The Effect of Vitamin B12 and Folic Acid Supplementation on Serum Homocysteine, Anemia Status and Quality of Life of Patients with Multiple Sclerosis

Plasma homocysteine level and megaloblastic anemia status are two factors that can affect the quality of life of patients with multiple sclerosis (MS). We conducted this study to determine the effect of vitamin B12 and folic acid supplementation on serum homocysteine, megaloblastic anemia status and quality of life of patients with MS. A total of 50 patients with relapsing remitting multiple sclerosis (RRMS) included in this study which divided into 2 groups. The vitamin group received 5 mg folic acid tablet daily and 3 doses of vitamin B12 (1,000 mcg) injection and the other group received placebo and normal saline injection (same doses). The quality of life was measured by using Multiple Sclerosis Quality of Life-54 questionnaire (MSQOL-54). Fully automated fluorescence polarization immunoassay was used to measure serum homocysteine, vitamin B12 and folate. Complete blood count blood test was conducted to determine the anemia status. The mean homocysteine level reduced by 2.49 ± 0.39 µmol/L (p = 0.001), hemoglobin increased from 11.24 ± 1.54 to 13.12 ± 1.05 g/dL (p = 0.001), and mean corpuscular volume decreased from 95.50 ± 6.65 to 89.64 ± 4.24 in the vitamin group (p = 0.001). There was a significant improvement in the mental field of life quality in the placebo group (37.46 ± 19.01 to 50.98 ± 21.64; p = 0.001), whereas both physical and mental fields of quality of life were improved significantly in the vitamin group (40.38 ± 15.07 to 59.21 ± 12.32 and 29.58 ± 15.99 to 51.68 ± 18.22, respectively; p = 0.001). Serum homocysteine level decrease and anemia status improvement with vitamin B12 and folic acid supplementation reveal the potential role of these two vitamins in improving the life quality of MS patients. TRIAL REGISTRATION: Iranian Registry of Clinical Trials Identifier: IRCT2015100313678N7

[Educational purpose and medical student's achievements in clinical training in an university hospital in Kermanshah]

One of the most important components of educational technology is an educational plan. Medical education needs to evaluate regular educational achievements particularly in clinical training. This study was carried out to investigate medical students achievement compare to educational prepuces in clinical training in Kermanshah Emam Reza hospital. In this descriptive-analytical study. 135 students in level of replacement and internship were selected through satisfied random sampling method during the first semester of year 2008. Data was collected using researchers planned questionnaire. 15 experts in medical education area confirmed its face and content validity. To confirm the reliability of the questionnaire were checked Spearma-Brown in a pilot study [r=0.86]. Data were analyzed using SPSS13. The finding indicated that 11.1% of students were not achieved, 85.2% moderately achieved and only 3.7% of them were completely achieved to educational aims in clinical training. No significant differences were observed between gender, year of study and level of study. However there were statistically significant difference associations between students' achievement to educational aims in clinical training and introducing training objectives, evaluation methods and having an introduction session at the beginning of clinical training as well as induction training in the emergency ward. This study reveals that there are still some spaces and opportunities for increasing the medical students' achievements to educational aims in clinical training. This study recommended that at the beginning of clinical training with use of: aim, evaluation methods, justify session presented to the students and use of emergency wards for education, could increase achievement to educational aims in clinical training in medical students