Accreditation the education development centers of medical-sciences universities: another step toward quality improvement in education

In order to improve the quality of education in universities of medical sciences [UMS], and because of the key role of education development centers [EDCs], an accreditation scheme was developed to evaluate their performance. A group of experts in the medical education field was selected based on pre-defined criteria by EDC of Ministry of Health and Medical education. The team, worked intensively for 6 months to develop a list of essential standards to assess the performance of EDCs. Having checked for the content validity of standards, clear and measurable indicators were created via consensus. Then, required information were collected from UMS EDCs; the first round of accreditation was carried out just to check the acceptability of this scheme, and make force universities to prepare themselves for the next factual round of accreditation. Five standards domains were developed as the conceptual framework for defining main categories of indicators. This included: governing and leadership, educational planning, faculty development, assessment and examination and research in education. Nearly all of UMS filled all required data forms precisely with minimum confusion which shows the practicality of this accreditation scheme. It seems that the UMS have enough interest to provide required information for this accreditation scheme. However, in order to receive promising results, most of universities have to work intensively in order to prepare minimum levels in all required standards. However, it seems that in long term, implementation of a valid accreditation scheme plays an important role in improvement of the quality of medical education around the country

Febrile seizure and anemia

Considering the controversial results in present day literature regarding the relationship between febrile seizures and anemia and the high rate of such seizures in children, this study was conducted to evaluate the association between pediatric febrile seizures and anemia. In this case-control study, conducted in 2003, 60 children with febrile seizure [cases] and 60 febrile children without seizure [controls] were evaluated in the Kashan Shahid Beheshti hospital; all patients were matched for age, sex, type of feeding, and use of supplemental iron. Thirty-six [60%] and 39 [65%] of the patients in case and control groups respectively were male, and the remaining female. Levels of hemoglobin, hematocrit, and red blood cell indices were determined in all children and Chi-square and Fisher exact tests were used to analyze data. Of the case group, 13.3% [6 male, 2 female] and of controls, 20% [9 male, 3 female] of children had anemia [p= 0.327], the condition being more common in male children aged over 5 months. Febrile seizures were found to occur mostly between the ages of 6 to 24 months. The risk of febrile seizure occurrence in anemic children seems to be less than that in children who do not suffer from the condition

Comparison of metronidazole and furazolidone against giardia lamblia in children

This study was conducted on children infected by Giardia lamblia to evaluate the effectiveness and side effects of Metronidazole and Furazolidone drugs in Kashan. One hundred twenty two individuals infected with Giardia lamblia were assigned in 2 groups. They were 5-12 years old. Patients were surveyed four weeks following the therapy with Metronidazole and Furazolidone. Results were compared using chi-square method. Of 122 infected patients, 68.8% were urban residents, 43.4% were females and 56.6% were males. Abdominal pain was the most common clinical symptoms [84.2%]. Four weeks after the therapy, the efficacy of metronidazole and furazolidone were 87 and 81.6%, respectively. Malaise [12.9%] and dark urine [25%] was the most frequents side effects of metronidazole and furazolidone, respectively. With respect to the efficacy of antiparasite drugs in the treatment of giardiasis, further studies in different parts of the country are highly recommended

Neonatal sepsis due to Klebsiella: frequency, outcome and antibiotic sensitivity

Sepsis is a significant cause of morbidity and mortality in neonates. The most common pathogens of bacterial sepsis and antibiotic sensitivity patterns vary in different parts of the world. The aim of this study was to determine the most common pathogens and outcome of neonatal sepsis and also antibiotic sensitivity patterns of Klebsiella species. A retrospective descriptive study was carried out. The study was performed at a neonatal care unit in Kashan between October 2000 to October 2003. Only those neonates with positive blood culture were included. Patients with Klebsiella septicemia were categorized into two groups of early and late-onset sepsis. Patterns of the antibiotic resistance of the bacterial isolates were studied by disc diffusion technique. Frequencies and Fisher's Exact test was used to compare the early-onset outcome versus late -onset outcome. One hundred and thirty -six neonates had positive blood cultures out of 453 cases. The most common pathogens were Pseudomonas, Klebsiella and coagulase negative Staphylococci respectively. Overall crude mortality rate was 39% [Pseudomonas was the predominant cause]. All Klebsiella species were resistant to ampicillin. Twenty-three percent of Klebsiella species were multiresistant considering our most common etiologic pathogens of bacterial sepsis and the significant number of resistant bacteria to ampicillin and gentamicin; it seems prudent to consider revising the present choice of empirical antibiotic treatment

Normal values of doppler derived right ventricular myocardial perfomance index in neonates

Doppler-derived Myocardial Performance Index [MPI] is defined as the sum of isovolumetric contraction and relaxation durations divided by ejection time. It is an easily measured and reproducible index that shows both systolic and diastolic myocardial function. The goal of this study was to define normal values of right ventricular MPI in neonates in the first 48 to 72 hours of life. Patients and Fifty-one quite or asleep healthy and term neonates underwent complete M-mode, two-dimensional color-doppler echo-cardiography examination and RV MPI was calculated for them. Statistical analysis was performed, using SPSS software. P values less than 0.05 were considered as significant. RV MPI was 0.23 +/- 0.14 in healthy neonates. No correlation between RV MPI and either age or weight of the newborn infants was found. RV MPI in healthy neonates was 0.23 +/- 0.14 in our study. While this closely resembles to the results of some researches, but is lower than those previously reported by the other investigators in healthy children. The lower value of RV MPI in neonates can be possibly explained by the higher pulmonary arterial pressure of the lower ventricular mass in the first few days of life in neonates. Further studies for evaluation of the effect of pulmonary arterial pressure and right ventricular mass on RV MPI is recommended

Doppler-derived right ventricular myocardial performance index in neonates: Normal values

Doppler-derived myocardial performance index [MPI], defined as the sum of isovolumetric contraction and relaxation durations divided by ejection time, is an easily measured and reproducible index that shows both systolic and diastolic myocardial function. The goal of this study was to define normal values of right ventricular MPI in neonates in the first 48 to 72 hours of life. Fifty-one quiet or sleeping healthy and term neonates underwent complete M-mode, two-dimensional color-Doppler echocardiographic examination and RV MPI was calculated in them. Statistical analysis was performed using SPSS software. A P value less than 0.05 was considered as significant. RV MPI was shown to be 0.23 +/- 0.14 in healthy neonates. There was no correlation between RV MPI and either age or weight of the newborn infants. While this value closely resembles the results of some researchers, it is lower than that previously reported by other investigators in healthy children. The lower value of RV MPI in neonates may be possibly related to the higher pulmonary arterial pressure or right ventricular mass in the first few days of life in neonates. Further study to evaluate the effect of pulmonary arterial pressure and right ventricular mass on RV MPI is recommended