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Iran Occupational Health ; 19(1):486-499, 2022.
Article in English | Scopus | ID: covidwho-20242318


COVID-19 disease has shocked the lives of developed and developing societies and has affected various aspects of individual and social life of citizens by creating devastating and irreparable effects. While everyone was counting down the hours to get treatment for the disease, the unveiling of emergency-licensed vaccines sparked a variety of social and legal issues. In Iran, according to the decision of the National Corona Management Headquarters, government employees along with some other groups of people were obliged to be vaccinated, and absenteeism was the punishment of deniers. Consequently, legal validity of these enactments has also been discussed by scholars. Clarifying the position of domestic law and international human rights regarding mandatory vaccination can have an effect on persuading citizens and whether or not to do vaccination. Central issue of the following research is the evaluation of compulsory vaccination according to the provisions of Iranian law and the rules of international human rights. Based on the library resources and in a descriptive-analytical method, it was concluded that according to the laws and regulations of Iran, the obligation to vaccinate and in particular the provision of punishment is within the competence of the Parliament and according to the Charter of Patients' Rights, they were required to provide information about the vaccine and its effects, and to monitor the health status of individuals during and after the injection. In international law, it is also possible to make specific treatments mandatory, such as vaccinations under the right to health, in order to guarantee the right to life in the event of an epidemic. In addition, although this requirement conflicts with citizens' right to privacy, international law provides for restrictions on individual rights to ensure public health, subject to conditions such as appropriateness and necessity. © 2022 Iran University of Medical Sciences. All rights reserved.

Neurology ; 98(18 SUPPL), 2022.
Article in English | EMBASE | ID: covidwho-1925461


Objective: To compare conventional, inpatient acute ischemic stroke (AIS) care with telestroke inpatient AIS care at a comprehensive stroke center (CSC). Background: The COVID-19 pandemic disrupted specialist stroke care. New barriers to healthcare delivery including physical distancing, personal protective equipment shortages, and provider illness may be surmountable through telemedicine, however, the efficacy of telestroke for inpatient management of AIS patients at CSCs is unknown. Design/Methods: TELECAST-CSC is a pre-post study examining AIS care at a single CSC. All patients with a clinical or radiographic diagnosis of AIS were included. In the first phase (December 1, 2019-March 15, 2020), all inpatient stroke specialist care was delivered conventionally in-person;in the second phase (March 16, 2020-June 29, 2020) all inpatient stroke specialist care was delivered via telestroke. The primary outcome was the composite adherence rate to AHA guidelines for inpatient AIS care. Secondary outcomes were adherence rates for subcategories of the primary outcome and 30- and 90-day rates of readmission and recurrent cerebrovascular events. Results: One hundred forty-four patients were included in the “in-person” cohort and 141 patients in the “telestroke” cohort (overall median age 72 [IQR 61-82], median NIHSS 2 [IQR 0- 8], 17.2% received thrombolysis, 10.2% received thrombectomy). There was no difference in adherence AHA guidelines for inpatient AIS care between the in-person and telestroke cohorts (96.9% vs 96.3%, p=0.26), or any subcategories of the primary outcome. There was no difference in readmission rates within 30 days (11.8%, vs. 13.5%, p>0.999) and 90-days (18.8% vs 19.2%, p>0.999) or rates of recurrent stroke within 30 days (2.1% vs 2.1%, p>0.999) and 90 days (3.5% vs. 3.6%, p>0.999) for the in-person and telestroke cohorts, respectively. Conclusions: At an academic CSC adherence to AHA guidelines for inpatient AIS were similar when care was delivered in-person or exclusively via telestroke, without differences in recurrent stroke or readmission rates between cohorts.

Pak. Heart J. ; 55(1):57-62, 2022.
Article in English | Web of Science | ID: covidwho-1791249


Objectives: To determine the incidence of ST-Elevation myocardial infarction (STEMI), patterns of care, and outcomes during the COVID-19 era in a hot-spot region. Methodology: From February to April 2020, all the STEMI patients were recruited and compared with the STEMI patients in the equivalent period of the previous year. Demographic and clinical information, coronary angiography data, and in-hospital mortality were collected and compared with the non-COVID-19 group. All data analysis was done using IBM SPSS version 20. Results: There was found a 40% reduction in STEMI admissions during the COVID-19 era compared to the equivalent period in 2019 (55 vs. 92, Rate Ratio (RR):0.60, 95% CI, 0.49-0.70, p<0.001). Compared with the pre-COVID-19 study group, STEMI patients hospitalized during the pandemic were significantly younger (mean age: 56.10 in 2020 vs. 60.83 in 2019 p=0.012). The percentage of primary percutaneous coronary intervention referral was significantly higher than the previous year (47.8% vs. 75.9% p=0.001). In-hospital death occurred in 4 (4.4%) of STEMI patients admitted before the COVID-19 time, while none of the COVID-19 period studied cases died in hospital (p=0.298). Conclusion: Admissions for STEMI were substantially reduced during the COVID-19 pandemic. No changes in overall in-hospital mortality or quality indicators were detected.

Nutrition and Food Science ; 2021.
Article in English | Scopus | ID: covidwho-1501276


Purpose: It is argued that COVID-19 patients show various neuropsychiatric symptoms, including fatigue, depression and anxiety. On the other hand, epidemiological and experimental evidence indicated that green tea could potentially have antiviral effects and ameliorate psychiatric disorders. However, there is a lack of clinical evidence. The purpose of this study was to investigate whether drinking green tea can clinically improve psychiatric complications of COVID-19 infection. Design/methodology/approach: This study included 40 patients with laboratory confirmed mild-to-moderate COVID-19 disorder in the current randomized open-label controlled trial. Patients were instructed to include three cups/day of green tea (intervention) or black tea (control) to their usual diet for four weeks immediately after diagnosis of the disease. At the study baseline and after the intervention, the enrolled patients’ fatigue, depression and anxiety were assessed by the Chalder Fatigue Scale, Beck Depression Inventory-Fast Screen and State-Trait Anxiety Inventory questionnaires. Findings: A total of 19 COVID-19 cases in the intervention group (mean age = 52 years) and 14 cases (mean age = 50 years) in the control group completed the study. Analysis of covariance adjusted for baseline levels, and confounders revealed that those who consumed three cups/day of green tea compared to the patients who received black tea experienced significantly lower fatigue, depression and state and trait anxiety levels (adjusted means for fatigue = 12.3 vs 16.2 (P = 0.03), depression = 0.53 vs 1.8 (P = 0.01), 37.4 vs 45.5 (P < 0.01) and 37.9 vs 45.2 (P < 0.01)). Research limitations/implications: The open-label design may bias the evaluation of the self-reported status of fatigue, depression or anxiety as the main outcomes assessed. Moreover, as this study did not include patients with severe COVID-19, this might affect the generalizability of the present results. Thus, the recommendation of daily drinking green tea may be limited to the subjects diagnosed with mild-to-moderate type of infection or those with long-term neuropsychiatric complications owing to COVID-19. Besides, considering the ethical issues, this study could not exclude the drug therapy’s confounding effects;thereby, this point should be considered when interpreting the current results. Besides, it is worth noting that Guilan province in the north of Iran is recognized as a tea (and particularly green tea) producing region;thereby, it is an available and relatively inexpensive product. Considering this issue, the recommendation to consume this medicinal plant in adjunct to the routine treatment approach among patients with mild-to-moderate COVID-19 based on its beneficial effects may be widely accepted. Practical implications: Green tea consumption could be considered an option to combat COVID-19 associated psychological complications, including fatigue, depression and anxiety among patients suffering from mild-to-moderate type of this viral infection. Originality/value: To the best of the authors’ knowledge, in this study, for the first time, the effects of green tea compared to black tea on COVID-19 associated fatigue, depression and anxiety status within an open-label controlled trial have been investigated. © 2021, Emerald Publishing Limited.