Avicenna Journal of Medicine最新文献

{"title":"Adnexal Incarceration in a Posterior Pelvic Peritoneal Defect Associated with Ovarian Torsion: A Case Report.","authors":"Lina Qattea, Wafa Alshahrani, Samaher Samer Alouch, Abdulrazzaq Qattea, Wafaa Qatteh, Sami Qattea","doi":"10.1055/s-0045-1801841","DOIUrl":"10.1055/s-0045-1801841","url":null,"abstract":"<p><p>Ovarian torsion is one of the gynecological emergencies and surgical intervention is the standard management for ovarian salvage as well as reveals some unexpected anatomical defects that increase the risk of ovarian torsion. We report a case of a 27-year-old single, nulliparous female taken for diagnostic laparoscopy with suspicion of ovarian torsion. Intraoperatively, we found right adnexa torsion (ovary with tube) along with incarceration of the right ovary and tube into the big peritoneal sac, which was located medial to the right uterosacral ligament. Detorsion and careful pulling of the swollen adnexa were done to the outside of the big peritoneal sac using nontraumatic laparoscopic forceps. The left side was normal with normal left adnexa. The patient had a second laparoscopic look with a plan for peritoneal closure of the big peritoneal defect. There are two cases which have previously reported ovarian incarceration, but were not associated with ovarian torsion, and did not involve peritoneal closure unlike our report of ovarian detorsion and peritoneal defect closure. The etiology of this condition is thought to be likely congenital as there were no other visible etiologies like pelvic trauma, previous surgery, pelvic inflammatory disease, or endometriosis. Our clinical assessment suggests that a peritoneal sac can enhance the course of ovarian torsion to involve ischemic changes of the ovary when trapped inside of it, by its prevention of spontaneous detorsion. This condition will result in the compression of the cells between the sac wall and subsequent tissue edema enhancing the ischemic effect.</p>","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":"14 4","pages":"223-227"},"PeriodicalIF":0.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11896718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional Assessment of Congenital Radioulnar Synostosis in Children.","authors":"Isam Sami Moghamis, Hasan Abuhejleh, Yousef Abuodeh, Hazem Mohamad Nasef, Harris Manova Thanaraj, Ilse Du Preez, Mohamad Alaa Kawas","doi":"10.1055/s-0045-1802671","DOIUrl":"10.1055/s-0045-1802671","url":null,"abstract":"<p><p><b>Background</b>  Congenital radioulnar synostosis (CRUS) is a rare condition caused by segmentation failure in embryonic life. The forearm is usually fixed in pronation, affecting the upper limb and hand functions. Treatment ranges from observation to surgical options to restore limb function and prevent disease recurrence. The study aimed to assess the functional outcome of patients with CRUS. <b>Methods</b>  We conducted a prospective evaluation of eight patients with CRUS between 2010 and 2020. The data involved history, physical examination, and functional assessment using the ABILHAND-Kids functional scale to determine children's adaptation to this deformity and the indication for surgical management. A control sample of four patients was included in the study for comparison. <b>Results</b>  Eight patients with 11 limb deformities were included in the study. The affected limbs' range of motion (ROM) was compared with the ROM of the unaffected limbs and the control patients. There were no statistically significant differences in ROM between the two groups except for fixed pronation deformity of the synostosis ( <i>p</i>  = 0.0133). The average ABILHAND-Kids score for all children was 38.625 ± 3.021, close to the average score of 42. Only one patient with bilateral involvement underwent surgical correction of the deformity 5 years from the initial presentation. <b>Conclusion</b>  CRUS is a rare congenital condition that can affect daily living activities. Surgical correction is rarely indicated and is only preserved for patients with bilateral involvement and significant functional impairment.</p>","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":"15 1","pages":"24-28"},"PeriodicalIF":0.0,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When to Consider a Diagnosis of Maturity-Onset Diabetes of the Young: Precise Diagnosis Leads to Better Management and Quality of Life for the Patients.","authors":"Yujia Gao, Kalyan Mansukhbhai Shekhda, Sarah N Ali","doi":"10.1055/s-0045-1802584","DOIUrl":"10.1055/s-0045-1802584","url":null,"abstract":"<p><p>Maturity-onset diabetes of the young (MODY) is often misclassified and can significantly impact the management of these patients and their families. We present three cases initially diagnosed as type 1 diabetes mellitus (T1DM), type 2 diabetes mellitus (T2DM), and fasting hyperglycemia, which were later identified as MODY. A 38-year-old Caucasian lady, previously diagnosed with T2DM, was referred to the diabetes antenatal clinic. She was treated with gliclazide and metformin before pregnancy. She required insulin glargine during her pregnancy. Her diabetes autoantibodies were negative. MODY was suspected and genetic testing confirmed <i>HNF1A</i> MODY gene mutation. A 57-year-old Caucasian lady was diagnosed with T1DM at the age of 18 years. Since diagnosis, she was treated with insulin glargine without any short-acting insulin, yet persistently suffered from hypoglycemia. MODY was suspected and genetic testing confirmed <i>HNF4A gene</i> mutation. A 33-year-old South Asian lady was referred to a diabetes clinic for suspected T2DM due to strong family history of T2DM, ethnicity, and persistently elevated fasting blood glucose levels. Her genetic testing confirmed <i>GCK</i> - <i>MODY</i> ( <i>Glucokinae-maturity-onset diabetes of the young</i> ). MODY represents a group of genetic diabetes that can often go unrecognized due to misdiagnosis. Achieving an accurate diagnosis is important as it guides appropriate treatment strategies, improves patient outcomes, and has an impact on other family members due to the hereditary nature of the condition. Employing a systematic approach is crucial. Our cases highlight that it is never too late to challenge the diabetes classification.</p>","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":"15 1","pages":"41-45"},"PeriodicalIF":0.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Radiological Outcomes of Stand-alone Cage versus Cage and Plate in Anterior Cervical Discectomy and Fusion: A Retrospective Cohort Study.","authors":"Isam Sami Moghamis, Abduljabbar Alhammoud, Amgad M Elshoeibi, Abedallah Abudalou, Jawad Derbas, Mutaz Awad Alhardallo, Salahuddeen Abdelsalam, Abdulmoeen Baco","doi":"10.1055/s-0044-1801833","DOIUrl":"10.1055/s-0044-1801833","url":null,"abstract":"<p><p><b>Background</b>  Anterior cervical discectomy and fusion (ACDF) is one of the most commonly used techniques for neural decompression in degenerative cervical radiculopathy and cervical myelopathy. Controversies regarding the superiority of cage augmentation with anterior cervical plate remain, yet several surgeons are still performing ACDF with a stand-alone cage (ACDF-SA). Our study aimed to compare the radiological outcomes between the ACDF augmented with anterior cervical plate (ACDF-CPA) and ACDF-SA in single-level cervical degenerative disc disease. <b>Methods</b>  A retrospective data review was conducted for patients who underwent ACDF between January 2011 and December 2019. All adult patients who underwent single-level ACDF for cervical radiculopathy and myelopathy with at least 12 months of follow-up were included in the study. Patients who had a systemic infection, trauma injury, history of malignancy, inadequate radiographs, and less than 12 months of follow-up were excluded from the study. Radiological outcomes, including cage subsidence, fusion rate, and adjacent segment degeneration, were assessed by two senior orthopaedic spine fellows. Adjusted risk ratios were used to compare the radiological outcomes of ACDF-SA and ACDF-CPA, adjusting for age and gender. <b>Results</b>  A total of 43 patients were included. Among them, 58% of the patients underwent a stand-alone cage ACDF, while 42% had anterior cervical plate augmentation. The overall fusion rate at 6 months was 76%. The ACDF-SA group's fusion rate was 88%, while that of the ACDF-CPA group was 61%. At 12 months, the overall fusion rate was 81% and was comparable between the two groups. Cage subsidence and adjacent segment degeneration rates were similar between the groups at 6 and 12 months. Adjusted relative risk analysis showed a 50% higher probability of fusion at 6 months in the ACDF-SA group compared with the ACDF-CPA group (95% confidence interval [CI]: 1.01-2.22) and a 22% higher probability at 12 months, though not statistically significant (95% CI: 0.90-1.64). Female gender was associated with higher fusion rates and lower subsidence risk at 12 months. <b>Conclusion</b>  Augmentation with the anterior cervical plate in ACDF did not show superiority to the conventional stand-alone cage in mono-segmental ACDF. Our study showed similar outcomes regarding cage subsidence, adjacent segment disease, and fusion rates at 12 months. However, the stand-alone cage achieved faster fusion at 6 months than the plate group.</p>","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":"14 4","pages":"216-222"},"PeriodicalIF":0.0,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11896729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seroprevalence and Associated Outcomes of Parvovirus B19 Infection in Human Immunodeficiency Virus Patients: A Systematic Review.","authors":"Sagad O O Mohamed, Reem A A Mohamedelmugadam, Safa A M Almardi, Tassnem H M Ahmed, Malaz E H Ibrahim, Abdalla O O Mohamedali","doi":"10.1055/s-0045-1801865","DOIUrl":"10.1055/s-0045-1801865","url":null,"abstract":"<p><p>Several case reports have highlighted the presence of serious clinical outcomes in patients with human immunodeficiency virus (HIV) related to parvovirus B19 (PVB19). However, epidemiological studies have produced inconsistent and varying results regarding the prevalence of PVB19 and its associated clinical outcomes in this population. These inconsistencies highlight the need for a thorough summary and analysis of present data to better understand burden and impact of PVB19 on HIV patients. This review aims to provide an overview of current evidence and identify areas for further research. Following the Meta-analyses of Observational Studies in Epidemiology (MOOSE) guidelines, a comprehensive search was conducted across Medline/PubMed, Google Scholar, and World Health Organization Virtual Health Library Regional Portal. The pooled prevalence with the corresponding 95% confidence interval (CI) was measured using Comprehensive Meta-Analysis Software version 3.3. Publication bias was estimated based on Begg's test, Egger's test, and examination of the funnel plots. A total of 16 studies, with 2,122 HIV patients, were included in the meta-analysis. The pooled prevalence of detecting anti-PVB19 immunoglobulin G, anti-PVB19 immunoglobulin M, and PVB19 DNA particles among HIV patients was 43.6% (95% CI: 23.5-66.1%), 5.10% (95% CI: 2.10-12.10%), and 6.40% (95% CI: 4.10-9.90%), respectively. In the overall population of HIV patients, most of the included studies did not establish a statistically significant association between PVB19 infection and the occurrence of anemia. PVB19 infection is commonly detected in individuals with HIV. However, anemia due to PVB19 is not common in this population. Findings from a few studies suggest that PVB19 infection may contribute to anemia in individuals with advanced HIV disease or significant immunosuppression. Additional research is needed to confirm and clarify these relationships in individuals with HIV, particularly those with compromised immune systems.</p>","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":"14 4","pages":"185-193"},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11896723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The First Medical Research Conference in Hama, Syria: Students' Experience to Encourage and Improve the Research Reality during the War.","authors":"Kenana Tawashi, Maher Almousa, Yamama Tawashi, Ahmed Al-Beiruti, Ahmad Khaled AlFaris","doi":"10.1055/s-0044-1801258","DOIUrl":"10.1055/s-0044-1801258","url":null,"abstract":"","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":"14 4","pages":"183-184"},"PeriodicalIF":0.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11896719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Frailty on Inpatient Mortality and Resource Utilization for Primary Pulmonary Hypertension.","authors":"Rayaan Rauf, Cheryl A Gibson, Mohamad Alhoda Mohamad Alahmad","doi":"10.1055/s-0044-1801349","DOIUrl":"10.1055/s-0044-1801349","url":null,"abstract":"<p><p><b>Background</b>  Frailty has been associated with inferior outcomes in patients with primary pulmonary hypertension (PPH). There is a lack of national data to assess if hospital frailty risk score (HFRS) is associated with worse inpatient outcomes in PPH. <b>Methods</b>  Our retrospective study used the Nationwide Readmission Database (NRD). First, we extracted all cases older than 18 years who were discharged with a principal diagnosis of PPH between January and November 2016 to 2019 to allow for a 30-day follow-up. Appropriate survey and domain analyses were applied to obtain national estimates using SAS 9.4. <b>Results</b>  We identified 4,555 cases. HFRS <5 was present in 56% ( <i>n</i>  = 2,555) of the cohort. Patients with an intermediate-to-high frailty risk score (HFRS ≥5) were older than those with a low frailty risk score (HFRS <5), with a mean age of 61 versus 54 years ( <i>p</i>  < 0.01), and had slightly fewer women (75 vs. 78%, <i>p</i>  = 0.09). Patients with HFRS >5 had a higher prevalence of dementia, depression, diabetes mellitus, malignancy, acute encephalopathy, coagulopathy, heart failure, and chronic (liver and renal) diseases ( <i>p</i>  < 0.01). Also, they had higher inpatient mortality during index admission (14 vs. 2%, <i>p</i>  < 0.001), and all-cause 30-day readmission rates (38 vs. 33%, <i>p</i>  = 0.01). Univariate analysis suggests a positive correlation between the degree of frailty and the odds of inpatient mortality (referenced to HFRS <5). The HFRS 5 to 10 group has an odds ratio (OR) of 5 (95% confidence interval [CI]: 3.3-8), the HFRS 10 to 15 group has an OR of 14 (95% CI: 8-23), and the HFRS >15 group has an OR of 20 (95% CI: 9-45). Even after adjusting for age, gender, and significant comorbidities, the single most important factor associated with higher odds of inpatient mortality was HFRS >5 (OR: 5.5 [95% CI: 3.7-8.3], <i>p</i>  < 0.001) followed by acute myocardial infarction, acute encephalopathy, heart failure, chronic liver disease, and malnutrition. Length of stay had linear trend with HFRS (mean of 6 days for HFRS <5 vs. 11 days for HFRS 5-10 vs. 19 days for HFRS >10, <i>p</i>  < 0.001). <b>Conclusion</b>  Adverse inpatient outcomes correlate with the severity of HFRS in PPH.</p>","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":"14 4","pages":"204-209"},"PeriodicalIF":0.0,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11896733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reduction of Antibiotic Prescription in Complicated Appendicitis through Behavioral Change Measures.","authors":"Alberto A Artiles Garcia, Humberto Guanche Garcell, Miguel J Pinto Echevarría, Carlos A Sanchez Portela, Carlos M Sanchez Rivas, Marlon Arias Medina, Niuvis Seoane Perez, Osiris I Escobar More, Tania M Fernandez Hernandez","doi":"10.1055/s-0044-1801350","DOIUrl":"10.1055/s-0044-1801350","url":null,"abstract":"<p><p><b>Background</b>  Variability in the prescription of antibiotics constitutes an area for improvement related to patient safety issues, including the risk of infection and health care efficiency based on evidence. <b>Objectives</b>  The study aims to evaluate the effect of an intervention to reduce the duration of antibiotic treatment in complicated appendicitis. <b>Methods</b>  A quality improvement program was implemented in the surgical department of The Cuban Hospital (Doha, Qatar). During a 3-month baseline period, data about antibiotic duration, consumption (daily defined doses), and cost (in Qatary Riyals) were identified, as well as during two plan-do-study-act (PDSA) intervention periods. Interventions include action focused on staff education, monitoring antibiotic use, feedback, and reminders during discharge planning. <b>Results</b>  At baseline, 13 patients with complicated appendicitis were documented, while there were 41 and 15 patients during PDSA cycles 1 and 2, respectively. A 29.5% reduction in days of antibiotic treatment was observed during the PDSA cycle 2 in comparison with the baseline. Accordingly, a reduction of 38.7% in the consumption of antibiotics and a reduction of 24.6% in cost were observed, with no adverse outcomes for patients during the 30-day follow-up period. <b>Conclusion</b>  The intervention resulted in an improvement in antibiotic use with satisfactory patient outcomes and an additional effect on the efficiency of health care and the prevention of microbial resistance and other adverse effects.</p>","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":"14 4","pages":"210-215"},"PeriodicalIF":0.0,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11896716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Impact of USMLE Step 1 Going Pass-Fail: A Brief Review of the Performance Data.","authors":"Kevan English","doi":"10.1055/s-0044-1800830","DOIUrl":"10.1055/s-0044-1800830","url":null,"abstract":"<p><p>On January 26, 2022, the United States Medical Licensing Examination (USMLE) Step 1 exam transitioned to a pass-fail grading system instead of the conventional three-digit score. This move was intended to decrease the emphasis on Step 1 scores and facilitate a more holistic approach by programs in the residency selection process. However, since the implementation of the new grading system, we have seen a lower passing percentage among all medical students, including U.S. MDs, DOs, and international medical graduates. In this article, we assess the USMLE Step 1 performance data since the change in scoring and some factors that may have contributed to the lower passing rates among all medical students.</p>","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":"14 4","pages":"228-230"},"PeriodicalIF":0.0,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11896725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical School Curricular Changes and Their Impact on Mental Health during the Onset of the COVID-19 Pandemic.","authors":"Leen Al Kassab, Laila Fozouni, Christopher Reynolds, Phuong Pham, Valerie Dobiesz","doi":"10.1055/s-0044-1795152","DOIUrl":"10.1055/s-0044-1795152","url":null,"abstract":"<p><p><b>Objectives</b>  The main objectives were to identify and categorize the curricular changes that occurred in U.S. medical schools during the onset of the coronavirus disease 2019 (COVID-19) pandemic, and to identify the relationship between curricular changes and COVID-19 surges and student mental health. <b>Methods</b>  This Institutional Review Board-approved study consisted of a voluntary online survey of U.S. medical students. A convenience sample of students was reached through Facebook groups, medical student organizations, and administrators. The survey consisted of questions about demographics, curricular changes, and mental health. Univariate and backward stepwise multivariate linear regression were used to assess associations between mental health outcomes and demographic characteristics, curricular changes, and stressors. <b>Results</b>  Four-hundred and nine medical students completed the survey from 21 states between May 29, 2020, and August 29, 2020. Seventy-nine percent of respondents reported continuing their basic science curricula virtually. Forty-five percent reported that rotations continued virtually; those reported being offered virtually included internal medicine (77%), family medicine (78%), surgery (70%), obstetrics/gynecology (73%), pediatrics (74%), and psychiatry (76%). The majority of students reported that core clerkships (78%) and subinternships (86%) were not allowed, and away rotations were universally canceled. In univariate linear regression, having in-person subinternships and core clerkships allowed, as well as not relocating for coursework or residence (experienced by 35% of students), was associated with improved mental health outcomes, while experiencing graduation changes (15%) or being from the Southern region was associated with worse outcomes ( <i>p</i>  < 0.001). <b>Conclusion</b>  During the early COVID-19 pandemic, students reported that their medical schools adapted by converting to virtual platforms for basic science and core clerkships. Allowing in-person rotations and limiting relocation were associated with improved mental health outcomes among students. Limitations included sample size, selection bias, and student perceptions.</p>","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":"14 4","pages":"194-203"},"PeriodicalIF":0.0,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11896715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}