[Comparing lecture and problem-based learning methods in teaching limb anatomy to first year medical students]

Problem-based learning has replaced traditional teaching in most universities around the world but still there are many challenges in replacing traditional methods by this new method of learning. Two methods of lecture and problem-based learning [PBL] for teaching anatomy to junior medical students are compared in this study. Forty students of Artesh University of Medical Sciences, who entered university in 2005, were divided into two groups randomly. Groups were matched based on their Diploma average score, the raw score achieved in entrance exam, and the average score of their previous term. Then, limb anatomy was taught to both groups during two semesters, one group was taught through traditional method and the other through problem-based learning method. The headings of the lesson were the same for the two groups. Students were evaluated through a pre-test at the beginning of the semester and a post-test which was held at the end of the semester. Their viewpoints were also asked at the same time with post-test. Data was analyzed by SPSS software using independent T-test and paired T-test. Post-test scores in both groups were higher than the pre-test scores significantly. The mean difference for correct answers to judgment questions in post-test was higher significantly in PBL group compared with the traditional group. PBL group students were more satisfied with their teaching method. Students' viewpoints in PBL group concerning three domains of developing a sense of participation, encouraging students to study more and teacher's teaching abilities, earned higher scores compared to the traditional group. Students are encouraged to reflect more, and avoid memorizing the material in PBL method. Moreover, this method motivates students to study more by encouraging them into more group interaction

[ comparative study of distal latency of Palmar cutaneous branch of Median nerve with its main sensory branch among patients with diabetic neuropathy, carpal tunnel syndrome and normal population]

Background: It was established that nerve conduction studies are very sensitive and reliable in diagnosis of the diabetic neuropathy. In addition, it was known that asymptomatic carpal tunnel syndrome diagnosed by neuroelectrophysiologic study, is common in patients with diabetes. So, they should be differentiated to select appropriate treatment. This study was designed to identify distal latency ratio of palmar cutaneous branch of median to main branch of median [PCDL/MDL] in the normal, diabetic neuropathy and carpal tunnel syndrome [CTS]

Materials and methods: In the analytic, descriptive cross-sectional study, 60 patients with diabetic neuropathy, 60 patients with CTS and 60 normal cases who presented to 501 army medical center in Tehran, included in the study during 2004.The latency of main branch of median and its palmar cutaneous branch was measured by using EMG-NCV device in each patients

Results: The mean distal latencies of main branch of median nerve in normal, diabetic neuropathy and CTS groups were 3.23+/-0.2, 4.48+/-0.29 and4.10+/-0.21, respectively [P<0.05].The mean distal latencies of palmar cutaneous branch of median nerve in normal, diabetic neuropathy and CTS groups were 2.19+/-0.17, 2.81+/-0.12 and 2.25+/-0.18 [P<0.05]. The mean ratio of PCDL/MDL in normal, diabetic neuropathy and carpal tunnel syndrome groups were 0.67+/-0.07, 0.62+/-0.02 and 0.54+/-0.04, respectively [P<0.05].The PCDL/MDL ratio was not statistically depended on sex in each group. In normal and CTS group, PCDL/MDL ratio had direct colerration with age respectively [0.4 and 0.2] [P<0.05]. In patients with diabetic neuropathy, PCDL/MDL ratio had reverse colerration with age [P<0.05, -0.6]

Conclusions: In patients with diabetic neuropathy, the mean PCDL/MDL ratio was more than that in patients with CTS [P<0.05]

comparitive study of distal latency of palmar cutaneous branch of median nerve with its main sensory branch among patients with diabetic neuropathy, carpal tunnel syndrome and normal population

It was established that nerve conduction studies are very sensitive and reliable in diagnosis of the diabetic neuropathy. In addition, it was known that asymptomatic carpal tunnel syndrome diagnosed by neuroelectrophysiologic study, is common in patients with diabetes. So, they should be differentiated to select appropriate treatment. This study was designed to identify distal latency ratio of palmar cutaneous branch of median to main branch of median [PCDL/MDL] in the normal, diabetic neuropathy and carpal tunnel syndrome [CTS]. ln the analytic, descriptive cross-sectional study, 60 patients with diabetic neuropathy, 60 patients with CTS and 60 normal cases who presented to 501 army medical center in Tehran, included in the study during 2004.The latency of main branch of median and its palmar cutaneous branch was measured by using EMG-NCV device in each patients. The mean distal latencies of main branch of median nerve in normal, diabetic neuropathy and CTS groups were 3.23 +/- 0.2, 4.48 +/- 0.29 and4.10 +/- 0.21, respectively [P<0.05].The mean distal latencies of palmar cutaneous branch of median nerve in normal, diabetic neuropathy and CTS groups were 2.19 +/- 0.17, 2.81 +/- 0.12 and 2.25 +/- 0.18 [P<0.05]. The mean ratio of PCDL/MDL in normal, diabetic neuropathy and carpal tunnel syndrome groups were 0.67 +/- 0.07, 0.62 +/- 0.02 and 0.54 +/- 0.04, respectively [P<0.05].The PCDL/MDL ratio was not statistically depended on sex in each group. In normal and CTS group, PCDL/MDL ratio had direct colerration with age respectively [0.4 and 0.2] [P<0.05]. In patients with diabetic neuropathy, PCDL/MDL ratio had reverse colerration with age [P<0.05, -0.6]. In patients with diabetic neuropathy, the mean PCDL/MDL ratio was more than that in patients with CTS [P<0.05].

[Effects of training programs of pregnant women on their delivery type selection: a single blind, randomized control trial]

Background: There has been an increasing demand for cesarean section delivery [C/S] by pregnant women in recent years. This increase in demand, not only adversely affects the rate of delivery complications, but also imposes a great amount of extra expenses on families, government and insurance companies. It was assumed that by training programs for pregnant women during their prenatal care visits, they can play an active role in the process of decision-making regarding their type of delivery. The goal of the present study is to determine the effect of such training programs on pregnant women in selecting the type of the delivery and to specify if the current rate of C/S can be change by such training programs

Material and methods: In this single-blind randomized control trial, 200 primi-par pregnant women [age 18-30 years old] with gestational ages of less than 30 weeks, referring to the Ob-Gyn clinic of Be'sat general Hospital [IRIAF central hospital] for prenatal care were included. These pregnant women were randomly divided into two groups: Group A which received planned training program during their pregnancy and group B with no training program. None of the assessors knew about the women's status in the mentioned groups. Distribution of women in both groups were equal considering factors like age, education, profession and selected method of delivery at their first interview. In group A, films and pamphlets were used for training. Pamph lets were explained by professional midwives. Patients visited the Ob-Gyn department and delivery ward and spoke to women in their post-delivery phase. At their 36th week of gestational age, all patients in both groups were interviewed again and data were collected and analyzed by proper software using chi square test

Results: In group A, the level of patient's awareness regarding Normal Vaginal Delivery [NVD] and cesarean section [C/S] was markedly increased, expectedly [78%vs.4%] and [71 % vs. 4%], while in group B the level of patient's awareness did not changed on their second interview. The rate of selecting C/S in group A [test] was markedly reduced, [25%vs. 39%], [p < 0.05], while there were no changes in this rate among patients in group B [40% vs. 41%]

Conclusions: It can be concluded that basic trainings for pregnant women can effectively reduce the rate of demand for C/S delivery. It is therefore, recommended that this kind of training to be available for all patient [regardless of their level of education] referring to prenatal care clinics