[Effect of early clinical exposure on attitude and performance of first year medical students]

Background and aim: Encountering clinical environments as an inseparable part of studying medicine could bring about tension and anxiety for medical students. Early clinical exposure has been suggested to decrease these stresses and to motivate students for a better attitude and awareness. This study was performed to determine the effect of a short-term period of exposing to clinical environment on medical students' attitude toward medical education and their educational function

Methods: In an interventional study performed as pre-test/post-test, 43 first year medical students were encountered clinical environments in rounds, operating rooms and emergency ward. Students' attitude was assessed by a questionnaire using Likret scale. We compared students' function in specific lessons and result of comprehensive basic examination with previous entrance students as an external control group

Results: Significant differences were found in the student's attitude before and after the course [P<0.01]. Results showed a significant increase in the student's attitude toward importance of the patients' history and physical exam versus para-clinical exams. In addition, their attitude about therapeutic stuff duties in all levels. The rules between physician and patient, patients rights in hospital, diagnosis and therapeutic management, different steps of medical education and merging basic and clinical sciences, simple physical exam and assistance management were increased significantly after the course. No significant difference was observed in the students' educational function in any items

Conclusion: Based on the results of this study, we found a positive effect of early clinical exposure on attitude of first year medical students. Therefore, we suggest that early clinical exposure be added to educational curriculum for medical students

Effect of lamotrigine on prophylaxis of pediatric classic migraine

This study was conducted to evaluate the preventive effect of lamotringine on migraine aura and migraine attacks in children, afflicted with classic migraine. Conducted between October 2005 and April 2008 in the neurology clinic of Kashani hospital, Shahrekord, this study was a clinical trial, aimed at evaluating the prophylactic effects of Lamotringine administered to 21 children suffering from migraine with aura. Of the subjects, 52.4% of patients were female. The most common type of aura was visual [42.9%]. Following use of Lamotrigine, significant reductions were seen in the frequency [from 5 +/- 0.83 to 3.04 +/- 1.65] and in intensity [from 6. 33 +/- 1.08 to 3.66 +/- 1.1] of migraine aura [P= 0.002]. After 6 months of drug usage 66.6% of patients were improved. Lamotringine is effective in reducing the migraine aura and intensity of attacks in patients suffering from migraine with aura, and is hence beneficial for prophylactic therapy in children with classic migraine

[Frequency and severity of Post Traumatic Stress Disorder and efficacy of mental health intervention in children and young adults from a rural region in Chaharmahal and Bakhtyari Province, Safilan]

Disasters cause disability, economic burden and death, annually. The casualties following the catastrophes such as earthquake, hurricane, and etc. leads to stress, anxiety, depression, and somatizaten. Post Traumatic Stress Disorder [PTSD] is one of these complications occurred after the unpleasant events. One of these events was happened in a rural region in Chaharmahal and Bakhtyari province, Safilan. Therefore, the aim of this study was to assess the frequency of post disaster psychologic complication in the children of the area and the effect of mental health intervention on them. This is a quasi-experimental study in which all children aged 5-15 years from this region who experienced this event were interviewed. The face to face interview was performed with the parents of the children and the Yoll questionnaire was filled immediately after the event. Subsequently, the psychologic interventions including psychological re-explanation, recognition of social thinking and treatment mechanisms were used for two weeks through 4 seasons. Repeatedly, five months after the event, the same procedures were performed. Results were analyzed with paired t-test, independent t-test and ANOVA. In the first round of measurement, the mean score of PTSD was 61.14 +/- 15.03, and in the 2nd time it was 48.19 +/- 9.6 [p<0.001]. This score in the age groups of 5-10 and 10-15 years was 54.26 +/- 13.8 and 65.5 +/- 14.3, respectively before the intervention [p<0.05] and was 43 +/- 5.7 and 51 +/- 10.28, respectively after that [p<0.01]. This difference was not sex dependent. Analysis of variance showed that with increasing education, score of PTSD significantly was increased and using Tukey test, it was shown that the difference was significant between the two level of education [p<0.01]. The results of this study showed the effect of hygienic interventions and educations in the problem faced. Therefore, use of preventive mechanisms in all 3 preventive levels is essential in the case of this event

[Rate of satisfaction and evaluation of medical students [interns and externs] from the quality of clinical education in the Shahre-kord university of medical sciences-2005]

Revolution of information in medical sciences as one of the important parts of knowledge has made the attention to medical education more critical. This study was performed to evaluate the satisfaction of Shahre-kord university medical students [interns and externs] from the quality of education in clinical courses. In this descriptive-analytical study, the rate of satisfaction of 77 medical students [interns and externs] from the quality of education in Shahre-kord university clinical courses was evaluated using a locally standardized questionnaire. The findings were classified as: high, moderate and low. Data were analyzed using SPSS software [version 11]. A total of 77 students completed the questionnaire. The high rate of satisfaction from the quality of education in different clinical clerkship periods was reported as follows: Internal medicine 25/7%, surgery [general surgery and orthopedic] 27/4%, pediatric medicine 17/5%, gynecology 6/3%, infectious disease 54/5%, neurology 36/5%, ENT 54/5%, ophthalmology 47/5%, poisoning 21/2%, psychiatry 37/7%, urology 6/3%, health science 17/6%. In addition, high rate of satisfaction from professional skills teaching was reported by 17/4% of the students. The most satisfaction rate in internal and pediatric courses was from morning reports and in surgery clerkship period, from outpatient clinic and theory courses. In gynecology period the lowest rate of satisfaction was reported from outpatient clinic and theory courses. High rate of satisfaction in minor clerkship periods was reported from ENT, infectious disease, psychiatry, and neurology periods respectively. In major clerkship periods, the students were unsatisfied from teaching rounds, outpatient clinic and theory courses. In contrast, high rate of satisfaction belonged to morning report programs. Due to the low rate of satisfaction from gynecology, poisoning and urology courses and also un-satisfaction from CPR and labor management teaching, reviewing the educational programs by teaching managers is recommended