Razi Journal of Medical Sciences
Year:2017 | Volume:23 | Issue:153|Papers Count:8

Background: Medical students' clinical exposures review is important to assess clinical education field and clinical education deficiencies compensation. This study aimed to Gap analysis of medical students' clinical exposures with standard in pediatrics clerkship educational minimums and providing interventional strategies to improve clinical competency in different seasons was done in academic year 2014-15.Methods: This descriptive-analytical and cross sectional study was performed in 129 Isfahan University of Medical Sciences medical students in three pediatrics clerkship in three season winter, autumn and spring. Data collection tool was standard checklist to compare number of recorded clinical exposures in students' log books with standard educational minimums by Mann-Whitney U test (p<0.05) and Significant of exposures comparison with standard rate was determined as low, Borderline and over exposure.Results: Based on entering the study conditions, clinical exposures result of 97 students were studied (%75.2). Mean of exposures in educational Rotations: "general, emergency, and clinic and respiratory" was much lower than standard in more than half of educational minimums. Against not mentioned Rotations had better conditions.Conclusion: According to obtained results in pediatric clerkship clinical education deficiencies, totally 33 of 63 items of clinical minimums in gap analysis had low exposure and therefore to compensate for its educational interventions including workshops, films, educational slides and introducing case recommended.

Background: Rabies is anacute viraldisease ofthe central nervous systemand themortality rateis veryhighand one hundredpercent.Rabies transmitted to-human through the bite of a rabid animal, especially canine and feline. Annual, 40 to 70 million deaths occur worldwide from rabies. Rabiesincubation periodwas reported of 5 days toayearand an average of 3-1 months. The aim of this study was reported a rare case of rabies death by the marten bites.Report of Case: patient's was a46-year-old with symptom such as headache, fever, pharyngitis and tingling and burning refer to doctor. History of animal bite (bites probable marten) about 50 days ago, doctor was suspected rabies. The clinical symptoms of rabies appeared in patients after hospitalization, then patient getting loss of consciousness, trismus, hydrophobia, photophobia, increased salivation andmuscle paralysis. Biopsies taken after the patient's death was confirmed rabies by Institute Pasteur. Eventually, after 6 days hospitalization patient was death.Conclusion: Usually, rabies progresses during the 14-7 days. After theonset of symptoms, injection of vaccine and serum cannot prevent for rabies. Therefore any animal bites consider the suspected rabies and injected vaccine.

Background: Polycystic ovary syndrome (PCOS) is the most common endocrinopathy of premenopausal women in different populations. There is no precise consensus on the exact definition of this disorder and there is no laboratory criterion so it is useful to find a laboratory marker for diagnosis. Anti mullerian hormone (AMH) produced by the granulosa cells of small follicles in the early stages of follicular growth, has recently been proposed as a marker for the diagnosis of PCOS. This study was performed to compare AMH levels in PCOS versus nonPCOS patients and determine its relation to other parameters especially hormone levels.Methods: This case-control study was carried out on 176 patients who attended Vali-e-Asr clinic. Eighty eight patients were diagnosed as the PCOS group according to the Rotterdam criteria and 88 normal ovulatory women participated as the control group. AMH and other data from both groups were recorded and analyzed using the SPSS software version 19.Results: Based on the results obtained in the two groups, it was shown that in women with PCOS, mean Anti-mullerian hormone (AMH) level is significantly higher (8.7 versus 2.9ng/ml) independent of other factors (p<0.0001).Conclusion: According to this study, Anti-mullerian hormone is significantly higher in PCOS patients when compared to normal ovulatory women without relation to other findings in this disorder. Hence it can probably be used as an independent marker for diagnosing PCOS. Nevertheless further studies are recommended to establish its value.

Background: Autism Spectrum Disorder (ASD) is a devastating, developmental disease and has several significant impacts on the patient’s life: impairment in social interactions as in both verbal and nonverbal behaviors, failing to develop relationships and respond to normal teaching methods, intellectual disabilities, and repetitive behaviors, being unable to instinctively express natural empathy, pragmatic language impairment and severely limited activities.The prevalence of ASD has increased in children globally including our country. Latest studies conclude that ASD affects boys four to five times more than girls and the average age of initial diagnosis is often before the age of 3 years.ASD is a multifactorial disorder and studies so far indicate a strong genetic basis for its development, showing the cause for more than 90% of brain function disorders and autistic behavior to be of genetic roots. However, genetics only do not consider for all cases of autism. Environmental factors are crucial issues in the development of autistic behaviors for example, prenatal exposure to the chemicals, low levels of vitamins especially vitamin D, stress, maternal depression or antidepressant use, advanced paternal age, exposure to air pollutants and pesticides, parental obesity and diabetes in the mother during pregnancy, live in crowded infected in the brains, has been linked to increased risk of autism.In this review, we discussed the definition and prevalence of ASD immune dysfunctions and genetic factors in autism.According to the previously studies, environmental factors alone cannot cause autistic behavior in children, but genetics and environmental factor can converge to causes disease with neurological problems and may cause abnormal autistic behaviors in children. However environmental factor can affect genetic and epigenetic in the parents that this event created a prominent role of environmental factors in autism spectrum disorders.

Background: hypertension is a common disease and is asymptomatic and is easily diagnosed and easily treated, but if untreated, leads to fatal complications in patients are concerned. Causing the deaths of 6% in the world.Methods: This case-control study (Case-Control) was performed. The study population included patients with primary hypertension who were referred to specialized clinics of the city of Ilam was in 1391-92. Based on tissue Doppler echocardiography, the two groups of patients with diastolic dysfunction and diastolic dysfunction were divided and HS-CRP serum levels of these patients were compared with baseline serum HS-CRP levels in the patients into four groups: less than half a liter of 5% mg/L 0-1 mg, 1.3 mg L more than 3 milligrams per liter division and its relationship with different variables were examined. Data analyzed using SPSS V19 statistical software was used.Results: 31% were male and 69% female. The mean age of patients was 45.42, 76.1% had diastolic dysfunction. HS-CRP serum high association between diastolic dysfunction was (p<0.005).Conclusion: The high association between serum HS-CRP serums levels of diastolic dysfunction there, the HS-CRP levels higher possibility that higher diastolic function platter

Background: Evaluation and accreditation of hospitals have important roles in improving the quality, safety, and effectiveness of healthcare services in hospitals. The effectiveness of an accreditation system depends on appropriateness, quality and consistency of methods, standards and surveyors. This study aimed to evaluate the content of hospital accreditation standards from the perspective of the hospital managers.Methods: The study was conduct in 2015 using a valid and reliable questionnaire. 547 hospital managers were surveyed using stratified random sampling method. Descriptive and inferential statistical methods including Kruskal, Mann-Whitney and logistic regression were used for data analysis.Results: Hospital managers were moderately satisfied with the content of national hospital accreditation standards (the mean score of 2.64±0.67 out of 5). Only 15.1 percent of hospital managers were satisfied with the content of the hospital accreditation standards. Most complaints were related to a lack of transparency of standards and criteria, number of standards and using the same weight for criteria.Conclusion: Reducing the number of standards and criteria, leveling criteria and making them more transparent, changing the scale of scoring, applying functional approach and also considering the diversity of hospitals in the formulation of criteria help improve the content of accreditation standards.

Background: Burnout syndrome signs and symptoms include emotional exhaustion, depersonalization and reduced performance that affects almost about 40% of individuals in industrial societies. In this regard, this study was an attempt to investigate the relationship between satisfaction of basic psychological needs and job burnout among basic and clinical sciences faculty members of faculty of Medicine, Iran University of Medical Sciences.Methods: The survey was conducted in 2015, and the population included 449 faculty members from which 100 participants were selected by cluster random sampling. The instruments were Maslach and Jackson’s Burnout Inventory and Deci and Rayan’s Basic Psychological Needs Scale.Results: The findings indicated that satisfaction of basic psychological needs had significant negative relationship with emotional exhaustion (p<0.01, r=-0.378) and depersonalization (p<0.01, r=-0.359), and significant positive relationship with personal accomplishment (p<0.01, r=0.586). Thus, satisfaction of basic personal needs decreases emotional exhaustion and depersonalization, and personal accomplishment increases satisfaction of these needs. There was no significant difference between job burnout of participants and their marital status, academic degree, department (basic or clinical sciences), type of employment (tenured or contractual), type of job (full or part time), and academic ranking, while there were significant gender-related differences (p=0.49).Conclusion: This study confirmed that satisfaction of basic personal needs of faculty members has a significant effect on reducing general job burnout. Moreover, autonomy increases personal accomplishment, and decreases emotional exhaustion and depersonalization. Although, in cases of job burn-out, competency and personal accomplishment are increased.