ABSTRACT
Background: Trichobezoar is a rare gastrointestinal pathology in paediatric population. Patients present with a range of symptoms from being asymptomatic to abdominal pain with a palpable abdominal mass. Once diagnosed it warrants urgent retrieval as delayed diagnosis may lead to serious complications. Methods: We present a series of six cases between March 2021 and March 2022 who presented to Children's Hospital and were diagnosed as a case of Gastric Trichobezoars. Patients were optimized and prepared for surgery. All patients underwent Surgical exploration and a tuft of hair were removed. They were followed up throughout the course of treatment and three of the patients underwent psychiatric evaluation. Discussion and conclusion: Trichobezoar is a rare but important surgical case that is a manifestation of underlying psychiatric ailment. Presentation varies from asymptomatic masses to life threatening complications with delayed presentations. A multi-disciplinary approach including Psychiatric, Paediatrician and Paediatric surgeon should be undertaken. Follow-up is the mainstay of treatment and recurrence may be seen due to non-compliance or inadequate management.
ABSTRACT
BACKGROUND: During the pandemic, disruption of work schedule and constant health risks causes physician burnout. This study aims to identify Burnout in physicians working in COVID ICU and isolation Ward. METHODS: A cross-sectional study was conducted on 200 physicians who had worked in either COVID ICU or Isolation ward. A survey of 23 questions was designed to assess the work-related Burnout using the Copenhagen burnout inventory and the implementation of NIH guidelines. RESULTS: Among the 200 physicians, 151 (75.5%) were well informed of the guidelines, of which 52 (34.4%) participants believed the guidelines were not sufficient. These 34.4% of individuals showed a mean burnout score of 70.05% (p-value 0.001). Medical registrars and Medical Officers suffered the highest burnout mean percentage score of 76% and 72.42%, respectively. 89 (44.5%) individuals arranged PPE suits on their own and suffered a burnout score of 71.3% ±14.35 (p-value <0.001). Seventy-two (36%) claimed their administration was not cooperative in resolve safety issues. These individuals showed a mean burnout score of 74.3% ±13.82 (p-value <0.001). CONCLUSIONS: Lack of physician's faith in the adequacy of the NIH guidelines has been found to be a significant factor in contributing to work-related Burnout. Due to the shortage of PPE, a majority of physicians have to reuse their PPE multiple times and even have to personally arrange their PPE suits, which further compounds the burnout. Increase administrative cooperation in resolving issues related to safety measures should help elevate work-related burnout in physicians working in the ICU and isolation ward.
