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Background: The risk for transmission of COVID-19 to people in close contact with infected people, especially healthcare workers, has not been well estimated. Therefore the present study was conducted to assess the household secondary attack rate (SAR) of COVID-19 among healthcare workers and related factors. Material(s) and Method(s): The present prospective case-ascertained study was conducted on 202 healthcare workers with confirmed COVID-19 in Hamadan, diagnosed from March 1, 2020, to August 20, 2020. For households with close contact with the index case, RT-PCR was performed regardless of symptoms. We defined SAR as the proportion of secondary cases from the total contacts that live in the index case household. SAR was reported as a percentage and 95% confidence interval (CI). Multiple logistic regression was performed to explore the predictors of COVID-19 transmission of index cases to their households. Result(s): We found 36 secondary cases out of 391 household contacts with laboratory confirmation (RT-PCR), representing a household SAR of 9.2% (95% CI: 6.3, 12.1). Among factors related to the family member, female gender (OR: 2.9, 95% CI: 1.2, 6.9), being the patient's spouse (OR: 2.2, 95% CI: 1.0, 4.6), and living in the apartment (OR: 2.78, 95% CI: 1.24, 6.23), and among factors related to index cases, hospitalization (OR: 5.9, 95% CI: 1.3, 26.9) and caught (OR: 2.4, 95% CI: 1.1, 5.2) were the significant predictors of disease transmission to other family members (P<0.05). Conclusion(s): The findings of this study suggest that the SAR is remarkable in household contacts of infected healthcare workers. Some characteristics of family members of the index case, including female gender, being the patient's spouse, and living in the apartment, and some characteristics of the index case, including hospitalization and caught, were associated with the increased SAR.Copyright © 2022 NRITLD, National Research Institute of Tuberculosis and Lung Disease, Iran.
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Coronaviruses has been spreading across the planet for more than two years now. Emerging new competent variants makes the surge never ending. With over thirty crore cases as on first week of January 2022 this virus has caused serious havoc to humanity. Due to evolutionary selection, new variants become predominant. These new variants are associated with higher transmissibility, increased severity, re infection, immune and diagnostic escapes. It has been prescribed that emergence of herd immunity either achieved by vaccination or by natural infection will be the game changer. Nonetheless COVID appropriate behavior has to be strictly followed. We take the opportunity to describe the variants which created and are still creating havoc all along the world.
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Objectives The medical and health facilities are at high risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. This study tested the preprocedural prophylactic mouthwash rinses to reduce the oral viral load. The findings from this study will help the practitioners to select the best mouthwash for the patients to mitigate the risk of transmission during aerosolizing. This study aimed to evaluate the effectiveness of four commonly used types of mouthwash in reducing intraoral viral load among hospitalized coronavirus disease 2019 patients. Materials and Methods This prospective cohort study was conducted with 116 patients referred to the Masih Daneshvari Hospital in Tehran, Hamadan University of Medical Sciences of Hamadan City, and Mashhad University of Medical Sciences. Patients were randomized into four groups with each group rinsed their mouth with 20 mL of 2% povidone-iodine, 1% hydrogen peroxide, normal saline as a control study group, or 0.12% chlorhexidine, respectively, for 20 seconds. The standard reverse transcription polymerase chain reaction method evaluated the virus load before and at 1 hour, 2 hours, and 4 hours after using the mentioned mouthwash. Results Our results revealed that chlorhexidine and H 2O 2showed the highest efficiency in reducing SARS-Co-2 load in the oral cavity and nasopharyngeal region of patients;they increased the Ct values by 9 to 10 (before: 25.84 vs. after 32. 4, p < 0.455) (17.333 vs. after 26.497, p <0.097). Conclusion Our findings suggest that chlorhexidine and H 2O 2could be used in dental clinics to reduce the risk of transmitting the SARS-CoV-2 virus from infected individuals to dentists before dental procedures. © 2022 Wolters Kluwer Medknow Publications. All rights reserved.
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This study tries to determine if social media argument quality, social media source credibility and perceived usefulness can predict information adoption by the user shared through social media platforms. Data was collected from 376 social media users through online surveys that helped gauge user behavior. The results of the study revealed that perceived usefulness is not a predictor of information adoption. The results of the study revealed that perceived usefulness is not a predictor of information adoption but there is a significant relationship between information adoption and participatory behavior especially when the information is shared through social media networks. The study would help its stakeholders understand the predictors of information adoption. It reveals the importance of credibility of the source Moreover, the central point at issue is still argument quality. Acceptance of the information would lead to the participatory behavior by the user. In this study information exchange and user-generated content have both benefited from social networking. © 2022. Journal of Content, Community and Communication. All Rights Reserved.
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The second wave of COVID-19 has affected India substantially, with the highest number of daily cases reaching 0.4 million in a single day. COVID-19 infection, its treatment, resultant immune suppression, and pre-existing co-morbidities have made patients vulnerable to secondary infections including mucormycosis. Nasal irrigation is an ancient and well-practiced treatment for nasal and sinus pathologies. It has been proved that Mucorales live as commensals in nasal epithelium and a drop in immunity leads to its super-infection. This practice of nasal douching reduces its survival and washes out the spores from the nasal cavity. The study aims to prove that practicing Nasal Irrigation with prescribed medications reduces the incidence and severity of Mucormycosis. 110 patients who reported with Post-Covid sinusitis were selected for the study. History of Covid-19 infection was taken. Pre-treatment KOH and culture were advised. Also, pre-treatment radiological analysis was done to assess the severity of involvement. According to the guidelines, antibiotic, antifungal, decongestant, anti-inflammatory, and antacid drugs were prescribed. Along with this, nasal irrigation of buffered saline solution, povidone-iodine, and 2% acetic acid was prescribed to alleviate the symptoms or to prevent them all together. Post-treatment culture and radiological analysis were carried out if symptoms persisted. Collected data underwent Chi-square test. The P-value of the study was kept at less than 0.05 according to the sample size. The study revealed a significant decrease in the incidence and severity of symptoms of mucormycosis. This study concludes that Nasal Irrigation has an important role in the prevention of crippling Mucormycosis in Post-Covid patients with initial symptoms of sinusitis. © 2022. Journal of International Dental and Medical Research.All Rights Reserved
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COVID-19, known as the “novel coronavirus disease 2019”, is a respiratory illness, and the causative pathogen is officially named as Sars-CoV-2, whose epidemic has spread rapidly worldwide. Thus, human-to-human transmission has reduced as people's attention to health has increased and precautionary measures have been implemented. It is known that the virus can survive on infected surfaces and hands for hours or days. It is possible to get infected by touching the contaminated surface of food packaging by customers in the grocery and then touching their own mouth, nose, or eyes. Thus, the public supposes that touching food or food packing by salesmen and buyers in the grocery can transmit the virus to the customers. Therefore, the World Health Organization encourages people to wash their hands regularly and disinfect areas where the virus can survive, such as metal and plastic surfaces. However, overwashing can cause disadvantages such as moisture penetration into food packages and increased water activity in food, which provides the conditions for fungi to grow and cause spoilage in food. Accordingly, this phenomenon would have shown significant negative effects on public health as the post-pandemic phase of COVID-19. The coronavirus has had a significant impact on people's behavior in the food chain, washing and disinfecting food in these critical situations. People also quickly changed the way they bought and procured food from supermarkets to ensure food safety and eradicate the virus. Use of substances/disinfectants such as Sodium hypochlorite reduce COVID-19 from surfaces and objects or reduce viral particles from surfaces and objects. Washing and disinfecting food packaging may cause damage to products thereby reducing their shelf life and utilization. Therefore, health experts report public awareness of hands and disinfect surfaces regularly to eliminate the virus. It is also recommended to wash and disinfect hands and disinfect surfaces. © 2021 the Author(s), Licensee PAGEPress, Italy. All Rights Reserved.
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Aims: Survival of people with advanced colorectal cancer (CRC) can be prolonged through treatment pathways including cytoreductive surgery and hypothermic intraperitoneal chemotherapy (CRS-HIPEC), pelvic exenteration, liver resection, and palliative chemotherapy without surgery. Virtually no qualitative research has compared the experiences and needs of advanced CRC survivors who receive these treatments. This study aims to fill this gap. Methods : Adult survivors of CRC who have undergone the aforementioned treatments are being recruited 0.5-2 years post-surgery or, for palliative chemotherapy participants, 0.5-2 years post-diagnosis of advanced CRC. Recruitment will continue until approximately N = 40 or data saturation is reached. Quantitative data include: demographic and clinical data, Functional Assessment of Cancer Therapy - Colorectal (FACT-C), Distress Thermometer, and Comprehensive Score for Financial Toxicity (COST). Quantitative data will undergo descriptive analysis to characterise the sample. All participants will participate in a qualitative semi-structured telephone interview exploring quality of life, employment, finances, stigma, supportive care needs, social functioning, perceptions of survivorship, and impacts of COVID-19. Interviews are analysed via the framework approach of thematic analysis. Results : Preliminary analysis of 36 interviews (n = 10 CRS-HIPEC, n = 10 pelvic exenteration, n = 9 liver resection, n = 7 palliative chemotherapy) reveals some advanced CRC survivors report post-surgical complications and chemotherapy-induced peripheral neuropathy, which can limit physical activity. CRC impacted some participants' psychosocial well-being ability to work, and sense of identity. Participants reportedly manage these impacts through distraction, positive reframing, and contact with other CRC survivors. Most participants appeared satisfied with their cancer treatment teams. Some viewed GPs as important healthcare coordinators. COVID-19 made some participants more cautious when leaving the house. Telehealth was considered less personal, but convenient. Conclusions : The study's findings will help guide development of interventions to improve the survivorship experience of patients who receive treatment for advanced CRC. This may include an information booklet, patient-reported outcome measure, clinical pathway, or targeted intervention.
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Background: Candida auris, within the last decade, has emerged as a multidrug resistant public health threat that can lead to hospital outbreaks1. It is an invasive fungal yeast resistant to multiple antifungal agents. The mode of transmission is through contaminated hospital items (including clothes and furniture) and interventions by staff. Two Candida auris outbreaks occurred in Qatar. The first outbreak was in Al Wakra Hospital (AWH), which is a facility of Hamad Medical Corporation (HMC), the principal public healthcare provider in the State of Qatar. As concluded by Eyre DW, et al. (2018), a series of interventions and environmental screening program may reduce the Candida auris outbreak2. A screening toolkit that includes a checklist based on an existing protocol and operationally defined criteria is a key preventive measure for Candida auris identification. We aim to attain 100% compliance with screening suspected patients and preventing further outbreaks. Methods: A screening protocol toolkit was created for eligible patients that allowed early identification and prompt intervention therefore enhancing the provision of high-quality, efficient, cost effective, and safe patient care. Furthermore, implementation of an Outbreak Prevention Bundle had been proven effective in preventing the spread and comprised: (1) prophylactic contact precautions, (2) blanket screening of at risk/exposed patients, (3) environmental sampling, and (4) hydrogen peroxide disinfection. Results/Findings/Recommendations: In 2020, continuous screening was maintained for patients fitting the HMC criteria. The protocol for the management of outbreaks was implemented. The number of COVID-19 positive cases peaked during July - August 2020 when COVID-19 patients were transferred to AWH (Figure 1). Overall, AWH reached 407 cumulative days without Candida auris outbreak (Figure 2). Conclusion: Candida auris outbreak is preventable through early identification via screening and implementation of an Outbreak Prevention Bundle. This method has led to no active outbreak in AWH since August 2019 until October 2020.
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Background: The incidence of AKI in COVID 19 is very variable across the world. In New York City it was as high as 36% in a large series in early 2020. However, the incidence of AKI during the second surge between Oct of 2020 to early 2021 is unknown. In this study, we compared these two COVID-19 periods for the incidence of AKI amongst hospitalized patients. Methods: This was a multi-center, retrospective cohort study of patients hospitalized with COVID-19 between March 1st and July 16th 2020 (n=1,719), and between October 15th 2020 and February 28th 2021(n=997) in two NYC public hospitals, (total n= 2,716). Patients < 18 years, with End Stage Kidney Disease or a kidney transplant were excluded. Chi-squared test and Fisher's exact test were used to compare the clinical characteristics of the patients. A p-value less than 0.05 was considered statistically significant. Results: The baseline clinical characteristics and demographics of the two surges were similar. The incidence of AKI as defined by KDIGO criteria, during admission decreased from 28.7% in the first surge to 18.6% in the second surge (p<0.0001). This trend was seen both at encounter level too as shown below. For laboratory characteristics, more patients with hypernatremia and with peak CRP > 50 (Ref range: <50) presented in the first surge than the second surge (p<0.0001). No differences in the peak potassium and peak D-Dimer, or ICU admission rates were seen between two surges. However, significantly more AKI patients in the first surge were on mechanical ventilation as compared to the second surge (p=0.0196). Conclusions: To our knowledge this is the first comparison reported between rates of AKI in hospitalized patients with COVID-19 during two different surge periods. The difference may be related to less severe disease during the second surge, though ICU admission rate was the same. Better care established by the time of the second surge and improved therapeutics such as early use of anti-viral agents, corticosteroids, and anticoagulation may have contributed to better outcomes. Improvement in care of COVID-19 in the second surge may have contributed to a decline in the incidence of AKI. Future studies are needed to see if this trend towards lower AKI incidence continues.
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Background: Acute Kidney Injury (AKI) is a frequent complication in ICU patients with a negative impact on patient outcomes. High body mass index (BMI) is reported to be associated with a higher risk of AKI in critically ill patients. Obesity is also a risk factor for developing COVID-19 and for severe illness requiring hospital admission, mechanical ventilation and is associated with mortality Methods: A multi-center retrospective cohort study was conducted on 2,716 electronic health records (EHR), (n=1,719 in first surge dates of 3/1/20 until 7/16/20), (n=997 in second surge dates of 10/15/20 until 2/28/21 with COVID-19. Patients without a recorded BMI value were excluded. AKI at admission was defined as the difference between first measured creatinine and nadir creatinine within the first 7 days of admission that was greater than 0.3 mg/dL[JB1]. The Chi-squared test was used to compare BMI as a categorical variable between AKI and non-AKI groups at admission. The Mann-Whitney U test was used for the same comparison when BMI was treated as a continuous variable. A p-value less than 0.05 is considered statistically significant. Results: BMI was dichotomized to < 25kg/m2 and >= 25 kg/m2. The non-AKI group had a significantly higher percent of patients with BMI greater or equal to 25 kg/m2 (80.2% vs. 73.7%, p = 0.0108). BMI was not found to be associated with either peak CRP or peak D-Dimer among AKI patients in both surges. Conclusions: A direct relationship between BMI and AKI is well known, mostly from data that included surgical patients with multiple comorbidities and did not account for peri operative stress[JB1]. The proinflammatory state in obesity may lead to endothelial damage. In CKD and ESRD, obesity is paradoxically associated with a better prognosis. Few studies have shown an inverse relationship between BMI and AKI risk. High levels of lipoproteins in obesity is thought to lead to endothelial protection in the kidney vasculature. A 'pre-conditioning' effect of obesity attenuating against abrupt bursts of hyper-inflammation on renal vasculature has been shown. Altered adipokine and cytokine profiles produced by adipose tissue can exert protective effects by decreasing inflammation. We describe here the first study showing an inverse relationship between BMI and developing AKI at hospital admission in COVID-19.
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Background: Approximately 18% of colorectal cancer (CRC) diagnoses are advanced cancer, whereas 30%-40% of patients develop recurrence after treatment with curative intent. More modern treatments enable longer survival for people with advanced CRC, including cytoreductive surgery and hypothermic intraperitoneal chemotherapy (CRS-HIPEC), pelvic exenteration, liver resection, and palliative chemotherapy without surgery. Yet, virtually no qualitative research has compared the perspectives and quality of life (QoL) experiences of survivors of these different treatments. This study aims to fill this gap. Methods: Approximately N = 40 adult survivors of CRC are being recruited from two major Australian hospitals 0.5-2 years posttreatment or post-diagnosis. All participants will complete the Functional Assessment of Cancer Therapy - Colorectal (FACT-C), Distress Thermometer and Comprehensive Score for Financial Toxicity (COST) questionnaires. Questionnaire data, participant demographics and clinical data will undergo descriptive analysis to characterise the sample. Participants will participate in a qualitative semi-structured telephone interview, analysed via the framework approach of thematic analysis. Qualitative interviews explore QoL, survivorship experiences, employment and finances, supportive care needs, stigma and social functioning and impacts of COVID-19. Results: Preliminary analysis of 30 interviews (n=10 CRS-HIPEC, n=9 pelvic exenteration, n = 5 liver resection, n = 6 palliative chemotherapy) reveals someadvancedCRCsurvivors report post-surgical complications and chemotherapy-induced peripheral neuropathy, which can limit physical activity and daily functioning. Participants reportedly manage these through distraction, positive reframing and contacting other CRC survivors. Most participants appeared satisfied with their cancer treatment teams. Some viewed their GPs as important coordinators in their health care. Some CRC survivors viewed the change to telehealth due to COVID-19 as less personal;however, rural/regional participants prefer its convenience. Conclusions: The study findings will help guide development of interventions to improve the survivorship experience of patients who receive treatment for advanced CRC. This may include an information booklet, patient-reported outcome measure, clinical pathway or targeted intervention.
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Nowadays, higher education worldwide is affected by the COVID-19 pandemic. It has affected students' attendance in the universities and causes universities to close down in more than 190 countries. On the other hand, novice engineers studied only a few lectures related to highway engineering. Their lectures have included very little knowledge about asphalt pavement construction as highway engineering consists of many areas that are not studied in detail during their studying years subject to their traditional education. Due to all mentioned, a new drive to promote online learning paves the way to evaluate our future approach to curriculum development and delivery of educational materials for engineering courses. However, experts can offer solutions to these problems using their past experience. Hence, a system that allows experts to share their experience with other engineers after completing a project is needed. Nevertheless, the web-based expert system for maintaining flexible pavement problems in tropical regions (ESTAMPSYS) designed in this study is a novel concept. Prior to developing this system, the need for such a system was determined through literature review and validated through a questionnaire survey. Experts were interviewed, and a questionnaire survey was conducted to construct the knowledge base of the system. Knowledge was presented as rules and coded in software through PHP programming. Web pages that support the user interface were designed using a framework that consists of CSS, HTML, and J-Query. Furthermore, the system was tested by an array of users engaged in highway engineering, namely, experts, teaching experts, novice engineers, and students. The mean values of the overall system evaluation performed by 20 users using a five-point Likert scale were 4, 4.5, 3.75, 4.25, 5, 4, and 3.5. Expert and user satisfaction prove the effectiveness of the proposed system. © 2021 Abdalrhman Milad et al.
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The strict lockdown measures not only contributed to curbing the spread of COVID-19 infection, but also improved the environmental conditions worldwide. The main goal of the current study was to investigate the co-benefits of COVID-19 lockdown on the atmosphere and aquatic ecological system under restricted anthropogenic activities in South Asia. The remote sensing data (a) NO2 emissions from the Ozone Monitoring Instrument (OMI), (b) Aerosol Optical Depth (AOD) from the Moderate Resolution Imaging Spectroradiometer (MODIS), and (c) chlorophyll (Chl-a) and turbidity data from MODIS-Aqua Level-3 during Jan–Oct (2020) were analyzed to assess the changes in air and water pollution compared to the last five years (2015–2019). The interactions between the air and water pollution were also investigated using overland runoff and precipitation in 2019 and 2020 at a monthly scale to investigate the anomalous events, which could affect the N loading to coastal regions. The results revealed a considerable drop in the air and water pollution (30–40% reduction in NO2 emissions, 45% in AOD, 50% decline in coastal Chl-a concentration, and 29% decline in turbidity) over South Asia. The rate of reduction in NO2 emissions was found the highest for Lahore (32%), New Delhi (31%), Ahmadabad (29%), Karachi (26%), Hyderabad (24%), and Chennai (17%) during the strict lockdown period from Apr–Jun, 2020. A positive correlation between AOD and NO2 emissions (0.23–0.50) implies that a decrease in AOD is attributed to a reduction in NO2. It was observed that during strict lockdown, the turbidity has decreased by 29%, 11%, 16%, and 17% along the coastal regions of Karachi, Mumbai, Calcutta, and Dhaka, respectively, while a 5–6% increase in turbidity was seen over the Madras during the same period. The findings stress the importance of reduced N emissions due to halted fossil fuel consumption and their relationships with the reduced air and water pollution. It is concluded that the atmospheric and hydrospheric environment can be improved by implementing smart restrictions on fossil fuel consumption with a minimum effect on socioeconomics in the region. Smart constraints on fossil fuel usage are recommended to control air and water pollution even after the social and economic activities resume business-as-usual scenario. © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.