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کاربرد نوع شرط:
- جایگاه : پژوهشی
- مجله: Journal of Advances in Medical Education and Professionalism
- نوع مقاله: Journal Article
- کلمات کلیدی: Medical students,Education,Medical assessment
- چکیده:
- چکیده انگلیسی: Introduction: Clinical reasoning as a critical and high level of clinical competency should be acquired during medical education, and medical educators should attempt to assess this ability in medical students. Nowadays, there are several ways to evaluate medical students’ clinical reasoning ability in different countries worldwide. There are some well-known clinical reasoning tests such as Key Feature (KF), Clinical Reasoning Problem (CRP), Script Concordance Test (SCT), and Comprehensive Integrative Puzzle (CIP). Each of these tests has its advantages and disadvantages. In this study, we evaluated the reliability of combination of clinical reasoning tests SCT, KF, CIP, and CRP in one national exam and the correlation between the subtest scores of these tests together with the total score of the exam.
Methods: A total of 339 high ranked medical students from 60 medical schools in Iran participated in a national exam named “Medical Olympiad”. The ninth Medical Olympiad was held in Shahid Beheshti University of Medical Sciences, Tehran, Iran, under the direct supervision of the Ministry of Health and Medical Education in summer 2017. The expert group designed a combination of four types of clinical reasoning tests to assess both analytical and non-analytical clinical reasoning. Mean scores of SCT, CRP, KF, and CIP were measured using descriptive statistics. Reliability was calculated for each test and the combination of tests using Cronbach’s alpha. Spearman’s correlation coefficient was used to evaluate the correlation between the score of each subtest and the total score. SPSS version 21 was used for data analysis and the level of significance was considered <0.05.
Results: The reliability of the combination of tests was 0.815. The reliability of KF was 0.81 and 0.76, 0.80, and 0.92 for SCT, CRP, and CIP, respectively. The mean total score was 169.921±41.54 from 240. All correlations between each clinical reasoning test and total score were significant (P<0.001). The highest correlation (0.887) was seen between CIP score and total score.
Conclusion: The study showed that combining different clinical reasoning tests can be a reliable way of measuring this ability.- انتشار مقاله: 14-02-1398
- نویسندگان: ANAHITA SADEGHI,ALI ALI ASGARI,NEZARALI MOULAEI,VAHID MOHAMMADKARIMI,SOMAYEH DELAVARI,MITRA AMINI,SETAREH NASIRI,ROGHAYEH AKBARI,MOJGAN SANJARI,IRAJ SEDIGHI,PARISA KHOSHNEVISASL,MANOUCHEHR KHOSHBATEN,SAEED SAFARI,LEILY MOHAJERZADEH,PARISA NABEIEI,BERNARD CHARLIN
- مشاهده
- جایگاه : پژوهشی
- مجله: Iranian Journal of Basic Medical Sciences
- نوع مقاله: Journal Article
- کلمات کلیدی: Iran,Drug resistance,Pseudomonas aeruginosa,Acinetobacter baumannii,Carbapenems
- چکیده:
- چکیده انگلیسی: Objective(s): Pseudomonas aeruginosa and Acinetobacter baumannii resist antibiotics by different intrinsic and acquired mechanisms. This study aims to define various carbapenem-resistant mechanisms of isolated P. aeruginosa and A. baumannii from nine different provinces of Iran.
Materials and Methods: In this cross-sectional study, all carbapenem-resistant P. aeruginosa and A. baumannii samples from nine provinces of Iran on a one-year time horizon were gathered. Modified Hedge Test (MHT) and Carba NP-Test were applied to the identification of producing-carbapenemase strains. The most important carbapenemase genes recognized by PCR and gene overexpression of the efflux pump were surveyed by efflux pump inhibitors (EPIs) and confirmed by Real-Time PCR.
Results: Twenty-one percent and 43.5% of P. aeruginosa and A. baumannii isolates were resistant to carbapenem, respectively. MHT and Carba-NP tests identified 21% and 11% carbapenemase-producing strains in these Gram-negative bacteria, respectively. NDM-1 was the most prevalently detected carbapenemase in P. aeruginosa; OXA-51 and OXA-23 were the most significant genes in A. baumannii. EPIs identified active efflux pumps in 20% and 28% of P. aeruginosa and A. baumannii, respectively. Real-time PCR confirmed gene overexpression of efflux pumps in 54% and 30% of positive EPIs in P. aeruginosa and A. baumannii, respectively.
Conclusion: P. aeruginosa and A. baumannii may become multi-drug-resistant (MDR) and Extensively Drug-Resistant (XDR) strains and cause a high rate of mortality and morbidity. Thus, it is of necessity to prohibit the spread of antibiotic-resistant strains in hospitals.- انتشار مقاله: 16-09-1398
- نویسندگان: Leila Azimi,Fatemeh Fallah,Abdollah Karimi,Mehdi Shirdoust,Taher Azimi,Iraj Sedighi Sedighi,Mohammad Rahbar,Shahnaz Armin
- مشاهده
- جایگاه : پژوهشی
- مجله: Iranian Journal of Basic Medical Sciences
- نوع مقاله: Journal Article
- کلمات کلیدی: Iran,Drug resistance,Pseudomonas aeruginosa,Acinetobacter baumannii,Carbapenems
- چکیده:
- چکیده انگلیسی: Objective(s): Pseudomonas aeruginosa and Acinetobacter baumannii resist antibiotics by different intrinsic and acquired mechanisms. This study aims to define various carbapenem-resistant mechanisms of isolated P. aeruginosa and A. baumannii from nine different provinces of Iran.
Materials and Methods: In this cross-sectional study, all carbapenem-resistant P. aeruginosa and A. baumannii samples from nine provinces of Iran on a one-year time horizon were gathered. Modified Hedge Test (MHT) and Carba NP-Test were applied to the identification of producing-carbapenemase strains. The most important carbapenemase genes recognized by PCR and gene overexpression of the efflux pump were surveyed by efflux pump inhibitors (EPIs) and confirmed by Real-Time PCR.
Results: Twenty-one percent and 43.5% of P. aeruginosa and A. baumannii isolates were resistant to carbapenem, respectively. MHT and Carba-NP tests identified 21% and 11% carbapenemase-producing strains in these Gram-negative bacteria, respectively. NDM-1 was the most prevalently detected carbapenemase in P. aeruginosa; OXA-51 and OXA-23 were the most significant genes in A. baumannii. EPIs identified active efflux pumps in 20% and 28% of P. aeruginosa and A. baumannii, respectively. Real-time PCR confirmed gene overexpression of efflux pumps in 54% and 30% of positive EPIs in P. aeruginosa and A. baumannii, respectively.
Conclusion: P. aeruginosa and A. baumannii may become multi-drug-resistant (MDR) and Extensively Drug-Resistant (XDR) strains and cause a high rate of mortality and morbidity. Thus, it is of necessity to prohibit the spread of antibiotic-resistant strains in hospitals.- انتشار مقاله: 16-09-1398
- نویسندگان: Leila Azimi,Fatemeh Fallah,Abdollah Karimi,Mehdi Shirdoust,Taher Azimi,Iraj Sedighi Sedighi,Mohammad Rahbar,Shahnaz Armin
- مشاهده
- جایگاه : پژوهشی
- مجله: International Journal of Advanced Biological and Biomedical Research
- نوع مقاله: Journal Article
- کلمات کلیدی: Iran,Hypersensitivity,Asthma,Wheezing
- چکیده:
- چکیده انگلیسی: Asthma is the most common cause of recurrent wheezing, cough and dyspnea in childhood. Delay in diagnosis and lack of appropriate treatment can cause sustained changes which decrease respiratory capacity of children in future. Therefore, identifying the symptoms relating to asthma is the key for timely diagnosis and treatment of this disease. This study was done to investigate asthma incidence in khomein and compare it to other cities of Iran susceptible to asthma, including Tehran. The present study was a descriptive cross-sectional one based on standard questionnaire of International Study of Asthma and Allergies in Childhood (ISAAC). For conducting this study, 1621 students of first grade in some primary schools and junior high schools of khomein were selected through nonrandom sampling and census and were evaluated during 2015-2016. Both groups were studied and evaluated in terms of being affected by asthma and its severity (current and previous wheezing ,night-time cough, talking limitation due to coughing or wheezing, exercise-induced wheezing, nocturnal awaking due to cough). Results were analyzed through the chi-square test. The asthma diagnosed in Khomein students by the physician during the study was 3.5% while 73.2% of the children under study had at least one asthma symptom. One eighth of the students under study had severe asthma. Comparing with polluted Tehran and northern cities of Iran, Asthma symptoms incidence was higher in khomein where the humidity and industrial pollution is less than in those cities and the asthma cases diagnosed by physicians were much fewer than expected asthma incidence.
- انتشار مقاله: 18-09-1397
- نویسندگان: Babak Abdolkarimi,Javad Javaheri,Iraj Sedighi,Mahshid Garmsiri,Saman Sedighi
- مشاهده