فهرست مطالب پویا طباطبایی

Chronic renal failure refers to an irreversible deterioration of renal function that follows a progressive course and ultimately leads to necessity of dialysis in most of patients. As some studies have indicated that the mentioned patients may eventually develop lipid profile abnormalities, the present study aimed to evaluate the effective factors in lipid profile changes in these patients over one year.

In this cross-sectional study, 251 patients under peritoneal dialysis, whose profiles were available in the archives of Alzahra hospital, Isfahan, Iran, during 2018-2019, were randomly selected. Demographic data and lipid profile of these patients including total cholesterol (TCH), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglyceride (TG), and blood glucose levels were recorded and analyzed at baseline as well as six months and one year after the start of dialysis.

Changes in the lipid profile of the patients during one year of dialysis were significant (P < 0.050). Sexuality had a direct and significant relationship with all the changes in lipid profile items (P < 0.001). In addition, as well as an increase in the hemoglobin (Hb) level, it had a direct and significant relationship with elevated levels of LDL, TCH, and TG (P < 0.001 for all). Moreover, blood glucose level had a significant relationship with increased levels of TCH (P = 0.040) and TG (P = 0.014). Finally, dialysis solution with 2.5% and 4.25% dextrose had a significant and direct effect on increasing the levels of TCH (P =0.035) and LDL (P = 040), respectively.

According to the results of the present study, the lipid profiles of patients undergoing peritoneal dialysis revealed significant changes. The most significant factors associated with lipid profiles were the type of dialysis solution, and the levels of blood glucose and Hb.

Early clinical exposure is a learning strategy, which can expose medical students during their first year of education with clinical environment. In view of this, this study has been carried out a different kind of early clinical exposure to practice medical professionalism.

This study was a development study that was conducted in the academic years 2017-2018. Initially, needs assessment was performed based on literature review and expert panel. Then, the design of early exposure was depicted through a focus-group interview with the presence of Olympiad students. After that, the program was implemented. The topics were presented individually in the workshop and audio podcasts were presented in the Learning Management System. In the second practical round, namely early clinical exposure, the students were divided into multiple groups and practiced communication skills and professionalism in the clinical contexts by a tutor who was in higher level of education. To evaluate this program, satisfaction forms were employed to assess the students' learning through multiple-choice and descriptive tests.

In the evaluation, great level of the students' satisfaction was about the selected environments, the educational program (78.1%), the employed methods of the course (73.2%) and recognition of professional responsibilities (73.2%). The least level of the students' satisfaction was the amount of learning opportunities (65.8%). 75.6% of students acknowledged the increase in their professionalism.

Early clinical exposure is a rich opportunity for enhancing professionalism and communication skills for medical students who are in the introductory level of medical education. This way, repeating the outcomes of this study in experimental and clinical trials is recommended. Early clinical exposure should be followed seriously for long-term as well.