Introduction Access to health care and care delivery during the COVID-19 pandemic may be challenging for cancer patients. Several guidelines have been developed, which recommend treatment adjustments depending on the site of cancer, grade, and stage. However, few studies in India and across the globe have looked into the real challenges faced by cancer patients and assessed the effectiveness of the adopted interventions. This study was undertaken with the objective to study the challenges faced by cancer patients in India during the COVID-19 pandemic. Materials and Methods This was a cross-sectional study undertaken between May 1, 2020 and May 15, 2020. A link to a prestructured questionnaire was sent through email to 100 randomly selected cancer patients in different stages of treatment and follow-up. Data were decoded and entered in Microsoft Excel 2010 and analyzed using descriptive statistics. Results Slot availability for teleconsultation, network issues, deferral of radiotherapy dates and long waiting hours beyond appointment time, transportation problems from residence to hospital, restriction of visitors/attendants, deferral of surgery, deferral of tumor boards, delay and deferral of advice of the nutritionist, problems faced in extension of visa, unavailability of peer group support services and psychological counseling sessions, difficulty in maintaining precautionary measures, availability of chemotherapy medications and availability of chemotherapy slots in day care were cited as problems faced by cancer patients. Majority (91.7%) of the study respondents mentioned an increase in their anxiety levels. Conclusion As highlighted in the study, cancer patients faced challenges in cancer care delivery during the COVID-19 pandemic. This study suggests the need for larger studies on cancer patient care during a pandemic.
Introduction: Hospital-acquired infection (HAI) rates were reported to have declined in healthcare settings during the Covid-19 pandemic. Needless to mention that HAI is of paramount interest and relevance to a primary care physician who need to care from womb to tomb inside pandemic. Objectives: This study was conducted to find the impact of Covid-19 pandemic on the four parameters of HAIs, namely, catheter-associated urinary tract infections (CAUTI), central-line-associated bloodstream infections (CLABSI), ventilator-associated pneumonia (VAP) and surgical site infections (SSIs) with hand hygiene compliance rates among healthcare workers. Materials and Methods: This retrospective data mining was undertaken in a 700 bed multispecialty teaching hospital in the Eastern India which was a Government of Bihar approved speciality Covid Care Hospital. Data from the monthly routine infection control monitoring and surveillance activities was collated from January 2019 to December 2020. Control charts with upper and lower control limit set at mean ± 1 SD were used to monitor monthly trends of HAIs. Results: The CAUTI rates reduced by 28.01%; the CLABSI rates declined by 37.61%, the SSI rates reduced by 62.39%, while the highest VAP rates were reported in November 2019 (1.9 per 1000 ventilator days). The hand hygiene compliance rates from January 2019 to December 2020 among different healthcare staffs showed a sharply rising trend. Conclusion: Covid-19 pandemic highlighted paramount importance regarding compliance to hand hygiene and implementation of standard infection control practices as recommended by World Health Organisation and Centres for Diseases Control and Prevention (CDC), which can drastically reduce range of HAIs.
Introduction: "Code blue" (CB) is common emergency code, used by hospitals to alert trained emergency response team of any cardiac arrest. The factors affecting the outcome of resuscitative services are inherent to the patient and also to the functioning of the Code Blue System (CBS). The primary objective was to assess the success of 'Code Blue' in terms of survival. The other objective was to identify the patient and system variables associated with a favorable outcome. Material and methods: This was a cross sectional retrospective study done in a multispecialty teaching hospital in Bihar during the period from April 2018 to March 2019. The study was conducted after approval from the Institutional Ethics Committee. Data was gathered from the Code Blue Report Form and further details of individual patients were tracked from their medical records. Data was entered in an Excel Spreadsheet and analyzed using descriptive statistics, Chi-square test and logistic regression analysis using SPSS Version 21 software. Results: A total of 111 CB calls were initiated during the period. Code Blue activated for cardiac arrest situations only were considered in the study. Emergency response calls for physiologically acute changes in the patients were excluded. Immediate success of resuscitation services for Code Blue calls was 63.06%, beyond 24 hours this was 27.03% and at discharge this was just 9.01%. Factors such as age, time of Code Blue during or outside routine hospital working hours, associated comorbidities, procedures like dialysis, operation or chemotherapy done in the last 24 hours preceding the Code Blue and duration of CPR were found to have a significant effect on the success rate. Conclusion: We conclude, that formal training of all the healthcare providers on BLS is of paramount importance. Further in depth analysis is required to find out the root cause of the problems that are associated with the 'Code Blue' process which is affecting the success rates beyond routine hospital working hours.
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