Smart Device and Tracer to Overcome COVID-19 Using Digital Technology for Better Protection

A number of nations have experienced challenging circumstances as a result of the coronavirus disease (COVID-19), which has turned into a global pandemic. As a result of the social changes it has caused, this crisis will also have an impact on future generations. With the help of this technology, health organizations can quickly locate individuals who are infected with COVID-19 and provide them with medical care. The objective of this work is to develop a COVID-19 Tracer that is capable of COVID-19 detection and mitigation. The goal of this research is to reduce the number of COVID-19related fatalities in Sri Lanka while also enabling users who are infected with the disease to access appropriate care and hospitalization. This software uses digital technologies to acquire accurate data and provide precise interpretations based on that data. Through the proposed method, patients can be treated using the application to get a precise diagnosis of their disease, maintaining social distance, stabilizing the mental level of the patient through AI, predicting the epidemic, providing COVID-19 vaccinations, as well as ambulance services through this application. Using every preventative measure available, this mobile application has now been developed to safeguard against COVID-19. © 2022 IEEE.

Audit of Clinical Care Received by COVID-19 Patients Treated at a Tertiary Care Hospital of Nepal in 2021.

Like the world over, Nepal was also hard hit by the second wave of COVID-19. We audited the clinical care provided to COVID-19 patients admitted from April to June 2021 in a tertiary care hospital of Nepal. This was a cohort study using routinely collected hospital data. There were 620 patients, and most (458, 74%) had severe illness. The majority (600, 97%) of the patients were eligible for admission as per national guidelines. Laboratory tests helping to predict the outcome of COVID-19, such as D-dimer and C-reactive protein, were missing in about 25% of patients. Nearly all (>95%) patients with severe disease received corticosteroids, anticoagulants and oxygen. The use of remdesivir was low (22%). About 70% of the patients received antibiotics. Hospital exit outcomes of most (>95%) patients with mild and moderate illness were favorable (alive and discharged). Among patients with severe illness, about 25% died and 4% were critically ill, needing further referral. This is the first study from Nepal to audit and document COVID-19 clinical care provision in a tertiary care hospital, thus filling the evidence gap in this area from resource-limited settings. Adherence to admission guidelines was excellent. Laboratory testing, access to essential drugs and data management needs to be improved.

Merchandise and Service Trade Deviations During COVID-19: A Performance Comparison Between India and China

The current study compares trade performance between India and China during COVID period (January?December 2020). The merchandise trade and commercial service exports and imports from both countries were obtained from the official World Trade Organization website to compare the output (deviation of actual from projected during COVID-19) of India and China?s foreign trade with the rest of the world. The present study employs models of autoregressive integrated moving average using a three-step model creation process. As per the results obtained, we can conclude that India is behind China in achieving the amount of merchandise exports and imports in relation to the output of its previous years, while China?s variance between expected and real is relatively lower. When comparing service exports and imports, it can be found that the gap between service exports is not much, but in the case of service imports, China?s deviation from India is much greater.

The COSMIC Bubble Helmet: A Non-Invasive Positive Pressure Ventilation System for COVID-19.

Goal: COSMIC Medical, a Vancouver-based open-source volunteer initiative, has designed an accessible, affordable, and aerosol-confining non-invasive positive-pressure ventilator (NIPPV) device, known as the COSMIC Bubble Helmet (CBH). This device is intended for COVID-19 patients with mild-to-moderate acute respiratory distress syndrome. System Design: CBH is composed of thermoplastic polyurethane, which creates a flexible neck seal and transparent hood. This device can be connected to wall oxygen, NIPPVs including Continuous Positive Airway Pressure and Bi-level Positive Airway Pressure, and mechanical ventilators. Discussion: Justification of CBH design components relied on several factors, predominantly the safety and comfort of patients and healthcare providers. Conclusion: CBH has implications within and outside of the pandemic, as an alternative to invasive mechanical ventilation methods. We have experimentally verified that CBH is effective in minimizing aerosolization risks and performs at specified clinical requirements.

Critical COVID-19 Complicating Recovery From Surgical Repair of Congenital Heart Disease.

This case highlights the need for accurate and rapid testing for severe acute respiratory syndrome coronavirus 2 and also underscores the need for caregivers to remain vigilant for coronavirus disease 2019 in the postoperative setting despite negative preoperative testing.

Healthcare workers' knowledge, attitude and practices during the COVID-19 pandemic response in a tertiary care hospital of Nepal.

BACKGROUND: COVID-19 is an ongoing pandemic, for which appropriate infection prevention and control measures need to be adopted. Healthcare workers' adherence to prevention and control measures is affected by their knowledge, attitudes, and practices (KAP) towards COVID-19. In this study, we assessed the KAP among healthcare workers towards the COVID-19 during the ongoing pandemic. METHOD: A self-developed piloted KAP questionnaire was administered to the recruited healthcare workers involved in the COVID-19 response at the Universal College of Medical Sciences Teaching Hospital (UCMSTH), in Bhairahawa, Nepal. The knowledge questionnaire consisted of questions regarding the clinical characteristics, prevention, and management of COVID-19. Assessment on attitudes and practices towards COVID-19 included questions on behaviour and change in practices made towards COVID-19 response. Knowledge scores were calculated and compared by demographic characteristics and their attitude and practices towards COVID-19. Data were analysed using bivariate statistics. RESULTS: A total of 103 healthcare workers participated in the study. The mean age of the participants was 28.24±6.11 years (range: 20-56); 60.2% were females; 61.2% were unmarried; 60.2% had a medical degree, and 39.8% were the nursing staff. The mean knowledge score was 10.59±1.12 (range: 7-13), and it did not vary significantly when adjusted for demographic characteristics. The attitude was positive for 53.4% of the participants with a mean knowledge score of 10.35±1.19 and negative for 46.6% participants with a mean knowledge score of 10.88±0.98 (p = 0.02). The practice was good (≥3 score) for 81.5% participants with a mean knowledge score of 10.73±1.12 and poor for 18.5% participants with a mean knowledge score of 10.46±1.13 (p = 0.24). The attitude of the participants improved with increasing age (29.55±7.17, p = 0.02). CONCLUSION: There is comparably better knowledge regarding COVID-19 among healthcare workers. Appropriate practice correlates with better knowledge and positive attitude towards COVID-19 infection is seen with increasing age. Hence, training on protection and protective measures for having a positive attitude among healthcare workers is necessary against the fight with COVID-19 infection.

Healthcare workers knowledge, attitude and practices during the COVID-19 pandemic response in a tertiary care hospital of Nepal (preprint)

BackgroundTo control the spread of ongoing COVID-19 infection, extremely important measures need to be adopted. Healthcare workers adherence to prevention and control measures is affected by their knowledge, attitudes, and practices (KAP) towards COVID-19. In this study, we assessed the KAP among healthcare workers towards COVID-19 during the ongoing pandemic. MethodA self-developed piloted KAP questionnaire was used among the recruited healthcare workers working for the COVID-19 response in the Universal College of Medical Sciences Teaching Hospital (UCMSTH), in Bhairahawa, Nepal. The knowledge questionnaire consisted of questions regarding the clinical characteristics, prevention and management of COVID-19. Assessment on attitudes and practices towards COVID-19 included questions on behaviour and change in practices while working during this response. Knowledge scores were calculated and compared by demographic characteristics and their attitude and practices towards COVID-19. Data were analysed using bivariate statistics. ResultsA total of 103 healthcare workers participated in the study. The mean age of the participants was 28.24{+/-}6.11 years (range: 20-56); 60.2% were females; 61.2% were unmarried; 60.2% had medical degree and 39.8% were nursing staff. The mean knowledge score was 10.59{+/-}1.12 (range: 7-13) and it did not vary by demographic characteristics. Attitude was positive for 53.4% participants with a mean knowledge score of 10.35{+/-}1.19 and negative for 46.6% participants with a mean knowledge score of 10.88{+/-}0.98 (p = 0.02). Practice was good ([≥]3 score) for 81.5% participants with a mean knowledge score of 10.73{+/-}1.12 and practice was poor for 18.5% participants with a mean knowledge score of 10.46{+/-}1.13 (p = 0.24). The attitude of the participants improved with the increasing age of the participants (29.55{+/-}7.17, p = 0.02). ConclusionThere is comparably better knowledge regarding COVID-19 among healthcare workers along with appropriate practices, however attitude was less optimistic with better knowledge but more optimistic with higher age of the healthcare workers. Hence, protective measures for healthcare workers in order to improve their attitude is necessary during the pandemic response.

Effect of the COVID-19 pandemic response on intrapartum care, stillbirth, and neonatal mortality outcomes in Nepal: a prospective observational study.

BACKGROUND: The COVID-19 pandemic response is affecting maternal and neonatal health services all over the world. We aimed to assess the number of institutional births, their outcomes (institutional stillbirth and neonatal mortality rate), and quality of intrapartum care before and during the national COVID-19 lockdown in Nepal. METHODS: In this prospective observational study, we collected participant-level data for pregnant women enrolled in the SUSTAIN and REFINE studies between Jan 1 and May 30, 2020, from nine hospitals in Nepal. This period included 12·5 weeks before the national lockdown and 9·5 weeks during the lockdown. Women were eligible for inclusion if they had a gestational age of 22 weeks or more, a fetal heart sound at time of admission, and consented to inclusion. Women who had multiple births and their babies were excluded. We collected information on demographic and obstetric characteristics via extraction from case notes and health worker performance via direct observation by independent clinical researchers. We used regression analyses to assess changes in the number of institutional births, quality of care, and mortality before lockdown versus during lockdown. FINDINGS: Of 22 907 eligible women, 21 763 women were enrolled and 20 354 gave birth, and health worker performance was recorded for 10 543 births. From the beginning to the end of the study period, the mean weekly number of births decreased from 1261·1 births (SE 66·1) before lockdown to 651·4 births (49·9) during lockdown-a reduction of 52·4%. The institutional stillbirth rate increased from 14 per 1000 total births before lockdown to 21 per 1000 total births during lockdown (p=0·0002), and institutional neonatal mortality increased from 13 per 1000 livebirths to 40 per 1000 livebirths (p=0·0022). In terms of quality of care, intrapartum fetal heart rate monitoring decreased by 13·4% (-15·4 to -11·3; p<0·0001), and breastfeeding within 1 h of birth decreased by 3·5% (-4·6 to -2·6; p=0·0032). The immediate newborn care practice of placing the baby skin-to-skin with their mother increased by 13·2% (12·1 to 14·5; p<0·0001), and health workers' hand hygiene practices during childbirth increased by 12·9% (11·8 to 13·9) during lockdown (p<0·0001). INTERPRETATION: Institutional childbirth reduced by more than half during lockdown, with increases in institutional stillbirth rate and neonatal mortality, and decreases in quality of care. Some behaviours improved, notably hand hygiene and keeping the baby skin-to-skin with their mother. An urgent need exists to protect access to high quality intrapartum care and prevent excess deaths for the most vulnerable health system users during this pandemic period. FUNDING: Grand Challenges Canada.

Development of Autonomous Advanced Disinfection Tunnel to Tackle External Surface Disinfection of COVID-19 Virus in Public Places

Background Sleep services are assigned a non-essential status during COVID-19. The American Academy of Sleep Medicine strongly urges sleep clinicians to continue postponing non-urgent care until a later date, if such a recommendation is made by state officials due to local conditions. At the same time, one cannot ignore the fact that sleep is important for people's health and wellbeing. Therefore, to protect the health of the population, it is essential to find ways and means to continue the practice of sleep medicine even during the COVID-19 pandemic.