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The key manufacturing industry was badly affected by the COVID-19 in India. In this study, we found that the product demand is dynamic during COVID-19. We selected one of the electrical OEMs in India to execute the value added-Flow analysis and VSM study which showed 96% and 85% of total delivery lead time is contributed by NVA activities at the manufacturing process respectively. We also plotted the spaghetti diagram and analysed that total product movement is 287 metres in the current state with the complex flow. We did total of six main Kaizens after Ishikawa and FMEA. We constructed single-piece flow with saving of the half shop floor space and total product movement was reduced from 287 to 96 metres, while total delivery lead time was reduced from 14.6 to 7.72 days. We concluded that lean Six Sigma deployment in the manufacturing industry solved the problems of demand fluctuations.
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Objective: To share our experience of tracheostomy in COVID-19 positive patients. Study Design: Prospective observational study. Place and Duration of Study: Pak-Emirates Military Hospital, Rawalpindi Pakistan, from Apr to Jul 2020. Methodology: A total of 94 COVID-19 positive cases admitted to the Intensive Care Unit of this hospital, placed on ventilatory support and who ultimately underwent tracheostomy (whether percutaneous or surgical) were included in the study. Patients were included irrespective of any age group or gender. Results: Out of 94 patients placed on ventilator, tracheostomy was performed only in 17 patients. Male predominance was 13 (76%), with mean age of patients as 55.59 ± 12.93 in 12 patients, surgical tracheostomy was performed (70.58%) whereas in 5 (29.4%) cases percutaneous tracheostomy was done. On post-operative follow-up 8 out of 17 (47%) patients recovered and were successfully decannulated whereas 9 (52.9%) patients could not survive. Tracheostomy was successfully performed as early as 8th day of mechanical ventilator support. Health Care Workers (HCWs) involved were subjected to RT-PCR and remained negative for SARSCoV-2. There was statistically significant association between the type and indication of tracheostomy, p=0.002. Conclusion: Tracheostomy, in COVID-19 positive patients, being aerosolgenerating procedure remains a medical hazard for the HCWs. By following strict safety protocols according to the medical resources available and training of the HCWs, it can be performed with complete safety. It can be done as early as 8th day of ventilator support.
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Background The first case of coronavirus disease 2019 (COVID-19) in the United Arab Emirates (UAE) was reported on January 29, 2020. Various anecdotal reports suggest that fewer patients with ST-segment elevation myocardial infarction (STEMI) have been presented to the hospital during the COVID-19 pandemic. In this study, we examined the patient characteristics, in-hospital management, and outcomes of the patients with STEMI before and during the COVID-19 pandemic in Abu Dhabi, UAE. Methods We analyzed the data retrospectively from January 1, 2019 to December 31, 2020 and stratified the same into two periods: before the pandemic (January 1, 2019 to January 28, 2020) and during the pandemic (January 29, 2020 to December 31, 2020). The patient-level data for the two periods were compared to identify the differences in the patient characteristics, in-hospital management, and 30-day mortality outcomes of the patients with STEMI. Results During the COVID-19 pandemic, the number of STEMI cases was lower (n = 234) than before the pandemic (n = 266), and 11patients (4.7%) tested positive for COVID-19 during their hospital encounter. In comparison to before the pandemic, patients with STEMI were significantly younger (mean age: 50.39 years, standard deviation (SD) ± 10.32 years), less likely to present to the emergency department (ED), and more likely to have histories of hypercholesterolemia (P < 0.001) and coronary artery disease (P < 0.001). Significantly shorter door-to-balloon time (56.6 ± 27.26 min, P < 0.001) and decreased length of stay (4.7 ± 6.8 days, P < 0.001) were observed during the pandemic. However, no considerable difference in the 30-day mortality was observed in 2020 as compared to before the pandemic (2.1% versus 3.0%, respectively). Conclusions Hospital presentation for the patients with STEMI decreased during the COVID-19 pandemic, with significant differences in the door-to-balloon time and length of hospital stay. This indicates that the hospital systems of care continued to operate with higher efficiency during the COVID-19 pandemic than before the pandemic in the UAE.
ABSTRACT
BACKGROUND: The first case of coronavirus disease 2019 (COVID-19) in the United Arab Emirates (UAE) was reported on January 29, 2020. Various anecdotal reports suggest that fewer patients with ST-segment elevation myocardial infarction (STEMI) have been presented to the hospital during the COVID-19 pandemic. In this study, we examined the patient characteristics, in-hospital management, and outcomes of the patients with STEMI before and during the COVID-19 pandemic in Abu Dhabi, UAE. METHODS: We analyzed the data retrospectively from January 1, 2019 to December 31, 2020 and stratified the same into two periods: before the pandemic (January 1, 2019 to January 28, 2020) and during the pandemic (January 29, 2020 to December 31, 2020). The patient-level data for the two periods were compared to identify the differences in the patient characteristics, in-hospital management, and 30-day mortality outcomes of the patients with STEMI. RESULTS: During the COVID-19 pandemic, the number of STEMI cases was lower (n = 234) than before the pandemic (n = 266), and 11patients (4.7%) tested positive for COVID-19 during their hospital encounter. In comparison to before the pandemic, patients with STEMI were significantly younger (mean age: 50.39 years, standard deviation (SD) ± 10.32 years), less likely to present to the emergency department (ED), and more likely to have histories of hypercholesterolemia (P < 0.001) and coronary artery disease (P < 0.001). Significantly shorter door-to-balloon time (56.6 ± 27.26 min, P < 0.001) and decreased length of stay (4.7 ± 6.8 days, P < 0.001) were observed during the pandemic. However, no considerable difference in the 30-day mortality was observed in 2020 as compared to before the pandemic (2.1% versus 3.0%, respectively). CONCLUSIONS: Hospital presentation for the patients with STEMI decreased during the COVID-19 pandemic, with significant differences in the door-to-balloon time and length of hospital stay. This indicates that the hospital systems of care continued to operate with higher efficiency during the COVID-19 pandemic than before the pandemic in the UAE.
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OBJECTIVE: To evaluate the anxiety and depression amid novel coronavirus disease-19 (COVID-19) pandemic in health sciences students around the globe. MATERIALS AND METHODS: This cross-sectional observational study comprised 523 health science students. A well-structured online questionnaire consisting of closed-ended questions based on student's general information, Patient Heath Questionnaire (PHQ)-9 and Generalized Anxiety Disorder (GAD)-7 scales were used to assess the psychological impact of COVID-19. STATISTICAL ANALYSIS: SPSS-25 was used to analyze the outcome of this study. Multiple linear regression analysis test was used to assess variables which had impact on PHQ-9 and GAD-7 scores among the participants. A p-value of ≤ 0.05 was considered as statistically significant. RESULTS: Among the 523 participants, 365 (69.55%) students were from developing countries and 158 (30.21%) from developed countries; 424 (81.1%) students were tested negative for COVID-19 and 99 (18.9%) had suffered from severe acute respiratory syndrome coronavirus 2 infection during pandemic. The mean GAD-7 and PHQ-9 scores were 7.16 ± 5.755 and 7.30 ± 6.166, respectively. Significant impact on anxiety levels was associated with age, gender, education status, and COVID-19 positive patient, while depression was not significantly associated with gender, COVID-19, and its reported symptoms in participants. CONCLUSION: As the world is trying to contain the health effects of COVID-19, the psychological effects might take a longer time to be addressed. Our study highlights the dire need to identify mental well-being of health science students as this may have a direct impact on their professional commitments and future responsibilities.
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There is a burden of adequate energy supply for meeting demand and reducing emission to avoid the average global temperature of above 2 °C of the pre-industrial era. Therefore, this study presents the exergoeconomic and environmental analysis of a proposed integrated multi-generation plant (IMP), with supplemental biomass-based syngas firing. An in-service gas turbine plant, fired by natural gas, was retrofitted with a gas turbine (GT), steam turbine (ST), organic Rankine cycle (ORC) for cooling and power production, a modified Kalina cycle (KC) for power production and cooling, and a vapour absorption system (VAB) for cooling. The overall network, energy efficiency, and exergy efficiency of the IMP were estimated at 183 MW, 61.50% and 44.22%, respectively. The specific emissions were estimated at 122.2, 0.222, and 3.0 ×10−7 kg/MWh for CO2, NOx, and CO, respectively. Similarly, the harmful fuel emission factor, and newly introduced sustainability indicators—exergo-thermal index (ETI) and exergetic utility exponent (EUE)—were obtained as 0.00067, 0.675, and 0.734, respectively. The LCC of $1.58 million was obtained, with a payback of 4 years, while the unit cost of energy was estimated at 0.0166 $/kWh. The exergoeconomic factor and the relative cost difference of the IMP were obtained as 50.37% and 162.38%, respectively. The optimum operating parameters obtained by a genetic algorithm gave the plant’s total cost rate of 125.83 $/hr and exergy efficiency of 39.50%. The proposed system had the potential to drive the current energy transition crisis caused by the COVID-19 pandemic shock in the energy sector.
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The pandemic of Coronavirus disease (COVID-19) has emerged as a global catastrophe that is plaguing mankind. In the past eight months since the world discovered about COVID-19, we learned a lot about server acute respiratory syndrome coronavirus 2 (SARS CoV-2) and perhaps there is much more to discover and understand about the virus. With the current understanding of the disease, we assume it will remain in an active state of transmission and progression among the community for a long time. Thus, it is advisable to adopt the disease's prevention protocol in our daily and work routine. During this pandemic patient requiring dental treatment cannot be neglected and the role of dental imaging is crucial in delivering treatment. Hence, this article attempts to provide an evidence-based compilation about the mode of transmission and clinical features of COVID-19. It also throws light on the potential source of disease transmission in the dental radiology setting. In addition, it suggests preventive measures to curb the infection and infrastructural model of the clinical setting that will assist in achieving control over the disease transmission. This article intends to project a strategy about protocols, infrastructure, and daily activities in a dental radiology office that institutions can adopt with modifications according to their local scenario.