Management of COVID-19 during the second wave at a tertiary care public hospital in Eastern India: An experience from the administrative control room.

Context: Though many arrangements had been made during the first wave, multiple complaints were reported regarding the arrangements made for COVID patients. The control room was set up as a 24 × 7 administrative coordination center to attend to issues after the initial setup of COVID units. Aim: To identify the major problems reported to the control room during the second wave of COVID-19 and find the related cause for the same. Methods and Materials: Issues reported to the control room were recorded from April to June (2021). The control room residents were asked to allocate each problem into six categories. Next, the residents allotted a frequency score to each of the problems depending on how regularly it was reported. Secondary data from various reports were also considered. Statistical Analysis Used: Data were analyzed using MS Excel software. Results: Various administrative issues were identified to be due to issues in communication and coordination (23%), policy and procedures (22%), human resource and training (16%), administration and implementation (15%), infrastructure (14%), and HMIS and IT (10%). Conclusion: Most frequent problems reported to the control room were related to infrastructure, policy implementation, and manpower training. After the initial implementation of new processes, there was a requirement for regular follow-up and coordination. This model of setting up an administrative control room and evidence-based approach will serve as a template for public hospitals to ensure coordination of hospital operations.

COVID 19 Pandemic and biomedical waste management practices in healthcare system.

The whole world was shaken with the pandemic of Coronavirus Disease (COVID-19) in end of the year 2019. Due to its novel origin, it was required to follow all precautions possible. Dealing with the massive amount of infectious healthcare waste became an enormous challenge. This review identifies the impacts of the pandemic on biomedical waste management. This systematic review was made by using keywords "biomedical waste" and "COVID 19" in open access databases like PubMed, Science Direct, Scopus, Google Scholers etc. 2124 articles downloaded and 765 found duplicate and 634 not related to the topic. after scrutiny with inclusion criteria 102 articles were considered to analyze the practices related to biomedical waste management during pandemic using PRISMA guideline.. The COVID-19 waste segregation, collection, storage, transportation, and disposal are a big challenge with all stakeholders. In order to control the virus spread, strict monitoring of the complete waste management cycle is required. Adoption of appropriate guidelines is paramount to worker safety and containment of infection. Sustainable recycling methods are needed to deal with the ever-increasing plastic waste resulting from mandatory personal protective equipment (PPE) usage. The situation also demands a rethinking of the healthcare system. Overall, there was an increase in BMW generation, and municipal waste had increased globally. Pandemic preparedness requires a global public health strategy and long-term investments. This will be vital for making a robust community capable enough to fight against any public health pressures in the future, as well as the pandemic tremors. Systematized efforts from all stakeholders, at all levels, not only refines epidemic preparation but also helps to attain a sustainable development of health for a healthier future.

Bilateral central serous chorio-retinopathy in pregnancy presenting with severe visual loss.

INTRODUCTION: Bilateral central serous chorio-retinopathy is an unusual presentation. OBJECTIVE: To report a case of pregnancy-induced bilateral central serous chorio-retinopathy. CASE: A thirty-year-old woman complaining of reduced vision in both the eyes was referred for ophthalmoscopic evaluation in her third trimester of pregnancy. The best-corrected visual acuity was 6/60 in the right eye and finger counting at four meters in the left. The funduscopic examination revealed serous macular detachment with white sub-retinal exudates in both the eyes. Optical coherence tomography sections through the macula demonstrated serous elevation of the retina and retinal pigment epithelial detachment in both the eyes. The serous macular detachment resolved and the patient recovered to the visual acuity of 6/6 in both the eyes after twelve weeks of delivery. The OCT showed resolution of the sub-retinal fluid and disappearance of the sub-macular exudate in the right eye, but the resolution was partial in the left eye. CONCLUSION: Pregnancy is a risk factor for CSCR and it can present with severe bilateral visual diminution.

Restoration of gait and motor recovery by functional electrical stimulation therapy in persons with stroke.

PURPOSE: To evaluate the clinical efficacy of functional electrical stimulation (FES) therapy of the tibialis anterior (TA) muscle on gait restoration and enhancing motor recovery with stroke patients. METHOD: Thirty hemiparetic participants with spastic foot-drop impairments who were at least 3 months post-stroke were recruited from a rehabilitation institute and were assigned either to a control group or a FES group. Both the groups participated in a conventional stroke rehabilitation program for 60 min per day, 5 days a week, for 12-weeks. The FES group received the electrical stimulation to the TA muscle for correction of foot-drop. RESULTS: Functional electric stimulation (FES) resulted in a 26.3% (p < 0.001) improvement of walking speed measured with 10-m walkway, whereas the improvement in the control group was only 11.5% (p < 0.01). The FES group also showed significantly greater improvements compared to control group in other gait parameters (e.g. cadence, step length), physiological cost index (PCI), ankle range of motion, spasticity of calf muscle, Fugl-Meyer scores, and the maximum value of the root mean square (RMS(max)), which reflects the capacity of the muscle output. CONCLUSIONS: These findings suggest that, the FES therapy combined with conventional therapy treatment more effectively improves the walking ability and enhances the motor recovery when compared with conventional therapy alone in stroke survivors.