need for reviewing of log books in Birjand University of Medical Sciences clinical wards

Clinical education can be taken as a facilitating activity for learning in the clinical settings in which students gain experiences from patients' bedside and apply their previously learned concepts through their interactions with their teachers and routine works. Clinical education provides an opportunity for students to transform their theoretical knowledge into diverse intellectual and psychomotor skills essential to patient care. The evaluation process of teaching and learning is one of the noticeable activities in educational institutions because the training of skilled and competent manpower, to a large extent, is dependent on this process. The use of modern educational techniques, increasing productivity, and ultimately enhancing the effectiveness of educational centers is the goal followed all over the world but, this is more emphasized in the field of medical sciences that are directly connected with maintaining and improving the health of people and society. This is why for more effectiveness of medical education applying new methods is necessitated. One of the evaluated and structured methods focusing on learning experiences in education is "logbook". Logbook is a simple means for learners, a framework for organizing various educational activities and recording them. One of the unique characteristics of a logbook is that it requires students acquire a certain number of skills. This causes the students to do their tasks as planned and objectively too; and thanks to repetition and practice they would prevent probable errors. At present, a lot of clinical education aspects are different than in the past. Technology development, changes in the pattern of people's lifestyle and higher exposure to environmental risk factors [Such as the development of chemical industry, natural or synthetic chemicals, biological agents including viruses and other microorganisms, behavioral factors including psychological stress and drug addiction] cause changes in the pattern of diseases in general and particularly in the domain of communicable and non-communicable diseases. Therefore, in accord with these changes, the graduates and scholars are expected to promote their skills and abilities. Since, identification and analysis of the effectiveness of educational needs are prerequisite for a successful educational system, revision and continuous reviewing of educational programs based on the possibilities, conditions, and new needs are inevitable. Thus, the results of a study on 233 medical students passing their clinical stage [externs or interns] in Birjand University of Medical Sciences in the academic year 2016-2017 showed that 24.5% of them knew high or very high helpful completion of their log books activities in attaining of clinical wards skills and 74.5% expressed the necessity of reviewing available log books in clinical wards. According to the obtained results the necessity of reviewing log books used in clinical wards of BUMS considering the latest clinical issues, diseases- including emerging and reemerging ones- and diagnostic - therapeutic methods in accordance with changes in diagnostic - therapeutic guidelines using the newest resources is critically felt. Furthermore, due to the pervasive use of electronic log books in recent years in medical universities across the country that are in line with developments and innovations in medical education, it is recommended that the log books at this university too, should be presented and evaluated electronically. Electronic log books with ongoing record of activities and clinical techniques based on educational objectives, in addition to learning consolidation, determine unavailable measures to achieve clinical objectives and, thus, cause regular monitoring and evaluation on the part of students

Cardiovascular Risk Factors: a Study on the Prevalence of MS among 11-18 Years Old School Children in East of Iran, 2012

Metabolic syndrome [MS] is associated with increased risk of cardiovascular disorders. MS is increasing among adolescents. This study was conducted to determine the prevalence of MS in 11-18 years old Birjandi school children in 2012. This cross–sectional study was conducted on 2394 eleven-eighteen years old school children in Birjand [1304 girls and 1090 boys] through Multiple-Cluster Sampling. Height, weight, waist circumference and blood pressure were measured by standard methods. Blood glucose, triglycerides, cholesterol, HDL-C and LDL-C were measured after a 12-hour fasting. MS was defined according to the modified Adult Treatment Panel III criteria. Data were analyzed by the SPSS software [ver. 16] using statistical T test, logistic regression and Chi square at P<0.05. According to this study, 6.9% of adolescents [4.5% of females and 9.9% of males] had MS. Occurrence rate of MS in male students was 2.32 times of female ones. Components of MS included low HDL [27.7%], hypertriglyceridemia [23.7%], central obesity [16.2%], systolic hypertension [9.4%], diastolic hypertension [0.9%], and high FBS [0.6%]. This study showed a significant relationship between MS, and overweight, obesity and central obesity. 48.5% of the adolescents had at least one component of MS. MS has a high prevalence in Birjandi adolescents, particularly in the obese ones. Thus, preventive measures such as correcting life style, having appropriate nutrition, and encouraging adolescents to have more physical activity are recommended

Risk factors for premature myocardial infarction: a matched case-control study

Myocardial infarction in young age is increasing. Identifying risk factors could be important for health promotion. We studied classic atherosclerotic risk factors in premature myocardial infarction. In this matched case-control study, which was conducted from 2005 to 2007 in Birjand County, the east of Iran, atherosclerotic risk factors [hypertension, family history of coronary artery diseases, obesity, diabetes mellitus, dyslipidemia] of 98 patients affected by acute myocardial infarction aged under 50 years were compared with that of 98 healthy neighborhood controls. Mean levels of cholesterol, triglyceride, low-density lipoprotein, as well as systolic blood pressure and body mass index were significantly higher in cases than in controls. There was a positive association between coronary artery disease at younger age and dyslipidemia OR=2.8 [95% CI: 1.5, 5.2], smoking OR=6.4 [95% CI: 3.0, 13.5], systolic hypertension OR=3.1 [95% CI: 1.5, 6.3], family history of coronary artery diseases OR=10.9 [95% CI: 3.2, 37.9] and diabetes OR=2.5 [95% CI: 1.04, 6.2]. Smoking, systolic hypertension and dyslipidemia were the most common risk factors among patients with premature myocardial infarction

[ effect of using cardiology ward logbook on students training in Birjand university of medical sciences]

Introduction: Being competent in performing clinical skills is necessary in medical profession. Acquiring essential competencies requires for time, patience, and practice in an appropriate context. Logbook is an instructional notebook in which there is a list of skills students must learn. These skills have been organized according to the opinion of faculty members of each ward and the international objectives set by ministry. The educational process could be evaluated continuously by means of these logbooks. This study was performed to evaluate the effect of using log books on clinical skills learning in cardiology ward

Methods: This quasi-experimental study was performed on 60 clerkship and internship students of cardiology ward in 2007-2008. In the first phase, students entering cardiology ward were selected as the control group. They received the usual instructions on clinical skills of the ward. In the second phase, logbooks were distributed among the next group of students as the experiment group and necessary explanations were provided for them. Students were asked to fill the required parts in the logbook and confirm them by their teacher. The educational content for both groups was the same. At the end of the course, students of each group were evaluated by their teachers using checklists for every single competency. Scores achieved for each competency were added up separately. The Mean scores of competencies achieved by students of both groups were compared using t-test

Results: The mean scores of all competencies achieved by the experiment group were significantly higher compared to those of the control group [alpha<0.05]. In addition to comparing mean scores, total scores of competencies of clerks and interns in both groups were summed up and ranked qualitatively. So, the control group was ranked as average and the experiment group as good

Conclusion: Identifying educational objectives and providing guidelines through logbook could be an effective model for directing students towards clinical goals and improving the quality of education

[Epidemiology of trend of acute myocardial infraction in Birjand between 2002- 2006 years]

Recognition of epidemiology of acute myocardial infarction [AMI] in every region could be a need for design the programs for prevention of AMI. In this study we assessed the epidemiology of changes in AMI from 2002-2006 in Birjand [east of Iran]. All of the patients which hospitalized by AMI diagnosis from 2002-2006 years, included in this study. We compared mean of age, gender, location of living, medications used, condition at discharge and cardiac risk factors in this period. From 1 233 patients, 880 were male [71.4%]. Overall, mean age of patients was 62/2 +/- l 2/8 years and in five years was increased [from 61.7 +/- 13/2 in 2002 to 63.5 +/- 12/4 in 2006 and p=0.37]. The most risk factors in patients were: Hypertension [HTN] [34/8%], cigarette smoking [32/1%] and dyslipidemia [24%]. These risk factors did not show any significantly changes during 5 years. But the prevalence of HTN [30/9% in 2002 to 38% in 2006, p=0/62] and DM [15/5% in 2002 to 21% in 2006, p=O/23] raised. Cardiac drugs use tended to increase during 5 years, however only this increase about STK and Statin was statistically significant. The hospital mortality rate was decreased in 5 years [11.3%] but it was not statistically significant [p= 0.48]. Regarding the accelerating the rate of AMI, designing an appropriate program for prevention and modifying cardiac risk factors is recommended