Investigating the Association between Gender and Age Distribution with Severity of COVID-19: A Single-Center Study from Southern Iran

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused a highly contagious disease, which led to a pandemic health emergency. However, age distribution and sex, regarding factors affecting the severity of COVID-19, are controversial. Therefore, this study is designed to investigate the effect of gender difference on the severity of COVID-19 infection in the studied age groups.Methods: Patients with COVID-19 of Valiasr Hospital (Khorrambid, Fars, Iran) from February 20, 2020, to February 20, 2021, are included in this retrospective study. The inclusion criteria were the age of above 15 years old and being residents of Khorrambid. COVID‐19 severity was classified as mild and moderate/severe according to the WHO standards. The obtained demographical and clinical data from the patient registry forms were analyzed using SPSS-24; P value <0.05 was considered as the level of significance. Chi-square and independent t-test were used to assess the variables.Results: Herein, 218 patients were recruited with a mean age of 45.6±17.2 and a relatively equal distribution of men and women population. Out of this population, 23.8% had comorbid diseases, 48.2% had mild, and 51.8% had moderate/severe infections. Our results indicated that male gender and the age range of 25-64 years in men are the most important risk factors associated with the disease severity (P<0.0001).Conclusions: The current study revealed that the leading risk factor of the disease severity was higher age (≥65 years) in the studied women. Meanwhile, in the men group, this factor was the age range of 25-64 years. These results suggest that further research is required to identify the possible impacts of gender and age on various aspects of the ongoing epidemic

An evaluation study of Virtual Master of Public Health in family Medicine in Shiraz University of Medical Sciences, Iran

Background & Objective: Master of public health (MPH) Course is designed for Increasing competency in family physicians employed in Iran's health system. The Contents of this course is based on society needs for increasing managing and public health. This study was designed to evaluate the virtual education in MPH Course in Shiraz University of Medical Sciences. Methods: This research was a qualitative and quantitative study. The evaluation was according Kirkpatrick's Model. The study was done on 25 family physicians in Shiraz University of medical Sciences. We used questionnaire which included goal attainment, learning assessment, compact disc (CD) quality and Dundee Ready Educational Environment Measure (DREEM) questionnaire. Data was gathered and then analyzed with SPSS software. Also, an Objective Structured Clinical Examination (OSCE) was designed in education development center for third level evaluation according to Kirkpatrick's Model. For qualitative evaluation, we did a semi structured interview with teachers. Open questionnaires also were designed for students and data were extracted. Results: 15 physicians full filled the questionnaires and 12 of them participated the OSCE. The most interested and practical lessons were about geriatrics diseases out patient management and epidemiology basics. The least interested lessons were about health promotion, case management and managed health cares. In OSCE, the best scores were for obstetrics – gynecology and the least scores for pediatrics lessons. Conclusion: According to participants' viewpoints, the disadvantages of the course were low quality compact discs, future employment participants, compact course and assessment methods. The best advantages of this course were efficient learning and increasing knowledges of the students. Keywords General physician Master of public health Family medicine Evaluation Virtual educatio

Actinomyces and Nocardia Infections in Chronic Granulomatous Disease

Objective : Chronic granulomatous disease (CGD) is an inherited disorder of the Nicotinamide adenine dinucleotide phosphate reduced oxidase complex characterized by recurrent bacterial and fungal infections. Disseminated infection by combination of opportunistic agents is being increasingly reported in CGD patients. We presented in the retrospective review of medical records, the etiology, presentation, clinical characteristics the infections detected, predisposing condition and outcome of nocardiosis and actinomycosis involved in a group of pediatric patients diagnosed with CGD. Materials and Methods: The clinical presentation of CGD-related infections was reviewed retrospectively from the medical records of all 12 patients with CGD. We studied respectively 12 patients between 2001 and 2008, and we analyzed two pediatric patients with CGD who acquired Nocardia and Actinomyces infections, and their clinical and microbiological characteristics were described. The material for investigations was collected from scrapings, crusts, pus from subcutaneous abscesses or exudation from sinus tracts, surgical debridement, and biopsy specimens. The microbiological diagnosis was determined by biochemical tests, histology, microscopy, and culture of clinical samples. Results: The medical records of 12 diagnosed CGD patients with suspected nocardiosis or actinomycosis were reviewed. One patient was diagnosed with actinomycosis and one patient with nocardiosis. Patients consisted of seven males and five females with ranging ages of 3 to 18 years. Nocardiosis and actinomycosis isolated in the two patients were confirmed by histology and culture methods. Neutrophil oxidative burst were absent (NBT=0) in both patients. The most common manifestations of CGD due to fungal infections, actinomycosis, and nocardiosis were osteomyelitis (42.8%), pulmonary infections (28.6%), lymphadenopathy (14.3%), and skin involvement (14.3%) during their illness. Conclusion: Nocardiosis and actinomycosis in children indicate the need for evaluation for an underlying immunological deficiency. Early diagnosis remains critical for decreased morbidity and occasional mortality. Physicians caring for patients with CGD should maintain a high index of suspicion for nocardiosis and actinomycosis especially if work up for TB and fungal infections are negative

The validity and reliability of script concordance test in otolaryngology residency training

Introduction: The script concordance test (SCT) is one the best tools used to evaluate clinical reasoning in ill-defined clinical situations. The aim of this study was to demonstrate SCT application in otolaryngology residency training. Methods: A 20 item otolaryngology SCT containing 60 questions was administered to 26 otolaryngology residents. The test was prepared by two otolaryngologists familiar to medical education. These questions have been validated by otolaryngology experts. The panel consisted of 9 academic staff in the field of otolaryngology. Pearson correlation test was used to assess the reliability of the test. Results: The obtained mean scores were 68.4±5.8 (out of 100) for residents and 78.2±6.4 (out of 100) for experts. There was a significant difference between the two scores (p<0.005). Cronbach’s alpha value was 0.80. Conclusion: The SCT is a reliable tool to evaluate clinical reasoning in otolaryngology residents. It should be included in otolaryngology residency training

In Vivo Comparative Evaluation of the Pomegranate (Punica granatum) Peel Extract as an Alternative Agent to Nystatin against Oral Candidiasis

Background: The pomegranate peel extract is a rich source of natural antioxidant and antimicrobial activity. The aim of the present investigation was to evaluate the in vivo antifungal activity of the pomegranate peel extract and to compare it with nystatin against oral candidiasis in Wistar rats. Methods: Thirty-five male Wistar rats, 6 to 8 weeks old and 220 to 250 g in weight, were used for animal studies. The rats were randomly divided into 7 groups. All the rats, except the control group, were immunosuppressed with cyclosporine (40 mg/kg/d) and hydrocortisone acetate (500 µg/kg/d). Then oral candidiasis was induced via the oral administration of a suspension of Candida albicans (ATCC 10231) (2×107 cell/mL) in PBS on the palate and tongue of the animals on days 3 and 5. Treatment was initiated by using 3 different concentrations of the pomegranate peel extract (125, 250, and 500 µg/mL/kg) and nystatin 100000 U/mL/kg by gavage daily. The statistical analysis was performed using the SPSS, version 22.0. In this study, generalized estimating equations were used for data analysis to determine the effects of the pomegranate peel extract and nystatin on oral candidiasis. Results: Regardless of the concentration of the pomegranate peel extract used for the treatment of oral candidiasis, a significant improvement was seen after 15 days of treatment. All the doses of the pomegranate peel were effective against candidiasis after 15 days; the pomegranate peel extract had no adverse effects following administration in the rats. Conclusion: Our results indicated that the pomegranate peel extract is a promising approach to oral candidiasis treatment, and it may serve as a natural alternative prospect due to its potency against oral candidiasis