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

Antioxidant and Histopathological Effect of Galantamine Against Paracetamol-Induced Side Effect

The goal of this research was to find out more about the possible protective role of galantamine (GAL) (0.3 mg/kg P.O) for 28 successive days against paracetamol (PCM) toxicity that was administrated on day 29 of the experiment, at day 30, blood sample were collected for evaluation of antioxidant enzymes and tissues for histopathological studies. Oxidative stress biomarkers which included serum superoxide dismutase, glutathione peroxidase, catalase, and malondialdehyde and histopathological studies indicated that GAL has protective effects by prohibiting the improvement in oxidative stress biomarkers and improved the histopathological lesions seen in livers and kidneys in vivo model against hepatic and renal toxicity induced by PCM in rats

Pharmacological activities and medicinal uses of berberine: A review

Berberine (BBR) is an isoquinoline derivative alkaloid that has been identified from a variety of plant species including Cortex phellodendron (Huang bai), Hydrastis canadensis (goldenseal), and Rhizoma coptidis (Huanglian). A growing body of research has demonstrated that this chemical has a wide range of biological functions, including antioxidant and anti-inflammatory, anticancer, and anti-hyperglycemic properties. BBR has been proven in studies to reduce the production of inflammatory mediators such as TNF-, IL-1, IL-6, and IL-8. Furthermore, BBR appears to boost the cellular antioxidant defense mechanism by raising the activity of CAT, SOD, and GPx while reducing OS variables such as protein carbonyl (PC) content, MDA, and NO levels. This review threw light on the pharmacological activities and medicinal uses of BBR

Pharmacological activities and medicinal uses of berberine: A review

Berberine (BBR) is an isoquinoline derivative alkaloid that has been identified from a variety of plant species including Cortex phellodendron (Huang bai), Hydrastis canadensis (goldenseal), and Rhizoma coptidis (Huanglian). A growing body of research has demonstrated that this chemical has a wide range of biological functions, including antioxidant and anti-inflammatory, anticancer, and anti-hyperglycemic properties. BBR has been proven in studies to reduce the production of inflammatory mediators such as TNF-, IL-1, IL-6, and IL-8. Furthermore, BBR appears to boost the cellular antioxidant defense mechanism by raising the activity of CAT, SOD, and GPx while reducing OS variables such as protein carbonyl (PC) content, MDA, and NO levels. This review threw light on the pharmacological activities and medicinal uses of BBR

Assessment of the Protective Role of Prenatal Zinc versus Insulin Supplementation on Fetal Cardiac Damage Induced by Maternal Diabetes in Rat Using Caspase-3 and KI67 Immunohistochemical Stains

Maternal diabetes mellitus (DM) affects early organogenesis. Metabolic disorders of DM are associated with a depleted zinc status. This study evaluated the effect of maternal DM on cardiac development of rat fetuses and protective roles of prenatal zinc versus insulin supplementation. Pregnant rats were divided into 4 groups ((I) control, (II) STZ-induced DM, (III) STZ-induced DM treated with Zn, and (IV) STZ induced DM treated with insulin), all sacrificed on GD 20. Fetal heart weight of diabetic rats showed significant decrease compared to controls (P<0.05). H&E stained section of controls had normal appearance of the myocardium, compared to diabetics that showed myocardial disarray with characteristic degenerative changes. Sections of zinc treated group showed restored architecture of normal myofibrils with minimal degenerative changes, while those of insulin treated group show partial restoration of the normal architecture of cardiomyocytes with focal improvement of cardiac tissue. Caspase-3 immunostained slides showed positive cytoplasmic immunoreactivity in diabetic group. But KI67 immunostained slides revealed negative nuclear immunoreaction in diabetics. We observed that gestational diabetes was associated with increased risk of fetal myocardial damage that might be caused by increased apoptotic level. Treating diabetic pregnant subjects with zinc and insulin was associated with improvement in myocardial integrity

Ameliorative Effects of Vitamin E against Ceftriaxone-induced Adverse Effects in Broilers Challenged with E. coli

Ceftriaxone is a broad spectrum antimicrobial that commonly used in chicken farms for the purpose of the control of avian bacterial diseases. However, the use of ceftriaxone can be associated with some adverse effects. This study examined vitamin E's protective properties against ceftriaxone-induced histopathological, inflammatory, and oxidative damage in broiler chickens challenged with E. coli. When broiler chicks are exposed to E. coli O78, colibacillosis was developed. The sickened birds displayed a variety of general clinical symptoms. Ceftriaxone was used as a treatment and could lower morbidity and fatality rates to 10% and 4%, respectively. The use of ceftriaxone was associated with the occurrence of some histopathological lesions. In addition, either E. coli or ceftriaxone could cause alterations in erythrogram, antioxidant status, and induction of inflammatory markers. Interestingly, the use of vitamin E with ceftriaxone could markedly improve the histopathological alterations and upregulate the antioxidant status and reduce the release of the inflammatory markers. In conclusion, the present study's findings showed that ceftriaxone is a powerful antibacterial drug, especially when used to treat E. coli in broilers. Vitamin E is strongly advised for usage in broilers to minimize ceftriaxone-induced adverse effects.

The use of ractopamine as a feed additive: A review

Ractopamine hydrochloride is a β-adrenergic agonist that increases growth, feed efficiency, and fat deposition. Because of its ability to increase muscling, average daily gain, efficiency, and carcass weight, ractopamine hydrochloride has been used as a feed additive growth enhancer. Ractopamine is also a member of the phenylethanolamine class of chemicals, which is used as a feed supplement in meat-producing animals. This review threw the light on the use of ractopamine to improve weight gain and as a feed addition. Furthermore, the potential negative health effects of ractopamine were explored

The use of ractopamine as a feed additive: A review

Ractopamine hydrochloride is a β-adrenergic agonist that increases growth, feed efficiency, and fat deposition. Because of its ability to increase muscling, average daily gain, efficiency, and carcass weight, ractopamine hydrochloride has been used as a feed additive growth enhancer. Ractopamine is also a member of the phenylethanolamine class of chemicals, which is used as a feed supplement in meat-producing animals. This review threw the light on the use of ractopamine to improve weight gain and as a feed addition. Furthermore, the potential negative health effects of ractopamine were explored

Comparison of the early cardiac electromechanical remodeling following transcatheter and surgical secundum atrial septal defect closure in adults

Abstract Background Secundum atrial septal defect (ASD) closure leads to electrical and mechanical remodeling that occurs early after shunt disappearance. The relationship between electromechanical remodeling using electrocardiogram (ECG) and cardiac magnetic resonance (CMR) after percutaneous and surgical closure has not yet been recorded in prospective studies. Objective We thought to study right atrium (RA) and right ventricle (RV) changes by CMR 3 months after transcatheter and surgical closure and their comparison with electrical remodeling by ECG. Results We prospectively evaluated 30 consecutive adult patients with isolated secundum ASD who were referred for (transcatheter and surgical) ASD closure. There was significant reduction in all of the electrical parameters within the same group as compared to the baseline values, except P wave dispersion (Pd). (P max was 97.33 ± 16.67 (pre closure) to 76 ± 15.49 (post closure) in the device group and 97.33 ± 12.79 (preclosure) to 73.33 ± 16.32 (post closure) in the surgical group, QRS complex was 104 ± 18.82 (preclosure) to 80 ± 18.51 (post closure) in the device group and 106.67 ± 14.47 (preclosure) to 86.67 ± 17.99 (post closure) in the surgical group. QTc maximum was 478.53 ± 36.79 (preclosure) to 412.53 ± 38.03 (post closure) in the device group and 470.53 ± 65.70 (preclosure) to 405.93 ± 63.08 (post closure) in the surgical group, and QTc dispersion was 70.33 ± 24.04 (preclosure) to 60.26 ± 28.56 (post closure) in the device group and 80.73 ± 30.38 (preclosure) to 60.27 ± 28.57 (post closure) in the surgical group).There was no significant difference between two groups indicating that transcatheter and surgical closure had led to equivalent value of electrical remodeling. In CMR study, we measured RA maximal volume and right ventricle end diastolic volume (RVEDV), RA maximal volume decreased significantly as compared to the base line values post closure in both groups (P value < 0.001). The reduction in RA max volume was more in the transcatheter closure group; however, this difference was not statistically significant when compared with the surgical arm (P value = 0.5).RVEDV decreased significantly in both groups as compared to the baseline values (P value < 0.001). Transcatheter closure resulted in more significant reduction in the RVEDV than the surgical closure (P value = 0.03). Conclusion Our study showed early significant electromechanical reverse remodeling in most of the study parameters from the baseline values after ASD closure. We found no significant differences in all of the electrical and RA mechanical remodeling parameters with significantly better mechanical remodeling of RV in the device group