Outcomes of cirrhotic patients admitted to the intensive care unit after a successful cardiac arrest resuscitation.

OBJECTIVES: To evaluate the outcomes of cirrhotic patients admitted to the intensive care unit (ICU) following cardiac arrest. METHODS: This was a single centre retrospective study of all the cirrhotic patients, admitted to the ICU at King Abdulaziz Medical City, Riyadh, Saudi Arabia, after a successful cardiac arrest resuscitation, from 1999 to 2017. The characteristics of the hospital survivors and non-survivors were compared. RESULTS: A total of 76 patients were admitted to the ICU during the study period, with a median age of 64 years. In addition to cirrhosis, the patients had other chronic comorbidities, including chronic renal disease (32.9%) and diabetes (47%). Of this group, 67 (88.2%) died in the hospital, and 54 (71%) died while in ICU. Compared to the group who survived, all non-survivors required mechanical ventilation and had a higher median APACHE II score of 38 (p=0.006), a lower median Glasgow coma score (GCS) of 3 (p=0.0003), and a higher median lactic acid of 6.4 mmol/L (p=0.032). On multivariable logistic regression analysis, the important predictors of hospital mortality were APACHE II score (p=0.006), bilirubin level (p=0.008) and GCS (p=0.005). CONCLUSION: Cirrhotic patients admitted to the ICU following cardiac arrest have high mortality. Patients with higher APACHE II scores, higher bilirubin and lower GCS have higher risk of in-hospital mortality.

Health care worker burnout during the COVID-19 pandemic: A cross-sectional survey study in Saudi Arabia.

OBJECTIVES: To estimate the prevalence of burnout among health care workers (HCWs) who are working in Saudi Arabia during the Coronavirus disease 2019 (COVID-19) pandemic, and explore individual and work-related factors associated with burnout in this population. METHODS: In this cross-sectional study conducted between June to August of 2020, we invited HCWs through social channels to complete a questionnaire. The questionnaire inquired about demographics, factors related to burnout, and used the Copenhagen Burnout Inventory scale to indicate burnout. A total of 646 HCWs participated. RESULTS: The mean (SD) age of participants was 34.1 (9.5) years. Sixty-one percent were female. The prevalence of burnout among HCWs was 75%. Significant factors associated with burnout were age, job title, years of experience, increased working hours during the pandemic, average hours of sleep per day, exposure to patients with COVID-19, number of times tested for COVID-19, and perception of being pushed to deal with COVID-19 patients. CONCLUSION: Health care workers as frontline workers, face great challenges during this pandemic, because of the nature of their work. Efforts should be made to promote psychological resilience for HCWs during pandemics. This study points out the factors that should be invested in and the factors that may not be influential.

Occupational-Related Contact Dermatitis: Prevalence and Risk Factors Among Healthcare Workers in the Al'Qassim Region, Saudi Arabia During the COVID-19 Pandemic.

Objective This study aimed to estimate and investigate the prevalence and the risk factors implicated in contact dermatitis among healthcare workers in the Al'Qassim region, Saudi Arabia, during the COVID-19 pandemic. Methodology We conducted a cross-sectional survey among healthcare workers at hospitals in the Al'Qassim region. Data was collected using a standardized and validated Nordic Occupational Skin Questionnaire version 2002. We included 408 participants in the analysis. Results The majority of the respondents (66.7%) were females. The mean age of participants was 34 (SD: ±9) years. Most of the participants who reported contact dermatitis were nurses (58.6%). Direct patient care roles represent 78% of participants. Respondents who work 40-50 hours per week represent 61.5% of the sample. The most commonly recorded symptoms were dryness (92.9%), itchiness (50%), and redness (46.4%) of the skin. The most affected site was hand 93.5%. Hand cleanser was the commonest substance implicated in the worsening of the skin changes (59.2%). Protective glove material that worsens contact dermatitis, such as natural rubber/latex, represents 76% of responses. A significant association (p=0.001)was seen in the occurrence of contact dermatitis in those with a history of allergic eye symptoms (33.3%) and those without (58%). Participants with a mean age of 26.47 years were more prone to develop contact dermatitis (CI: 1.19-7.06; p=0.067). Pharmacists and interns had 3.69 and 4.90 times higher odds of having contact dermatitis (CI: 0.95-7.33; CI: 22.1; p=0.027; p=0.038, respectively). Those involved in patient education and research activities at work were 6.48 (p=0.017) and 20.51 (p=0.024) times likely to develop contact dermatitis (CI: 1.38-30.31; CI: 1.49-282.15, respectively). Conclusions We explored the prevalence and risk factors for occupational contact dermatitis among healthcare workers in Saudi Arabia. The prevalence of reported skin changes during the pandemic was 46.4%. Our study also showed that the risk factors of developing contact dermatitis include female gender, history of eye allergies, and young age group.

The Influence of Modern Social Media on Dermatologist Selection by Patients.

Objective Social media have become the platform of choice for people seeking immediate access to information. They have become so ubiquitous and pervasive that many people are using them to research health care providers and communicate with them about their issues. This study looks into this phenomenon, focusing on how it affects people's thinking when deciding which doctor to see for skin-related concerns. Methodology A cross-sectional study was conducted among patients at Derma Clinic in Riyadh, Saudi Arabia. Data were collected using a validated self-administered questionnaire. A total of 365 patients were included in the analysis. Results Out of 365 participants, 44.9% visited the center for medical purposes, while 45.8% visited for cosmetic purposes. Sixty-six percent of the participants (n=241) went to a dermatologist they knew, and only 21% of those participants knew their dermatologist from social media (Twitter, Instagram, Snapchat, Facebook, and Telegram). About 44.54% preferred to know more about their dermatologists from Twitter, followed by Instagram 27.96%, Snapchat 24.64%, and Facebook 2.84%. A significant proportion of Instagram users came to the dermatology clinic for cosmetic purposes. Conclusion As per the findings of this study, we found the highest preferred way of knowing the doctor for medical or cosmetic purposes was through a friend, followed by a family member and social media. Although most of the participants still preferred to visit a dermatologist based on their friend's recommendation, social media offer patients a platform upon which to launch their search for a dermatologist. Among social media users, patients who visit dermatology clinics for medical reasons preferred Twitter, while those who came for cosmetic reasons preferred Instagram to follow their doctors, underlining the importance of aesthetic dermatology as a visual field.