RESUMO
Trichilemmal cyst (TC), commonly known as the pilar cyst of the scrotum wall, is an uncommon disease. It is a type of epidermoid cyst (EC) with a benign course, and malignant change is quite rare. This disease is unusual in the scrotum; therefore, multiple cysts in the scrotum are much more unusual. There have been reports of TCs in other parts of the body, but this is the first instance of scrotal TCs in Pakistan. Case presentation: We discuss the case of a 60-year-old male patient who presented to the clinic with a right-sided scrotal swelling, which was identified as a right-sided inguinal hernia on examination, and multiple small swellings on the scrotal skin identified as TCs. The patient had scrotoplasty after hernia surgery to remove the cysts and reconstruct the excised scrotum. Following scrotoplasty, the patient's discomfort was resolved, and cosmetic satisfaction was achieved. Clinical discussion: Excision is required if TCs become infected or for esthetic reasons. In the event of big cysts, full scrotal wall resection followed by scrotoplasty is necessary. The thigh fasciocutaneous flap is used to cover the denuded testes after scrotoplasty. The procedure's advantages include a good outcome, low morbidity, early discharge, and great esthetic outcomes. Conclusion: We present a literature review about multiple TCs in the scrotum and their surgical management. This case will guide surgeons and future researchers in dealing with similar cases in the future.
RESUMO
Workplace bullying (WPB) in the healthcare system (HCS), whether perpetrated by healthcare professionals (HCPs) or patients, is a serious problem. The goal of this research study was to find out how common WPB is among HCPs. We conducted a questionnaire-based cross-sectional study in the three public tertiary care hospitals of Karachi, Pakistan from May to October 2020. A validated Negative Acts Questionnaire-Revised (NAQ-R) was used to measure WPB prevalence. The final sample size was 449, out of which 72.4% were females and 27.6% were males. The majority of respondents were house officers or 1st-year trainees who had completed their MBBS (n = 252, 56.1%). Residents (n = 197, 43.9%) who were pursuing specialty training made up the remainder of the respondents. As per NAQ-R cut-offs, the prevalence of bullied, being bullied, and not bullied was 41, 29, and 30%, respectively. WPB prevalence was higher in males (53%) than females (38%), whereas it occurred more often in residents (48%) than house officers (36%). We found similar findings while using the self-reported definition for WPB. Based on our findings, we conclude that WPB is pervasive among HCPs, particularly for males and residents in tertiary care hospitals in Pakistan.
