shahnam sedighmaroufi

Pre-anesthetic evaluation is the initial stage of anesthesia procedures for patients. This evaluation involves elucidating the patient's medical history, determining patient readiness, screening for undisclosed disorders, and identifying risk factors. Safety measures help mitigate patient-related risks within medical environments. The aim of this study is to investigate the role of Pre-anesthetic evaluation in patient safety.

The present study was a review conducted in the year 2024. Databases including PubMed, Direct Science, MEDLINE, Proquest, SID, Scopus, Google Scholar, Magiran, and library resources were searched using keywords such as Pre-anesthetic evaluation, pre-anesthetic visit, anesthesia clinic, patient safety, and their English equivalents. A logical combination of these keywords was performed using "OR," "AND," and "NOT" operators. The search was conducted in relevant articles from the year 2000 to January 2024.

Initially, 22,000 articles were screened, and ultimately, 16 relevant articles were used for preparing this paper. In all the reviewed articles, pre-anesthetic evaluation played a key role in patient safety.

Studies indicate that pre-anesthetic evaluation is a key improver of surgical outcomes. These measures not only mitigate potential risks but also enhance surgical outcomes. Overall, pre-anesthetic evaluation has a direct correlation with patient safety, playing a significant role in postoperative improvement and elevating the quality of medical care.

One of the basic principles in the safety of drug therapy for patients is the correct registration and labeling of anesthetic drugs, which can lead to the reduction of drug errors, the increase of drug and patient safety, the reduction of drug consumption and the environment, and the optimization of hospital costs.

This descriptive-analytical and cross-sectional research was conducted in February 2022 in the operating rooms of Iran University of Medical Sciences hospitals. The participants included 177 Anesthesia experts working in the hospitals’ operating rooms, who were included in the study by census method. The data was collected using the checklist for evaluating anesthetic drug registration and labeling guidelines and analyzed using SPSS software and one-way ANOVA, Fisher, and Pearson correlation coefficient statistical tests. The significance level was considered P value < 0.05.

The average compliance with the guidelines for registration and labeling of anesthetic drugs in all hospitals was 3.559 out of the total score of 16. The average adherence to guidelines in 8 hospitals was significantly different from each other (P < 0.001). Hazrat Ali Asghar Hospital had the highest compliance rate, averaging 10.333 out of 16. Firouzgar and Shahid Akbarabadi hospitals were in the next rank, averaging 10.11 and 6.65, respectively. There was a negative and significant correlation between the level of compliance with the guidelines and the average work experience and age of the experts (P=0/17); However, gender did not significantly correlate with the degree of adherence to the guidelines(P=0/596).

According to the obtained results, compliance with the guidelines for registration and labeling of anesthetic drugs in most hospitals was assessed as weak and at an unfavorable level. Considering the importance of this issue in reducing medication errors and increasing patient safety, it is necessary to use empowerment and retraining courses for Anesthesia experts according to the latest guidelines.

The correct registration and labeling of anesthetic drugs in the operating room are the basic and important principles in order to maintain patient safety, reduce the wastage of drugs and their subsequent costs, and reduce environmental pollution. Therefore, the present study was conducted with the aim of designing and psychometry of evaluation checklist for the registration and labeling guidelines of anesthetic drugs in the operating room.

This descriptive-analytical research was conducted in 2022 in the Iran University of Medical Sciences. In order to design the checklist, the latest and most reliable scientific sources in the field of anesthesia were examined and the opinions of experts of the university’s Department of Anesthesia were used. To determine the validity of the checklist, face and content validity (content validity index and content validity ratio) were calculated. In order to determine the reliability of the checklist, two methods of test-retest reliability and inter-rater reliability were used. The research results were analyzed using SPSS 22 software.

An initial checklist was designed with 19 items. In the face validity check, all the items remained on the checklist with the optimal level of 1.5. In the content validity check, three items with a content validity ratio of less than 0.62 and a content validity index of less than 0.79 were removed from the checklist. The intraclass correlation coefficient was calculated as 0.992 in reliability by the test-retest method and 0.987 in the inter-rater method, which indicates the good reliability of the checklist.

The research findings show the checklist’s face and content validity and good reliability. Therefore, it can be used to evaluate the level of observance of the guidelines for registering and labeling anesthetic drugs.

Medical education has special features due to the need various areas of learning. The present study was conducted to provide a complete picture of the evaluation system in Iran University of Medical Sciences for improving the evaluation system and medical sciences examinations.

The research was cross‑sectional study that conducted through self‑reporting of educational departments, a comprehensive review of the student evaluation system in the affiliated faculties of Iran University of Medical Sciences from 2017 to 2018. Educational members and heads of nine faculties and 80 departments participated in this study. The research tool was a researcher‑made questionnaire, include two parts: (1) 10 general questions about the activities of the educational groups regarding the student evaluation system and (2) 20 questions about the types and quality of examinations.

From 80 questionnaires, 71 were completed by the managers of the departments. The results showed that 62% of the faculty members in the educational departments in the last 2 years did not participate in the workshop on the methods of evaluation and making tests. 56% of the faculties have a reference for continuous monitoring of students’ assessment and evaluation, and in 87% of the cases, the content is given in accordance with the objectives. The use of logbooks was more common (28%) than other methods to assess practical skills.

Empower faculty members on the use of various tools, strengthening the supervision of formative evaluation and use of medical education graduates to promote evaluation methods seems necessary

 Postoperative nausea and vomiting (PONV) is still a common complication that occurs frequently at the time of recovery from eye surgery.

 The present study aimed to compare the effect of oral Ondansetron and Ginger on the frequency and severity of postoperative nausea and vomiting in patients undergoing eye surgery.

 A total of 148 patients were randomly assigned to Ginger, Ondansetron, and placebo groups. Group A received a Ginger capsule (1,000 mg), group B Ondansetron capsule (16 mg), and group C placebo capsule with 30 ml water, one hour before surgery. The frequency of nausea and vomiting and the severity of nausea were recorded immediately after recovery, 1, 2, and 4 hours after recovery. Also, some side effects following prescription such as headache, stomach ache, dizziness, and cardiac arrhythmias were recorded.

 Of the 148 participants, 54% were men, and 46% were women. The average age was in group Ginger (36.14 ± 2.17), group Ondansetron (36.24 ± 2.49), and group placebo (36.24 ± 2.20). There was no significant difference in the frequency of vomiting between the three groups immediately after recovery (P = 0.19) and 4 hours after surgery (P = 0.18). However, the frequency of vomiting in Ginger and Ondansetron groups 1 and 2 hours after the surgery was significantly lower than that in the control group (P = 0.003). No significant difference was observed in the severity of nausea between the three groups at certain times (P > 0.05). There was no significant difference in terms of the need for injection antiemetic drugs after surgery (P = 0.2).

 Ginger and Ondansetron can reduce the frequency of vomiting. However, Ginger was more effective, safer, and less expensive than Ondansetron; therefore, it may be a better substitute for Ondansetron to prevent PONV.

Improving the quality of education is based on recognizing the effective factors that require consideration of the views of the education authorities (professors and students).The purpose of this study was to explain and identify effective factors the quality of theoretical education of the Operating room from students and teachers viewpoints in Medical Sciences Universities of Tehran city.

The present study is a cross-sectional (descriptive-analytical) study. The statistical population includes students and faculty members of the operating room in Medical Sciences Universities of Tehran city.342 people were selected by census and stratified random sampling. A researcher-made questionnaire was used for data collection. Data were analyzed using Friedman tests,T-test and Mann-Whitney test in SPSS software.

In the ranking of the factors affecting the quality of theoretical education from the perspective of students and teachers, the highest average was related to the domain of teacher-related factors and the lowest to the domain of professional ethics and behavior. Among the components of each domain from the studentschr('39') point of view, the most important factor, properly evaluating the teaching and research activities of teachers and providing them with appropriate feedback And to Them, and from the Teacherschr('39') perspectives, interest and tendency toward field of study and ethics on the part of teachers and students. The mean scores of these components were significantly different between teachers and students (P<0.001).

The results show that from the perspective of students and teachers of the operating room, the role of teachers has a very significant effect on the quality of theoretical education.And It seems that to increase the quality of teaching in the operating room, it is necessary to consider the factors that lead to the improvement of the quality of the role of teachers. It also promoted the quality of the six fields discussed in this study.

The Severity of Stuttering Instrument-fourth edition (SSI-4) form can be used to assess the severity of stuttering. In this study, in order to increase students’ competence and objectively assess their clinical skills, the validity and reliability of the DOPS test in assessing the clinical skills of speech therapy students in using the SSI-4 form were assessed.

This study was a non-interventional descriptive study conducted in the School of Rehabilitation Sciences. Nineteen students were selected by the census method. An evaluation checklist related to the DOPS method was prepared. After obtaining the consent and training of students and examiners on the implementation of the DOPS assessment method, the student’s work was observed by the examiners and rated, and then the student’s strengths and weaknesses were given feedback.

The results showed that the questions are related to the measured subject and have high face validity. The content validity index was more than 0.9, and the content validity ratio was more than 0.6. The results confirmed the test's reliability and indicated the optimal internal structure of the test and its structural validity. 

According to this study, the use of the DOPS test to objectively assess the clinical skills of speech therapy students in the assessment of stuttering is appropriate and according to the results, DOPS has appropriate validity and reliability and this test can be used clinically.

One of the common disorders in Speech Language Pathology (SLP) is speech sound disorder. To increase students’ competence and objectively evaluate their clinical skills, we used the Direct Observation of Procedural Skills (DOPS) test in a clinical setting and examined its validity and reliability

This research is a non-interventional descriptive study. Twenty students who participated in this study were selected by the census method. Traditional treatment approach skill for speech sound disorder was selected. Then an evaluation checklist of DOPS was prepared. After obtaining the consent of students and professors, they entered the study. Two professors observed the work of all student during the procedure on a real patient. Results were recorded in a checklist, and feedback was given to the students about their strengths and weaknesses.

The content validity index of the DOPS test was more than 0.8, and its content validity ratio was more than 0.62. The correlation coefficients of questions indicate the optimal internal structure of the test and its structural validity. The results showed that the test questions were related to the predetermined subject. Results confirmed high face validity. The obtained Cronbach α coefficient (0.865) confirmed DOPS reliability. There was a significant inter-rater correlation coefficient (0.901) between evaluators (P<0.001).

According to the study, the use of DOPS for objective assessment of clinical skill has validity and reliability. This test can be used to evaluate the clinical work of SLP students, provide feedback, identify their strengths and weaknesses, and improve them.

Aims and background

PACU, which locates next to surgery room is designed to take care of patients recovering from anesthesia and surgery. Patients which are transferred to this room are exposed to risks and irreparable complications. Therefore, standardization of this unit has a great importance for proper evaluation of patients. Therefore researchers aimed to assess the condition of PACU in Iran medical university in order to improve this unit based on new worldwide standard.

The present research is a cross-sectional descriptive study which is performed using a census report of PACU in medical university of Iran. A check-list was used as a data collection tool which surveys 3 main standards of PACU concerning the structure, equipment and functionality of these units. Data was analyzed using SPSS25.

Results showed that 7 of 11 surveyed hospitals reached the standard concerning equipments, 3 of them were near the standard index and one was below the standard index. Investigations concerning the Structure Standard showed only that 2 of 11 hospitals reached the standard, 5 were near the standard and 4 was below the standard index. Besides, no significant relation was observed between the demographic features and functional aspect in our study.

the structure of PACU in the surveyed hospitals need to be modified and reformed based on the new standards indices. Additionally, it is necessary to provide new modern equipment to these units to improve the care services for the patients.

Postoperative nausea and vomiting (PONV) is considered a common complication of anesthesia, which, particularly in eye surgery, may exert pressure on stitches and open or leak the surgical wound, leading to bleeding.

We aimed to study the effect of ginger on PONV and changes in vital signs after eye surgery.

In this triple-blind randomized controlled trial, 120 candidate patients for eye surgery were divided into group A (n = 40) and group B (n = 40). Patients in group A received the capsules of ginger 1 g while patients in group B received a placebo one hour before the procedure with 30 mL water. The incidence of nausea and the frequency of vomiting were evaluated at 0, 15, 30 minutes, and 2 hours after the operation. Also, the vital signs of the participants were recorded at certain times.

The results demonstrated a statistically significant difference in the frequency of nausea between group A and group B (P < 0.05). The severity of nausea was lower in group A than in group B immediately and 2 hours after recovery (P < 0.05). The incidence of vomiting was significantly lower in group A than in group B (P < 0.05). The vital signs were not significantly different between group A and group B (P > 0.05).

Ginger was effective in the prevention of PONV after eye surgery but had no impact on vital signs. Hence, ginger is proposed to use as a low-cost, prophylactic measure for PONV reduction.

Disasters and emergencies have been increasing all over the world. Todays, with technological advancement, acquiring knowledge and its application in the realm of action is regarded as the only effective way for prevent disasters or reducing its effects. The present study aimed to review the importance of education and the effect of different methods of education on disaster risk reduction and preparedness in vulnerable people. To this aim, some articles indexed in Database of PubMed, Web of Science, Google Scholar, Scopus, Science Direct, and ProQuest were searched. The search was limited to reviewed articles in English published between 1990 and 2017. In addition, the selected articles were reviewed for relevant citations. The conducted studies were reviewed by two researchers independently. The primary search generated 128 relevant references. After eliminating the duplicates and articles which were not related to the review of the abstract, 41 references were identified for inclusion. After reviewing more, 31 references, which failed to meet inclusion index, were excluded from the study. Disaster education aims to provide knowledge among individuals and groups to take actions to reduce their vulnerability to disasters. During the last decades, the issue that trained people can be prepared for disasters and responding well has been extensively investigated. Based on the results, disaster education is a functional, operational, and cost‑effective tool for risk management. Based on some evidence, it is important for vulnerable people to learn about disasters. There are different methods to educate vulnerable people, but no method is better than others. Trained people can better protect themselves and others. In this regard, planning and designing comprehensive educational programs are necessary for people to face disasters.

Behavioral, social, psychological and biological factors influence health and disease; and, to achieve professional competency, physicians should be knowledgeable about their society and its inhabitants’ behavior. This knowledge will help physicians to become competent in communication, professional behavior, self-awareness, ethical reasoning, and understanding cultural and social differences. In this regard, this research is an attempt to explore perspectives of medical faculty members on necessity of integrating Behavioral and Social Sciences (BSS) components into the medical curriculum.
In this qualitative study, data were collected by semi-structured interview and observation of participants who were recruited from educational departments of faculty of medicine of Iran University of Medical Sciences. 12 faculty members were interviewed individually and were ask about their experiences and perspectives on integration of BSS subject matters into medical curriculum. Data were analyzed using content analysis.
The six following themes were emerged from data analysis: “physician-patientinteraction”, “medical culture”, “facilitating behavior change”, “socio-cultural issues”, “mind-body medical experience” and “physician interaction with health care system”.
The results revealed that “physician-patient interaction” was the most prominent among the emerged themes. The participants emphasized communication, professionalism, social accountability, and socio-cultural psychological aspects.

Otitis media is one of the most common infectious diseases in children. Approximately 85% of children will have otitis media at least once by the age of 3 months, and nearly 50% of children would have more than three times. The objective of the this research was to detect Haemophilus influenza, the most common cause of otitis media in children, and to determine the antibiotic susceptibility pattern of this organism. In this cross-sectional study,a total of 102 specimens were collected during 6 months period from patients with otitis media referred to Amir Alam Hospital in Tehran.Specimens were evaluated for Haemophilus influenzae by microscopic examination and culture. The antibiotic susceptibility test was performed by disk diffusion method of Kirby-Bauer and sensitivity rate of tested antibiotics were assessed by evaluation diameter of the growth inhibitory zone. Out of 102 tested specimens, 7 (6.9%) were identified as Haemophilus influenzae. The rate of sensitivity of isolated Haemophilus influenzae to different antibiotics was trimethoprim (100%), vancomycin (85%), streptomycin (57%), tetracycline (57%), and doxycycline (56%),and the rate of resistance to gentamycin (85%), carbenicillin (70%) and cefixime (70%), clindamycin (70%) amikacin (57%) amoxicillin (57%). With respect to appearance of new resistance species especially to clinidomycin, amikiacin and amoxicilin it is recommended to perform antibiotic susceptibility tests before the initiation of treatment.

Although vancomycine is used for the treatment of methicillin resistant Staphylococci, but vancomycine alone might not be effective for the treatment of methicillin resistant Staphylococci in compromised host. In the same time antimicrobial activity of cefepim on gram positive bacteria especially Staphylococci is well known. In this study the synergism effect of cefepim and vavcomycin on positive and negative coagulase Staphylococci in vitro condition was investigated.

In total, 100 clinical samples of coagulase positive and negative Staphylococci were isolated from urine and blood samples from patients in Imam Khomeini Hospital during one year and identified. The modified Bauer-Kirby were used for the antibiotic susceptibility and macrodilution method for the MIC according to NCCLS procedure.

The results showed that after adding vancomycin to cefepime in concentration from 0.05+ 0.5, to 0.8+8, growth reduction reached from 3.5% to 100%.The synergism effect of the two mentioned antibiotics on coagulase negative Staphylococci resistant to methicillin were shown that from concentration of 0.05+ 0.5 to 0.8+8, a reduction in growth from 4.5% to 100% was observed.

The results of this study showed that vancomycin and cefepime has synergic effect on Staphylococci.