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کاربرد نوع شرط:
- جایگاه : پژوهشی
- مجله: Future of Medical Education Journal
- نوع مقاله: Journal Article
- کلمات کلیدی: Iran,Education,Internal medicine,Residency
- چکیده:
- چکیده انگلیسی: Background: Internal Medicine (IM) is one of the main medical specialties. In this paper, the features of the Iranian IM residency training program, duties and salary were evaluated and compared with some countries.
Methods: Using the Iranian Ministry of Health and Medical Education (IMHME) directive, the features of educational curriculum, compulsory working hours, duties and salary were extracted and compared with some countries whose full details were available.
Results: The annual capacity of IM residency admission in Iran is about 280 residents in 34 countrywide medical universities. The training curriculum of IM is designed uniformly for all universities by IMHME and is consisted of a 4-year training of gastroenterology, endocrinology, nephrology, pulmonary, hematology and rheumatology plus cardiology, neurology, intensive care, emergency medicine, radiology and dermatology in hospital departments and continuity clinics. Residency training period in Iran is similar to Turkey and Canada and is shorter than most European countries. Average weekly working hours for IM residents is 84 hours in Iran, which is higher than Turkey European countries, Canada and the USA. Two to eight years of medical service in underserved areas have been assigned for Iranian graduates of IM residency before receiving certification for working in larger cities.
Conclusion: Residency training in each country is affected by different factors such as economic status, work force, national health priorities and available facilities. Training of residents with more knowledge and skills that did not bear remarkable job burnout during their training period is a challenging goal for medical education policymakers- انتشار مقاله: 18-03-1396
- نویسندگان: Seyed Mostafa Monzavi,Bita Dadpour,Kianoush Shahraki,Maryam Nemati
- مشاهده
- جایگاه : پژوهشی
- مجله: Future of Medical Education Journal
- نوع مقاله: Journal Article
- کلمات کلیدی: Iran,Education,Internal medicine,Residency
- چکیده:
- چکیده انگلیسی: Background: Internal Medicine (IM) is one of the main medical specialties. In this paper, the features of the Iranian IM residency training program, duties and salary were evaluated and compared with some countries.
Methods: Using the Iranian Ministry of Health and Medical Education (IMHME) directive, the features of educational curriculum, compulsory working hours, duties and salary were extracted and compared with some countries whose full details were available.
Results: The annual capacity of IM residency admission in Iran is about 280 residents in 34 countrywide medical universities. The training curriculum of IM is designed uniformly for all universities by IMHME and is consisted of a 4-year training of gastroenterology, endocrinology, nephrology, pulmonary, hematology and rheumatology plus cardiology, neurology, intensive care, emergency medicine, radiology and dermatology in hospital departments and continuity clinics. Residency training period in Iran is similar to Turkey and Canada and is shorter than most European countries. Average weekly working hours for IM residents is 84 hours in Iran, which is higher than Turkey European countries, Canada and the USA. Two to eight years of medical service in underserved areas have been assigned for Iranian graduates of IM residency before receiving certification for working in larger cities.
Conclusion: Residency training in each country is affected by different factors such as economic status, work force, national health priorities and available facilities. Training of residents with more knowledge and skills that did not bear remarkable job burnout during their training period is a challenging goal for medical education policymakers- انتشار مقاله: 18-03-1396
- نویسندگان: Seyed Mostafa Monzavi,Bita Dadpour,Kianoush Shahraki,Maryam Nemati
- مشاهده
- جایگاه : پژوهشی
- مجله: Asia Pacific Journal of Medical Toxicology
- نوع مقاله: Journal Article
- کلمات کلیدی: Viperidae,Snake Bites,Antivenins,Envenomation Syndrome,Species Specificity
- چکیده:
- چکیده انگلیسی: Background: Despite sharing common evolutionary features, Viperidae species including Echis carinatus and Macrovipera lebetina possess venoms with different proportions of toxic agents, thereby causing clinical effects with potentially variable severity. This study was an effort to differentiate the clinical effects and outcomes of E. c. sochureki and M. l. obtusa victims.
Methods: In this prospective cross-sectional study, snakebite patients treated at a reference poisoning center in northeast of Iran in 2012 were enrolled. The features of snakebite event, demographic and clinical data of patients were recorded in checklists.
Results: Twenty-seven patients (63% male) with mean age of 34.8 ± 18.1 years were included. The offending snakes were recorded as "E. c. sochureki" in 63%, "M. l. obtusa" in 25.9% and "unknown" in 11.1% of cases. The most common clinical findings were fang mark in 100%, local pain in 81.5% and local edema in 74% of patients. Although the victims of both species showed classic features of viper envenoming syndrome including marked local effect and hemostatic disturbances, the victims of M. l. obtusa had significantly higher creatine kinase levels (P = 0.031) and lower platelet counts (P = 0.043), whereas marked edema (> 15cm) was significantly more common in E. c. sochureki victims (P = 0.028). Envenomation severity, other clinical effects and outcomes did not differ between the two species. Patients with delayed presentation to hospital had greater envenomation severity and edema extent and higher rate of coagulopathy.
Conclusions: Species-specific description of clinical effects following snakebite envenoming is useful for syndromic approach to human victims. The clinical envenoming syndromes by E. c. sochureki and M. l. obtusa show many common similarities despite the difference in severity of some effects. The delay in hospital admission and antivenom therapy is a risk for increased severity of envenomation and development of poorer clinical outcomes.
- انتشار مقاله: 25-07-1398
- نویسندگان: Seyed Mostafa Monzavi,Reza Afshari,Ali Reza Khoshdel,Amir Ahmad Salarian,Hamid Khosrojerdi,Azam Mihandoust
- مشاهده
- جایگاه : پژوهشی
- مجله: Asia Pacific Journal of Medical Toxicology
- نوع مقاله: Journal Article
- کلمات کلیدی: Cost-benefit analysis,Comparative Effectiveness Research,Employee Performance Appraisal,Journal Impact Factor,Social Change
- چکیده:
- چکیده انگلیسی: Evaluation of scientists working in a specific area of science is necessary, as they may strive for same limited resources, grants and academic promotions. One of the most common and accepted methods of assessing the performance and impact of a scientist is calculating the number of citations for their publications. However, such method suffer from certain shortcomings. It has become more and more obvious that evaluation of scientists should be qualitative in addition to quantitative. Moreover, the evaluation process should be pragmatic and reflective of the priorities of an institution, a country or an intended population. In this context, a scoring scale called "360-degree researcher evaluation score" is proposed in this paper. Accordingly, scientists are evaluated in 5 independent domains including (I) science development, (II) economic impact, (III) policy impact, (IV) societal impact and (V) stewardship of research. This scale is designed for evaluation of impacts resulted from research activities and thus it excludes the educational programs done by a scientist. In general, it seems necessary that the evaluation process of a scientist’s impact moves from only scintometric indices to a combination of quantitative and qualitative indices.
- انتشار مقاله: 15-08-1393
- نویسندگان: Reza Afshari,Seyed Mostafa Monzavi
- مشاهده
- جایگاه : پژوهشی
- مجله: Asia Pacific Journal of Medical Toxicology
- نوع مقاله: Journal Article
- کلمات کلیدی: Black Widow Spider,Health Status Indicators,Severity of Illness Index,Spider Bites
- چکیده:
- چکیده انگلیسی: Background: In order to describe the patients and evaluate the effectiveness of treatments for widow spider envenomation, investigators require a reliable assessment tool. In this paper, the development of a clinical index for measuring the widow spider bite severity, Latrodectus Envenomation Severity Score (LESS), is described.
Methods: According to the valid methods for index development, a Delphi group process was applied. A panel of 13 experienced medical toxicologists and physician experts in treatment of black widow spider bites was assembled in December 2013. The participants were asked to score clinical manifestations of Latrodectus envenomation based on their importance on the severity and patients’ prognosis. Hence, an initial draft of the severity index was developed and in the second phase of study, the draft was discussed in a focus group of experts to finally comment on each variable and vote about the final scores.
Results: The proposed version of LESS comprises of 34 clinical items categorized in 8 organ systems. The index includes definition of each clinical variable to help users of the index how to ascertain or rule out the clinical finding. The maximum theoretical score according to LESS is 87. Acute renal failure, myocarditis, pulmonary edema and ileus received the highest scores in this index.
Conclusion: The LESS is a new assessment tool that is designed to more objectively evaluate the severity and progression of envenomation in victims of widow spider bite. The prognostic-ability, reliability and sensitivity to change of the index should be investigated in future studies.
How to cite this article: Monzavi SM, Afshari R. Development of Latrodectus Envenomation Severity Score (LESS); a Severity Index for Widow Spider Bite: Initial Step. Asia Pac J Med Toxicol 2014;3:18-22.- انتشار مقاله: 25-09-1392
- نویسندگان: Seyed Mostafa Monzavi,Reza Afshari
- مشاهده
- جایگاه : پژوهشی
- مجله: Asia Pacific Journal of Medical Toxicology
- نوع مقاله: Journal Article
- کلمات کلیدی: Snakebite,Prognostic factor,Thrombocytopenia,Therapeutic response,Initial control
- چکیده:
- چکیده انگلیسی: Background: The goal of antivenom administration for snake-bitten patients is to achieve therapeutic response (initial control), which means reversal of the venom-induced effects through neutralizing the venom. The aim of this study was to identify snakebite prognostic factors of weak therapeutic response prior to antivenom administration.
Methods: This was a retrospective study of patients with viperidae snakebite envenomation who were admitted to Mashhad Toxicology Centre during 2007-2011. Demographic features, clinical manifestations and snakebite severity score (SSS) were collected prior to antivenom administration. Total number of antivenom vials administered to achieve therapeutic response and duration of hospitalization were also recorded. Potential factors in snakebite prognosis were analyzed by comparing in two groups of achieving therapeutic response with less than 5 vials and over 5 to calculate odds ratio.
Results: Total of 108 patients (male/female: 85/23) with mean (SD) age of 34.5 (17.0) were studied. The most common manifestations included fang marks (100%), pain (100%), ecchymosis (89%), swelling (83%), blister formation (48%) and thrombocytopenia (25%). In univariate analysis, thrombocytopenia (P=0.01), spontaneous bleeding (P=0.02), coagulopathic disturbances (P=0.007), swelling (P=0.003), progressive swelling (P=0.005), ecchymosis (P=0.05) and respiratory distress (P= 0.05) were significantly correlated to weak therapeutic response. Swelling and spontaneous bleeding were the strongest snakebite prognostic factors, as respectively they put the patients at 12.4 and 10.4 fold risks for difficult achievement of therapeutic response.
Conclusions: In snakebite, some clinical manifestations in the first hours of admission and prior to antivenom administration are associated with weak therapeutic response. Identifying these prognostic factors, can assist health care providers to better estimate the patient’s needs and predict the final consequences.- انتشار مقاله: 18-06-1391
- نویسندگان: Bita Dadpour,Azam Shafahi,Seyed Mostafa Monzavi,Abbas Zavar,Reza Afshari,Ali Reza Khoshdel
- مشاهده