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Ergonomic Injuries in Endoscopists and Their Risk Factors
Lubna Kamani,Hamid Kalwar 대한소화기내시경학회 2021 Clinical Endoscopy Vol.54 No.3
Background/Aims: Prolonged repetitive strain caused by the continuous performance of complex endoscopic procedures enhancesthe risk of ergonomic injuries among health-care providers (HCPs), specifically endoscopists. This study aimed to assess the riskfactors of ergonomic injuries among endoscopists and non-endoscopists. Methods: This cross-sectional study was conducted at the Gastroenterology Department of Liaquat National Hospital, Karachi,Pakistan. A total of 92 HCPs were enrolled, of whom 61 were involved in endoscopic procedures and 31 were non-endoscopists. Data were collected through a self-administered questionnaire during national gastroenterology conferences and analyzed usingSPSS version 22 (IBM Corp. Chicago, IL, USA). Results: Of the total study population, 95.08% of endoscopists were observed to have ergonomic injuries, whereas only 54.83% ofnon-endoscopists had ergonomic injuries (p<0.00). The most common injury associated with musculoskeletal (MSK) pain sites wasback (41%), leg (23%), and hand (19.7%) pain among endoscopists. Of 28 endoscopists performing ≥20 procedures/week, 26 hadMSK injury. However, 95.08% of endoscopists had developed MSK injury irrespective of working hours (>5 or <5 hr/wk). Conclusions: Endoscopists are at high risk of developing ergonomic injuries, representing the negative potential of the endoscopyassociatedworkload. To overcome these issues, an appropriate strategic framework needs to be designed to avoid occupationalcompromises.
Nonthalee Pausawasdi,Penprapai Hongsrisuwan,Lubna Kamani,Kotchakon Maipang,Phunchai Charatcharoenwitthaya 대한소화기내시경학회 2022 Clinical Endoscopy Vol.55 No.1
Background/Aims: Endoscopic ultrasonography (EUS) is warranted when cross-sectional imaging demonstrates common bile duct(CBD) dilatation without identifiable causes. This study aimed to assess the diagnostic performance of EUS in CBD dilatation ofunknown etiology. Methods: Retrospective review of patients with dilated CBD without definite causes undergoing EUS between 2012 and 2017. Results: A total of 131 patients were recruited. The mean age was 63.2±14.1 years. The most common manifestation was abnormalliver chemistry (85.5%). The mean CBD diameter was 12.2±4.1 mm. The area under the receiver operating characteristic curve(AUROC) of EUS-identified pathologies, including malignancy, choledocholithiasis, and benign biliary stricture (BBS), was 0.98(95% confidence interval [CI], 0.95-1.00). The AUROC of EUS for detecting malignancy, choledocholithiasis, and BBS was 0.91(95% CI, 0.85-0.97), 1.00 (95% CI, 1.00-1.00), and 0.93 (95% CI, 0.87-0.99), respectively. Male sex, alanine aminotransferase ≥3× theupper limit of normal (ULN), alkaline phosphatase ≥3× the ULN, and intrahepatic duct dilatation were predictors for pathologicalobstruction, with odds ratios of 5.46 (95%CI, 1.74-17.1), 5.02 (95% CI, 1.48-17.0), 4.63 (95% CI, 1.1-19.6), and 4.03 (95% CI, 1.37-11.8), respectively. Conclusions: EUS provides excellent diagnostic value in identifying the etiology of CBD dilatation detected by cross-sectionalimaging.