مجله علوم پزشکی رازی
سال بیستم شماره 11 (پیاپی 116، بهمن 1392)

One of the most important activities in educational processes is evaluation of students. For evaluating the students’ professional performance، selecting an appropriate evaluation system is important. The aim of this study was to assess the clinical performance of medical interns and its affecting factors by mini-CEX test.

This study was semi-experimental and mini-CEX test was given to the emergency department interns’ twice at the beginning and end of the period and the assessor gave score the interns’ performance according to the checklist. Test scores were compared.

In total 76 participants were able to fulfill the first and second tests. Mean of test scores increased from 11. 3 with a standard deviation 1. 67 to 12. 3 with a standard deviation 1. 53 and increased 1. 07 score (p value= 0. 000).

The result of the study emphasizes the affect of the variables on improvement of the clinical skills of interns’ and evaluating them at the beginning and end of the courses to investigate learning outcomes.

Heavy metals are one of the compounds that can enter the water sources through different ways. Consumption of heavy metals in amounts that exceed standard levels is associate with risks such as toxicity and carcinogenesis and development of disease.. This study was carried out to determine heavy metals concentration (Cr،Cd &Pb) in Mashhad drinking water and its comparison with national and international standards.

This cross study was done in spring and summer 2011، samples were collected from different points of urban drinking water network according to the standard methods، and tested by atomic absorption spectrophotometeric method. Health centers were selected as sampling stations because they cover the entire city. Data were analysed by SPSS and One-way ANOVA، Paired t- test and One sample t- test on the significant level p<0. 05.

Cadmium (Cd) and Chrome (Cr) concentrations did not exceed national and international standards، only Lead (Pb) concentration was slightly higher than standard level in some areas and its mean difference in spring and summer was significant (p=0. 03)، while this difference was not significant for Cr and Cd. There was no significant correlation between the metals concentrations and water sources.

It seems the old water pipes can lead to an increase in metals concentrations particularly Pb in some areas of the city since that Cr&Cd concentrations in whole and Pb concentration in major areas were lower than the standard. There for، due to cumulative effects of these metals، it is necessary to conduct needful measures by responsible agencies.

Lateral epicondylalgia of Humerus is the most common type of overuse injuries with different methods of treatment controversial. This randomized clinical trial aims to evaluate the effectiveness of Cyriax deep friction massage versus Ultrasound (US) plus passive stretching on lateral epicondylalgia.

In this study، patient with more than 6 weeks pain in lateral epicondyl were included. Evaluation of Pain via visual analog scale (VAS) in daily activities، resisted wrist extension، resisted middle finger extension، resisted fingers 2 to 5 extension، local tenderness and finally pain-free grip strength were assessed in all eligible patients. Patients randomized in two therapeutic groups. Pulsed ultrasound for 8 minutes plus passive stretching after that for 10 sessions in every other day was the selected intervention in the control group. Experimental group received 7 minutes of deep transverse friction massage plus mill’s manipulation in the end of each intervention for 5 sessions in every other day. All variables were assessed in follow up sessions including last therapeutic session then 1، 2 and 4 weeks followed the last therapeutic session. Inter and intra groups analysis were performed by Independent samples T Test، Repeated measure analysis and paired-sample T Test respectively.

Fifty patients (Deep friction massage=28 and Ultrasound=22) completed their therapeutic and 4 weeks follow up. In Deep friction massage group 75% were woman and 25% were man، while in Ultrasound group 86. 4% were woman and 13. 6% were man. The mean age of patients in Ultrasound group and Deep friction massage group is 48. 8 and 46. 1 respectively. Affected extremity in 62% patients is their dominant arm. In Ultrasound group، difference in pain score (VAS) in daily life and local tenderness variables before and after the therapy is significant (P<0. 05). In the rest of the variables، no difference is observed (P>0. 05). In Deep friction massage group، significant improvement is observed in all variables (P<0. 05). In inter group comparison، right after the therapy، considerable improvement is not observed in pain score (VAS) in daily life and local tenderness (P>0. 05)، However in other time intervals، it is reported (P<0. 05). Furthermore، in the rest of variables، we observe a significant improvement in all the groups and time intervals (P<0. 05).

It is concluded that in short term، Cyriax physiotherapy is statistically more effective than pulsed ultrasound plus passive stretching in improvement of lateral epicondylalgia.