Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Knowledge, Attitudes, and Practices of the Population in Jazan Region, Saudi Arabia Regarding Dengue Fever and Its Prevention Measures: A Community-Based Cross-Sectional Study

In previous studies, there was an apparent lack of health education about dengue fever (DF) among the Saudi population. Therefore, we conducted this study to assess the knowledge, attitude, and practices (KAP) about dengue fever among the Jazan region population, which is one of the most prevalent diseases in the region in Saudi Arabia (KSA). This was a cross-sectional and community-based study. The adult population was divided into governorates according to the regions that were close to each other, and then a convenient stratum was selected from each region. Next, random sampling was applied. Data were collected using a self-administered questionnaire. Exclusion criteria were young people (<18 years old) and health workers. Data analysis was performed using descriptive statistics, the Pearson’s correlation coefficient, and multiple linear regression. Of the 392 participants in this cross-sectional study, 59.18% were male, 76.28% were aged 18–35 years, 72.96% had a university degree, and 63% had a monthly income of less than SAR 5000 (USD1 = 3.76). The scores (mean ± SD) for KAP regarding DF among the responders were 22.77 ± 7.9, 22.68 ± 7.24, and 25.62 ± 9.4, respectively. KAP constructs were positively correlated according to the Pearson’s coefficient. In multiple linear regression analysis, males were favorably and substantially linked with attitude score (β = 2.76, p = 0.001) and negatively associated with practice score (β = −2.45, p = 0.023). No-degree participants scored lower on knowledge (β = −2.78, p = 0.003). There is potential for more research in Saudi Arabia to increase the generalizability to reduce the impact of dengue epidemics

AN OVERVIEW ON HEREDITARY AND ACQUIRED HYPERCOAGULABILITY

A typical definition of hypercoagulability is the predisposition to develop venous thromboembolism due to an underlying hypercoagulable state caused by hereditary or acquired blood coagulation or fibrinolysis problems. Clinical signs of hypercoagulability can be fatal or extremely damaging. About 80% to 90% of patients can have hypercoagulability diseases accurately recognised. Determining the origin of hypercoagulability may influence the kind and length of treatment for the accompanying thrombosis. As a result, hypercoagulability is not a single, unified disease process but rather a collection of risk factors that may or may not lead to thrombosis, depending on the severity and number of risk variables as well as environmental exposures. The former includes prothrombotic polymorphisms in the genes encoding for factor V (i.e., factor V Leiden) and prothrombin, as well as shortages of natural anticoagulants such antithrombin, protein C, and protein S. It also includes elevated values of clotting factors (particularly factor VIII). The latter problems mostly include hyperhomocysteinemia, acquired elevations of coagulation factors or acquired reductions of natural inhibitors, malignancy, and antiphospholipid antibody syndrome