Purpose: This study aims to investigate further how the coronavirus disease 2019 (COVID-19) pandemic is affecting orthopaedic surgeon in Malaysia in terms of exposure, general perceptions of risk, and the impact on their current and future practice. Methods: Orthopaedic surgeons nationwide were invited through email and text messages to answer an online self-administered questionnaire collecting demographic information, COVID-19 exposure experience, perception of risk, and impact on orthopaedic practice. Results: Of the respondents, 4.7% and 14.0% were involved in frontline treatment for COVID-19 patients with non-orthopaedic and orthopaedic problem, respectively. Respondents working in Ministry of Health had highest percentage of involvement as frontliner, 7.8% (8/103) and 20.4% (21/103) for non-orthopaedic and orthopaedic related COVID-19 treatment, respectively (not significant). Their main concern was an infection of family members (125/235, 53.2%). Majority of respondents were still working (223/235, 94.9%), running outpatient clinics (168/223, 75.3%), and continued with their semi-emergency (190/223, 85.2%) and emergency surgeries (213/223, 95.5%). Of the surgeons, 11.2% (25/223) did not screen their patients for COVID-19 prior to elective surgeries, 30.9% (69/223) did not have any training on proper handling of personal protective equipment (PPE), 84.8% (189/223) make decision to manage more conservatively due to COVID-19 and 61.9% (138/223) had their income affected. Of the surgeons, 19.3% (43/223) started using telehealth facilities. Conclusion: Direct exposure to treatment of COVID-19 patients among the respondent is low and the main concern was infecting their family member. There are still several surgeons who did not conduct preoperative COVID-19 screening and practice without proper PPE training.

Background: Beta-thalassaemia (β-thalassaemia) major patients are severely anaemic and require life-long blood transfusions for survival. These patients require iron-chelation therapy as a result of iron overload due to the monthly blood transfusions. The iron over load can cause oxidative damage and pro-inflammation and therefore, hasten mortality. Thus, regular monitoring of the oxidative stress and pro-inflammation status may be useful in these patients. Methods: Measurement of biomarkers is usually performed on serum samples but the evaluation in non-invasive samples such as saliva would be more favourable in paediatric cases. In this study, the levels of pro-inflammatory cytokines such as tumour necrosis factor-α (TNF-α) and interleukin-6 (IL-6) as well as oxidative indices such as lipid hydro peroxide, advanced oxidation protein products (AOPP), ferric reducing antioxidant power (FRAP), uric acid (UA) and glutathione peroxidase (GPx) activity in a total of 65 β-thalassaemia major patients (all on iron chelation) and 55 healthy control subjects were assessed. All the above biochemical parameters, measured using well established assay techniques, were detectable in saliva samples. Results: Non parametric analyses showed that lipid hydroperoxide (LH) and glutathione peroxidase (GPx) activities were significantly higher in β-thalassaemia major patients. All other parameters were not significantly different between patient and control groups implying that iron chelation therapy was successful in attenuating oxidative stress. Strong positive correlation was observed between FRAP and UA levels. There was also a notable difference in tumour necrosis factor-α (TNF-α) between the patients and healthy controls when analysed according to ethnicity and age. AOPP level in β+-thalassaemia homozygous patients were significantly higher than β+/β0-compound heterozygous and β0-thalassaemia homozygous patients. Conclusion: Saliva may serve as a reliable, non-invasive sample which can be used to assess oxidative indices and pro-inflammatory cytokines in β-thalassaemia major patients.

No abstract

No abstract