Prevalence of Occupational Hand Eczema among Healthcare Workers and its Associated Risk Factors in a Tertiary Hospital in Sarawak During Covid-19 Pandemic.

Background: Occupational hand eczema (OHE) is common among healthcare workers (HCWs), especially during the coronavirus disease 2019 (COVID-19) pandemic. Aims: Our study aimed to determine the prevalence of OHE among HCWs and to identify its associated risk factors. Methods: We conducted a cross-sectional study. A self-administered questionnaire study was done. It was followed by a clinical assessment of subjects with skin changes on their hands to determine the likely cause and its severity. Descriptive analysis and inferential analysis were performed to determine the prevalence of OHE and its associated risk factors. Results: A total of 1004 HCWs with a mean age of 34.58 years old were recruited. Of these, 50.1% were nurses, another 24.6% were doctors. A 1-year prevalence of 42.3% and a point prevalence of 16.5% were reported. Dry skin (n = 368, 86.6%) and itching (n = 274, 64.5%) were the common symptoms. Risk factors that were significantly associated with OHE were atopic eczema, allergic rhinitis, frequent hand washing and caring for children under four years old, whereas HCWs who frequently use alcoholic disinfectant and moisturizer hand cream showed lower odds of OHE. No significant association was found between age, gender, profession, involvement in COVID-19 care, number or duration of glove usage and occurrence of hand eczema. Conclusions: We report a high prevalence of OHE among HCWs during the current COVID-19 pandemic. Education and effective preventive measures are paramount to prevent and improve occupational dermatosis.

Programmed death ligand 1 expression in EBUS aspirates of non-small cell lung cancer: Is interpretation affected by type of fixation?

BACKGROUND: Much of the reluctance about using cytology specimens rather than histology specimens to assess programmed death ligand 1 (PD-L1) expression for guiding the use of immune modulating drugs in the management of non-small cell lung cancer (NSCLC) is based on the belief that the alcohol-based fixatives favored by cytopathologists might reduce the antigenicity of PD-L1 and lead to artifactually low expression levels and false-negative reporting. Therefore, this study was performed to determine whether there is any difference in PD-L1 expression between endobronchial ultrasound (EBUS)-guided aspirates of NSCLC fixed in alcohol-based fixatives and those fixed in neutral buffered formalin (NBF), the standard laboratory fixative for histology specimens. METHODS: The expression of PD-L1 was compared in 50 paired EBUS aspirates of NSCLC taken from the same lymph node during the same procedure. One aspirate of each pair was fixed in an alcohol-based fixative, and the other was fixed in NBF. RESULTS: In none of the 50 pairs was there any significant difference, qualitative or quantitative, in the strength, pattern, or extent of PD-L1 expression. In the great majority, the expression was identical, regardless of fixation. CONCLUSIONS: There is no evidence from this study showing that the use of alcohol-based fixatives has any effect on the expression of PD-L1 or its interpretation. Notwithstanding the general challenges in accurately assessing such expression in cytology specimens, pathologists should feel able to interpret them with confidence, and clinicians should feel able to rely on the results.

Using entropies of reaction to predict changes in protein stability: tyrosine-67-phenylalanine variants of rat cytochrome c and yeast Iso-1 cytochromes c.

Using the voltammetric method of square-wave voltammetry, a direct electrochemical examination was made of the wild type and Tyr67Phe mutant of both rat cytochrome c and yeast iso-1-cytochrome c. In addition to determining the equilibrium reduction potential (E0') for each cytochrome, the entropy of reaction, deltaS0'(Rxn)(deltaS0'(Rxn) = S0'(Red) - S0'(Ox)), for the reduction process was determined via the non-isothermal method. Having determined deltaS0'(Rxn) and E0', deltaH0' was calculated. For rat cytochrome c, it was found that deltaS0'(Rxn) = -43 J mol(-1) K(-1) for the wild type and -53 J mol(-1) K(-1) for the Tyr67Phe variant, with the deltaH0' for both the wild type and variant nearly identical, indicating that the changes in reduction potential and probably stability are due to changes in deltaS0'(Rxn). In contrast the measured deltaS0'(Rxn) for yeast iso-1-cytochrome c demonstrated significant changes in both entropic and enthalpic contributions in going from wild type to mutant cytochrome c. The entropy of reaction provides information regarding the relative degree of solvation, and very likely the degree of compactness, of the oxidized state versus the reduced state of the redox protein. A thermodynamic scheme and stability derivation are presented that show how the entropies of reaction of wild type versus variant cytochromes contribute to and predict changes in stability in going from oxidized to reduced protein. For yeast iso-1-cytochrome c, the thermodynamically predicted change in stability was very close to the experimentally observed value, based on previous differential scanning calorimetric stability measurements. While such data is not available for rat cytochrome c, consideration of the enormously increased local stability of the rat oxidized cytochrome c variant predicts that the reduced rat variant will be even more stable than the already stabilized oxidized variant.

[Eating and drinking in patients with Alzheimer dementia. A study of interactions]. / Essen und Trinken bei Menschen mit Alzheimer-Demenz. Eine Interaktionsstudie.

Eating and drinking become difficult for people afflicted with dementia. We have therefore analysed the mealtime constellation in five cases of institutionalised people suffering from Alzheimer using video in an open technique. The process of eating and drinking entailed intensive interaction between patients and their nurses. The demented were apparently in possession of extensive nonverbal communicative ability to both transmit and receive signals. It proved possible to identify behavioral factors that hinder or benefit the mealtime procedure of the analysed cases.

Analysis of pesticide residues in Peninsular Malaysian waterways.

The use of organochlorine pesticides has caused concern due to their effects on human health and the Malaysian aquatic ecosystem, particularly so in view of their persistent and bioaccumulative properties. Since the extent of organochlorine pesticide pollution in Malaysian waterways is unknown except for isolated instances, a systematic survey has now been carried out. Water samples from various rivers were extracted, cleaned up with Florisil and analysed for the individual organochlorine pesticides by gas chromatography (GC) with an electron capture detector (ECD). DDE, DDT and heptachlor were present in all the river water samples of the west coast of Peninsular Malaysia. Other organochlorine pesticides were also identified from the water samples. However, the levels of all these are still below criteria values for Malaysian aquatic life, indicating that organochlorine pesticide pollution is less of a problem than other organic or inorganic pollutants.

Determination of antiamoebic IgG, IgM, IgA and IgG subclasses in sera from patients with amoebiasis by enzyme-linked immunosorbent assay.

The HK-9 strain of Entamoeba histolytica was cultured axenically. A crude extract of the trophozoites was used as antigen in the enzyme-linked immunosorbent assay (ELISA) for the determination of antiamoebic IgG, IgM, IgA and IgG subclasses in sera of patients with E. histolytica infection. Sera from amoebiasis patients had significantly higher mean ELISA values for all classes and subclasses of immunoglobulins examined compared with healthy controls. The ELISA for IgG, IgM and IgA was positive for 76 (97.4%), 34 (43.6%) and 62 (79.5%) respectively of 78 amoebiasis sera. Analysis of IgG subclasses by ELISA showed that 76.7%, 25%, 33.3% and 66.6% of the patients were positive for antiamoebic IgG1, IgG2, IgG3 and IgG4 respectively. IgG1 and IgG4 were the dominant IgG subclasses involved in amoebiasis. The role of antiamoebic antibodies in amoebiasis is discussed.

A comparison of the ELISA with other serological tests in the serodiagnosis of amoebiasis.

The sera of 78 patients with invasive amoebiasis were tested for antiamoebic antibodies by the techniques of enzyme-linked immunosorbent assay (ELISA), indirect haemagglutination (IHA), indirect fluorescent antibody (IFA) and counterimmunoelectrophoresis (CIEP). Results showed that the ELISA compared favourably with IHA and IFA tests in terms of sensitivity and specificity. ELISA, IHA and IFA detected 97.4%, 96.2% and 98.7% of the patients respectively. CIEP was the least sensitive of the 4 serological methods with a sensitivity of 88.5%. The advantages and disadvantages of the 4 serodiagnostic procedures are discussed.

Health statistics for health planning.

PIP: As the objective of health services is to satisfy the health needs and demands of the population, the information necessary for planning the delivery of these services must both evaluate the present services and anticipate the future needs and demands of the people. In 1971 it was indicated that the 1st task of a health service is to reach all the people all the time and at the best level of care the country can afford, and this is 1 of the precepts upon which health planning is conducted. Additionally, expenditures for health services are regarded as an investment that will pay economic dividends in the form of decreased invalidity, reduced unemployment caused by illness, and increased industrial productivity. Ashospitals are the most expensive part of any health service, it is considered good economics to do all possible to keep patients out of the hospital. In any program for national development, there must be concomitant development in all sectors if future programs are to be maintained or improved. Consequently, health planning is an integral component of the national development program in Singapore. In Singapore the need for good statistical information has been recognized, and a relevant information system was developed which includes: 1) a decentralized statistical system with an expansion of the Department of Statistics and the establishment of a Research and Statistical Unit in 7 ministries, 2) a scheme of service for statistical personnel in government service, 3) training programs for statistical officers, 4) formation of the National Statistical Commission, and the passage of the Statistics Act by Parliament in 1973. Attention is also given in this report to methods and procedure for health planning; review of the present health information system in the context of existing health planning; required health information for existing or proposed health planning; and identification of problems in the present health information system. The main problems that exist are: 1) problems associated with rapid growth of health services, 2) problems associated with human resources, and 3) problems associated with the production and utilization of information.^ieng