Evaluation of Educational Environment for Medical Students of a Tertiary Pediatric Hospital in Tehran,Using DREEM Questionnaire

Background:

Tertiary pediatric hospitals usually provide excellent clinical services, but such centers have a lot to do for educational perfection.

Objectives:

This study was performed to address under-graduate educational deficits and find feasible solutions.

Patients and Methods:

This cross-sectional study was done in a target population of 77 sixth year undergraduate medical students (response rate = 78%) who spent their 3-month pediatric rotation in the Children’s Medical Center, the Pediatrics Center of Excellence in Tehran, Iran. The Dundee ready educational environment measure (DREEM) instrument was used for assessing educational environment of this subspecialized pediatric hospital.

Results:

Among 60 students who answered the questionnaires, 24 were male (40%). Participants’ age ranged from 23 to 24 years. The mean total score was 95.8 (48%). Comparison of scores based on students’ knowledge showed no significant difference. Problematic areas were learning, academic self-perception, and social self-perception.

Conclusions:

Having an accurate schedule to train general practitioner, using new teaching methods, and providing a non-stressful atmosphere were suggested solutions.     

CD4⁺Foxp3⁺ Treg and its ICOS⁺ Subsets in Patients with Myocardial Infarction

Background: Atherosclerosis is a multifactorial disorder with chronic inflammatory conditions in which immune cells play a significant role in its pathogenic process. Regulatory T cells (Treg), as a part of immune system, are involved in controlling auto-immune and inflammatory diseases. Tregs have been shown to play an atheroprotective role and may also promote plaque stabilization. Objective: To assess if inducible costimulatory molecule (ICOS) expression on one subtype of Treg cells with high suppressive potential correlates with the pathogenesis of atherosclerosis. Methods: Patients with myocardial infarction (MI) and/or stable angina (SA), diagnosed as atherosclerosis by angiography, and a group of individuals with normal coronary angiography (NCA) were recruited for the present study. Peripheral blood mononuclear cells (PBMCs) were prepared and the expression of ICOS, Foxp3 and CD4 molecules was tested by flowcytometry. Results: The percentage of CD4+Foxp3+ Treg cells was reduced in MI group compared to NCA and SA groups (p<0.005). Evaluation of the two Treg subsets according to ICOS expression showed a decreased ICOS+/ICOS- Treg ratio in MI and SA groups compared to NCA individuals (p=0.002 and p=0.048, respectively). Conclusion: The present data indicate that Tregs and its ICOS+ subsets are decreased in patients with MI or SA, suggesting a potential role for Treg in atherosclerosis progression or onset of acute coronary syndrome.     

A novel TNFRSF1A gene mutation in a patient with tumor necrosis factor receptor-associated periodic syndrome

Tumor necrosis factor receptor-associated periodic syndrome (TRAPS) is a periodic fever syndrome inherited in an autosomal dominant fashion. It stems from mutations in the TNFRSF1A (accession number: NM_001065) gene expressing the receptor for tumor necrosis factor α. A patient with TRAPS may present with prolonged episodes of fever attacks, abdominal pain, severe myalgia, and painful erythema on the trunk or extremities. Here, we report an 8-year-old boy with febrile attacks occurring every 1–2 months and continuing for 3–4 days. The patient experienced 40 °C-fever attacks without chills. Approximately 80% of fever attacks were accompanied by abdominal manifestations. Direct sequencing analysis was used to assess the genomic DNA of the patient, and a heterozygous R426L mutation in exon 10 of the TNFRSF1A gene in an autosomal dominant inheritance fashion was identified. Further genetic analyses were also carried out on his parents. Due to the fact that the mutation was not inherited from the parents, it was likely that R426L was a de novo and novel mutation in the TNFRSF1A gene, which can trigger TRAPS or TRAPS-like symptoms.     

The Effect of Licorice Protein Fractions on Proliferation and Apoptosis of Gastrointestinal Cancer Cell Lines

Background: Several methods for the treatment of colon cancer have been introduced, but none of them are safe and effective. We planned to evaluate the inhibitory effect of protein extract of licorice root on HT-29 and CT26 cell lines proliferation and apoptosis. Methods: Protein extract of licorice root was prepared in phosphate-buffered solution, and SDS-PAGE was used to isolate its fractions. HT-29, CT-26, and HEK293 cell lines were treated with various concentrations of the fractions and full extract of licorice. Cytotoxicity of licorice at various concentrations was assessed using MTT assay. Flow cytometry analysis was applied to evaluate the apoptosis. Results: Our results demonstrated that the concentrations of 5 μg/mL from 25 to 33 kDa fraction and concentration of 8 μg/mL from 62 kDa fraction had a significant inhibitory effect on both cancerous cell lines (P < 0.05), with no significant effect on the noncancerous cell line. The concentrations of 50 and 100 μg/mL from full extracts significantly increased apoptosis in CT26 cells [35.52 ± 7.5 (P = 0.048*) and 47.72 ± 8 (P 0.026*), respectively], but not in HT29 and noncancerous cell lines. Conclusions: Protein compounds of licorice showed anticancer properties and were able to induce apoptosis in both human colon cancer and mouse colon carcinoma cell lines.