ABSTRACT
In view of diminishing the transmission of the coronavirus pandemic (COVID-19) in the community, an essential intervention strategy has been the consideration of public health measures. However, at the present scenario, these measures can be considered as the only available tools for mitigation of this virus impact. An attempt was made in this study with the use of grey technique for order of preference by similarity to ideal solution (Grey-TOPSIS) method for prioritizing the precautionary measures for the public health in order to enable taking appropriate steps by the general public of India to protect them from virus transmission. © 2022 IGI Global. All rights reserved.
ABSTRACT
Background: Management of trauma and emergency orthopaedic conditions during the pandemic was reorganised across the United Kingdom including our hospital following the COVID-19 British Orthopaedic Association and National Health Service England guidelines. Aims: This retrospective, observational cohort study analyses the impact of the first wave of COVID-19 pandemic on trauma and emergency patient care at a district general hospital. A comparative analysis to assess patient characteristics and clinical outcomes during the initial phase of COVID-19 outbreak with a cohort of patients treated during a similar period in 2019 was undertaken. Methods: Patients who underwent trauma and emergency surgeries between 01 April to 31 May 2020 at a Northwest Mersey NHS Trust were studied and compared to a similar period in 2019. The outcome measures assessed were 30- and 60-day mortality, Time to Surgery, length of stay after surgery, systemic and orthopaedic complications including the subsequent need for surgery. Results: Overall, there was a decrease in the number of patients who underwent trauma or emergency surgery from 184 in 2019 to 116 in 2020. 30- and 60-day mortality slightly increased by 2.05% and 2.68%, respectively. Time to surgery and hospital length of stay were comparable between both cohorts. Conclusion: Continuity of services to patients with obligatory injuries was managed using enhanced personal protective equipment and infection control strategies including segregation of patients based on COVID-19 status. Lessons learnt during this period such as COVID-19 testing regime and care pathways have prepared us for the near future. Level of Study: Retrospective Cohort study;Level III.
ABSTRACT
As COVID-19 pandemic spread worldwide, policies have been developed to contain the disease and prevent viral transmission. One of the key strategies has been the principle of "'test, track, and trace" to minimize spread of the virus. Numerous COVID-19 contact tracing applications have been rolled around the world to monitor and control the spread of the disease. We explore the characteristics of various COVID-19 applications and especially the Aarogya Setu COVID-19 app from India in its role in fighting the current pandemic. We assessed the current literature available to us using conventional search engines, including but not limited to PubMed, Google Scholar, and Research Gate in May 2020 till the time of submission of this article. The search criteria used MeSH keywords such as "COVID-19, " "pandemics, " "contact tracing, " and "mobile applications." A variable uptake of different COVID-19 applications has been noted with increasing enrolment around the world. Security concerns about data privacy remain. The various COVID-19 applications will complement manual contact tracing system to assess and prevent viral transmission. Test, track, trace, and support policy will play a key role in avoidance of a "second wave" of the novel coronavirus severe acute respiratory syndrome coronavirus 2 outbreak.
ABSTRACT
Background: Concerns have been raised about the escalated mortality in patients of proximal femoral fractures (PPFs) with COVID-19. A meta-analysis to evaluate the mortality in patients with PPFs managed during the current COVID-19 pandemic was conducted. Methods: A systematic review and meta-analysis of all published studies were conducted with a search on PubMed, Scopus, Web of Science, and Cochrane Library databases using appropriate keywords from January 01, 2020 to January 29, 2021. Results: 35 relevant studies reporting 4255 patients with hip fracture in the current ongoing pandemic, out of which 692 patients were COVID-19 positive. Twenty studies reported mortality and other relevant statistics on hip fracture patients with and without COVID-19 (4123 hip fracture patients in the year 2020-21, out of which 560 had or were suspected of having COVID -19). A meta-analysis of mortality statistics in patients with and without COVID revealed increased odds of mortality among COVID patients [odds ratio (OR) 6.31, 95% confidence interval (CI) [5.09, 7.83] and meta-analysis on the subgroup of surgically treated patients also showed markedly increased mortality risk among those with COVID-19 (OR) 5.99, 95% CI [3.88,9.24]. Conclusion: The mortality risk is markedly increased in hip fracture with concomitant COVID-19 as compared to those without it. This increased risk persisted in those managed surgically. It could be due to the inflammation induced by the fracture or surgery for fracture fixation, further exacerbating inflammation, leading to cytokine storm. It is imperative that such patients are informed regarding increased mortality risk during the consent and shared decision-making process.
ABSTRACT
INTRODUCTION: The social lockdown measures imposed to contain the COVID-19 pandemic, have had profound effects on the healthcare systems across the world and India has been no exception to it. The study was aimed to evaluate the impact of COVID-19 on orthopaedic practice in India during the lockdown period and assess the preparedness of orthopaedic surgeons for resuming clinical practice after the initial lockdown was lifted. MATERIALS AND METHODS: An online survey of 35 questions was conducted to evaluate impact on (i) general orthopaedic practice (ii) hospital protocols (iii) out-patient practice (iv) surgical practice (v) personal protective equipment (PPE) use and (vi) post-lockdown preparedness. RESULTS: A total number of 588 practising orthopaedic surgeons from India completed the survey. Majority (88.3%) found severe impact (>50%) on trauma surgery and non-trauma surgery with significant reduction in out -patient attendance compared to corresponding time in 2019. There were significant changes made in individual hospital protocols (91.7 %). Appropriate required PPE was available in majority of the hospitals (74.3%). No remodelling or upgrading of the existing operating theatre infrastructure was done by most surgeons (89.5%). CONCLUSION: This pan India survey of orthopaedic surgeons has indicated that COVID-19 has had a profound impact on their outpatient and surgical trauma and non-trauma practice, due to the lockdown and resulted in significant changes to hospital protocols. Preparedness to resume clinical and surgical practice was associated with anxiety in two-thirds of the respondents. Majority of the orthopaedic practitioners felt that they would continue to conduct pre-operative COVID-19 screening and use PPE even after the lockdown is over.
ABSTRACT
Corona Virus Disease (COVID-19) has resulted in restriction of face-to-face consultations and mechanisms to access health care. Oesteoarthritis (OA) is one of the most common forms of musculoskeletal disease encountered and a leading cause of painful disability in adults and elderly. The assessment of the challenges and strategies encountered in the non-operative management of OA of knee care during the COVID-19 pandemic was done. A comprehensive review of the literature using suitable keywords such as 'COVID-19', 'OA', 'OA knee' 'knee joint' on the search engines of PubMed, SCOPUS, Google Scholar and Research Gate in May 2020 on developments and guidance during the current COVID-19 pandemic. The management of OA has been hampered by COVID-19 pandemic lock down with subsequent suspension of elective surgeries. Non-operative complementary therapy has been evaluated with National Institute for Health and Care Excellence (NICE) recommendations to guide management. Conservative strategies including judicial use of analgesia as recommended by NICE, supportive orthosis, patient education and advice using remote telecommunication consultations play an important role in the non-operative management of OA till elective surgery can safely resume.