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Background: Approximately 25% of the residents' time in each shift is allocated to educating lower-level assistants and interns. Assistants have played a major role in interns' education. Aim: To assess the teaching abilities of emergency medicine assistants in the training and monitoring of medical interns and undergraduate students. Methods: This cross-sectional study was performed in 2015 at the emergency center of Imam Reza hospital in Mashhad University of Medical Sciences. We employed a researcher-made questionnaire to search the capability of emergency medicine residents to assess the teaching capabilities of emergency medicine residents to interns. This questionnaire was completed by 106 interns. The Validity of the questionnaire was confirmed by three specialist experts and reliability of the questionnaire was confirmed by Cronbach's alpha (0.94). This questionnaire consists of 24 questions in six areas. The analysis was performed by descriptive statistics using SPSS 16. Result: The study showed that the least favorable score was related to "residents get feedback on each shift" and the highest score was given to "a friendly relationship with the Interns and residents". Conclusion: Considering the key role of residents in the education and training of future healthcare specialists, training interventions and allocating sufficient time to the proper education of different members of healthcare teams and medical students could largely contribute to the development of clinical training systems. [ABSTRACT FROM AUTHOR]

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Pain is the most common complaint in emergency department and there are several methods for its control. Among them, pharmaceutical methods are the most effective. Although intravenous morphine has been the most common choice for several years, it has some adverse effects. There are many researches about intravenous acetaminophen as an analgesic agent and it appears that it has good analgesic effects for various types of pain. We searched some electronic resources for clinical trials comparing analgesic effects of intravenous acetaminophen vs. intravenous morphine for acute pain treatment in emergency setting. In two clinical trials, the analgesic effect of intravenous acetaminophen has been compared with intravenous morphine for renal colic. The results revealed no significant difference between analgesic effects of two medications. Another clinical trial revealed that intravenous acetaminophen has acceptable analgesic effects on the post-cesarean section pain when combined with other analgesic medications. One study revealed that administration of intravenous acetaminophen compared to placebo before hysterectomy decreased consumption of morphine via patient-controlled analgesia pump and decreased the side effects. Similarly, another study revealed that the infusion of intravenous acetaminophen vs. placebo after orthopedic surgery decreased the consumption of morphine after the surgery. A clinical trial revealed intravenous acetaminophen provided a level of analgesia comparable to intravenous morphine in isolated limb trauma, while causing less side effects than morphine. It appears that intravenous acetaminophen has good analgesic effects for visceral, traumatic and postoperative pains compare with intravenous morphine. [ABSTRACT FROM AUTHOR]

Objective(s): Incidence of neurocognitive and psychological disorders may be related to serum homocystein (Hcy), cobalamin (vitamin B12) and folate levels in old people. The aim of this study was to assess the relation between Hcy, cobalamin, folate and neurocognitive and/or psychological disorders in the elderly. Materials and Methods: In this cross-sectional study, 280 subjects with = 65 years old, were evaluated. The subjects were selected from 12 regions of Mashhad, Iran, over March to October 2009. After blood sampling, data were collected by questionnaire, face to face interview and performing neurocognitive and psychological tests. The sera of 250 persons were analyzed for cobalamin and folate by RIA method. Amongst the aforementioned samples, 78 cases with cobalamin <300 pg/ml and folate <6.5 ng/ml were analyzed for Hcy by ELISA method. Results: Amongst the people, 126 (45%) were male and 154 (55%) were female. The prevalence of hyperhomocysteinemia (HHcy) was 59.5% and 37.1% in male and female respectively (P -value =0.049). Hcy inversely correlated to cobalamin (r=-0.282, P=0.014) and to folate (r=-0.203, P=0.014). Hcy, cobalamin and folate correlations to neurocognitive and psychological impairments were not statically significant. Conclusion: Hyper Hcy or low cobalamin and folate in the elderly, are prevalent but their relationships with neurocognitive and psychological impairments is controversial. If these relationships had been confirmed, performing a single serum Hcy or cobalamin test would have been enough to diagnose and prevent neurocognitive impairments and inversely, neurocognitive-psychological sign and symptoms could have meant probable tissue vitamin deficiencies. However methods of assessing neurocognitive and psychological markers with validity and reliability of clinical and laboratory tests for finding aforementioned relationships should be revised. [ABSTRACT FROM AUTHOR]

Quantitative understanding of stress transfer between major fault systems can elucidate the kinematics of large-scale plate interactions. This study analyzed right-lateral strike-slip motion on the North Tabriz fault (NTF) in an area where this structure appears to transition into a thrust fault known as the North Mishu fault (NMF). These faults play an important but cryptic role in accommodating stress related to the Arabia-Eurasia plate collision. We analyzed regional velocity vectors from permanent and temporary GPS arrays to estimate changes in fault-parallel and fault-normal slip rates in the transition zone between the NTF and NMF. Independent of its compressional motion, the NMF exhibits a dextral strike-slip rate of ~2.62 mm/yr. Along the NTF, the right-lateral slip rate decreases and the vertical slip rate on increases at rates of 0.08 and 0.38 mm/yr km, respectively, as the NTF approaches the NMF. This study also used small baseline (SBAS) PS-InSAR results to reveal a NE-SW-striking reverse fault and a developing syncline hidden beneath the Tabriz Basin. Additionally, we calculated the vertical displacement rates using horizontal vectors from the GPS data and mean line-of-sight rate estimates from the SBAS data. While the study area does not express large-scale extrusion, such as that observed in the Anatolian Plate, the transformation of strike-slip motion into thrusting and crustal shortening along the NMF-NTF fault zone accommodates most of the N-S compression affecting the northwestern Iranian Plateau. In this region, small-sized, right-lateral strike-slip faults, and other folded structures form horsetail features. These dispersed structures accommodate eastward extrusion of the northwestern Iranian Plateau.

Objectives: Migraine is the second most common cause of headaches. There are several methods in treatment of migraine including herbal medicine. Tanacetumparthenium (feverfew), a kind of chrysanthemum is traditionally used for treatment of headaches. The aim of this research was to assess the effect of feverfew in treatment of migraine. Materials and Methods: This is a double blinded clinical trial with patient observation for eight months. 168 participants were enrolled in three groups: feverfew, placebo and dihydroergotamine. Participants with migraines more frequent than three times a month were included in our research. Severity and frequency of headache and kind of the prescribed drug were the investigated variables in this study. Results: 155 of 168 participants (92.26%) completed the three month study protocol. After 15 days, 40 people (75.5%) in the feverfew group, 28 people (60.9%) in the placebo group and 49 people (89.1%) in dihydroergotamine group were well or better than before treatment. After 45 and 105 days these percentages showed an increase but there was no significant difference between treatment periods. After medication, we observed a statistically significant reduction in these groups, compared to baseline, for number of migraine headaches, migraine days and headache severity. Although assessment of efficacy showed that dihydroergotamine and feverfew groups were better than placebo, only the difference between dihydroergotamine and placebo groups was significant (p<0.05). Conclusion: feverfew is as effective as dihydroergotamine. Therefore, in some conditions like hypertension, feverfew is a good alternative for migraine treatment. [ABSTRACT FROM AUTHOR]

Background and purpose: Stroke is the most common and the most deadly neurological disease that is accompanied with many complications. The aim of this study was to compare the diagnostic value of hs-CRP and ABCD2 criteria in predicting the future incidence of acute cerebrovascular events during follow-up in patients with transient ischemic attack (TIA). Materials and methods: This cohort study was performed in TIA patients during the first 24 hours of onset of symptoms. Blood samples were taken and demographic information was obtained, then hs-CRP was measured in all patients. History of hypertension, atherosclerosis, and ABCD2 scores were also recorded. Results: The patients (n= 135) included 69 (51.11%) male and 66 (48.88%) female cases. Eight subjects had a stroke within three months. There was no significant relationship between hs-CRP level and stroke incidence (P= 0.303), but ABCD2 cut-off scores of >1.5 had the most sensitivity (87.5%) and specificity (81.9) that could significantly predict the occurrence of stroke (P= 0.011). Systolic blood pressure (OR=1.04) and ABCD2 score (OR=2.43) could predict the occurrence of stroke (P <0.05). Findings showed a significant relationship between hs-CRP level and age (over 60 years) and the incidence of slurred speech (P <0.05). Conclusion: CRP level was not significantly associated with the incidence or absence of stroke in three months after TIA, but ABCD2 score was found to be more accurate in this regard. [ABSTRACT FROM AUTHOR]

Arapid, simple, and sensitive procedure based on modified solid phase extraction was developed for the pre-concentration and determination of trace amount of lead in water resources. Lead was reacted with ammonium pyrrolidinedithiocarbamate (APDC) to make a complex. The complex was then collected in a column packed with surfactant-coated alumina. The parameters affecting the collection efficiency and desorption rate of the lead complexes from the column were investigated and optimized. The collection efficiency of the lead complex on the adsorbent was excellent under the optimized conditions. The results obtained from the recovery test showed the capability and reliability of the method for the analysis of trace amounts of lead. The proposed pre-concentration procedure made it possible to apply conventional flame atomic absorption spectrometry (FAAS) for the sensitive determination of trace amounts of lead in water resources.