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INTRODUCTION: The Continuing Medical Education (CME) programs in the medical community aim to improve the knowledge of practitioners and its effect on changing their performance. Previous studies showed that CME causes minimum changes in physicians' behaviors, so it is important to pay attention to the views of this group. In this regard, this qualitative study aimed to explain the Iranian Ophthalmologists' perceptions and experiences concerning the CME Programs in Iran. METHODS: In this qualitative study, 18 participants, including 10 subspecialists and 8 general ophthalmologists, were recruited to participate in in-depth interviews concerning their experiences with CME. The required data were collected from April 2018 to Feb 2019. Each interview was conducted in medical universities; eye research centers; and the ophthalmology departments, offices, and operating rooms of public and private hospitals. The current study was performed using a content analysis based on the Granheim and Lundman's methods. The codes, sub- categories, categories, and themes were then explored through an inductive process in which the researchers moved from specific to general. RESULT: The data obtained from interviews, and filed notes were analyzed and then classified into the following four themes: "growth and development of the ophthalmology's CME program over time", "challenges of the ophthalmology's CME program", "reasons for the participation of the ophthalmologist in the CME program", and "strategies for improvement". CONCLUSION: Based on the qualitative study's results, in spite of growth and development of the design and implementation of the Ophthalmologic CME programs, we are still facing multiple challenges. Enhancing the interactivity between the providers and participants can also improve the ophthalmology CME programs.
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Green synthesis is a biocompatible and stable method of producing zinc oxide nanoparticles (ZnONPs).In the present study, ZnONPs were biosynthesized using Fumaria parviflora extract by the green method, and the antibacterial and antioxidant properties of these NPs were evaluated. The characteristics of the synthesized ZnONPs were determined by ultraviolet-visible spectrophotometry (UV-VIS), X-ray diffraction (XRD), and scanning electron microscopy (SEM). The antioxidant activity of the NPs was tested by the α-diphenyl-ß-picrylhydrazyl (DPPH) method. Antibacterial properties of the synthesized ZnONPs were evaluated against Staphylococcus aureus and Escherichia coli by disc diffusion and microdilution methods. The results of UV-VIS spectroscopy revealed an absorption peak at 370 nm. XRD results showed the formation of a hexagonal wurtzite structure, and SEM analyses demonstrated that ZnONPs had a spherical shape with an average size 42 to 60 nm. Free radical scavenging capacity of ZnONPs was assessed using the DPPH assay with varying concentrations of ZnONPs, and scavenging activity was observed with IC50 of 30.86 µg/ml. In the antibacterial assay, the inhibition zone of the synthesized NPs at 100 µg/ml concentration for S. aureus (24.6 ± 0.72) was greater than that of the antibiotics vancomycin (23 ± 0.51) and a mikacin (13 ± 0.40) and was greater for E. coli (13.2 ± 0.81)than that of vancomycin (12 ± 0.41) (P ≤ 0.05). The minimum inhibitory concentration (MIC) and the minimum bactericidal concentration (MBC) values of ZnONPs for S. aureus and E. coli were 1.56 and 3.125 µg/ml, and 6.25 and 12.5 µg/ml, respectively. The biosynthesized ZnONPs showed strong antibacterial and antioxidant activities.
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BACKGROUND: Focused assessment with sonography in trauma (FAST) is a method for prompt detection of the abdominal free fluid in patients with abdominal trauma. OBJECTIVES: This study was conducted to compare the diagnostic accuracy of FAST performed by emergency medicine residents (EMR) and radiology residents (RRs) in detecting peritoneal free fluids. PATIENTS AND METHODS: Patients triaged in the emergency department with blunt abdominal trauma, high energy trauma, and multiple traumas underwent a FAST examination by EMRs and RRs with the same techniques to obtain the standard views. Ultrasound findings for free fluid in peritoneal cavity for each patient (positive/negative) were compared with the results of computed tomography, operative exploration, or observation as the final outcome. RESULTS: A total of 138 patients were included in the final analysis. Good diagnostic agreement was noted between the results of FAST scans performed by EMRs and RRs (κ = 0.701, P < 0.001), also between the results of EMRs-performed FAST and the final outcome (κ = 0.830, P < 0.0010), and finally between the results of RRs-performed FAST and final outcome (κ = 0.795, P < 0.001). No significant differences were noted between EMRs- and RRs-performed FASTs regarding sensitivity (84.6% vs 84.6%), specificity (98.4% vs 97.6%), positive predictive value (84.6% vs 84.6%), and negative predictive value (98.4% vs 98.4%). CONCLUSIONS: Trained EMRs like their fellow RRs have the ability to perform FAST scan with high diagnostic value in patients with blunt abdominal trauma.
