فهرست مطالب زهرا عباسی رنجبر

The high prevalence of undiagnosed diabetes and the high risk for diabetes in the general population is alarming. In addition, the frequency of coronary artery diseases (CAD) in patients with undiagnosed diabetes is higher than in non-diabetic patients. This study aimed to investigate the frequency of people at risk of diabetes in patients undergoing coronary artery angiography (CAG) in a university referral hospital in Guilan Province, Iran.

In this cross-sectional study, data from 300 non-diabetic patients who were candidates for CAG were collected using a simple sampling method. The risk of developing diabetes was calculated according to American Diabetes Association (ADA) risk score. ADA scores higher than five were considered high risk, and ADA scores equal to 4 and lower than 4 were as moderate and low risk, respectively.

The mean age of the study population was 59.44±15.7 years. Most subjects were male (59.3%). Only 24.3% of patients were in the low-risk group while 32% were in moderate risk and 43.7% were in the high-risk group. The frequency of patients with at least two coronary artery involvement was significantly higher in the high-risk group (43.1%) than in the moderate group (34.4%), and the low-risk (22.5%) group.

A high proportion of the patients undergoing CAG were at high risk of developing diabetes. Hence, it seems essential to address cardiometabolic risk factors in coronary artery diseases (CAD) after discharge from the hospital.

Evaluating the quality of educational services in universities is a necessity to move towards excellence. Internal evaluation as the first step of the accreditation process leads to the identification of strengths and weaknesses and correction of processes. The aim of this study was to evaluate the internal residency training course of Guilan University of Medical Sciences, determine the strengths and weaknesses of this department and present the results to the relevant authorities to eliminate the shortcomings.

This descriptive cross-sectional study was performed in the internal department of Guilan University of Medical Sciences in 2022. The statistical population included all faculty members and residents of the internal department of Razi Educational and Medical Center of Guilan University of Medical Sciences (N=76). In this study, the accreditation model based on the standards of the World Federation of Medical Education (WFME) has been used for internal evaluation. Data collection tools were identified for each standard including questionnaire, observation and review of available documents. The designed questionnaires were administered through EPOLL platform after confirming the validity and reliability. Necessary information was also collected from observational data. Data were analyzed using descriptive statistics using SPSS.

The findings of the present study showed that in the domain of mission and goals, residency training program of the internal department of Guilan University of Medical Sciences, was at 67% of the major compliance and 33% of full compliance. In the domain of managerial structure 100% full compliance, in the domain of educational process 55% of full compliance, and 45% of major compliance, in the domain of rules and regulations of the residency course 69% of full compliance and 31% of major compliance, in the domain of evaluation 89% full compliance and 11% of major compliance and in the domain of educational conditions and resources, 62% of full compliance and 38% of major compliance were observed. Overall, out of 52 standards reviewed in the process of internal evaluation of the internal medicine department, 67% were at full compliance and 33% were at major compliance.

Based on the findings of this study, it can be concluded that according to the mission and goals of the internal department, although with all its might has been relatively successful in training internal residents, but also has some shortcomings that by planning and eliminating of the identified deficiencies in this research we can make a qualitative leap in the training of internal residents.

Neuroendocrine dysfunction following traumatic brain injury (TBI) is frequently missed due to the absence of major symptoms and very often, no appropriate management is prescribed, thus delaying the patient recovery. This study is aimed to determine the frequency and pattern of anterior pituitary dysfunction following TBI.

From June to December 2009, overaperiod of seven months, a total of 156 cases were admitted to a trauma center following TBI. Of the seventy patients, (61 males and 9 females mean age 30 years) included in the study, 39 patients had moderate (GCS; 9 – 12) and 31 cases had severe (GCS < 8) TBI. Patients were tested 6 months after injury for possible secretory abnormalities of anterior pituitary hormones. Anterior pituitary secretary function was assessed by measurement of serum levels of FT4, TSH, basal GH, IGF-1, 8 am Cortisol, FSH, LH, total testosterone and prolactin. Dynamic tests of ACTH and glucagon stimulation were used to evaluate the pituitary-adrenal axis and GH secretory status.

Forty-one patients (58.6%) were found to be suffereding from at least one hormonal secretory abnormality, with patterns and frequencies of: Gonadotropins (LH, FSH), 12.9%, corticotropin (ACTH), 12.9%, somatotropin (GH), 4.3%, and prolactin (PRL), 1.4%. There was no case with thyrotropin deficiency. Hyperprolactinemia was found to be present in 23 cases (31.5%).

The results of this study showed that anterior pituitary hormone deficiencies occur frequently, 6 months following traumatic brain injury. The two most commonly involved axes were the pituitary-gonadal and the pituitary-adrenal. Hypocortisolism may be particularly harmful for the patient's health.