scholarly journals Burnout Among ENT Residents During Covid-19 Pandemic: What Are The Contributing Factors?

2022 ◽  
Vol 2 (2) ◽  
pp. 258-268
Author(s):  
Andrey Dwi Anandya ◽  
Abla Ghanie ◽  
Ahmad Hifni
Keyword(s):  
Female Gender ◽  
Medical Faculty ◽  
Burnout Syndrome ◽  
Medical Residents ◽  
Contributing Factors ◽  
Work Time ◽  
Work Related ◽  
Study Population ◽  
The Mean

Introduction. Resident doctors are susceptible to burnout syndrome, which are the combination of physical and psychological fatigue, that may affect their performance. Long-term pandemic of Covid-19 may also contribute to increase the severity of burnout among residents doctor, might be because the increasing of work time and effort to treat the patients during the time while maintaining prevention against the possible exposure that may harm themselves. This study was aimed to evaluate burnout prevalence among ENT (Ear-Nose-Throat) medical residents in Covid-19 pandemic, and its relation to certain factors of demographic and wellness. Methods. Thirty ENT medical residents of Medical Faculty of Sriwijaya University were enrolled as study population. Burnout was measured by Copenhagen Burnout Inventory (CBI) and divided by three parameters (personal,work-related, patient-related). Results. Among 30 ENT resident doctors at Rumah Sakit Moh. Hoesin, the mean level of personal burnout was 53.056 (SD 17.125), work-related burnout was 47.975 (SD 17.663), and patient-related burnout was 34.861 (SD 20.746). Conclusion. Marriage, female gender, and inadequacy of PPE may contribute to the development of burnout. The burnout among resident doctors is a serious matter regarding their role as a frontline doctor during the pandemic era, because it may affect not only their performance at work, but toward their life as well.

Long-term outcome of transcanalicular microdrill dacryoplasty: a minimally invasive alternative for dacryocystorhinostomy

2020 ◽  
pp. bjophthalmol-2020-316146
Author(s):  
Natasa Mihailovic ◽  
Alina Friederike Blumberg ◽  
Friederike Rosenberger ◽  
Viktoria Constanze Brücher ◽  
Larissa Lahme ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Minimally Invasive ◽  
Success Rate ◽  
Complication Rate ◽  
Lacrimal Duct ◽  
Microdrill Dacryoplasty ◽  
Study Population ◽  
The Mean

Background/AimDacryocystorhinostomy (DCR) remains the gold standard therapy for nasolacrimal duct obstruction (NLDO), but is invasive and does not maintain the physiology of the lacrimal pathway. With transcanlicular microdrill dacryoplasty (MDP), there is a minimally invasive alternative surgical approach. This study aimed to present this modern lacrimal duct surgery technique and to evaluate its long-term success rate in a large study population.MethodsThe medical records of 1010 patients with acquired NLDO were retrospectively reviewed. Adult patients who had undergone transcanalicular MDP were included. The evaluation included the following parameters: age, gender, success rate, complication rate, obstruction grade and patient satisfaction. Long-term results regarding patient satisfaction and success rate were evaluated by a telephone survey. Only a complete resolution of symptoms was defined as success.Results793 eyes of 576 patients after transcanalicular MDP could be included in the study. The mean follow-up time was 8.7±0.9 years. Initial surgical success rate was 84.0%. At the time of the follow-up, 57.5% (n=229) still had full resolution of symptoms. The mean patient satisfaction with the procedure was 6.9±3.2 out of 10 points. Heavy bleeding occurred in two cases only (0.25%).ConclusionThis is the first study to show the success rate of microendoscopic lacrimal duct surgery after such a long follow-up period and in such a large study population. Transcanalicular MDP is a minimally invasive technique with a very low complication rate and can be used as an alternative procedure before performing more invasive lacrimal duct surgery such as DCR.

scholarly journals Carpal Tunnel Syndrome After Recurrent Pregnancies

2020 ◽  
Author(s):  
Mesude Kisli
Keyword(s):  
Retrospective Study ◽  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Grand Multiparity ◽  
Study Population ◽  
Tunnel Syndrome ◽  
The Mean ◽  
Severity Of The Disease ◽  
Number Of Births

Abstract Background: The primary aim of the retrospective study was to study whether the number of births in women ( primipara, multipara and grand multipara women ) the long term after deliveries has an impact on the development of Carpal tunnel syndrome ( CTS ).Methods: Our study population is composed of patients who are referred with suspicion of CTS. Four hundred and fifty female patients ( 150 primara, 150 multipara and 150 grand multipara women ) referred to the electrophsiology laboratory with clinical suspicion CTS were included into the descriptive and retrospective study between November 2016 and June 2018. Primiparity, multiparity and grand multiparity were defined as women having 1, 2 – 5 and 6 - 9 deliveries, respectively. Patients who passed 2 years after their last birth were included in the study. All of the patients were assessed and compared in terms of electrophysiological CTS presence and degree of CTS. Also BMI was calculated for each patient and it compared among groups.Results: The disease has not been changed with the number of births ( p > 0.05 ). The mean BMI of the primipara, multipara and grand multipara women were 28,06 ± 1,12 kg / m2, 27,59 ± 3,72 kg / m2 and 27,82 ± 3,11 kg / m2, respectively. There was no significant statistically difference in BMI among groups ( p > 0.05). However, the severity of the disease varies according to BMI ( p < 0.05 ). It was calculated that as the BMI increases, the severity of the disease increases. Conclusions: Number of pregnancies in women ( primipara, multipara and grand multipara women ) concerning the long term after deliveries has not impact on the development of CTS. Other risk factors such as BMI may play a significant role in the development of CTS in these patients.

scholarly journals Work Related Complaints among Dentists

2008 ◽  
Vol 47 (170) ◽  
Author(s):  
Bikram Prasad Shrestha ◽  
GK Singh ◽  
SR Niraula
Keyword(s):  
Risk Factors ◽  
Back Pain ◽  
Neck Pain ◽  
Shoulder Pain ◽  
Musculoskeletal Complaints ◽  
Factors Affecting ◽  
Work Related ◽  
Common Complaint ◽  
Study Population ◽  
The Mean

The objective of this study was to describe the occurrence of neck pain, shoulder pain and back painamong dentists and to assess the risk factors affecting them.Sixty-eight dentists from Dharan and Biratnagar were interviewed using pretested questionnairesin January 2006. Back pain was the most common complaint affecting almost 80% of the study population, followed by neck pain (58.8%) and shoulder pain (47%). The frequency of shoulder pain among female dentists was nearly double that of males (P=0.009). The mean days of neck painamong males was significantly higher as compared to females (P=0.048). The study suggests that musculoskeletal complaints are commonamongdentists,thoughtheyarenot of severenature.Thereis a scope forfurtherdecreasingtheprevalence andseverityofthesedisordersbyperformingregularspecific exercises.Key words: back pain, dentists, neck pain, shoulder pain

The Prevalence of Aspirin Hypersensitivity in Patients with Nasal Polyposis and Contributing Factors

2011 ◽  
Vol 25 (6) ◽  
pp. 411-415 ◽  
Author(s):  
Sevim Bavbek ◽  
Berna Dursun ◽  
Engin Dursun ◽  
Hakan Korkmaz ◽  
Durdu Sertkaya Karasoy
Keyword(s):  
Nasal Polyposis ◽  
Provocation Test ◽  
Female Gender ◽  
Endoscopic Examination ◽  
Contributing Factors ◽  
Aspirin Exacerbated Respiratory Disease ◽  
Prolonged Duration ◽  
History Of ◽  
Single Blind

Background Aspirin (acetylsalicylic acid [ASA]) hypersensitivity is frequent in patients with nasal polyps (NPs) and is called aspirin exacerbated respiratory disease, previously known as Samter's syndrome. However, studies evaluating the prevalence of ASA hypersensitivity in patients with NPs using the oral aspirin provocation test (APT) are quite limited. This study was designed to determine the prevalence of ASA hypersensitivity and factors associated with ASA hypersensitivity in patients with NPs. Methods Sixty-eight patients with NPs with or without asthma were recruited. Extension of NPs was evaluated by endoscopic examination/paranasal CT. A 2-day, single-blind placebo-controlled APT was used to detect ASA hypersensitivity. Results APT was performed in 53 (21 women/ 32 men) patients (mean age, 39.34 ± 1.76 years). APT resulted positive in 12 patients (22.6%) of whom 3 (25%) had no history of ASA hypersensitivity. Of the positive APTs, three were isolated rhinitis and nine had classic responses. APT was negative in 41 patients (77.4%) although three (7.3%) had a history of ASA hypersensitivity. History of ASA hypersensitivity and prolonged duration of NPs were associated with positive APT (p < 0.05). Advanced NP with multiple operations was also correlated with APT positivity but was not statistically significant. Presence of asthma was associated with age, female gender, NP duration, and ASA hypersensitivity history (p < 0.05), but not with smoking, atopy, NP extension, and positive APT. Conclusion ASA hypersensitivity is quite common in patients with NP. Patients with extensive and long-term NP with multiple polyp operations require evaluation for the presence of ASA hypersensitivity in terms of chronic management and future risks of the disease.

scholarly journals A four-year community hospital experience regarding procedures for the replantation and revascularization of fingers

2021 ◽  
Vol 32 (2) ◽  
pp. 383-390
Author(s):  
Kaan Gürbüz ◽  
Yalçın Yontar
Keyword(s):  
Community Hospital ◽  
Functional Results ◽  
Clinical Results ◽  
Dominant Hand ◽  
Severity Scale ◽  
Cold Intolerance ◽  
Work Related ◽  
The Third ◽  
The Mean

Objectives: This study aims to evaluate the clinical results and experiences in a community hospital regarding procedures for the replantation and revascularization of fingers. Patients and methods: Between June 2015 and December 2019, a total of 58 patients (51 males, 7 females; mean age: 33.4±6.3 years; range, 23 to 46 years) who were followed after total and/or subtotal amputation and replantation were retrospectively analyzed. The patients were evaluated at nine months in terms of cold intolerance, static two-point discrimination, and functional results using the range of motion (ROM) and Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire. Results: The majority of the patients presented with work-related injuries (70%), most commonly by the mechanism of guillotine (64%), and to the dominant hand (76%) and the third finger (36%) most frequently. The overall success rate of digit salvage was 72.9% (n=51). Of 19 digits with unsuccessful surgical outcomes, seven were from total and 12 were from subtotal amputations. In the long-term, cold intolerance was observed in 14 patients (24.1%) according to the cold intolerance severity scale. The mean static two- point discrimination value was 6.0±0.7 mm and the mean QuickDASH score was 22.3±5.0. The mean ROM measured at nine months after surgery in the metacarpophalangeal and interphalangeal joints of the third and fourth digits was significantly lower than that in the others (p<0.05). Conclusion: The predictors of survival of a replanted digit indicated in this study can be used as a guide and decision-making aid for any attempts for replantation.

scholarly journals Burden and depressive symptoms in health care residents at COVID-19: A preliminary report

2021 ◽  
Vol 5 (1) ◽  
pp. 005-008
Author(s):  
Parro-Pires Daniela Betinassi ◽  
de C Matias Barros Sérgio Henrique ◽  
HD Araújo Fernanda Sabina ◽  
Santos Daniel Zandoná ◽  
Nogueira-Martins Luiz Antônio ◽  
...  
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Mental Health Service ◽  
Health Service ◽  
Burnout Syndrome ◽  
Medical Residents ◽  
First Year ◽  
The Mean ◽  
Preliminary Study ◽  
Medical And Healthcare

This paper focuses on the mental health burden on medical and healthcare residents during the 1st wave of COVID-19 pandemic crisis in 2020 describing the activities of a mental health service for residents (NAPREME) in a public university, UNIFESP, Sao Paulo, Brazil; and a preliminary study showing an increasing of depressive symptoms and depression among residents. Data is related to the screening interviews of medical residents and healthcare multi-professional residents who sought the mental health service from March to December 2020. A comparison was conducted with the same period in 2019 (covering a period when Covid-19 was not affecting the Brazilian population). There was a 22% demand increase in 2020. Of the total amount who sought treatment: 23% were medical residents, 22% nursing residents, and the remaining distributed among other professions; and 58% were first year residents and 34% second year. Data from the BDI questionnaire showed some variance between the two years: the mean score for 2020 was 24.67 (± 7.86) which is in the depression range, higher than the mean score of 19.91 points in the previous year (± 10.15) which is only in the depressive symptoms range (p < 0.005). In the pandemic period there was an increase in residents with depression from 49% to 70%. Depression, anxiety, stress and burnout syndrome were observed, demanding psychological and psychiatric care for this population. Assessment of residents’ mental health will continue during 2021, during the 2nd wave of COVID-19 and an additional analysis will be conducted along the year.

scholarly journals Hypoglycemia Is Independently Associated with Multidimensional Impairment in Elderly Diabetic Patients

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
A. Pilotto ◽  
M. Noale ◽  
S. Maggi ◽  
F. Addante ◽  
A. Tiengo ◽  
...  
Keyword(s):  
Prognostic Index ◽  
Female Gender ◽  
Diabetic Patients ◽  
Predictive Tool ◽  
Study Population ◽  
The Mean ◽  
Oral Hypoglycemic Drugs ◽  
Cohabitation Status ◽  
Study Inclusion

Aim. To identify the characteristics associated with multidimensional impairment, evaluated through the Multidimensional Prognostic Index (MPI), a validated predictive tool for mortality derived from a standardized Comprehensive Geriatric Assessment (CGA), in a cohort of elderly diabetic patients treated with oral hypoglycemic drugs.Methods and Results. The study population consisted of 1342 diabetic patients consecutively enrolled in 57 diabetes centers distributed throughout Italy, within the Metabolic Study. Inclusion criteria were diagnosis of type 2 diabetes mellitus (DM), 65 years old or over, and treatment with oral antidiabetic medications. Data concerning DM duration, medications for DM taken during the 3-month period before inclusion in the study, number of hypoglycemic events, and complications of DM were collected. Multidimensional impairment was assessed using the MPI evaluating functional, cognitive, and nutritional status; risk of pressure sores; comorbidity; number of drugs taken; and cohabitation status. The mean age of participants was 73.3 ± 5.5 years, and the mean MPI score was 0.22 ± 0.13. Multivariate analysis showed that advanced age, female gender, hypoglycemic events, and hospitalization for glycemic decompensation were independently associated with a worse MPI score.Conclusion. Stratification of elderly diabetic patients using the MPI might help to identify those patients at highest risk who need better-tailored treatment.

scholarly journals Fatigue and recovery among Malaysian doctors: the role of work-related activities during non-work time

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e036849 ◽  
Author(s):  
Mohd Fadhli Mohd Fauzi ◽  
Hanizah Mohd Yusoff ◽  
Nur Adibah Mat Saruan ◽  
Rosnawati Muhamad Robat ◽  
Mohd Rizal Abdul Manaf ◽  
...  
Keyword(s):  
Chronic Fatigue ◽  
Public Hospitals ◽  
Work Time ◽  
Cross Sectional ◽  
Work Task ◽  
Face To Face ◽  
Work Related ◽  
Time Work ◽  
The Mean

ObjectivesThis paper aims to estimate the level of acute fatigue, chronic fatigue and intershift recovery among doctors working at public hospitals in Malaysia and determine their inter-relationship and their association with work-related activities during non-work time.DesignCross-sectional.SettingSeven core clinical disciplines from seven tertiary public hospitals in Malaysia.ParticipantsStudy was conducted among 330 randomly-sampled doctors. Response rate was 80.61% (n=266).ResultsThe mean score of acute fatigue, chronic fatigue and intershift recovery were 68.51 (SD=16.549), 54.60 (SD=21.259) and 37.29 (SD=19.540), respectively. All these scores were out of 100 points each. Acute and chronic fatigue were correlated (r=0.663), and both were negatively correlated with intershift recovery (r=−0.704 and r=−0.670, respectively). Among the work-related activities done during non-work time, work-related ruminations dominated both the more frequent activities and the association with poorer fatigue and recovery outcomes. Rumination on being scolded/violated was found to be positively associated with both acute fatigue (adjusted regression coefficient (Adj.b)=2.190, 95% CI=1.139 to 3.240) and chronic fatigue (Adj.b=5.089, 95% CI=3.876 to 6.303), and negatively associated with recovery (Adj.b=−3.316, 95% CI=–4.516 to –2.117). Doing work task at workplace or attending extra work-related activities such as locum and attending training were found to have negative associations with fatigue and positive associations with recovery. Nevertheless, doing work-related activities at home was positively associated with acute fatigue. In terms of communication, it was found that face-to-face conversation with partner did associate with higher recovery but virtual conversation with partner associated with higher acute fatigue and lower recovery.ConclusionsWork-related ruminations during non-work time were common and associated with poor fatigue and recovery outcomes while overt work activities done at workplace during non-work time were associated with better fatigue and recovery levels. There is a need for future studies with design that allow causal inference to address these relationships.

scholarly journals The incidence and effect of tethered cord release for tethered cord syndrome in patients with myelomeningocele: a population-based study

2020 ◽  
Vol 26 (3) ◽  
pp. 269-274 ◽  
Author(s):  
Joel Haakon Borgstedt-Bakke ◽  
Thea Overgaard Wichmann ◽  
Gudrun Gudmundsdottir ◽  
Mikkel Mylius Rasmussen
Keyword(s):  
Surgical Procedures ◽  
Tethered Cord ◽  
Population Based ◽  
Short Term ◽  
Population Based Study ◽  
Long Term Follow Up ◽  
Study Population ◽  
The Mean

OBJECTIVEThe goal of this study was to establish an incidence and assess the effect of tethered cord release for tethered cord syndrome in patients with myelomeningocele.METHODSThe study population was based on the Western Denmark Myelomeningocele Database, which contains all patients born with myelomeningocele in western Denmark since 1970. The study population was cross-referenced in 2015 with a database for surgical procedures containing all surgical procedures performed in the central Denmark region since 1996. Patients alive between 1996 and 2015 were identified. Incidences was calculated and presented for year of age. File reviews were conducted for all patients who underwent the procedure. Follow-up was divided into short-term and long-term follow-up.RESULTSOne hundred sixty-six patients were alive during various time periods between 1996 and 2015. Of these, 45 patients underwent the procedure. Seven underwent reoperation. The median age for the procedure was 12 years and the highest incidence was found at 15 years of age. Incidence was bimodal with highest incidence in children and adolescents. The most common indications were progressive spine deformity (40%), deteriorating ambulation (38%), and deteriorating neurogenic bladder and/or bowel dysfunction (32%). The mean short-term follow-up was 4.7 months and the mean long-term follow-up was 72.6 months. Postoperatively, the majority had improved (27%) or stabilized (27%) at short-term follow-up. At long-term follow-up, most patients were stable (27%) or had deteriorated (24%). For both follow-up terms there was a loss of approximately one-third of all patients. Complications occurred in 17% of the procedures.CONCLUSIONSIn this population-based study, tethered cord release has the highest incidence in children and adolescents. The beneficial effect of the procedure seems to be short term. Due to the uncertainty of a long-term effect of the procedure in patients with myelomeningocele and the registered complications, the authors suggest that this surgical indication should be reserved for well-selected patients.

Long-term survival and clinical efficacy in patients with advanced pancreatic and small bowel metastatic neuroendocrine tumors (GEP-NET) after I.V. 90Y DOTATATE.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e15045-e15045
Author(s):  
Wojciech Rogowski ◽  
Ewa Wachula ◽  
Jolanta Zok ◽  
Anna Lewczuk ◽  
Jaroslaw Cwikla ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Small Bowel ◽  
Neuroendocrine Tumour ◽  
Somatostatin Receptor ◽  
Univariate Analysis ◽  
Female Gender ◽  
Term Survival ◽  
Long Term Outcome ◽  
The Mean

e15045 Background: Current therapeutic options for patients with progressive metastatic gastroenteropancreatic neuroendocrine tumour/neoplasm (GEP-NET/NEN) are limited. Treatment with SST analogues is method of choice, due to good symptoms control. [DOTA0, D-Phe1,Tyr3] octreotate[DOTATATE] has a higher affinity for SST2 receptors and thus is able to achieve longer disease control. The aim of this study was to evaluate long term radiological and clinical therapeutic effect of 90Y-DOTATATE in patients with progressive somatostatin receptor–positive small bowel and pancreatic neuroendocrine tumour/neoplasm (GEP-NET/NEN).The primary end point was assessing OS and PFS in long term follow-up. Methods: 67 patients progressing after treatment with SST analogues were inlcuded in the study. The mean treatment activity was 3.8GBq. The mean interval between therapies was 7 weeks (range 6 -9 weeks). Patients were treated up to mean a cumulative activity of 11.2 GBq. Due to pure beta emission (90Y) internal dosimetry was evaluated. Results: Median overall survival (OS) and progression-free survival (PFS) are shown in the Table. In univariate analysis Ki-67 (p=0.048) was the only significant factor influencing OS in pancreatic tumors. That was not confirmed in multivariate analysis. In small bowel tumors we defined three factors influencing survival in univariate analysis. These were: female gender (p=0.023), performance status at the beginning of therapy (p=0.031) and presence of liver metastases (p=0.026). Female gender (HR=0.30, 95% CI 0.11-0.81; p=0.018) was confirmed as positive prognostic factor in multivariate analysis. Factos influencing PFS were also assessed and will be presented as well. Conclusions: 90Y DOTATATE PRRT is effective in long term outcome (OS and PFS) in patient with advances progressive pancreatic and small bowel GEP-NET. This therapy is relatively safe as initial systemic therapy and after previous treatment with chemotherapy or somatostatine analogues as well. [Table: see text]

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