Isolation Ward Research Articles

Autonomous Fever Detection, Medicine Delivery, and Environmental Disinfection for Pandemic Prevention

In facing the outbreak of the pandemic, robots are highly appealing for their non-contact nature. Among them, we have selected the mobile robot manipulator to develop an autonomous system for pandemic prevention, as it possesses both mobility and manipulability. The robot was used as a platform for performing autonomous fever detection, medicine delivery, and environmental disinfection system for the fever station and isolation ward, which are the two primary units that deal with the pandemic in a hospital. The proposed novel algorithms aim to ensure both human safety and comfort by automating fever detection and recognizing medicine taking. Additionally, they address environmental disinfection by effectively covering blind spots. We conducted a series of experiments to evaluate their performance in a hospital-like setting, which was designed specifically for the testing of intelligent medical systems developed in our university. Quantitative assessment was administered to analyze how the introduction of the proposed autonomous system reduced the risk of infection, and feedback was also collected from participants through questionnaires.

Investigating the impact of HVAC and Sanitizer system design on the transmission of SARS-CoV-2 in Hospital Isolation Units

The COVID-19 pandemic has presented unprecedented challenges to healthcare facilities worldwide. Hospital isolation units have played a crucial role in the management of COVID-19 patients. However, the transmission of the virus within these units can lead to severe consequences for patients, healthcare workers, and the broader community. This research proposes a framework to evaluate the impact of HVAC (Heating, Ventilation, and Air Conditioning) and sanitizer system design on the transmission of SARS-CoV-2 in isolation unit at Saniat Rmel Hospital in Tetouan Morocco by using computational fluid dynamics (CFD) and the realizable k−ϵ turbulence model. Furthermore, the study investigates the effect of different inlet air velocities on the dispersion of airborne viral particles in the isolation unit. The results indicate that the air change rate plays a critical role in the spread and concentration of pathogens in the isolation unit. It was determined that the high inlet air velocity can lead the particles fluid including the virus reaches the exhaust port in a short time, in addition, it can facilitate the distribution of sanitizer throughout an isolation unit, which could potentially reduce the concentration of the virus. The outcome suggests that the placement and orientation of the air conditioner combined with the sanitizer system have a significant impact on the movement characteristics of fluid particles within the enclosed environment.

SARS-CoV-2 induced urinary tract infection in an infant: a rare case

BackgroundThe incidence of SARS-CoV-2 infection in pediatric population is less than 7% that too when associated with a urinary tract infection, the presentation is very rare. There have been numerous case reports in adults and adolescent population but very few in pediatrics and none in our socioeconomic.Case presentationWe present here the case of a 1-year-old boy with SARS-CoV-2 induced urinary tract infection whose urine biochemistry showed severe urinary tract infection but no hematuria. His COVID-PCR was positive. His chest radiograph showed bilateral lung infiltrates with peri-hilar lymphadenopathy. His computerized tomography scan showed infiltrates with lung fibrosis. He was admitted to the isolation ward, successfully managed, and discharged home after 5 days of in-hospital treatment.ConclusionPediatricians and pediatric emergency physicians should be vigilant and well aware of the atypical presentation of SARS-CoV-2 infection in infants and children, as they can present with both gastrointestinal and renal manifestations. And once missed, the patient may end up with devastating complications.

Using a novel ambulatory monitoring system to support patient safety on an acute infectious disease ward during an unfolding pandemic.

To gain staff feedback on the implementation and impact of a novel ambulatory monitoring system to support coronavirus patient management on an isolation ward. Qualitative service evaluation. Semi-structured interviews were conducted with 15 multidisciplinary isolation ward staff in the United Kingdom between July 2020 and May 2021. Interviews were audio-recorded, transcribed and analysed using thematic analysis. Adopting Innovation to Assist Patient Safety was identified as the overriding theme. Three interlinked sub-themes represent facets of how the system supported patient safety. Patient Selection was developed throughout the pandemic, as clinical staff became more confident in choosing which patients would benefit most. Trust In the System described how nurses coped with discrepancies between the ambulatory system and ward observation machines. Finally, Resource Management examined how, once trust was built, staff perceived the ambulatory system assisted with caseload management. This supported efficient personal protective equipment resource use by reducing the number of isolation room entries. Despite these reported benefits, face-to-face contact was still highly valued, despite the risk of coronavirus exposure. Hospital wards should consider using ambulatory monitoring systems to support caseload management and patient safety. Patients in isolation rooms or at high risk of deterioration may particularly benefit from this additional monitoring. However, these systems should be seen as an adjunct to nursing care, not a replacement. Nurses valued ambulatory monitoring as a means of ensuring the safety of patients at risk of deterioration and prioritizing their workload. The findings of this research will be useful to all those developing or considering implementation of ambulatory monitoring systems in hospital wards. This manuscript follows the Consolidated criteria for Reporting Qualitative Research (COREQ) guidelines with inclusion of relevant SQUIRE guidelines for reporting quality improvement. No Patient or Public Contribution.

A Compliant Self-Stabilization Nanopositioning Device With Modified Active–Passive Hybrid Vibration Isolation Strategy

Micro/mini light-emitting diodes (LEDs) display panel inspection and repairs have a high demand for vibration isolating devices to protect industrial-level atomic force microscopes (AFM scanning head) against vibrations. The motivation of this work is to combine the advantages of both passive and active vibration isolation strategies to improve inspection performance. The developed self-stabilization device achieves this objective with a design that incorporates a suspension-type passive vibration isolation unit and integrates it with the modified active–passive hybrid (MAPH) vibration isolation strategy using piezoelectric ceramics (PZT) and voice coil motors (VCM) as compensators. First, the design, modeling, and optimization of a self-stabilization device are presented based on the MAPH vibration isolation strategy. To satisfy the requirements of vibration isolation performance and a lightweight design, a multiobjective optimization task was conducted. Next, a tailor-made double compensating PID controller was designed to allow this mechanism to run in the MAPH method to effectively isolate vibrations. Finally, a series of validation experiments, including passive vibration isolation performance tests and MAPH closed-loop tests, were applied. From 1 to 500 Hz, more than 98% frequency domain achieved a vibration isolation rate of 90%, the vibration amplification effect of the passive vibration isolation was significantly suppressed, the steady-state positioning accuracy reached <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"><tex-math notation="LaTeX">$\pm 0.1\;\mu$</tex-math></inline-formula> m, load capacity was up to 2.5 kg, the attenuation ratio of the disturbances reached up to 70%, and the heat of the VCM was effectively reduced. All results comprehensively confirmed that the developed compliant MAPH vibration isolation system has achieved a satisfactory self-stabilization function.

Influence of talking behavior of infected patients and the associated exposure risk in a ventilated negative-pressure ward

Negative-pressure isolation ward is a primary choice in preventing the spread of outbreaks and safeguarding patient recovery. Inside the ward, patients with respiratory diseases generate virus-carrying bioaerosols through breathing and talking, posing a very high risk of infection to healthcare workers. In this paper, we used numerical simulation to compare the effects of different respiratory behaviors, such as normal breathing, prolonged talking, short talking, and alternating talking, on the spatial and temporal distribution of aerosols in a ward, and to study the risk of infection for healthcare workers. It was found that a short period of time in which a patient talked in a ward increased aerosol concentrations by four orders of magnitude compared to normal breathing. In the ward with the ventilation of up-supply, or the one with side-supply, the impacts of aerosol generation from talking accounted for 62.4% and 42.6% of the total time, respectively. The overall infection risk in wards designed with side-supply ventilation was lower. Patient talking time changes did not affect high-risk areas. However, when healthcare worker and patient talked alternately, the aerosol impact time was slightly extended. In addition, the aerosols produced by talking were mainly deposited on the beds and floors, leading to higher exposure risk for healthcare workers during direct contact with beds. It is hoped that the results of this study can be used as the data basis for the study of aerosol pollution control strategies in medical scenarios, and provide useful suggestions for reducing the risk of infection.

The risk of aerosol transmission of respiratory infectious diseases in the isolation ward

The risk of aerosol transmission of respiratory infectious diseases in the isolation ward

Sheet-Isolated MoS2 Used for Dispersing Pt Nanoparticles and its Application in Methanol Fuel Cells.

It is highly challenging to activate the basal plane and minimize the π-π stacking of MoS2 sheets, thus enhancing its catalytic performance. Here, we display an approach for making well-dispersed MoS2 . By using the N-doped multi-walled carbon nanotubes (NMWCNTs) as an isolation unit, the aggregation of MoS2 sheets was effectively reduced, favoring the dispersion of Pt nanoparticles (noted as Pt/NMWCNTs-isolated-MoS2 ). Excellent bifunctional catalytic performance for methanol oxidation and oxygen reduction reaction (MOR/ORR) were demonstrated by the produced Pt/NMWCNTs-isolated-MoS2 . In comparison to Pt nanoparticles supported on MoS2 (Pt/MoS2 ), the MOR activity (2314.14 mA mgpt -1 ) and stability (317.69 mA mgpt -1 after 2 h of operation) on Pt/NMWCNTs-isolatedMoS2 were 24 and 232 times higher, respectively. As for ORR, Pt/NMWCNTs-isolated-MoS2 holds large half-wave potential (0.88 V) and high stability (92.71 % after 22 h of operation). This work presents a tactic for activating the basal planes and reducing the π-π stacking of 2D materials to satisfy their applications in electrocatalysis. In addition, the proposed sheet-isolation method can be used for fabricating other 2D materials to promote the dispersion of nanoparticles, which assist its application in other fields of energy as well as the environment.

Assessing airborne transmission risks in COVID-19 hospitals by systematically monitoring SARS-CoV-2 in the air.

The continuous emergence of highly infectious SARS-CoV-2 variants with the capability of immune evasion demands more effective risk assessment and management approaches for infection prevention and control. Controlling nosocomial transmission is critical in response to the COVID-19 pandemic upon the resumption of day-to-day activities. Here, we systematically analyzed the presence of airborne SARS-CoV-2 in the isolation ward and within the contaminant, emergency, and clean zones of a designated COVID-19 hospital. A total of 359 air samples collected in the clean and emergency zones tested negative for SARS-CoV-2, demonstrating the interruption of airborne transmission in a designated COVID-19 hospital by combining the closed-loop management, unidirectional airflow, and negative pressure of isolation wards. In contrast, some air samples in the corridor outside the isolation wards tested positive for SARS-CoV-2. The leakage of virus-containing air from patient rooms to adjoining areas during rounds and meal delivery sheds light on the need for intensive and widespread virus monitoring in designated COVID-19 hospitals. In conclusion, by systematically monitoring viruses in the air, the study provides a starting point for the standardization of transmission risk management in designated hospitals for the future pandemic of a newly emerged respiratory infectious disease.IMPORTANCERisk management and control of airborne transmission in hospitals is crucial in response to a respiratory virus pandemic. However, the formulation of these infection control measures is often based on epidemiological investigations, which are an indirect way of analyzing the transmission route of viruses. This can lead to careless omissions in infection prevention and control or excessively restrictive measures that increase the burden on healthcare workers. The study provides a starting point for standardizing transmission risk management in designated hospitals by systemically monitoring viruses in the air of typical spaces in COVID-19 hospitals. The negative results of 359 air samples in the clean and emergency zones demonstrated the existing measures to interrupt airborne transmission in a designated COVID-19 hospital. Some positive cases in the corridor of the contaminant zone during rounds and meal delivery highlighted the importance of monitoring airborne viruses for interrupting nosocomial infection.

Optimal adaptive fuzzy fault-tolerant control applied on a quadrotor attitude stabilization based on particle swarm optimization

This article discusses the problem of stabilizing the attitude control of a quadrotor system, which is subject to uncertainty, external disturbances, and sensor and actuator faults. To address these challenges, the control stage employs universal approximators, such as fuzzy systems, which estimate the system’s uncertainties and eliminate nonaffine nonlinear actuator faults. In addition, the particle swarm optimization technique is used to adjust the adaptive parameters and fuzzy initial values. The robust control term is carefully designed to handle approximation errors, time-varying sensors, and external disturbances. To solve the issue of the unavoidable algebraic loop during the actuator approximation phase, a Butterworth low-pass filter is integrated. This approach automatically deals with external disturbances, and no further approximation is necessary. Furthermore, the controller can be reconfigured online to enable fast-fault compensation without requiring a fault detection or isolation unit. To prove the global stability and boundedness of all signals in the closed-loop system, Lyapunov theory is used.

Abstract 080: Continuous Automated Stroke Screening Software for Early Detection of Neurological Impairment

Introduction Stroke is the second leading cause of death worldwide leaving up to 50 % of Survivor chronically disabled after their event. Early diagnosis and treatment can significantly lower mortality and morbidity, significantly reducing the economic burden of long‐term disability. Due to the painless nature of most stroke events, many lack the stimulus to seek emergency assistance, further compounded by a symptomatology of deficit resulting in being unaware of the symptoms or lacking the ability to call for help when needed. A continuous automated stroke screening software tool was developed to address these pitfalls in prehospital care, allowing for the early detection of neurological impairment and the release of a medical emergency alert to facilitate emergency medical care. Methods Python version 3.11.3, NumPy, OpenCV, and mediapipe were used for facial and hand land marking with mathematical models employed to detect eye gaze direction, facial symmetry, eyelid closure and left or right hand detection. Results We were able to demonstrate consistent performance of the final software to continuously detect the eye gaze deviation, or center in real time video capturing (Figure‐1). Software is also capable of detecting lower facial palsy through facial symmetry recognition of smiling to demonstrate a right or left sided palsy (Figure‐2). The ability to blink can be detected to differentiate motor neuron palsy and used as a measure of mental status demonstration of the ability to follow a simple midline command (Figure‐3). Detection of lateralizing hand presentation to the camera allows the software to be used in detecting hemi‐neglect, and antigravity muscle strength in upper extremity. (Figure 1‐3). Conclusion Our developed automated stroke screening software can be used for continuous, physician independent, monitoring of neurologic patients and the detection of acute deficits and emergency alert to facilitate early care. The software is designed for use in medical emergency alert systems, tele stroke assessments, and remote surveillance of the neurological examination in intensive care unit or patients in isolation. Here we present the initial software development and capability, we are currently studying our detection models on patients with neurological deficits in varied practice settings.

Disease Outcomes of COVID-19 in Diabetic and Hypertensive Patients During the Hospital Stay.

Background A single-stranded RNA genome-encapsulated virus known as severe acute respiratory syndrome coronavirus 2 is known to cause severe acute respiratory syndrome in humans. People with diabetes and hypertension are often more susceptible to developing coronavirus disease 2019 (COVID-19) and experience a disproportionately higher rate of morbidity and death compared to the general population. The COVID-19 pandemic has become an urgent worldwide issue. Therefore, the main goal of this study is to assess how diabetes and hypertension,both separately and together, affect clinical outcomes in terms of morbidity and mortality in patients hospitalized with COVID-19. This study aimed to evaluate the disease outcomes in hypertensive and diabetic patients hospitalized with COVID-19. Methodology This descriptive, cross-sectional study was conducted from June 2022 to November 2022. Using purposive selective sampling, a total of 90 known hypertensive and diabetic patients with COVID-19 aged 18-90 years admitted in COVID-19 isolation wards and intensive care units (ICUs) of Mayo Hospital Lahore were recruited in this study after obtaining informed consent and IRB approval from the Institutional Review Board of King Edward Medical University, Lahore. Patients who did not provide consent, patients whose positive polymerase chain reaction reports for COVID-19 were not available, pregnant females, and patients with other comorbidities were excluded from the study. Data were collected from the COVID-19 isolation medical wards and ICUs from patient charts containing age, the status of hypertension and diabetes, disease status, severity, and levels of inflammatory markers, i.e., D-dimers, serum lactate dehydrogenase (LDH), serum ferritin, C-reactive protein (CRP). Data were analyzed using SPSS version 23 (IBM Corp., Armonk, NY, USA). Quantitative variables such as age were presented as mean ± SD. Qualitative variables such as hypertension, diabetes, and levels of inflammatory markers were presented as frequency and percentages. Results In this study, 90 patients were included, with 51 (57%) females and 39 (43%) males, all of whom were either hypertensive, diabetic, or both. In total, 70 (78%) patients were admitted to ICUs and 20 (22%) to COVID-19 medical isolation wards. Among 70 ICU patients, 39 (43.3%) were on continuous positive airway pressure/bilevel positive airway pressure, seven (7.8%) were on ventilators, and 44 (48.8%) were on normal oxygen masks/non-rebreather masks with high-flow oxygen. Overall, 100% of the patients included in the study had raised levels of inflammatory markers, low lymphocyte count, and increased neutrophil count. In total, 84 (93%) patients had severely high and six (7%) patients had moderately high CRP levels. Moreover, 33 (36.7%) patients had severely high and 57 (63.3%) patients had moderately high D-dimer levels. Further, 25 (28%) patients had severely high, 26 (29%) patients had moderately high, and 39 (43.3%) patients had significantly raised levels of serum ferritin. In total, 21 (23%) patients had severely high, 37 (41%) had moderately high, and 32 (36%) had significantly raised levels of serum LDH. Among the 90 patients, 65 (73%) expired and 25 (27%) survived. Of the expired patients, 62 (95%) were admitted to ICUs, and three (5%) were admitted to wards. Conclusions Diabetes and hypertension are strong predictors of COVID-19 severity in terms of morbidity and mortality due to respiratory deterioration.

Clinical and Epidemiological Characteristics of Hospitalized COVID-19 Patients in an Isolation Centre in South-West Nigeria.

The clinical presentation of coronavirus disease 2019 (COVID-19) can vary widely, and while the primary infection involves the respiratory system, other organs can also be affected. This study presents the clinical and epidemiological characteristics of hospitalized COVID-19 patients in a tertiary hospital in Ado Ekiti, South-West Nigeria. This is a retrospective study involving COVID-19 patients admitted to the isolation ward between August 2020 and January 2021. The data used for this study was obtained from the patient's medical record, which includes demographic characteristics, clinical presentation, baseline co-morbidities, and laboratory investigations. The average age of the patients was 60.3 years, and more than two-thirds were male. The most common symptoms were fever, shortness of breath, cough, and tiredness. Comorbidities identified among the patients included diabetes mellitus, heart disease, obesity, and chronic kidney disease. The most common radiological findings were bilateral homogeneous patchy opacities and peripheral fluffy infiltrates. The overall mortality rate was 21.9%, with 13 deaths in patients with severe disease. Age and duration of admission were found to be significant predictors of death. The results of this study provide valuable insights into the clinical presentation of COVID-19 in Nigeria and may guide future management strategies for similar infections.

Evaluation of the Performance of the COVID-19 Rapid Antigen Tests in a Tertiary Level Hospital in Bangladesh

The tests providing high sensitivity and specificity are essential to identify and manage COVID-19 patients.There is aheavy demand for low-cost rapid antigen tests (RATs) for COVID-19 with a decent diagnostic value. Globally,several RATs for COVID-19 have been developed, but their clinical efficacy has not been well recognized.Thepurpose of the study was to evaluate the performance of RATs. We conducted this prospective observational study atShaheed Suhrawardy Medical College hospital from February 2021 to April 2021 in Dhaka, Bangladesh. This studyincluded the patients admitted in this hospital at the COVID-19 isolation unit or referred from the triage facility of theoutdoor department of this hospital suspected as COVID-19 case. Two nasopharyngeal samples were collectedsimultaneously. We used one sample on the spot for the RATs and the other was sent to the adjacent ShaheedSuhrawardy Medical College COVID-19 RT-PCR laboratory for real-time reverse transcription PCR (RT-PCR). Theperformance of the RATs was evaluated by consuming the real-time RT-PCR results as a reference. In thisinvestigation, SARS-CoV-2 was identified in 84 (30.7%) of the 223 patients who participated. Of these 84 patients, 9(10.7%) were asymptomatic. The overall sensitivity and specificity of RATs were 78.6% and 99.3%, respectively. Thesensitivity was 81.3% in symptomatic cases and 55.6% in asymptomatic cases. There were 18 false-negativespatients,including 3 asymptomatic cases, who had a low viral load (cycle threshold(Ct) &gt; 30). When the Ct value was up to24, the detection rate of RATs was 100%. The detection rate was 42.3% when the Ct was &gt;29. When symptoms beganwithin three days, the detection rate was 92.3%. When the start of symptoms was over 7 days, the detection rate was33.3%. RATs for COVID-19 used in this study delivered an acceptable performance in patients with high viral loadand within the first week of the onset of symptoms. This method can be a supplementary method to RT- PCR for thediagnosis of symptomatic COVID-19 patients. Bangabandhu Sheikh Mujib Med. Coll. J. 2022;1(2):58-64

Islets-on-Chip: A Tool for Real-Time Assessment of Islet Function Prior to Transplantation.

Islet transplantation improves metabolic control in patients with unstable type 1 diabetes. Clinical outcomes have been improving over the last decade, and the widely used beta-score allows the evaluation of transplantation results. However, predictive pre-transplantation criteria of islet quality for clinical outcomes are lacking. In this proof-of-concept study, we examined whether characterization of the electrical activity of donor islets could provide a criterion. Aliquots of 8 human donor islets from the STABILOT study, sampled from islet preparations before transplantation, were characterized for purity and split for glucose-induced insulin secretion and electrical activity using multi-electrode-arrays. The latter tests glucose concentration dependencies, biphasic activity, hormones, and drug effects (adrenalin, GLP-1, glibenclamide) and provides a ranking of CHIP-scores from 1 to 6 (best) based on electrical islet activity. The analysis was performed online in real time using a dedicated board or offline. Grouping of beta-scores and CHIP-scores with high, intermediate, and low values was observed. Further analysis indicated correlation between CHIP-score and beta-score, although significance was not attained (R = 0.51, p = 0.1). This novel approach is easily implantable in islet isolation units and might provide means for the prediction of clinical outcomes. We acknowledge the small cohort size as the limitation of this pilot study.

Guardians of Safety: Indonesian Nurses and COVID-19 PPE Practices

BackgroundSince the emergence of the COVID-19 outbreak in Wuhan, China, the world has undergone drastic changes. The Delta variant has high transmissibility and evades human cellular defenses. Data from the World Health Organization (WHO) recorded over 31.654 million cases and 4 million COVID-19 deaths as of December 2022. Hospitals have faced challenges in patient management and healthcare worker protection. This study discusses the relationship between nurses' knowledge, attitudes, and behaviors regarding the use of personal protective equipment in Indonesian COVID-19 referral hospitals. MethodsThis study utilized a quantitative analytical observational method with a cross-sectional approach. The research was conducted in four COVID-19 referral hospitals in the Yogyakarta Special Region in Indonesia. ResultsThis study shows that there is no significant relationship between attitudes and behaviors in the use of PPE; however, a positive correlation exists. ConclusionMost nurses in COVID-19 isolation wards demonstrate good knowledge, attitudes, and behaviors toward the use of PPE. There is a positive correlation between knowledge and attitudes, as well as nurses' behaviors in using PPE.

Frequency of Co-Morbidities in Patients with COVID-19

Background: This very contagious virus and the pandemic that resulted from its effects on human health resulted in major disruptions and has virtually interrupted every aspect of daily human life including transportation, business, education, and health care delivery worldwide. Patients of COVID-19 having various co-morbidities have worse outcomes when compared with patients without any co-morbidities. Patients with COVID-19 having history of diabetes mellitus, cardiovascular disease, obesity, hypertension and chronic lung disorders have poor prognosis and often lead to worsening outcomes like Pneumonia &amp; ARDS. Old patients, patients with chronic kidney disease and patients with various cancers are not only at risk for acquiring COVID-19, but there are increased chances of mortality among these patients. Objective: The objective of our study was to determine frequency of co-morbidities in patients with COVID-19 Pneumonia. Study Design: Retrospective Cross-sectional Analytical study. Settings: Isolation Wards/HDU of Allied Hospital, Faisalabad Pakistan. Duration: 06 Months from April 16, 2021 to October 15, 2021. Methods: 100 Patients diagnosed with COVID-19 according to definition and inclusion criteria were included in the study. Following demographic features of the patients admitted in Isolation wards/ HDU’s of Allied Hospital were collected: age; sex; clinical presentation; smoking history; duration between onset of disease and presentation to hospital; history of co-morbid factors like hypertension, diabetes mellitus Obesity, Cardiovascular Disease, Malignancy, history of intake of Immunosuppressive agents. Mean ± SD was calculated for the age of the patients, oxygen saturation of patients and lung involvement of patients. Frequency and percentages were calculated for the Co-Morbidities for COVID-19 pneumonia, gender of the patients, symptoms of patients. Comparative analysis of lung involvement with co-morbidities of patients was done with p value of ≤ 0.05 being considered significant. Results: Our study included 100 patients. 52 patients (52%) were males while 48 (48%) were females. Mean Age of patients was 54.91 ± 15.56 and mean oxygen saturation was 90.88 ± 5.8. Mean lung involvement of patients with COVID-19 was 30.82 ± 16.27. Fever was the commonest symptom amongst the patients included in the study (40%), followed by cough (33%) and shortness of breath (29%). Amongst the co-morbidities in patients with COVID-19, diabetes was found in 54% of the patients, followed by hypertension 34% and ischemic heart disease 6%. Conclusion: Our study concludes that individuals having underlying chronic diseases are more prone to contract COVID-19 virus and eventually develop more severe disease as compared to normal healthy persons. Thus, vaccination of this segment of society and early identification of disease among these people can help reduce morbidity and mortality. Keywords: Co-Morbidities, COVID-19, Diabetes, Hypertension.

THE RISK OF OCCUPATIONAL CONTACT DERMATITIS IN COVID-19 ISOLATION WARD SETTING

Occupational contact dermatitis (OCD) is a prevalent skin condition affecting healthcare workers, particularly those in high-risk environments such as COVID-19 isolation wards. This study aims to summarize the findings of a study conducted on patients to explore the risk factors associated with OCD development among healthcare professionals in COVID-19 isolation ward settings. This prospective observational study aimed to assess the risk of occupational contact dermatitis (OCD) among healthcare professionals working in the COVID-19 isolation ward setting. The study was conducted at Chaudhary Mohammad Akram Hospital for six months, from November 2021 to April 2022. Data was collected from 150 participants of both genders. The participants ranged from 22 to 55 years, with a mean age of 32.5 ± 6.8 years. The study population consisted of 55% females and 45% males. The occupation distribution included doctors (40%), nurses (50%), and support staff (10%). Clinical evaluations revealed that 38 healthcare professionals (25.3%) exhibited signs consistent with occupational contact dermatitis. Among them, 18 participants (47.4%) were diagnosed with irritant contact dermatitis (ICD), while 20 participants (52.6%) showed signs indicative of allergic contact dermatitis (ACD). It is concluded that this study highlights the significant prevalence of occupational contact dermatitis among healthcare professionals in COVID-19 isolation wards. Prolonged PPE usage and frequent hand hygiene practices contribute to skin irritation.

Study on the Correlation of Elevated Neutrophil-To-Lymphocyte Ratio and Platelet-To-Lymphocyte Ratio With Covid-19 Mortality among Patients in a Hospital Isolation Ward in Baler, Aurora

Neutrophil-to-Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR) are inflammatory biomarkers known to assess several disease types effectively. With the surge of Coronavirus disease (COVID-19) cases, many patients manifested various systemic inflammatory conditions suggesting a possible relationship between the predictive values of NLR and PLR to COVID-19 mortality. The study aims to assess a correlation between elevated biomarker values of NLR and PLR with COVID-19 mortality. A single-center, cross-sectional study of COVID-19 patients, admitted to a hospital isolation ward in Baler, Aurora, between May to October 2021 was conducted. Secondary data, namely demographic profiles, complete blood count results, and comorbidities upon admission, were collected. The effect of NLR and PLR on the risk of mortality, along with the impact of covariate variables that may affect the study’s outcome, was determined using a multiple binary logistic regression model and the computation of the odds ratio. 264 COVID-19 patients were included in the study–202 were recovered and 62 were deceased. Multiple binary logistic regression demonstrated a higher mortality risk in patients with elevated NLR (OR=2.607; 95% CI: 1.276 to 5.324; p=.009). Other risk factors such as age (OR=1.053; 95% CI: 1.029 to 1.077; p&lt;.001) and diabetes mellitus (OR=3.537; 95% CI: 1.441 to 8.682; p=.006) are risk factors for COVID-19 mortality. Patients with elevated NLR values indicate poor clinical outcomes with a higher mortality risk compared to those with low NLR in COVID-19 patients. Moreover, age and diabetes must be considered in patient assessment upon admission due to their correlation to COVID-19 mortality. Keywords: COVID-19 mortality, inflammatory biomarker, Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR).

Differential responses to artificial photoperiods of the rising and falling phases of human melatonin rhythm are consistent with a dual oscillator hypothesis.

Circadian rhythms and sleep-wake cycles were measured in volunteers staying singly in temporal isolation unit where they were exposed to artificial short and long light-dark (LD) cycles for 7 days. The long day consisted of 16-h light and 8-h dark (LD 16:8) and the short day consisted of 8-h light and 16-h dark (LD 8:16). During the light period, bright light of approximately 5,000 lux was given from the ceiling and during the dark period there was no illumination. Sleep was monitored by bed sensors, wrist actiwatch, and polysomnography (PSG) on the first and last nights of the schedule. Sleep length was significantly longer under LD 8:16 than under LD 16:8 and the sleep quality estimated by PSG was worse under LD 8:16 than under LD 16:8, which were comparable to natural seasonality in sleep. The circadian rhythm in plasma melatonin was measured in dim light (10 lux) before and after the LD exposures. The nocturnal melatonin secretion (NMS) was significantly longer after LD 8:16 than after LD 16:8 due to differential phase shifts of the rising and falling phases of NMS. After LD 8:16, the falling phase was much advanced than the rising phase, whereas after LD 16:8 the rising phase was much delayed than the falling phase, resulting in the NMS compression. These results indicate that the light sensitivity in terms of phase shifting is different in the two circadian phases, supporting a dual oscillator hypothesis with different phase-response curves for light in the human circadian system.NEW & NOTEWORTHY The present study demonstrated differential light responsiveness of the rising and falling phases of nocturnal melatonin secretion in human subjects exposed to artificial long (LD 16:8) and short days (LD 8:16) and suggested the involvement of different oscillators under these phases. The findings well mimicked the seasonality of the circadian rhythms in nature and consisted with the evening/morning dual oscillator hypothesis proposed originally for nocturnal rodents, providing a new concept for the human circadian system.