Attitude and Knowledge of Medical Students of Tabriz University of Medical Sciences Regarding Organ Donation.

BACKGROUND: The shortage of organ donation is the key rate-limiting factor for organ transplantation in Iran. Many strategies have been proposed to increase donation; one strategy aims to improve awareness of organ donation and transplantation among medical students. Medical students may play an important role in the acceptance of organ donation in the population. This requires both a positive attitude and an appropriate knowledge about the concept of organ donation and transplantation. The objective of this study was to determine the knowledge and attitude of the medical students of the largest medical university in northwestern Iran. METHODS: Four hundred medical students in the 5th and 6th years of their education were enrolled in this study. They completed a self-administered 3-section questionnaire. Section 1 gathered demographic characteristics, section 2 covered attitude, and section 3 assessed knowledge regarding organ donation. RESULTS: The concept of brain death and criteria involved in organ transplant was understood by 57% of the students. Most of the students thought that there is a need to increase awareness regarding brain death and organ donation transplantation (ODT). Eighty-five percent of the students said that they would donate their organs, but 15% did not, most likely because of religion and body disfigurement. Seventy-eight percent of students would donate their organs to their family, relatives, or friends. Sixty-four percent thought that the family can decide regarding ODT. Seventy percent were willing to donate the organs of their family members after brain death. Religion and source of information regarding ODT has a significant effect on knowledge and attitude of students. CONCLUSIONS: Students had a high level of attitude, but a low level of basic understanding about organ donation that lacked detailed knowledge. They accept its importance and desire further teaching to supplement their current knowledge to be able to understand the issues related to organ donation. The results of this study supported a greater emphasis on revising the curricula in medical schools to improve the knowledge of future health care workers. This strategy may be part of the solution to the chronic shortage of donor organs for transplantation.

Assessment of Attitude and Knowledge of Personnel in the Intensive Care Unit of Tabriz University of Medical Sciences Hospitals Toward Organ Donation.

BACKGROUND: The increasing gap between organ supply and demand remains a worldwide problem and can be attributed to several reasons. Because health care workers play an important role in management of brain dead patients, we performed a survey to evaluate the attitude and knowledge of personnel in the intensive care unit (ICU) at Tabriz University of Medical Sciences hospitals toward organ donation. MATERIALS AND METHODS: This cross-sectional study was included personnel from 8 university affiliated ICUs in Northwest of Iran from May to July 2014. The questionnaire included parts of demographic data and socioeconomic situations as well as status of knowledge and attitude of personnel regarding organ donation. RESULTS: Gender, age, marital status, and type of department in which personnel work did not affect attitude toward organ donation. The most common reasons for disagreement for organ donation were religious considerations, fear of surgery, and body mutilation. Nurses have a better acceptance rate than assistants and nonmedical personnel. CONCLUSIONS: Increasing the knowledge of health care workers in ICUs has strong impact on transplantation rate. The most important thing that should be clarified for this group is the concept of brain death to achieve a multidisciplinary team that believes in organ donation and transplantation.

Reliability of calcium-binding protein S100B measurement toward optimization of hyperosmolal therapy in traumatic brain injury.

BACKGROUND: Osmotherapy is a cornerstone for the management of severe Traumatic Brain Injury (TBI). Hypertonic saline (HTS) has advantages as being preferred osmotic agent, but there is inadequte knowledge regarding dose and its saftey in comparison to mannitol. S100B, as a specific neuroinflammatory biomarker in TBI might be a reliable therapeutic index following osmotic therapy. AIM: To compare both administration ways of HTS 5% (bolus and infusion) with mannitol upon S100B as a therapeutic tool for monitoring treatment in TBI patients. METHOD: Adult patients wih modrate to severe TBI were recruited and have randomly received one of the three protocols: 125 cc of HTS 5% every 6 hrs (N: 11) as bolus; 500 cc of HTS 5% (N: 12) as infusion for 24 hrs; or 1 g/kg mannitol of 20% (N: 10) as a bolus, repeated with a dose of 0.25-0.5 g/kg every 6 hrs based on patient's response for 3 days. Serum S100B, blood pressure, serum sodium and osmolality and Glascow coma score (GCS) were measured at baseline and daily for 3 days. RESULTS: Initial serum S100B level in TBI patients was higher than control group (p < 0.0001). Levels of measured S100B have decreased for all treatment groups, but reduction wasn't significantly after hyperosmolal therapy. GCS level increased significantly in infusion group (p = 0.002) and there were negative and significant correlation between serum S100B level and GCS level in some days. Mean arterial pressure increased significantly in HTS groups (bolus: p = 0.002, infusion < 0.0001). CONCLUSIONS: S100B is closely related to the pathophysiological mechanism in TBI and may be useful as a therapeutic tool for treatment monitoring in TBI patients HTS is a safe and effective osmotic agent in TBI setting.  

Examination of Setarud (IMOD™) in the management of patients with severe sepsis.

BACKGROUND AND THE PURPOSE OF THE STUDY: Analysis of current immunomodulating strategies indicates that monovalent approaches are unlikely to restore immunostasis or achieve complete therapy of sepsis. Setarud (IMOD) as a mixture of urtica, carotenoids, urea, and selenium has been recently patented for its potential in reduction of Tumor Necrosis Factor alpha (TNF-α) and Interferon-γ and Interleukin-2 levels. The aim of this study was to examine efficacy of IMOD in the management of patients with severe sepsis. METHODS: Twenty patients with severe sepsis and acute physiology and chronic health evaluation (APACHE) score of more than 20 were randomized to receive standard treatment of severe sepsis (control group) or standard treatment plus IMOD (IMOD group). The group treated with IMOD for 14 days was according to the pilot study and regarding the stability of patient's conditions in the ICU. Of course patients in both groups received standard treatment and all were monitored for 28 days. Blood samples were analyzed for interleukins (IL-1, IL-2, IL-6), plasminogen activator inhibitor (PAI-1), TNF-α, total thiol molecules (TTM), nitric oxide (NO), total antioxidant power (TAP), and lipid peroxidation (LPO). Daily APACHE, Sequential Organ Failure Assessment (SOFA), and Simplified Acute Physiology Score (SAPS) were calculated. RESULTS AND MAJOR CONCLUSION: Comparing with controls, IMOD was significantly effective in improving SAPS, SOFA, and APACHE scores, and reduction of mortality rate. Among tested inflammatory biomarkers, IMOD significantly improved TTM and TNF-α values. It is concluded that IMOD might be added as a safe adjutant to standard treatment of severe sepsis.