Evaluation of Multiple Choice Questions in the School of Medicine, Mazandaran University of Medical Sciences, the First Semester of 2007

Background & Objective : Multiple Choice Questions (MCQs) are the commonest form of exams in medical education which are highly reliable however their structural and content validity, taxonomy and structural principles have always been considered by researchers. This study was designed to evaluate quality of MCQs in the school medicine, Mazandaran University of Medical Sciences, regarding taxonomy and structural principles. Methods : In this descriptive study, all MCQs of written exams held during a whole semester in the school of medical in Mazandaran University of Medical Sciences were evaluated. All questions were assessed according to taxonomy (in three levels of recall, comprehension, and application) and structure using a checklist which was based on Millman’s principles for designing stem and choices of questions. Results : Among 1478 questions related to 25 exams, questions related to lessons of basic sciences, physiopathology, and clerkship were 28.7%, 18.7%, 52.6% respectively. 77.4 percent of questions were in Taxonomy I and the rest were designed in Taxonomy II and III. 46 percent of all questions had no structural problems while the rest had one or more structural problems. Taxonomy and structural problems in exams related to clerkship and physiopathology were significantly less than basic science lessons (p=0.023 and p=0.001 respectively). Questions of higher taxonomy had less structural problems. Conclusion : Our present study showed that the quality of MCQs regarding structural principles and taxonomy were different in exams of different levels which necessitate further revisions. Keywords: Educational improvement, Multiple Choice Question, Taxonomy, Millman’s principles

Prevalence and type distribution of high-risk human papillomavirus in patients with cervical cancer: a population-based study.

BACKGROUND: Cervical cancer is the greater cause of cancer death in women in many developing countries. Persistent infection with human papilloma virus (HPV), primarily high risk types 16 and 18, is recognized as a causal and essential factor for the development of cervical cancer. We aimed to determine the distribution of high-risk HPV genotypes in archival biopsies with cervical carcinoma in patients from Mazandaran Province, Northern Iran. METHODS: A total of 98 paraffin-embedded cervical samples consisted of 63 Squamous Cell Carcinomas (SCC), 4 Adenocarcinomas, 19 Cervical Interaepithelial Neoplasia grade I (CIN-I), 4 CIN-II and 8 CIN-III diagnosed during 2009-2011, were selected to perform high risk HPV genotyping using AmpliSens(R) HPV HCR DNA genotyping kit. The prevalence of HPV infections was assessed in low and high grade cervical lesions by age. RESULTS: Of the 98 cervical samples analysed by DNA PCR, 78 (79.59%) were positive for HPV DNA. HPV was detected in the 52 of SCC, 4 of Adenocarcinomas, 14 of CIN-I, 4 of CIN-II, and 4 of CIN-III for HPV. From the 78 HPV positive samples, 23 (29.5%) samples were positive for HPV type 16, 32 (41%) were positive for HPV 18, 19 (24.4%) were positive for HPV 45, and 4 (5.1%) of cervical specimens were positive for HPV 39. CONCLUSIONS: This study provides valuable baseline data for future assessment of the impact of current prophylactic vaccination programs that is protective against the two most common oncogenic types of HPV found in cervical cancer, HPV-16 and HPV-18, but not against other high-risk mucosal HPVs, 39 and 45, reported in this population

Examination of MHC-1 Expression by J774 Macrophage Cells Treated with Recombinant Protein HIV-1 Tat 49-59 / HPV16, 18, 6, 11 E7 In Vitro

Background and purpose: Human papillomavirus (HPV) is one of the infectious agents that causes genital and non-genital warts and skin cancers in humans. The E7 protein of this virus is one of the small oncoproteins that may be the main target in therapeutic vaccines. E7 protein with HIV-1 Tat peptide (49-59), plays a protective role that cause immune Th1 and CTLs response. The aim of this study was to design a recombinant HIV-1 Tat 49-59 / HPV16, 18, 6, 11 E7 protein in vitro and the function of this antigen for MHC-1 expression. Materials and methods: In this study, macrophage cell line J774 was used to evaluate the expression of MHC-1 and the function of Tat peptide in delivery of recombinant protein to the surface of MHC-1. J744 mouse macrophage cell line was treated by10, 50, and 100 μg of each of the proteins with and without Tat peptide. After 24 hours, the cells were collected and then analyzed by flow cytometry. Results: In this study, J774 cells were treated and analyzed by E7-Tat and E7 proteins at different concentrations. The study showed that 10 μg of E7-Tat protein increased the expression of MHC-1, while at higher concentrations of this protein, the expression of MHC-1 molecule decreased considerably compared to the group without Tat peptide. Conclusion: E7-Tat protein at lower concentrations can act as a stimulant for increasing the MHC-1 expression and could be used in therapeutic vaccines

The Prevalence of HBV and HCV Infection in HIV Positive Patients in Norht of Iran

Background: HIV infected persons are also at risk for Infection with other pathogens, like Hepatitis B virus (HBV) and Hepatitis C virus (HCV). One of the main steps in the planning of treatment and prevention is the study of the HIV positive population who have HBV and/or HCV infection. The objective of this study was to determine the prevalence of HIV and Hepatitis B and C dual infection in north of Iran Materials and methods: Blood samples were collected into EDTA containing tubes by sterile syringes and needles from 83 HIV positive patients which were previously confirmed by Real-time Polymerase chain reaction in the HIV center of the north of IRAN. A structured questionnaire was used to obtain socio-demographic data from participants. Samples were screened for Hepatitis B surface antigen (HBsAg) and anti-HCV antibody. All non-reactive samples were recorded as negative. Results: Out of the 83 patients, 50(60%) were male and 33 (40%) were female. Positive hepatitis C antibody was found in 28 (33%) and positive hepatitis B surface antigen was present in 15 (18%) of patients. The frequency of all these three viruses co-infection was 7 (8%). Conclusion: Seroprevalence of HCV and HIV co-infection was high and it was strongly related to mutual ways of acquisition

Prevalence of influenza A/H3N2 virus in northern Iran from 2011 to 2013

Background: Influenza A virus is the most virulent human pathogen and causes the most serious problem. Having epidemiological knowledge about this disease is important. The aim of this study was to determine the prevalence of influenza A/H3N2 virus infection in northern Iran from 2011 to 2013 using the real-time polymerase chain reaction (RT-PCR). Methods: In this cross-sectional study 57 samples were collected from patients with influenza-like illness (T≥ 38 °C and cough or sore throat. Influenza-RNA was extracted from the samples using PureLinkTM Viral RNA/DNA Kit. RT-PCR was one using SuperScript III Platinum, Quantitive Real Time PCR system from invitrogen with a specific type of primers and probs. All samples were examined in the Influenza laboratory of Mazandaran University of Medical Sciences. Results: The mean age of patients was 38.2±14.5 year, 278 (48.69%) were males and 293 (51.31%) females. A total number of 201 patients (35.2%) were diagnosed as influenza A1 H3 N2 infection. Conclusion: The results show that the prevalence of A/H3N2 in the North of Iran is considerable and needs more attention for preventive measure

Glycyrrhetinic Acid Inhibits Cell Growth and Induces Apoptosis in Ovarian Cancer A2780 Cells

Purpose: Accumulating evidence indicates that glycyrrhizin (GZ) and its hydrolyzed metabolite 18-β glycyrrhetinic acid (GA) exhibit anti-inflammatory and anticancer activities. The objective of this study was to examine the in vitro cytotoxic activity of GA on human ovarian cancer A2780 cells. Methods: A2780 cells were cultured in RPMI1640 containing 10% fetal bovine serum. Cells were treated with different doses of GA and cell viability and proliferation were detected by dye exclusion and 3-bis-(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide (XTT) assays. Apoptosis induction and expression of Fas and Fas ligand (FasL) were analyzed by flow cytometry. Results: We observed that GA decreases cell viability and suppressed cells proliferation in a dose-dependent manner as detected by dye-exclusion and XTT assayes. In addition, our flow cytometry data show that GA not only induces apoptosis in A2780 cells but also upregulates both Fas and FasL on these cells in a dose-dependent manner. Conclusion: we demonstrate that GA causes cell death in A2780 cells by inducing apoptosis

The effect of eight weeks endurance training and high-fat diet on appetite-regulating hormones in rat plasma

Objective(s):Consumption of high-fat foods is one of the major causes of obesity. Physical exercise is a strategy used to counteract obesity. The aim of this study was to investigate the effect of eight weeks endurance training and high-fat diet (HFD) on appetite-regulating hormones in rat plasma. Materials and Methods:Twenty eight male Wistar rats were randomly divided into four groups: Control group with standard diet (CSD), endurance training with a standard diet (ESD), control group with high-fat diet (CHFD) and endurance training with high-fat diet (EHFD). Twenty-four hr after the last training session, the blood samples were obtained and analyzed for hormones levels. Results: The significant increased weight gain and food intake and decreased plasma nesfatin-1 and PYY3-36 levels were observed in CHFD group, while exercise under the HFD antagonized these effects. There were no significant changes in ghrelin, insulin and leptin levels in different groups. Conclusion: These results suggest that exercise can prevent fattening effect of HFD. Probably, performing exercise makes a reduction of food intake and weight gain in rat via the increase in nesfatin-1 and PYY levels. However, further studies are necessary to understand the exact mechanisms involved in this field

Burden of Ischemic Heart Disease and Its Attributable Risk Factors in North Africa and the Middle East, 1990 to 2019: Results From the GBD Study 2019

Background The North Africa and Middle East (NAME) region has one of the highest burdens of ischemic heart disease (IHD) worldwide. This study reports the contemporary epidemiology of IHD in NAME. Methods and Results We estimated the incidence, prevalence, deaths, years of life lost, years lived with disability, disability‐adjusted life years (DALYs), and premature mortality of IHD, and its attributable risk factors in NAME from 1990 to 2019 using the results of the GBD (Global Burden of Disease study 2019). In 2019, 0.8 million lives and 18.0 million DALYs were lost due to IHD in NAME. From 1990 to 2019, the age‐standardized DALY rate of IHD significantly decreased by 33.3%, mostly due to the reduction of years of life lost rather than years lived with disability. In 2019, the proportion of premature death attributable to IHD was higher in NAME compared with global measures: 26.8% versus 16.9% for women and 18.4% versus 14.8% for men, respectively. The age‐standardized DALY rate of IHD attributed to metabolic risks, behavioral risks, and environmental/occupational risks significantly decreased by 28.7%, 37.8%, and 36.4%, respectively. Dietary risk factors, high systolic blood pressure, and high low‐density lipoprotein cholesterol were the top 3 risks contributing to the IHD burden in most countries of NAME in 2019. Conclusions In 2019, IHD was the leading cause of death and lost DALYs in NAME, where premature death due to IHD was greater than the global average. Despite the great reduction in the age‐standardized DALYs of IHD in NAME from 1990 to 2019, this region still had the second‐highest burden of IHD in 2019 globally

Evaluation of the diabetes care cascade and compliance with WHO global coverage targets in Iran based on STEPS survey 2021

Abstract This study aimed to investigate the diabetes mellitus (DM) and prediabetes epidemiology, care cascade, and compliance with global coverage targets. We recruited the results of the nationally representative Iran STEPS Survey 2021. Diabetes and prediabetes were two main outcomes. Diabetes awareness, treatment coverage, and glycemic control were calculated for all population with diabetes to investigate the care cascade. Four global coverage targets for diabetes developed by the World Health Organization were adopted to assess the DM diagnosis and control status. Among 18,119 participants, the national prevalence of DM and prediabetes were 14.2% (95% confidence interval 13.4–14.9) and 24.8% (23.9–25.7), respectively. The prevalence of DM treatment coverage was 65.0% (62.4–67.7), while the prevalence of good (HbA1C < 7%) glycemic control was 28.0% (25.0–31.0) among all individuals with diabetes. DM diagnosis and statin use statics were close to global targets (73.3% vs 80%, and 50.1% vs 60%); however, good glycemic control and strict blood pressure control statistics, were much way behind the goals (36.7% vs 80%, and 28.5% vs 80%). A major proportion of the Iranian population are affected by DM and prediabetes, and glycemic control is poorly achieved, indicating a sub-optimal care for diabetes and comorbidities like hypertension