Who Would Be the Ideal Minister to Run the Current Health System of Iran?

International Journal of Preventive Medicine (Int J Prev Med)2008-78021320170910Who Would Be the Ideal Minister to Run the Current Health System of Iran?18151815ENNational Institute of Health Research, Tehran University of Medical Sciences, TehranCommunity Based Participatory Research Center, Knowledge Utilization Research Center, National Institute of Health Research, Tehran University of Medical Sciences, Tehran20170904In the course of progress toward achieving universal health coverage in the new term of President Rouhani, the health system of Iran will face with several challenges that have to be appropriately addressed. Sustainable financing, good governance, and comprehensive and fair health service delivery are examples of such challenges. A key issue is, therefore, who as a minister of health is qualifed for this position? In this editorial, we answer this question based on the challenges that our health‑care system has to go through and the criteria that have to be considered to deal with these challenges.Keywords: Health system, Iran, leadership <br style="font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px;" />http://ijpm.mui.ac.ir/index.php/ijpm/article/view/1815http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1815/2104

International Journal of Preventive Medicine (Int J Prev Med)2008-78021320170910Premenstrual Syndrome: Symptomatic and Diagnosed Prevalence, Dualistic Treatment Approach – A Cross‑Sectional Study in Ukraine18221822ENResearcher, University of Geneva, Faculty of Medicine, Institute of Global Health, GenevaResearcher, University of Geneva, Faculty of Medicine, Institute of Global Health, Geneva & University of Applied Sciences Western Switzerland, Haute Ecole de Santé, Delémont20170910Background: Diagnosing and treatment of premenstrual syndrome (PMS) still pose a challenge in the routine medical practice which usually focuses on single pharmacological therapy. Recent research suggests that the combination of treatments including complementary alternative medicine (CAM) therapies may be more benefcial. The objective of this study was to assess the percentage of diagnosed and nondiagnosed PMS/premenstrual dysphoric disorder (PMDD) based on the presence of adequate symptoms and to compare population using hormonal or pharmaceutical agents versus CAM therapies. Methods: This is a cross‑sectional study targeting sample population of 160 females of potentially reproductive age done in Ukraine between May 2014 and April 2015. Results: According to declared symptoms, 29% females versus 26% previously diagnosed by a medical professional qualify for “moderate/severe PMS,” P > 0.05. In 30% persons using pharmacological agents, major side effects, namely, nausea, insomnia, headache was caused by painkillers, contraceptives, and antidepressants. Only 37.5% of study population has been using CAM therapy methods to deal with the symptoms of PMS. Of these, 22% have achieved moderate degree in relief of the symptoms long term.Conclusions: We have concluded that when dealing with the burden of PMS/PMDD, the affected treatment‑seeking women should have choice and access to the variety of therapies within integrative medicine (both conventional and nonconventional).Keywords: Complementary alternative medicine, cross‑sectional study, premenstrual dysphoric disorder, premenstrual syndrome <br style="font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px;" />http://ijpm.mui.ac.ir/index.php/ijpm/article/view/1822http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1822/2111

International Journal of Preventive Medicine (Int J Prev Med)2008-78021320170910Comparison of Interleukin‑33 Serum Levels in Asthmatic Patients with a Control Group and Relation with the Severity of the Disease18211821ENDivision of Asthma, Allergy and Clinical Immunology, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Noncommunicable Disease, Isfahan University of Medical Sciences, Isfahan & FASA University of Medical Sciences, FASADepartment of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, MashhadDepartment of Pediatric Pulmonology, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Noncommunicable Disease, Isfahan University of Medical Sciences, IsfahanDepartment of Immunology, Gasteroenterohepatology Research Center, Shiraz University of Medical Sciences, ShirazChild Growth and Development Research Center, Research Institute for Primordial Prevention of Noncommunicable Disease, Isfahan University of Medical Sciences, IsfahanDepartment of Pediatric Pulmonology, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Noncommunicable Disease, Isfahan University of Medical Sciences, Isfahan20170910Background: The relation between interleukin‑33 (IL‑33) and asthma is not precisely known yet. The present study set to compare the serum level of IL‑33 in patients with asthma and controls and study the relation with the severity of disease. Methods: The serum level of IL‑33 and total IgE in 89 asthmatic patients and 57 controls were analyzed. The association of levels of IL‑33 with the severity of disease, levels of total IgE, measures of spirometry (forced expiratory volume in 1 s [FEV1]), age, sex, presence or absence of other allergic diseases, and the disease duration was evaluated. Results: Higher levels of IL‑33 and total IgE were detected in asthmatic patients compared with controls (P = 0.0001 and P = 0.008, respectively). In the asthmatic group, a signifcant direct association of IL‑33 with age (P = 0.02, R = 0.23) and with total IgE level (P = 0.003, R = 0.31) were observed, but there was no relationship between other variables. Comparison of mean level of IL‑33 in different asthma groups concerning the disease severity showed the statistically signifcant difference between them and a signifcant increased serum level of total IgE was observed in more severe disease. The results showed a signifcant negative correlation between FEV1 and total IgE (P = 0.028, R = -0.23) and IL‑33 level (P = 0.0001, R = -0.83). Conclusions: IL‑33 is suggested as a new inﬂammatory marker of severe and refractory asthma. Therefore, it may be a unique therapeutic target in these patients. Keywords: Asthma, interleukin‑33, severity <br style="font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px;" />http://ijpm.mui.ac.ir/index.php/ijpm/article/view/1821http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1821/2110

International Journal of Preventive Medicine (Int J Prev Med)2008-78021320170910Short-term High Dose of Quercetin and Resveratrol Alters Aging Markers in Human Kidney Cells18201820ENStudent Research Committee, Birjand University of Medical Sciences, BirjandDepartment of Anatomy, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran, 2Cardio Vascular Research Center, Birjand University of Medical Sciences, BirjandStudent Research Committee, Birjand University of Medical Sciences, BirjandStudent Research Committee, Birjand University of Medical Sciences, Birjand20170910Background: Hyperglycemia-mediated oxidative stress implicates in etiology of kidney cell aging and diabetic nephropathy. We evaluated the effects of different doses of resveratrol and quercetin and their combination therapy on aging marker in human kidney cell culture under hyperglycemia condition. Methods: Human embryonic kidney cell (HEK-293) was cultured in Dulbecco’s Modifed Eagle Medium (DMEM) containing 100 mM (18 mg/L) for 24 h. The cells were treated with resveratrol (2.5, 5, 10 µm), quercetin (3, 6, 12 µm), and combination of these (R 2.5 µm, Q 3 µm) and (R 5 µm, Q 6 µm) and (R 10 µm, Q 12 µm) for 48 h, and then, cells were lysed to access RNA and lysate. Results: The analysis of data showed that beta-galactosidase enzyme gene expression as an aging marker in all treatment groups has reduced in a dose-dependent manner. Gene expression of Sirtuin1 and thioredoxin (Trx) in all treated groups in comparison to control group increased in a dose-dependent fashion. Trx interacting protein (TXNIP) gene expression decreased in a dose-dependent manner in all treated groups, especially in resveratrol and combination therapy. Conclusions: According to the results of this research, quercetin, resveratrol, and especially combination treatments with increased expression levels of antioxidants, can reduce aging markers in HEK cell line in hyperglycemia conditions. These results lead us to use ﬂavonoids such as resveratrol for anti-aging potential.Keywords: Aging, human embryonic kidney cell-293, quercetin, resveratrol, thioredoxins <br style="font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px;" />http://ijpm.mui.ac.ir/index.php/ijpm/article/view/1820http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1820/2109

International Journal of Preventive Medicine (Int J Prev Med)2008-78021320170910Is Cost of Medication for Quit Smoking Important for Smokers, Experience of Using Champix in Iranian Smoking Cessation Program 201618191819ENTobacco Prevention and Control Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran20170910Background: Providing smoking cessation services are special importance to tobacco control programs. To date, Champix is a new expensive medication for smoking cessation available nationally. Champix has both agonist and antagonist activities and can reduce nicotine dependence and withdrawal symptoms. The purpose of this study was to evaluate the duration of using Champix based on its cost. Methods: This quasi‑experimental study was conducted with smokers presenting to the Tanaffos Smoking Cessation Clinic in Tehran, Iran 2016. Smokers were visited by a physician 3 times at 1‑week intervals for counseling. Smokers started to use Champix and stopped smoking in the 2nd week of counseling and were followed up by phone and through regular visits to the clinic at 1, 3, and 6 months postintervention. Some of them did not continue medication for 12 weeks because of its cost. Results: A total of 227 smokers including 133 males (58%) with a mean age of 43 years were enrolled of whom 116 (51.1%), 89 (43.6%), and 34 (20.6%) had quit smoking after 1, 3, and 6 months, respectively. Quit rates were signifcantly higher among those who used Champix for more than 6 weeks, and this rate was not correlated with age, sex, educational level, or nicotine dependence. Conclusions: Use of Champix for more than 6 weeks increases the quitting success rate compared with using for a shorter time. The cost of Champix was important for smokers and adding Champix to the list of insurance medication or getting it free of charge is needed.Keywords: Champix, quit, smoking <br style="font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px;" />http://ijpm.mui.ac.ir/index.php/ijpm/article/view/1819http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1819/2108

International Journal of Preventive Medicine (Int J Prev Med)2008-78021320170910Compliance of Specifc Provisions of Tobacco Control Law around Educational Institutions in Delhi, India18181818ENEIS Cell, Epidemiology Division, National Centre for Disease Control, New DelhiNational Tobacco Control Program, Directorate General Health Services, Ministry of Health and Family Welfare, New DelhiNon communicable diseases division, Regional Offce for South‑East Asia, World Health Organization, New Delhi20170910Background: Tobacco use is leading preventable cause of premature deaths. Sales of tobacco products within 100 yards of educational institutions (EIs) in India are restricted under Section 6 of Cigarettes and Other Tobacco Products Act (COTPA), 2003. This study accessed compliance of Section 6 of COTPA around EIs in Delhi. Methods: A cross‑sectional study was conducted in randomly selected 100 EIs from 6600 schools/colleges in Delhi. Activities related to Section 6 of COTPA around EIs, such as the sale of tobacco products within a radius of 100 yards, sale of tobacco products to and by minors, and existence of display boards prohibiting sale of tobacco products were observed using Global Positioning System (GPS)‑enabled tablet computers preloaded with maps and Open Data Kit software. Data analysis was done using Epi Info version 7. Results: Among the 100 EIs surveyed (53 government, 47 private), tobacco products were sold at 43 outlets within a radius of 100 yards of 27 EIs. No outlet had a display board prohibiting sale of tobacco products to minors. One outlet sold tobacco products to minors during the period of observation, but sale of tobacco products by minors was not observed. Only 38% of EIs displayed board prohibiting tobacco sales; private EIs were signifcantly less likely to display signs prohibiting tobacco sales than government EIs (45% vs. 81%; P < 0.001). Conclusions: Sale of tobacco products is common around EIs in Delhi. The use of simple technology provided quick results to policy‑makers. Similar periodic surveys should help regulatory agencies to strictly enforce provisions of COTPA.Keywords: Cigarettes and Other Tobacco Products Act, Delhi, educational institutions, tablet computers, tobacco <br style="font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px;" />http://ijpm.mui.ac.ir/index.php/ijpm/article/view/1818http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1818/2107

International Journal of Preventive Medicine (Int J Prev Med)2008-78021320170910Comparison of Melatonin and Sertraline Therapies on Tinnitus: A Randomized Clinical Trial18171817ENDepartment of Otorhinolaryngology, School of Medicine, Isfahan University of Medical SciencesDepartment of Otorhinolaryngology, School of Medicine, Isfahan University of Medical SciencesDepartment of Otorhinolaryngology, School of Medicine, Isfahan University of Medical SciencesAudiology Department, Communication Disorders Research Center, Isfahan University of Medical Sciences, Isfahan20170904Background: Tinnitus is the perception of noise or ringing without external acoustic stimulants which affects almost 10% of general population. Many therapies have been recommended including diet modifcations, herbal remedies, and chemical drugs. Most common utilized drugs for tinnitus are melatonin and antidepressants such as sertraline which have been proven in different studies. In this study, we aimed to compare the effcacy of melatonin and sertraline in treating tinnitus for the frst time. Methods: In this clinical trial, 70 patients with tinnitus according to inclusion and exclusion criteria were included and randomly divided into two groups: melatonin group, taking melatonin 3 mg once daily and sertraline group taking sertraline 50 mg once daily, all treating for 3 months. Before and after treatments, every patient received Tinnitus Handicap Inventory (THI) questionnaire and severity of tinnitus was assessed, and data analysis was performed. Results: Before treatments, the mean of THI score for melatonin and sertraline groups were 45.02 ± 17.67 and 44.85 ± 20.57, respectively. There was no signifcant difference between both groups THI score (P = 0.23). After 3 months, the mean of THI scores for melatonin and sertraline groups were 30.29 ± 19.62 and 36.96 ± 25.03, respectively which the mean of THI scores in two groups was decreased signifcantly (P < 0.01, for‑both). In addition, indicated the signifcant decline in THI score of melatonin group who were under treatments with melatonin 3 mg once daily (P = 0.02). Conclusions: Here in this clinical trial, we demonstrated that both melatonin and sertraline are effcient in treating tinnitus, but the usage of melatonin 3 mg once daily is more effective. Keywords: Melatonin, sertraline, tinnitus <br style="font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px;" />http://ijpm.mui.ac.ir/index.php/ijpm/article/view/1817http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1817/2106

International Journal of Preventive Medicine (Int J Prev Med)2008-78021320170910Issues Surrounding HIV Status Disclosure: Experiences of Seropositive Women in Lagos, Nigeria18161816ENDepartment of Community Health and Primary Care, College of Medicine, University of Lagos, PMB 12003, LagosDepartment of Community Health and Primary Care, College of Medicine, University of Lagos, PMB 12003, LagosDepartment of Community Health and Primary Care, College of Medicine, University of Lagos, PMB 12003, Lagos20170904Background: Disclosure of human immunodefciency virus (HIV) seropositivity by infected women is crucial in HIV control. To determine the rates, patterns, effects, and determinants of disclosure of status among HIV‑positive women in Lagos, Nigeria. Methods: This was a descriptive cross‑sectional study. Simple random sampling method was used to select 364 HIV‑positive women accessing care in HIV treatment centers in Lagos Island. Data were collected using interviewer‑administered questionnaires and analyzed with Epi Info (version 3.5.3). Inferential statistics done was Chi‑square test and level of statistical signifcance was set at <5%. Results: Mean age of respondents was 37.3 ± 3 years, and most were married or cohabiting in monogamous families. The disclosure rates were 81.9% to anyone (excluding a health care professional); 60.4% to spouse/sexual partners; and 67.7% disclosed on the same day of diagnosis. Main reasons for disclosure were failing health (49.3%) and a sense of responsibility to the spouse/sexual partner (33.6%). Major reasons for nondisclosure were negative public opinion (84.8%) and fear of losing relationships (40.3%). Positive reactions following disclosure were mostly acceptance: 75.2% (family member) and 72.3% (spouse/sexual partner) while blame was the main negative outcome. Longer duration of diagnosis signifcantly improved disclosure to anyone (P < 0.001). Older age (P < 0.001) and awareness of spouse/sexual partner’s HIV status (P < 0.001) signifcantly improved disclosure to spouse/sexual partner. Conclusions: Many respondents had not disclosed their status and require support and counseling to do so. Community education regarding stigmatization should be intensifed. Keywords: Human immunodefciency virus disclosure, human immunodefciency virus stigmatization, infectious disease control, Nigeria <br style="font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px;" />http://ijpm.mui.ac.ir/index.php/ijpm/article/view/1816http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1816/2105

International Journal of Preventive Medicine (Int J Prev Med)2008-78021320170827Protective Effect of Two Extracts of Cydonia oblonga Miller (Quince) Fruits on Gastric Ulcer Induced by Indomethacin in Rats18141814ENDepartment of Pharmacology and Toxciology, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, IsfahanDepartment of Pharmacognosy, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, IsfahanDepartment of Pharmacology, Isfahan Pharmaceutical Sciences Research Center, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan20170827Background: In various studies, Cydonia oblonga Miller (quince) has been reported to have many properties such as antioxidant and anti‑ulcerative effects. This study has aimed to investigate the protective effects of quince aqueous extract (QAE) and quince hydroalcoholic extract (QHE) on gastric ulcer caused by indomethacin and the relevant macroscopic, histopathology, and biochemical factors in rats.Methods: Ten groups of male Wistar rats, six in each, were used in this study. These groups included: normal (distilled water), control (distilled water + indomethacin), reference (ranitidine or sucralfate + indomethacin), and test groups (QAE or QHE + indomethacin) treated with three increasing doses (200, 500, and 800 mg/kg). Extracts and drugs were given orally to rats 1 h before injecting the indomethacin (25 mg/kg, intraperitoneally). Six hours later, the abdomen of rats was exposed, its pylorus was legated, gastric acid content was extracted, and its pH and the amount of pepsin secreted were measured by Anson method. Then, histopathology indices, ulcer area, ulcer index, and myeloperoxidase (MPO) activity were measured in gastric mucus.Results: Both extracts of quince were effective to reduce the acidity of stomach and pepsin activity. Compared to control group, the average of enzyme activity of MPO was significantly declined in all treated groups. Control group had the highest level of gastric ulcer indices including severity, area, and index while the evaluated parameters had decreased in all extract treated groups although it seems that QAE was somewhat more effective.Conclusions: Protective effect of QAE and QHE on gastric ulcer was done by undermining offensive factors including decreasing the secretion of gastric acid and pepsin activity and by strengthening the protective factors of gastric mucus including antioxidant capacity.Keywords: Gastric ulcer, indomethacin, quince extract, ratshttp://ijpm.mui.ac.ir/index.php/ijpm/article/view/1814http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1814/2103

International Journal of Preventive Medicine (Int J Prev Med)2008-78021320170827Construct and Criterion Validity of the PedsQL™ 4.0 Instrument (Pediatric Quality of Life Inventory) in Colombia18131813ENClinical Research Institute, School of Medicine, Universidad Nacional de Colombia, BogotáClinical Research Institute, School of Medicine, Universidad Nacional de Colombia, Bogotá20170827Background: This study aimed at determining the validity of the Pediatric Quality of Life Inventory 4.0 (PedsQL™ 4.0) for the measurement of health‑related quality of life (HRQOL) in Colombian children.Methods: Validation study of measurement instruments. The PedsQLTM 4.0 was applied by convenience sampling to 375 pairs of children and adolescents between the ages of 5 and 17 and to their parents‑caregivers, as well as to 125 parents‑caregivers of children between the ages of 2 and 4 in five cities of Colombia (Bogota, Medellin, Cali, Barranquilla and Bucaramanga). Construct validity was assessed through the use of exploratory and confirmatory factor analysis, and criterion validity was assessed by correlations between the PedsQL™ 4.0 and the KIDSCREEN‑27.Results: The instrument was applied to 375 children (ages 5–18) and 125 parents of children between the ages of 2 and 4. Factor analysis revealed four factors considered suitable for the sample in both the child and parent reports, whereas Bartlett’s test of sphericity showed inter‑correlation between variables. Scale and subscales showed proper indicators of internal consistency. It is recommended not to include or review some of the items in the Colombian version of the scale.Conclusions: The Spanish version for Colombia of the PedsQL™ 4.0 displays suitable indicators of criterion and construct validity, therefore becoming a valuable tool for measuring HRQOL in children in our country. Some modifications are recommended for the Colombian version of the scale.Keywords: Child, outcome assessment (health care), PedsQL™4.0, psychiatric status rating scales, quality of life, validation studieshttp://ijpm.mui.ac.ir/index.php/ijpm/article/view/1813http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1813/2102

International Journal of Preventive Medicine (Int J Prev Med)2008-78021320170809The Effects of Aerobic Exercises and 25(OH) D Supplementation on GLP1 and DPP4 Level in Type II Diabetic Patients18121812ENDepartment of Exercise Physiology, Physical Education and Sport Sciences Faculty, Hamedan University, HamedanDepartment of Exercise Physiology, Physical Education and Sport Sciences Faculty, Hamedan University, HamedanDepartment of Endocrine and Metabolism, Medicine Faculty, Isfahan University of Medical Sciences, IsfahanDepartment of Exercise Physiology, Physical Education and Sport Sciences Faculty, Hamedan University, Hamedan20170809Background: The purpose of this study was to investigate the effects of an 8‑week aerobic exercise and supplementation of 25(OH)D3 on GLP1 and DDP4 levels in men with type II diabetes. Methods: In this semiexperimental research, among 40–60‑year‑old men with type II diabetes who were referred to the diabetic center of Isabn‑E Maryam hospital in Isfahan; of whom, 48 patients were voluntarily accepted and then were randomly divided into 4 groups: aerobic exercise group, aerobic exercise with 25(OH) D supplement group, 25(OH) D supplement group, and the control group. An aerobic exercise program was conducted for 8 weeks (3 sessions/week, each session 60 to75 min with 60–80% HRmax). The supplement user group received 50,000 units of oral Vitamin D once weekly for 8 weeks. The GLP1, DPP4, and 25(OH) D levels were measured before and after the intervention. At last, the data were statistically analyzed using the ANCOVA and post hoc test of least signifcant difference. Results: The results of ANCOVA showed a signifcant difference between the GLP1 and DPP4 levels in aerobic exercise with control group while these changes were not statistically signifcant between the 25(OH) D supplement group with control group (P < 0.05).Conclusions: Aerobic exercises have resulted an increase in GLP1 level and a decrease in DPP4 level. However, consumption of Vitamin D supplement alone did not cause any changes in GLP1and DPP4 levels but led to an increase in 25‑hydroxy Vitamin D level.Keywords: Aerobic exercises, insulin resistance, mellitus diabetes, Vitamin D <br style="font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px;" />http://ijpm.mui.ac.ir/index.php/ijpm/article/view/1812http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1812/2101