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

Preservative Effect of Chitosan Coating on Shelf Life and Sensory Properties of Chicken Fillets during Chilled Storage

Background: Chicken fillets contain essential amino acids besides many minerals and vitamins, which are necessary for maintaining life and promoting growth. Moreover, it is low in calories and cholesterol; therefore, it can be used for feeding infants, young children, and some patients. Methods: Chicken fillets were initially coated by dipping in different concentrations of chitosan (1.0%, 1.5%, and 2.0%), and then the shelf life of coated samples was investigated under refrigeration storage (4 &plusmn; 1 &deg;C) for 15 days. The control (uncoated) and coated samples were analyzed periodically for bacteriological, pH value, and sensory characteristics. Results: The sensory evaluation results correlated with the microbial analyses. Chitosan-coated samples achieved a shelf-life extension of 12 days at chilled storage temperature (4 &plusmn; 1 &deg;C) whereas the non-coated samples had a shelf life of 3 days at the same storage temperature. There were no significant organoleptic changes within the chitosan-coated samples (P > 0.05). The pH values of all coated samples were significantly lower than the control group (P < 0.05). However, the obtained data revealed that chicken fillets samples coated with chitosan (1.0%, 1.5%, and 2.0%) led to a significant reduction (P < 0.05) of the total aerobic bacterial count (TBC), total Enterobacteriaceae, and total Staphylococcus counts along the storage period. Conclusion: The present study established that application of chitosan coating on chicken fillets could have a potential for preserving the microbiological quality and enhancing sensory attributes during chilled storage

Bacteriological Quality of Retailed Chicken Meat Products in Zagazig City, Egypt

Chicken meat products have a high biological value; they are good sources of amino acids, vitamins, and minerals. Despite this high biological value, these products act as a good substrate for different types of bacteria and have been implicated in many foodborne disease outbreaks. Therefore, a total of 60 random samples of chicken meat products (nuggets, luncheon and pane, 20 of each) were collected from Zagazig City, Sharkia Governorate, Egypt for bacteriological examination (Aerobic Plate Count, Staphylococci count, Pseudomonas count, determination of most probable number of Coliform and E. coli.). The obtained results revealed that the mean aerobic plate counts were 5.18±0.19, 4.88±0.20 and 4.73±0.29 log10 CFU/g; Staphylococci counts were 2.96±0.20, 3.14±0.21 and 3.32±0.16 log10 CFU/g; Pseudomonas counts were 2.17±0.30, 2±0.28 and 2.34±0.21 log10 CFU/g; most probable numbers of Coliforms were 3.37±0.11, 3.83±0.27 and 3.64±0.30 log10 CFU/g; and most probable numbers of E. coli were 2.14±0.17, 2.56±0.30 and 2.64±0.25 log10 CFU/g in the examined nuggets, luncheon and pane, respectively. According to the Egyptian Organization for Standardization and Quality (EOS), the examined chicken product samples were 10(21.67%), 9(15%), 28(46.67%), 49(81.67%), 31(51.67%) and 30(50%) accepted for aerobic plate count, Staphylococci count, S. aureus, Pseudomonas count, Coliform and E. coli, respectively. In conclusion, the examined chicken meat products revealed unsatisfactory hygienic measures. Therefore, strict hygienic practices should be adopted during processing of chicken meat products to improve the bacteriological quality of such products

Prevalence of Listeria Monocytogenes in Meat Products Retailed in Egypt and Worldwide: A Review

Meat products are regarded as major sources of essential amino acids, minerals, and vitamins. However, during all stages of the processing of meat products, including the slaughter of the animal, dressing, evisceration, and subsequent transportation and distribution, may expose the product to a wide range of bacteria. The microbial community of the finished goods may be influenced by handling and raw materials used in the production of the meat products. The microbiological condition of meat products may be affected by a number of factors, including worker hands, clothing, knives, cutting boards, slaughterhouse and meat processing plant environments, including walls, floors, washing water, etc. Listeria monocytogenes (L. monocytogenes) is considered as one important foodborne pathogen that is responsible for many cases of food poisoning among consumers worldwide. This study aimed at investigating the current scenario of the prevalence of L. monocytogenes in retailed meat products in Egypt and worldwide. The cited literatures in the current review demonstrated that effective sanitary practices should be used throughout all phases of handling meat to produce meat products with a high level of storage quality and free from L. monocytogenes

Potential of Natural Phenolic Compounds as Antimicrobial Agents against Multidrug-Resistant <i>Staphylococcus aureus</i> in Chicken Meat

Staphylococcus aureus is one of the most widespread foodborne bacteria that cause high morbidity, mortality, and economic loss, primarily if foodborne diseases are caused by pathogenic and multidrug-resistant (MDR) strains. This study aimed to determine the prevalence of S. aureus in chicken meat in Egyptian markets. Thus, this study might be the first to assess the efficiency of different natural phenolic compounds as novel antibacterial agents against MDR S. aureus pathogens isolated from raw chicken meat in the Egyptian market. The incidence and quantification of pathogenic S. aureus were detected in retail raw chicken meat parts (breast, thigh, fillet, and giblets). In total, 73 out of 80 (91.3%) of the chicken meat parts were contaminated, with S. aureus as the only species isolated. Of the 192 identified S. aureus isolates, 143 were coagulase-positive S. aureus and 117 isolates were MDR (81.8%, 117/143). Twenty-two antibiotic resistance profile patterns were detected. One strain was randomly selected from each pattern to further analyze virulence and resistance genes. Extracted DNA was assessed for the presence of antibiotic-resistance genes, i.e., vancomycin-resistance (vanA), aminoglycosides-resistance (aacA–aphD), apramycin-resistance (apmA), and methicillin-resistance (mecA), penicillin-resistance (blaZ), and virulence genes staphylococcal enterotoxins (sea and seb), Panton–Valentine leucocidin (pvl), clumping factor A (clfA), and toxic shock syndrome toxin (tst). Clustering analyses revealed that six S. aureus strains harbored the most virulence and resistance genes. The activity of hydroquinone was significantly higher than thymol, carvacrol, eugenol, and protocatechuic acid. Therefore, phenolic compounds, particularly hydroquinone, could potentially alternate with conventional antibiotics against the pathogenic MDR S. aureus inhabiting raw chicken meat. Hence, this study indicates that urgent interventions are necessary to improve hygiene for safer meat in Egyptian markets. Moreover, hydroquinone could be a natural phenolic compound for inhibiting foodborne pathogens

Virulence and Antimicrobial Resistance Profiling of Aeromonas hydrophila Recovered from Retail fish in Sharkia Province, Egypt

Fish is one of the most important foods because of its high nutritional value, high palatability, and easy digestion. At the same time, it acts as a vehicle for many types of pathogenic microorganisms especially Aeromonas species, which results in public health hazards. Therefore, the present study was conducted to evaluate the prevalence of Aeromonas species in fresh fish (catfish, mullet, lizardfish, and coralfish) marketed in Zagazig city, Sharkia Governorate, Egypt. In addition, multiplex PCR was performed to detect some virulence-associated genes in A. hydrophila isolates. Furthermore, antimicrobial susceptibility testing was carried out on A. hydrophila isolates using commonly used antimicrobials in Egypt through the disc diffusion method. The achieved results indicated contamination of fish with different species of Aeromonas such as A. veronii, A. sobria, A. caviae and A. hydrophila. The results revealed that Aeromonas species isolated with an overall percentage of 55% of all examined fish. Bacteriological examinations revealed 20% A. hydrophila, 20% A. sobria, 10% A. caviae and 5% A. veronii. Antibiotic sensitivity declared high resistance of the isolates to different antimicrobial agents used in Egypt, including penicillin (100%), Ampicillin (90.0%), Streptomycin (90.9%), Cephalothin (72.7%), Tetracycline (72.7%), Cefotaxime (63.6%), and Sulfamethoxazole (54.5%). Therefore, hygienic measures should be adopted to control microbial contamination either in the aquatic environment or in fish markets

Microbiological Evaluation of Fresh Retail Rabbit Meat Cuts from Zagazig City, Egypt

The present study was conducted to evaluate the microbiological status of rabbit carcasses marketed in Zagazig City, Sharkia province, Egypt. Eighty random samples of fresh rabbit meat cuts representing shoulder, loin, ribs, and thigh regions (20 of each) were obtained from different rabbit markets in Zagazig City during 2022. Aerobic plate count (APC), Enterobacteriaceae, total mould and yeast counts were determined in the collected samples, as well as the isolation and identification of E. coli and Salmonella spp. The results showed that the mean values of APC and Enterobacteriaceae were 1.1x106 and 4.7x104 CFU/g for shoulders, 9.6x105 and 5.7x104 CFU/g for ribs, 1.0x106 and 5.1x104 CFU/g for loins, 1.2x106 and 6.0x104 CFU/g for thigh samples, respectively. Moreover, the total mould and yeast count ranged from 2.6x104 to 1.9x105 with mean values of 9.7x104 ± 1.1x104, 8.2x104 ± 9.9x103, 9.5x104 ± 1.4x104 and 9.8x104 ± 8.5x103 CFU/g in the of examined rabbit meat samples from shoulder, ribs, loin, and thigh regions, respectively. In terms of food poisoning bacteria, 6 (30 %), 7 (35 %), 6 (30 %) and 4 (20 %) out of 20 rabbit cuts tested positive for Salmonellae in the shoulder, ribs loin, and thigh regions, respectively. However, E. coli was found in 18 (90%), 16 (80%), 15 (75%) and 19 (95%) of the examined rabbit meat samples, respectively. The obtained results suggested that fresh rabbit meat cuts may carry numerus microorganisms from different sources, emphasizing the importance of stringent sanitary precautions during the slaughtering, handling and cooking procedures

Heavy Metal Content in Chicken Meat Products: A Health Risk Assessment Study

There is an increasing demand for chicken meat products due to their high nutritive value, specific aroma and flavor, and cheap price compared to red meat. However, there is a clear lack of information on the residual content of toxic metals such as lead (Pb), cadmium (Cd), mercury (Hg), and trace elements such as zinc (Zn), and copper (Cu) in such products. Therefore, this study was undertaken to estimate the residual contents of Pb, Cd, Hg, Zn, and Cu in five chicken meat products including chicken burger, chicken fillet, chicken luncheon, chicken nuggets, and chicken panne. Moreover, estimated daily intakes (EDI), and the potential health risks of heavy metals due to consumption of such meat products were calculated for Egyptian adults and children. The achieved results indicated no detection of Hg in any sample. However, the other measured elements were detected in all examined chicken meat product samples at variable concentrations. The chicken burger had the highest metal concentrations. Several samples had higher Pb and Cd levels than the set maximum permissible limits. However, the calculated EDI, hazard ratio, and hazard index revealed no potential risks associated with the consumption of such chicken meat products among Egyptian adults and children