Context: Novel coronavirus (COVID-19) has become a new public health crisis, posing a great threat to the people all around the world. We aimed to review the articles on COVID-19 in pediatric population to help physicians and other healthcare workers understand the importance of detecting silent disease carriers in this age group and stop further transmission to other healthy individuals and manage symptomatic patients based on the latest recommendations. Methods: We searched databases including PubMed, Scopus, Google Scholar, and Medline and reviewed 70 articles from December 2019 to mid-July 2020. Relevant articles about COVID-19 in children were included. Results: According to the latest reports, 1% - 5% of infected patients were under 19 years old. Death in this age group was rare but it can occur in children with severe disease. The overall course of disease -mainly pulmonary involvement- of the infected children tend to be milder than adults. This may be related to both host factors and exposure. The lab tests and computed tomography (CT) scan findings are nonspecific and milder compared to those in older ages. The cornerstone of COVID-19 management in pediatric group is supportive care. Of note, there is not any approved specific drug for treatment of children affected by COVID-19. Conclusions: COVID-19 disease characteristics in children are not yet fully established, which poses a significant problem for pediatric medical specialists. It should be considered that most children are asymptomatic or have mild symptoms. Critical cases, although uncommon, can occur especially in children with underlying diseases.

Introduction: This study aims to measure the diagnostic accuracy of chest computed tomography (CT) and reverse transcription polymerase chain reaction assay (RT-PCR) in COVID-19 in a systematic review and meta-analysis. Methods: PubMed, Scopus, Embase, and Google Scholar, WHO, SSRN, and MedRxiv have been searched on March 26, 2020 for all the alternative names of the disease and virus. Risk of bias assessment was based on QUADAS-2. Data from English-language studies after January 12, 2019 were pooled to calculate necessary diagnostic values and underwent diagnostic test accuracy, random-effects, proportions, and subgroup meta-analysis. Results: Pooled from 27 included studies, the sensitivity of chest CT was calculated 96.6%, specificity 22.5%, diagnostic odds ratio (DOR) 8.2, positive likelihood ratio (PLR) 1.2 (95% CI: 1.1-1.4), and negative likelihood ratio (NLR) 0.15 (95% CI: 0.1-0.3). The sensitivity for initial RT-PCR was 79.7%, the specificity 100%, and NLR 0.18. Conclusion: Considering the results, in order to diagnose COVID-19 (coronavirus disease 2019), it is recommended to initially performing chest CT to rule out the uninfected people. In suspicious cases, we suggest RT-PCR to confirm the disease. Performing serial RT-PCR instead of the one-time test is highly recommended, to let the viral loads reach the diagnostic levels, especially in cases of high clinical suspicion.

A BSTRACT Medical education is socially responsible for a global educational movement that transforms the development and presentation of medical schools in higher education. Therefore, in the present systematic review, we aimed to evaluate the impact of socially accountable health professional education. Published research articles were reviewed by searching the relevant terms invalid databases. In the initial search, 2340 records were obtained. At this stage, 1482 records were deleted due to duplication, and 773 records were removed due to indirect connection with the subject. Then, 85 articles were retrieved for full-text review. Finally, the complete review led to the selection of nine studies that met all inclusion criteria. Based on the results of the present systematic review, among the nine reviewed articles, four studies (44.44%) evaluated the effectiveness of social accountability on increasing the sense of empowerment, self-confidence, competencies such as teamwork, communication skills, and readiness for work. Three studies (33.333%) assessed the effectiveness of social accountability on providing further and better medical services and reducing infant mortality. Also, in two articles (22.22%), students’ lack of knowledge about social accountability was studied. Social accountability can help cultivate a healthy and skilled medical workforce and be effective in improving health services provided to the people. On the other hand, there are different perceptions and views on what social responsibility really is and how its effectiveness can be measured. Also, it is highly important to provide awareness in this regard for students.

Introduction and Objective: The study of the methods of controlling labor pain is very important. One of the methods of pain relief is spinal anesthesia. Due to the different opinions about the effects of spinal anesthesia on the delivery process and maternal and fetal consequences, this study aimed to evaluate the effects of spinal anesthesia and compare it with normal vaginal delivery without spinal anesthesia. Methods: In this retrospective cohort study, 120 mothers, who were admitted to the maternity ward of Firoozabadi Hospital for delivery, were examined. The patients who met the inclusion criteria were divided into two groups of 60 people, one group receiving spinal anesthesia and one without spinal anesthesia, and then, were evaluated in terms of clinical variables and complications of the mother and fetus. Data were analyzed using SPSS statistical software. Results: The mean age of the mothers was 26.6 ± 5.9 years. Five mothers (4.2%) who received spinal anesthesia underwent emergency cesarean section and a significant difference was shown between the two groups ( P = 0.02). The mean duration of the active phase of labor did not show a statistically significant difference between the two groups ( P = 0.2), but the duration of the second phase of labor was significantly longer in the mothers who received spinal anesthesia ( P = 0.008). Conclusion: Spinal anesthesia can be used as a low-complication method in vaginal delivery to reduce pain.