Medical Journal of Mashhad university of Medical Sciences

Abstract Introduction:Chronically toxic cadmium, in addition to affecting the immune system and inflammatory markers, can affect the transmission pathway and development of pain tolerance. In contrast, exercise and pollen protect the immune, inflammatory, and nervous systems. The aim of the present study was to investigate the interactive effect of high-intensity interval training and pollen consumption on some inflammatory factors and pain tolerance threshold in the hippocampus of rats exposed to cadmium.
Material& Methods:In this experimental study, 25 male rats were randomly divided into 5 groups: healthy control, cadmium, pollen, high-intensity interval training, and pollen-high-intensity interval training. They performed high-intensity interval training for8 weeks, 3days a week. They simultaneously consumed cadmium chloride(40 mg/kg/w/d) and pollen(200 mg dissolved in 2.4cc of normal saline)daily. Pain threshold was measured by hot plate test and interleukin-1 beta and tumor necrosis factor-alpha were measured by ELISA.Two-way analysis of variance, an independent t-test at a significance level of P0.05).The interaction effect of training and pollen was not significant for IL-1β (p=0.227) and TNF-α (p=0.846).The main effect of training(p=0.067) and the interaction effect of training and pollen for the tolerance threshold did not show a significant increase (p=0.095), but the main effect of pollen was significant (p=0.001).
Conclusion:High-intensity interval training combined with bee pollen consumption was unable to improve inflammatory factors and pain threshold in rats exposed to cadmium. However,bee pollen may be able to increase pain tolerance.

Abstract Drug addiction is a health problem that can have a wide range of effects on various aspects of a person's health. Methadone and buprenorphine are commonly used as treatments in this field, but the effects of these drugs on sexual function and hormone levels are still under debate and research. This study examines the differences in the effects of these two drugs on sexual function and testosterone levels in men. In this study, relevant studies from relevant databases were reviewed. The results showed that methadone use significantly reduced testosterone levels and caused sexual problems such as decreased libido, erectile dysfunction, and orgasm quality. In contrast, buprenorphine had fewer effects on sexual function and testosterone levels. However, long-term use of both drugs can cause problems in this area, but the severity of these problems is less severe in buprenorphine than in methadone. While both drugs can cause sexual problems, the severity of these problems is greater in methadone users than in buprenorphine users.

Abstract The objective of the present study was the structural model of cognitive Functioning based on quality of life and psychological distress with the mediating role of the family's expressed emotion in people with schizophrenia. The research is applicative and the research method was correlational through structural equations modeling. The statistical population of the study included people suffering from schizophrenia who referred to Shafa and Parham rehabilitation centers in Isfahan in the spring of 2023. 240 people with schizophrenia were selected from the statistical population as the available sampling. The research instruments were Quality of Life Questionnaire, Cognitive Performance Evaluation Questionnaire and Expressed Emotion Questionnaire. The results showed that quality of life has a significant direct effect on cognitive Functioning (p < 0.05, β = 0.512) and family's expressed emotion (p <0.05, β = 0.566) of people with schizophrenia and it was able to explain 26.2 and 32 percent of the variance of these variables, respectively. Also, family's expressed emotion had a significant direct effect on cognitive Functioning (p<0.05, β =-0.457) of people with schizophrenia and was able to explain 20.9% of the variance of this variable. Meanwhile, family's expressed emotion has a significant mediating role in the relationship between quality of life with cognitive Functioning in people with schizophrenia (p<0.05). Considering the significant mediating role of family's expressed emotion, it is possible to improve the executive function of people with schizophrenia by using effective interventions such as emotional management and regulation training that lead to improvement of family members' interactions.

Abstract Background and Objective: Educational and therapeutic packages based on Islamic mysticism can facilitate the empowerment of counselors and the promotion of clients' mental health as a native and complementary approach. The present study aimed to validate an educational and therapeutic package based on Islamic mysticism for psychologists and counselors.
Methods: This study is the second phase of larger research that was conducted after the package was designed in the qualitative phase. For validation, 20 experts including mystics, Islamic psychologists, counselors, and doctoral students in psychology were used. The content validity of the package was measured with CVI and CVR indices. Also, a single-group t-test was used to evaluate the significance of the indices, the inter-rater agreement coefficient using Kendall was 0.86, and the reliability of the instrument was examined with Cronbach's alpha of 0.97.
Results: The results showed that all sessions of the educational package had acceptable content validity (CVI ≥ 0.79) in terms of relevance to the goals of psychology and psychotherapy. The single-group t-test also showed that the average expert scores of the judges for each session were significantly higher than the standard (p < 0.01). The Kendall coefficient of agreement and Cronbach's alpha coefficient indicate high stability and reliability of the educational package.
Conclusion: The findings show that the designed educational therapy package is reliable in terms of content, application, and science for use by counselors and can be used as an effective tool in counseling and psychotherapy centers.

Abstract The main aim of this study is to examine the elderly in terms of some psychological phenomena and help them live better in this period of life. The method was based on descriptions of a non-experimental causal-comparative method. The statistical population consisted of elderly men and women over 65 years of age living in Khorramabad city in 1401. Based on systematic random sampling, given the availability of their names in the Sib system of Lorestan University of Medical Sciences, 200 elderly people were systematically selected from the list of characteristics over a period of nearly two months and, after determining a specific time to administer the tool, they responded in person to the perceived social support and death anxiety questionnaires. The results of multivariate analysis of variance indicate that a difference in social support and death anxiety was observed in the gender variable.The comparison shows that men tend to have social support and elderly men show higher scores in terms of death anxiety. Also, there was a difference between them in terms of marital status. Their comparison showed that elderly people who have a spouse tend to have more of this support. Regarding the interaction of the three variables of gender, marriage, and social class, evidence for death anxiety indicates the existence of an interaction between these three variables, while no interaction was observed for the variable of perceived social support.

Abstract Prostate cancer is considered one of the major challenges in cancer physiology due to disruption in the balance between cell survival and cell death. Exercise training may act as a non-pharmacological intervention capable of influencing the molecular pathways involved in this process. The aim of the present study was to compare the effects of continuous aerobic training and interval aerobic training on the molecular pathways of apoptosis in the prostate tissue of Wistar rats with prostate cancer. In this experimental study, 50 male Wistar rats were randomly assigned to five groups of 10 animals each: healthy control, sham, cancer without training, cancer + continuous aerobic training, and cancer + interval aerobic training. Following the induction of prostate cancer, the training groups performed treadmill exercise for 8 weeks, 5 sessions per week. Continuous aerobic training was performed at approximately 60% of maximal capacity, whereas interval aerobic training consisted of high-intensity bouts at 85–90% of maximal capacity interspersed with active recovery at 50–60%. At the end of the intervention, the expression levels of p53, Caspase-3, Bax, Bcl-2, and NF-κB genes in prostate tissue were assessed using real-time PCR, and the Bax/Bcl-2 ratio was calculated. Data were analyzed using MANOVA, one-way ANOVA, and Tukey’s post hoc test in SPSS version 27. The findings showed that prostate cancer decreased p53, Caspase-3, and the Bax/Bcl-2 ratio, while increasing NF-κB expression. Both types of aerobic training moderated these alterations;

Abstract Introduction: The long-term success of dental implants depends on the process of osseointegration. The application of stem cells as a novel tissue engineering approach has demonstrated considerable potential for accelerating and enhancing this process. This systematic review aimed to evaluate the existing evidence regarding the effectiveness of stem cells in promoting peri-implant osseointegration.
Methods: A systematic search was conducted in the PubMed, Scopus, and Cochrane Central databases up to 2026. Interventional studies (including in vivo studies and clinical trials) investigating the effects of different types of stem cells on peri-implant bone formation and bone density were included. The methodological quality of the included studies was assessed using the Cochrane Risk of Bias tool and the SYRCLE Risk of Bias tool.
Results: Among the identified records, 15 studies met the eligibility criteria. The findings indicated that the use of bone marrow-derived mesenchymal stem cells (BMSCs) and dental pulp stem cells (DPSCs), particularly when combined with biological scaffolds, significantly increased the bone-to-implant contact (BIC) compared with the control groups and reduced the time required before implant loading.
Conclusion: Stem cell-based therapies appear to be an effective strategy for accelerating peri-implant osseointegration. However, due to the heterogeneity of cell isolation and transplantation protocols, further large-scale, standardized human clinical trials are required to confirm their clinical efficacy and safety.

Abstract Introduction: Chronic sinusitis is one of the most common causes of referring to physician and creates longterm discomfort for people. The common bacterial organisms include: Streptococcus pneumonia, Hemophillous influenza, Moraxella catarrhalis, Staphylococcus aurous, biofilm and superantigen produced by some of these bacteria should be considered.
This study aimed to compare the efficacy of Doxycycline, Azithromycin and Clarithromycin in the treatment of chronic bacterial rhinosinusitis. 
Materials and Methods: In this clinical trial, 55 patients with a mean age of 36 years with chronic bacterial rhinosinusitis who were documented clinically and by imaging (CT Scan), were treated in three groups with Doxycycline (100mg BD), Azithromycin (8mg/kg BD), and Clarithromycin (500mg BD). The patients were followed by clinical signs, symptoms and imaging. Data were analyzed by SPSS software and Chi Square, Anova and T test. 
Results: At the end of treatment, Doxycycline’s treatment success rate was higher than Azithromycin and Clarithromycin (the clinical cure rates respectively were 73 % versus 57% and 40%, and CT Scan cure rate results respectively were 70% versus 33% and 25%).
Conclusion: The results of present study indicated that the Doxycycline in the treatment of chronic bacterial rhinosinusitis was more effective than Azithromycin and Clarithromycin in clinical response and improved CT Scan results.
Acknowledgment: Thanks to Mr. Bahrami for data analysis, Mr.Einollah Alipur, Ms. Darwish to collect samples , the University of Medical Sciences and the  staff of CT Scan ,Shahid Rajaee &Emam Sajjad Hospital  clinics of Ramsar for the necessary cooperation in this research project.

Abstract Introduction:Helicobacter pylori has infected almost half of people around the world . The annual incidence of helicobacter pylori infection is 4-15% and 0.5% in developing and developed countriesrespectively. The aim of this study was to review antibiotic resistance of this organism in Iran and other parts of the world.
Method: In this study Pubmed, (SID),ISI, Embase, Google scholar and Scopus databases were searched. In this study 20 Iranian, 8 Asian, 3African, 2 American and 17 European articles have been selected and reviewed. Studies had been selected in the period 1994 -2014.
Results:Iranian studies reported very high resistance against metronidazole (57. 4%), which is roughly consistent with the results of other Asian countries (46. 6%). The average resistance was lower in Iranian in comparison with African countries (97. 55%). The mean ciprofloxacin resistance was 18% in Iran; it was 13. 2% in France and 39. 47% in Italy.
Discussion:The average antibiotic resistance is higher in Iran than developed countries . According to the available statistics various antibiotic resistance tests are necessary for better treatment strategy selection. 

Abstract Introduction: The most common cause of short  delayed arousal is due to “overdose of a sedative-hypnotic” medication after general anesthesia and it is not of clinical importace. However,  long term delayed arousal is due to several important conditions that can confuse anesthesiologists.. Case report:  The  patient was a 28 years old woman with mucormycosis, candidate  for  sinuses drainage by endoscopic intervention .One months before surgery,  while she was in 18-19 weeks of  gestational age, she suddenly felt dyspnea and fatigue.In  further investigations,  severe anemia was diagnosed and in bone marrow biopsy AML-M5 was detected. Physicians decided to end her pregnancy by D&C. After one week of chemotherapy with Cytosar(Cytarabine) and Idarubicin,  pneumonia and sepsis occured. Therapy with Vancomycin and Amphotericin B and Imipenem leads to epistaxis and rhinorrhea. CT Scan of sinuses demonstrated mucormycosis. She was alert and awake before general anesthesia with Fentanyl and Cisatracurium and Propofol for induction and maintenance.  At the end of operation she could not be awake .Her delayed arousal had been continued for one day ,then awakened spontaneously and discharged from hospital. Conclusion: Several factors such as chemotherapy drugs(affects on liver and brain),length of operation, imbalance in levels of electrolytes and low proteins due to malnutrition caused by cancers are the possible causes of the condition. Use of BIS  maybe a good offer to decrease anesthetic drug doses during general anesthesia.

Abstract Background and Purpose: Obesity is a major health problem and its prevalence in the world is increasing. Based on studies the diseases caused by adipocytokine production and secretion from adipose tissue are associated with obesity. Some studies have showns the speed up in fat loss due to the effects of chromium supplementation on insulin regulation. Therefore this study investigated effects of chromium picolinate supplementation combined with 30 minutes of aerobic exercise on weight, body mass index (BMI), waist circumference of overweight and obese individuals.
Methods: This clinical trial involved 100 volunteers,20-50 years old with a body mass index above 25 kg/m²; Participants were randomly divided into two groups: intervention and non-intervention. The intervention group received gμ200 of chromium picolinate daily and 30 minutes of aerobic exercise for 3 months but non-intervention group had only 30 minutes of aerobic exercise. Height, weight and waist circumference were measured before and after intervention.
Results: Weight, BMI and waist circumference were reduced in both groups significantly. But the changes in weight (p˂0.001), BMI (p˂0.001) and waist circumference (p˂0.001) in intervention group were significantly more than non-intervention group.
Conclusions: In the present study it was shown that chromium picolinate supplementation combined with 30 minutes of aerobic exercise decreases weight, BMI and waist circumference in overweight and obesity significantly.

Abstract Introduction
This study aimed to investigate the effect of organizational bullying on turnover intention with the mediating role of burnout and moderating role of Compulsory citizenship behavior.
Material and Method
this is Quantitative research and applied descriptive-survey study in which the statistical population includes 1132 registered and contract registered nurses of ImamReza Hospital in Mashhad. Cochran's formula was used to determine the sample size, based on this, 287 of them were selected as statistical sample with the random sampling method. To collect data, the Inarsen et al.'s (2009) organizational bullying questionnaire, Memon et al.'s turnover intention (2014), Copenhagen burnout (2005), and Vigoda-gadot (2007) Compulsory citizenship behavior questionnaires and For analyzing them, Structural equation modeling with partial least squares approach and smart-PLS software were used.
Results
Data analysis using structural equation modeling showed that the direct effect of organizational bullying on turnover intention is 0.524 and significant (p<0.05). The direct effect of organizational bullying on burnout is 0.752 and significant (p<0.05). The direct effect of burnout on organizational bullying is 0.492 and significant (p<0.05). Also, burnout mediates the relationship between organizational bullying and turnover intention (t=3.863 and β =0.371).In addition, Compulsory citizenship behavior moderates the relationship between organizational bullying and turnover intention.
Conclusion
The result of this research showed that burnout plays a mediating role in the relationship between organizational bullying and nurses' turnover intention. Based on this, it is suggested to through identifying the causes of nurses' burnout and reducing it's occurrence, The rate of their turnover intention should also be reduced. This result can also be achieved by reducing Compulsory citizenship behavior in nurses.

Abstract Introduction: Given the high prevalence of chronic diseases, complementary treatments can be one of the ways to decrease the prevalence of these diseases. It has been shown that honey consumption can have beneficial effects on cardiovascular disease risk factors. The current study aimed to investigate the effect of honey intake compared with sucrose on blood pressure and fasting blood glucose among young healthy subjects.
Subjects & Methods: There were 60 healthy subjects, aged 18 to 30 years that were enrolled in this double blind randomized trial for one month. Participants were assigned randomly into two groups: honey (received 70 gram honey per day) and sucrose (received 70 gram sucrose per day). We measured Systolic and diastolic blood pressure and collected fasting blood glucose from all subjects in the beginning and end of study.
Results: In the present study, there was no difference on the baseline FBS, SBP and DBP between the two groups (P > 0.3). Results showed that honey intake can decrease the FBS in healthy young individuals, but sucrose consumption increased it. In addition, The effect of sucrose on FBS was move significant than honey (P < 0.001). Intake of sucrose and honey cannot significantly decrease the SBP and DBP. Confounding variables including age, physical activity and some nutrient intakes were adjusted in all analyses.
Conclusion: It is our conclusion that honey consumption decreases the FBS, but has no significant effect on SBP and DBP. Further studies are required to confirm these findings.

Abstract Introduction : Surgery is an option for multinodular goiter (MNG), but extension of surgery is controversial due to risk of recurrence and post operative complications. So, we decided to compare these problems between subtotal (ST) and total (TT) thyroidectomy  as surgical  treatment of MNG.
Materials & Methods: This cross-sectional retrospective study was done between  2011-2012 .  104 patients with  benign MNG ( 52 in TT and 52 in ST groups) that operated before  year 2006 in Imam Reza Educational Hospital ,were enrolled. Rate of recurrence and surgical complications compared between two groups. P < 0.05 considered significant.
Results : Mean age of patients was 45.3 years .Mean duration of  Follow up was  74 months . 8 patients in ST group( 15.4 %)  and no patient in TT group had recurrence of goiter . ( p< 0.05) . There was no significant differences in transient and permanent hypoparathyroidism , transient and permanent recurrent laryngeal  nerve palsy , mortality ,hematoma,wound infection and hospital stay duration between two groups.
Conclution : Total thyroidectomy as procedure of choice for multinodular goiter is recommended in Educational Hospitals with experienced surgens.