Synthesis, spectroscopic, thermal and anti-microbial studies of transition metal complexes of hydrazone derived from 4,6-diacetylresorcinol and S-methyldithiocarbazate

New series of copper(II), nickel(II), cobalt(II), zinc(II), cadmium(II), iron(III) and oxovanadium(IV) complexes of hydrazone, H3L, ligand derived from the condensation of S-methyldithiocarbazate and 4,6-diacetylresorcinol, in the molar ratio 1:1, has been synthesized. All the metal complexes are dimmers. The structures of the ligand and its transition metal complexes were characterized by elemental analyses, spectral (Infrared, electronic, Mass, 1H NMR and ESR) data and magnetic susceptibility, molar conductivity measurements and thermal gravimetric analysis. The structure of the ligand is dibasic tridentate with ONS sites. The bonding sites, in all cases, are the azomethine nitrogen, phenolic oxygen and thiol sulfur atoms, as illustrated from the spectral data. The metal complexes exhibit different geometrical arrangements such as square planar, tetrahedral, square pyramidal and octahedral arrangements. Kinetic parameters (DG, DH, DS and DE) of the metal complexes were calculated from the thermal behaviour of the metal complexes using Coats-Redfern method. The ligand and its metal complexes were screened for its antimicrobial activity against Staphylococcus aureus and Staphylococcus pyogenes as Gram-positive bacteria, Pseudomonas phaseolicola and Pseudomonas fluorescens as Gram-negative bacteria and the fungi Fusarium oxysporum and Aspergillus fumigatus

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

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Geotechnical Investigation of Sewage Wastewater Disposal Sites and Use of GIS Land Use Maps to Assess Environmental Hazards: Sohag, Upper Egypt

Land application is the only currently available technique for sewage wastewater disposal along the Nile Valley in Upper Egypt. Wastewater disposal projects have been established in the lowland desert zone extending between the cultivated floodplain and the Eocene Limestone plateau. The plan is to use the treated wastewater in irrigating woody farmlands. Some wastewater disposal sites are already operating, and several others will be established in the near future. The proposed wastewater disposal sites are located in a sensitive desert zone that is extremely narrow and situated very close to vital resources including the cultivated floodplain, reclaimed lands, residential areas, and surface water resources. In addition, the subsurface sediments of this zone (Pleistocene sand-gravel succession) constitute a significant part of the Quaternary aquifer of the valley. The objective of this study is to characterize and investigate the wastewater disposal sites and assess their probable environmental hazards. The study showed that the available lands are insufficient to accommodate the projected quantities of wastewater. At the currently operating sites, excess raw wastewater is accumulating on the ground surface forming large uncontrolled ponds. Such wastewater ponds represent a potential environmental hazard and might cause disastrous health effects, where chemical and bacteriological pollution of soil, crops and water resources may occur

Effect of gamma irradiation and/or certain entomopathogenic fungi on the larval Mortality of Galleria mellonella L

Abstract The present investigation was carried out to study the effect of LC50 of the entomopathogenic fungi (EPF), Paecilomyces lilacinus and Beauveria bassiana, on larval mortality of the greater wax moth (GWM), Galleria mellonella L., under laboratory conditions and also to study the effect of different doses of gamma irradiation (70, 100, 125, and 150 Gy), separately or combined with the LC50 of the isolates of the EPF, B. bassiana, and P. lilacinus, on the second-instar larvae of G. mellonella larval mortality. The combined treatment of gamma irradiation and EPF increased the larval mortality rates than that at each treatment alone. The highest percentage of larval mortality was 78 and 84%, with 125 Gy + B. bassiana in the case of F1 male and F1 female, respectively. According to the obtained results, the gamma irradiation increased the pathogenicity of the fungi against the tested larvae. The combination between the two control tools may provide satisfactory control of the insect-pest, especially, in the storage