Premarital Screening for Beta-Thalassemia in Birjand City

Background: Thalassemia is a common inherited anemia; and population-level screening followed by molecular evaluation is the most effective way to prevent it. Given the significance of beta-thalassemia minor and its prevalence in communities, this study aimed to identify the prevalence of beta-thalassemia minor among participants in the pre-marital screening program in Birjand City, located in South Khorasan province, Iran.Methods: The study included individuals who underwent pre-marital testing between 2014 -2019 and were categorized as high-risk for beta-thalassemia based on their blood indices and medical diagnosis. Data on their blood indices and follow-up results were collected from Birjand City's health center using a pre-designed form. The data were analyzed using statistical tests to assess significance.Results: Out of 35,801 couples who underwent premarital testing, 195 (390 individuals) were identified as the high-risk group for beta-thalassemia. Among these high-risk couples, 67.2% responded to iron therapy. Thalassemia prevalence was 9.7% among high-risk couples, 31.6% among individuals at actual risk, and 76% among those who underwent Prenatal Diagnosis (PND). The mean values of MCV, MCH, and Mentzer indices were significantly higher in the group that responded to iron therapy compared to the group eligible for PND.Conclusion: It was demonstrated that the prevalence of beta-thalassemia carriers among marriage applicants attending the health center in Birjand City is currently low. However, the implementation and continuity of beta-thalassemia screening programs for couples in this region can effectively prevent the birth of infants with thalassemia major and prevent unexpected medical treatment expenses

Comparison of the Effects of Deferasirox (Nanojade®) and Deferoxamine (Desferal®) on Serum Ferritin Level Changes in Major Beta-Thalassemia Patients: A Randomized Clinical Trial

Background: Different drugs with different mechanisms have been used to remove iron overload in thalassemia patients. This study aimed to compare the effects of Nanojade and Deferoxamine in reducing serum ferritin levels. Methods: This randomized clinical trial was conducted on 41 major thalassemia patients. The selected patients were allocated to two groups by the permuted block randomization method. The first group was treated with Deferasirox (Nanojade) and the second group was treated with Deferoxamine (Desferal). All patients received the drugs at 14 mg/kg. Blood samples were collected at baseline, after 3 and 6 months after intervention. Chi-square test, Mann-Whitney U-test, and Friedman test were used for analytical statistics at the significance level of 0.05. Results: 51.9% of patients in the Nanojade group and 40% in the Desferal group were females. Before the intervention, no difference was observed in terms of basic and demographic information. Before the intervention, as well as 3 months, and 6 months after the intervention, none of the blood parameters in the studied groups were significantly different (p> 0.05). The overall mean ferritin levels had a significant decrease, in both groups, 6 months after the intervention (PDeferasirox = 0.001 vs PDeferoxamine = 0.043); However, in the comparison between the two groups, no significant difference was observed between the levels of ferritin and creatinine at any of the time points (p> 0.05). Conclusions: Deferasirox oral tablet (Nanojade®) is as effective as an injectable form (deferoxamine (Desferal®)) in reducing serum ferritin in patients with beta-thalassemia major without causing nephrotoxic effects. Therefore, it can be a suitable alternative to its injectable form

Formulating a New Pharmaceutical Drug; Acetaminophen Tablet Containing N-acetyl Cysteine, To Alleviate the Severity of Liver Damage in Rats: Phase I, Animal Study

Background and Aim: Acetaminophen (APAP) is a commonly used analgesic and also the leading cause of medication-induced liver damage. On the other hand, N-acetylcysteine (NAC) is a medication widely used to treat APAP overdose. Despite this interest, a few studies have investigated the co-administration effects of these medications. Therefore, this study aimed to evaluate the effects of NAC and APAP on renal and liver functions in rats when they use concurrently. Methods: Male Wistar rats were orally treated with a single dose of APAP (700 mg/kg) alone or in combination of NAC at the three different doses (200, 500, and 700 mg/kg). After 24 hours, the blood and liver samples were collected for biochemical and histopathological evaluations. Results: Liver damage was well established in the 700 mg/kg APAP-treated rats, as evidenced by elevated the plasma levels of aspartate transaminase (AST) and alanine transaminase (ALT). In addition, the plasma level of blood urea nitrogen (BUN) was significantly increased in the APPA group compared to the control group.   Moreover, histological examinations revealed that liver degeneration was evident in APAP-treated animals. NAC only at the highest dose (700 mg/kg) could inhibit ALT elevation, but had no effect on AST and BUN levels. Interestingly, co-administration of NAC (700 mg/kg) with APAP (700 mg/kg) could slightly shift liver histological alterations from the irreversible stage (fibrosis) toward reversible lesions such as necrosis and hemorrhage. Conclusion: The study findings indicate that co-administration of NAC and APAP can reduce the severity of APAP-induced liver damage in rats. *Corresponding Author: Mehran Hosseini; Email: [email protected]; ORCID: https://orcid.org/0000-0002-6793-2035 Please cite this article as: Mehrpour O, Dastjerdi M, Nakhaee S, Amirabadizadeh A, Bijari B, Roomi H, Hosseini M. Formulating a New Pharmaceutical Drug; Acetaminophen Tablet Containing N-acetyl Cysteine, To Alleviate the Severity of Liver Damage in Rats: Phase I, Animal Study. Arch Med Lab Sci. 2021;7:1-8 (e14). https://doi.org/10.22037/amls.v7.3552

Evaluation of the Prevalence of Congenital Cytomegalovirus Infection and its Clinical Outcomes in Neonates Born in Vali-e-Asr Hospital of Birjand, Iran

Background Cytomegalovirus (CMV) has been known as the most common cause for congenital infections worldwide which can lead to death in fetus and neonates as well as neuropsychiatric deficits. The aim of this study was to determine the prevalence of congenital CMV infection in newly born neonates and to evaluate the medical outcomes. Materials and Methods In this cross-sectional study, 868 neonates were selected using unconditional random sampling in 2017. Neonatal saliva was given on the first or second day of birth using a Dacron swab and tested by PCR for the presence of CMV DNA. All infants with positive CMV infection went through further tests and examinations to evaluate the clinical outcomes. Results: 787 (90.67%) and 81 (9.33%) births were term and preterm respectively. The PCR test was positive results only in 14 term neonates (1.61%). Thus, the prevalence of CMV infection in term neonates (n=14, 1.61%) was higher than that of preterm infants (n=0), although there was no statistically significant difference (P>0.05). The most common abnormalities were neutropenia (50%, n=4) followed by anemia (37.5%, n=3). Conclusion The prevalence of CMV infection in this study (1.61%) was within the global range and there was no association between CMV infection and birth weight, infant gender, and as well ae neonatal type. The frequency of symptomatic neonates at birth in this study was higher than the average global range, but almost the same as in developing countries

Effect of Integrated Teaching on Students' Learning

Background: Currently medical education in Iran consists of basic sciences, physiopathology and clinical stages. Medical students learn them separately and often are confused that how basic sciences materials would be helpful for the patient’s diagnosis and treatment. Integration of various related subjects during medical education is one the proposed strategy to overcome this problem. Objectives: The present study was conducted to assess the effect of an integrated teaching approach on medical students’ attitudes and knowledge about infection diseases. Methods: This quasi-experimental study was conducted in the infectious disease ward of Valiae-asr Hospital affiliated to Birjand University of Medical of Sciences, Birjand, Iran. A total of 60 medical students (stagers) were randomly selected and assigned to the control and intervention groups. The two groups were matched based on their grade point average (GPA), age, and gender. An integrated teaching approach was adopted in the intervention group by four epidemiology, microbiology, infectious diseases, and pharmacology professors. The students’ knowledge was assessed by a written exam, and their attitude was evaluated using a questionnaire. Data was analyzed by SPSS version 16 and using paired and independent samples t-test. Results: The analyses showed that 52% of the participants were male. The mean scores in the cognitive and emotional domains were not correlated with students’ gender, and they were not significantly different before (p= 0.12) and after (p= 0.25) the intervention. The students’ final learning scores were significantly higher in the intervention group than that of the control group (16.16±1.17 vs 14.12±1.73; p=0.001). Conclusion: The integration of basic and clinical subjects helps students to better understand the physiopathology of diseases and enhances their satisfaction. Keywords: Infectious Diseases, Integrated Teaching, Learning, Medical Student

Predictive Validity of Comprehensive Basic Science Examination for Medical Students’ Academic Performance in Birjand University of Medical Sciences

Introduction: Basic science materials are important for medical students considering the understanding of clinical subjects and evaluation of academic performance in subsequent levels. The aim of this study was to assess predictive validity of comprehensive basic science examination for students’ academic performance in Birjand University Medical Sciences. Methods: In this descriptive cross-sectional study, 145 medical students that were admitted to Birjand University Medical Sciences within years 2002 to 2004 were selected through census. Information of these students including grades of comprehensive basic science examination (CBSE) and pre-internship examination (CPIE), average point grade (GPA) of clinical course and total average grade of students were collected from students’ files of records. Data was analyzed using t tests, ANOVA, and Pearson correlation coefficient. Results: Mean scores of comprehensive basic science examination (CBSE) and comprehensive pre-internship examination (CPIE) for medical students were 128.86±19.27 and 118.54±18.82 respectively. Mean of clinical course average grade and total grade point averages were 17.09±0.96 and 16.77±1.04 respectively. The difference between mean scores of two genders was not statistically significant. The Pearson correlation coefficient for comprehensive basic science examination grade with clinical course average, pre-internship examination grade, and total grade point averages was 0.56, 0.55 and 0.68 respectively. Conclusion: A moderate to high correlation between CBSE scores and scores of higher academic levels determined that the CBSE is a valid measurement to identify students at the risk of educational failure in subsequent academic levels

Medical students\\\' perspective of Clinical Educational Environment of Hospitals Affiliated with Birjand University of Medical Sciences, Based on DREEM Model.

Background and Aim: Clinical education environment is very important to better prepare medical students. The aim of this study is to determine the current status of the of the main parts of the Clinical Hospital of Birjand University of Medical Sciences from the residents and interns viewpoint. Materials and Methods: This study is across-sectional study, which was conducted between Mar to Oct 2014.116 Intern and resident Participated in this study. checklist of demographic information and DREEM questionnaire were completed by students. DREEM questionnaire included 50 questions in 5 domains: students’ perceptions of learning; perceptions of teachers; academic self-perception; perceptions of the atmosphere; and social self-perception. Data analyses by SPSS915 using T test and ANOVA. Results: Mean age of student was 25.8±2.8 years. The mean scores of clinical education in the main Hospital wards was 155.03±27.86 from maximum 200.mean scores of students’ perceptions of learning was 35.89±8.30; perceptions of teachers was 34.32±6.36; academic self-perception was 25.93±4.82; perceptions of the atmosphere was 37.19±6.49; and social self-perception  was 21.55±5.12. The mean score of clinical education in assistants was higher than the interns. (p=0.004) The mean score of clinical education were significant difference in the main Hospital wards. (p=0.001) Conclusion: The current status of the clinical education environment is desirable from Learners' Viewpoint. In some wards, such as the internal section of the need to pay more attention to improve clinical learning from University authorities

Interns and Medical graduates\\\' self-assessment of .their attitde regarding common outpatient diseases of children in 2013

Background and Aim: Management of patients with outpatient diseases is the most important part of general practitioners working environment in future. The present study aimed at evaluating medicalinterns and graduates’ self-assessment regarding their attitude about children outpatients in pediatric ward. Materials and Methods: In this cross-sectional and descriptive study 40 medical interns. and 20 medical graduates were selected as samples in 2013 and their attitude about quality and effectiveness of pediatric ward education was evaluated through their self-assessment by means of a researcher-designed questionnaire based on Likert scale. Mean attitude points of the subjects in three domains of diagnosis, treatment, and prescription of drugs regarding four groups of diseases including microbial diseases, parasitic diseases, neonatal diseases, and malnutrition were accounted. Finally, the obtained data was fed into SPSS (V :11.5) software and and was analyzed using independent T-test at the significant level of α=0.05. Results: The medical graduates’ attitude scores in the three domains of diagnosis, treatment, and prescription were 3.2.±0.27 , 3.21±0.30, and 3.06±0.37; and those of medical interns were 3.44±0.58 ,3.21±0.55 , and 2.97±0.59, respectively. The highest and lowest attitude mean scores of both groups in all of the three domains belonged to neonatal disorders and parasitic diseases. Mean attitude scores of the two groups  in the three mentioned domains were not significantly different. Conclusion: The intern’ self-assessment scores of attitude about children outpatients were not at a high level; and they did not increase parallel to working experience. Thus, improving clinical education is the main solution of the problem