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

[Pattern of empiric antibiotic prescription in patients referred to an emergency department of a medical university affiliated hospital in Tehran]

Resistance in microorganisms is a serious problem in infectious medicine which the most reason is inappropriate antibiotic prescription by physicians. As there was not any information about the pattern of empiric antibiotic prescription in Iran, this study designed for recognition of antibiotic prescription pattern in one of emergency departments in a hospital affiliated to Shahid Beheshti medical university. This cross sectional study was performed during the years 2006-7 in the emergency department of the above mentioned hospital on 200 patients whom at least received one antibiotic. Physicians, after taking history and physical examination, completed the information form according to the patients chart in emergency department. Our references on appropriateness of empiric prescribed antibiotics were a] textbook of "Mandell's Principles and Practice of Infectious diseases, 6[th] Edition; 2005", and b] protocols from the "Infection Control Committee" of the same hospital. Among 200 patients to whom at least one antibiotic was prescribed, for 108 cases [54%], prescribed antibiotic was without indication and among 92 cases which antibiotic was indicated, in 55 cases [59.8%] the prescribed antibiotic was appropriate, i.e., the prescribed antibiotic was appropriate by type, dose and interval. According to the results, it is prudent that the prescription of antibiotics without clear indication and wrong selection of empiric antibiotics in this hospital's emergency department were disproportionately high. Thus it seems that using solutions like periodic education programs for physicians and supervision for prescribed antibiotics are mandatory

[Epidemiologic survey of documented measles outbreak in Tehran]

Background: in spite of extended vaccination programs against measles, it is the most preventive contagious disease that leads to death. For adaptation of WHO policy for measles in Iran; we should determine susceptible age population whom at present lay out of current vaccination program

Methods and Materials: in this descriptive study which was performed in the public health School of the Tehran medical university we obtained 13 I documented measles cases among 650 suspected case of measles [as WHO discrimination] According to serum samples analysis [ capture IgM EIA 71% and 29 % HJ]

Results: in this study 63. 4 % of cases were male and 39.6 % were females. Between patients, the most prevalent age group was between 15 - 19 years old. Two peaks of the time of the disease were March and June. History of past vaccination against measles showed that 43 % had unknown history; 24. 4 % had two vaccinations 39. 3 % had one vaccination and 3.1 % had no vaccination history

Conclusions: it is suggested [by further investigations in future] the need for revaccination of measles/or age group of 15-19 in Iran will be determined