Aims:We hypothesised that omega-3 fatty acids would be an appropriate adjunct therapy for alleviating the inflammatory response and clinical manifestation in hospitalised patients with Covid-19 disease. Methods: This was a single-blind randomised controlled trial in Amir-Alam hospital in Tehran. Thirty adult men and women diagnosed with Covid-19 were allocated to either control group (receiving Hydroxychloroquine) or intervention group (receiving Hydroxychloroquine plus 2 grams of Docosahexaenoic acid [DHA] + Eicosapentaenoic acid [EPA]) for 2 weeks. Primary outcome of the intervention including C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) as well as clinical symptoms including body pain, fatigue, appetite and olfactory and secondary outcomes including liver enzymes were determined at the baseline and after omega-3 supplementation. Clinical signs were measured using self-reported questionnaires. There were commercial kits for determination of CRP and liver enzymes concentrations in the serum of patients. For determination of ESR automated haematology analyser was applied. The study of "Comparison of the effectiveness of omega-3 and Hydroxychloroquine on Inflammatory factors, liver enzymes and clinical symptoms in diabetic Covid-19 patients" was registered in Iranian Registry of Clinical Trials (IRCT) with ID number: IRCT20200511047399N1. Results:In comparison to control group, patients receiving omega-3 indicated favourable changes in all clinical symptoms except for olfactory (P < .001 for body pain and fatigue, P = .03 for appetite and P = .21 for olfactory). Reducing effects of omega-3 supplementation compared with control group were also observed in the levels of ESR and CRP after treatment (P < .001 for CRP and P = .02 for ESR).However, no between group differences in the liver enzymes serum concentrations were observed after supplementation (P > .05). Conclusion:Current observations are very promising and indicate that supplementation with moderate dosages of omega-3 fatty acids may be beneficial in the management of inflammation-mediated clinical symptoms in Covid-19 patients.

Introduction: Early detection and monitoring of mild cognitive impairment (MCI) and Alzheimer's Disease (AD) patients are key to tackling dementia and providing benefits to patients, caregivers, healthcare providers and society. We developed the Integrated Cognitive Assessment (ICA); a 5-min, language independent computerised cognitive test that employs an Artificial Intelligence (AI) model to improve its accuracy in detecting cognitive impairment. In this study, we aimed to evaluate the generalisability of the ICA in detecting cognitive impairment in MCI and mild AD patients.Methods: We studied the ICA in 230 participants. 95 healthy volunteers, 80 MCI, and 55 mild AD participants completed the ICA, Montreal Cognitive Assessment (MoCA) and Addenbrooke's Cognitive Examination (ACE) cognitive tests.Results: The ICA demonstrated convergent validity with MoCA (Pearson r=0.58, p&lt;0.0001) and ACE (r=0.62, p&lt;0.0001). The ICA AI model was able to detect cognitive impairment with an AUC of 81% for MCI patients, and 88% for mild AD patients. The AI model demonstrated improved performance with increased training data and showed generalisability in performance from one population to another. The ICA correlation of 0.17 (p = 0.01) with education years is considerably smaller than that of MoCA (r = 0.34, p &lt; 0.0001) and ACE (r = 0.41, p &lt; 0.0001) which displayed significant correlations. In a separate study the ICA demonstrated no significant practise effect over the duration of the study.Discussion: The ICA can support clinicians by aiding accurate diagnosis of MCI and AD and is appropriate for large-scale screening of cognitive impairment. The ICA is unbiased by differences in language, culture, and education.

Background: Paying attention to the issue of mental health in the workplace, especially with current pandemic conditions of COVID-19 is of significant importance. Therefore, this study aimed to determine the factors affecting occupational burnout among health care center staff during the pandemic of coronavirus infection. Methods: The present study was a case-control study carried out in the first half of the year 2020 on medical staff working in hospitals in Tehran. The sample size was 324 individuals, including 175 employees working in general (non-COVID) wards and 149 people working in COVID-19 wards. Demographic characteristics questionnaire and two standard questionnaires of Maslach Burnout Inventory and Parker and DeCotiis Job Stress Scale were distributed. Results: Total score of job stress and its two dimensions (time and pressure) had a significant relationship with different levels of occupational burnout. Logistic regression analyses showed significant relations between job stress with emotional exhaustion (95% CI, 1.11-1.19, OR=1.15) and depersonalization. Participants in both wards experienced statistically significant increasing trends given the different components of occupational burnout concurrently by increasing their total stress score. Conclusion: Hospital staff’s levels of stress and occupational burnout regardless of where they worked (COVID-19 wards or general wards) were not significantly different and existed among the members of both groups. On the other hand, job stress and its dimensions (time pressure and anxiety) had a significant relationship with the main dimensions of occupational burnout.

BACKGROUND:As the elderly population increases dramatically, the chronic age-related disease should be noted. In the elderly, chronic pain is a common health problem.METHODS:This search was performed in 3 databases (PubMed, Google Scholar, Embase). We have reviewed articles related to pain management in the elderly.RESULT:The prevalence of pain in people aged above 60 is twice that in younger people. Pain is estimated to be 45-85 per cent in the elderly. Pain is not a part of the ageing process, but many older people can experience it. Perception of pain can be affected by environmental, emotional, cultural and cognitive factors. Pain in the elderly often remains untreated and misdiagnosed.CONCLUSION:Pain management in elderly needs different approach because of unreported pain in this population, and usually they have multiple problems and comorbidities that complicate evaluation and treatment.