Journal of Shahid Sadoughi University of Medical Sciences

October 16, 2025 World Anesthesia Day; A Reflection on the Need for Continuing Education, Clinical Research, and Safety Standards

Mehdi Farasat — 2025-10-04

Introduction: World Anesthesia Day (16 October) is a valuable opportunity to re-examine patient safety in anesthesia. This note proposes a three-part approach—continuing professional development, clinically focused research, and robust safety standards—to improve care quality. Simulation-based training enhances non-technical skills such as communication, decision-making, and crisis leadership, thereby reducing preventable harm. Evidence supporting Enhanced Recovery After Surgery (ERAS) pathways indicates shorter hospital stays and fewer complications, while large trials remind us that innovation requires sound judgement and high-quality data. Hemodynamic decision-support tools help anticipate and prevent intraoperative hypotension. In terms of standards, capnography during procedural sedation outside the operating room, current guidance on awake tracheal intubation, safe medication labeling, and re-implementation of the Surgical Safety Checklist are pivotal. Action points: allocate time for CPD; engage in planned, interdepartmental research with a quality registry; and audit checklists regularly.

Conclusion: Advancing these three pillars helps close the gap between knowledge and action and leads to clear improvements in patient safety and experience. World Anesthesia Day 2025 provides a chance to put this framework into practice across all departments.

A Case Report of Management of Camel Bite Injury in the Maxillofacial Region

Mohsen Barzegar — 2025-10-04

Introduction: Camel bites are relatively rare, but they can lead to severe maxillofacial injuries. Because of the unique oral flora of camels in contrast to non-domesticated animals, the choice of antibiotic and wound closure strategy is critical. Moreover, the simultaneous involvement of deep structures such as the parotid duct, facial nerve branches, and the facial skeleton makes management more challenging.

Case Report: A 23-year-old male arrived with a camel bite to the right of his face affecting the preauricular and perimandibular regions The laceration were approximately 15 cm in length, with a suspected parotid duct injury. The wound was extensively irrigated, tetanus toxoid was given, and rabies post-exposure prophylaxis was initiated. A CT scan showed a comminuted fracture of the zygomatic arch, along with temporal and possible buccal injury to the branches of the facial nerve. The patient received ciprofloxacin and metronidazole, and wound closure was delayed during infection surveillance. A parotid duct repair was conducted using an intraoral approach. Conventional stenting was not feasible because of inflammation; therefore, a neonatal Foley catheter was used as a temporary stent for 14 days. Pressure dressings and anti-sialogogue therapy were administered. No salivary leakage, infection, or sialocele formation was observed. At the 2-week, 1-month, and 3-month follow-ups, no signs of infection or sialocele, and mouth opening improved to approximately 35 mm.

Conclusion: This report emphasizes that in camel bite injuries with concomitant skeletal and parotid duct damage, appropriate antibiotic therapy, delayed closure when indicated, and innovative use of accessible tools such as a neonatal Foley catheter for duct stenting can lead to positive outcomes and prevent complications such as infection and sialocele.

Role of HOXA10 and HOXA11 Genes in Endometrial Development and Infertility in the Polycystic Ovary Syndrome

Maryam Parvini Kohneh Shahri — 2025-10-04

Introduction: Polycystic ovary syndrome (PCOS) is a reproductive endocrine disorder. Homeotic genes like HOX genes, a group of conserved transcription factors, are essential for the development of the reproductive tract and the functioning of the endometrium. The HOXA genes play essential roles in embryo organogenesis and the functioning of the adult uterine. Regarding reproductive health, HOXA genes such as HOXA10 and HOXA11 are crucial for endometrial receptivity and implantation. The HOXA10 gene is a vital element in embryo implantation, endometrial receptivity, uterine biogenesis, and immune regulation in the adult uterus. It promotes cell growth during decidualization and the maturation of endometrial cells, making the endometrium for implantation. HOXA10 and HOXA11 are dynamically regulated by estrogen and progesterone, showing peak expression during the secretory phase of the menstrual cycle when implantation occurs. Research has shown that infertility in women with PCOS can be associated with the dysregulation of the HOXA10 and HOXA11 genes, resulting in implantation failure due to disrupted endometrial receptivity.

Conclusion: Collectively, the HOXA10 and HOXA11 genes are crucial for the endometrium for implantation and thus maintaining fertility. In women afflicted with PCOS, the dysregulation of these genes might significantly contribute to infertility by causing decreased endometrial receptivity and impaired implantation processes. A thorough comprehension of the molecular pathways and hormonal regulation of these genes could pave the way for the development of novel therapeutic strategies focused on improving fertility outcomes for patients with PCOS.

Effect of High-Intensity Interval Training and Fisetin on the Gene Expression of NLRP3 and IL18 in Kidney Tissue of Mice with Type 2 Diabetes

Shima Bandad — 2025-10-04

Introduction: Obesity is closely associated with type 2 diabetes, inflammation and kidney dysfunction. In this study, the effect of high-intensity interval training (HIIT) and Fisetin on NLRP3 and IL18 gene expression in kidney tissue of mice with type 2 diabetes was investigated.

Methods: In this experimental study, 30 male C57bl/6 mice were randomly divided into 2 main control groups (6 mice) and a high-fat diet (24 mice). T2D was induced by a high-fat diet over 16-week period. Upon confirming T2D, diabetic mice were randomly allocated into diabetes, diabetes-exercise, diabetes-Fisetin, and diabetes-exercise-Fisetin groups. The Fisetin supplement was injected via intraperitoneal injection at a dosage of 20 mg/kg/day. The HIIT protocol consisted of 2-minute intervals at an intensity of 80-110% of maximal aerobic power (VO2max) followed by 2-minute rest periods at an intensity of 50% of VO2max, with 2-8 repetitions over 8 weeks. NLRP3 and IL-18 gene expression in kidney tissue was determined. Data analysis utilized one-way analysis of variance along with SPSS Software version 16 (p<0.05).

Results: Following 8 weeks, NLRP3 (p<0.001) and IL-18 (p<0.001) gene expression increased in the diabetic group compared to the control group (p<0.001). Additionally, gene expression of NLRP3 and IL-18 was significantly lower in the HIIT, fisetin, and combined intervention groups when compared to the diabetes group (p<0.001). The effect of the combined intervention in reducing gene expression of these variables was significantly higher compared to the other two interventions (p<0.0001).

Conclusion: HIIT, Fisetin and their combined intervention can protect diabetic kidney tissue by decreasing inflammation via inhibition of the NLRP3/IL-18 axis gene expression pathway.

Assessment of Knowledge, Attitude, and Practice among Undergraduate Dental Students about Radiation Exposure Protection for Pediatric Patients

Motahare Baghestani — 2025-10-04

Introduction: Compliance with the principles of radiation protection by dentists can reduce many possible risks of dental X-ray radiography on children. The present study was conducted to investigate the knowledge, attitude, and practices of dental students in School of Dentistry in Yazd City regarding the protection of children against radiation.

Methods: In this descriptive-cross and sectional study, 56 undergraduate dental students in 2023 in Yazd School of Dentistry who had completed practical courses in radiography 1 and 2 participated. The data collection tool was a valid and reliable questionnaire containing basic information (gender and grade point average), 8 questions on knowledge, 5 questions on attitude, and 5 questions on practices related to radiation exposure protection. Data were analyzed using SPSS16 statistical software, Mann-Whitney, T-test, and Spearman's correlation coefficient.

Results: Out of 65 target groups, 56 students filled out the questionnaire (90.3% response rate). The mean score of undergraduate dental students' knowledge of radiation exposure protection was 5.48±1.74 out of 8, their mean attitude score was 11.87±2.05 out of 20, and their mean practice score was 3.43±1.55out of 5;a direct statistical correlation was found, yet no significance existed among the average scores of knowledge, attitude, and performance of the studied students. The average score for students' knowledge, attitude, and practice based on their gender and grade point average were not statistically significant (P >0.05).

Conclusion: The results of the present study indicated that the knowledge, attitude, and practice of undergraduate dental students towards protecting children from radiographic radiation was moderate. Gender and grade point average did not significantly impact students' knowledge, attitude, and practices. The students’ knowledge and attitude positively influenced their practice.

Phytochemical Analysis and Biological Activity of Ricinus Communis: Investigating Antioxidant and Antibacterial Properties

Mahdie Hor — 2025-10-04

Introduction: Castor oil bean (Ricinus communis) belongs to the Euphorbiaceae family and is valued for its oil and medicinal uses. It contains several bioactive compounds including ricin, ricinine and flavonoids, and has attracted considerable attention for its various biological effects, including antioxidant and anti-inflammatory effects. The aim of this article was to investigate the antioxidant, antibacterial effects, and phenolic and flavonoid bioactive compounds of castor bean seeds from different regions.

Methods: In this study, methanol and hexane extracts from castor bean seeds were prepared via two different extraction methods (stirring and Soxhlet). The antioxidant effect of these extracts was measured using the DPPH (2, 2-diphenyl-1-picrylhydrazyl) method. For antibacterial effect, both disk diffusion and minimum inhibitory concentration (MIC)/minimum bactericidal concentration (MBC) methods were employed across several types of bacteria. The study also evaluated the total phenolic and flavonoid contents.

Results: The results indicated that the stirring extraction method using methanol yielded the highest level of total phenolic and flavonoid content from castor bean seeds sourced from the Mazandaran region. In contrast, the soxhlet- methanolic extraction of castor bean seeds from the Qom region exhibited the most significant free radical scavenging activity. Notably, Bacillus cereus and Staphylococcus aureus strains depicted the highest sensitivity, with mean diameters 21.16 ± 0.84 mm and 15.33 ± 0.47 mm, respectively, at a concentration of 400 mg/mL of stirring-methanolic extraction. Additionally, the methanol extract from the Mazandaran region displayed strong inhibitory and bactericidal effects against various bacterial strains.

Conclusion: The results revealed that the cultivation region of the seeds, the used solvent, and the extraction method had a substantial impact on the bioactive properties of the castor bean seeds.

Study of Relationship between Job Stress and Quality of Life among Nurses

Seyd Mostafa seyed Askari — 2025-10-04

Introduction: Job stress is a primary issue in the nursing profession, and nurses experience significant stress due to their work. Stress can adversely affect both the quality of life and the delivery of services to patients. This study aimed to study the relationship between job stress and quality of life among nurses.

Methods: This cross-sectional analytical study was conducted on 274 nurses working in educational and therapeutic centers affiliated with Kerman University of Medical Sciences in 2021. The sample was selected through a stratified random sampling method. Data were collected using a demographic questionnaire, Health and Safety Executive (HSE) Job Stress Questionnaire, and World Health Organization Quality of Life (WHOQOL) Questionnaire. Data analysis was performed using SPSS version 16, which included descriptive statistics such as frequency, percentage, mean, and standard deviation. To examine the relationships between variables, independent t-tests, one-way ANOVA, Kruskal-Wallis tests, Pearson correlation coefficient, and linear regression were employed to investigate the relationship among variables.

Results: The total job stress score and quality of life were 2.97±0.23 and 3.48±0.48, respectively. The results indicated a significant inverse relationship between job stress and quality of life (r=-0.88; p<0.001). The outcomes of the regression analysis showed that job stress by itself could predict 78.6% of the changes in quality of life (B=-1.862; SE=0.59; R²adj=0.787; p<0.001).

Conclusion: Occupational stress significantly affects nurses’ quality of life and may lead to adverse effects on their health and job performance. To reduce stress, it is essential to enhance working conditions, implement supportive and educational programs, and provide counseling services. Additionally, increasing awareness about stress management and coping strategies can support mental health and improve job performance.

Assessment of Awareness and Practice of General Dentists Regarding the Diagnosis, Treatment, and Referral of Patients with Periodontal Diseases in 2022–2023

Mehdi Qadiri Sardasht — 2025-10-04

Introduction: Periodontal diseases rank among the most prevalent oral health issues and significantly contribute to the onset of systemic conditions. Given that general dentists are the initial point of contact for patients, their awareness of the diagnosis, treatment, and appropriate referral timing for these conditions is essential. This study aimed to evaluate the knowledge and clinical performance of general dentists in Yazd City in managing patients with periodontal diseases.

Methods: This descriptive-cross-sectional study involved 159 general dentists in Yazd City, Iran, during the periods of 2022–2023. Data were collected through a questionnaire that included 20 items concerning demographic information, work experience, attendance at continuing education courses, clinical activity types, and experience in periodontal treatment. Statistical analysis utilized the T-test, ANOVA, Tukey's test, and Pearson correlation in SPSS version 16.

Results: The mean knowledge score was 5.15±1.51, while the clinical performance score was 6.38±2.28 out of 10, indicating a moderate level in both domains. Knowledge and performance scores were significantly associated with age (P<0.01) and work experience (P=0.013), whereas no significant differences were observed regarding gender, clinical activity types, or history of periodontal treatment. Dentists who had participated in continuing education courses showed lower knowledge scores (P=0.004) but higher practice scores (P=0.007). A significant positive correlation was also reported between knowledge and practice scores.

Conclusion: General dentists in Yazd City demonstrate moderate levels of knowledge and performance in managing periodontal diseases. Structured educational programs and revisions in general dental curricula are recommended to address identified gaps.