ABSTRACT
Background Nearly after 6 months of the spread of Corona Virus Disease 19, along with the world Nepal is still trying to control the spread and prevent general population from acquiring it. With limited resources in manpower, technology and evidence it has been a difficult battle. But with time and more understanding of the virus new technology to detect the virus are coming up. It is a major breakthrough in the diagnostic field as this helps us in not only detecting the virus but also helps us to mobilize our human resources. This comes in a time where the cases are increasing at an alarming rate. Although numbers of Polymerase Chain Reaction testing have increased but due to the time consuming and the cost wise, we need a faster and equally reliable alternative. Antigen test approved by different countries can be used for point of care, screening and surveillance depending upon the requirements after calculating its sensitivity, specificity and accuracy. Objective To find out sensitivity and specificity of the Antigen test kit for COVID-19. Method Antigen tests were compared with Reverse Transcription Polymerase Chain Reaction as a reference standard in calculated sample size of 113 subjects in a high risk population. Both Reverse Transcription Polymerase Chain Reaction and antigen test were performed in a same subject with in maximum of 2 days' interval. Convenience sampling technique was used to select the subjects. Ethical approval was taken from Nepal Health Research Council before data collection. Study was done from August to September 2020 from Quarantine center of Province 3. Result There were total of 113 test carried out, among those 47 were positive and 66 were negative in Reverse Transcription Polymerase Chain Reaction. After preparing two by two table, Sensitivity and specificity of the tested was calculated which came out to be 85% and 100% respectively, with accuracy of 93.80%. Conclusion Even though the sensitivity and specificity came to be higher, this test should be interpreted cautiously depending upon the prevalence of Corona Virus Disease 19 in that particular community and the clinical and epidemiological context of the person who has been tested. When in doubt by clinical correlation should be confirmed with Reverse Transcription Polymerase Chain Reaction. Copyright © 2020, Kathmandu University. All rights reserved.
ABSTRACT
Background: Nationally agreed hip fracture standards have contributed to the improvement of outcomes in hip fracture patients. In 2020, our hospital was awarded “The Golden Hip” for achieving highest compliance with Irish Hip Fracture Standards (IHFS) nationally for 2019. Methods: Data from the Irish Hip Fracture Database (IHFD)was retrospectively analysed to assess our performance in 2020 versus 2019 in hip fracture patients over sixty. Multiple quality improvement interventions were put in place throughout 2019 to ensure improvement in IHFS1-6 compliance: Creation of the Hip Fracture Pathway Subgroup, IHFS 1 Breaches Audit, Orthogeriatric input at Orthopaedic inductions, weekly Multi-disciplinary Team meetings, a Nutritional Hip Fracture Pathway and addition of the Fracture Liaison Service Advanced Nurse Practitioner. Results: There were 239 hip fracture patients in 2020 vs 249 in 2019. IHFS1 compliance improved with the percentage of patients admitted to the Orthopaedic ward within 4 hours increasing to 71% in 2020 from 56% in 2019. There was improvement in IHFS2-time to surgery <48 hours- 66% in 2020 vs 60% in 2019. IHFS3-pressure ulcer rate-was at the national average, 3% in 2020 vs 2% in 2019. IHFS4 (reviewed by a Geriatrician), IHFS5 (received a bone health assessment) and IHFS6 (received a specialised falls assessment) were lower overall;87% in 2020 vs 98% in 2019. For all quarters (Q),43% of patients met all IHFS in our hospital in 2020 vs 32% in 2019, resulting in €90,000 in Best Practice Tariff funding. Conclusion: Lower results for IHFS 4,5 and 6 reflect the arrival of the COVID-19 pandemic which led to redeployment of the Orthogeriatric Service and redeployment of the MDT from end of Q1 to Q3. When services in 2020 were preserved,1 in 2 hip fracture patients met all IHFS, vs 1 in 3 patients in 2019. Despite the pandemic, we continued to achieve the highest level of IHFS compliance nationally, being awarded a second consecutive “Golden Hip” for 2020.
ABSTRACT
Background: Scotland first demonstrated that adherence to nationally agreed hip fracture standards improve patient survival, reduces the duration of admission, and reduces the need for high dependency care. Our study aims to assess adherence to the Irish Hip Fracture Standards (IHFS) in our hospital for 2021 amidst the COVID-19 pandemic, translating to improved clinical outcomes for our patients. Methods: The IHF database was retrospectively analysed, comparing quarters 1-4 in 2021 with our 2020 results. Results: IHFS1, patient time to the ward < 4hours, was maintained at 67% in 2021 versus 71% overall in 2020. There was improvement in IHFS2, time to surgery within 48 hours, up to 73% in 2021 versus 66% in 2020. IHFS3 was 4% in 2021 versus 3% overall in 2020. Further improvements were noted for IHFS4, with 95% of patients reviewed by a Geriatrician in 2021 versus 87% in 2020. IHFS5 also improved with 97% of patients receiving a bone health assessment in 2021 versus 87% in 2020. Moreover, IHFS6, improved with 97% of patients undergoing a specialised falls assessment in 2021 versus 87% in 2020. Conclusion: The improvement in 2021 figures is reflective of the return of redeployed services during the COVID-19 pandemic inclusive of the Orthogeriatric Service, the Fracture Liaison Service Advanced Nurse Practitioner, the Trauma Co-ordinator, and the specialist Orthopaedic ward complete with its Orthopaedic nurses and Multi-Disciplinary Team, and improved Emergency Department pathways. These continued improvements in the IHFS further emphasise that success is dependent on a team that is joined at the hip
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Introduction We have 262 patients under the care of older persons movement disorders service in East Suffolk, whom due to a combination of retirement and COVID pandemic hadn’t seen a consultant for their follow up in up to 18 months. There are the facilities to see patients closer to their homes with satellite outpatient clinics in Eye, Stowmarket, Felixstowe and Aldeburgh, and via telephone and video consultation. We found that 137 of these patients live in rural areas closer to these satellite clinics. An opportunity was sensed to tailor the future service to the preferences of our patients, with the aim of improving experience and satisfaction. Method We sent a postal survey to these 137 patients asking them about the importance of having one responsible consultant, the type and location of their appointment. Results We sent a postal survey to these 137 patients, we received 81 Reponses. 91% of respondents ranked it either important, quite important or very important that they see the same consultant. It was the 1st preference to be seen at a local healthcare facility with 71% of patients choosing this as their first choice versus 22% for Ipswich hospital. 7% had a 1st preference of telephone appointment. 0 patients had a 1st choice preference of video conference it was the least favourable preference for 52% of respondents. Conclusion Our cohort of patients place a high value on continuity of care and would prefer to be seen at a community clinic that is closer to home. These preferences have been discussed with PDUK and CCG and have informed how we deliver our service as of August 2021 with all patients having a locality based clinic and named consultant. Our results are at odds with the ethos of NHSX [1] and the drive to see patients virtually.
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Stock market is place where financial securities tradingtakes place of public companies. Public company first liststheir shares in the primary market. There are two primarymarket in context of India that is bombaystockexchnage (bse) and national stock exchange(nse). Investors can buy and sell their shares throughsecondary market. Covid-19 changed every event extraordinarily. Due to covid-19 caused "lockdown"everyeconomic sector went down due to no monetary transactionand shut down of every business sector. Indian economy hadnever experienced such a massive breakdown in both demandand supply in its past. The share market first hit the economy downturn at the beginning of the pandemic and the after some month the market increased in increasing order as thecovid-19 decreased.in this study we consider the aspects like gdp, indianeconomy, gold market, stock market-covid 19, stock return, investor behavior and economy downturn. © 2022 Author(s).
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This study examines the effect of strategies adopted by Chitkara International School for the continuous improvement of online learning of kindergarten students, during the transition of classes from offline mode to online mode. The objective of this study is to increase the interest of the students in online classes, to increase the engagement of the parents in the child's learning process and upskilling the teachers for handling online classes during COVID-19 time. The study was conducted on 373 kindergarten students, parents and 25 teachers of Chitkara International School. The study was conducted using Pre-test-post-test single group design. The sample was analysed based on the qualitative and quantitative data. The findings of the study reported that there was significant improvement in the attendance of the students of the kindergarten classes, the cooperation and involvement of the parents increased and there was a significant increase in the participation of the students in all the activities. This study was conducted with a purpose of providing Quality Education to students even during Covid times and all efforts were made in sync with the Sustainable Development Goal 4 which focusses on Quality Education. © The Electrochemical Society
ABSTRACT
Background: Nearly after 6 months of the spread of Corona Virus Disease 19, along with the world Nepal is still trying to control the spread and prevent general population from acquiring it. With limited resources in manpower, technology and evidence it has been a difficult battle. But with time and more understanding of the virus new technology to detect the virus are coming up. It is a major breakthrough in the diagnostic field as this helps us in not only detecting the virus but also helps us to mobilize our human resources. This comes in a time where the cases are increasing at an alarming rate. Although numbers of Polymerase Chain Reaction testing have increased but due to the time consuming and the cost wise, we need a faster and equally reliable alternative. Antigen test approved by different countries can be used for point of care, screening and surveillance depending upon the requirements after calculating its sensitivity, specificity and accuracy.
ABSTRACT
Background Nearly after 6 months of the spread of Corona Virus Disease 19, along with the world Nepal is still trying to control the spread and prevent general population from acquiring it. With limited resources in manpower, technology and evidence it has been a difficult battle. But with time and more understanding of the virus new technology to detect the virus are coming up. It is a major breakthrough in the diagnostic field as this helps us in not only detecting the virus but also helps us to mobilize our human resources. This comes in a time where the cases are increasing at an alarming rate. Although numbers of Polymerase Chain Reaction testing have increased but due to the time consuming and the cost wise, we need a faster and equally reliable alternative. Antigen test approved by different countries can be used for point of care, screening and surveillance depending upon the requirements after calculating its sensitivity, specificity and accuracy. Objective To find out sensitivity and specificity of the Antigen test kit for COVID-19. Method Antigen tests were compared with Reverse Transcription Polymerase Chain Reaction as a reference standard in calculated sample size of 113 subjects in a high risk population. Both Reverse Transcription Polymerase Chain Reaction and antigen test were performed in a same subject with in maximum of 2 days’ interval. Convenience sampling technique was used to select the subjects. Ethical approval was taken from Nepal Health Research Council before data collection. Study was done from August to September 2020 from Quarantine center of Province 3. Result There were total of 113 test carried out, among those 47 were positive and 66 were negative in Reverse Transcription Polymerase Chain Reaction. After preparing two by two table, Sensitivity and specificity of the tested was calculated which came out to be 85% and 100% respectively, with accuracy of 93.80%. Conclusion Even though the sensitivity and specificity came to be higher, this test should be interpreted cautiously depending upon the prevalence of Corona Virus Disease 19 in that particular community and the clinical and epidemiological context of the person who has been tested. When in doubt by clinical correlation should be confirmed with Reverse Transcription Polymerase Chain Reaction.