Journal of Arak University of Medical Sciences

The Effect of 12 Weeks of Strength Training on Muscular Strength, Body Fat Percentage, Irisin and BDNF in Active Middle-aged Women

Masoud Rahmati

Introduction: Considering the synthesis and secretion of irisin and BDNF from muscle tissue during exercise and the possible relationship of these factors with improving muscle strength and performance, the present study aimed to investigate the effect of 12 weeks of strength training on muscle strength, body fat percentage, irisin, and BDNF in inactive middle-aged women.
Methods: In a semi-experimental study, 20 inactive middle-aged women (mean age 37.70 ± 5.91 years, weight 79.80 ± 5.82 kg) were selected and randomly assigned to two strength training groups (n = 10) and control groups (n = 10). The training group performed 12 weeks of strength training, three sessions per week at an intensity of 65 to 80% of maximum strength. Then, blood samples were taken using ELISA to measure irisin and BDNF. Independent t-test and Pearson correlation test were used to analyze the data. The significance level (P ≤ 0.05) was considered.
Results: Strength training significantly increased serum irisin concentration (P = 0.035) and serum BDNF concentration (P = 0.058) and also considerably decreased body fat percentage (P = 0.058) in middle-aged women. There was also a positive and significant relationship between lower body strength and serum irisin levels (P = 0.040). The Results from the Pearson correlation test indicate a significant positive relationship between BDNF and upper body strength (P = 0.038).
Conclusions: Based on the results of the present study, it seems that increased secretion of serum irisin and BDNF hormones is related to increased muscle strength following strength training in middle-aged individuals.

The Effectiveness of Treatment Based on Acceptance and Commitment to the Health-Enhancing Lifestyle and Emotional Distress of Women Undergoing Infertility Treatment with in Vitro Fertilization

Narges Babakhani

Introduction: The present study was conducted to investigate the effectiveness of acceptance and commitment-based therapy on the lifestyle of improving the health and emotional distress of women undergoing infertility treatment with the in vitro fertilization (IVF) method.
Methods: The method of this study was semi-experimental with a pre-test-post-test design with a control group and a follow-up stage. The statistical population of the study included women undergoing infertility treatment with the IVF method referring to the infertility center of Imam Khomeini Hospital in Tehran in the first six months of 2012. In this research, 27 women undergoing infertility treatment with IVF method were selected by voluntary sampling method and replaced by random method in test and control groups. The experimental group underwent acceptance and commitment therapy (10 sessions) for two and a half months. A health-promoting lifestyle questionnaire (HPLP) and an emotional distress questionnaire (Lavibond and Lavibond, 1995) were used as research tools. The data were analyzed using a mixed analysis of variance and Bonferroni post hoc test.
Results: It showed that the treatment based on acceptance and commitment to the lifestyle level improves health (Eta = 0.56, F = 19.74) and has a significant effect on the dimensions of emotional disorders such as depression (P < 0.0001, Eta = 0.58, F = 0.58). F = 34), anxiety (P > 0001; Eta = 0.59; F = 35.69), and stress (P > 0.0001; Eta = 0.61; F = 40.12) of women undergoing infertility treatment with the IVF, and has been able to lead to increase a healthy lifestyle, reduce depression, anxiety, and stress in these individuals.
Conclusions: Acceptance and commitment therapy, utilizing six psychological acceptance processes, cognitive breakdown, self under context, interaction with the present, specified values, and committed behavior, can be used as an effective treatment to reduce emotional distress in women undergoing IVF infertility treatment.

Investigating Job Hardiness and Its Related Factors Among Emergency Medical Technicians in Qom, Iran

Leila Ghanbari-Afra

Background and Purpose: Emergency medical technicians (EMTs) are the frontline medical personnel who often face stressful and critical situations. Job hardiness can enhance their capacity to withstand challenging circumstances and both physical and mental pressures. Therefore, this study was conducted to identify the level of job hardiness among EMTs and its associated factors.
Materials and Methods: This study employed a cross-sectional descriptive design involving 216 EMTs from Qom University of Medical Sciences in 2024. A stratified random sampling method was utilized. Data were collected using a demographic and occupational information checklist and a job hardiness scale. Data analysis was conducted employing ANOVA, independent t-tests, and regression analyses. A significance level of less than 0.05 was deemed statistically significant.
Findings: The average age of participants was 32.26 ± 6.34 years, with over two-thirds having bachelor's degrees and working rotating shifts. The average score for job hardiness was 44.67 ± 5.30. Results from multivariable regression indicated that educational status and a sufficient number of personnel accounted for 42% of the variance in job hardiness among EMTs.
Conclusion: Findings reveal that EMTs exhibit moderate to high job hardiness. Furthermore, adequate staffing levels and higher educational attainment positively correlated with increased job hardiness scores.

Comparison of the Effects of Strength and Endurance Training on Irisin, Insulin Resistance, and Body Composition of Obese Male Students

Mohammad Ali Gharaat

Introduction: Different training methods increase performance capabilities in addition to metabolic changes in body organs. The present study aimed to compare the effect of endurance and strength training on anthropometric indicators, glucose changes, fat metabolism, and irisin levels of young male students.
Methods: Thirty-six obese students (age: 21.19 ± 2.43 years; weight: 88.59 ± 6.20 kg; height: 175.41 ± 12.96 cm; body mass index: 30.45; fat percentage: 25.73%) were randomly placed in one of control, endurance, and strength training groups (n= 12). The strength training group trained for 8 week/3 session/4 sets/10 repetitions/ from 50 to 70% of the one repetition maximum (incremental manner, every 2 weeks), and the endurance training group trained for 30 minutes of aerobic jogging with 60 to 80% heart rate maximum. Plasma irisin, glucose, insulin, insulin resistance, fat percentage, body mass index, weight, waist circumference, and hip circumference were measured. The data were analyzed by one-way analysis of variance and Tukey's test at 0.05.
Results: Body weight (P = 0.03), fat percentage (P = 0.04), and body mass index (P = 0.04) significantly decreased in the post-test of endurance training group. Irisin level in the post-test in the control group had a significant difference with endurance and strength training (P = 0.01 and P = 0.02, respectively). Insulin in the post-test of the control group was significantly different from the endurance and strength group (P = 0.00 and P = 0.00, respectively). The level of insulin resistance in the post-test of the endurance and strength group had a significant difference compared to the control (P = 0.00 and P = 0.00, respectively).
Conclusions: Eight weeks of aerobic treadmill training and strength training with free weights can improve body composition, increase irisin levels, and reduce insulin resistance in obese male adolescents.

Comparison of the Effect of Concurrent Moderate-Intensity Continuous Training and High-Intensity Interval Training with High-Intensity Interval Training Alone on Body Composition, Cortisol and Mental Health of Overweight 16-19-Year-old Male Students

Ali Heidarianpour

Introduction: Being overweight is associated with increased cortisol secretion, along with heightened anxiety and depression. This study aimed to compare the effect of six weeks of concurrent moderate-intensity continuous training (MICT) and high-intensity interval training (HIIT) with HIIT training alone on body composition, plasma cortisol levels, and anxiety and depression levels in overweight male students.
Methods: In this semi-experimental research, 27 overweight students were selected and randomly divided into three groups 9: MICT+HIIT concurrent training, HIIT training, and a control group. The MICT )15 minutes of exercise per day at 60-65% of maximum heart rate with an additional 5 minutes every two weeks). The HIIT (3 minutes of running at 70-75% of maximum heart rate, followed by 3 minutes of active rest at 50% of maximum heart rate, with three repetitions in the first two weeks, four repetitions in the second two weeks, and five repetitions in the final two weeks).
Results: Both types of training protocols resulted in reductions in weight, body mass index, cholesterol, low-density lipoprotein, cortisol levels, anxiety, depression, and an increase in high-density lipoprotein (P < 0.05). There was no significant difference between the two types of exercise in terms of effectiveness on these variables; however, only peak oxygen consumption and triglycerides were associated with better changes in the MICT+HIIT group.
Conclusions: For overweight male adolescents aiming for weight loss and improved mental health, HIIT alone is sufficient, and adding MICT does not provide additional clinical benefits.

Prevalence of Adverse Events and Hypoglycemia in Patients with Type 2 Diabetes Treated with Novel Antidiabetic Medications

Ebrahim Mohammadi

Introduction: Novel antidiabetic medications are employed to manage glycemic control and mitigate the long-term complications of type 2 diabetes. This study aimed to investigate the prevalence of adverse events, including hypoglycemia, associated with these novel antidiabetic agents in a cohort of patients with type 2 diabetes.
Methods: This cross-sectional analytical study was conducted on 157 patients with type 2 diabetes mellitus attending the Endocrinology Clinic at Imam Khomeini Hospital, Urmia, during the summer of 2024. A convenience sampling method was employed to recruit participants. Data on demographics, the incidence of hypoglycemia, and reported adverse drug reactions were collected from all eligible patients through a structured interview. Subsequently, patients were stratified into three treatment groups based on the specific novel antidiabetic medication they received.
Results: In patients receiving sitagliptin, the most prevalent adverse events included arthralgia and rheumatic problems (26.31%), dermatological manifestations (36.84%), and allergic reactions (21.06%). Nausea (52.94%) and abdominal pain (17.65%) were the most frequent adverse events observed in patients treated with liraglutide. Polydipsia (28.72%), weakness and lethargy (26.6%), and dry mucous membranes (27.66%) were commonly reported in patients receiving empagliflozin. Hypoglycemia was observed predominantly in male patients aged 51-55 years receiving sitagliptin.
Conclusions: The findings of this study demonstrate a low incidence of hypoglycemia among patients treated with modern antidiabetic medications. Prevalent short-term adverse events observed included gastrointestinal disturbances, allergic reactions, and dermatological manifestations.

Effect of Needle Gauge on Children's Pain and Anxiety Level During Palatal Infiltration Anesthesia Injection: A Triple-Blind Randomized Controlled Trial Study

Hamid Sarlak

Introduction: Pain of anesthesia injection in children is necessary and one of the most painful local anesthetics is palatal infiltration anesthesia. So, the purpose of this study was to compare the effect of needle gauge on pain and anxiety during palatal infiltration anesthesia injection in children 4-8 years.
Methods: This triple-blind cross-over clinical trial study was performed on 60 children 4-8 years candidates for pulpotomy and SSC treatment of both maxillary first molar teeth. Based on the sequence of using 27- and 30-gauge needles, children were treated during 2 sessions. The anxiety level of children during palatal infiltration local anesthesia was measured using pulse rate (PR) and the pain level of patients was measured using SEM and FPR (objective and subjective criteria).
Results: Anxiety during palatal anesthesia injection with gauge 27 was higher than gauge 30 (treatment effect < 0.001). In subjective and objective criteria, the injection pain in the palatal mucosa with a 27-gauge needle was higher than 30-gauge needle (treatment effect < 0.001). There was no significant difference between earlier and later injection of palatal infiltration with different gauges during treatment sessions (P < 0.05) and according to 0.021 for the period effect, it can be said that the period of receiving two needle gauges had an effect on the average heart rate difference.
Conclusions: The pain of injection in the palatal mucosa with a 27-gauge needle is higher than with a 30-gauge needle, and the use of a 30-gauge needle in the palatal injection of children 4-8 years causes less discomfort than a 27-gauge needle.

Prophylactic Effect of Venous Caffeine on Apnea in the Very Preterm Infants

Zahra Juodi

Introduction: One of the most common problems in newborns is apnea of prematurity. Given the importance of preventing apnea in very premature infants, the present study was designed and conducted to investigate the preventive effect of caffeine on reducing the frequency of apnea events in very premature infants.
Methods: This randomized, double-blind, controlled clinical trial was conducted on premature infants hospitalized in the neonatal intensive care unit of Shahid Motahari Hospital in Urmia. Infants were randomly divided into two intervention and control groups. The intervention group received intravenous caffeine at an initial dose of 20 mg/kg and a maintenance dose of 5 mg/kg for 14 days. In contrast, the control group received an equal volume of normal saline intravenously for the same period. Apnea events, cyanosis attacks, and bradycardia were recorded by the researchers in a standard checklist.
Results: Of the 50 infants in each group, 2% of the caffeine and 4% of the control group required prolonged oxygen therapy, respectively. Also, 6% of the caffeine group and 4% of the control group experienced intraventricular hemorrhage. In addition, 4% of the caffeine group and 2% of the control group required surgery to close the patent ductus arteriosus, and 14% of the caffeine group and 18% of the control group experienced apneic events. However, there was no statistically significant difference between the two groups regarding the incidence of apneic events (P = 0.58). Ultimately, 20% of the caffeine group and 14% of the control group died.
Conclusions: Although the findings of the present study were not statistically significant, they indicate a decrease in the frequency of apnea events in the group of premature infants receiving caffeine compared to the control group.

Morphometric and Histological Study of the Kidney of Offspring of Diabetic Mothers Treated with Insulin

Tahereh Foroutan

Introduction: This study aimed to investigate the effects of insulin drug therapy on the kidney structure of offspring of insulin-treated diabetic mice.
Methods: After pregnancy, female Sprague-Dawley rats were divided into control, sham, diabetics induced by streptozotocin, and diabetics receiving insulin groups. Diabetic rat offspring were sacrificed on the 10th day after natural childbirth, and the left kidneys were studied for morphometric and histological studies.
Results: The weight of children of diabetic mothers showed a significant decrease compared to children of healthy mothers (P < 0.001). The weight of the offspring of diabetic mothers receiving insulin did not show a substantial change compared to the offspring of diabetic mothers. The weight of the kidneys of the offspring of diabetic mothers showed a significant decrease compared to the control group. However, the weight of the kidneys of the offspring of diabetic mothers receiving insulin did not increase compared to those of diabetic mothers. The results of the kidney sections stained with hematoxylin-eosin and trichrome Masson showed that the offspring of diabetic mothers treated with insulin did not show a significant improvement compared to the control group.
Conclusions: Although the use of insulin is one of the momentous therapeutic ways to control blood glucose in diabetics, it cannot significantly lead to the normal health of the kidneys of the offspring of diabetic mothers under insulin treatment.

Identification of Pathogenic Mutation c.286dupA in TYR Gene in an Individual with Oculocutaneous Albinism Using Exome Sequencing

Parto Hekmatpou

Introduction: Oculocutaneous Albinism is a hereditary disease with an autosomal recessive pattern. The incidence of this disease is about 1 in every 17 thousand births. Most of the affected people in Iran are the result of consanguineous marriages. White hair, fair skin, and reduction of iris pigments are the main manifestations of this disease. Also, exposure to sunlight increases the susceptibility of these patients to skin cancer. This study aimed to investigate the genetic cause of a person with Oculocutaneous Albinism by whole exome sequencing.
Methods: A 6cc peripheral blood sample was obtained from a child with oculocutaneous Albinism with an autosomal recessive inheritance pattern. DNA extraction and whole exome sequencing were performed. After analyzing the exome sequencing data, the pathogenic mutation was identified. Then, the Sanger sequencing method was used to confirm and segregate.
Results: The affected case showed homozygous pathogenic mutation (NM_000372.5): c.286dupA p.(Met96AsnfsTer73) in exon 1 of the TYR gene. Oculocutaneous albinism IA was determined according to the mutated gene. Also, the parents of the affected person were heterozygous for the mutation.
Conclusions: The mutation causing oculocutaneous albinism was identified in the affected person using the high-efficiency whole exome sequencing method and then confirming the mutation through Sanger sequencing. Considering the parents' consanguineous marriage of the parents, this finding can be used for preventive measures in the future.