farnood rajabzadeh

Educational program evaluation is one of the most important strategies for receiving feedback and can lead to the dynamics of education. The aim of this study was to determine the self-assessment ability of medical students to use what they learned from the radiology internship.

This cross-sectional study was conducted on 64 medical students of Islamic Azad University of Mashhad in 2018-2020. For all the participants, an individual information checklist was completed with the researcher made questionnaire, which was prepared to evaluate the ability to use radiology knowledge, Then the data were entered into SPSS version 25 software and analyzed.

The average score of the questionnaire was 37.37 ± 4.86 and the majority of the participants (87.5%) had a score of more than 30. The score of the radiology internship evaluation questionnaire was 35.37 ± 3.95 for people under 30 years old and 39.79 ± 4.82 for people 30 years and older. Also, the score was 39.78 ± 4.98 in 2018 graduates, 35.67 ± 4.06 in 2019 graduates, and 34.37 ± 2.79 in 2020 graduates. The score of the questionnaire assessing the ability to use the learnings of the radiology internship in people with less than one year of work experience was 33.10 ± 3.29, in people with one to three years of work experience was 37.48 ± 2.97 and 45.1 ± 2.42 in people with more than three years of work experience (p<0.001). There was no significant difference in the score of the questionnaire according to gender and marital status.

According to the results, it can be concluded that the ability of the medical graduates to use what they have learned in the radiology training course is favorable.

Nowadays, improving anxiety, depression, and stress is important in managing non-alcoholic fatty liver (NAFLD). Thus, this study aimed to evaluate eight weeks of pomegranate peel (PP) supplementation on depression, anxiety, and stress scale changes among NAFLD patients.  This randomized clinical trial was conducted on 76 NAFLD patients assigned to the PP (n=39) or placebo (n=37) groups. Participants received the pomegranate peel (1500 mg/day) or placebo for eight weeks. PP capsules were prepared fromdry extract of PP by soaking. A diet with reduced calorie intake and healthy recommendations was given to all participants. The status of NAFLD was checked with two-dimensional elastography. Mental health was evaluated using depression, anxiety, and stress scale, and dietary intake was assessed by 3-day recall before and after the intervention.  The average age of the participants was 43.1±8.6 years, of whom 51.3% were women. In the PP group, weight, liver stiffness, and hepatorenal sonography index changes significantly differed from the placebo group before and after adjusting potential covariates, including weight and physical activity (P< 0.001). Depression and stress scores changed significantly in the PP group during the study before and after adjusting potential covariates (P= 0.002, 0.05, respectively). Anxiety score changes were insignificant between the two groups (P= 0.1).  Based on the results, eight-week supplementation of pomegranate peel ameliorated depression and stress symptoms among NAFLD patients.

Non-alcoholic fatty liver disease (NAFLD) is a serious public health issue. Even though various natural and synthetic therapies are in the advanced stages of development, there is no authorized therapy for NAFLD. The use of anti-oxidant and anti-inflammatory compounds is one of these natural treatments. Portulaca oleracea aerial parts' extracts have shown various pharmacological properties, including antioxidant, anti-inflammatory, and liver protection due to alkaloid compounds, flavonoids, terpenoids, sterols, omega-3 unsaturated fatty acids, and many vitamins and minerals.

We intend to examine the effectiveness of Portulaca oleracea extract in improving the symptoms caused by NAFLD.

A randomized, double-blinded, controlled, parallel clinical trial is designed to study the effects of P. oleracea supplementation on the clinical and paraclinical findings in patients with NAFLD. An intervention group will get 700 mg of P. oleracea supplementation for eight weeks, while a control group will receive a placebo. Throughout the intervention, the clinical and nutritional status will be assessed three times. At the 0, 30, and 60th days of the intervention, anthropometric evaluation, blood pressure, and gastrointestinal problems will be monitored. Transient elastography will be done at the start and end of the research to assess the liver state. In addition, an International Physical Activity Questionnaire (IPAQ) and a 3-day food record will be collected, as well as biochemical variables, such as CBC-diff (complete blood count with differential count), lipid profiles, FBS, Fasting Blood Sugar; serum insulin, hepatic-related parameters, namely enzymes [ALP (alkaline phosphatase), AST (aspartate aminotransferase), ALT (alanine aminotransferase), GGT (gamma-glutamyl transferase)], total and direct bilirubin, and inflammatory [hs-CRP (C-reactive protein), ESR (erythrocyte sedimentation rate) and IL-6 (interleukin-6)] and oxidative stress markers [SOD (super oxide dismutase), GSH-Px (glutathione peroxidase) and MDA (malondialdehyde)].

This is the first randomized clinical trial (RCT) protocol specifically created for patients with NAFLD to evaluate the impact of P. oleracea supplementation. We intend to demonstrate that the suggested procedure is a novel and effective approach to decreasing NAFLD's laboratory and clinical symptoms. We also expect that supplementation with 700 mg of P. oleracea for 60 days will improve liver steatosis and clinical and nutritional status and reduce NAFLD patients' inflammation and oxidative stress.

Psoriasis is a chronic inflammation of the skin-immune system characterized by arterial erythematous plaques. Carotid artery intima measurement can be a tool for early detection of atherosclerosis in the pre-occlusion stage and has clinical signs.Material&

This case-control study was performed on 30 patients with psoriasis and 30 control people aged 20 to 60 years who referred to the dermatology clinic at 22 Bahman Hospital in Mashhad during 2018-2019 , sampling was performed by available method. After explaining the research process and obtaining patients informed concept, data was recorded in the checklist.Radiologist colleague of this study using ultrasound for a Carotid-Intima Media Thickness (CIMT) measurement. In this study of SPSS16 and statistical tests of Anova, Man Whitney, and Pearson were used to analyze the data.

CIMT was found in patients and the control group at 0.059 ± 0.51 and 0.047 ± 0.47 mm, respectively ( p value= 0.010). Pearson correlation coefficient did not report a significant relationship between mean CIMT in patients with age, sex and BMI.

Since CIMT has been reported to be significantly higher in patients with psoriasis, stricter control of other risk factors for atherosclerosis than others and stricter control of inflammation in these individuals are necessary.

Pandemic covid  19 has had a profound effect on health and education systems around the world, and many day-to-day works in teaching hospital settings, including hours and teaching methods, have changed dramatically due to student and physician safety and changing inpatients. And medical education policymakers face many challenges in optimizing the education and evaluation of medical students, and should make more use of alternative methods of online education and training technologies and make fundamental changes to traditional methods of medical education. This section is a review of educational curricula and emphasis on educational minimums, which is important to remove and change or create new teaching methods. Different countries pay attention to the fact that the safety of students and professors is an important and necessary point in educational institutions at this critical stage. These points underscore the importance of greater interdisciplinary collaboration and creativity in training and greater adaptation to change.

Coronavirus disease 2019 (Covid-19) is expanding worldwide. Although it seems to be a purely respiratory disease, occasional reports of lesions in other organs have been published. We report here an asymptomatic child with Covid-19 and with the main symptom of abdominal pain distension and without any respiratory symptoms. A 14-year-old male patient with main complaints of fever, malaise, anorexia, and severe abdominal pain was admitted to a hospital in Mashhad, Iran. Laparotomy revealed distension of the small intestine and an adhesive ileocaecal band that had produced ileum herniation without free fluid in the abdomen. Chest radiography and high-resolution computed tomography of the lungs showed bilateral and diffuse, peripheral dense areas of ground-glass appearance. A nasopharyngeal swab for diagnosis of Covid-19, was ordered due to lymphopenia together with these diffuse lung infiltrations, which showed a positive result. This led to drug treatment with lopinavir/ritonavir, hydroxychloroquine, ribavirin/oseltamivir, and meropenem. The patient was febrile and developed tachycardia on the third day, accompanied by a respiratory rate of 44/min. At this point, tracheal intubation was done, but the patient died after 3 hours due to cardiac arrest. The case report brings forth the hypothesis that the gastrointestinal manifestation may be an atypical symptom of Covid-19 infection and highlights the importance of the diagnosis based on combined laboratory-based data and scanning imagery.

Atherosclerosis is involved in inflammatory diseases, and inflammation can be a valuable predictor of cardiovascular disease. On the other hand, an increase in intima-media thickness (IMT) is usually considered as a primary marker of atherosclerotic lesions. Hence, measurement of IMT may be useful for early detection of atherosclerosis in patients with inflammatory bowel disease (IBD). The aim of this study was to systematically review the literature in which the IMT had been evaluated as diagnostic marker for the detection of atherosclerosis in patients with IBD.
A systematic literature search was performed in PubMed, Scopus, and Google scholar using the following search method ((inflammatory bowel disease OR IBD OR Crohn’s disease OR ulcerative colitis)) AND (intima OR intima media thickness OR intimal medial thickness OR IMT OR carotid intima-media thickness OR CIMT) to evaluate the association between IBD and IMT. After collecting the eligible documents, the desired data were extracted and analyzed.
Of total 278 collected documents, only 14 relevant articles with total 1333 participants including 720 patients with IBD and 613 healthy controls were included for data assessment. The results of the articles did not support significant association between IMT and IBD. However, in some studies it was shown that IMT was elevated in patients with IBD.
The results of this survey showed that there was no significant difference in IMT between the patients with IBD and healthy control groups; therefore, IMT cannot be considered as a predictor of atherosclerosis and future cardiovascular events in patients with IBD.

Chronic hepatitis B infection (CHB) is a major global health problem. Hepatitis B e antigen (HBeAg)-negative is a common type of CHB in Iran. Liver damage in HBeAg-negative CHB leads to progressive form of the liver disease with poor prognosis. Therefore, it seems necessary to perform a comprehensive evaluation of different spectrum of laboratory measurements accompanying histological findings. The aim of this study was to evaluate the association between the biochemical, virologic and histologic features in HBeAg-negative CHB. Furthermore, we assessed the application of new cut-off values for alanine aminotransferase in HBeAg-negative CHB patients.
HBeAg- negative CHB patients referring to hepatology clinics at Ghaem and Imam Reza hospitals during two years period were enrolled. Patients with alcohol consumption, liver mass, fatty liver and whom with positive results of Anti HDV, Anti HCV or Anti HIV were excluded. Liver enzymes were requested and Hepatitis B viral loads were measured by real time polymerase chain reaction (RT-PCR) in all patients. Liver biopsies were assessed by two expert pathologists. The relationship between viral loads, liver enzymes and histopathological features was analyzed using descriptive and analytic statistical methods.
One hundred and fifty HBeAg-negative and HBe Ab-positive CHB patients (males=110, mean age=38.44±11.34 years) were assessed. Serum ALT levels had a significant relation with the logarithm of serum HBV-DNA levels (P In HBeAg-negative CHB patients, serum AST levels had a better predicting value for liver necrosis and inflammation. Moreover, age could be regarded as an independent predictor of the stage of liver fibrosis. This study revealed that the new cutoff values for ALT had superiority over the conventional values to identify patients with a higher risk of liver fibrosis.

There are no data on familial aggregation of colorectal cancer (CRC) in northeastern Iran. The aim of this study was to determine the prevalence of early-onset CRC and patients suspected for hereditary non-polyposis colorectal cancer (HNPCC) based on the clinical criteria in this area.
Documents were collected from two hospitals in Mashhad regarding 326 inpatients during 2013-2015. Demographics, clinical, and tumor-related features were recorded. Interviews were done to identify cancer in the family up to second-degree relatives.
326 patients with CRC (48.5% male) were evaluated. The mean age at diagnosis was 55.44±14.85 years, with 91 patients (27.9%) below 45 years old. Eleven (3.4%) patients fulfilled the Amsterdam II criteria and 136 (41.7%) patients met at least one criterion of the revised Bethesda guideline. There was no difference between early- and late-onset CRC regarding the frequency of CRC in 1st degree relatives or tumor site (p=0.73, p =0.64). However, CRC in second-degree relatives and cases suspected for HNPCC were more common in early-onset of the disease (p =0.022, p =0.024). The patients who fulfilled the Amsterdam II criteria had lower mean age and higher frequency of proximal cancer (p =0.03, p =0.048).
As CRC is common in the young population and CRC clustering and patients suspected for HNPCC are also frequently encountered, measures should be taken to CRC screening policy and genetic studies in this area.

Splenic artery aneurysm (SAA) is a rare and potentially life-threatening clinical entity that carries a risk of rupture and peritoneal hemorrhage. When ruptured, it typically manifests as abdominal pain with hemodynamic instability. This is a report about a 29-year-old male admitted for evaluation of recent-onset ascites following the spontaneous resolution of a transient episode of severe epigastric and left upper quadrant pain with syncope the preceding day. Paracentesis revealed bloody fluid. Abdominal computed tomographic angiography (CTA) and magnetic resonance venography (MRV) showed a three centimeter SAA. During admission, prompt exploratory laparotomy was performed that revealed excessive intraperitoneal hemorrhage due to a ruptured SAA. The pathology report confirmed that the SAA had developed secondary to atherosclerosis. Careful history taking together with appropriate imaging tests and emergent surgical intervention led to a timely diagnosis and the patient''s survival.

A 65-year-old man presented to the emergency department with abdominal pain, abnormal liver function tests (cholestatic pattern), and normocytic anemia. He had been an opium user for 20 years. Clinical and preclinical findings including the bluish discoloration of periodontal tissues, or Burton’s sign, and generalized ileus on abdominal x-ray led us to the possibility of lead poisoning. Lead levels were higher than normal (150 µg/dL). Magnetic resonance cholangiopancreatography (MRCP) and abdominal ultrasound were performed to rule out extra hepatic causes of cholestasis.. To evaluate the possibility of lead-induced hepatotoxicity, a liver biopsy was performed. Histological features of lead-induced hepatotoxity have rarely been described in humans. In this patient, focal canalicular cholestasis and mild portal inflammation were confirmed.. Thus, treatment with ethylenediaminetetraacetic acid (EDTA) and British anti-lewisite (BAL) were initiated and continued for five days. The patient''s liver function tests returned to their normal values, clinical findings including nausea, vomiting, and abdominal pain subsided, and the patient was discharged from the hospital in good condition..