https://mjms.mums.ac.ir/ Medical Journal of Mashhad university of Medical Sciences en daily 1 Thu, 23 Jul 2026 00:00:00 +0330 Thu, 23 Jul 2026 00:00:00 +0330 https://mjms.mums.ac.ir/article_27946.html Introduction: With the increasing complexity of occupations in academic centers, the importance of employee training has grown substantially. Given the service-oriented nature of health systems and their strong dependence on human resources, in-service training is a key lever for developing knowledge, awareness, and workforce capacity. This study aimed at designing and validated a skill-based in-service training model for employees of medical universities.Material and Methods:A mixed-methods design was employed. In the qualitative phase, content analysis was conducted using in-depth semi-structured interviews with 12 purposively selected experts and managers in curriculum planning, instructional design, education, and human resources (snowball sampling). In the quantitative phase, a field study using structural equation modeling was performed. The statistical population included 805 headquarters employees of Mashhad University of Medical Sciences across eight vice-chancellorships; based on the Morgan table, 263 participants were selected through non-probability convenience sampling.Results: A total of 11 categories and 36 components were identified, including objectives, needs assessment, content, educational materials and resources, training methods, strategies, implementation, evaluation, levels of training evaluation, and outcomes of skill-based training. The extracted components provide a comprehensive framework for designing, implementing, and evaluating skill-based training programs and may support improvements in training effectiveness and efficiency.Conclusion:The proposed model offers a comprehensive and context-based framework for enhancing in-service training in the health system. Its implementation, with an emphasis on a skill-based approach, can improve educational system performance, develop job-related competencies, and enhance service quality in medical universities, and may serve as a strategic model for similar organizations. https://mjms.mums.ac.ir/article_26220.html Introduction: This systematic review and meta-analysis aimed to investigate the effects of exercise training on flow-mediated dilation (FMD) in overweight and obese children and adolescents Materials and Methods. Methods: A comprehensive search was conducted in three electronic databases including Scopus, PubMed, and Web of Science until April 2023 using keywords such as "exercise training", "endothelial function", "children and adolescents", and "obesity". Weighted mean difference (WMD) and 95% confidence intervals (95% CIs) were calculated using a random effects model to compare exercise training with the control group. Also, subgroup analysis was performed based on the duration of exercise intervention and the age of the subjects (age up to 10 years and age 10 to 18 years).Results. A total of 379 overweight and obese children and adolescents from 9 studies were included in the meta-analysis. Exercise training significantly increased FMD compared to control [WMD: 1.36 (CI: 0.12 to 2.61), P=0.03], but had no significant effect on body weight [WMD: -0.54 (CI: -0.56 to -1.64), P=0.33]. Subgroup analysis by intervention duration showed that short-term interventions had a significant positive effect on FMD [WMD: 1.51 (CI: 0.17 to 2.84), P=0.02], while subgroup analysis by age showed no significant difference.Conclusion. The results of the present study confirm that exercise can improve vascular function in overweight and obese children and adolescents without the need for weight loss and is effective as a non-pharmacological strategy in preventing cardiovascular diseases. https://mjms.mums.ac.ir/article_27948.html Introduction: Depression and sexual disorders are common problems in postmenopausal women.This study aimed to compare the effects of 12 weeks of moderate-intensity endurance training, Aphrodit supplement, and their combination on depression, sexual function, and the expression of NRF-1, SIRT1, and NGF genes in postmenopausal women.Methods: In this randomized, semi-experimental, single-blind clinical trial, 100 sedentary postmenopausal women (aged 50–60 years) were divided into four groups of 25: control, aerobic exercise, Aphrodit supplement, and combined intervention. The intervention lasted 12 weeks, involving aerobic exercise (three days per week) and daily consumption of two Aphrodit capsules. Data were collected using the Beck Depression Inventory and Sabiston Sexual Functioning Questionnaire, as well as biochemical measurements, at pre-test and post-test stages. Data were analyzed using Analysis of Covariance (ANCOVA) and paired t-tests in SPSS version 24 (P≤0.05).Results: The combined intervention had a significant effect on reducing depression (P<0.001) and improving sexual function (P<0.001). Mean weight (P=0.001) and body fat percentage (P=0.022) showed significant reductions in the combined group. Furthermore, the expression of NRF-1, SIRT1, and NGF genes, as well as serum levels of dopamine and norepinephrine, increased significantly in the combined group (P<0.001).Conclusion: The combination of aerobic exercise and Aphrodit supplement, by increasing the expression of SIRT1, NGF, and NRF-1 genes and improving neurotransmitter balance, can be an effective non-pharmacological strategy for improving mental health and biochemical indices in postmenopausal women. https://mjms.mums.ac.ir/article_26436.html 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 P<0.05 was used for data analysis.Results:The main effect of high-intensity interval training and pollen was not significant for inflammatory factors (p>0.05).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. https://mjms.mums.ac.ir/article_27951.html Introduction: Students' health behavior is of great importance, as it has a direct impact on their physical and mental health, academic performance, and social interactions. The main objective of the present study is to develop a model of the relationship between health behaviors and students' personality characteristics, with the mediating role of physical activity among female high school students in Tehran.   Methods: The present study is a descriptive survey research based on its purpose, application and data collection, which was conducted in a field manner. The statistical population of this study is all female high school students (about 6 million people) in the academic year 1402-1403. This research is an applied field study with the correlation method and structural equation modeling (PLS-SEM) which was conducted with a cluster sampling of 345 students and the data were analyzed with descriptive statistics (mean, standard deviation) and inferential statistics including confirmatory factor analysis and path analysis in SPSS and SmartPLS software. Results: Health behaviors have a negative and significant effect on the consequences of personality traits (P < 0.05). The results of the study showed that health behaviors have a positive and significant effect on physical activity (P < 0.05). Conclusion: Physical activity has a mediating role, the increase of which increases the intensity of the relationship between health behaviors and the consequences of personality traits. https://mjms.mums.ac.ir/article_27953.html هدف این پژوهش پیش‌بینی گرایش به خودکشی بر اساس حساسیت به طرد و خودسرزنش‌گری با نقش میانجی پذیرش خود در نوجوانان دختر انجام شد.روش: پژوهش از نوع توصیفی ـ همبستگی و با رویکرد تحلیل مسیر بود. جامعه آماری شامل دانش‌آموزان دختر ۱۳ تا ۱۸ ساله متوسطه اول و دوم مناطق ۲، ۷ و ۹ شهر تهران در سال تحصیلی ۱۴۰۳-۱۴۰۴ بود. نمونه‌ای به حجم ۲۲۵ نفر با روش نمونه‌گیری خوشه‌ای چندمرحله‌ای انتخاب شد. ابزارها شامل پرسشنامه‌های حساسیت به طرد داونی و فلدمن (1996)، مقیاس سطوح خودانتقادی تامپسون و زوروف (2004)، پرسشنامه پذیرش بی‌قیدوشرط خود چمبرلین و هاگا (2001) و مقیاس احتمال خودکشی کال و گیل (1982) بود. داده‌ها با روش مدل‌سازی معادلات ساختاری (SEM) به شیوه تحلیل مسیر و برآورد پارامترها به روش بیشینه درستنمایی در نرم‌افزار AMOS تحلیل شد.یافته‌ها: شاخص‌های برازش مدل ساختاری اصلاح‌شده، همگی در دامنه قابل‌قبول قرار داشتند. بین حساسیت به طرد (305/0=β) و خودسرزنش‌گری (330/0=β) با گرایش به خودکشی، بین حساسیت به طرد (226/0-=β) و خودسرزنش‌گری (345/0-=β) با پذیرش خود، و بین پذیرش خود و گرایش به خودکشی (274/0-=β) رابطه معناداری مشاهده شد. همچنین بین حساسیت به طرد نوجوانان دختر و گرایش به خودکشی با نقش میانجی پذیرش خود (062/0=β)، و بین خودسرزنش‌گری نوجوانان دختر و گرایش به خودکشی با نقش میانجی پذیرش خود (094/0=β) ، رابطه برقرار بود.بحث و نتیجه‌گیری: نتایج آزمون فرضیه‌ها نشان داد که مدل پیش‌بینی گرایش به خودکشی بر اساس حساسیت به طرد و خودسرزنش‌گری با نقش میانجی پذیرش خود در نوجوانان دختر با داده‌های تجربی برازش مطلوبی دارد. https://mjms.mums.ac.ir/article_26216.html 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. https://mjms.mums.ac.ir/article_27995.html Objective: Sleep disturbances and reduced marital satisfaction are significant and common challenges among women suffering from postpartum depression, profoundly affecting their mental health and quality of life. This study aimed to compare the effectiveness of two psychological interventions—emotion-focused schema therapy and Fortinberry & Murry’s seven-step therapy—on sleep disorders and marital satisfaction in this population.Method: This was a randomized clinical trial with pre-test, post-test, and follow-up design. The study population included women diagnosed with postpartum depression; 60 participants were randomly assigned into two groups receiving either emotion-focused schema therapy or seven-step therapy. Interventions were delivered over a series of structured sessions. Data were collected using standardized questionnaires including the Pittsburgh Sleep Quality Index (PSQI) and a marital satisfaction scale. Data analysis employed repeated measures ANOVA.Results: Findings showed that both therapies significantly improved sleep quality and increased marital satisfaction in women with postpartum depression (p < 0.01). However, emotion-focused schema therapy demonstrated more enduring effects on marital satisfaction compared to the seven-step therapy, while no significant differences between groups were observed in sleep quality at follow-up.Conclusion: The present study highlights that both emotion-focused schema therapy and Fortinberry & Murry’s seven-step therapy effectively alleviate sleep disturbances and improve marital satisfaction in postpartum depressed women. Combining these approaches and tailoring interventions may optimize therapeutic outcomes. Integrative psychological interventions alongside family-centered support are recommended in postpartum care protocols. https://mjms.mums.ac.ir/article_26533.html Malaria is one of the oldest parasitic diseases in Iran. Among malaria vector mosquitoes, Anopheles stephensi is a major human malaria vector across the Middle East and South Asia, including the Indian subcontinent and Pakistan, extending westward through Iran and Iraq to the Middle East and Arabian Peninsula. Recently, this species has spread to parts of Africa, raising concerns about increased malaria transmission in new areas. Anopheles stephensi exists as intermediate, type, and mysorensis biotypes. This study aimed to evaluate the biological parameters of Anopheles stephensi biotype mysorensis in water from Chah-Nimeh reservoirs (Sistan and Baluchistan), Karun River (Khuzestan), Aliabad Waterfall (Golestan), and Minab River (Hormozgan) at the National Insectarium of Iran, Pasteur Institute.Mosquitoes were reared under controlled conditions (27±2°C, 75±5% relative humidity, 12:12 light-dark cycle). Key life table parameters—finite population growth rate, mean generation time, net reproduction rate, eggs laid, mortality rates, sex ratio, and egg hatching rates—were analyzed. Results showed that the mysorensis biotype exhibited the highest values of R, λ, R0, and T in eastern and southern waters of Iran, with greater adaptation to eastern water quality. Generation time ranged from 14.64 to 17.01 days. The highest net reproduction rate (R0) was observed in eastern (104) and southern (102.44) regions.Female adult survival rates in southern, northern, eastern, and western waters were 0.39, 0.38, 0.41, and 0.33, respectively, while male survival rates were 0.25, 0.25, 0.27, and 0.2. Overall, Anopheles stephensi biotype mysorensis showed the highest adaptability to eastern Iran’s water compared to other regions. https://mjms.mums.ac.ir/article_26556.html Introduction: The aim of this study was to investigate the effect of 12 weeks of endurance training with sumac intake on the serum levels of SIR3, SIR4 and AMPK in Alzheimer's male rats.Methods: In this experimental study, 35 Wistar rats aged 8-10 weeks and average weight of 230±30 grams were randomly divided into five groups: control, Alzheimer's disease, Alzheimer's disease with sumac supplementation, Alzheimer's disease with endurance training, and Alzheimer's disease with They were divided by endurance training and receiving sumac supplements. To induce Alzheimer's disease, 8 mg/kg of trimethyl tin chloride along with 200 microliters of normal saline were injected into mice. Endurance training was done for 12 weeks and 5 days a week and blood samples were taken. Serum levels of SIR3, SIR4 and AMPK were evaluated by ELISA method. The data were analyzed by one-way ANOVA method along with Tukey's post hoc test at a significance level of P<0.05.Results: The results of this research showed that 12 weeks of endurance training increased the levels of SIR3 (P<0.002), SIR4 (P<0.001) and AMPK (P<0.031) compared to the Alzheimer group. In addition, adding sumac to the endurance training program had a significant effect on SIR3 (P<0.001), SIR4 (P<0.001) and AMPK (P<0.0001).Conclusion: Our results suggest that endurance training is associated with improving the levels of sirtuin 3, sirtuin 4 and adenosine monophosphate kinase in Alzheimer's rats, and receiving sumac antioxidant compound leads to doubling of these responses. https://mjms.mums.ac.ir/article_26896.html 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. https://mjms.mums.ac.ir/article_27985.html AbstractAIDS in adolescents presents a significant health challenge that necessitates awareness, early diagnosis, and appropriate treatment. By recognizing the symptoms and conducting the necessary tests, the progression of the disease can be halted, and the quality of life for affected adolescents can be enhanced. This case report examines an instance of AIDS in an adolescent. A 17-year-old male patient, with no prior history of underlying health issues, was admitted to the hospital following a hunger strike, which resulted in severe weight loss, anorexia nervosa, bloody diarrhea, and vomiting. The patient received medical nutrition therapy and underwent endo-colonoscopy, subsequently being transferred to the relevant department due to active colitis. Initially suspected to have inflammatory bowel disease (IBD), he was ultimately diagnosed with HIV. Team-based treatment measures resulted in partial improvement of symptoms, including reduced appetite, diarrhea, and muscle pain. Optimal nutrition is crucial for maintaining lean body mass, alleviating the severity of HIV-related symptoms, supporting antiretroviral therapy, and enhancing overall quality of life. According to ESPEN guidelines, energy requirements should increase by 20 to 30% during the recovery phase following opportunistic infections. These guidelines also recommend a protein intake of 1.2-1.5 g/kg during both the active and inactive phases of the disease. Additionally, micronutrients, such as vitamins C and D, play a vital role in bolstering immune system health in these patients and can effectively help manage AIDS symptoms, including inflammation and gastrointestinal issues like diarrhea. https://mjms.mums.ac.ir/article_28001.html The present study was conducted to investigate the effectiveness of spiritual coping skills training on health anxiety and negative affect in women with hypertension. The current study was a semi-experimental application with a pre-test-post-test design with a control group and a two-month follow-up period. The statistical population of the study was women with hypertension who referred to Eqbal Hospital in Tehran in the summer of 2024. In this research, 35 with hypertension were selected by Voluntary sampling method and randomly assigned to experimental and control groups (18 woman in the experimental group and 17 woman in the control group). The women in the experimental group received the spiritual coping skills training during eight weeks in eight 90-minute sessions. Health Anxiety Questionnaire (HAQ) and Positive and Negative Affect Questionnaire (PNAQ) were used in the present study. The data were analyzed through mixed ANOVA via SPSS23 software. The results showed that spiritual coping skills training has significant effect on the health anxiety (p<0.0001) and negative affect (p<0.0001) in women with hypertension. Based on the research findings, it can be concluded that spiritual coping skills training with an emphasis on heartfelt faith in God, teaching the problem-solving process and planning based on problem-oriented coping skills can be used as an effective method to reduce health anxiety and negative emotions in women with hypertension. https://mjms.mums.ac.ir/article_27993.html Introduction:VitaminC, as an antioxidant may influence the quantity and quality of platelets in repeated platelet donors through oxidative stress and platelet activation, thereby exerting a supportive role in improving platelet indices. This study was designed to investigate the effect of daily vitamin C supplementation on platelet indices in platelet donors.Methods:This quasi-experimental study with a pretest–posttest design and a control group was conducted on 60 healthy volunteers. The intervention group received 1000 mg of vitamin C daily for 30 days, while the control group received no intervention. Platelet indices, including platelet count, mean platelet volume, platelet distribution width and plateletcrit were measured before the intervention and at the end of the study period. Data analysis was performed using paired t-test for within-group comparisons and independent t-test for between-group comparisons. A significance level of 0.05 was considered.Results:Following vitamin C supplementation, the intervention group demonstrated a significant increase in PLT (ΔPLT = 12.4 ± 3.21 ×10³/µL; p = 0.021; effect size d = 0.84) and a significant decrease in MPV (ΔMPV = 0.32 ± 0.58 fL; p = 0.045; d = 0.63) compared with baseline values. The observed pattern was consistent with improved platelet quality and maturation, as well as enhanced thrombopoiesis.Conclusion:VitaminC supplementation in repeated platelet donors resulted in a significant increase in platelet count, a reduction in mean platelet volume, and an increase in plateletcrit. These findings suggest that vitamin C may exert a protective and enhancing effect on platelet indices by reducing oxidative stress and supporting thrombopoiesis. https://mjms.mums.ac.ir/article_27399.html AbstractIntroduction: Nowadays, docosahexaenoic acid is considered an effective substance for preventing and improving diabetes. Therefore, our goal was to review some previous trials related to the use of docosahexaenoic acid along with exercise on the heart tissue of diabetic patients.Subjects & Methods: The present study is a descriptive review study that was conducted using several databases, including Google Scholar, Web of Science, Science Direct, PubMed, and Scopus. It used the titles of diabetes and its types and related names for the keywords of diabetes heart, docosahexaenoic acid, and sports activities until the end of 2024.Results: Focusing on the effects of DHA, which has been used in various studies, it can be said that many studies on the positive role of DHA in the heart tissue of diabetic patients include different methods and outcome measures, the vast majority of studies show the positive capacity of this supplement for diabetics. There are several proposed pathophysiological mechanisms responsible for the effects of reduced activity on the function of various tissues in diabetic patients with different lesions.Conclusion: Based on a review of various studies, this research can emphasize the fundamental role of docosahexaenoic acid in diabetic lesions in heart tissue, which should be considered. https://mjms.mums.ac.ir/article_28010.html 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. https://mjms.mums.ac.ir/article_28029.html Introduction: Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system, commonly accompanied by symptoms such as fatigue and depression. Brain-derived neurotrophic factor (BDNF) plays a critical role in neuronal health, myelin repair, and mood regulation. The purpose of this study was to investigate the effects of eight weeks of Pilates training on serum BDNF levels, fatigue, and depression in women with MS. Materials and Methods: In this quasi-experimental study, 22 women with MS were randomly assigned to a Pilates training group (n =12) or a control group (n =10). The training group performed a Pilates program for eight weeks, three sessions per week. Serum BDNF levels (ELISA method), fatigue scores (FSS), and depression scores (BDI-II) were assessed before and after the intervention. Data were analyzed using analysis of covariance (ANCOVA) with baseline adjustment in SPSS version 26 (p < 0.05). Results: ANCOVA results indicated that, after controlling for baseline values, serum BDNF levels increased significantly in the training group compared to the control group (p < 0.05). Adjusted reductions in fatigue and depression scores were also significantly greater in the training group than in the control group (p < 0.05). No significant correlations were found between changes in BDNF and changes in fatigue (r = −0.29) or depression (r = 0.18). Conclusion: Eight weeks of Pilates training may effectively enhance serum BDNF levels and improve fatigue and depression symptoms, supporting its use as a safe and beneficial complementary intervention in the rehabilitation of patients with MS.