Burnout among postgraduate medical trainees in Lebanon: Potential strategies to promote wellbeing.

Objective: Burnout is a widespread issue in healthcare for many years. Lebanon combatted political and economic crises before the coronavirus disease 2019 (COVID-19) pandemic, in addition to the port explosion in August 2020. The study aimed to identify the determinants of personal burnout, patient-related burnout, and work-related burnout among postgraduate medical trainees (PGMT) and evaluate its relationship with sociodemographic characteristics. Design: A cross-sectional study utilized the Copenhagen Burnout Inventory (CBI) involving electronic, voluntary, and anonymous survey. The survey was completed by 188 PGMT including residents and fellows from all specialties and all levels of training. Results: The prevalence rates are 68.6% for personal burnout, 63.3% for work-related burnout, and 35.1% for patient-related burnout. Conclusion: Results improve our understanding of the phenomenon of burnout, and the role of program leadership in shaping the impact of burnout on training and promoting wellbeing of PGMT. Discussion focuses on providing potential wellbeing strategies for program directors to follow for mitigating burnout.

Antenatally diagnosed intraspinal-posterior mediastinal neurenteric cyst - what is the optimal management?

Neurenteric cyst is a rare congenital anomaly that belongs to the spinal dysraphism spectrum. It is classically a disease of late childhood, with some rare reports of intrauterine and adult presentation. The increase in incidental antenatal diagnosis raises new management questions. We present a case of an asymptomatic combined intraspinal-posterior mediastinal neurenteric cyst. The cyst was diagnosed on antenatal ultrasound and was initially treated with image-guided aspiration in early infancy. However, the cyst recurred and the patient developed recurrent episodes of bacterial meningitis. Two-stage surgical resection was performed, although the infection prohibited complete excision. We caution against image guided aspiration of neurenteric cysts, and suggest a management algorithm based on the available literature.

Mass casualty management during a pandemic surge: The American University of Beirut Medical Center experience.

Mass casualty incidents can be devastating events associated with a large number of fatalities, morbidities, and long-lasting sequelae. The negative outcomes can be further amplified if the incident occurred during a pandemic surge, such as what occurred in Beirut, Lebanon with the August 4, 2020 Beirut Port explosion. To decrease the mortality and morbidity and avoid inefficiency, management depends on having an established coordinated multidisciplinary approach from transport and triage to emergency department care and in-hospital management. In this article, the mass casualty management and the impact of the coronavirus disease 2019 pandemic will be discussed based on the American University of Beirut Medical Center experience.