[ attitude of residents, interns and clerkship students towards teaching role of residents]

Appropriate and effective education for medical students is critically important in promoting and maintaining society's health and the role of residents is undeniable in medical students' education. The aim of this study was to determine the attitude of clerkship students, Interns and residents towards the teaching role of residents in Sari Medical School in 2007. In this descriptive cross-sectional study, the statistical population included all clerkship students, interns, and residents [n=250] in all wards having residents in medical school of Mazandaran University of Medical Sciences in 2007. Using census sampling method, 192 persons were investigated. The data gathering tool was a questionnaire including 4 demographic and 20 attitude items. The data was analyzed by SPSS software using descriptive statistics, Chi[2], and AN OVA. Among respondents, 47%, 39% and 13% were clerkship students, interns, and residents, respectively. The participants' attitudes were dissimilar in different clinical departments. The most positive attitude belonged to psychiatry department [70% with positive attitude] and after that in pediatrics, gynecology, internal medicine, and surgery departments, 50% or less had a positive attitude. The attitude of residents was much more positive than that of clerkship students and interns. So that, 23% of clerkship students, 38% of interns, and 58% of residents had a positive attitude and none of the residents had a negative attitude toward their own education. The attitude of participants towards the teaching role of residents was dissimilar in different wards and the attitude of residents was much dissimilar to that of clerkship students and interns. It is necessary to pay more attention to the teaching role of residents

[Botulinum toxin in treatment of chronic idiopathic anal fissure]

Anal fissure is a chronic condition characterized by painful defecation and rectal bleeding. The aim of this study was to compare the injection of botulinum toxin [BT], versus with surgical lateral internal sphincterotomy [LIS]. In this clinical trial, 40 patients enrolled with chronic idiopathic anal fissure [CIAF] and were divided into 2 groups [20 BT group and 20 LIS group]. Both groups were compared according to complications and healing process during one week, following, 2 and 4 months after interventions. There were no statistical significant differences between 2 groups as a viewpoint of duration of disease, pain and other symptoms at the beginning of the study. The rate of healing in the LIS group was greater than the BT group within the first month [16/0], and second month [16/7] [p<0.05], however, there were no significant differences between the two groups in the 4[th] month [17/11] of the study [p>0.05]. In comparison with the BT group, the severity of pain in the LIS group decreased significantly. There were no significant differences between the two groups regarding complications. Healing in the BT group was approximately similar to the LIS; yet it appears to occur slower than LIS. Therefore, according to the results of the study, injection of the BT is recommended within the first step of CIAF treatment. To obtain the maximum healing effects of BT, a minimum period of 4 months is needed

[Evaluation of adverse effects of nasogastric intubations in abdominal surgery]

For the past years, tubes have been inserted into the stomach via the nose [nasogastric Tube: NGT] for the purpose of evacuating gas and liquid routinely, and for the prevention of nausea, and vomiting. However, there are no evidences regarding its efficacy. The aim of this study was to evaluate the post abdominal surgery complications either NGT inserted or not. In this clinical trial comparative study, 100 consecutive patients who underwent abdominal surgery [elective or urgency] were included in the study. They were divided in two groups: one was inserted NGT before anesthesia and remained until after initiation of bowel movement [control] and another without an incubated [case]. Post surgery complications was similar in both groups [P>0.05]: nausea [26% vs. 18%], vomiting [4% vs. 6%], fever [10% vs. 6%], bowel movement time [22.8 +/- 10.84 vs. 21.84 +/- 9.21], pulmonary complications [2% in both], wound infection [4% in both], duration of stay in hospital [2.58 +/- 1.62 vs. 2.47 +/- 1.6 days] in controls and cases respectively. Only sore throat was significantly more frequent in control group [74% vs. 16%]. These results suggest that routine and prophylactic insertion of NGT is not necessary, cannot reduce complications and also leads to patients' discomfort. Therefore, it must be saved in some specific indications

[Evaluation of faculty members' and students' attitude towards ambulatory teaching quality]

Ambulatory medicine is one of the most important parts of medical education. Due to its profound relation with professional future of physicians, ambulatory medicine is especially under attention and many studies have been performed to survey its quality and to design some ways to promote it. There is obvious deficiency in our evidence about ambulatory medicine. The aim of this study was to survey the quality of teaching of the ambulatory medicine from the viewpoint of the faculty members and students of medical faculty of Mazandaran. This was a descriptive and cross-sectional study. The study's population consisted of students, residents and clinical faculty members who were included by simple sampling. Data collection was performed by a questionnaire with 22 questions about demographic and educational variables as well as respondents' opinions about environmental conditions, independent activities, instructors' supervision, and social training in the ambulatory clinics. The validity of the questionnaire was controlled by content validity with expertise consultation, and its reliability was controlled by test-retest[r=0.85]. Data were analyzed using spss13 software. Response rate was 79%, the mean age of 36 faculties was 43.6 +/- 8.7 years and 32% of them were female. The mean age of 146 students was 25 +/- 3.6 years and 61% were female. The attitude of the majority of the students [88.3%] towards the quality of ambulatory teaching was negative, but majority of faculties [66.7%] had positive attitudes. There was no significant difference among teaching departments. Attitude of junior trainees was even worse. Attitude of faculty members and students was similar towards inappropriate physical environment of ambulatory clinics, but it was significantly different from independent activities of trainees in clinics [p=0.000]; relational drugs prescription [p=0.000]; management [p=0.004], and supervision of faculty members [p=0.000]. The overall attitudes towards the current condition of ambulatory teaching [especially trainees] were negative because of the impossibility of independent activities for trainees, low supervision of faculties, absence of teaching for rational drug prescription, differential diagnosis and management