54 1560-652X Kurdistan University of Medical Sciences 3905 General Effect of Hydro-alcoholic extract of Jasminum sambac on morphine withdrawal symptoms in rats Moloudi Mohammad Raman b Moqbel Hila c Dastan Dara d Hasanzadeh Katayoon e Noori Bijan f Izadpanah Esmael g b Neurosciences Research Center. Kurdistan University of Medical Sciences, Sanandaj, Iran. c Student of Medicine, Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran. d Medicinal Plants and Natural Products Research Center, Hamedan University of Medical Sciences and Health Services, Hamadan, Iran. e Department of Physiology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran. f Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran g Cellular and Molecular Research Center. Kurdistan University of Medical Sciences, Sanandaj, Iran 1 4 2018 23 1 1 7 15 03 2018 15 03 2018 ABSTRACT Background and Aim: The exact mechanisms of morphine dependence and withdrawal syndrome remain unclear. Many studies have been performed to find agents with low dependency in order to decrease withdrawal symptoms. On the other hand studies have shown the anticonvulsant and sedative effects of Jasminum sambac. The traditional use of this plant has shown its analgesic, anti-depressant, anti-inflammatory, disinfectant, sedative, and anti-spasmodic effects. The aim of this study was to investigate the effect of hydroalcoholic extract of Jasminum sambac on morphine withdrawal symptoms in rats. Material and Methods: Adult male Wistar rats with weight range of 225 - 275 g were randomly selected and divided into 5 groups. Each group consisted of 6 rats. In order to induce dependency, additive doses of morphine were injected subcutaneously for 13 days. On the 13th day, after the last dose of morphine, intraperitoneal saline injection (1 ml/kg:) was given to the morphine-saline group. We gave intraperitoneal injections of 100, 200, 400 mg/kg of hydroalcoholic extract of Jasminum sambac to the three treatment groups respectively. Thirty minutes later, intraperitoneal injections of naloxone (4 mg/kg) was given to the treatment groups and the withdrawal symptoms including: jumping, rearing, genital grooming, abdominal writhing, wet dog shake and weight loss were recorded for 60 minutes. Results: Results of this study showed that 100 mg/kg of hydroalcoholic extract of Jasminum sambac significantly reduced the number of jumping and at all doses reduced rearing and genital grooming in the treatment groups compared to those in the morphine-saline group (P <0.01 and P <0.001). In addition, hydroalcoholic extract of Jasminum sambac decreased total withdrawal scores at all used doses. Conclusion: We found that hydroalcoholic extract of Jasminum sambac was effective in decreasing the symptoms of morphine withdrawal symptoms. This effect is probably attributed to its antioxidant and anti-inflammatory effects. Keywords: Hydroalcoholic extract of Jasminum sambac, Morphine, Withdrawal symptoms.   Received: Aug 7, 2017     Accepted: Nov 1, 2017
3906 General Comparison the effects of ginger (Zingiber officinale) jelly and piroxicam jelly on pain of knee osteoarthritis Dehghan Morteza h Abdoli-tafti Abbas i Ganji Foroozan j Ghaedi Rasoul k h Medical Plants Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran. i Orthopedic Surgery Dept, Shahrekord University of Medical Sciences, Shahrekord, Iran j Social Medicine Dept, Shahrekord University of Medical Sciences, Shahrekord Iran. k Shahrekord University of Medical Sciences, Shahrekord, Iran. 1 4 2018 23 1 8 17 15 03 2018 15 03 2018 Background and Aim: Oral drugs and nonsteroidal anti-inflammatory drugs which are used to relieve pain are associated with certain side effects in the patients with knee osteoarthritis. The aim of this study was to compare the effects of a herbal drug, Zingiber officinale jelly, and piroxicam jelly on pain relief, morning stiffness, and physical performance in the patients with knee osteoarthritis. Material and Methods: In this semi-experimental study one hundred and twenty patients with osteoarthritis were randomly assigned to three groups of 40. Z. officinale 2% jelly, piroxicam jelly, and placebo were given twice a day for 14 days to the 1st, 2nd and 3rd groups respectively. Concurrently, diclofenac tablet 100mg/ day was given to all groups. Physical examination was performed before intervention and two weeks after completion of the treatment. The level of pain was measured by use of visual analogue scale. Furthermore, the WOMAC index was used to investigate the effect of pain on the patients' performance. Using SPSS software, data were analyzed by paired t-test, chi-square and ANOVA. Result: There were no significant difference between Z. officinale jelly and piroxicam jelly in relation to relief of overall pain and morning stiffness, (P>0.05). The relief of pain (P=0.01) and morning stiffness (P=0.002) were significantly more marked in the piroxicam-treated group compared to those in the placebo group. Improvement of the physical functioning was not significantly different between the piroxicam-treated and Z. officinale-treated groups (P>0.05). Conclusion: Z. officinale jelly and piroxicam jelly were effective in pain relief, amelioration of morning stiffness, and improvement of physical functioning in the patients with knee osteoarthritis, and there were no significant differences between the effects of the jellies. Key words: Osteoarthritis, Ginger jelly, Piroxicam jelly.   Received: Jun 28, 2017     Accepted: Jan 8, 2018 3910 General Effectiveness and complications of ESWL in the treatment of renal pelvis stones in the children less than 8 years of age in Sanandaj, Iran 2007-2015 Sofimajidpour Heshmatollah l Sajadi Adel m l Department of Urology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran. m Kurdistan University of Medical Sciences, Sanandaj, Iran. 1 4 2018 23 1 18 25 17 03 2018 17 03 2018 Background and Aim: Extracorporeal shock wave lithotripsy (ESWL) has revolutionized the treatment of kidney stones in children. However, use of this technology has several complications which cast doubt on its safety and effectiveness. The aim of this study was to evaluate the effectiveness and complications of extracorporeal shock wave lithotripsy in the treatment of renal pelvis stones in the children less than 8 years of age. Material and Method: This retrospective study included children less than 8 years of age with renal pelvis stones who had been referring to Tohid Hospital in Sanandaj, between 2007 and 2015. Data of the patients, such as age, sex, clinical status, stone free rate, days of hospitalization, response rate to treatment and complications were obtained from the patients' medical records. We used a checklist to collect data of 35 children less than 8 years of age (including 37 kidneys) with renal pelvis stones who had been treated with ESWL in Tohid Hospital. SPSS software and descriptive statistics (absolute and relative frequency, mean and standard deviation) were used for data analysis. Result: The sizes of the stones were between 8 and 25 mm. Thirty three patients (94.5%) were treated after one ESWL session and two patients (5.5%) were treated after two ESWL sessions. Six patients (16.2%) developed fever due to urinary tract infection; in two cases free stones lodged in ureter and 8 cases (21.6%) required hospitalization after ESWL. Hematuria occurred in all cases. Subcapsular hematoma was not observed in the patients. Blood transfusion was not given to the patients. The effectiveness of ESWL and stone free rate had inverse relationship with the age of the patients and sizes of the stones. Conclusion: In this study extracorporeal shock wave lithotripsy was an extremely effective method for the treatment of renal pelvis stones in children and major and irreversible complications were not common. ESWL was more suitable for the treatment of the stones of less than 20 mm. Key words: Children, Kidney stone, ESWL, Complications.   Received: Aug 15, 2017     Accepted: Nov 6, 2017 3911 General Protective effects of aqueous extract of internal septum of walnut fruit on diabetic hepatopathy in streptozotocin-induced diabetic mice Zangeneh Akram n Zangeneh Mahdi o Ghoodarzi Nader p Najafi Fariba Hagh Nazari Lida n DVM Student, Faculty of Veterinary Medicine, Razi University, Kermanshah, Iran. o DVM Student, Faculty of Veterinary Medicine, Razi University, Kermanshah, Iran. p Department of Basic and Pathobiological Sciences, Faculty of Veterinary Medicine, Razi University, Kermanshah, Iran Department of Dermatology, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran. Department of Biochemistry, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran. 1 4 2018 23 1 26 37 17 03 2018 17 03 2018 Backgrounds and Aim: Treatment of diabetes by ethnomedicinal plants which have fewer side effects than chemical drugs has been on the rise. In this study we assessed hepatoprotective and antidiabetic effects of aqueous extract of internal septum of walnut fruit (ISWF) on diabetic mice. Material and Methods: In this experimental study 35 mature male mice were made diabetic by administration of 60 mg/kg of streptozotocin intraperitoneally. The mice were randomly divided into 5 groups. The negative (non diabetic) and positive (diabetic) control groups received normal saline and the 1st, 2nd and 3rd treatment groups received 0.5 mg/kg of glibenclamide, 200 and 400 μl/kg of aqueous extract of ISWF through gavage respectively for 15 days. On the last day, serum levels of blood glucose, ALT (alanine aminotransferase), AST (aspartate aminotransferase) and ALP (alkaline-phosphatase) were measured. After tissue processing, we measured total volume of the liver, hepatocytes, sinusoids, portal vein, central vein, hepatic arteries and bile ducts in the sections of the tissues. Results: Use of aqueous extract of ISWF in the treatment groups led to significant decrease in blood glucose levels, AST and ALP enzymes and also total volume of liver, sinusoids and central vein (p<0.05) compared to those in the non-treated diabetic group. Conclusion: According to the results, aqueous extract of ISWF, can regulate the blood glucose level and inhibit hepatic damage in streptozotocin-induced diabetic mice. Key Words: Internal septum of walnut fruit, Streptozotocin, Diabetes, Liver, Mice.   Received: May 30, 2017     Accepted: Jan 8, 2018 3912 General Assessment of the eligibility of the patients with chronic renal failure for peritoneal dialysis in Kurdistan Province Mohammadi Baneh Anvar Rahimi Ezatollah Mahmoodnejad Delpak Internal Medicine Department, Kurdistan University of Medical Sciences, Sanandaj, Iran Liver and Digestive Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran. General Practitioner, Kurdistan University of Medical Sciences, Sanandaj, Iran. 1 4 2018 23 1 38 44 17 03 2018 17 03 2018 Background and Aim: Peritoneal dialysis is one of the most important issues in nephrology. The aim of this study was to assess the possibility of performance of peritoneal dialysis and its associated factors in the patients chronic renal failure. Material and Methods: This cross-sectional study included 146 patients with chronic kidney disease requiring hemodialysis between 2013 and 2014. Data were collected by interviewing patients and review of the patients' records and visiting the life places of the patients. Data were analyzed by inferential statistic including t-test and chi- square. Result: The results showed that 58.9% of the patients were men and 41.1% were woman. The mean age of the participants was 58.06±13.22.  78 (53.4) patients were eligible for peritoneal dialysis. There was a significant relationship between eligibility of the patients for peritoneal dialysis and their blood pressures (p<0.05). Conclusion: We concluded that eligibility of the patients for peritoneal dialysis does not comply with the demographic variables. But physical and psychological condition of the patients can affect it. Keyword: Peritoneal dialysis, kidney disease, Kurdistan.   Received: Jan 16, 2017     Accepted: Nov 6, 2017   3913 General The effect of acetone extract of Moringa peregrina on Trichomonas vaginalis, Candida albicans and macrophage cells in vitro. Ebrahimi Mina Sadraei Javid Roudbarmohammadi Shahla Nikoomanesh Fatemeh Department of Parasitology, Faculty of Medical Science, Tarbiat Modares University, Tehran, Iran. Department of Parasitology, Faculty of Medical Science, Tarbiat Modares University, Tehran, Iran Department of Mycology, Faculty of Medical Science, Tarbiat Modares University ,Tehran, Iran. Department of Mycology, Faculty of Medical Science, Tarbiat Modares University ,Tehran, Iran. 1 4 2018 23 1 45 56 17 03 2018 17 03 2018 Background and Aim: Vulvovaginal candidiasis and trichomoniasis account for at least 50 percent of all cases of vaginal infections. The main drugs used to treat these infections have numerous side effects and drug resistance to them is on the rise. The aim of this study was to investigate the anti-trichomonas and anti candidal effects of acetone extracts of Moringa peregrina in vitro. Material and Methods: We used acetone extracts of Moringa peregrina at concentrations of 375, 750, …, 3000 and 4000 µg/ml for the treatment of trichomoniasis; and concentrations of 0/003,…, 1 and 2mg/ml for the treatment of candidiasis. We evaluated the effect of the extracts after 24 and 48 hours. The final number of viable parasites were determined by trypan blue staining and neobar lamella; and IC50 (50% Inhibitory Concentration) value was calculated. We also calculated MIC (Minimum Inhibitory Concentration) of the extract for candida. The cytotoxic effect of the extract on  the mice macrophage cells was investigated. Result: Comparison between treatment and control groups revealed a significant decrease in the viability of parasites in the treatment group at all concentrations after both 24 and 48 hours (P <0.05). After 24 hours the IC50 and SI values were calculated as 682 and 4.1 for parasite respectively and MIC value was 2 mg/ml for Candida albicans. Conclusion: Considering favorable effects of acetone extract of Moringa peregrina on inhibiting the growth of Trichomonas vaginalis and Candida albicans identification and isolation of active ingredients of the plant, may lead to use of this extract for the treatment of both infections in the future studies. Keywords: Trichomonas vaginalis, Candida albicans, Acetone extract of Moringa peregrina, Cytotoxicity, IC50, MIC.   Received: Jun 19, 2017     Accepted: Jan 8, 2018 3914 General Comparison of the effects of laminectomy alone and laminectomy with fusion and fixation in the patients over 50 years of age with degenerative spinal canal stenosis Rasras Saleh Safari Hosein Azizzadeh Aref Department of Neurosurgery, Jundishapur University of Medical Sciences, Ahvaz, Iran Department of Neurosurgery, Jundishapur University of Medical Sciences, Ahvaz, Iran Department of Neurosurgery, Jundishapur University of Medical Sciences, Ahvaz, Iran 1 4 2018 23 1 57 63 17 03 2018 17 03 2018 Background and Aim: Low back pain is a major health problem. About 10% of patients develop chronic disability. Prevalence of some disorders such as spinal canal stenosis will rise with increasing age. When preservative treatment fails to improve symptoms in the patients with stenosis of the lumbar canal, surgical measures can be considered. Laminectomy alone or laminectomy with fusion and fixation are surgical procedures for spinal canal stenosis. Each of these procedures has its own advantages and disadvantages. Comparison of the clinical effects of these two methods in the patients with stenosis of the canal is a way to obtain more accurate results in order to select the appropriate procedure. Material and Methods: This retrospective study included 42 patients with degenerative spinal canal stenosis, who had underwent surgery at least six months ago. Selection of surgical procedure (single laminectomy or laminectomy with fusion and fixation) was based on clinical condition of every patient. Oswestry Disability Index scale was used for clinical comparison of the two groups at least 6 months after surgery. Results: Considering the results, we found no significant differences between the two groups in terms of surgical complications, radiculer pain improvement, low back pain and neurogenic claudication; but fusion and fixation laminectomy resulted in improved performance of the patients (p ≤ 0.011)  Conclusion: The findings of this study and other studies suggest that laminectomy with fusion surgery is preferable for the treatment of degenerative spinal canal stenosis. Key words: Laminectomy, Fusion, Spinal canal stenosis.   Received: Oct 11, 2017     Accepted: Nov 11, 2017 3915 General Expression of aap and icaR genes involved in biofilm production in clinical strains of Staphylococcus aureus resistant to methicillin and gentamicin Heydari Narges Tahmasebi Hamed Zeini Behrooz Dehbashi Sanaz Arabestani Mohammad Reza Department of Microbiology,Hamadan University of Medical Sciences, Hamadan, Iran. Department of Microbiology,Zahedan University of Medical Sciences, Zahedan, Iran. Department of Microbiology,Zahedan University of Medical Sciences, Zahedan, Iran. Department of Microbiology,Hamadan University of Medical Sciences, Hamadan, Iran. Nutrition Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran 1 4 2018 23 1 64 75 17 03 2018 17 03 2018 Backgrounds and Aim: Staphylococcus aureus biofilms are involved in a multitude of serious chronic infections. Production of biofilms is a defensive-invasive process controlled and regulated by the aap and icaR genes. The expression levels of these genes play an important role in the formation of biofilm. The aim of this study was to investigate the expression of icaR and aap regulatory genes in clinical isolates of S. aureus resistant to methicillin and gentamicin. Materials and Methods: In this analytical study, among 285 samples, we detected 100 isolates of methicillin resistant and 82 isolates of gentamicin resistant S. aureus. Resistant strains were evaluated for the presence of biofilm regulatory genes. The expression levels of regulatory genes were measured by real-time PCR method. We used SPSS software 16 for statistical analysis and also REST 2008 V3 software for analysis of quantitative results. Results: Among 100 methicillin resistant and 82 gentamicin resistant isolates of S. aureus the highest expression levels of icaR and aap genes were detected in the smears obtained from the wounds and catheters. Moreover, a different pattern of gene expression was observed in multidrug resistant strains in comparison to the strains with lower rate of resistance. Also, there was a significant relationship between the presence and activity of regulatory genes and biofilm formation in different samples (p≤0 / 05). Conclusion: Considering the frequency of biofilm producing strains of S. aureus in the smears from the catheters and wounds and also increased gene expression, appropriate therapeutic measures should be considered for methicillin and gentamicin resistant of S. aureus. Keywords: Drug resistance, S. aureus, Virulence factors, Methicillin, Gentamicin, Gene expression.   Received: Aug 2, 2017     Accepted: Nov 6, 2017 3916 General In vitro study of the effect of hydroalcholic extracts of Carum copticum and Ferula asafetida against Trichomonas vaginalis, Vazini Hossein Rahimi Esboei Bahman Nursing Department, Basic Sciencses faculty, Hamedan Branch, Islamic Azad University, Hamedan, Iran Department of Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. 1 4 2018 23 1 76 83 17 03 2018 17 03 2018 Background and Aim: Ttrichomoniasis is a disease with high prevalence in the world that can impose dangerous consequences on human beings. It is caused by Trichomonas vaginalis. Although, the disease has certain treatment methods but the emergence of drug resistance has emphasized the need for new therapeutic approaches. The purpose of this study was to evaluate the in vitro effect of hydroalcoholic extract of Carum copticum (C. copticum) and ferula asafetida (F. asafetida) against Trichomonas vaginalis. Material and Methods: We prepared hydroalcoholic extracts of F. asafetida and the C. copticum. Then, the concentrations of 100, 200, 400 and 800µg/ml of the extracts were used against the T. vaginalis at the exposure times of 30, 60, 120 and 180 min. Anti-parasitic effects of the extracts at every dose and also the positive and negative controls were studied. Finally, the data were analyzed by SPSS 18 software. Results: The results showed that different concentrations of both plant extracts had anti-trichomonas effect, although the effect of the F. asafetida extract was more remarkable. We also found that the anti-parasitic effect of the extracts increased by increasing the exposure time and also concentration. At the higher concentrations of F. asafetida extract (concentrations of 200, 400 and 800 µg/ml) and at the more prolonged exposure times (120 and 180 min), the anti-trichomonas effect of F. asafetida was similar to that of metronidazole. Conclusion: The anti-trichomonas effects of the hydroalcoholic extract of F. asafetida was higher than that of  C. copticum. Complementary studies such as gas chromatography and spectophotometery can help to identify the effective ingredient of these plants which may result in the introduction of F. asafetida as a suitable alternative for metronidazole. Keywords: Carum copticum, Ferula asafetida, Trichomonas vaginalis.   Received: Jul 4, 2017     Accepted: Nov 20, 2017 3917 General The effects of two traditional and post-activation potentiation warm-up methods on ground reaction forces during squat-jump Avazzadeh Samani Sajad Anbarian Mehrdad Ghasemi Mohammad Hossein Faculty of Sport Sciences, Bu Ali Sina University, Hamedan, Iran. Faculty of Sport Sciences, BuAli Sina University, Hamedan, Iran PhD candidate, Faculty of Sport Sciences, Bu Ali Sina University, Hamedan, Iran. 1 4 2018 23 1 84 92 17 03 2018 17 03 2018 Background and Aim: A proper warm-up method can be used as a strategy to improve performance of athletes in various sport fields. The purpose of the present study was to assess the effect of traditional and post-activation potentiation warm-up methods on ground reaction forces during squat jump. Materials and Methods: Fourteen trained male athletes (age=26.5±3.64 years, weight=70±10.65 kg, height=180 ± 8.39 cm) participated voluntarily in this study. Athletes randomly performed three different warm-up protocols on three separate days: typical traditional warm-up method, static and dynamic post-activation potentiation implementing half-squat at 90% 1RM. After performing the warm-up protocols, the subjects completed squat jump test on a force platform in order to assess ground reaction forces. Results: In the jumping and landing phases, the peak values of horizontal and vertical ground reaction forces in the traditional warm-up method were significantly lower than those in the static (P=0.001 for both phases) and dynamic (P=0.001 for both phases) PAP warm-up methods. Also, we found a significant difference in the horizontal peak ground reaction force in the jumping phase between the static and dynamic PAP warm-up methods (P=0.003). In addition, significant differences in the vertical jump height and rate of force development (RFD) were observed between the traditional and static PAP warm-up methods (P=0.001 for both methods), between the traditional and dynamic PAP warm-up methods (P=0.001 for both methods), and also between the static and dynamic PAP warm-up methods (P=0.002 and P=0.003, respectively). Conclusion: According to the results of this study, it seems that the PAP warm-up method may have more advantage over traditional warm-up method in order to improve record and performance of the athletes during squat jump movement. Keywords: Warm-up, Ground reaction force, Post-activation potentiation (PAP), Squat jump.   Received: Sep 6, 2017     Accepted: Jan 8, 2018 3918 General Mycobacterium gordonae pulmonary infection with clinical manifestations similar to tuberculosis Kikha Masood Khorshidi Mehdi Navid Sepehr Microbiology Department, Isfahan Medical School, Isfahan, Iran Microbiology Department, Isfahan Medical School, Isfahan, Iran Microbiology Department, Isfahan Medical School, Isfahan, Iran 1 4 2018 23 1 93 98 17 03 2018 17 03 2018 Background and Aim: Mycobacterium gordonae is one of the most important human mycobacterial pathogens that is found in immuno-compromised patients and also healthy people. This study is the first case report of Mycobacterium gordonae infection from Iran. Material and Methods: A 39-year-old woman with fever, weight loss, anorexia, chest pain and persistent cough referred to the emergency department of Al-Zahra Hospital in Isfahan,. A sputum sample was taken from the patient. After eleven days bacterial colonies were observed on the Lowenstein–Jensen Medium. Using microscopic evaluation and biochemical tests, the bacterial colonies were identified as Mycobacterium gordonae. Considering the antibiotic resistance pattern clarithromycin and levofloxacin, were prescribed for the patient. The patient's clinical signs were improved after 6 weeks. Conclusion: The clinical and radiological manifestations of mycobacterium gordonae and tuberculosis are similar and may be mistaken for each other. In addition, therapeutic regimen for non-tuberculosis mycobacteria and tuberculosis are different. Therefore it is necessary to identify mycobacteria to the species level. Key words: Mycobacterium gordonae, Tuberculosis, Laboratory diagnosis, Non-tuberculosis mycobacteria.   Received: Jul 8, 2017     Accepted: Nov 25, 2017 3919 General A pattern for conceptual extent and measurement of nurses social undermining Ahmadi Kiomars Department of Management, Sanandaj Branch, Islamic Azad University, Sanandaj, Iran 1 4 2018 23 1 99 109 17 03 2018 17 03 2018 Background and Aim: In recent years, researchers in the field of behavioral sciences have pointed to one of the complications and dark points of the organizational communication system which is called social undermining. In organizations with high rates of interactions this communication can have more consequences. Social undermining includes all negative and exhausting behavior of the transactors which can result in impaired abilities and exhaustion of the nurses during work time. Due to high rate of interactions with the patients, patients' companions, doctors, nurses' colleagues, paramedics, head nurse, servants, guards, laboratory staff and administrative colleagues, nurses are more prone to social undermining and exhaustion. Our study included the interactions with more impacts on the nurses. Material and Methods: The aim of this study was to present a model for conceptual extent and mesurenment of nurse’s social underminig and identify the dimensions and components of this concept. This was a qualitative study. Considering the aim of the study this was an  applied – developmental study, and according to the methodology, it was an explorative study. Considering the time of data collection this was a longitudinal study.  We evaluated the theoretical adequacy level using Delphi method and Kendall's test. The study population consisted of expert nurses, selected by a non-random method. Results: In this study using Delphi method we obtained 12 experts' views, on the concept of nurses social undermining. We identified 7 dimensions, 21 components and 49 indices at the significant level of less than 0.01. Conclusion: Based on this model, we can deal with the concept of social undermining in the nursing profession. Also we can evaluate a kind of assessment system to determine the rate of social undermining for the nurses and in every ward. Key words: Communication, Social Undermining, Exhaustion, Nursing.   Received: Apr 9, 2017     Accepted: Oct 16, 2018