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Bahloul Ghorbanian, Ahmad Barani,
Volume 20, Issue 1 (4-2017)
Abstract

Abstract

Background: Diabetes mellitus is a common disease in human societies that dealing with its complications imposes enormous cost to the health system. The previous studies have shown that bone biochemical markers can be used for evaluation of bone metabolism in response to physical activity. The purpose of this study was to examine the effect of increasing 10-week aerobic exercise (AE) on serum osteocalcin, PTH and glycemic and anthropometric indices in postmenopausal women with type II diabetes.

Materials and Methods: In this semi-experimental study, 40 postmenopausal women with type II diabetes (40-60 years) as available subjects were selected and randomly assigned into two exercise (20) and control (20) groups. Exercise protocol was AE and walking activity for 10 weeks (3d/wk, 45 to 60 min/d with 45% to 60% HRRmax intensity). Blood samples were taken before and after exercise to measure serum variables. Data were analyzed by T-test and statistical significance criterion was set as p<0.05.

Results: AE makes a significant increase in osteocalcin levels and a decrease in insulin resistance index, insulin and fasting blood glucose in the experimental group (p<0.05). Changes in other variables such as PTH, HbA1c and anthropometric indices were not significant (p>0.05).

Conclusion: Due to the favorable effects of AE on osteocalcin and glycemic indices, it seems that this training method can be recommended as a non-invasive treatment for maintaining bone density and controlling blood glucose in diabetic patients.


Mojgan Ahmari Nejad, Mojdeh Ahmari Nejad, Hamid Rezghian, Mohammad Ghenaati,
Volume 20, Issue 3 (6-2017)
Abstract

Abstract

Background: Internal marketing is one of the applied instruments for managers to plan human force. This study aimed to investigate the effect of internal marketing on organizational commitment in a remedial center.

Materials and Methods: This study has an applied purpose and its nature is causal-survey. Statistical population consisted of 450 working employees in Ghods hospital in Arak city. Out of these, 207 samples were selected by available random cluster sampling. Data were gathered by standard questionnaires and the reliability of them validated by Cronbach’s alpha coefficient. Data analysis was performed by linear regression by using SPSS 19 software.

Results: The findings of this study showed that internal marketing had an effect on organizational commitment and the value of it was 0.2. Also, reward affected on organizational commitment which was equal to 0.13. The effect of communication on organizational commitment was positive and the value of it was 0.16. Development had an effect on organizational commitment which was equal to 0.16. In addition, safe workplace had an effect on organizational commitment and the value of it was 0.12. Also, the effect of job recruitment and appointment was positive which was equal to 0.11.

Conclusion: According to the results, it is essential to pay attention to necessary requirements and conditions for providing an appropriate bed to expand internal marketing and employees’ participation to develop organizational commitment.


Atefe Azimi, Abdollah Omidi, Elham Shafiei, Arash Nademi,
Volume 20, Issue 10 (1-2018)
Abstract

  1. Abstract
  2. Background: Students face a lot of emotional problems and psychological stress that affect their individual and social adaptation as well as their quality of life. Therefore, examining treatment models for these problems is very important. One of these models, the Fractal Diagnostic Treatment Model, is based on emotional regulation skills for a wide range of emotional disorders that can be used properly. The purpose of this study was to investigate the effectiveness of integrated diagnostic therapy on individual and social adaptations and emotional adjustment.
  3. Materials and Methods: A total of 70 female students were selected and assigned into two diagnostic groups (35 patients) and control (35 people). The experimental group received 12 sessions of diagnostic diagnosis weekly. Data were gathered in this study by Social Compliance Scale and Graz's Regulatory Emotion Questionnaire. Data were analyzed using descriptive statistics and multivariate covariance analysis (MANCOVA).
  4. Results: The results showed that transdiagnostic treatment focused on the dimensions of emotional regulation, including: refusal of emotional responses (F = 120.69, p < 0.01), impulse control problems (F = 14.57, p < 0.01), lack of emotional awareness (F =104.82, p< 0.01), lack of emotional resolution (F=42.64, p< 0.01), participation problems (F = 41.00, p<0.01), and limitations in achieving emotional regulation (F = 85.33, p<0. 01) is effective. Also, the results showed that exacerbation-based fetal diagnostic therapy was effective on individual adaptations (F = 146.76, p < 0.01) and social (F = 85.02, p<0.01).
  5. Conclusion: Regarding the effect of Fract-Intervention therapy based on emotional adjustment on personal and social adaptation and student's emotional adjustment dimensions, these results are applicable to clinical practitioners, counselors and practitioners in academic counseling centers.

Alireza Zoalfaghari, Hadi Bahrami, Kamran Ganji,
Volume 20, Issue 12 (3-2018)
Abstract

Abstract
Background: The present study aims to provide a comparative analysis of studies on Acceptance-Commitment and Cognitive-Behavioral interferences effectiveness on generalized Anxiety disorder.
Materials and Methods: This is a quasi-experimental research. Students at the Islamic Azad University of Toyserkan, Iran, who have been in contact with the counseling office in the educational year 2016-2017, were selected as statistical population. These students, in a diagnostic interview with a psychiatrist, met the DSM5 standards for generalized anxiety disorder and were approved by a trusted psychiatrist. Then, these selected subjects gave average or more score in beck anxiety test and were randomly divided into two groups of 20. After executing interferences for each group, data were analyzed by t-test and covariance.
Results: The findings indicated that the average acceptance and commitment interference was 12.3 (t= 16.01 and p < 0.001) and the average cognitive-behavioral interference was 11.25 (t= 10.60 and p < 0.001) on generalized anxiety disorder. Also, covariance analysis showed that ACT was more effective than CBT and f (0.03) was significant. Therefore, all hypotheses turned out to be approved.
Conclusion: The research demonstrated that both interferences are effective in treating generalized anxiety disorder, although Acceptance and Commitment interference is more effective than Cognitive and Behavioral interference.

 

Masoomeh Sofian,
Volume 21, Issue 5 (10-2018)
Abstract

Hepatitis C is one of the important causes of liver disease in the world. It seems that HCV will emerge as the leading cause of viral hepatitis-related advanced liver diseases and death in the near future. There are approximately 71 million chronically infected individuals worldwide, many of whom are unaware of their infection (1).
It has been estimated that the prevalence of HCV in the Iranian general population is less than 0.5%. In Iran, the average prevalence of HCV is among thalassemia patients (16.6%), hemophilia patient (54%), individuals under dialysis (8.3%) and among injection drug users (51.4 percent).
After screening of blood donors for HCV in Iran, the burden of HCV infection decreased significantly in hemophilia, thalassemia and patients on hemodialysis. Unfortunately, injecting illicit drugs still continues to be a major source of infection in Iran (2, 3).
Iran has the lowest prevalence for HCV infection in the Middle East. Countries such as Pakistan and Azerbaijan with high prevalence of HCV infection are neighbors of Iran (2).
The main populations at risk of HCV infection in Iran include intravenous drug users (IDUs) followed by people with tattoos, use of common razor, multi partner, homosexuality, receiving blood, and patients on hemodialysis (2).
Clinical care for patients with hepatitis c infection has advanced considerably thanks to an enhanced understanding of the pathophysiology of the disease and because of developments in diagnostic procedures and improvement in therapy and prevention, and HCV elimination has been considered by the World Health Organization till 2030 (2,3).
Screening and treating patients is necessary to eradicate HCV, So, EIA test is used for initial screening and detecting antibody against hepatitis C. Rapid diagnostic tests (RDTs) using serum, plasma, finger stick, whole blood or saliva as matrices can be used for initial screening. If anti-HCV antibodies are detected, the presence of HCV RNA or alternatively HCV core antigen in serum or plasma should be determined to identify patients with ongoing infection. Although the sensitivity of the core antigen assay is less than HCV RNA assay, but because of low cost and good sensitivity, it is a valuable test for HCV. The positive Anti HCV by EIA and negative PCR may be occurred by following reasons: 1-false positive 2-spontaneous viral clearance 3- treatment –induced viral clearance, 4- low levels of virus DNA in the Blood that is not determined by PCR. Following spontaneous or treatment –induced viral clearance, anti HCV antibodies may be persist lifelong. Thus, the follow of treated patient use of PCR or core Ag is necessary (1). HCV has a high rate of genetic heterogeneity (1-7 genotype), therefore, no vaccine to prevent this infection today. Genotype 1a and 3a are the most prevalent genotypes in Iran. HCV reinfection can occur after spontaneous or treatment induced viral clearance, essentially if patient at high risk of infection and re exposure (4).
Strategies to promote diagnosis, screening, and treatment should be targeted to high-risk groups rather than the general population. Annual screening is recommended for Individuals with a history of injecting illicit drug. In the past, treatment of HCV was interferon and ribavirin for 24 to 48 weeks. This treatment regimen associated with low response to treatment, high drug complication and high drug cost. In 2011, protease inhibitors, the first generation of DAAs (Telaprevir and Boceprevir), were emerged as the third component of the standard of care. These drugs had a lot of complications such as drug-drug interactions, severe skin rashes/pruritus and anemia. In 2013, Sofosbuvir, a new DAA, was introduced for treatment of HCV infection. SOF-containing regimens had a shorter duration of therapy, with fewer side effects in comparison with protease inhibitor-based triple therapy (5).
At present, in Iran, the basis of treatment is sofosbovir 400 milligram that combined with second drug daclatasvir (60 mg) or velpatasvir in pan genotype and or ledipasvir (90 mg) in genotype 1a. These drugs exist in separated or combination form with different brand names. In fact, the patient with hepatitis C in both treatment-naive and non-cirrhotic, taking a combination pill daily for 12 weeks associated with high treatment response. However, in cirrhotic patients or patients with previous treatment experience, treatment prolongs 24 weeks or ribavirin (1000 -1200 mg, 5-6 200mg tablets) is added to 12 weeks of treatment according patient weight. Accurate assessment of liver fibrosis and cirrhosis is essential for predicting prognosis and for planning treatment duration and adding RBV to the standard therapy of patients with chronic HCV infection. So, percutaneous liver biopsy or elastography non-invasive methods have been considered as the gold standard for assessing hepatic fibrosis. If biopsy or elastography not available, platelet count, liver sonography and liver enzyme level is helpful for determination of liver fibrosis (6).
In EASL Recommendations on Treatment of Hepatitis C 2018, other drugs of DAAs like pibrentasvir, glecaprevir, elbatasvir and grazoprevir are recommended. Also 8, 16 and 28 weeks of treatments are suggested in special cases and treatment without sofosbovir is mentioned (1).
Determination of viral load by quantitative PCR and genotyping of HCV recommend before the treatment, if viral load and genotyping is not available, qualitative PCR without genotyping is sufficient for treatment with pan genotyping drugs (1, 5).
New treatments are free-INF and these drugs have low cost and low adverse effect (5, 7). Todays, HCV is treated very simply by consuming only one pill daily for 12 weeks. Sustained viral response (SVR) that defined negative PCR 12-24 weeks after discontinuing treatment occurred in more than 90% of patients (1, 4). In patients with cirrhosis, despite SVR, sonography of liver and αFP level test for screening of liver malignancy is recommended every 6 months (1).
It seems that the best strategy for HCV prevention in the community is increasing case finding and therapy with the ultimate goal of stopping the vicious cycle in the community. Todays, there is no vaccine for HCV prevention yet. The incidence of HCV infection should be reduced by providing safe blood transfusion and medical procedures in hospitals and out-patient clinics, increasing people awareness and public education regarding the risks of exposure such as unsafe tattooing and unsafe sexual contacts and finally implementation of harm reduction for IDUs (1, 5).

Azam Ahmadi, Ali Arash Anoushirvani,
Volume 21, Issue 6 (12-2018)
Abstract

Cancer is a multifactorial Disorder caused by variations in multiple genes coupled with environmental risk factors. The genes involved in the carcinogenesis can be classified into several groups, including proto-oncogenes, tumor suppressor genes, genes involved in genome stability and cell migration. The accumulations of genetic changes lead to tumor mass and formation of new blood vessels to grow. The tumor is not a collection of single cells and has bilateral interactions with its environments. The tumor microenvironment (TME) has a similar function to stem cells niches that affect tumor progression and metastasis. The study of this environment is effective in diagnosis and treatment of cancer and provides valuable and new information for controlling tumor malignancy and risk assessment (1). This paper focuses on TME components and the molecular targets for cancer treatment. Investigating of TME by cellular and molecular profiles indicated that there are different types of cells in this environment that promote neoplastic changes and metastasis and protect the tumor from the immune system and lead to resistance to treatment (2). Among the different types of cells present in the TME, including parenchymal tumor, fibroblasts, epithelial and inflammatory cells, extracellular matrix and signaling molecules, blood and lymph vessels, the highest number of cells are fibroblasts. In the early stages of carcinogenesis, normal fibroblasts prevent tumor growth. The genetic changes of these cells, with the help of inflammatory agents, release the growth factors that directly inhibit tumor-stimulating cells or indirectly inhibit apoptosis by stimulating growth and inducing angiogenesis. Therefore, a complex system of interactions is created by the involvement of a variety of cellular factors and molecular signals (3,4). Within the TME infrastructure, there are interactions of tumor cells with extracellular matrix (ECM), tumor-associated macrophages (TAMs), cancer-associated fibroblasts (CAFs), mesenchymal stem cells (MSCs) and endothelial cells (EC). These communications have been established with the help of chemokines, growth factors, matrix metalloprotezes (MMPs) and ECM proteins, that lead to migration, invasion to distant organs and metastasis (5). TME restores tissue and induces metabolic changes in the tumor by making changes in the stromal and immune cells. This remodeling in a TME is similar to around of scar surrounded by different cells (6). Based on tissue type’s cancers, more than 40% of the CAFs can be derived from bone marrow progenitors that are recruited to the growing TME. Although CAFs may also be derived of epithelial cancer cells or stained fibroblasts that differentiate into myofibroblasts. In epithelial tumors, fibroblasts, mainly through the secretion of growth factors and chemokines, led to an altered ECM, and increase signals of proliferation and metastasis, and ultimately lead to tumor progression (7). The ECM also accumulated a scaffold of inflammatory and immune cells, lymph and nerve arteries. In general, in the metastatic phenomenon, the invasive tumors should be able to move, to break up the extracellular matrix of the tissue, to form new blood vessels, to survive in the blood and to stabilize in a new tissue environment. In studies that have been conducted to understand how these capabilities are achieved in cancer cells, TME has been identified as critical to the development of this phenomenon. TME stabilizes invasion of tumor to distant organs via signals to stromal or non-malignant cells and activation of transcription of genes (8,9). Also, angiogenesis precursor cells that are recruited to TME under hypoxic conditions are associated with metastasis. Some studies have shown that miRNA molecules are the main regulator of this activity, leading to changes in fibroblasts in the TME. MiR-21, miR-31, miR-214 and miR-155 play an important role in differentiation of normal fibroblasts to CAF (10). Although miRNAs in TME have not yet been fully identified, some studies indicated that miRNAs produced by TME cells and specially CAFs affect on tumor growth (11). Musumeci and colleagues showed the role of miRNAs in TME in prostate cancer. Their study found that expression of miR-15a and miR-16 down-regulated in fibroblasts of TME in prostate cancer. MiRNAs target oncogenes such as Bcl-2 and WNT pathway components (12). Several strategies have been proposed to remodel TME components in cancer treatment (2). Blocking the recruitment and activation of stromal cells in TME is one of these molecular approaches. Based on this strategy, Avastin has been designed to treat clone and glioblastoma cancer. Some drugs also block the interaction between the TME cells with the tumor and angiogenesis, ECM and inflammatory compounds in TME. Siltuximab is a human anti-IL-6 antibody that inhibits the pathway of IL-6 / STAT3 in cancer cells and its therapeutic effects have been reported in xenografet models. The effect of this drug in the Phase II clinical trials in platinuim-resistant ovarian cancer is under survey. More accurate identification of gene networks and cell pathways will help us improve our understanding of the pathogenesis of cancer and the advancement of therapeutic approaches. Therefore, in addition to controlling the signaling pathway inside the tumor, it is also necessary to identify the TME. Although, despite the recognition of the importance of TME in carcinogenesis, due to the multiplicity of involved cells, the origin of molecular mutations in its components is still not fully detected and requires extensive research in this area.

Esmail Asadpour, Saied Veisi,
Volume 21, Issue 7 (2-2019)
Abstract

Background and Aim: Marital and sexual problems of chronic patients, especially diabetes, that often are ignored, need special attention to proper treatment. The aim of this study was to investigate the effectiveness of acceptance and commitment therapy on marital satisfaction, sexual self-esteem and burnout martial among women with type 2 diabetes.
Materials and Methods: This study was a quasi-experimental research design with pretest-posttest and control group. The statistical population included women with type 2 diabetes in the city of Tehran. 30 patients were chosen as samples and randomly were divided into two groups of individuals as control and experimental. The experimental groups practiced the acceptance and commitment therapy 8 sessions and 60 minutes in each session. Then, post-test was performed for them. For data collecting, the marital satisfaction scale of Enrich (1993), sexual self-esteem scale of Doyle, Zeanah and Schwarz (1996) and burnout martial questionnaire of Pines (1993) were used. Data analysis was done by using multivariate analysis of multi covariance.
Ethical Considerations: This study with research ethics code IR.KHU.REC.1397.5 has been approved by research ethics committee at Kharazmi university of Tehran, Iran.
Findings: Results illustrated that after acceptance and commitment therapy, amounts of marital satisfaction and sexual self-esteem were significantly increased in experimental than control group (p<0.05). Also, acceptance and commitment therapy decreased burnout martial among women with type 2 diabetes significantly (p<0.05).
Conclusion: Acceptance and commitment therapy can be used as an effective psychological intervention on marital satisfaction, sexual self-esteem and burnout martial among women with type 2 diabetes.

Zahra Zare Bidaki , Mohammad Mahdi Jahangiri,
Volume 21, Issue 7 (2-2019)
Abstract

Background and Aim: The purpose of this study was to investigate the effectiveness of acceptance-based treatment on psychological flexibility of mothers of children with autism disorder.
Materials and Methods: This study was a quasi-experimental pretest-posttest with control group. The statistical population of the present study included mothers with autistic children referring to the autism community in Qom city at 2017. According to the semi-experimental design and Criteria for research, a sample of 30 patients (each group of 15) was selected voluntarily. Samples were randomly assigned to two experimental and control groups. The experimental group received 8 sessions of "acceptance and commitment therapy. The instrument for collecting information included the Acceptance and Action Questionnaire-II (AAQ-II). Data were analyzed by SPSS software using covariance.
Ethical Considerations: This study with research ethics code IR.IAU.ARAK.REC.1396.39 has been approved by research ethics committee at Islamic Azad University of Mahallat, Iran.
Findings: Based on study findings, the acceptance- and commitment-based therapy had significant impact on psychological flexibility in mothers of children with autism.
Conclusion: Based on the findings, it can be concluded that acceptance and commitment therapy is effective in improving the mental health of mothers with childhood autism.

Masoud Rezagholizamenjany, Parsa Yousefichaijan,
Volume 21, Issue 7 (2-2019)
Abstract

Nephrotic syndrome
Nephrotic syndrome is a manifestation of glomerular disease as a proteinuria in the nephrotic and triad of hypoalbuminemia, edema, hyperlipidemia, and high protein in the urine. Nephrotic proteinuria is defined as protein excretion of more than 40 mg/m2 of body surface per hour or protein to creatinine ratio of more than 2-3 at the first morning urine sample. Its annual incidence in most western countries is 2-3 cases per 100000 children per year, and in developing countries it is often higher due to malaria (1). New findings in this area are often about treatment, which are evaluated and reviewed in following.

Ali Esfahani, Shirin Zeinali, Roghayeh Kiani,
Volume 23, Issue 2 (5-2020)
Abstract

Background and Aim: Breast cancer is the most common cancer among women which leaves a profound impact on their psychosocial health and pain experience. The aim of this study was to determine the effect of group psychotherapy based on Acceptance and Commitment Therapy (ACT) on pain-related anxiety and cognitive emotion regulation of women with breast cancer. 
Methods & Materials: In this quasi-experimental study, subjects were 68 women with breast cancer refereed to Shahid Ghazi Hospitalin Tabriz, Iran who were selected using a convenience sampling method. Then, they were randomly assigned into two groups of intervention (n = 34) and control (n = 34). The intervention group underwent eight 90-min sessions of ACT-based group therapy, while the control group received no any intervention. They completed Pain Anxiety Symptom Scale Short Form and Cognitive Emotion Regulation Questionnaire before and one week after treatment. Collected ata were analyzed by using t test, chi-square test, ANCOA and MANCOVA. 
Ethical Considerations This study has obtained its ethical approval from the Research Ethics Committee of Tabriz University of Medical Sciences (code: IR.TBZMED.REC.1397.287) and has been registered by Iranian Registry of Clinical Trials (code: IRCT2017100615590N5).
Results: The ACT-based intervention improved the dimensions of pain-related anxiety (8.44±1.5) and cognitive regulation of negative (8.40±3.5) and positive (8.39±7.5) affects (P<0.001).
Conclusion: ACT-based intervention can help breast cancer patients to accept their negative thoughts and current conditions. 

Alireza Amani, Ali Kamali, Bahman Sadeghi, Ali Reza Sistani, Mahdi Tavakolizadeh, Sajad Ghodibigi, Farid Saghabi, Mojtaba Ahmadlou,
Volume 23, Issue 4 (9-2020)
Abstract

Background and Aim: Ankle injuries are among the most common musculoskeletal injuries in sports, accounting for 10% to 15% of all injuries. Since controlling pain and inflammation in ankle sprains is one of the main goals of treatment, we decided to compare the therapeutic effects of Cheleh daghi Herbal ointment with a common therapeutic gel such as piroxicam.
Methods & Materials: This study was performed as a double-blinded clinical trial for 6 months from January 2019 to August 2019. After referral, all patients completed the consent form, and the patient's details and study variables were recorded by the evaluator in the research form. To measure joint inflammation, we measured the ankle with a meter tape in the ankle area (cm) and recorded. A goniometer was also used to measure the degree of ankle movements. The symptoms of ankle ecchymosis were also checked by physical examination and observation and recorded in the checklist. Statistical analysis was performed in SPSS V. 18 using statistical tests (the Mann-Whitney U test, the Chi-square, and the independent t-test).
Ethical Considerations: The Research Ethics Committee of Arak University of Medical Sciences approved the study (Code: IR.ARAKMU.REC.1396.55) and registered by the Clinical Trial (Code: IRCT2017071720258N53).
Results: The Mean±SD age in the control group was 34.2±8.6 years, and in the case group was 35.4±8.9 years. There was no statistically significant difference according to the Mann-Whitney U test (P<0.05). Also, the Mean±SD height in the control group was 1.7±0.12 m and in the case group was 1.72±0.11 m. The results also showed a statistically significant difference between the two groups studied before and after the intervention regarding the mean indicators of pain, swelling, and inflammation around the joints (P<0.05).
Conclusion: The results of our study showed that Cheleh daghi Herbal ointment for 3 weeks could be more effective in reducing local pain and inflammation than piroxicam gel treatment.
Ali Hojabr Rajeooni, Parvaneh Mehrbod,
Volume 23, Issue 5 (11-2020)
Abstract

Background and Aim: Coronavirus Disease 2019 (COVID-19) is one of the most important viral diseases in the current decade which has caused widespread crisis worldwide. The disease was first reported on December 8, 2019 in Wuhan, Hubei Province, China, in the patients with acute respiratory distress syndrome. On January 8, 2020, the Centers for Disease Control and Prevention in China identified the virus, and it was named 2019-nCoV by the World Health Organization (WHO). The name of the disease was later changed to COVID-19. According to the International Committee on Taxonomy of Viruses, the virus is called SARS-CoV-2 which belongs to the family of Coronaviridae. The viruses of this family have caused outbreaks in several countries (SARS in 2003 and MERS in 2013) which have led to death and economic loss. 
Methods & Materials: In this review study, COVID-19 was studied from various aspects including evolutionary process and molecular biology of its virus. The selected articles were examined based on the information available in the WHO database. SARS-CoV-2 proteins were identified molecularly and functionally using data analysis and bioinformatics methods, and then related drugs and their effects on virus replication and inhibition were investigated.
Ethical Considerations: All ethical principles were observed in this study.
Results: Studies on the structure of SARS-CoV-2 and drug therapies to inhibit the disease progression showed that the use of different pharmaceutical strategies is effective in treating COVID-19 depending on the progression of the disease. Molecular studies showed that the use of nucleoside analogues and protease inhibitors is effective in the course of the disease and intravenous immunoglobulin, aminoquinoline compounds, TMPRSS2 inhibitors and viral S protein can be effective in the early stages of disease.
Conclusion: In order to control COVID-19, it is very important to study the structure of SARS-CoV-2 virus and its biology in the body. It is essential to identify the drugs that affect the virus based on its biological structure. Due to the structural changes of the virus and successive mutations in the virus genome as well as the emergence of resistant strains or highly contagious strains, further studies on the structure of SARS-CoV-2 and its changes in the body are recommended for designing pharmaceutical and therapeutic strategies. These strategies varies according to the stage of the disease, such that some drugs prevent the virus from entering the target cells in the early stages of the disease and other drugs, in combination with the virus’ surface glycoproteins, prevent the virus antigen from binding to receptors in the host cells. In the late stages of the disease, antiviral drugs including protease inhibitors and nucleoside analogues, interfere with the replication and structure of the virus. Due to intermittent changes in the virus and the development of drug-resistant viruses, it is important to continuously review virological and clinical studies and the performance of existing drugs against SARS-CoV-2.
Niloofar Agharezaee, Flora Forouzesh,
Volume 23, Issue 5 (11-2020)
Abstract

Background and Aim: Coronaviruses are a large family of viruses that cause disease in humans and animals. Coronavirus Disease 2019 (COVID-19) is an acute respiratory infectious disease caused by a new coronavirus. The World Health Organization has declared this infectious disease as a global pandemic.
Objective: This study aims to review the latest research advances in genetics, pathogenicity, and clinical features of COVID-19, as well as current therapies to combat this disease.
Methods & Materials: This is a systematic review study on articles published from 2010 to 2020 by searching in reputable databases such as PubMed, Scopus, Google Scholar, Web of Science, and ScienceDirect.
Ethical Considerations: Ethical principles have been observed in accordance with the guidelines of the National Ethics Committee and the COPE regulations.
Results: Examining the genome and genetic studies of the virus, it can be said that there are many similarities between different coronavirus types, but there are differences in their genomic and phenotypic structures that can affect their pathogenesis. Re-use of existing therapeutic drugs, previously designed for other infections and viral pathologies is currently the only practical approach to fight COVID-19. The tests for SARS-CoV-2 genome-specific vaccines and the therapeutic antibodies are currently being tested, but they require a long-term process and complete safety testing.
Conclusion: Rapid diagnosis of SARS-CoV-2 infection is the basis of disease control. There is currently no specific antiviral drug approved for SARS-CoV-2 infection. Therefore, preventive measures are necessary to stop and control the spread of COVID-19, according to genetic studies and the obtaining knowledge of the molecular mechanism of this virus.

Maryam Moradi, Mahla Salarfard, Zahra Abedian, Seyed Reza Mazloum, Ehsan Mousa Farkhani,
Volume 23, Issue 6 (11-2020)
Abstract

Background and Aim: The adherence of diabetic patients to the recommended treatment regimens is among the major challenges in diabetes control. Dietary adherence is low in pregnant women with gestational diabetes. Non-compliance can reduce the beneficial effects of treatment, symptoms, and signs, increase complications, or even cause death. Therefore, further research on the determinants of follow-up behaviors is essential.
Methods & Materials: This was a descriptive-analytical study. In total, 260 women with gestational diabetes treated with diet referring to healthcare centers, and Imam Reza (AS), Ghaem, and Umm Al-Banin Hospitals in Mashhad City, Iran participated in this research. The study subjects were selected using convenience, multistage, class, and cluster sampling methods. The required data were collected using a demographic and pregnancy profile questionnaire and a researcher-made questionnaire of adherence to the treatment regimen. The obtained data were analyzed by inferential statists and regression tests in SPSS v. 16.
Ethical Considerations: This study was registered with ethics code of IR.MUMS.NURSE.REC.1397.091 in the ethics committee of Mashhad University of Medical Sciences.
Results: The regression analysis results indicated that dietary adherence, blood glucose monitoring, and exercise adherence scores presented a significant and positive effect on the total treatment adherence score (P<0.001). Furthermore, education (P=0.044), unwanted (P=0.006), or unplanned pregnancy (P=0.21) provided a positive and significant effect on the overall score of treatment adherence. Women with a history of diabetes in first-degree relatives (P=0.010) and those with a history of miscarriage (P=0.021) obtained higher scores of total treatment adherence.
Conclusion: According to the present study findings, some demographic and pregnancy characteristics can affect the rate of adherence to the treatment regimen in women with gestational diabetes. Healthcare providers need to pay attention to the impact of these factors in improving adherence to patients’ treatment regimens.

Farideh Ranjbaran, Hamid Reza Jamilian, Bahman Sadeghi Sade,
Volume 24, Issue 1 (3-2021)
Abstract

Background and Aim: Major Depressive Disorder (MDD) is the most common mental health condition, with a severe decline in performance, disability, and a 15% risk of suicide. Allopurinol increases the level of tryptophan in the body by inhibiting xanthine oxidase, and by elevating the level of tryptophan, i.e., a precursor to serotonin. Accordingly, it can improve the symptoms of depression. This study aimed to investigate the impact of allopurinol on MDD.
Methods & Materials: In this double-blind clinical trial, 70 patients with MDD, diagnosed based on the Diagnostic and Statistical Manual of Mental Disorders- Fourth Edition-Third Edition (DSM IV-TR) were randomly (paired & individual patient records) divided into two equal groups. Both research groups received 40 mg of citalopram daily for 6 weeks. In addition to citalopram, the intervention group received 300 mg allopurinol daily and the control group received a placebo. At the end of the third and sixth weeks, the examined patients were tested for Hamilton Depression Rating Scale (HDRS).
Ethical Considerations: This study was approved by the Ethics Committee of the Arak University of Medical Sciences (Code: IR.ARAKMU.REC.1394.68). Also, it was approved by the Iranian Registry of Clinical Trials (Code: IRCT201508277373n6).
Results:  The Mean±SD HDRS’s score, after 3 weeks of treatment, in the control and allopurinol groups was measured as 28.42±3.1 and 23.02±3.4, respectively. After 6 weeks after treatment, the Mean±SD depression score in the control and allopurinol groups was equal to 23.28±4.1 and 20.4±1.2, in sequence. A significant difference was observed between the research groups; thus, the intervention group obtained a lower mean score in the HDRS than the controls.
Conclusion: Allopurinol can improve the symptoms of depression and can also be used as an adjunct in the treatment of depression.
Doctor Monireh Nadeali, Doctor Mojtaba Bayani, Doctor Vahideh Nazari, Doctor Rahmatollah Moradzadeh,
Volume 24, Issue 6 (1-2022)
Abstract

Background and Aim: Different implant angulation, which is unavoidable in clinical situations, can affect the accuracy of impression. The aim of this study was to investigate the effect of fixture position on the accuracy of connecting impression coping to implants with internal hex.
Materials and Methods: A gypsum model with 4 implants with internal hex connection was prepared. The implants were installed in different mesiodistal angles of 0, 15, 25 and 35 degrees to the longitudinal axis in the gypsum model. To simulate the gums, a gingival mask was injected around the implants to a height of 2 mm. After a training session for senior dental students on how to close the impression coping, forty students were asked to close the impression copings on four implants. The correctness of the impression coping was evaluated by an expert prosthodontist. Data were statistically analyzed using Cochran Q test. Significance level was considered 0.05.
Ethical Considerations: this article is approved by ethics committee of Arak University of Medical Sciences.
Findings: The correct performance of students in connecting the impression coping to the implant at angles of 0, 15, 25 and 35 degrees was equal to 85%, 72%, 52%, 35%, respectively. With the exception of 0 and 15 degree groups, a statistically significant difference was observed between different study groups.
Conclusion: The fixture position has a significant effect on the accuracy of connecting impression coping to the implants with the internal hex and by increasing the implant angulation, the accurate connection the impression coping to the implant decreases. 
Pardis Mirmoeini, Mohammad Hosseini Bayazi, Javad Khlatbari,
Volume 25, Issue 1 (3-2022)
Abstract

Background and Aim Given the increasing number of patients with multiple sclerosis and the psychological complications that affect this group, the present study was conducted to compare the effectiveness of acceptance and commitment therapy and compassion-focused therapy for these patients
Methods & Materials This research was a quasi-experimental study with a pre-test-post-test design with a control group. A total of 45 patients with multiple sclerosis were selected from MS patients in Tehran Clinic, Tehran City, Iran, in 2020. They were randomly divided into three groups: the first group was under treatment based on acceptance and commitment therapy, the second group was assigned to the compassion-focused therapy, and the third group was the control. The participants completed the Connor and Davidson resilience questionnaire and the Pennsylvania concern questionnaire in the pretest and post-test stages. The first and second groups participated in eight sessions of acceptance and commitment therapy and ten sessions of compassion-focused therapy, respectively. The control group did not receive any intervention. The post-test was done at the end of the therapy sessions. Data were reported by analysis of covariance.
Ethical Considerations This research was approved by the Torbat Jam Branch, Islamic Azad University (Cod: IR.IAU.TJ.REC.1399.012).
Results The results of univariate analysis of covariance were obtained at the statistical level of P<0.05. In this regard, F=5.88 for resilience and F=42.60 for anxiety intensity were obtained, which indicated the greater effectiveness of acceptance and commitment treatment.
Conclusion Considering the effectiveness of both treatments, it is suggested that these treatments be given more attention to controlling patients’ psychological symptoms.

Bakhtyar Tartibian, Leila Fasihi, Rasoul Eslami,
Volume 25, Issue 1 (3-2022)
Abstract

Background and Aim Menopause is a period in a woman’s life that can be physically damaging. However, its effect on bone mineral density is still debatable. This study investigated the relationship between serum calcium, phosphorus, and alkaline phosphatase indices with lumbar bone mineral density in active and inactive postmenopausal women.
Methods & Materials The number of subjects was 55 active postmenopausal women and 60 inactive postmenopausal women aged 45 to 85 years. Serum indices of calcium, phosphorus, and alkaline phosphatase and anthropometric of the subjects were measured. The Pearson correlation coefficient test was used to analyze the research data. SPSS software v. 26 was used to analyze the data.
Ethical Considerations This study was approved by the Research Ethics Committee of Allameh Tabataba’i University with code IR.ATU.REC.1399.038.
Results The results showed a significant correlation between serum levels of alkaline phosphatase (P=0.021), calcium (P=0.019), and phosphorus (P=0.011) with lumbar bone mineral density in active postmenopausal women and also between body mass index with lumbar bone mineral density in both groups of active (P=0.014) and inactive (P=0.038) postmenopausal women. No significant relationship was found between other indicators.
Conclusion According to the results of the present study, being active may have had beneficial effects on bone metabolism and has led to a better state of bone mineral density. It may also help to use these blood and anthropometric variables in identifying people at risk for osteoporosis in adulthood and old age.

Fatemeh Rostamkhani, Mohammad Ghamari, Vahideh Babakhani, Effat Sadat Merghati Khoei,
Volume 25, Issue 3 (8-2022)
Abstract

Background and Aim Sexual function is an important part of menopausal women's lives, and changes in it, especially during menopause, can affect their health. The aim of this study was to compare the effectiveness of cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT) on the sexual function of postmenopausal women.
Methods & Materials This research was a quasi-experimental with pre-test, post-test and follow-up design with control group. The statistical population of the study included postmenopausal women who referred to Zanjan Health Center in 2020 to receive services. Among them, 45 were selected using the available sampling method and were randomly assigned to three groups of 15, and control group using randomly assigned block allocation method. Therapeutic sessions were held in 8 sessions and each session was held for 2 hours. Data were collected by FSFI (Female Sexual Function Index) and were analyzed using ANOVA with repeated measures analysis via SPSS software, version 24.
Ethical Considerations This study was approved by the ethics committee of the Zanjan University of Medical Sciences (Code: IR.ZUMS.REC.1398.328).
Results In the post-test and follow-up phase, there was a significant difference between both CBT and ACT methods compared to the control group in sexual function respectively (P<0.05, F=17.857), (P<0.05, F=12.115). That is, treatment with CBT and ACT improved the sexual function of postmenopausal women, which had a lasting effect for three months, and there was no significant difference between the groups involved in sexual function (P>0.05, F=0.494).
Conclusion Cognitive-behavioral therapy and acceptance-based therapy have improved sexual function in postmenopausal women, so it is recommended that these therapies be used to improve the sexual function of postmenopausal women in health centers.

Mrs Fatemeh Jahanshahi, Dr. Morteza Ghasemi, Mr. Pooyan Falahi, Mrs Neda Ghasemi,
Volume 26, Issue 1 (4-2023)
Abstract

Introduction: The current research was conducted with the aim of "investigating the role of medical staff in health policies during the corona virus pandemic".
Methods: This research is practical in terms of purpose and exploratory research in terms of method.
Results: The statistical population of this research is all the medical staff of Arak city Since access to all these people is not possible; Therefore, the sampling method is used. The data collection tool in this research was a questionnaire. This research was done using the factor analysis model.
Conclusions: The data and information extracted from the factor analysis test showed that: establishing proper communication with patients, interacting with citizens and the government, paying attention to the laws and encouraging others to comply with them, learning specialized training to contain the corona virus, explaining the situation to worried people, Adhering to health protocols and informing others, perception of organizational justice, alignment between individual and organizational goals, transfer of sense of responsibility to the work environment, existence of an efficient evaluation system and encouragement to inject vaccines are the most important role of the medical staff in health policies. They were during the corona disease pandemic.
 

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