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[This retracts the article DOI: 10.7759/cureus.20502.].
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[This retracts the article DOI: 10.7759/cureus.19067.].
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Burnout in healthcare workers (HCWs) is defined as a state of emotional, physical, and mental exhaustion that results from unmanaged, excessive, and long-term workplace stressors. This study aims to assess the prevalence of burnout and the levels of anxiety and depression among HCWs who primarily work with children who have autism spectrum disorder (ASD). A quantitative cross-sectional survey was conducted utilizing the Arabic version of the Maslach Burnout Inventory (MBI), Areas of Worklife Survey (AWS), Patient Health Questionnaire for Generalized Anxiety Disorder (GAD-7), and Patient Health Questionnaire for Depression (PHQ-9). Among the 381 participants working in autism centers, the majority were young Saudi females (326) working full-time as specialists in the private sector with less than five years of experience. The HCWs' overall mean scores on the three Maslach Burnout Inventory (MBI) subscales: emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA) were 62%, 23.7%, and 76.5%, respectively. A total of 51.4% of HCWs reported moderate to high anxiety levels on GAD-7, and 47.8% showed moderate to very high levels of depression on PHQ-9. The mean perceived EE converged significantly but negatively on their overall mean perceived satisfaction with AWS (p-value < 0.001), demonstrating that greater emotional fatigue predicts less satisfaction with their work. The PA scores correlated significantly and positively with their overall mean satisfaction with their AWS score (p-value < 0.001). Considering sociodemographic variables, HCWs aged between 20-29 years have significantly lower mean PA scores than HCWs aged thirty and older (p = 0.007). Also, male HCWs perceived significantly higher work-related DP than females. More research is required to determine the nature of variables that contribute to burnout, depression, and anxiety in HCWs helping children with ASD.
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Chest pain is one of the most common complaints in the emergency department. The etiologies of chest pain include a wide spectrum of conditions, ranging from mild and self-limited to life-threatening conditions. Gastrointestinal origins of acute chest pain, including esophageal, gastric, and biliary conditions, are not uncommon. We present the case of a 67-year-old man who presented to the emergency department with chest pain of three hours duration with pressure-like quality. The pain was associated with sweating, palpitation, nausea, and vomiting. The past medical history of the patient was remarkable for ischemic heart disease and percutaneous cardiac intervention. Both the electrocardiograph and cardiac biomarkers were normal. The patient experienced severe episodes of vomiting with one episode containing a small amount of blood. Upper gastrointestinal endoscopy revealed distorted anatomy of the stomach. Subsequently, the patient underwent a computed tomography scan which demonstrated an organoaxial gastric volvulus. The patient was resuscitated and underwent laparoscopic repair of the volvulus. Acute gastric volvulus is a very rare etiology of chest pain. Despite its rarity, physicians should keep a high index of suspicion of this condition after excluding the possible cardiac causes of chest pain.
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Small intestinal obstruction is a common surgical emergency that has a wide range of underlying etiologies. The most frequent causes of small intestinal obstruction include adhesions, hernias, and malignancies. The diagnosis of small intestinal obstruction is primarily dependent on the clinical findings, but imaging investigations are crucial to confirm the diagnosis and evaluate the complications. We report the case of a middle-aged woman with a complaint of abdominal pain for one week that was associated with abdominal distension and decreased bowel motion. Examination of the abdomen showed a distended abdomen. There was generalized tenderness, but no guarding or rigidity was noted. Initial laboratory investigation showed no derangement in the basic hematological and biochemical parameters. Abdominal CT was performed, which showed a segment of jejunojejunal intussusception causing a small intestinal obstruction. There was a well-defined, oval-shaped fat-attenuation mass lesion acting as a lead-point. Such radiological findings conferred the diagnosis of jejunojejunal intussusception due to jejunal lipoma. The patient underwent laparotomy, which confirmed the radiological finding. The intussusception was reduced, but a gangrenous intestine was observed. Resection of the affected intestine was performed, followed by a primary anastomosis. The patient recovered with no complications. Following the operation, oral feeding was started gradually according to the patient's tolerance. She was discharged after 10 days of hospitalization. At the follow-up visit after three months, the patient had no active symptoms. This case illustrated a rare etiology of small intestinal obstruction due to gastrointestinal lipoma. A computed tomography scan is strongly advised to reach the diagnosis and identify the lead points.