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Ali Khazaee, Mohammad Ali Sepahvandi, Fazlolah Mirdarikvand,
Volume 27, Issue 4 (10-2024)
Volume 27, Issue 4 (10-2024)
Abstract
Introduction: The main consequence of heart failure is a decline in patients' functional abilities, leading to limitations in occupational and social-family tasks, as well as impairments in cognitive and emotional health, ultimately resulting in a reduced quality of life. This research was conducted to assess the effectiveness of emotion regulation training in improving the quality of life and life expectancy of cardiovascular patients referred to health centers in Khorram Abad City.
Methods: The current research used a semi-experimental design of pre-test-post-test type and three-month follow-up with experimental and control groups. The statistical population of the research included all patients with cardiovascular diseases referred to the health centers of Khorram Abad City in 2023. Among the statistical population, 40 people were selected by direct sampling and randomly divided into two experimental (20 people) and control (20 people) groups. The experimental group was trained in emotion regulation during eight 90-minute sessions for 8 weeks. Both groups completed the World Health Organization Quality of Life Questionnaire (WHO-QOL-BREF) and Schneider et al.'s (1991) Life Expectancy Questionnaire in the pre-test, post-test, and follow-up. The multivariate covariance analysis method and Bonferroni post hoc test were used to analyze the results.
Results: The results showed that emotional regulation training is efficacious in improving the quality of life and life expectancy of cardiovascular patients (P < 0.01), and this effect remained stable in the three-month follow-up phase (P < 0.01).
Conclusions: Emotion regulation training is recommended to enhance cardiovascular patients' quality of life and life expectancy.
Mohammad Ali Gharaat,
Volume 27, Issue 4 (10-2024)
Volume 27, Issue 4 (10-2024)
Abstract
Introduction: Physical activity causes cardiac hypertrophy by a non-pathological change in cardiac structure, called physiological hypertrophy. Several molecular changes are involved in this process. Insulin-like growth hormone-1 (IGF-1) is an important hormone involved in hypertrophy of cardiomyocytes. Also, the role of GATA4 as a possible gene involved in cardiac hypertrophy is controversial. Therefore, the present study was conducted to find the effect of aerobic and interval training on IGF-1, GATA4 gene, and cardiac tissue.
Methods: Eighteen male Wistar rats (243.72 ± 23.41 g) were randomly divided into control, aerobic, and interval training groups (n = 6). The aerobic group trained for 8 weeks/4 days a week/38 minutes/ 65% of maximum oxygen consumption (VO2 max). The intermittent group trained 8 weeks/4 days a week/5 set/4 minutes/85-90% of VO2 max running with 2 minutes rest between the sets. The weight of the heart and left ventricle, IGF-1 concentration, and GATA4 gene expression were measured 48 hours after the training. The evaluation was conducted with a one-way analysis of variance and Tukey's post hoc test at a significance level of 0.05.
Results: The weight of the heart and left ventricle increased significantly in trained groups. IGF-1 and GATA4 gene expression increased in both the training groups than the control group.
Conclusions: Aerobic and Interval training increases IGF-1, GATA4 gene, left ventricle, and heart weight. Considering the shorter time interval training takes, it seems that interval training is more beneficial than aerobic training.
Pariyan Azad Derakht, Mohammad Fathi, Dr Raziyeh Rezaei, Raziyeh Rezaei,
Volume 27, Issue 5 (12-2024)
Volume 27, Issue 5 (12-2024)
Abstract
Introduction: Physical activity positively influences various physiological factors, laying the groundwork for beneficial changes. Myostatin and follistatin are among these factors, whose levels are influenced by gender and physical activity. The present study was conducted with the aim of investigating the effect of traditional resistance training (RT) and high functional training (HIFT) on the serum levels of myostatin and follistatin in young women.
Methods: In this semi-experimental study, 30 young women were selected and divided into three groups: intense functional training, traditional resistance training, and control. Blood was drawn 24 hours before and 48 hours after the end of the interventions to measure the serum levels of myostatin and follistatin. The exercise protocols were performed for eight weeks, 3 days a week and 60 minutes a day. Ultimately, the collected data were analyzed using the ANOVA statistical method, with a significance level set at P < 0.05.
Results: The results showed that follistatin level was significantly higher in the RT and HIFT groups than in the control group (P = 0.001). Also, the amount of follistatin in the HIFT group was considerably higher than the RT group (P = 0.01). The results showed that the level of myostatin in the RT and HIFT groups was significantly lower than the control group (P = 0.001). Also, the amount of this factor in the HIFT group was substantially lower than in the RT group (P = 0.01).
Conclusions: In general, the findings of the present study show that performing intense resistance and functional exercises causes a favorable change in the expression of physiological factors related to muscle growth in women. It seems that the effect of intense functional exercises is greater than resistance exercises.
Hamid Moghavemi, Sadegh Abbasian, Mohammad Ali Sardar,
Volume 27, Issue 5 (12-2024)
Volume 27, Issue 5 (12-2024)
Abstract
Introduction: Reducing physical activity as well as consuming more calories than the body needs increases obesity and its related disorders, such as metabolic syndrome. Therefore, this study aimed to determine the effect of eight weeks of high-intensity interval training (HIIT) and resistance training (RT) on brain tissue gene expression of AKT2 and insulin resistance in obese Wistar rats.
Methods: 30 male rats weighing 160 to 185 grams were fed a high-fat diet for 12 weeks. After the approval of the obesity protocol of increasing the weight of the rats, which to be more than 300 grams, the rats were divided into three groups, including the control group (n = 10), HIIT group (n = 10), as well as RT group (n = 10). Until the end, the rats continued to eat a high-fat diet. HIIT was performed for eight weeks and five sessions per week, with an intensity of 80 to 95% of maximum oxygen consumption on a treadmill. Moreover, RT was performed with an intensity of 40-60% of a maximum repetition on the ladder. After eight weeks of training interventions, the expression level of the AKT2 gene in brain tissue was measured by the real-time PCR method.
Results: The results of the present study demonstrated a significant increase in AKT2 gene expression of HIIT and RT groups compared to the control group (P < 0.05). Furthermore, the results illustrated that the insulin resistance of rats in both training groups was significantly reduced (P < 0.05).
Conclusions: According to the findings of the present research, it could be concluded that HIIT, as well as RT interventions, probably causes an increase in AKT2 gene expression and could be effective in reducing insulin resistance and improving glucose profile.
Parvin Roosta, Dr Sayed Abdollah Sadat Bahreinian, Ghasem Ahi, Mohammad Hassan Ghanifar,
Volume 27, Issue 5 (12-2024)
Volume 27, Issue 5 (12-2024)
Abstract
Introduction: One of the problems during adolescence is the existence of conflict with parents, which creates object relationships and feelings of shame and guilt in them. This research was conducted to determine the effectiveness of treatment based on the mentalization of object relations and feelings of shame and guilt in conflicting mother-child relationships.
Methods: This research method was semi-experimental and pre-test-post-test with a control group. The statistical population of this research included all mothers and adolescents with conflicting relationships who were referred to counseling centers in Shiraz in 2022. By using the available sampling method, 30 people from the mentioned community were selected as a sample and were randomly divided into two experimental (15 people) and control (15 people) groups. Asadi et al.'s parent-child conflict questionnaires (2010), Bell's object relations (1995), and Cohen et al.'s (2011) feelings of shame and guilt were used to collect information. The experimental group underwent executive function training for 13 sessions twice a week for 60 minutes, and the control group did not receive any training. The research data was analyzed using correlation.
Results: The mean ± standard deviation of the experimental group in the post-test in the variable of object relations from 1.5 ± 1.37 to 28.6 ± 4.3 and in the variable of shame and guilt from 5 ± 1.60 to 5.60 ± 3. 51.2 ± 9.1 decreased. The results showed that in the post-test stage, the mean scores of object relations and feelings of shame and guilt in the experimental group decreased significantly compared to the control group (P < 0.01).
Conclusions: Treatment based on mentalization was effective in improving object relationships and reducing feelings of shame and guilt. Therefore, this treatment can be suggested to reduce the conflict between adolescents and mothers.
Mohammadreza Pourmohammad, Jina Khayatzadeh, Bibi Fatemeh Mazlom, Maryam Tehranipour, Nasser Mahdavi Shahri,
Volume 27, Issue 6 (1-2025)
Volume 27, Issue 6 (1-2025)
Abstract
Introduction: Dermatoglyphic is a science that study the lines in the skin of the palms and fingertips properly. In some studies, the relationship between dermatoglyphic patterns with some diseases has been proven Arthritis Rheumatoid is a chronic inflammatory disease with autoimmune pathogenesis. The aim of this study was to investigate the qualitative and quantitative characteristics of dermatoglyphics in people with rheumatoid arthritis compared to the control group.
Methods: This case-control study was conducted on 50 patients with rheumatoid arthritis and 50 people in the control group living in Mashhad. The fingerprint was recorded by the scanner. The distribution of the frequency of fingerprint patterns, including Arch, Loop and Whorl, along with the counting of fingerprint lines in both groups was investigated. Finally, the obtained data were analyzed using ANOVA and X2 tests.
Results: According to the results, the maximum frequency of dermatoglyphic patterns in both hands was related to the ulnar loop type. After that, in the patient group, simple Whorl patterns and double Whorl patterns and in the healthy group, double Whorl patterns and simple Whorl patterns were the most frequent. Between the average finger ridge count in the right hand of healthy people with the right hand of patient’s people and the left hand of healthy people with the left hand of patient’s people showed a significant difference in the error level of 0.05.
Conclusions: It seems that this difference can be used as a biological diagnostic marker to screen people prone to rheumatoid arthritis. This information in prognosis of psychological, medical and therapeutic plans, issues related to anthropology and social sciences can also be useful.
Hosein Sarmadian, Nader Zarinfar, Masoud Bahrami, Mohammad Matin Arjmandzadegan, Dr Roham Sarmadian, Yasamin Zarinfar,
Volume 27, Issue 6 (1-2025)
Volume 27, Issue 6 (1-2025)
Abstract
Introduction: The Symptoms of Omicron are still unknown. Primary data show that the Omicron symptoms are mainly related to the respiratory system, including runny nose, sore throat, headache, fatigue, and sneezing. Based on the need for more evidence about Omicron symptoms, this study was conducted to investigate the symptoms of this COVID serotype.
Methods: This descriptive-analytical cross-sectional study was performed for 6 months in Arak city on 160 definitively diagnosed patients with Omicron. For all patients who entered the study, the information evaluation checklist, including demographics and symptoms (24 symptoms), was completed. Disease diagnosis was done by PCR.
Results: The disease of 55% of people was mild, 35% moderate, and 10% severe. Fifty-one people (31.9%) mentioned a history of previous infection with COVID-19. Pulmonary involvement, the type of drug used, and anxiety at the time of infection were related to the severity of the disease (P < 0.05). The five most common symptoms of Omicron (%) were sore throat (86.3), cough (82.5), weakness and lethargy (76.3), headache (72.5) and dry mouth (62.5). There was also a relationship between old age with dry mouth and headache, underlying disease with sneezing, anxiety during illness with joint pain and chest pain, and smoking with abdominal pain (P < 0.05).
Conclusions: The most common symptoms included sore throat, cough, weakness and lethargy, headache, and musculoskeletal pain. However, reduced smell and taste, night sweats, fever, and joint pain, common in the previous serotypes, were among the less frequent symptoms of Omicron.
Zohreh Mohammadi Kamalabadi, Allahyar Arabmomeni,
Volume 27, Issue 6 (1-2025)
Volume 27, Issue 6 (1-2025)
Abstract
Introduction: Exercise and physical activity have always been recommended as a core treatment for knee osteoarthritis. However, it is unclear which types of exercises have the most splendid effect on this condition. This study aimed to evaluate the impact of two methods of water exercise (Traband exercise and NASM exercise) on pain and motor function in women with knee osteoarthritis.
Methods: In this semi-experimental study, with a design pre and post-test and a control group, 45 women with knee osteoarthritis with an average age = 56.5 years and a BMI = 29.04 kg/m2 were purposefully selected and divided into three groups (n = 15); Water Exercise with Theraband, Water Exercise with the NASM Approach and Control randomly. An exercise protocol with Theraband and NASM approach (approved by the Medical College of Georgia for patients with knee osteoarthritis) was performed for eight weeks, three sessions per week, and each session lasted about 60 minutes in the water. Visual Analog Scale (VAS) and physical performance tests of the Osteoarthritis Research Society International (OARSI) were used to estimate the study variables. MANCOVA and post hoc Bonferroni tests were conducted to analyze the data at a significant level (P ≤ 0.05).
Results: The results showed that, similarly, in both experimental groups, the amount of pain and the time of tests TUG, 40MW, and SCT decreased significantly (P≥ 0.05). In addition, in both experimental groups, there was a significant increase in the scores of the 30-S-CS and 6MWT tests (P≥ 0.05).
Conclusions: These results showed the beneficial effects of training in water with the traband and training in water with the NASM approach on pain and motor performance indicators. Therefore, the use of these training methods is recommended as a suitable prevention and treatment method for knee osteoarthritis.
Mohammad Ali Gharaat, Sajjad Karami,
Volume 28, Issue 1 (3-2025)
Volume 28, Issue 1 (3-2025)
Abstract
Introduction: Different training methods increase performance capabilities in addition to metabolic changes in body organs. The present study aimed to compare the effect of endurance and strength training on anthropometric indicators, glucose changes, fat metabolism, and irisin levels of young male students.
Methods: Thirty-six obese students (age: 21.19 ± 2.43 years; weight: 88.59 ± 6.20 kg; height: 175.41 ± 12.96 cm; body mass index: 30.45; fat percentage: 25.73%) were randomly placed in one of control, endurance, and strength training groups (n= 12). The strength training group trained for 8 week/3 session/4 sets/10 repetitions/ from 50 to 70% of the one repetition maximum (incremental manner, every 2 weeks), and the endurance training group trained for 30 minutes of aerobic jogging with 60 to 80% heart rate maximum. Plasma irisin, glucose, insulin, insulin resistance, fat percentage, body mass index, weight, waist circumference, and hip circumference were measured. The data were analyzed by one-way analysis of variance and Tukey's test at 0.05.
Results: Body weight (P = 0.03), fat percentage (P = 0.04), and body mass index (P = 0.04) significantly decreased in the post-test of endurance training group. Irisin level in the post-test in the control group had a significant difference with endurance and strength training (P = 0.01 and P = 0.02, respectively). Insulin in the post-test of the control group was significantly different from the endurance and strength group (P = 0.00 and P = 0.00, respectively). The level of insulin resistance in the post-test of the endurance and strength group had a significant difference compared to the control (P = 0.00 and P = 0.00, respectively).
Conclusions: Eight weeks of aerobic treadmill training and strength training with free weights can improve body composition, increase irisin levels, and reduce insulin resistance in obese male adolescents.
Ebrahim Mohammadi, Laya Hooshmand, Arash Masumi,
Volume 28, Issue 1 (3-2025)
Volume 28, Issue 1 (3-2025)
Abstract
Introduction: Novel antidiabetic medications are employed to manage glycemic control and mitigate the long-term complications of type 2 diabetes. This study aimed to investigate the prevalence of adverse events, including hypoglycemia, associated with these novel antidiabetic agents in a cohort of patients with type 2 diabetes.
Methods: This cross-sectional analytical study was conducted on 157 patients with type 2 diabetes mellitus attending the Endocrinology Clinic at Imam Khomeini Hospital, Urmia, during the summer of 2024. A convenience sampling method was employed to recruit participants. Data on demographics, the incidence of hypoglycemia, and reported adverse drug reactions were collected from all eligible patients through a structured interview. Subsequently, patients were stratified into three treatment groups based on the specific novel antidiabetic medication they received.
Results: In patients receiving sitagliptin, the most prevalent adverse events included arthralgia and rheumatic problems (26.31%), dermatological manifestations (36.84%), and allergic reactions (21.06%). Nausea (52.94%) and abdominal pain (17.65%) were the most frequent adverse events observed in patients treated with liraglutide. Polydipsia (28.72%), weakness and lethargy (26.6%), and dry mucous membranes (27.66%) were commonly reported in patients receiving empagliflozin. Hypoglycemia was observed predominantly in male patients aged 51-55 years receiving sitagliptin.
Conclusions: The findings of this study demonstrate a low incidence of hypoglycemia among patients treated with modern antidiabetic medications. Prevalent short-term adverse events observed included gastrointestinal disturbances, allergic reactions, and dermatological manifestations.
Davoud Shamsi, Mohsen Mohammadian Saravi, Khalil Ali Mohamadzadeh, Azadeh Ashrafi,
Volume 28, Issue 2 (4-2025)
Volume 28, Issue 2 (4-2025)
Abstract
Introduction: Good governance, as one of the fundamental concepts in healthcare system management, plays a key role in enhancing the efficiency, effectiveness, and equity of healthcare services. This concept, Emphasizing principles such as transparency, accountability, participation, and legality, has been considered as a framework for improving policymaking and management in Iran's healthcare system.
This study conducted in 2024 aimed to design and present a model of good governance in the healthcare system using a mixed approach of thematic analysis and Partial Least Squares (PLS) method.
Methods: The research method included both qualitative and quantitative components. The qualitative phase, involved managers, health policy experts, specialists from the Ministry of Health and Medical Education, and academic scholars. Sampling was done using purposive and snowball sampling methods, with 17 participants selected until theoretical saturation was reached. In the quantitative phase, the Partial Least Squares (PLS) method was used for model fitting. The statistical population for this section included all experts and managers in Iran's healthcare sector, with a minimum sample size of 384 determined based on Cochran's formula.
Results: The results of thematic analysis of the qualitative data and model fitting showed that the final good governance model in the healthcare system consists of seven main dimensions: effectiveness, efficiency, equity, transparency and accountability, participation, legality, and leadership. Each dimension comprised specific components, and the importance of each was confirmed in strengthening good governance.
Conclusions: This study presents a comprehensive good governance model for the healthcare system, offering a framework for improving policymaking, management, and performance in this sector. The proposed model can be used as a strategic decision-making tool and improving management structures.
Mostafa Mirzaei, Mohammadreza Amiri Nikpour, Rezvan Noruzzadeh,
Volume 28, Issue 2 (4-2025)
Volume 28, Issue 2 (4-2025)
Abstract
Introduction: Imaging of the vascular system supplying the brain parenchyma is a diagnostic tool in the evaluation of stroke patients. This study aimed to compare the results of digital subtraction angiography with color Doppler ultrasound of the carotid arteries in patients with ischemic stroke.
Methods: In this cross-sectional-analytical study, the medical records of patients with ischemic stroke admitted to Imam Khomeini Hospital from July 1401 to July 1402 were reviewed to collect data. Demographic information, along with the results of color Doppler ultrasound and digital subtraction angiography of the patients, were extracted and evaluated.
Results: This study included 48 patients with ischemic stroke with a mean age of 12.8 ± 0.67 years. Hypertension was present in 68.8%, diabetes mellitus in 20.8%, and smoking in 25% of patients. Based on the results of digital subtraction angiography and color Doppler ultrasound, the most common vascular abnormality was plaque (79.2%). Vascular stenosis and occlusion were present in 91.7% of patients. Color Doppler ultrasound in examining the right and left internal carotid arteries had a sensitivity of 94.9% and 92.8%, specificity of 66.7% and 38.9%, positive predictive value of 92.1% and 70.3%, and negative predictive value of 75% and 77.8%.
Conclusions: Color Doppler vascular ultrasound demonstrated high sensitivity and specificity in detecting the presence and severity of stenosis in internal carotid arteries of ischemic stroke patients, supporting its use as a non-invasive and cost-effective method in clinical practice.
Mohammad Javad Gouran, Soodeh Hooshmandi, Sajjad Rahimi Pordanjani,
Volume 28, Issue 3 (8-2025)
Volume 28, Issue 3 (8-2025)
Abstract
Background and Aim: Echogenic Intracardiac Foci (EIF) are non-structural markers identified during the routine 18-20-week fetal anomaly ultrasound scan yet their maternal and neonatal risk factors is unclear. At present, there are few data on the effect of hypothyroidism on fetal cardiovascular structure and function. The objective of this study was to investigate the prevalence of maternal hypothyroidism in women with fetal echogenic foci.
Methods: In this cross-sectional study which carried out from September 2022 to September 2023, 100 clinical records of pregnant women who referred to the Amir-Al-Momenin Hospital and their fetal echogenic foci were diagnosed and confirmed using echocardiography, were assessed. Demographic characteristics, including maternal age, gestational age, underlying disease, and also fetal gender, were recorded. Statistical analyzes were performed using SPSS software version 24.
Results: The mean ± SD of maternal age and gestational age were 34 ± 41.55 and 21.4 ± 3.65 years, as well as delivery frequency was 2.36 ± 1.41. Seven (7%) pregnant women have been diagnosed with hypothyroidism. Five (5%) pregnant women had a history of blood hypertension, 2 (2%) cases suffered from systemic lupus erythromatose, 1 (1%) had a history of epilepsy, while the rest (92%) had no history of any underlying disease. Totally, 54 (53.5%) of fetus were male. A significant association was found between maternal hypothyroidism and fetal EIF (P= 0.00). Further significant association was also found between maternal hypothyroidism and underlying disease and fetal gender (P= 0.00). However, there was no statistically significant association between maternal hypothyroidism with mothers age and gestaional age (P= 0.761 and 0.916, respectively). Fetal EIF was also significantly associated with maternal underlying disease and fetal gender (P= 0.00).
Conclusion: This study revealed a high prevalence of hypothyroidism in pregnant women with fetal EIF. Moreover, maternal hypothyroidism and fetal EIF were also associated with underlying disease and fetal gender. Further investigation is warranted to develop strategies to optimize the outcome of these fetuses.
Safieh Azadi Fard, Mehdi Moradi, Mohammad Malekipooya,
Volume 28, Issue 3 (8-2025)
Volume 28, Issue 3 (8-2025)
Abstract
Introduction: Plasma levels of adhesion molecules are considered important indicators in estimating the risk of cardiovascular diseases. Since endurance training and a fasting diet are effective in reducing the symptoms of heart diseases, this study aimed to investigate the effect of a period of endurance training with electrical stimulation on the expression of ICAM and VCAM genes in the heart tissue of obese fasting rats.
Methods: In this study, 35 male Wistar rats (8 weeks old, avg. weight 200±19 g) were randomly assigned to 5 groups (obese control, fasting, fasting with endurance training, fasting with electrical stimulation, fasting with endurance training with electrical stimulation) after inducing obesity. Fasting utilized a 16/8 protocol for all groups except the obese control. The endurance training lasted 4 weeks, increasing intensity from 50% to 65% of max oxygen consumption. Electrical stimulation was delivered via foot shock (0.5 mA for 20 min). Heart tissue was collected 24 hours post-training under anesthesia, with ICAM-1 and VCAM-1 gene expression measured via Real-time PCR. Data was analyzed using two-way ANOVA and Tukey's post hoc test in SPSS version 26, with significance at P≥0.05.
Results: The results of the present study demonstrated that intermittent fasting, endurance training, and electrical stimulation—each independently—led to a significant reduction in the gene expression of vascular adhesion molecules in the cardiac tissue of obese rats (P = 0.001). Moreover, it appears that the combination of all three interventions exerts a greater effect in reducing the expression levels of these adhesion molecules in the cardiac tissue of obese rats (P = 0.001).
Conclusion: Based on the findings, the simultaneous application of endurance training, intermittent fasting, and electrical stimulation exerts a considerable impact on decreasing the expression of VCAM and ICAM in cardiac tissue. However, it is still not possible to definitively determine the directionality of the individual or combined effects of intermittent fasting, endurance training, and electrical stimulation (foot-shock stimulation) on adhesion molecules under conditions of obesity and intermittent fasting.
Amirali Jafarnezhadgero, Sajjad Ghadimi Khesht Masjedi, Abbas Ghadimi Khesht Masjedi, Mohammad Eslamzadeh, Ebrahim Piri,
Volume 28, Issue 3 (8-2025)
Volume 28, Issue 3 (8-2025)
Abstract
Introduction: One of the common undesirable postural abnormalities that poor mobility has brought to humans due to the significant growth of technology and widespread use of tools and communication devices is the excessive increase of the back arch (hyperkyphosis) and forward head deformity. Therefore, the aim of this research is to review the effects of rehabilitation exercises on people with kyphosis and forward head posture.
Methods: The current study was a systematic review, searching for articles in Persian and Latin from the beginning of December 2005 to the beginning of April 2023, using the Wos, SID, Magiran, Scopus, ISC, PubMed and Google Scholar databases.
Results: A number of seven articles in the field of rehabilitation exercises reported that corrective exercises improve forward head and kyphosis, as well as posture. One article indicated that the use of braces reduced trapezius muscle electrical activity in patients with kyphosis, which may delay fatigue onset.
Conclusions: : The current review study showed that exercise protocols improve kyphosis and forward head complications, as well as improve pain and maintain proper posture in affected individuals.
Mohammad Parastesh, Zahra Yousefvand, Behzad Aria, Majid Mardaniyan Ghahfarrokh, Jamileh Ahmadi,
Volume 28, Issue 3 (8-2025)
Volume 28, Issue 3 (8-2025)
Abstract
Introduction: Cisplatin, a widely used chemotherapy agent, offers therapeutic benefits for cancer treatment but often leads to adverse effects on neurogenesis and oxidative stress. On the other hand, physical activity has been proposed as a potential strategy to counteract these side effects. Therefore, the aim of the present study was to investigate the effect of an endurance training period on oxidative stress markers in the brain tissue of rats induced with cisplatin.
Methods: In this study, 32 male rats with an average weight of 220 grams were divided into four groups: healthy control, cisplatin-injected control, endurance training, and cisplatin + endurance training. After 8 weeks of endurance training, the rats were dissected, and blood serum was separated to measure oxidant and antioxidant factors. Additionally, the brain was removed under sterile conditions for the examination of the desired markers. Data were analyzed using one-way ANOVA.
Results: The results showed that cisplatin significantly decreased MDA and significantly increased TAC and CAT in the cisplatin-receiving control group. On the other hand, 8 weeks of endurance training significantly decreased MDA and significantly increased TAC and CAT. Moreover, no significant change was observed in serum SOD levels. In brain tissue, MDA levels significantly increased, and TAC, CAT, and SOD levels significantly decreased in the cisplatin-receiving group. Conversely, 8 weeks of endurance training reduced MDA levels and increased TAC, CAT, and SOD levels.
Conclusions: Based on the findings of the present study, it appears that physical exercise has protective effects against cisplatin-induced oxidative stress in the brain, which may be attributed to its antioxidant capabilities
Mir Amirhossein Seyednazari, Amir Mohammad Dorosti,
Volume 28, Issue 3 (8-2025)
Volume 28, Issue 3 (8-2025)
Abstract
In global healthcare systems, nurses are recognized as the main pillars of care, but their voices, despite their vital role, are often lost amidst a cacophony of loud silences. This silence does not signify tranquility, but rather reflects hidden pressures, unexpressed fears, and an imposed passivity in the face of structures that limit the freedom of expression.
"Organizational silence," a concept recognized for years in the fields of management and organizational psychology, has become a global crisis in nursing. According to a qualitative meta-synthesis, over 91% of nurses have experienced organizational silence at least once in their professional careers [1].
The causes of silence among nurses are multifaceted. Part of it stems from defensive silence, meaning a nurse refrains from speaking up before superiors or in hierarchical structures for fear of negative consequences. At other times, we encounter acquiescent silence, where the nurse believes that speaking out is futile and will not bring about any change. Previous experiences of having concerns ignored or autocratic leadership styles reinforce this feeling [1,2]. Furthermore, in some cultures, such as Japan or Egypt, prioritizing group harmony over individual expression leads to the normalization of silence [3].
Silence is not just an individual reaction but a response to an inefficient work environment. Nurses who feel their voices are not heard eventually experience job burnout, decreased motivation, and ultimately, leave the profession [2,3,4]. In a study from Spain, half of the nurses surveyed had considered leaving the profession [3,5]. Job burnout not only harms the nurse's mental health but also reduces the quality of patient care. Fatigue, reduced concentration, and impaired communication with patients increase the risk of clinical errors [1,6].
This vicious cycle of silence and its consequences creates a downward spiral in healthcare organizations:
Silence on staff or resource shortages → Increased stress and workload → Job burnout → Decreased quality of care → Intensified dissatisfaction → More silence.
If nurses feel that their concerns are ignored even when expressed, silence becomes an adaptive strategy [4].
Meanwhile, the financial impact of nurse turnover is also significant. According to estimates, the turnover cost for a single nurse in the United States is over $44,000, and hospitals lose an average of $3.6 to $6.1 million annually due to nurse turnover [7]. This substantial figure provides an economic incentive for systemic interventions to reduce silence and retain human resources.
Solving this problem is not possible through individual training or psychological resilience alone. Although strengthening skills like professional assertiveness can be effective, it will not be sustainable without structural and cultural support [4]. Creating psychological safety in the workplace—where nurses can freely express their concerns without fear of punishment—is a vital starting point for change [6].
Leaders of healthcare organizations play a key role in shaping or dismantling a culture of silence. When managers interact with nurses with empathy, a listening ear, and responsiveness, trust is built, and the space for expression becomes safer. A transformational leadership style, participation in decision-making, and the creation of professional growth paths are among the most important factors in retaining nurses and reducing silence [8].
There is also a need for macro-level policymaking at national and international levels. Programs like the "Global Nursing Workforce," which focuses on supporting the sustainability of the profession, can be effective in addressing the root causes of the problem [7]. Moreover, new guidelines from bodies such as The Joint Commission on preventing workplace violence (effective July 2024), which define requirements for reporting and accountability, can serve as models for combating silence on other issues as well [8].
Ultimately, organizational silence in nursing is not just a communication issue; it is an alarming indicator of the ethical, psychological, and systemic health of healthcare institutions. This phenomenon should be considered an "organizational vital sign." The healthcare system has a duty not only to listen but to act. The voices of nurses must lead to decisions, policies, and structural reforms, so that their silence is no longer loud, but is transformed into an effective cry on the path to improvement.
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