OBJECTIVE: To determine if a repurposed silicone-based dressing used underneath a N95 mask is a safe and beneficial option for facial skin injury prevention without compromising the mask's seal. METHODS: Since February 21, 2020, staff in high risk areas such as the ED and ICU of King Hamad University Hospital have worn N95 masks when doing aerosol-generating procedures to protect against the novel coronavirus 2019. At that time, without education enablers or resources that could be directly translated into practice, the hospital's Pressure Injury Prevention Committee explored and created a stepwise process to protect the skin under these masks. This procedure was developed over time and tested to make sure that it did not interfere with the effectiveness of the N95 mask seal. RESULTS: Skin protection was achieved by repurposing a readily available silicone border dressing cut into strips. This was tested on 10 volunteer staff members of various skin types and both sexes who became part of this evidence generation project. Oxygen saturation values taken before and after the 4-hour wear test confirmed that well-fitted facial protection did not compromise the mask seal, but rather improved it. An added advantage was increased comfort with less friction as self-reported by the staff. An educational enabler to prevent MDRPI from N95 mask wear was an important additional resource for the staff. CONCLUSIONS: This creative and novel stepwise process of developing a safe skin protection method by which staff could apply a repurposed silicone border dressing beneath an N95 mask was largely effective and aided by the creation of the enabler.

Background:The role of Immune system in the pathophysiology of depressive disorders is a field of active research, however Indian literature is sparse. The present study was planned to assess the immunological response in depression.Materials and Methods:The study comprised of 100 subjects. There were fifty cases of depression satisfying the ICD-10 criteria with no physical illness and HIV negative status and fifty age and sex matched healthy volunteers. Depression was assessed on HRSD and BDI scales. Assessment of three markers each of cellular immunity (NK cells, CD4, CD8 cells) and humoral immunity (Il-2, IL-6 and CRP) was carried out on both groups and depressed patients were reassessed on all parameters after 08 weeks of treatment with antidepressants (SSRIs or TCAs).Results:NK Cells were significantly higher in the depressed group and CD 8 Cells and CD 4 Cells were higher in the control group (P = 0.001). Depressed group before treatment v/s control group differed significantly in the cell mediated immune markers. IL-2 levels were higher in the control group. The markers of cell mediated immunity i.e., NK cells, CD4, CD8 had increased significantly after treatment (P =< 0.001). The humoral immunity markers (CRP and IL-2) decreased significantly after treatment (P =< 0.001). However IL -6 levels were raised significantly in the subjects after treatment (P =< 0.001).Conclusion:Dysregulation of immune response occurs in depressed patients with changes in both cell mediated and humoral immunity. Further, antidepressant treatment affects the immune status of depressed patients.

Around 100 persons in the same age group of 18e45 years were again randomly assigned to each group. Chi Square test was used to assess the effectiveness of the intervention.

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