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Introduction: During the early phase of Coronavirus disease (COVID-19), there were various uncertainties, which had a detrimental impact on the prevalence of burnout among critical care personnel worldwide. This study aims to investigate the prevalence of burnout and its associated factors in critical care personnel involved in the COVID-19 pandemic. Methods: This is a single-center, cross-sectional study with 81 critical care personnel for a survey using Copenhagen Burnout Inventory. Binary logistic regression analysis was conducted to identify factors associated with personal burnout. Results: More than half of the respondents were female (60.5%) over the age of 30 (61.7%), and 54.3% were medical doctors. A large number (72.8%) of the respondents experienced personal burnout, with two-thirds of them experiencing work-related (65.4%) and client-related burnout (59.3%). Personal burnout was found to be associated with those who had children [OR: 11.31 (1.90, 67.37), p = 0.008], stayed with family, relatives, or friends [OR: 9.40 (1.27, 69.46), p = 0.028], were medical doctors [OR: 26.52 (2.79, 252.22), p = 0.004], worked more than 45 hours per week [OR: 8.68 (1.45, 58.09), p = 0.018], and previously never had COVID-19 viral test [OR: 6.93 (1.17, 40.89), p = 0.033]. Conclusion: Overall, more than half of the critical care personnel experienced burnout. There were possible associations between personal burnout with social characteristics such as having children and living with family, relatives, or friends, and occupational characteristics such as being a medical doctor, long working hours, and previously never had COVID-19 viral test. © 2023 Authors. All rights reserved.
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Introduction: Coronavirus disease 2019 (COVID-19) related acute kidney injury (AKI) is a recognized complication of the disease and may result in high morbidity and mortality rate. The reported incidence and outcome vary worldwide. This study aimed to assess the AKI rate in hospitalized COVID-19 patients and identify risk predictors/prognosticator associated with the complication. Method(s): This is a retrospective study of hospitalized COVID-19 patients at the University Malaya Medical Center admitted from January 2021 until June 2021. Data on patients who were>= 18 years old and hospitalized for >= 48 hours for confirmed COVID-19 infection were captured. Clinical parameters and demographic of patients were collected from electronic medical records. The staging of AKI was based on criteria as per KDIGO guidelines. Result(s): A total of 1529 patients were found to have fulfilled the criteria for the study with a male-to-female ratio of 759 (49.6%) to 770 (50.3%). The median age was 55 (IQR: 36-66). 500 patients (32.7%) had diabetes, 621 (40.6%) had hypertension, and 5.6% (n=85) had pre-existing chronic kidney disease (CKD). The incidence rate of AKI was 21.1% (n=323). The proportion of different AKI stages of 1,2 and 3 were 16.3%, 2.1%, and 2.7%, respectively. A total of 15 hospitalized patients (0.98%) needed dialysis. 190 patients (58.8%) of AKI group had complete recovery of renal function. Demographic factors that were associated with an increased risk of developing AKI included: age (p< 0.001), diabetes (p<0.001), hypertension (p<0.001), CKD (p<0.001) and vaccination status (p=0.002). Analysis of biochemical parameters in AKI cohort revealed statistically significant lower lymphocytes & platelet counts, higher ferritin levels, and poorer renal function (creatinine based)) compared with the non-AKI cohort. Outcome analysis in our cohort revealed that AKI was associated with prolonged hospitalization (p<0.001) and higher mortality rates with P< 0.001). [Formula presented] Conclusion(s): AKI is a common complication among hospitalized COVID-19 patients. The increased risk was associated with underlying comorbidities and had an adverse outcome on patient morbidity and mortality. No conflict of interestCopyright © 2023
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N95 masks are worn daily by healthcare workers, and have become a part of mandatory PPE in many hospitals during this COVID-19 pandemic. It is well established that adverse skin reactions (ie. pressure sores, dermatitis, acne, cheilitis, etc) are associated with N95 mask use. There is, however, little information as to which N95 masks are more closely associated with these adverse reactions. Aim: This cross sectional study analyses the association between the different N95 masks, the rate and type of skin reactions reported, and the involvement of general practitioners and dermatologists in their management. Method: Healthcare workers (ie. doctors, nurses, allied health professionals etc.) at three major. Melbourne metropolitan health care networks were sent a digital survey questionnaire. The questionnaire contained 52 questions regarding the frequency, duration and type of N95 mask worn, as well as the frequency, severity and type of adverse skin reactions experienced. The survey also asks about the use of preventative measures for adverse skin reactions, and whether management was initiated by a general practitioner, dermatologist or the participant themself. Results: Different N95 masks have variable frequency and nature of adverse skin reactions. Fit testing has allowed healthcare workers to choose between masks that will provide the best seal to protect from airborne and aerosol disease spread. In addition, selecting fit appropriate N95 masks based on frequency of adverse skin reactions, may provide further guidance on mask selection, and reduce the frequency of N95 mask related adverse skin reactions.
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Introduction: Kidney biopsy (KB) tissues are usually dissected 0.5-1.0 cm for fresh sample immunofluorescence study (FSIF). Paraffin washed-out immunofluorescence (PWIF) technique doesn’t require segmentation of the kidney biopsy sample that may jeopardise the sample adequacy for histopathological examination (HPE). Hypothetically, it reduces biopsy passes and complications. We examine the safety and adequacy of native kidney biopsy (NKB) and transplant kidney biopsy (TKB) using the FSIF technique and PWIF technique in HPE preparation for immunofluorescent study. Methods: We retrospectively collected clinical history, blood results, and renal biopsy reports for all the patients who had undergone KB using electronic medical records at University Malaya Medical Centre, Kuala Lumpur, Malaysia from 1/1/2015 to 31/4/2021. We performed 1520 KBs (795 NKBs & 725 TKBs) and 1336 KBs with complete data analysed (670 NKBs & 666 TKBs). Sixty-one of the 670 (9.1%) NKBs and 48 of the 666 (7.2%) TKBs employed the PWIF method from 13/10/2020 to 31/4/2021 (6 months) because of the COVID-19 pandemic. We collected 62 NKBs and 65 TKBs from 13/10/2018 to 31/4/2019 (6 months) as the control group which used the FSIF method. The control is chosen as such to correlate with the same months of another year. Results: There were no statistically significant differences in the baseline characteristics between the two groups of each cohort respectively except for the ethnicity distribution in the TKB cohort (p=0.037) and INR in NKB and TKB cohorts (p=0.000 & p=0.002 respectively). PWIF group in NKB and TKB recorded lesser pass (p=0.000 for both), longer HPE core (p=0.001 & p=0.024 respectively), better HPE adequacy (p=0.006 & p=0.012 respectively). There were no statistical differences in the diagnostic yield, immediate pain, gross haematuria, haematoma, and admissions or prolong hospitalisation due to biopsy complications in both groups for NKB and TKB cohorts (Table 1 & 2). [Formula presented] Conclusions: Paraffin washed-out immunofluorescence technique increased the native and transplant kidney biopsy adequacy with a lesser pass and better biopsy sample adequacy for histopathological examination but no difference in the incidence of complications. However, a greater number of cases are required to assess the statistically significant difference in the incidence of complications. No conflict of interest
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The number of patients requiring intensive care has surged since the outbreak of the SARS-CoV-2 virus. This had rendered the intensive care unit (ICU) a huge challenge not only to provide care for the existing patients but also to support the COVID-19 patients. The ICU was restructured to ensure strict adherence to the infection control guidelines. The aspects of change in the ICU had been ranging from the clinical operation, medication equipment and facilities, medications supply, and staffing. Strategies required upon implementation of change include having contingency plans, being innovative, getting the collaboration from other ICUs, exchanging information, getting support from the health policymakers, and ensuring the safety of the healthcare workers. This article aimed to share the experience of challenges and strategies in managing an ICU for the COVID-19 pandemic in Malaysia. © 2022 UPM Press. All rights reserved.
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Objectives: Patient satisfaction was used as an indicator of service quality in the public hospitals. The pharmacy value-added services (VAS) were intensified after the COVID-19 outbreak, and evaluation of user's satisfaction was important for service improvement. Methods: This was a single-centre, cross-sectional, web-based study in the outpatient pharmacy in a tertiary hospital in the Perak state of Malaysia. Patients and caregivers aged 18 years and above, received at least one prescription refill using the pharmacy VAS from April to September 2020, were included. The questionnaire was adapted from a validated tool, underwent face and content validation before dissemination. The link was disseminated to the targeted population through short messages service (SMS). Key findings: Out of 1200 invited people, 303 agreed to participate. Majority of the respondents were male (160, 52.8%), Chinese (156, 51.5%), with tertiary education (201, 66.3%) and retiree (112, 37.0%). Out of a maximum score of 5, the overall mean satisfaction score was 4.42 (SD: 0.55). The respondents were most agreeable to time-saving benefits of the pharmacy VAS (4.56 +/- 0.63). Majority of the respondents felt that pharmacy VAS had made their life easier (290, 95.7%) and planned to recommend the pharmacy VAS to others (292, 96.4%) Respondents aged more than 60 (versus age 18-35, beta = 2.375, P < 0.001) and those who used drive-through service (versus SPUB, beta = 2.272, P = 0.001) reported higher satisfaction scores. Several suggestions were made for service improvement, including longer operating hours (18, 6.0%), upgraded communication system (9, 3.0%), smoother registration process (9, 3.0%), more polite staff (9, 3.0%), selection of preferred postage delivery time (6, 2.0%) and promotion of VAS (4, 1.3%) Conclusions: Majority of the respondents were highly satisfied towards the pharmacy VAS. Future studies should compare the satisfaction of VAS with traditional counter service to compare the level and factors that contributed to the users' satisfaction.
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The authors conducted a worldwide survey to explore the experiences of higher education faculty who converted classes to distance learning during the COVID-19 pandemic. Most respondents experienced much higher workloads and stress than in face-to-face classes. Previous experience with Online Distance Learning (ODL) predicted positive faculty response. Less than half used a school-provided LMS, instead using a wide range of other technologies. Respondents said they learned the need for adaptability and good planning, emphasizing doing what it takes to serve their students. There was high variability in most answers, indicating that the experiences of individual teachers ranged widely between positive and negative. The researchers provide recommendations based on the findings, including the need for better ODL instructional design training as part of long-term professional development for faculty and remembering the importance of all student higher education experiences, many of which are beyond the scope of the actual classes.