A prolonged pandemic impacts the mental health of orthopaedic patients

Background and aimsMajority of elective orthopaedic operations are postponed to accommodate the reallocation of healthcare resources to combat the pandemic. The aim of this paper is to evaluate the mental state of orthopaedic patients amidst limited orthopaedic management options. The secondary aim of this paper is to identify areas of significant stressors and to provide avenues for improvements.MethodsA survey was administered on patients in outpatient clinics within a tertiary institution from 31 May to 13 June 2021 where government interventions prevented elective orthopaedic surgeries from being performed. Individuals' fatigue level were assessed with Chalder fatigue scale (CFS) and they were surveyed on their areas of stressors.ResultsA total of 160 orthopaedic patients (67 males and 93 females) were surveyed with an average age of 48.3 years old (range 17-88). 65 out of 160 (40.6%) were deemed to be severely fatigued (CFS > 4) with a higher prevalence amongst females than males (47.3% vs 31.3% respectively.) The top three areas identified as stressors included transmitting to family/friends, travel restrictions/quarantine orders and limitation on recreational/social activities (67.5%, 45.6% and 57.5% respectively). 25.6% of the patients indicated that the increased difficulty in accessing healthcare was a stress factor.Discussion and conclusionThere is a high proportion of severe fatigue amongst orthopaedic patients. Combined with postponement of orthopaedic care and treatment, the detrimental effects of a prolong pandemic can be more pronounced on orthopaedic patients. Identified areas of stressors provide avenues for improvements to safeguard the mental health of orthopaedic patients.

3-(5-Hydroxyphenyl)-5-Phenyl-2-Pyrazolines as Toll-Like Receptor 7 Agonists

Toll-like receptor 7 (TLR7) is an attractive target for developing immune modulators to enhance innate immunity against ssRNA virus infections, including hepatitis C and COVID-19. Ten 3-(5-hydroxyphenyl)-5-phenyl-2-pyrazolines were tested using TLR7 reporter cells, overexpressing TLR7 and the NF-B-inducible SEAP reporter gene to discover a novel TLR7 agonist enhancing innate immunity. Of these, 2-(3-(2-hydroxynaphthalen-1-yl)-5-(4-methoxyphenyl)-4,5-dihydro-1H-pyrazol-1-yl)thiazol-4(5H)-one (compound 6) showed the best TLR7 agonistic activity, and further experiments were carried out to study the immune-modulatory capability of compound 6. Treatment with compound 6 rapidly induced phosphorylation of IRAK4, IKKα/β, IBα, and p65/RelA in THP1 monocytic cells. In addition, it increased the expression of NF-B-regulated innate cytokines, such as TNFα and IL1β, in THP1 monocytic cells. These data suggest that compound 6 induces an innate immune response by agonizing TLR7 activity in THP1 human monocytic cells. Therefore, compound 6 can be used as an innate immune modulator to develop antiviral agents and vaccine adjuvants. © 2023 Ji Hwan Kim et al.

Healthcare workers' preparedness and response during COVID-19 pandemic

Background: Healthcare workers (HCWs) are most at risk of contracting SARS-CoV-2 and COVID-19 infection. Their preparedness, as a result of provision and access to personal protective equipment (PPE), training programmes and awareness and practices on infection prevention and control measures, is integral for the prevention of infectious disease transmission. Objective(s): This study was conducted to assess the preparedness and practices of HCWs during COVID-19 first wave outbreak in Brunei Darussalam. Method(s): A cross-sectional study using a pre-designed and self-administered web-based questionnaire was conducted among HCWs from government and private health sectors ranging from primary to tertiary health facilities in Brunei Darussalam. Data were analysed using descriptive statistics, and chi-square test was used for statistical significance. Result(s): A total of 511 HCWs participated in the study. Nurses (64%) and HCWs based at hospitals (66%) made up the majority of the study participants, with 74% having occupational exposure to COVID-19 cases. More than 99% of HCWs used respiratory PPE, and 94% used gloves. 74% had undergone respirator fit testing and 65% had received PPE awareness session within the last one year. Coverage in training programmes was found to be low among HCWs from private health facilities. Conclusion(s): Majority of HCWs who had received updated training programmes and therefore were better prepared came from government health facilities. HCWs from private health facilities lacked preparedness training programmes and as such, there needs to be improvement to enhance preparedness measures in light of the ongoing COVID-19 pandemic and for future infectious disease outbreaks. Copyright © The Author(s) 2021.

Original article healthcare workers’ preparedness and response during COVID-19 pandemic

Background: Healthcare workers (HCWs) are most at risk of contracting SARS-CoV-2 and COVID-19 infection. Their preparedness, as a result of provision and access to personal protective equipment (PPE), training programmes and awareness and practices on infection prevention and control measures, is integral for the prevention of infectious disease transmission. Objectives: This study was conducted to assess the preparedness and practices of HCWs during COVID-19 first wave outbreak in Brunei Darussalam. Methods: A cross-sectional study using a pre-designed and self-administered web-based questionnaire was conducted among HCWs from government and private health sectors ranging from primary to tertiary health facilities in Brunei Darussalam. Data were analysed using descriptive statistics, and chi-square test was used for statistical significance. Results: A total of 511 HCWs participated in the study. Nurses (64%) and HCWs based at hospitals (66%) made up the majority of the study participants, with 74% having occupational exposure to COVID-19 cases. More than 99% of HCWs used respiratory PPE, and 94% used gloves. 74% had undergone respirator fit testing and 65% had received PPE awareness session within the last one year. Coverage in training programmes was found to be low among HCWs from private health facilities. Conclusions: Majority of HCWs who had received updated training programmes and therefore were better prepared came from government health facilities. HCWs from private health facilities lacked preparedness training programmes and as such, there needs to be improvement to enhance preparedness measures in light of the ongoing COVID-19 pandemic and for future infectious disease outbreaks. © The Author(s) 2021.