Educational programs' quality assessment based on graduates' comments

The specific goal of this study was quality assessment the educational programs of basic and clinical sciences of Tehran University of Medical Sciences [TUMS] according to the graduates' viewpoints. We obtained the list of all 1200 graduates of TUMS in 2007. Using a random generation table, 350 subjects were selected from the seven faculties of TUMS in proportion to the number of graduates from each faculty. The data collection device was a 15 item researcher-made questionnaire according to the existing problems in the educational system of the university. All the items of the questionnaire were constructed and standardized in terms of validity and reliability based on the latest reliable sources and textbooks on educational assessment [Likert indices]. Cronbach alpha was estimated to be 0.85. The most satisfaction from educational programs in basic sciences and clinical sciences was related to practical skills [4.36 +/- 1.22] versus satisfaction with education [4.76 +/- 1.66]. The quantity indices in basic sciences were 68.44% [3.42] which is in a fairly optimal range; for clinical sciences it was 77.2% [3.86], being also in an optimum range. TUMS must make an attempt to reach the optimal point in every educational aspect

Threatened abortion: a risk factor for poor pregnancy outcome

The scientific literature regarding threatened abortion is relatively limited on the subject of outcomes and viability at term. To investigate prospectively the risk of adverse pregnancy outcome in women presenting with first-trimester threatened miscarriage, a prospective case control study was performed on 600 subjects, 150 women presenting with bleeding in the first trimester and 450 asymptomatic age-matched controls. Main outcome measures included gestational age and weight at delivery as well as incidence of adverse pregnancy outcome such as preterm labor, preterm prelabor rupture of membranes [PPROM], placental abruption, and low birth weight [LBW]. The first-trimester miscarriage rate in the threatened miscarriage group was 42.7%. Compared with controls, women presenting with threatened miscarriage were more likely to deliver prematurely, 14.7% compared with 52.9%, respectively [relative risk 3.6, 95% confidence interval [CI] 2.4-4.8]. They were also more likely to have PPROM, 6.4% compared with 27.5%, respectively [relative risk 4.2, 95% CI 2.6-6.9]; placental abruption, 5.7% compared with 1.5%, respectively [relative risk 3.6, 95% CI 1.2-11.3]; LBW, 14.9% compared with 7.1%, respectively [relative risk 2.1, 95% CI 1.1-3.8] and low lying placenta, 1.1% compared with 18.2%, respectively. birth weight 2866 +/- 523.3 g compared with 312.45 +/- 591.4 respectively, gestational age 35.71 +/- 4.3 compared with 38.07 +/- 3.2 respectively. First-trimester vaginal bleeding is an independent risk factor for adverse obstetric outcome and this risk factor should be taken into consideration when deciding upon antenatal surveillance and management of their pregnancies

Homocysteine in gestational diabetes and normal pregnancy plus effects of folic acid

The aim of study was to assess serum homocysteine and its relation with serum folate, vit B12 and lipid profiles in gestational diabetes mellitus and comparison with normal pregnant women as well as effect of different doses of folic acid on Homocysteine [Hcy] and pregnancy outcome. In a biphasic study first prospective controlled study 80 pregnant women were chosen at 24-28 weeks of gestation. In case group pregnant women with gestational diabetes mellitus and control group who had normal Oral Glucose Tolerance test [GTT] results. Levels of fasting glucose, homocysteine, vit B12, and folic acid, uric acid, total cholesterol, triglyceride, LDL, HDL, were measured. In phase II study a randomized clinical trial was done with diabetic women 15 with 1mg folic acid and 15 with 5 mg folic acid for six weeks and then above variables and pregnancy outcome was evaluated. The mean levels of homocysteine in Gestational Diabetes Mellitus [GDM] group were significantly higher but folic acid and vit B12 were significantly lower. Hcy levels were decreased in both groups after six weeks folic acid but decrease in Hcy for group 5mg was significantly more than 1mg group. Homocysteine levels were higher in GDM than normal pregnancy. High dose folic acid can reduce Hcy levels more than low dose and it may be a safe, simple, inexpensive intervention that prevents major pregnancy complications

[Risk factors for recurrent preterm delivery in three university hospitals]

Preterm labor is defined as delivery before 37 weeks of gestation. Recurrence of preterm labor in future pregnancies is 6-8%. History of preterm labor is a strong risk factor for future preterm labor. Preterm labor is the leading cause of neonatal mortality in developed countries, but permanent morbidity in these premature neonates has many side effects for the newborn as well as their family members and society. For this reason we conducted a survey to identify risk factors for recurrent preterm delivery among primiparous women with previous preterm delivery. This prospective case-control study included patients from three university hospitals, namely Imam Khomeini, Shariati and Mirza Koochakkhan Hospitals, all in Tehran, Iran. Subjects, including 539 primiparous women who delivered preterm [22-36 weeks], were divided into two groups: 47 had a second preterm delivery [study group] and 492 had first preterm delivery [control group]. Exclusion criteria were induced preterm delivery due to medical indications in mother and primigravid. Data collection and analysis was performed using SPSS 10 and t-test and chi[2] test were used to analyze the significance of the results. From a total of 6,537 deliveries, we found 539 cases of preterm delivery, among which 47 cases were identified as recurrent preterm delivery. The control group was composed of 492 deliveries. The recurrence of preterm delivery was 8.7%. Uterine anomaly, cardiovascular, renal and thyroid disease in mother and blood group A had a significant correlation with recurrent preterm delivery. Expectant mothers with uterine anomalies, cardiovascular, renal or thyroid diseases or group A blood type should receive extra care, observation and instructions in order to limit the risk of preterm delivery and its subsequent effects

Short RIB polydactyly syndrome: a case report

Short rib polydactyly syndrome [SRPS] is a very rare congenital anomaly that is classified into four subtypes. It is an autosomal recessive inherited disease. We report a case of this syndrome without a previous family history of congenital defects