Knowledge, intention, and practice of wearing face mask by common people to ensure protection against COVID-19 during pandemic

Background: Since the outbreak of global pandemic, wearing face mask not only protects the individual but also limits the spread of corona virus infection in the community. However, certain sociocultural and personal factors have created hinderance in wearing face mask by general people against COVID-19 virus. Aims and Objectives: The aim and objective of this study is to assess the knowledge, intension, and practice of wearing face mask among common people. Materials and Methods: It was a cross-sectional study conducted among general people in a part of Western Odisha after ethical approval. A total of 1050 adults above 18 years participated in this study. The data were collected from different locality of the town using a pretested self-administered questionnaire by all authors and research assistants of this project. The period of study was from July 2021 to December 2021. The results were tabulated, processed, and analyzed using SPSS-20. Results: Regarding knowledge score, we observed that 57% had average, 18% had poor, and 25% had good knowledge. Furthermore, we found 42% participants had positive intention and 58% had negative intention. Again we assessed that 35% of participants were practicing face mask appropriately and 65% practicing inappropriately. Conclusion: In this study, the score of knowledge, intention, and also the practice of wearing face mask against COVID-19 was lower than the average as compared to previous researches. Hence, health authorities should promote the people to wear mask and encourage awareness programs for the benefit of the society.

Prevención de eventos de superpropagación de COVID-19 en autobuses que transportaron pacientes presintomáticos / Prevention of COVID-19 superspreader events in buses boarded by presymptomatic patients

Resumen Introducción: Ha ocurrido superpropagación de COVID-19 cuando individuos sintomáticos sin uso de cubrebocas abordaron autobuses. Objetivo: Reportar el riesgo de superpropagación cuando individuos presintomáticos abordaron autobuses junto con pasajeros no vacunados, pero se mantuvieron intervenciones preventivas no farmacológicas. Métodos: Estudio prospectivo de personal de salud transportado durante dos semanas en autobuses a un centro de vacunación contra COVID-19. Fue obligatorio llevar ventanas abiertas, uso correcto de cubrebocas y exclusión de personas con síntomas. La vigilancia prospectiva identificó a trabajadores con COVID-19 los 14 días siguientes a la vacunación. Cada pasajero asintomático de autobuses donde se detectaron casos fue vigilado durante un periodo similar. Los resultados de tamizaje voluntario estuvieron disponibles para los trabajadores que se realizaron prueba el mes previo o el siguiente a la vacunación. Resultados: 1879 trabajadores abordaron 65 autobuses. El tiempo a bordo varió de tres a ocho horas. Veintinueve casos de COVID-19 y cuatro casos asintomáticos fueron identificados entre 613 pasajeros de 21 autobuses. La mediana de tiempo entre la vacunación y el inicio de síntomas de COVID-19 fue de seis días. Fue identificado un caso de transmisión sospechada en autobús. Conclusiones: Las intervenciones preventivas no farmacológicas estrictas redujeron sustancialmente el riesgo de superpropagación de COVID-19 en autobuses ocupados por individuos presintomáticos.

Abstract Introduction: COVID-19 superspreader events have occurred when symptomatic individuals without wearing face masks boarded buses. Objective: To report the risk of superspreader events when presymptomatic individuals boarded buses together with unvaccinated passengers, but with non-pharmacological preventive interventions being maintained. Methods: Prospective study of health personnel transported in buses to a COVID-19 vaccination center for two weeks. Open windows, correct use of face masks and exclusion of symptomatic individuals were mandatory. Prospective surveillance identified workers with COVID-19 within 14 days after vaccination. Each asymptomatic passenger of buses where cases were identified was monitored for a similar time period. Voluntary screening results were available for workers who were tested in the month before or after vaccination. Results: 1,879 workers boarded 65 buses. On-board time ranged from three to eight hours. Twenty-nine cases of COVID-19 and four asymptomatic cases were identified among 613 passengers of 21 buses. Median time between vaccination and COVID-19 symptoms onset was six days. One case of suspected transmission on a bus was identified. Conclusions: Strict nonpharmacological preventive interventions substantially reduced the risk of COVID-19 superspreader events in buses boarded by presymptomatic individuals.

Microbiological Assessment of Used Face Masks in Port Harcourt Secondary Schools in COVID-19 Era

Aim: This study was aimed at identifying bacterial and fungal contaminations in used face masks from different secondary schools in Port Harcourt during COVID-19 EraStudy Design: The study employs statistical analysis of the data and interpretation.Place and Duration of Study: Five Secondary Schools–Three public schools: Federal Government College Rumuokoro; Rumueme and Rumuokuta Girls’ Secondary Schools; Two Private Schools: Solid Steps and Istan Secondary Schools; all located in the city of Port-Harcourt, Nigeria. Sample collection lasted for a week and the analysis lasted for six months.Methodology: The research study was facilitated through Laboratory analysis and the use of questionnaire to get the age and sex from the school children. A total of 25 used face masks samples were collected from school children between ages of 12-18years and they were examined microbiologically. Sterile swab sticks soaked in sterile nutrient broth were employed to swab the inner surface area of the used face mask of circular diameter 10 cm. The swabbed samples were dipped and shaken in 9ml of sterile saline water for 1-3 minutes to dislodge the organisms; the mixture was then diluted through a ten-fold serial dilution, after which an aliquot of 0.1ml were inoculated unto Nutrient Agar (dilution used 10-6, incubated at 370C for 24h), Mac Conkey Agar (dilution used 10-3, incubated at 44±0.20C for 24-48h) and Sabouraud Dextrose Agar (dilution used 10-3; incubated at 370C for 5-7 days). Frequency evaluation and identification of isolates were carried out using standard microbiological techniques.Results: The entire face masks sampled were found contaminated with microorganisms. The Microbial load (Log10 CFU/cm2;) and Percentage (%) occurrence of bacterial isolates from used facemask were; Bacillus spp (6.10±2.13)(30.81) > Staphylococcus auerus (3.89±3.01)(19.57%) > Proteus spp (2.25±2.45)(11.35) > Paenibacillus spp (1.55±2.52)(7.82) > Escherichia coli (0.36±0.81)(1.82) while fungal isolates were Aspergillus spp (2.20±0.55)(11.09) > Mucor spp (2.19±0.96)(11.04) > Penicillum spp (1.29±0.61)(6.51). The contaminated used face masks with microorganism were highest in school children of ages 16-18years (72%) and the lowest occurred in children of 12-14years of age (12%).Conclusion: The presence of potential pathogen such as Staphylococcus auerus, Bacillus spp etc. are of public health significance. It is therefore recommended that crowd should be controlled in such environments with high bacterial and fungal load such as schools and COVID-19 protocols duly observed.

Knowledge, attitude, and practices of 2nd year MBBS students regarding the use of face mask to limit the spread of the new coronavirus disease

Background: The onset of the aggressive Coronavirus disease 19 (COVID-19) pandemic has necessitated masks for the health care community. For healthcare workers, proper knowledge, a good attitude and increased comfortability with masks are of great essence. Knowledge of proper use and handling of masks among health care workers and medical students is of utmost importance as they protect the wearer and those around from transmission of infection. Aim and Objectives: To assess the Knowledge, Attitude, and Practices of 2nd year MBBS Students Regarding the Use of Face Mask to Limit the Spread of the New COVID-19. Materials and Methods: After obtaining ethical approval from the Institutional Ethical Committee with an ethical approval no. of IEC/2020/2/42, a questionnaire with 14 questions was prepared to investigate the knowledge, attitude, practices, and problems faced by 2nd Year MBBS students with regards to wearing a face mask during the COVID-19 pandemic. The questionnaire was sent electronically, consent was obtained and the responses were analyzed. Results: Assessment of knowledge revealed that 87.3% of participants knew the correct way of using a mask, 87.3% knew that there are three layers in it and 83.3% knew that the middle layer acts as the filter media barrier. Only 32.4% of participants knew that a surgical mask can be used for 8 hours and 92.2% incorrectly indicated cloth masks to be as effective in protection from COVID-19 as surgical masks are. About 97.1% of participants knew the purpose of metal strips and 93.1% knew the extent to which a surgical mask must cover. The attitude was excellent with 95.1% of participants believing that surgical masks can help, 90.2% saying they knew the steps of wearing a mask, and participants wearing masks at all times when conversing with patients and in public as well. Perturbingly, only 24.5% of participants faced no issues when wearing a mask. Conclusion: Overall, respondents displayed thorough knowledge and exuded a highly positive attitude but less than a fourth of respondents faced no issues while wearing a mask. Continued educational efforts and more research into mask comfort is the need of the hour.

Assessing the efficacy of 3D-printed ear protectors on mask adherence at an academic ophthalmology center

Purpose: In the ophthalmology setting, given the close proximity required for the clinical exam, appropriate mask usage and fit is essential. This study aims to assess how a simple, cost?effective 3D?printed face mask ear protectors (EP) attachment may decrease discomfort, increase compliance, and improve fit in an academic institution’s Ophthalmology department. Methods: Face mask EPs were distributed to patients and providers in the Ophthalmology department. A validated questionnaire was administered before and 2 weeks after EP usage. The survey included questions on demographics and frequency of mask usage during a spectrum of activities. Descriptive statistics were performed with Fischer’s t test. Results: Post-EP responses demonstrated an increased likelihood of mask usage across all activities, although not statistically significant. The greatest change was during outdoor activities, with a 14.3% increase in highest utilization. Post?EP, all subjects were very likely to wear masks while shopping and 91.7% while in the workplace. EP usage decreased the number of noncompliant individuals while spending time with friends and family by 93.3%. Almost no subjects reported mask removal of >15 times per hour post?EP. The increase in mask compliance was greatest for low mask utilizers. 91.9% reported improved comfort, 91.9% reported improved fit, and 81.6% reported increased mask usage. Conclusion: Our results suggest that simple cost?effective 3D?printed ear protectors may improve fit, comfort, and overall mask compliance. The results of this study should drive broader public health efforts to further investigate whether mask attachments can improve overall mask compliance through better comfort and fit

Safety and efficacy of high-flow nasal oxygen for pre-oxygenation before anesthesia induction: a meta-analysis / 中华麻醉学杂志

Objective:To systematically review and evaluate the safety and efficacy of high-flow nasal oxygen (HFNO) for pre-oxygenation before anesthesia induction.Methods:Pubmed, Cochrane Library, Embase, China National Knowledge Infrastructure, Wanfang Database, China Science and Technology Journal Database and China Biomedical Literature Database were searched from inception to March 2022.All randomized controlled trials comparing HFNO and facemask ventilation for pre-oxygenation before anesthesia induction were collected.Two researchers independently assessed the quality of trials and extracted data.The primary outcome was the safe apnea time, the secondary outcomes were the lowest SpO 2 during intubation, oxygenation-related complications, patient comfort, PaO 2 and PaCO 2 before and after pre-oxygenation and after intubation.Meta-analysis was performed using RevMan 5.4 software. Results:Seventeen randomized controlled trials involving 843 patients were included in this meta-analysis.The results of meta-analysis showed that the safe apnea time was significantly longer ( MD=67.61, 95% CI 5.94-129.28, P=0.03), the lowest SpO 2 was higher during tracheal intubation ( MD=3.27, 95% CI 2.25-4.29, P<0.01), and PaO 2 was higher after pre-oxygenation ( MD=54.39, 95% CI 9.32-99.46, P=0.02) in the patients using HFNO than those using facemask ventilation.There were no statistically significant differences in the other outcomes ( P>0.05). Conclusions:HFNO for pre-oxygenation before anesthesia induction can significantly prolong the safe apnea time, increase the lowest SpO 2 during tracheal intubation, and improve the levels of PaO 2 after pre-oxygenation, and HFNO does not affect the patient′s comfort or increase the development of preoxygenation-related complications when compared with facemask ventilation.

Workflow and error analyses of patient setup based on open-face mask immobilization combined with AlignRT for head tumor radiotherapy / 中华放射医学与防护杂志

Objective:To propose a markless patient setup workflow based on the optical surface monitoring system (AlignRT) and open-face mask immobilization for whole-course head tumor radiotherapy, assess the setup time and repositioning frequency of the proposed workflow, and conduct a comparative analysis of the differences, correlation, and consistency of the setup errors of the AlignRT and cone beam CT (CBCT) systems.Methods:A retrospective analysis was conducted for the data on the errors of 132 fractionated setup based on open-face mask immobilization of 33 head tumor patients. AlignRT-guided markless patient setup workflow was applied throughout the radiotherapy. Meanwhile, the body structures automatically generated by the treatment planning system were used as body references. The 6-degree-of-freedom (6DoF) setup errors (lateral, vertical, longitudinal, rotation, pitch, roll, and yaw directions), setup time, and repositioning frequency of the AlignRT and CBCT systems were recorded and analyzed. The Wilcoxon and Spearman analyses were used to statistically assess the differences and correlation of the setup errors of the two systems. Moreover, the Bland-Altman analysis was employed to evaluate the consistency of the two systems.Results:The 6DoF setup errors of CBCT were within the clinical tolerance (linear motions: -0.30 to 0.30 cm; rotational motions: -2.0° to 2.0°). The setup time and repositioning frequency of CBCT were (98 ± 31) s and 1.51% (2/132), respectively. There was no significant difference in setup errors between the two systems except those in x-axis ( Z = -3.11, P= 0.002), y-axis ( Z = -7.40, P<0.001), and Pitch ( Z= -4.48, P<0.001). There was a significant positive correlation between the setup errors along lateral ( rs = 0.47, P<0.001) and vertical ( rs = 0.29, P = 0.001) directions, rotation (Rtn; rs = 0.47, P<0.001), pitch (Pitch; rs = 0.28, P = 0.001) and roll (Roll; rs = 0.45, P<0.001) of the two systems. The 95% limits of agreement (95% LoA) of 6DoF setup errors were -0.12 to 0.09 cm, -0.07 to 0.17 cm, -0.19 to 0.20 cm, -1.0° to 0.9 °, -1.0° to 1.5°, and -0.9° to 1.0°, respectively. The 95% confidence interval (95% CI) of 95% LoA was -0.14 to 0.11 cm, -0.09 to 0.19 cm, -0.23 to 0.23 cm, -1.2° to 1.1°, -1.2° to 1.7°, and-1.0° to 1.1°, respectively, all of which were within the permissible error ranges. The 6DoF setup error difference of 3.41% (27/792< 5%) was beyond the 95% LoA. The maximum absolute differences of 6DoF setup errors within the 95% LoA were 0.12, 0.16, 0.19 cm, 0.9°, 1.5°, and 1.0°, respectively. Conclusions:The proposed markless setup workflow based on AlignRT combined with open-face mask immobilization for whole-course head tumor radiotherapy exhibits reasonable agreement and consistency with the patient setup using CBCT, with acceptable clinical efficiency. It can be applied to the first radiotherapy and the real-time monitoring of therapy to improve the safety and thus is of value in clinical applications.

Impact of the COVID-19 facemask disposal on environment and perception of people of the Sultanate of Oman

Environmental concerns are increasing in and around us due to improper discharge of personal protective gear or equipment (PPEs) during the current pandemic with SARS-CoV-2.The residents of Salalah, under the Dhofar governorate of Oman,were hastening to take every possible measure to safeguard their health against the COVID-19 pandemic. In this scenario, improper discard of facemasks in the environment entails a significant problem forpublic health and aquatic environments. Objective:This study aimsto assess how the SARS-CoV-2 virus disrupted the household waste management chainin the Sultanate of Oman. In addition, descriptivesurvey has also identified people's perception about the existing household waste management system. Methods:Total 200 respondents were personally selected under the purposive sampling category. Data were analyzed using SPSS version 26. The mean, standard deviation, and distribution shapewere calculated based on the retrieved data. The variables and frequencies were tabulated for categorical variables. Results show negative impacts on the environment, wildlife, and public health. It was also observed that there was a significant difference when grouped according to residence location since the obtainedalso observed a significant difference when grouped according to residence location since thep-value of 0.007 was less than 0.05 alpha level. This means that the responses differ significantly. It shows from the test conducted that participantsfrom the village experienced and observed a negative impact on the discarded face masks comparedto those in the city.Conclusion and recommendation: This study illustrates the real impact of the COVID-19 facemasks on the environment, wildlife, and public health. In addition, the new management of the user's facemasks for eliminating or reducing the risks to human health and the environmenthas been suggested. [Ethiop. J. Health Dev. 2022; 36(2):000-000]

Impact of the COVID-19 facemask disposal on environment and perception of people of the Sultanate of Oman

Background:Environmental concerns are increasing in and around us due to improper discharge of personal protective gear or equipment (PPEs) during the current pandemic with SARS-CoV-2.The residents of Salalah, under the Dhofar governorate of Oman,were hastening to take every possible measure to safeguard their health against the COVID-19 pandemic. In this scenario, improper discard of facemasks in the environment entails a significant problem forpublic health and aquatic environments. Objective:This study aimsto assess how the SARS-CoV-2 virus disrupted the household waste management chainin the Sultanate of Oman. In addition, descriptivesurvey has also identified people's perception about the existing household waste management system. Methods:Total 200 respondents were personally selected under the purposive sampling category. Data were analyzed using SPSS version 26. The mean, standard deviation, and distribution shapewere calculated based on the retrieved data. The variables and frequencies were tabulated for categorical variables. Results show negative impacts on the environment, wildlife, and public health. It was also observed that there was a significant difference when grouped according to residence location since the obtainedalso observed a significant difference when grouped according to residence location since thep-value of 0.007 was less than 0.05 alpha level. This means that the responses differ significantly. It shows from the test conducted that participantsfrom the village experienced and observed a negative impact on the discarded face masks comparedto those in the city.Conclusion and recommendation: This study illustrates the real impact of the COVID-19 facemasks on the environment, wildlife, and public health. In addition, the new management of the user's facemasks for eliminating or reducing the risks to human health and the environmenthas been suggested. [Ethiop. J. Health Dev. 2022; 36(2):000-000

Tolerancia a la prueba ergométrica graduada al utilizar barbijo o tapaboca / Exercise Testing Tolerance when Using Face Mask

RESUMEN Introducción: es poco conocida la tolerancia al ejercicio con el uso de barbijo. Objetivo: investigar tolerancia al barbijo en ergometrías (PEG). Material y métodos: estudio multicéntrico con PEG con barbijo. Resultados: 118 PEG (62 cinta, 56 cicloergómetro), 68 hombres, edad 46,74 ± 16,7 años. Setenta (59,3%) completaron PEG con barbijo, 48 (40,7%) debieron retirarlo: 17 en cinta (27,4%), 31 (55,4%) en bicicleta (p = 0,002). Porcentaje de frecuencia cardíaca al retirar barbijo con respecto a máxima alcanzada: 94,5±5,35%. Edad de quienes retiraron barbijo: 42,69±17,35 años y de quienes toleraron: 49,51 ± 15,88 (p = 0,003). Saturación basal: 97,46 ± 1,01%; en esfuerzo máximo con barbijo: 96,58 ± 1,37% (p <0,0001). Al retirar barbijo, saturación de 97,06 ± 1,35% (p < 0.0001). Edad menor y uso de cicloergómetro fueron predictores de no tolerar el barbijo. Conclusiones: la mayoría completó el ejercicio máximo con barbijo. La intensidad de ejercicio al retirar el barbijo fue alta. La saturación cayó en ejercicio con barbijo, aunque sin repercusión clínica.

ABSTRACT Background: Tolerance to exercise with the use of face mask is not well known. Objective: The aim of this study was to investigate the tolerance of exercise parameters during exercise stress testing (EST) while wearing a face mask. Methods: Multicenter study of EST while wearing face mask. Results: 118 ESTs (62 on treadmill, 56 on cycle ergometer), 68 men, age 46.74 ± 16.7 years. Seventy patients (59.3%) completed the EST wearing a face mask, and 48 (40.7%) removed it; 17 patients (27.4%) were on treadmill and 31 (55.4%) on cycle ergometer (p = 0.002). Percentage of maximum predicted heart rate attained when the patients removed their face mask: 94.5 ± 5.35%. Age of those who removed the face mask: 42.69 ± 17.35 years and of those who tolerated the face mask: 49.51 ± 15.88 years (p = 0.003). Baseline SpO2 was 97.46 ± 1.01% and 96.58 ± 1.37% on peak exercise wearing face mask (p < 0.0001). SpO2 when the face mask was removed: 97.06 ± 1.35% (p <0.0001). Younger age and use of cycle ergometer were predictors of intolerance to face mask. Conclusion: Most patients completed peak exercise with face mask. Exercise intensity was high when the face mask was removed. Oxygen saturation dropped during exercise with face mask without clinical impact.

Impacto en la morbimortalidad por COVID-19 según las regulaciones del uso de mascarilla / Impact on COVID-19 morbidity and mortality according to the regulations on the use of face mask

Resumen Introducción: Actualmente, la mascarilla representa un símbolo incomparable cuyo valor pasó del trabajo clínico a impactar en la contención de la propagación del virus SARS-CoV-2; se convirtió en un elemento de discordia en la población general. Objetivo: Establecer el impacto de las políticas de uso de mascarilla en la morbimortalidad por COVID-19. Métodos: Se asociaron las variables de política de uso de cubrebocas, obtenidas de la página web del movimiento científico #Masks4All, con el número de contagios, muertes y aplanamiento de la curva publicados por el centro de recursos de la Universidad Johns Hopkins y EndCoronavirus.org. Resultados: Las políticas de uso de mascarilla fueron de tipo universal (requerido en tiendas, restaurantes, transporte público), parcial (recomendado, requerido en cualquier lugar público) y ausente. Las asociaciones de la política de uso de mascarilla con casos totales (p = 0.01), casos por millón (p = 0.04) y muertes por millón de habitantes (p = 0.02) resultaron estadísticamente significativas. Las asociaciones de las variables con la tendencia de la curva epidemiológica también resultaron estadísticamente significativas (p = 0.00). Conclusión: La recomendación del uso generalizado de mascarilla es una medida con suficiente respaldo científico para reducir el número de contagios y muertes por COVID-19.

Abstract Introduction: Currently, the face mask represents an incomparable symbol whose value went from clinical work to impacting the containment of the spread of SARS-CoV-2, although it has become an element of discord in the general population. Objective: To establish the impact of face mask use policies on COVID-19 morbidity and mortality. Methods: Face mask use policy variables, obtained from the website of the #Masks4All scientific movement, were associated with the number of infections, deaths and flattening of the curve published by the Johns Hopkins University resource center and EndCoronavirus.org. Results: Face mask use policies were universal (required in shops, restaurants, public transport), partial (recommended, required in any public place) and absent. Associations of the face mask use policy with total cases (p = 0.01), cases per million (p = 0.04) and deaths per million population (p = 0.02) were statistically significant. Associations of the variables with the epidemiological curve trend were also statistically significant (p = 0.00). Conclusion: The recommendation for face mask widespread use is a measure with sufficient scientific support to reduce the number of COVID-19-related infections and deaths.

The importance of nonmedical face masks in the general population during the COVID-19 pandemic. A narrative review / La importancia de las mascarillas no médicas en la población general durante la pandemia de COVID-19. Una revisión narrativa

Abstract: The COVID-19 pandemic is a new and great challenge that medicine has had to face. Scientific evidence is growing rapidly and one of the aspects that has generated controversy is the role that the use of non-medical face masks can play when trying to stop the dissemination of cases. This narrative review examines the possible transmission mechanisms of the SARS-COV-2 virus, making emphasis on the role of aerosols, the history of their use inside and outside the hospital environment, the mechanisms by which they offer protection, as well as the efficiency in laboratory test where it is shown that face mask made with several layers of hybrid materials are more effective, and the beneficial impact that they have demonstrated in the general population. Evidence shows its widespread use helps reduce infection by decreasing the transmission of infectious droplets and aerosols, emphasizing that these results are superior when its use is more generalized. Given that it's impossible to provide the entire population with a medical face mask, public policies should be implemented in order to ensure the generalized use of non-medical face masks, along with hygiene strategies, social distance, avoiding closed places and contact tracking.

Resumen: La pandemia de COVID-19 es un nuevo y gran reto al que la medicina se ha tenido que enfrentar. La información científica crece rápidamente y uno de los aspectos que ha generado controversia es el posible papel que puede jugar el uso generalizado de los cubrebocas no médicos para tratar de detener la diseminación de casos. En esta revisión narrativa se examinan los posibles mecanismos de transmisión del virus SARS-CoV-2 con énfasis en el papel de los aerosoles, la historia de su uso dentro y fuera del medio hospitalario; se revisan los mecanismos por los que ofrecen protección, la eficiencia en pruebas de laboratorio donde se demuestra que los cubre bocas de varias capas de materiales híbridos son más eficaces, y el impacto benéfico que han demostrado en la población general. La evidencia demuestra que su uso generalizado ayuda a reducir los contagios al disminuir la transmisión de gotas y aerosoles infecciosos, y el resultado es superior mientras más generalizado es su empleo. Ante la imposibilidad de dotar a toda la población con cubre bocas médicos, se deben adoptar políticas públicas para el uso generalizado de cubre bocas no médicos de un diseño adecuado, junto con estrategias de higiene, distancia social, evitar lugares cerrados y seguimiento de contactos

Role of Non-pharmaceutical Interventions (NPIs) During COVID-19 Pandemic: A Systematic Literature Review

@#Non-pharmaceutical interventions (NPIs) as a means of prevention during the COVID-19 pandemic have gained increasing attention. NPIs are important to reduce infectious diseases and flatten the curve of infection. However, data or literature on the effectiveness of NPIs is scarce. In this review, we aim to investigate the effectiveness of NPIs in the community based on previous literature. A literature search was conducted on seven databases (OVID, EBSCOHOST, WOS, SCOPUS, TRIP, JSTOR, and PUBMED) using the PICO method which yielded 208 articles from 12th March to 1st April 2020. A PRISMA flow diagram and extraction tables were used to analyze the final 14 eligible articles spanning nine countries. There were nine articles on human surveillance, two on patient and contact management, two on community restrictions, and one article discussing the combination of NPIs (quarantine, closure of facilities, and transit site surveillance). With the use of NPIs, there was a significant reduction of infection episodes among the target population. There has been an increasing demand for scientific evidence on NPIs during the COVID-19 pandemic, and present policy recommendations rely heavily on expert judgement. Randomized trials are required to obtain better evidence for these interventions. However, this review will help experts create feasible and widely acceptable policies and protocols for mitigation plans in the absence of definitive evidence.

Is face mask with face shield more effective than face mask alone in reducing SARS-CoV-2 transmission? A systematic review

@#<p style="text-align: justify;"><strong>Background.</strong> The use of face shield in addition to face mask is thought to reduce the transmission of SARS-CoV-2 by blocking respiratory droplets and by preventing one from touching facial orifices.</p><p style="text-align: justify;"><strong>Objective.</strong> To determine the effectiveness of face mask with face shield, compared to face mask alone, in reducing transmission of SARS-CoV-2.</p><p style="text-align: justify;"><strong>Methods.</strong> We searched MEDLINE, Cochrane Library, as well as trial registers, preprint sites and COVID-19 living evidence sites as of 30 September 2021. We included studies that used face shield with face mask versus face mask alone to prevent COVID-19. We screened studies, extracted data, assessed the risk of bias and certainty of evidence using the GRADE approach. Review Manager 5.4 was used to estimate pooled effects.</p><p style="text-align: justify;"><strong>Results.</strong> There is no available direct evidence for face shield plus face mask versus face mask alone in the general public. Five (5) observational studies with very low certainty of evidence due to serious risk of bias and indirectness were included. Participants in all the studies were health care workers (HCWs) who used the face shield with their standard personal protective equipment (PPE). Four (4) of the studies were in the hospital setting (three case control studies, one pre- and post-surveillance study); one was done in the community (one pre- and post-surveillance study) in which HCWs visited the residence of the contacts of SARS-CoV-2 positive patients. The case control studies done in the hospital setting showed a trend toward benefit with the use of face shield or goggle but this was inconclusive (OR 0.85, 95% CI 0.68-1.08) while the pre- and post-surveillance study showed significant benefit when face shield (OR 0.28, 95% CI 0.22-0.37) use became a requirement for HCWs upon hospital entry. In the study done in the community setting, significant protection for HCWs was noted with the use of face shield (OR 0.04, 95% CI 0.00-0.69) but the results were limited by serious risk of bias and imprecision.</p><p style="text-align: justify;"><strong>Conclusion.</strong> In the hospital setting, there was a lower likelihood of COVID-19 infection in HCWs who used a face shield or goggles on top of their PPE. For the general public in the community, there is presently no study on the use of face shield in addition to the face mask to prevent COVID-19 infection.</p>

Knowledge, Practices and Attitude of Healthcare Providers about Using Face Mask to Limit the Spread of the Novel Coronavirus Disease

Aim: There is evidence that health care providers have insufficient knowledge and poor practices regarding the use of surgical mask. Therefore, this study aimed to explore the knowledge, practices and attitudeof healthcare providers about using face mask in order to limit the spreading of the novel coronavirus disease.Methodology:This was a cross sectional pilot study included a questionnaire about the knowledge of health care workers regarding the use of surgical face mask to prevent the new COVID-19 spreading and about their practices and the attitude of them regarding the use of surgical face mask to limit the new COVID-19 exposure Results: About 86.21% of health care workers said that the correct way ofusing surgical face maskisWhite side facing in and about 65.52% of them said that N-95 mask is the mask type that actually protect against COVID-19. All of the respondents reported that they wear a mask in public places to protect themselves against COVID-19 and that they wear a mask in hospital premises to protect themselves against COVID-19 (100.00%).Conclusion: The Knowledge, attitude, and practice of health care providers regarding the use of surgical face masks were found to be good but still more knowledge is required about several aspects such as the types of masks, the duration of using masks and the disposal of the masks

Particulate-Matter Related Respiratory Diseases / 결핵

Particulate matter (PM) is suspended dust that has a diameter of <10 µm and can be inhaled by humans and deposited in the lungs, particularly the alveoli. Recent studies have shown that PM has an adverse effect on respiratory diseases. The aim of this article is to review respiratory diseases associated with PM. According to existing studies, PM is associated with chronic obstructive pulmonary disease, bronchial asthma, and several other respiratory diseases and increases the mortality rates of these diseases. Moreover, increased exposure in the high concentration of atmospheric PM is associated with the development of lung cancer. The most simple and common way to protect an individual from airborne PM is to wear a face mask that filters out PM. In areas of high concentration PM, it is recommended to wear a face mask to minimize the exposure to PM. However, the use of N95 or KF94 masks can interfere with respiration in patients with chronic respiratory diseases who exhibit low pulmonary function, leading to an increased risk of respiratory failure. Conclusionally, reduction of the total amount of PM is considered to be important factor and strengthening the national warning notification system to vulnerable patients and proper early management of exacerbated patients will be needed in the future.

A Randomized Comparison of Patient’s Ventilation at Induction of Anaesthesia Between Tulip GT® Airway and Guedel Airway-Face Mask by Anaesthesia Residents

The Tulip® airway is a recently introduced single sized ventilating oropharyngeal airway. Methods: We performed a randomized, controlled study of lung ventilation by anaesthesia residents using either Tulip GT® airway or face mask with Guedel airway in 100 anaesthetised patients, where the ease of insertion, intracuff pressure and volume were measured, as were the end-tidal carbon dioxide levels, airway pressures and tidal volumes over first three breaths. Results: Successful ventilation was observed with Tulip airway which provided a patent airway in comparison to facemask with a Guedel airway but 15 patients required additional cuff volume in Tulip airway. Conclusion: We conclude Tulip® airway can be used as an adjunct for airway management even by inexperienced users.

Nondepolarizing muscle relaxant improves direct laryngoscopy view with no effect on face mask ventilation / Relaxantes musculares não despolarizantes melhoram a visibilidade em laringoscopia direta sem efeito sobre a ventilação via máscara facial

Abstract Background: Difficult or impossible face mask ventilation complicated with difficult tracheal intubation during anesthesia induction occurs in 0.4% of adult anesthesia cases, possibly leading to life-threatening complications. Because of such catastrophes, muscle relaxants have been recommended to be administered after confirming adequate face mask ventilation without a solid scientific validation of this principal. Methods: In this observational study, the ease of ventilation and the scores of direct laryngoscopy views before and after administration of cisatracurium were assessed in ninety young healthy adults, without anesthetic risks and without foreseen difficult intubation and who were scheduled for general elective surgeries. Results: Before muscle relaxation, 43 patients (48%) were Cormack Grade I, while the remaining 47 patients (52%) were either Cormack Grade II (28 patients, 31%) or Cormack Grade II (19 patients, 21%). Following muscle relaxation with cisatracurium, the number of patients with Cormack Grade I significantly increased from 43 patients (48%) to 65 patients (72%) (p = 0.0013). Only 1 patient out of 19 patients (5%) improved his Cormack grade from Grade III to Grade I while 16 out 19 patients (84%) improved their Cormack grade from Grade III to Grade II after the use of cisatracurium. The quality of face mask ventilation did not differ with and without muscle relaxants in all patients. Conclusion: The use of cisatracurium in healthy young adults undergoing general elective surgeries with no anticipated difficult endotracheal intubation had no effect on the quality of face mask ventilation despite resulting in a quantifiable improvement in the laryngeal view.

Resumo Justificativa: A ventilação difícil ou impossível via máscara facial complicada pela intubação traqueal difícil durante a indução da anestesia ocorre em 0,4% dos casos de anestesia em adultos, possivelmente leva a complicações fatais. Devido a tais catástrofes, recomendou-se que a administração de relaxantes musculares seja feita após a confirmação de ventilação adequada via máscara facial, sem uma validação científica sólida dessa conduta. Métodos: Neste estudo observacional, a facilidade de ventilação e os escores de visibilidade em laringoscopia direta antes e após a administração de cisatracúrio foram avaliados em 90 adultos jovens e saudáveis, sem riscos anestésicos e sem intubação difícil prevista, agendados para cirurgias eletivas gerais. Resultados: Antes do relaxamento muscular, 43 pacientes (48%) eram Cormack Grau I, enquanto os 47 (52%) restantes eram ou Cormack Grau II (28, 31%) ou Cormack Grade III (19, 21%). Após o relaxamento muscular com cisatracúrio, o número de pacientes com Cormack Grau I aumentou significativamente de 43 (48%) para 65 (72%) (p = 0,0013). Apenas um paciente (5%) dos 19 melhorou sua classificação de Cormack do Grau III para o Grau I, enquanto 16 dos 19 (84%) melhoraram suas classificações de Cormack do Grau III para o grau II após o uso de cisatracúrio. A qualidade da ventilação via máscara facial não diferiu com ou sem relaxantes musculares em todos os pacientes. Conclusão: O uso de cisatracúrio em adultos jovens saudáveis submetidos a cirurgias eletivas gerais sem intubação traqueal difícil prevista não teve efeito sobre a qualidade da ventilação via máscara facial, mesmo resultando em melhora quantificável da visibilidade da laringe.

Clinical value of humidified high flow nasal cannula oxygen therapy for acute hypoxic respiratory failure / 医疗卫生装备

Objective To explore the clinical value of humidified high flow nasal cannula oxygen therapy (HHFNC) oxygen therapy for acute hypoxic respiratory failure.Methods Totally 37 patients with acute hypoxic respiratory failure were enrolled who entered ICU from January 2016 to June 2016 and randomly divided into FM group (n=l8) and HHFNC group (n=19).The values of blood gas analysis were recorded as before treatment,1 h and 5 h after therapy,respectively.Results 1 h and 5 h after therapy,both groups had significant increase in pa(O2) compared to before treatment (P＜0.05).Meanwhile,HHFNC group had higher level ofpa(O2) in comparison to FM group (P＜0.05).Conclusion HHFNC oxygen therapy has a therapeutic effect on acute hypoxic respiratory failure which helps to correct hypoxemia and improve subject feeling of comfort.