The COVID-19 pandemic emerged in late 2019. Previous research has shown a significant prevalence of burnout among physician trainees, with concern that the pandemic will increase burnout. We aimed to assess this risk among trainees at a large academic hospital. We performed a cross-sectional study during the pandemic using a survey that included the Maslach Burnout Inventory. The response rate was 94.7%. Among trainees, 58.5% changed their living arrangements to protect family. Psychological well-being was negatively affected in 81.7% and clinical performance in 64.3%; 13.8% were at high risk of burnout. Emotional exhaustion (EE) scores were high in 50% and depersonalization (DP) scores in 28.8%; a sense of personal accomplishment was low in 41.9%. Increased risk of burnout was associated with male gender and increased exposure to suspected COVID-19 cases. Risk of high EE correlated with an increased number of children and risk of high DP with male gender. High EE and DP score correlated with increased exposure to suspected and confirmed COVID-19 patients. Trainees who self-isolated to protect family were more likely to experience high DP and burnout. Trainees in surgical specialties were more likely to feel their clinical performance was negatively affected. The results suggest that a significant percentage of trainees are at high risk of burnout during the pandemic especially those that attempted self-isolation. Training programs should incorporate methods to maintain well-being and coping, including adequate time off between shifts. Future research should evaluate other aspects of trainee well-being in relation to self-isolation and/or changed living arrangements. Key words: Burnout, Medical education, pandemic, coronavirus, psychological wellbeing, medical residents

Amaç: Muğla Sıtkı Koçman Üniversitesi Tıp Fakültesi Adli Tıp Anabilim Dalına; meslekte kazanma gücü kayıp oranı tespiti amacıyla başvuran olguların kalıcı iş göremezlik oranları ve takdir oranlarının değerlendirmesi ile; hangi arızalara takdir uygulandığı ve takdir oranlarının neler olduğu ortaya konmuş, uygulama içinde ilgili Yönetmeliğin kısıtlılıkları tespit edilmeye çalışılmış ve öneriler geliştirmek amaçlanmıştır. Gereç ve Yöntem: Haziran 2015-Aralık 2016 tarihleri arasında trafik kazası sonrası kalıcı sakatlık iddiası ile meslekte kazanma gücü kayıp oranı tespiti için başvuran 259 olgunun raporları geriye dönük değerlendirildi. Raporlarda kayıtlı, yaş, cinsiyet, kaza ile rapor düzenleme arasında geçen süre, arızaların dağılımı, iyileşme süreleri, hangi arızalar için takdir uygulandığı ve takdir oranları irdelendi. Veri analizinde, yüzde, oran, ortalama değerlerinin verildiği tanımlayıcı istatistikler kullanıldı. Bulgular: Çalışma Gücü ve Meslekte Kazanma Gücü Kayıp Oranı Tespit İşlemleri Yönetmeliğine göre meslekte kazanma gücünden kayıp oranı raporu düzenlenen 259 olgunun 182’si (%70.3) erkek, 77’si (%29.7) kadındı. En fazla olgu (%45.2) 20-39 yaş gru- bundaydı. Kaza tarihi ve son muayene tarihi arasında geçen süre 1-111 ay arasında değişiyordu. Toplamda 73 olgudaki arızalara (%23.1) takdir uygulanmıştı. Takdir uygulanan olguların arızaları ve takdir gerekçeleri ayrıntılı olarak tartışıldı ve ilgili Yönetmeliğin kısıtlılıkları ortaya konmaya çalışıldı. Sonuç: İlgili Yönetmelikte farklı klinik durumları gözetecek şekilde oranlar belirlenmemiş olmasının bir kısıtlılık olduğu, bu konuda uygulama birliğine, güncel tedavi yaklaşımları düşünülerek arıza ağırlık cetvelinin yenilenmesine ve adli tıp ve branş hekimlerinin birlikte yürüteceği çok kapsamlı bir çalışmaya ihtiyaç olduğu kanısındayız.

Objective: To investigate the effectiveness of interferential current implementation following total knee arthroplasty surgery. Design: Double-blind randomized controlled study. Setting: Orthopedics and traumatology in-patient clinic. Participants: From an initial enrollment of 132 patients, 113 who met the study inclusion criteria were randomly separated into two groups: the interferential current group (n = 57) and the sham current group (n = 56). A total of 98 patients completed the study: 49 in the interferential current group and 49 in the sham group. Intervention: Patients in the interferential current group received interferential current treatment for 30 minutes, twice a day for five days postoperatively. For the patients in the sham interferential current treatment group, the same pads were applied to the patients for the same time periods but no electrical stimulation was applied. Main outcome measures: Patients were assessed in respect of pain, range of motion (ROM), edema, and the amount of paracetamol used at baseline and on the 5th and 30th days after surgery. Results: No significant difference was determined between the groups in respect of pain, ROM, and edema at days 0, 5, and 30. At the end of the 5th day, the amount of paracetamol used was significantly lower in the interferential current group (P < 0.05). Conclusion: In this study, both groups showed significant improvements in pain, ROM, and edema with no significant difference between the groups. Although there was a significant difference in paracetamol intake of the two groups, this cannot be argued as showing the effectiveness of interferential current.

BackgroundKnee osteoarthritis is a current problem that causes limitations in patients' activities of Daily living (1). There are many therapeutic options. Total knee arthroplasty is one of these treatment methods.Postoperative pain is one of the most commonly seen problems after this operation.The target of postoperative pain management is pain alleviation with minimum morbidity that is caused by analgesic modalities (2). Interferential current (IFC) therapy is a physical modality whose effects on postoperative pain, range of motion, edema and analgesic use has previously been shown (3).ObjectivesIn this double-blind randomized controlled study, we aimed to investigate the effectiveness of interferential current (IFC) following total knee arthroplasty (TKA) surgeryMethods98 patients who had TKA surgery were included into the study. Patients were randomized into two groups: Group 1: IFC (n=49) and group 2: sham IFC group (n=49). After all patients received the same rehabilitation programme and cold pack, the patients in group 1 administered IFC 30 minutes 2 times a day for 5 days. Same treatment instructions were given in sham group blindly. Patients were assessed at days 0, 5 and 30th after surgery with following parameters: VAS pain (cm), edema (cm), range of motion (ROM), Short Form 36 (SF 36) and paracetamol intake (gr)ResultsAll patients had significant improvements in all evaluation parameters (p<0,05) except the subscales of the physical role and mental health in the SF 36. In comparison of the groups, paracetamol intake was significantly lower in the IFC group at 5th day (p<0.05). There was no difference between groups for other evaluation parameters in all visits.ConclusionsAlthough all patients showed significant improvement in all parameters during the study, paracetamol intake was significantly lower in the IFC group. This finding supports that IFC can decrease pain -even postoperative pain-. However, it is still uncertain which frequency is most suitable, how many times and how much minutes we need to use IFC in these patients in order to improve pain significantly.ReferencesGuyton J. Arthroplasty of ankle and knee. In: Canale S, editor. Campbell's operative orthopaedics. St. Louis: Mosby; 1998.p.232–95.Hedenstierna G, Lofstrom J. Effect of anaesthesia on respiratory function after major lower extremity surgery. A comparison between bupivacaine spinal analgesia with low-dose morphine and general anaesthesia. Acta Anaesthesiol Scand 1985;29: 55–60.Jarit GJ, Mohr KJ, Waller R, Glousman RE. The effects of home interferential therapy on postoperative pain, edema, and range of motion of the knee. Clin J Sport Med 2003;13: 16–20.Disclosure of InterestNone declared