Effects of training on medical student's capabilities in performing cutdown and inserting chest tube in clinical skill department

To determine the effect of training on medical students' capabilities in performing cutdown and inserting chest tube in clinical skill department. A questionnaire was used to gather data separately in two procedures, with 10 questions for each procedure and Likert scale [from very much=6 to very little=1] was used. Data were analyzed using statistical descriptive method. Regarding the needed skills in inserting chest tube students' average significantly increased from 40.4 +/- 17.39 to 81.2 +/- 16.71, and in the case of performing cutdown, it significantly increased from 39.4 +/- 16.91 to 83.5 +/- 10.43 [p < 0.000]. The needed skills significantly increased medical students' self-perceived effectiveness of the trainings in their performances regarding inserting chest tube and performing cutdown in the training center of clinical skills department

[Comparison of the effect of incentive spirometry on pulmonary volumes and arterial blood gases after coronary artery bypass surgery]

Following thoracic and abdominal surgery, all patients experience a decrease in pulmonary volumes and atelectasis. Different methods such as lung physiotherapy, intermittent positive pressure breathing, positive expiratory pressure and incentive spirometry are suggested for improvement of pulmonary volumes and blood gas parameters in these patients. Due to cheap, simple and easy use of incentive spirometry, we aimed at evaluating the effects of it on pulmonary volumes and blood gases parameters [ABG] in coronary artery bypass patients. This is a randomized, clinical trial study. From February 2004 to February 2005, 150 consecutive male patients who were hospitalized for coronary artery bypass surgery in Madani heart hospital were divided into two groups at random. On the first day of operation, group I used incentive spirometry and group II was routinely followed up. Data were collected through a questionnaire including age, left ventricular function [LVEF], smoking and number of grafts. Blood gases parameters and spirornetry volumes were measured in 3 phases before, in the morning of the first day of operation and after using incentive spirometry. Data were analyzed by SPSS software using paired or unpaired student's t-test. There were no significant differences between two groups as to the mean age, LVEF, number of grafts and duration of mechanical ventilation in ICU. Comparison of ABGs before anesthesia and on the first day of surgery showed a significant decrease in systemic O[2] saturation and arterial Po2 in all cases [p<0.001], but no significant differences were found between the second and third phases in both groups. Spirometry parameters showed a decrease of forced expiratory volume in the first second [FEV[1]] and forced vital capacity [FVC] after surgery in all patients [p<0.0001], but by using incentive spirometery, no significant changes in spirometeric pulmonary volumes occurred. Using incentive spirometery on the first day of operation has no significant impact on pulmonary volumes and blood gases parameters

Early results of median sternotomy versus right anterolateral thoracotomy in atrial septal defect closure

Atrial septal defect [ASD] closure by surgery is a standard method with low mortality and complication rate. Nowadays, surgeons prefer to use less invasive methods including interventional and limited thoracotomy. The aim of this study was to compare the post surgical results in two groups undergoing ASD surgery, by sternotomy or thoracotomy method. This retrospective study was performed in Shahid Madani heart hospital from 1998-2003 on 73 patients who underwent ASD surgery. Data were collected by filling out a questionnaire. Group I [thoracotomy] included 38 patients with mean age of 23.84 +/- 3.2 years and group II [complete sternotomy] included 35 patients with mean age of 21.82 +/- 2.3 years. The results were almost the same in both groups except for longer operation time [p=0.01] and shorter hospitalization period [p=0.01] in group I. Considering lower injury by surgery and better cosmetic results, ASD repair by thoracotomy seems to be a suitable method

effect of formal training of cardiopulmonary resuscitation [CPR] skills on medical students perceived self-sufficiency

Background: experience of cardiopulmonary resuscitation [CPR] in real clinical setting is not easily possible for all medical students

Purpose: to assess medical student perceived self-sufficiency on three procedural skill on internship courses after they had taken a training course in clerkship period

Methods: forty three medical students who had attended a workshop on CPR, tracheal intubations and venopuncture answered the questionnaires on their perceived self-sufficiency in performing these procedures after serving a few months as interns

Results: the mean score for perceived self-sufficiency [PSS] was 75.84 [+/-18.63].Thre were a high correlation between the score given for the applicability of training in real life situation and the stress reduction scores on first time performing the procedure

Conclusion: the high degree of correlation between PSS scores and applicability scores, may warrant the consideration of new methods in procedural skills