ABSTRACT
Background: Improving basic infection control (IC) practices, diagnostics and anti-microbial stewardship (AMS) are key tools to handle antimicrobial resistance (AMR). Material(s) and Method(s): This is a retrospective study done over 6 years (2016-2021) in an oncology centre in North India with many on-going interventions to improve IC practices, diagnostics and AMS. This study looked into AMR patterns from clinical isolates, rates of hospital acquired infections (HAI) and clinical outcomes. Result(s): Over all, 98,915 samples were sent for culture from 158,191 admitted patients. Most commonly isolated organism was E. coli (n = 6951;30.1%) followed by Klebsiella pneumoniae (n = 5801;25.1%) and Pseudomonas aeroginosa (n = 3041;13.1%). VRE (Vancomycin resistant Enterococcus) rates fell down from 43.5% in Jan-June 2016 to 12.2% in July-Dec 2021, same was seen in CR (carbapenem resistant) Pseudomonas (23.0%-20.6%, CR Acinetobacter (66.6%-17.02%) and CR E. coli (21.6%-19.4%) over the same study period. Rate of isolation of Candida spp. from non-sterile sites also showed reduction (1.68 per 100 patients to 0.65 per 100 patients). Incidence of health care associated infections also fell from 2.3 to 1.19 per 1000 line days for CLABSI, 2.28 to 1.88 per 1000 catheter days for CAUTI. There was no change in overall mortality rates across the study period. Conclusion(s): This study emphasizes the point that improving compliance to standard IC recommendations and improving diagnostics can help in reducing the burden of antimicrobial resistance.Copyright © 2023 Indian Association of Medical Microbiologists
ABSTRACT
The recent COVID-19 pandemic has made the world suffer ravaging costs and damage to human lives, perhaps never seen in modern world. Pandemics will keep reviving till such time the humans attain a disease-less world state. Till such realizations are attained, we need to attempt retarding the pandemics by exploiting information systems enabled with new genre IT technologies, and blockchain offers one such way for realization. This paper proposes medical IoT architecture enabled by blockchain and further augmented with distributed storage protocol to retard any such pandemics ahead. The works have been performed on a Multichain permissioned blockchain platform and IPFS protocol. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
ABSTRACT
Global health security concerns have gained vast importance in recent times with outbreak of COVID-19. Today, the growing interdependence among countries and states has effected into accelerated growth of pandemics. A global need for rugged medical systems on a common platform is deemed today. Pandemics will not stop, they will resurrect again, they will happen irrespective till such times the medical world attains a disease less world in future. But till then, we can attempt to decelerate the pandemics growth enabled with new generation technologies. Medical cyber-physical systems are marred by a number of challenges and this paper proposes a model to negate these identified challenges enabled on multichain blockchain platform that imparts peculiar blockchain characteristics to the network of effected systems. The proposed model also enables to share encrypted data on select blockchain nodes granted defined access controls with proven encryption algorithms. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.
ABSTRACT
Background: Patients with cancer are at an increased risk of severe coronavirus disease-2019 (COVID-19). Hence, safe and efficacious vaccination against COVID-19 may play a crucial role in conferring protection to this group of patients. Objectives: As there are no dedicated trials testing the safety and efficacy of COVID-19 vaccines in immunocompromised individuals or patients with cancer, we conducted this study to assess the vaccination status of Indian patients with cancer. Materials and Methods: This single-center observational study was conducted in the Department of Medical Oncology at the Rajiv Gandhi Cancer Institute and Research Centre, Delhi, India, between March and June 2021. Patients with cancer were interviewed telephonically to obtain information related to their vaccination status. The primary endpoint was the proportion of patients with cancer who received a COVID-19 vaccine. The Chi-squared test and McNemar's test were used to determine the associations between the different variables and the vaccination status. Results: Of the 752 patients included in the study, 219 (29.1%) had received at least one dose of the COVID-19 vaccine. Of these, 34 (15.5%) patients subsequently developed COVID-19. They were treated in domiciliary care and did not require hospitalization. Of the 533 patients (70.9%) who were not vaccinated, 117 (21.9%) tested positive for COVID-19 and 14 (11.9%) succumbed to the disease. Conclusion: Our study suggests that there is probably a lack of awareness or fear related to vaccination, which should be addressed to avoid COVID-19-related cancer mortality. © 2021 Cancer Research, Statistics, and Treatment ;Published by Wolters Kluwer - Medknow.