Razi Journal of Medical Sciences

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Background: The purpose of this study was to evaluate “the effect of intensive activity and regular exercise with carbohydrate ingestion on cortizol, lymphocyte, monocyte, white blood cell, fast blood suger, CD3, CD4, CD8 and CD4 to CD8 ratio, cell-mediated immunity”.

 

Methods: This semi experimental, cross sectional and double blind study performed to investigate the responses of cell-mediated immunity after 12 weeks intensive activity and regular exercises. 39 sedentaryand healthy studentswith same-life style, were selected .They did not use cigarette, alcohol, supplementary and they had not infection diseases. Students selected randomly and then divided into three groups: Glucose and train (TG) 23±2.1years, 73±8.2 Kg, 179±4.7Cmand with 22±2.5 BMI.

 

 Train (T), 23.5±1.8 years, 71.7±7.8 Kg, 176.4±3.6 Cmand 22±1.9 BMI. Control (C) 23.7±1.1 years, 72.4±6.6 Kg, 174.8±3.5 Cmand 22±2 BMI, they did endurance and speed train for 12 weeks. TG group drank 2cc/Kg, glucose5% monohydrate & water solution, in the middle of their train session. T group drank 150 – 200 ml water. Bloods sample were withdrawn from antecubital vein after 14±2/hr fasting and evaluated before, immediately and after 48/hr of train. As well as cellular determined by immunology assay. For analyze in between groups ,one way ANOVA with significan used from modify method of green house-ghezer (GG), level      , were used.

 

Results: There were not any differences in T, TG and C group before 12 weeks exercise. The amounts of cortizol in TG & T groups significantly increased after exercise, but there was a lower increase in TG group. Results was significantly decreased after 48/hrs of train in before and after train parameters. The FBS in TG and T groups had not any differences but in TG group / T group results was significantly lower, after 48 hours. There was not any diffrences in amount of LYM after train but after 48/hrs, it significantly increased in TG group. The amount of WBC increased in after train but significantly decreased after 48/hr in TG group. The CD4 significantly increased after train in TG group, and CD3 significantly increased after train and after 48/hrs in TG group. Monocytes, ratio CD4/CD8 and CD8 amount had not any differences in TG and T groups.

 

Conclusion: This research showed that intensive activity and regular exercise with cabohydrat digestion induced increase some of immune cells and cellular defence against infection disease that caused from intensive exercises. Another finding of this investigation indicates that drinking a CHO solution during exercise, improves performance. This study has practical implications for those sports and drinking CHO solution during activity. Carbohydrates as a factor can increase security against infection disease risk in recovery time and after intensive exercise.

 

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In December 2019, a new type of viral pneumonia emerged in Wuhan, Hubei Province, China. Subsequently, the World Health Organization (WHO) named this unknown virus as (2019-novel coronavirus) on January 12, 2020, and then designated as “SARS-CoV-2”. This novel disease has no comprehensive guidelines of treatment, diagnosis, control, and prevention. An evidence-based guideline needs to be developed forthwith for frontline physicians and other involved healthcare workers in the fight against COVID-19 pneumonia. Therefore, we prepared this guideline following WHO recommendation, clinical studies, and clinical data of different studies. At present, the RT-PCR technique is approved as a determined diagnostic method for COVID-19. In addition, CT scans and Chest-X-Rays play a prominent role in follow up treatment and recovery statues of disease, and applicable for early detection of COVID-19. Regarding the treatment, drugs such as Chloroquine, an anti-malarial drug, and Lopinavir/Ritonavir, an anti-HIV drug, have shown significant antiviral activity against COVID-19. Other candidate drugs such as approved nucleoside analogues (favipiravir and ribavirin) and experimental nucleoside analogues (Remdesivir and Galidesivir) may have potential antiviral activity against COVID-19. Further, Pegylated Interferon Alfa-2a/b, an approved drug for the treatment of HBV and HCV, can also be exerted to stimulate the intrinsic antiviral response in patients with covid-19. Eventually, we further discussed other potential therapeutic agents and diagnostic strategies for the treatment, detection, and evaluation of covid-19 pneumonia to assist the healthcare workers in clinical sections.

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Background: Lumbar disc herniation is one of the most common causes of low back pain and after pulmonary disease, low back pain is the second most common reason to see a doctor. Diagnosis of lumbar disc herniation in a patient presenting with sciatica is based on history, clinical signs, physical examination, and MRI or CT imaging techniques. Pain Most patients who present with sciatica due to lumbar disc herniation respond to conservative and rest treatments, but patients who do not respond to medical treatment and rest undergo lumbar MRI imaging without contrast and if indicated Clinically, the presence of a disc herniation undergoes surgery with a pressure effect on the spinal sac or nerve root. Clinical indication for lumbar disc herniation surgery occurs when, despite rest, the pain persists for more than 4 weeks, due to high pressure, the person develops paresthesia in the lower extremities, the patient's pain recurs frequently and the patient's life Disrupt. Chronic diseases such as back pain have important consequences, including changes in people's quality of life. Quality of life is a multidimensional structure that is characterized by social, mental and physical vitality and causes a feeling of vitality and satisfaction with life, and certainly spinal surgery affects the quality of life in all dimensions. In the present study, the quality of patients' health before and after lumbar disc herniation surgery and the necessity of disc surgery were investigated.
Methods: In this descriptive-analytical study in which samples were selected by convenience, 90 patients with chronic low back pain who were candidates for lumbar disc herniation surgery were studied. Data were collected through the 36-SF Health Quality Questionnaire and also using a demographic questionnaire, patient demographic information including age, sex, height, weight, smoking, occupation and level of education was collected. Before the operation, the 36-SF questionnaire was used to assess the quality of patients' health. After the operation, patients were followed up in two stages of 6 months and then 12 months with the help of the questionnaire and their quality of life was re-evaluated. Exclusion criteria included patients who had complications from surgery during the follow-up period, including wound infection, nerve root damage and neurological defects, incomplete recovery of lower back and lower extremity pain, and recurrence of disc herniation. They were lumbar or found a new history of other diseases such as stroke, rheumatoid arthritis, autoimmune disease, in which case they were excluded from the study. Descriptive statistics including calculation of numerical indices (mean and standard deviation) for quantitative traits and percentage for qualitative traits were used for summarization. Also, paired t-test was used to analyze quantitative data and Wilcoxon test was used if necessary and KS test was used for data normality. The stratification method was used for comparative purposes in terms of contextual variables. Then the samples were analyzed with SPSS-20 software.
Results: Mean and standard deviation of score improvement in physical dimension of quality of life before and 6 months after treatment in terms of sex were 38.60 9 9.13 in men and 31.90 56 8.56 in women, which was statistically different. Was significant (p = 0.005). Also, the mean and standard deviation of the score improvement in physical dimension of quality of life before and 12 months after treatment was 43.58 6 6.72 in men and 40.37 24 7.24 in women, which was not statistically significant (p=0.009). The mean and standard deviation of the score improvement in the psychological dimension of quality of life before and 6 months after treatment was 18.41 ± 11.72 in men and 14.26 37 7.37 in women, which was statistically significant (p<0.001)), also the mean and standard deviation of the score improvement in the psychological dimension of quality of life before and 12 months after treatment was estimated to be 24.93 9 9.69 in men and 29.26 86 8.86 in women, which was statistically significant. In women, there was more improvement than men. Mean and standard deviation of score improvement in physical dimension Quality of life before and 6 months after treatment in patients based on the duration of low back and lower limb pain, in two groups under 2 months and above 2 months were studied. The results showed that in the group under 2 months, 39.06 18 7.18 in the group above 2 months was 32.59 36 9.36 which was statistically significant (p=0.012) so that Patients with less back and lower limb pain (less than 2 months) showed more improvement. Also, the mean and standard deviation of the score improvement in the physical dimension of quality of life before and 12 months after treatment in the group under 2 months was 45.37 86 7.86 in the group over 2 months was 38.68 10 10.31, which was different from Statistically significant (p=0.08) that patients with less back and lower extremity pain (less than 2 months) showed more improvement. In general, the mean score of physical and mental health improvement was significantly different from Paying attention to body mass index, number of involved discs and smoking before, 6 and 12 months later showed that according to the results of independent t-test, the score of improving the quality of life in physical and mental dimensions; Compared to before, 6 months and 12 months after surgery were statistically significant among men and women and showed an increase in quality of life in both physical and psychological dimensions (p<0.001).
Conclusion: The results of the present study showed that the quality of life in the present study in the time periods before treatment, 6 and 12 months after treatment caused a significant improvement in the physical and mental condition of patients with lumbar disc herniation so that the mean score of quality of life Before the intervention, it was increased to 5.94 29 29.5, 6 months after the intervention to 60.17 4 4.55 and in 12 months after the intervention to 65.26 6 6.18, which statistical test also showed a significant increase (p<0.001).

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Backgroiund and Aims: Today, customers are the most important assets of any organization and organizations that strive to have committed and loyal customers have taken a big step towards success (3). In the meantime, paying attention to important aspects of customer orientation can have positive and desirable effects on their decisions and behaviors and also subject customers' behaviors to fundamental changes (4). In this regard, one of the important functions of customer orientation and customer attention in industries and companies is to influence the behavioral tendencies of customers (5). Behavioral tendencies influence the behavior of influential people and increase the likelihood of performing a behavior and improve their loyalty, as well as the likelihood of customers buying (6, 7). Improving customer behavioral tendencies and adapting it to industry policies has been one of the constant concerns of managers. In an effort to align customer behavioral tendencies with the services provided by companies and organizations (8). The outbreak of Covid-19 virus has disrupted people's lives due to economic, social, occupational and psychological problems. Due to the lack of vaccines, non-pharmacological interventions are the only way to prevent the disease, which significantly affects the daily habits of the body, mental conditions, social and economic status (12). Meanwhile, the criteria of social distance, school closures and work environments challenge people and lead to many psychological problems that will have long-term effects (13). Coronary heart disease is now a pandemic. While this pandemic is spreading rapidly around the world, it has caused fear and anxiety among the general public (14). Also, the spread of this virus while involving industries has caused the world to face major challenges from an economic, political, social and cultural perspective (15).
Understanding the behavioral tendencies of customers in some markets, including the opening of child services in the event of a Quid-19 virus outbreak, can help to determine the current state of customer tendencies in these markets. This issue undoubtedly raises the necessary concern to respond to the above situation in order to improve the behavior and psychology of customers in the child service market. Therefore, the researcher is trying to answer the question, what is the state of behavioral and psychological tendencies of these people at the time of the outbreak of Quid-19 virus?
Methods: The present study was a descriptive-survey and applied research that was conducted in the field. The statistical population of this study consisted of all people related to child services in Gorgan, but unfortunately accurate statistics were not available. Based on the Cochran sample size formula in the uncertainty of the community, 384 people were identified as the research sample. To identify the research samples, we first referred to some stores active in the field of child services market in Gorgan. In selecting these stores, we tried to consider the geographical areas of Gorgan. After obtaining the necessary licenses to obtain initial information from some customers of these stores, the contact information of some of these customers was received and through the information system of the stores, the link of the research questionnaire was sent for research samples. Due to the possibility of a large drop in research samples, 400 text messages were sent to customers of the child services market in Gorgan. After distributing and collecting research questionnaires, 327 questionnaires were collected and analyzed. Data collection tools included the standard questionnaire of Bayrak et al. (2016) and the researcher-made psychological inclination questionnaire.
Finally, descriptive statistics, Smirnov clomograph test, one-sample t-test, independent t-test, one-way analysis of variance and Tukey's follow-up were used to compare the behavioral tendencies of the research samples. The whole process of data analysis was performed in SPSS software version 20.
Resaults: The results showed that there is a significant difference between the levels of behavioral and psychological tendencies and also the post hoc test between all groups in all components. Table 2 shows the results of the independent t-test on the status of behavioral and psychological tendencies at the time of the outbreak of Quid-19 virus according to gender characteristics. The results showed that there was a significant difference between the behavioral and psychological tendencies of male and female samples of child service market customers during the outbreak of Quid-19 virus. It was also found that the average behavioral and psychological tendencies of the research samples at the time of the outbreak of Quaid-19 virus were lower than 0.05, which indicates the undesirable behavioral and psychological tendencies of customers.
Conclusion: The present study showed that the level of behavioral and psychological tendencies of customers in the child services market at the time of the outbreak of Quid-19 virus among the research samples is significantly lower than the desired level (number 3). Low visibility of this disease not only threatens the physical health of people, but also affects the mental health of people, especially in terms of emotions and cognition. Prolonged negative emotions reduce a person's immune function and upset the balance of their normal physiological mechanisms. People may overreact to any illness, leading to avoidant behaviors. Uncertainty about the future also causes cognitive inconsistencies and insecurity, and people behave conservatively and cautiously when they feel threatened by illness (21). These cases may be the reason for the undesirable behavioral and psychological tendencies of customers

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Introduction: Recently, the rapid spread of the Coronavirus Disease 2019 (COVID-19) has become a health challenge in worldwide. Dealing with outbreaks of highly pathogenic COVID-19 in the first stage requires preventive actions and self-care behaviors from individuals themselves. The purpose of this study was to determine self-care instructions for people not requiring hospitalization for COVID-19 disease.
Methods: This study was a narrative review to identify self-care instructions for people not requiring hospitalization for COVID-19. A regular search was conducted in PubMed, Science Direct, Scopus, and Google scholar. In this manner, related studies and guidelines in the English language were reviewed. The keywords used were: Self-care, Coronavirus, Covid-19, and Instructions.
Results: Based on the findings, self-care instructions for people with COVID-19 that not requiring hospitalization were identified in 10 main categories. According to WHO guidelines, patients and household members should be educated about personal hygiene, and how to care for the member of the family suspected of having COVID-19 disease as safely as possible to prevent the infection from spreading to household contacts.
Conclusion: Since there is no definitive treatment and the unknown behavior of COVID-19, self-care behaviors have been the best possible strategy to control the virus.

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Background & Aims: Addiction is one of the four world crises, along with environmental degradation, poverty and famine, war and bloodshed, and the emergence of emerging diseases, threatening the health of human societies. Drug addiction is a neuropsychiatric disorder that is associated with unpleasant habits and a strong desire to consume among its users and has caused many sufferings and calamities for many years by causing health problems for its abusers. Many people, due to the unpleasant side effects of addictive substances, its unwanted dangers, as well as the legal problems that these substances cause them over time, insist on using these substances and suffer from physical and psychological consequences by repeating their consumption pattern.. Substance abuse disorder can lead to many substance abuse patients with psychological disorders such as stress, anxiety and depression. Nervous aggression, severe mood swings, high irritability, manic, suspicious and risky behaviors, high-risk behaviors such as aggression to oneself and others, are some of the psychological effects of addiction that occur over time. In this disease, the importance of psychological therapies and coping methods (prevention) are considered as basic principles.The importance of addiction in Iran is the highest prevalence in the world with 2.8%. The aim of this study was to evaluate the effect of hypnotherapy on impulsivity, coping styles and addiction symptoms of addicts.
Methods: This quasi-experimental study was performed on 36 patients with a mean age of 29.38 years with a standard deviation of 3.38 in the hypnotherapy group and in a control group of 30.77 years with a standard deviation of 4.45 from clients referred to the Bandar Anzali Liberation Cottage Camp, with opioid use disorder in Aban to Bahman 1398. Questionnaire compilers were selected by available methods and randomly assigned to experimental and control groups. The present study was a quasi-experimental study with a pretest and posttest design with a control group. Experimental method is a set of research methods that is used to find cause and effect relationships between two or more variables. The statistical population in this study is all patients referred to the short-term and medium-term residential center (camp) of Bandar Anzali Liberation Cottage in 1398 who have opioid use disorder conditions. Second, they were eligible through a clinical interview based on DSM-5 criteria. Sampling method is available. In this way, among the clients to the short-term and medium-term accommodation center (camp) of Anzali Port Liberation Cottage, a questionnaire was provided to those who were eligible to participate in the research. And then in the second stage for sample selection, among those who received a high score in the questionnaire, 36 people (in a pilot study, a sample size of at least 15 people in each group is recommended. The group was considered) randomly assigned to two groups of 18 people (one experimental group and one control group). The experimental group underwent hypnotherapy for 8 two-hour sessions and the control group was placed on a waiting list. At the end of the intervention, the groups were retested. The method of data collection in the form of clinical interviews and questionnaires was as followsData collection tools, Barat Impulsivity questionnaire, Madsley addiction profile and Lazarus and Folkman coping styles (WOCQ) were completed with high validity and reliability before and after treatment. The experimental group underwent hypnotherapy in 8 sessions of 2 hours for 4 months.
Results: The results showed that hypnotherapy reduced impulsivity, emotion-focused coping style and addiction symptoms, and increased problem-oriented coping style of addicts.
Conclusion: The concept of hypnosis is reminiscent of the innumerable perceptions of non-specialist clinicians. Even the term hypnosis can be misleading because it is derived from the Greek root hypnos meaning sleep. In fact, hypnosis is not a dream, but rather a complex process that requires conscious concentration and attention. Hypnosis is a powerful tool for directing the innate abilities of imagery, imagination and attention. Many believe that the ballinger transmits hypnotic trance to the patient, or that the ballinger has the power to penetrate the patient. In fact, it is the patient who is prone to hypnosis, and the key role is to assess the patient's ability to exploit this strength and help the patient to discover and use it effectively. Patient motivation, personality style, and biological aptitude may play a role. During hypnotic trance, focused attention and visualization are enhanced and at the same time environmental awareness is reduced. This ecstasy can be induced by a hypnotist through a coded method of induction, but ecstasy can also occur spontaneously. Hypnosis and spontaneous trance are traits that vary from person to person, but remain relatively constant throughout one's life cycle. Hypnotherapy can be used as a powerful tool to orient innate abilities, imagery, imagination, attention, hypnotic inductions and involuntary indoctrination to increase the mental health of addicts.
 

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Background & Aims: Due to the international pain association, pain is usually defined as sensory and emotional experiences associated with actual or potential tissue damage. Chronic pain: pain with unknown etiology that lasts for more than 6 months after the lesion has healed and leads to emotional distress and increased use of resources in health care systems (1). Studies conducted among the Iranian population indicating that pain is a common phenomenon (2). and also, in some groups of patients, especially patients with experience of trauma and patients with post-traumatic stress disorder (3). The literature indicates that the experience of trauma can be considered as a predisposing factor in many diseases with chronic pain (4).in addition people who experienced trauma were more likely to develop physical, psychosomatic, and psychological disorders. And this issue, in the absence of the necessary precautions, leads to huge financial and psychological costs among the affected population for recovery and treatment (9,10). According to researches, in our country, Iran, less attention has been paid to the experience of trauma in the research. Also, there is no proper tools for screening these patients to use it for early assessment and identification of injured patients. In this regard, the Life Events Checklist (LEC) tool was developed and evaluated in accordance with the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (LEC). The tool consists of 17 items and is designed to assess exposure to potentially traumatic events based on diagnostic criterion A for PTSD in accordance with the DSM-5 (9). Therefore, the researcher had two options to build a new tool or translate existing tools from the original language into Persian and determine its validity and reliability and cultural adaptation to his country and society.
Methods: The method of study is a cross-sectional descriptive and validation research. The statistical population of the study consisted of all patients that suffer from chronic pain. The sample size was determined by considering at least 300 participants for studies based on confirmatory factor analysis (15) and also using Krejcie and Morgan chart (16). The sample size was 350 participants. Three chronic pain clinics (chronic pain clinic, chronic pain clinic of Imam Khomeini, chronic pain clinic of Dr. Shariati hospital) were selected in Tehran. Due to the prevalence of COVID-19 to reduce the risk of transmission of the disease, an online questionnaire was designed to send links to the participant's cellphones, and after the necessary explanations, the individuals completed the questionnaires if they were satisfied. Inclusion criteria include age over 18 years, diagnosis of chronic pain by a chronic pain specialist, literacy and exclusion criteria include disagreement with the research conditions and having any physical disability that prevents participation in the study. Data collection was done with a life events checklist that contains 17 phrases which scored on a 6-point scale. To prepare the tool, first, items of the questionnaire was translated into Persian by two master's degree students in psychology. The validity of the content was then assessed by a faculty member in psychology. In the next step, the items were returned to English by a senior English language expert who had not previously read the original version of the questionnaire, and then the original version and the translated version of the questionnaire were reviewed by psychologists to prevent semantic difference in it. After the final version was prepared, the questionnaire was distributed among 36 participants with chronic pain as a pilot and the desired problems in some items were resolved. All participants were given written letter consent including a brief explanation of the objectives, research method, and principle of confidentiality and anonymity. After obtaining consent, participants were asked to complete a package of self-report questionnaires including a life event checklist scale, a chronic pain catastrophe scale, chronic pain self-efficacy, and life satisfaction.
Data were analyzed by SPSS software version 25 and LISREL software version 8/8. In order to analyze the data from descriptive statistics (mean, standard deviation, frequency and percentage) as well as Cronbach's alpha method and retest test to examine internal consistency, the correlation of life events checklist scale with DASS-21 questionnaires and chronic pain catastrophe To assess convergent validity and the correlation of this questionnaire with chronic pain self-efficacy and life satisfaction questionnaires was used to assess divergent validity. Confirmatory factor analysis of LISREL version 8/8 was used for construct validity. Exploratory factor analysis was also used to determine the frequency of factors.
Results: The results showed that the phrases had good internal consistency and diagnostic power, except for the seventeenth question, which was excluded from the questionnaire. The correlation of the phrases with the total score varied from 0.27 for phrase 16 to 0.66 for phrase 4 and 14, Cronbach's alpha for the whole scale was equal to 0.86, which indicates the acceptable internal consistency of this instrument. The rate of retesting the questionnaire with a sample of 40 individuals in a period of 3 weeks was equal to 0.85, which is an acceptable score. Also, by considering the KMO value equal to 0/85 and rejecting the null hypothesis in the Bartlett sphericity test (p = 0.000, df = 136, x2 = 1786.27), The results showed that the conditions are ready for factor analysis. Primary analysis indicated four factors. The Scree diagram also supported the four-factor structure. The results related to factor loads show that all expressions have a common variance and a factor load greater than 0.46, in total, the four factors explain 0.56 variance. In the study, RMSEA between 0.8 and 0.10 indicates acceptable model and 0.95 CFI≥ indicates good model fit (27). According to the obtained results and the number of indices after using CFI (comparative fit index) correction indices value 0.95 GFI (goodness of fit index) value 0.90 and (normed fit index) NFI value 0.93 and also index the standardized root error of the mean squares of the RMSEA approximation is 0.7 and the degree of freedom x2 / df is less than 3, all indicating the relative suitability of the model after reformation.
Conclusion: Findings of the study indicated that the Persian version of the scale has an acceptable internal consistency in a sample of chronic pain patients. The findings were consistent with the results of Matt Gray et al., In which Cronbach’s alpha was reported in the study (18). The findings consistent with the study of Halip Bae et al., In whose study Cronbach's alpha was reported 0.66 (12). Another study conducted in South Korea were inconsistent with our findings. In explaining this issue, the concept of culturally oriented trauma can be well justified. In other words, the phenomenon of trauma has a cultural aspect and it is the cultural beliefs of a society that determine the traumatic nature of an event (29, 30). In general, according to the results it can be concluded that the checklist of life events in the Iranian sample with chronic pain is valid and the LEC scale has acceptable psychometric properties. Therefore, therapists and specialists in the field of mental health can use this screening tool in research to diagnose and evaluate trauma in order to prevent or reduce consequences and pathological symptoms.
 

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Background & Aims: Recent findings suggest that type 2 diabetes is associated with abnormal production of adipokines (2). Impaired circulating levels of adipokines are associated with multiple cardiovascular complications in diabetes (3). Lipocalin-2 is one of the adipokines that increases in diabetic patients and its secretion is associated with insulin resistance and hyperglycemia in these patients (4). also, Omentin-1 concentrations have been reported to decrease in patients with type 2 diabetes (11).
Many efforts are being made to develop a drug that improves metabolism and prevents the complications of diabetes. Canagliflozin is an SGLT2 inhibitor drug that acts by inhibiting glucose reabsorption by the body, lowers plasma glucose levels, and improves insulin resistance (13). Prescribing this drug to type 2 diabetes can help improve blood glucose control and reduce body weight in these patients (14, 15).
On the other hand, exercise has been used as an adjunct in drug therapy in the management of diabetes complications. Resistance training has been reported to be associated with significant increase in lipocalin-2 concentration in men with type 2 diabetes (16). However, the results of Hosseini et al showed that eight weeks of combined training did not have significant effect on lipocalin 2 in diabetic women (18). Also, significant increase (19) and no change (20, 21) of omentin-1 has been reported in patients with type 2 diabetes after exercise.
Since no research has been done on the effect of combined exercise with medication on adipokines in type 2 diabetics, Therefore, the aim of this study was to investigate the effect of combined training with Canagliflozin on lipocalin-2 and omentin-1 in type 2 diabetic men.
Methods: This is a semi-experimental study. The statistical population of this study consisted of all patients with type 2 diabetes in the Tehran city in 2019. 44 men with type 2 diabetes (mean age 25-40 years) were randomly divided into four groups (n=11) of control, drug, exercise and exercise-drug groups. Subjects were given 200 mg of canagliflozin for 12 weeks (25). Combined exercises were performed 3 sessions per week, 45 minutes for 12 weeks (26). Blood samples and anthropometric characteristics were obtained before and 24 hours after the intervention at 12-hour fasting. Data were analyzed using two-way ANOVA with repeated measures, t-test and Tukey post hoc test at P<0.05.
 Results: The results showed that combined training and combined training with canagliflozin significantly reduced lipocalin-2 and significantly increased omentin-1 in type 2 diabetic men (P=0.001). Also, after the combined training intervention, canagliflozin and combined training with canagliflozin, the levels of lipocalin-2 and omentin-1 were lower and higher than the pretest, respectively (P=0.001).
Conclusion: The findings of the present study show that combined training and combined training with canagliflozin significantly reduced lipocalin-2 and significantly increased omentin-1 in type 2 diabetic men. The findings of this study were consistent with the results of Previous research (19, 26-28, 33). Various studies have examined the mechanisms of change in lipocalin-2 induced by exercise. Perhaps one of the reasons for the decrease in lipocalin-2 levels in the present study is the intensity of exercise. also, exercise has been reported to reduce the activity of the NF-κB and inflammatory markers such as TNF-α, IFN-γ, and interleukin-1 beta, which activate lipokalin-2 expression (31), therefore It is possible that combined training in this study reduced lipocalin-2 by reducing the above factors. Some studies have reported that the reduction of lipocalin-2 is highly correlated with the reduction of adipose tissue, so that with the reduction of adipose tissue after exercise, the amount of lipocalin-2 decreases (28). also, Omentin-1 changes are largely a function of changes in body composition, including weight loss, fat mass, and body mass index and adipocyte size (35). In addition, in a study, changes in inflammatory levels have been reported to be an influential factor in regulating the expression of omentin-1 (36). Therefore, it is possible that in the present study, combined training increased the amount of omentin-1 in patients with type 2 diabetes by improving the composition of the body and inflammatory agents. The pharmacological effects of canagliflozin in the produced doses cause a significant increase in urinary glucose excretion and a decrease in hyperglycemia. Therefore, in explanation the results obtained in the present study, it can be said that canagliflozin with exercise, by lowering fasting blood glucose and also increasing insulin, may significantly improve the levels of adipokines in type 2 diabetic men. combined training was the strengths of the present study; because this type of exercise can have different responses and adaptations than other exercise programs. There were some limitations in the present study, such as the lack of measurement of other adipokines. According to the results, it seems that diabetics can benefit from combined exercise with canagliflozin to improve adipokines levels.

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