فهرست مطالب

Thrita - Volume:6 Issue: 20, 2017
  • Volume:6 Issue: 20, 2017
  • تاریخ انتشار: 1396/04/20
  • تعداد عناوین: 5
|
  • Alireza Amirzadegan, Kaveh Hosseini, Masih Tajdini, Abdolvahab Baradaran*, Ali Hosseinsabet Page 1
    Background
    Left bundle branch block (LBBB) is an important and independent determinant of mortality among patients with cardiovascular disease (CVD). Close follow-up and management of isolated LBBB to prevent cardiomyopathy is controversial.
    Methods
    In this retrospective cohort study, patients with isolated LBBB, with no concomitant evident cardiac disease, or risk factors of heart failure with reduced EF such as hypertension or diabetes mellitus (DM) were included. The mean follow-up of the patients was 56 months. At the onset of the study, coronary angiogram and EF of the patients were normal. Patients with reduced EF underwent coronary angiogram at the end of their follow-up interval.
    Results
    In this study, 36 patients, with the mean age 62.1 years (45 - 81) were followed. LV ejection fraction (EF) was reduced in 24 patients, and the other 11 patients continued to have a normal EF during the follow-up. The follow-up interval between the 2 groups was not statistically different (Mann-Whitney, P = 0.9). Most of the patients with reduced EF were male (Mann-Whitney, P = 0.01). New- onset HTN had a negative correlation with a decrease in EF% (Spearman correlation coefficient = -0.36, P = 0.031). Based on surface ECG parameters, 8 new notched-QRS were detected, all of which had decreased EF during follow-up.
    Conclusions
    Not all patients with isolated LBBB develop cardiomyopathy at a definite time interval. Male gender, notched-QRS in ECG, and longevity of conduction delay are important predictors of cardiomyopathy among these patients. They may benefit from anti-remodeling drugs and routine close follow-ups with echocardiogram.
    Keywords: Isolated Left Bundle-Branch Block, Heart Failure
  • Maliheh Kadivar, Mahboobeh Khabaz Mafinejad*, Javad Tavakkoly Bazzaz, Azim Mirzazadeh Page 5
    Recognizing the importance of improvement of professionalism and ethics in medical students, the association of American medical colleges (AAMC) and the Liaison committee on medical education (LCME) and others have called for medical educators to pay attention to this critical competency and use different methods and tools for teaching professionalism in training. This article will share the author’s experience using movies as a flexible and interactive teaching tool and technique. The taskforce, which aims to teach medical professionalism via movies, was established in 2012 at the Tehran University of Medical Sciences (TUMS). The researchers used movies for teaching professionalism and ethics in medical education as an optional program. First, they invited faculty members, who have expertise and interest in this field. The duration of the programs varied from 3 to 4 hours. During the programs, students received a brief introduction about the program objectives and after implementing the program, they criticized and analyzed them through reflection. An anonymous evaluation form was distributed to evaluate the effect of the program on the students’ motivation and satisfaction. These programs thus provided the opportunity for students to learn medical professionalism by observing and reflecting on movies.
    Keywords: Reflection, Professionalism, Education, Medical Student
  • Amir Ghaffarzad, Alireza Ala, Kavous Shahsavri Nia, Ramin Farajpour *, Fariba Abdollahi, Sajjad Pourasghary Page 7
    Background
    In all burn care systems; first aid, covering, and transferring burn-injury patients to the hospital all have an important role in managing and achieving a successful outcome. It seems there are wide differences in the main methods of providing first aid and pre-hospital care on burn patients. Despite several researches, the epidemiological specifications, level of care, as well as offered treatments is various in different regions.
    Objectives
    This study was performed to determine the various aspects of pre-hospital management of burn patients in Sina and other hospitals affiliated to the Tabriz University of Medical Sciences.
    Methods
    In this retrospective study, data of 100 patients admitted from 2014 to 2015 were collected. According to the standard questionnaire, transferring patients, training of technicians, and quality of pre-hospital treatment were checked out and recorded in the questionnaires, then data were analyzed by the SPSS v.21 software.
    Results
    Regarding the status of EMS technicians, only 30% of them were trained; in 22% of accidents, before dispatching, coordination with the burn center had been done. The total mortality rate was 13%. In all the burn cases reported, temperature regulation of inner ambulance environment hadn’t been measured.
    Conclusions
    The results of this study showed that the level of emergency burn management and training is relatively low and therefore the strengthening of pre-hospital emergency management training is recommended. In order to prevent and reduce the incidence and mortality rate of burns, short and long term plans should be formulated. It is recommended that courses such as EMS training for technicians in the field of pre-hospital care, burn training in the hospitals for proper communication, and transferring to a primary care center needed to be done.
    Keywords: Burn, Pre-hospital care, Technician, Tabriz
  • Sedigheh Ebrahimi *, Hassan Fozooni, Sahar Hosseini Page 12
    Background
    One of the most important aspects of providing healthcare is the respect for patients’ rights. It is therefore necessary that all medical staff, including clinical students, are aware and appropriately provide care according to patients’ rights.
    Objectives
    This study was aimed to evaluate the knowledge and attitudes of the interns towards patients’ rights in order for provision of effective strategies to teach them.
    Methods
    The Cross-sectional study was conducted by a descriptive analytical design among all interns of Shiraz Medical University during the academic year of 2012 and 2013 (120 interns) with the census method. The data were collected using a 3-part questionnaire containing 39 questions with demographic data and questions in the area of patients’ rights. Data were analyzed using SPSS version 15. Descriptive statistics, Pearson’s Chi-square, and t-tests were applied to evaluate significant differences between variables.
    Results
    The findings suggest that the mean score of the interns’ knowledge was “weak” in 15.5%, “intermediate” in 14.6%, and “Good” in 69.9%. In general, the average score of the interns’ awareness of patients’ rights was “intermediate” level (14.46 ± 4.58 out of 29). The highest score was in the area of the “right to confidentiality” and the least score was in the realm of the “individual freedom of the patient” (P
    Conclusions
    Awareness and protecting the patient’s rights means the accountability of all health care providers. Given that the level of awareness of medical interns regarding patients’ rights is not at a desirable level, hence, the necessity of organizing medical educational programs including components on patients’ rights should be offered more seriously.
    Keywords: Patient Rights, Ethics, Medical Intern
  • Hamidreza Karimi-Sari, Seyed Moayed Alavian* Page 18