Evaluation of Basic Sciences Curriculum Modifications in Isfahan University of Medical Sciences: The Students’ Viewpoint

Introduction: Basic sciences curriculum faces various challenges in Iran. Proper curriculum designing can have a major impact on learning, performance, educational achievement and satisfaction of students of medicine. This study was carried out in order to evaluate the effectiveness of the rearrangement of basic sciences curriculum in Isfahan University of Medical Sciences from the viewpoint of the students. Methods: In this descriptive study with interrupted time series design, students of medicine at Isfahan University of Medical Sciences admitted at 2005-2006 academic years were selected through convenient sampling. The case group were students in the new curriculum design, and the control group were the students in the traditional curriculum design. Data collection tool was a valid and reliable researcher-made questionnaire. The collected data were analyzed using descriptive statistics and an independent t-test. Results: Students’ satisfaction rate with the new curriculum (2.95± 0.48 out of 5) was significantly (P = 0.00, t = -3.25) more than students’ satisfaction in the traditional curriculum (2.78±.68). Students receiving the new curriculum during 5 semesters ranked (6.34±1.81) the arrangement of the specialized courses higher (P=0.001, t=7.42) than the students in the traditional curriculum (4.29±2.15). The scores for the given preparation time for basic sciences examination in the 5th semester was not significantly different between the two groups (2.86±1.10 vs. 2.77±1.34, p=0.72, t=0.35). The students’ stress for this exam was not significantly different between groups (3. 49±1.15 vs. 3. 48±1.22, P=0.99, t=0.01). Conclusion: The findings showed that even minor modifications could affect the attitudes of the students of medicine. However, merely rearranging the courses may not be sufficient. Thereby, continuous modification of the curriculum according to new approaches such as integrated courses through organ-based model, considering other contributing factors in improving students' satisfaction, such as modifying the content, method and learning environment are strongly recommended

Does percutaneous nephrolithotomy cause elevated cardiac troponins?

BACKGROUND: Percutaneous nephrolithotomy is the treatment of choice in large and staghorn renal stones, and myocardial infarction is one the possible complications during and after the surgery. We investigated if renal and skeletal muscle injury, caused by percutaneous nephrolithotomy, can cause elevation in cardiac troponins (cTn). METHODS: This study was conducted on otherwise healthy patients with renal stone undergoing percutaneous nephrolithotomy. A baseline 12-lead electrocardiogram, echocardiography, and cTn assessment confirmed no cardiac pathology in any patients. Cardiac troponins T (cTnT) and I (cTnI), and also creatine kinase (CK) were assessed before and after surgery. RESULTS: A total of 55 patients (69.1% males, mean age: 40.5 &plusmn; 13.8 year) were included. Serum creatinine level ranged from 0.7 to 1.3 mg/dl (mean = 1.03 &plusmn; 0.17). The level of CK was significantly increased by 469.5 &plusmn; 201.4 U/l (P &lt; 0.001), and no positive cTnT or cTnI was observed after surgery. CONCLUSION: The results of the present study showed that renal cell injury, caused by percutaneous nephrolithotomy, is not associated with elevated cardiac troponins. These findings show that increasing troponins in patients undergoing percutaneous nephrolithotomy indicate a cardiovascular pathology. &nbsp; Keywords: Percutaneous Nephrolithotomy, Coronary Artery Disease, Acute Coronary Syndrome, Cardiac Markers, Troponin&nbsp;</div