مجله طب جنوب
سال بیست و چهارم شماره 3 (امرداد و شهریور 1400)

Sox genes are growth regulators that serve functions in sex determination, neural crest development, and neurogenesis. SoxC proteins include Sox4, Sox11, and Sox12, which cause the development of neural progenitor cells to immature neurons. In other words, one of the functions of these factors is the role they play in neurogenesis. Therefore, the aim of this study was to investigate the changes in the expression of SoxC genes in Multiple Sclerosis (MS).

This descriptive-analytical study seeks to evaluate the relative expression of SoxC genes. For this purpose, blood samples from 40 patients with MS and 40 healthy controls were examined. Total RNA extraction and complementary DNA synthesis (cDNA) were then performed, and the relative expression of the three genes Sox4, Sox11 and Sox12 was then obtained by real-time PCR. The data collected were analyzed using statistical methods.

The results showed that the expression of Sox4, Sox11 and Sox12 genes were significantly downregulated in the patients with MS compared to the controls (P=0.009, P=0.019, and P=0.001). Also, with increasing disability in individuals with MS, gene expression decreased significantly for Sox4 and Sox11, but the change was not significant for Sox12.

The present study revealed that the expression of SoxC genes is lower in MS. Considering the functional role of Sox genes as proteins involved in neurogenesis, the abnormal expression of members of this gene family is implicated in various diseases.

Patent Ductus Arteriosus (PDA) stenting is an interventional method to supply pulmonary blood flow in patients with ductal dependent pulmonary blood flow. This study was conducted to evaluate neonatal PDA stenting at Shiraz University of Medical Sciences, Shiraz, Iran.

Thirty neonates with a diagnosis of pulmonary valve atresia and ventricular septal defect (VSD) were included in this study. Neonatal PDA stenting had been performed on them from February 2017 to November 2019 at Shiraz University of Medical Sciences. The mortality rate, stent lumen stenosis and stent redilation and also SpO2 of all the patients were assessed before stenting and one year after and compared with the data from other studies. A CT angiography of the aorta and pulmonary arteries had been performed on ten patients at the age of one year; the McGoon ratio was calculated for them and compared against this ratio at their neonatal angiography.

PDA stenting was successful in 23 cases (77%) and non-successful in seven cases (23%); meanwhile, four patients expired during or early after stenting. Regarding the access sites for PDA stenting, 22 PDAs were accessed via the axillary artery, six via the femoral arteries and two via the inferior vena cava using an antegrade approach. SpO2 and the McGoon ratio had improved significantly one year after stenting compared to before, with SpO2 increasing from 54.43±6.54 to 83±7.33 and McGoon ratio from 1.18±0.23 to 1.67±0.31.

Ductal stenting is an effective and less invasive therapeutic method for increasing arterial O2 saturation and maintaining pulmonary blood flow. Most of our patients had good SpO2 one year after PDA stenting without any additional re-intervention and the McGoon ratio had increased sufficiently in them.

The use of allergen immunotherapy is one of the definitive treatments for allergic diseases due to the cellular and molecular changes developed in the immune system response. The aim of this study was to assess the efficacy of subcutaneous immunotherapy in patients with allergic diseases presenting to the allergy clinic of Persian Gulf Hospital in Bushehr, Iran.

Patients with  respiratory allergic diseases were enrolled in this observational study. The patients who had a positive skin prick test underwent immunotherapy for one year and were randomly included in this study. To evaluate the efficacy of immunotherapy, two questionnaires were completed for all the patients before and one year after the start of immunotherapy, including the Total Nasal Symptom Score (TNSS) and Asthma Control Test (ACT).

A total of 878 patients (53.6% male and 46.4% female) entered the study, including 45.8% who had allergic rhinitis, 25.5% with asthma and 28.5% with both diseases. The mean TNSS was examined for 258 patients before and after immunotherapy and was 13.64 and 5.83 (P<0.001), respectively. Moreover, the mean ACT score before and after immunotherapy was examined for 186 patients and was 1.71 and 17.82 (P<0.001), respectively.

The mean TNSS and ACT score before and after the treatment showed a significant improvement in the patients’ symptoms in both genders, and women showed a relatively better response to immunotherapy. To conclude, immunotherapy is effective in patients with asthma and allergic rhinitis.

One of the most effective modalities for reducing surgical site infection is the use of prophylactic antibiotics, but the inappropriate consumption of antibiotics before operations leads to an increased prevalence of resistant bacterial infections, adverse drug side-effects and financial burden. This study examined the logical administration of prophylactic antibiotics and its patient outcomes and compared the results with international guidelines.

In this study, 348 patients who were elective surgery candidates were assessed over six months. The patients’ demographic information, type of operation, and antibiotic indication, type, dosage, and time and duration of administration before the operation were entered into a checklist and the results were compared against the American Society of Health system Pharmacists (ASHP) guidelines.

The indication for prophylactic antibiotics was correct in 88.5% of the 348 patients examined. In those with prophylactic antibiotic indication, the antibiotic type used before surgery was appropriate in 73 (83.9%) out of 87 cases. The antibiotic dosage before the surgery was correct in 72 (98.6%) patients. The timing of antibiotic administration was correct in 36 (49.4%) cases. The duration of antibiotic administration was in accordance with the standard guidelines in 53 patients (27.7%).

In this study, the lowest accordance with standard guidelines was observed in the duration of prophylactic antibiotic intake. Considering the side effects of antibiotic overuse and its financial burden, developing a unique standard guideline, providing training to the prescribers of medications to adhere to this guideline, and the careful tracking and receiving of feedback seem desirable solutions to overcome this challenge.

High job stress exposes individuals to job burnout. People who experience constant, high and uncontrolled stress in the workplace are more prone to job burnout. The aim of this study was to determine the frequency of different levels of job burnout and their related factors in the workers of comprehensive health
centers in Bushehr and Borazjan, Iran.

This cross-sectional study was conducted on 203 healthcare workers. Data were collected using the Maslach Burnout Inventory and HSE Management Standards questionnaires in 2019. Data were analyzed in SPSS software, version 24, using descriptive statistics (mean, frequency and percentage), the independent t-test, ANOVA, Chi-square test, Pearson’s correlation test and linear regression.

The mean age of the research units was 36.74±8.40. Ninety-nine percent of the healthcare workers had low and moderate levels of job burnout. There was a strong negative correlation between job burnout and the management standards (r=-0.69, p<0.001). The two components including organizational role and job relationship predicted job burnout and explained 63% of the changes in job burnout.

Most of the healthcare workers had low and moderate job burnout. The two components including organizational role and job relationship were the greatest predictors of job burnout. The lack of familiarity with onechr('39')s role in the system and unfavorable interpersonal relationships in the workplace were the main stressors that affected job burnout and which need special attention from health policymakers.

One method for the assessment of dentistry curricula is to evaluate dentistry graduateschr('39') satisfaction with their acquired clinical skills. Given the lack of data on this subject at the national level, this study aimed to evaluate the satisfaction with clinical skills training in general dentistry graduates in Iran.

This cross-sectional descriptive-analytical study was conducted on 614 general dentistry graduates participating in the dentistry residency exam in 2019 in Iran. Data were collected using a questionnaire consisting of three sections. The validity and reliability of the designed questionnaire were approved using statistical tests. The questionnaires were distributed among the participants before the residency exam. After collecting the completed questionnaires, their data were extracted and analyzed in SPSS-26 using Mann-Whitney’s U-test and the Kruskal-Wallis test to compare the distribution of satisfaction according to entrance year and university type.

The response rate was 100%, which must be because the questionnaires were distributed during the residency exam session. According to the participants, the highest level of satisfaction with the practical skills acquired pertained to pediatric dentistry (76.5%), operative dentistry (71.4%) and radiology (64.7%), and the lowest pertained to endodontics (38.1%), orthodontics (41.9%) and oral maxillofacial pathology (45.3%).

Overall, the general dentistry graduateschr('39') satisfaction with the acquired skills was above average (more than 50%) in most of the skills. Nevertheless, entrance year, practical skills and faculties had a significant impact on the level of satisfaction.

Ethnopharmacology, as a multidisciplinary approach for novel drug discovery, provides valuable data about medicinal plants in different cultures.The aim of this ethnopharmacological study was to identify medicinal plants in the Giskan mountain area.

The medical uses of medicinal plants were gathered from 20 local nformants by face-to-face interviews. The relative frequency of citation (FRC) and cultural importance (CI) indices were calculated.

A total of 126 medicinal plants belonging to 58 families were identified. Zataria multiflora, Achillea eriophora DC, Matricario chamomilla, Glycyrrhiza glabra, Pistacia Atlantica, Plantago psyllium, Teucirum polium, Scrophularia striata, Cichorium intybus, Foeniculum vulgare had the highest CI and FRC indices. The highest medical uses were for respiratory diseases, gastrointestinal discomforts, obstetrics and gynecology, general conditions (temprament and weakness), infectious diseases and  metabolic disorders.

There is a vast variety of medicinal plants in the Giskan mountain area. Although most of the therapeutic applications of these plants in this area are the same as Iran’s traditional medicine, the people in the Giskan mountain area use some of these plants for some diseases which are unique for this region. Thus, investigation about these plants should be initiated to discover novel drugs for clinical applications.