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Introduction: In the UK between the March 23, 2020 and May 10, 2020, the government enforced a lockdown. This, combined with COVID, caused OMFS hospitals across London to experience a change in staffing, resources and patient presentations. This study examines these changes, how patient care was adapted during this period and what can be learnt for the future. Method(s): Data was collected from OMFS units attached to all 4 level 1 trauma centers in London. Prospective data was collected from March 23, 2020-May 10, 2020 (1st period). Retrospective data was collected from hospital coding records for 23rd of March - May 10, 2019 (2nd period). Data was collected on all referrals to the OMFS team including diagnosis, patient demographics and treatment received. Result(s): There was an 84% reduction in patients presenting with mandible fracture. 2 units with dental emergency services experienced no change in dental abscess presentations whilst the other 2 units saw a decrease of 70-75%. There was a trend towards reducing admission and general anaesthetic treatments. Most mandible fractures were treated in the outpatient setting with 1 unit discharging 100% of mandible fractures that presented to A&E. Only 13 of 72 paediatric lacerations were treated with general anaesthetic. Conclusion(s): The COVID lockdown period, like war time, posed great challenges to healthcare provision. This paper presents the changes experienced and how patients were managed. Aiming to allow reflection and learning to guide changes in management to be adopted for the future.Copyright © 2022
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Introduction We previously presented the outcome of a pathway incorporating 2-tiered fibrosis assessment into annual diabetic reviews in primary care. This 3 year follow up study looks at: 1. Outcomes in patients referred into secondary care with moderate-advanced fibrosis Ongoing service delivery requirements after the first year of case finding Effectiveness of the pathway in detecting patients with advanced disease, by looking at the number of patients missed in the pathway presenting with advanced disease. Methods All patients aged >35 years with Type 2 Diabetes Mellitus (T2DM) attending annual review at two primary care practices in North East England between April 2018 and September 2019 (n=467) had a Fib-4 requested, followed by transient elastography (TE) if the Fib-4 was above the high sensitivity threshold. Those with a liver stiffness measurement (LSM) >8kPa were reviewed in secondary care. This pathway was continued in both practices after the end of the initial study period. We reviewed the outcomes of all patients referred to secondary care;the number of patients referred in the subsequent years with ongoing case-finding;and any patients missed from initial screening presenting with decompensated/ symptomatic disease. Results From the 467 patients in the initial study, 58 were referred for TE, 25 had a LSM>8kPa and 20 had advanced disease (on imaging/biopsy/endoscopy). 6/20 (30%) patients with advanced disease have died- 2/20 liver related deaths (hepatocellular carcinoma (HCC) and decompensated cirrhosis);1 patient diagnosed with HCC was treated with curative transarterial chemoembolisation;3 patients had varices on OGD (2 started on carvedilol for primary prophylaxis);12 remain under follow up. In all patients with LSM >8kPa (n=25): 8/25 (32%) died (3/8 from COVID-19);24% (6) LSM improved, 8% (2) LSM deteriorated;32% (8/25) lost weight. No patients missed by the pathway presented with decompensated disease. Serial FIB- 4 at annual screening 2019-2021: 4 patients new raised Fib-4 scores - 1 DNA, 1 TE is awaited, 1 LSM <8kPa (discharged), 1 advanced disease (LSM 17.1kPa). Conclusion Incorporation of a two-tiered liver fibrosis assessment into primary care annual diabetic screening significantly improves identification of advanced liver disease and no patients have presented with advanced disease out-with the pathway. It allows for early detection and interventions against the complications associated with advanced liver disease. Mortality in patients with advanced liver disease remains high. Referrals for TE and into secondary care dramatically reduce after the initial year of case finding.
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In the wake of the Coronavirus Disease 2019 (COVID-19) pandemic, scientists all over the world are in a relentless search for a cure. None of the therapies advised till date have shown significant benefit in treating COVID-19 infection. An antibody cocktail consisting of a combination of casirivimab and imdevimab is the newest weapon in the armamentarium against the disease. Currently, it has shown great promise in treating mild non hospitalized cases. The authors present the results of a series of 10 cases aged 18-70 years that demonstrate the efficacy of this cocktail in treating moderate to severe cases as well. All the patients received Roche's Antibody cocktail
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Mountains of Nepal are rich in natural resources as well as shelter for many ethnic group and indigenous community. Mountain people depend on natural resources and unique landscapes to survive, to preserve a unique sense of identity, and to provide livelihoods for centuries. The COVID-19 pandemic has brought unprecedented damage to the mountain economy given the immediate effect on ecotourism and remittance, which are the main source of income for communities in the mountains. People in mountains have been using indigenous and local knowledge for utilization of natural resources for their survival. Skilled manpower returning home from abroad can be beneficial and with the use of appropriate technology will be beneficial for those returning from the abroad due to various reasons. Sustainable harvesting of natural resources and various micro/small enterprises can be developed using the appropriate technology. These enterprises not only creates jobs but also can contribute to improve the local to national level economy. A new approach is required combining the science and engineering aspect with local communities contributing their local knowledge and practices, which can develop socio-environmental resilience-building and transformation in mountains of Nepal. © 2021 Elsevier Inc.
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As we know that before the novel coronavirus, we all majorly dependent on the old and traditional ways of conducting examinations which is very slow and, thus, decreases the efficiency of our current system. Many businesses have overturned due to COVID-induced lockdowns. There are school closures and social distancing everywhere. Normality is questioned. Governments across countries have initiated universities and higher education systems to adapt to remote instruction to cover lectures, exams, evaluations, and result publications. This technology-driven measure to promote education with equity during lockdown might work for online learning and teaching, but “how could it support online examinations?” is one of the top questions now. An online examination system during COVID could be a way out. The online examination system is a digital platform that evaluates students in a hassle-free way. The entire examination process is simplified, and exams are taken from anywhere, anytime. Eventually, with online examinations becoming the new normal, protecting the integrity of exam and exam data are becoming key areas of concern too. Experts and veterans are looking for software that comes with security features so they could evaluate student performance confidently and provide timely remediation measures for improvement, now and beyond COVID. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
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Purpose: Face-touching behavior has the potential for self-inoculation and transmission of the SARS-2 Coronavirus. The purpose of this study was to observe unconscious face-touching behaviors of dental hygiene and dental students in a non-clinical setting.Methods: Twenty minutes of archived proctoring videos of dental and dental hygiene students (n=87) while taking final examinations were watched for incidents of face-touching behavior. Data were analyzed for descriptive frequencies;independent sample t-tests were used to determine differences between dental and dental hygiene students and between males and females.Results: There was a significant difference in face touching behaviors between the student groups. Dental hygiene students (n=42) were observed 11.9 times (SD. 11.4) and dental students (n=45) were observed 8.9 times (SD, 7.9) touching the nose, mouth, and eyes (T-zone) (p=0.049). Differences in frequencies of touching the T-zone failed to reach significance between genders.Conclusion: Findings suggest both dental hygiene and dental students frequently touch their faces in non-clinical settings and need to be aware of this unconscious behavior. Given the significance of the COVID-19 pandemic, it is important to identify and quantify known risk factors that can be easily addressed to prevent/reduce infection transmission.
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The novel coronavirus was renamed as coronavirus disease 2019 (COVID-19) by the world health organization, began its spread in December 2019, in the city of Wuhan, China. Global bodies and governments weren't prepared to handle the impact of the virus on society. Nepal's landlocked nation encountered its incident confirmed case of COVID-19 during the first week of January, with the primary host being a student with a travel history from its place of inception. The nation is deficient in its health resources. The country mainly focused on the stringent implementation of washing of hands, wearing masks, restricting general movement, and maintaining social distancing in public. The disease transmission reached to the third stage, which began within three months after the confirmation of the first case of COVID-19. The lack of tropical hospitals, laboratory and diagnostic facilities added to the challenges faced by the country. This paper is a comprehensive review of the overall preparation and steps taken by the federal system of Nepal to combat the virus's effects till the third stage of transmission. It concludes with the practical limitations faced by the governing authorities of the nation while implementing these measures.
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Background: With the COVID-19 pandemic, many changes were made in healthcare institutions including but not limited to canceling elective surgeries, limiting face-to-face clinic visits, and implementing visitor restrictions. Phased reopening began at West Virginia University (WVU) Medicine on May 25, 2020. While preparing for transition, concern was raised regarding potential for more employee exposures to persons with SARS-CoV-2 infection. In West Virginia (WV), we did not get the predicted surge of SARS-CoV-2. Current cumulative percent positivity for SARS-CoV-2 PCR in WV is 2332 positives of 133,142 tests (1.75%). We provided appropriate personal protective equipment (PPE), including controlled air purifying respirators for all healthcare workers (HCW) caring for persons with suspected or confirmed COVID-19 from the beginning. Policies requiring masks for all HCW and patients took effect on March 27, 2020 and April 29, 2020, respectively. We hypothesized that due to appropriate PPE use there would be no difference in SARS-CoV-2 antibody positivity in HCW working in high versus low risk areas. Methods: Serum samples from 1042 randomly selected HCW across 4 WVU Medicine hospitals, ranging from 170 to 690 beds with 121 cumulative SARS-CoV-2 PCR positive patients at the time of the study, were tested for SARS-CoV-2 IgG between May 26, 2020 and June 5, 2020. Physicians, nurses, and respiratory therapists were characterized as high or low risk based on work location. Environmental services (EVS) workers were included but not risk-stratified. A questionnaire was used to obtain information on demographics, chronic medical conditions, symptoms, and exposures. Results: SARS-CoV-2 IgG was positive in 9 of 1042 (0.86%) randomly selected HCW. Seroprevalence was lower in high risk 5/835 (0.60%) versus low risk 4/176 (2.27%) group. This was not statistically significant. No EVS workers tested positive 0/31 (0%). Of 9 HCW who tested positive, 2 had previously tested positive for SARSCoV- 2 PCR. Conclusion: SARS-CoV-2 IgG seroprevalence in a large sample of HCW across 4 WVU Medicine hospitals was low (0.86%). Low seroprevalence among HCW in high risk areas may be related to appropriate PPE use. Seroprevalence in HCW not caring for patients with COVID-19 could be from community or other inadvertent exposure.
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Severe acute respiratory syndrome coronavirus2 (SARS-CoV-2) belongs to the beta corona virus genera of the Coronaviridae family, which is a pathogenic virus that causes coronavirus disease 2019 (COVID-19) and is responsible for the ongoing pandemic affecting more than 210 countries. The virus has currently posed a global threat to the human population and demands the urgent need for sensitive and effective methods of diagnosis. Real-time reverse transcription polymerase chain reaction (RT-PCR) is currently used as a gold standard technique for detecting and quantifying the transcript of viral ribonucleic acid. Yet many factors are essential for successful COVID-19 diagnosis, including sample sources, amount of viral load, isolation of ribonucleic acid, and the selection of the molecular targets. Although broncho alveolar lavage fluid (BALF) and sputum sample contain a high viral load with a high diagnostic value, they cannot be collected from mild to asymptomatic cases, therefore nasopharyngeal swab is considered better and is collected in all cases that contain a viral load significantly, whereas the use of blood and faecal specimens needs further examination with respect to systemic infection and viral shedding. Furthermore, rapid diagnostic test, clustered regularly interspaced short palindromic repeats (CRISPR)-based testing, chest computerized tomography (CT) scans, matrix-assisted laser desorption/ionization mass spectrometry (MALDI-MS), reverse transcriptional loop-mediated isothermal amplification (LAMP), point of care (POC) testing and genexpert recently tool may help with COVID-19 diagnosis. In this review, we focus on diagnostic approaches for effective detection of SARS-CoV-2 infection. © 2020, Editorial board of Journal of Experimental Biology and Agricultural Sciences. All rights reserved.
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Background: The current situation of pandemic is unusual and rare. Understanding common public mindset towards the COVID-19 pandemic is essential. Hence, this study aimed to understand the people’s thinking, apprehension, and reaction towards the pandemic. Method: A Google survey form (26-item questionnaire) was created and shared through social media to include as many participants as possible. The questionnaire consists of questions regarding general identity (socio-demographic factors), emotional and physical health, empathy, economic impact, feelings towards measures taken by the Government, daily routine as well as their thoughts on this pandemic. Summary statistics (mean, median, mode) were used to represent the data based on their characteristics of data. Results: The response rate is 36 % (288) out of which majority were female (62.5%). 182 (62.8%) respondents followed the guidelines recommended by WHO. Around 73% of participants donated to either charity/trust or personally to known needy persons. Many people are using social media (n=170) more than ever before and the least number of people were praying (n=2). During lockdown most of the participants (n=156) were working/studying from home. Conclusion: The ordinary citizen has painted a rather grim picture of the current crisis and has become mentally depressed due to the global situation, extreme health concerns, and loss of job or income opportunities. This will lead to an increasing number of self-harm incidents and also suicides as the person might feel overwhelmed, hence to prevent and mitigate this the Psychiatry Health Services must be available, reach out to people and reassure them. © 2020, Advanced Scientific Research. All rights reserved.