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Background: Perineal pain following episiotomy affects mothers’ mental health and their quality of life. Using cooling gel pad is a new approach which is used for pain relief, but the pain related to episiotomy is still typically treated with oral analgesics. This study was conducted to investigate the effect of gel pad on post-episiotomy pain in primiparous women in Kamali Hospital of Karaj. Materials and Methods: This single-blind clinical trial was conducted on 60 primiparous women who referred for labor to Kamali Hospital of Karaj. The participants were randomly allocated to two groups: Those receiving gel pads (for 20 minutes four hours after labor and in case necessary, for up to 5 days) and the control (receiving the hospital routine). The two groups were evaluated in terms of episiotomy pain intensity through visual analogue scale (VAS) and analgesics usage. Results: The two groups did not show any significant differences in demographic features and other intervening variables. In terms of reduction in pain intensity, there were significant differences between the two groups 4 hours (p=0.002), 12 hours (p=0.009), and 5 days (p=0.000) after episiotomy. Analgesics usage, five days after delivery, in gel pad group was significantly lower than the control group (p<0.001) Conclusion: Using gel pad reduces the perineal pain intensity following episiotomy and decreases the need for using analgesics.

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Background and Aim: Several microRNAs are involved in regulating muscle mass, which plays an essential role in hypertrophy and atrophy of skeletal muscle, The present study examined the expression of some genes as regulators of muscular atrophy following a period of inertia in rats.
Methods & Materials: For this purpose, 18 male Sprague-Dawley rats were divided into three groups (Control, Exercise+inactivity, and Inactivity). The exercise+inactivity group run on the treadmill for 18 weeks and five times per week. The hindlimb of the animal was immobilized for seven days with the casting method. Soleus muscle was extracted and the expression of the genes was measured by the RT-PCR method. Univariate ANOVA and Tukey post hoc test was used to determine the differences (α=0.05). 
Ethical Considerations: The Ethics Committee of the Tehran University of Medical Sciences Research approved this study (Code: IR.SUMS.REC.1396.S 463).
Results: Results showed that immobilization in both Exercise+ inactivity and inactivity groups, compare to the control group, increased expression of miR-1 genes (P<0.10), FOXO3a (P<0.001) and decreased expression of miR-206 (P<0.007) and IGF-1 (P<0.001). This difference was statistically significant.
Conclusion: According to the results of this study, it can be said that changes in the expression of RNAs by chromatography cause changes in the expression of muscle regulating genes, and although endurance exercises have protective effects, they cannot prevent these changes.

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On average, patients suffering from non-alcoholic steatohepatitis after about seven years, their disease turns into fibrosis and reversibility at this stage becomes very difficult because this disease is an irreversible stage of the disease. Fatty liver is non-alcoholic (2). Researches have come to the conclusion that liver inflammation and insulin resistance decrease and insulin sensitivity increases with sports activity (3). TNF-α has a high inflammatory effect; So that different agents and species of this family and their receptors play a role in NASH disease and liver fibrosis (5). However, exercise increases prostaglandins and cAMP. The mentioned hormones inhibit the function of TNF-α (6). On the other hand, anti-inflammatory cytokines increase due to exercise and inhibit the increase of TNF-α. With the increase in production and secretion of TNF-α, other inflammatory factors such as TGF-β1 signaling are activated and fibrosis signaling will start in liver cells (5). TGF-β1 (Transforming growth factor beta 1) is one of the members of the large family of transforming growth factors beta (TGF-β) and a key cytokine in obesity and insulin resistance (7). In a research, during 48 weeks of applying a high-fat diet to rats, they found that steatosis occurs in the liver of rats from the eighth week onwards, and the amount of TGF-β1 in them increased significantly. In the end, they came to the conclusion that this factor can be one of the main characteristics of determining the degree of liver fibrosis in patients with NASH (10). High-intensity interval training (HIIT) is one of the new training models whose positive effects have been identified in a variety of metabolic diseases (13). On the other hand, there are very few researches about the effect of aquatic environment and swimming on the improvement of metabolism and inflammation in NASH patients. Based on the results of a systematic review in 2018, it was shown that endurance exercise in water improved systemic inflammation and weight control (18). Despite the conflicting results in this field and the beneficial effects of exercise in water and also human's innate interest in water, the effect of high-intensity interval exercise in water in patients with non-alcoholic steatohepatitis has not been observed by the researchers of this study. Therefore, the effect of eight weeks of high-intensity interval training in water on inflammatory factors in patients with non-alcoholic steatohepatitis was investigated.
Materials and methods
In this study, eight-week-old rats were divided into two groups: healthy (n=20) and high-fat diet (HFD) (n=20). After eight weeks and proof of disease induction, the HFD group was randomly divided into two groups: control-disease (n=9) and exercise-disease (n=9); Also, the healthy group was divided into two groups: control-healthy (n=9) and exercise-healthy (n=9). The rats in the training group performed HIIT swimming training, including 20 times of 30 seconds of swimming with 30 seconds of rest between each time, for eight weeks (three days a week). One-way ANOVA and Bonferroni's post hoc test (P<0.05) were used to determine the difference between groups.
Ethical Considerations
The proposal of this study has been approved by the Ethics Committee of Shiraz University of Medical Sciences (IR.SUMS.REHAB.REC.1400.008).
Findings:
As shown in diagram 1; Based on the results of the one-way analysis of variance test, it can be said that there was a significant difference between the mean TNF-α blood serum (P=0.001). According to the results of Bonferroni's post hoc test, these differences in blood serum TNF-α variable between the control-healthy and control-disease groups (P=0.001), exercise-disease (P=0.001) and exercise-healthy (P=0.002), control-disease with exercise-disease (P=0.012) and exercise-healthy (P=0.001), exercise-healthy with exercise-disease (P=0.002) was.
According to graph 2, it can be seen that there is no significant difference in TGFβ1 variable in all four groups (p=0.068). However, by comparing the averages, it is found that the amount of TGFβ1 protein has decreased by 49.1968% in the patient-exercise group after high-intensity intermittent swimming exercise compared to the control-patient group. Meanwhile, this protein in the exercise-healthy group was reduced by 45.2741% compared to the control-patient. Figure 1 shows the protein bands related to TGFβ1 protein.
Discussion and conclusion: The results of the present research showed that high-intensity intermittent swimming exercises reduce inflammatory and fibrotic factors, and in general, it can be concluded that eight weeks of high-intensity intermittent swimming exercises improve the inflammatory and fibrotic factors associated with non-alcoholic steatohepatitis. . However, to obtain a definitive result, this type of exercise should be studied in human studies in this patient community.
Appreciation and thanks: This article is taken from the master's thesis in sports physiology (first author) of Zand Institute of Higher Education, Shiraz, with ethics code IR.SUMS.REHAB.REC.1400.008. In the end, we sincerely thank all friends and colleagues who helped us during the stages of this research.
Conflict of interest:The authors of this article have no mutual benefit from its publication.
Authors' share (participation rate): All four authors participated in the preparation of this article.
Key words: high-intensity swimming interval training, non-alcoholic steatohepatitis, tumor necrosis factor alpha, transforming growth factor beta