Are Asian international medical students just rote learners?

A wide variety of countries are seeking to attract international medical students. This could be due to the fact that their universities not only receive the economic benefit from these students, but also because they recognise the issues of cultural diversity and pedagogical practice. This review paper draws on literature to understand more fully the learning process of Asian international students. Whereas views on learning are different across cultures, medical school teachers must understand how Asian international students learn based on their culture. Two general themes emerged from the literature review: firstly culture’s influence on learning and secondly memorisation versus understanding, both of which relate to the learning process of Asian international students. This study shows that Asian international students have a different approach to learning, which is not just about rote learning. Changes in attitudes towards Asian international students may stimulate the internationalisation of a more culturally sensitive form of medical education. The paper suggests further work on the area of appreciative thinking in order to identify the epistemological and ontological dimensions for a flexible approach to learning.     

<Emphasis Type="Italic">Iranian johnsongrass mosaic virus</Emphasis>: the complete genome sequence,molecular and biological characterization,and comparison of coat protein gene sequences

Iranian johnsongrass mosaic virus (IJMV) is one of the most prevalent viruses causing maize mosaic disease in Iran. An IJMV isolate, Maz-Bah, was obtained from the maize showing mosaic symptoms in Mazandaran, north of Iran. The complete genomic sequence of Maz-Bah is 9544 nucleotides, excluding the poly(A) tail. It contains one single open reading frame of 9165 nucleotides and encodes a large polyprotein of 3054 amino acids, flanked by a 5′-untranslated region (UTR) of 143 nucleotides and a 3′-UTR of 236 nucleotides. The entire genomic sequence of Maz-Bah isolate shares identities of 84.9 and 94.2 % with the IJMV (Shz) isolate, the lone complete genome sequence available in the GenBank at the nucleotide (nt) and deduced amino acid (aa) levels, respectively. The whole genome sequences share identities of 51.5–69.8 and 44.9–74.3 % with those of other Sugarcane mosaic virus (SCMV) subgroup potyviruses at nt and aa levels, respectively. In phylogenetic trees based on the multiple alignments of the entire nt and aa sequences, IJMV isolates formed a separate sublineage of the tree with potyviruses infecting monocotyledons of cereals, indicating that IJMV is a member of SCMV subgroup of potyviruses. IJMV is most closely related to Sorghum mosaic virus and Maize dwarf mosaic virus and less closely related to the Johnsongrass mosaic virus and Cocksfoot streak virus. To further investigate the genetic relationship of IJMV, 9 other isolates from different hosts were cloned and sequenced. The identity of IJMV CP nt and aa sequences of 11 Iranian isolates ranged from 86.4 to 99.8 % and 90.5 to 99.7 %, respectively, indicating a high nt variability in CP gene. Furthermore, in the CP-based phylogenetic tree, IJMV isolates were clustered together with a maize potyvirus described as Zea mosaic virus from Israel (with 86–89 % nt identity), indicating that both isolates probably are the strains of the same virus.     

Expression of recombinant parvalbumin from wolf-herring fish and determination of its IgE-binding capability

In this study, we produced the recombinant form of parvalbumin from wolf-herring fish and determined its IgE reactivity. Parvalbumin cDNA was sub-cloned into pET28 and expressed in Escherichia coli BL-21. The immunoreactivities of the recombinant and native parvalbumins were compared, and the effect of calcium binding was determined by sera from 25 fish-allergic patients. ELISA and Western blotting confirmed similar IgE-reactivities of the recombinant and native proteins and confirmed that this phenomenon is highly dependent on calcium binding. The recombinant protein was 94.5% similar to carp parvalbumin (Cyp c1). Approximately 72% of patients reacted strongly with recombinant parvalbumin, 80% of them reacted with the native form and only 56% showed IgE reactivity with crude extract. Because the IgE-binding capacity of recombinant wolf-herring parvalbumin is retained and is highly similar to Cyp c1, the wild and hypoallergenic forms of this allergen could be used for diagnosis and immunotherapy of fish allergy, respectively.     

Vaccine-associated paralytic poliomyelitis in a patient with MHC class II deficiency.

Vaccine-associated paralytic poliomyelitis (VAPP) is a rare complication of oral polio vaccine. We describe a fatal case of VAPP in an 8-month-old boy with Major Histocompatibility Class II deficiency. The isolated poliovirus was a Sabin type 2-type 1 recombinant that showed 1.4% VP1 divergence from Sabin type 2.     

Survey of sarcocystis infection in slaughtered sheep in Kerman Abattoir, Kerman, Iran

Sarcocystosis caused by different Sarcocystis species and is a zoonotic protozoan infection with worldwide distribution in man and many animal species. In the present study, three techniques — direct inspection, impression smears and digestion method — were used for the diagnosis of Sarcocystis infection in 112 slaughtered sheep in a Kerman abattoir from November 2010 to May 2011. A total of 450 slaughtered sheep were selected randomly during three seasons, and their oesophagus and diaphragm were inspected using naked eye examination. In the second stage, 112 carcasses out of the 450 which had no apparent infection were selected randomly and their meat investigated using two techniques: impression smear with staining and pepsin digestion. The percentage of macroscopic cysts found in the oesophagus and diaphragm muscle was 6% and 2.88%, respectively, and microscopically, infection was found in 100% of the organs. There was no significant difference between different ages or between males and females. Although all of the sheep were found to be infected with Sarcocystis, majority of the cysts were demonstrated microscopically. This suggests that meat should be cooked sufficiently, since a macroscopic inspection may not provide true results.     

Detection of malaria infection in blood transfusion: a comparative study among real-time PCR, rapid diagnostic test and microscopy: sensitivity of Malaria detection methods in blood transfusion

The transmission of malaria by blood transfusion was one of the first transfusion-transmitted infections recorded in the world. Transfusion-transmitted malaria may lead to serious problems because infection with Plasmodium falciparum may cause rapidly fatal death. This study aimed to compare real-time polymerase chain reaction (real-time PCR) with rapid diagnostic test (RDT) and light microscopy for the detection of Plasmodium spp. in blood transfusion, both in endemic and non-endemic areas of malaria disease in Iran. Two sets of 50 blood samples were randomly collected. One set was taken from blood samples donated in blood bank of Bandar Abbas, a city located in a malarious-endemic area, and the other set from Tehran, a non-endemic one. Light microscopic examination on both thin and thick smears, RDTs, and real-time PCR were performed on the blood samples and the results were compared. Thin and thick light microscopic examinations of all samples as well as RDT results were negative for Plasmodium spp. Two blood samples from endemic area were positive only with real-time PCR. It seems that real-time PCR as a highly sensitive method can be helpful for the confirmation of malaria infection in different units of blood transfusion organization especially in malaria-endemic areas where the majority of donors may be potentially infected with malaria parasites.     

11C-methionine PET/CT in 99mTc-sestamibi-negative hyperparathyroidism in patients with renal failure on chronic haemodialysis

Purpose Scintigraphic localisation of parathyroid glands is often unsuccessful in patients with renal failure on chronic haemodialysis who have secondary hyperparathyroidism (HPT). The purpose of this study was to investigate the use of ¹¹C-methionine PET/CT to detect hyperfunctioning parathyroid glands in patients with renal failure on chronic haemodialysis who had ^99mTc-sestamibi-negative HPT. Methods ¹¹C-methionine PET/CT was performed in 18 patients (11 women and 7 men, aged 42–79 years; mean age 57.8 years) on haemodialysis for renal failure (2–14 years’ duration), with normo-, hypo- or hypercalcaemia and HPT not localised by either dual-tracer ^99mTc-pertechnetate/^99mTc-sestamibi subtraction scans or dual-phase ^99mTc-sestamibi scans. Results In three of ten patients with normo- or hypocalcaemic HPT there was increased ¹¹C-methionine accumulation in one gland. Seven of eight patients with hypercalcaemic HPT showed increased uptake: in five of these patients increased ¹¹C-methionine accumulation was present in one gland, while in two it was demonstrated in two glands. All patients also had high-resolution ultrasound of the neck and were treated with subtotal parathyroidectomy, leaving a remnant of the smallest of the four glands. Regardless of their size, all glands with abnormal ¹¹C-methionine parathyroid uptake were removed, and all demonstrated parathyroid hyperplasia. All patients developed post-parathyroidectomy hypoparathyroidism and one patient with normocalcaemic HPT relapsed 8 months after surgery. Conclusion These data suggest that ¹¹C-methionine PET/CT may be used to identify hyperfunctioning parathyroid glands in non-primary HPT, and especially hypercalcaemic HPT, when conventional ^99mTc-sestamibi imaging is non-localising.     

The therapeutic effect of cerium oxide nanoparticle on ischaemia/reperfusion injury in rat testis

Testicular torsion is a dangerous urogenital disorder which is caused by twisting of spermatic cord, and unless immediate treatments happen at a proper time, oxidative stress, occurred during ischaemia reperfusion, finally leads to irreversible disintegration of testicular tissue. One of the first preventive lines is to administrate antioxidant factors. In the present study, we investigate the therapeutic effect of cerium oxide nanoparticle on the injury. We divided 45 rats into nine groups, subjected eight groups to testicular torsion–detorsion, injected different doses of cerium oxide nanoparticle into the peritoneum of six groups and analysed all the groups regarding spermatogenetic indices including sperm count, sperm viability and Johnson mean. Our results showed that cerium oxide nanoparticle can alleviate oxidative stress in testis, and this alleviation promotes the reproductive indices as the concentration of cerium oxide nanoparticles increases. The catalase-mimetic and superoxide dismutase-mimetic activities of cerium oxide nanoparticle are the most probable theories to explain the antioxidant effect of the nanoparticle.     

Prevalence of hepatitis C virus infection and related risk factors among Iranian haemodialysis patients

Hepatitis C virus (HCV) infection is common among patients undergoing haemodialysis, and liver disease is an important cause of morbidity and mortality in this population. Management of HCV-related liver disease is a major health concern in patients with end-stage renal disease (ESRD) undergoing haemodialysis. To investigate the prevalence of HCV infection in patients on haemodialysis and its associated risk factors, we conducted a prospective case series study of 838 patients on haemodialysis in Tehran, Iran. Patients were selected randomly (cluster sampling) and all were screened for anti-HCV antibodies, using ELISA 3rd generation and confirmed by using RIBA 2nd generation. We found that 111 patients (13.2%) were infected. By applying univariate analysis, longer duration on haemodialysis (P = 0.000), more weekly dialysis sessions (P = 0.03), history of blood transfusion (P = 0.03) and history of previous renal transplantation (P = 0.01) were found to be associated with a higher rate of HCV infection. Multivariate analysis revealed that only length of time on dialysis (P = 0.000) and history of blood transfusion (P = 0.02) were significantly associated with HCV infection. The more the units transfused, the higher the rate of HCV infection. Our results suggest that early transplantation and avoidance of blood transfusion, as much as possible, are the two most important practical interventions to reduce the HCV exposure rate in our patients on haemodialysis.     

Traumatic hyoid bone fracture �C a case report and review of the literature

Objective:

To present a case of traumatic hyoid bone fracture and a review of the literature

Rationale:

Traumatic hyoid bone fractures are rare, however with the increasing popularity of martial arts the incidence of traumatic hyoid bone fracture may increase in prevalence.

Clinical Features:

A thirteen year old taekwondo athlete collapsed after receiving a kick to the anterior neck. Following first aid emergency care the athlete reported pain with speaking and swallowing and was suffering from dyspnea. Ecchymosis and tenderness were noted over the hyoid bone.

Intervention and Outcome:

Lateral radiographs revealed fracture of the hyoid. Patient was sent home with analgesics and instructed to rest. The athlete was cleared for sport at 4 weeks post injury.

Conclusion:

Ensuring airway integrity and screening for signs of laryngeal laceration are essential in the management of suspected hyoid bone fractures. Observation for 48–72 hours is highly recommended.