Demographic, clinical, and paraclinical characteristics of COVID-19 pediatric cases in southeast Iran.

BACKGROUND: Even though children seem to be less vulnerable to the Coronavirus disease 2019 (COVID-19) infection, still a diverse range of clinical presentations and symptoms have been reported in children. Few studies assessed the clinical presentations of COVID-19 among Iranian children. We aimed to evaluate the clinical and paraclinical characteristics of COVID-19 infected children. METHODS: All COVID-19 suspected and confirmed children were referred to the Ali-ibn-Abitaleb Hospital, Zahedan, Iran. Patients were included in this longitudinal study. Patients were evaluated at admission and during hospitalization. Patients with some of the main COVID symptoms with positive PCR test were defined as confirmed cases. Clinical, imaging and laboratory results were collected for all patients. RESULTS: A total of 62 patients participated in this study. The male:female ratio was 1:1.03. There was a significant difference in fatigue prevalence between age groups (P = 0.002). There was no significant difference between groups in terms of fever duration (P = 0.624) and maximum temperature (P = 0.629). There was a significant difference between PCR positive and negative patients in terms of neurologic signs (P = 0.003), Intensive care unit admission (P = 0.001), white blood cell (P = 0.047). CONCLUSIONS: Even though our population was small, most of the findings matched other studies conducted on pediatric cases in Iran or other countries. It was also found that some clinical features such as pneumonia, cough, diarrhea, and tachycardia at admission time were statistically different among age groups.

What do Iranian general practitioners expect from family physician contracts?

BACKGROUND: Family medicine has become a main prerequisite of providing primary healthcare and a main reforming strategy to ensure the delivery of efficient and high-quality health services. AIM: This study aimed to investigate general practitioners' (GP) preferences regarding family physician contract. DESIGN AND SETTING: Cross-sectional study was conducted among GPs who registered in Ministry of Health and Medical Education (MoHME) family physician plan and were working in the health network of moderately developed regions in Iran. The sample size was calculated to be 150 GPs who were randomly selected from MoHME database. METHOD: Developed questionnaire was distributed to GPs. Results were analysed by ordinal regression model. RESULTS: Study results confirmed that 'type of employer' had the most significant effect on GPs' preferences (ß=0.86). Then attributes including 'allocating quota for being accepted in medical specialty' (ß=0.78), 'increased length of contract' (ß=0.00.42) and 'capitation payment+15% bonus' had respectively the great effects on participants' decision. Findings also revealed that a scenario of contracting with medical council was 2.4 times more likely to be chosen by GPs compared with a scenario of contracting with a medical university. Furthermore, a scenario that allocated a quota for admission to medical specialty courses was 2.18 times more probable to be preferred by them (p<0.001). CONCLUSION: Successful implementation of family medicine requires development of suitable solutions for attracting and attaining GPs in the programme. It seems that using a variety of incentives and applying them in physicians' work contract would be helpful in this regard.

Effect of Oral Methadone on ECG Characteristics and Endocrine Hormonal Changes and Their Inter-relationship.

INTRODUCTION: Methadone is the most common opioid in use for opioid substitution therapy. The relation of methadone and electrocardiographic findings is nearly well known while the relationship between its electrocardiographic indexes and hormonal changes is not well recognized. OBJECTIVE: To evaluate the hormonal changes in patients who are taking methadone maintenance treatment (MMT) and its effects on electrocardiographic indexes, in comparison with healthy control groups. PATIENTS AND METHODS: 40 patients receiving MMT therapy for at least last six months and 40 healthy subjects were enrolled in the study. Serum estradiol, testosterone, luteinizing hormone, follicle stimulating hormone and thyroid function tests were measured. Mean QT Interval, P-R Interval (PRi) and QRS duration were also documented in maximum. RESULTS: There were no significant differences in hormonal parameters between MMT and control groups. No significant relation was found between hormonal parameters, dose and duration of methadone usage in patients group. QTc was significantly higher in methadone users than control groups. QTc had a significant negative correlation with Testosterone level (r=-0.581, P=0.007) in males. Significant difference was found between PRi in patients and control groups (P=0.007). CONCLUSION: Electrocardiographic changes are an important complication of methadone that seems to be related to low testosterone level in men.