A Case Based-Shared Teaching Approach in Undergraduate Medical Curriculum: A Way for Integration in Basic and Clinical Sciences.

To present a multiple-instructor, active-learning strategy in the undergraduate medical curriculum. This educational research is a descriptive one. Shared teaching sessions, were designed for undergraduate medical students in six organ-system based courses. Sessions that involved in-class discussions of integrated clinical cases were designed implemented and moderated by at least 3 faculties (clinicians and basic scientists). The participants in this study include the basic sciences medical students of The Tehran University of Medical Sciences. Students' reactions were assessed using an immediate post-session evaluation form on a 5-point Likert scale. Six two-hour sessions for 2 cohorts of students, 2013 and 2014 medical students during their two first years of study were implemented from April 2014 to March 2015. 17 faculty members participated in the program, 21 cases were designed, and participation average was 60 % at 6 sessions. Students were highly appreciative of this strategy. The majority of students in each course strongly agreed that this learning practice positively contributed to their learning (78%) and provided better understanding and application of the material learned in an integrated classroom course (74%). They believed that the sessions affected their view about medicine (73%), and should be continued in future courses (80%). The percentage demonstrates the average of all courses. The program helped the students learn how to apply basic sciences concepts to clinical medicine. Evaluation of the program indicated that students found the sessions beneficial to their learning.

Traffic noise exposure increases gastric acid secretion in rat.

Noise is considered as one of the most severe sources of environmental and work place constraints. Noise effects on immune function, hormonal levels, cardiovascular and respiratory systems are well known. The aim of the study is to evaluate the effects of traffic noise on basal and stimulated gastric acid secretion. 48 healthy rats were divided into five traffic noise exposures (1, 7, 14, 21, 28 days) and a control groups. Pentagastrin was used i.p. for stimulation of gastric acid secretion. The gastric contents were collected by the wash-out technique and then titrated. Histological studies were performed on gastric epithelial layer. In the 1, 7, 14 and 21 days traffic noise exposure, basal and pentagastrin-stimulated gastric acid secretion increased compared to the control group (P<0.001), but a significant decrease was seen in hyperacidity in 28th days, in the both basal and stimulated states (P<0.05). Histological study showed that mucosal layer thickness of stomach increased, while the number of oxyntic glands and cell nuclei decreased. It seems that 1,7,14 and 21 days traffic noise increase gastric acid secretion, while 28 days traffic noise can induce adaptation.

The effect of insulin-dependent diabetes mellitus on basal and distention-induced acid and pepsin secretion in rat.

BACKGROUND: Diabetes mellitus is one of the most common endocrine diseases and affects most body organs. It affects gastric acid secretion, but this effect has not been fully understood. As the effects of diabetes on gastric pepsin secretion has not been proved yet, in this experimental study basal and distension-stimulated acid and pepsin secretions of diabetic and non-diabetic rats have been compared. MATERIAL AND METHODS: Female N-Mari rats weighing 200-250 g were used. Diabetic state was induced by intraperitoneal injection of 75 mg/kg streptozotocin. Animals were anaesthetized by the interaperitoneal injection of 60 mg/kg thiopental sodium. Then tracheostomy and laparotomy were done and gastric secretions were collected by a cannula entered via duodenum. Gastric distention induce by 1.5 ml normal saline per each 100g of body weight in stomach. Acid and pepsin were measured by titration and Anson's method, respectively. RESULTS: Basal gastric secretions were similar in diabetic and non-diabetic animals. Distention-stimulated acid secretions in diabetic and non-diabetic rats were 3.24 +/- 0.16 and 8.05 +/- 0.21 micromol/15 min, respectively, which were significantly different (P = 0.00001). Distention-induced pepsin secretion in diabetic and non diabetic rats were 3.16 +/- 0.13 and 5.24 +/- 0.16 microg/15min, respectively, which were significantly different (P = 0.00001). CONCLUSION: In this study the stomach of diabetic animals showed less reaction to distention, which may be due to the reduction of acid and pepsin secretary cells, reduction of the function of the cells, gastric atrophy or gastric vagus neuropathy. These probabilities need to be examined.