Nowadays, owning to the failure of the Traditional Educational System, the only option left is the Virtual Educational, which will change the educational system at 180 degrees. The aim of this study was to investigate and evaluate the relationship between different factors associated with the level of satisfaction amongst students of Medical Science University during the pandemic outbreak of COVID-19. This cross-sectional study was performed among students of Birjand University of Medical Sciences in 2020. They completed the questionnaire was created using a Google platform and their answers was collected online. Satisfaction towards virtual educational learning plus total evaluation scores for various dimension of questionnaire was analyzed. A total of 320 out of 2700 students participated in the study voluntarily. Students' satisfaction with blended method in teaching style was higher and significant than two separate styles (p<0.05), but there was no significant relationship between satisfaction level and some demographic characteristics. Also, the majority of participants (41.7%) have a medium level of Satisfaction. There was significant relationship between the amount of computer skills, Semester and sex with overall satisfaction (p<0.05). Students demonstrated a moderate satisfaction and positive attitude towards VR educational system which comprises of a "Virtual Learning Room" at home for both the teacher and student. To be able to implement education in medical universities in the coronavirus crisis, electronic and internet infrastructures need to be completed quickly, and officials should take steps to empower students and teachers to take advantage of this opportunity.

Recent pharyngeal infection has been implicated in the case of psoriasis. In addition, the risk for an aggravation or an abrupt recurrence of this autoimmune disease is very high. In spite of the high incidence and recurrence rate of psoriasis in Iran, the etiological studies in this field are very sparse. →What this article adds: Data on recurrent events have been studied extensively using marginal and random effects models. In these models, it is often assumed that the effect of risk factors is unchanged over the follow-up period; however, time-dependent coefficient rates model is appropriate in situations where the effect of an exposure or covariates changes over time.

Background: Individuals with breast cancer may experience multiple types of recurrence and a terminal event during their life. Follow-up may be interrupted for several reasons, including patients lost to follow-up or end of a study. Death is considered as a dependent terminal event.Objectives: The main objective was to model the dependency between (locoregional and metastaticrelapses and death in breast cancer patients. Methods: This retrospective cohort study was conducted in Cancer Research Center, Shahid Beheshti University of Medical Sciences on 342 patients with BC. Patients were followed up to 20 years from January 1996 until February 2015. This study considers the analysis of diseases recurrence and survival for joint modeling of three correlated evens: Local recurrence, metastasis, and death. The aims are to detect the effects of relapses on death and the correlation between local and distant recurrences. We propose a joint frailty model for multiple recurrent events with a terminal event.Results: According to all obtained results of the fitted models, the risk of local and metastatic relapses or death increased for women with positive lymph node (N+) or for women with a grade higher than I. Also, it was found that if the association between these 3 times to events are not taken into account, we may lose a significant association. The variable HR+ was significantly correlated with the hazards of two types of recurrences, and death for both reduced and proposed models (P < 0.05). Conclusions: We concluded that the risk of locoregional recurrences is correlated with the risk of metastatic and the risk of metastatic relapse is also correlated with death. In this special setting, it can be difficult to get an independence between locoregional and distant recurrences. Also, these results should be considered with caution, with the few number of recurrences.

No abstract

BackgroundNonalcoholic fatty-liver disease (NAFLD) is the most common cause of chronic liver disease worldwide. Although NAFLD has been studied extensively, potential risk factors for NAFLD among chronic hepatitis B (CHB) patients and their comparison with healthy individuals have remained understudied in Iran. As such, we examined the association between HBV infection and the development of NAFLD in two groups.MethodsA case–control study was done on 376 CHB patients and 447 healthy subjects randomly selected from Birjand, South Khorasan province, Iran. We used logistic regression to estimate adjusted ORs with 95% CIs for incidence of NAFLD. Potential risk factors for NAFLD were evaluated while adjusting for age, sex, marital status, and educational level. Also, χ2 was used to compare demographic characteristics between the two groups.ResultsA total of 373 CHB patients (mean age 40.1±12.9 years) versus 447 individuals in the control group (mean age 39.8±13.9 years) were included in this study (p=0.337). Liver characteristics were found to be significantly different in CHB and healthy groups (p<0.05). According to the results obtained from logistic regression, the adjusted OR (95% CI) for NAFLD incidence of comparing HBsAg-positive to HBsAg-negative participants was 0.62 (0.45–0.84).ConclusionThe results suggested that HBsAg seropositivity was associated with lower risk of developing NAFLD. This study also revealed that mild cases of fatty liver in carriers of hepatitis B are more common than in healthy subjects. However, moderate and severe cases of this condition are more common in healthy people than in hepatitis B carriers.