مجله فیض
سال بیست و هفتم شماره 4 (پیاپی 132، مهر و آبان 1402)

The levels of inflammatory biomarkers ESR and CRP are significantly increased in the early stages of the COVID-19 and their levels are related to the severity of the disease. The present study was conducted to determine the diagnostic value of CRP and ESR in COVID-19.

This cross-sectional study was conducted on 287 patients with COVID-19 hospitalized in Shahid Beheshti Hospital in Kashan, Iran, in 2021. A questionnaire containing demographic data, clinical symptoms, laboratory findings and final outcome was completed by reviewing the medical records and HIS system. Patients were divided into moderate and severe groups according to the severity of lung involvement in CT scan and oxygen saturation (SPO2). The data were entered into SPSS-16 software and the ESR and CRP levels were compared between the two groups. Moreover, the sensitivity, specificity, positive and negative predictive values, and the cut-off point were determined and the ROC curve was drawn.

Out of 287 patients, 151 (52.6%) were women and 136 (47.4%) were men, and the mean age of the patients was 56.14±18.45 years. Hypertension (35.5%) was the most common underlying disease. Shortness of breath (56.8%) and cough (52.3%) were the most common clinical symptoms. In this study, 34.1% of the patients had a severe form of the disease. Finally, 18 patients (6.3%) died. ESR test with a cut-off point of 30, sensitivity of 81.6%, and specificity of 71.4% and CRP test with a cut-off point of 38, sensitivity of 84.7%, and specificity of 82.5% have the necessary accuracy to diagnose the severity of COVID-19.

According to the current findings, ESR with a cut-off point of 30 and CRP with a cut-off point of 38 had the necessary diagnostic accuracy to assess the severity of COVID-19. Therefore, in the initial examination of COVID-19 patients, according to the cut-off point of these two important biomarkers, severe cases of the disease should be quickly identified and the necessary treatment measures should be started as soon as possible to prevent poor outcomes.

One of the important and effective physiological systems in the pathogenesis of type 2 diabetes is the local renin-angiotensin system. The aim of the current study was to determine the effect of aerobic exercise on the function of the local renin-angiotensin system and the gluconeogenesis pathway in the liver tissue of type 2 diabetic rats.

In this experimental study, 18 rats were fed a high-fat diet (HFD) for 8 weeks, and then they developed type 2 diabetes by injecting a single dose of streptozotocin and HFD for four weeks. After the induction of type 2 diabetes, the rats were randomly divided into two groups: 1. diabetes-non-exercise group, 2. diabetes-exercise group. Rats in the exercise group trained 5 days/week, 45 minutes/session for 8 weeks on a treadmill with a mean speed of 20 meters per minute. Blood was collected from rats and liver tissue was extracted and frozen in liquid nitrogen to check the expression of angiotensin II, phosphoenolpyruvate carboxykinase (PEPCK), At1 receptor and Mass receptor genes.

Results of the present study showed that HFD consumption and streptozotocin injection increased blood glucose in rats (P=0.001). The ANOVA test showed that eight weeks of aerobic training caused a significant decrease in the expression of angiotensin II (P=0.001), PEPCK (P=0.003), At1 receptor (P=0.001) genes and the amount of blood glucose (P=0.002) in diabetes-exercise rats compared to diabetes-non-exercise group. Moreover, aerobic training led to a significant increase in the expression of Mass receptor (P=0.001) in diabetes-exercise rats compared to diabetes-non-exercise group.

Eight weeks of aerobic exercise can improve insulin sensitivity and type 2 diabetes by reducing angiotensin II, At1 receptor gene expression, inhibiting hepatic gluconeogenesis and increasing Mass receptor activity.

Physical activity has an effect on the prevention and control of diabetes and its complications. The aim of the present study was to determine the effect of an incremental training period on cardiomyocyte fibrosis in streptozocin-diabetic male Wistar rats.

In this experimental study, 40 male Wistar rats (6-8 weeks) weighing 200 to 250 gr were randomly assigned into four groups: diabetes (n=10), healthy (n=10), diabetes+exercise (n=10) and healthy+exercise (n=10). The diabetes+exercise and healthy+exercise groups participated in an endurance activity program (treadmill running) for 6 weeks, 5 days a week (30 sessions). In this study, 48 hours after the completion of the protocol, rats were anesthetized and under sterile conditions, their heart tissue was isolated to evaluate the expression of collagen and transforming growth factor beta (TGF-β) genes using real-time PCR.

At the end of the research protocol, a significant change was observed in weight (P₌0.0001), myocardial TGF-β level (P₌0.0001) and myocardial collagen level (P₌0.0001).

The findings demonstrate that diabetes increases the expression of collagen and TGF-β genes in the heart tissue of male Wistar rats, while endurance activity reduces the increased expression of these genes.

The use of different drugs in withdrawal syndrome usually has little effectiveness and causes the person to become dependent on new substances. The aim of the present study was to determine the effect of eight weeks of resistance training on the level of Bax and Bcl-2 proteins in the heart tissue of rats with morphine withdrawal syndrome.

In this experimental study, 32 male Wistar rats were randomly divided into four groups including control, withdrawal syndrome, and incremental resistance training and incremental resistance training with withdrawal syndrome. Addiction to morphine was induced by oral administration of 0.4 mg/dL morphine sulfate for 21 days. To ensure morphine dependence, a number of rats were injected with naloxone (2mg/kg, ip). Then the training groups participated in the incremental resistance training protocol for eight weeks. Afterwards, rats were killed and their heart tissue was removed. ELISA kits were used to evaluate apoptotic factors.

A significant increase in the level of Bax protein (proapoptotic) (P=0.03) and a significant decrease in the level of Bcl-2 protein (antiapoptotic) (P=0.006) were reported in the morphine group compared to the healthy control group. In addition, the increase in Bcl-2 level (P=0.043) and the decrease in Bax protein (P=0.01) in the incremental resistance training with the withdrawal syndrome group showed a significant difference compared to the withdrawal syndrome group.

The incremental resistance training can probably have a positive and protective effect on the reduction of apoptotic factors in heart tissue in rats with morphine withdrawal syndrome.

The prevalence of obesity is one of the most important health issues in the world. The aim of this study was to determine the effect of intermittent resistance training with different intensities on the levels of interleukin-10 (IL-10) and interleukin-1 beta (IL-1β) in obese men.

In this study, 44 obese men (20-30 years old) were assigned into four groups of control, low-intensity intermittent resistance training, moderate-intensity intermittent resistance training, and high-intensity intermittent resistance training. Subjects trained for 12 weeks, 3 sessions per week with three different intensities (80% 1RM with 10 repetitions, 60% 1RM with 13 repetitions and 40% 1RM with 20 repetitions). IL-10 and IL-1β indices were measured 48 hours before the first and 48 hours after the last resistance training session.

A significant difference was reported in IL-10 and IL-1β levels between the intermittent resistance training groups with different intensities. After the training period, IL-1β had a significant decrease in the low (P=0.001), moderate (P=0.01) and high (P=0.001) intensity intermittent resistance training groups. A significant increase in the IL-10 was observed in the resistance training groups with low (P=0.01), moderate (P=0.01) and high (P=0.001) intensity.

According to the present findings, it may recommend intermittent high and moderate intensity resistance training as an effective method for treating obesity and having a favorable effect on its indicators.

Vitiligo aggravates psychological problems such as anxiety and depression and ultimately reduces the quality of life in patients. This study aimed to compare the efficacy of acceptance and commitment therapy (ACT) with compassion-focused therapy (CFT) on psychological well-being and internalized shame in female students with vitiligo.

This semi-experimental study was performed based on a pre-test, post-test, and follow-up design with a control group. The study population consisted of all female students with vitiligo in the secondary high school in Tabriz, Iran, in the academic year of 2022. The research sample was 45 students who were selected by purposive sampling method and were randomly divided into experimental and control groups of 15 people. Both experimental groups received their treatment in eight 1.5-h sessions, but the control group did not receive any treatment.

Compared to the control group, both treatments (ACT and CFT) increased the psychological well-being of female students with vitiligo in the post-test (P<0.001) and decreased their internalized shame (P<0.001). In the follow-up phase, the effect of these two treatments on the quality of psychological well-being and internalized shame was lasting (P<0.001). The effect of these two treatments on psychological well-being and internalized shame was the same in post-test and follow-up phases (P>0.05).

Due to the effectiveness of these two treatments (ACT and CFT) on psychological well-being and internalized shame in girls with vitiligo, it can be used to increase psychological well-being and reduce internalized shame in these people.

Sleep deprivation causes impairment in learning and memory. Several studies have shown the positive effect of nitric oxide on learning and memory processes. Therefore, in the present study, the effect of using L-arginine as a precursor of nitric oxide on spatial learning and memory impairment following rapid eye movement (REM) sleep deprivation in rats was investigated.

In this experimental study, 50 rats were divided into five groups: control, sleep deprivation, sleep deprivation plus triple doses of 100, 200 and 300 mg/kg L-arginine (intraperitoneal injection). The method of multiple platforms was used to induce 72 hours of sleep deprivation. Then, the spatial learning and memory levels of all rats were checked using the Morris water maze (MWM) task.

Administration of 200 mg/kg L-arginine attenuated the effects of REM sleep deprivation on learning, but it had no effect on memory impairment caused by sleep deprivation.

According to the findings of the present study, it seems that nitric oxide can improve the negative effects of REM sleep deprivation on learning.

Rheumatoid arthritis is an autoimmune, chronic and multisystem disorder. The present study was conducted with the aim of determining the prognosis of COVID-19 in patients with rheumatoid arthritis.

This cross-sectional study was conducted on 241 rheumatoid arthritis patients with covid-19 who had referred to medical centers in Kashan and Tabriz cities, Iran, in 2021. Rheumatoid arthritis disease activity score was measured based on the DAS28-ESR system. The prognosis of Covid-19 was calculated based on the CALL scoring system.

The mean age of the patients was 53.06±13.37 years and 82.2% were women. Based on the disease activity score, most patients (61.8%) were in the remission phase at the time of Covid-19 diagnosis. The underlying diseases of diabetes and hypertension and DAS28 score had a significant relationship with the prognosis of patients (P<0.05). Moreover, 92% of patients who were in the active phase of rheumatoid arthritis at the time of Covid-19 diagnosis had a poor prognosis, this percentage was significantly lower in patients who were in other phases of the rheumatoid arthritis disease (P<0.001).

The results of the present study show that the prognosis of COVID-19 in rheumatoid arthritis patients with severe activity was worse than those whose disease was inactive or had mild or moderate activity.

Urinary tract infection (UTI) is an acute disease, particularly in children, and also the second most common bacterial disease in children after upper respiratory tract infection. Due to the high prevalence of UTI in children and its high importance, the present study was conducted to determine frequency of risk factors of UTI in children aged 2 months to 12 years at Shahid Beheshti Hospital in Kashan, Iran.

In this cross-sectional study, 274 children aged 2 months to 12 years were examined in Shahid Beheshti Hospital in Kashan, Iran. Data on age, gender, circumcision status, labia adhesion, urinary tract obstruction status, mother's and father's education status, mother's employment status, child care status, and child's underlying diseases were recorded. The collected data were analyzed using descriptive statistics.

The findings showed that nearly 87% of children with urinary tract infections were girls. More than 60% of uncircumcised boys and 5% of girls had labia adhesions. Also, nearly 15% of children had urinary stones. In addition, diabetes has been the most common underlying disease among children.

Urinary tract infections are involved in causing kidney damage in children, therefore, knowing the related risk factors can be helpful in preventing its occurrence.

Chronic diseases such as cancer in children can increase the risk of depression in different degrees. The aim of this study was to investigate the frequency of anxiety and depression in children under 16 years of age with cancer referred to the chemotherapy unit of Shahid Beheshti Hospital in Kashan, Iran.

In this cross-sectional study, 60 children from 7 to 16 years of age referred to the chemotherapy unit of Shahid Beheshti Hospital in Kashan, Iran, in 2019 were investigated using the available sampling method. Anxiety disorders were measured by the Hamilton Anxiety Questionnaire and depression disorders were measured using the Mariaquaks Depression Questionnaire. Data of age, sex, type of disease, first stage or relapse, oral or injectable drugs of chemotherapy and radiotherapy, history of invasive treatment and psychiatric diseases were also recorded.

The results showed a statistically significant difference between relapse, current treatment status and radiotherapy with anxiety and depression disorders (P<0.05). A statistically significant difference was found between the type of cancer and anxiety disorder, as well as between oral chemotherapy and history of family psychiatric disorders and depression disorder (P<0.05). The highest frequency of depression and anxiety were reported in adult acute lymphoblastic leukemia (ALL) cancer.

The type of cancer, oral chemotherapy and history of family disorders can be related to children's anxiety and depression. Therefore, early diagnosis of mental disorders in children with cancer can prevent the development of anxiety and depression.

Medicine is one of the stressful fields that can threaten the mental health of students of this field. This study was conducted with the aim of evaluating the state of mental health, academic burnout and distress tolerance of medical students of Kashan University of Medical Sciences during their internship.

This cross-sectional study was conducted at Kashan University of Medical Sciences, Kashan, Iran. The statistical population included medical students (n=390) in the internship stage in the academic year of 2021-2022 who were enrolled by the census method. A total of 250 students completed the informed consent form and answered the questionnaires of general health (GHQ-28), distress tolerance (DTS) of Simon and Gaher, and Maslach academic burnout.

The mean of mental health was 25.47±8.02, distress tolerance was 45.62±11.8, and academic burnout was 39.42±16.03, which according to the cut-off points for each of the questionnaires, it can be said that 39.2% had no psychological symptoms, 52.8% had mild symptoms and 8% had moderate symptoms. Also, 47.2% of students reported low distress tolerance. Regarding academic burnout, 74.4% of students reported very high emotional exhaustion.

On average, the students had mild psychological symptoms, but despite relatively good distress tolerance, they suffered from high emotional exhaustion. Considering the role of emotional exhaustion in the occurrence of psychological problems in the future, it is important to find the factors affecting it and provide psychological services to reduce it and prevent the psychological problems.

Growth differentiation factor 15 (GDF15) is a cytokine with anti-inflammatory effects, which the influences of acute and chronic exercise on it are not clearly known. Therefore, the aim of the present meta-analysis was to determine the effect of the acute and chronic exercise on circulating GDF15.

To extract original articles published in Farsi and English language journals, a comprehensive search was conducted in PubMed, Web of Science, Scopus, Magiran, Noormags and SID databases until December 22, 2022. Two separate meta-analyses were performed to calculate the effect size of standardized mean difference (SMD) and 95% confidence interval for the acute and chronic effects of exercise on GDF15.

A total of 18 studies including 551 subjects were included in the meta-analysis. The results showed that acute exercise activity leads to a significant increase in GDF15 [P=0.001, (1.65 to 0.80 CI: 1.23)], while chronic exercise activity had no significant effect on GDF15 [P=0.24, (0.96 to 0.24-CI: 0.35)].

Exercise leads to a transient and short-term increase in GDF15, which may contribute to the beneficial metabolic effects of exercise.