Peri-operative SARS-CoV-2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS-CoV-2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with pre-operative SARS-CoV-2 infection were compared with those without previous SARS-CoV-2 infection. The primary outcome measure was 30-day postoperative mortality. Logistic regression models were used to calculate adjusted 30-day mortality rates stratified by time from diagnosis of SARS-CoV-2 infection to surgery. Among 140,231 patients (116 countries), 3127 patients (2.2%) had a pre-operative SARS-CoV-2 diagnosis. Adjusted 30-day mortality in patients without SARS-CoV-2 infection was 1.5% (95%CI 1.4-1.5). In patients with a pre-operative SARS-CoV-2 diagnosis, mortality was increased in patients having surgery within 0-2 weeks, 3-4 weeks and 5-6 weeks of the diagnosis (odds ratio (95%CI) 4.1 (3.3-4.8), 3.9 (2.6-5.1) and 3.6 (2.0-5.2), respectively). Surgery performed ≥ 7 weeks after SARS-CoV-2 diagnosis was associated with a similar mortality risk to baseline (odds ratio (95%CI) 1.5 (0.9-2.1)). After a ≥ 7 week delay in undertaking surgery following SARS-CoV-2 infection, patients with ongoing symptoms had a higher mortality than patients whose symptoms had resolved or who had been asymptomatic (6.0% (95%CI 3.2-8.7) vs. 2.4% (95%CI 1.4-3.4) vs. 1.3% (95%CI 0.6-2.0), respectively). Where possible, surgery should be delayed for at least 7 weeks following SARS-CoV-2 infection. Patients with ongoing symptoms ≥ 7 weeks from diagnosis may benefit from further delay.
SARS-CoV-2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri-operative or prior SARS-CoV-2 were at further increased risk of venous thromboembolism. We conducted a planned sub-study and analysis from an international, multicentre, prospective cohort study of elective and emergency patients undergoing surgery during October 2020. Patients from all surgical specialties were included. The primary outcome measure was venous thromboembolism (pulmonary embolism or deep vein thrombosis) within 30 days of surgery. SARS-CoV-2 diagnosis was defined as peri-operative (7 days before to 30 days after surgery); recent (1-6 weeks before surgery); previous (≥7 weeks before surgery); or none. Information on prophylaxis regimens or pre-operative anti-coagulation for baseline comorbidities was not available. Postoperative venous thromboembolism rate was 0.5% (666/123,591) in patients without SARS-CoV-2; 2.2% (50/2317) in patients with peri-operative SARS-CoV-2; 1.6% (15/953) in patients with recent SARS-CoV-2; and 1.0% (11/1148) in patients with previous SARS-CoV-2. After adjustment for confounding factors, patients with peri-operative (adjusted odds ratio 1.5 (95%CI 1.1-2.0)) and recent SARS-CoV-2 (1.9 (95%CI 1.2-3.3)) remained at higher risk of venous thromboembolism, with a borderline finding in previous SARS-CoV-2 (1.7 (95%CI 0.9-3.0)). Overall, venous thromboembolism was independently associated with 30-day mortality ). In patients with SARS-CoV-2, mortality without venous thromboembolism was 7.4% (319/4342) and with venous thromboembolism was 40.8% (31/76). Patients undergoing surgery with peri-operative or recent SARS-CoV-2 appear to be at increased risk of postoperative venous thromboembolism compared with patients with no history of SARS-CoV-2 infection. Optimal venous thromboembolism prophylaxis and treatment are unknown in this cohort of patients, and these data should be interpreted accordingly.
Problem statement: 5S practice is one of the techniques to improve quality environment, health and safety at the workplace. Evaluation of 5S practice can be done through implementation of 5S audit at each division in the company. Approach: Through 5S audit, it enables each company to identify the potential level of quality improvement and at the same time can analyze their ability and weakness of each division in the company. Therefore, in order to assess the implementation of 5S practice, two manufacturing companies were involved in this study. Results: The study started with understanding background of the company, recognizing divisions to be assessed in the company and come out with the complete 5S checklist for each division for auditing process. Based on the result, both companies basically perform an excellent 5S practice, but there are a few weaknesses that still need to be considered such as arrangement of the documents, tool and equipment. Conclusion/Recommendations: Moreover, both companies agreed that the 5S practice is seen as an effective technique that can improve housekeeping, environmental performance, health and safety standards in their workplace. However, effort and participation from top management is a key factor that determines the success of the 5S practice.
This study examines the poverty and food security analysis of fishermen households in a selected area of Gopalganj Sadar Upazila in Gopalganj District in Bangladesh. A sample size of 60 households was selected purposively from four villages. Data was collected through field survey by using pre-designed and pre-tested questionnaire. Calorie intake levels were calculated and statistical comparisons were done. Multiple regression analysis was carried out to determine the factor influencing calorie intake in individual levels. Food consumption scores were used to determine calorie intake levels. The major findings of the study were that income, education, cultivable area and rented area had positive impact on calorie intake but age of the respondents and family size had negative impact on calorie intake. About 68.33% of the respondents belonged to hard core poor whose average calorie intake was 1692.32 k. calories and 25% of the respondents had an average calorie intake 1890.93 k. calories and they belonged to absolute poor. The rest 6.67 % of the respondents took above 2122 kilo calories and average calorie intake was 2193.50 k. calories. There was 20% households having poor food consumption and 42% having borderline food consumption. Only 6.67% fishermen households have acceptable low food consumption and 3.33% have acceptable high food consumption.
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