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We retrospectively report a case of rapid exchange of a percutaneous radiologic gastrostomy tube (balloon-occluded type catheter) via off-label use of a pigtail catheter for nutrition supply during a very early episode of coronavirus disease 2019 (COVID-19) in an outpatient clinic. This case demonstrates that minimally invasive percutaneous procedures might be provided safely and effectively under appropriate precautions for preventing COVID-19 transmission during the pandemic.Copyright © 2023, Society of Gastrointestinal Intervention.
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Objective: The objective of this study is to evaluate the awareness of cross-infection control measures followed by DHCPs during the 5th wave of Covid-19 pandemic, Omicron variant in a government sector university of Karachi, Pakistan. Method(s): A Cross-sectional study was conducted from June till September 2022 at Sindh Institute of Oral Health Science during the 5th wave of Covid 19 pandemic, Omicron variant. Data was collected from 153 DHCPs from government sector university using a self-administered questionnaire, comprising of 20 closed ended question to assess the awareness and practice of cross infection protocols by DHCPs. Result(s): 98.7% of the participants were vaccinated against Covid 19. 96% of the participants used surgical gowns, face shields, and face masks as part of PPE during examining patients and while performing procedure. After treatment 99.3% of participants washed hands with hand wash, soap or used antiseptic solution. 77.1% of participants asked for Covid 19 test report and 68.6% of participants asked for proof of vaccination against covid 19 before treating patients. 96.1% of participants recommended disinfection of dental unit after every patient. 98% of participants changed glove after every patient. 88.2% of the participants said they would carry all elective and emergency procedures. Conclusion(s): The results of this study show that DHCPs practicing at government sector university have adequate knowledge regarding prevention of cross infection protocols and their importance to limit spread of infections. But their practice of prevention of cross infection during Covid 19 pandemic is not ideal as percentage of DHCPs requiring proof of vaccination or negative reports for Covid 19 were rather low and the percentage of DHCPs willing to carry elective procedures along with emergency ones was rather high.Copyright © 2023 Lahore Medical And Dental College. All rights reserved.
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The purpose of research was to study practices, barriers, and solutions of Phetchabun health massage establishments under COVID-19 situation. Non-participant observation, informal interview, in-depth interview, and participation observation were carried out respectively. Purposive sampling was used with 15 health consumer protection officers in charge;11 district level, 2 provincial level, 2 regional level as well as each representative of 11 districts. Results after implementation of "Preparation Guidelines for Health Spa, Health Massage, and Beauty Massage to Promote Health Tourism During COVID-19 Pandemic" were categorized into two sections. Firstly, the practices, barriers, and solutions of government officer performances included preparation for reopening, monitoring of the provider practices, and performance report. Secondly, the provider operations consisted of doing "Self-Assessment of Health Establishment", logging-in webpage before reopening, and practices for clients included screening and report of patients under investigation, establishment monitor, service, and establishment cleaning. In summary, the preparation guidelines were purposed to reopen their business with numerous contents and messages written by official language, it caused establishment providers and practitioners difficultly understood when applying. LINE Application and making calls were easy and accessible methods for their communication to reach current data and to ensure exact information. Various encouragements and having compliments were also considerable to form trust and confidence among them, they also raised their proud.Copyright © 2023, World Informations Syndicate. All rights reserved.
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Background Since March 2020, Chile has been affected by the coronavirus disease 2019 (COVID-19) pandemic, which has caused disruptions throughout the world, greatly impacting health services and healthcare workers. Objective To describe the demographic characteristics related to the COVID-19 pandemic in orthopedic surgeons and orthopedic surgery residents in Chile. Methods We conducted an on-line survey requesting data on demographics, work, exposure to and infection by COVID-19, symptoms, and protection practices. Results A total of 567 surgeons answered the survey;37 (6.4%) had had COVID-19, without gender differences. Therewas a higher rate of infectionamong residents, 9 from73 (12.3%), than among surgeons, 28 from 494 (5.7%), as well as higher rates of infection among those working more than 60 hours (p<0.05). Among those infected, 31 (83.8%) were from the Metropolitan Region (MR), where the rate of infection was significantly higher compared with other regions (p< 0.05). Only 8 (21.6%) of those infected had medical history. Hospitalization was required by 3 (5.4%), 1 of them in the Intensive care Unit (ICU), and the remaining were handled at home. The most frequent location of infection was the workplace, with the common areas being the main suspected sites, followed by outpatient clinics and orthopedic surgery wards. In total, 40.5% (15) of the sample reported having infected other individuals. There was also an impact in the surgeon s income: 14.8% (84) reported a decrease lower than 20%, and 45% (256), a decrease higher than 50%. This decrease was higher among surgeons than among residents, and higher among those from the MR compared to other regions (p< 0.05). Conclusion Even though orthopedic surgery practice has been reduced by the pandemic, orthopedic surgeons have been exposed to the risk of infection by COVID-19. The workplace seems to be the site that poses the greatest risk, especially the common areas.Copyright © 2022 Georg Thieme Verlag. All rights reserved.
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Introduction: The COVID-19 pandemic highlighted the importance of the use of personal protective equipment (PPE) such as a face shield, face mask, and protective eyewear by Health Care Workers (HCWs). Research has documented that usage of PPEs could lead to musculoskeletal disorder (MSDs), headache, impingement of neck etc. Objective(s): To identify the perceptions of face-shield use and its relation to MSDs among Health Practitioners (HPs). Material(s) and Method(s): An online cross-sectional survey was conducted among 145 Health Practitioners (HPs) in Chennai during April and September 2021 to identify their perceptions about wearing a face shield and MSDs using a validated self-administered questionnaire. We analysed the data using Pearson's chi-squared test on SPSS. Result(s): Among 145 HPs, 52.4% reported to have experienced MSDs. 44.7% of the HPs reported MSDs due to continuous wearing of the face shield. This was found to have a significant association. It was found that 95% of the HPs reported discomfort and poor visual clarity. The MSD risk was 3.4 times higher among those HPs using PPEs (95% CI: 1.03-11.28;p=0.035). 72% of them perceived that movement restriction due to PPE had caused MSD. Those who perceived thus, were 2.5 times more likely to experience MSD (95%CI: 1.27-5.07;P=0.007). Although, the duration of PPE use was not associated with MSD, 9% of the HPs who work for more than 6 hrs reported higher MSD. A significant association was found between having previous history of work-related MSDs and prevalence of MSDs among the HPs (OR: 9.5;95% CI: 2.71-33.53;p=0.000). Conclusion(s): Majority of the participants perceived discomfort, lack of visual clarity, movement restriction as factors that were found to be significantly associated with MSD among HPs. Recommendation: Hence adaptation and proactive intervention are required to safeguard HPs against the detrimental effects of face shields.
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The coronavirus disease 2019 (COVID-19) pandemic is a challenge for all health care providers (HCPs). Anesthesiologists are vulnerable to acquiring the disease during aerosol-generating procedures in operating theater and intensive care units. High index of suspicion, detailed history including travel history, strict hand hygiene, use of face masks, and appropriate personal protective equipment are some ways to minimize the risk of exposure to disease. Neurologic manifestations of COVID-19, modification of anesthesia regimen based on the procedure performed, and HCP safety are some implications relevant to a neuroanesthesiologist. National and international guidelines, recommendations, and position statements help in risk stratification, prioritization, and scheduling of neurosurgery and neurointervention procedures. Institutional protocols can be formulated based on the guidelines wherein each HCP has a definite role in this ever-changing scenario. Mental and physical well-being of HCPs is an integral part of successful management of patients. We present our experience in managing 143 patients during the lockdown period in India.Copyright © 2020 Wolters Kluwer Medknow Publications. All rights reserved.
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One fundamental question about any novel pathogen is: how does it transmit? Answering this question will help to protect ourselves from the agent, at least until effective vaccines and antiviral therapies can be developed, especially if it is an agent of moderate to high lethality. Initially, at the start of the Coronavirus disease 2019 (COVID-19) pandemic, more emphasis was placed on handwashing rather than on droplet and aerosol transmission. Although severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2)-infected secretions such as saliva can spread the virus to hands, it became increasing evident that the virus mostly transmitted through close contact (though not necessarily touching), whilst people were breathing, talking, laughing, singing, coughing and sneezing near one another. During such respiratory activities, droplets and aerosols are produced together, and the amount of transmission due to these differentsized liquid particles will likely vary between individuals at different stages of their infection and illness. This question became even more complex as it emerged that viral transmission can occur for several days before symptom onset, and that asymptomatic cases can also shed just as much virus and potentially transmit it just as well as symptomatic cases. This chapter summarizes our understanding of how SARS-CoV-2 transmits and the infection control precautions to reduce this. © 2023 by World Scientific Publishing Co. Pte. Ltd.
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Due to global supply chain disruptions and high demand for personal protective equipment (PPE), the rapidly expanding COVID-19 crisis left millions of front-line fighters unprotected. The disposal of PPE in the environment caused significant environmental pollution. Hence, indigenous initiatives have been taken to fabricate antiviral and biodegradable face shields with the help of neoteric and cleaner technologies. This paper describes a novel endeavor to design, manufacture, and performance analysis of a face shield made by plastic injection molding and LASER Cutting. Because of the requirement of permanent wear, the face shield's ergonomic design is considered low weight and easy head fixation, alongside high production ability. Here, face shield frames are made with lightweight, biodegradable plastic called Poly Lactic Acid (PLA), whereas an optical grade PLA sheet is used as the visor for better clarity. Visors PLA Sheet is coated with Nano-Silver disinfectant spray to incorporate antiviral properties to the Faceshield. Partially circumferential adjustable elastic straps are used for comfortable head fixation. To evaluate the product, clinical fit tests along with statistical survey were conducted, and the feedback from the end-users on comfort (41% Excellent, 30% Good, 26% Average and 3% Poor), clear view (33% Excellent, 38% Good, 24% Average, and 5% Poor), design features (43% Excellent, 35% Good, and 22% Average), simplicity of installation and disassembly (29% Excellent, 33% Good, and 38% Average), and ease of wearing/removing (45% Excellent, 40% Good, and 15%Average) are encouraging.
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Background: The COVID-19 pandemic was a challenge for all dental professionals who had to rapidly update infection prevention and control (IPAC) guidelines and protocols due to increased risk of SARS-CoV-2 transmission during common aerosol-generating procedures (AGPs), and a lack of consensus on how best to mitigate the risk of transmission in a dental office. Thus, the purpose of this descriptive study was to compare the variance in IPAC guidelines for dental offices that emerged, and to assess practice consistency from early to mid-2020. Methods: A comprehensive literature search was conducted from May 26 to July 8, 2020 for IPAC documentation specific to the dental office during the COVID-19 pandemic. Documents that met the inclusion criteria were independently reviewed. Data was extracted using a framework based on the following IPAC domains: pre-appointment, waiting room, personal protective equipment (PPE) selection, treatment room, and post-dismissal. Results: A total of 67 IPAC documents specific to dental offices were reviewed in this study. Included documents originated from 22 dental associations, 17 peer-reviewed articles, 13 dental regulators, 11 government bodies, two public health units, and two dental corporations. There was a great degree of variance with IPAC guidelines from the pre-appointment stage, during treatment, and post-treatment. Recommendations that emerged with some level of consistency involved pre-screening patients for COVID-19 symptoms (97%), staggering appointments (84%), social distancing, minimizing occupants in the waiting room, wearing a face shield over protective eyewear for AGPs (92%), and preprocedural rinses (84%). There was less consistency with recommendations for consolidating multiple appointments (36%), waiting room ventilation (46%), N95 masks (47%) versus FFP2/FFP3 masks (30%) use for AGPs, fit-testing respirators (37%), enclosing open operatories for AGPs (28%), prioritizing minimally invasive procedures (30%), and using third-party laundry companies (32%). Conclusions: The risk of SARS-CoV-2 transmission, lack of consensus on mode of spread, and need for rapid action resulted in a significant variation in most downstream IPAC interventions in the hierarchy of controls, including choice of PPE, treatment room, and post-dismissal domains. Upstream interventions, including pre-appointment and waiting room domains, were relatively consistent in practices in early to mid-2020.
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BACKGROUND: As all the dental staff, including nurses and practitioners, are exposed to various routes of contamination due to the novel COVID-19 virus, which is still unknown to the scientific world, developing strategies to reduce the risk of transmission and decontaminate surfaces in a dental office would be of high importance. Although there is still insufficient data on managing this virus in dental offices, several studies have suggested protocols for improving care. AIM: This study aimed to review present investigations and reach a conclusion on what we know and need to know to combat this virus. MATERIALS AND METHODS: In this review, Scopus, PubMed, and MEDLINE databases were searched using the keywords "COVID-19,” "SARS-CoV-2,” "Medical Disinfectants,” "Personal Protective Equipment's,” and "Surface Decontamination.” Articles were reviewed, and finally, relevant articles published during 2000–2022 were included in the final paper. RESULTS: The present research concluded that using a combination of the face shield and N95 masks protected the eyes, nose, and mouth. To have more efficient protection, water-resistant long-sleeved gowns and gloves were highly suggested. To overcome aerosols, high-performance air filters and ultraviolet were found quite effective. Allowing the patient to use antiseptic mouthwash before starting the treatment could reduce oral microorganisms and the following airborne contamination. CONCLUSION: This review has gathered all available data regarding dentistry and COVID-19 in order to conclude what has been achieved yet in the prevention of this virus through dental offices;however, more investigations are needed to have a definitive protocol against the virus.
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Face shields (also referred to as visors), goggles and safety glasses have been worn during the COVID-19 pandemic as one measure to control transmission of the virus. However, their effectiveness in controlling facial exposure to cough droplets is not well established and standard tests for evaluating eye protection for this application are limited. A method was developed to evaluate face shields, goggles, and safety glasses as a control measure to protect the wearer against cough droplets. The method uses a semi-quantitative assessment of facial droplet deposition. A cough simulator was developed to generate droplets comparable to those from a human cough. The droplets consisted of a UV fluorescent marker (fluorescein) in water. Fourteen face shields, four pairs of goggles and one pair of safety glasses were evaluated by mounting them on two different sizes of breathing manikin head and challenging them with the simulated cough. The manikin head was positioned in seven orientations relative to the cough simulator to represent various potential occupational exposure scenarios, for example, a nurse standing over a patient. Droplet deposition in the eyes, nose and mouth regions were visualised following three 'coughs'. Face shields, goggles, and safety glasses reduced, but did not eliminate exposure to the wearer from droplets such as those produced by a human cough. The level of protection differed based on the design of the personal protective equipment and the relative orientation of the wearer to the cough. For example, face shields, and goggles offered the greatest protection when a cough challenge was face on or from above and the least protection when a cough challenge was from below. Face shields were also evaluated as source control to protect others from the wearer. Results suggested that if a coughing person wears a face shield, it can provide some protection from cough droplets to those standing directly in front of the wearer.
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Background: Healthcare workers (HCWs) are most at risk of contracting SARS-CoV-2 and COVID-19 infection. Their preparedness, as a result of provision and access to personal protective equipment (PPE), training programmes and awareness and practices on infection prevention and control measures, is integral for the prevention of infectious disease transmission. Objective(s): This study was conducted to assess the preparedness and practices of HCWs during COVID-19 first wave outbreak in Brunei Darussalam. Method(s): A cross-sectional study using a pre-designed and self-administered web-based questionnaire was conducted among HCWs from government and private health sectors ranging from primary to tertiary health facilities in Brunei Darussalam. Data were analysed using descriptive statistics, and chi-square test was used for statistical significance. Result(s): A total of 511 HCWs participated in the study. Nurses (64%) and HCWs based at hospitals (66%) made up the majority of the study participants, with 74% having occupational exposure to COVID-19 cases. More than 99% of HCWs used respiratory PPE, and 94% used gloves. 74% had undergone respirator fit testing and 65% had received PPE awareness session within the last one year. Coverage in training programmes was found to be low among HCWs from private health facilities. Conclusion(s): Majority of HCWs who had received updated training programmes and therefore were better prepared came from government health facilities. HCWs from private health facilities lacked preparedness training programmes and as such, there needs to be improvement to enhance preparedness measures in light of the ongoing COVID-19 pandemic and for future infectious disease outbreaks. Copyright © The Author(s) 2021.
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This work presents the development of an individual protection device, a smart and active ventilated face shield that can also incorporate an air filtering system. The device can work with the front shield or just with the ventilation structure. The system was produced by additive manufacturing technology, based on a chassis that incorporates an electronic control unit, a rechargeable battery, a fan, and a humidity/temperature sensor. The performed system tests showed that the forced ventilation system prevents fogging even in the most adverse situations and increases user comfort when it is used simultaneously with an individual protective face mask, due to the air flow generated by the integrated fan. The filtered ventilated air guarantees the user's safety. Results also show that, with or without the front visor, the equipment prevents fogging, both on the face shield and glasses for users who wear them. The forced air flow promotes isolation of the breathing zone, decreasing the contact with potentially contaminated aerosols, thus reducing the risk of contagion. © 2022 IEEE.
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This work presents the development of an individual protection device, a smart and active ventilated face shield that can also incorporate an air filtering system. The device can work with the front shield or just with the ventilation structure. The system was produced by additive manufacturing technology, based on a chassis that incorporates an electronic control unit, a rechargeable battery, a fan, and a humidity/temperature sensor. The performed system tests showed that the forced ventilation system prevents fogging even in the most adverse situations and increases user comfort when it is used simultaneously with an individual protective face mask, due to the air flow generated by the integrated fan. The filtered ventilated air guarantees the user's safety. Results also show that, with or without the front visor, the equipment prevents fogging, both on the face shield and glasses for users who wear them. The forced air flow promotes isolation of the breathing zone, decreasing the contact with potentially contaminated aerosols, thus reducing the risk of contagion. © 2022 IEEE.
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The Coronavirus made a new normalization of life where communal distancing and use of masks for covering their face perform an essential part in monitoring the effects of spreading of the corona virus, still the majority of population are found not using face shields or masks in public areas that accelerates the spreading of the corona virus. This might lead to the serious issue of rise in scattering of the disease. Therefore, to neglect any kind of circumstances we are in need to explore and alert the public for wearing masks. Persons can't be deployed for this procedure, as the risk of getting affected by corona virus increases. Henceforth, the presented model for mask detection is surrounded along the theories of artificial intelligence (AI), deep learning, object detection technologies and convolutional neural networks (CNN) which are the key subject of this project. The project performs by recognizing the people are wearing their face shields or masks or not in public areas via utilizing image processing and deep learning practices and transmitting data to the governing authorities. These algorithms for abject detection have been optimized for recognition of people with face masks or not. This paper is attempting for development of a model for real-time monitoring which will turn out to be pretty effective and simple. This model magnificently recognizes whether an individual is wearing a mask or not up to 98% of accuracy as achieved till date and observed that it has yielded outstanding outcomes for the detection. Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.