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Background: The conditions related to the Covid-19 pandemic and quarantine have endangered the mental health of people in the community, especially psychiatric patients. This study aims to determine the mental health services usage of outpatient psychiatric patients who attended a public mental health clinic in Tehran, during the quarantine. The study sample consisted of 387 patients with an active record in the mental health clinic. They were selected using systematic random sampling. Data was gathered with the telephone interviews using the researcher-made checklist. The data were then collected and analyzed. Results: Participants in this study included 141 male and 264 female patients. One-hundred forty-two patients (36.7%) felt better during this period, and the rest got worse or did not make a difference. Among the patients who felt the need to visit, 144 (47.2%) referred for services, of which 81.7% had visited in person. Among the applicants, 84 (56%) succeeded in receiving the service. A total of 53.5% of patients had used at least one face to face, telephone, or online visit. Among them, women are compared to men (p= 0.002), educated people to low education (p< 0.001), and adults to children and the elderly (p= 0.02), and Tehran residents to foreigners (p= 0.01) used significantly more services. Conclusions: Experience with pandemic quarantine conditions has shown that face-to-face use of these services faces significant barriers. In this situation, the expansion of online services can help improve the condition of patients and should be on the agenda of mental health policymakers.

Study Design This is a systematic review.Objective This study aims to compare effects of sequestrectomy versus conventional microdiscectomy for lumbar disc herniation.Summary of Background data Open surgery for LDH can be performed by sequestrectomy or conventional discectomy. Generally, it has been assumed that the former is associated with higher risk of recurrence and less radicular pain and low back pain after surgery.Methods We searched MEDLINE and EMBASE from 1980 to November 2014. We selected randomized controlled trials (RCTs) and prospective studies that compared conventional discectomy versus sequestrectomy for adult patients with LDH and evaluated the following primary outcomes: radicular pain or LBP as measured by a visual analogue scale, neurological deficit of lower extremity. We also evaluated the following secondary outcomes: complications of surgery, reherniation rate, duration of hospital stay, postoperative analgesic use, and health-related quality of life measures. Two authors independently reviewed citations and articles for inclusion. We assessed the risk of bias as well as the level of evidence for each study, and we used standard methodological procedures recommended by the Cochrane Collaboration.Results We identified five studies (746 participants) that met our inclusion criteria comparing sequestrectomy versus microdiscectomy. Comparison revealed that with low-quality evidence, there is no significant difference for radicular pain, LBP, functional outcome, complications, and hospital stay for 2 years. In addition, with moderate-quality evidence, there is no significant difference for recurrence rate. Meanwhile, there is very low-quality evidence that analgesic consumption is lower in sequestrectomy than micro/discectomy.Conclusion Both interventions had similar effect on pain after surgery, recurrence rate, functional outcome, and complications; however, sequestrectomy may be superior in terms of postoperative analgesic consumption.