Teaching nutrition to medical students: a community-based problem-solving approach

This paper presents a community-based problem-solving educational programme which aims at teaching medical and other health science students the importance of nutrition and its application. Through community surveys students assess the nutritional status of children under five using different anthropometric methods. They understand the cultural beliefs and customs related to food fads and the reasons for them. They also acquire the skill to educate the community using the information gathered. They use epidemiological methods such as case control study to find associations between malnutrition and other causative factors. Feedback from students has been positive and evaluation of students' knowledge before and after the programme has shown significant improvement.     

Salivary parameters and efficiency of dietary instructions to reduce sugar intake among 7–8-year-old schoolchildren

Abstract — The efficiency of dietary instructions was tested in a group of 7–8-yr-old schoolchildren. The instructions were given in the presence of the child's mother either verbally (control group n = 14) or both verbally and written (test group n = 12). For this purpose the salivary status of the first grade pupils ( n = 79) of a primary school in Turku was screened. Salivary flow, buffer capacity, sucrase activity, lactobacillus, yeast and S. mutans counts were determined. Children whose salivary lactobacillus count was over 10⁴ CFU/ml ( n = 32) were selected for the present study. The efficiency of the dietary instructions was measured as a reduction of salivary lactobacilli. There were no differences in the number of children with reduced LB counts or in the caries increment of 1 yr between the test and the control groups. However, children who succeeded in reducing the number of salivary lactobacilli (42%) within 4 wk revealed a significantly ( P <0.05) lower caries increment after 1 yr than the rest of the subjects. We concluded that children whose lactobacillus counts were reduced by the dietary instructions developed significantly less caries than children whose lactobacillus counts remained high after the instruction. No additional effect on lactobacillus counts and caries increment could be demonstrated by supplementing the verbal dietary counseling with written instructions.     

Frequency and Clinical Manifestations of Patients with Primary Immunodeficiency Disorders in Iran: Update from the Iranian Primary Immunodeficiency Registry

Primary immunodeficiency disorders (PID) are a heterogeneous group of diseases, characterized by an increased susceptibility to infections. A total of 930 patients (573 males and 357 females) are registered in Iranian PID Registry (IPIDR) during three decades. Predominantly antibody deficiencies were the most common (38.4%), followed by congenital defects of phagocyte number and/or function (28.3%), other well-defined immunodeficiency syndromes (17.7%), combined T- and B-cell immunodeficiencies (11.0%), complement deficiencies (2.4%), and diseases of immune dysregulation (2.3%). Common variable immunodeficiency was the most frequent disorder (20.8%), followed by chronic granulomatous disease, ataxia-telangiectasia, btk deficiency, selective IgA deficiency, and T-B-severe combined immunodeficiency. The frequency of other PID disorders was less than 50 in number (<5%). There is an increasing trend in recognition of more PID in the recent years. Construction of such registry is not only important for its epidemiological aspect but also for its role in increasing the physician's knowledge about such disorders.     

Significant Reduction of Atrial Defibrillation Threshold and Inducibility by Catheter Ablation of Atrial Fibrillation

Background: Radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF) has antiarrhythmic effects by multiple mechanisms. We hypothesized that RFCA curtails atrial defibrillation threshold (A‐DFT) and postablation induction pacing cycle length (iPCL), making critical mass reduction one potential mechanism by which antiarrhythmic effect is achieved. Methods: We included 289 patients with AF (male 77.9%, 55.7 ± 10.8 years old; 197 paroxysmal AF: 92 persistent AF) who underwent RFCA. A‐DFT (serial internal cardioversion 2, 3, 5, 7, and 10 J) and iPCL (serial 10 mA 10‐second atrial pacing with pacing cycle length 250, 200, 190, 180, 170, 160, and 150 ms) were evaluated before and after RFCA. Results: (1) RFCA of AF reduced the A‐DFT from 6.7 ± 3.7 J to 3.0 ± 3.0 J (P < 0.001). (2) AF ablation reduced AF inducibility from 95.4% before the procedure to 56.3% after the procedure (P < 0.001), and the iPCL from 194.8 ± 32.6 to 160.9 ± 26.2 ms (P < 0.001). (3) In patients who underwent a greater number of ablation lines, the post‐RFCA A‐DFT (P < 0.001) was lower, and %ΔA‐DFT (P = 0.003) and proportion of atrial tachycardia (P = 0.022) were higher than those with a lower number of ablation lines. Conclusion: AF ablation significantly reduced A‐DFT, AF inducibility, and iPCL, and the degree of their reduction was related to the number of ablation lines. (PACE 2012;35:1428–1435)