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As of November 14, 2020, there are >404,000 confirmed cases of COVID-19 in the Philippines of which 83% are mild cases. Alexidine It is worthwhile to mention that before full-scale implementation and issuance of a license to operate a COVID-19 testing regimen, both hospital and nonhospital-based diagnostic laboratories undergo a multistage process for COVID-19 laboratory assessment. The requirements prescribed in the DOH assessment tool for licensing a COVID-19 testing laboratory include but are not limited to the availability of safety equipment and trained laboratory personnel, the facility must be a BSL-2 laboratory, and must have an updated protocol including a biosafety manual. In this article, the biosafety concerns associated with establishing a COVID-19 testing laboratory and running COVID-19 clinical samples will be highlighted. In addition, mitigation control measures that can be put into place for aerosol-generating procedures and key performance indicators will also be identified.Introduction Laboratory technicians are routinely exposed to occupational health hazards that can be a serious threat to their health. To safeguard themselves against laboratory-acquired infections, they must be aware of universal work precautions. A targeted educational intervention to increase awareness about universal precautions was designed to result in behavioral changes in attitudes and practices to help reduce the incidence of laboratory-acquired infections. This study was planned to assess the preexisting levels of knowledge, attitudes, and practices of laboratory technicians regarding universal work precautions at a tertiary care hospital in central India and to evaluate the effectiveness of educational interventions on the same. Method The 40 lab technicians participating in the study were subjected to educational interventions in the form of training on universal precautions. Pretest and posttest evaluations using questionnaires were conducted to evaluate the learning gain. Pretest and posttest responses to each question were compared using the Pearson chi-square test. The subjects' mean pretest and posttest scores were compared using paired t tests, and the significance level was set at .05. Results There was remarkably significant improvement in knowledge, attitudes, and practices of laboratory technicians regarding universal work precautions after the educational intervention/training sessions. Conclusion On the basis of the findings, it was suggested that such training sessions should be conducted regularly for laboratory technicians to help in better retention of knowledge and to instill a positive attitude toward universal precautions.Background In this study, we aimed to perform a biosafety risk assessment to determine measures to be taken against coronavirus disease 2019 (COVID-19) in the routine diagnostic parasitology laboratory of a tertiary health care center. Methods The risk assessment template included in the supplement of the interim guidance of "WHO Laboratory Biosafety Guidance Related to COVID-19" was used for the risk assessment. Risk assessments were carried out for the "diagnosis of protozoan diseases in respiratory tract samples" and "diagnosis of intestinal parasitic diseases" processes. Initial risk of the laboratory activities was determined before additional risk control measures and overall initial risk was estimated for each process. Overall residual risk of the laboratory activities after risk control measures was estimated for each process. Results Overall initial risk for both processes was "very high." Fresh microscopic examination steps in both processes and concentration steps for "diagnosis of intestinal parasite diseases" were discontinued. All aerosol-generating steps were moved into a class-IIA biological safety cabinet. Overall residual risk was "medium" for both processes. Conclusion This study serves as an example for clinical laboratories regarding how the risk assessment approach in guidelines can be transferred to daily practice.Background With increased rates of laboratory-acquired infections from clinical and research laboratories globally, efforts have been made to improve awareness of modern practices and pursue innovations in biosafety to manage risks and laboratory exposures arising from infectious agents and other hazards. Objectives This article demonstrates a sustainable biosafety training model developed to enhance laboratory quality and support accreditation in health facilities in Kenya. Methods A biosafety technical working group was formed, and sensitization meetings held with health managers. Trainings were then conducted for training of trainers (TOTs) who then cascaded trainings in health facilities. This was followed by mentorships and monitoring for implementation. Results Five sensitization meetings were carried out for 264 health managers. TOTs was done for 48 trained trainers and 1044 laboratory workers in 216 facilities covering 44 counties. Site visits were done in 51 facilities, with biosafety achievements measured in 21 (41%), respectively. Achievements in 21 facilities included the following improvised eye wash stations in 16 facilities (76%), biological spill kits in 17 (81%), buckets of sand in 15 (71%), fire extinguishers in 12 (57%), hepatitis B vaccination in 14 (66%), establishment of phlebotomy areas in 18 facilities (85%), material safety data sheets in 18 (85%), documentation of incidents and exposures in 16 (76%), and proper waste segregation in 17 (81%). Conclusion This model ensured rapid scale-up to multiple counties and enabled learners to understand biosafety principles. Due to management buy-in, resources were availed to implement interventions, and this was demonstrated by remarkable achievements across all assessed facilities.

Acetabular aseptic loosening due to bone defect in total hip arthroplasty revisions is a great challenge and several solutions have been proposed, but a broadly accepted consensus in the literature has not been reached yet. The aim of this study is to compare the clinical and radiographic results of acetabular bone defects treatment with biological-only graft or with a mixture of bone graft substitute and biological graft.

33 patients had revision hip arthroplasty using impaction grafting with biological-only graft (21 patients, Group A) or a 1/3 mixture of allograft and tricalcium phosphate bone graft substitute (12 patients, Group B). Patients were reassessed at a minimum of one year after surgery with new x-rays and the Harris Hip Score (HHS).

Survivorship of bone graft was 86% in Group A and 100% in Group B at a mean follow-up of 35 months. No statistical difference between the two groups was found in terms of implants survivorship (

), clinical (

) or radiographic (

7) outcomes.

In our experience the use of tricalcium phosphate bone graft substitutes in combination with allo and autograft provides good outcomes, low risk of failure and great clinical and radiographic results. Further investigations on larger samples are needed to impact clinical practice.

In our experience the use of tricalcium phosphate bone graft substitutes in combination with allo and autograft provides good outcomes, low risk of failure and great clinical and radiographic results. Further investigations on larger samples are needed to impact clinical practice.

This study aimed to estimate the within-day and between-day reliabilities of sonoelastography to measure the strain ratios of lumbopelvic muscles, including multifidus (MF), piriformis (P), quadratus lumborum (QL), and gluteus medius (GM), in a resting position by the sonoelastography device in both patients with unilateral discogenic lumbar pain and healthy individuals. Failthe treatment of deep infection of peri-articular fracture fixation.

First of all, the participants (n=25) were enrolled in this study, including patients (n=15) and healthy subjects (n=10). In the first session, an examiner estimated the strain ratio of lumbopelvic muscle three times by sonoelastography. The last session was held at a one-week interval. The collected data were analyzed using an intraclass correlation coefficient (ICC) and a standard error of measurement.

The ICC calculated for MF, P, QL, and GM measurements indicated good to excellent reliabilities in both healthy and patient groups for within- and between-intra-ex the present study in other patients.

Failed open reduction internal fixation (ORIF) of peri-articular fractures due to deep infection is associated with decreased functional outcomes and increased mortality rates. Two-stage revision total joint arthroplasty (TJA) is often needed as a salvage procedure. The aim of this study was to evaluate the outcome of two-stage revision total hip and knee arthroplasty as a salvage procedure for the treatment of deep infection of peri-articular fracture fixation.

Using propensity score-matching, a total of 120 patients was evaluated 1) 40 consecutive patients were treated with planned salvage two-stage revision for the treatment of deep peri-articular infection, and 2) a control group of 80 patients who underwent two-stage revision for periprosthetic joint infection (PJI) after non-IF TJA. An infection occurred after a fracture of the acetabulum (27.5%), femoral neck (22.5%), intertrochanteric femur (15.0%), subtrochanteric femur (5.0%), femoral shaft (7.5%), distal femur (5.0%), and tibia (15.0%).

At anctures was high with 35% reinfection rates associated with the presence of mixed and resistant pathogens.

Orthopedic surgeons are sometimes hesitant to assess and address psychosocial factors. Surgeon-specific modifiable factors may contribute to surgeon attitudes and beliefs regarding the mental and social aspects of illness. A better understanding of these factors could help inform interventions to support surgeons and improve patient outcomes. We aimed to investigate whether orthopedic surgeons' self-reported compassion, perceived stress, and experiential avoidance are independently associated with various surgeon attitudes and beliefs regarding psychosocial aspects of health.

This is a cross-sectional study of 165 members of the Science of Variation Group (SOVG). Surgeons completed measures of compassion, stress, experiential avoidance, and demographics. They answered questions addressing attitudes and beliefs regarding psychosocial aspects of care, which were condensed to the following 6 dimensions through factor analysis (1) confidence, (2) perceived resource availability, (3) blame towards patients, (4, experiential avoidance) via supportive/educational programs may decrease barriers and increase their abilities to address psychosocial factors, resulting in improved patient outcomes.

Orthopaedic trauma surgeons believe that nutritional status is important. The primary aim of this study was to prospectively investigate the prevalence and progression of malnourishment in orthopaedic trauma patients and determine when and what labs should be ordered. The secondary aim was to determine if malnourished patients had increased complications.

Prospective cohort study of orthopaedic trauma patients at a Level I trauma center. Assessment of nutritional status over the hospital course was performed using the Rainey MacDonald nutritional index (RMNI) and nutritional laboratory markers on admission, day 3, day 7, and 6 weeks post-op.

98 patients were enrolled and included. On admission, 60%, 41%, and 38% of patients were malnourished based on albumin, prealbumin, and RMNI values, respectively, with 31% in severe acute-phase response (APR) as determined by CRP. By day 3, a significant increase in the percent of malnourished patients was noted based on the laboratory markers, 85%, 90%, and 80%, respectively, with 70% in severe APR.