ABSTRACT
Background Depression and anxiety are among the most prevalent illnesses worldwide. Although depression affects many individuals throughout their lives, physicians are at a heightened risk of developing the disorder due to their high-stress levels and enormous responsibilities. The study aimed to examine the prevalence of depression and anxiety disorders among surgical doctors in Makkah city hospitals as well as the risk factors. Methods Analytical cross-sectional research was performed at all public hospitals in Makkah city, Saudi Arabia. The Arabic version of the Hospital Anxiety and Depression Scale (HADS) was used as the screening tool. Results Of the 153 surgeons, 47.1% were Saudis, 81.7% were men, and 46.7% were residents. A personal history of anxiety or depression was apparent among 11.8% of the surgeons, while 4.6% had a family history of a mental disorder. Based on the HADS questionnaire responses, the prevalence rate of anxiety was 30.7%, and 27.5% of the surgeons had depression. Based on the univariate regression analysis, anxiety was significantly linked with being a participant in the Saudi Board program (p=0.010), working for more than nine hours (p=0.020), and having work-related stress (p=0.011 for moderate stress and p=0.001 for severe stress) as well as related to those who were rarely or never satisfied with their income (p=0.016 and p=0.047, respectively) and who was rarely satisfied with their career (p=0.019). Depression among surgeons was significantly linked with the age of 50 to 59 (p=0.023) as well as related to those who were usually satisfied with their career (p=0.022) and those with moderate work-related stress (p=0.016). Conclusion Psychological disorders such as depression and anxiety are prevalent among surgeons. They should be appropriately evaluated at regular intervals throughout life, especially during residency programs, to ensure physical and mental well-being, appropriate training exposure, and patient safety.
ABSTRACT
BACKGROUND: Implanted vascular access devices play an essential role in the management of pediatric patients. The objectives of this study were to assess our experience with port-a-cath insertion in pediatric patients, report its complications, and compare open versus percutaneous approaches. METHODS: We performed a retrospective cohort study, including 568 patients who underwent port-a-cath insertion between 2013 and 2019 in our center. We grouped the patients according to the technique of insertion into two groups: group 1 (n = 168) included patients who had the open approach and group 2 (n = 404) included patients who had the percutaneous technique. (p < 0.001). RESULTS: Patients in group 1 were younger (4.10 ± 3.45 years) compared to patients in group 2 (5.47 ± 3.85 years). The main indications of insertion were hematological malignancy 57.74% (n = 328), solid organ malignancy 25.18% (n = 143), pure hematological diseases 5.46% (n = 31), metabolic diseases 2.64% (n = 15), and others for poor vascular access 8.8% (n = 50). The most common site for insertion in group 1 was the left external jugular (n = 136; 82.98%) and the left subclavian in group 2 (n = 203; 50.25%). Two hundred and two patients had a central line before catheter insertion (36.6%). Complications during insertion were comparable between both groups (p = 0.427). The catheter got stuck in 6 patients; all required additional incision and two needed venotomy. The most common reason to remove the catheter was the completion of the treatment (63.69% and 61.14%, in groups 1 and 2, respectively). The duration of the catheter was comparable between the two groups (13.14 ± 14.76 vs. 14.44 ± 14.04 months in group 1 vs.2; p = 0.327). CONCLUSIONS: Open and percutaneous port-a-cath insertions are safe in children with chronic diseases. Port-a-cath improved patients' management, and complications are infrequent. The most common complications are infection and catheter malfunction, which can be managed without catheter removal in some patients.
