Left Ventricular Systolic Dysfunction in Patients of Obstructive Sleep Apnea Syndrome

Objective: To determine the left ventricular systolic dysfunction and the association of various factors with this dysfunction in patients with obstructive sleep apnea syndrome. Study Design: Cross-sectional study. Place and Duration of Study: Pak Emirates Military Hospital, Rawalpindi Pakistan, from Dec 2020 to May 2021. Methodology: We included the patients diagnosed with sleep apnea syndrome by a consultant pulmonologist based on a sleep study. Patients were labelled as having left ventricular systolic dysfunction if the ejection fraction was less than 40% on echocardiography. Results: Eighty patients diagnosed with sleep apnea syndrome were included in the study. The mean age of the study participants was 48.551±9.971 years. Out of 80 patients, 19(23.75%) had left ventricular systolic dysfunction on echocardiography, while 61(76.25%) had no evidence of left ventricular systolic dysfunction. With the application of relevant statistical tests, we found that patients with high body mass index and the presence of comorbid illnesses had a statistically significant relationship (p-value<0.05) with the presence of left ventricular systolic dysfunction among patients with sleep apnea syndrome. Conclusion: Considerable number of patients suffering from obstructive sleep apnea syndrome showed the presence of left ventricular systolic dysfunction on echocardiography. High Body mass index and comorbid illnesses emerged as risk factors for left ventricular systolic dysfunction in our study population

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10&nbsp;years; 78.2% included were male with a median age of 37&nbsp;years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020