Comparison of quality of clinical supervision as perceived by attending physicians and residents in university teaching hospitals in Tehran

Background: Clinical supervision is an important factor in the development of competency in residency program. Attending physicians play a key role in supervision of residents. However little is known about how attending physicians and residents perceive the quality of clinical supervision. The aim of this study was to explore the differences between perceived qualities of supervision in these two groups in different wards in teaching hospitals in Tehran, Iran. Methods: A valid questionnaire were completed by 219 attending physicians and residents from surgery, psychiatry, gynecology, pediatrics, internal medicine, orthopedics and radiology wards in two teaching hospital affiliated to Iran University of Medical Sciences. This questionnaire contained 15 items in regards to supervisory roles, rated on a five point Likert scale (1=never, 2=seldom, 3=sometimes, 4=often, 5=always). Results: Out of 219 participants, 90 (41) were attending physicians and 129 (59) were residents. The overall mean±SD scores of perceived clinical supervision achieved by attending physicians and residents were respectively, 4.20±0.5 and 3.00±0.7 which was statistically significant (p<0.05). Attending physicians and residents acquired minimum scores (mean=4.06 and 2.7, respectively) regarding expectation from their supervisor to know and do during training period of residency. Conclusion: It seems that the clinical supervisory does not have an efficient performance in teaching hospitals which needs to be more assessed and improved. Therefore it is suggested that policymakers in medical education system pay more attention to this important issue and enhance some faculty development programs for clinical educators in Iran

Resistance of different tomato cultivars to the two-spotted spider mite, Tetranychus urticae Koch (Acari: Tetranychidae)

Two-spotted spider mite, Tetranychus urticae Koch (Acari: Tetranychidae), is one of the most important pests of tomato crops. Using resistant cultivars is a useful control method against the pest in integrated pest management programs. In this study, resistance of the tomato cultivars Super Chief, Super Strain B, Korral, Khorram, HAS 2274, Super H, Calji, Early Urbana Y and Mobil to two-spotted spider mite were evaluated under laboratory conditions at 25 ± 2 °C, 60 ± 10% R.H. and a photoperiod of 16: 8 (L: D).The shortest pre-adult stage was recorded on Super Strain B. Female life span ranged from 26.47 to 30.40 days, on Super Chief and Early Urbana Y, respectively. The intrinsic rate of increase (rm) was from 0.091 to 0.163 day-1 which the lowest rm was observed on Super Chief and the highest rm was on Super Strain B. The lowest net reproductive rate (R0) and finite rate of increase (λ) belonged to Super Chief cultivar. Super Chief cultivar showed the highest antibiosis resistance against the two-spotted spider mite

Mini-Exon Genotyping of Leishmania Species in Khuzestan Province, Southwest Iran

Background: Leishmaniasis is a protozoan disease cause by Leishmania genus. Anthroponotic and zoonotic cutaneous leishmaniasis are endemic in Iran. The aim of this study was to identify the causative agent of cutaneous leishmaniasis by mini-exon gene in five regions of Khuzestan Province, southwest of Iran. Methods: From 2007 to 2008 in this cross-sectional study, cutaneous samples were collected from patients referred to Health Centers and Hospitals of the Khuzestan Province for cutaneous leishmaniasis diagnosis and cultured in Novy-MacNeal-Nicolle (NNN) and RPMI 1640. The propagated promastigotes were harvested and Leishmania species of cutaneous leishmaniasis were identified by RFLP and DNA sequencing of the PCR generated fragments. Results: L. major and L. tropica were the causative agents of cutaneous leishmaniasis by predominantly of L. major species. The alignment of the mini-exon sequencing isolates with reported sequencing of L. major and L. tropica revealed 92-99 identity. Conclusion: Our study showed that mini-exon PCR-RFLP was useful method to identify the causative species of cutaneous leishmaniasis

Conjugated linoleic acid stimulates apoptosis in RH and tehran strains of Toxoplasma gondii, in vitro

Background: The aim of this study was to evaluate the effects of conjugated linoleic acid (CLA) on apoptosis of tachyzoites of T. gondii, RH strain (type I) and the cyst-forming Tehran strain (type II) in vitro. Methods: Toxoplasma strains were injected into the peritoneal cavity of BALB/c mice. The Tehran strain forms cysts in the brain of mice. Bradyzoites within the cysts are reactivated to proliferative tachyzoites, by dexamethasone. Tachyzoites were aspirated from the peritoneum of infected mice, and the percentage of viable parasites was estimated with trypan blue staining. Tachyzoites were inoculated into HeLa cells cultivated in DMEM medium. Different concentrations of CLA were evaluated on T. gondii in HeLa cells by the tetrazolium (MTT) colorimetric assay. Differentiation between apoptosis and cell death was determined by flow cytometry using Annexin V and propidium iodide (PI) double staining. The statistical analysis performed by GraphPad Prism version 6.00. Results: CLA induces apoptosis in virulent (RH) and avirulent (Tehran) strains of T. gondii. The results of MTT indicated that CLA could decrease the proliferation of tachyzoites of both strains in HeLa cells. Conclusion: Conjugated linoleic acid has anti-toxoplasmacidal activity on tachyzoites of T. gondii. Therefore, we recommended further studies on this component in order to achieve a new drug against the parasite. © 2015, Tehran University of Medical Sciences (TUMS). All rights reserved

Cross-sectional analysis of baseline differences of candidates for rotator cuff surgery: a sex and gender perspective

<p>Abstract</p> <p>Background</p> <p>The word "sex" refers to biological differences between men and women. Gender refers to roles, behaviors, activities, and attributes that a given society considers appropriate for men and women. Traditionally, treatment decisions have been based on patient's sex without including the gender. Assessment of disability secondary to musculoskeletal problems would not be complete or accurate unless potentially relevant biological and non-biological aspects of being a man or woman are taken into consideration. The purposes of this study were to: 1) investigate the difference in pre-operative characteristics between men and women who were candidates for rotator cuff surgery; and, 2) assess the relationship between level of disability and factors that represent sex and factors that signify gender.</p> <p>Method</p> <p>This was a cross-sectional study. The primary outcome measure of disability was a disease-specific outcome measure, the Western Ontario Rotator Cuff (WORC) index, and independent variables were sex, age, hand dominance, shoulder side involvement, BMI, co-morbidity, medication use, work status, smoking habits, strength, range of motion, level of pathology, concurrent osteoarthritis, expectations for recovery, and participation restriction. Parametric, non-parametric, univariable, subgroup, and multivariable analyses were conducted.</p> <p>Results</p> <p>One hundred and seventy patients were included in the study. The mean age was 57 ± 11, 85 were females. Women reported higher levels of disability despite similar or lower levels of pathology. Scores of the WORC were strongly influenced by factors that represented "gender" such as participation restriction (F = 28.91, p < 0.0001) and expectations for improved activities of daily living (F = 5.80, p = 0.004). Painfree combined range of motion, which represented an interaction between "sex" and "gender" was also associated with disability after being adjusted for all other relevant baseline factors (F = 25.82, p < 0.0001).</p> <p>Conclusion</p> <p>Gender-related factors such as expectations and participation limitations have an independent impact on disability in men and women undergoing rotator cuff related surgery.</p

A Phase IV Study of Thromboembolic and Bleeding Events Following Hip and Knee Arthroplasty Using Oral Factor Xa Inhibitor

AbstractBackgroundMultiple randomized controlled trials have documented the effectiveness of rivaroxaban in the prevention of venous thromboembolism up to 1-month following total joint arthroplasty. However, the effectiveness and safety of rivaroxaban in the real-world setting, outside of the strict protocols used by randomized clinical trials, are unknown.MethodsThis was a prospective, observational, noninterventional, phase IV study of 3914 consecutive patients who underwent total joint arthroplasty from June 2010 to December 2012. Patients were treated with rivaroxaban 10 mg by mouth daily starting postoperative day 1 and continued for 15 days. Participants were followed up in clinic at 6 weeks and contacted by telephone at 12 weeks. The primary outcome of interest was symptomatic venous thromboembolism; secondary outcomes included bleeding events, transfusion requirements, and death.ResultsThe incidence of symptomatic deep venous thrombosis at 3 months was 0.5% (n = 18). Only 1 deep venous thrombosis event occurred within 7 days of surgery. The incidence of symptomatic pulmonary embolism (PE) at 3 months was 0.7% (n = 28). Thirteen PEs (46%) occurred within 7 days of surgery. The rate of major bleeding while on prophylaxis was 0.1%. Only 5% of patients received a blood transfusion. No deaths were attributed to thromboembolic events.ConclusionThis prospective, observational, phase IV study demonstrates that rivaroxaban appears to protect patients against symptomatic PE and is not associated with major bleeding events when used in a real-world setting as described

Resistance of wheat cultivars to bird cherry-oat aphid, Rhopalosiphum padi (Hem.: Aphididae)

The bird cherry-oat aphid, Rhopalosiphum padi (L.), is polyphagous with a nearly worldwide distribution and known as an important pest of wheat and the main vector of barley yellow dwarf virus. In this study, the possibility of antixenosis, antibiosis and tolerance of six common wheat cultivars of Chamran, Darab 2, Shiraz, Ghods, Marvdasht and Niknezhad was investigated at 2-3 leaf growth stage in the Fars province, Iran. The experiments were conducted at 24 ± 5°C, 65 ± 5% R.H. and natural light in a greenhouse, using a randomized complete design. The analysis of variance in regard to the number of adult aphids attracted to each cultivar, was indicative of significant differences among the cultivars (P < 0.01). The highest (21 ± 0.71) and the lowest (11.6 ± 0.51) mean number of adult aphids attracted per plant was observed on Shiraz and Darab 2, respectively. The antibiosis test, based on nymphs per female was significantly different among the cultivars (P < 0.01) whose average values were 62.05, 55.84, 49.89, 47.63, 42.76 and 40.65 nymphs per female on Niknezhad, Shiraz, Ghods, Marvdash, Chamran, and Darab 2, respectively. The tolerance studies based on the damage index, showed that Chamran and Darab 2, with the lowest damage index (1.33), were the most tolerant cultivars while Shiraz and Niknezhad, with the highest damage indexes of 3.00 and 3.67 respectively, were the most susceptible cultivars. The cutivars Niknezhad and Shiraz are found to be susceptible, Ghods and Marvdasht partially resistant, and Chamran and Darab 2 resistant to the bird cherry - oat aphid

Digestive proteolytic activity of Scrobipalpa ocellatella (Lepidoptera: Gelechiidae) on various sugar beet cultivars

فعالیت پروتئولیتیک گوارشی بید چغندرقند، Scrobipalpa ocellatella (Boyd)، روی ارقام مختلف چغندرقند(Rosire, Laetitia, Ardabili, Persia, Aras and Flores) تحت شرایط مزرعه‌ای بررسی شد. لاروهای سن سوم روی رقم Flores بیشترین فعالیت آنزیمی و لاروهای پرورش‌یافته روی رقم Aras کمترین فعالیت آنزیمی را داشتند. آنالیز زایموگرام نشان داد که کمترین تعداد آیزوزایم‌های پروتئاز در عصاره معده میانی لاروهایی بود که از رقم Aras تغذیه کرده بودند. با توجه به نتایج به دست آمده، رقم چغندرقند بر فیزیولوژی گوارشی بید چغندرقند تأثیرگذار بود

Effect of vermicompost on functional response of the parasitoid wasp Aphidius colemani (Hym., Braconidae) to the melon aphid, Aphis gossypii (Hem., Aphididae)

Changing of host plant quality via agricultural practices such as application of fertilizer may influence the behavioral traits of natural enemies. In this study, the effect of improving cucumber plants with different vermicompost: soil ratios (0:100 (control), 10:90, 20:80 and 30:70 % by volume) were studied on the functional response of the parasitoid wasp Aphidius colemani Viereck to the melon aphid, Aphis gossypii Glover. The logistic regression analyses revealed that the functional response of the parasitoid wasp to the melon aphid was type II in all treatments. The different vermicompost: soil ratios were differently affected the parameters of the functional response of the wasp. The results suggest that A. colemani can be efficiently used in integrated management programs against the melon aphid using vermicompost

Comparative biological parameters of the cotton bollworm, Helicoverpa armigera (Lep.: Noctuidae) on various corn hybrids

برخی پارامترهای زیستی کرم غوزه پنبه، Helicoverpa armigera (Hübner) روی هیبریدهای مختلف ذرت (SC700، SC704، SC500، DC370 و SC260) در قالب رژیم غذای مصنوعی تحت شرایط آزمایشگاهی (دمای 1 ± 25 درجه سلسیوس، رطوبت نسبی 5 ± 65 درصد و دوره نوری 16 ساعت روشنایی و 8 ساعت تاریکی) بررسی شد. لاروهای پرورش‌یافته روی هیبرید SC700 طولانی‌ترین دوره رشدی قبل از بلوغ (21/41 روز)، کم‌ترین باروری روزانه (90/100 روز) و کم‌ترین شاخص زیستی (69/0 گرم در روز) را نشان دادند. براساس نتایج به‌دست آمده، هیبرید SC700 میزبان نامناسبی برای رشد و نموکرم غوزه پنبه بود