RESUMO
Recurrent pyogenic cholangitis (RPC), which is most commonly seen in Asian populations, is characterized by strictures and dilatation of both intrahepatic and extrahepatic bile ducts, along with the formation of pigmented stones inside the ducts. The most common symptoms are recurrent right upper quadrant pain, jaundice, and fever. Additionally, leukocytosis and elevated alkaline phosphatase and bilirubin levels may also be present. We report the case of a 43-year-old Bangladeshi male patient with a medical background of chronic hepatitis B infection and recurrent liver abscesses who presented to the emergency department with abdominal pain and fever lasting for two days. Given the clinical context of our patient, a diagnosis of RPC was made, and the patient was referred to a higher-level center for further management. Our case highlights the importance of considering RPC as part of the differential diagnosis in patients presenting with recurrent liver abscesses and features of ascending cholangitis.
RESUMO
AIM: The aim of the study was to examine the relationship between stress, psychological symptoms and job satisfaction among frontline nursing staff at a military hospital in Saudi Arabia during the COVID-19 pandemic. DESIGN: Descriptive cross-sectional study. METHODS: Data were collected using an online survey. All Registered Nurses (N = 1,225) working at a military hospital between February to April 2021 were contacted, 625 responded (51%). Data were analysed using descriptive and multivariate analysis, Student's t-test for independent samples and one-way analysis of variance followed by Tukey's multiple comparison tests. RESULTS: Stress was experienced more significantly than depression or anxiety. Approximately 29% of the change in scores for psychological symptoms was explained by age group, being a Saudi national and working in emergency departments (F[3,620] = 19.063, p < 0.0001). A 37% change in nursing stress scores was explained by nationality and work department. (F[5,618] = 19.754, p < 0.0001). A 29% change in job satisfaction scores was explained by nationality and work department (F[3,620] = 19.063, p < 0.0001).