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

Three Decades of Experience in Managing Immune Thrombocytopenia in Children in Arab Countries

There are scattered and limited data in the literature on immune thrombocytopenia (ITP) in children from the Arab region. The aim of the current review is to present data from this region on the diagnosis, therapy, and morbidity associated with ITP. The first report was published three decades ago. It was assumed that there was a different disease pattern of ITP, but this was later discovered to be inaccurate and the frequencies of different ITP patterns were not different from other regions. The initial work-up for diagnosis of newly diagnosed ITP included routine bone marrow evaluation for all patients in most studies; however, a limited need for bone marrow for the initial evaluation was reported. An Egyptian multicenter study on the morbidity and mortality of intracranial hemorrhage (ICH) with other sporadic data was reported. Neither regional nor national guidelines for ITP management in most Arab countries have been reported. However, the use of initial intravenous immunoglobulin (IVIG) therapy in the Arabian Gulf region in contrast to corticosteroids in most other countries was obvious. Limited data on the use of anti-CD20, avoidance of unnecessary splenectomy, and the use of thrombopoietin receptor analogue in chronic ITP were published recently. A unified consensus for ITP management in the Arab region is essential but not yet realistic. More publications from this region are needed

Frequency of Agranulocytosis and Mild Neutropenia During Deferiprone Therapy in Clinical Practice

54th Annual Meeting and Exposition of the American-Society-of-Hematology (ASH) -- DEC 08-11, 2012 -- Atlanta, GAWOS: 000314049600309…Amer Soc Hematol (ASH