Comparative analysis of N95 respirators fit testing with commercially available and in house reagent

Background: Due to COVID-19, thousands of healthcare workers have been affected and have lost their lives in the line of duty. For the protection of healthcare workers, WHO and CDC have made standard guidelines and requirements for PPE use. N95 masks are amongst the most readily used PPE by healthcare professionals and it is highly recommended by OSHA that every make and model of N95 should go through a fit test at least once in a year.Method: A total of 30 randomly selected healthcare professionals (who were a regular user of N95 respiratory masks) were subjected to assess in-house (saccharin sodium benzoate) reagent for use for standard qualitative fit testing in our hospital. Threshold testing with the in-house reagent at three different concentrations was performed prior to establish participants\u27 sensitivity to the reagent. After successful completion of threshold testing, fit test was performed on participants wearing an N95 mask.Results: All the participants included in the study passed the sensitivity testing with three concentrations of the reagents, while it was concluded that the concentration of the in-house reagent that was well suited for the sensitivity testing was a concentration of 1g/dl saccharin with 10g/dl sodium benzoate. For fit testing 12g/dl was found to be more appropriate.Discussion: Our study provided a low cost solution to ensure safety of healthcare workers who are regular users of N95 masks following guidelines implemented by OSHA and CDC.Conclusion: The in-house test solution prepared was found to be equally sensitive to its commercially available counterpart

Intimate partner violence through the lens of gender, finance, and ethics

Intimate partner violence (IPV) is a pervasive public health concern affecting women around the globe. It refers to the detrimental actions that cause harm physically or psychosexually to the partner predominantly women, in an intimate relationship. Regardless of any age, sexual orientation, or ethnicity, women make the most vulnerable group to IPV by virtue of their customary social and demographic characteristics. The traditional and preset societal roles have a direct influence on the development of intimate partner relationships. The predetermined gender roles tend to uphold male privileges and degrade women for subordination. However, a patriarchal society based on male dominance is produced by the socioeconomic and political systems. Financial impediments among women along with the societal subservience further limit their freedom and autonomy, ultimately forcing them to submit to the vices of their male partners. IPV is a serious medico-legal offense which has various ethical implications. Various ethical frameworks establish the connections between IPV and medical ethics and guide the ways to address them. A collaborative and multidisciplinary approach is essential to effectively address the issue of intimate partner violence (IPV), which is prevalent in both developing and developed countries. The chapter explains IPV in association to the gender roles, power disparities, financial insecurities, and biomedical ethics and outlines the key recommendations for mitigation

Validation and impact of the use of automated urine culture streak system in a diagnostic laboratory on surveillance of catheter-associated urinary tract infections at a tertiary care setting

Background: Quantitative urine culture reporting on plates inoculated by automated streaking system (PREVI® Isola) demonstrates maximum growth only equivalent up to 104 colony-forming unit (CFU)\ml, according to the manufacturer\u27s recommendation. Therefore, there is a probability of erroneous catheter-associated urinary tract infection (CAUTI) surveillance data as a count of ≥105 CFU/ml is required according to CAUTI definition. This study aimed to validate automated urine culture streak system for improving the surveillance of hospital-acquired CAUTIs. Materials and Methods: This was a prospective, cross-sectional study. In 1-month duration, urine samples of 1000 consecutive patients reported to the microbiology section for culture and sensitivity were included. Samples were processed simultaneously manually (1 μl loop) and with an automated streaking system. Plates streaked by automated method were arbitrarily divided into eight equally sized segments. After 24 h of incubation at similar conditions, microbial growths in each segment were noted and correlated with its manual colony count. To minimize the error, colony count and morphotype were analyzed by a senior technologist and counterchecked by a consultant. Results were recorded on an Excel sheet. Results: Growth on the 7th and 8th segments corresponded with ≥105 CFU/ml. Growth up to the 4th, 5th, and 6th segments corresponded with 104 CFU/ml, whereas the 3rd segment with \u3e103 but \u3c104 CFU/ml. Any growth in the 1st and 2nd sectors was considered insignificant. Conclusion: Quantitative urine culture analysis inoculated by automated streak system corresponds to the CAUTI surveillance definition. Colony count requires validation with manual method before implementing in laboratory