Early clinical exposure program in learning renal physiology

Introduction: Teaching renal physiology for undergraduate medical students in an understandable way using methods which improve their deep learning has always been a problem. In this study, Early Clinical Exposure [ECE] was used in teaching renal physiology for the second year medical students in Shiraz Medical School. This article aims to introduce and develop this program and also measure the attitude of medical students toward ECE in learning renal physiology

Methods: This is a mixed method study conducted on 120 second year undergraduate students. After performing the course, both qualitative and quantitative methods were used for measuring the viewpoints of the students. In the qualitative part, 10 high rank medical students were selected. These students participated in brain storming sessions to express their opinion about the program based on the strengths and weaknesses. For trustworthiness of the qualitative part, member check and peer check were done. In the quantitative part, a researcher-made questionnaire was used based on the objectives of the program in a 4 point Likert scale. The validity of questionnaire was determined by medical education experts and reliability was determined after a pilot study

Results: Based on the results of the quantitative part of the study, 98 percent of the students stated that the ECE program was generally a useful program. In the qualitative part, the students' comments were obtained. The benefits of the program were summarized in 4 main themes. These themes are "understanding of renal physiology", "Integration of basic and clinical knowledge", "Improvement of attitude toward importance of physiology", and "encouragement to study". In response to the questions about negative aspects of this program in qualitative part, the two main themes were insufficient time and large group size

Conclusion: Students reported that ECE was useful, but they stated that they needed to have more encounter with patients and more hospital teaching. The results also reveal that this ECE program is an excellent approach to strengthen learning in a difficult subject like renal physiology. This approach is adjustable to other basic science topics and subjects as well

Colony forming unit endothelial cells do not exhibit telomerase alternative splicing variants and activity

Endothelial progenitor colony forming unit-endothelial cells [CFU-EC] were first believed to be the progenitors of endothelial cells, named endothelial progenitor cells. Further studies revealed that they are monocytes regulating vasculogenesis. The main hindrance of these cells for therapeutic purposes is their low frequency and limited replicative potentials. This study was undertaken to determine telomerase activity and alternative splicing variants in CFU-EC as a potential cause of limited replicative capacity in these cells. CFU-EC were isolated from peripheral blood using a standard cell culture assay. Colonies were detached mechanically and alternative splicing variant mRNA were evaluated using real-time PCR. Telomerase enzyme activity was assessed using telomerase repeat amplification protocol. The same procedures were done on the cancer cell line Calu6 as the positive control. The cultured peripheral blood mononuclear cells formed colonies with spindle-shaped monocytic cells sprouted from the clusters. These morphological characteristics fulfill the definition of CFU-EC. Telomere length amplification protocol assay revealed no telomerase activity and real-time PCR showed no expression of telomerase enzyme mRNA in CFU-EC. Both parameters were significantly higher in the cancer cell line Calu6 taken as the positive control. The absence of telomerase activity in the CFU-EC is a result of pre-transcriptional regulation of gene expression rather than other mechanisms for controlling telomerase activity such as post-transcriptional modifications. This finding can explain the limited proliferative activity of CFU-EC cells. We propose that absence of telomerase activity in CFU-EC can be attributable to their more mature monocytic nature that needs further investigations

Hydatid cyst of ovary: a case report

Echinococcus granulosus is considered the major cause of human hydatid cysts. Usually the duration of cyst formation is 10-20 years. This period shortens significantly upon rupture of a primary cyst. The literature describes low incidence of primary involvement of ovary as a site of hydatid cyst formation. Our case is the first report on ovarian hydatid cyst in Iran. A 60-year-old woman was presented with abdominal pain in the left lower quadrant area. Paraclinical data were suggestive of neoplasia and preoperative diagnosis was ovarian tumor. During laparotomy, multiple cysts resembling hydatid cysts were observed in the left ovary. Pathological examination confirmed the diagnosis of hydatid cyst. Although there is a small possibility of secondary ovarian echinococcal disease, it is more probable for this case to be primary infection, as the patient had developed ovarian hydatid cysts 15 years after hepatic involvement and recurrence after 30 months is very uncommon