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

Assessing the impact of bacteriophages in the treatment of Salmonella in broiler chickens

Salmonellosis is one of the main bacterial infections affecting commercial poultry, causing losses to poultry production, and posing a public health concern. Samples from internal organs (liver, cecum and spleen) of one hundred diseased broiler chickens were collected and subjected to Salmonella isolation, identification and serotyping. S. typhimurium and S. enteritidis were selected from the isolated Salmonella to prepare bacteriophages from sewage water taken at broiler farms. An experimental infection of one day old specific pathogen free (SPF) chicks followed by treatment with the prepared bacteriophages isolated from both Salmonella was performed. Caecal samples from infected chicks were subjected at intervals to bacteriophage isolation and Salmonella quantitation. The effectiveness of bacteriophage treatments on Salmonella colonization in cecum of infected chicks increased after five successive doses. At 3 day post infection (dpi), cecal contents showed a marginal decrease in Salmonella loads with more reduction at 5 dpi. From 7 dpi to the end of the experiment at 15 dpi, all the chicks were cleared for both Salmonella. The findings of this study demonstrate that bacteriophage treatment is efficacious in reducing S. typhimurium and S. enteritidis colonization in broiler chickens within a short period and could be used as an alternative to antibiotics

Antimicrobial efficacy of quaternary ammonium compounds (QACs) against multidrug resistant bacterial species causing cellulitis in broiler chicken

Avian cellulitis is one of the most important field problems facing the poultry sector. Sever financial losses resulted from the condemnation of the broiler carcasses infected with cellulitis lesions. In light of this, the current study was aimed to isolation and identification of the bacterial species causing cellulitis in broiler chickens in Dakahlia and Sharkia Governorates, Egypt. The bacterial isolates were tested for their antimicrobial susceptibility and molecular detection of some virulence and antimicrobial resistance genes. In addition to evaluate the antibacterial activity of quaternary ammonium compounds and glutaraldehyde (TH4 ®) against the bacterial isolates. Four bacterial species were isolated; E. coli, S. aureus, P. aeruginosa and Proteus mirabilis with percentages of (75%), (20%), (6%) and (5%) respectively. E. coli was recorded as the most predominant isolated bacteria in this study with12 different sero- groups (O1, O2, O26, O55, O78, O91, O121, O125, O126, O128, O153 and O158). E. coli O78 and O91 were the most prevalent identified sero- groups.  The antimicrobial susceptibility testing revealed higher resistances against doxycycline and ampicillin (95.6%), amoxicillin (90.7%), norfloxacin (84%), oxytetracycline (79.1%) and amikacin (71.6%) in E. coli, doxycycline (73.3%), oxytetracycline (80%)            ,ampicillin(75%), streptomycin (80%), erythromycin (73.3%), and oxacillin (86.7%) in S. aureus, doxycycline (83.3%), oxytetracycline (77.8%), ampicillin (83.3%), amoxicillin (88.9%), neomycin (72.2%) and erythromycin (77.8%) in P. aeruginosa and doxycycline, oxytetracycline, ampicillin, amoxicillin, streptomycin and erythromycin (100% for each of them) in Proteus mirabilis. All isolated bacterial species were multidrug resistance (MDR). The molecular identification showed the detection of virulence genes: iutA in E. coli, nuc in S. aureus, toxA in P.aeruginosa and rsbA in Proteus mirabilis., with percentage of (100%). blaTEM, tetA (A), qnrA, tetK, mecA, aac(6')aph (2''), ereA and aada1 resistance genes were  reported in this study. Quaternary ammonium compounds in combination glutaraldehyde (TH4 ®) with 2% concentration showed the highest antibacterial activity against the examined multidrug resistant bacterial isolates. These results suggested for application of 2% TH4 ® to achieve effective disinfectant programs in poultry farms

Antimicrobial efficacy of quaternary ammonium compounds (QACs) against multidrug resistant bacterial species causing cellulitis in broiler chicken

Avian cellulitis is one of the most important field problems facing the poultry sector. Sever financial losses resulted from the condemnation of the broiler carcasses infected with cellulitis lesions. In light of this, the current study was aimed to isolation and identification of the bacterial species causing cellulitis in broiler chickens in Dakahlia and Sharkia Governorates, Egypt. The bacterial isolates were tested for their antimicrobial susceptibility and molecular detection of some virulence and antimicrobial resistance genes. In addition to evaluate the antibacterial activity of quaternary ammonium compounds and glutaraldehyde (TH4 ®) against the bacterial isolates. Four bacterial species were isolated; E. coli, S. aureus, P. aeruginosa and Proteus mirabilis with percentages of (75%), (20%), (6%) and (5%) respectively. E. coli was recorded as the most predominant isolated bacteria in this study with12 different sero- groups (O1, O2, O26, O55, O78, O91, O121, O125, O126, O128, O153 and O158). E. coli O78 and O91 were the most prevalent identified sero- groups.  The antimicrobial susceptibility testing revealed higher resistances against doxycycline and ampicillin (95.6%), amoxicillin (90.7%), norfloxacin (84%), oxytetracycline (79.1%) and amikacin (71.6%) in E. coli, doxycycline (73.3%), oxytetracycline (80%)            ,ampicillin(75%), streptomycin (80%), erythromycin (73.3%), and oxacillin (86.7%) in S. aureus, doxycycline (83.3%), oxytetracycline (77.8%), ampicillin (83.3%), amoxicillin (88.9%), neomycin (72.2%) and erythromycin (77.8%) in P. aeruginosa and doxycycline, oxytetracycline, ampicillin, amoxicillin, streptomycin and erythromycin (100% for each of them) in Proteus mirabilis. All isolated bacterial species were multidrug resistance (MDR). The molecular identification showed the detection of virulence genes: iutA in E. coli, nuc in S. aureus, toxA in P.aeruginosa and rsbA in Proteus mirabilis., with percentage of (100%). blaTEM, tetA (A), qnrA, tetK, mecA, aac(6')aph (2''), ereA and aada1 resistance genes were  reported in this study. Quaternary ammonium compounds in combination glutaraldehyde (TH4 ®) with 2% concentration showed the highest antibacterial activity against the examined multidrug resistant bacterial isolates. These results suggested for application of 2% TH4 ® to achieve effective disinfectant programs in poultry farms

Wild Birds in Live Birds Markets : Potential Reservoirs of Enzootic Avian Influenza Viruses and Antimicrobial Resistant Enterobacteriaceae in Northern Egypt

Wild migratory birds are often implicated in the introduction, maintenance, and global dissemination of different pathogens, such as influenza A viruses (IAV) and antimicrobial-resistant (AMR) bacteria. Trapping of migratory birds during their resting periods at the northern coast of Egypt is a common and ancient practice performed mainly for selling in live bird markets (LBM). In the present study, samples were collected from 148 wild birds, representing 14 species, which were being offered for sale in LBM. All birds were tested for the presence of AIV and enterobacteriaceae. Ten samples collected from Northern Shoveler birds (Spatula clypeata) were positive for IAV and PCR sub-typing and pan HA/NA sequencing assays detected H5N8, H9N2, and H6N2 viruses in four, four, and one birds, respectively. Sequencing of the full haemagglutinin (HA) gene revealed a high similarity with currently circulating IAV in Egypt. From all the birds, E. coli was recovered from 37.2% and Salmonella from 20.2%, with 66-96% and 23-43% isolates being resistant to at least one of seven selected critically important antimicrobials (CIA), respectively. The presence of enzootic IAV and the wide prevalence of AMR enterobacteriaceae in wild birds highlight the potential role of LBM in the spread of different pathogens from and to wild birds. Continued surveillance of both AIV and antimicrobial-resistant enterobacteriaceae in wild birds' habitats is urgently needed

Dietary effect of soybean lecithin on the growth performance, digestive enzyme activity, blood biomarkers, and antioxidative status of striped catfish, Pangasianodon hypophthalmus.

Soybean lecithin (SBL) is usually added to aquafeed as a lipid source because aquatic animals cannot synthesize phospholipids. Hence, this study aimed to investigate the role of SBL on the growth, nutrient consumption, digestive enzyme activity, blood parameters, and antioxidant capability of striped catfish. The fish were fed on five experimental diets with five grading levels of SBL (0, 2, 4, 6, and 8%) for 60 days. The final weight, weight gain, specific growth rate, feed intake, and protein efficiency ratio were markedly higher in striped catfish treated with 2-4% SBL than the control level (0% SBL). However, the lowest feed conversion ratio was in the fish-fed groups of 4-6% SBL. The carcass lipid content was significantly higher in fish fed 2-4% SBL compared to the control level (0% SBL). The lipase, amylase, and protease activities were significantly increased in the fish fed 2-6% SBL compared to 0% SBL-fed group. The gradually increased levels of SBL improved the structural appearance and increased the intestinal villi length and branching appearance. The triglycerides and total cholesterol were increased in the fish fed with 4, 6, and 8% compared to the control level, with the highest being in the fish fed with 8%. The lysozyme activity was higher in the fish fed with 2, 4, and 6% of SBL compared to the control level, with higher activity in the fish fed with 2 and 4% than 6%. Superoxide dismutase, glutathione peroxidase, and catalase activities were increased in the fish fed with 2, 4, and 6% SBL. The malondialdehyde level was lower in the fish fed with 4-6% SBL compared to the control level. The regression analysis revealed that the optimum dose of SBL is required at 3.65-4.42% for better productivity and health performances in striped catfish

Brachyolmia, dental anomalies and short stature (DASS): Phenotype and genotype analyses of Egyptian and Pakistani patients

Brachyolmia is a heterogeneous group of developmental disorders characterized by a short trunk, short stature, scoliosis, and generalized platyspondyly without significant deformities in the long bones. DASS (Dental Abnormalities and Short Stature), caused by alterations in the LTBP3 gene, was previously considered as a subtype of brachyolmia.The present study investigated three unrelated consanguineous families (A, B, C) with Brachyolmia and DASS from Egypt and Pakistan. In our Egyptian patients, we also observed hearing impairment. Exome sequencing was performed to determine the genetic causes of the diverse clinical conditions in the patients. Exome sequencing identified a novel homozygous splice acceptor site variant (LTBP3:c.3629-1G > T; p. ?) responsible for DASS phenotypes and a known homozygous missense variant (CABP2: c.590T > C; p.Ile197Thr) causing hearing impairment in the Egyptian patients. In addition, two previously reported homozygous frameshift variants (LTBP3:c.132delG; p.Pro45Argfs*25) and (LTBP3:c.2216delG; p.Gly739Alafs*7) were identified in Pakistani patients.This study emphasizes the vital role of LTBP3 in the axial skeleton and tooth morphogenesis and expands the mutational spectrum of LTBP3. We are reporting LTBP3 variants in seven patients of three families, majorly causing brachyolmia with dental and cardiac anomalies. Skeletal assessment documented short webbed neck, broad chest, evidences of mild long bones involvement, short distal phalanges, pes planus and osteopenic bone texture as additional associated findings expanding the clinical phenotype of DASS. The current study reveals that the hearing impairment phenotype in Egyptian patients of family A has a separate transmission mechanism independent of LTBP3

Growth performance of striped catfish fed dietary soybean lecithin for 60 days.

Growth performance of striped catfish fed dietary soybean lecithin for 60 days.</p

Carcass composition of striped catfish fed dietary soybean lecithin for 60 days.

Carcass composition of striped catfish fed dietary soybean lecithin for 60 days.</p