Thrita
Volume:2 Issue: 5, Sep 2013

Morning report was initially performed at non-educational hospitals. The on-service nurse and medical staff reported the problems enfaced for the management of patients of the previous working day to the head of ward (1). The aim of this program was modified in teaching hospitals (2). Thereby, morning report is now considered as one of the key elements in medical students’ training curriculum. A variety of educational groups participate in morning report; however, residents are the main target population (3). Residents carry on the session and discuss the difficulties in the diagnosis and management of patients (4).Routinely, the medical students are not actively involved in the program and they usually get bored. Sometimes the scientific level of discussed issue is so high that they cannot follow the conference. To overcome this shortcoming, medical student-based morning report was designed at internal medicine ward of Sina hospital, affiliated to Tehran University of Medical Sciences. During the student-based morning reports, the on-service senior medical students and residents help the juniors to complete their report before the session. Afterward, the junior medical students present the cases in front of a panel that consists of senior medical students and a resident. Accordingly, senior medical students ask questions about the ambiguous issues in the presentation and clarify the pitfalls of junior students'' presentation. The resident is the leader of the panel and handles the coordination of the team. We implemented a new role for the residents in this especially designed program that is known as ‘resident as a teacher’ (5). The attending professor facilitates the process at each step.A survey on this program showed that it has a progressive character. In fact, the drawbacks in data collection were the major findings in sessions at the beginning of the semester. Comments on how to take a precise report from the patient halted the program at this stage. Medical students were prepared for entering to the next step through resolving the problems with regard to a more accurate history taking. Next step was to make decisions and express the differential diagnosis. Through this step, they were prepared for clinical reasoning and presenting the diagnosis plan later in the semester. The result of this survey also showed that the students were satisfied with the program. The participants’ level of self-esteem in oral case presentation, independent decision-making ability, and clinical reasoning was improved after participating in this program.

Keratinophilic fungi are a small but well-defined and important group of fungi that can degrade the hard keratin. So, keratinophilic fungi may be pathogenic with regard to keratinized tissues of human and animal. In this study we took samples from the soil of Tehran parks, to investigate the role of keratinophilic fungi in soil, because of the frequent contacts of human being with soil, especially children. Two hundred soil samples from different parks were examined for the presence of geophilic keratinophilic fungi. Fungi were isolated from the samples by the method of hair baiting. A total of 222 isolates of keratinophilic fungi were obtained. The following species were isolated: Acremonium (17.5%), Chrysosporium (12.6%), Fusarium (11.3%), Cunninghamella (11.3%), Microsporum gypseum (10.4%), Gliocladium (9.9%), Ulocladium (6.7%), Penicillium (4.0%), Aspergillus niger (3.6%), Aspergillus (2.7%), Alternaria (2.2%), Scopulariopsis (1.8%), Verticillium (1.8%), Mucor (1.3%), Drechslera (0.9%), Rhizopus (0.9%), Trichophyton mentagrophytes (0.4%), Cladosporium (0.4%). The soil represents the main reservoir of keratinophilic fungi including dermatophytes and non-dermatophytes. Therefore, soil can be a source of infection for humans and animals. From the results presented in this study, an association exists between keratinophilic fungi and the soil of parks in municipality districts of Tehran.

Purkinje cells play a critical role in the normal function of the cerebellum and are highly susceptible to a variety of abnormal conditions including protein deprivation, which may lead to brain dysfunction. The aim of this study was to investigate the effects of low-protein diet on the frequency, diameter and distance between Purkinje cells of the cerebellum. Twenty two male Wistar adult rats were randomly divided into two groups including animals with normal diet and trial animals that underwent protein deprivation for ten months. Then the animals were sacrificed with aldehyde solutions and their cerebella were removed for sectioning. Forty µm coronal sections were prepared and stained with Hematoxylin and Eosin (H & E) and neutral red. Morphometeric parameters including the frequency and diameter of Purkinje cells and distances between them were studied by light microscopy. Statistical analysis was done with Mann-Whitney U test. \the low-protein group did not gain weight as much as control group (P < 0.05). The diameter of Purkinje cells was 151 ± 8 µm in control group compared to 179.5 ± 11 µm in low-protein group (P < 0.05). The mean number of Purkinje cells was 14.2 ± 4 in control group and was 8.3 ± 7 in low-protein group (P < 0.05). Distances between Purkinje cells was 363.9 ± 12 µm in control group, but increased to 472.1 ± 27 µm in low-protein group (P < 0.05). Considering that neuronal function highly depends on environmental conditions, any adverse alteration may affect the function and morphology of neurons. In this regard, our results showed the adverse effects of protein malnutrition on the morphology of the Purkinje cells of cerebellum

Critical thinking disposition has been recognized as an essential feature in nursing. We conducted this study to determine the effect of guided questioning on the disposition of critical thinking among nursing students. In this quasi-experimental study, all the second year nursing students (n = 54) from Tabriz nursing and midwifery faculty of Iran in 2010-2011 were selected. In autumn semester, the students (n = 28) were chosen as control group and in the spring semester the students (n = 26) were considered as experimental group. The experimental group was trained for the course of cardiac medical surgery in six days by Guided Reciprocal Peer Questioning (GRPQ) method. The control group was trained with the same course using conventional method. The critical thinking disposition was determined in both groups using California Critical Thinking Disposition Inventory (CCTDI) before and after the intervention. Data were collected and analyzed by SPSS 17. The mean age of participants was 19.85 years and 55.6% of them were female. There was no significant difference concerning demographic and educational characteristics between the two groups. The mean CCTDI scores for all students in the control group was 267.59 ± 16.66 while in experimental group was 273.90 ± 20.79. Paired t-test between pre-test and post-test data showed significant differences in the overall score of disposition to critical thinking in the experimental group (P = 0.002). But no difference was found in the control group (P = 0.70). Independent t-test did not show differences in CCTDI in the two groups before the intervention (P = 0.8) and after the intervention (P = 0.2). Students who were trained with GRPQ in clinical settings presented higher level of CCTDI compared to control students. This strategy may be applied to help the nursing students to construct and elaborate on their decisions in the clinical fields through using the GRPQ process.

The validity of clinical measurements such as Arch Index for the evaluation of flat foot has not been fully established for the physicians. We conducted this study to compare the Arch Index (AI) and Foot Posture Index (FPI) between normal and flat foot children and to assess the differences between the pattern of arch and score of FPI.Patients & Clinical measurements of Arch Index (AI) and Foot Posture Index (FPI) were performed on 40 subjects (18 boys and 22 girls), aged from 5 to 7 years referred to Adabian rehabilitation center, Kermanshah, Iran. The study was carried out from May to September, 2012. These clinical measurements were then compared according to AI and FPI in right and left foot between healthy and flat foot children. All two clinical measures demonstrated significant associations for left and right foot between healthy and flexible flatfoot of children (P < 0.05). Mann-Whitney test showed that the mean of AI for the left and right foot in healthy children was significantly lower than flatfoot children (P < 0.001). Also, the mean of FPI for the left and right foot in healthy children was significantly lower compared to the corresponding foot in flatfoot children (P < 0.001). According to our results, these clinical measurements would provide valid information regarding the structure of the medial longitudinal arch

Experiencing stress can notoriously affect people’s mental and physical health. A major source of stress can be the workplace environment. According to the numerous studies, job stress among nurses is relatively higher than that of the other jobs. The aim of this study was examination of the relation between workplace environment and stress among operating room personnel in the training hospitals of Ilam University of Medical Science (IUMS). This cross-sectional study was performed on all personnel of operating rooms (operating room technicians, anesthesia technicians and nurses) in training hospitals of IUMS. Fifty subjects were selected by sequential sampling. To collect data, demographic data and job stress questionnaires (Cooper) were used. Data were analyzed by descriptive and inferential statistics tests such as Chi-square, Pearson correlation coefficient, ANOVA and T-test. Higher levels of stress were due to the fear of being infected by HIV and hepatitis patients with mean of 3.2 and 58%; and lack of weekends with mean of 3 and 44%. The lowest levels of stress were related to inadequate skills with mean of 2.18 and 32%, and environment light with mean of 2.14 and 34.7%. Stress was significantly related to job status, conflict of doctors and nurses as well as spouses’ attitude about work (P < 0.05). But there was no significant relation between stress and work shift, age, being experienced, type of hospital and marital status. According to the pivotal role of environmental and mental factors in the emergence of stress among operating room personnel, several considerations such as increasing the level of knowledge regarding infections, providing adequate resting time and improvement of the communications should be given among operating room personnel.

With regard to the multidimensional concept of the voice, different assessments are needed to diagnose and treat voice disorders. Additionally, it is important to know how various aspects of voice are compared and related to each other.

The purpose of this study was to examine the correlation between the Voice Handicap Index (VHI) score and the acoustic measures in different types of Muscle Tension Dysphonia (MTD).Patients and

Eighteen females including 12 with primary MTD (group 1) and 6 with secondary MTD (group 2) participated in this cross-sectional study. All subjects completed VHI and were provided with voice samples including three trials of the sustained vowel /a/ at a comfortable loudness level as well as a connected speech sample. Acoustic measures were performed with Praat software and included fundamental frequency, jitter %, shimmer % and intensity.

Certain correlations were found between fundamental frequency in vowel and total VHI, physical, functional and emotional domains of VHI in group 1 (r = 0.636, 0.649, 0.613 and 0.592 respectively). There was good correlation between speaking fundamental frequency and total VHI and its subscales - except the physical subscale - were also correlated. In group 2, the correlations between jitter and total VHI as well as the emotional domain of VHI was very good (r = 0.829, and 0.812 respectively). Furthermore, we found very good correlation between the intensity of speech and functional domain (r = 0.812).

VHI and acoustic parameters likely measure different aspects of voice and thus are not interchangeable. However, the correlation between VHI and some laboratory measurements increases in dysphonia of the same nature, origin and same sexuality.

Diabetes type 1 has a variety of destructive effects on different parts of the body including kidney tissue. Diabetic nephropathy is among the serious complications of diabetes. Oxidative stress plays a central role in the development of diabetic nephropathy with glomeruli dilation. Due to the known anti-oxidant and anti-diabetic effects of Origanum majorana (OM), this study was conducted to survey its effects on oxidative stress and histopathology of renal tissue among diabetic rats. In this experimental investigation, 32 male rats, weighing 200 - 250 g, were divided into four groups: 1: control, 2: control receiving treatment with OM, 3: diabetic, and 4: diabetic receiving treatment with OM. Diabetes was induced by intraperitoneal injection of streptozotocin (60 mg/kg). Groups under treatment received food containing 6.25% of OM. Tissue levels of malondialdehyde (MDA) were measured to evaluate the oxidative stress. In addition, renal histopathology was evaluated using hematoxylin and eosin (H & E) staining. Data were analyzed using ANOVA. A significant increase in the renal tissue level of MDA was observed in diabetic and OM-treated diabetic groups versus control group (P = 0.01 and P = 0.04, respectively). OM treatment non-significantly reduced the tissue level of MDA (P = 0.11). Also, diabetes caused a significant increase in glomerular size compared to the control group (P = 0.03), and treatment of diabetic rats with OM caused a non-significant decrease in glomerular size compared to the diabetic group (P = 0.17). Taken together, long term treatment of diabetic rats with OM can partially protect the renal tissue via attenuation of oxidative stress and glomerular expansion.

Urinary bladder is the most common site for foreign body in the urinary tract. Self insertion of a long object into the bladder is very difficult in males. We present a case of self-inserted foreign body, a 105 cm long electronic wire, in the bladder. A 13 year-old boy was referred to our clinic with chief complaint of hematuria. Intravenous pyelogram (IVP) revealed a foreign body in the bladder. Cystoscopy was performed and an electronic wire about 105 cm long was removed from his bladder by forceps. This case has two unusual features. First, it is difficult for a foreign body to reach the urinary bladder in males. Second, the presented case was left unattended for two whole weeks