Background Apart from infecting a large number of people around the world and causing the death of many people, the COVID-19 pandemic seems to have changed the healthcare processes of other diseases by changing the allocation of health resources and changing people’s access or intention to healthcare systems. Objective To compare the incidence of endpoints marking delayed healthcare seeking in medical emergencies, before and during the pandemic. Methods Based on a PICO model, medical emergency conditions that need timely intervention was selected to be evaluated as separate panels. In a systematic literature review, PubMed was quarried for each panel for studies comparing the incidence of various medical emergencies before and during the COVID-19 pandemic. Markers of failure/disruption of treatment due to delayed referral were included in the meta-analysis for each panel. Result There was a statistically significant increased pooled median time of symptom onset to admission of the acute coronary syndrome (ACS) patients; an increased rate of vasospasm of aneurismal subarachnoid hemorrhage; and perforation rate in acute appendicitis; diabetic ketoacidosis presentation rate among Type 1 Diabetes Mellitus patients; and rate of orchiectomy among testicular torsion patients in comparison of pre-COVID-19 with COVID-19 cohorts; while there were no significant changes in the event rate of ruptured ectopic pregnancy and median time of symptom onset to admission in the cerebrovascular accident (CVA) patients. Conclusions COVID-19 has largely disrupted the referral of patients for emergency medical care and patient-related delayed care should be addressed as a major health threat.

No abstract

Introduction: While our knowledge is limited about COVID-19 immunity, recent cases of reinfection have raised concerns. Case presentation: Here, we report a case of COVID-19 reinfection after three months from recovery in a healthcare worker with negative IgM and IgG at the second infection and positive nasopharyngeal swab Reverse transcription polymerase chain reaction (RT-PCR) test despite being discharged with two negative RT-PCR tests at the first admission. Symptoms at first admission were fever, headache, sore throat, diarrhea, and vomiting and got changed to myalgia and anosmia. Conclusion: The strength of this case report is the long period (three months) between the infection and reinfection while other cases reported in literature were reinfected less than one month after their first infection.

Introduction: The present study aimed to compare analgesic effects of IV lidocaine vs. IV morphine on the management and relief of acute pain caused by the extremity trauma. Materials and Methods: The present study was a triple-blind randomized clinical trial that was conducted in the emergency department of Peymanieh Hospital of Jahrom. Patients aged 16 to 65 with acute extremity traumas and the need for pain control were eligible for the study. Meaningly, one group received IV Lidocaine (1.5 mg/kg) and another group received IV Morphine (0.1 mg/kg). Pain scores, side effects, and vital signs were evaluated in the admission, and 15, 30, 45, and 60 minutes after the injection. Data were analyzed by descriptive and inferential statistical tests in SPSS software at a significant level of P< 0.05. Results: 60 patients with a mean age of 35.31 ± 11.10 years were included in the study. Correspondingly, demographic characteristics and pain scores were similar in both groups. Median pain was higher in the intravenous morphine group than the Lidocaine group at the 15th minute after the injection (P= 0.035), but it was higher in the Lidocaine group than the IV morphine group at the 60th minute after the injection (P= 0.045). There was no significant difference between research groups at other times. Furthermore, there was a significant difference between IV Lidocaine and morphine in terms of pulse rates during the drug injection (P= 0.012), but no significant difference was seen in terms of their side effects (P>0.05). Conclusion: Based on the research results, IV Lidocaine could be considered as an appropriate alternative for the emergency pain management in the emergency department.