Personal Protective Equipment Associated Symptoms amongst Frontline Health Care Workers in COVID-19 Pandemic � A Cross Sectional Study

Context : During COVID-19 Pandemic, frontline Health Care Worker (HCW) in hospitals were mandated to Personal Protective Equipment (PPE), while caring for suspected or confirmed COVID-19 patients, which involved the donning of close-fitting N95 Face Masks, Protective Eyewear, Gowns, Surgical Gloves and the use of Powered AirPurifying Respirators (PAPR). Aims : This study is to know the challenges faced during use of PPE among frontline HCW. Methods and Material : This is a cross-sectional study among HCW at our Tertiary Institution who were working in high-risk hospital areas during COVID-19. All respondents completed a self-administered questionnaire Statistical analysis used : Data were entered in Microsoft Excel and analyzed using SPSS version 23. Baseline characteristics were described using frequency and percentages. Association between predictors of PPE associated symptoms were assessed using Chi-square test with p-value of <0.05 considered as significant. Results : Total of 190 Health Care Workers participated in the study. Doctors- contributed most [143/189 (75.2%)]. Majority of the respondents reported usage of Masks, Eyewear, Shield and Gown [126/189 (66.7%)], in which most of them donned N-95 mask [152/189(80.5%)], and Goggles [110/189 (58.2%)] average for 6.32 (2.40) hours a day and 18.15(8.65) days in a month. 83 respondents reported a new onset headache associated with usage of PPE. Majority of the respondents localized Headaches as frontal (69.9%) which was statistically significant. Other symptoms were Tiredness (73.5%), Excess Sweating (45.4%) and Giddiness (20.6%). Conclusions : Prevalence and characteristics of PPE- associated symptoms in HCW working in high-risk areas in Tertiary Care Centers necessitates better measures and strategies for designing PPE and reducing the exposure time in HCW and also the impact on their work performance

Hairdressers in Johannesburg: knowledge, attitudes and practices regarding occupational health

Introduction: Hairdressers are exposed to hazardous chemicals in haircare products, which can cause adverse respiratory, skin, and reproductive effects. The incidence of these effects can be reduced with good occupational health and safety (OHS) knowledge, attitudes, and practices (KAP). Objective: The objective of the study was to assess Johannesburg hairdressers' knowledge, attitudes, and practices towards occupational health and safety. Methods: Three hundred and eighty-three hairdressers were recruited into this crosssectional study. They were categorised into employees/wage earners (earning a salary or wage, n = 151), or business owners (self-employed, n = 232). Data were collected using an interviewer-administered questionnaire. The data were analysed using Statistical Package for Social Sciences (SPSS) version 26. Frequency tables were generated and chi-square tests were used to test differences between KAP amongst business owners and wage earners. Results: Most of the study participant were female (n = 237, 61.9%). A higher proportion of business owners than wage earners knew that hairdressing was hazardous to their health, in general (n = 44, 29.1% and n = 120, 51.7%, respectively), and with regard to specific health risks such as asthma, cancer, and skin diseases. However, more of the wage earners than the business owners had good attitudes towards the wearing of personal protective equipment (PPE) such as gloves, (n = 143, 94.7% and n = 210, 90.5%, respectively). Overall, wage earners practised better OHS than business owners, e.g. 67.5% (n = 102) and 55.2% (n = 128) reported that they wore gloves, respectively. Conclusion: Wage earners had poorer OHS knowledge than those who owned or operated hairdressing salons. Both had good attitudes towards OHS, but self-employed hairdressers had poorer OHS practices. Training, including workshops and seminars, is needed to improve KAP regarding OHS amongst all hairdressers, regardless of their employment status.

Ethical Issues in Surgery during COVID-19 Pandemic

Surgeons were facing considerable ethical dilemma during this COVID-19 pandemic-whichpatient to select for surgery and which patient to be deferred for a later date. Surgeons also had a difficult taskof protecting themselves and their team and perform a safe surgery without infecting the patient. There were also ethical issues of using Oxygen or an Intensive Care Unit (ICU) bed during this time for the surgical patient when it was in short supply. A critical factorwas balancing the benefit of surgery for the patient against the risk of contacting the COVID-19 virus and the complications of the disease process.

Practice of Cardiovascular Surgery on Patients with COVID-19 : a Questionnaire Survey / 日本心臓血管外科学会雑誌

The purpose of this study is to assess the impact of coronavirus disease 2019 (COVID-19) on the performance of cardiovascular surgery in Japan. The information gathered may be useful to prepare for a surgery in Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) positive patients and prevent COVID-19 transmission from surgical patients to healthcare workers. [Methods] A web-based questionnaire was distributed to all accredited cardiovascular surgery centers in Japan. A total of 550 questionnaires were sent, and 310 (56.4%) were returned. [Results] Preoperative PCR or antigen testing was performed in all patients at 68.8% of centers. The proportion of surgeries postponed or cancelled was the highest for elective valvular and aortic surgeries and for emergency aortic surgeries. In most facilities elective surgeries were restricted to less than 50% of usual case volumes, while approximately 40% did not experience any negative impact on the case volume. Among the surgical patients, 32 were suspected to be SARS-CoV-2 positive, and 10 were confirmed. As preventive measures against spreading infection, more than 90% of the patients wore N95 masks, 33.3% full PPE, and 66.7% N95 mask+face shield. No case of patient-to-healthcare-worker transmission was reported. There were no postoperative deaths among the confirmed SARS-CoV-2 patients. [Conclusion] Restriction of surgical practice was placed on many institutions in the COVID-19 pandemic, but the degree of restrictions varied. Preoperative screening of all surgical patients and intraoperative use of PPE in those with suspected or confirmed SARS-CoV-2 infection adequately prevented transmission to healthcare workers. Since COVID-19 has a nationwide impact, it is important to continuously monitor surgical outcomes and infection rate by conducting perioperative surveys of COVID-19 patients.

The handling of safety concerns among anaesthetists when restarting full surgical lists during the COVID-19 pandemic

@#Around June 2020, many institutions restarted full operating schedules to clear the backlog of postponed surgeries because of the first wave in the COVID-19 pandemic. In an online survey distributed among anaesthestists in Asian countries at that time, most of them described their safety concerns and recommendations related to the supply of personal protective equipment and its usage. The second concern was related to pre-operative screening for all elective surgical cases and its related issues. The new norm in practice was found to be non-standardized and involved untested devices or workflow that have since been phased out with growing evidence. Subsequent months after reinstating full elective surgeries tested the ability of many hospitals in handling the workload of non-COVID surgical cases together with rising COVID-19 positive cases in the second and third waves when stay-at-home orders eased.

Caracterización clínico epidemiológica de pacientes pediátricos con profilaxis postexposición no ocupacional al VIH. Hospital Nacional Mario Catarino Rivas / Clinical epidemiological characterization of pediatric patients with non-occupational post-exposure pro- phylaxis to HiV. Mario Catarino Rivas National Hospital

Antecedentes: La agresión sexual, sigue siendo la principal causa de exposición al VIH no ocupa- cional en niños; se presenta en todas las clases so- cioeconómicas, y casi en todos los países del mun- do únicamente con diferencias en la magnitud. Objetivo: Identificar las características clíni- co epidemiológicas de los pacientes pediátricos que recibieron profilaxis post exposición no ocu- pacional en el Hospital Nacional Doctor Mario Ca- tarino Rivas de enero 2020 a septiembre 2021. Pacientes y métodos: se trató de un estudio cuanti- tativo con un enfoque descriptivo y un diseño no ex- perimental transversal, donde se realizó la revisión de 18 expedientes de pacientes que recibieron la atención inmediata posterior a la exposición no ocupacional al VIH, utilizándose cómo método de recolección la ficha epidemiológica del Protocolo de profilaxis Post Expo- sición PPE al VIH y otras ITS (Infecciones de trans- misión Sexual) de la Secretaria de Salud de Honduras 2017 modificada para esta investigación. Resultados: El 78,0% de los casos se encontraron en el grupo etario de adolescentes, en su mayoría de sexo femenino y el 83,0% de los casos provenían del departamento de Cor- tés. La agresión sexual fue la causa más frecuente, don- de el 44,0% resultó haber tenido exposición en su hogar; siendo el agresor un pariente o conocido en el 52.8%. *Médico Residente tercer año de Pediatría, UNAH-VS **Médico Pediatra, servicio de Atención Integral, HNMCR Fecha de entrega: 06/10/2021 Fecha de aprobado 20/10/2021 Dirigir correspondencia a: eloapuerto@gmail.com Así mismo, el 94,1% de la serología del agresor para VIH era desconocida. Al momento de captación el 89,0% de los casos tenían una serología de VIH negativa, al mes de seguimiento el 46,6% presentó una serología negativa. Sin embargo, a los 12 meses el 100% de los casos fueron perdidos en seguimiento. Únicamente el 53,8% cumplió con la profilaxis con terapia antirretroviral y el 88,0% con la profilaxis para infecciones de transmisión sexual. Conclusiones: El incumplimiento del protocolo es atri- buible a la situación por la pandemia de COVID-19 y/o al desconocimiento general de la población so- bre la importancia del cumplimiento total del mismo...(AU)

To Keep COVID-19 Out of Hospitals in India - Are We Prepared?

The current viral outbreak of the Novel Corona virus, or COVID-19 has turned into a global health crisis. The World Health Organization (WHO) has declared it a public health emergency of international concern. Hospitals are known to have played a very important role in giving necessary medical treatment to the society, particularly at the time of a disaster. Preventive measures such as masks, hand hygiene practices, avoidance of public contact, case detection, contact tracing, and quarantines have been discussed as ways to reduce transmission. During the current outbreak of COVID-19, a break in these vital modalities and goods would lead to a break in the provision of acute health care by a not fully prepared health-care facility. Adding to it an elevated rate of personnel absence is predictable. A scarcity of important equipment and goods could prevent access to desired care and have a direct impact on health care delivery. Health workers and carers are at high risk of infection, and healthcare associated amplification of transmission is of concern as is always the case for emerging infections. Non-pharmaceutical interventions remain central for management of COVID-19 because there are no licensed vaccines or coronavirus antivirals. To date, effective treatment is lacking; however, clinical trials investigating the efficacy of several agents, including remdesivir and chloroquine, are underway in China. Currently, effective infection control intervention is the only way to prevent the spread of the infection. Considering this, India has issued several notifications on how one can be affected by this deadly disease, what the symptoms are, and what preventive measures could be adopted. In addition, the Government of India has issued guidelines for prevention and preparedness of hospitals. This review is to better understand the epidemiology, causes, clinical diagnosis, prevention and control of this virus and steps which are to be followed to prevent spread of disease in hospitals.

Practical guidance for healthcare professionals during the COVID-19 pandemic; with special emphasis on the care of cardiovascular patients and personal protection

A novel, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is causing the COVID-19 pandemic. There are concerns regarding the spread of disease by asymptomatic carriers to healthcare workers who continue to see patients and to perform procedures on them. The infection then could be transmitted through them to other patients who eventually, could infect persons in the community. Further, limitations of existing tests to detect new cases that are negative early in the disease; and the inability to use appropriate personal protection equipment (PPE)also contribute to the spread of infection. This document, from the COVID-19 Working Group of Wellness and Radial Intervention Society, describes considerations for management and care of cardiovascular disease (CVD) patients with the concept of COVID 19 `designated` Vs. enabled` centers for those with symptoms of and/ or confirmed COVID-19 disease Vs. asymptomatic suspects. It also provides guidance to healthcare professionals, hospital administrators, and policymakers in general and to those managing patients with CV and other diseases, regarding the concept of `levels of personal protection` for staff; with suggestions for `equivalent innovative alternatives`, and a` protection plan` for patients to prevent the spread of disease. The guidance can also be broadly applied to surgical branches in general and to other specialties involved with invasive, semi-invasive, and non-invasive procedures such as gastroenterology, urology, anesthesiology, otolaryngology, and ophthalmology which carry a higher risk of exposure for healthcare professionals.

COVID-19, Various Treatment Options and Special Considerations for Dentistry

Objective:The aim of this article is to analyze the epidemiology of COVID-19, comparison of routes of transmission in children and adults, comparing the clinical symptoms in adults and children, treatment protocol to be followed and possible treatment options duringthis pandemic. Data Sources:Data is collected from Pubmed, Medline and Embase databases. Discussion from Previous References Used: Few studies have been done to analyze its effect on children comparing the symptoms of adults and children. Also very lesswork is done to analyze the special precautions taken while doing dental treatment during this pandemic. Conclusion:The widespread effect of Coronavirus (COVID-19) or SARS-CoV-2 has created health concerns in the world. Although efforts have been taken to control the disease, it is still increasing due to the community spread. Health professionals may get patients in their practice with this infection and should prevent its spread.Clinical Significance of this Article:It will help us to differentiate the specific clinical symptoms of adult and pediatric patients coming to dental clinics and the special considerations for them including the emergency dental treatment during COVID-19

Biossegurança laboratorial na pandemia do SARS-CoV-2 / Laboratory biosafety in the SARS-CoV-2 pandemic

Devido à emergência do SARS-CoV-2, os laboratórios necessitaram se adequar na mes-ma velocidade em que a pandemia se instalou para atender com segurança à crescentedemanda pelos testes diagnósticos. Com o alto potencial de disseminação do vírus, o contato com pacientes e o manuseio laboratorial das amostras tornou-se um desafio sem precedentes para os laboratórios. A necessidade de práticas de biossegurança nunca foi globalmente tão enfatizada como nas circunstâncias atuais da pandemia. O objetivo desta revisão narrativa foi destacar medidas para prevenção da contaminação pelo SARS-CoV-2 nos laboratórios clínicos, utilizando como referência a literatura publicada em livros, artigos científicos, orientações técnicas de autoridades sanitárias e científicas, e na análise crítica e pessoal da autora. Alguns temas abordados foram: compreensão dos riscos, medidas de biossegurança, níveis de biossegurança, barreiras de contenção, uso correto dos equipamentos de proteção individual (EPI), desinfecção das áreas de laboratório, descarte seguro de resíduos, e biossegurança nas fases pré-analítica e analítica. As orientações são baseadas em evidências limitadas e frequentemente fracas, oriundas de opiniões, estudos observacionais ou extrapolações de epidemias anteriores causadas por outros coronavírus. As boas práticas de biossegurança destacadas foram estabelecidas muito antes do surgimento da COVID-19. No entanto, a pandemia trouxe à tona, aos profissionais de laboratório e à população em geral, boas práticas que estavam esquecidas, como a higienização das mãos, a etiqueta respiratória e a forma correta de paramentação e desparamentação dos EPI. Na pandemia, os laboratórios com poucos recursos necessitaram adaptar soluções seguras e econômicas para garantir a segurança laboral.

Due to the emergence of SARS-CoV-2 the laboratories had to adapt, as quickly as the pandemic was installed, to safely meet the growing demand for the diagnostic tests. The high potential for virus spread, contact with patients and laboratory handling of samples has become an unprecedented challenge for laboratories. The need for biosafety practices has never been more globally emphasized as in the current circumstances of the pandemic. The purpose of this narrative review was to highlight strategies to prevent contamination by SARS-CoV-2 in clinical laboratories, using as reference the literature published in books, scientific articles, technical guides from health and scientific authorities, and the critical and personal analysis of the author. Some topics that were covered: understanding risks, biosafety strategies, biosafety levels, containment barriers, correct use of personal protective equipment (PPE), disinfection of laboratory areas, safe disposal of waste, and biosafety in the pre-analytical and analytical phases.The orientations are based on limited and often weak evidence arising from opinions, observational studies or extrapolations from the previous epidemics coronaviruses. The highlighted good practices on biosafety were established long before the emergence of COVID-19. However, the pandemic brought up to the laboratory professionals and population in general, good practices that had been forgotten, such as hands hygiene, respiratory etiquette and the correct way of donning and doffing PPE. In the pandemic, laboratories with limited resources had to adapt safe and economical solutions to ensure safety in the clinical laboratory.

Screening specific binding peptides of Mycobacterium tuberculosis PPE17 protein by Phage display technique / 公共卫生与预防医学

Objective The specific binding peptide of Mycobacterium tuberculosis PPE17 protein was screened by phage display technique. Methods PPE17 gene was amplified from Mycobacterium tuberculosis genome, cloned into pET28a, expressed in E. coli BL21, purified by Ni2+ column, and identified by SDS-PAGE and Western blot. The purified PPE17 protein was coated into an ELISA plate and screened by phage 7 peptide library. After three rounds of panning, phage plaques were randomly selected for sequencing. DNAMAN was used to analyze and compare the amino acid sequences of the polypeptide encoded by the positive clones. Results PPE17 gene was successfully constructed and expressed, and soluble protein with molecular weight of about 37kD was obtained. From the third round of eluents, 20 plaque were randomly selected. The sequencing results could be translated into 8 polypeptide molecules, among which the polypeptide sequence repeated for 6 times was LKWGHVY. Conclusion The specific binding peptide of PPE17 protein is screened by phage display technology, which is expected to be a small molecular diagnostic reagent for the identification of this antigen.

Reducing the consumption of personal protective equipment by setting up a multifunctional sampling station in the emergency department to screen for COVID-19 infection in Taiwan

In Taiwan, high-risk patients have been identified and tested for preventing community spread of COVID-19. Most sample collection was performed in emergency departments (EDs). Traditional sample collection requires substantial personal protective equipment (PPE), healthcare professionals, sanitation workers, and isolation space. To solve this problem, we established a multifunctional sample collection station (MSCS) for COVID-19 testing in front of our ED. The station is composed of a thick and clear acrylic board (2 cm), which completely separates the patient and medical personnel. Three pairs of gloves (length, 45 cm) are attached and fixed on the outside wall of the MSCS. The gloves are used to conduct sampling of throat/nasal swabs, sputum, and blood from patients. The gap between the board and the building is only 0.2 cm (sealed with silicone sealant). ED personnel communicate with patients using a small two-way broadcast system. Medical waste is put in specific trashcans installed in the table outside the MSCS. With full physical protection, the personnel conducting the sampling procedure need to wear only their N95 mask and gloves. After we activated the station, our PPE, sampling time, and sanitization resources were considerably conserved during the 4-week observation period. The MSCS obviously saved time and PPE. It elevated the efficiency and capacity of the ED for handling potential community infections of COVID-19.

Recent updates on drug-resistance mechanisms in Mycobacterium tuberculosis and the role of PE/PPE proteins in drug resistance / 中国临床药理学与治疗学

Tuberculosis (TB), an infectious disease caused by Mycobacterium tuberculosis (M. tb) and mainly spread by airborne transmission, remains a global health problem. After the wide clinical utilization of antibiotics in treatment of TB, the drug resistance has become a major threat to global TB control and this threat has been heightened by the emergence and propagation of multi-drug resistant tuberculosis (MDR-TB), extensively drug-resistant tuberculosis (XDR-TB) and totally drug-resistant tuberculosis (TDR-TB). The research in the mode-of-action mechanisms of anti-TB drugs and the drug resistance mechanisms of M. tb will facilitate the novel anti-TB drugs development, the optimization of current anti-TB drugs and the development of new drug resistance diagnosis technologies. This review provides a comprehensive overview of mode-of-action mechanisms of new anti-TB drugs and mechanisms of resistance to these drugs in M. tb, with particular attention to the role of newly-identified mycobacterial outer-membrane channel proteins (PE/PPE proteins) in TB drug resistance.

Uso de EPI's pelos profissionais de saúde da atenção básica de um município de Goiás / Use of PPE by primary care health professionals in a municipality of Goiás

Objetivo: compreender o entendimento dos profissionais de saúde básica de um município de Goiás, no que se refere a utilização dos Equipamentos de Proteção Individual, focado nos Técnicos de Enfermagem e Enfermeiros dos postos de saúde. Método: foram elaborados questionários sobre a mesma abordagem para esses profissionais, refletindo na parcialidade de retorno dos questionários entregues, embora não influenciou no estudo pretendido, por se tratar de uma pesquisa por amostragem. Resultados: Foram submetidos ao estudo por meio deste recurso, 13 (treze) Técnicos de Enfermagem e 20 (vinte) Enfermeiros. Diante do recurso utilizado, seguiu-se a pesquisa a luz de autores que abordam o tema em estudo. Conclusão: embora pareça lógico, algumas intervenções precisam ser feitas no sentido de melhorar o uso dos EPIs em meio aos profissionais que constituem o sistema de saúde desde um município até a configuração nacional, pois o entendimento é que o todo se constitui por unidades.

Objective: to know the understanding of basic health professionals in a city of Goias state, regarding the use of Personal Protective Equipment, focused on Nursing Technicians and Nurses in health posts. Method: questionnaires were elaborated on the same approach for these professionals, reflecting on the partial return of the questionnaires delivered, although it did not influence the intended study, as it was a sample survey. Results: Through this resource, 13 (thirteen) Nursing Technicians and 20 (twenty) Nurses were submitted to the study. Given the resource used, the research followed the light of authors addressing the subject under study. Conclusion: although it seems logical, some interventions need to be made in order to improve the use of PPE among professionals who constitute the system. from a municipality to the national configuration, because the understanding is that the whole is constituted by units.

Peer Physical Examination’ As A Tool For Learning Human Anatomy And Clinical Skills

Background: Academic achievement is considered as a key to judge one’s potentialities and capacities. Lowachievement may be related to poor self concept, lack of family involvement, damaging peer pressure, culturaldeprivation, study skill deficiency, emotional problems, physical illness, lack of academic motivation. Anatomyhas been considered a key element of medical education for centuries and has survived current challengingpedagogic test of time. The teaching hours of anatomy have been reduced but the traditional teaching predominatesand lacks integration and clinical correlate. As living and surface anatomy forms the bridge between clinicalpractice and gross anatomy; the reduced course hours compelled many medical institutes to upgrade thedevelopment of anatomical resources via new technological advancements and by inculcating living anatomysessions by peer examination, life models and imaging. Further evidence is needed to define which method ofanatomy teaching leads to the most effective clinicians and if the choice of method affects students. Peerphysical examination (PPE) was considered as one of the important and widely accepted teaching tool inconducting living and surface anatomy sessions. In the present study, PPE is used as a teaching tool to help lowachiever students to escalate their academic performance.Results: Two groups A and B are made of 25 each from 50 low achiever students. Five topics of living anatomywere taught with traditional method in group A and with PPE in group B. Then students were assessed byobjectively structured practical examination (OSPE) of both groups. There was statistically significant differencein scores of students in group A and group B.Conclusions: So we concluded that there is definitely an academic improvement in the low achiever students withthe use of PPE. But future studies are required to compare the findings presented here with those of other medicalcolleges. So that PPE can be included as a regular teaching tool to facilitate not only low achievers but all of thestudents for their academic enhancement and future goal of becoming competent and ideal clinician.

Personal protective equipment compliance among laundry workers in secondary and tertiary health facilities in Nigeria

Background: Generally, personal protective equipment (PPE) should be used by healthcare workers, as they provide a physical barrier between hazards and the wearer. Exposure to occupational hazards in the laundry can be limited by the use of PPE such as barrier gowns, gloves, eyewear, foot coverings and face masks. This study provides information on the PPE compliance of the workers at the laundry, as this would prove useful in order to establish appropriate interventions to minimize occupational risks of workers in the healthcare laundries.Methods: This study was a comparative cross-sectional study. It was conducted in six hospitals with a laundry department in Benin-city, composed of one available tertiary healthcare facility and five secondary healthcare facilities. Questionnaire was administered to the workers concerning the availability and use of PPE.Results: The common PPE used were nose masks (7.9%), hand gloves (39.5%), safety boots (3.6%) and coveralls (84.5%). Respondents revealed that eye goggles or face shields and ear plugs or muffs were never provided for them.Conclusions: Compliance of respondents to PPE was not at an optimally recommended level. It is recommended that efforts be made to ensure that workers comply with PPE use, while providing all necessary protective equipment, which should first be assessed before selection and use.

The use of bony septum as an extended spreader graft in primary and secondary rhinoplasty

@#<p><strong>OBJECTIVE:</strong>  To describe a surgical technique using bony septum, specifically vomer or perpendicular plate of the ethmoid (PPE), as an extended spreader graft (ESG) for securing septal extension graft (SEG) and for correcting internal nasal valve dysfunction.</p><p><strong>METHODS</strong>:</p><p>            <strong>Design:</strong>            Descriptive Case Series</p><p>            <strong>Setting:</strong>           Tertiary Private Hospital</p><p>            <strong>Participants:</strong> Thirty-two (32) patients who underwent aesthetic rhinoplasty from May 2016 to October 2017 were evaluated, and ten (10) patients presenting with symptomatic obstruction were considered for inclusion. The surgical technique was applied in patients with weak SEG for control of nasal length and tip projection who had inadequate septal cartilage for SEG and ESG intraoperatively. Results were evaluated grossly under direct vision intra-operatively and post-operatively to check the patency of the internal valve.</p><p><strong>RESULTS:</strong>  Bony septum was used as an ESG in five (5) patients (1 male, 4 females, ages 35 to 50-years-old) with inadequate septal cartilage. Intraoperative evaluation under direct vision showed anterior caudal septal deviation in all 5 patients in whom correction was confirmed after placement of SEG and ESG. Immediate post-operative evaluation confirmed bilaterally patent nasal valve in all 5, who reported subjectively improved breathing at 2 and 4 weeks post-operatively.  Post-operative photographs showed improvement of nasal length and tip.</p><p><strong>CONCLUSION:</strong> The use of the bony septum (vomer and PPE) as an ESG for primary or secondary rhinoplasty is a potentially effective means of supporting and securing the SEG for control of nasal length, preventing tip deviation or rotation and for improving internal valve function. Further trials are needed to establish its reliability and long-term effectivity.</p>

Personal Protective Equipment Availability and Utilization Among Interventionalists

OBJECTIVE: This study explored personal protective equipment (PPE) availability and PPE utilization among interventionalists in the catheterization laboratory, which is a highly contextualized workplace. METHODS: This is a cross-sectional study using mixed methods. Participants (108) completed a survey. A hyperlink was sent to the participants, or they were asked to complete a paper-based survey. Purposively selected participants (54) were selected for individual (30) or group (six) interviews. The interviews were conducted at conferences, or appointments were made to see the participants. Logistic regression analysis was performed. The qualitative data were analyzed thematically. RESULTS: Lead glasses were consistently used 10.2% and never used 61.1% of the time. All forms of PPE were inconsistently used by 92.6% of participants. Women were 4.3 times more likely to report that PPE was not available. PPE compliance was related to fit and availability. CONCLUSIONS: PPE use was inconsistent and not always available. Improving the culture of radiation protection in catheterization laboratories is essential to improve PPE compliance with the aim of protecting patients and operators. This culture of radiation protection must include all those involved including the users of PPE and the administrators and managers who are responsible for supplying sufficient, appropriate, fitting PPE for all workers requiring such protection.

Analysis of Factors Related to Use of Personal Protective Equipment (PPE) in Laboratory

Abstract@#Introduction: Laboratories are not inseparable from the risk of work hazards. Laboratory workers are exposed to a high risk of occupational accidents and with contracting occupational diseases originating from specimens or human body fluids, such as blood and urine. The availability of PPE is very important and needed to protect laboratory staff from possible unwanted events. This study describes what factors are associated with the use of PPE in the laboratory. Methods: This research is an analytic study with a cross sectional study approach. 31 students from the Epidemiology Department of the Faculty of Health, Universitas Airlangga in 2018 were taken as respondents in this study. Data collection was done by using questionnaire method and interview with several students. The independent variables are knowledge, perceptions, compliance, motivation, attitudes, PPE regulations in the workplace, supervision, availability, and dissemination of PPE. Results: The results showed that there was a relationship between the use of PPE with several independent variables, which are, student perceptions, student compliance, student motivation, student attitudes, availability of PPE, and socialization of PPE. Several independent variables that have no relationship with the use of PPE are student knowledge, regulations on the use of PPE, and monitoring the use of PPE. Conclusion: Some independent variables that showed an association with the use of PPE included perceptions, compliance, motivation, attitudes, availability, and socialization of the use of PPE.