Evaluation of the Quality of Teaching in Neurology Ward, Kerman University of Medical Sciences, Iran, from the Point of View of Medical Students

Background & Objective: In educational systems, evaluation is considered as one of the key elements. The evaluation of university students on the educational processes is of specific value. There has been no study on the evaluation of the Neurology Department, Kerman University of Medical Sciences, Iran, through carrying out a poll. Therefore, we intended to improve the quality of education in the department through evaluation. Methods: From among the medical students admitted in 2007 in Kerman University of Medical Sciences, Iran, 67 students participated in the present study. The questionnaire used was prepared according to reliable sources and the professors’ points of view, and considered validity and reliability. The questionnaire’s data was entered into SPSS, and it was statistically analyzed through descriptive and analytical statistical methods. Results: 63 students (94%) rated the methodology of the professors of the ward, and 62 students (92.5%) rated the methodology of the professors of theoretical courses a moderate or high score. 65 students’ (97%) evaluation of good behavior of professors with students was moderate or high. In terms of efficiency, 35 students (52.2%) rated morning reports, 28 students (41.7%) rated weekly conferences, and 18 students (26.8%) rated journals a moderate to high score. Conclusion: According to the medical student’s opinion, the neurology department has a good position in general standards of medical education, ethics, and regulation. However, it has to reconsider some parts of educational procedures such as conferences and journal clubs which are held in collaboration with the residents. Keywords Medical students Evaluation Neurolog

Assessing the Effect of Opium Dependence on Visual Evoked Potential (VEP) in Men

Abstract Background: Opium-dependence having different effects on the nervous system is a common problem, especially in the Middle East and Iran. The aim of this study is evaluating the effects of opium-dependence on visual evoked potential (VEP) in men. Methods: Thirty subjects with both chronic cigarette smoking and opium-dependence (group 1) and 30 subjects with only chronic cigarette smoking (group 2) were included in this cross-sectional case-control study and after urinary tests of opium, the pattern reversal visual evoked potentials (PRVEP) were recorded in the standard condition and variables such as N75, P100, N135 and amplitude were obtained and then analyzed with SPSS16. P value < 0.05 was assumed significant statistically. Findings: The mean of N75 (70.426 ± 22.028), P100 (115.457 ± 29.176) and N135 (165.402 ± 66.712) was not significantly different between the two groups. The mean of the amplitude of VEP in group 1 (6.856 ± 3.248) was significantly higher than group 2 (4.933 ± 2.50) (p < 0.05). Conclusion: Our study showed that chronic cigarette smoking and opium dependence have no significant effect on the late components of the VEP (N75, P100 and N135), but chronic cigarette smoking and opium-dependence together significantly increase the amplitude of VEP compared with chronic cigarette smoking alone, probably due to the chronic stimulatory effects of concomitant use of these two substances on the eyes and the visual nervous system. Keyword: Opium, Cigarette, Visual evoked potentia

Quality Assessment of Educational Services for Residents in Teaching Hospitals of Kerman University of Medical Sciences, Iran, based on the SERVQUAL Model

Background & Objective: Quality assessment of educational services is one of the most important actions in line with an improvement in the services. If the qualitative dimension of services is not taken into account, we will observe significant academic failure and reduction in creativity among the learners. Therefore, one of the salient steps in improving the quality of educational services is quality assessment from the viewpoints of its users. The aim of the present study was to determine the quality of educational services from the viewpoints of residents based on the SERVQUAL model. Methods: In this descriptive-analytical study, 204 residents from the educational hospitals of Kerman, Iran, participated. The participants were selected using simple random sampling method. The data collection tool was the Evaluation of Educational Quality Questionnaire that evaluates educational quality based on the SERVQUAL gap analysis method. This tool compares respondents’ perceptions and expectations of the quality of educational services in 5 domains (reliability, responsibility, confidence, assurance, empathy, and tangible physical). Content validity of this questionnaire was approved by experts' opinions and its reliability was confirmed using Cronbach's alpha (r = 0.88). To analyze data, SPSS software was used for performing descriptive (mean, standard deviation) and analytical (independent t-test) tests. Results: The findings showed that there was a negative gap between residents' perceptions and expectations of the quality of educational services in all 5 dimensions. The highest and lowest level of gap was related to the tangible physical (-1.50) dimension and the responsibility (-0.51) dimension, respectively. Conclusion: There is a negative gap between residents' perceptions and expectations in different dimensions of educational services quality based on the SERVQUAL model. In order to improve the quality of education, a review of educational infrastructures (environment and facilities) and education management seems necessary. This requires the efforts of relevant authorities toward the development and improvement of these infrastructures. Keywords: Evaluation; Quality; Residents; Educational services; SERVQUAL mode

Educational Needs Assessment for General Practitioners in the Field of Neurological Diseases in the Regulatory Zone of Rafsanjan University of Medical Sciences, Iran

Background & Objective: Regarding the significance of neurological diseases, training general practitioners has a key role and they should be well-trained in diagnose and approaching different diseases in this field. We focused on educational needs assessment for general practitioners in the field of neurological diseases. Methods: All the general practitioners practicing in the regulatory zone of Rafsanjan University of Medical Sciences, Iran, (urban and rural areas), who agreed to participate, were entered the study. 104 participants of the total of 170 general practitioners in this area completed a researcher-made questionnaire and mailed us. The questionnaire encompassed 54 neurological diseases, four paraclinical tests and 9 approaches for neurological signs and symptoms, as well as their practical framework, satisfaction from their education, and demographic and educational items. Results: In 47.9% of cases, educational expectations were at the level of screening and refer, in that 31.4%, at the level of diagnosis and treatment and in 18.8%, at the level of acquaintance and describing. The remainders (1.88%) were the cases with no need to know and unfamiliar ones. Statistically, screening and refer, just the diagnosis, and the treatment were the mentioned educational expectations, respectively. Most of general practitioners were not fully satisfied from their externship and internship educational programs. Conclusion: This study, in a more systematic way, outlines the general practitioner’s points of view and their tendency to intervene in the procedure of neurological managements which can also be of great use to any further modifications in medical training curricula. Absence of perfect satisfaction about educational programs shows us that we should change our educational methods to more practical and clinical forms. Key Words: Educational needs, Neurological diseases, General practitioner

A Study of the Seasonal Incidence of Multiple Sclerosis Attacks in Kerman, Iran

Abstract: Background & Aims: Multiple sclerosis (MS) is a chronic disease of the nervous system, the cause of which remains unknown. Its prevalence rate has been estimated at 2.5 million individuals across the globe, and 31.5 individuals per 100,000 in Kerman province, Iran. Although different studies have reported disparate results, there are many authentic reports claiming that seasonal changes affect MS prevalence in certain months. The present study investigated the rate of MS seizures in terms of different seasons. Methods: Patients referring to the Neurology Ward of Shafa medical center, affiliated to Kerman University of Medical Sciences, Iran, were examined in a 5 year period from 2007 to 2011. A specially developed form, containing demographic and background information, and results of examinations, was filled out for each and every patient. A neurology faculty member approved MS seizures or otherwise rejected irrelevant observations. Findings were analyzed through SPSS20 software. Results: In the present study, 802 attacks of MS were detected; 187 cases in men (23.32%) and 615 cases in women (76.68%). The mean age of the participants was 32.69 years. The highest rate of hospitalization occurred in winter and spring. This finding is mostly related to MS attacks in women, but in men the rate of attacks are equal in different seasons. Conclusion: During the past 5 years, 802 acute cases of multiple were registered (187 cases (23.3%) in men and 615 cases (76.68%) in women). Most cases occurred in winter and spring, which may be due to seasonal infections or other factors triggered by certain climatic conditions specific to these periods. Keywords: Multiple sclerosis, Season, Winter, Spring, Kerman, Ira

Serum prolactin level in multiple sclerosis patients

BACKGROUND: Multiple Sclerosis (MS) is the most common demyelinating disease. An autoimmune basis has been confirmed for pathogenesis of MS. Prolactin (PRL) has roles in these mechanisms. Its serum levels change in MS according to some reports. The purpose of this study was to survey these changes in MS patients. &#13; METHODS: Sixty MS patients were included in this cross-sectional study. The same number of controls matched for sex and age were studied. Pregnant, lactating women, consumers of specific medications and patients with underlying diseases were excluded from our study. RIA was used for determination of serum levels of PRL. &#13; RESULTS: In this study, PRL level in male patients was 14.23 ± 11.47 ng/ml compared to controls with mean level of 7.21 ± 4.12 ng/ml (P value &lt;0.001). Mean PRL level in female patients was 20.18 ± 11.04 ng/ml whereas controls had a mean level of 14.45 ± 6.93 ng/ml (one-tailed P value &lt;0.05). So there were significant differences in serum PRL level between case and control groups in both men and women&#13; CONCLUSIONS: PRL has a positive relation with MS in both sexes. Further studies for determination of causality relation and drug effect in endocrine system on MS pathogenesis are suggested. &#13; KEY WORDS: Multiple Sclerosis, prolactin, male, femal

Frequency of Opium Addiction with Ischemic Stroke Patients and Comparing Their Cerebrovascular Doppler Ultrasound Alternations to Non-Addicts

Background: Ischemic stroke is a major cause of mortality and morbidity worldwide. Various studies on the etiology of this disease are in progress. Some studies have suggested that opium abuse may is associated with increased risk of ischemic stroke. The present study aimed to analyze the frequency of opium addiction and to compare cerebrovascular ultrasound patients’ changes to non-addicts. Methods: This cross-sectional study was performed on 97 patients with ischemic stroke. The diagnosis was confirmed by imaging and paraclinical studies. All the patients underwent cerebrovascular ultrasound in the first 4 days of symptoms onset. A questionnaire containing demographic data, opium use information [based on the 4th Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria], and vascular ultrasound findings were completed for each patient and the results were analyzed using descriptive statistics and chi-square test. Findings: In this study, 38 patients (39.18%) were addicted to opium and the remaining were non-addicts. Among the addicted patients, 31 patients were male and 7 patients were female, while 26 and 33 patients of non-addicts were male and female, respectively (P < 0.01). Among the risk factors for stroke, smoking was higher in the addicts than in non-addicts (P = 0.04). Frequency of vascular stenosis and stenosis location did not show a statistical significant difference between the addicted and non-addicted patients. Conclusion: More than one-third of the patients with stroke were addicted to opium which was higher than general population; although the pattern of stenosis in these patients was similar to the non-addicts. Keywords: Opium, Transcranial Doppler Ultrasound, Strok

Frequency of Opium Addiction in Patients with Ischemic Stroke and Comparing their Cerebrovascular Doppler Ultrasound Changes to Non-Addicts

Abstract Background: Ischemic stroke is a major cause of mortality and morbidity worldwide. Various studies on the etiology of this disease are in progress. Some studies have suggested that opium abuse may is associated with increased risk of ischemic stroke. The present study aimed to analyze the frequency of opium addiction and to compare cerebrovascular ultrasound patients’ changes to non-addicts. Methods: This cross-sectional study was performed on 97 patients with ischemic stroke. The diagnosis was confirmed by imaging and paraclinical studies. All the patients underwent cerebrovascular ultrasound in the first 4 days of symptoms onset. A questionnaire containing demographic data, opium use information [based on the 4th Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria], and vascular ultrasound findings were completed for each patient and the results were analyzed using descriptive statistics and chi-square test. Findings: In this study, 38 patients (39.18%) were addicted to opium and the remaining were non-addicts. Among the addicted patients, 31 patients were male and 7 patients were female, while 26 and 33 patients of non-addicts were male and female, respectively (P < 0.01). Among the risk factors for stroke, smoking was higher in the addicts than in non-addicts (P = 0.04). Frequency of vascular stenosis and stenosis location did not show a statistical significant difference between the addicted and non-addicted patients. Conclusion: More than one-third of the patients with stroke were addicted to opium which was higher than general population; although the pattern of stenosis in these patients was similar to the non-addicts. Keywords: Opium, Transcranial Doppler Ultrasound, Strok

Assessing the Effect of Opium Dependence on Visual Evoked Potential (VEP) in Men

Abstract Opium-dependence having different effects on the nervous system is a common problem, especially in the Middle East and Iran. The aim of this study is evaluating the effects of opium-dependence on visual evoked potential (VEP) in men. Thirty subjects with both chronic cigarette smoking and opium-dependence (group 1) and 30 subjects with only chronic cigarette smoking (group 2) were included in this cross-sectional case-control study and after urinary tests of opium, the pattern reversal visual evoked potentials (PRVEP) were recorded in the standard condition and variables such as N75, P100, N135 and amplitude were obtained and then analyzed with SPSS16. P value < 0.05 was assumed significant statistically. The mean of N75 (70.426 ± 22.028), P100 (115.457 ± 29.176) and N135 (165.402 ± 66.712) was not significantly different between the two groups. The mean of the amplitude of VEP in group 1 (6.856 ± 3.248) was significantly higher than group 2 (4.933 ± 2.50) (P < 0.05). Our study showed that chronic cigarette smoking and opium dependence have no significant effect on the late components of the VEP (N75, P100 and N135), but chronic cigarette smoking and opium-dependence together significantly increase the amplitude of VEP compared with chronic cigarette smoking alone, probably due to the chronic stimulatory effects of concomitant use of these two substances on the eyes and the visual nervous system