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INTRODUCTION: Disaster planning is of significant importance for the healthcare professional and the healthcare setting. Hospital-based disaster protocols form the cornerstone of disaster response. There is a paucity of data on disaster preparedness training using the virtual tabletop exercise (VTTX) module for interprofessional education from in-hospital and prehospital settings. With the coronavirus disease 2019 (COVID-19) pandemic, we have seen a paradigm shift of education strategies to the virtual realm. Here we attempt to study the impact of an online tabletop exercise workshop on the knowledge and confidence of disaster preparedness among Interprofessional trainees. MATERIAL AND METHODS: Interprofessional trainees from medical, dental, nursing, respiratory therapy, and paramedic domains who consented were included in this study. Institutional ethics committee approval was received and the study was registered with the clinical trials registry India (CTRI), before initiation. The VTTX module has been adapted from the World Health Organization (WHO) COVID-19 training resources. Three international experts from the disaster medicine domain validated the module, questionnaire, and feedback. Wilcoxon signed-rank test was used to compare the parameters (Knowledge and confidence level) pre and post-workshop. RESULTS: A total of 76 candidates with a mean age was 21.67 ± 2.5 (range:19-36) were part of the workshop. Comparison of the median scores and interquartile range of confidence level and knowledge respectively before [38 (29.25-45.75), 9 (7-11)] and after [51.50 (45-60), 11 (10-12)] the workshop showed vital significance (p-value < 0.001). All participants gave positive feedback on the workshop meeting the objectives. The majority agreed that the workshop improved their self-preparedness (90%) and felt that the online platform was appropriate (97.5%) CONCLUSIONS: This study sheds light on the positive impact of the online VTTX based workshop on disaster preparedness training among interprofessional trainees. Disaster preparedness training using available online platforms may be effectively executed with the VICTEr workshop even during the COVID-19 pandemic. The VICTEr workshop serves as a primer for developing online modules for effective pandemic preparedness training in interprofessional education. Copyright © 2023 Via Medica.
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There is a proliferation of digitalisation of urban and health services in India under the Smart City and Digital Health missions, respectively. This study brings digital and feminist geographies together to understand the role of technologies in urban areas, particularly in health service delivery and how healthcare workers mediate these health platforms. Using a case study of Varanasi city in Uttar Pradesh, India this study documents whether-and to what extent-digital technologies and services enable citizens and service providers to access and improve their lived experiences. The findings indicate a top-down, innovation-focussed model is adopted which excludes and alienates different user groups and citizens shaping their interaction and access to these services.
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Viral infection may be a serious threat for human beings. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is a highly transmissible virus causing coronavirus disease 2019 (COVID-19) in humans and creating a universal pandemic outbreak. The current methods for detection of SARS-CoV-2 include real-time reverse transcription-polymerase chain reaction (RT-PCR), enzyme-linked immunosorbent assay (ELISA), and loop-mediated isothermal amplification (LAMP). Though the methods are widely used for the diagnosis of COVID-19, they too have their limitations such as time-consuming process, sophisticated instrumental setup, which requires highly skilled personnel for operation, and prevalence of false positive/negative reports. Therefore, there is a pressing need to develop alternative tools such as point-of-care testing (POCT) devices to detect SARS-CoV-2 rapidly, accurately, and user-friendly. Here, the authors propose a one-step diagnostic method using aptamer-based sensing technology. The intended design of aptamer-based biosensors (also known as aptasensors) utilizes the optical properties of gold nanoparticles (AuNP) conjugated with angiotensin-converting enzyme-2 (ACE-2) aptamers targeting SARS-CoV-2 using lateral flow assay (LFA). This study leads to the development of portable nanoscale aptasensors for viral diagnostics. © 2022 by the authors.
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The coronaviruses, belonging to the family Coronaviridae, have caused a massive pandemic in December 2019 after their previous outbreaks as SARS-CoV and MERS. The outbreak is believed to have originated from the seafood and live market in the Hubei province of China. The Rhinolophus species are the natural hosts of this virus. This virus caused pneumonia and took away many lives be-fore it was recognized as the novel Coronavirus. Very little information is available about the biology and nature of the novel Coronavirus. This article reviews multiple aspects encompassing its origin, epi-demiology, pathogenesis, symptoms, and the global statistics of spread. Acute respiratory distress syndrome (ARDS) is the key symptom of this condition. Angiotensin-converting enzyme 2 (ACE2) helps in the penetration of the virus into the target cells. Deeper research and understanding are essential for the identification of antibodies that inhibit ACE2 and can prevent viral replication. Drug design and control of disease are crucial. In countries like India, where plant diversity is extensive, it is prudent to focus on plant-based alternative drugs. Many attempts have been made to review and curate the drug discovery attempts using immuno-informatic and bioinformatic tools.Copyright © 2021 Bentham Science Publishers.
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The novel coronavirus disease (COVID-19) is an ongoing pandemic with large global attention. However, spreading fake news on social media sites like Twitter is creating unnecessary anxiety and panic among people towards this disease. In this paper, we applied machine learning (ML) techniques to predict the sentiment of the people using social media such as Twitter during the COVID-19 peak in April 2021. The data contains tweets collected on the dates between 16 April 2021 and 26 April 2021 where the text of the tweets has been labelled by training the models with an already labelled dataset of corona virus tweets as positive, negative, and neutral. Sentiment analysis was conducted by a deep learning model known as Bidirectional Encoder Representations from Transformers (BERT) and various ML models for text analysis and performance which were then compared among each other. ML models used were Naïve Bayes, Logistic Regression, Random Forest, Support Vector Machines, Stochastic Gradient Descent and Extreme Gradient Boosting. Accuracy for every sentiment was separately calculated. The classification accuracies of all the ML models produced were 66.4%, 77.7%, 74.5%, 74.7%, 78.6%, and 75.5%, respectively and BERT model produced 84.2 %. Each sentiment-classified model has accuracy around or above 75%, which is a quite significant value in text mining algorithms. We could infer that most people tweeting are taking positive and neutral approaches. © 2023, Universidad Politecnica Salesiana. All rights reserved.
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The spread of the Covid-19 virus that initially surfaced in China in late 2019 eventually emerged as a global pandemic which adversely affected the worldwide population, including Malaysia. Consequently, the Malaysian government implemented many social and public health measures to help control the spread of Covid-19 in the country. The Covid-19 pandemic affected every level of society in Malaysia, including children who are susceptible to being emotionally, psychologically, and mentally affected due to lockdown measures, school closures, and loss of employment suffered by family members.There is a gap in existing research concerning the impact of Covid-19 on children deprived of liberty in detention centres in Malaysia. Hence, this study aims to identify whether the legal framework in Malaysia adequately protects the rights of children deprived of liberty in detention centres, in line with the international legal framework. A qualitative research design was adopted to explore the issues surrounding the impact of Covid-19 on children in detention centres. Library-based research and semi-structured interviews were carried out with officers from detention centres and the Department of Social Welfare. This research demonstrates that sound policies and guidelines and the availability of fully trained staff are essential in meeting the emotional, physical, and mental needs of children in detention centres. This research is significant for policymakers to strengthen the current legal framework in order to afford better protection for children in detention centres, in line with the Ministry of Women, Family and Community Development Policy (2021–2025) as well as the international legal framework. © 2023, UUM Journal of Legal Studies. All Rights Reserved.
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Background: Idiopathic inflammatory myopathies (IIM) are a class of long-lasting autoimmune diseases that typically affect the proximal muscles. Dermatomyositis (DM), polymyositis (PM), necrotizing autoimmune myopathy (NAM), and sporadic inclusion body myositis are the most prevalent kinds. Patients usually have subacute to chronic proximal weakness, which presents as difficulty getting out of a chair, getting up the stairs, lifting objects, and brushing their hair. They are distinguished by their clinical presentation, which includes muscular and ex-tramuscular signs. Elevated serum creatine kinase (CK) levels and myositis-specific antibodies may help distinguish clinical phenotypes and confirm the diagnosis. Biopsy of the muscle, on the other hand, is still the gold standard for determining the cause of the problem. These disorders may be cured with proper diagnosis and treatment. The treatment's goals are to reduce inflammation, restore muscle performance, and alleviate pain. Method(s): 36-year-old man K/C/O dermatomyositis came complaints of redness swelling in the right eye for 3 months, dysphagia, easy fatiguability. Patient was neither hypertensive nor diabetic. Result(s): This case describes the severity of NXP2 autoantibody and a potential to be life threatening. Patient was started with immunoglobulins, monoclonal antibodies. After which patient improved from his present condition.Copyright © 2022 Novyi Russkii Universitet. All rights reserved.
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INTRODUCTION: We describe our outcomes in patients with Acute Respiratory Failure (ARF) prior to and during the Coronavirus-19 (COVID-19) pandemic with regards to salvage therapies for ARF METHODS: In our single center retrospective matched cohort study, we collected demographic variables, comorbid conditions, laboratory data, variables on the ventilator, vasopressor use, use of prone ventilation, neuromuscular blockade, and inhaled pulmonary vasodilators. Data was collected from electronic health records for all patients for whom a consultation for Extra Corporeal Membranous Oxygenation (ECMO) for ARF was sought from January 2018 to April 2022. RESULT(S): Two hundred and fifty-three patients (253) received consultation for ECMO for ARF. Of those 189 patients were non COVID-19 related ARF and 141 met the criteria for acute respiratory distress syndrome (ARDS), 64 patients had ARF due to COVID-19, of which 63 patients met criteria for ARDS. Consultation for ECMO was obtained after 3.94 +/- 4.75 days of ARDS and 3.86 +/- 4.91 of Mechanical Ventilation (MV) vs 4.92 +/- 4.67 days of ARDS and 6.11 +/- 4.82 of MV in patients with non-COVID ARF and COVID-19 ARF respectively (p < 0.0001). Patients with non-COVID-19 ARF tended to have higher lactate, more vasopressor needs and were on higher tidal volumes. Prone positioning (67% vs 14.8%;p=0.0001), corticosteroid use (85.9% vs 50.2%, p=0.001) and neuromuscular blockade (87.5% vs 61.3%;p= 0.001) were used more in the COVID-19 ARF group when compared to non-COVID ARF group. There were no statistically significant differences between the two groups in their PRESERVE score, RESP score, Oxygenation Index (OI) or the percentage of patients deemed candidates and initiated on VV-ECMO. In the non- COVID-19 ARF group 30% patients were extubated versus 3.1% patients (p=0.001) in the COVID-19 ARF group, and 32 % patients received tracheostomy versus 47% patients received tracheostomy (p=0.04) in the COVID-19 ARF group. CONCLUSION(S): Patients with ARF and ARDS received ECMO consultation later in the disease course and the use of salvage therapies was more pronounced during the COVID-19 pandemic. There was no difference in risk prognostication scores or use of ECMO in either group. Protocolized ARDS management can help avoid ECMO, subsequent complications and limit resource utilization.
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Background: Major bulk of treatment-related morbidity and mortality in childhood acute lymphoblastic leukemia (ALL) is attributed to infection. The study aimed to analyze the infection profile in children with ALL during maintenance chemotherapy. Method(s): In this 18-month prospective study, clinical and laboratory data of infection profile were collected and analyzed in children with ALL undergoing maintenance chemotherapy at M R Khan Shishu Hospital and Institute of child health, Dhaka, Bangladesh in collaboration with TATA Medical Center, Kolkata, India. Result(s): Of the 42 children, the male to female ratio was 1:1 with the median age of 7.8 years (IQR 4-12.8). Among them, 81% (n=34) had precursor B-ALL and 72% (n=28) had high-risk (HR) disease. Twenty-eight patients (67%) developed infection for a total of 72 episodes and febrile neutropenia (25%) was most common. Major site of infection was lung;21% had upper respiratory tract infection and 8% had radiologically proven pneumonia. Other episodes of infection commonly seen were fever without neutropenia (19%), COVID-19 infection (7%), diarrhoea (4%). Blood culture was positive in only three (4%) infective episodes. Two-third episodes (65%) required hospital admission with no PICU support and infection related mortality. No significant association was found in terms of age, sex, type of ALL, NCI- Risk and type of maintenance therapy with development of infections. Conclusion(s): Although maintenance therapy is considered mild, a significant proportion of children with ALL in maintenance therapy had infective episodes and two-third of them requiring hospital admission. However, no significant association was seen in terms of age, sex, type of ALL, NCI Risk and type of maintenance therapy and infection occurrence. Copyright © 2022
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Background: Acute respiratory distress syndrome (ARDS) occurs commonly in intensive care units. The reported mortality rates in studies evaluating ARDS are highly variable. Objective: To investigate mortality rates due to ARDS from before the 2009 H1N1 influenza pandemic began until the start of coronavirus disease 2019 (COVID-19) pandemic. Design: We performed a systematic search and then ran a proportional meta-analysis for mortality. We ran our analysis in three ways: for randomised controlled trials only, for observational studies only, and for randomised controlled trials and observational studies combined. Data sources: MEDLINE and Embase, using a highly sensitive criterion and limiting the search to studies published from January 2009 to December 2019. Review methods: Two of us independently screened titles and s to first identify studies and then complete full text reviews of selected studies. We assessed risk of bias using the Cochrane RoB-2 (a risk-of-bias tool for randomised trials) and the Cochrane ROBINS-1 (a risk-of-bias tool for non-randomised studies of interventions). Results: We screened 5844 citations, of which 102 fully met our inclusion criteria. These included 34 randomised controlled trials and 68 observational studies, with a total of 24 158 patients. The weighted pooled mortality rate for all 102 studies published from 2009 to 2019 was 39.4% (95% CI, 37.0–41.8%). Mortality was higher in observational studies compared with randomised controlled trials (41.8% [95% CI, 38.9–44.8%] v 34.5% [95% CI, 30.6–38.5%];P = 0.005). Conclusions: Over the past decade, mortality rates due to ARDS were high. There is a clear distinction between mortality in observational studies and in randomised controlled trials. Future studies need to report mortality for different ARDS phenotypes and closely adhere to evidence-based medicine. PROSPERO registration: CRD42020149712 (April 2020). © 2022, College of Intensive Care Medicine. All rights reserved.
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SESSION TITLE: Pulmonary Issues in Transplantation Case Report Posters SESSION TYPE: Case Report Posters PRESENTED ON: 10/19/2022 12:45 pm - 01:45 pm INTRODUCTION: Fibrotic interstitial lung disease (fILD) can be idiopathic or associated with several underlying conditions and in response to various types of injury. Post COVID-19 fILD is an increasingly recognized clinical entity with the potential for a large burden of morbidity and mortality.[1] We present a series of 6 patients with progressive pulmonary fibrosis as sequela of COVID-19 requiring lung transplantation. CASE PRESENTATION: Four of the 6 patients had known underlying chronic ILD prior to COVID-19 infection (2 with idiopathic pulmonary fibrosis [IPF] and 1 each with scleroderma and rheumatoid arthritis associated ILD). The other 2 patients had no prior history of lung disease and asymptomatic before infection. One of these had a strong family history of IPF. The presentations involved signs of progressive respiratory failure after the initial lung injury from COVID-19. 4 patients were hospitalized during their acute COVID-19 illness and had varying treatments including steroids, antibiotics, anti-virals, convalescent plasma, Tocilizumab, and non-invasive positive pressure ventilation. At the time of transplant evaluation, CT imaging showed prominent interstitial thickening, honeycombing consistent with fibrotic processes for all our patients;PFT revealed severe restrictive ventilatory defect with reduced diffusion capacity ranging 24%-53%;3 patients required venous-venous extracorporeal membrane oxygenation (ECMO) as a bridge to transplantation for 14 and 93 days. The remainder required 6-10 L of supplemental oxygenation at rest. Two patients underwent initial transplant evaluation while in respiratory failure.5 patients received bilateral lung transplantation and one single left lung transplantation.Duration of time between initial COVID-19 induced lung injury and transplantation ranged from 3-13 months, with a median 6-7 months.Lung explant pathology showed advanced usual interstitial pneumonia in all. Superimposed diffuse alveolar damage was noted in 3 cases. Post-transplant to discharge ranged 10-31 days and at 2 months follow-up, all patients were liberated of oxygen needs. All subjects remain alive at a median 11-12 months, with no evidence of allograft dysfunction. DISCUSSION: Since the emergence of SARS-COV2 in 2019, histopathological fibrotic anomalies have been found to be present in up to one-third of those who recover from ARDS due to COVID-19 [2] and their incidence increases as duration of ARDS increases [3]. Further work is required to understand the pathogenesis of the fibrotic process following acute COVID-19. CONCLUSIONS: We highlight this syndrome with our case series of 6 patients who showed progressive fibrotic disease after COVID-19. Patients with pre-exiting ILD appear to be particularly at risk but this entity may occur in those without pre-existing ILD. Lung transplantation offers a viable treatment option for selected patients with an otherwise poor prognosis. Reference #1: 1.Bharat, A., Querrey, M., Markov, N. S., Kim, S., Kurihara, C., Garza-Castillon, R., Manerikar, A., Shilatifard, A., Tomic, R., Politanska, Y., Abdala-Valencia, H., Yeldandi, A. V., Lomasney, J. W., Misharin, A. V., & Budinger, G. (2020). Lung transplantation for pulmonary fibrosis secondary to severe COVID-19. medRxiv : the preprint server for health sciences, 2020.10.26.20218636. https://doi.org/10.1101/2020.10.26.20218636 Reference #2: 2. Rai DK, Sharma P, Kumar R. Post covid 19 pulmonary fibrosis. Is it real threat?. Indian J Tuberc. 2021;68(3):330-333. doi:10.1016/j.ijtb.2020.11.003 Reference #3: 3. Williamson EJ, Walker AJ, Bhaskaran K, Bacon S, Bates C, Morton CE, Curtis HJ, Mehrkar A, Evans D, Inglesby P, Cockburn J, McDonald HI, MacKenna B, Tomlinson L, Douglas IJ, Rentsch CT, Mathur R, Wong AYS, Grieve R, Harrison D, Forbes H, Schultze A, Croker R, Parry J, Hester F, Harper S, Perera R, Evans SJW, Smeeth L, Goldacre B. Factors associated with C VID-19-related death using OpenSAFELY. Nature. 2020 Aug;584(7821):430-436. doi: 10.1038/s41586-020-2521-4. Epub 2020 Jul 8. PMID: 32640463;PMCID: PMC7611074. DISCLOSURES: no disclosure on file for Philip Camp;research relationship with United Therapeutics Please note: 2016- ongoing by Reda Girgis, value=Grant/Research research relationship with Pfizer Please note: 2014-2020 by Reda Girgis, value=Grant/Research Speaker/Speaker's Bureau relationship with Boehringher Ingelheim Please note: 2016-ongoing by Reda Girgis, value=Honoraria Speaker/Speaker's Bureau relationship with Genentech Please note: 2016-ongoing by Reda Girgis, value=Honoraria No relevant relationships by Ryan Hadley No relevant relationships by Sheila Krishnan No relevant relationships by Sheetal Maragiri No relevant relationships by Edward Murphy No relevant relationships by Jay Patel No relevant relationships by Keval Ray No relevant relationships by Gayathri Sathiyamoorthy No relevant relationships by Neel Shah No relevant relationships by Subhan Toor
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SESSION TITLE: Lung Transplantation: New Issues in 2022 SESSION TYPE: Rapid Fire Original Inv PRESENTED ON: 10/19/2022 11:15 am - 12:15 pm PURPOSE: Immunosuppressed patients are more susceptible to severe infection due to COVID-19. Management of lung transplant recipients is especially difficult due to constant exposure of the graft to the environment, leading to increased risk of rejection and requiring higher levels of maintenance immunosuppressive regimens. Mortality rates for lung transplant recipients with COVID-19 infection have ranged from 15% to 40% in published case series. We report our centers experience in managing lung transplant recipients with COVID-19 infections in a moderate-volume lung transplant center in Grand Rapids, Michigan. METHODS: This is a single center review of all lung transplant recipients with a COVID-19 diagnosis from March 2020 to December 2021. Recipients’ demographics and baseline characteristic, as well as their management, post infectious complications, and mortality data, were reviewed. RESULTS: In 2019, our center performed 48 lung transplants. During the study period, 42 of the 219 (19%) lung transplant recipients followed at our center had COVID-19 infections diagnosed by nasal or nasopharyngeal PCR testing. Twenty-four (57%) were male, mean age of 60.5 (range 25-77). Thirty-six (86%) patients had bilateral lung transplants. The diagnosis leading to their transplantation were COPD (N=18, 43%), idiopathic pulmonary fibrosis (N=12, 29%), cystic fibrosis (N=5, 12%), other pulmonary fibrosis (N=3, 7%), alpha-1 antitrypsin deficiency (N=2, 5%), Sarcoidosis (N=1, 2%), and ARDS (N=1, 2%). Almost all patients were on standard three drug immunosuppressive regimens which included a steroid, calcineurin inhibitor, and nucleotide-blocking agent, at the time of diagnosis. Mean time from transplant to diagnosis of COVID-19 was 34.6 months (range 1 to 104 months). Fifteen (36%) of the patients were unvaccinated. Once diagnosed, patients were advised to monitor their home spirometry and vitals at least daily. They were evaluated weekly via telemedicine by a physician or advanced practice provider. They received the following treatments: monoclonal antibody (N=31, 74%), increased steroids (N=5, 12%), remdesivir (N=2, 5%), Tocilizumab (N=1, 2%). Eleven (26.2%) patients required hospitalization, 4 (10%) required ICU admission and intubation. Mean length of stay was 7.5 days (median of 3 days). Three (7%) patients required oxygen at discharge. Of the 42 infected patients, 3 (7.1%) died on day 3, 16 and 326 days from the date of infection. CONCLUSIONS: Our center reports a lower mortality rate than previously published data in lung transplant recipients infected with COVID-19. We attribute this to availability of the vaccine, early detection and treatment, as well as close monitoring of the patients. CLINICAL IMPLICATIONS: Though COVID-19 infection can have devastating complications in lung transplant recipients, vaccinations and monoclonal antibody treatment reduce morbidity and mortality in this population. DISCLOSURES: No relevant relationships by Phillip Camp research relationship with United Therapeutics Please note: 2016- ongoing by Reda Girgis, value=Grant/Research research relationship with Pfizer Please note: 2014-2020 by Reda Girgis, value=Grant/Research Speaker/Speaker's Bureau relationship with Boehringher Ingelheim Please note: 2016-ongoing by Reda Girgis, value=Honoraria Speaker/Speaker's Bureau relationship with Genentech Please note: 2016-ongoing by Reda Girgis, value=Honoraria no disclosure on file for Ryan Hadley;No relevant relationships by Sheila Krishnan No relevant relationships by Edward Murphy No relevant relationships by Gayathri Sathiyamoorthy
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Background: Obesity in children has reached epidemic proportions in the United States, and increased weight gain in school-aged children during summer months has been well documented. During the COVID-19 pandemic in the United States, there was concern that extended school closures would lead to increased obesity due to risk factors including more sedentary lifestyle and increased caloric intake. Obesity has multiple effects on asthma including on lung function and response to therapy. Significant weight gain in children with asthma during the pandemic could have sequelae beyond the known health effects of overweight and obesity in the general population. Methods: A retrospective chart review was performed of patients aged 6-18 years with asthma, seen in-person at a predominantly suburban pediatric pulmonology practice during four office visits from four time periods: January-April 2019 and July- October 2019 (pre-pandemic), January- April 2020 and July- October 2020 (pandemic). For each visit, data was collected on current height, weight, asthma medications, recent hospitalizations and exacerbations requiring systemic steroids. BMI and BMI percentile for age were calculated and patients were categorized by weight status based on Centers for Disease Control (CDC) definitions. Asthma severity was classified based on current therapies as per the Expert Panel Report-3 guidelines. Prevalence of overweight and obesity during each of the time periods was compared. Mean change in BMI between the two time periods in 2020 were compared to mean change in BMI between the two time periods in 2019. Results: 267 patients were included. Mean age was 10.0 + 2.5 years at the beginning of the study. 163 patients (61%) were male. 50.9% were overweight or obese during the pandemic compared to 46.8% in the previous year (p=0.34). Mean change in BMI was 0.81± 1.75 during the pandemic as compared to 0.5 ± 0.95 in the previous year (p = 0.01). Figure 1 demonstrates that BMI steadily increased for children in all weight categories for the first three time periods. Unlike normal weight children, BMI of overweight or obese children decreased during the last time period, i.e., the pandemic summer (2020). There were no differences in mean change in BMI during the pandemic compared to the year prior when stratified by sex, age group, type of insurance, asthma severity or prior CDC weight category. (Table 1). Conclusion: In this single-site retrospective study of children with asthma, there was a greater overall increase in BMI during the pandemic as compared to the previous year. However, children who were overweight or obese were more likely to lose weight during the pandemic. Reasons for this are unclear, but in this suburban community, may include increased participation in family outdoor activities and better nutrition with increased consumption of home-cooked foods in at-risk children.
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The present study is aimed at examining the wellbeing of palliative care workers in India (n = 114) with special reference to work related variables. The World Health Organization's five item wellbeing index was used to measure the wellbeing of the respondents. In general, the wellbeing of the respondents was found to be good. Furthermore, the age of the respondent (p < 0.001), gender (p < 0.05), work setting (hospital vs. non-hospital) (p < 0.05), work environment (p < 0.01), recent unemployment (job loss) (p < 0.01), years of experience in palliative care (p < 0.05), number of hours of work per week (p < 0.05), and the number of clients who died in the previous month (p < 0.01), were all found to be associated with the wellbeing of the respondents. Specifically, young and female respondents, those engaged in hospital based palliative care, having a poor work environment, facing recent unemployment, having less experience, working for more number of hours, and having more number of patients dying in the previous month, all had a lower level of wellbeing. The implications for social work practice have also been discussed in detail.
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Background & Aim: Background: Traditionally, ‘fresh’ Hematopoietic progenitors cell (HPC) infusions have been preferred over cryopreserved HPC in Allo-HCT because cryopreservation and thawing leads to cell loss, besides DMSO-related adverse reactions in patients. Emergence of COVID-19 pandemic has severely affected fresh HPC infusions and most professional bodies recommend cryopreservation of HPC products before initiating conditioning chemotherapy. Although some western studies suggest no significant impact of graft manipulation on patient outcome, there is no available data from the developing world.Aim: We compare neutrophil and platelet engraftment in patients undergoing Allo-HCT with fresh and cryopreserved HPC products. Methods, Results & Conclusion: Material and Method: Allo-HCT data from October 2018 to October 2021 were analyzed. Cryopreservation was performed by controlled-rate freezing using 10% DMSO, plasmalyte- A and human albumin ( 1:2:1) as cryoprotectant. Cryopreserved products were stored in vapour-phase of Liquid nitrogen tank. CD34+ enumeration and viablity( by 7-AAD) was done on Flow-cytometry on fresh and post-thaw HPC samples. Neutrophil engraftment was defined as absolute neutrophil count >0.5 ×109/L for 3 days. Platelet engraftment was defined as independence from platelet transfusion for at least 7 days with a platelet count >20 × 109/L. Statistical analysis using Wilcoxon Rank Sum test. Results: Ninety-six patients underwent allo-HCT (46 received fresh and 50 received cryopreserved HPC products) (Table 1). There was no significant difference in neutrophil engraftment with fresh and cryopreserved grafts (p>0.05) in different types of transplants( Matched related/unrelated and haploidentical). 22% (11/50) of cryopreserved graft infusions were associated with Grade-1 DMSO-related adverse reactions, which were managed with symptomatic treatment. Cryopreservation increased the cost of related allogeneic transplants by USD1100. No cryopreserved HPC product was culture positive on microbiological assessment. Conclusion: In our experience, the engraftment kinetics were similar with fresh and cryopreserved HPC products as CD34+cell dose administered was almost the same. Cryopreserved grafts had a median 7% CD34+cell loss, associated with mild DMSO-related adverse reactions and cost increment. Even though, graft cryopreservation is a feasible alternative during the pandemic, it is crucial to ensure graft quality and promptly manage DMSO-related adverse reactions.(Table Presented) Table 1 Comparison of Fresh and cryopreserved HPC products in Allo-HCT
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Background. Work-related musculoskeletal disorders (WRMSDs) have become an increasing cause of concern among sonologists. In this study, we evaluate the incidence and risk factors for WRMSDs among sonologists in the pre-COVID-19 and present COVID-19 era while identifying high-risk zones for WRMSDs and providing a brief review of optimal working conditions to avoid WRMSDs. Methods. A "Google form" questionnaire with close-ended questions regarding musculoskeletal discomfort was sent to 350 radiologists during the period of February-March 2021. Data was collected by time-based sampling over a period of 15 days. Statistical analysis was performed using SPSS version 26. Results. 77% (n = 100) of the respondents reported suffering from musculoskeletal discomfort, and 70% (n = 100) attributed such discomfort to their profession as a sonologist (p = 0.001). Among sonologists who attributed their musculoskeletal discomfort to their profession, shoulder pain (p = 0.001), neck pain (p = 0.001), lower back pain (p = 0.001), and wrist pain (p = 0.017) were the most common symptoms. When musculoskeletal discomfort was attributed to the profession, a statistically significant association was found with stress level during the COVID-19 pandemic (p = 0.001) and musculoskeletal discomfort attributed to using extra barrier precautions such as transparent screens during ultrasound (US) scans (p = 0.009). Conclusions. Adapting to new safety and ergonomics is the need of the hour. A regular review of the work practices adopted by sonologists, especially in the current context of COVID-19, enforced protective strategies may greatly help in risk identification and minimizing the precipitation of WRMSDs.
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Social distancing is the one of the preferred ways to get out of the current situation and it has become difficult to follow it. Most people use public transport as a medium to travel. It becomes very difficult to maintain an effective social distance in public transports. So, we have planned to give a solution to address this problem by ensuring safeness in buses. Here, we kept a fixed limit for persons entering into the bus and before that they had to pass the temperature check and mask detection checks. The device consists of a Raspberry pi Module which acts as a system, a Camera module, PIR Sensors, Infrared Temperature Sensors, LCD Monitor. LCD Monitor shows the details of the number of persons that can be accommodated in a particular bus and the number of people present inside the bus. Temperature sensors, such as infrared temperature sensors, are used to detect the temperature of people entering the bus. It is captured and determined whether or not the person is wearing their mask in the entrance by the Camera Module. PIR Sensors are used to monitor the count of the persons entering or exiting the bus which is displayed in the LCD monitor. So, these work together and make the entry screening while entering a transport system. © 2022 IEEE.
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Introduction: Disaster planning is of significant importance for the healthcare professional and the healthcare setting. Hospital-based disaster protocols form the cornerstone of disaster response. There is a paucity of data on disaster preparedness training using the Virtual Tabletop exercise (VTTX) module for interprofessional education from in-hospital and prehospital settings. With the COVID-19 pandemic, we have seen a paradigm shift of education strategies to the virtual realm. Here we attempt to study the impact of an online tabletop exercise workshop on the knowledge and confidence of disaster preparedness among Interprofessional trainees. Methods Interprofessional trainees from medical, dental, nursing, respiratory therapy, and paramedic domains who consented were included in this study. Institutional ethics committee approval was received and the study was registered with the clinical trials registry India (CTRI), before initiation. The VTTX module has been adapted from the WHO COVID-19 training resources. Three international experts from the disaster medicine domain validated the module, questionnaire, and feedback. Wilcoxon signed-rank test was used to compare the parameters (Knowledge and confidence level) pre and post-workshop. Results A total of 76 candidates with a mean age was 21.67 ± 2.5 (Range:19–36) were part of the workshop. Comparison of the median scores and interquartile range of confidence level and knowledge respectively before [38 (29.25–45.75), 9 (7–11)] and after [51.50 (45–60), 11 (10–12)] the workshop showed vital significance (P-value