Introduction

Gastroenterologists are exposed to various health-related risks in their professional roles,
Because they have various roles including endoscopists, clinicians, and in some cases, academic professionals. Our study aims to assess the work-life balance model and the prevalence of work-related physical and mental symptoms, as well as the effects of work-life balance on the health of Moroccan gastroenterologists.

Aims & Methods

A total of 152 gastroenterologists from various cities in the country participated in an anonymous electronic questionnaire regarding their daily activities and symptoms. A work-life balance ratio was calculated by dividing the number of working hours (per week) by the number of hours spent outside of work (including activities and sleep). Musculoskeletal, gastrointestinal, and mental symptoms were recorded. The Maslach Burnout Inventory (MBI) was used to measure the burnout score.
Data was entered and analyzed using the JAMOVI 2.2 software for Mac.

Results

152 Moroccan gastroenterologists were included in the study, with 72.4% being female and 27.6% male, resulting in a sex ratio of 0.38.
The median age of the respondents was 31 years (range: 26 to 64 years), with 61.8% being married, of which 70.2% were married to physicians.
The mean number of working hours per week was 50.2 ± 12.7, with a median number of endoscopies per week of 6.5 (range: 2 to 12). 86.8% reported musculoskeletal disorders, and 71.1% reported digestive disorders.
Regarding mental symptoms, 23.7% reported anxiety, and 46.1% reported depression, with 21.1% experiencing both simultaneously.
The median work-life balance ratio was 0.42 (range: 0.32-0.55).
In univariate analysis, this ratio was not correlated with sex or musculoskeletal and digestive symptoms but was correlated with age (p < 0.001) and mental symptoms (p < 0.001 for depression and p = 0.007 for anxiety). However, in multivariate analysis by adjusting the parameters studied, namely age, sex, presence of confirmed depression, and confirmed anxiety, only age emerged as an associated factor (Beta = -0.24 + (-0.46; 0.013)).
Using the MBI scale, 72.4% of the respondents were found to be experiencing burnout. Burnout was not correlated with sex but was associated with the work-life balance ratio (p = 0.04). It is noteworthy that two of the three categories of this scale, namely depersonalization and personal accomplishment, were associated with the age of the respondents (p = 0.002 and p = 0.003). Indeed, a moderate negative correlation was found between age and depersonalization (r = -0.32), and a moderate positive correlation was found between age and personal accomplishment (r = 0.31).

Conclusion

Moroccan gastroenterologists suffer from musculoskeletal, digestive, and mental symptoms, and are prone to burnout likely due to long and laboting work. Our study found that younger individuals worked more and were more likely to experience burnout, particularly with decreased empathy towards patients and diminished personal accomplishment.

Disclosure

No conflict of interested was noted

Introduction

Variceal gastrointestinal bleeding is a serious complication of cirrhosis.About one-third of patients have esophageal varices at the time of cirrhosis diagnosis,and this number increases over time.Early detection and grading of these varices are important to prevent bleeding,identify high-risk patients, and start appropriate treatment.However, endoscopic screening is invasive, expensive, and places a strain on endoscopy units.To address this, non-invasive methods have been suggested,such as using clinical and laboratory markers.One of these markers is thrombocytopenia (a low platelet count,below 150.000/μL),which may help predict the presence and severity of esophageal varices.

Aims & Methods

The aim of this study was to examine the relationship between platelet count and variceal grades to determine if platelet levels can be used as a reliable tool to predict variceal severity.
We conducted a descriptive and analytical study involving 51patients newly diagnosed with cirrhosis,all of whom presented with esophageal varices of varying grades confirmed by endoscopy.The diagnosis of cirrhosis was based on a combination of clinical,laboratory, imaging, and histological criteria.Patients with hepatocellular carcinoma,portal vein thrombosis,those receiving prophylactic beta-blockers, or with a history of endoscopic band ligation or sclerotherapy were excluded.
For each patient, we collected demographic data, laboratory findings (with a focus on platelet count),and results from esophagogastroduodenoscopy,particularly the grade of esophageal varices.
Patients were divided into 4 groups based on their platelet count:

• Group 1: < 50.000/μL
• Group 2: 50.000–99.000/μL
• Group 3: 100.000–150.000/μL
• Group 4: > 150,000/μL

Results

The study included a total of 51patients, of whom 66%were male and 34%female,with a mean age of 62 ±15.03years.Regarding platelet count,16% of patients(n=8)had a count below
50.000/μL,50%(n=25)had values between 50.000 and 99.000/μL,14%(n =7) between100,000 and 150.000/μL,and 20%(n=10) had counts above 150.000/μL.
Grade I esophageal varices were found in 26% of patients(n=11), grade IIin 28%(n=14),and grade III in 46% (n=23).The mean platelet count was 167.538/mm³ in patients with grade I varices,88.500/mm³ in those with grade II, and 59.043/mm³in those with grade III varices.
There was a statistically significant association between platelet count and variceal grade: patients with lower platelet counts were more likely to have high-grade varices,where as those with higher platelet counts tended to have low-grade varices(p < 0.001).
Spearman’s rank correlation analysis showed a significant negative correlation between platelet count and esophageal variceal grade (p < 0.001).
Receiver Operating Characteristic(ROC)curve analysis identified an optimal platelet count cutoff value of 91.000/mm³ for predicting the presence of large esophageal varices,with an area under the curve(AUC)of 0.9.At this cutoff,the sensitivity was 100%,specificity 81%, positive predictive value 65%,and negative predictive value 100%.

Conclusion

A significant negative correlation was observed between platelet count and esophageal variceal grade. Indeed, a low platelet count is associated with more severe esophageal varices. These results indicate that platelet count could serve as a predictive marker for esophageal variceal grade.

Introduction

Gastroenterology is a medical specialty that includes several areas of study. Endoscopy occupies a central role in professional practice, whether in hospitals or in the private sector. The quality of initial training and the different needs of trainees are key to the quality of care delivered to the population. This study aims to assess endoscopic training experience during fellowship.

Aims & Methods

This is a cross-sectional, multicenter study conducted on gastroenterology residents practicing endoscopy and in the final phase of their curriculum (6th, 7th and 8th semesters). Postgraduated doctors have been excluded from the study. An electronic survey made by Google Forms and was sent nationwide on January 9, 2024. The survey consisted of 42 questions divided into 3 parts: The first part focused on the participants' socio-demographic data and their endoscopic experience, the second part focused on the quality of training of core endoscopic skills (cognitive and motor skills) during fellowship where a 5-point Likert scale was used to express residents' satisfaction with their skills, ranging from 1="very dissatisfied", 2="dissatisfied", 3="neither satisfied nor dissatisfied", 4="satisfied" and 5="very satisfied". The third part included questions in which participants expressed their needs and expectations for improving their training in endoscopy. A statistical analysis using the Student-t test and the Fisher’s exact test were performed. P values of <0.05 were considered statistically significant. Data were analyzed using Jamovi (Version 2.3).

Results

We were able to collect data from 56 respondents. Most were female residents n=40 (71.4) with a mean age of 29.2 ± 2.5 years. The majority of fellows started practicing EGD in their 4th semester (91.1%), and colonoscopy in their 6th semester (57%). On average, the fellows are supervised by 5 senior doctors, including 2 who practice interventional endoscopy. Furthermore, 37.5% of participants report performing approximately more than 100 EGDs, 14.2% more than 100 colonoscopies, 80.4% report that they have performed less than 20 endoscopic variceal ligation and 14.3% have performed more than 10 polypectomies. An average rating score of 3.34 (1= very dissatisfied; 5= very satisfied) concerning the quality of training and feedback on cognitive aspects of endoscopy was found and we reported greatest emphasis for Procedure indication/contraindication and least on Capsule endoscopy interpretation.
The quality of training in technical aspects of endoscopy was rated higher (average rating score of 3.5). We reported greatest emphasis for Withdrawal/mucosal inspection and least on Esophageal dilation.
A significant association between motor skills and cognitive skills was found with a p<0.001.
Finally, to improve their training, 87.5% of respondents considered simulation to be important/very important, 98.2% of respondents intend to complete their endoscopy training at the end of their curriculum, and 87.5% are prepared to finance such a project (median: 1000 USD [1000;3000]).

Conclusion

Despite a significant improvement in training sites and technical facilities, training in endoscopy in healthcare institutions does not yet provide all the cognitive and technical skills required to enable fellows to be fully autonomous. With the development of endoscopic procedures, it seems essential for fellows to be able to perform more standard endoscopic procedures such as polypectomy and mucosectomy by the end of their curriculum. This may involve introducing regular endoscopy conferences and simulation training as a part of the curriculum.

Introduction

Gastroenterology (GE) is a medical discipline that studies all diseases of the digestive system. It comprises several areas of study and offers a large variety of sub-specializations: proctology, interventional endoscopy or even digestive oncology. The decisive elements in the choice of this specialty vary among interns. The aim of our study is to determine the various factors influencing the choice of gastroenterology as a specialty among medical interns.

Aims & Methods

This is a cross-sectional, multicentric, survey-type study, conducted from September 1 to 30, 2023, involving 7 national medical faculties. All medical interns, regardless of sex or age, participated in our study.
An electronic survey with 29 items was created using Google Forms®. It was divided into two parts: the first part contained 13 questions on socio-demographic characteristics and exposure to GE during the academic curriculum, while the second part concerned the factors motivating the choice or not of GE as a specialty.
A statistical analysis using the Fisher’s exact test was performed. P values of <0.05 were considered statistically significant. Data were analyzed using Jamovi (Version 2.3).

Results

A total of 329 responses were collected: the majority were women 208 (63.2) with a F/M sex ratio of 1.7 and a median age of 27 [25; 28] years. The majority had already completed a GE rotation during their training course n=205 (62.3), of which 90 (44.1) had found it "satisfactory". More than half of the participants n= 178 (54.1) had already considered GE as a future specialty, and this choice was mostly made during GE lectures given in medical school n= 66 (36.9). Among those who had never considered GE, the main reasons were lack of interest in the specialty, the fact that it is a medical specialty, lack of information about GE, potential remuneration, and dissatisfaction with GE rotation during the training course (59.2%, 28.9%, 13.9%, 10.4% and 10% respectively).
Among those who finally opted for GE, the majority were women (70.2% vs. 29.8%, p=0.004). Satisfaction with the GE rotation during the training course had an impact on the final choice: "satisfactory" vs. "mediocre" (43.8% vs. 6.3% p=0.009).
Multivariate analysis showed that early interest in fields such as endoscopy (OR= 4.46, CI95%: 1.44-13.78, p=0.009) or proctology (OR= 4.26, CI95%: 1.01-18.01, p=0.05) increased the chance of choosing GE.

Conclusion

This study showed that there is a gender disparity in the choice of GE as a specialty. The fact that it is a medical discipline may lead men to choose another path. Our study also highlighted the importance of GE training courses during the medical curriculum to motivate interns to join our specialty, as well as the need to spotlight certain areas such as endoscopy or proctology.

Introduction

Gastroesophageal reflux disease (GERD) and its long-term complications are a common condition that affects the quality of life of patients. Reflux can reach the oral cavity and affect the teeth and oral mucosa. Dental erosions represent the main oral risk of GERD.
Our research aimed to evaluate the prevalence and severity of oral manifestations in patients with GERD.

Aims & Methods

It was a prospective, descriptive and analytical study, over 4 years (January 2019 to January 2023). We enrolled 40 subjects with GERD and 40 healthy patients (control group). All patients were assessed for oral status by using a survey on oral hygiene habits and a meticulous clinical investigation (assessment of dental erosion, mucosal lesions and measurement of salivary pH). P < 0.05 was considered significant.
All clinical data were collected and analyzed by SPSS20 software.

Results

The results showed that the mean age of our patients was 39.5 ± 14.2 years. The sex ratio M/F was 0.5. There was a significant association between the presence of GERD and the presence of oral mucosal lesions (p=0.02) as well as the presence of dental erosions (p<0.001 for the upper right and lower sectors and p<0.01 for the upper left sector).
The presence of dental erosions in the lower sectors was significantly associated with the presence of mucosal lesions (p=0.05).
Patients with GERD had on average a more acidic salivary pH than the control group (6.53 vs 7.17; p=0.03) and patients with dental erosions had a more acidic salivary pH than those without erosions (6.61 vs 7.15; p=0.01).

Conclusion

GERD is the cause of oral manifestations, of which dental erosion is considered to be the most important. We emphasize the importance of collaboration between gastroenterologists and dentists in the management of the complications associated with this condition.