Background: We aimed to assess the gastrointestinal (GI) manifestations of patients with severe acute respiratory syndrome coronavirus 2 infection and determine factors predicting disease prognosis and severity among patients with GI symptoms. Methods: In this retrospective study, we evaluated laboratory confirmed (by real-time polymerase chain reaction) inpatient cases of coronavirus-associated disease 2019 (COVID-19), referred to Sina hospital, a tertiary educational hospital of Tehran University of Medical Sciences, from March 10 to May 20, 2020. Demographic and clinical characteristics, laboratory data, outcomes and treatment data were extracted and analyzed using SPSS version 20. Results: A total of 611 patients (234 women and 377 men) were included with 155 patients having GI symptoms. The most prevalent reported GI symptom was nausea/vomiting in 115 (18.8%) of patients. A total of 20 patients (3.2%) only had GI symptoms (without respiratory symptoms). There was no statistically significant difference in the clinical outcomes, disease severity, intensive care unit (ICU) admission and mortality between patients with and without GI symptoms. Aspartate Aminotransferase level was associated with 446% increased risk of disease severity (adjusted odds ratio: 5.46, 95% CI: 2.01 to 14.81) (P=0.040) among patients with GI symptoms. Additionally, we found that treatment with antibiotics in addition to mechanical ventilation was associated with increased survival among patients with GI symptoms (Pearson Chi square: 6.22; P value: 0.013). Conclusion: More attention should be paid to patients with only GI symptoms for early patient detection and isolation. Moreover, patients with GI manifestations are not exposed to higher rates of disease severity or mortality.

Objective The curricular reform at Tehran University of Medical Sciences (TUMS), Iran, has been implemented since 2011 when peer mentoring program started. The program is believed to have a crucial role in students’ perception of the educational environment (EE). We aimed to determine how students perceive the educational environment and compared the mentees and non-mentees’ perception of EE. Methods A cross-sectional descriptive study was conducted among 190 first-year medical students enrolling at Tehran University of Medical Sciences from March to September 2019. A questionnaire was used to collect information on students’ age, gender, marital status, dormitory status, and their mentoring status including satisfaction of mentor-mentee relationship. The study also employed Dundee Ready Education Environment Measure (DREEM). The collected data were then entered and analysed using SPSS version 20. To compare the perception of EE between mentees and non-mentees, we used independent t-test. Results The mean (SD) for total DREEM score for EE was 144.1 (19.3), which signifies a more positive than negative educational environment perception. Nonetheless, the mean scores of total DREEM was not significantly different between students with or without mentors (P =0.390). The overall mean score for student perceptions of learning for mentees was 32.47 (4.5) while for those without a mentor, the score was 31.70 (4.9) (P =0.491). The items concerned with “emphasizing factual learning” and “teacher-based teaching” were rated the least. The item “having an appropriate support system” was scored significantly different between students with or without mentors (P =0.009). Conclusions Since having an appropriate support system was significantly different between groups, we suggest curriculum designers focus on the above-mentioned issue under caption for improvement during the reform programs.

This study aimed to evaluate the quality of the educational environment in Tehran University of Medical Sciences across different medical specialties and its correlation with residents' burnout. Materials and methods: This cross-sectional study was conducted at Tehran University of Medical Sciences among residents drawn from three largest teaching hospitals affiliated. The Maslach Burnout Inventory and Postgraduate Hospital Educational Environment Measure (PHEEM) questionnaire were used to collect data through web-based, as well as paper-and pencil questionnaires. The data was analyzed using SPSS. Results: A total of 221 residents completed the survey, with a response rate of 82%. Burnout was reported by 67.4% of medical residents. The total PHEEM score had a negative correlation with emotional exhaustion (r ¼ -0.57, P < 0.001), depersonalization (r ¼ -0.40, P < 0.001), and a positive one with personal accomplishment (r ¼ 0.42, P < 0.001). Perception of social support significantly predicted burnout subscales (P < 0.05). PHEEM subscales also explained a small proportion of variance in emotional exhaustion (R ¼ 0.55, R 2 ¼ 0.308, P < .001). Clinical learning environment independent of personal characteristics was associated with residents' burnout according to multivariate regression analysis [OR ¼ 0.567 (0.170-0.883), P ¼ 0.012]. Conclusion: Clinical learning environment independent of personal characteristics was associated with residents' burnout in Iran. We suggest some initiatives to be introduced ranging from improving the clinical environments, reduce workloads and provide social support to all residents as well as encouraging them to involve in other extracurricular activities like music and physical exercise.

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