Sleep quality and sleep pattern among resident physicians and its relation to anxiety and depression during the pandemic (COVID-19) in a private tertiary hospital

INTRODUCTION@#Due to the skeletal workforce in the hospital during the COVID-19 pandemic, physicians are subject to great pressure, irregular work time, and frequent day-night work shifts, which may lead to the increase of sleep disturbances. @*OBJECTIVES@#This was a single-center, cross-sectional, questionnaire-based study which aimed to (1) evaluate the quality of sleep and sleeping pattern of resident physicians in Makati Medical Center during the of COVID-19 Pandemic and (2) measure the association of sleep quality and sleep pattern with depression and anxiety. @*RESULTS@#A total of 187 resident physicians were included in this study. 38.0% of participants had fair to poor sleep hygiene, 79.1% had short sleep pattern, and 74.9% had poor sleep quality. 44.4% of participants had probable anxiety and 47.6% had probable depression. Having probable anxiety (OR=5.1, 95% CI=2.3 to 11.4, p-value <0.001) and probable depression OR=2.6, 95% CI=1.3 to 5.2, p-value=0.006) were both significantly associated with poor sleep quality. @*CONCLUSION@#There is high prevalence of poor sleep quality among resident physicians in Makati Medical Center. In addition to this, almost half of the resident physicians show notable signs of anxiety and depression. Both sleep hygiene and sleep quality are significantly associated with risk for anxiety and depression.

A case of eccrine carcinoma presenting with neurological manifestations

@#<p style="text-align: justify;"><strong>INTRODUCTION:</strong> Eccrine  carcinoma  is  an  extremely  rare  skin tumor where only 1/13000 specimens have been submitted to dermatopathological  laboratories  in  the  United  States.There  is  no  data  yet  to compare the Philippines with the international  incidence  of  eccrine  carcinoma.  This is a case of a 69-year-old Filipino female who presented with a recurring invasive indolent tumor at the right fronto-parietal area who presented with left sided hemiparesis and seizure.<br /><strong>CASE:</strong> The patient was presented with a recurrent invasive indolent  mass  on  her  right  front-parietal  area,  grossly measuring five by four centimeters, nodular flesh colored,which  extended  intracranially.This was associated with left sided hemiparesis and due to the extent of the tumor encroaching through the brain parenchyma, patient was noted  to  have  seizure  episodes.  The  patient  was  given surgical and radiologic options however, she did not comply and died last December 2015.<br /><strong>RESULTS:</strong> A cranial MRI with MRA showed a  heterogenous enhancing intracranial mass with extracranial component with compressed entrapped and depressed superior sagittal sinus  by  the  axial  mass  witin  calvarial  penetration  and scalp involvement compressing on the right parietal lobe with parenchyma edema. Biopsy was eventually done and findings were consistent with an eccrine carcinoma.<br /><strong>CONCLUSION:</strong> This is the first case of eccrine carcinoma in our institution. Due to the paucity of data, there are no guidelines to the management of an eccrine carcinoma. Hence the imperative need to raise awareness regarding this rare tumor because,  without  a  high  index  of  suspicion  this  rare  entity may be overlooked or misdiagnosed. When presented with an indolent invasive recurrent tumor a high index of suspicion that  an  eccrine  Carcinoma  may  be  suspected.Excision biopsy may be done for correct identification of the tumor.</p>