Role of Non-pharmaceutical Interventions (NPIs) During COVID-19 Pandemic: A Systematic Literature Review

@#Non-pharmaceutical interventions (NPIs) as a means of prevention during the COVID-19 pandemic have gained increasing attention. NPIs are important to reduce infectious diseases and flatten the curve of infection. However, data or literature on the effectiveness of NPIs is scarce. In this review, we aim to investigate the effectiveness of NPIs in the community based on previous literature. A literature search was conducted on seven databases (OVID, EBSCOHOST, WOS, SCOPUS, TRIP, JSTOR, and PUBMED) using the PICO method which yielded 208 articles from 12th March to 1st April 2020. A PRISMA flow diagram and extraction tables were used to analyze the final 14 eligible articles spanning nine countries. There were nine articles on human surveillance, two on patient and contact management, two on community restrictions, and one article discussing the combination of NPIs (quarantine, closure of facilities, and transit site surveillance). With the use of NPIs, there was a significant reduction of infection episodes among the target population. There has been an increasing demand for scientific evidence on NPIs during the COVID-19 pandemic, and present policy recommendations rely heavily on expert judgement. Randomized trials are required to obtain better evidence for these interventions. However, this review will help experts create feasible and widely acceptable policies and protocols for mitigation plans in the absence of definitive evidence.

Occupational Sharps Injury Among Healthcare Workers In Hospital Melaka 2013 – 2015: A Cross Sectional Study

@#Sharps injury imposed a major threat towards safety and health among healthcare workers (HCWs). Many studies in Malaysia concentrated on prevalence of needle stick injury (NSI), however the prevalence of sharps injury among HCWs based on local guideline was still scarce in Malaysia. This information gap leads us to conduct this study. Our study aimed to determine the prevalence of sharps injury among HCWs in Hospital Melaka and to describe the factors among staff with sharps injury. This cross-sectional study was conducted in Hospital Melaka, Malaysia. 165 reported cases from 2013-2015 were reviewed and secondary data extracted. Data was analyzed using IBM SPSS version 20. Among reported sharps injury cases in this study, 65 (39.4%) were male, while 100 (60.6%) were female. The mean age was 27.41 (SD: 6.06). More than half of the reported sharps injury occurred among doctor, 113 (68.5%) specifically House Officer; 89 (53.9%) followed by paramedic, 26 (15.8%) and others, 26 (15.8%). Mostly occurred in ward, 114 (69.1%). The device which accounted for most of sharps injury cases was hypodermic needle, 67 (40.6%). Many of the sharps injury cases occurred while withdrawing needle from patient, 26 (15.9%). Prevalence of sharps injury among HCWs in this study was 0.8% in year 2013, 1.1% in year 2014 and 0.5% in year 2015. Nearly half from the total number of reported sharps injury cases among HCWs in Hospital Melaka were from Medical Department, 71 (43%). Recommended measures include usage of Safety-engineered devices (SEDs) and emphasize on standard precaution.

Understanding Myths in Pregnancy and Childbirth and the Potential Adverse Consequences: A Systematic Review

@#The trend of choosing natural birth at home without proper supervision is gaining more attention and popularity in Malaysia. This is partly due to wrong beliefs of modern medical care. It prompts the need to explore further into other myths and wrong beliefs present in communities around the world surrounding pregnancy and childbirth that may lead to harmful consequences. A total of 25 literatures were selected and reviewed. The most reported wrong belief is the eating behaviour such as avoiding certain nutritious fruits besides eating saffron to produce fairer skinned babies which in fact contains high doses of saffron that may lead to miscarriage. The most worrying myth however, is that unregulated birth attendants such as doulas have the necessary knowledge and skills to manage complications in labour which may well end up in perinatal or even maternal death. Other myths suggested that modern medical care such as vaginal examinations and baby’s heart monitoring in labour as unnecessary. A well-enforced health education programme by well-trained healthcare personnel besides sufficient number of antenatal care visits are needed to overcome these myths, wrong beliefs and practices. In conclusion, potential harmful beliefs and practices in pregnancy and childbirth are still abound in today’s communities, not just in least developed and developing countries but also in developed countries. Women and children are two very vulnerable groups, therefore debunking myths and eliminating harmful practices should be one of a healthcare provider priority especially those in the primary care settings as they are the closest to the community.

Risk Factors for Prolonged Mechanical Ventilation Post Cardiac Surgery in Al Thawra Hospital, Sana'a, Yemen

Prolonged mechanical ventilation among cardiac surgery patient has been found to be correlated with negative clinical outcome and increased healthcare resources utilization. Prolonged mechanical ventilation (PMV) was defined as the accumulative duration of 24 hours or more of postoperative endotracheal intubation starting from transfer of the patient to cardiac ICU. This study is aimed to identify the risk factors preoperative, intra operative and postoperative for prolonged ventilation among cardiac patients in AL-Thawra Modern General Hospital (TMGH). Observational study design was conducted during a two-month period (from 1 August 2014 to 30 September 2014). It was among 70 patients who were admitted to cardiac surgery intensive care unit in Al-Thawra Modern General Hospital and selected by convenient sampling. The soci-demographic characteristic and clinical patient data were collected using short questionnaire developed by researcher. All patients had the same anesthetic and postoperative management. Statistical analysis was performed with SPSS version 20 and using bivariate analysis and multivariate logistic regression. The p-value of < 0.05 was found to be statistically significant. Incidence of prolonged mechanical ventilator post cardiac surgery was 37.1% (26/70) through bivariate analysis, multivariate logistic regression. Low Ejection fraction of Left Ventricle was inversely related to mechanical ventilation time (AOR= 0.872) with 95% confidence interval [0.790 - 0.963], hemodynamic instability were associated with prolonged mechanical ventilation time (AOR=16.35) with 95% confidence interval [2.558 - 104.556]. Low ejection fraction of Left Ventricle and Hemodynamic Instability post operation were identified risk factors for prolonged mechanical ventilation post cardiac surgery.​