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

Association between cognitive function and parameters of echocardiography and coronary artery angiography

ABSTRACT We aimed to determine whether there is an association between cognition and the results of echocardiography and angiography, based on neuropsychological assessments. Methods: We assessed the cognition of 85 patients who had recently undergone coronary artery angiography. We calculated the Gensini score for the coronary artery disease index. We also performed echocardiography to find indices of cardiac functioning. Results: The lower left ventricular ejection fraction correlated with lower scores on visuospatial, executive function, processing speed/attention and verbal memory capacities (p ≤ 0.05). A higher Gensini score and left atrial size correlated with lower executive function and processing speed/attention (p ≤ 0.05). In the group of patients with an impaired cognitive state, higher Gensini scores correlated with decreased processing speed/attention (p = 0.01) and the e' index was associated with lower capacity of executive function (p = 0.05). Conclusion: Decreased processing speed/attention and executive function may correlate with cardiac dysfunction and coronary artery disease. The Color Trail Test may be considered for simple screening for cognitive problems in elderly patients with coronary artery disease or diastolic dysfunction

Comparative evaluation of captopril, spironolactone, and carvedilol effect on endothelial function in breast cancer women undergoing chemotherapy

Background: Breast cancer is the most prevalent malignancy in females which needs chemotherapy treatment. Studies demonstrated that anti-cancer agents used for chemotherapy in cancer patient causes endothelium dysfunction. Several researches showed the efficacy of angiotensin-converting enzyme inhibitors, Carvedilol and Spironolactone on improving endothelial function. This study aimed to evaluate the effect of the combination of Spironolactone, Carvedilol, and Captopril on endothelial function in breast cancer patients. Materials and Methods: This study is a prospective Randomized Clinical Trial in breast cancer patients who underwent chemotherapy. Patients were divided into two groups who received the combination of Captopril, Spironolactone, and Carvedilol or standard regimen for 3 months during chemotherapy. Before and after intervention, ejection fraction (EF), E/A ratio and e' and flow-mediated dilation (FMD) properties were calculated and then compared. Results: Fifty-eight patients with a mean age of 47.57 ± 9.46 years were evaluated. The mean FMD after the intervention is statistically different in case and controls (<0.001). E/A ratio and e' are not statistically different between groups after intervention. The mean EF was not statistically different between the two groups after intervention. Conclusion: Prescribing combination of Carvedilol, Spironolactone, and Captopril in breast cancer patients undergoing chemotherapy can improve endothelial function and may have beneficial effects on diastolic function

Association between cognitive function and parameters of echocardiography and coronary artery angiography

<div><p>ABSTRACT We aimed to determine whether there is an association between cognition and the results of echocardiography and angiography, based on neuropsychological assessments. Methods: We assessed the cognition of 85 patients who had recently undergone coronary artery angiography. We calculated the Gensini score for the coronary artery disease index. We also performed echocardiography to find indices of cardiac functioning. Results: The lower left ventricular ejection fraction correlated with lower scores on visuospatial, executive function, processing speed/attention and verbal memory capacities (p ≤ 0.05). A higher Gensini score and left atrial size correlated with lower executive function and processing speed/attention (p ≤ 0.05). In the group of patients with an impaired cognitive state, higher Gensini scores correlated with decreased processing speed/attention (p = 0.01) and the e' index was associated with lower capacity of executive function (p = 0.05). Conclusion: Decreased processing speed/attention and executive function may correlate with cardiac dysfunction and coronary artery disease. The Color Trail Test may be considered for simple screening for cognitive problems in elderly patients with coronary artery disease or diastolic dysfunction.</p></div

QTc interval measurement in patients with right bundle branch block: A practical method

Abstract Background and Aim Prolonging the QT interval in the right bundle branch block (RBBB) can create challenges for electrophysiologists in estimating repolarization time and eliminating the effect of depolarization changes on QT interval. In this study, we aimed to develop a practice formula to eliminate the effect of depolarization changes on QT interval in patients with RBBB. Methods This prospective study evaluated accidentally induced RBBB in patients undergoing electrophysiological study. Two expert electrophysiologists recorded the ECG parameters, including QRS duration, QT interval, and cycle length, in the patients. The formula was developed based on QT interval differences (with and without RBBB) and its proportion to QRS. Additionally, the Bazzet, Rautaharju, and Hodge formulas were used to evaluate QTc. Results We evaluated 96 patients in this study. The mean QT interval without RBBB was 369.39 ± 37.38, reaching 404.22 ± 39.23 after inducing RBBB. ΔQT was calculated as 34.83 ± 17.61, and the ratio of ΔQT/QRS with RBBB was almost 23%. Our formula is: (QTwith RBBB − 23% × QRS). Subtraction of 25% instead of 23% seems more straightforward and practical. Our formula could also predict the QTc interval in RBBB based on the Bazzet, Rautaharju, and Hodge formulas. Conclusion Previous formulas for QT correction were hard to apply in the clinical setting or were not specified for RBBB. Our new formula allows a rapid and practical method for QT correction in RBBB in clinical practice