Effect of N-95 Mask on Oxygen Saturation Level in Health Care Workers and Their Experience While Using N-95 Mask

Background N-95 masks are in high demand during this COVID-19 pandemic but wearing an N-95 mask is a real challenge to the health workers during their duty hours. The present study aims to measure the effect of the N-95 mask on oxygen saturation level in the blood and the discomforts experienced while using it. Materials and Methods Oxygen saturation was measured in 80 health care workers before and after wearing the N-95 mask continuously for more than 6 hours. The participants were asked to fill a questionnaire regarding various discomforts of N-95 mask usage, which consisted of 14 questions. Results The most common discomfort was pain around the pinna followed by difficulty in breathing and fogging of spectacles or goggles. In addition, 71% of them had decreased oxygen saturation by 1%. Conclusion N-95 mask can alter the oxygen saturation but it does not produce significant effects in healthy individuals. It can significantly affect patients with compromised airways.

Major Inflammatory Markers and Their Significance in Predicting Severity of COVID-19 Disease Pattern

The unanticipated outbreak of the COVID-19 pandemic has shocked the world in terms of both lives and livelihood. SARS-CoV-2 virus primarily affects the respiratory system, although other organ systems are also involved. Early diagnosis followed up by a retrospective analysis and tracking of a few markers relevant to the immunological status of the individual may aid in determining the state of the patient's disease prognosis. The aim of the present study was to evaluate immunological parameters such as neutrophil to lymphocyte ratio (NLR), C-reactive protein (CRP), and D-dimer, taking into account the patient's age and oxygen saturation level. Our retrospective analysis of clinical data revealed that such parameters as CRP, D-dimer, and NLR should be taken into consideration to predict severe COVID-19-related complications. The data obtained indicate that patients over age 60 are especially vulnerable to severe COVID-19.

Causes and Treatment of Hypoxia during Total Hip Arthroplasty in Elderly Patients: A Case Report

Intraoperative hypoxia occurs in approximately 6.8% of surgeries and requires appropriate management to avoid poor outcomes, such as increased mortality or extended hospitalization. Hypoxia can be caused by a variety of factors, including laryngospasm, inhalational anesthetics, and surgery for abdominal pathology or hip fractures. In particular, elderly patients are more vulnerable to hypoxia due to their existing lung diseases or respiratory muscle weakness. This study presents the cases of two elderly patients who developed hypoxia during total hip arthroplasty under general anesthesia. Positive end expiratory pressure, the recruitment maneuver, and increased fraction of inspired oxygen improved hypoxia only temporarily, and patients’ oxygen saturation level again dropped to 79–80%. We suspected that hypoxia was caused by atelectasis and, therefore, resumed spontaneous respiration. Thereafter, both the patients showed an improvement in hypoxia. Intraoperative hypoxia that is suspected to be caused by atelectasis can be improved by securing sufficient lung volume for respiration through increased muscle tone with spontaneous respiration.

Non-conveyance of older adult patients and association with subsequent clinical and adverse events after initial assessment by ambulance clinicians: a cohort analysis

Background Older adults (age ≥ 65 years) represent a significant proportion of all patients who are not transported to hospital after assessment by ambulance clinicians (non-conveyed patients). This study aimed to fill the knowledge gap in the understanding of the prevalence of older adult non-conveyed patients and investigate their characteristics and risk factors for subsequent and adverse events with those of younger non-conveyed patients comparatively. Methods This population-based retrospective cohort study included all adult non-conveyed patients who availed the ambulance service of Region Stockholm, Sweden in 2015; they were age-stratified into two groups: 18–64 and ≥ 65 years. Inter-group differences in short-term outcomes (i.e. emergency department visits, hospitalisations, and mortality within 7 days following non-conveyance) were assessed using multivariate regression analyses. Results Older adult patients comprised 48% of the 17,809 non-conveyed patients. Dispatch priority levels were generally lower among older non-conveyed patients than among younger patients. Non-conveyance among older patients occurred more often during daytime, and they were more frequently assessed by ambulance clinicians with nonspecific presenting symptoms. Approximately one in five older adults was hospitalised within 7 days following non-conveyance. Patients presenting with infectious symptoms had the highest mortality risk following non-conveyance. Oxygen saturation level < 95% or systolic blood pressure > 160 mmHg had significantly higher associations with hospitalisation within 7 days following non-conveyance in older adult patients. Conclusions Older adult patients have an increased risk for adverse events following non-conveyance. In combination with a complex and variating presentation of symptoms and vital signs proved difficult for dispatch operators and ambulance clinicians to identify and assess, the identified risks raise questions on the patient safety of older adult non-conveyed patients. The results indicate a system failure that need to be managed within the ambulance service organisation to achieve higher levels of patient safety for older non-conveyed patients.

Hybrid Repair with Reversed Sequence Supra-aortic Debranching in Ruptured Arch Aneurysm

Aortic arch pathology in a high-risk patient in whom the resternotomy approach is unfeasible due to treated mediastinitis after ascending aortic replacement presents a unique challenge for hybrid arch repair (HAR) because of the need for supra-aortic debranching from unusual inflow sites other than the ascending aorta. This report describes a “reversed sequence” extra-anatomical supra-aortic debranching procedure as a salvage technique performed to enable HAR. An 83-year-old woman with a history of ascending aortic replacement for type A aortic dissection, mediastinitis complicated by sternal osteomyelitis, and a chest wall reconstructed with a rectus abdominis myocutaneous flap presented with chest pain because of a contained dissecting arch aneurysm rupture. The patient underwent supra-aortic debranching from the bilateral common femoral arteries and thoracic endovascular aortic repair to the ascending aorta under cerebral near-infrared spectroscopy (NIRS) monitoring. Completion imaging by angiography demonstrated successful exclusion of the ruptured aneurysm. The regional cerebral oxygen saturation level, monitored by NIRS, did not change markedly during surgery. The patient was neurologically intact with adequate cerebral blood flow assessed postoperatively by 123I-IMP single photon emission computed tomography. Total debranching of the supra-aortic vessels from the common femoral artery for inflow is feasible and provides adequate cerebral perfusion. This procedure may offer an alternative treatment option in patients with complex conditions involving aortic arch pathology.

Multipurpose medical assistant robot (Docto-Bot) based on internet of things

<span>The world's population is growing every day, and so is the number of patients. People's life expectancy is increasing due to technology's welfare, but the problem is that the health sector has always faced a shortage of inadequate doctors. This research main objective was to design and implement a biomedical-based medical assistant robot named "Docto-Bot" to deal with this problem. This research concerns this medical assistant robot's design and development for the disabled and the patients in need. Such a robot's prime utilization is to minimize person-to-person contact and ensure the cleaning, sterilization, and support in hospitals and similar facilities such as quarantine. This prototype robot consists of a medicine reminding and medicine providing system, Automatic hand sanitizer and IoT based physiological monitoring system (body temperature, pulse rate, ECG, Oxygen saturation level). A direct one-to-one server-based communication method and user-end android app maintaining system designed. It also included the controlling part, which control automatically and manually by users. Docto-Bot will play a very significant factor in bio-medical robot applications. Though the achievements described in the paper look fruitful and advanced, shortcomings still exist.</span>

Effect of Wearing Surgical Face Masks During Exercise: Does Intensity Matter?

Face masks are widely recommended as means of controlling the coronavirus disease outbreak. This study aimed to examine the physiological and perceptual responses of wearing surgical face masks while exercising at different intensities. Thirteen healthy young adults (mean age, 21.9 ± 1.4 years) conducted randomized crossover trials with or without a surgical face mask. In each trial, participants completed an incremental treadmill protocol, with three 6-min stages (light, moderate, and vigorous at 25, 50, and 75% maximal oxygen uptake, respectively). Physiological outcomes (heart rate, blood lactate, and oxygen saturation level), perceived exertion and discomfort feeling were assessed. No significant differences were observed in physiological outcomes with or without masks at different exercise intensities (p &gt; 0.05). However, the rating of perceived exertion (RPE) was significantly higher when exercising vigorously (mask: 15.5 ± 1.5 vs. no-mask: 14.2 ± 2.1, p &lt; 0.05). Participants wearing masks reported marked discomfort, such as feeling hot, humid, and breathing resistance. Although face mask-wearing during exercise may not have detrimental effects on major physiological parameters, it can increase perceived exertion level and discomfort when the exercise intensity exceeds a certain threshold. Therefore, healthcare professionals should cautiously evaluate each person’s ability to exercise while wearing a mask and tailor their prescription accordingly.

Correlation between Arterial Blood Oxygen Saturation, Underlying Diseases and Clinical Signs of COVID-19 Patients with Their Final Outcome

Introduction: COVID-19 can rapidly cause lung damage and severe respiratory distress and subsequently reduce oxygen saturation (SPO2), especially in generally ill patients, which may be exacerbated if severe clinical symptoms or underlying diseases are added. This may lead to deterioration of blood oxygenation or even increase the risk of death when severe clinical symptoms or underlying diseases are present. Therefore, the aim of this study was to Evaluation of the relationship between arterial blood oxygen saturation level and outcome in COVID-19 patients.Material and Methods: A cross-sectional study of 250 patients referred to Imam Sari Hospital with symptoms of respiratory infection, gastrointestinal, and general symptoms in January 2020 to September 2020. Data were analyzed using SPSS version 26.Results: 27 out of 250 patients died. There is a positive correlation between systemic patient, SPO2 and less than 90% with death results (P<0/02). Patients with heart disease (44.4%), cancer (30.1%), diabetes (11.1%), cerebrovascular accident (18.5%) died (P<0/05). There was no positive correlation between weakness, fever, dyspnea, nausea, and diarrhea and appetite loss with death.Conclusion: Based on the present study, it was found that patients whose clinical symptoms were associated with underlying disease and SPO2 to a severe and critical degree had a higher risk of adverse outcome such as death. People with underlying conditions such as DM, CVD, HTN, and a history of angiography and cancer are also more likely to die due to COVID-19. Most deaths in the present study had low SPO2 at before admission, indicating a strong association between patient mortality and severity of lung involvement and low SPO2.

IoT-Based Smart Health Monitoring System for COVID-19 Patients

During the ongoing COVID-19 pandemic, Internet of Things- (IoT-) based health monitoring systems are potentially immensely beneficial for COVID-19 patients. This study presents an IoT-based system that is a real-time health monitoring system utilizing the measured values of body temperature, pulse rate, and oxygen saturation of the patients, which are the most important measurements required for critical care. This system has a liquid crystal display (LCD) that shows the measured temperature, pulse rate, and oxygen saturation level and can be easily synchronized with a mobile application for instant access. The proposed IoT-based method uses an Arduino Uno-based system, and it was tested and verified for five human test subjects. The results obtained from the system were promising: the data acquired from the system are stored very quickly. The results obtained from the system were found to be accurate when compared to other commercially available devices. IoT-based tools may potentially be valuable during the COVID-19 pandemic for saving people’s lives.