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One in six nursing home residents and staff with positive SARS-CoV-2 tests ≥90 days after initial infection had specimen cycle thresholds (Ct) <30. Individuals with specimen Ct<30 were more likely to report symptoms but were not different from individuals with high Ct value specimens by other clinical and testing data.
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[...]wave had significantly higher mortality as compared to first wave (18.5% vs. 4.4%). [...]wave of COVID-19 was being considered less likely to explosive due to factor such as high seroprevalence among inhabitants, vigorous guidelines, rapid and cost effective diagnostic tests availability, improved health infrastructure, and most significant availability of vaccines against COVID-19. [5,9] Few studies are available that compare clinicepidemiological profile and death rate between first wave and the second wave of COVID-19 in India. [...]we performed this study to compare clinicoepidemiological features of the COVID-19 patients of first and second wave admitted in our tertiary care teaching hospital. First group (first wave) contains 135 COVID-19 patients admitted between April 1, 2020, and January 31, 2021. [...]group (second wave) contains 135 COVID-19 patients admitted between April 7, 2021, and July 5, 2021.
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The SARS-CoV-2 pandemic has increased the demand for antiviral technologies to mitigate or prevent the risk of viral transmission. Antiviral treated textiles have the potential to save lives, especially in healthcare settings that rely on reusable patient-care textiles and personal protective equipment. Currently, little is known about the role of textiles in cross-contamination and pathogen transmission, despite the wealth of information on hard surfaces and fomites harboring viruses that remain viable in certain circumstances. In addition, there is no international standard method for evaluating residual viral activity on textiles, which would allow a thorough investigation of the efficacy of antiviral textile products. Therefore, this pilot study aims to develop and refine a standardized protocol to quantitatively evaluate residual viral activity on antiviral textiles. Specifically, we focused on general textiles, such as bed linens, commonly used in healthcare settings for patient care. The Tissue Culture Infectious Dose 50 (TCID50) method is frequently used to quantitatively evaluate viral infectivity on textiles, but has not been established as a standard. This procedure involves observing the cytopathic effect of a given virus on cells grown in a 96-well plate after several days of incubation to determine the infectivity titer. We used HCoV-229E and Huh-7 human liver cancer cells for this investigation. We worked to improve the TCID50 method through variations of different steps within the protocol to attain reproducible results. Our proposed optimized hybrid protocol has shown evidence that the protocol is technically simpler and more efficient, and provides successful, consistent results. The analysis showed a significant difference between the treated fabric compared with controls.
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Introduction: Covid 19 is a disease caused by a virus belonging to SARS Co V2 family of viruses. It primarily effects the lungs resulting in inflammation and pneumonia. Objective(s): The main objective of the study is to compare the outcomes and efficacy of solumedrol and dexamethasone in moderate to severe COVID disease. Material(s) and Method(s): This cross sectional study was conducted in Central Park Medical College and Teaching Hospital, Lahore and the duration of this study was from August 2021 to March 2022. The data was collected from 100 COVID-19 patients diagnosed with moderate to severe condition of the diseases. The data was collected through non-probability consecutive sampling technique. Result(s): The data was collected from 100 patients of moderate to severe COVID-19 condition. There were 35 patients in group I and 65 patients' group II. The mean age for dexamethasone (group II) was 55.41 +/- 10.4 years and solumedrol (group I) was 56.86 +/- 9.3 years. Conclusion(s): It is concluded that both drugs dexamethasone and solumedrol are effective in improving clinical and biochemical parameters of moderate to severe covid 19 disease. Copyright © 2022 Lahore Medical And Dental College. All rights reserved.
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In this work, an electroanalytical procedure for sensing umifenovir (arbidol) by square wave adsorptive stripping voltammetry (SW-AdSV) was developed utilizing an anodically pretreated boron-doped diamond electrode. Measurements of umifenovir using cyclic voltammetry with phosphate buffer solution (PBS, 0.1 M, pH 2.5) revealed irreversible behaviour, adsorption-controlled as well as an ill-defined (+1.13 V, PA1) and a well-defined (+1.47 V, PA2) two oxidation peaks. Umifenovir oxidations depend critically on supporting electrolytes and pH. The second oxidation peak (PA2) current of the umifenovir was enhanced by adding sodium dodecyl sulfate (SDS, anionic surfactant) in the chosen supporting electrolyte. Umifenovir was quantified using its second oxidation peak (PA2) at about +1.39 V. Using the optimized condition, the oxidation peak current of PA2 showed a linear relationship for umifenovir determination in the concentration range from 0.005 to 1.0 μg ml−1 (9.73 × 10−9−1.95 × 10−6 M), with a detection limit of 0.0014 μg ml−1 (2.72 × 10−9 M) in PBS (PH 2.5) with SDS. Finally, the developed approach was successfully utilized to determine umifenovir in the pharmaceutical formulation and urine samples. To the best of our knowledge, this is the first electroanalytical approach for voltammetric sensing of umifenovir. © 2023 The Electrochemical Society ("ECS”). Published on behalf of ECS by IOP Publishing Limited
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Introduction: Pandemic coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 coronavirus has recently emerged. Objective(s): The main objective of the study is to find the outcome comparison between tocilizumab and pulse solumedrol in severe COVID disease among resource depleted areas. Material(s) and Method(s): This cross sectional study was conducted in Central Park Medical College and Teaching Hospital, Lahore and the duration of this study was from August 2021 to March 2022. The data was collected through non-probability consecutive sampling technique. The data was collected into two groups. Men and non-pregnant women over 18 years old COVID diagnosis confirmed by real time polymerase chain reaction (RT-PCR) Pao2 / FIO2 <200 Laboratory: high sensitivity C reactive protein> 5 mg / L;lactic dehydrogenase (LDH) > 245 U / l;Ferritin> 300;D-dimer> 1500;Interleukin-6> 7.0 pg / ml were included. Result(s): The data was collected from 300 patients, 150 in each group. There were 72.9% male aged 41-60 years 45.8% were female with a mean age of 55.4 +/- 10.6 years. Diabetes and hypertension was the most common comorbidity in selected patients. Tocilizumab group had more number of males (P = 0.017), with higher incidence of coronary artery disease (CAD, P = 0.008). Conclusion(s): It is concluded that Tocilizumab decreased the propensity of severe COVID-19 patients to require invasive mechanical ventilation when compared to high-dose solumedrol pulse, especially in those with severe ARDS, but this did not translate to improved 30-day survival in them. Copyright © 2022 Lahore Medical And Dental College. All rights reserved.
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The SARS-CoV-2 pandemic has increased the demand for antiviral technologies to mitigate or prevent the risk of viral transmission. Antiviral treated textiles have the potential to save lives, especially in healthcare settings that rely on reusable patient-care textiles and personal protective equipment. Currently, little is known about the role of textiles in cross-contamination and pathogen transmission, despite the wealth of information on hard surfaces and fomites harboring viruses that remain viable in certain circumstances. In addition, there is no international standard method for evaluating residual viral activity on textiles, which would allow a thorough investigation of the efficacy of antiviral textile products. Therefore, this pilot study aims to develop and refine a standardized protocol to quantitatively evaluate residual viral activity on antiviral textiles. Specifically, we focused on general textiles, such as bed linens, commonly used in healthcare settings for patient care. The Tissue Culture Infectious Dose 50 (TCID50) method is frequently used to quantitatively evaluate viral infectivity on textiles, but has not been established as a standard. This procedure involves observing the cytopathic effect of a given virus on cells grown in a 96-well plate after several days of incubation to determine the infectivity titer. We used HCoV-229E and Huh-7 human liver cancer cells for this investigation. We worked to improve the TCID50 method through variations of different steps within the protocol to attain reproducible results. Our proposed optimized hybrid protocol has shown evidence that the protocol is technically simpler and more efficient, and provides successful, consistent results. The analysis showed a significant difference between the treated fabric compared with controls.
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CONTEXT: Between April 2020 and May 2021, the Centers for Disease Control and Prevention (CDC) awarded more than $40 billion to health departments nationwide for COVID-19 prevention and response activities. One of the identified priorities for this investment was improving infection prevention and control (IPC) in nursing homes. PROGRAM: CDC developed a virtual course to train new and less experienced public health staff in core healthcare IPC principles and in the application of CDC COVID-19 healthcare IPC guidance for nursing homes. IMPLEMENTATION: From October 2020 to August 2021, the CDC led training sessions for 12 cohorts of public health staff using pretraining reading materials, case-based scenarios, didactic presentations, peer-learning opportunities, and subject matter expert-led discussions. Multiple electronic assessments were distributed to learners over time to measure changes in self-reported knowledge and confidence and to collect feedback on the course. Participating public health programs were also assessed to measure overall course impact. EVALUATION: Among 182 enrolled learners, 94% completed the training. Most learners were infection preventionists (42%) or epidemiologists (38%), had less than 1 year of experience in their health department role (75%), and had less than 1 year of subject matter experience (54%). After training, learners reported increased knowledge and confidence in applying the CDC COVID-19 healthcare IPC guidance for nursing homes (≥81%) with the greatest increase in performing COVID-19 IPC consultations and assessments (87%). The majority of participating programs agreed that the course provided an overall benefit (88%) and reduced training burden (72%). DISCUSSION: The CDC's virtual course was effective in increasing public health capacity for COVID-19 healthcare IPC in nursing homes and provides a possible model to increase IPC capacity for other infectious diseases and other healthcare settings. Future virtual healthcare IPC courses could be enhanced by tailoring materials to health department needs, reinforcing training through applied learning experiences, and supporting mechanisms to retain trained staff.
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COVID-19 , COVID-19/epidemiology , COVID-19/prevention & control , Health Personnel/education , Humans , Infection Control , Nursing Homes , Public HealthABSTRACT
We describe a large outbreak of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) involving an acute-care hospital emergency department during December 2020 and January 2021, in which 27 healthcare personnel worked while infectious, resulting in multiple opportunities for SARS-CoV-2 transmission to patients and other healthcare personnel. We provide recommendations for improving infection prevention and control.
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PURPOSE: This paper aims to clarify the concept of reflective practice in nursing by using Rodgers' evolutionary method of concept analysis. DATA SOURCES: Literature and references on the concept of reflective practice were obtained from two databases: Scopus and Nursing and Allied health database. Peer-reviewed articles published in English language between 2011-2021 that included the terms 'reflection' and/or 'reflective practice' in the title were selected. Seminal pieces of work were also considered in this analysis. A total of 23 works were included. Most of the selected works addressed the concept of reflective practice in nursing education or nursing practice. DATA SYNTHESIS: The data analysis integrated the stages identified in Rodgers' method of concept analysis to analyze the concept of reflective practice. Analysis of selected works provided an understanding of common surrogates, antecedents, attributes, and consequences of the concept of reflective practice. CONCLUSIONS: Reflective practice is a cognitive skill that demands conscious effort to look at a situation with an awareness of own beliefs, values, and practice enabling nurses to learn from experiences, incorporate that learning in improving patient care outcomes. It also leads to knowledge development in nursing. Considering the current circumstances of the COVID-19 pandemic, this paper identifies the need for nurses to go beyond reflection-on-action and also include reflection-in-action and reflection-for-action as part of their practice. IMPLICATIONS FOR NURSING PRACTICE: This analysis identifies the need for future nursing researchers to develop reflective models or strategies that promote reflection among nurses and nursing students before, during, and after the clinical experiences.
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COVID-19 , Education, Nursing , Students, Nursing , Concept Formation , Humans , Knowledge , PandemicsABSTRACT
Importance: The number of clinics marketing stem cell products for joint diseases, chronic pain, and most recently, COVID-19, has increased despite warnings from the US Food and Drug Administration that stem cell products for these and other indications have not been proven safe or effective. Objective: To examine bacterial infections in 20 patients who received umbilical cord blood-derived products marketed as stem cell treatment. Design, Setting, and Participants: This case series is a national public health investigation including case-finding, medical record review and abstraction, and laboratory investigation, including sterility testing of products and whole-genome sequencing of patient and product isolates. Participants included patients who developed bacterial infections following administration of umbilical cord blood-derived products marketed as stem cell treatment during August 2017 to September 2018. Data analysis was performed from March 2019 to September 2021. Exposures: Umbilical cord blood-derived products marketed as stem cell treatment. Main Outcomes and Measures: Data were collected on patient infections and exposures. The Centers for Disease Control and Prevention performed sterility testing on undistributed and distributed vials of product marketed as stem cell treatment and performed whole-genome sequencing to compare patient and product bacterial isolates. Results: Culture-confirmed bacterial infections were identified in 20 patients (median [range] age, 63 [2-89] years; 13 male patients [65%]) from 8 US states who sought stem cell treatment for conditions including pain, osteoarthritis, rheumatoid arthritis, and injury; all but 1 required hospitalization. The most frequently isolated bacteria from patients with infections were common enteric species, including Escherichia coli (14 patients) and Enterobacter cloacae (7 patients). Of unopened, undistributed products sampled for testing, 65% (22 of 34 vials) were contaminated with at least 1 of 16 bacterial species, mostly enteric. A patient isolate from Arizona matched isolates obtained from products administered to patients in Florida, and patient isolates from Texas matched undistributed product sent from the company in California. Conclusions and Relevance: Unapproved stem cell products can expose patients to serious risks without proven benefit. Sequencing results suggest a common source of extensive contamination, likely occurring during the processing of cord blood into product. Patients and health care practitioners who are considering the use of unapproved products marketed as stem cell treatment should be aware of their unproven benefits and potential risks, including serious infections.
Subject(s)
Bacterial Infections/etiology , Blood Safety/statistics & numerical data , Cord Blood Stem Cell Transplantation/adverse effects , Disease Outbreaks , Adolescent , Adult , Aged , Aged, 80 and over , Bacterial Infections/epidemiology , Bacterial Infections/prevention & control , Blood Safety/standards , Centers for Disease Control and Prevention, U.S. , Child , Child, Preschool , Cord Blood Stem Cell Transplantation/standards , Female , Humans , Male , Marketing , Middle Aged , Outcome Assessment, Health Care , Public Health Surveillance , United States/epidemiology , United States Food and Drug Administration , Young AdultABSTRACT
The coronavirus disease 2019 (COVID-19), which became a global pandemic by March 2020, forced almost all countries over the world to impose the lockdown as a measure of social distancing to control the spread of infection. India also strictly implemented a countrywide lockdown, starting from 24 March to 12 May 2020. This measure resulted in the reduction of the sources of air pollution in general: industrial, commercial, and vehicular pollution in particular, with visible improvement in ambient air quality. In this study, the impact of COVID-19 lockdown on the ambient concentration of air pollutants over the city of Bangalore (India) is assessed using Continuous Ambient Air Quality Measurement (CAAQM) data from 10 monitoring stations spread across the city. The data was obtained from Central Pollution Control Board (CPCB) and Karnataka State Pollution Control Board (KSPCB). The analysis of the relative changes in the ambient concentration of six major air pollutants (NO, NO2, NOX, PM2.5, O3, and SO2) has been carried out for two periods: March-May 2020 (COVID-19 lockdown) and the corresponding period of 2019 during when there was no lockdown. The analysis revealed significant reduction in the concentration of ambient air pollutants at both daily and monthly intervals. This can be attributed to the reduction in sources of emission; vehicular traffic, industrial, and other activities. The average reduction in the concentration of NO, NO2, NOX, PM2.5, and O3 between 01 March and 12 May 2020 was found to be 63%, 48%, 48%, 18%, and 23% respectively when compared to the same period in 2019. Similarly, the comparative analysis of pollutant concentrations between pre-lockdown (01-23 March 2020) and lockdown (24 March-12 May 2020) periods has shown a huge reduction in the ambient concentration of air pollutants, 47.3% (NO), 49% (NO2), 49% (NOX), 10% (SO2), 37.7% (PM2.5), and 15.6% (O3), resulting in improved air quality over Bangalore during the COVID-19 lockdown period. It is shown that the strict lockdown resulted in a significant reduction in the pollution levels. Such lockdowns may be useful as emergency intervention strategies to control air pollution in megacities when ambient air quality deteriorates dangerously.
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Air Pollutants , Air Pollution , COVID-19 , Air Pollutants/analysis , Air Pollution/analysis , Cities , Communicable Disease Control , Environmental Monitoring , Humans , India , Particulate Matter/analysis , SARS-CoV-2ABSTRACT
On February 26, 2020, the first U.S. case of community-acquired coronavirus disease 2019 (COVID-19) was confirmed in a patient hospitalized in Solano County, California (1). The patient was initially evaluated at hospital A on February 15; at that time, COVID-19 was not suspected, as the patient denied travel or contact with symptomatic persons. During a 4-day hospitalization, the patient was managed with standard precautions and underwent multiple aerosol-generating procedures (AGPs), including nebulizer treatments, bilevel positive airway pressure (BiPAP) ventilation, endotracheal intubation, and bronchoscopy. Several days after the patient's transfer to hospital B, a real-time reverse transcription-polymerase chain reaction (real-time RT-PCR) test for SARS-CoV-2 returned positive. Among 121 hospital A health care personnel (HCP) who were exposed to the patient, 43 (35.5%) developed symptoms during the 14 days after exposure and were tested for SARS-CoV-2; three had positive test results and were among the first known cases of probable occupational transmission of SARS-CoV-2 to HCP in the United States. Little is known about specific risk factors for SARS-CoV-2 transmission in health care settings. To better characterize and compare exposures among HCP who did and did not develop COVID-19, standardized interviews were conducted with 37 hospital A HCP who were tested for SARS-CoV-2, including the three who had positive test results. Performing physical examinations and exposure to the patient during nebulizer treatments were more common among HCP with laboratory-confirmed COVID-19 than among those without COVID-19; HCP with COVID-19 also had exposures of longer duration to the patient. Because transmission-based precautions were not in use, no HCP wore personal protective equipment (PPE) recommended for COVID-19 patient care during contact with the index patient. Health care facilities should emphasize early recognition and isolation of patients with possible COVID-19 and use of recommended PPE to minimize unprotected, high-risk HCP exposures and protect the health care workforce.