The psychological impact of the COVID-19 pandemic on otolaryngologists: Should we be concerned?

OBJECTIVE: Physicians on the frontline of the COVID-19 pandemic are at increased risk of contracting the disease. Otolaryngologists are amongst the high-risk practitioners, as they are in close proximity to patient's upper airway, which may induce their psychological stress. METHODS: A cross-sectional survey study, conducted among otolaryngologists in Saudi Arabia from June 11 to June 22. Survey consisted of sociodemographic questionnaire, Coronavirus Anxiety Scale (CAS), Obsession with COVID-19 Scale (OCS) and Patient Health Questionnaire-9 (PHQ-9). Available otolaryngologists with no history of mental health problems were included. A P-value lower than .05 was considered statistically significant. RESULTS: The study included 129 participants; 63.6% men and 36.4% women. 81.4% of participants were living with family, 57.4% living with either a child or an elderly family member. Nearly 7.8% of participants had dysfunctional COVID-19 anxiety and 75.2% had COVID-19-related depression symptoms ranging from minimal to severe. Obsession and dysfunctional thinking regarding COVID-19 were found in 26.4% of participants. Single otolaryngologists had significantly higher CAS (P = .025), OCS (P = .048), and PHQ-9 (P < .001) scores. Participants who lived with children or elderly individuals had significantly higher OCS scores (P = .005). When comparing job ranks, residents had significantly higher scores for the CAS (P = .016) and PHQ-9 (P < .001). CONCLUSION: COVID-19 has a considerable psychological impact on otolaryngologists. Specifically, the young and single who have less social support. This indicates the importance of psychological support to this group. Additional thorough studies should explore the psychological impact of COVID-19 in this field as it may carry devastating long-term consequences if left unattended. LEVEL OF EVIDENCE: Level 4.

Knowledge and practice of Protective Personal Equipment (PPE) among healthcare providers in Saudi Arabia during the early stages of COVID-19 pandemic in 2020.

Introduction: Healthcare providers are at high risk of becoming infected when taking care of patients who have COVID-19, especially while attending aerosol generating procedures. Protective personal equipment must be used in the correct manner to prevent transmission of the disease. Published protocols on protective personal equipment (PPE) donning and doffing have been issued by disease control agencies. Methods: A questionnaire-based cross-sectional study was designed. An online anonymous questionnaire, which was validated and tested for reliability, focused on PPE related knowledge, donning and doffing practices of healthcare providers across the eastern region of Saudi Arabia. Results: A total of 312 healthcare providers across the eastern region of Saudi Arabia participated in the study, 208 physicians (66.7%) and 104 non-physicians (33.3%). Results indicate poor practice regarding PPE donning (13.8% reported the correct sequence) and PPE doffing (3.5% reported the correct sequence) among participants. In addition, practice and confidence scores regarding other issues with PPE were analyzed. Based on questionnaire responses, being male (T = 2.825; p = 0.008), being a non-physician (T = -2.120; p = 0.014) and being an allied medical professional (F = 5.379; p = 0.003) were significantly associated with higher confidence levels. Also, being a consultant was significantly associated with higher practice scores (F = 4.774; p = 0.008). Conclusion: The study demonstrates deficiencies among healthcare providers in following the recommended practices for correctly using PPE during the pandemic. Poor practice in PPE donning and doffing necessitates additional educational and training programs focused on infection control practices.

Laparoscopic management of appendicular mucinous cystadenoma, case report.

INTRODUCTION: Appendectomy is the most common emergency surgical procedure performed worldwide. Mucinous cystadenoma is a rare benign tumor of the appendix. There is no agreement on the best surgical approach for its management. Recently, laparoscopic approach is being increasingly tried. Careful excision of the tumor is mandatory to avoid content spillage into peritoneum resulting in pseudomyxoma peritonei. CASE PRESENTATION: A middle-age male patient presented to the emergency department complaining of chronic abdominal pain, bleeding per rectum and recurrent attacks of vomiting. Preoperative imaging confirmed presence of cystic lesion in the right lower quadrant. He underwent a diagnostic laparoscopy with resection of appendicular mucocele. The histopathological examination confirmed the diagnosis of appendicular mucinous cystadenoma. He was followed up in the clinic for two years. CONCLUSION: Appendicular mucinous cystadenoma should be considered in differential diagnosis of cystic mass detected in the right lower quadrant of the abdomen on US or CT. Laparoscopic excision of the tumor is safe and feasible with extra care taken to avoid pseudomyxoma peritonei.'