Migrant workers' perception and awareness of health insurance coverage in Brunei Darussalam.

BACKGROUND: Migrant workers are recognized as a vulnerable group of population in the context of accessibility to healthcare services as they are likely to experience multiple challenges and barriers. This study aimed to assess the awareness and perceived knowledge on health insurance coverage among documented migrant workers in Brunei Darussalam. METHODS: This cross-sectional, interviewer-administered study used a pre-designed questionnaire on migrant workers attending the Foreign Worker Health Screening Centre from June until September 2019. Data were analyzed for association between perceived insurance status on health-seeking behavior. RESULTS: The study obtained responses from 469 documented migrant workers (93.8%). 75.1% reported being aware of and having health insurance coverage; and of these, 57.1% were aware of the type of health insurance cover they had. 45.5% and 50.6% had poor knowledge whether their health insurance covered for hospitalization or outpatient expenses, respectively. No significant association was found between the migrant workers' perceived status of insurance and not seeking medical care due to financial barriers (p > 0.05). CONCLUSIONS: A high proportion of documented migrant workers in Brunei Darussalam reported knowledge of having health insurance; however, there was lack of awareness on its actual coverage. By including migrants' health in a nation's healthcare governance, the health rights of migrant workers can be addressed thus aiming to achieve universal health coverage for all individuals.

A test-based strategy for early return to work for health-care workers with COVID-19 during the Omicron wave, Brunei Darussalam, 2022.

Objective: This paper summarizes and evaluates a test-based strategy for early return to work for health-care workers (HCWs) with mild coronavirus disease in Brunei Darussalam during the Omicron wave in February 2022 and compares the characteristics of HCWs by how long it took them to return to work. Methods: The early return-to-work strategy involved testing on day 3 of infection with reverse transcription-polymerase chain reaction and with a rapid antigen test on days 5 and 6 or days 5 and 7. Data about infected HCWs were extracted from the Ministry of Health's public health surveillance database. Percentages and proportions were used for descriptive statistics, and Pearson's χ2 test and the paired t-test were used to compare return-to-work patterns with demographic factors and vaccination status of the HCWs, as well as between cycle threshold (Ct) values and occupational groups of HCWs. Results: From 15 February to 15 March 2022, a total of 1121 HCWs were notified as being infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Of these, 175 (15.6%) were able to return to work on day 4 of their infection, 153 (13.6%) on day 6 and 268 (23.9%) on day 7; 525 (46.8%) required 10 days of home isolation. Statistically significant associations were observed between return-to-work periods and occupational group (P < 0.01) and Ct value (P < 0.01), but not between return to work and age, sex or vaccination status. Discussion: This test-based strategy ensured a balance between mitigating a shortage of HCWs and enabling them to return to work early without compromising their safety and that of their patients.

Three-Dimensional Printed Lingual Arch Space Maintainer: A Game Changer in Pediatric Dentistry.

Early loss of deciduous teeth is a challenging situation to handle. In recent years, the loss of deciduous teeth has become very frequent because of the increased risk of caries. Space maintainers play a vital role in preventing space loss. Lingual arch space maintainers are effectively used to maintain space in the lower arch. In order to retain the length of the lower arch and to prevent mesial migration of the mandibular first permanent molar, lingual arch space maintainers are often indicated. Conventional lingual arch fabrication is technique-sensitive and cumbersome. Additionally, it has many documented drawbacks like solder breakage, cement loss, soft tissue lesions, etc. With the advent of newer technology like three-dimensional (3D) printing, the fabrication of appliances and prostheses has become more predictable, accurate, and relatively easier. The present case report highlights the technique and advantages of 3D printing to fabricate lingual arch space maintainers, which has the potential to revolutionize preventive orthodontics in pediatric dentistry.

SARS-COV-2 Screening of Health Care Workers in Brunei Darussalam.

BACKGROUND: Health care workers (HCWs) are at high risk of COVID-19 infection; therefore, screening is recommended for early detection and management to break the chain of transmission. Globally, multiple strategies have been utilized for the screening of HCWs. This article reports and evaluates an active surveillance and screening strategy for severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) among HCWs following work or nonwork exposures in Brunei Darussalam to prevent health care-associated COVID-19 transmission. METHODS: In March 2020, the Ministry of Health through the Occupational Health Division adopted an active screening strategy for symptomatic and asymptomatic HCWs, which involved symptom screening, risk assessment, SARS-COV-2 testing, and management following work/nonwork exposure and recent overseas travel, and those with influenza-like illness (ILI) symptoms. Screening frequency was based on the HCWs' symptoms and exposure, with the intent to evaluate all possible sources of exposure. FINDINGS: As of December 31, 2020, 821 HCWs were screened, of which 632 (77%) had ILI symptoms and 14 (1.7%) had high-risk occupational exposure. Reverse transcription polymerase chain reaction (RT-PCR) swab testing was carried out on 577 (70.3%) HCWs, with the highest proportion of swabs done on doctors (85.1%; p < .01) due to their workplace exposure (34.3%) and overseas travel (38.7%). CONCLUSION: By July 2021, Brunei Darussalam had recorded zero cases of COVID-19 among HCWs from occupational exposure. Our strategy of active screening for SARS-COV-2 RT-PCR testing since early in the outbreak has proven to be successful, in combination with infection control practices and public health measures, in the prevention of occupational transmission, thereby facilitating early return to work for HCWs with low-risk exposure and without symptoms.

A Preliminary Assessment of Health and Safety in the Automobile Industry in Brunei Darussalam: Workers' Knowledge and Practice of Organic Solvents.

Automobile industries worldwide extensively use organic solvents. Yet, limited studies have examined the health and safety of handling these solvents, which can only be assured if workers have appropriate knowledge and demonstrate safe practices. A cross-sectional study was conducted to preliminary explore the knowledge and practice among workers who are involved in handling organic solvents in the automobile industry in the largest urban district in Brunei Darussalam. Qualitative data were sourced from open-ended questions, observations, and pictorial evidence through still photographs. Quantitative analysis showed that 75% of the workers practice reading labels, 94.1% use fully covered clothes, 82.4% wear gloves, and 98.5% practice proper hand washing. Furthermore, 98.5% of workers cover container lids. The qualitative analysis illustrated that workers have general knowledge of materials containing solvents but could not identify the exact solvents, the harmful effects of the solvents, pathophysiology, and harmful effects on specific body systems. Health and safety were found to be practiced, albeit not consistently. Health and Safety Authorities in Brunei Darussalam must review and enforce specific policies on the use of organic solvents so that they can be practiced consistently and safely in the automobile industry. Cooperation and collaboration in adhering to the policies are mandatory to ensure health and safety at work.

Non-fatal occupational accidents in Brunei Darussalam.

Globally, ILO estimates 374 million non-fatal and 380,500 fatal by occupational accidents annually. Slips, trips, falls and contact with objects are the leading mode of injury, with extremities being the most common body part involved. Occupational accidents are of major concern for high risk occupational groups such as migrant workers, or work areas e.g. construction, manufacturing, wholesale, and retail industries. This study was aimed to determine the prevalence of non-fatal occupational injuries and its trends among industry workers in Brunei Darussalam. A retrospective cross-sectional review of occupational accidents notified to the Occupational Health Division, Ministry of Health, over a five-year period from January 2014 until December 2018 was conducted. A total of 424 non-fatal occupational accidents were notified, with increasing trend from 44 in 2014 to 132 in 2018. Accidents were more common in males (98%), migrant workers (86%), in the 30-39 age group (42.5%), and in the construction industry (56.4%). Struck by object (37.7%) was the commonest cause and upper limb (43.9%) was the commonest body part involved. There is a need for workplaces to develop capabilities and support mechanisms for risk assessments, as well as auditing and reviewing performances to minimize occurrence of preventable occupational injuries.

Workplace fatalities in Brunei Darussalam.

In 2012, there were about 2.3 million deaths worldwide attributed to work. The highest workplace fatality rate (WFR) was reported on construction sites due to high risk activities. Globally, fall from height is the leading cause of fatal injuries for construction workers. The objectives are to determine Brunei Darussalam's demographic distribution of occupational fatality; identify causal agents and industry where occupational fatalities commonly occur; and determine WFR by year. This cross-sectional study retrospectively reviewed records of occupational fatality which were notified to the Occupational Health Division, Ministry of Health, from January 2012 until December 2016. Notified occupational fatalities in Brunei over a five-year period was 50. Most of the cases were in 31-40 age group. 38% of fatality cases occurred in Indonesian workers. 60% were from the Construction industry. 38% were due to fall from height. WFR averaged 5.28 and the highest industry-specific fatality rate was seen in the Construction industry, ranging from 27.94 to 56.45 per 100,000 workers. WFR for Brunei Darussalam from 2012 to 2016 was similar to that of Malaysia, but higher than Singapore and the UK. Industry-specific fatality rate for the Construction and Manufacturing industries were higher than those of Singapore and the UK.

Dynamic changes in global microRNAome and transcriptome reveal complex miRNA-mRNA regulated host response to Japanese Encephalitis Virus in microglial cells.

Microglia cells in the brain play essential role during Japanese Encephalitis Virus (JEV) infection and may lead to change in microRNA (miRNA) and mRNA profile. These changes may together control disease outcome. Using Affymetrix microarray platform, we profiled cellular miRNA and mRNA expression at multiple time points during viral infection in human microglial (CHME3) cells. In silico analysis of microarray data revealed a phased pattern of miRNAs expression, associated with JEV replication and provided unique signatures of infection. Target prediction and pathway enrichment analysis identified anti correlation between differentially expressed miRNA and the gene expression at multiple time point which ultimately affected diverse signaling pathways including Notch signaling pathways in microglia. Activation of Notch pathway during JEV infection was demonstrated in vitro and in vivo. The expression of a subset of miRNAs that target multiple genes in Notch signaling pathways were suppressed and their overexpression could affect JEV induced immune response. Further analysis provided evidence for the possible presence of cellular competing endogenous RNA (ceRNA) associated with innate immune response. Collectively, our data provide a uniquely comprehensive view of the changes in the host miRNAs induced by JEV during cellular infection and identify Notch pathway in modulating microglia mediated inflammation.

Virtual Screening of Natural and Synthetic Ligands Against Diabetic Retinopathy by Molecular Interaction With Angiopoietin-2.

PURPOSE: Diabetic retinopathy (DR) is the most common diabetic eye disease and a leading cause of blindness. The role of angiopoietin-2 a tyrosine kinase receptor is well-reported in angiogenesis during the onset of the disease. The purpose of this study is to screen out more potential herbal molecules which can evidently be used as a better, natural and safe herbal drug against this disease. DESIGN: In silico virtual screening and molecular interaction studies were performed. METHODS: The current course of work focused on molecular interactions on angiopoietin-2 protein with selected natural ligands, namely allicin, ajoene, D-pinitol and salacinol, along with synthetic ones like nateglinide, biguanide, tolbutamide and tolazamide. There was an attempt to carry out the virtual comparative study between natural and synthetic ligands. Proceeding toward this approach, docking of all molecules was performed using the Autodock 4.2 program. RESULTS: Inference of this interaction study is that D-pinitol, which is the herbal extract of Glycine max, shows a very reliable docking pattern as compared with the synthetic ligand tolazamide. Although the binding energy of a synthetic ligand is lower compared to that of the natural ones, the binding energy of synthetic and natural ligands are at an approximate level. The lower the binding energy, the better the ligand molecular interaction. CONCLUSIONS: Our findings suggest that D-pinitol, the natural, safe ligand, can be used in the treatment of diabetic retinopathy with few or no side effects after estimating and calculating proper doses using in vitro approaches.

A novel peptide interferes with Mycobacterium tuberculosis virulence and survival.

Tuberculosis (TB) is a huge global burden, with new and resistant strains emerging at an alarming rate, necessitating an urgent need for a new class of drug candidates. Here, we report that SL3, a novel 33-amino acid peptide, causes debilitating effects on mycobacterial morphology. Treatment with SL3 drastically inhibits the growth of Mycobacterium tuberculosis in vitro as well as in a pre-clinical mouse model for M.tb infection. Microarray analysis of SL3-expressing strain demonstrates wide-scale transcriptional disruption in M.tb. We therefore believe that SL3 and similar peptides may herald a new approach towards discovering new molecules for TB therapy.

Perception and prevalence of domestic violence in the study population.

BACKGROUND: Domestic violence is a major contributor to physical and mental ill health of the victim, and it is evident to some degree, in every society of the world. OBJECTIVES: 1) To study perception about domestic violence in the study population. 2) To compare prevalence of domestic violence within the three subgroups of the study population (i.e. spouses of psychotic patients, spouses of non-psychiatric patients and hospital staff). MATERIALS AND METHODS: A cross-sectional study was conducted among married men and women coming to Dhiraj General Hospital. Interviews were conducted using a semi-structured questionnaire. Inquiry was done about their perception regarding domestic violence, own experience any time in their life, and about the form of violence. Data was entered and analyzed using SPSS. RESULTS: 42.7% of study participants had never heard the words domestic violence. The overall prevalence of any form of violence in the study population as a whole was 32.3%. There was no significant difference found in the proportion of domestic violence among the three groups. The prevalence of physical, emotional, sexual and economic domestic violence was 16.3%, 25.3%, 2% and 11.3% respectively. Younger age group and female sex were significantly associated with the occurrence of domestic violence. CONCLUSION: Apart from the high prevalence of domestic violence in the present era, it is evident from the study that the participants' perception about domestic violence was low. Efforts should be made to raise public consciousness and reporting of domestic violence and its attendant consequences.

A simple and rapid method for simultaneous estimation of glycyrrhetinic Acid and piperine by hptlc in a herbomineral formulation.

Many of the traditional herbal formulations contain extracts of Piper longum and Glycyrrhiza glabra, piperine and glycyrrhetinic acid respectively, being active constituents of these two herbs. An attempt has been made to develop a simple, precise, rapid, and cost-effective high-performance thin-layer chromatographic (HPTLC) method for simultaneous estimation of these in a herbomineral formulation (Efiplus(®) Capsules). Precoated silica gel 60 F(254) plates with toluene-ethyl acetate-glacial acetic acid 12.5:7.5:0.5, as mobile phase were used in chromatographic determinations. The plates were scanned and the compounds were quantified at their wavelengths of maximum absorption of 260 and 331 nm for glycyrrhetinic acid and piperine respectively. The respective R(F), values of glycyrrhetinic acid and piperine were 0.51 and 0.55. Under these experimental conditions linearity was observed between 0.8-2.6 µg/ spot for glycyrrhetinic acid and between 10-50 ng/ spot for piperine and average recovery was 96.25% for glycyrrhetinic acid and 98.55% for piperine.

Rapid validated high performance thin layer chromatography method for simultaneous estimation of mangiferin and scopoletin in Canscora decussata (South Indian Shankhpushpi) extract

AbstractMangiferin (polyphenolic xanthone) and scopoletin (phenolic coumarin) are well-studied biological markers present in Canscora decussata(Roxb.) Roem. & Schult., Gentianaceae. The objective set for the present studies is to establish and develop a new, simple, selective, sensitive, and precise high performance thin layer chromatography method for the simultaneous estimation of mangiferin and scopoletin in hydroalcoholic extract of C. decussata. The thin layer chromatographic separation of these biomarkers was carried out on aluminum plate pre-coated with silica gel 60F254, eluted with ethyl acetate:acetic acid:formic acid:water (10:0.5:0.5:1.5). The plate was then dried and densitometric scanning was performed at 254 nm using a Camag TLC scanner III. The system was found to give compact spots for mangiferin (RF 0.22) and scopoletin (RF 0.78). A good relationship of linear precision between the concentrations (100–600 ng/spot) and peak areas was obtained with correlation coefficient (r) of 0.9979 (mangiferin) and 0.9962 (scopoletin), respectively. The limits of detection and limit of quantification were determined to be 46 and 94 ng/spot for mangiferin and 31 and 78 ng/spot for scopoletin respectively. The percentage of recovery was found from 99.91 to 99.94% for mangiferin and 99.75 to 99.86% for scopoletin. Results obtained from recovery studies showed excellent reliability and reproducibility of the method. Present communication on validated high performance thin layer chromatography method may provide a new, selective, sensitive, and precise method to estimate mangiferin and scopoletin as phytomarkers in the hydroalcoholic extract of C. decussata used in Ayurvedic formulations.

Phylogenetic analysis of poly and non structural protein in Japanese Encephalitis virus with other related viral families.

BACKGROUND: Japanese encephalitis (JE) causes inflammation of brain. The mortality rate due to JE is 30% while 10 -15 % of patients make full recovery. The disease spreads through infected mosquito bites breeding in rice fields and feeds on pigs, birds, and ducks. PURPOSE: As proteins show important structure to function relationship the study was designed to carry out the identification of poly and non-structural proteins in the infective virus group using different strains of Japanese encephalitis virus i.e. JAOARS982, Nakayama Strain SA (V), Strain SA-14. METHODS: With reference to non structural proteins we obtained protein sequences of the following Japanese encephalitis virus groups: Japanese encephalitis virus, Weatnile virus, Kunjin virus. Further comparative and phylogenetic analysis was performed to explore evolutionary relationship among these groups. RESULTS: Results of phylogeny of alignment score was found to be 375184 using multiple alignment, Jal view, ClustalW (1.83) and ClustalW2. However, the analysis among the non-structural proteins of Japanese Encephalitis Virus, Westnile Virus, and Kunjin Virus revealed the phylogeny alignment score to be 875 through multiple sequence alignment and Tree view respectively. CONCLUSION: Phylogenetic analysis revealed that these four strains are interrelated as well as showing high similarity with the other viruses of this group due to conserved regions among their sequences.

Comparative pharmacognostical investigation on four ethanobotanicals traditionally used as Shankhpushpi in India.

People in Indian region often apply Shankhpushpi and other Sanskrit-based common name to Evolvulus alsinoides, Convolvulus pluricaulis, Canscora decussata, and Clitorea ternatea. These are pre-European names that are applied to a medicinal plant. Before the establishment of British rule, like the other books, ayurvedic treatises were also hand written. This might be one of the reasons due to which ayurveda could not stand parallel to the western medicine and an ambiguity is reflected in the interpretation of names and description of drugs found in the books like Charaka Samhita and Sushruta Samhita. The most widespread application of Shankhpushpi is for mental problems, but they have been considered for an array of other human maladies. The present investigation deals with the comparative pharmacognostical evaluation of four ethanobotanicals of Shankhpushpi. A comparative morphoanatomy of the root, stem, and leaves has been studied with the aim to aid pharmacognostic and taxonomic species identification. Various physicochemical, morphological, histological parameters, comparative high-performance thin-layer chromatography (HPTLC), and comparative high-performance liquid chromatography (HPLC), chromatogram of methanolic extract presented in this communication may serve the purpose of standard parameters to establish the authenticity of commercialized varieties and can possibly help to differentiate the drug from the other species. All the parameters were studied according to the WHO and pharmacopoeial guidelines.

Comparative modeling of retinol-binding protein-3 and retinal S-antigen in Eales' disease and prediction of their binding sites using computational methods.

Retinal S-antigen and interphotoreceptor retinoid-binding protein-3 play a significant role in the etiopathogenesis of Eales' disease. Protein 3D structures are functionally very important and play a significant role in progression of the disease, hence these 3D structures are better target for further drug designing and relative studies. We developed 3D model structure of retinol-binding protein-3 and retinal S-antigen protein of human involved in Eales' disease. Functional site prediction is a very important and related step; hence, in the current course of analysis, we predicted putative functional site residues in the target proteins. Molecular models of these proteins of Eales' disease as documented in this study may provide a valuable aid for designing an inhibitor or better ligand against Eales' disease and could play a significant role in drug design.

Experimental and numerical analysis of short-pulse laser interaction with tissue phantoms containing inhomogeneities.

The objective is to perform an experimental and numerical study to analyze short-pulse laser propagation through tissue phantoms without and with inhomogeneities embedded in them. For a short-pulse laser the observed optical signal has a distinct temporal shape, and the shape is a function of the medium properties. The scattered temporal transmitted and reflected optical signals are measured experimentally with a streak camera for tissue phantoms irradiated with a short-pulse laser source. A parametric study involving different scattering and absorption coefficients of tissue phantoms and inhomogeneities, as well as the detector positions and orientations, is performed. The temporal and spatial profiles of the scattered optical signals are compared with the numerical modeling results obtained by solving the transient radiative transport equation by using the discrete ordinates technique.

Anticardiolipin antibodies and mortality in patients with ischemic stroke: a prospective follow-up study.

The purpose of the present prospective observational study was to assess whether or not the presence of anticardiolipin antibodies (aCL) in unselected first ischemic stroke patients is associated with adverse outcome. Consecutive patients (n = 300; mean age 64 years; 48% males) presenting with a first acute ischemic stroke were evaluated for IgG aCL and were systematically followed up. During a median follow-up of 21 months, 58 patients (19%) died. Mortality rates were higher in patients with aCL >20 IgG phospholipid units (GPL) [33 vs. 18%; relative risk (RR) 1.94, 95% confidence interval (CI) 1.02-3.67; p = 0.042] or >40 GPL (40 vs. 19%; RR 2.46, 95% CI 1.05-5.75; p = 0.037). Elevated aCL did not confer an increased risk during follow-up of a combined end point of stroke, myocardial infarction and vascular death or of nonfatal thrombo-occlusive events. Rates of malignancy detected during follow-up were higher among patients with aCL >20 GPL (19 vs. 5%, p = 0.007) and >40 GPL (27 vs. 6%, p = 0.01). The excess mortality associated with elevated aCL was eliminated after adjustment for age, cardiovascular risk factors and malignancy. These results demonstrate that aCL above 20-40 GPL among consecutive ischemic stroke patients is a marker of increased mortality during follow-up, but older age and higher rates of cardiovascular risk factors and malignancy detected during follow-up account for the higher mortality.