Health Status and Inconveniences of Asthmatic Children During the First Year of the COVID-19 Pandemic.

The Coronavirus Disease 2019 (COVID-19) pandemic has been the most significant health concern in recent years, with respiratory symptoms being the most prominent. In children, asthma is the most prevalent chronic disease. Due to the similarities between the symptoms of these two conditions, we sought to assess the general health status of pediatric patients with asthma and their COVID-19-related difficulties during the first year of the pandemic in Iran. We collected data for this study by administering a questionnaire to the parents of 200 children with asthma who were registered in the database of the Asthma Clinic at a tertiary medical center in Tehran, Iran. Forty-five (22.5%) of 200 patients were suspected of having COVID-19, 11 (24.4%) underwent polymerase chain reaction (PCR) testing, and 10 (90.9%) assays were positive. During the first year of the pandemic, 41 patients (20.5%) were referred to a medical center at least once, with 31.7% due to an asthma attack. One hundred eighty-nine patients (94.5%) reported an improved disease status than the previous year, and only 31 patients (15.5%) were using asthma-related medications such as Salbutamol. The estimated mean Asthma Control Test (ACT) scores for two age categories, 4-11 years and 12-18 years, were 25.55±2.27 and 23.28±3.31, respectively, indicating satisfactory disease control. In the majority of our study population, asthma control was acceptable. However, the pandemic caused a significant increase in the anxiety levels of patients and their parents.

Our experience using synthesized mammography vs full field digital mammography in population-based screening.

Background: Synthesized Mammogram (SM) from Digital Breast Tomosynthesis (DBT) images is introduced to replace the routine Full Field Digital Mammography (FFDM) to reduce radiation dose. Purpose: to compare the conspicuity of cancer related findings between SM and FFDM and combination of these methods with DBT. Methods: The study was conducted in a tertiary breast imaging center, where 200 women referred for screening were enrolled in the study sequentially. Patients underwent FFDM and DBT simultaneously and a two-year follow-up was done. Data was evaluated for Breast Imaging Reporting and Data System (BI-RADS) score, breast density, mass lesions, calcification, and focal asymmetry by two expert breast radiologists. Comparison between different methods was made by Cohen Kappa test. Results: 22 patients with likely malignant findings went under biopsy. Taking histopathologic findings and two-year follow up as reference, the overall sensitivity and specificity for FFDM+DBT (86.1 and 88.9 respectively) and SM+DBT (86.1 and 88.2) didn't show a meaningful difference. Comparing SM and FFDM, calcification in 20 subjects were overlooked on SM, but later detected when combined with DBT. Considering breast composition and BI-RADS categorization, an excellent agreement existed between the readers. Conclusion: Screening with SM+DBT shows comparable results with FFDM+DBT considering BI-RADS categorization of the patients. Although SM showed slightly inferior sensitivity compared to FFDM, after combining DBT with SM no malignant appearing calcification or mass lesion was missed.

Direct Costs of Asthma in a Referral Public Children's Hospital in Tehran, Iran.

Asthma is one of the most common chronic diseases all over the world, which impacts socioeconomics of families and health care systems. We need to estimate the costs of asthma to set health policies and structural adjustments to control burden of asthma in societies. The aim of present study was to evaluate direct costs of asthma in children in Tehran-Iran. In a descriptive-analytical study, 100 children who were referred to Children's Medical Center of Tehran University of Medical sciences, from March 2014 to March 2015, were selected randomly and studied. In an interview with parents we evaluated direct costs of asthma including physician fees, admission fees, medication costs, costs of transportation, and others. In present study, 72 patients (72.0%) were male and 28 patients (28.0%) were female with mean age of 6.9±0.3 years old. Annual mean of direct costs of outpatient care were calculated 5,179,000±620,000 Rials (159.3±19$), and with considering the admission costs, direct medical expenditure were calculated 6,069,600±140,000 Rials (186.7±4$) throughout the year. Non-medical annual costs of asthma in children were calculated 4,439,700±437,540 Rials (136.6±13$) during 2014-2015 in Tehran-Iran. Based on findings of present study, total costs of asthma with the help of close physician follow ups and effective usage of medications has decreased in recent decades; furthermore, in our study, outpatient management costs which accounted for 85.5% of total direct costs of asthma in children, had the largest share of direct costs of asthma management.