The medical and biochemical knowledge of health care professionals regarding the management of MERS-CoV: lessons from 2019 pilgrimage season in Al-Madinah, Saudi Arabia: A cross-sectional study

Background: Middle East respiratory syndrome coronavirus (MERS-CoV) epidemic was a serious healthcare concern not responding to conventional anti-viral therapies between 2012 and 2017 with high fatality rates. Saudi Arabia is still among the best world examples in combating both MERS-CoV and COVID-19 pandemics. Objectives: Investigating the medical and biochemical knowledge of healthcare professionals in Al-Madinah, Saudi Arabia on preventive, diagnostic and therapeutic measures against MERS-CoV epidemic. Subjects and methods: In 2019, this cross-sectional study included 416 healthcare personnel of which 402 participants answered the questions with a response rate of 96.7%. Specialties of participants were medical students (1.4%), physicians (64.4%), nurses (23.6%) and others (10.7%). Results: The vast majority of the investigated healthcare personnel gave the right answers. 96.7% of the participants answered that washing hands using water helps prevent MERS-CoV. 90.8% of the participants answered that wearing a clean non-sterile long-sleeved gown and gloves does helps prevent MERS-CoV infection. 94.7% of participants answered that using alcohol-based hand rub helps prevent MERS-CoV infection. 92.03% of the participants thought that wearing protective equipment does help preventing MERS-CoV infection. 86.1% answered that there is no vaccine available against MERS-CoV infection and 86.1% answered that taking vaccines is suitable for preventing MERS-CoV infection. 90.04% of the participants answered that MERS-CoV patients should be diagnosed using PCR and 84.3% thought that the highest levels of anti-CoV antibodies are in abattoir workers while 87.8% thought that isolation of suspected cases helps preventing MERS-CoV infection. Conclusion: The investigated healthcare workers had a satisfactory knowledge on the preventive and therapeutic measures and biochemical knowledge against MERS-CoV epidemic at mass gatherings as pilgrimage season

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

Green Biosynthesis of Silver Nanoparticles Using <i>Annona glabra</i> and <i>Annona squamosa</i> Extracts with Antimicrobial, Anticancer, Apoptosis Potentials, Assisted by In Silico Modeling, and Metabolic Profiling

Annona glabra L. (AngTE) and Annona squamosa L. (AnsTE) fruits have been widely used in cancer treatment. Accordingly, their extracts were used to synthesize silver nanoparticles via a biogenic route (Ang-AgNPs) and (Ans-AgNPs), respectively. Chemical profiling was established using UPLC-QTOF-MS/MS. All species were tested for anticancer activity against human cervical cancer cells (HeLa), prostate adenocarcinoma metastatic (PC3), and ovary adenocarcinoma (SKOV3) using sulphorhodamine B assay. Apoptosis was determined using Annexin flow cytometry along with cell cycle analysis and supported by a molecular docking. The antibacterial and synergistic effect when combined with gentamicin were evaluated. A total of 114 compounds were tentatively identified, mainly acetogenins and ent-kaurane diterpenes. AnsTE and Ans-AgNPs had the most potent cytotoxicity on HeLa and SKOV3 cells, inducing a significant apoptotic effect against all tumor cells. The AnsTE and Ans-AgNPs significantly arrested PC3, SKOV3, and HeLa cells in the S phase. The nanoparticles demonstrated greater antibacterial and antifungal activities, as well as a synergistic effect with gentamicin against P. aeruginosa and E. coli. Finally, a molecular docking was attempted to investigate the binding mode of the identified compounds in Bcl-2 proteins’ receptor, implying that the fruits and their nanoparticles are excellent candidates for treating skin infections in patients with ovarian or prostatic cancer