilibrium. PCR products were analyzed on 2.5% agarose gel using a DNA marker with a molecular weight of 100 bp. The results of statistical studies showed that the studied groups did not differ significantly in terms of gender and age. The frequency percentages of AA, AG and GG genotypes were 82%, 18% and 0% in the control group and 56%, 32% and 12% in the patient group, respectively. This difference is significant at the level of 0.05 (p = 0.014). Also, the frequency of A and G alleles in the control group were 91% and 9%, respectively, and in the patient group were 72% and 28%, respectively. Therefore, this difference is significant at the level of 0.05 (p = 0.002).The results showed that there is a significant difference in the frequency of alleles between the two groups; so the G allele is detected more in people with psoriasis than healthy group and in terms of genotypic distribution, the GG genotype in the psoriasis group is more than the controls. Also, due to the fact that this significant difference may be related to interfering and in Fisher's exact test, these factors were not controlled, so logistic regression was used to remove these factors. The results showed that even after matching and eliminating the interfering factors, there were still significant differences between the genotypes. Therefore, a significant relationship is observed between rs 1800896 rs polymorphism of interleukin 10 gene and susceptibility to psoriasis.

    Conclusion

    We conclude that IL-10 gene polymorphism (rs 180096) is likely to increase the risk of susceptibility to psoriasis in western Mazandaran and eastern Gilan. According to various studies, it can be seen that one of the reasons for explaining the contradictory results could be that these studies have been conducted on different populations around the world. Another possible reason is that the regulation of IL-10 varies in different cell types (T cells, B cells, and macrophages) and with different stimuli. In addition, transcriptional levels and IL-10 protein levels may differ due to post-transcriptional regulation of IL-10 gene expression. Other causes of different results in the study of gene polymorphisms include different gene pools, molecular methods used; and the size of the study population. Using the right sample size for each type of disease phenotype can better reflect the true effect of the polymorphism on the characteristics of that disease (1, 13,15, 44). More research is needed focusing on different populations to reach a definitive overall conclusion about this relationship. Also; studies should be conducted in a larger group of patients as high as possible and on all polymorphisms of this gene in order to validate these findings.

    Keywords: Psoriasis, Interleukin-10, Polymorphism, ARMS PCR
  • Moein Fasihiyan, Maryam Taheri, Khosrow Ebrahim, Maryam Nourshahi* Pages 89-104
    Background & Aims

    Many studies have shown that after ischemic stroke, survivors experience motor dysfunction, memory impairment, and cognitive problems. Exercise is an effective and widely used factor in rehabilitation strategy to improve cognitive recovery and motor control following ischemic conditions caused by stroke, which is effective by increasing signaling pathways related to neurogenesis, synaptogenesis, etc. Recognizing and examining these factors as a result of exercise can be a principled solution to prescribe the most efficient and effective training method for the faster recovery of people suffering from stroke.Stroke is a type of injury related to blood vessels in different levels of the brain. A clinical study of people who had a stroke showed that over several years after the stroke, people who had different types of exercise in their rehabilitation program showed good functional results in neurological rehabilitation, but in groups Without exercise, most people developed aggravated neurological disorders, with mortality in this group being much higher than in the other group. Lack of blood supply to nerve cells in the CNS causes neurological and cognitive disorders, in which all parts of the nerve cell such as the cell body, axons, axonal terminus, and dendritic cavity in the penumbra region Deprived of blood affects the healing processes of various therapies, often involving neurogenesis and angiogenesis, which regenerate damaged cells in neural circuits. The neuroplasticity process in the central nervous system is divided into two parts: structural and functional changes, which have the ability to adapt to learning processes, and cognitive memory following neurological damage, which are dynamic processes that a number of centers Different parts of the central nervous system will undergo numerous changes and interactions. However, by natural mechanisms, the body produces simultaneous changes after ischemic brain injury, but these changes are not sufficient to reverse and repair the damage. In normal conditions or in conditions of brain injuries, rehabilitation can be created as a dynamic process in the nervous system with the aim of adapting to different conditions.Recently, exercise has been considered an effective and practical factor to increase cognitive function and motor function in rehabilitation conditions that increase dendritic branching and axonal myelination through neuroplasticity processes such as increased neural activity and postsynaptic stimulation ability. These phenomena can occur after a stroke. Due to the importance of recognizing and examining the effective factors in the rehabilitation period after stroke, exercise in recent years has shown a very effective role in improving the physical and cognitive condition of these patients. Therefore, the aim of this study was to identify the effective mechanisms in the neurogenic and angiogenic process and also to inhibit apoptotic processes due to exercise as effective factors in improving motor function and cognitive ability after stroke.

    Methods

    To conduct this study, search the Google Scholar, PubMed, Web of Science databases on the effect of various types of exercise on neuronal molecular and cellular changes in the post-ischemic stroke rehabilitation period from 2005 to 2021. Mainly in the title, abstract of articles, and keywords in the studied articles, the words, Ischemic stroke, Rehabilitation, Endurance training, cognitive training, Neuroplasticity, were searched. The inclusion criteria for the selected papers were to be published in Latin in international and prestigious journals, and in general to be about the effect of exercise on molecular cellular signaling in the post-stroke rehabilitation period. Finally, based on the standard principles and the title of the articles, the title of the present study was done with 65 articles

    Results

    In this review, we discussed recent studies on the cellular and molecular mechanisms of exercise-induced neuroplasticity and Neuroprotective after stroke, analyzed the type of exercise rehabilitation. Studies from 2005 to 2021 have shown that exercise, depending on the type, can inhibit nerve cell-degrading factors and rehabilitate them, as well as the formation of new neurons in the penumbra region with cellular and molecular changes specific to neurogenesis. In general, among the various training methods, high-intensity interval training had more advantages, which was also very important considering the time to start training after a stroke. Finally, it was found that the types of exercise in post-stroke rehabilitation will vary greatly based on the type of exercise that should be used based on the type and amount of stroke, in order to determine the exact effects of different types of exercise, more research is needed in the future.

    Conclusion

    It seems that one of the effective strategies in designing exercises for rehabilitation and recovery disorders caused by stroke is to use incremental methods in duration and intensity levels that start with very low-intensity exercises and increase the intensity of exercises over time.

    Keywords: Ischemic stroke, Rehabilitation, Endurance training, cognitive training, Neuroplasticity
  • Hamid Damiri, Amaneh Zare*, Amin Karim Nia, MohammadHossein Sharafzadeh Pages 105-114
    Background & Aims

    Chomsky (1981)'s theory of governance and referentiality, which distinguished between superstructure and deep construction, was considered as a candidate for describing syntactic disorders in grammatical aphasia speech. Depth is a surface that contains the lexical features of sentence structures and thetaic relations between these structures. The structure is derived from the depth of motion by kinematic moments. Role nuclei and their projections are of special importance in derivation. Match markers are time and state that are associated with lexical constructs such as verbs and nouns. Role structures such as complement and auxiliary verbs are produced in their original position, the role nuclei. Role nuclei and their identifiers are the landing sites of structures. Which have moved from their position in the depths of construction. Many studies have shown that the omission and replacement of mere adjectives is one of the main signs of grammatical production speech. Linguistic disorders caused by brain damage are categorized as generalized aphasia. Patients with disabilities have different language abilities depending on which area of their brain is damaged. Damage to the broca area usually leads to a disorder that has several symptoms, the first and most obvious of which is poor production. The second characteristic of Broca's aphasia is the regular omission and substitution of sounds, which is called relative phonological aphasia (also called motor aphasia). The third characteristic of Broca's aphasia is a defect in the ability to construct morphological and syntactic patterns. The most common of these symptoms is the loss of most sub-categories, such as prepositions and adjectives, as well as adjectives. Broca's aphasia is also associated with deficiencies in syntactic knowledge. Although patients seem to understand language well as long as they can rely on their knowledge of word meaning and pragmatics, they do not seem to be able to. Use syntactic knowledge in interpreting sentences. As mentioned earlier, this language center not only controls production but also plays a vital role in word formation and sentence construction. The Broca area seems to deal mainly with the structural and organizational aspects of language and is therefore responsible for the production rules governing the creation of sound patterns as well as the morphological and syntactic rules governing the construction of words and groups. Research shows that language is a complex cognitive skill that plays a vital role in human cognition, so it is directly related to other cognitive skills and should not be evaluated alone. In patients with aphasia, disorders in cognitive skills such as attention, memory. they cause disorders in language functions and if left untreated, they can delay the healing process of language disorders. Injury or disorder in the Broca area of the left hemisphere of the brain leads to different levels of speech disorders. The present study focuses on the domain of Inflection; tense and agreement in verbs produced by Persian agrammatic aphasics. Two main objectives are considered in this research. 1. Is the construction of a morphological structure preserved in the speech of grammar? 2- Are the grammatical errors produced in the speech of Boka people (grammars) as a result of a disorder (a disorder) the selection of role categories in the linguistic productions of Persian grammatical individuals by observing the behavior and performance of the verb definition?

    Methods

    The present study is a field, descriptive and analytical research. First, the researcher prepared a list of Broca aphasia patients to collect the desired data and referred to Neyriz Martyrs Hospital and with the help and assistance of a neurologist, reviewed the patients' medical records and CT scans. He has been performing his tests on the site of the brain lesion for 6 months. However, during these tests, he also faced some problems, including the fact that the number of sick men was higher than that of women. Sometimes patients died during treatment or suffered other serious injuries. Due to the medications they were taking and the special care taken to treat these patients, it was not possible to interview the researcher at any time; Therefore, sometimes the tests were performed in several stages and in a short time. In this research, data analysis is presented in the form of tables and graphs. This study was performed on 6 patients who were referred to Shohada Hospital in Neyriz, Fars province in 2019. The subjects were 35-80 years old, with at least elementary education, monolingual, Persian-speaking and right-handed. Data collected by Persian Aphasia Tests. This issue is analyzed in the theoretical framework of generative grammar, Pollock’s (1989) Split INFL Hypothesis, Friedmann and Grodzinsky’s (1997) Tree Pruning Hypothesis and also Chomsky's Minimalist Program (1992).

    Results

    The findings suggest that Friedmann and Grodzinsky’s syntactic tree pruning hypothesis (1997) does not have the explanatory adequacy to describe this disorder. Moreover, Persian agrammatic aphasics omit verb inflectional markers while showing no tendency to substitute morphemes. Observation of verb conjugation errors shows that 6 subjects tend to omit the current time and match markers. Cognitive studies have shown that the specific characteristics of each language determine the patterns of elimination and substitution observed in brain-injured patients. Since Persian is also an analytical language and usually by removing a grammatical word, the root of the word can be alone. It is conceivable as a word, so the removal of restricted monosyllables is conceivable and the replacement of one monosyllabic with another is not expected. According to the statistical data of Table 7, substitution errors rarely occur in the speech of prescriptive patients and include only 12% of misstatement errors, while 88% of errors are omission of morphologies. In short it can be stated that the result C. The present tense in Table 7 is a testament to the fact that prescriptive patients follow the rules of well-constructed vocabulary in their language.

    Conclusion

    In general, patients with Persian dyslexia suffer from speech disorders in various dimensions, which indicates that a cognitive-linguistic method should be developed to improve their speech abilities. The findings of the research can be discussed from different axes. According to the findings of the analysis of the data produced by patients with grammatical dysfunction, grammatical insufficiency was observed in their speech. By reviewing and analyzing the data, we found that adjective morphemes have limited application time and correspondence in their speech, and this finding is consistent with the results of research on the limited use of these morphemes. This study claims that the origin of this disorder Production is associated with limitations of processing capacity. That is, it activates slowly and slowly affects its lexical units. Therefore, it is better to look at grammatical disease as a computational disorder than a conceptual disorder. They face problems. Due to lack of access to syntactic knowledge, patients resort to adaptation as a strategy, thus eliminating the vocabulary units that had a problem processing. In fact, patients call aphasia a processing disorder, ie their ability to link information. Syntactically and affect morphology. Therefore, a cognitive-linguistic method should be used to assess linguistic abilities in grammars.

    Keywords: Agrammatic aphasia, Syntactic tree pruning, Minimalism, Agreement, Tense
  • Iraj Abedi*, Negar Abdi, Mozaffar Naserpour, Masoud Rabbani Pages 115-122
    Background & Aims

    Prostate cancer is the most common malignancy in men and the second leading cause of death in all countries of the world. According to the US statistics, about 27% of men in the United States were diagnosed with prostate cancer in 2014, and 10% will die of cancer. Over the past decades, prostate cancer management has reached a point where the degree, stage, and location of cancer determine the type of treatment. Treatment for prostate cancer depends on the spread of cancer at the time of diagnosis. Several clinical trials, including the digital rectal examination (DRE), biochemistry such as prostate-specific Antigen (PSA), and pathology such as ultrasound-guided biopsy (TRUS) are used to assess the size and spread of prostate cancer. However, these tests alone are not enough and reliable to diagnose and stage prostate cancer. In addition to the above methods, there are extensive imaging techniques for the diagnosis and staging of prostate tumors. Initially, CT scans were used for staging, but due to the inherent weakness of CT scans in differentiating prostate disease, MRI and ultrasound were used to diagnose and determine the of stage prostate cancer. Although, the standard method for diagnosing and staging prostate cancer is sampling and determining the Gleason index. In this study, the relationship between Gleason score as a standard method in patients with prostate cancer was compared with the parameters extracted from Diffusion-weighted imaging (DWI). In the DWI method, based on the diffusion of water molecules among intracellular molecules, a parameter called the apparent diffusion coefficient (ADC) is determined in the images and can provide precise contrast to differentiate tumor cells from healthy cells. Sensitivity to the diffusion of water molecules is defined by the gradient factor b (b-value) in s / mm2. This factor indicates the intensity and time of applying gradients to produce diffusion-weighted images. The higher b-value, the stronger effect of the diffusion of water molecules and results in better contrast, greater propagation and lower T2 shine-through effect, but a lower signal-to-noise ratio and a higher sensitivity artifact. Magnetic Resonance Imaging (MRI) provides information on the biological behavior of prostate cancer tissue in diffusion weighted (DW) MR images. The diffusion rate measured by DWI is related to the average path length traveled by water molecules so that the longer path leads to an increase in ADC. The three-dimensional diffusion of water molecules into the tissue is not random due to the presence of cell membrane impedance. Also in tissues with high cell density, increasing cell membrane may significantly inhibit the diffusion of intercellular water molecules and reduce the diffusion pathway and hence reduce ADC. Therefore, this parameter can indirectly provide information about tissue cells. The anatomical structure of normal prostate tissue consists of a glandular component associated with stroma tissue. Water molecules are easily diffused into the glandular component of prostate tissue. But as cancer becomes more distinct, the cell density increases, and the glandular structure becomes unrecognizable.

    Methods

    This fundamental study was performed on 90 patients with prostate cancer, according to McDonald's criteria, who were referred to Shafa Imaging Center in Isfahan, from March 2020 to January 2021. First, the informed consent form was obtained from all patients and then they participated in the study. In this study, patients were first referred to the MRI imaging department and routine MRI protocols were performed on them. Then, in order to evaluate the accuracy of the MRI-diffusion imaging method in comparison with the surgical and pathological results of patients and also to determine the optimal value of the resulting parameters, this sequence was performed on patients to evaluate the extent of tumor invasion. Free-breathing DW MR axial images were obtained using Siemens Avanto system 1.5 Tesla (with b-values equal to 0, 1000, 1500, and 2000 mm2 / s). The European Society of Urogenital Radiology (ESUR) recommends a b-value in the range of 800-1000 mm2 / s for prostate imaging. ROIs were plotted independently on ADC maps. To measure ADC in prostate cancer, tumor areas on T2W images were used to measure ADC, which accounted for a total of 24 ADC measurements in all three diffusion gradients for each patient. ADC values were measured by inserting ROI with an average area of 30 mm2. Using Medcalc software version 15 with a 95% confidence level, the indicators of sensitivity, specificity, accuracy, threshold, positive, and negative predictive value were calculated.

    Results

    The results showed that in 6 patients with Gleason score 6, the mean value of ADC using 32 ROIs (Region of Interests) was 0.982 ± 0.909 SD s/mm2. In 9 patients with Gleason score 7, the mean ADC value using 52 ROIs was 0.961 ± 0.806 SD s/mm2. In 6 patients with Gleason score 8, the mean ADC value using 52 ROIs was 0.924 ± 0.786 SD s/mm2. In 4 patients with Gleason score 9, the mean ADC value using 24 ROIs was 0.812 ± 0.726 SD s/mm2. Pearson correlation analysis showed a significant negative correlation between Gleason score and ADC measurements (r = -0.926, P = 0.01).

    Conclusion

    According to the guidelines of the European association of urology in 2013, the main tools for diagnosing prostate cancer include DRE (Digital Rectal Examination), PSA (Prostate Specific Antigen) and TRUS (Trans-Rectal Ultrasonography)-guided biopsy. Prostate cancer is often multifocal. It is generally accepted that GS determines the prognosis, the lesion with the highest GS has the weakest prognosis. The correlation of imaging with histopathology is very important for the validation and creation of new imaging biomarkers. In particular, accurate correlation allows to analyze relationships between quantitative MRI-based parameters and histopathology, and allows to evaluate the accuracy of imaging in tumor examination. The main limitation of previous studies was the unreliability of the amount of GS obtained from biopsy and problems in determining the exact location of the tumor on MRI. To overcome this limitation, prostatectomy specimens were used for the image and GS communication in this study. The results showed that there was a significant negative relationship between ADC values calculated from DW images and GS of prostate cancer obtained from a prostatectomy sample.

    Keywords: Magnetic Resonance Imaging, Prostate Cancer, Gleason score, b-value
  • Shadi Jalalian*, Farshad Ghazalian Pages 122-133
    Background & Aims

    Aging is a process that Based on slow and progressive changes with age, it covers the whole human being. Today, 31 countries in the world have more than 2 million elderly people over the age of 60, and the number of these countries is increasing day by day (1). The need to care for the elderly living at home will increase significantly in the coming years due to population growth and lack of physical activity (2). Most older people get older at home, and most have one or more chronic disorders (3). What is certain is that with age, the risk of acute and chronic diseases increases and people's functional abilities as well as their power of senses and perception decrease. These changes in the biological, psychological and social spheres threaten the quality of life of the elderly, to the extent that they prevent them from carrying out daily activities (4). One of the factors observed due to increasing aging is cognitive dysfunction, i.e. a decrease in BDNF levels and in line with this issue, a decrease in quality of life (5). Neurotrophin is a substance that enhances the survival and regeneration of nerve cells and strengthens, stimulates and grows neurons and is essential for memory.Neurotrophic factors support and grow a variety of brain neurons (6).BDNF is a protein encoded by a gene called BDN.This factor belongs to the family of neurotrophies that causes the expansion of the neural network.Brain-derived neurogenic factor is one of the most important members of this family and by binding to specific kinase tyrosine receptors, it triggers intracellular cascades and ultimately produces and differentiates new neurons (7,8).This factor acts as a mediator for synaptic effects, neural connections and plasticity in the brain.One study found that lowering BDNF levels in the elderly could reduce learning and functional impairment (9).On the other hand, increased BDNF and neurogenesis in the body can prevent nerve and muscle coordination in the elderly.Exactly the decrease in nerve and muscle coordination is one of the reasons that occurs with a decrease in BDNF levels in the elderly and will affect the quality of life of these people.In recent years, the possibility of using exogenous BDNF as a therapeutic approach against neurological diseases has been estimated (9).However, the role of exercise and nutrition in increasing BDNF and quality of life still has many challenges.Exercise and nutrition itself are an exogenous factor in increasing BDNF.Research has shown that exercise in young rats increases the number of new cells in the hippocampus and improves brain function.Physiological studies have also shown that physical activity increases the electrical activity of the hippocampus, which can be caused by altered neuronal activity and neurotransmitters (10). The effect of aerobic exercise in young rats shows that exercise increases spatial learning and neuronal density of the hippocampus in the dentate gyrus and other parts of the hippocampus without changing the rate of apoptosisand improves short-term memory. Researchers believe that exercise may strengthen the hippocampus in humans.In the meantime, resistance training has been able to have a significant impact on changes in the hippocampus (11). Doing resistance training can also make a positive difference in BDNF levels (12). On the other hand, nutrition can also help increase BDNF levels.ginkgo biloba has been shown to be used for brain-related issues, including memory enhancement or even the treatment of Alzheimer's patients (13).ginkgo biloba is well known for its antioxidant components and has the ability to scavenge free radicals and lipid peroxidation.ginkgo biloba contains more than 60 bioactive compounds, the most important of which are terpene lactones and flavonoids (14).Recent research has also highlighted the importance of the effect of ginkgo biloba supplementation on cognitive function.In this regard, it has been found that ginkgo supplementation has neuroprotective effects and improves cognitive function capacity, and it performs these actions by reducing oxidative stress and increasing BDNF concentration (15). Therefore, due to the importance of increasing old age and lack of physical activity and the existence of conflicting studies regarding the importance of supplementation and combination with exercise in the elderly, the present study decided to fill the scientific gap of the present study as the effect of twelve weeks of exercise. Check serum BDNF levels and quality of life of inactive elderly with ginkgo biloba supplementation.

    Methods

    The statistical sample of the present study consisted of 40 elderly men and women (75-60 years), who were selected in a targeted and accessible manner.And were randomly divided into 4 groups of exercise (n=10), supplement (n=10), exercise + supplement (n=10) and placebo or control (n=10).Criteria for inclusion in the present study of the subjects according to the callBeing over 60 years old, having Iranian nationality, ability to speak Persian, not having a known mental illness (psychosis), having full consciousness while studying, ability to communicate, ability to answer study questions and living in Tehran.Exclusion criteria from the present study included refraining from answering the questionnaire during work and interviews, as well as refusing to perform the desired training program or supplement, as well as unwanted events.After selecting the participants during an introductory session, the steps, process and purpose of the research were fully explained to them and a informed consent form was obtained.This study was also registered in the Clinical Trial Center with the code IR.SSRC.REC.1398.116. The training sessions were supervised by trained personnel and will last for 20 minutes 5 times a week for 12 weeks. Each training session included 5 minutes of warm-up, 5 minutes of resistance training, 5 minutes of balance and walking training, and 5 minutes of cooling. Subjects were randomly assigned to receive 240 mg (once daily and in the morning) of EGb761 or placebo (cellulose). To do the chair exercise, get on your toes, get on your heels, lift your knees, open your knees, and do other movements while standing behind the chair to maintain more balance. To strengthen the ankle weight bearing exercise, to strengthen the legs, a fixed weight was placed on the ankle and strengthening exercises were performed.

    Results

    The results of one-way analysis of variance showed that there was a significant difference between serum levels of neurotrophic factor derived from the brain of the elderly in the study groups after twelve weeks of aerobic exercise with ginkgo biloba supplementation (P = 0.05).The results of one-way analysis of variance showed that there was a significant difference between the quality of life of the elderly in the study groups after twelve weeks of exercise with ginkgo biloba supplementation (P = 0.05).

    Conclusion

    The aim of this study was to evaluate the effect of 12 weeks of physical activity with ginkgo biloba on serum BDNF levels and quality of life in the elderly in Tehran.The results of this study showed that there was a significant difference between BDNF levels in the elderly and quality of life (QoL) in the study groups after twelve weeks of aerobic exercise with ginkgo biloba supplementation (P <0.05). The intergroup results also showed that there was a significant difference in serum BDNF levels between all groups (P <0.05).Also, the results of Tukey test for comparison between QoL index showed that there was a significant difference between all groups (P <0.05) but there was no significant difference between the complementary and control groups (P> 0.05). In general, the results of the present study show thatExercising and taking ginkgo biloba supplements at the same time for 12 weeks will improve serum BDNF levels and quality of life in the elderly, thereby reducing aging mortality and improving the living conditions and independence of the elderly.

    Keywords: Aerobic training, Ginkgo biloba, Elderlies, BDNF
  • Masoumeh Rahat Dehmardeh, Vali Mehdinejad*, Fatemeh Soghra Karbalaei Harfteh Pages 134-143
    Background & Aims

    Physical activity and a moderate level of fitness is a focal point in health benefits associated with lifestyle. Regular physical activity in adults can promote good health, improve cognitive function, and prevent disease. Abundant research from the health and exercise science literature also presents empirical evidence of positive “non-health effects” induced by physical activity or sports participation. Among the non-health effects, physical activity improves life satisfaction, happiness, subjective well-being, mental health, and interpersonal relations. Emotion regulation is a vital component of everyday life and inappropriate emotion regulation has been associated with a variety of psychiatric disorders and aggression. Broadly speaking, emotion regulation refers to a diverse set of processes by which “individuals influence which emotions they have, when they have them, and how they experience and express these emotions”. Although there are many different approaches people can use to regulate their emotions, two well-studied strategies are expressive suppression and emotional reappraisal. These two processes appear to differ in their effect on emotional experience and the associated psychophysiological processes, such as heart rate, skin conductance responses and neural activity. Whereas reappraisal is often capable of lowering emotional experience, reducing or altering psychophysiological activity, and improving social functioning, expressive suppression seems much less effective in these respects and might even have negative social consequences. Nevertheless, regulatory effects of suppression on neural responses have been observed, albeit later in time than was observed for reappraisal and which may reflect increased effort to continue inhibition or cognitive control when people are asked to suppress negative emotions. The effectiveness of regulation has been tested in various circumstances including the ability to increase and decrease positive emotions, the associated physiology and neural responses as induced by film clips and expectations of reward. However, the majority of studies to date are restricted to measuring the ability to regulate negative feelings induced by either the viewing of negatively-valenced images or by the anticipation of negative events, such as electric shocks. Nevertheless, the effectiveness of emotion regulation strategies is dependent to some degree on the specific type of stimulus and the emotion to be regulated. Regulation of emotion and social relationships are important factors related to participatory activities for students; Therefore, the purpose of this study was the role of teaching science and knowledge through physical activity on improving social relationships and emotional regulation.

    Methods

    In this quasi-experimental study, the statistical population included all female second and third grade elementary school students in Zahedan in the academic year 2010-2011. Due to the quasi-experimental study, 30 people were selected by purposive sampling. They were randomly assigned to experimental (n = 15) and control (n = 15) groups. Barton (1990) Social Relations Questionnaire and Gross and John (2003) Emotional Regulation Questionnaire were used to collect data. The method of physical activity intervention was 12 sessions and each session for one hour for experimental groups. Data analysis was performed using dependent t-test and independent t-test.

    Results

    The results of intra-group study showed that in the experimental group the level of social relations and re-evaluation increased significantly (P = 0.002 and P = 0.002, respectively), but the level of repression decreased (P = 0.001). On the other hand, the intergroup study showed that training through physical activity led to improved social relationships, re-evaluation and repression in the experimental group compared to the control group (P = 0.002, P = 0.001, P = 0.003, respectively).

    Conclusion

    Social support, a potential correlate of leisure time physical activity (LTPA), can broadly be defined as resources provided by other persons. It is a multidimensional concept; emotional support provides love and caring, whereas practical support provides tangible assistance with a task or goal. Lack of social support has repeatedly been associated with higher morbidity and mortality. It is possible that part of this relationship is attributable to the association between social support and LTPA, mental health being a plausible intermediary factor. For example, social ties and integration in social networks play a role in the maintenance of psychological well-being, which in turn might motivate self-care in individuals, including regular physical exercise. High levels of social support are also assumed to increase self-esteem, self-efficacy and perceptions of control over the environment, all of which can potentially help an individual to adopt a proactive lifestyle and to resist unhealthy behaviours, such as sedentariness. Furthermore, indirect evidence is consistent with a causal chain linking low social support to an increased risk of psychiatric morbidity and psychiatric morbidity to lower physical activity. On the other hand, it can also be argued that people with fewer social ties have more time to exercise. The mechanisms explaining these associations remain unclear. A positive role identity and feelings of being useful provided by nurturing close social relationships can lead to greater motivation to take care of oneself and maintain a physically active lifestyle. High social support may also indicate positive involvement and active influence of a close person, which can encourage the individual to maintain health-promoting behaviours, such as regular exercise. In addition, it is possible that higher social support is associated with better access to resources and may help to buffer the impact of daily stressors and life events and thereby reduce the likelihood of unhealthy coping behaviours such as discontinuing LTPA. A growing literature examines the outcomes associated with sports participation by using large-scale surveys. The literature can be grouped into three strands. First, many authors have studied the impact of sports participation among other activities as one of the ways social capital can be generated. Second, other studies have focused on the role of sports on children, that is, how sports activities favor the development of prosocial skills and attitudes. Finally, several authors have recently focused on the effects of social identity and a sense of belonging induced by team sports. Looking at the effects of sports participation on skills development in children, Felfe, Lechner, and Steinmayr (2016) find that cognitive and noncognitive skills are both affected by sports participation. They also find that children participating in sports have fewer problems with peers, and this fosters better relationship. In general, the results showed that in smart schools, physical activity interventions should be used for learners to improve the level of psychological factors.

    Keywords: Physical Activity, Social Relations, Emotional Regulation, Smart Schools
  • Morteza Chenari, Alireza Rahimi*, Amir Sarshin, Foad Feizolahi Pages 144-154
    Background & Aims

    Diabetes is the most common metabolic disease in humans. It causes a group of metabolic disorders that are caused by decreased insulin secretion or resistance to its function. In general, diabetes mellitus refers to a heterogeneous group of metabolic disorders that is characterized by decreased insulin secretion, decreased insulin function, or both, and is divided into two main categories: type 1 diabetes and type 2 diabetes (1). Excessive blood sugar leads to irreversible damage to various parts of the body, especially the heart tissue. Damage to heart tissue in diabetics causes inflammation and destruction of heart cells, which in turn leads to apoptosis or cell death (2). Apoptosis or programmed cell death plays a key role in regulating the balance between reproduction and cell death in various tissues, especially somatic tissues such as the myocardium. It ends with the crumpling of the nucleus and cell membranes and the production of vacuoles containing apoptotic (3). Research has shown that BAX protein, by reducing the stability of the outer mitochondrial membrane, can lead to the release of apoptotic agents such as cytochrome C from the interstitial space. In the meantime, the common denominator of all apoptotic pathways is the activation of caspase-3 and the breakdown of vital cell proteins (4). Physical activity is one of the most effective ways to prevent diabetes and control it if you have the disease (8). Exercise is also known as one of the best non-pharmacological interventions in controlling apoptosis (9). Montazery taleghani et al. (2019) showed that eight weeks of resistance training led to a significant reduction in Bax gene expression and the ratio of bax to Bcl-2 in the heart tissue of diabetic rats (10). Arjmand et al. (2021) showed that endurance training significantly reduced the expression of caspase-3 and Bax genes in comparison with the diabetic control group (11). However, Kwak et al. (2006) reported that 12 weeks of exercise significantly increased left ventricular apoptosis (13). So far, no comprehensive study has been conducted, especially in the country, comparing the effect of aerobic and resistance training on cardiac muscle apoptosis during diabetes and possible molecular changes and proteins involved in apoptosis. It is expected that by conducting the present study, while answering some of the existing ambiguities and determining the effect of exercise on apoptosis, appropriate practical suggestions can be made on how to perform the exercise and also predict the possible consequences of aerobic and resistance training. Therefore, the aim of this study was to investigate compare the effect of aerobic and resistance training on Bax and Caspase 3 apoptotic indices of the heart tissue in male diabetic rats.

    Methods

    In this experimental study, 24 male Wistar rats were divided into six groups: aerobic training, resistance training, aerobic sham, resistance sham, control and healthy. Diabetes was induced by intraperitoneal injection of a single dose of streptozotocin. The aerobic and resistance training program was performed for six weeks. Western blotting was used to measure BAX and caspase-3. Data were analyzed by one-way analysis of variance and Tukey post hoc test at the P <0.05.

    Results

    The results showed that the mean difference of caspase-3 between aerobic training group with healthy and sham group (P=0.000), resistance training group with sham group (P=0.000) and aerobic training group with resistance training group (P=0.000), was significant and the amount of caspase-3 in the resistance training group was lower than aerobic training. There was a significant difference between the mean BAX between the aerobic training group with the healthy and sham groups (P=0.000), the resistance training group with the sham group (P=0.000) and the aerobic training group with the resistance training group (P=0.014). And BAX level in resistance training group was less than aerobic training.

    Conclusion

    The results of the present study showed that aerobic and resistance training led to a significant reduction in BAX levels in the heart tissue of diabetic rats and resistance training had a greater effect than aerobic exercise. The findings of this study were consistent with the results of Previous research (10,11,17). According to existing research, BAX protein plays an effective role in modulating cell death processes. Any factor that alters BAX levels leads the environment to apoptosis and inhibition of apoptosis (18,19). Normally, there is a balance between inhibitory factors and apoptotic stimuli, but in physiological and pathological situations, this balance is always disturbed, and one of these situations is physical activity. It is possible that exercise activities can prevent cell death by affecting the most important factors affecting the apoptotic process (20). Regular exercise increases myocardial BCl2 protein and changes the ratio of BAX to BCl2 to an anti-apoptotic medium (21). Activation of the BAX protein increases the permeability of the mitochondrial membrane. One of the important biological aspects of mitochondria is the role that this organ plays in apoptosis. Mitochondria are an integral part of the internal pathway of apoptosis and the locus of many proteins involved in the early stages of this process, including members of the BCl2 family (22). BAX entry into mitochondria and release of cytochrome C triggers apoptotic signaling of downstream caspase cascades (21). Evidence suggests that regular exercise (resistance and endurance) can counteract the (onset of cardiovascular disease) apoptosis of diabetic rat heart cells and its adverse consequences. Also, the results of our study showed that aerobic exercise has a significant effect on reducing the amount of caspase-3 in the heart tissue of diabetic rats. On the other hand, resistance training has a significant effect on reducing the amount of caspase-3 in the heart tissue of diabetic rats. This finding is consistent with the findings of some previous studies that have reported a decrease in caspase-3 after exercise (24-27). Caspase-3 is activated by activating caspase-12 through the calcium release pathway or by activating caspase-9 internally or by increasing serum TNF-α externally (21). The exact mechanisms of exercise-induced apoptosis are unclear. Mitochondria and endoplasmic reticulum in the internal pathway are the focus of the process, in which the focus of mitochondria has been the most important in causing apoptosis (1). Under stress, factors such as glucocorticoids, ROS, nitrogen monoxide, chemotherapy drugs, radiation, reduced growth stimulants, and cytokines cause changes in mitochondrial stress, causing changes in its permeability, and cytochrome c in the inner membrane and cytokine. It is located between the membranes, is released into the cytosol, binds to apoptosis-activating factor 1 protease 1, and forms a compound called dATP. This compound then induces apoptosis by activating procaspase 9, caspase 9, and caspase 3 (32). Inhibitors of cell death pathway proteins such as Bcl- 2 and Bcl-XL inhibit the release of cytochrome c and thus play a role (33). According to the results of studies, it can be said that regular resistance and endurance activity of each separately in the present study, is an effective factor in reducing the expression of caspase-3 in preventing cardiac cell apoptosis in male Wistar diabetic rats. One of the limitations of the present study is the lack of measurement of other apoptotic markers in cardiac tissue. It is also suggested that BCL-2 anti-apoptotic factor and inflammatory markers for their relationship with apoptotic markers in cardiac tissue of diabetic specimens for better explanation and interpretation. Measure the results. According to the findings of the present study, exercise can reduce the effects of diabetes on cardiac cell apoptosis in male Wistar rats. It is on the control of apoptotic signaling pathway in diabetic rats. Therefore, the use of both resistance and aerobic exercise is recommended as effective treatments to reduce the apoptosis of heart cells in male Wistar diabetic rats. Meanwhile, the effect of resistance training on reducing the complications of diabetes on cardiac tissue apoptotic factors was greater than aerobic exercise and closer to the levels of pre-apoptotic factors in the healthy group.

    Keywords: Diabetes, Bax, Caspase 3, Aerobic training, Resistance training
  • Mojtaba Rasoolian, Jashid Banaei Borojeni*, Parvin Farzanegi Pages 155-168
    Background & Aims

    Diabetes mellitus is a common metabolic disease that occurs with high blood sugar due to a lack of insulin secretion, insulin resistance, or a combination of both (1). One of the possible mechanisms for resistance to insulin and type 2 diabetes is dysfunction and impaired mitochondrial biogenesis (3). Mitochondrial density and function are associated with cardiovascular disease, sarcopenia, insulin resistance and type 2 diabetes, the aging process, and aerobic capacity (5, 6). Today, a complete understanding of mitochondrial biogenesis is associated with an understanding of various cellular pathological conditions (7). Mitochondria play a role in increasing mitochondrial function. Quality, mitochondria represent an improvement in mitochondrial biogenesis. In tissues with high oxidative capacity, such as skeletal muscle, activated by gamma receptor joint proliferator, an alpha activated by peroxisome proliferator (PGC-1α) is considered to be the most important regulator of biogenesis and mitochondrial function (3).TFAM is a transcription and replication agent for mitochondrial DNA and plays an important role in mitochondrial biogenesis processes (8). A study by Madrasa (2018) showed that decreased expression of this group of genes is associated with decreased capacity, whole body aerobics in patients with type 2 diabetes and decreased expression of PGC-1α and nuclear genes encoding mitochondria in individuals. Insulin resistance can mean that these people have low levels of aerobic exercise (3). Exercise can play an important role in accelerating mitochondrial biogenesis, possibly leading to a reduction in mitochondrial dysfunction that occurs during the aging process, metabolic diseases such as type 2 diabetes, and conditions of muscle inactivity resisting fatigue and increasing the quality of life (7). The method of training is in the form the although metabolic control is available in type2 diabetes (25). The effect of aerobic exercise and the chemical drug atrostatin on the expression of genes affecting the mitochondrial biogenesis of cardio myositis in samples with type 2 diabetes has not been studied and because of its importance in controlling mitochondrial function following diabetes. Type 2 is impaired, it is necessary to study it, so the aim of the present study was to investigate the protective effect of continuous and intermittent exercise with atrostatin on some markers of mitochondrial biogenesis signaling myositis (PGC-1a and TFAM) in diabetic elderly rats.

    Methods

    Thirty-five male rats (20 weeks old) weighing between 300 and 350 g were randomly divided into 7 groups. Diabetes was induced in 6 groups. To make diabetic mice, streptozotocin (STZ) was injected intraperitoneally at a dose of 50 mg per kg body weight (26). Atorvastatin was taken orally after a meal at a dose of 2 mg per kg body weight (27). The first week of continuous training program at a speed of 15 meters per minute for five minutes, the rats started running on the treadmill. Then, every week, increasing the speed by 1 to 2 meters per minute for 1 to 2 minutes increases the running time. 48 hours after the last training session with 10 to 12 hours of night fasting, intraperitoneal injection of a combination of ketamine and xylazine was performed in anesthetized mice and tissue samples were taken. Their heart tissue was isolated and stored at -80 ° C and then transferred to a laboratory for genetic testing. To investigate the significant changes in each of the research changes between different groups, one-way analysis of variance was used and if a statistically significant difference was observed to determine the location of ANOVA, Tukey post hoc test was used. Significance level P <0.05 was considered for all calculations.

    Results

    In the present study, the effect of continuous and intermittent exercise combined with atorvastatin administration on PGC-1α and TFAM gene expression in cardiac myocytes of elderly diabetic rats was investigated. The first finding of the present study showed that the expression of PGC-1α gene in cardiac myocytes of rats with type 2 diabetes was significantly reduced compared to the healthy control group, while after 8 weeks of intervention, the mean PGC-1α to Significantly decreased compared to the healthy control group, while after 8 weeks of intervention, the mean PGC-1α increased in the exercise and atorvastatin groups, but in the combined intervention group, this increase was significantly greater.

    Conclusion

    It seems that taking atorvastatin with 8 weeks of continuous and intermittent physical activity has been able to make changes beyond taking atorvastatin alone or continuous and intermittent exercise. In this regard, Baghdam et al. (2019) by examining the effect of 8 weeks of aerobic exercise on the expression of RGC-lα gene in heart tissue in diabetic rats, concluded that aerobic exercise significantly increases the concentration of PGC-lα in heart tissue (29). However, in contrast to the findings of Chavanel et al. (2017) showed that exercise has no significant effect on the level of PGC-1α mRNA or other mitochondrial biogenesis regulators such as TFAM (30). One of the most important reasons for inconsistency in Chavanel research with the results of the present study may be the age, sex and race of the subjects as well as the type of training protocol.PGC-lα is one of the most important transcriptional coordinator coagulators that positively regulates the expression of genes associated with metabolic and mitochondrial adaptations, thus influencing cardiac substrate selection, mitochondrial function, ATP production capacity, and species production. Reacts to oxygen (ROS). (31) Physical activity is one of the factors that trigger these messaging pathways. In other words, mitochondrial biogenesis in the cell is induced by environmental stimuli such as physical activity (30). Another result of the present study was the decrease in TFAM gene expression in cardiac myocytes of elderly diabetic rats compared to the healthy control group, while after 8 weeks of intervention, a significant increase in TFAM gene expression was observed in atorvastatin and combination groups compared to the patient group. This increase was greater in the combination of diabetic + atorvastatin + periodic exercise. It seems that when the volume of training is the same, the intensity of training can be an effective factor in the expression of TFAM; Therefore, this study showed that with a constant volume of periodic training is more effective than continuous training in the expression of TFAM gene. The present study showed that intermittent and continuous exercise with atorvastatin increased TFAM in the heart cells of elderly diabetic rats, which decreased due to diabetes and aging. Consistent with the results of the present study, Popo et al. Examined the effect of two months of aerobic exercise on skeletal muscle TFAM in human diabetic specimens and reported a significant increase (37). Therefore, the effect of the training period is enhanced at higher intensities. Exercise frequency is also one of the effective factors in increasing mitochondrial biogenesis. Chavanel et al. (2017) have shown that exercise has no significant effect on the level of mRNAPGC-1α or other mitochondrial biogenesis regulators including TFAM (30). One of the most important reasons for inconsistency in Chavanel research with the results of the present study may be in the condition of the subject and the type of muscle fiber as well as the type of training protocol. TFAM is a high-mobility transcription factor group responsible for replication and transcription of mitochondrial DNA. Impairment of the TFAM target specifically in cardiac tissue leads to a significant reduction in electron transport capacity, spontaneous cardiomyopathy, and heart failure. In contrast, increased TFAM expression in cardiac tissue protects against heart failure due to myocardial infarction.Another finding of the present study was the positive and significant effect of atorvastatin on the expression of TFAM and PGC-1α genes in mice with type 2 diabetes. Studies show that atorvastatin improves mitochondrial function and prevents apoptosis in myocardial hypertrophy (41). In the present study, Chen et al. (2018) inhibited the decrease in the expression of PGC-1α and UCP3 in mice with myocardial insufficiency by treatment with atorvastatin (42). According to the results obtained in the present study, the effects of atorvastatin may be fundamentally different in different patients and with different races, and also its effects may vary depending on the dose or duration of use and the type of statin used. However, the effect of co-administration of atorvastatin and exercise with TFAM and PGC-1α on cardiac tissue has not been investigated. Reduces oxidative stress and inflammation in a variety of metabolic syndrome diseases such as diabetes and therefore improves these diseases by inhibiting mitochondrial damage (45). The combined use of both has more effective therapeutic effects on type 2 diabetes. The results of this study on improving heart function have been confirmed by previous studies.

    Keywords: Mitochondrial Biogenesis, Atorvastatin, Training
  • Maryam Mahdavi, Seyedeh Olia Emadian*, Ramazan Hassanzadeh Pages 169-177
    Background & Aims

    Inflammatory bowel disease, including ulcerative colitis (UC) and Crohn's disease (CD), is a chronic debilitating condition characterized by an unpredictable period of flare-ups and periods of recovery that often affect people. And require lifelong follow-up and medical treatment (1). UC is characterized by diarrhea, severe cramps, and weight loss (3). Due to the bad consequences of this disease on individual and social life, various methods such as anti-inflammatory and immunosuppressive drugs such as aminosalicylates, corticosteroids, anti-tumor necrosis agents, dolizumab, sticnomab and tonacitinib are used to control the disease. (3). In general, inflammatory bowel diseases not only affect the patient in terms of physical complaints, but also challenge psychosocial issues, which necessitates the need for psychotherapy (12).One of the third wave therapies that has recently been widely used in physical and psychological health problems is commitment-based therapy, which has six central processes: acceptance, failure, self as context, communication with the present., Values and practice are committed. Mindfulness based on acceptance and commitment to manage inner experiences teaches us effective skills of mindfulness (13). For years, the main end point of IBD treatment was recovery and clinical response, followed by normalization of biomarkers and improvement of mucosa. In this regard, in recent decades, different therapies have been proven to be effective in treating IBD and the outcome reported by the patient (PRO) has made it more relevant (1).Considering the above and the negative impact of ulcerative colitis on the one hand and the role of treatment based on acceptance and commitment on the other hand, it is necessary to review the research conducted in the country and abroad so far. No individual has been performed in patients with ulcerative colitis. Research has been done on the psychological factors of other patients and the results have been contradictory, so the researcher seeks to answer the question of whether acceptance and commitment-based therapy has an effect on interpersonal sensitivity in patients with ulcerative colitis.

    Methods

    The present study was a quasi-experimental with a pretest-posttest design with a control group. The statistical population of this study consisted of men and women with ulcerative colitis referred to Sari and Amol clinics in 1400. 24 people were selected as a sample by purposive sampling method and by observing the entry and exit criteria. They were randomly divided into two groups based on acceptance, commitment and control. After completing the consent form and the interpersonal sensitivity questionnaire of Bayes and Parker (1989) in the pre-test, the experimental group received 8 sessions (90 minutes each session) of acceptance and commitment based treatment once a week (8) according to the table. 1 were trained and the control group waited for treatment. Also, immediately after the intervention and after 2 months, the questionnaire was completed again by all subjects. Finally, descriptive statistics, Shapiro-Wilk tests, multivariate analysis of covariance, repeated measures analysis of variance and Bonferroni post hoc using SPSS software version 23 were used for statistical analysis.

    Results

    The results showed that there was a difference between the two groups (Eta=0.504, p = 0.001, F = 21.21 (21, 1) F). In other words, there is a significant difference between the interpersonal sensitivity of the experimental group and the control group. The Eta size indicates that 50.4% of the improvement in interpersonal sensitivity of the subjects in the experimental group can be attributed to the effect of acceptance and commitment-based therapy.According to Table 3, there is a significant difference between the three stages of the values of interpersonal sensitivity variables (P <0.05), which indicates that the amount of interpersonal sensitivity variables during the three stages of pre-test, post-test and follow-up is different. Also, the results of pairwise comparisons showed that there was a significant difference between the adjusted means of the interpersonal sensitivity variable in the pre-test and post-test (P <0.001). Also, there was a significant difference between the adjusted means of the interpersonal sensitivity variable in the pre-test and follow-up stages (P <0.001). Also, there was no significant difference between the adjusted means of the interpersonal sensitivity variable in the post-test and follow-up stages (P <0.05). Therefore, it can be concluded that treatment based on acceptance and commitment has had an effect on patients' interpersonal sensitivity and the effects of treatment have remained in the follow-up stage.

    Conclusion

    The aim of this study was to evaluate the effectiveness of acceptance and commitment therapy on interpersonal susceptibility of patients with ulcerative colitis. It was also found that in the post-test phase, there was a significant difference between the interpersonal sensitivity of the experimental and control groups and the effects of treatment were stable in the follow-up phase. In explaining these findings, it can be said that one of the things that is emphasized in the treatment of acceptance and commitment is evaluation. Evaluation is the application of a comparative relation to two or more verbal events. Unlike comparisons made by other beings, all of which are based on experience, evaluation for humans can be based entirely on verbal events that have never been experienced (21). Since non-evaluation and acceptance are among the goals of treatment in this treatment, it can be said that patients who receive this treatment learn to avoid evaluation and comparison, life events and people who are with them. Relate the relationship without judgment and accept it without evaluation, all of which can improve non-judgmental attitudes in these people and these people are less affected by negative thoughts related to interpersonal problems and havea more receptive attitude to people. All of this leads to less interpersonal sensitivity.Patients accept their mentality and being in the present and consciously instead of avoiding experiences and realities, and commit to expressing the right way of expressing their individuality and value (23) and this is the same flexibility. ذ is psychological receptivity. It seems that mental flexibility can free the individual from the trap of dysfunctional thoughts that lead to incompatibility in relationships and increase the development of interpersonal skills and constructive interactions; Thus, those who received this training can perform techniques such as mindfulness in this treatment by reducing the severity of the dysfunctional thoughts involved in interpersonal problems as well as adhering to the inner values that Can be a link between social relationships, improve their tolerance level and show less interpersonal sensitivity.

    Keywords: Acceptance, Commitment Therapy, Interpersonal Sensitivity, Ulcerative Colitis
  • Behrad Zadafshar, Tayebeh Sharifi*, Reza Ahmadi, Maryam Chorami Pages 178-187
    Background & Aims

    Sexual harassment, or in other words, the use of children and adolescents for sexual gratification, is one of the forms of harassment of children and adolescents that occurs at all ages from childhood to adolescence, and the adverse consequences and sometimes irreparable harm to health and well-being. Adults are large in size (2). In this regard, research has shown that child abuse, in addition to the destructive short-term consequences it has on the child, causes the child to feel insecure, anxious, distracted, afraid, depressed, inattentive, and post-traumatic stress disorder behaviors; It will also have long-term consequences (4).Given the above and the negative impact of sexual harassment in childhood on individual and social life and causing great material and spiritual damage to the individual and society, researchers and experts are constantly seeking to discover new ways to reduce these effects. And help the mental and physical condition of the victims, and in this regard, various medical and non-arbitrary methods have been used. However, among the methods that have been considered recently, emotion-oriented therapy can be modernist and experimental therapy (5), which points to the important role of emotions and emotional communication in organizing communication patterns and considers emotions as a factor of change. Takes (6).On the other hand, existential psychotherapy, by emphasizing important concepts such as responsibility, presence in existence, freedom, choice, search for meaning and especially constant self-awareness, has provided a unique way to treat existential anxiety (11). Existential therapy provides the therapist and client with the opportunity to understand how the client chooses how to express their "individuality." In the existential treatment of worldviews, values, beliefs, as well as the type of worldview of people and the events we face; It becomes clear (12).In general, the review of existing research shows that so far no comprehensive and similar research has been conducted that simultaneously examines the impact of both emotion-oriented and existential therapies on the psychological issues of victims of sexual harassment. Therefore, the aim of this study was to compare the effect of emotion-oriented and existential group therapy on the defense mechanisms of victims of child sexual abuse in Isfahan.

    Methods

    For the present quasi-experimental research, which was performed with a pre-test-post-test-follow-up plan and a control group, among those with a history of being victims of any sexual abuse in a child who had referred to psychology centers in Isfahan in 1398 and 1399, Eligibility criteria for the study were 45 people were selected as available and randomly divided into three groups of emotion-oriented therapy, existential and control. After completing the consent form, the subjects in the experimental groups received 8 sessions of interventions. It should be noted that before, after and 3-month follow-up period, research variables were measured. The research tool also included the following:Laserman Sexual Harassment Questionnaire (LSHQ) which includes 7 questions with yes and no answers. Scoring in this test indicates that the person is a victim of at least one type of sexual harassment. And the Defense Styles Questionnaire (DSQ-40), a new version of which was developed by Andrews et al.In the present study, the reliability of the internal consistency method using Cronbach's alpha coefficient for the three defense styles developed, immature and psychotic is equal to 0.68, 0.75 and 0.71, respectively, which are acceptable coefficients.

    Results

    The results showed that there was a significant difference in the scores of developed and psychoactive defense mechanisms in the three stages of pre-test, post-test and follow-up measurement and the interactive effect of their measurement stages with the group (P <0.01). The results also showed that in the developed defense mechanism, a significant difference is observed in the measurement stages, while such a difference is not seen due to the interaction of time with the group (Table 3).As the results of Table 4 show, with the significance of time within the groups with F calculated for immature (28.86), mature (3.11) and psychotic (13.61); Confirms the existence of a significant difference between the three measurements of pre-test, post-test and follow-up at the level of P <0.01.The results also showed that the interactive effects of the two immature and psychotic styles with F calculated at 11.86 and 10.14 were significant, but with no significant source in the group between the control and experimental groups in all three styles; It can be said that there is no significant difference between the mean scores of the experimental groups, emotion therapy, existential therapy and the control group (P <0.05). No (Table 4).

    Conclusion

    The results showed that there was no significant difference between the mean scores of the experimental therapy, existential therapy and control groups. Regarding the findings of the present study, it should be noted that sexual harassment is a complex problem that has various physical, psychological and legal aspects. The use of coping strategies and defense mechanisms reduces vulnerability in stressful situations such as sexual harassment (18). But it should be noted that emotionally empowered people make it easier for them to face life's challenges and, as a result, have better mental health. These people are more successful in coping with negative experiences and show better adaptation to the environment and others (19).In emotion-oriented therapy, the therapist focuses on raising awareness of the mental content that has been denied or distorted by the therapist in order to create new meaning influenced by the client's physical experience (5). Approaching bitter mental and emotional experiences for victims of child sexual abuse is often a difficult and tedious process. In addition to building an effective relationship, the therapist's mission is to teach emotion regulation skills. Therefore, the therapist has based his treatment on the self-improvement and balance of the person and tries to self-regulate the person and his emotional system through positive self-concept, and in treatment sessions, he widely uses treatment methods to express new feelings. Slowly (12).An existential therapist helps individuals and victims of child sexual abuse find meaning in life in the face of anxiety and stress, and this is achieved through the use of thinking power, responsible action, and coping with negative thoughts and social pressures. According to what has been stated in the above explanation, it can be stated that since the existential components directly involve the victim with the existence and existential processes, the person looks at the process of change in a deep and conscious way. This process always requires the victim to allow a part of him or her that has been hidden or repressed to come to the realm of awareness and analysis so that the person has the opportunity to make a more informed choice and gain a deeper perspective on issues.

    Keywords: Emotion group therapy, existential group therapy, sexual harassment, defense mechanisms
  • Hadi Karami, Amin Farzaneh Hesari*, Parvin Farzanegi Pages 188-198
    Background & Aims

    Hypertension is a chronic disease that affects approximately 1 billion people worldwide and is estimated to continue to increase. High blood pressure causes long-term damage to the heart and other organs that may be potentially life-threatening and often begins at the cellular and subcellular levels (1). Despite the greater understanding of the pathological processes of hypertension and the use of various drug interventions in recent years, the mortality rate of this disease is still high. Therefore, new intervention strategies are needed to prevent and control pathological changes to improve high blood pressure disease. In this regard, exercise training can reduce blood pressure in hypertensive individuals and it has been shown to improve several factors involved in the pathophysiology of hypertension (9). For a long time, continuous exercise for a period of 30 minutes or more has been recommended to improve patients with high blood pressure and also to prevent this disease. However, recent studies have suggested that HIIT exercises may compete with new blood pressure treatments. Some studies have shown that HIIT has a higher priority for improving cardiovascular fitness, endothelial function, markers of sympathetic activity, arterial stiffness, lipoproteins and blood glucose in people with hypertension (10). It has also been shown that HIT leads to adaptations similar to traditional endurance training, such as increasing mitochondrial capacity and improving endurance performance (10).In addition to exercise intervention, the effect of nutritional interventions in controlling blood pressure has attracted much attention. In this regard, the consumption of antioxidants can play a significant role. Alpha lipoic acid (ALA) supplement is a strong antioxidant and acts as a cofactor in the mitochondrial dehydrogenase enzyme complex in metabolism (14). Alpha-lipoic acid is a powerful antioxidant. This substance exerts its antioxidant effect by directly clearing free radicals and chelating metal ions, as well as affecting other antioxidants and increasing intracellular glutathione (15). Alpha-lipoic acid and dehydro-alpha-lipoic acid reduce oxidative damage by their cooperative action and through the activation of the antioxidant system and the regeneration of endogenous antioxidants (16). Therefore, the researcher is trying to discover the question of whether there is a difference between the effect of two different intensities of interval training with alpha lipoic acid consumption on mfn2 gene expression in the heart tissue of rats with hypertension?

    Methods

    To carry out this experimental research, 35 eight-week-old male Wistar rats weighing 190 to 220 grams were selected and after one week of familiarization, 5 rats were randomly separated as the healthy group and the remaining 30 rats were hypertensive. They were randomly divided into six groups: control, moderate interval training, intense interval training, alpha lipoic acid supplement, supplement + intense interval training, supplement + moderate interval training. To induce high blood pressure, L-nitroarginine methyl ester solution was used orally at a dose of 40 mg per kilogram of body weight per day for three weeks. High and medium intensity interval training program was implemented for six weeks and five sessions per week. For the purpose of supplementation, 20 mg of liposomal alpha lipoic acid supplement per kilogram of body weight was dissolved in methyl cellulose and given to the rats by gavage one hour after training. Real-time PCR method for the relative expression of mRNA of mfn2 gene were used. At the end, descriptive statistics (mean and standard deviation) and Shapiro-Wilk tests, one-way analysis of variance and Tukey's follow-up at a significance level of p<0.05 were used for statistical analysis of the data using SPSS version 23 software. became.

    Results

    The average weight of the subjects is presented using descriptive statistics. The results showed all the mice are in a certain range, which indicates their homogeneity. The results of the one-way variance test showed a significant difference between the mfn2 gene expression in the heart tissue of different groups (F=3.821, p=0.018). The results of Tukey's post hoc test showed that the expression of the mfn2 gene in the heart tissue was significantly decreased in the hypertension group compared to the healthy group (P=0.018). Compared to the blood pressure group, ALA supplementation (P=0.008), moderate exercise+supplement (P=0.039) and intense exercise+supplement (P=0.014) increased the expression of mfn2 gene in heart tissue. An interesting point is that intense interval training (P=0.991) and moderate training (P=0.916) led to a non-significant increase compared to the blood pressure group. No significant difference was observed between other groups (P>0.05).

    Cocclusion:

    The results of the present study showed that six weeks of intense and moderate intermittent exercise did not change the expression of the mfn2 gene in the heart tissue in hypertensive rats. The exact mechanism of control of mitochondrial regeneration in hypertension is not clear. However, it seems that reactive oxygen species (ROS) play an important regulatory role in this process. Sports activity can lead to the production of mitochondrial ROS, and as a result, the expression of mitochondrial fission and fusion proteins increases. As recent evidence has shown that oxidative stress increases mitochondrial fission. However, it should be noted that apparently the role of ROS in mitochondrial fission depends on the amount and duration of exposure. Based on this, it seems that different intensities of sports activity are associated with different levels of ROS increase and subsequently affect protein fission and fusion. Despite the different effects of sports activity on the production of ROS and antioxidant defense, however, doing bouts and sessions of sports activity in long-term training protocols also leads to a transient increase in ROS, which is probably dependent on the intensity and duration of the sports activity. Based on the findings of the present study, exercise intensity was not a factor affecting the mitochondrial dynamics of heart tissue, so that none of the moderate and high intensity intermittent exercise did not change the indices of mitochondrial dynamics. Few studies have been conducted regarding the effect of training intensities on mitochondrial dynamics. In this regard, Demirchi et al. showed that moderate intensity interval training had a better effect on mitochondrial dynamic indices than intense interval training. It is possible that moderate intensity interval training has led to optimal production of ROS, which has more favorable effects than high and low intensity exercise on mfn2 proteins, so that high intensity interval exercise with an increase in high concentration of ROS leads to a reduction in the effects. Material and exercise as well as intermittent exercise with moderate intensity with much lower levels did not lead to reaching the desired threshold in order to stimulate proteins related to mitochondrial dynamics.

    Keywords: Exercise training, Alpha Lipoic Acid, Mitochodria dynamic, Hypertension
  • Rahim Solgi, Faribourz Bagheri*, Hasan Ahadi Pages 199-209
    Background & Aims

    Oppositional Defiant Disorder (ODD) The most common clinical disorders in children and adolescents those in the class of Disruptive Behavior Disorders are the largest group of disorders in children and adolescents referred to mental health clinics. According to Diagnostic and Statistical Manual 5 (DSM5) the prevalence of this disorder ranges from 1 to 11% with an average prevalence estimated at about 3.3%. These children have an angry and irritable temperament, they often become angry, they are quick-tempered, angry, or easily offended They have an argumentative and confrontational behavior pattern, often arguing with authorities, actively opposing or refusing to follow rules, they mostly intentionally upset others, often blaming others for their mistakes or misconduct, and engaging in vindictive or retaliatory behaviors.In finding the cause, we can refer to a set of genetic and biological characteristics and tendencies, including inefficient parenting. The prognosis of Oppositional Defiant Disorder is unfavorable as well as chronic. Patients with it are prone to psychiatric disorders in adulthood, such as antisocial personality disorder, calcium, addiction, and interpersonal, academic, and psychological problems.Therefore, due to the adverse consequences of disobedient disobedience disorder and the wide-ranging impact it has on individual and social life requires fundamental steps to be taken to treat children with the disorder. Including treatments for Oppositional Defiant Disorder Drug therapy, as well as part of the treatment of individual interventions and the rest of the family interventions, focused. Among the various therapeutic approaches, treatment for children in addition to medication, is Parent Management Training. The basis of PMT is based on the view that childrenchr('39')s behavioral disorders arise and persist as a result of incorrect interactions between child and parent. On the other hand, parental therapy is a unique approach used by trained play therapy professionals to teach parents to be part of their childrenchr('39')s healing or healing factors. One of these new methods is child-parent relationship Training (CPRT), which is one of the most effective methods in the treatment of Oppositional Defiant Disorder that focuses on the participation of families in the treatment of children. Since the effectiveness of these treatments and the comparison of these two treatments on these children had not been done so far, the aim of the present study was to compare the effectiveness of parent management Training (PMT) with child-parent relationship Training (CPRT) on total reduction. Childrenchr('39')s morbid syndrome has an Oppositional Defiant Disorder.

    Methods

    The present study was applied according to the purpose and was a quasi-experimental clinical trial in the form of a pretest-posttest design with a control group. The population of the present study was all parents of children aged 11-5 years with confrontational disobedience disorder who referred to clinics and psychological and psychiatric centers in Tehran. The study sample consisted of 45 participants who were selected by available sampling and randomly divided into three groups of 15 people. After selecting the sample members, the SNAP questionnaire was completed by the parents. Then, the parents of the CPRT experimental group participated in 10 2-hour group sessions for 10 weeks and the parents of the PMT experimental group participated in 9 2-hour group sessions for 9 weeks, and the control group received only medication. At the end of the course, the SNAP questionnaire was again given to the parents of the experimental and control groups by a psychologist. The data were then analyzed using SPSS software and the statistical method of analysis of covariance.

    Results

    The results of the analysis of covariance test for pediatric morbidity syndrome scores showed that the F-statistic for morbid scores of disobedient children (75.34) was significant at the level of 0.001. These findings indicate that there is a significant difference between the groups in the morbid scores of disobedient children. The results show the effectiveness of parent management training (PMT) and child-parent relationship Training (CPRT) in reducing the symptoms of children with Oppositional Defiant Disorder. In order to examine the changes in scores more accurately, Tukey test was used. The results of comparison of means showed that the mean of the total corrected experimental group was PMT (7.81) and the mean of experimental group was CPRT (10.9). It is significant to the results of pairwise comparison at the level of 0.001. This means that both trainings are effective and the reduction of morbid symptoms has occurred in both of them. Parents are considered as the strongest influence on the interactive patterns of the family. They can provide the best and most effective way of socializing and building a proper upbringing by creating healthy and constructive emotional relationships, expressing love, accepting the right interactions and appropriate treatment methods. Bring. On the other hand, the root of many abnormalities should be sought in the relationships of family members and parenting methods. Most childrenchr('39')s behavioral problems reflect the complex interpersonal conditions of family members, especially parents. In other words, the creation or exacerbation of behavioral problems The child can also be a defective relationship between family members and related to the wrong parenting training methods and their defective interactions with children. In order to reduce these problems and improve those parent participation training programs (such as PMT and CPRT) that A unique perspective is used, that is, how parents can be a good alternative to therapists and become therapists or therapeutic agents by teaching some therapeutic skills to treat their childrenchr('39')s problems and disorders at home.

    Conclusion

    Both of PMT and CPRT has been shown to be effective in reducing ODD in children. Between these methods, PMT was more effective than CPRT.

    Keywords: Parent Management Training (PMT), Parent - Child Relationship Based Training (CPRT), Oppositional Defiant Disorder (ODD)
  • Ahmad Asmar, MohammadAli Azarbayjani *, Maghsoud Peeri Pages 210-219
    Background & Aims

     The use of deep frying oils (DFO) for cooking due to their toxic compounds, oxidation and per-oxidation of lipids and proteins in the long term can lead to neurodegenerative damage and causes the loss of nerve and glial cells of the CNS.Antioxidant defenses include antioxidant enzymes such as superoxide dismutase (SOD), catalase, glutathione peroxidase (GPx), and glutathione reductase, which act as protective mechanisms in brain tissue and reduce the effects of oxidative stress on the brain by removing free radicals.Reactive lipid aldehydes during a process called carbonylation, change the structure of cellular proteins and create protein carbonyl (PC) which indicates the overall oxidation of proteins and one of the markers of oxidative stress.

    Methods

      In this study, 30 adult male rats with an average weight of 300-350 gr were examined and tested. The rats were kept in special cages with a temperature of 23 ±3 ° C, humidity of 50% and a cycle of 12 hours of light and 12 hours of darkness and were subjected to a standard diet. The subjects were divided into 5 equal groups(n=6) including: 1) Control (CO), 2) Control+DFO (DFO), 3) exercise+DFO, 4) DFO+octopamine,5) DFO+exercise+octopamine.Eight liters of sunflower oil were exposed to 190 - 200 °C for 4 days and eight hours each day.  On the first day, the oil was exposed to heat. But from the second day, every day, chicken nuggets, carbohydrates and protein products were fried in it for eight hours.At the beginning of the first week, the subjects were exposed to deep frying oils poisoning 0/1cc per 100 gr of body weight. After induction of DFO intoxication by gavage, octopamine supplementation was injected at doses 81 mMol / kg body weight into rats for 4 weeks. Also, the aerobic exercise protocol was performed for 4 weeks, five times a week on a treadmill at a speed of 26 meters per minute for 20 minutes per day. Chemical analyzes were performed by ELISA method to evaluate the concentration of protein carbonyl (PC) and the activity of glutathione peroxidase (GPx) on cerebellum tissue of rats. Data were analyzed by independent-samples t-test , ANOVA and  Bonferroni post hoc test at (p <0.05) significancy level .

    Results

     The results of this study showed that the concentration of PC in DFO-fed rats increased significantly while the activity of GPx enzyme decreased significantly compared to the control group. It was observed in the groups aerobic exercise increased GPx activity significantly in cerebellum tissue. Also octopamine supplementation increased GPx activity significantly. Although the highest level of GPx activity was observed in the trained group receiving octopamine supplementation, but the interaction between aerobic exercise and octopamine supplementation did not show a significant effect on GPx activity. Aerobic exercise reduced the concentration of PC significantly in cerebellum tissue. Also octopamine supplementation reduced PC concentration significantly. In spite of the lowest concentration of PC was observed in the group of aerobic exercise and octopamine supplementation, the synergistic effects of octopamine and exercise on reducing  PC  levels were not significant.

    Conclusion

     Nowadays, due to the industrialization of societies and changes in people's lifestyles, the consumption of instant and ready meals, which are often cooked by frying in high-temperature oils, shows a growing trend. Studies have shown that the constant use of fast foods because they are prepared by frying in heated oils several times poses serious health risks and causes obesity, hypertension, neurodegenerative diseases, diseases cardiovascular, type 2 diabetes and other metabolic disorders. Due to the importance of this issue, in this study, the effects of consuming deepfrying oils (DFO) on the induction of oxidative stress in the cerebellum tissue of rats were first studied. For this purpose, transformation of protein carbonyl  (PC) as a marker of induction of oxidative stress in the body and changes in the activity of glutathione peroxidase (GPx) as one of the active antioxidant enzymes in the body's defense system against oxidative stress were measured in DFO  fed rats. As expected, the results of  ELISA tests showed that PC increased and GPx activity decreased in the rats  fed by DFO  compared to the control group, which indicates the induction of oxidative stress in the treatment group. The results of this study showed that aerobic exercise combined with octopamine can reduce the oxidative damage caused by unhealthy diets such as deep frying oils in the brain tissue of rats. The use of octopamine with aerobic exercise through regulation of protein carbonyl levels and the activity of antioxidant enzymes such as GPx appears to be effective in improving the risk of oxidative damage to brain tissue in rats fed deep frying oils. Therefore, it is recommended to use these two interventions as a suitable solution to support the nervous system against oxidative damage in the conditions of regular intake of deep frying oils.

    Keywords: Octopamine, Endurance training, Glutathione peroxidase, Protein carbonyl, DFO