Comparison between the Effect of Teaching through Student-Based Group Discussion and Lecture on Learning in Medical Students

Background & Objective : It has been years that the traditional method of lecture is used for teaching and both teachers and students are unsatisfied with this method’s tediousness and low efficacy. According to low experience in teaching theoretical clinical courses via student-based group discussion in small groups, this study was performed to compare learning resulted from the aforementioned method and lecture. Methods In this semi-experimental study, lecture and group discussion in small groups (6 to 8 members) were tested in theoretical course of pediatrics in four series of students in Zanjan School of Medicine. Some topics were taught using lecture while others were taught using student-based group discussion. At the end of all classes, quizzes were given to the students the results from these quizzes and final exams were compared in both teaching methods. Results The mean percentage of correct answers in quizzes in methods of group discussion and lecture were 84% and 45%, respectively, which was significantly different (P = 0.0001). The mean percentage of correct answers to the questions in final exams was 67% and 65% for group discussion and lecture accordingly while there was no significant difference(P=0.19). Conclusion : Regarding the results of this study and similar researches, learning via group discussion seems to be more profound and effective, but this profundity was not present in the final exam, which may be due to the defects in designing questions and emphasizing on students’ memorized content. Keywords: Group discussion, Small group, Lecture, Teaching method, Medical student

The Effect of Ondansetron on Decreasing the Hospitalization Rate in Children with Gastroenteritis and Recurrent Vomiting

Background: Diarrhea is one of the most common disorders in infancy and childhood and recurrent vomiting is a main reason for hospitalization for these patients. This study was to assess the effect of injective ondansetron on decreasing the hospitalization rate in children with diarrhea and recurrent vomiting. Methods: In this clinical trial study, patients between six months and six years, with acute viral diarrhea and recurrent vomiting, were assessed for the possibility of being treated as outpatients, based on their response to ondansetron, compared to a control group who did not receive ondansetron. The sample size was 100 for each group. Cases for the ondansetron group were under observation for at least two hours in the emergency ward and were followed until 72 hours to find out if there was any need for them to return to the hospital due to vomiting. Otherwise, all cases in the control group were hospitalized. Data of both groups, including the rate and duration of hospitalization, was analyzed. Results: Of the 100 individuals who received ondansetron (n = 91) 91% did not need to be hospitalized and 9 patients needed to be admitted in the next 72 hours, while (n = 100) 100% of control group were hospitalized (P value = 0.003). Vomiting in the control group continued in 35% of patients after 72 hours of admission. The duration of hospitalization for the patients of the control group was 2.94�1.40 (mean�SD) days. Interpretation: Ondansetron can be considered as an effective agent to decrease the hospitalization rate in infants and children with diarrhea as well as vomiting. Injective forms of ondansetron seem to be more achieved than oral forms

Trans-cutaneous bilirubinometery versus serum bilirubin in neonatal jaundice

Abstract- Hyperbilirubinemia is a common problem in neonates and causes serious complications. Thus, serial measurements of bilirubin should be done. This assessment is done through two methods of laboratory measurement in serum sample and transcutaneous bilirubinometer. This descriptive study compared transcutaneous bilirubin assessment and laboratory serum bilirubin. Bilirubin level was assessed among 256 neonates admitted to the Qods Children’s Hospital in Qazvin- Iran, because of neonatal indirect jaundice, through two methods of transcutaneous bilirubinometery from two sites of forehead and sternum and laboratory measurement of bilirubin in serum. The cases were non-hemolytic icteric term neonates weighing 2500 gram or more and had not received phototherapy or other treatments. Neonates with hemolytic forms of jaundice, sepsis and suspicious to metabolic disorders were excluded. Assessments by means of KJ-8000 transcutaneous bilirubinometer from two sites of forehead and sternum and through laboratory measurement of serum bilirubin were registered and analyzed. The results of the current study showed that there was a correlation of 0.82 between serum bilirubin and transcutaneous forehead bilirubin assessment and for the used device sensitivity of 0.844; specificity of 0.842, Youden Index of 0.709 and Shortest of 0.042 for a cut-off of 12.4 in bilirubin of participants. Furthermore, Likelihood Ratio positive and negative (LR) were 5.665 and 0.164, respectively and diagnostic Odds Ratio (LR+/LR-) was 34.56. Transcutaneous bilirubinometery can be considered as a reliable tool to assess bilirubin for the screening of neonatal jaundice in term neonates. © 2015 Tehran University of Medical Sciences. All rights reserved. Acta Med Iran 2015;53(12):764-769. Keywords: Neonatal Jaundice; Transcutaneous bilirubinometery; Bilirubin; Sensitivity; Specificit

The effect of ondansetron on decreasing the hospitalization rate in children with gastroenteritis and recurrent vomiting

Background: Diarrhea is one of the most common disorders in infancy and childhood and recurrent vomiting is a main reason for hospitalization for these patients. This study was to assess the effect of injective ondansetron on decreasing the hospitalization rate in children with diarrhea and recurrent vomiting. Methods: In this clinical trial study, patients between six months and six years, with acute viral diarrhea and recurrent vomiting, were assessed for the possibility of being treated as outpatients, based on their response to ondansetron, compared to a control group who did not receive ondansetron. The sample size was 100 for each group. Cases for the ondansetron group were under observation for at least two hours in the emergency ward and were followed until 72 hours to find out if there was any need for them to return to the hospital due to vomiting. Otherwise, all cases in the control group were hospitalized. Data of both groups, including the rate and duration of hospitalization, was analyzed. Results: Of the 100 individuals who received ondansetron (n = 91) 91% did not need to be hospitalized and 9 patients needed to be admitted in the next 72 hours, while (n = 100) 100% of control group were hospitalized (P value = 0.003). Vomiting in the control group continued in 35% of patients after 72 hours of admission. The duration of hospitalization for the patients of the control group was 2.94 ± 1.40 (mean ± SD) days. Interpretation: Ondansetron can be considered as an effective agent to decrease the hospitalization rate in infants and children with diarrhea as well as vomiting. Injective forms of ondansetron seem to be more achieved than oral forms. Keywords: Infant, Child, Diarrhea, Vomiting, Ondansetron, Hospitalizatio

Prevalence of Metabolic Syndrome and Insulin Resistance in Children and Adolescent of Qazvin, Iran

BACKGROUND: The prevalence of metabolic syndrome (MetSyn) is increasing worldwide. The aim of this study was to determine the prevalence of MetSyn and insulin resistance (IR) in children and adolescents in Qazvin, Iran. METHODS: A cross-sectional study was conducted in 338 children and adolescents aged 10–18 years old who were selected by a multistage cluster random sampling method. We performed standardised measurements of variables including waist circumference (WC), blood pressure, plasma glucose level, total cholesterol, high-density lipoprotein cholesterol (HDL), triglycerides, and insulin. MetSyn was defined according to the International Diabetes Federation criteria. IR was estimated by the homeostatic model assessment. RESULTS: Of the 338 total subjects, 172 were female. The overall prevalence of MetSyn and IR were 3.4% and 18.2%, respectively. There was no sex difference for the prevalence of MetSyn. A total of 185 subjects (56.4%) had one or two components of MetSyn. The most common component was low HDL levels in both sexes, which was followed by high WC in females and high fasting plasma glucose levels in males. CONCLUSION: The lack of a standard definition of MetSyn in children and adolescents combined with the geographical and socioeconomic differences make it difficult to compare the results from different studies. Modification of lifestyle habits is an important strategy in preventing MetSyn and IR

Sleep architecture and obstructive sleep apnea in obese children with and without metabolic syndrome: a case control study

Purpose Obesity and biochemical parameters of metabolic disorders are both closely related to obstructive sleep apnea (OSA). The aim of this study was to compare sleep architecture and OSA in obese children with and without metabolic syndrome. Methods Forty-two children with metabolic syndrome were selected as case group and 38 children without metabolic syndrome were matched for age, sex, and BMI as control group. The standardized Persian version of bedtime problems, excessive daytime sleepiness, awakenings during the night, regularity and duration of sleep, snoring (BEARS) and Children’s Sleep Habits Questionnaires were completed, and polysomnography (PSG) was performed for all study subjects. Scoring was performed using the manual of American Academy of Sleep Medicine for children. Data were analyzed using chi-square test, T test, Mann–Whitney U test, and logistic regression analysis. Results Non-rapid eye movement (NREM) sleep and N1 stage in the case group were significantly longer than the control group, while REM sleep was significantly shorter. Waking after sleep onset (WASO) was significantly different between two groups. Severe OSA was more frequent in the control group. Multivariate logistic regression analysis showed that severe OSA (OR 21.478, 95 % CI 2.160– 213.600; P = 0.009) and REM sleep (OR 0.856, 95 % CI 0.737–0.994; P = 0.041) had independent association with metabolic syndrome. Conclusions Obese children with metabolic syndrome had increased WASO, N1 sleep stage, and severe OSA. But the results regarding sleep architecture are most likely a direct result of OSA severity. More longitudinal studies are needed to confirm the association of metabolic syndrome and OSA. Keywords Metabolic syndrome X . Obesity . Obstructive sleep apnea . Sleep stages . Polysomnograph

The Effect of Ondansetron on Decreasing the Hospitalization Rate in Children with Gastroenteritis and Recurrent Vomiting

Background: Diarrhea is one of the most common disorders in infancy and childhood and recurrent vomiting is a main reason for hospitalization for these patients. This study was to assess the effect of injective ondansetron on decreasing the hospitalization rate in children with diarrhea and recurrent vomiting. Methods: In this clinical trial study, patients between six months and six years, with acute viral diarrhea and recurrent vomiting, were assessed for the possibility of being treated as outpatients, based on their response to ondansetron, compared to a control group who did not receive ondansetron. The sample size was 100 for each group. Cases for the ondansetron group were under observation for at least two hours in the emergency ward and were followed until 72 hours to find out if there was any need for them to return to the hospital due to vomiting. Otherwise, all cases in the control group were hospitalized. Data of both groups, including the rate and duration of hospitalization, was analyzed. Results: Of the 100 individuals who received ondansetron (n = 91) 91% did not need to be hospitalized and 9 patients needed to be admitted in the next 72 hours, while (n = 100) 100% of control group were hospitalized (P value = 0.003). Vomiting in the control group continued in 35% of patients after 72 hours of admission. The duration of hospitalization for the patients of the control group was 2.94�1.40 (mean�SD) days. Interpretation: Ondansetron can be considered as an effective agent to decrease the hospitalization rate in infants and children with diarrhea as well as vomiting. Injective forms of ondansetron seem to be more achieved than oral forms

Trans-Cutaneous Bilirubinometery versus Serum Bilirubin in Neonatal Jaundice

Abstract- Hyperbilirubinemia is a common problem in neonates and causes serious complications. Thus, serial measurements of bilirubin should be done. This assessment is done through two methods of laboratory measurement in serum sample and transcutaneous bilirubinometer. This descriptive study compared transcutaneous bilirubin assessment and laboratory serum bilirubin. Bilirubin level was assessed among 256 neonates admitted to the Qods Children’s Hospital in Qazvin- Iran, because of neonatal indirect jaundice, through two methods of transcutaneous bilirubinometery from two sites of forehead and sternum and laboratory measurement of bilirubin in serum. The cases were non-hemolytic icteric term neonates weighing 2500 gram or more and had not received phototherapy or other treatments. Neonates with hemolytic forms of jaundice, sepsis and suspicious to metabolic disorders were excluded. Assessments by means of KJ-8000 transcutaneous bilirubinometer from two sites of forehead and sternum and through laboratory measurement of serum bilirubin were registered and analyzed. The results of the current study showed that there was a correlation of 0.82 between serum bilirubin and transcutaneous forehead bilirubin assessment and for the used device sensitivity of 0.844; specificity of 0.842, Youden Index of 0.709 and Shortest of 0.042 for a cut-off of 12.4 in bilirubin of participants. Furthermore, Likelihood Ratio positive and negative (LR) were 5.665 and 0.164, respectively and diagnostic Odds Ratio (LR+/LR-) was 34.56. Transcutaneous bilirubinometery can be considered as a reliable tool to assess bilirubin for the screening of neonatal jaundice in term neonates. © 2015 Tehran University of Medical Sciences. All rights reserved. Acta Med Iran 2015;53(12):764-769. Keywords: Neonatal Jaundice; Transcutaneous bilirubinometery; Bilirubin; Sensitivity; Specificit