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Almohsen C, Soqia J, Mohsen S. Burnout levels and correlates among healthcare providers in Syria following the 2023 Turkish-Syrian earthquakes: A cross-sectional study. Health Sci Rep 2024; 7:e2080. [PMID: 38690009 PMCID: PMC11058084 DOI: 10.1002/hsr2.2080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 03/25/2024] [Accepted: 04/07/2024] [Indexed: 05/02/2024] Open
Abstract
Background and Aims This article examines the prevalence of burnout among healthcare providers in the aftermath of the recent earthquakes in Syria and Turkey and explores the associated risk factors. Methods This cross-sectional study included 270 healthcare providers in three Syrian cities damaged by earthquakes. Participants were asked to fill out a validated questionnaire on the fifth day of emergency response using the Geldard Occupational Burnout questionnaire. Results The mean score for the Geldard Occupational Burnout Questionnaire was 129.79, with 81.4% indicating moderate burnout risk and only 3% indicating high risk. Gender was not significantly associated with burnout, but there was a significant difference in burnout scores between city groups, with Latakia scoring significantly lower than Aleppo. Conclusion This study highlights the prevalence of burnout among healthcare providers in the aftermath of an earthquake in Syria, with the majority having a moderate risk of burnout. Gender was not significantly associated with burnout risk. Further research is needed to develop effective interventions and address study limitations. The study emphasizes the importance of prioritizing healthcare providers' mental health to ensure high-quality care after natural disasters.
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Affiliation(s)
- Caroline Almohsen
- Department of Clinical Psychology, Faculty of Health SciencesDamascus UniversityDamascusSyria
| | - Jameel Soqia
- Faculty of MedicineDamascus UniversityDamascusSyria
| | - Samer Mohsen
- Faculty of MedicineDamascus UniversityDamascusSyria
- Department of Audiology, Faculty of Health SciencesDamascus UniversityDamascusSyria
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Kamil S, Mohsen S. Diode Laser for Juvenile Recurrent Respiratory Papillomatosis: A Case Series of 13 Patients. Indian J Otolaryngol Head Neck Surg 2024; 76:536-539. [PMID: 38440491 PMCID: PMC10909036 DOI: 10.1007/s12070-023-04205-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 08/19/2023] [Indexed: 03/06/2024] Open
Abstract
Juvenile recurrent respiratory papillomatosis (JRRP) is the most common benign tumor in the larynx. It is uncommon; however, it is potentially life-threatening because it compromises the respiratory tract and required several surgeries to manage recurrences. Currently, the carbon dioxide laser is the treatment of choice. There are no studies about the role of the diode laser which is easy to use and has lower usage cost. This case series presentation reported on the therapeutic effects and recurrence rate of JRRP when using Diode laser. This is a case series presentation of 13 children, who were diagnosed with JRRP and operated for laryngeal papillomatosis with Diode laser in Otorhinolaryngology and Head and Nick Surgery Department et al. Mouwasat Hospital, Damascus, Syria between 2015 and 2022. 13 children required 56 surgeries at a rate of 1-2 surgeries/year, mean number of surgeries for each child was 4.31. That suggests that Diode laser might have a role in reducing the number of surgeries compared to a study used cold instrument and CO2 laser. The complications rate was 30.8%, which is considered a high rate compared to the other studies. In conclusion, we encourage using it when the CO2 laser device is not available. However, we suggest, reducing the power as low as possible and avoiding of two opposing raw surfaces, especially at the anterior commissure and deep excision. Further longitudinal studies are recommended to validate these results.
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Affiliation(s)
- Sara Kamil
- Department of Otolaryngology, Faculty of Medicine, Damascus University, Damascus, Syria
| | - Samer Mohsen
- Department of Otolaryngology, Faculty of Medicine, Damascus University, Damascus, Syria
- Department of Audiology, Faculty of Health Sciences, Damascus University, Damascus, Syria
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Mohsen S, Sadeghijam M, Talebian S, Pourbakht A. Use of Some Relevant Parameters for Primary Prediction of Brain Activity in Idiopathic Tinnitus Based on a Machine Learning Application. Audiol Neurootol 2023; 28:446-457. [PMID: 37331332 DOI: 10.1159/000530811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 04/17/2023] [Indexed: 06/20/2023] Open
Abstract
INTRODUCTION Tinnitus is one of the most common complaints, distressing about 15-24% of the adult population. Because of its pathophysiology heterogeneity, no curable treatment has been attained yet. Even though a neuromodulation management technique based on the tinnitus network model is currently being developed, it has not yet worked because the most involved brain areas still remain unpredictable from the patient's individual clinical and functional profile. A remarkable correlation between tinnitus network activity and the subjective measures of tinnitus like perceived loudness and annoyance and functional handicap is well established. Therefore, this study aimed to develop software for predicting the involved brain areas in the tinnitus network based on the subjective characteristics and clinical profile of patients using a supervised machine-learning method. METHODS The involved brain areas of 30 tinnitus patients ranging from 6 to 80 months in duration were recognized by using QEEG and sLORETA software. There was a correlation between subjective information and those areas of activities in all rhythms by which we wrote our software. RESULTS For verification and validation of the software, we compared and analyzed the results with SPSS data and the receiver operating characteristic (ROC) curves. CONCLUSIONS The findings of this study confirmed the effectiveness of the software in predicting the brain activity in tinnitus subjects; however, some other important parameters can be added to the model to strengthen its reliability and feasibility in clinical use.
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Affiliation(s)
- Samer Mohsen
- Department of Otolaryngology, Faculty of Medicine, Damascus University, Damascus, Syrian Arab Republic
- Department of Audiology, Faculty of Health Sciences, Damascus University, Damascus, Syrian Arab Republic
| | - Maryam Sadeghijam
- Rehabilitation Research Center, Department of Audiology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Saeed Talebian
- Motor Control Laboratory, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Akram Pourbakht
- Department of Audiology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
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Sadeghijam M, Talebian S, Mohsen S, Akbari M, Pourbakht A. Shannon entropy measures for EEG signals in tinnitus. Neurosci Lett 2021; 762:136153. [PMID: 34352341 DOI: 10.1016/j.neulet.2021.136153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 07/22/2021] [Accepted: 07/30/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND AIM Tinnitus is known as a common clinical symptom, and it comprehensively is essential to understand the underlying mechanisms. Time-varying EEG is considered an appropriate technique to explore brain regions and related activities, and nonlinear methods may extract the irregularities in the EEG signal and gather more expanded information. Therefore, we studied Shannon Entropy in EEG raw data obtained from normal subjects and compared it to data from chronic tinnitus sufferers before and after an intervention. METHODS From the qEEG database of Iran University of Medical Sciences, the School of Rehabilitation Sciences, we have selected 23 healthy and 24 chronic tinnitus subjects. Nineteen subjects of the tinnitus group had benefited from a complete course of sound therapy (binaural beat for a month). QEEGs were measured with a 27-channel EEG amplifier in the sitting and eye-closed position for 3 min. Shannon entropy was investigated for all electrodes separately and compared among groups using a one-way ANOVA statistical test. FINDINGS Our results revealed a significant difference between healthy and tinnitus subjects (p < 0.05). Post-hoc comparisons using the Bonferroni test showed increased entropy in the tinnitus group for all electrodes (p < 0.05) at low frequencies and most electrodes at mid frequencies. In addition, after the intervention, paired t-test showed a reduction in entropy to somehow above normal control levels for all electrodes at low-frequencies. Such results were accompanying clinical improvement after the intervention. CONCLUSION The increased entropy in tinnitus patients might reflect the chaotic behavior of the brain. Nonlinear methods in EEG studies (Entropy) could be of great importance in understanding tinnitus neurophysiology and might potentially be a suitable criterion for clinical practice.
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Affiliation(s)
- Maryam Sadeghijam
- Department of Audiology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Saeed Talebian
- Motor Control Laboratory, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Samer Mohsen
- Department of Otolaryngology, Faculty of Medicine, Department of Audiology, Faculty of Health Sciences, Damascus University, Damascus, Syria
| | - Mehdi Akbari
- Department of Audiology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Akram Pourbakht
- Department of Audiology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
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Mohsen S, Pourbakht A, Farhadi M, Mahmoudian S. The efficacy and safety of multiple sessions of multisite transcranial random noise stimulation in treating chronic tinnitus. Braz J Otorhinolaryngol 2019; 85:628-635. [PMID: 30528654 PMCID: PMC9443048 DOI: 10.1016/j.bjorl.2018.05.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 04/24/2018] [Accepted: 05/21/2018] [Indexed: 01/15/2023] Open
Abstract
Introduction Objective Methods Results Conclusions
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Mohsen S, Mahmoudian S, Talbian S, Pourbakht A. Correlation Analysis of the Tinnitus Handicap Inventory and Distress Network in Chronic Tinnitus: An EEG Study. Basic Clin Neurosci 2019; 10:499-514. [PMID: 32284839 PMCID: PMC7149958 DOI: 10.32598/bcn.9.10.215] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 02/10/2019] [Accepted: 07/17/2019] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Tinnitus is a common disorder with a considerable amount of distress that affects the patient's daily life. No objective tools were approved for measuring tinnitus distress. It can be estimated only by subjective scales and questionnaires, albeit, the Electroencephalography (EEG) studies have reported some alterations regarding tinnitus distress network. This study aimed to investigate the correlation between Tinnitus Handicap Inventory (THI) and the recorded EEG data. METHODS A total of 33 chronic tinnitus cases (9 females) with the mean age of 42.67 years were recruited. Their THI scores were collected, and a 3-minute EEG recorded with eye closed at resting-state. The correlation analysis was performed on THI scores and the current density in the selected Region of Interests (ROIs) concerning the distress network for the eight frequency bands. The patients grouped depending on the THI cutoff point of 56 into low and high THI groups, and then the groups were compared for source analysis and functional connectivity between ROIs using standardized low-resolution brain electromagnetic tomography. RESULTS A significant positive correlation was seen between THI scores and the electrical activity in the Anterior Cingulate Cortex (ACC), the prefrontal cortex, and the parahippocampus for an alpha band (P<0.05) and in the ACC for beta (P<0.01). Source analysis showed significant differences with increased activity in the high THI group for alpha, beta and gamma bands. Functional connectivity was also elevated in the high THI group between the ROIs in alpha and beta bands. CONCLUSION THI can be a useful tool for measuring tinnitus distress, and it has a high correlation with EEG data.
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Affiliation(s)
- Samer Mohsen
- Department of Otolaryngology, School of Medicine, Damascus University, Damascus, Syria
| | - Saeid Mahmoudian
- ENT and Head & Neck Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Saeed Talbian
- School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Akram Pourbakht
- Department of Audiology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
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Mohebbi M, Daneshi A, Asadpour A, Mohsen S, Farhadi M, Mahmoudian S. The potential role of auditory prediction error in decompensated tinnitus: An auditory mismatch negativity study. Brain Behav 2019; 9:e01242. [PMID: 30895749 PMCID: PMC6456780 DOI: 10.1002/brb3.1242] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 12/08/2018] [Accepted: 12/10/2018] [Indexed: 01/25/2023] Open
Abstract
INTRODUCTION Some tinnitus subjects habituate to their tinnitus but some others do not and complain of its annoyance tremendously. Normal sensory memory and change detection processes are needed for detecting the tinnitus signal as a prediction error and habituation to tinnitus. The purpose of this study was to compare auditory mismatch negativity as the index of sensory memory and change detection among the studied groups to search for the factors involving in the perception of tinnitus and preventing habituation in decompensated tinnitus subjects. METHODS Electroencephalography was recorded from scalp electrodes in compensated tinnitus, decompensated tinnitus, and no tinnitus control subjects. Mismatch negativity was obtained using the oddball paradigm with frequency, duration, and silent gap deviants. Amplitude, latency, and area under the curve of mismatch negativities were compared among the three studied groups. RESULTS The results showed lower mismatch negativity amplitude and area under the curve for the higher frequency deviant and for the silent gap deviant in decompensated tinnitus group compared to normal control and compensated tinnitus group. CONCLUSIONS This study revealed a deficit in sensory memory and change detection processing in decompensated tinnitus subjects. This causes persistent prediction errors; tinnitus signal is consistently detected as a new signal and activates the brain salience network and consequently prevents habituation to tinnitus. Mismatch negativity is proposed as an index for monitoring tinnitus rehabilitation.
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Affiliation(s)
- Mehrnaz Mohebbi
- ENT and Head & Neck Research Center and Department, The Five Senses InstituteHazrat Rasoul Akram Hospital, Iran University of Medical SciencesTehranIran
| | - Ahmad Daneshi
- ENT and Head & Neck Research Center and Department, The Five Senses InstituteHazrat Rasoul Akram Hospital, Iran University of Medical SciencesTehranIran
| | - Abdoreza Asadpour
- Department of Electrical EngineeringSharif University of TechnologyTehranIran
| | - Samer Mohsen
- Department of Otolaryngology, Faculty of MedicineDamascus UniversityDamascusSyria
| | - Mohammad Farhadi
- ENT and Head & Neck Research Center and Department, The Five Senses InstituteHazrat Rasoul Akram Hospital, Iran University of Medical SciencesTehranIran
| | - Saeid Mahmoudian
- ENT and Head & Neck Research Center and Department, The Five Senses InstituteHazrat Rasoul Akram Hospital, Iran University of Medical SciencesTehranIran
- Department of OtorhinolaryngologyHannover Medical University (MHH)HannoverGermany
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Mohsen S, Hanafy F, Fathy A, El-Gilany AH. Nonadherence to treatment and quality of life among patients with chronic obstructive pulmonary disease. Lung India 2019. [DOI: 10.4103/0970-2113.257719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Mohsen S, Pourbakht A. An overview of the tinnitus network activity and its clinical implications. AVR 2018. [DOI: 10.18502/avr.v27i4.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background and Aim: Tinnitus, the phantom perception of sound, in which many cortical and subcortical areas are involved has become one of the popular subjects of neuroscience research. Neuroimaging studies have introduced the tinnitus network model to explain the involvement of auditory and non-auditory areas in this perception. In such a model, the cognitive and emotional aspects of tinnitus can be interpreted conveniently. Therefore, this paper aimed to review the neural basis of tinnitus networks, including data from neuroimaging studies, and discuss the clinical implication of this concept, as well.Recent Findings: The data from neuroimaging studies were reviewed and discussed in order to complete the overall image of tinnitus network and its correlates such as the distress network, attentional network and other cognitive mechanisms. In addition to the auditory system, the anterior cingulate cortex (ACC) and dorsolateral prefrontal cortex (DLPFC) were considered to be important hubs in tinnitus distress network, especially for having important connectivity with the other networks like attention and salience networks. Moreover, the top-down control of DLPFC over the other brain areas was regarded as the most important brain area to be targeted using the non-invasive interventions and the results were compelling.Conclusion: Understanding the network model has helped in optimizing the neuromodulation protocols like electrical stimulation techniques. Thus, the clinical implications of this model can be generalized to the other types of treatments and the outcomes might be satisfying.
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Mohsen S, Mahmoudian S, Talebian S, Pourbakht A. Prefrontal and auditory tRNS in sequence for treating chronic tinnitus: a modified multisite protocol. Brain Stimul 2018; 11:1177-1179. [PMID: 29730252 DOI: 10.1016/j.brs.2018.04.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 04/20/2018] [Accepted: 04/23/2018] [Indexed: 10/17/2022] Open
Affiliation(s)
- Samer Mohsen
- Department of Audiology, School of Rehabilitation Sciences, The International Campus, Iran University of Medical Sciences, Tehran, Iran
| | - Saeid Mahmoudian
- ENT and Head & Neck Research Center, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Saeed Talebian
- Motor Control Laboratory, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Akram Pourbakht
- Department of Audiology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
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Affiliation(s)
- I Galadari
- Department of Dermatology, UAE University, Dubai
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