Operations Throughput as a Determinant of Golden-Hour in Mass-Gathering Medicine

Khan, Inam Danish; Asima, Buhra; Khan, Shahbaz Ali

doi:10.11603/ijmmr.2413-6077.2017.1.7804

Cited by 5 publications

(7 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Post-vaccination serosurveillance of anti-VZ antibodies can be done by simple latex agglutination, which can detect antibodies up to 11 years and is more sensitive than the enzyme-linked immunosorbent assay (ELISA). The community should also be exposed to health education programs in schools and community centers during high-attendance events such as parents-teacher meetings, ladies meeting, and cultural programs (24,25). Monitoring can be done electronically through Delphi techniques and creation of text-based communication systems for clientele feedback, early reporting and passive surveillance (2,26,27).…”

Section: Discussionmentioning

confidence: 99%

Outbreaks of Varicella Zoster in a Military Nursing Institute: Infection Control in Hospital and Institutional Environments

et al. 2018

View full text Add to dashboard Cite

Background: Varicella zoster (VZ) is a highly contagious exanthematous disease. The Indian VZ clade 5 has a high outbreak potential with attack rates of 90%, which thwarts all the infection control endeavors in hospital and institutional environments. Four VZ outbreaks occurring over four different years were investigated with military nursing students in a tertiary-care hospital in order to delineate infection control protocols. Methods: VZ outbreaks were investigated by hospital infection control committee utilizing standard definitions and protocols after establishing epidemiological linkage. A total of 114 nursing students were evaluated through a questionnaire developed to assess clinicodemographic, exposure, confinement and vaccination parameters. Outbreak control measures included isolation of patients; quarantined close-contacts and suspects; acyclovir treatment; immunization of susceptible candidates against VZ. Results: There were four different outbreaks comprising a total of 23 patients including five breakthrough patients with cumulative attack rate of 39%. Most patients had mild VZ. Most common sources were friends. Also, 25 students had no exposure to VZ or VZ vaccine, and were identified to be susceptible candidates and accordingly, were vaccinated. Conclusions: Outbreaks of VZ are emerging in the developing countries due to inadequate immunization coverage, primary failure to seroconvert, or failure to mount immune response despite seroconversion, or secondary failure due to waning immunity. Outbreaks of VZ may have variable epidemiological dynamics and may not be controlled with standard infection-control programs. There is a need to augment existing capabilities for optimizing outbreak management in institutional settings.

show abstract

Section: Discussionmentioning

confidence: 99%

Outbreaks of Varicella Zoster in a Military Nursing Institute: Infection Control in Hospital and Institutional Environments

et al. 2018

View full text Add to dashboard Cite

show abstract

“…20 This is particularly worrying as the detection of such infections is limited in mass gathering settings. 21 Furthermore, the clinical presentation of certain respiratory infections may be non-specific, especially in cases of seasonal influenza and H1N1, thus increasing the burden of laboratory testing. During Hajj, the Saudi Arabian healthcare system has limited resources at its disposal, particularly when it comes to the sophisticated molecular tests required for the diagnosis and identification of novel respiratory pathogens.…”

Section: Discussionmentioning

confidence: 99%

“…During Hajj, the Saudi Arabian healthcare system has limited resources at its disposal, particularly when it comes to the sophisticated molecular tests required for the diagnosis and identification of novel respiratory pathogens. [21][22][23] While there are operational stringencies in place for the isolation of suspected cases of infection, there are no approved antiviral drugs for treating novel respiratory pathogens-the teratogenic effects of which would need to be assessed in any case-nor available guidelines for their specific monitoring, prognosis or follow-up. 21 Moreover, hospitalisation can further increase the transmission of respiratory pathogens.…”

Section: Discussionmentioning

confidence: 99%

Obstetric and Neonatal Outcomes of Pregnant Indian Pilgrims: A three-year experience at the Indian Hajj Medical Mission

Khan

2018

Sultan Qaboos Univ Med J

View full text Add to dashboard Cite

Objectives:The Hajj, an annual mass gathering of Muslim pilgrims, is known for its high morbidity and mortality rates. However, pregnant women sometimes participate in this pilgrimage, despite guidelines that discourage such an undertaking due to potential fetomaternal complications. This study aimed to evaluate fetomaternal outcomes among pregnant Indian Hajj pilgrims. Methods: This prospective cross-sectional study was conducted at two Indian Hajj Medical Mission (IHMM)-affiliated secondary care hospitals in Saudi Arabia during the Hajj periods of August-October 2015 and 2016 and July-September 2017. All female Indian pilgrims of reproductive age who underwent pregnancy screening at secondary care IHMM hospitals during this period were included in the study. Definitive obstetric care was provided at the Makkah Maternity & Child Hospital. Data regarding the pilgrims' obstetric characteristics, antenatal complications, management and fetomaternal outcomes were evaluated. Results: A total of 114 pregnant Indian pilgrims were identified during the study period. The most common antenatal complications were respiratory tract infections (51.75%), followed by iron deficiency anaemia (17.54%), hyperemesis gravidarum (14.04%), hypothyroidism (9.65%) and gestational diabetes mellitus (5.26%). There were 20 vaginal deliveries (17.54%), two Caesarean sections (1.75%) and 32 abortions (28.07%). The cumulative three-year birth rate was 24.60 per 1,000 females. Conclusion: During Hajj, pregnant pilgrims have a high risk of abortion, respiratory tract infections and various antenatal, perinatal and neonatal complications which may go unreported or untreated. Women should therefore be educated regarding the risk of adverse fetomaternal outcomes which may occur while undertaking a Hajj pilgrimage during pregnancy. Advances in Knowledge-This prospective study is the first of its kind to evaluate fetomaternal outcomes among pregnant Indian Hajj pilgrims.-The cumulative three-year birth rate was 24.60 per 1,000 women.-The most common antenatal complications were respiratory infections, followed by iron deficiency anaemia. There was also a high incidence of abortions and other adverse pregnancy and neonatal outcomes. Application to Patient Care -Mass gatherings increase the transmissibility of respiratory pathogens. In addition, local healthcare systems may not be able to detect antenatal complications during Hajj or may experience transport difficulties due to crowded conditions, potentially leading to neonatal morbidity and mortality. Pregnant women considering undertaking Hajj pilgrimage should be educated regarding such risks.

show abstract

“…First response along with on-site management form the most important determinants in prognosis. [29][30][31][32] This concept has been elaborated as the "golden hour in heatstroke. " 23 A comprehensive, public health surveillance system enabled Hajj organizers to recognize heatstroke as a significant cause of morbidity, which was noticeably reduced after the provision of gratis potable cold water, sun cover, water sprinklers, and air misters along the pilgrimage routes.…”

Section: Discussionmentioning

confidence: 99%

Emergency Response of Indian Hajj Medical Missionto Heat Illness Among Indian Pilgrims in Tent-Clinics atMina and Arafat During Hajj, 2016

Khan

Hussaini

Khan³

et al. 2017

Int J Travel Med Glob Health

View full text Add to dashboard Cite

Operations Throughput as a Determinant of Golden-Hour in Mass-Gathering Medicine

Abstract: Background. Golden-hour, a time-tested concept for trauma-care, involves a systems approach encompassing healthcare, logistics, geographical, environmental and temporal variables. Golden-hour

Cited by 5 publications

References 13 publications

Outbreaks of Varicella Zoster in a Military Nursing Institute: Infection Control in Hospital and Institutional Environments

Outbreaks of Varicella Zoster in a Military Nursing Institute: Infection Control in Hospital and Institutional Environments

Obstetric and Neonatal Outcomes of Pregnant Indian Pilgrims: A three-year experience at the Indian Hajj Medical Mission

Emergency Response of Indian Hajj Medical Missionto Heat Illness Among Indian Pilgrims in Tent-Clinics atMina and Arafat During Hajj, 2016

Contact Info

Product

Resources

About