Background: Studies show that healthcare workers from previous pandemics have experienced high levels of stress, anxiety with negative psychological impacts. This paper aims to identify factors affecting mental health outcomes of healthcare workers during Coronavirus Disease (COVID-19) pandemic. Methods: A cross-sectional design was used to determine factors affecting mental health outcome of healthcare workers with direct contact to patients with COVID-19. Depression, anxiety and distress were measured by the nine-item Patient Health Questionnaire, seven-item Generalized Anxiety Disorder scale, and 22-item Impact of Event Scale–Revised, respectively. Binomial multiple logistic regression model was used to identify the factors associated with mental health outcome. Results: 172 healthcare workers were included. Prevalence of depression, anxiety and distress symptoms among all healthcare workers were 57%, 47.7%, 65.1%, respectively. Age and living with a family with comorbidities are significantly associated with depression and anxiety. Healthcare workers aged 31 years and above are 70% less likely to have depression symptoms (OR 0.278, CI 95%, 0.11-0.72 p=0.008 and OR 0.273, CI 95%, 0.12-0.61, p=0.002). Those living with relatives with comorbidities are 2.7 times more likely to experience depression symptoms (OR 2.731, CI 95%, 1.36-5.5, p=0.005). Healthcare workers age 31-40 years has 80% less likely to experience anxiety symptoms (OR 0.212, CI 95%, 0.09-0.5, p<0.001), and those age 41 and above have 73% less likely to have anxiety symptoms (OR 0.37, CI 95%, 0.14-0.98, p<0.045). Those living with relatives with comorbidities are 2.9 times more likely to have anxiety symptoms (OR 2.889, CI 95%, 1.46-5.73, p=0.002). Level of knowledge on COVID-19 among health care workers significantly differs across severity but has no significant association with prevalence of depression. No factors were associated with distress symptom. Conclusion Cognizant of high rates of depression, anxiety and distress among our younger healthcare workers living with relatives with comorbidities will be a challenge to establish and/or improve existing programs to promote and address mental health needs. Psychological stress can accumulate over time and have an impact later in the outbreak which should be investigated in future studies.
Health Personnel ; COVID-19

BACKGROUND

Moyamoya angiopathy (MMA) is a rare cause of stroke, yet its incidence and outcomes are understudied in Southeast Asia, despite being the third most populous geographical region in the world. Our aim was to enhance understanding of MMA in this population and present a case from our experience

A systematic literature search on MMA in the Southeast Asian population was performed via PubMed, Scopus, and Wiley Online Library, including local journals and databases up until May 2024. Descriptive statistics were used to synthesize data. We also present a case of a 36 year-old Filipino female diagnosed with MMAfollowed by superficial temporal artery-middle cerebral artery (STA-MCA) bypass and resolution of symptoms.

Out of the 275 articles retrieved, 23 articles detailing 37 patients of Southeast Asian nationality were included in this review. Stroke predominated (76.3%, n=29) as initial presentation, followed by seizures (36.8%, n=14), movement disorders (n=4, 10.5%) and headaches (n=4, 10.5%). Treatment included antiplatelet therapy for 57.9% (n=22), and anti seizure medications for 26.3% (n=10) of cases. Only 21% (n=8) underwent surgical intervention, primarily via direct bypass. Outcomes based on the Modified Rankin Scale (MRS) showed 94.7% (n=36) had retained a functional score of MRS ≤2.

Our review underscores the scarcity of data on MMAin Southeast Asians, and highlights the varied clinical presentation. Effective management requires a tailored approach, with surgical management showing favorable outcomes. Future research should focus on longitudinal studies to assess long-term outcomes, explore the genetic and environmental factors, and develop standardized treatment protocols to improve patient care in this ethnically diverse population.

There have been multiple reports already regarding acute carbon monoxide/CO poisoning in the Philippines secondary to misuse of portable generators, especially during the times of typhoon. We present a case of unintentional carbon monoxide poisoning in a Filipino household wherein three of its members were found dead and leaving other five unconscious before they were rushed to the hospital. The index patient had increased serum fraction percentage of carboxyhemoglobin level and presented with rhabdomyolysis during admission. Neuroimaging confirmed a hypoxic-ischemic encephalopathy secondary to carbon monoxide intoxication. Even without hyperbaric oxygen therapy, patient improved with adequate hydration, early rehabilitation and trauma-focused psychotherapy.
Carbon Monoxide Poisoning ; Carbon Monoxide ; Family Characteristics