Effectiveness of E-learning compared to classroom learning in the diagnostic approach to bioterrorism and chemical terrorism for emergency physicians

Background and purpose: Emergency physicians play an important role in the immediate diagnosis of bioterrorism activities. The present study was conducted with the purpose of comparing the effectiveness of e-learning and classroom learning in approach to bioterrorism and chemical terrorism for emergency physicians

Methods: This was a semi-empirical study, which was conducted via testing knowledge before and after the educational intervention in the field of bioterrorism and chemical terrorism on the emergency physicians in Tehran. The external validity of the questionnaire was confirmed by two academic experts in order to determine the ability to detect bioterrorist and chemical terrorist diseases. In this study, education was done in both virtual and classroom forms. The education regarded 6 bioterrorist diseases in group A [anthrax, plague, viral hemorrhagic fever, tularemia, smallpox], and 5 chemical terrorist diseases [nerve gas, mustard, lewisite, phosgene, chlorine]

Results: 160 doctors participated in this study. 96 people [60%] were men and 64 people [40%] were women. The average age of the participants was 36.2 +/- 5.5 years. In e-learning method, the pre-test scores average was [30.6%], while the post-test scores average was [81.6%] [p=0.001]. In classroom learning method, the pre-test scores average was [41.9%], while the post-test scores average was [72.9%], which the pre-test and post-test scores average differences in both cases are significant [p<0.001]. In e-learning method, the difference was [51%], and in the classroom method it was [31%], which these two represent a 20% difference between methods. From statistical point of view, this difference indicates that the e-learning method being more effective [p=0.02]

Conclusions: Based on the study results, it seems that in comparison to the classroom learning, e-learning method is more effective in helping emergency physicians to diagnose bioterrorism or chemical terrorism factors

Comparative study on the effectiveness of coumavec and zinc phosphide in controlling zoonotic cutaneous leishmaniasis in a hyperendemic focus in central Iran

Zoonotic cutaneous leishmaniasis [ZCL] is an increasing health problems in many rural areas of Iran. The aim of this study was to introduce a new alternative rodenticide to control the reservoirs of ZCL, its effect on the vector density and the incidence of the disease in hyperendemic focus of Esfahan County, central Iran. The study was carried out from January 2011 to January 2012. In intervention areas, rodent control operation was conducted using zinc phosphide or Coumavec. Active case findings were done by house-to-house visits once every season during 2011-2012. To evaluate the effect of rodent control operation on the vector density, sand flies were collected twice a month using sticky traps. The reduction rate of rodent holes in intervention areas with Coumavec and zinc phosphide were 48.46% and 58.15% respectively, whereas in control area results showed 6.66 folds intensification. The Incidence of ZCL significantly reduced in the treated areas. Totally, 3200 adult sand flies were collected and identified in the intervention and control areas. In the treated area with zinc phosphide, the density of Phlebotomus papatasi was higher in outdoors in contrast with the treated area by Coumavec which the density of the sand fly was higher in indoors. Both rodenticides were effective on the incidence of ZCL and the population of the reservoirs as well. Coumavec seems to be effective on the outdoor density of the vector. This combination of rodenticide-insecticide could be a suitable alternative for zinc phosphide while bait shyness or behavioral resistance is occurred

[Comparison of urine and milk iodine concentration among congenitally hypothyroid neonates and their mothers and a control group]

Although Iran is known as an iodine sufficient area, congenital hypothyroidism [CH] is prevalent. Because iodine excess can contribute to hypothyroidism we evaluated the role of iodine excess and ID in the etiology of CH. In a cross sectional study UICs [Urine Iodine Concentration] in newborns with CH as well as UIC and MIC [Milk Iodine Concentration] of their mothers were compared with a control group. After acid digestion of urine samples milk samples, iodine concentrations were determined by the Sandell-Kolthoff method. Chi-square and Wilcoxon, and Pearson correlation tests were used for statistical analysis. A P value less than 0.05 was considered statistically significant. The median of MIC of CH [n=68] and healthy subjects [n=179] was different [210 vs. 170 micro g/L respectively, P<0.05]. However the median of UIC in neonates and those of mother's of CH and healthy subjects were not different statistically [305 vs. 300 micro g/L and 150 vs. 130 micro g/L respectively, P>0.05]; 71.2% and 46.7% of mothers of hypothyroid and healthy subjects had MICs above 180 micro g/I [iodine excess] respectively [p=0.002]. Based on the higher levels of MIC in mothers of CH neonates, iodine excess could be a possible risk factor for CH. Since however comparison of UIC between the control and neonate groups showed no differences, further investigations are needed to facilitate deeper insight into and clarification of the etiology of CH

[Introduction of a new index to compare function of screening labs of thalassemia prevention program in Isfahan province]

Although major beta-thalassemia prevention and control program is one of the most successful programs in genetics field, there are new cases of major beta-thalassemia due to laboratory errors. So the laboratory quality control [QC] is very important to diagnose carriers in preventive programs. At present, there is not a distinct and measurable index for function assessment and comparison in screening laboratories; this urged us to create an objective, measurable and explicit index for health care givers. For this purpose, we compared the function of screening labs in districts of Isfahan Province. In this cross-sectional study, we collected the data from "pre-marriage screening program" in 18 districts [19 screening labs] covered by Isfahan University of Medical Sciences from 2006 to 2008. The percentage rates of "screened males with low blood indexes" in every 3 months [P index] were assessed; then, the average and coefficient variants in duration of 3 years were calculated with excel software. Based on these findings, "screening labs' functions" were assessed and compared. The least "CVs of P index" within 19 labs were found to be in Mobarakeh laboratory [10.4%] and Provincial reference lab [10.9%], respectively. The highest CVs were found in Khour [76.3%] and Tiran and Karvan labs [58.2%], respectively. The P index average in all centers was 14% [13.9% in reference lab] with the highest being in Mobarakeh[24.2%] and the lowest in Khour[8.8%]. Whereas the number of marriage candidates in each screening lab is relatively stable, the centers with the highest CV value of P index are probably lower in function level as compared with the centers with the lowest CV value of P index [as in reference screening lab]. CV of P index may be a good evidence for quality of "screening lab function" and should be evaluated annually. The screening labs with high CV of P index need more attention and evaluation

[Dental students' competencies in community dentistry course]

Graduated dentistry students ought to be competent in different fields of community dentistry such as health education, needs assessment, planning and policy making. The aim of this study was to assess the effect of community dentistry course on dental students' competencies in different fields of community dentistry through self-monitoring method in Isfahan School of dentistry. This quasi-experimental study was conducted on two groups using pre-test and post-test. Through census sampling method, 50 students were studied before and after passing the community dentistry course, as experiment group and 40 students who did not pass this course were studied as the control group at the time of graduation. The data gathering tool was a questionnaire which was completed by students as self-administered. The questionnaire assessed students' competencies in 6 determined areas with a scale ranging from unacceptable to excellent. The results were analyzed by SPSS software using Paired t-test and t-test. The difference between the scores of experiment group's competencies in all six determined areas was significant, before and after passing the course. Comparing the scores of the experiment and control groups showed significant differences in all areas except in "preventive dentistry services". Community dentistry course has been successful in making the students competent in community dentistry fields. In order to improve these results, it is recommended to devote more time and facilities to the subjects such as needs assessment and course planning