Iranian Surgeons Research Articles

Medical Researchers React to Peer Review: Attitudes towards and Challenges of Iranian Surgeons Publishing in English

Despite the recent growth of attention to English for research publication purposes, little is known about how researchers view the role of peer review in their success of publication. In light of this gap, the present study investigated Iranian surgeons’ attitudes towards peer review and the challenges they face in getting their papers published. To this end, 26 Iranian surgeons were interviewed, and the transcribed data were analyzed through thematic analysis. The results revealed that firstly the surgeons attested to the positive and negative contributions of peer review in terms of changing or unchanging their attitudes, respectively. Secondly, the authors faced a myriad of challenges related to editors, reviewers, and socio-political-linguistic factors in getting their papers published. Moreover, they associated these challenges with positive and negative effects in being connected to their career-stage development and motivating them to conduct and submit more papers. The study concludes with implications for research and practice in how researchers can craft more quality papers to enhance their chance of publication in high-quality journals.

Photographic Evaluation of Burn Depth via Telemedicine: Insights from Iranian Surgeons.

The accurate assessment of burn depth is crucial for determining appropriate treatment. Telemedicine has emerged as a promising tool for supporting burn diagnosis and decision-making, as it allows for remote consultation with burn specialists and access to high-quality imaging. The aim of this study was to evaluate the diagnostic capabilities of telemedicine in diagnosing burn depth. A total of 15 Iranian surgeons participated in this study; they were presented with 13 images of partial thickness burn ulcers located on the extremities and trunk of patients. The participating surgeons were required to provide their diagnoses of burn type and depth, as well as the necessity of surgical intervention, and their responses were recorded. Data from 11 participants and 143 responses were analyzed. The average diagnostic accuracy for superficial burns was 79.3%, while for deep burns, it was 13.72%. The mean total diagnostic accuracy was 75.2%. The results of this study suggest that photographs can be a reliable diagnostic tool for evaluating superficial burns. However, photographs are neither valid nor reliable for assessing burn depth. These findings have important implications for the use of telemedicine in burn diagnosis and indicate that additional diagnostic tools may be necessary for accurate assessment of deep burns.

Defensive medicine and its related risk factors: evidence from a sample of Iranian surgeons

ABSTRACT Objectives Defensive medicine (DM) is the deviation of a physician from normal behavior or what is a good practice and is aimed at reducing or avoiding the risk of legal litigation from patients or their families. Therefore, this study aimed to determine DM-related behaviors and associated risk factors among Iranian surgeons. Methods In this cross-sectional study, 235 surgeons were selected using convenience sampling. The data gathering tool was a researcher-made questionnaire confirmed as a reliable and valid tool. Factors associated with DM-related behaviors were identified using logistic regression analysis. Results DM-related behaviors ranged from 14.9% to 88.9%. The most common positive DM-related behaviors, including unnecessary biopsy (78.7%), imaging and laboratory tests (72.4% and 70.6%), and refusing high-risk patients (61.7%), was the most common negative DM-related behavior. The likelihood of DM-related behaviors was more in younger and less experienced surgeons. Other variables, such as gender, specialty, and lawsuit history, positively affected some DM-related behaviors (p < 0.05). Conclusion This study showed that the proportion of surgeons who frequently performed DM-related behaviors was higher than those who rarely performed it. Therefore, strategies including reforming the rules and regulations for medical errors and litigations, developing and implementing medical guidelines and evidence-based medicine, and improving the medical liability insurance system can reduce DM-related behaviors.

Treatment Options of Maxillofacial Fractures in Iran: A Comprehensive Systematic Review.

The aim of this study was to systematically review the literature on the treatment options of maxillofacial fractures in Iran, complementing a previous article regarding causes and the overall prevalence. A systematic search of PubMed, Cochrane Library, Web of Science (WS) and Google Scholar (GS) electronic databases was conducted to identify the relevant articles published up to January 2023. Studies reporting the treatment option of maxillofacial fractures in Iran were included in the analysis. MOOSE guidelines were adopted for the current systematic review. No data or language restriction were applied. Risk of bias across the articles was assessed. This systematic review included 13 articles with a total of 19,147 treated patients for maxillofacial fractures. ORIF was the most common type of treatment, but complications occurred in approximately 5% of cases. Mandible fractures were not statistically more treated by ORIF than closed reduction or conservative treatment, and no type of treatment was considered statistically preferable depending on the anatomical region affected by Iranian maxillofacial surgeons. The included studies were considered to have a low risk of bias, but many were not clear in reporting cross-referenced data regarding the type of treatment, which could be considered a major flaw. Overall, this study provides valuable insights into the types of treatment used for maxillofacial fractures by Iranian surgeons and highlights the importance of clear reporting of data in research articles.

Assessment of needlestick injuries and hepatitis B and C infection among surgeons

BackgroundSpecialist surgeons are at high risk of exposure to hepatitis viruses through occupational exposure to blood or body fluids. Protective measures against occupational exposure to the hepatitis B virus (HBV) and hepatitis C virus (HCV) must be taken in order to prevent infection in surgeons. We aimed to determine the needlestick injuries, and markers HBV and HCV in Iranian surgeons.MethodsThis study was cross-sectional research, performed in Baqyatallah, Shohada, Rasoul Akram, Sina, Taleghani, and Emam Hossein hospitals (all university hospitals) of Tehran, Iran. Overall 318 eligible surgeons were included. Anonymous questionnaires were used containing data about demographic characteristics, self-reported blood and needlestick contacts, occasional exposures, risk behaviors and vaccination. Also, the blood samples were taken and tested for hepatitis B surface antigen (HBsAg), antibody against Hepatitis B surface antigen (antiHBs) and HCV antibody (HCVAb). Fisher exact test and Kruskal Wallis test were used to analyze the data.ResultsThe mean age of the surgeons was 47.76 ± 8.95 years and 177 of them (55.66%) were male. The average number of needle–sticks was 28.28 ± 16.58 during the surgeons’ working life. Among them, 5 cases (1.59%) were positive for HBsAg and 2 cases (0.66%) were positive for HCVAb. ConclusionIn spite of the high needlestick rate in Iranian surgeons, prevalence of hepatitis B and C is not very high among them. A high degree of vigilance and a careful surgical technique is the only means available to prevent the transmission of the viruses.

Ethnic Rhinoplasty in Iranians: The Oral and Maxillofacial Surgery Experience

Rhinoplasty is a common esthetic procedure in Iran. The aim of the present study was to evaluate Iranian patient satisfaction. The role of ethnicity in surgical planning was assessed. This cross-sectional study examined participants aged between 18 and 45 years who underwent primary rhinoplasty. Patients' photographs were analyzed for tip projection, nasolabial angle, and nasofrontal angle. The surgical methods were chosen on the basis of the anatomic part of the nose treated. Patient satisfaction was assessed. Of 279 participants, 210 (75.53%) had a chief complaint of a large nasal tip. A hump nose was a problem for 230 (82.44%) of the participants. Tip droop was a problem for 248 participants (88.89%). The number who wished to have a natural nose was 213 (76.34%), and 66 (23.66%) preferred to have an exaggerated nose. For the recall phase of the study, 248 patients (89 men, 159 women) agreed to participate. Men were more satisfied than women 1year after rhinoplasty. Patients with an elevated tip had a higher satisfaction rate than others. The satisfaction level of patients increased when nose projection decreased. It seems that tip defining and elevation were major concerns of Iranian surgeons. Iranian patients were satisfied with an elevated and low-profile tip.

Iranian surgeons’ compliance with the American Society of Health-System Pharmacists guidelines: Antibiotic prophylaxis in private versus teaching hospitals in Shiraz, Iran

To assess compliance with the American Society of Health-System Pharmacists (ASHP) guidelines of prophylactic antibiotic use in private hospitals in Shiraz, Iran. This cross-sectional study was performed using prospective data gathered from April to September 2010 in the surgical wards of all private hospitals in Shiraz. Administrative data, patient characteristics, and antibiotic prophylaxis criteria were collected. Adherence to five criteria according to ASHP guidelines was evaluated: justification of the use of prophylactic antibiotics, appropriateness of the agent, dose, initiation time, and duration of the agent's effect. Only if all of the above criteria were fulfilled would the individual be labeled as completely compliant. We used descriptive analysis, including frequencies, to evaluate the results. From April to September 2010, 365 patients from 63 surgical wards of eleven private hospitals were enrolled in our study. Prophylactic antibiotics were inappropriately given to 64.6% of patients. Twenty out of 26 patients did not receive an appropriate course of antibiotics. In cases requiring antibiotic prophylaxis per ASHP guidelines, antibiotic choice was concordant in 32 (25.4%) out of 126 procedures. In cases that required and received prophylactic antibiotics, the duration and initiation time of prophylaxis were concordant with the guidelines for 37 (29.4%) and 77 (61.1%) cases, respectively. The overall compliance with ASHP guidelines was 10.13%. Our study revealed that in private hospitals in Shiraz, Iran, approximately 90% of patients received inappropriate surgical prophylaxis. Practical measures to improve the implementation of guidelines are urgently needed.

Prevalence and Risk Factors Associated with Low Back Pain in Iranian Surgeons

ObjectivesLow back pain (LBP) is a common and costly occupational injury among health care professionals. The purpose of this study was to investigate the prevalence and risk factors of LBP in surgeons and to analyze how individual and occupational characteristics contribute to the risk of LBP. MethodsA cross sectional study was conducted on 250 randomly selected surgeons including 112 general surgeons, 95 gynecologists and 43 orthopedists from 21 hospitals at northern Iran. A structured questionnaire including demographic, lifestyle, occupational characteristics as well as prevalence and risk factors of LBP was used. Visual analogue scale and Oswestry low back disability questionnaires were also used to assess the pain intensity and functional disability, respectively. ResultsPoint, last month, last six months, last year and lifetime prevalence of LBP was 39.9%, 50.2%, 62.3%, 71.7% and 84.8%, respectively. The highest point prevalence was related to the gynecologists with 44.9%, and the lowest for general surgeons (31.7%). Age, body mass index, smoking, general health, having an assistant, job satisfaction, using preventive strategies and years of practice were found to be correlated with the prevalence of LBP (P < .05 in all instances except for age and job satisfaction). Prolonged standing, repeated movements and awkward postures were the most prevalent aggravating factors (85.2%, 50.2% and 48.4%, respectively). Rest was found to be the most relieving factor (89.5%). ConclusionsThe results of this study demonstrate that the prevalence of LBP amongst surgeons appears to be high and highlights a major health concern. Further large scale studies, including other specialties and health professions such as physical therapy, chiropractic, and general medicine, should be performed.

Iranian surgeons’ compliance with the American Society of Health-System Pharmacists guideline: antibiotic prophylaxis in private versus teaching hospitals of Shiraz, Iran

Surgical site infections (SSIs) are the prevalent and grave complication following surgery, that significantly increase the length of hospital stay, morbidity and mortality, and subsequently drain healthcare system resources. To address the compliance with the American Society of Health-System Pharmacists (ASHP) guideline of prophylactic antibiotic in private hospitals in Shiraz, Iran.

Knowledge, Attitude, and Practice of Iranian Surgeons About Blood-Borne Diseases

Perhaps more than any other healthcare worker, it is the surgeons who are at an increased risk of exposure to hepatitis B (HB) virus, hepatitis C virus, and human immunodeficiency virus. The aim of this study was to evaluate surgeons' concerns regarding risk awareness and behavioral methods of protection against blood-borne pathogen transmission during surgery. A 31-item questionnaire with a reliability coefficient of 0.73 was used. Of 575 surgeons invited to participate from three universities and one national annual surgical society between May and July 2007, 430 (75%) returned completed forms. Concern about being infected with blood-borne diseases was more than 70 (from a total score of 100). Only 12.9% of surgeons always used double gloves. Complete vaccination against HB was done in about 76% of surgeons and only 56.8% had checked their HB surface antibody (anti-HBs) level. Older surgeons never used double gloves (P = 0.001). Iranian surgeons are not aware of the correct percentage of infected patients with and seroconversion rate of blood-borne diseases, do not use double gloves adequately, do not report their needlestick injuries, vaccinate against HB, and check anti-HBs after vaccination. Educational meetings, pamphlets, and facilities must be provided to health care workers, informing them of hazards, prevention, and postexposure prophylaxis to needlestick injuries, vaccination efficacy, and wearing double gloves.

Breast conserving surgery versus mastectomy: cancer practice by general surgeons in Iran

BackgroundThere appear to be geographical differences in decisions to perform mastectomy or breast conserving surgery for early-stage breast cancer. This study was carried out to evaluate general surgeons' preferences in breast cancer surgery and to assess the factors predicting cancer practice in Iran.MethodsA structured questionnaire was mailed to 235 general surgeons chosen from the address list of the Iranian Medical Council. The questionnaire elicited information about the general surgeons' characteristics and about their work experience, posts they have held, number of breast cancer operations performed per year, preferences for mastectomy or breast conserving surgery, and the reasons for these preferences.ResultsIn all, 83 surgeons returned the completed questionnaire. The results indicated that only 19% of the surgeons routinely performed breast conserving surgery (BCS) and this was significantly associated with their breast cancer case load (P < 0.01). There were no associations between BCS practice and the other variables studied. The most frequent reasons for not performing BCS were uncertainty about conservative therapy results (46%), uncertainty about the quality of available radiotherapy services (32%), and the probability of patients' non-compliance in radiotherapy (32%).ConclusionThe findings indicate that Iranian surgeons do not routinely perform BCS as the first and the best treatment modality. Further research is recommended to evaluate patients' outcomes after BCS treatment in Iran, with regard to available radiotherapy facilities and cultural factors (patients' compliance).

Breast conserving surgery versus mastectomy: Iranian surgeons experience

Breast conserving surgery versus mastectomy: Iranian surgeons experience