Pamphlet as a tool for continuing medical education: Performance assessment in a randomized controlled interventional study

Background: Pamphlet is a tool used for distance continuous professional development programs. In this study, we assessed the impact of an educational pamphlet on improving prescription writing errors in general physicians' performance. Methods: In this randomized controlled interventional study, we prepared a training pamphlet according to the most prevalent prescription writing problems. We randomized 200 participants among general physicians affiliated with Tehran Social Security Insurance Organization, and randomly divided them into intervention and control groups. Participants' prescriptions (N= 34888) were investigated over a month, and then the prepared pamphlet was sent out to the participants in the intervention group. After three months we examined their one-month prescriptions again (N= 30296) and investigated the changes in prescription errors. Results: There was no significant difference in the mean number of prescriptions in two groups before and after intervention (p= 0.076). Mean number of medicinal items reduced significantly in intervention group. Also mean number of prescriptions including injection drugs (p= 0.024), Corticosteroids (p= 0.036), Cephalosporin (p= 0.017) and non-steroidal anti-inflammatory drugs (p=0.005) reduced significantly. No significant differences were found for other errors. Conclusion: This study showed that use of an appropriate pamphlet has a considerable impact on improving general physicians' performance and could be applied for continuous professional development

Protective effects of Lithium on Sumatriptan-induced memory impairment in mice

Lithium is a drug used for the treatment of bipolar disorder. It has several mechanisms of action, and recently it is shown that lithium can antagonize the 5-HT1B/1D serotonin receptors. Sumatriptan is a 5- HT1B/1D receptor agonist used for the treatment of cluster headaches and migraine which might cause memory impairment as a potential side effect. In this study, effects of lithium on sumatriptan-induced memory impairment have been determined in a two trial recognition Y-maze and passive avoidance tests. Male mice weighing 25-30 g were divided into several groups randomly. In Y-maze test, effects of lithium (1,5,10,20,40,80 mg/kg) and sumatriptan (1,5,10 mg/kg) were assessed on memory acquisition, then lithium (0.1,1,10 mg/kg) and sumatriptan (1,10 mg/kg) were studied in passive avoidance test. Effects of lithium (1mg/kg) on sumatriptan (10 mg/kg)-induced memory impairment were studied in both of tests. The present study demonstrated that sumatriptan impaired memory in Y-maze and passive avoidance tests (P0.05), but significantly reversed sumatriptan-induced memory impairment in Y-maze and passive avoidance tests (P<0.001, P<0.05, respectively). It is concluded that lithium reverses the sumatriptan-induced memory impairment probably through 5-HT1B/1D receptors antagonism. © 2016 Tehran University of Medical Sciences. All rights reserved

Stem cell-based approach for the treatment of Parkinson's disease

Parkinson's disease (PD) is the second most common neurodegenerative brain disorder which is around 1.5 times more common in men than in women. Currently, drug medications, surgery, and lifestyle changes are common approaches to PD, while all of them focused on reducing the symptoms. Therefore, regenerative medicine based on stem cell (SC) therapies has raised a promising hope. Various types of SCs have been used in basic and experimental studies relevant to PD, including embryonic pluripotential stem cells, mesenchymal (MSCs) and induced pluripotent SCs (iPSCs). MSCs have several advantages over other counterparts. They are easily accessible which can be obtained from various tissues such as bone marrow, adipose tissue, peripheral blood, etc. with avoiding ethical problems. Therefore, MSCs is attractive clinically because there are no related ethical and immunological concerns . Further studies are needed to answer some crucial questions about the different issues in SC therapy. Accordingly, SC-based therapy for PD also needed more complementary evaluation in both basic and clinical study areas

Isofuranodiene, a natural sesquiterpene isolated from wild celery (Smyrnium olusatrum L.), protects rats against acute ischemic stroke

The myrrh-like furanosesquiterpene isofuranodiene (IFD) is the main constituent of wild celery (Smyrnium olusatrum L., Apiaceae), an overlooked vegetable that was cultivated during the Roman Empire. In the present study, we investigated the protective effects of IFD pre-treatment against oxidative stress and inflammatory response in an animal model of ischemic stroke. IFD was isolated by the crystallization of Smyrnium olusatrum essential oil, and its structure and purity were confirmed by NMR and HPLC analyses. Acute pre-treatment of IFD (10 mg/kg i.p.) significantly reduced the levels of the inflammatory cytokines IL-1β and TNF-α, the expression of pNF-κB/NF-κB, and the lipid peroxidation indicator MDA. Finally, IFD boosted a faster recovery and better scores in grid-walking and modified neurological severity scores (mNSS) tests. Taken together, these findings indicate IFD as a promising lead compound for the discovery of new treatments of brain ischemia

Medical podcasting in Iran; pilot, implementation and attitude evaluation

Podcasting has become a popular means of transferring knowledge in higher education through making lecture contents available to students at their convenience. Accessing courses on media players provides students with enhanced learning opportunities. Development of teaching methods able to cope with ever-changing nature of medicine is crucial to train the millennium students. Pharmacology education in Tehran University of Medical Sciences has been based on lectures so far; our aim was to implement a pilot study to evaluate the advantages and disadvantages of offering the course contents as podcasts as well as evaluating whether such program can be feasible in our educational program. 46% of students downloaded the podcast according to our download center. 48% favored usage of both internet and DVD-ROM concurrently. Overall 96% of students perceived that podcasting had a positive impact on their learning in pharmacology course. Our results indicate that most of attendants proposed the positive yields of podcasting despite low usage of it, mainly as a pre-class preparing tool.publisher versio

Silymarin-albumin nanoplex: preparation and its potential application as an antioxidant in nervous system in vitro and in vivo

In this study, we formulated silymarin-HSA nanoplex and assayed its ability to reduce LPSinduced toxicity in vitro and in vivo. Silymarin molecules were encapsulated into HSA nanoplex and the loading efficiency and characterization of fabricated nanoplex were performed by using HPLC, TEM, SEM, DLS, FTIR analysis, and theoretical studies. Afterwards, their protective effect against LPS (20 µg/ml) -induced toxicity in SH-SY5Y cells was investigated by MTT, ROS, and apoptosis assays. For in vivo experiments, rats were pre-treated with either silymarin or silymarin -HSA nanoplex (200 mg/kg) orally for 3 days and at third day received LPS by IP at a dose of 0.5 mg/kg, 150 min before scarification followed by SOD and CAT activity assay. The formulation of silymarin-HSA nanoplex showed a spherical shape with an average diameter between 50 nm to 150 nm, hydrodynamic radius of 188.3 nm, zeta potential of -26.6 mV, and a drug loading of 97.3%. In LPS-treated cells, pretreatments with silymarin-HSA noncomplex recovered the cell viability and decreased the ROS level and corresponding apoptosis more significantly than free silymarin. In rats, it was also depicted that, silymarin-HSA noncomplex can increase the SOD and CAT activity in brain tissue at LPS-triggered oxidative stress model more significantly than free counterpart. Nanoformulation of silymarin improved its capability to reduce LPS-induced oxidative stress by restoring cell viability and elevation of SOD and CAT activity in vitro and in vivo, respectively. Therefore, formulation of silymarin may hold a great promise in the field of antioxidant agent development

EFFECTS OF VERAPAMIL ON CHICKEN BIVENTER - CERVICIS MUSCLE

- Verapamil produces a sustained contraction in isolated biventer-cervicis muscle of chickens between 2-8 days old. From cumulative dose-response curves, ED50 of was calculated for this effect of verapamil. when isolated chicken biventer-cervicis muscle was electrically stimulated, verapamil had no effect on twitch contractures but increased the base line tone of the muscle. Glycerol treatment of the muscle reduced the responses to acetylcholine and KCl but had little effect on contracture produced by verapamil, and no effect on contracture produced by caffeine. Incubation of the muscles with calcium-free Krcbs solution omitted the responses of the muscle to acetylcholine and reduced the response to caffeine. Again, the responses to caffeine and verapamil were less affected compared to KCL. Addition of ethylene glycol tetra-acetic acid (EGTA) (2.5 mM) abolished the responses of muscle to all compounds. It was concluded that verapamil produces contracture of the muscle by release of calcium from intracellular stores