Ablative Fractional CO2 Laser may be a Novel Treatment for Tattoo Allergic Reaction

A 47 year-old woman presented with eight-month history of tattoo allergic reaction of eyebrows after botulinum toxin A injection that was resistant to oral, topical and intralesional injection of corticosteroids. Multiple sessions of treatment with CO2 fractional laser resulted in significant flattening of allergic papules and plaques as well as reduction of tattoo pigmentatio

Deep Spatiotemporal Clutter Filtering of Transthoracic Echocardiographic Images Using a 3D Convolutional Auto-Encoder

This study presents a deep convolutional auto-encoder network for filtering reverberation artifacts, from transthoracic echocardiographic (TTE) image sequences. Given the spatiotemporal nature of these artifacts, the filtering network was built using 3D convolutional layers to suppress the clutter patterns throughout the cardiac cycle. The network was designed by taking advantage of: i) an attention mechanism to focus primarily on cluttered regions and ii) residual learning to preserve fine structures of the image frames. To train the deep network, a diverse set of artifact patterns was simulated and the simulated patterns were superimposed onto artifact-free ultra-realistic synthetic TTE sequences of six ultrasound vendors to generate input of the filtering network. The artifact-free sequences served as ground-truth. Performance of the filtering network was evaluated using unseen synthetic as well as in-vivo artifactual sequences. Satisfactory results obtained using the latter dataset confirmed the good generalization performance of the proposed network which was trained using the synthetic sequences and simulated artifact patterns. Suitability of the clutter-filtered sequences for further processing was assessed by computing segmental strain curves from them. The results showed that the large discrepancy between the strain profiles computed from the cluttered segments and their corresponding segments in the clutter-free images was significantly reduced after filtering the sequences using the proposed network. The trained deep network could process an artifactual TTE sequence in a fraction of a second and can be used for real-time clutter filtering. Moreover, it can improve the precision of the clinical indexes that are computed from the TTE sequences. The source code of the proposed method is available at: https://github.com/MahdiTabassian/Deep-Clutter-Filtering/tree/main.Comment: 18 pages, 14 figure

Evaluation of the effects of Matricaria chamomilla aroma on intensity of the labor pain in primparous women in Emdadi Hospital of Abhar in 2013

Labor pain relief is one of the challenges in health care systems in the most countries and is the main goal in midwifery cares. Introduction: This study aimed to investigate the chamomile breath on this pain intensity in the first stage of labor on prim parous women in Abhar Emdadi hospital in 2013. Methods and Results: This study was a randomized clinical trial carried out on 130 eligible prim parous women (65 in intervention and 65 in control group) at Emdadi Hospital of Abhar. The pain severity was measured at the moment of enrolling in the study. In the aroma therapy group gauze was soaked in 2 drops of Matrica camomilla water and in the control group gauze were soaked in 2 drops of distilled water and attached to the woman collars. The intervention was repeated every half an hour. Pain severity was measured in first and after intervention in 3-4, 5-7, and 8-10 centimeter dilatations. The samples were followed up until delivery. The materials used in this study were the demographic and obstetrics questionnaire, observation and exam checklist and the numeral scale of pain measurement. Independent T-test, the Mann-Whitney and Chi-squared test was implemented to analyze the data using SPSS v22 while the significance level was (0.05). The two groups were homogenized regarding age, profession, education, wanted pregnancy and number and severity of uterus contraction. The bishop score was calculated as well. Before intervention, the mean pain severity score after the intervention in intervention group in 3-4 cm (5.75±1.99), 5-7cm (7±1.52) and 8-10cm (7.01±1.22) decreased significantly compared with control group in dilatation 3-4 cm (8.93±1.96), 5-7 cm (9.41±0.63) and 8-10 cm (9.8±0.40) (p<0.005). Conclusions: The findings of the study revealed that aromatherapy of M. chamomilla water alleviates the labor pain. Therefore this method is recommended due to reducing the labor pain

Exploring Faculty Members’ Perceptions about Socially Accountable Medical Education Challenges: A Qualitative Content Analysis

Background & Objective: In recent decades, medical education has been expanding as part of the higher education system in the world. Due to the complexities of clinical education, the effect of various environmental factors on and changes in clinical environment, the importance of accountability to society and patients, and socially accountable medical education (SAME) challenges, the exploration of faculty members’ perceptions about SAME challenges is necessary. Thus, the aim of this study was to explore faculty members’ perceptions on the challenges of SAME. Methods: This qualitative study was conducted using qualitative content analysis in Shahid Beheshti University of Medical Sciences, Iran, in 2014. Knowledge obtained through qualitative content analysis is based on the unique views of the participants and actual data of the text. The participants were 8 faculty members who provided the most data on the fundamental factors effective on SAME (purposive sampling). Semi-structured interviews were conducted with the participants and they were asked to describe their experiences of and views on SAME. Data collection was continued until achieving data saturation. Data collection and analysis were carried out simultaneously through consideration of trustworthiness. Results: The main themes extracted in this study were "defective education which is not community-based", "lack of adequate commitment of teachers as role models", "lack of motivation in students", and "management problems and lack of resources". Conclusion: The results of the present study illustrate the necessity for fundamental and comprehensive modification of training programs and improvement of their processes, so that they can accommodate the community’s requirements. Moreover, there is need for strategies to increase motivation among teachers and students. Key Words: Qualitative content analysis, Socially accountable medical education (SAME), Accountability, Challenge

Evaluation of the Quality of Clinical Education Based on the Perspective of Medical Students of Shahroud University of Medical Sciences

Background: Improving the quality of clinical education requires a continuous review of the existing situation to identify strengths and weaknesses. The aim of the study was to evaluate the quality of clinical education based on the perspective of medical students of Shahroud university of medical sciences. Methods: This descriptive-analytical study was conducted at1397-98. Participants were 230 medical students and interns in Shahroud university of medical sciences who were enrolled in the study. The data were collected using the clinical education quality assessment questionnaire, with a range of 0-66 points and divided into three levels: weak, moderate and desirable. T-test was used for data analysis. The Significanl level was set at 0.05. Results: The results showed that the mean of the standard deviation of clinical education quality in terms of goals and curriculum (12.95), teacher performance (10.23), and student treatment (4.09) was desirable from medical students' point of view. (Given that the significance level is less than 0.05, these averages are desirable) while in terms of educational environment (4.60) and supervision and evaluation (4.01), it is not desirable. Conclusions: According to the findings, clinical quality status is desirable in most aspects, but it is necessary to eliminate the weaknesses to improve the quality of clinical education in this university in terms of the educational environment, monitoring and evaluation according to the students' viewpoints. Keywords: Quality, Clinical education, Medical students

Evaluation of the Quality of Clinical Education Based on the Perspective of Medical Students of Shahroud University of Medical Sciences

Background: Improving the quality of clinical education requires a continuous review of the existing situation to identify strengths and weaknesses. The aim of the study was to evaluate the quality of clinical education based on the perspective of medical students of Shahroud university of medical sciences. Methods: This descriptive-analytical study was conducted at1397-98. Participants were 230 medical students and interns in Shahroud university of medical sciences who were enrolled in the study. The data were collected using the clinical education quality assessment questionnaire, with a range of 0-66 points and divided into three levels: weak, moderate and desirable. T-test was used for data analysis. The Significanl level was set at 0.05. Results: The results showed that the mean of the standard deviation of clinical education quality in terms of goals and curriculum (12.95), teacher performance (10.23), and student treatment (4.09) was desirable from medical students' point of view. (Given that the significance level is less than 0.05, these averages are desirable) while in terms of educational environment (4.60) and supervision and evaluation (4.01), it is not desirable. Conclusions: According to the findings, clinical quality status is desirable in most aspects, but it is necessary to eliminate the weaknesses to improve the quality of clinical education in this university in terms of the educational environment, monitoring and evaluation according to the students' viewpoints. Keywords: Quality, Clinical education, Medical students

Professional Ethics in Teaching from the Perspectives of Professors and Graduate Students of Mazandaran University of Medical Sciences: A Comparative Study

Background: Teaching and training require ethical considerations. Objectives: The present study aimed at evaluating teaching ethics from the perspectives of professors and postgraduate students of Mazandaran University of Medical Sciences based on a comparative approach. Methods: A cross-sectional study was performed on all postgraduate students and their professors in the academic year of 2019-2020. A total of 284 postgraduate students and 42 professors were selected using a stratified random sampling method, according to the size of each stratum. The data collection instrument was the standard teacher's professional ethics scale including six subscales and 48 items, scored based on a five-point Likert scale from 1 to 5. Data were analyzed by SPSS version 21 using descriptive statistics, independent samples t-test, and one-way analysis of variance. Results: The total mean score of professional ethics for professors was 3.67±0.63 and 4.29 ± 0.59 from the students' and professors’ perspectives, respectively. There was a significant difference between the students' and professors’ perspectives in each of the subscales (P <0.0001). There was a significant difference among schools in the teaching techniques mastery and observation of rules subscales. Conclusion: From the perspective of students, the status of teaching ethics is still far from the standard, and it needs more educational plans to improve. Keywords: Professional Ethics, Teaching, Professors, Student

Production and Characterization of Biosurfactants Using Bacteria Isolated from Acidic Hot Springs

&nbsp; Background and objective: Biosurfactants are increasingly used by food industries due to their low toxicities and unique structures. In this study, biosurfactants were produced and characterized for the first time using acidic bacteria isolated from acidic hot springs in Bushehr Province, Iran. Material and methods: Screening and identification of the most efficient species for biosurfactant production were carried out on 12 bacterial species using several experiments such as hemolysis, surface tension, emulsification index and diameter of clear zone. In addition to biosurfactant production, kinetics, stability and structural and thermal analysis were carried out for the bacterial strains using thin layer chromatography, Fourier Transform Infrared, nuclear magnetic resonance and differential scanning calorimetry. Results and conclusion: The biosurfactant from the selected bacteria (0.1 g l-1) was thermally stable at 120°C for 30 min. Stability at temperatures up to 140°C was confirmed using differential scanning calorimetry. The most significant novelty included the fact that the surface property was preserved until an osmolarity of 4% w v-1. Decreased surface tension and the emulsification potential were only reported at concentrations higher the highlighted concentration. Biological assay showed that Staphylococcus aureus was susceptible to produced biosurfactants, while no susceptibility was seen in Escherichia coli. Degeneration of SW480 cell line exposed to 0.601 µg µl-1 of the biosurfactant was detected after 24 h. The structural analysis showed that the biosurfactant was similar to surfactin as a food bioemulsifier. Conflict of interest: The authors declare that they have no conflict of interest

Using modified Direct Observation of Procedural Skills (DOPS) to assess undergraduate medical students

Introduction: Nowadays according to competency based curriculum, selecting an appropriate assessment method is inevitable. This study aimed to investigate application of Direct Observation of Procedural Skills (DOPS) in undergraduate medical students. Methods: This is a cross sectional study conducted during emergency ward rotation in last year medical students using consensus sampling method. Each student performed 2 procedures at least twice under the observation of 2 assessors using modified DOPS rating scales designed for each procedure simultaneously. Correlation between DOPS score and final routine exam was measured. Face and content validity was determined by the panel of experts. Moreover, through the test-retest and interrater reliability, the correlation of each score and total score was investigated. The spent time was calculated too. The statistical analysis was carried out using SPSS version 18. Results: Totally 60 students did 240 procedures under DOPS. The face and content validity confirmed by an expert panel. The findings showed that there was a significant correlation between the scores of each test and the total DOPS score (r1=0.736**, r2=0.793**, r3=0.564**, r4=0.685**; p<0.001). There was a significant correlation between the first and second scores of doing the same procedure (Pearson Cor.=0.74, p<0.001) and also between the scores of the two individual examiners when observing the same procedure (Pearson Cor.=0.84-0.94, p<0.001). The results showed that there was no correlation (Pearson Correlation=0.018, p<0.89) between the scores of this test and the final routine ward exam scores. The average time for doing DOPS test and the average time for providing feedback were 11.17±7.5 Max and 9.2±4.5 Min, respectively. Conclusion: The use of novel performance assessment methods such as DOPS is highly beneficial in order to ensure the adequacy of learning in medical students and assess their readiness for accepting professional responsibilities. DOPS as a practical and reliable test with acceptable validation can be used to assess clinical skills of undergraduate medical students