Introduction:: Quarantine is a public health measure commonly used to contain spread of an infectious disease; however, it can have significant psychological effects. Methodology:: This cross-sectional study used a web-based self-administered questionnaire to assess the psychological impact of quarantine and isolation, and its association with demographic factors, quarantine/isolation circumstances, travel and medical history. DASS-42 assessment tool was used to measure for depression, anxiety and stress among individuals who underwent quarantine and isolation during the first wave of COVID-19 outbreak from 9 March until 6 May 2020 in Brunei Darussalam. Results:: This study obtained 31% (544) response rate. 29.9% reported presence of psychological impact as a result of their quarantine. Based on bivariate and multivariate analyses, female, younger age group, longer quarantine/isolation duration, and pre-existing medical conditions experienced higher psychological effects (anxiety, depression and stress). Depression was significant in younger age individuals, unemployed/retired individuals, and those with pre-existing medical conditions, whilst anxiety was significant in individuals who had contact with a positive COVID-19 case. Pre-existing medical conditions had higher impact on depression (OR 3.82), anxiety (OR 3.26) and stress (OR 3.66). Conclusion: This study identified individuals at risk for developing depression, anxiety or stress during quarantine or self-isolation, and who would benefit from additional support and intervention to protect their mental health during this time.

The incidence of humeral osteomyelitis is relatively rare as compared to incidence of lower limb osteomyelitis. Despite having no guideline in the management of humeral osteomyelitis, surgeons have utilised their experience in managing lower limb osteomyelitis to treat humeral osteomyelitis. By adhering to principles including thorough debridement of necrotic bone and soft tissue, staged bony and/or soft tissue reconstruction, and targeted antimicrobial therapy, a good outcome can be achieved in the management of humeral osteomyelitis. We report a case of Cierny-Mader type IV proximal humeral osteomyelitis after a severe crush injury of the left shoulder and its subsequent two-stage reconstruction using internal fixation and pedicled Latissimus dorsi musculocutaneous flap.