Prevalence and antimicrobial sensitivity of Escherichia coli and Salmonella species in field cases of rabbit intestinal coccidiosis treated with prebiotic

This study aimed to investigate the effect of prebiotic treatment on E. coli and Salmonella species during natural intestinal coccidiosis in rabbits. The experiment was conducted on 45 selected farm rabbits of which 15 were coccidian free (Negative control; NC, group) and 30 were naturally coccidian infected. The infected animals were allocated into two equal groups including positive control (PC) and prebiotic treated (PT) that were orally treated with prebiotic for 8 successive days. Fecal oocyst count was assessed daily during the course of treatment. Meanwhile, the PC group had a significantly high oocyst count (21.67×103 ± 0.82 OPG), with a significant increase in the prevalence of E. coli and Salmonella (86.7 % and 46.7 %, respectively). Moreover, the NC group remained coccidian free and exhibited E. coli infection only with no detection of salmonella isolates. Findings of in-vitro susceptibility testing showed that E. coli isolates were highly resistant to most of the tested antimicrobials while Salmonella isolates showed variable degrees of resistance. In conclusion, the prebiotic treatment significantly reduced the prevalence of E. coli and Salmonella infections coexisted with intestinal coccidiosis in naturally infected rabbits

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

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Children patients with COVID‐19: How can parental and peer support lessen the psychological burden of isolation

Abstract Aim To assess the effect of parental and peer support on children's self‐esteem during the isolation period in COVID‐19‐infected children is the main objective of this study. Design This is a descriptive cross‐sectional study. One hundred ninety children with a confirmed diagnosis of COVID‐19 were included. Methods A survey questionnaire to assess family and children's demographic characteristics was used for this study. A 13‐item scale to assess parental support during the isolation period and a 10‐item scale to assess peers' support during the isolation period were evaluated. Along with it, a 10‐item scale to assess self‐esteem during the isolation period was also measured. Results Home isolation was associated with higher parental and peer support scores than hospital isolation. The mean age of study participants was 13.23 ± 4.05 years; 52.6% were isolated at home versus 47.4% in hospital isolation. Phone calling and WhatsApp/messenger chat were methods of communication for 44.2% and 33.2% of patients, respectively. 6.3% of them had no method of communication. Child self‐esteem was significantly affected by both parental and peer support during isolation. The increase in pronounced negative psychological effects such as disorientation, anger, low self‐esteem and post‐traumatic distress may be caused by a lack of parental care. No patient or public contribution to this study Patients or the general public were not involved in the design, analysis or interpretation of the data in this study. The study's aim and objectives were developed based on children's self‐esteem, which was limited by questionnaire data information, so the researchers completed demographic and disease‐related questionnaires by interviewing them