ABSTRACT
Most diagnostic tests for biliary atresia [BA] are invasive. This study evaluates the sensitivity and specificity of serum tumor necrosis factor-alpha [TNF-alpha] for diagnosing extra hepatic biliary duct atresia [EHBA] in infants. Infants with cholestasis who were admitted to Children's Medical Center Hospital were evaluated. A total of 50 infants [20 with EHBA and 30 non-EHBA] were included in this study. We evaluated the definite cause of cholestasis. Intra-operative cholangiography and, if possible, Kasai portoenterostomy were performed in infants with high suspicion for EHBA. Upon admission and prior to surgical intervention, infants had their serum TNF-alpha levels measured by ELISA. We compared the mean TNF-alpha level between the two groups, in addition to the sensitivity and specificity of serum TNF-alpha for diagnosis of EHBA. This study enrolled 28 [56%] male and 22 [44%] female infants. Infants'' mean age was 2.87 months in the EHBA group and 2.6 months in the non-EHBA group. Sensitivity of serum TNF was 60% and its specificity was 76.66% for predicting EHBA. The positive predictive value was calculated as 63.1%, the negative predictive value was 74.1%, and accuracy was 70%. There was a significantly higher mean serum TNF-alpha level in the EHBA group [220 pg/ml] compared to the non-EHBA group [79.8 pg/ml, p=0.023]. Serum TNF-alpha cut off point for determining EHBA from non-EHBA was calculated as 80 pg/ml. Mean serum TNF-alpha in males [171.28 pg/ml] was more than females [90.80 pg/ml]. There was a significantly higher mean serum TNF-alpha level in the EHBA group than the non-EHBA group. Serum TNF-alpha could be a proper test that has comparatively good sensitivity, specificity, positive predictive value and negative predictive value for predicting EHBA
ABSTRACT
Background and Objective: Evaluation is an essential process for educational institutions, and one of the most common methods of evaluation of teachers is evaluation by students. Students are the real customers in the educational process; therefore, their judgments should be important variables in determining teaching status of teachers. According to customer-centric principles, the consumer's satisfaction must be met. This study assessed the validation of the current teacher evaluation form in theoretical courses
Methods: This was a cross-sectional study investigating the validity and reliability of the teacher evaluation form that is completed by students, and identifying some factors affecting student evaluations. To determine content validity of the teacher evaluation form, 20 expert teachers were selected proportional to the number of teachers of each school of the Hamadan University of Medical Sciences. To assess the reliability coefficient of the form, 189 students were selected from different schools by proportional random sampling
Results: According to the results, questions such as rate of adherence to the determined topics, providing practical application of teaching materials, and the efficacy of determined assignments did not have the necessary validity score. However, the results indicated that validity of the questionnaire was acceptable. In the present study, the Spearmen-Brown correlation coefficient indicated that the teacher evaluation form did not have an acceptable reliability [r = 0.456, P < 0.001]
Conclusion: The current teacher evaluation form has an acceptable content validity, but it does not seem reliable
ABSTRACT
Cytomegalovirus [CMV] is the most common cause of congenital infection. Although most of the involved neonates are asymptomatic but virus can cause a range of problems from mild to severe illness with involvement of different organs like central nervous system, gastrointestinal and liver. Proneness to CMV is very high [up to 1% of neonates]. In the other hand trosinemia type I is a rare metabolic disorder with involvement of liver, neurologic, bone and other organs. A 3-month-old infant, product of twin pregnancy was hospitalized because of jaundice, FTT, hepatomegaly and sepsis. The other twin showed normal growth with no problems. Work up for cholestasis and FTT was suggestive of two different entities. Polymerase chain reaction for CMV in liver tissue and serum was positive. Meanwhile laboratory findings for metabolic disorder led to the diagnosis of type 1 tyrosinemia. The other twin was infected with CMV too. Although coexistence of two causes for cholestasis is very rare, it is sometimes necessary to study more to rule out other entities like metabolic disease including tyrosinemia [if any symptoms exist]