Reasons for the use of masks in open areas after the Peruvian government announced that it will no longer be mandatory in the context of COVID-19 in 2022

Introduction: In Peru, a high proportion of fully immunized people against COVID-19 has been achieved, which has mitigated the severity of the disease. Thus, under the recommendation of experts, the Peruvian government issued Supreme Decree 118-2022-PCM, which indicated that the use of masks is optional in open and ventilated enclosed spaces as of October 1, 2022. Objective: The aim of the present study was to find out the reasons why people continued to wear masks even though it was not mandatory in outdoor environments. Methods: A total of 335 people participated, with an average age of 26.11 years (73.1% women). A data collection form was prepared where sociodemographic and health information was requested; in addition, the question "Why do you continue to wear mask despite it being optional in open and closed ventilated spaces?" was included. The data obtained from the last open question of the instrument was analyzed by means of a discursive textual analysis (DTA) and an exploratory analysis through IRAMUTEQ. Results: Results indicate that people continue to wear masks, despite the lifting of the restrictions, to avoid contagion of COVID-19 and other respiratory diseases. In addition, the prevention of possible infection and transmission of the virus also focused on the family and vulnerable people. Discussion: It is concluded that the practice of wearing masks may be influenced by individual perceptions of risk and interpretations of responsibility and solidarity towards others.

Introducción: En el Perú, se logró una alta proporción de personas completamente inmunizados contra COVID-19 que ha mitigado la severidad de la enfermedad. Es así que, bajo la recomendación de expertos el gobierno peruano emitió el Decreto Supremo 118-2022-PCM, donde se indicó que el uso de la mascarilla es opcional en espacios abiertos y espacios cerrados ventilados a partir del 1 de octubre del 2022. Objetivo: El presente estudio fue conocer las razones por las cuales las personas continuaron usando mascarilla a pesar de que no era obligatorio en ambientes exteriores. Metodología: Participaron un total de 335 personas con un promedio de edad de 26.11 años (73.1% mujeres). Se elaboró una ficha de recolección de datos donde se solicitó información sociodemográfica y de salud; además, se incluyó la pregunta "¿por qué sigue utilizando la mascarilla a pesar de que es opcional en espacios abiertos y cerrados ventilados?" Los datos obtenidos de la última pregunta abierta del instrumento se analizaron mediante un análisis textual discursivo (ATD) y un análisis exploratorio a través de IRAMUTEQ. Resultados: Los resultados indicaron que, las personas seguían utilizando mascarillas, a pesar de estar levantadas las restricciones, para evitar contagios de la COVID-19 y de otras enfermedades respiratorias. Además, esta prevención de una posible infección y transmisión del virus es enfocada también a la propia familia y personas vulnerables. Discusión: Se concluye que, la práctica de usar mascarillas puede estar influenciada por las percepciones individuales del riesgo y las interpretaciones de responsabilidad y solidaridad frente a los demás.

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.

A comparison between propofol and sevoflurane for easy insertion of laryngeal mask airway among adults in minor elective surgeries: An observational study

Background: The laryngeal mask airway (LMA) has reached ample popularity for the management of airway during surgery. Propofol, used as induction agent, causes change in blood pressure and heart rate (HR) while insertion of LMA. Sevoflurane, whereas, has the potential to be a good induction agent as propofol. We have compared propofol and sevoflurane for easy insertion of LMA among adults in minor surgeries. Aim and Objectives: The primary objective of the study was to compare the ease of insertion of LMA and its characteristics related to insertion among adults in minor elective surgeries using intravenous propofol or inhalational sevoflurane. While time taken to set induction and actual event of LMA insertion along with number of attempts, jaw relaxation time, LMA insertion time, apnea time, monitoring hemodynamic changes, and occurrence of complications were taken as secondary objectives. Materials and Methods: It was a prospective and observational study done in Department of Anesthesiology and Operation Theaters of Fortis Hospital, Kolkata, after getting ethical approval. Total 100 patients were recruited by consecutive sampling and divided into two groups - P (propofol) and S (sevoflurane) group. Anesthesia induction time, jaw relaxation time, LMA insertion time, etc. were noted. LMA insertion conditions were assessed by a 3-point scale using six variables, total score was calculated for each group. Hemodynamic parameters and induction complications were also recorded. Results: There was no significant difference in demographic parameters, American Society of Anesthesiologists class, Modified Mallampati Grading, and LMA size, between the groups. LMA insertion time was comparable between the two groups. Regarding complications, there was no incidence of coughing while minor gagging (4%) and laryngospasm (6%) were noted only with sevoflurane. Final summation of scores showed excellent insertion characteristics with propofol (94%) and sevoflurane (84%), respectively, with no significant difference. Conclusion: Inhalational sevoflurane may be regarded as a viable alternative to inj. propofol for insertion of laryngeal mask among adults in minor elective surgeries.

Inferior altitudinal visual loss and mask-wearing practices: A case series

Face mask-wearing practices and their impact on the visual field bear particular importance in the coronavirus disease 2019 (COVID-19) pandemic era. This case series examines 10 participants with no history of ocular impairment or visual field defects who underwent age-corrected visual field testing in both eyes with different types of face masks. Wearing duckbill N95 masks was consistently associated with increased accuracy errors in the inferior altitudinal visual field when compared to wearing surgical masks or no masks. These findings support public health guidance that has previously attributed the risks of falls and accidents to face mask wearing.

Comparison results of the population's COVID-19 preventive behaviours / Монголын Анагаах Ухаан

Background@#As of September 21, 2021, 65.3 percent of Mongolia's population was vaccinated at full dose. However, as of COVID-19 confirmed cases, Mongolia is in the top five countries in the West Pacific. This indicates that there is a lack of practice to prevention from coronavirus infection in the population.@*Goal @#This survey aims to compare the level of knowledge, attitudes, and practices of the population towards coronavirus infection with the results of the baseline survey results @*Material and Methods@#This is a cross-sectional study. A total of 1896 people aged 15-60 years old participated in the study. The survey data were collected using quantitative (questionnaire) and qualitative (observation) methods. The research methodology was approved at the Scientific Committee of the National Center for Public Health on November 9, 2021 (Protocol № 5) and the Medical Ethics Review Committee of the Ministry of Health on January 20, 2022 (Resolution №261) was issued the Ethical permission of the survey. @*Results@#Out of 14 knowledge questions that should be known about coronavirus infection, survey participants had known in an average of 8.27 ± 3.73 (95%CI: 8.12-8.43) correct answers, which was lower than the results of the baseline study. The average knowledge score of the surveyed participants of the follow-up survey (9.23±3.2, 95%CI: 9.09-9.38) was smaller than the baseline survey by 0.96 percent. 54.5 percent of surveyed participants believed that the pandemic is “very dangerous”. However, it has decreased by 25.6 percent compared to the baseline survey. Positive attitudes toward the right place at the onset of symptoms of COVID-19 and non-discrimination against infected people are more prevalent in a population with a high average knowledge score. In the baseline study, the average duration to wear a mask was 29 hours, while in the follow-up survey, it was 4.2 hours, which shows improvement in the correct behavior. @*Conclusions@#As the population’s level of education increased, the average knowledge score on the coronavirus infection has increased, and the statistically significant high of the participant with higher education levels was 8.81±3.53 (p=0.0001). In the baseline survey, 64.9 percent of the participants had an attitude toward a discriminant person infected with COVID-19, whereas it was declined by 41.9 percent in the follow-up survey. The practice of wearing masks in crowded places and outdoors were increased by 6.8 percent from the baseline survey. Compared to the baseline survey results, in the follow-up survey, practices of wearing masks in the workplace or indoor environment (73.0%) had increased.

Effects of chewing gum on mask contamination

Aims@#The aim of this study was to evaluate whether chewing gum affects mask contamination.@*Methodology and results@#Two groups of participants were requested to wear a mask for 15 min with (experimental group) or without (control group) chewing gum. Then, masks were collected and CFU calculation and 16S rDNA sequencing was performed. We found that temperature, humidity and bacterial CFU inside of the mask significantly increased when wearing a mask while chewing gum. Staphylococcus epidermidis was found in both groups. Staphylococcus aureus, Staphylococcus haemolyticus, Streptococcus oralis, Streptococcus parasanguinis and Bacillus wiedmannii were found in only the experimental group.@*Conclusion, significance and impact of study@#Chewing gum significantly increased the temperature, humidity and bacterial CFU inside the mask. Staphylococcus epidermidis, S. aureus, S. haemolyticus, S. oralis, S. parasanguinis and B. wiedmannii were detected inside the mask after chewing gum.

Clinical Efficacy of Da Vinci Robot-assisted Subxiphoid Versus Lateral Thoracic Approach for Treatment of Anterior Mediastinal Tumors / 肿瘤防治研究

Objective To compare the perioperative efficacy and safety of da Vinci robot-assisted thoracoscopic surgery (RATS) for treatment of anterior mediastinal tumors through subxiphoid versus lateral thoracic approaches under the laryngeal mask anesthesia. Methods We retrospectively analyzed the clinical data of 102 patients with anterior-mediastinal tumors treated by RATS under laryngeal mask anesthesia completed by the same operator. Forty-five patients underwent the subxiphoid approach (subxiphoid group), and 57 patients were treated with the lateral thoracic approach (lateral thoracic group). The operating time, intraoperative bleeding, and total postoperative drainage volume in the two groups were compared and analyzed. Results All patients successfully completed resection of the anterior mediastinal tumor without the occurrence of perioperative death. In terms of total postoperative drainage volume, postoperative drainage time, postoperative hospital stay, and VAS pain on postoperative days 2 and 3, the subxiphoid group was more advantages (P < 0.05). No statistically significant difference was found between the two groups in terms of operative time, docking time, total operative time, intraoperative bleeding volume, postoperative day 1 VAS pain score, or postoperative complications (P > 0.05). Conclusion The subxiphoid approach of RATS is safe and feasible for resection of anterior mediastinal tumors. Compared with the lateral thoracic approach, the subxiphoid approach has advantages in terms of rapid postoperative recovery and postoperative pain.

Cross-sectional study on the use of masks among occupational groups with high-risk positions for overseas import and pollution transmission / 中华劳动卫生职业病杂志

Objective: To investigate the wearing of masks and the knowledge of masks among high-risk positions for overseas import and pollution transmission. Methods: From May 14 to 17, 2022, a convenient sampling method was used to conduct an online survey among 963 workers in high-risk positions for overseas import and pollution transmission in Beijing. The behaviors of individual use and wearing masks, the distribution and supervision of the unit, the knowledge of personal mask protection and the subjective feelings of wearing masks were analyzed. The χ(2) test and logistic regression model were used to analyze the influencing factors of the correct selection of masks. Results: The majority of the workers in high-risk positions for overseas import and pollution transmission were male (86.0%, 828/963), age concentration in 18-44 years old (68.2%, 657/963), and the majority of them had college or bachelor degrees (49.4%, 476/963). 79.4%(765/963) of the workers chose the right type of masks, female, 45-59 years old and high school education or above were the risk factors for correct selection of masks (P <0.05). Workers had good behaviors such as wearing/removing masks, but only 10.5% (101/963) could correctly rank the protective effect of different masks. 98.4% (948/963) of the workers believed that their work units had provided masks to their employees, and 99.1% (954/963) and 98.2%(946/963) of them had organized training and supervision on the use of masks, respectively. 47.4%(456/963) of the workers were uncomfortable while wearing masks. Conclusion: The overall selection and use of masks among occupational groups in high-risk positions for overseas import and pollution transmission in China need to be further standardized. It is necessary to strengthen supervision and inspection on the use of masks among occupational groups, and take improvement measures to improve the comfort of wearing masks.

External compression headache during Covid-19 pandemic: a neglected entity / Cefaléia por compressão externa durante a pandemia de Covid-19: uma entidade negligenciada

Introduction: Personal Protective Equipment (PPE) is part of the work routine of health professionals, especially during pandemics. During the Covid-19 pandemic, the use of PPE became constant for long working hours, resulting in adverse effects on the health of professionals, especially headache. Objective: In this review, we explore the scientific literature on headache associated with prolonged use of PPE during the coronavirus pandemic. Method: This is a narrative literature review conducted through the PubMed and Web of Science databases according to the following MeSH descriptors: "Face shield", "Headache" and "Covid-19". Articles that analyzed the presence of headache and other adverse events in health professionals in prolonged use of PPE were included. Results: The included studies point to headache as the most prevalent adverse event, which may be a new headache or the worsening of a previous headache. Other effects were also found, such as pressure marks on the skin, hyperemia in contact areas; suffocation; reduced concentration and excessive sweating. Conclusion: The use of PPE for long periods can cause headaches due to external pressure, in addition to other unwanted events.These effects reveal the importance of studies to make PPE more efficient, ensuring protection for the individual without causing discomfort.

Introdução: Os Equipamentos de Proteção Individual (EPI) fazem parte da rotina de trabalho dos profissionais de saúde, principalmente durante as pandemias. Durante a pandemia da Covid-19, o uso de EPI tornou-se constante durante longas jornadas de trabalho, resultando em efeitos adversos à saúde dos profissionais, principalmente cefaleia. Objetivo: Nesta revisão, exploramos a literatura científica sobre cefaleia associada ao uso prolongado de EPI durante a pandemia do coronavírus. Método: Trata-se de uma revisão narrativa da literatura realizada por meio das bases de dados PubMed e Web of Science segundo os seguintes descritores MeSH: "Face Shield", "Headache" e "Covid-19". Foram incluídos artigos que analisaram a presença de cefaleia e outros eventos adversos em profissionais de saúde em uso prolongado de EPI. Resultados: Os estudos incluídos apontam a cefaleia como o evento adverso mais prevalente, podendo ser uma nova cefaleia ou o agravamento de uma cefaleia anterior. Também foram encontrados outros efeitos, como marcas de pressão na pele, hiperemia nas áreas de contato; asfixia; concentração reduzida e transpiração excessiva. Conclusão: O uso de EPI por longos períodos pode causar dores de cabeça por pressão externa, além de outros eventos indesejados. Esses efeitos revelam a importância de estudos para tornar os EPI mais eficientes, garantindo proteção ao indivíduo sem causar desconforto.

Perception and Practices of COVID Appropriate Behavior: A Cross‑Sectional Study among Adult Populations in Rural and Urban West Bengal

Introduction: Recent COVID‑19 pandemic is an unprecedented public health problem worldwide. Knowledge about the disease and adoption of COVID Appropriate Behavior (CAB) are of utmost importance in combating the pandemic. The study was conducted to assess and compare the knowledge, attitude, and practice and to determine different misconceptions and wrong practices related to the disease among urban and rural populations. Materials and Methods: A community‑based analytical study with cross‑sectional design was conducted from January 2021 to March 2021 among 144 adult residents from urban and rural West Bengal. Multistage sampling was adopted and a predesigned, pretested, semistructured schedule was used for interviewing study subjects. Results: Urban people were significantly more knowledgeable and more appropriate in attitude and practice than rural people (P < 0.05). The mean knowledge and attitude scores of urban population were significantly higher than the rural population across age groups, gender, occupation, and education (P < 0.05), whereas mean practice score was significantly higher across gender and occupation in the urban population compared to the rural population (P < 0.05). Many cultural and indigenous practices such as drinking warm water, using mouth wash, using home remedies were more common in urban areas and consumption of homeopathy medicines, lighting candles, making sound with utensils, blowing conch shells, and worshipping corona were observed more in rural areas. Conclusions: Wide gap exists in knowledge, attitude, and practice between urban and rural population and there were many wrong perceptions and practices surrounding COVID‑19 among both urban and rural population. Appropriate policy for improving knowledge, attitude, and CAB is the need of the hour.

Intubación orotraqueal a través de mascarilla laríngea Ambu AuraOnceTM en paciente con lesión de médula espinal cervical / Orotracheal intubation through Ambu AuraOnceTM laryngeal mask in patient with cervical spinal cord injury

Resumen: Reportamos el manejo exitoso de la vía aérea con intubación orotraqueal a través de una máscara laríngea AuraOnceTM en un paciente con lesión de la médula espinal cervical. Su uso fue como dispositivo de rescate de la vía aérea tras intubación orotraqueal fallida con laringoscopía directa y dificultad para la ventilación con mascarilla en una paciente traumatizada de 46 años. Se tomó la decisión de utilizar la mascarilla laríngea sin intubación como conducto para la colocación de un tubo orotraqueal, lo cual se realizó con éxito. Este uso alternativo de la mascarilla laríngea Ambu AuraOnce podría ser de gran valor para los trabajadores de la salud en países de escasos recursos donde los dispositivos avanzados para las vías respiratorias no están fácilmente disponibles.

Abstract: We reported a successful airway management in a patient with a diagnosed cervical spinal injury with a non-intubating laryngeal mask AuraOnceTM. Its use was as a rescue airway device after failed orotracheal intubation with direct laryngoscopy and difficulty with facemask ventilation in a 46-year-old trauma patient. The decision was made to use the non-intubating laryngeal mask as a conduit for the placement of an orotracheal tube, which was done successfully. This alternative use of the Ambu AuraOnce laryngeal mask could be of great value to healthcare workers in resource-poor countries where advanced airway devices are not readily available.

Comparing CPAP masks during initial titration for Obstructive Sleep Apnea Syndrome: one-year experience

Abstract Objective: Continuous Positive Airway Pressure (CPAP) is the gold standard treatment for OSA. A wide variety of masks are used during CPAP therapy. The aim of the study is to compare polysomnography outcomes during titration for different types of masks (oronasal, nasal and pillow) and assess the impact on PAP titration. Methods: We retrospectively analyzed all CPAP titration polysomnography for one year. Anthropometric data and baseline apnea severity were documented. Results: A total of 497 patients were evaluated. Nasal masks were used in 82.3% (n = 409), pillow in 14.1% (n = 70) and oronasal in 3.6% (n = 18). There was no difference according to body mass index and baseline apnea-hypopnea index among the groups. The oronasal group was older and had higher titrated CPAP pressure, higher residual apnea-hypopnea index, lower sleep efficiency, more superficial N1 sleep and longer wake time after sleep onset. All other polysomnography outcomes were similar among the groups. The mean CPAP level was 11.6 ± 2.1 cm H2O for the oronasal mask, 10.1 ± 2.1 cm H2O for the nasal mask and 9.8 ± 2.2 cm H2O for the pillow. The residual apnea-hypopnea index was 10.4 ± 7.9 for the oronasal mask, 5.49 ± 5.34 events/h for the nasal mask and 4.98 ± 5.48 events/h for the pillow. The baseline apnea-hypopnea index was correlated with of a higher CPAP pressure for all the groups (p< 0.001 for the nasal group, p = 0.001 for the pillow group and p = 0.049 for the oronasal group). Body mass index and residual AHI were correlated with of a higher CPAP pressure for the nasal and pillow groups only (p < 0.001). Conclusion: The interface can have a significant impact on the effectiveness of PAP titration. Patients with oronasal masks have higher CPAP pressure, higher residual apnea-hypopnea index, lower sleep efficiency and higher wake time after sleep onset. Oronasal masks should not be recommended as the first choice for apnea patients. Level of evidence: Level 3.

Unilateral lingual nerve and hypoglossal nerve injury caused by a novel laryngeal mask airway: a case report

Abstract Cranial nerve injury by a laryngeal mask airway is rare but a serious complication. The nerve injuries must be prevented during the intubation using a laryngeal mask airway. We report a female patient who complained of tongue numbness, slurred speech, and slight difficulty in swallowing solid food after a hand surgery. She was then diagnosed with unilateral lingual nerve and hypoglossal nerve injuries. Extreme head rotation, relatively small oral cavity, and wide rigid composition at the lower part of the novel laryngeal mask probably resulted in cranial nerve injury.

Changes in the frequency and clinical features of acute rheumatic fever in the COVID-19 era: a retrospective analysis from a single center

SUMMARY OBJECTIVE: Coronavirus disease 2019 (COVID-19) pandemic resulted in significant changes in the frequency of many diseases. In this study, we aimed to investigate the changes in the frequency and clinical features of acute rheumatic fever (ARF) in this period and determine the effect of health measures taken against COVID-19 on this change. METHODS: The cases with initial attack of ARF between January 2016 and March 2022 in Ataturk University, Division of Pediatric Cardiology, were determined from the clinic's database, and case per month ratios were calculated for each period, retrospectively. Also the frequency of the clinical manifestations was compared among patients before and during the outbreak. RESULTS: Frequency of the major clinical manifestations among patients before and during the outbreak was similar. On average, the number of cases reported per month in the years 2016, 2017, 2018, and 2019 are, respectively, 1.75, 2, 2.25, and 2.58. In the first 3 months of 2020, the average number of cases reported per month was 3.67. After the advent of the pandemic, in the period from April to December 2020 and from January to September 2021, an average of 0.56 and 0.22 cases were reported per month, respectively. The frequency of clinical features between patients diagnosed before and during the outbreak was similar. CONCLUSIONS: Our results indicated an important decrease in frequency of ARF, but no change in the clinical features of the disease during the COVID-19 pandemic. It is thought that this is the result of health measures taken for COVID-19. Children with an increased risk of acute rheumatic fever should be encouraged in terms of wearing mask, social distance, and cleaning, especially during the seasons when upper respiratory tract infections are common. Thus, a permanent decrease in the incidence of ARF and its recurrences may be achieved.

Evaluation of COVID-19 appropriate behavior among fully vaccinated students in a medical college of north-east India

Background: The current COVID-19 pandemic is one of the greatest public health challenges. The spread of COVID-19 infection continues unabated despite vaccination. Adherence to COVID-19 appropriate behavior is critical to prevent COVID-19 infection. Aim and Objectives: To find out the pattern of COVID-19 appropriate behavior among vaccinated medical students and to estimate the incidence of COVID-19 infection after vaccination. Materials and Methods: A cross-sectional observational study using a questionnaire was carried out for a period of 3 months. The questionnaire was prepared based on the guidelines of Ministry of Health and Family Welfare, Government of India. The data were collected using a pretested Google Form (online digital questionnaire) by means of a web-based survey. Results: About 96.5% of the participants wear face cover or mask while meeting someone or during visit to public places and 91.6% maintain respiratory hygiene, whereas 11.6% spit in the open, 16.1% travel unnecessarily, and 36.8% do not discourage crowd. There is significant (P < 0.05) increase in COVID-19 infection after vaccination. Conclusion: This study suggests that more emphasis should be given on sensitizing the medical students about the standard COVID appropriate behaviors because strict adherence to COVID-19 appropriate behavior is the key to the long-term management of this pandemic.

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.

Aplicação das medidas de prevenção e controle do SARS-CoV-2 entre universitários de instituição pública do Ceará, Brasil / Application of SARS-CoV-2 prevention and control measures among university students of a public institution in Ceará, Brazil

Introdução: Universidades são ambientes propícios à disseminação de infecções respiratórias agudas de elevada transmissibilidade, como a COVID-19. Objetivo: Avaliar a aplicação das medidas de prevenção e controle da COVID-19 entre estudantes de uma comunidade universitária do Ceará, Brasil. Método: Trata-se de estudo transversal desenvolvido junto aos estudantes da graduação de uma universidade pública do estado do Ceará, regularmente matriculados no semestre 2020.1, em atividades remotas (não presenciais). Para o cálculo da amostra, considerou-se uma população de 30.152 universitários, uma confiança de 95%, 3% de erro amostral e 50% de frequência esperada de uso das medidas de proteção e controle contra a COVID-19 (n = 1.031). Das 2.097 respostas recebidas, ocorreram 360 perdas e foram analisadas 1.737. A coleta de dados foi realizada em  dezembro de 2020, por meio de questionário eletrônico, disponibilizado online, para esta finalidade. Realizou-se uma análise descritiva dos aspectos pesquisados. Resultados: Apesar de 91,2% dos universitários referirem que sempre usavam máscara ao sair de casa, somente 1,4% cumpriram com todas as recomendações para seu manuseio correto; 43,3% referiram lavar as mãos conforme as recomendações das autoridades sanitárias, mas outras medidas de higiene pessoal foram insuficientes; 65,4% referiram que costumavam sair para participar de atividades que não eram de extrema necessidade; e 70,0% eram usuários de transportes públicos. Conclusões: As evidências encontradas predispõem os universitários a riscos frente a COVID-19.

Introduction: Universities are favorable environments for the spread of highly transmissible acute respiratory  infections, such as COVID-19. Objective: To evaluate the application of COVID-19 prevention and control measures among students from a public university in the state of Ceará, Brazil. Method: This is a cross-sectional study developed with undergraduate students, regularly enrolled in semester 2020.1, in remote (non-face-to-face) activities. To calculate the sample, a population of 30,152 students was considered, a confidence of 95%, 3% sampling error and 50% expected frequency of use of protection and control measures against COVID-19 (n = 1,031). Of the 2,097 responses received, 360 were lost and 1,737 were analyzed. Data collection was carried out in December 2020, through an electronic questionnaire, available online, for this purpose. A descriptive analysis of the researched aspects was carried out. Results: Although 91.2% of students reported that they always wore a mask when leaving the house, only 1.4% complied with all the  recommendations for its correct handling. 43.3% reported washing their hands according to the recommendations of the health authorities, but others' personal hygiene measures were insufficient; 65.4% reported that they used to go out to participate in activities that were not of extreme necessity; and 70.0% were public transport users. Conclusions: The evidence found predisposes university students to risks in the face of this pandemic.

A COMPARATIVE STUDY TO EVALUATE HEMODYNAMIC CHANGES BETWEEN ENDOTRACHEAL INTUBATION AND PROSEAL LARYNGEAL MASK AIRWAY INSERTION IN PATIENTS UNDERGOING GENERAL ANAESTHESIA

Background: Hemodynamic stability is an important aspect to the anesthesiologist for patients. Laryngoscopy and endotracheal intubation can cause striking changes in Hemodynamics as result of intense stimulation of sympathetic nervous system. ProSeal LMA (PLMA)minimizes this response without compromising the airway. The aim of this study was to compare PLMA and Endotracheal tube with respect to intra-operative hemodynamic responses in patients undergoing general anaesthesia. Material and Methods: This prospective observational study was conducted on 30 patients of either sex, age group of 18-60 years, ASA (I or II), Mallam Pati (I or II) posted for elective surgery under general anaesthesia. They were randomly divided into two group 15 each. For group A, airway was secured with laryngoscopy and intubation with appropriate size endotracheal tube and for group B, appropriate size PLMA was inserted to secure airway. The hemodynamic responses like Heart rate and Blood pressure were recorded at base line, at insertion, after 1st min, 3rd min, 5th min and after extubation. Mean increase was statistically more after endotra Results: cheal intubation than PLMA insertion. The elevation in these hemodynamic parameters significantly persisted for a longer period of time in the ETT group, where it returned to the baseline value by 5 minutes as compared to the PLMA group where it returned by 3 minutes. The hemodynamic res Conclusion: ponse produced when PLMA was used for securing airway was less than the laryngoscopy and endotracheal intubation. Thus, PLMA proved to be a suitable alternative to endotracheal tube for airway management with stable hemodynamic.

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.