1.Unilateral ovarian fibrothecoma with menorrhagia
Danendran Krishnan ; Komal Kumar ; Anitha Ann Thomas
The Malaysian Journal of Pathology 2014;36(1):55-58
Ovarian fibrothecoma is a relatively new term that is used to describe an ovarian sex cord stromal
tumour that has mixed features of both fibroma and thecoma. The prevalence of ovarian fibrothecoma
tumours is very rare and is reported to be about 1.2% of all ovarian tumours. We report a case of
a 32-year-old woman who presented with acute menorrhagia with no previous medical, surgical
or gynecological history. She was amenorrhic for four years after the insertion of a levonorgestrelreleasing
intrauterine system (LNG-IUS) for contraception. The efficacy and location of LNG-IUS
was reflected due to the sudden onset of menorrhagia. On pelvic examination and ultrasound the
LNG-IUS could not be visualized and a uterine fibroid was noted. A diagnostic laparoscopy was
done to identify the LNG-IUS, which revealed an incidental large ovarian mass on the left ovary.
CA-125 level was elevated to 45 kU/L (Normal range <35 kU/L). Total abdominal hysterectomy, left
salpingo-oopherectomy and cystectomy were performed. On histopathology, the mass was proven
to be an ovarian fibrothecoma. No signs of malignancy were noted on peritoneal fluid cytology.
The LNG-IUS was found inside the uterus. Our case is reported on the basis of the rare incidence
of ovarian fibrothecoma and the possible effect it may have on the efficacy of LNG-IUS causing
menorrhagia.
Menorrhagia
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Fibroma
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Thecoma
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Ovarian Neoplasms
2.Safety attitudes, burnout and well-being among healthcare workers during the COVID-19 pandemic: an Indo-Pacific regional cross-sectional study.
Abhiram KANNEGANTI ; Benjamin Yong Qiang TAN ; Nik Hisamuddin NIK AB RAHMAN ; Aloysius Sheng-Ting LEOW ; Max DENNING ; Ee Teng GOH ; Lucas Jun HAO LIM ; Ching-Hui SIA ; Ying Xian CHUA ; James KINROSS ; Melanie TAN ; Li Feng TAN ; Yi Min WAN ; Arvind SHARMA ; Rivan DANUAJI ; R N KOMAL KUMAR ; Chew Keng SHENG ; Cheah Phee KHENG ; Sarah Shaikh ABDUL KARIM ; Mohd Najib ABDUL GHANI ; Suhaimi MAHMUD ; Yiong Huak CHAN ; Vijay Kumar SHARMA ; Kang SIM ; Shirley Beng SUAT OOI
Singapore medical journal 2023;64(11):667-676
INTRODUCTION:
The coronavirus disease 2019 (COVID-19) pandemic has had an unprecedented impact in Asia and has placed significant burden on already stretched healthcare systems. We examined the impact of COVID-19 on the safety attitudes among healthcare workers (HCWs), as well as their associated demographic and occupational factors, and measures of burnout, depression and anxiety.
METHODS:
A cross-sectional survey study utilising snowball sampling was performed involving doctors, nurses and allied health professions from 23 hospitals in Singapore, Malaysia, India and Indonesia between 29 May 2020 and 13 July 2020. This survey collated demographic data and workplace conditions and included three validated questionnaires: the Safety Attitudes Questionnaire (SAQ), Oldenburg Burnout Inventory and Hospital Anxiety and Depression Scale. We performed multivariate mixed-model regression to assess independent associations with the SAQ total percentage agree rate (PAR).
RESULTS:
We obtained 3,163 responses. The SAQ total PARs were found to be 35.7%, 15.0%, 51.0% and 3.3% among the respondents from Singapore, Malaysia, India and Indonesia, respectively. Burnout scores were highest among respondents from Indonesia and lowest among respondents from India (70.9%-85.4% vs. 56.3%-63.6%, respectively). Multivariate analyses revealed that meeting burnout and depression thresholds and shifts lasting ≥12 h were significantly associated with lower SAQ total PAR.
CONCLUSION
Addressing the factors contributing to high burnout and depression and placing strict limits on work hours per shift may contribute significantly towards improving safety culture among HCWs and should remain priorities during the pandemic.
Humans
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Cross-Sectional Studies
;
Pandemics
;
COVID-19/epidemiology*
;
Burnout, Psychological
;
Health Personnel