Assessment of the Educational Environment of Major Clinical Wards in Educational Hospitals Affiliated to Hormozgan University of Medical Sciences, Iran, from the Perspective of Medical Students

Background & Objective: The educational environment has a fundamental role in the quality and efficiency of education. The present study was undertaken to identify the perceptions of students on the educational environment in 4 major clinical wards at teaching hospitals affiliated to Hormozgan University of Medical Sciences, Iran, in 2014. Methods: In this descriptive cross-sectional study, educational environment was evaluated using the Dundee Ready Educational Environment Measure (DREEM). Sampling was conducted through census and the study population included all medical students (n = 184) passing their clinical courses in the internal, pediatrics, surgical, obstetrics and gynecology wards in 3 hospitals affiliated to Hormozgan University of Medical Sciences. Data were analyzed using ANOVA and Tukey’s tests. Results: The mean score achieved from the total 200 scores of the questionnaire was 104.83 (52.4%). Although there was no significant difference between total scores of major clinical wards, the pediatrics and obstetrics and gynecology wards obtained the highest lowest scores, respectively. No significant correlation was found between education and gender, and the subscales of educational environment. A significant difference was observed between major clinical wards in the subscale of teachers (P < Conclusion: The educational environment at clinical wards was considered as "good" by students. Nevertheless, problematic areas exist in all subscales of educational environment. The obtained results can be utilized to better understand and resolve educational environment issues in Hormozgan University of Medical Sciences. Key Words: Dundee Ready Educational Environment Measure (DREEM), Educational environment, Educational atmosphere, Clinical wards, Medical student

Comparison of Bandar Abbas Medical School\'s Educational Environment before and after the Implementing an Integrated Physiopathology Curriculum: Students’ Viewpoints

Introduction: In order to increase the efficacy education, Bandar Abbas Medical School underwent a curricular change in 2009 and integrated its curriculum in physiopathology phase and represented courses as organ-system-based approach. This study aimed to compare educational environment from the viewpoints of students in this medical school considering traditional and new curriculum in order to identify weaknesses and strengths of integration. Methods: In this descriptive cross-sectional study, educational atmosphere was evaluated using a standard questionnaire of DREEM. Sampling was completed through census and study population included all medical students (N=95) passing their physiopathology courses during 2008-2009 academic years in Hormozgan University of Medical Sciences. Physiopathology topic included 3 courses (one before and 2 after integration). Data was analyzed using one way ANOVA and Tukey’s test. Results: Mean scores of achieved points were (76.2±8.4) for the year before integration, (108±20.1) for the first year after integration, and (95±24.7) for the second year after intervention out of total 200 points of DREEM questionnaire. The results showed that integration lead to a significant promotion in students’ viewpoints toward educational atmosphere, but the total score achieved in second year decreased and was not significant compared to the year before integration. Conclusion: This study approved positive results of organ system-based integrated curriculum. But the study showed a notable failure through second semester of implementation that disclosed unstable achievements. It seems that reformative changes in curriculum solely are not the key to solve educational system problems. Administrators must develop an established educational system through identifying precise strategies

Physiological responses of Vetiver plant (Vetiver zizanioides) to municipal waste leachate

Vetiver plant is tolerant to acidity and temperature variations. Has rapid growth for biomass production and has high tolerance to organic and non-organic compounds in municipal waste leachate for example heavy metals. So this plant is good for landfill cultivation. In this study, physiological responses to municipal waste leachate were studied. Statistical design was a randomized complete block and each block treated with different concentrations of latex at levels of zero, 15, 30, 45 and 60 percent compared to the original latex waste. The leachate collected from the Shiraz landfill and brought into the greenhouse. The physiological characterization including leaf area, dry weight, chlorophyll, anthocyanin, proline, soluble sugars and total protein were measured. The result indicated that the dry weight, chlorophyll and anthocyanin decrease with increasing of latex concentration. The leaf area, leaf relative water, soluble sugars and total protein increased with increasing latex concentration. Proline concentration at 15 percent of leachate increased significantly compared to controls, whereas at higher concentrations decreased. According to the results, it is recommended that 45 percent of leachate in a landfill can be used to irrigate Vetiver. This is the maximum concentration of leachate that Vetiver plant can survive as green space. Primary filtration of leachate before using is recommended. If the aim is more growth or perfume application from root, less concentration of leachate is better

A Comparison of Academic Achievement between Deprived Regions Quota and non-Quota Students in Bandar Abbas Medical School

Introduction: Student quota is one the university admission criteria in the medical schools of Iran. In recent years a separate quota named deprived regions quota is allocated to participants who live in deprived regions such as Hormozgan province. This study aimed to compare the educational status of this quota with other students at Banadr Abbas medical school. Methods: In this descriptive-analytic study, all students’ data, entering Bandar Abass medical school during 8 years (2008 to 2015), namely, n=754, including educational and demographic characteristics collected through Student Recording System and personal files and analyzed using SPSS 19. Results: The evaluation of educational state of deprived regions quota students showed that the mean score of diploma (P<0. 01), first semester(P<0. 0001), basic science and physiopathology courses, comprehensive examination of basic sciences were lower than other quoata. They had the lowest graduation and the highest dropout rate (P<0. 0001). There was a significant difference in the student grades marital status. Conclusion: Considering policies to increase the number of empowered Physicians in deprived regions and the observed higher academic failure among deprived regions quota students, the educational authorities should make appropriate plans and strategies in order to improve their academic achievements

The association between iron status and some immunological factors in the pregnancy

Iron deficiency anemia (IDA) is a common problem in many developing countries. It is still considered the most common nutrition deficiency worldwide. Apart from its direct hematologic importance, IDA affects cellular and humoral immunity and predisposes the host to infections (1).Pregnant women are highly prone to IDA. Controversial results are reported in studies targeting this group of patients. Tang et al showed a direct association between hemoglobin concentration and the count of CD4+ T-cell lymphocytes, serum levels of IL-2 and IgG, and an inverse association with susceptibility to infection (2). Ironically, Leush et al reported an increase in IgM and IgG in the second and third trimesters of pregnancy in women with IDA (3).With regard to controversial results and the scarcity of studies focusing on pregnant women, we aimed to enlighten the relation between iron status and some immunological factors include some component of complement system, IgA, IgM, IgG subclasses of immunoglobulins and pro-inflammatory cytokines during the third trimester of pregnancy.In a descriptive-analytic study participants were recruited using convenient sampling from the women in the third trimester of pregnancyCorresponding author:Nadereh Naderi, Faculty of Medicine, First of Nabovat minicity, opposite of Workers Welfare Community, First of Imam Hossein Blv., Bandarabbas, Iran.Email: [email protected] to the labor room of gynecology and obstetrics ward of Dr. Shariati Hospital of Bandar Abbas, Iran. Patients with signs and symptoms of thalassemia, infectious diseases or autoimmune diseases were excluded.IDA were defined with two criteria, hemoglobin concentration of less than 10 mg/dL (its normal range during the third trimesters of pregnancy is 11-14mg/dL) (4) and ferritin less than 40 ng/dL. Patients were categorized into two groups: those with iron deficiency anemia (IDA) and those without this condition (no IDA).Red cell indices including hemoglobin (Hb) levels, hematocrit (HCT), mean corpuscular volume (MCV), red blood cell distribution width (RDW), and mean corpuscular hemoglobin (MCH), serum iron (SI) and total iron binding capacity (TIBC), concentration of ferritin, C3 and C4 complements and IgA, IgM and IgG subclasses of immunoglobulins were determined. Data was analyzed using SPSS version 11.5 using Student t-test, Pearson’s correlation test and Kolmogorov-Smirnov’s test of normal distribution.Ninety-two patients were studied. They were aged between 15 and 42 years (mean=25.69±6.2). According to our definition of IDA in pregnancy, 21 patients (22.8%) had IDA.Our analysis of differences between the two groups in regard to immunologic markers showed that C4 levels are lower in the IDA group (p=0.009) and the levels of C3, IgM, IgG, IgA, IL-1, IL-6 and TNF-α were not statistically different in the two groups .Sobhani et al252 Iranian Journal of Reproductive Medicine Vol. 9. No. 3. pp: 251-252, Summer 20111We noticed that higher levels of serum iron are correlated with higher levels of C3, C4 and IgG1. Due to important properties of IgG1 like complement fixation and opsonic activity, this subclass is dominant antibody to pneumococcal capsular polysaccharides and its deficiency is associated with current infections (5). Taken together noticing key roles of C3, C4 in complement-mediated bacteriolysis, opsonization, facilitated ingestion immune adherence (6) and association of C3, C4 with Iron serum levels found in this study we suggest that decreased level of Iron increases susceptibility of pregnant women to infections like chronic bacterial respiratory infections and recurrent genital herpes (5). Analyzing immunologic parameters differences between the two groups of IDA and no IDA we found that C4 levels are lower in the IDA group but not the levels of C3, IgM, IgG, IgA, IL-1, IL-6 and TNF-α .Our findings about IgM, IgG, IgA are in contradiction to scanty studies in this field. Tang et al (2) about significantly lower level of IgG, CD3+ and CD4+ cells, the ratio of CD4+/CD8+cells, serum IL-2 in second trimester of IDA pregnant woman and Leush et al (3) study showed increase of IgM and IgG in second and third trimesters of IDA groups.Our findings about non-significant difference in C3 and significant difference in C4 levels in IDA and no IDA groups is in agreement with Galan et al report about significantly positive correlation of C4 IgA, IgM and Serum ferritin (7). Despite of mounting evidence that TNF, IL-1, and IL-6 cytokines affect hemopoiesis and iron metabolism there was no significant association between IL-1, IL-6 and TNF-α and serum Iron, ferritin, TIBC in our study and inflammatory cytokines were statistically indifferent in the two IDA and no IDA groups. To our knowledge, there are no reports on inflammatory cytokine levels and Iron parameters in pregnant women, but a limited number of reports exploring this field in children and adults.Bergman et al which analyzed the in vitro production of IL-1beta, IL-2, IL-6, IL-10, and TNF-α by peripheral blood mononuclear cells from 20 patients with IDA report that the secretion of the cytokines other than IL-2 did not differ from that of controls (8). In another study there was no difference in serum levels of IL-6 in iron deficiency anemia before and after iron supplementation in children with IDA but in the iron-deficiency group the production of IL-2 was found to be significantly lower than that in controls and became normal after iron supplementation (9). Safuanova et al work about adequate therapy by iron-containing drugs in IDA patients resulted in decreased concentrations of IL-1, IL-6, TNF-alpha and INF-gamma and recovering the functional status of the immune system (10). It is possible that discrepancy seen between our results and mentioned reports in non-pregnant patients is a reflection of dramatic change of immune function in pregnancy.Analyze of the results of our study and similar researches leads us to the conclusion that unlike extensive immunological changes have been observed in children, IDA has little effect on humoral immunity system of pregnant women, but decrease in serum iron could predispose them to pyogenic infection and may predict increased susceptibility IDA pregnant women to infections