Evaluation of RANKL/OPG Serum Concentration Ratio as a New Biomarker for Coronary Artery Calcification: A Pilot Study

Objective. There is a strong need for biomarkers to identify patients at risk for future cardiovascular events related with progressive atherosclerotic disease. Osteoprotegerin (OPG) protects the skeleton from excessive bone resorption by binding to receptor activator of nuclear factor-κB ligand (RANKL) and preventing it from binding to its receptor, receptor activator of nuclear factor-κB. However, conflicting results have been obtained about association of serum level of OPG or RANKL with coronary artery disease (CAD). Based on their role in inflammation and matrix degradation and the fact that atherosclerotic plaque formation is an inflammatory process, we hypothesized that RANKL : OPG ratio could be a better biomarker for CAD. Methods. In this cross-sectional study, the correlation between RANKL : OPG ratio serum concentration and coronary artery calcification (CAC) in 50 patients with ischemic coronary disease has been investigated. We used ELISA method for measuring RANKL and OPG serum concentrations. Results. There was a significant correlation between RANKL : OPG serum concentration ratio and CAC in our study population (P = 0.01). Conclusion. Our results suggested that RANKL : OPG ratio concentration has a potential of being used as a marker for coronary artery disease

The Effects of Utilizing an Innovative Method to Mimic a Prescription, named “Prescomime”, on Medical Students’ Learning and clinical Skills Development in Pharmacology Course

Introduction: Pharmacology is an extremely practical course and at the same time hard to learn. Utilizing practical and innovative methods facilitates learning of theoretical courses. Therefore, this research aimed to investigate the effects of an innovative role-based method named “Prescomime” on medical students’ learning and clinical skills development in pharmacology course. Methods: This single-group post-test study was performed in the first and second semesters of 2012-2013 academic years among medical students in pharmacology course (all students: 22 in the first and 24 in the second semester) in North Khorasan University of Medical Sciences. The term Prescomime is derived from the words prescription and mimic and means mimic of a prescription. Participants were divided into two groups. The explorer group asked one of the participants in the same group, as a hypothetical middle class patient (without medical information), about her or his disease to get information about the medication that she or he had consumed in order to find that medication. Data collection tool was a researcher-made questionnaire in order to evaluate the method. Data were analyzed using descriptive and inferential statistics (ANOVA and T-test). Results: The mean scores for the idea of implementation of this method were 4.09±0.05 in the first semester and 4.09±0.09 (out of 5) in the second semester which did not show a significant difference (p=0.9, t=0.19) however, a significant difference (p<0.0001, t=3.48) was found between the mean scores for the method of implementation in the first semester (3.02±0.87) and the second semester (4.05±0.17). Conclusion: Findings showed that utilizing Prescomime in the form of role playing enhanced students’ motivation, self-confidence, and concentration on practical aspects of the course. Since there is no access to patients in theoretical courses, a combination of this method with theoretical courses might be the best solution to improve learning of pharmacology