Background and Objective: Nutritional knowledge can affect food choices and, as a result, sports performance. The study of nutritional knowledge, attitude, and performance in athletes can play a fundamental role in choosing the type of training and adapting suitable dietary interventions. This study was done to evaluate the knowledge, attitude, and nutritional performance of male bodybuilding athletes in Gorgan, Iran.
Methods: This descriptive-analytical study was done on 104 male bodybuilding athletes over 18 years old with a history of at least three months of continuous bodybuilding who were randomly selected from 13 bodybuilding clubs in Gorgan, Iran during 2020. Parmenter and Wardle’s standard questionnaire measured athletes’ nutritional knowledge, attitude, and performance. The questionnaire was completed by the athletes with the guidance of the researcher. A trained nutritionist collected anthropometric and body composition data using an Omron BF511 device.
Results: Poor nutritional knowledge, poor dietary attitude and poor nutritional performance was observed in 67.3%, 33.65% and 77.88% of the athletes respectively. A significant correlation was observed between nutritional knowledge with weight (r=0.23, P=0.02), BMI (r=0.27, P=0.01), and body fat percentage (r=0.22, P=0.02). Also A significant correlation was determined between nutritional performance with body weight (r=0.31, P<0.001), BMI (r=0.27, P<0.001), exercise time per week (r=0.22, P=0.02), and exercise timespan (r=0.32, P<0.001).
Conclusion: The level of knowledge, attitude, and nutritional performance of bodybuilding athletes was weak.

Background and Objective: Population growth and pollution caused by the discharge of all kinds of urban, industrial, and agricultural sewage, leachate from landfills, and surface water runoff cause an increase in pollution of water sources. The entry of heavy metals into the environment, especially aquatic ecosystems, due to entering the food chain and jeopardizing human health is one of the concerns of society. This study was conducted to determine the level of heavy metals in muscles of Cynoglossus arel and Pomadasys kaakan fishes in Boushehr coastal waters, north of the Persian Gulf.
Methods: This descriptive study was conducted on twenty pieces of Cynoglossus arel and twenty pieces of Pomadasys kaakan fishes take place from three coastal stations of Boushehr, north of the Persian Gulf, Iran during spring of 2022. The samples were randomly selected from the fish market. After preparation, bioassay, and digestion of fish muscle by concentrated nitric acid, the concentration of heavy metals including nickel, zinc, copper, lead, and cadmium (µg/g) in the muscle tissue was measured by ICP-OES device. The concentration of heavy metals in the fish muscle tissue for human consumption was compared with international standards (FAO, WHO, FDA, NHMRC, and UKMAFF). According to the method of the US Environmental Protection Agency for fish consumption, daily absorption estimates and heavy metal risk indicators were calculated.
Results: The risk potential index for both species was less than one. The daily and weekly absorption of Cynoglossus arel (zinc > copper > nickel > lead > cadmium) and Pomadasys kaakan (copper > zinc > nickel > lead > cadmium) were determined. The mean concentration of heavy metals nickel, zinc, copper, lead, and cadmium in the muscle tissue of the studied species was determined to be 1.88±0.07, 27.16±8.11, 11.55±4.12, 1.14±0.06, and 0.19±0.03 µg/g, respectively. The highest amounts of studied metals in aquatic animals were zinc > copper > nickel > lead > cadmium. The concentration of metals in the analyzed samples was lower than the international standards.
Conclusion: Regarding toxicity, the concentration of metals in Cynoglossus arel and Pomadasys kaakan was evaluated as acceptable for human consumption. In addition, the amount of risk potential and risk index for non-cancerous diseases in adults and children in fish muscle tissue was less than 1, and the consumption of this fish does not cause any problems for human health. 

Background and Objective: The application of different nanoparticles using green synthesis is increasing due to fewer complications. This study was conducted to identify the effect of cobalt ferrite nanoparticles synthesized with sumac extract on changes in biochemical and histological factors in rats.
Methods: In this experimental study, 30 five-month-old male Wistar rats with an approximate weight of 250-300 mg/kg of body weight were divided into three groups: The control group (saline receiving), the experimental groups receiving intraperitoneal cobalt ferrite nanoparticles synthesized with sumac extract at a dose of 10 and 20 mg/kg of body weight. Serum and tissue samples (liver, kidney, and spleen) were isolated. Serum concentrations of urea, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and creatinine were determined. The photometric method was used to measure liver enzymes, the calorimetric method without omitting proteins based on the Jaffe method was used to measure creatinine, and the urease-glutamate dehydrogenase (GLDH) method was used to measure urea. Tissue samples were assessed by hematoxylin-eosin staining. Transmission electron microscopy (TEM) and scanning electron microscope (SEM) microscopic studies were used for microscopic investigations.
Results: No statistical significance was observed in blood samples and factors (urea, creatinine, ALT, and AST) in the experimental groups compared to the control group. Similarly, in the morphological investigation, the size of the liver, kidney, and spleen of the groups receiving cobalt ferrite nanoparticles synthesized with sumac extract was normal compared to the control group.
Conclusion: Cobalt ferrite nanoparticles synthesized with sumac had no toxic effect on the rats’ liver, spleen, and kidney tissues.

Background and Objective: Neck pain is a prevalent problem negatively affecting individuals’ health and quality of life. Therefore, the present research was conducted to determine the impacts of neck stabilization and thoracic mobility exercises on disability, range of motion, and endurance of females with non-specific chronic neck pain.
Methods: This single-blinded clinical trial was conducted on 36 females with non-specific chronic neck pain in three 12-people groups in the city of Qom. The subjects of the first intervention group (those doing neck stabilization exercises) and the second intervention group (those doing neck stabilization exercises with thoracic mobility) performed the exercises as three 60-minute sessions per week for 8 weeks in the gym, and the control group received a set of corrective exercises. Disability, the neck range of motion, and muscular endurance were measured by the Neck Disability Index (NDI), goniometer and the Progressive Iso-inertial Lifting Evaluation (PILE) test, and biofeedback sphygmomanometer, respectively.
Results: Disability, range of motion, and muscular endurance of the subjects in both intervention groups significantly improved compared to the control group (P<0.05). Compared to the first intervention group, the range of motion and muscular endurance of subjects in the second intervention group showed a significant improvement (P<0.05).
Conclusion: Doing neck stabilization and thoracic mobilization exercises was found to be an influential intervention in the improvement of disability, range of motion, and muscular endurance of females with non-specific chronic neck pain.

Background and Objective: Dermatophytosis is a significant skin disease in humans and animals, with increasing resistance to conventional treatments. This study aimed to determine the antifungal activity of petroleum ether, dichloromethane, ethyl acetate, ethanol, and hydroethanol extracts from the aerial parts of Artemisia khorassanica, Artemisia scoparia, and Artemisia vulgaris against common dermatophytic fungi, including Trichophyton rubrum, Trichophyton verrucosum, Epidermophyton floccosum, and Microsporum canis.
Methods: This descriptive study examined the antifungal activity of various extracts from the aerial parts of Artemisia khorassanica, Artemisia scoparia, and Artemisia vulgaris against fungal isolates of Trichophyton rubrum, Trichophyton verrucosum, Microsporum canis, and Epidermophyton floccosum. The aerial parts of the three Artemisia species were extracted using five solvents: petroleum ether, dichloromethane, ethyl acetate, ethanol, and 50% hydroethanol. The extracts were screened for antidermatophytic effects against the fungi mentioned above, and the minimum inhibitory concentration (MIC) was determined using the agar dilution method. The most active extracts underwent preliminary phytochemical testing.
Results: In the initial screening, Microsporum canis and Trichophyton verrucosum showed the highest sensitivity (86.66%) and resistance (100%) to the tested extracts, respectively. Extracts from Artemisia scoparia exhibited the broadest range of activity. The most effective extracts, with an MIC of 78.12 µg/ml, were also from this plant. Hydroethanol extracts from all plant species demonstrated the least antidermatophytic activity. Preliminary phytochemical studies revealed the presence of terpenoids in all petroleum ether and dichloromethane extracts of the plant species.
Conclusion: Some lipophilic compounds, particularly in the petroleum ether and dichloromethane extracts of Artemisia scoparia, exhibit significant in vitro antidermatophytic activity.

Background and Objective: Ensuring suitable access to hemodialysis, which provides high-quality dialysis over an extended period, is a significant challenge for patients with End-Stage Renal Disease (ESRD). One crucial aspect of this is maintaining the performance of hemodialysis catheters. Our study, which aimed to evaluate the one-year performance of long-term catheters in chronic hemodialysis patients in Golestan Province, is a critical step toward improving patient care in this population.
Methods: This descriptive-analytical study was conducted on 99 patients (34 men and 65 women) with ESRD who were candidates for starting or continuing dialysis with a catheter in the educational and therapeutic centers of Golestan Province, Iran during 2021-22. Transjugular catheters were placed for the patients, and after one year, variables such as age, gender, history of diabetes, history of hypertension, catheter placement site (right or left jugular), and antiplatelet medication use were evaluated concerning the performance of long-term catheters in providing adequate flow for hemodialysis.
Results: In 91 patients (91.9%), the one-year catheter performance was assessed as satisfactory. The age of 61.6% of the patients were over 60 years old. Sixty-nine patients (69.7%) had a history of hypertension, and 58 patients (58.6%) had a history of diabetes. Fifty-seven patients (57.6%) received antiplatelet medication. The catheters were placed on the right side in 82 patients (82.8%). Catheter performance in patients taking antiplatelet medication was non-significantly higher than in those not taking antiplatelet medicines.
Conclusion: The performance of long-term catheters in chronic hemodialysis patients with ESRD showed no significant correlation with age, gender, diabetes, hypertension, antiplatelet medication use, or the side of the jugular vein where the catheter was placed.

Background and Objective: Weight regain following bariatric surgery is a significant challenge for this obesity treatment method. This study aimed to identify factors associated with weight regain after bariatric surgeries in obese patients in Gorgan, Iran.
Methods: This longitudinal study included 143 obese individuals (125 women and 18 men) with a mean age of 43.13±9.83 years who underwent bariatric surgery in Gorgan, Iran during 2013-19. Participants were invited to join the study via phone calls. Research variables (type of surgery, blood group, pre-surgery weight, and body mass index [BMI]) were extracted from patient records, and their current weight and waist circumference were measured and recorded. Weight regain was determined based on one of three different criteria: (1) regaining more than 25% of the maximum weight lost post-surgery, (2) regaining more than 10 kg from the minimum weight post-surgery, or (3) an increase of more than 5 BMI units from the lowest BMI post-surgery.
Results: Overall, 33% of individuals experienced weight regain, with 26.6% according to the first definition, 29.4% according to the second definition, and 18.2% according to the third definition. Men had a higher rate of weight regain (P<0.05). Additionally, 93.6% (44 cases) of those with weight regain had abdominal obesity. On average, 79.7% of participants who were 48 months post-bariatric surgery experienced some degree of weight regain. Individuals with a pre-surgery BMI of 50 or higher had a 2.69 times greater chance of weight regain compared to those with BMI lower 50 (P<0.05). The mean weight loss after surgery was significantly higher in individuals who experienced weight regain than those who did not (P<0.05). There was no significant statistical association between weight regain and the type of surgery, age, education level, marital status, or blood group.
Conclusion: Weight regain over time is a reality after bariatric surgery, indicating that this method is not a definitive cure for obesity. Therefore, long-term follow-up for weight control is crucial, especially for individuals with a pre-surgery BMI of 50 or higher or those who experienced significant weight loss post-surgery.

Background and Objective: Non-adherence to treatment regimens is a significant factor contributing to the persistence of cardiovascular diseases and their complications. This study aimed to compare the effects of two educational methods, with and without short message service (SMS) reminder, on adherence to treatment regimens among patients with acute coronary syndrome (ACS).
Methods: This clinical trial was conducted on 111 patients with ACS divided into three 37-people groups: A control group (receiving routine education), the first intervention group (receiving education and a booklet), and the second intervention group (receiving education, a booklet, and SMS reminders). The study was conducted in patients at the coronary care units (CCUs) and post-CCUs of the following educational therapeutic centers: Shahid Sayyad Shirazi in Gorgan, the Fifth Azar in Gorgan, Amir Al-Momenin in Kordkuy, and Al-E-Jalil in Aqqala, Iran, during 2019. The research instrument consisted of the Treatment Adherence Perception Questionnaire (TAPQ) in three domains, including dietary regimen, medication regimen, and exercise and activity, which was completed at the time of discharge and two months later.
Results: The mean scores of adherence to treatment dietary in patients with ACS two months after discharge in the three domains of dietary regimen, medication regimen, and exercise and activity were significantly higher in the group receiving education and SMS reminders (105.54±75.8, 16.00±2.71, and 23.67±3.85, respectively) compared to the education group (84.73±5.02, 11.05±1.69, and 17.45±2.48, respectively) (P<0.05). Moreover, the scores in the three investigated domains were significantly higher in both intervention groups compared to the control group (82.68±13.54, 11.40±1.96, and 17.67±5.04, respectively) (P<0.05).
Conclusion: The use of education and a booklet along with SMS reminders to patients with ACS discharged from the hospital increased adherence to treatment. This adherence was higher in the intervention group receiving SMS reminders.

Background and Objective: Prostate cancer is one of the most common malignancies worldwide. Docetaxel (DTX) is proposed as a well-known compound for prostate tumor chemotherapy, and its function is based on inhibiting microtubule depolymerization, disrupting microtubule balance, and consequently delaying cell cycle progression. Complications of DTX include hypersensitivity reactions, red blood cell aggregation, neutropenia, neurological problems, such as paralysis, fluid retention, bronchospasm, refractory hypotension, ADRS, respiratory impairment, cardiac dysfunction, ventricular tachycardia, cystoid macular edema, optic nerve damage, conjunctivitis, and keratopathy. This study aimed to determine the effect of curcumin on DTX-induced apoptosis in the DU145 (prostate) cell line using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay.
Methods: This descriptive analytical study was conducted on the DU145 (prostate) cell line, purchased from the National Genetic Resources Cell Bank, at the Cell Culture Laboratory of the F aculty of Pharmacy, Mazandaran University of Medical Sciences. Cells were passaged for exposure to the desired drugs. Groups included curcumin at concentrations of 2, 4, 6, 8, and 10 µg/mL and DTX at a concentration of 4.46 µg/mL. Cells were incubated in triplicate for 24 hours. For the MTT assay, the culture rate was 10⁴ cells per well. Apoptosis testing was designed for four groups (DTX at a concentration of 4.46 µM, curcumin at a concentration of 2 µM combined with DTX at an optimal concentration, curcumin at a concentration of 10 µM combined with DTX at an optimal concentration, and curcumin at a concentration of 10 µM alone), with the culture rate of 5×10⁵ cells per well in 6-well plates. After cell exposure, MTT and apoptosis determination assays were performed.
Results: DTX reduced the viability of DU145 (prostate) cells by approximately 50% (P<0.05). Groups treated with curcumin combined with DTX showed a dose-dependent decrease in cytotoxicity and an increase in the viability of DU145 (prostate) cells (P<0.05). Additionally, curcumin was able to reduce apoptosis in DU145 (prostate) cells by 90%.
Conclusion: Curcumin increases cell viability and reduces apoptosis in DU145 (prostate) cells.

Background and Objective: Docetaxel is an effective chemotherapy drug for treating lung cancer, but its side effects and cytotoxicity limit its use. Natural compounds like carvacrol and thymol, known for their anti-cancer and anti-inflammatory properties, have gained attention as adjunct agents to reduce toxicity and enhance the efficacy of chemotherapy drugs. This study aimed to investigate the impact of carvacrol and thymol on cell viability and function in A549 cancer cells exposed to docetaxel.
Methods: This experimental study was conducted on the epithelial cell line derived from lung cancer tissue (A549), obtained from the Pasteur Institute of Iran at the Faculty of Pharmacy, Mazandaran University of Medical Sciences in the year 1042. In this research, A549 cells were pre-treated with various concentrations of carvacrol and thymol (5, 10, 20, 40, 80, 100, and 200 µg/mL) along with a cytotoxic dose of docetaxel (8.92 µg/mL) over a period of 48 hours. Cytotoxicity was assessed using the MTT assay. Additionally, the levels of reactive oxygen species (ROS) in cells were measured using the DA-DCFH reagent, and malondialdehyde (MDA) levels were determined using the thiobarbituric acid (TBA) reagent.
Results: Carvacrol and thymol significantly reduced the cytotoxic effects of docetaxel at concentrations ranging from 5 to 200 µg/mL (P<0.05). The evaluation of cytotoxicity indicated that at a concentration of 200 µg/mL, carvacrol and thymol exhibited a more pronounced enhancing effect (98.11±1.64%) compared to the concentration of 5 µg/mL (54.64±2.03%). Furthermore, these compounds significantly mitigated the oxidative stress induced by docetaxel by decreasing the production of reactive oxygen species (ROS) and malondialdehyde (MDA) (P<0.05). Specifically, at the concentration of 200 µg/mL, the levels of ROS and MDA were (13.57±0.09%) and (0.55±0.003%), respectively, in contrast to the levels at 5 µg/mL, which were (20.50±0.59%) and (0.98±0.01%). This demonstrates a notable inhibitory effect on the growth of cancer cells by carvacrol and thymol.
Conclusion: Carvacrol and thymol demonstrate high potential as compounds to improve cell function and reduce the cytotoxicity induced by docetaxel in A549 cancer cells. These findings suggest the potential enhancement of chemotherapy regimens for cancer treatment.

Excessive weight gain during pregnancy is recognized as a global epidemic and is associated with complications, such as gestational diabetes. While a healthy diet and regular physical activity positively influence weight control and overall well-being, in-person consultations can be costly and time-consuming. The use of digital technologies, particularly smartphones, has increased for delivering lifestyle interventions and improving well-being. These technologies provide affordable access to health services for pregnant women, especially those in remote areas. This narrative review was conducted to evaluate the effect of telehealth on weight control and the promotion of a healthy lifestyle among pregnant women. A search was performed in the PubMed, Google Scholar, and Scopus databases. Of the 631 initial articles published during 2020-2024,
15 were selected and evaluated after excluding irrelevant articles, review articles, and those without full texts. The selected articles showed that mobile health (mHealth) could improve indicators, such as weight, body mass index (BMI), maternal and infant health, and lifestyle. However, certain limitations, including access issues, cultural barriers, and fluctuations in service quality, impacted their effectiveness. Based on the findings of these articles, it is suggested that personalized interventions be designed with continuous consultations and daily reminders. Forming virtual groups and providing timely feedback can strengthen the sense of belonging and promote adherence. These strategies are valuable for telehealth clinics and online counseling programs.
 

Background and Objective: One of the prominent challenges in the dental profession is patient complaints, many of which lead to legal and criminal prosecution. This study aimed to determine the prevalence and causes of patient complaints against dentists in Golestan Province.
Methods: This descriptive study was carried out on 96 complaint files against dentists in Golestan Province, Iran, using a census method during 2012-2022. The necessary information was extracted from the files and recorded in an information form.
Results: The most frequent complaints were related to prosthodontics (29.2%), surgeries (26%), and endodontics (18.8%). The dentists who received complaints were predominantly male (75%) and had a general dentistry degree (90.6%). In 33% of the complaints, the dentist was found liable. None of the complaints against specialists resulted in the practitioner being found at fault.
Conclusion: The most common complaints were in the fields of prosthodontics, surgeries, and endodontics. The dentists involved were mostly male general dentists. Moreover, 33% of the complaints led to a conviction. Complaints related to prosthodontics and surgeries primarily concerned cosmetic treatments and implant surgeries, highlighting the need to review the educational curriculum for general dentists.
 

Influenza is an acute viral respiratory disease with diverse clinical manifestations. Despite extensive research, ambiguities remain regarding its prognostic factors. In this cross-sectional retrospective study, conducted during 2021 on 993 samples (546 males 447 females) from patients with suspected acute viral respiratory infections who were hospitalized in hospitals of Golestan Province, we evaluated the clinical and laboratory findings of patients with influenza. The samples were sent to the provincial molecular diagnostics laboratory for real-time polymerase chain reaction (PCR) molecular testing. All samples were also tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Test results, along with demographic, clinical, and laboratory data, were collected using a standardized questionnaire. Of the 993 samples tested for influenza, 174 were reported as positive. All, but one, of these positive cases were influenza A. From 993 tests for SARS-CoV-2, 271 cases were also reported as positive. Additionally, 11 patients had influenza and SARS-CoV-2 co-infection. The mean age of influenza patients hospitalized in the intensive care unit (ICU) was determined to be 55.60±15.11 years, while in other wards, it was 37.51±12.1 years (P<0.05). Regarding gender, the ICU-hospitalized male-to-female ratio was 3 times and 1.35 times in other wards (P<0.05). In ICU-hospitalized patients, the highest percentage of clinical symptoms belonged to fever, cough, chills, and anorexia, and in patients hospitalized in other wards, the highest percentage belonged to fever, followed by cough, chest pain, and chills. There was a statistically significant difference between ICU-hospitalized patients and those hospitalized in other wards for symptoms, such as anorexia, arthralgia, myalgia, sore throat, cough, nausea, headache, and chills (P<0.05). Blood factors, such as white blood cell (WBC) count, neutrophil and lymphocyte percentages, hemoglobin, erythrocyte sedimentation rate (ESR), and platelets, were evaluated, and no statistically significant difference was observed between the two patient groups. Biochemical factors, including blood urea nitrogen (BUN), creatinine, sodium, potassium, liver enzymes, such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), lactate dehydrogenase (LDH), creatine phosphokinase (CPK), and direct and indirect bilirubin, were also examined, and no significant difference was found between the two patient groups. Additionally, other factors, such as oxygen and carbon dioxide saturation percentages, bicarbonate, and blood pH were assessed, and a statistically significant difference was found between the two groups for oxygen and carbon dioxide saturation percentages (P<0.05). Based on the findings of this study, age and gender are effective factors in the severity of influenza. Men and older adults are at particular risk for ICU hospitalization. The high prevalence of influenza A and cases of SARS-CoV-2 co-infection also highlight the importance of accurate diagnosis and appropriate treatment. Given the increased risk of infection and disease severity among the elderly, implementing preventive programs, such as annual influenza and coronavirus disease 2019 (COVID-19) vaccinations, is essential for this group. Additionally, attention to laboratory findings like blood oxygen levels can be effective in the early identification of high-risk patients.