Objective Coronary artery disease associated with an increment with a variety of markers, one of them Cystatin C, in this study we evaluate its role in a prospective study as prognostic marker, and evaluate the correlation between Cystatin C plasma level and variety of acute coronary syndrome (ACS) complications. Methods A total 51 patients who admitted for Merjan Teaching Hospital coronary care unit whom ACS was diagnosis was made depend on history, clinical examination and investigation, and then blood sample was taken to measure plasma level and follow up for 6 months of any new events including new ischemia, rehospitalization, electrical and mechanical complication. Results Patient who admitted with ACS with high level of cystatin C associated with more mortality (P value: 0.09) and more electrical complication (P value: 0.035) and more rehospitalization (P value: 0.01), but failed to show a correlation with mechanical complication. Conclusion Elevated level of Cystatin C in patient admitted to hospital with ACS associated with an increase in hospital mortality, electrical complication, and rehospitalization and lower ejection fraction than a patient with a normal Cystatin C level.
Background & Objectives: In this paper, we try to define learning, to describe how retention of memorized material can be improved and to describe how to help students improve clinical reasoning and problem solving skills. The goal of teaching is to improve learning, but how do we know that students are learning in the proper way? Methods: We depend on our experience in medical and clinical teaching of our undergraduate and postgraduate students during implementation of the curriculum. We interview 1 st year (preclinical) and 6 th year medical students by certain questionnaires (VARK) in order to know their learning methods and their knowledge about the styles of learning and the techniques of learning. Learning is viewed here as developing a way of thinking and acting that is a characteristic of an expert physician. Such a way of thinking consists of three important elements: We utilize Working Memory in 3 main approaches: First, attention in a way through questions, focus attention and uses of first letter of statement of the word; Second, rule of 7 (Teach < 7 steps); Third, concentration on important relevant materials. We have to keep in our mind that even if we remember something, it doesn't mean we understand it. In addition, the case learning approach & problem solving learning approach are the methods used and we try to be cooperative, active, and experimental and the student must be self directed and the students should be competent in his learning methods, most are confident of their ability. Results: Most of the first year students have poor knowledge in regards to style & learning techniques. For final year students around 30% learn two styles and 20% trimodel, especially more in female students, 10% mention single model in their learning and the remaining learn by Quad modals. In conclusion, learning how to learn must be a standard part of the curriculum in medical school, and student must be aware of that.
Ammar A., a 23-year-old male patient, who lives in Babylon, Haswa District, and his mother describes symptoms of growth retardation, skin changes, hair changes early graying and alopecia. These manifestation started early during his childhood period. There is canseguanity between the patient's mother & father also one of the patient's sister has similar illness and one male brother died few months following his birth. We admit the patient to hospital due acute pulmonary infection in Jan 2009, which is controlled after a course of antibiotic and after 5 months he develops generalised mucocuteneous bullous eruption which shows partial response to oral prednisolone 2 mg/Kg. The patient has normal IQ and he is in the secondary school and he has normal blood picture and the only abnormal biochemical abnormalities is mild hyperlipidemia Serum cholestrol of 5.8 mmol/L and Serum Triglyceride of 260 mg/dl. Ammar's Sister Qawthar A., who has a similar phenotypic manifestations, presented skin vitiligo and hepatosplenomegaly associated with sever anemia and jaundice and her presentation suggestive of autoimmune haemolytic anemia improved following blood transfusion, corticosteroid and azothioprim. In February 2014 Ammer presented with multiple and diffuse cuteneous ecchymymosis with markedly prolonged PTT and slightly proloned bleeding time highly consistent with acquired Von Willebrand's disease. In conclusion premature aging is a predisposing factor for disturbed immunity and development of autoimmune diseases.
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