فهرست مطالب ابراهیم نصیری

Medical ethics is a field focused on studying the code of conduct and principles that healthcare practitioners are required to adhere to. The progress of medical knowledge and new methods of biological research have created various ethical conflicts, which necessitate the need to pay attention to medical ethics. Medical ethics in Iran and Islamic civilization have a long history. In the era of Islamic civilization, Rhazes and Qutb al-Din Shirazi, two of the greatest scientists of the Islamic world, pointed out important issues about medical ethics. The purpose of this research is to examine the basics of Rhazes and Qutb al-Din Shirazi's medical ethics.

This study was conducted based on a descriptive-analytical approach using library research to collect information from historical sources and texts.

In general, Rhazes was known for being a rationalist and Qutb al-Din Shirazi for being a Shariatist and having a God-oriented manner. The results show that Rhazes has paid attention to the topics of physician-patient communication, physician's scientific and practical competence, physician's confidentiality, and patient's beliefs. Qutb al-Din Shirazi has stated the moral requirements of a physician in ten principles.

In general, the examination of the views of Rhazes and Qutb al-Din Shirazi in the field of medical ethics from the perspective of traditional Iranian medicine shows that both Rhazes and Qutb al-Din Shirazi, similar to many doctors bound by ethical principles in the relationship between doctor and patient, consider compliance with ethical principles as a professional requirement.  They have paid attention to the issue of medical ethics in various areas, such as behavioral qualifications and specialized treatment issues.

Information about the use and attitude of medical students towards complementary medicine is needed to determine its place in conventional medicine. The aim of this study was to determine the attitude and use of complementary medicine in general and specialized doctoral graduates of Mazandaran University of Medical Sciences.

I n this descriptive-analytical study, the attitudes of medical graduates were determined with a 23-item questionnaire and the use of 17 complementary medicine methods with a checklist, and the level of satisfaction at four levels. Quantitative variables were analyzed with ANOVA and qualitatively from Chi 2.

The attitude score of 276 participants in this study was 73 ± 9.2 (39 to 79). There was no statistical difference between the attitudes of the four educated groups (p=0 .436). 80 people (29%) believe that complementary medicine treatment methods are placebo effect and 103 people (37.3%) believe that there is no scientific evidence for the safety of complementary medicine use. 66 people (23.9%) had a positive attitude towards complementary medicine and 23 people (8.4 percent) had a negative attitude, 91 people (33 percent) used at least one of the complementary medicine methods. The most common method of massage therapy was 33 people (12 %). 38(41.8 %) people of the users of massage, acupressure, meditation and energy therapy methods had good satisfaction.

A quarter of doctoral students had a positive attitude towards complementary medicine methods. Considering the widespread use of complementary medicine methods by people in different societies of the world and the interference of these methods with conventional medicine in the matter of care and treatment. It is recommended to develop a curriculum and research program to familiarize and improve the attitude of all students of medical sciences towards complementary medicine methods.

Anxiety before Cesarean section (C-section) is one of the common disorders that is caused by different reasons. According to Iranian traditional medicine, temperament indicates the specific characteristics of each person and its understanding is of great benefit in prevention and treatment of diseases and implementing interventions. The present study was conducted to determine the relationship between temperament and anxiety before C-section.

This descriptive analytical study was conducted in 327 pregnant women candidates for C-section in Kerman, Iran 2020-2021. Spielberger State-Trait Anxiety Inventory and Salmannezhad Temperament (Mizaj) Questionnaire were completed at gynecology ward before C-section. Analysis of quantitative data was done applying ANOVA and T-test and analysis of qualitative variables was done using Chi-square test in SPSS V21.

The average age of pregnant women was 29.24±6.33 years and 37.3% were experiencing their second pregnancy. The mean scores for latent anxiety before C-section in cold-tempered mothers and warm-tempered mothers were 54.43±8.29 and 34.44±9.81, respectively, (P=0.001).

The level of latent anxiety before C-section was higher in cold-tempered mothers than warm-tempered and moderate-tempered mothers. Therefore, necessary measures considering traditional medicine are recommended for cold-tempered mothers before surgery.

Anxiety and hemodynamic changes are common complications of surgeries. The aim of this study is to investigate the effect of foot reflexology massage on overt anxiety and physiological parameters of patients undergoing tibia plaque surgery.

In this clinical trial study, 96 eligible patients who were candidates for Tibia plaque surgery, referred to Imam Ali (AS) Teaching Hospital in Bojnourd in the spring of 2016, were selected by the convenience sampling method. Then, they were randomly divided into two groups of 48 people: experiment and control. For the experiment group, one hour before the operation, the foot reflexology massage was performed for 10 minutes. For the control group, the foot was touched for 2 minutes. Patients’ anxiety was measured using the Spielberger Manifest Anxiety Questionnaire before and one hour after the intervention, and patients’ physiological parameters were measured before and after the intervention and at 2, 4, 6, 12 and 24 hours after the surgery. To compare and analyze the data, chi-square tests for qualitative variables and t-test, Mann-Whitney test and Repeated Measure ANOVA for quantitative variables were used on the SPSS software version 21.

This study showed that the average score of anxiety after the intervention was significantly different in both the control and experiment groups (P=0.038). Also, Foot reflexology massage significantly reduced systolic blood pressure after the intervention (P=0.039) and 4 hours after the surgery (P=0.007), and also reduced diastolic blood pressure immediately after the intervention (P=0.001). Heart rate decreased significantly at all measured times after the intervention (P<0.05).

Foot reflexology massage can reduce overt anxiety and improve physiological parameters of patients undergoing tibia plaque surgery. Therefore, this method can be used for reducing anxiety in the patients candidate for orthopedic surgery.

Many studies suggest that surgery in patients with COVID-19 increases the risk of complications and mortality after surgery. The purpose of this research was to compare the frequency of outcomes during and after surgery between patients with and without COVID-19 undergoing emergency surgery in Gonbad Kavus hospitals, 2020-2021.

In this cross-sectional study, two groups of adults (n= 114) with and without COVID-19 (group A and group B, respectively) who underwent emergency surgery were examined. Demographic data, laboratory findings, and during and post-operative outcomes were recorded. Data analysis was done in SPSS V26.

Average age and weight in group A (45.5 years, 78.3±16.6 Kg, respectively) were found to be higher than those in group B (39.3 years and 67.9±11.5 Kg, respectively). Significant difference was seen in the percentage of arterial blood oxygen saturation after operations between group A (94.7±1.38) and group B (91.7±2.83) (P<0.0001). Also, mean ICU and hospital length of stay were significantly longer in group A (8.5 and 9.8 days, respectively) compared with group B (5.4 and 6 days, respectively) (P<0.0001). Moreover, death was observed more in group A (76%) than group B (23%) (P=0.041).

All members of the surgical team are required to pay special attention to the increase in the incidence of complications during and after surgery in patients with COVID-19 undergoing emergency surgery in order to take necessary preventive and therapeutic measures.

Coronavirus disease (COVID-19) causes different symptoms. Mizaj or temperament in Persian traditional medicine is a specific feature of every human being. The aim of this study was to determine the relationship between Mizaj and severity of symptoms in patients with COVID-19.

A descriptive correlational study was performed in patients with symptomatic COVID-19 during recovery and interviews were carried out to record patients’ symptoms (fever, cough, chills, etc.). Salmannezhad Mizaj questionnaire was used to determine the patients’ temperament (warm, cold, wet, and dry). The number of symptoms in each patient was determined and the severity of symptoms was classified into three levels: mild, moderate, and severe. The relationship between Mizaj and COVID-19 clinical symptoms were assessed by Chi-square and Pearson correlation coefficients.

In this study, 168 patients (48 ± 13.3 years) were cared for between 4 and 30 days in COVID Recovery Center. Fever, dyspnea, and cough were seen in 73.2%. Among the patients, 47.6% had cold Mizaj and 26.2% had warm or moderate Mizaj. The frequency of severe symptoms was higher in patients with cold Mizaj compared with that in patients with warm or moderate Mizaj (P= 0.204). Myalgia was found to be considerably higher in cold-Mizaj patients than warm-Mizaj people (P= 0.006). Significant correlations were seen between wet and dry Mizaj and severity of symptoms (P<0.046,R= 0.554) and warm and cold Mizaj and frequency of symptoms (P< 0.054, R= 0.489).

Patients with COVID-19, who had cold or wet Mizaj had more symptoms, therefore, support, care, and preventive measures of Persian traditional medicine are recommended for people with cold or wet Mizaj exposed to Coronavirus.

Coronaviruses are a type of virus that can cause death due to pneumonia and respiratory problems. Pregnant women are at higher risk for developing COVID-19 and the disease has posed challenges to anesthesia in these patients. The aim of this study was to evaluate the consequences of general anesthesia and spinal anesthesia in expectant mothers with COVID-19 candidates for cesarean section.

This descriptive-analytical study was performed in 80 pregnant women with COVID-19 candidates for cesarean delivery in Sari Imam Khomeini Hospital and Qaemshahr Razi Hospital, 2021. The expectant mothers underwent general (n= 40) or spinal anesthesia (n= 40). A researcher-made checklist was completed before, during, and after the delivery. Data were analyzed applying Chi-square, Mann-Whitney, T-test, One-way analysis of variance, and repeated measure ANOVA.

No significant difference was found between the two groups in demographic characteristics (P> 0.05), but there was a significant difference between urgent surgery and the type of anesthesia (P <0.05). Significant differences were seen in heart rate and mean oxygen saturation between the two groups (P= 0.0001 and P< 0.05, respectively). Nausea and vomiting, and chills were observed to be more common during spinal anesthesia (P= 0.007 and P= 0.002). Changes in systolic and diastolic blood pressure occurred more in spinal anesthesia group than the general anesthesia group (P= 0.0001).

Both general anesthesia and spinal anesthesia in mothers with COVID-19 can be safe for both the mother and baby if carefully planned and performed by experienced anesthesiologists.

Tramadol poisoning is a serious medical emergency and one of the most common causes of drug poisoning. The present study aims to determine the epidemiological features of patients who were served by Qaemshahr pre-hospital emergency care due to tramadol toxicity in 2016.

In this descriptive cross-sectional study, medical records of patients with toxicity that received pre-hospital emergency care in Qaemshahr, Iran (2016-2017) were studied and relevant information were extracted.  Data analysis was done in SPSS V22.

Tramadol toxicity included 29.6% of the total poisonings and 50% of drug toxicity cases. There were 118 cases with tramadol poisoning, including 94.9% men and 5.1% women. The average age of patients was 26.61 years and the majority (66.1%) aged 21-30 years old. All patients took tramadol orally and the main cause of toxicity was drug abuse (94.1%). Among the patients, 65.3% had no medical history and 29.7% had the history of narcotic abuse.

In this study, tramadol toxicity was the most prevalent cause of drug poisoning especially in young people due to drug abuse. Therefore, informing young people and their families about the consequences of tramadol abuse, extra precautions in its distribution, and lower prescription rates are effective in preventing and reducing tramadol toxicity.

Hypothermia is a common complication during anesthesia and surgery which leads to complications such as shivering, delay in recovery, and prolonged hospital stay. Therefore, the aim of this study was to determine the effect of hypothermia prevention program on shivering and recovery time in patients undergoing abdominal surgery.

This single-blind clinical trial was performed in 80 patients who met the inclusion criteria and were randomly assigned to either an intervention group that received hypothermia prevention program (using warm prep solution, warm serum during surgery, and hot water bag to retain heat in recovery) or a control group. The patients were evaluated for shivering and recovery time. Data analysis was performed in SPSS V21 using t-test and Chi-square.

According to findings, temperature changes were different over time between the two groups (P=0.001). In control group, 82.5% had shivering, while in intervention group only 7.5% experienced shivering (P= 0.001). Recovery time was also significantly lower in intervention group (P= 0.001).

Due to the complications of hypothermia, implementing a hypothermia prevention program can greatly prevent the chills, shorten recovery time, and lower the risk of other complications. Therefore, it is recommended as a low-cost and effective care program in patients undergoing major surgeries such as abdomen and thorax and also in surgical practices of elderly patients.
 
(Clinical Trials Registry Number: IRCT20200304046691N1)

Millions of people undergo surgery worldwide each year. Families experience the highest levels of anxiety while waiting for a relative undergoing a surgical procedure. Communication between families and health care professionals reduces their anxiety at this time. The aim of this study was to determine the effect of Short Message Service (SMS) on the level of anxiety and satisfaction of patient companions during surgery.

This clinical trial was performed in 128 family members of patients undergoing surgery in Chalous Taleghani Hospital, 2020-2021. The participants were divided into an intervention group (n=64) and a control group (n=64). In intervention group, text messages were sent to companions and they were informed about their patient’s condition, while the control group received routine information about their patient. Anxiety levels were measured by Spielberger overt and covert questionnaire at two stages and satisfaction was measured by asking the level of satisfaction at the time of operating room discharge. Statistical analysis was performed using Chi-square, t-test, and Mann-Whitney test.

Demographic characteristics, including sex, educational level, and type of surgery were similar between the two groups. After the intervention, the mean scores for overt and covert anxiety were significantly lower in intervention group than the control group (P<0.001). Also, the mean score for satisfaction with the information provided about patient's condition was significantly higher in intervention group compared to the control group (P<0.001).

Using SMS is effective in reducing the anxiety level and increasing families’ satisfaction during the wait for a relative undergoing low-risk surgery, therefore, allocating facilities to support and care for families is recommended.

Pain and burning are the main complaints after hemorrhoidectomy. Traditional Iranian Medicine and medicinal plants have the potential to be used in many similar cases. The aim of this study was to determine the effect of Arnebia euchroma ointment on pain and burning in patients after hemorrhoidectomy.

A parallel clinical trial was conducted in patients candidate for hemorrhoidectomy in Mashhad Qaem Hospital, Iran. Eligible patients (n=115) were randomly assigned into an experimental group or a control group. The experimental group received 10% Arnebia euchroma ointment, twice a day for a week after the surgery and in control group, Eucerin ointment was used. Pain and burning were measured in recovery and at 4, 12, 24, and 48 hours and 4 and 7 days after the surgery using VAS scale.

There were no significant differences in sex, age, disease and surgery history, and level of education between the two groups (P<0.05). Compared to the control group, the experimental group was found to experience less pain in recovery and at 4, 12, 24 hours, and 7 days after the surgery (P<0.001). Burning was significantly lower in experimental group at 4 and 12 hours after the surgery compared to the control group (P<0.01). But in other times, burning was not significantly different between the two groups (P<0.20).

Arnebia euchroma ointment reduced pain and burning after hemorrhoidectomy and did not cause any complications.

Arthroscopic diagnosis is an invasive and expensive procedure used in diagnosis of meniscus rupture. The aim of this study was to compare findings of magnetic resonance imaging (MRI) and arthroscopy in internal derangements of the knee.

In a descriptive-analytical study using diagnostic approach, a total of 59 patients candidate for arthroscopy in Mazandaran medical centers (2019-2020) were included and the sensitivity and specificity of MRI were investigated and compared with arthroscopy findings as the gold standard. SPSS V22 was applied for data analysis. 

In this study, 59 patients aged 18-60 years (33.2 ± 8.2 years) were studied in three medical centers. The participants included 84.7% males and 15.3% females. The sensitivity, specificity, and accuracy of MRI in reference to arthroscopy for anterior cruciate ligament rupture were 97.7%, 93.7%, and 96.7%, respectively and 93.2%, 87.2%, and 88%, respectively for internal meniscus rupture, and 44.4%, 79.1%, and 71.2%, respectively for rupture of external meniscus.

MRI is a very effective and reliable method in diagnosis of anterior cruciate ligament injuries that could be a suitable alternative to arthroscopy. However, it has moderate accuracy and sensitivity in diagnosis of posterior horn of lateral meniscus injuries.

Today, the Coronavirus disease 2019 (COVID-19), as a pandemic disease, has a high incidence and mortality rate. The experiences of those who have recovered could be of great benefit in understanding and management of the disease. This study aimed at determining the experiences of patients who have recovered from COVID-19.

A phenomenological study was performed in recovered COVID-19 patients (n=17) in Yavaran Mehdi Convalescent Care Center in Qom, Iran 2020. Purposive sampling was done and continued until data saturation was reached. Semi-structured in-depth interviews were conducted. Data analysis was performed using Colaizzi method and MAXQDA 2018 was used to encode the data.

Data analysis led to identification of 304 primary codes and 48 sub-concepts which
were adjusted into four main concepts, including perception of COVID-19, causes of the disease, symptoms, and patients' concerns.

The main concepts of imagining and thinking about COVID-19, causes, and routes of transmission, signs, and symptoms, and concerns associated with the disease are the main dimensions, so, academic centers are recommended to provide people with informative programs.

 Poisoning is an important public health issue and causes high mortality rate each year worldwide. Having epidemiological information can lead to proper planning for its prevention and intervention. 

 This study aims to investigate the one-year prevalence and causes of poisoning in patients received pre-hospital emergency services in Ghaemshahr, Mazandaran, Iran.

This is a descriptive cross-sectional study. After reviewing the medical files of 12552 patients collected from the Medical Emergency and Accident Management Center in Ghaemshahr, Iran in 2016, 398 poisoned patients were found. Their data including age, gender, place of residence, agent and cause of poisoning, and received therapeutic interventions were extracted and recorded.

 Of 398 patients, 17.3% had received treatment; 271 (68.1%) were male and 127 (31.9%) were female. The most common cause of poisoning was abuse (58.1%); 58.3% of the poisonings were caused by the use of medications and the rest were non-medication poisonings. Tramadol (29.6%) was the most common medication that had caused poisoning. Among non-medication poisonings, the most common agent were substances (22.6%) and alcohol (13.1%). The most common route of exposure to poisoning agent (toxins) was by ingestion.

 Due to the increasing abuse of substances and medications such as tramadol among young people and considering the high prevalence of intentional poisoning in young women, there are a need for psychological support, proper monitoring of medicine distribution, and creating social and recreational opportunities for the young people in Iran.

Background and Purpose:

Gastrointestinal poisoning is a common type of poisoning caused by ingested foods, medicines and toxic substances. Considering the valuable sources of Persian medicine, this research has focused on classification, diagnosis and treatment of medical emergencies in gastrointestinal poisoning during the 3rd to 7th centuries AH in Persian Islamic medical texts in comparison with modern medicine.
 

This is a review study, in which relevant Farsi, Arabic and English keywords were searched in in the books Firdaws al-Hikma fi al-Tibb, Al-Qanun fi al-Tibb, Al-Hawi fi al-Tibb and Zakhireye Khwarazmshahi. Retrieved contents were taken notes of, filed and then studied and analyzed. Finally, the extracted results were summarized using a two-person team with traditional medicine and the history of medical sciences specialties, and results were reported.

The main results of this research indicate that traditional medicine physicians categorized gastrointestinal poisoning based on temperament, type of toxic substance (plant, animal and mineral), lethality and the essence of the toxic substance. Diagnosis methods included examination and close investigation of patients, body odor, examination of vomited substance and using pets and birds. In treatment of poisoning, general methods like taking quick actions, vomiting, drinking milk, enema or injection of fluid into the lower bowels; and specific treatments based on the type of toxic substance were used. Pharmacological and non-pharmacological measures were considered.

The findings of the present research show that the introduced patterns in the historical medical texts of Iran in classification, diagnosis and treatment of gastrointestinal poisoning have a lot in common with the modern views and approaches. Therefore, it is possible to achieve newer and easier methods with fewer side effects in treatment of gastrointestinal poisoning and promotion of present methods by reviewing traditional texts and researches and conducting clinical trials on properties of traditional medicines and contents.

The population of retired teachers is increasing every year. Studies show that several factors are effective in understanding aging and feelings about that in retirees. One of these factors is spiritual health. This study aimed to determine the relationship between spiritual well-being and perception of aging in retired teachers.

This descriptive analytical study was conducted in 350 retired teachers under the auspices of Sari Retirement Association in Iran, 2019. Data were collected using the Spiritual Well Being Scale and the Aging Perceptions Questionnaire. Data analysis was carried out applying t-test, Mann Whitney test, and regression test in SPSS V16.

Mean age of participants was 65.3±4.3 years. The results showed that 43.1% did not actually feel old while 56.9% of those questioned felt aged. The mean scores for perception of aging and spiritual health were 99.3 ± 16.9 and 94.1 ± 17.5, respectively. Pearson correlation coefficient showed a significant negative correlation between spiritual health and the feeling of aging (r = -0.213, P <0.001).

We observed inverse relationship between spiritual health and the feeling of aging in retired teachers, so, it is necessary to develop appropriate protocols to increase spiritual health which will consequently lead to better perception of aging in older adults.

Accompanying the patients' family members in hospital creates feeling of empathy, safety of and help with fulfilling their expectations. Because both the patients and careers suffer from high stress due to lack of awareness about medical condition and treatment process. It is important for health system to understsand the expectations of patients and family members to be responsive and fullfill it correctly. This study was conducted to discover the patients carers (family members) experiences and expectation of patients undergoing surgery.

This qualitative phenomenological study was performed on 15 family members of patients undergoing surgery by purposive sampling until complete saturation of information. Data were collected through semi-structured interviews and recorded using word software. Items were extracted and qualitative content analysis method was used to analyze the data.

By analyzing the data, the main theme is "anxious minutes" and 5 main categories including "associated internal conflicts, behavioral changes while waiting, concerns about the prognosis of surgery, concerns about the outcome of the treatment process, and doubts about Hospital components" were extracted.

While waiting for the end of the surgery, families experience many anxieties and worries about the patient's health and the treatment process. Considering the concerns of the patient's companions with principled planning, appropriate and practical interventions can improve the mental health of families and improve the quality of patient care.

In late 2019, an acute respiratory syndrome caused by Corona virus 2 led to an epidemic in Wuhan, China. The prevalence of this disease is significantly higher than other infectious diseases. Aerosol production is significantly increased during laparoscopic and endoscopic surgeries and when diathermy are used. In the face of a corona pandemic, medical staff are subject to more physical injury and stress.

This qualitative phenomenological study was performed on 14 participants of operating room staff with purposive sampling until complete saturation of information. Data were collected through semi-structured interviews and recorded using word software. The items were extracted and the colaizzi qualitative content analysis method was used to analyze the data.

By analyzing the main theme of the data entitled "Prosperity and the emergence of brilliant psychological-emotional-scientific function" including three subcategories "mental turmoil in the face of patients with Covid-19, the application of preventive measures to Inhibition of Covid-19 release, problems and negative effects of Covid-19 pandemic on operating room staff and their response were extracted.

Due to the occupational hazards of operating room staff and stress in dealing patients with Covid-19, it is recommended to use psychological counseling, hiring complementary staff and more welfare facilities for treatment staff.

In order to improve patient safety, countries are seeking to monitor the safety of health systems and since surgical safety is an important part of patient safety, this study aimed to determine performance of Operating Room Personnel regarding the observance of surgical safety principles.

This cross-sectional descriptive study was conducted on operating rooms of hospitals of Mazandaran university of medical sciences in 2019. Research population included 271 personnel of operating room selected via stratified random sampling. Data were collected using demographic characteristics questionnaire and Surgical Safety Checklist of the World Health Organization. The data was analyzed using SPSS software.

The mean scores of performance of surgical technologists in the circulating and scrub roles and anesthesia technologists regarding the observance of surgical safety principles, were 23.2±3.1, 18.4±3 and 28.2±3.5 respectively. The performance level of all three specialties was moderate. Findings showed that there was a significant difference between performance score with educational level. The mean score of performance was significantly higher in the technologists with bachelor’s degree as compared to the technologists with associate degree (p<0.05).

Considering that the performance of the participants of the study regarding the observance of surgical safety principles, it was not at a desirable level, thus it is recommended to encourage operating room personnel to upgrade their education and to continue monitoring the performance of them regarding the observance of surgical safety principles.

Education and observance of the principles of professional ethics in the clinical fields of medicine are always considered as important. The purpose of this study was to determine the views of trainees, interns and clinical assistants on the importance of observing clinical professional ethics.

This is a descriptive cross-sectional study. The statistical population of the study included all trainees, interns, clinical assistants and clinical faculty members of Mazandaran University of Medical Sciences in 2017-18, out of whom (380 people) 320 were selected by available sampling method. The questions were identified in five areas: conscientiousness, respect for others, career excellence, honor and honesty, and altruism. T-test and ANOVA were used to analyze the quantitative data and chi-square test was used for analyzing the qualitative variables. In this study, all ethical considerations have been observed and no conflict of interest was reported by the authors.

320 participants took part in the present study (84%), out of whom 163 (50.9%) were female. Their mean age was 26.8±6.4. With regard to their frequency distribution, 128 (40%) were externs, 127 (39.7%) were interns, 51 (17.5%) were assistants and 9 (2.8%) were professors. 84.1% of the participants considered avoiding the use of derogatory sentences towards patients as an important option in clinical professional ethics. Men and women did not differ in their views on the importance of moral statements (P<0.844). The views of externs, interns, residents and professors on the importance of ethical codes were significantly different (P<0.035).

From the perspective of clinical participants, some items such as respect for patients were more important but were less important in the field of job excellence. Therefore, there is a need to strengthen internal motivation and emphasize the position of clinical professional ethics indicators in medical training programs for some insignificant reported items.

Occupational skin diseases and hand contact dermatitis specifically are among the most common occupational diseases among the healthcare workers. Since surgical technologists have contact with allergens and irritant substances are more susceptible to hand contact dermatitis. Thus, the aim of this study was to evaluate the prevalence of occupational hand contact dermatitis and effective factors among surgical technologists in five educational centers affiliated to Mazandaran University of Medical Sciences.

The present cross-sectional study was conducted over 125 surgical technologists working in the hospitals affiliated with Mazandaran University of Medical Sciences who were selected via census sampling. Later, 97 participants who met the inclusion criteria were investigated. Data were collected by Nordic Occupational Skin questionnaire (NOSQ-2002) through interview and analyzed by SPSS software version 23.

The findings indicated that 68% of the examined technologists were female and 57.7% were over 37 years old. The prevalence of hand dermatitis was 45.4% (44 people). The highest prevalence was observed at the back of hands (24.7%) and between fingers (17.5%).  Contact hand dermatitis had a significant correlation with the participants’ gender (p = 0.002), work experience (p = 0.028), and frequency of hand washes (p = 0.021). Moreover, having a history of eczema and allergy (P-Value≤ 0.01) was significantly effective in increasing hand contact dermatitis.

The prevalence of hand contact dermatitis is high among surgical technologists. Therefore, hospital managers are required to plan for preventive measures and control the current situation. Furthermore, future researchers are recommended to carry out more studies on allergic dermatitis.

Stressfull innate of the operating room, unpredictable types of activities, and prolonged standing during surgeries cause chronic fatigue in surgical technologists, resulting in reduced quality of care. It is essential, therefore, to provide especialized methods to reduce the surgical technologists’ fatigue severity.. This study was conducted to evaluate the effect of concomitant exercise and inhalation of lavender fragrance on surgical technologists’ fatigue severity.

Ninety seven surgical technologists were recruited  in this clinical trial study, working in the operating rooms of Tabriz educational hospitals. They were randomly divided into three groups (Exercise, Lavender & Control) after fulfilling informed consent ,. The instruments for data collection included demographic information form as well as a multidimensional fatigue inventory questionnaire. In the experimental groups, concomitant exercise training and Lavender inhalation were both used for a period of six weeks while no intervention was given to participants in the control group. Statistical analyses were carried out using SPSS 20 as  well as  ANOVA and repeated measurement tests.

No significant difference was observed between Exercise, Lavender, and Control groups regarding demographic characteristics (P>0.05). The mean score of fatigue between exercise and control groups and between Lavender and control groups showed a significant decrease (P<0.05). However, the results showed no significant difference statistically between the exercise and Lavender groups (P>0.05).

The concomitant exercise and Lavender fragrance in the operating room positively affect and reduce the fatigue severity in surgical technologists. Planning to implement similar interventions in the operating room is recommended.

One of the major problems of patients after orthopedic surgeries is acute pain. The present study aims to evaluate the effect of foot reflexology massage on postoperative pain in patients undergoing plating surgery for tibia fracture.

 This study is a randomized clinical trial conducted on 96 patients who were candidates for tibia plating surgery referred to Imam Ali Hospital in Bojnourd, Iran, randomly divided into intervention and control groups. Foot reflexology massage in the intervention group was performed on patients’ healthy feet for 10 minutes, one hour before surgery. In the control group, the foot sole was touched for one minute without any pressure. Pain intensity was measured using the standard Visual Analog Scale before and immediately after the intervention and 2, 4, 6, 12 and 24 hours after surgery. Data were analyzed using chi-square test, t-test, repeated measures ANOVA, Mann-Whitney U and Friedman tests.

 The baseline pain scores in the intervention and control groups were reported 8.1±0.9 and 8.4±0.9, respectively. After the intervention, the pain score in these groups was reduced to 6.9±1.1 and 8.1±1.0, respectively (P<0.001). At other times, up to 24 hours after surgery, the pain reduction was higher in the intervention group (P<0.05). 

 Foot reflexology massage reduces postoperative pain of patients undergoing tibia plating surgery. Therefore, this method can be used to reduce pain and anxiety in orthopedic surgery patients.