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

Ultrasonographic Monitoring of Uterine Involution in Postpartum Buffalo Cows

A description of normal ultrasonographic alternations of the uterus in the postpartum (PP) in buffaloes is essential for the diagnosis of pathological conditions and improves the ability to differentiate puerperal pathology from normal physiological changes. The current study aimed to characterize the changes in uterine features assessed ultrasonographically in normal parturient Egyptian buffaloes (n=20) during the post-calving period (Until Day 60 PP). In the current data, ultrasonographic findings indicated that the uterine involution was completed at 4-6 weeks PP in normal calved Egyptian buffaloes. Moreover, calving during the spring season and female new born calves were associated with an enhanced uterine involution. Early cyclicity positively influences endometrial thickness (during early PP), dorsal and ventral uterine curvature, and uterine lumen diameter (during late PP) as compared with the late cyclic group. In conclusion, the uterine involution is ended by the 6th weeks PP in normal parturient Egyptian buffaloes. Moreover, season and calves gender implicate in the changes associated with uterine involution in buffaloes. It is extremely recommended to employ ultrasound examinations in the dairy herd to improve the reproductive efficiency of females by reducing the days open and increasing the number of milking animals

Ultrasonographic Monitoring of Uterine Involution in Postpartum Buffalo Cows: Uterine involution in Buffaloes

A description of normal ultrasonographic alternations of the uterus in the postpartum (PP) in buffaloes is essential for the diagnosis of pathological conditions and improves the ability to differentiate puerperal pathology from normal physiological changes. The current study aimed to characterize the changes in uterine features assessed ultrasonographically in normal parturient Egyptian buffaloes (n=20) during the post-calving period (Until Day 60 PP). In the current data, ultrasonographic findings indicated that the uterine involution was completed at 4-6 weeks PP in normal calved Egyptian buffaloes. Moreover, calving during the spring season and female new born calves were associated with an enhanced uterine involution. Early cyclicity positively influences endometrial thickness (during early PP), dorsal and ventral uterine curvature, and uterine lumen diameter (during late PP) as compared with the late cyclic group. In conclusion, the uterine involution is ended by the 6th weeks PP in normal parturient Egyptian buffaloes. Moreover, season and calves gender implicate in the changes associated with uterine involution in buffaloes. It is extremely recommended to employ ultrasound examinations in the dairy herd to improve the reproductive efficiency of females by reducing the days open and increasing the number of milking animals

Carbapenem-resistant Klebsiella pneumoniae isolates from Egypt containing blaNDM-1 on IncR plasmids and its association with rmtF

Objectives: The aim of this study was to characterize carbapenem-resistant Klebsiella pneumoniae (CRKP) isolates recovered from clinical specimens at a tertiary care hospital in Egypt over a period of 15 months. Methods: Eight CRKP isolates were included in this study. The minimum inhibitory concentrations of different antibiotics were determined by broth microdilution and Etest methods. Multilocus sequence typing was performed. Antibiotic resistance genes were assessed by PCR and DNA sequencing. Plasmid analysis was done by S1 nuclease digestion of whole genomic DNA followed by pulsed-field gel electrophoresis (S1-PFGE). Result: Eight carbapenem-resistant NDM-1-producing K. pneumoniae isolates of three different sequence types (ST) were identified (ST147, ST11, and ST17), in which blaNDM-1 was carried by either IncR or untypeable plasmids. Seven out of the eight isolates also contained the rmtF methylase gene. Conclusion: This study describes the occurrence of IncR plasmids carrying blaNDM-1 and rmtF in Egypt, raising concerns regarding this type of replicon and its role in the transmission of these resistance determinants