Mahmoud Danaee

Sexual Dysfunction in Heroin Dependents: A Comparison between Methadone and Buprenorphine Maintenance Treatment.

Introduction Methadone has long been regarded as an effective treatment for opioid dependence. However, many patients discontinue maintenance therapy because of its side effects, with one of the most common being sexual dysfunction. Buprenorphine is a proven alternative to methadone. This study aimed to investigate sexual dysfunction in opioid-dependent men on buprenorphine maintenance treatment (BMT) and methadone maintenance treatment (MMT). The secondary aim was to investigate the correlation between sexual dysfunction and the quality of life in these patients. Methods Two hundred thirty-eight men participated in this cross-sectional study. Four questionnaires were used, the Mini International Neuropsychiatric Interview, Opiate Treatment Index, Malay version of the International Index of Erectile Function 15 (Mal-IIEF-15), and World Health Organization Quality of Life-BREF Scale. Multivariate analysis of covariance was used to examine the relationship between MMT and BMT and the Mal-IIEF 15 scores while controlling for all the possible confounders. Results The study population consisted of 171 patients (71.8%) on MMT and 67 (28.2%) on BMT. Patients in the MMT group who had a sexual partner scored significantly lower in the sexual desire domain (p < 0.012) and overall satisfaction (p = 0.043) domain compared with their counterparts in the BMT group. Similarly, patients in the MMT group without a sexual partner scored significantly lower in the orgasmic function domain (p = 0.008) compared with those in the BMT group without a partner. Intercourse satisfaction (p = 0.026) and overall satisfaction (p = 0.039) were significantly associated with the social relationships domain after adjusting for significantly correlated sociodemographic variables. Conclusions Sexual functioning is critical for improving the quality of life in patients in an opioid rehabilitation program. Our study showed that buprenorphine causes less sexual dysfunction than methadone. Thus, clinicians may consider the former when treating heroin dependents who have concerns about sexual function.

Intensive resistance exercise and circadian salivary testosterone concentrations among young male recreational lifters.

Abstract Shariat, A, Kargarfard, M, Danaee, M, and Bahri Mohd Tamrin, S. Intensive resistance exercise and circadian salivary testosterone concentrations among young male recreational lifters. J Strength Cond Res 29(1): 151–158, 2015—Strength and morphological adaptations to resistance exercise are mediated in part by anabolic hormones such as testosterone, yet the time course of variability in circadian hormone concentrations is not well characterized. This study, investigated how the circadian rhythm of salivary testosterone is altered by resistance exercise in young men. Twenty healthy young male recreational lifters (age, 18.0 ± 1.3 years) with 2 years of experience in weightlifting were recruited. A randomized controlled trial was conducted, and subjects were randomly assigned to either the resistance exercise group (n = 10), who completed a series of resistance exercise (3 times a week, in the afternoon, 6–7 repetitions, at 85% of 1 repetition maximum for 3 weeks), or a control group (n = 10), who did not exercise during the 3 weeks. Before and after the study, an unstimulated saliva sample (2 ml) was taken every 2 hours for a maximum of 16 hours during each day. A significant decrease was observed in the resistance exercise (44.2%, p = 0.001) and control group (46.1%, p = 0.001) for salivary testosterone at each time point compared with baseline (p = 0.001). There was also no significant difference between the exercise and resting conditions in both groups for salivary testosterone (p > 0.05), except a significantly higher increase by 38.4% vs. −0.02% (p = 0.001), at 1730 hours during exercise sessions in the resistance exercise group compared with the control group. Resistance exercise has no noteworthy effect on circadian secretion of salivary testosterone throughout the 16 waking hours. These results indicate that athletes can undertake resistance exercise in either the morning or afternoon with the knowledge that a similar testosterone response can be expected regardless of the time of day.

Erectile Dysfunction Among Patients on Methadone Maintenance Therapy and Its Association With Quality of Life.

OBJECTIVES Erectile dysfunction (ED) is a problem commonly encountered by patients on methadone maintenance therapy (MMT). This study aimed to assess the prevalence of ED among this group of patients along with its risk factors and association with quality of life (QOL). METHODS Male patients on MMT in a tertiary hospital in Malaysia were included in the study. A total of 134 patients with sexual partners were assessed for ED using the International Index of Erectile Function. Patients were assessed for substance use using Opiate Treatment Index (OTI) and depression using the Malay version of the self-rated Montgomery-Asberg Depression Rating Scale (MADRS-BM). QOL was evaluated using World Health Organisation Quality of Life (WHOQOL)-BREF. RESULTS The prevalence of ED among patients on MMT was 67%, with 26.1% having mild ED, 30.4% having mild-to-moderate ED, 7.0% having moderate ED, and 17.2% having severe ED. Patients with depression were 4 times more likely to have ED compared with patients without depression, whereas increasing age significantly correlated with the severity of ED. Having ED predicted a poorer QOL in the social relationships domain. CONCLUSION Depression is highly associated with ED, which negatively influences the social aspect of QOL among patients on methadone maintenance therapy.

Strength-training and biological rhythm of male sex hormone among judoists

Testosterone is a steroid hormone that is secreted by the testes with a diurnal rhythm and has a strong anti-catabolic (anabolic) effect on muscles. There is a strong relationship (r > 0.9) between concentrations of testosterone in the saliva and blood. The main purpose of the current study is to investigate the effect of strength-training on levels of salivary testosterone in male judoists. In a cross-sectional investigation, a population of 18 fit young male judoists (aged 17.0 ± 1.2 year, body mass 72 ± 3 kg, height 175 ± 3 cm, means ± SD), with at least 1.5 years of experience in judo classes was examined in Isfahan, Iran, in December, 2012. The period of testing consisted of two days of “rest” and two days of “exercise”. Subjects were randomly divided into two conditions that performed either the “rest” or “exercise” days during the first week, with the opposite type of day in the second week. The training regimen consisted of three repetitions of nine tasks, with 1 min of rest between each of the three sets, performed on alternate days for 8 weeks. Unstimulated saliva was collected (1–2 ml) every 2 h from 06:00 till 22:00 h. ANOVA with repeated measures was used to assess differences between the rest and exercise days. Strength-training sessions caused a significant decrease in testosterone levels immediately after exercise (p < 0.001), but there was no significant difference between the daily profiles of testosterone during the rest or exercise days (p > 0.05). It is concluded that strength-training does not significantly affect the normal biological rhythm of salivary testosterone during the waking period in male judoists.

The application of a feasible exercise training program in the office setting

BACKGROUND Previous research support the claim that people who work in offices and sit for a long time are particularly prone to musculoskeletal disorders. OBJECTIVE The main objective of this paper is to introduce an exercise training program designed to decrease muscle stiffness and pain that can be performed in the office setting. METHODS Forty healthy office workers (age: 28±5.3 years old; body mass: 87.2±10.2 kg; height: 1.79±0.15 m) apart from suffering from any sub-clinical symptoms of muscle and joint stiffness, and who had at least two years of experience in office work were chosen and randomly assigned to either an experimental group (n = 20) or a control group (n = 20). The experimental group performed the exercise training program three times a week for 11 weeks. The Cornell Musculoskeletal Discomfort Questionnaire was used to measure the pain levels in the neck, shoulders, and lower back areas. The Borg CR-10 Scale was used to measure their perceived exertion when doing the exercises, and a goniometer was used to measure the changes in range of motion (ROM) of the neck, hips, knees, and shoulders. RESULTS The overall results indicated that the exercise program could significantly (p < 0.05) reduce the neck, shoulders, and lower back pains of the participants in the exercise group while those in the control group showed no improvement in those pains. There were significant (p < 0.05) increases in the ROM of the hips, the neck, both knees and shoulders in the exercise group. Participants showed significant (p = 0.011) decreases in perceived exertion scores after the exercises. CONCLUSIONS The exercise training program designed in this study not only can effectively reduce neck, shoulders, and lower back pains, but also can improve the ROM or flexibility of the office workers.

Prevalence Rate of Musculoskeletal Discomforts Based on Severity Level Among Office Workers

Summary There are a variety of body aches that fall under the umbrella term of Musculoskeletal Discomforts (MSDs). These can be distinguished based on the level of pain suffered by the patient, ranging from mild and sporadic to serious, constant and fatal. It has been suggested that a link exists between MSDs and risk factors involving one’s occupational conditions and physicality. Examining the prevalence rate of musculoskeletal discomforts based on the severity among office workers was the main objective of this study. In order to achieve this objective, we had, in February 2015, selected from a population of 20 000 Malaysian office workers, 753 subjects within the age range of 20-50 years who have had a minimum of a year’s working experience. For this study, a form of structured questionnaire, known as the Cornell questionnaire, has been evaluated and put to use. Under the watch of the researchers, the subjects were instructed to complete the questionnaire in the morning before they begin their respective jobs. Based on their responses, the Cornell questionnaire has revealed that at least one case of severe pain in the neck, shoulder or lower back, respectively, is suffered by 69.7% of the subjects. In the case of neck-related aches, 15% low pain, whereas 51% involved mild pain and 33.9% were cases of severe pain. That being said, 19.3% low pain in the lower back, while 50.7% suffered from mild pain and 30% had severe pain in the same region. Percentages of 34.9% for high severity, 45.4% for mild severity and 19.7% for low severity were simultaneously reported in the shoulder section. In a nutshell, the study has revealed that, in comparison with body aches in the arms, knees, upper back, forearms, wrists, hands, hips and thighs, the subjects are more vulnerable to body aches in the neck, shoulders and lower back.

Effectiveness of Methadone Maintenance Therapy and Improvement in Quality of Life Following a Decade of Implementation.

Methadone maintenance therapy has been found to be an effective harm reduction treatment for opioid use disorder. However evidence of its benefits over a longer duration of treatment is limited as most studies focus on its short term benefits. As methadone maintenance therapy reaches a decade since its implementation in Malaysia, this study sought to examine the effectiveness of methadone treatment, change in quality of life among patients since entry to methadone treatment, as well as factors predicting the magnitude of change in quality of life. This study found that methadone maintenance therapy was effective in reducing heroin use, injecting practices and crime, and in improving in social functioning and physical symptoms, but not in reducing sex-related HIV risk-taking behavior. Though patients had a significantly better quality of life at follow-up than at entry to methadone maintenance therapy, the improvement in quality of life was not significantly greater as the duration of treatment increased. Age above 50 years old, human immunodeficiency virus (HIV) positive status and physical symptoms predicted a poorer improvement in quality of life between baseline and follow-up. On the other hand, patients with hepatitis B showed a greater improvement in quality of life in the social relationships domain compared to patients without hepatitis B. In conclusion, methadone maintenance therapy is an effective treatment for opioid use disorder and improves quality of life but its benefits in further improving quality of life beyond a decade of treatment need further evaluation.

Office Exercise Training to Reduce and Prevent the Occurrence of Musculoskeletal Disorders among Office Workers: A Hypothesis

Pain in specific areas of the body (including the lower back, neck, and shoulders) due to extended periods of sitting and inactivity is the most widespread musculoskeletal disorder worldwide and has consequences that are both socio-economic and personal. This condition is particularly prevalent in industrialised countries, affecting roughly 70% to 80% of adults at some point in their lives; approximately 1% of the U.S. population is chronically disabled by this type of pain disorder. A practical way to reduce the prevalence of musculoskeletal pain among office workers would have a significant positive impact. More work is required to develop a package of exercises designed to prevent and treat musculoskeletal pain in office workers. Such a package would be preferable to pharmacological treatments, which can have undesirable side effects. The main objective of this package would be to increase the flexibility and strength of trunk muscles in order to decrease the soreness, pain, and degree of discomfort. In this article, we introduce our proposed package of exercises, which are based on guidelines issued bythe American College of Sports Medicine.

Preliminary Screening of Antioxidant and Antibacterial Activities and Establishment of an Efficient Callus Induction in Curculigo latifolia Dryand (Lemba)

Leaf, seed, and tuber explants of C. latifolia were inoculated on MS medium supplemented with various concentrations of BAP and IBA, alone or in combinations, to achieve in vitro plant regeneration. Subsequently, antioxidant and antibacterial activities were determined from in vitro and in vivo plant developed. No response was observed from seed culture on MS media with various concentrations of PGRs. The highest percentage of callus was observed on tuber explants (94%) and leaf explants (89%) when cultured on MS media supplemented with IBA in combination with BAP. A maximum of 88% shoots per tuber explant, with a mean number of shoots (8.8 ± 1.0), were obtained on MS medium supplemented with combinations of BAP and IBA (2.5 mg L−1). The best root induction (92%) and mean number (7.6 ± 0.5) from tuber explants were recorded on 2.5 mg L−1 IBA alone supplemented to MS medium. The higher antioxidant content (80%) was observed from in vivo tuber. However, tuber part from the intact plant showed higher inhibition zone in antibacterial activity compared to other in vitro and in vivo tested parts.

The effect of obsessive compulsive symptoms on psychopathology in patients with schizophrenia

There is a growing interest on the impact of comorbid obsessive-compulsive symptoms (OCS) on the course and severity of schizophrenia in recent years. Objective: This study determined the prevalence of OCS in schizophrenia patients and the clinical outcomes of the comorbidity. Methods: A total of 220 schizophrenia patients were recruited. All the participants completed Structure Clinical Interview version, Yale Brown Obsessive Compulsive Scale, Calgary Depression Scale for Schizophrenia, Columbia Suicide Severity Rating Scale and World Health Organization Quality of Life – Brief Version (WHOQOL-BREF). Results: Significantly higher number of schizophrenia patients with OCS were taking Clozapine (p = 0.023) and antidepressants (p = 0.013). Schizophrenia patients with OCS showed more severe positive (p < 0.001) and general symptoms (p < 0.001) of schizophrenia, higher depressive symptoms (p = 0.013), higher suicidality (p < 0.001), more hospitalization (p = 0.044), poorer physical (p = 0.034) and psychological (p = 0.032) domain in WHOQOL-BREF. Discussion: Schizophrenia patients with OCS are associated with more severe psychopathology and depressive symptoms which subsequently suffered poorer physical and psychological health. Hence, recognition of OCS in schizophrenia and early initiation of effective treatment may be able to reduce the burden for people with chronic mental illness