مجله تعالی بالینی
سال یازدهم شماره 2 (پیاپی 32، پاییز 1400)

Today's diseases cross borders quickly and show their transmission power very quickly. Some countries are surrounded by a common border that does not have good health care. This leads to rapid disease transmission and subsequent health problems. The corona virus pandemic has shocked countries that did not have good health care facilities and did not have crisis management in the face of epidemics and pandemics. Having common borders, non-observance of border laws, lack of standard health certificates at borders, lack of complete sanitary equipment to clear customs transfers, lack of complete quarantine of goods, illegal entry and exit in some cases, inconsistency of approaches Health of neighboring countries, the lack of a standard health card for individuals, authorized and unauthorized traffic and many other factors affect the process of disease control. Therefore, it is necessary to make decisions in order to apply the new laws on health at the borders as vital points of disease control and management.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that caused the coronavirus disease 19 (COVID19) pandemic, has imposed a serious public health threat, which requires effective treatments and vaccination strategies for disease control and prevention. In the vaccine development process, identifying the structure and role of viral antigens is unavoidable. Various vaccines using a range of design techniques, including inactivated virus-based vaccines, viral vectors, DNA vaccines, and protein recombinants are being developed, evaluated, and used to prevent the spread of disease. This review article was described SARS-CoV-2 antigens for vaccine development as well as recent advances in COVID19 vaccines. In this study, the websites of PubMed, Google Scholar, and Web of Science were searched and related articles up to 2021 were extracted. The results of these studies showed that SARS-CoV-2 vaccines had a significant effect in reducing the COVID19-related morbidity and mortality regardless of vaccine type. However, new variants harboring mutations in the spike protein enhanced the virus spreading and virus binding affinity to its receptor ACE2 and reduced the effectiveness of vaccines.

In 2019-2020, a new coronavirus called SARS-CoV-2 was identified as the cause of several acute respiratory infections named COVID-19. So far, more than 200 million cases of the disease have been reported. The disease is transmitted mainly through secretions and large and small respiratory droplets, and even very small particles suspended in the air or direct contact. Transmission of the infection occurs 2-3 days before the onset of the symptoms till 7-14 days after that. Contact within 2 to 14 days of the onset of symptoms with an infected person can cause infection. In children, symptoms usually appear between 2-14 days after sick contact. Although the course of the disease in children is much milder than in adults and most of the children are asymptomatic, mild symptoms similar to the common cold including fever, lethargy, fatigue, loss of appetite, cough and rhinorrhea, or gastrointestinal symptoms such as vomiting, diarrhea and abdominal pain are common complications in children. Skin manifestations include generalized maculopapular rash, petechiae, and urticaria, and the involvement of a variety of mucosal surfaces is seen. In a small number of patients, involvement of the heart and other organs including cardiac, skin, … occur in the second stage, as a syndrome related to COVID-19 called Multisystem-inflammatory syndrome-in children (MIS-c). Based on the probability of isolation of COVID-19 specific virus or antibody, radiological findings of the lung or other clinical signs, close contact with a suspected patient or a definite patient, the diagnosis of the disease is divided into three groups: definite, probable and suspicious. Suspected cases have symptoms and probable cases have radiological changes suggesting disease. The best way to diagnosing is RT-PCR. Stool RT-PCR is also helpful in patients with diarrhea. Chest imaging is performed according to the patient’s condition. Proper quarantine is required in infected people to prevent transmission of the infection. Covid-19 infection and disease, like most viral diseases, have no specific treatment. Supportive treatment of the symptomatic patients is supplying water-electrolyte and calories. In severe forms of the disease, non-specific antiviral drugs such as remdesivir or favipiravir, etc., other alternative therapies such as corticosteroids and IVIG, etc are used in addition to oxygen therapy and supportive treatment. To prevent the disease, in addition to appropriate social distancing and using masks and gloves, several vaccines have been proposed, none of which have been recommended under the age of 18.

Despite all the extensive research on hematopoietic stem cell cell transplantation (HSCT) techniques, viral infections as the main factors increase post-transplant mortality. According to the available data, long-term immunosuppression prior to HSCT, use of the myoablation regimen, and long-term hospital stay were associated with a higher risk of infection. So, COVID-19 pandemic is one of the risk factors in patients undergoing HSCT. The purpose of this study is to review the experiences of bone marrow transplant centers around the world and to present the solutions used in these centers during the outbreak of COVID-19. The present study is a review and the information collected in this article is based on internet search in scientific-medical databases such as SID, Google Scholar, PubMed in 2020 using English keywords; COVID-19; Coronavirus 2019; Hematopoietic Stem Cell Transplantation (HSCT); Due to the fact that the prevalence of COVID-19 has not been controlled in the world yet, Bone marrow transplantation cannot be delayed in patients, and according to the studies and experiences of medical centers in the last two years, follow the instructions and according to studies and experiences of medical centers during the last two years, follow the instructions in the field. Prevention of COVID-19 infection is recommended by the World Health Organization, in addition to the guidelines of the European and American Bone Marrow Transplant Association, can make this high-risk treatment possible for patients during the outbreak of COVID-19. The best way in the current situation is to prevent transplant patients and donors before bone marrow transplantation; the management and training of medical staff and patients are to prevent the transmission of the virus to patients undergoing bone marrow transplantation. Patients and donors must observe 14 days of home quarantine before entering the ward. Be screened. Training of medical staff and screening test if there are initial symptoms can prevent the transmission of the virus to patients admitted to the transplant ward by medical staff. Adherence to the principles of home quarantine in patients undergoing bone marrow transplantation prevents these patients from developing COVID-19 at the time of immune system failure after transplantation.

Humanity is currently facing a life-threatening challenge from the infectious and epidemic disease SARS-CoV-2. To date, the various modes of transmission of the virus have not been fully elucidated. In this regard, there is a possibility of transmission of the virus through food products. The covid-19 pandemic disease not only can be spread through the respiratory tract, such as diseases associated with SARS and MERS, but the presence of fragments of the genetic virus (RNA) in the feces of several patients suggests that their fecal-oral route may be expanded. In addition, people with gastrointestinal disorders such as metaplasia and atrophic gastritis may be prone to Covid-19 infection. Accordingly, food may act as a potential carrier of Covid-19 due to environmental or cross-contamination. According to the available evidence, the spread and possibility of transmission of Covid-19 contamination from humans to food products are possible. Beyond that, there is some evidence that some food sources of animal origin, such as pigs and rabbits, can be contaminated by Covid-19. Therefore, the transmission of the virus through some meat products may be conceivable. Due to the rapid release rate of Covid-19 and its stability in different environments, especially food processing surfaces, it may enter the matrix during different stages of traditional or industrial food processing. Therefore, preventive measures are recommended to be applied in food processing units. The present study investigated the risk of a variety of food products including meat and meat products, dairy products, bread, fruits, vegetables, and processed foods as potential carriers for the transmission of Covid-19.

Covid-19 disease has created a series of emergencies in the field of health and society, which can cause different psychological reactions in individuals due to the threat to their freedom and authority. The purpose of this study was to direct the attention of health and psychological experts to the issue of coronary psychological response and its psychological consequences on the health of people in the community. In this review study, articles published in Persian and English journals available in databases; Google, Scholar, ProQuest, Pubmed, Elsevier, ISI, Scopus, Medex, Direct Science, Springer and CIVILICA were used in recent years. Search for articles using keywords; Attachment styles, rumination and corona; Their Latin equivalents were Attachment Styles, Psychological Reaction, Covid-19 Mind Rumination. The article selection process was performed based on this strategy, and finally, after screening the title and abstract, materials, methods and results, and after studying and reviewing the full text, 31 articles were identified as eligible for inclusion in the article. Findings showed that two styles of insecure attachment (avoidant attachment and anxiety) increase negative psychological reactions in individuals and mental rumination and worries in individuals due to the emergence of this virus, increase and cause negative psychological reactions. To be. Eventually; It is suggested that with a series of trainings to recognize the unhealthy attachment style in anxious people, as well as by managing the rumination of people exposed to corona, their psychological response to corona can be reduced.

The today s most concerning problem in the world is the morbidity and mortality following covid19 infection. The aim of this study is to investigate different factors and their impacts on mortality rate of covid19 patients. In this review article, recent studies from February 2019 to April 2021 were assessed using English and Persian resources. The keywords were Covid19, mortality rate, underlying diseases, and demographic factors which were investigated through PubMed, Web of Science, Science Direct, Iran Medex, Ovid, Scopus, Scientific information database and Magi ran. At first 298 articles were collected. Then titles and abstracts were assessed. Due to inclusive, exclusive criteria, and aims of research, 51 articles were selected and entered to the study. Underlying diseases like hypertension, cardiovascular diseases, diabetes, and obesity could lead to the increase of covid19 complications and mortality by weakening the immune system, producing inflammation, inducing metabolic disorders, coagulopathy, and impairing respiratory system function. Demographic factors like age, sex, race and occupation could affect mortality rate of covid19 patients due to physiologic differences, rate of contacts, and protection measures. The impact of life-style on covid19 complications and mortality and preventing measures needed for modifications could be of high-interest in the future studies.

One of the most important consequences of Covid-19 is delirium, which is often overlooked or forgotten. Therefore, it is very important to consider early diagnosis, standard evaluation, and management of delirium symptoms, and it is necessary for the medical staff to be fully aware of its prevalence and proper management. Therefore, this review study was performed to investigate the prevalence of delirium and its consequences in the elderly with Covid-19. In this study, the prism method was used to review and report standard standard review studies. The present study included research published from 2019 to 2021 in the scientific database of PubMed, Scopus, Google Scholar, SID, Mgiran. After the initial search, 63 articles were obtained, and finally, by studying their abstracts, 14 articles that were in line with the research objectives were reviewed. Findings from these studies showed that approximately one-third to one-quarter of the elderly with Covid suffer from cognitive problems caused by delirium. Therefore, the training of more and more health care professionals active in the medical sector in the field of delirium prevention and management, as part of comprehensive medical-psychiatric care for the elderly is needed.

The present study was conducted by searching for the keywords e-learning, e-learning, virtual education, medical education, student, professor, university, pandemic, Covid-19 epidemic, in databases in the period from 2019 to 2021. The number of primary articles obtained from the search included 28 articles, upon which after a step by step reviewing and three-phase screening and applying the exclusion criteria, we reached 23 articles. The results showed that strengthening and necessitating to increase the skills of professors and students in the field of e-learning should be considered. Factors such as lack of proper infrastructure, inconsistency and disruption of websites, insufficient computer knowledge of students, professors, deprivation of supervision and proper evaluation of professors, etc. are the most important challenges in the development of e-learning.Therefore, it is necessary to create a national determination and a realistic view in the field of e-learning technology with hope for the future and moving forward in the implementation of the strategic statement of the second step of the revolution in the field of medical science technology.

Pneumonia caused by Covid-19 is highly contagious and contagious and has several transmissions. Due to the importance of breastfeeding for mothers and infants, many women refuse to breastfeed due to lack of knowledge about the transmission of coronary heart disease through breast milk. Therefore, the present study was performed with the aim of reviewing breastfeeding knowledge and its effective factors in Covid-19 pandemic. This study was a conceptual review method that was conducted by reviewing published sources in Persian in Mag Iran, SID, Barkat databases and in English in Pub Med, Library of Cochrane, Scopus and Google scholar databases. Search using Persian keywords including awareness, breastfeeding, Covid-19, effective factors and keywords; Awareness, Breastfeeding, COVID-19 was searched in the period December 2019 to June 2021. At the end of the 39 articles searched, 5 articles related to the purpose were reviewed. By classifying the results of the studies, women's knowledge about breastfeeding in the Covid-19 pandemic was divided into four areas, which include; Awareness of breastfeeding and strengthening the mother-infant relationship, Awareness of breastfeeding and Covid-19 transmission, Awareness of women of breastfeeding and reduction of neonatal mortality and Women's awareness of breastfeeding and reduction of breast and ovarian cancer. Factors such as age, education, marital status, place of residence, medical counseling and social support affect women's awareness of breastfeeding in the
Covid-19 pandemic. The results of studies showed that lactating women need to receive accurate information and it is recommended that due to the quarantine conditions in the Corona pandemic, this information should be provided to pregnant and lactating mothers by midwives and staff working in health centers through virtual groups.

The concept of education is defined by tangible material spaces such as school, classroom and teacher. But the new knowledge space is based on the "networked world" and the "information society", in which the "highways and information flows" in the "virtual world" are the determining factors and components. Digital University is a university based on transformational technologies, providing desirable experience for its diverse stakeholders, especially its students, faculty and staff. Digital University is a university based on transformational technologies, providing desirable experience for its diverse stakeholders, especially its students, faculty and staff. Digital University Approaches the evolutionary path of the university and the lessons learned in the wake of the Corona crisis and beyond that. Therefore, the present study aimed to investigate the digital university in the corona and post-corona pandemics. To reach the objectives, the present study was conducted by searching for the keywords of digital university, e-learning, virtual education, student, professor, university, pandemic, Covid-19 epidemic, in databases in the period from 2019 to 2021. The result of the primary articles included 36 articles, upon which after a step-by-step review and three-phase screening and search application of exclusion criteria, we obtained 28 articles. The results showed that the emergence of the coronavirus, along with all its related difficulties, was an opportunity to test the strength and ability of countries to use strategic tools of identity management and exercise governance and control the disease. Creating, strengthening and developing digital identity infrastructures at the national level has received more and more attention from countries. Therefore, the use and enjoyment of digital phenomenon is more necessary than ever because the future belongs to universities that have more to do with digital world.

Covid-19 disease is a disease that has surprised medical science in the face of unexpected manifestations, with the exception of the respiratory system, almost all organs of the body are affected by Covid disease. This conflict will be more severe despite the underlying diseases, the history of kidney diseases, and so on. Therefore, the present study was performed to evaluate renal manifestations in patients with Covid-19. The present study is a review by searching the Pubmed, New England Journal of Medicine and Uptodate databases, which found 109 articles during the three stages of screening in the search process and applying inclusion and exclusion criteria, kidney involvement is not very common during the initial infection, but degrees of this involvement occur in the course of the disease, the most important of which is acute kidney damage. However, we have no evidence that, chronic kidney patients and those receiving immunosuppressive therapy for any reason, have a higher risk of developing Covid disease and its severe forms and higher mortality. Vaccination in these patients should be done according to the plan and even in some of these patients an additional dose of vaccine is recommended.