معصومه معزی

Addiction is global problem, and general practitioners, as the first line of providing health services, have the most contact with addicted people. However, the needs of a general practitioner in relation to addiction are not met due to deficiencies in the educational curriculum. Therefore, the present study was conducted to determine the knowledge, ability and needs assessment of physicians and students with respect to addiction. This was a descriptive study conducted in Shahrekord University of Medical Sciences in 2019. The study population included medical interns and physicians working in health service centers who completed a self-assessment questionnaire of knowledge, ability and educational needs assessment with respect to addiction. The results showed that most of the participants in the study considered their knowledge and ability in the field of addiction to be moderate and poor. Educational needs assessment showed that most general practitioners admitted the strong urge to teach addiction topics in general medicine courses. More than 40 percent of the practitioners had a high exposure to patients with substance abuse, and the most important educational need from their point of view was how to deal with these patients. The most common way to obtain information in the field of addiction was to use the experiences of professors. Due to the undeniable role of general practitioners in addiction management and according to the results of needs assessment, it is necessary to modify the general medical education curriculum in accordance with the needs of the stakeholders.

Evaluating different fields of clinical education is necessary to improve the medical course. Among these, clinical rounds are an important part of clinical education. Therefore, achieving maximum realization in any clinical field is the goal of every medical training center.

Present descriptive cross-sectional study was conducted at Shahrekord University of Medical Sciences by census method on more than 67% of clinical medical professors and 79% of medical students who are on internship. The research instrument included a questionnaire of demographic information and a clinical round, which was prepared based on clinical standards approved by the Ministry of Health. 30 out of 44 clinical professors and 30 out of 38 interns succeeded in completing the questionnaires. The obtained data were analyzed by SPSS-16 software and tests (T-test and ANOVA).

The mean scores of clinical rounds of professors were 65± 13.16 and interns were 52.47± 35.19 and in general, the situation in this field was described as higher than the average (42) for both groups. Comparison of the two groups also showed a significant difference (P = 0.00). Thus, the mean scores of clinical round scores in the professors’ group were higher than the average scores of the interns’ group.

The current clinical rounds situation in Shahrkord University of Medical Sciences was described as more favorable than average. Therefore, in order to further promote medical education, it is recommended that universities continuously evaluate and monitor the status of various areas of clinical education in order to reach the ideal level as soon as possible.

Congenital anomalies are common causes of medical interventions, long-term illness and death. The aim of this study was to determine the risk factors of congenital anomalies in disabled patients under 15 years old registered in Welfare Organization of Shahrekord.

The present study was a case–control study. 350 disabled patients registered in the Welfare Organization of Shahrekord and 350 matched healthy children were included in study. Demographic information and probable risk factors were recorded in the checklist through the patient's file and interviews with parents.

The most common anomalies were cardiac disorders (31.1%), cerebral palsy (18.3%) and Down syndrome (14.9%). The body weight, length and head circumference at birth, mean father's and mother's age at the time of pregnancy , Father's and  mother's ethnicity, economic status , education, type of delivery, birth season, maternal body mass index during pregnancy, maternal diabetes mellitus, hypothyroidism, hypertension  and infectious disease during pregnancy, parental addiction, parents' smoking, folic acid and iron intake during pregnancy, drug use during pregnancy ,hypoxia, consanguinity and family history of congenital anomaly were significantly different in two groups (p <0.05). Based on the results of logistic regression Type of delivery (caesarean section) , low socioeconomic status, father’s age, family history of congenital anomalies, father’s smoking and infant hypoxia had a significant correlation with the congenital anomalies.

Since early identification of congenital anomalies is essential for preventive interventions, considering the risk factors of this study will be helpful for primary prevention.
Women at risk especially from poor socioeconomic should be mentioned and screened for more support and prenatal care.

Encountering clinical environments as an inseparable part of studying medicine could bring about tension and anxiety for medical students. Early clinical exposure has been suggested to decrease these stresses and to motivate students for a better attitude and awareness. This study was performed to determine the effect of a short-term period of exposing to clinical environment on medical students’ attitude toward medical education and their educational function.

In an interventional study performed as pre-test/post-test, 43 first year medical students were encountered clinical environments in rounds, operating rooms and emergency ward. Students’ attitude was assessed by a questionnaire using Likret scale. We compared student's function in specific lessons and result of comprehensive basic examination with previous entrance students as an external control group.

Significant differences were found in the student’s attitude before and after the course (P<0.01). Results showed a significant increase in the student’s attitude toward importance of the patient's history and physical exam versus para-clinical exams. In addition, their attitude about therapeutic stuff duties in all levels. The rules between physician and patient, patients rights in hospital, diagnosis and therapeutic management, different steps of medical education and merging basic and clinical sciences, simple physical exam and assistance management were increased significantly after the course. No significant difference was observed in the student's educational function in any items.

Based on the results of this study, we found a positive effect of early clinical exposure on attitude of first year medical students. Therefore, we suggest that early clinical exposure be added to educational curriculum for medical students.

In the last decades efforts have been dedicated to improve research activities among academic staff in the universities. However less attention has been paid to improve research skills among nonacademic staff of health system especially physicians. Thus in this research capability of the physician working in Chaharmahal va Bakhtiari for doing applied researches has been investigated.

In this interventional research the study population was consisted of all general physicians who were working in health care centers in Chaharmahal va Bakhtiari (CMVB) province. From the whole population of general physicians 60 physicians were selected and were randomly divided into two separate groups (30 physician as case group and 30 physicians as control group). Case group participated in a research methodology workshop. In this workshop they were trained how to find the health system priorities and how to write a research proposal. After finishing the workshop they returned to their work and conducted their research proposal and then they participated in the second workshop to present their research results. In second workshop they improved their abilities for writing a scientific article preparing a poster giving a scientific talk and paper publishing. Prior and after the workshop their knowledge about the subject was collected in both groups using a questioner. At the end results collected from both groups were analyzed using paired and independent-t tests.

The average scores of knowledge about research methodology in case group was 6.23±0.24 and 12.97±2.35 prior and after interventions respectively (P