Prevalence of Acute coronary syndrome (ACS) in COVID-19 affected patients in public hospital facility of Pakistan, a retrospective study

COVID 19 infection is a devastating viral disease-causing multiorgan damage and severity of the complications. Several studies have reported the major effect of COVID 19 on the respiratory, cardiac system as well as on other organs. There has been an increased prevalence of the COVID-19 infection observed in patients with the acute coronary syndrome (ACS) because of many unknown reasons.

Consequences of Migrating U.S. Contagious Facilities Into General Hospitals, 1900–1950

Until the 1880s, hospitals excluded contagious disease patients from admission because of the danger they posed to other patients; by the 1950s, contagious disease care had literally moved into the general hospital. This article correlates the changing isolation facility designs with changing disease incidence and prevention strategies. It argues that isolation moved into the hospital in stages that have consequence for isolation facility design today. Between the 1890s and 1940s, contagious disease care shifted from remote isolation hospitals (commonly known as pest houses) to separate contagious disease hospitals, to contagious disease “units” adjacent to or within a general hospital facility, and to isolation rooms included in nursing units. The architectural history of isolation facility designs shows that the integration of isolation facilities into general hospitals relied on the success of new aseptic nursing procedures that prevented contact transmission but which downgraded the need for spatial separation to prevent airborne transmission. In the second half of the 20th century, federal funding and standards made isolation rooms in the hospital the norm. This migration coincided with a historically unprecedented reduction in contagious disease incidence produced by successful vaccines and antibiotics. By the 1980s, the rise of new and antibiotic resistant diseases led to extensive redesigns of the in-house isolation rooms to make them more effective. This article suggests that it is time to rethink isolation not just at the detail level but in terms of its location in relation to the general hospital.

Awareness and Preparedness for the Ongoing Community Spread of Coronavirus Infections Among Healthcare Workers in a Nigerian Private Tertiary Facility

Background: Healthcare workers (HCWs) are at high risk of contracting and spreading the novel Coronavirus Disease 2019 (COVID-19) disease putting themselves, the patients and the community at large at risk. Therefore, there is a need for adequate preparedness in the face of this pandemic. Objectives: To assess the knowledge of HCW (clinical and non-clinical) on COVID-19, determine the level of HCWs preparedness against COVID-19 and evaluate the level of preparedness of the hospital facility against COVID-19. Methods: Purposive sampling technique was used in this cross-sectional study. A self-administered questionnaire adapted from a validated questionnaire was used to collect appropriate data on socio-demographics, knowledge about COVID 19 and preparedness. Results: A total of 170 HCWs with a mean age of 34.7±6.9 years participated in this study. More than half (56.5%; 96/170) were females. The average knowledge score among clinical staff was 9.04±13.77, with 80 clinical staff having good knowledge of COVID-19. The majority of non-clinical staff had a fair knowledge of COVID-19 with an average knowledge score of 5.11±47.07. About 63.4% were not confident enough in caring for a suspected coronavirus case even though more than half (57.6%) have had formal training in Infection Prevention and Control and above 77% (131/170) confirmed the availability of PPE in their facility. However, about three-quarters (74.7%; 127/170) believed the hospital is well prepared to manage COVID-19 cases. Conclusion: This study revealed that this cohort of HCWs have good knowledge of COVID-19 and are convinced that they and their facility are well prepared for outbreaks of COVID-19.

A Retrospective Study of COVID-19 Cases Based on Age and Gender in Patient’s Visiting Tertiary Care Centre, Tezpur Medical College and Hospital, Tezpur, Assam

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which is also called COVID-19 has affected millions of people globally and has led to unprecedented disruptions to health systems, as well as affected individuals social, economic and psychological lives very badly. The present study was an attempt to address the association between age and gender among positive COVID-19 cases and also to discuss the possible reasons for the variation among age categories and gender. This was a retrospective based study. Samples were collected in Viral Transport Media and sent to the testing laboratory for confirmation by nucleic acid–based reverse transcription polymerase chain reaction (RT-PCR). Data regarding patients’ details were collected in the hospital facility. A total of 1,11,379 (Assam - 1,08,836 and Arunachal Pradesh-2543) samples were collected from patient’s and tested for COVID-19 (April to December 2020). During this period a total of 2,600 positive cases were detected at the laboratory from Assam (n= 2,480, 95.38%) and Arunachal Pradesh (n= 120, 4.62%) respectively. Males (n=2106, 81%) was affected more than females (n= 494, 19%). In both male & female the age group which was affected the most was between 20-29 yrs and 30-39 yrs. Month wise distribution of the positive COVID-19 cases showed maximum spike in the month of August (n=902). Early diagnosis by real time PCR has helped in the identification of the pathogen in individuals at an early stage, which has facilitated the containment of positive cases.

Hospital Construction Cost Affecting Their Lifecycle: An Italian Overview

The need for 24/7 operation, and the increasing requests of high-quality healthcare services contribute to framing healthcare facilities as a complex topic, also due to the changing and challenging environment and huge impact on the community. Due to its complexity, it is difficult to properly estimate the construction cost in a preliminary phase where easy-to-use parameters are often necessary. Therefore, this paper aims to provide an overview of the issue with reference to the Italian context and proposes an estimation framework for analyzing hospital facilities’ construction cost. First, contributions from literature reviews and 14 case studies were analyzed to identify specific cost components. Then, a questionnaire was administered to construction companies and experts in the field to obtain data coming from practical and real cases. The results obtained from all of the contributions are an overview of the construction cost components. Starting from the data collected and analyzed, a preliminary estimation tool is proposed to identify the minimum and maximum variation in the cost when programming the construction of a hospital, starting from the feasibility phase or the early design stage. The framework involves different factors, such as the number of beds, complexity, typology, localization, technology degree and the type of maintenance and management techniques. This study explores the several elements that compose the cost of a hospital facility and highlights future developments including maintenance and management costs during hospital facilities’ lifecycle.

Evaluation and prioritisation of potential locations for investment in dental tourism

Medical tourism had notable growth in the past few years, and it is understood that one of the most prevalent types of medical tourism is dental tourism. This study aims to select the most suitable city for investment in dental tourism. Five dimensions and nineteen criteria associated with dental tourism have been specified, and the DEMATEL-based ANP (DANP) is used to determine the interrelation of criteria and compute their weights. Then, the VIKOR is used to evaluate the suitability of different cities for investment in dental tourism and determine the potential areas of the selected cities that need enhancement. A case study is conducted to present the applicability of the suggested model. The results indicate that the dental facilities and service is the most critical dimension, and reputation of hospital/facility and doctors, dental clinics with certification/accreditation scheme are the most important criteria for analysing the suitability of potential locations.

Gender Differences in the Level of Antibodies to Measles Virus in Adults

Individuals without a protective antibody level are susceptible to measles infection. There are differences in the persistence of antibodies after vaccination and infection, while the impact of gender on this process has not been sufficiently studied. Measles Ig G antibodies were measured in 1742 employees of a large hospital facility—403 men and 1339 women aged from 25 to 67 years; 15% participants had antibody levels less than the protective threshold of ≥0.18 IU/mL. Significant differences were found in the age group 40–49, where the level of IgG antibodies to measles among men was higher than among women (1.51 IU/mL (0.41; 3.38) vs. 0.70 IU/mL (0.22;1.98) respectively, (U = 3.2, p = 0,001)); in the age group 60 and older, by contrast, the level of antibodies among women was higher compared to men (3.29 IU/mL (1.72; 4.07) vs. 2.90 IU/mL (1.46; 3.53) respectively (U = 2.2, p = 0.03)). The proportion of seronegative women in the age group 40–49 was significantly higher than of seronegative men: 22 [18–26]% and 11 [6–18]% respectively (χ2 = 7.0, p = 0.001). The revealed gender characteristics that affect persistence of measles immunity may be important in personalization of vaccinal prevention for men and women.

Parsimonious Modelling for Estimating Hospital Cooling Demand to Improve Energy Efficiency

Of all the different types of public buildings, hospitals are the biggest energy consumers. Cooling systems for air conditioning and healthcare uses are particularly energy intensive. Forecasting hospital thermal-cooling demand is a remarkable and innovative method capable of improving the overall energy efficiency of an entire cooling system. Predictive models allow users to forecast the activity of water-cooled generators and adapt power generation to the real demand expected for the day ahead, while avoiding inefficient subcooling. In addition, the maintenance costs related to unnecessary starts and stops and power-generator breakdowns occurring over the long term can be reduced. This study is based on the operations of a real hospital facility and details the steps taken to develop an optimal and efficient model based on a genetic methodology that searches for low-complexity models through feature selection, parameter tuning and parsimonious model selection. The methodology, called GAparsimony, has been tested with neural networks, support vector machines and gradient boosting techniques. Finally, a weighted combination of the three best models was created. The new operational method employed herein can be replicated in similar buildings with similar water-cooled generators.