مجله علمی پزشکی جندی شاپور
سال بیست و دوم شماره 6 (پیاپی 147، بهمن و اسفند 1402)

Peroxisome proliferator-activated receptors (PPARs), belonging to the superfamily of nuclear receptors, serve as transcription factors upon ligand binding, either with endogenous or synthetic ligands, forming heterodimers with Retinoid X Receptors (RXRs). They initiate gene transcription to harmonize lipid and carbohydrate metabolism with cell proliferation and differentiation. Fatty acids and their derivatives are natural ligands. To date, three subtypes of PPARs have been identified: PPARα, PPARγ, and PPARβ/δ, each having drug agonists and antagonists developed. Furthermore, universal agonists have been designed to target combinations of these subgroups to mitigate drug side effects. PPARs control cellular energy homeostasis and are also expressed in immune cells, where they play a vital role in their differentiation and fate. Given the significant impact of PPAR activity on both innate and adaptive immune cell function and their involvement in immune-related diseases, e.g. antiphospholipid syndrome, hepatitis, myocarditis, neurodegenerative diseases, psoriasis, asthma, inflammatory bowel disease, renal inflammation and atherosclerosis, it is conceivable to treat some of these diseases by modulating these transcription factors. Furthermore, due to the significance role of PPARs in regulating tissue metabolism, several instances of them have been investigated.

One of the applications of CBCT images is the diagnosis of root resorption of the lateral maxillary teeth, which is often associated with canine impaction.

10 healthy single root teeth that extracted were collected. To simulate external resorption lesions, by using a carbide bur at the lateral surface of the middle third of the tooth root was incised and the teeth were mounted., both before and after teeth preparations, CBCT was prepared from the area with a thickness of 0.125 mm and a distance of 0.125 mm; Then the samples were processed with and without reverse contrast image processing filter and examined by two observers.

Specificity and sensitivity were either complete or very high for both with or without reverse contrast filter modes. The overall accuracy in both cases was high and no significant difference was observed between the two overall accuracy. Also in both with or without reverse contrast filter modes, the sensitivity and overall accuracy in the medium and high resorption groups was much higher than the low resorption group. But the specificity in all groups was equal to 100%.

The images with reverse contrast filter do not increase the detection power compared to unfiltered images, but since no loss of accuracy was observed with this filter, it can be accepted to use as a processing filter.Keywords: External resorption, Root middle portion, Computed beam computed tomography, reverse contrast filter

Since medical care providers are faced with complex issues in their profession, one of the important skills in making correct clinical decisions is critical thinking. Therefore, one of the standards of medical education is to instill critical thinking in students.

The present study was a cross-sectional descriptive-analytical study. Data was collected using a demographic questionnaire and the standard California B questionnaire. Mann-Whitney test was used to make comparisons, and Spearman's correlation coefficient was used to check the correlation between the data.

The findings showed that the average critical thinking score of the participating medical students was 8.05 (± 2.6). Also, analysis and inference had the highest 2.5 (± 1.58) and lowest 2.51 (± 1.04) levels of obtainable score, respectively. Critical thinking had a significant positive correlation with all its components (P<0.001). The critical thinking of the participants was not significantly different in terms of gender or university entrance examination regions (P>0.05). The analysis showed that critical thinking has a significant positive correlation with age (r=0.159, P=0.018) but a significant negative correlation with years of education (r=-0.216, P=0.001) and grade point average in the last semester (r=-0.492, P=0.012).

The studied medical students did not have an optimal level of critical thinking, which is necessary for making appropriate and effective decisions, and this skill was found to have an inverse relationship with the grade point average and academic years. Therefore, it can be argued that the current educational system in the university has not been able to enhance this vital skill among medical students.

Hypertension is one of the most important health problems in all countries of the world, and enhancing the level of health literacy and self-efficacy of people can be effective in controlling this disease. The aim of this study was to investigate the relationship between health literacy and self-efficacy in patients with hypertension in Ferdows.

This is a cross-sectional analytical study performed on 240 hypertensive patients in the comprehensive rural health centers of Ferdows city who were selected by systematic sampling. Data collection tools included Health Literacy Questionnaire by Montazeri et al. and the standard self-efficacy questionnaire in chronic diseases. Data were analyzed by SPSS software version 22, using descriptive statistics, Pearson correlation tests, one-way analysis of variance, and independent t-test at a significance level of 0.05.

The mean age of the participants was 53.26±7.38 years. Health literacy and self-efficacy showed differences between men and women (P>0.05). There was a significant relationship between education and income level with health literacy and self-efficacy (p<0.001), with health literacy and self-efficacy being higher in married people with higher educational attainment and income. Also, a significant relationship was observed between health literacy, age and self-efficacy (p<0.001).

Health literacy is one of the most important tools in improving the self-efficacy of patients with hypertension.

ULK1 and LC3-II are factors related to liver lipophagy. The purpose of this research was to investigate the effect of four weeks of aerobic training in fasting state on factors related to liver lipophagy (ULK1 and LC3-II) in male Wistar rats.

In this experimental research, 30 male Wistar rats were randomly divided into the following groups: control, fasting, 3 days of training, 5 days of training, fasting + 3 days of training, and fasting + 5 days of training. Unlike other rats that had 24-hour access to food, the fasting rats received the same amount of nutrition in 10 hours. Continuous aerobic running on a treadmill was performed for 4 weeks with a frequency of 3 and 5 sessions per week in both feeding and fasting conditions. Statistical analysis was done by SPSS using one-way variance analysis test and LSD. Significance level was set at P < 0.05.

The increase of LC3-II in the groups of fasting + 3 days of training and fasting + 5 days training was significant compared to fasting and 3 days training groups (P < 0.05). Also, the increase of ULK1 in the groups of 3 days of training and fasting + 3 days of training was significant compared to the fasting group, and the changes of ULK1 were significantly higher in fasting + 3 days of training group than in the fasting + 5 days training group (P < 0.05).

It can be said that aerobic training in fasting mode increases liver lipophagy and the expression of ULK1 and LC3-II genes is different compared to the amount of weekly activity.

undergoing congenital heart surgery and causes anxiety in the surgeon and the patient's parents. Proper diagnosis and management of fever requires careful preoperative patient evaluation, targeted physical examination, and comprehensive knowledge about the prevalence and common causes of fever. The aim of this study was to determine the prevalence of fever after congenital heart surgery in children.

This was a descriptive-analytical study on children under 10 years of age undergoing congenital heart surgery in the cardiac operating room of Golestan Hospital of Ahvaz in 2021. Data collection tools included a two-section checklist. The first section was related to demographic characteristics and the second addressed patients' clinical status and causes of fever. Data were analyzed using SPSS software.

After surgery, 21 patients (31.8%) developed fever and the prevalence of fever was not significantly associated with age, sex, presence of genetic syndrome, type of disease, type of operation, cardio pulmonary bypass, duration of aortic cross clamp, duration of cardiopulmonary bypass, or duration of operation. However, it was significantly correlated with the mean length of ICU stay (P> 0.05).

The prevalence of fever in patients undergoing congenital heart surgery was relatively high and had a significant relationship with the length of ICU stay.

A higher social anxiety rate is reported in adults who stutter (AWS) as opposed to those who do not stutter. Safety behaviors are a key factor in maintaining anxiety by reinforcing evidence related to destructive thoughts and lack of facilitating evidence related to constructive beliefs. The aim of this study was to translate and adopt the Persian version of Helgadottir questionnaire on safety behaviors in AWS and to determine its validity and reliability.

First, the original English questionnaire was translated into Persian language using the IQOLA method. Then, 17 speech and language pathologists and 5 AWS assessed the face validity of all items of the questionnaire using a 6-point Likert scale. Finally, 167 Persian-speaking AWS completed the questionnaire, and its construct validity was assessed, using exploratory factor analysis and internal consistency.

After translation and confirmation of face validity, the remaining 29 questions were categorized into 4 factors including general avoidance, practice and control, rehearsal, and choosing safe and easy people. The internal consistency of the questionnaire was found acceptable by obtaining a Cronbach’s alpha of 0.89.

The results suggest that this questionnaire has suitable psychometric characteristics. Therefore, it could be used to assess safety behaviors of adults who stutter.

Intravenous catheter placement is one of the most common invasive care measures performed by nurses. Considering the contradictory results obtained regarding the effect of local analgesic techniques, the present study was conducted to compare the effect of EMLA cream vs. 2% lidocaine gel vs. ice bag on pain intensity caused by venipuncture in children aged 6-12 years.

In this clinical trial, 160 children undergoing elective surgery were selected according to the inclusion and exclusion criteria and were divided into 4 groups of 40 using block randomization method. In this study, pain intensity was measured based on patient self-report and by nurses during venipuncture while applying EMLA cream, 2% lidocaine gel, and ice bag using the numeric analog scale (NAS) and the FLACC scale which included 5 criteria for child behavior. The range of scores in both scales is recorded from 0 to 10, where 0 indicates absence of pain. The data were collected using dispersion indices. Kruskal-Wallis test and chi-square test were used to compare the numerical scale of pain and behavior between groups using SPSS-16 statistical software.

The mean age of the participants was 7.79±1.79 years, and 80 (50%) were male. The results showed that the mean values of pain intensity based on the numerical scale in the control, EMLA cream, lidocaine gel, and ice bag group were 4±0.78, 0.9±0.75, 2.80±0.18, and 2.60±0.67, respectively. Moreover, there was a statistically significant difference between the groups according to numerical scale and behavioral scale (P<0.001), with the EMLA cream group expressing a lower level of pain based on both scales.

The results of the present study showed that the use of all three methods of EMLA cream, lidocaine gel, and ice bag reduced pain during venipuncture. The EMLA cream was associated with a higher amount of pain reduction compared to the other two methods. Therefore, EMLA cream could be recommended to be used routinely in the target area one hour before catheter placement.

Considering the spread of Covid-19, it is important to know its complications. In the present study, we examined the frequency of patients with myocarditis and Kawasaki disease and related demographic and laboratory findings in children before and during covid-19.

The present study was carried out in a descriptive-analytical manner on patients with myocarditis or Kawasaki disease during the years 2016 to 2016. During this study, demographic information, laboratory variables of the child were collected from the patients' files and statistically analyzed using SPSS version 24 software.

In this study, 65 patients (31 girls and 34 boys) with an average age of 41.28 ± 3.9 months were examined. Of these, 46 people (69.7%) had Kawasaki disease and 19 (28.8%) had myocarditis. The condition of being infected with Covid-19 was also observed in 22 of the patients (33.3%). The rate of hospitalization with the diagnosis of Kawasaki disease after Covid-19 was significantly higher than before [27 cases (58.7%) against 19 cases ( 41.3%)], while the hospitalization rate with the diagnosis of myocarditis decreased significantly after the onset of corona [1 case (5.3%) vs. 1 case (5.3%), (P<0.001)].

According to the results, the hospitalization rate with the diagnosis of Kawasaki disease after the occurrence of covid-19 was significantly higher than before, and the frequency of patients with Kawasaki disease with and without covid-19 was not significantly different.

This study was aimed to determine the effect of antihistamines on Covid-19 disease.

Two researchers searched online electronic databases PubMed, MEDLINE and Google Scholar from the beginning of the pandemic until December 30, 2022 using Mesh and keywords such as: "SARS-CoV-2" or "COVID-19" and "Antihistamine".

The results depicted that levocetirizine, diphenhydramine, hydroxyzine, azelastine, dexchlorpheniramine, cetirizine, loratadine, desloratadine, fexofenadine, triprolidine, dimetindene, and famotidine are effective in treating and reducing the symptoms of Covid-19. Among them, famotidine had contradictory results, and although it may be a useful supplement in the treatment of covid-19, laboratory studies have failed to show the direct role of famotidine in controlling this disease.

From the above-discussed findings regarding antihistamines and Covid-19, specific antihistamines should be identified and included as an essential therapeutic approach for the management of Covid-19 alongside other approaches. In fact, antihistamines appear to be promising in the management of Covid-19 with a short time to relieve symptoms while giving the body enough time to reset its defense mechanism, thus reaching a rapid recovery. They work by both modulating histamine pathways and suppressing virus growth. Despite the fact that more trials and clinical studies still need to be done on the identification and deployment of potential antihistamines in the management of Covid-19, there is not enough time for this given the enormous threat of this global health crisis. Selective antihistamines, particularly histamine H1 receptor antagonists, should now be approved for emergency use for the management of Covid-19.

Facial fractures in children are unusual injuries that make up to 15% of facial fractures. Although maxillofacial trauma is more common in children than in adults, the incidence of facial fractures is lower. Epidemiology and etiology of facial fractures vary from country to country, and depend largely on economic group, culture, and geographical area. Maxillofacial fractures are the most common type of facial fractures.

This 5-year (2014-2019) retrospective observational-descriptive and cross-sectional study was performed among pediatric patients (1 to 12 years old) referring to the maxillofacial surgery department of Imam Khomeini Hospital in Ahvaz (due to trauma and jaw fracture). The indicators included age, sex, time, cause of fracture, fracture position, type of fracture, and existence of accompanying fracture.

Based on the results obtained in this study, 32.7% of the participants were girls and 67.3% were boys. The most common causes of jaw fractures were MVA (63.4%) and falling (25%). The highest frequency of jaw fracture due to trauma (17.3%) was at the age of 12 years followed by the ages of 9 and 10 years (15.4%). The highest rate of jaw fracture due to trauma in children (1 to 12 years) was in summer (32.7%). The results of this study show that the most common type of fractures was in the mandible (87.5%) which was more reported in males. The most common treatments used were close reduction (67.3%) and ORIF (26.9%).

The results of this study show that the most common type of fractures are in the mandible and more in men. The highest rate of fractures was reported between the ages of 8 to 12 years. This study showed that the highest percentages of the cause of jaw fractures were MVA and falling, respectively. Also, the highest percentage of hydrotherapy methods used were close reduction and ORIF.

Serum electrolyte imbalance is very common in COVID-19 patients. However, there is conflicting evidence regarding their relationship with COVID-19 and its severity, and their prognostic value is unknown. Our aim of this study is to investigate electrolyte changes in COVID-19 patients admitted to the intensive care unit of Imam Khomeini Hospital in Ahvaz.

The present study is a cross-sectional and descriptive-analytical epidemiological type that was conducted in 1400. The target population was the COVID-19 patients admitted to the intensive care unit of Imam Khomeini Hospital in Ahvaz. Required tests were performed on all patients admitted to the special care department and diagnostic tests including Ca, K, Na, Cr, BUN, Mg, and P were collected and the effect on the prognosis of patients including intubation, mortality and extubating and discharge from the ward and The hospital was registered. Then the data were analyzed by SPSS 22 software and appropriate statistical tests.

Finally, 87 people were included in the study. Hyponatremia, hypokalemia, hypomagnesemia and hypocalcemia, Cr, and high BUN respectively in 2.55%, 3.4%, 6.27%, 8.59%, 8.82%, 5.5%, patients with covid- 19 were observed. There was a significant difference between the two groups of men and women and the average potassium was higher in women than in men (P=0.041). No significant relationship was found between other electrolytes and the variables of age, gender, history of disease, intubation, discharge, and mortality (P>0.05).

The present study showed that electrolyte imbalance is one of the common laboratory abnormalities in COVID-19 disease.