This study showed no overall benefit of the addition of zinc to antibiotics in reducing the time to recovery from pneumonia but showed a possible benefit of zinc supplementation in a subgroup of children with very severe pneumonia. Additional research is needed in specific subgroups such as children with very severe pneumonia. This trial was registered at http://www.controlled-trials.com as ISRCTN48954234.

Background This study aimed to determine the impact of pulmonary complications on death after surgery both before and during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. Methods This was a patient-level, comparative analysis of two, international prospective cohort studies: one before the pandemic (January–October 2019) and the second during the SARS-CoV-2 pandemic (local emergence of COVID-19 up to 19 April 2020). Both included patients undergoing elective resection of an intra-abdominal cancer with curative intent across five surgical oncology disciplines. Patient selection and rates of 30-day postoperative pulmonary complications were compared. The primary outcome was 30-day postoperative mortality. Mediation analysis using a natural-effects model was used to estimate the proportion of deaths during the pandemic attributable to SARS-CoV-2 infection. Results This study included 7402 patients from 50 countries; 3031 (40.9 per cent) underwent surgery before and 4371 (59.1 per cent) during the pandemic. Overall, 4.3 per cent (187 of 4371) developed postoperative SARS-CoV-2 in the pandemic cohort. The pulmonary complication rate was similar (7.1 per cent (216 of 3031) versus 6.3 per cent (274 of 4371); P = 0.158) but the mortality rate was significantly higher (0.7 per cent (20 of 3031) versus 2.0 per cent (87 of 4371); P < 0.001) among patients who had surgery during the pandemic. The adjusted odds of death were higher during than before the pandemic (odds ratio (OR) 2.72, 95 per cent c.i. 1.58 to 4.67; P < 0.001). In mediation analysis, 54.8 per cent of excess postoperative deaths during the pandemic were estimated to be attributable to SARS-CoV-2 (OR 1.73, 1.40 to 2.13; P < 0.001). Conclusion Although providers may have selected patients with a lower risk profile for surgery during the pandemic, this did not mitigate the likelihood of death through SARS-CoV-2 infection. Care providers must act urgently to protect surgical patients from SARS-CoV-2 infection.

Hospital Supportive Services complement the clinical services in any setting. They have a crucial role in mitigation of infection and delivery of safe care to the patients. The spectrum of hospital supportive services encompasses linen & laundry, dietary, Central Sterile Supply Department (CSSD), transport hospital stores, mortuary and engineering services. Each of these services has a significant role to help abort the ‘chain of transmission’ of COVID-19 infection across various patient care areas in the hospital, while providing them supportive services. The overall patient satisfaction greatly depends on the quality of hospital supportive services rendered to him during his stay. These Services usually work at the back end but their contribution in the overall care of a patient is no where less than that of the clinical services.

Gloves are reprocessed and reused in health-care facilities in resource-limited settings to reduce the cost of availability of gloves. The study was done with the aim to compute the cost of reprocessing of gloves so that an economically rationale decision can be taken. A retrospective recordbased cross-sectional study was undertaken in a central sterile supply department where different steps during reprocessing of gloves were identified and the cost involved in reprocessing per pair of gloves was calculated. The cost of material and manpower was calculated to arrive at the cost of reprocessing per pair of gloves. The cost of a reprocessed pair of surgical gloves was calculated to be Indian Rupee (INR) 14.33 which was greater than the cost of a new pair of disposable surgical gloves (INR 9.90) as the cost of sterilization of one pair of gloves itself came out to be INR 10.97. The current study showed that the purchase of sterile disposable single-use gloves is cheaper than the process of recycling. Reprocessing of gloves is not economical on tangible terms even in resource-limited settings, and from the perspective of better infection control as well as health-care worker safety, it further justifies the use of disposable gloves.