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Background: One of the expected competencies of physicians is clinical reasoning. Therefore, diagnostic thinking in medical students is important. The aim of this study was to investigate the effect of diagnostic thinking instructional program on medical students. Method: The research was quasi-experimental. The target group was medical students who spent their internship in the internal department. The sample size for each group was 20 participants. 20 interns in the three-month rotation of autumn 2018 were considered as control and 20 interns entering the department in the winter rotation of the same year were considered as the intervention group. Students were evaluated using Diagnostic Thinking Questionnaire (DTI). Data analysis was done with descriptive and analytical statistics. Results: The two groups did not differ in terms of the number of participants, age, grade point average and mean DTI score in the pre-test (P>0.05). The pre-test scores of two groups in the flexibility of thinking (P=0.09), memory structure (P=0.68), and the total score of diagnostic thinking (P=0.4) were not significantly different. The post-test scores of students in the sections of flexibility of thinking, memory structure, and the total score of diagnostic thinking of both groups did not change significantly compared to the pre-test scores (P>0.05). There was a significant relationship between only the two variables of grade point average and memory structure score in the post-test (r=0.46, P=0.004). Conclusion: The in-class diagnostic thinking instructional program did not affect students' diagnostic thinking in the absence of patients which is probably due to the lack of patient encounters. [ABSTRACT FROM AUTHOR]

Background: The adverse effects of methotrexate (MTX) mainly hepatotoxicity restrict its clinical use. This study was designed to investigate the protective effects of saffron (Crocus sativus) (CS) extract on MTX-induced hepatotoxicity. Methods: Twenty-eight male Wistar rats randomly divided into four equal groups. Except for control, all groups received a single intraperitoneal (i.p.) injection of MTX on the 3rd day of study. The CS extract was given (80 mg/kg i.p.) to rats 3 days before MTX and continued for the next 7 days (Pre&Post-CS group) or administrated after MTX injection and lasted for 7 days (Post-CS group). On the 11th day, all rats were sacrificed and their plasma levels of liver enzymes including aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP) and lactate dehydrogenase (LDH) were determined. Also, liver histopathology and hepatic levels of malondialdehyde (MDA), nitric oxide (NO) and super oxidase dismutase (SOD) were evaluated. Results: The results showed that MTX significantly incremented plasma levels of AST, ALT, ALP and LDH (all p<0.001) and hepatic MDA and NO levels; whereas, decreased SOD activity. Histological alterations such as early fatty changes were evident in the MTX group. Administration of CS extract at both methods could ameliorate liver enzyme elevation, oxidative/nitrosative stresses and morphological alterations of the liver. Pre-and-post treatment with CS extract showed better protective effects than only post-treatment. Conclusion: The present findings provide showing CS could effectively alleviate MTX-induced hepatotoxicity in rats. Further investigations are recommended to determine the exact mechanisms underlying the hepatoprotective potential of saffron. [ABSTRACT FROM AUTHOR]

Bckground: Adjuvant radiation therapy is commonly administered following breast-conserving surgery for breast cancer patients. Hypofractionated radiotherapy can significantly reduce the waiting time for radiotherapy, working load on machines, patient visits to radiotherapy departments and medical costs. Material/Methods: Fifty-two patients with operable breast cancer (pT1-3pN0M0) who underwent breast conservation surgery in Tehran Cancer Institute during January 2011 to January 2012, were randomly assigned to undergo radiotherapy in two arms (hypofractionated radiotherapy arm with 30 patients, dose 42.5 Gy in 16 fractions; and conventional radiotherapy arm with 22 patients, dose 50 Gy in 25 fractions). W compared these two groups in terms of overall survival, locoregional control, late skin complications and cosmetic results. Results: At a median follow-up of 52.4 months (range: 0–64 months), the follow-up rate was 82.6%. Overall, after 60 months, there was no detectable significant differences between groups regarding cosmetic results (p = 0.857), locoregional control or survival. Conclusions: The results confirm that hypofractionated radiotherapy with a subsequent boost is as effective as conventional radiotherapy, is well-tolerated and can be used as an alternative treatment method following breast conservation surgery., (Creative Commons Attribution License)