Necessity of accreditation standards for quality assurance of medical basic sciences

The present article reviews the significance of accreditation standards while emphasizing the necessity of implementation of such standards by basic medical science council, with an eye on such international standards as those published by WFME. This review article had to decide on the key words and expressions, data bases, to review relevant literature, review higher and medical education journals at GOOGLE, ELSEVIER, PUBMED, and such web sites as those of WFME and WMA's. Accreditation is a powerful leverage for institutional change and improvement and must be actively supported by academic and national health authorities worldwide. Considering the mission of the Basic Medical Science, Health and Post grad. Education, Ministry of Health and Medical Education, Tehran, Iran as accountable medical education, all specialists of the spectrum of disciplines agreed on the necessity of formulating the medical education standards for all disciplines of their interest. It is important that all efforts be joined in the endeavor to create effective and reliable instruments for quality assurance of Basic Medical Sciences Education

[Screening for celiac disease in growth retarded children with or without chronic diarrhea: a study on children in Kerman/Iran]

The aim of this study was to determine the yield of screening for celiac disease in children with failure to thrive and with or without chronic diarrhea. In this prospective study, 144 children aged 1-14 years and weighed below the fifth percentile with or without chronic diarrhea were studied during six months in 2010. Sample collection was done in the private office of one of the researchers, health care clinics, schools, and subspecialty clinic of Afzalipour Hospital, Kerman/ Iran. Screening was done by measuring anti-tissue transglutaminase IgG antibody test [tTG test]. All positive cases underwent upper endoscopy with pediatric Pentax video endoscope. Definitive diagnosis was made by doing small intestine biopsy and histological study. Mean weight and age of children were respectively 14 +/- 4.2kg and 6 +/- 3.3 years. One third of subjects had diarrhea. Positive tTG test was observed in 11.1% of children. Celiac was confirmed in all seropositive subjects by intestinal biopsy. Therefore, the predictive value of tTG test was 100%. There was no significant relationship between the prevalence of celiac and variables of age [p=0.445], sex [p=0.859] and chronic diarrhea [p=0.137]. Regarding the relatively high prevalence of celiac disease in growth retarded children [11.1%], and high sensitivity [100%] of tTG test found in the present study, screening of growth retarded children with or without chronic diarrhea for celiac disease seems logical

[Opium dependency with histopathologic changes of brain in rats]

Central nervous system is one of the primary targets of the detrimental effects of narcotics. Although opiates are among the most drugs of abuse, little is known about their side effects on the brain structures. Most investigations in this field are about their biochemical or psychological side effects. In this study pathologic changes in morphine dependent rats have been investigated. In this experimental study, 48 male wistar rats were divided into 6 groups. The dependent groups received 0.4mg/ml morphine in drinking water for 7, 28 and 56 days. The control groups received a solution of saccharose in drinking water for the same periods and then the histological studies of the brain samples were done. Significant neuronal loss in frontal and parietal lobes and hippocampus was observed. Results also showed a significant relationship between the duration of morphine intake and neuronal loss. The results of this study, in line with the other studies in this field indicate that opiate drugs might induce neuronal damage after long term exposure. These changes could be more significant in chronic addiction. Since brain atrophy is the most common pathology in dementia, further investigations for finding probable relations between dementia and opiate dependency is suggested

Validation of a Persian version of the oral health impact profile [OHIP-14]

The oral health-related quality of life indicators are increasingly used to measure the impact of the oral conditions on quality of life. One of the most used indicators in the Oral Health Impact Profile [OHIP- 14], but it has never been applied in Iran. The aim of this study was to validate the usage of OHIP-14 among Iranians. A cross-sectional study was performed in Kerman [Iran]. A consecutive sample [n=400] of the Kerman Dental School Clinics attending patients participated in this study. All participants self-completed the translated OHIP-14. Reliability analyses, validity tests, and responsiveness were carried out to evaluate the psychometric properties of the OHIP-14. The reliability coefficient [Cronbach's alpha] of the OHIP-14 was above the recommended 0.7 threshold and considered excellent [alpha: 0.85]. The coefficient of the test-retest reliability measured by ICC was 0.88 [CI 95%:0.80- 0.93]. Poorer oral condition was strongly associated with OHIP scores of the patients, supporting construct validity. More-over, for evaluation of responsiveness, the ES was measured to be 0.43 and the SRM was 0.67. The Persian version of OHIP-14 is a precise, valid and reliable instrument for assessing oral health-related quality of life among Persian population

Prevalence of cigarette smoking and relevant factors among school students in south of Iran

The aim of this research was to evaluate the prevalence of cigarette smoking and its relationship with some demographic features, among first and second grade of high school students in Kerman city. In this cross - sectional study 860 students [514 girls, 346 boys] were selected randomly in Kerman in 2003. They answered to the self - made questionnaire including issues related to smoking and demographic features and included Fagerstrom test for nicotine dependent. Data analysis was done by SPSS -10 software and using T- test, k[2] and Fisher test. In males 6.1% and in females 6.6% [6.4% totally] had smoked at least once in their life. 1.7% of males and 2.3% of females [2.1%] smoke sometimes. 2.8% of males and 0.4% of females [1.2%] were smokers. So 10.1% of males and 9.7% of females had experienced smoking. About 2.3% of males and 1.2% of females would like to quit smoking. In according to Fagerstrom test, 9 students, 5 males [1.5%] and 4 females [0.8%] were heavy smokers. 27 students, 15 males [4.4%] and 12 females [3.3%] were mild or moderate cigarette users. Cigarette smoking abuse is significantly high among teenagers in Iran therefore preventive activities should be directed in that way. This study showed that the prevalence of smoking was higher among boys but smoking for fun intentions was more in girls

Systemic effects of experimental spinal cord injury on bone healing in rabbit

loss after spinal cord injury leads to increased fragility of bone and subsequent risk for low-trauma fractures in the sublesional parts of the body. Although in such injuries upper limbs are normally innervated, bone loss may occur in the upper extremities. The present study was designed to de-termine the systemic effects of spinal cord injury on the fracture healing of upper limbs in rabbits. Twenty nine skeletally mature New Zealand white rabbits received a transverse mid-humeral open osteotomy in the left upper limb with the use of a standardized technique and spinal cord injury was done using forceps model at T8 level. The animals were divided into three groups: experimental [laminectomy, spinal cord injury, and osteotomy], sham [laminectomy and osteotomy], and control [osteotomy alone]. The bone healing score was calculated using modified Sandhu system by two independent pathologists. The mean ['SD] of healing scores in experimental, control, and sham groups were 7.22 [ +/- 3.6], 8.6 [ +/- 3.3], and 8.5 [ +/- 4.3] respectively [P = 0.68]. The percentage of mesenchymal [20%] and cartilaginous tissue [35%] showed a slightly higher value in the experimental group compared with the sham group [15% and 20% respectively]. A reverse pattern was seen concerning the percentage of trabecular bone, though as a whole there was no significant difference regarding the percentage of selected components of bone healing between the three trial groups. Fracture healing in innervated upper limbs is not influenced by the systemic effects of spinal cord injury

[ reliability and validity of the Persian version of the brief pain inventory in cancer patients]

The need for a standard instrument to assess pain in cancer patients is universally accepted. The aim of this study was to assess the psychometric properties of the Persian version of the Brief Pain Inventory [BPI] on a sample of Iranian Cancer patients. This cross-sectional study was conducted in Kerman on a sample of 211 cancer patients. At first the questionnaire was translated and back translated through standard methods. The face validity of the inventory was examined on 15 individuals with diverse educational levels to assess the comprehensibility and acceptability by the patients. The construct validity of the instrument was assessed by both exploratory and confirmatory factor analysis. The internal consistency was analyzed by Cronbach's alpha coefficient and item scale correlation. The response rate was 96%. Nearly 52% were female. The Persian version was compatible with the original version. The Kaiser's measure of sampling adequacy [MSA] before factor extraction of the questionnaire was 0.87, which indicated an acceptable factorability of the statements. The construct validity of the questionnaire was confirmed by exploratory and confirmatory factor analysis. The measures of internal consistency were in an acceptable level. Cronbach`s alpha for the whole questionnaire [11 items] was 0.87 and it was 0.87 and 0.89 for the intensity and reactive dimensions, respectively. The Persian version of BPI was a reliable and valid measure to assess pain in cancer patients

Knowledge, attitude and preventive practice of women concerning osteoporosis

To determine the knowledge, attitude and preventive practice of women above 45 years old. A total of 770 households in Kerman [southern Iran] were selected for inclusion in the study using cluster sampling from April through August 2005. The interview schedule consisted of 4 parts including questions about knowledge, attitude and practice [KAP] and also demographic questions. The average score for KAP was 9.3 out of 21, 2.6 out of 5 and 1.5 out of 6, respectively. Adequate osteoprotective exercise and sufficient calcium intake were found in 3.8% and 5.5% of subjects, respectively. A significant relationship between the score of preventive practice and all the following parameters was found: level of education, hearing about osteoporosis, knowledge score, perceived barrier to preventive actions and perceived seriousness of osteoporosis. Considering the Iranian women's inaccurate or insufficient knowledge and their negative attitude to the preventive actions and their weak practice in case of prevention, it is the responsibility of health policymakers and medical associations to plan for osteoporosis education and prevention initiatives

[Comparison of antioxidant system in patients with ischemic heart disease and control group and its relation to ceruloplasmin]

Coronary heart diseases, specially myocardial ischemias due to atherosclerosis, are among the major causes of mortality in industrialized societies. Oxidative stress occurs during ischemia. This finding has been confirmed by in vitro studies which have shown some changes in antioxidant concentration during ischemia. However, antioxidant system status and its relation to ceruloplasmin as a risk factor have not been studied in patients with ischemic heart disease [IHD]. This study was conducted to evaluate this status. This case-control study carried out on 99 men, aged 35-55 years. Two groups including 29 patients with IHD due to coronary artery stenosis above 70 percent, confirmed by angiography and exercise tests, and 70 healthy men without heart disease, diabetes and hypertension background were studied. Blood samples were collected from all subjects early in the morning. Then catalase and superoxide dismutase [SOD] activities, total antioxidant of serum [TAS], ceruloplasmin and malondialdehyde [MDA] concentrations were measured by a spectrophotometric method. TAS, SOD and catalase levels were 0.9 +/- 0.04 mmol/L, 1224 +/- 21.40 U/g Hb and 5657 +/- 290.60 U/g Hb respectively in patients which were significantly lower than those of controls 1.6 +/- 0.02 mmol/L, 1488 +/- 13.03 U/g Hb and 7546 +/- 176.80 U/g Hb [p<0.05]. MDA and ceruloplasmin concentrations were 36 +/- 0.92 mg/dl, 277 +/- 6.90 nmol/g Hb] respectively in cases and 29 +/- 0.60 mg/dl and 247 +/- 4.20 nmol/g Hb in controls which showed a significant difference [p<0.05]. There was no statistical correlation between antioxidants and ceruloplasmin level in these groups. In patients with IHD, antioxidant system capacity was lower than that of controls which can explain higher lipid peroxidation in these patients. Also we can not predict lipid peroxidation severity by measuring ceruloplasmin level because no association was found between these two factors

sources and their rate of use by interns for learning clinical skill

Centers presenting clinical skills training in medical schools improve the students' ability in practical skills, provide an appropriate setting to practice in an experimental setting and prevent probable mistakes in a real setting. This study is an attempt to determine the interns' attitudes in Kerman University of Medical Sciences about the amount and the resources of acquiring elementary clinical skills through self-assessment. All interns, who passed the clinical skills course, participated in this cross- sectional study in 2004. A researcher made questionnaire was used to gather the data and t-test and ANOVA were used to analyze them. Most of the respondents believed a separate center as clinical skills center was necessary. Vital signs measurement, NG-tube placement and communicating with patients [18,35,17,76, and 17,3, respectively] got the highest scores in acquiring skills [stagger's self-assessment] and the lowest scores were for cauterization, intubations and surgical tools identification [9,09, 12,84 and 14,11, respectively]. The mean of self-assessment score was 76, 7%. The most used resources to acquire skills were clinical skills ward [41%], self-learning [29%] and the professors and others [27%]. Since the self-assessment score was low and as the clinical skills center was used the most to acquire skills, improving training in this center and expanding its activities is necessary

Assessing the cost-effectiveness of contraceptive methods in Shiraz, Islamic Republic of Iran

To determine the cost-effectiveness of seven contraceptive methods from the providers' perspective, the cost per adjusted couple-years of protection [ACYP] was calculated for each method based on region-specific conversion factors. More than 74,800 ACYPs were provided during March 1999 to February 2000. Intrauterine devices and implants offered the highest and lowest ACYP respectively. Condom was the single most expensive contraceptive method. Vasectomy was the most cost-effective method and implant provided the highest cost per ACYP