Background Physicians during the COVID-19 pandemic are working under relentless stress. This study aimed to identify the impact of the perceived fears of COVID-19 virus infection on the quality of life and the emergence of burnout syndrome among physicians in Egypt during the COVID-19 outbreak. This cross-sectional study was conducted between May 10th and June 9th, 2020, and included 320 Egyptian physicians who were working during the outbreak of the COVID-19 pandemic. The participants were interviewed using the Fear of COVID-19 scale (FCV-19S), Hospital Anxiety and Depression Scale (HADS), Maslach Burnout Inventory, and World Health Organization Quality of Life Scale (WHOQOL-BREF) for assessment of the perceived fears of COVID-19 virus infection, associated anxiety and depressive symptoms, burnout symptoms, and quality of life, respectively. Results Overall, most physicians were females (63%). Ideas about death, moderate-to-severe anxiety, and depressive symptoms were reported by 11, 28, and 29% of physicians, respectively. For burnout symptoms, high emotional exhaustion, high depersonalization, and low personal accomplishment were reported by 20, 71, and 39% of physicians, respectively. The perceived fear of COVID-19 virus infection was positively correlated with anxiety, depression, and burnout emotional exhaustion, and depersonalization symptoms, and negatively correlated with personal accomplishment and all quality of life domains. Conclusions Egyptian physicians experienced higher levels of COVID-19-related fears, anxiety, and depressive and burnout symptoms. There was a robust correlation between these perceived fears, and higher burnout symptoms, and poor quality of life among physicians. Specific interventions should be tailored to minimize the physical and mental burdens on the physicians during the COVID-19 pandemic.

Background and Aim:Transnasal transsphenoidal resection of pituitary tumours is associated with blood loss and wide fluctuations in haemodynamic parameters. The aim of the present study was to compare the effect of dexmedetomidine and magnesium sulphate during the transsphenoidal resection of pituitary tumours.Methods:The study was a double-blind, randomised study and included 152 patients classified randomly into two groups: Group D: Dexmedetomidine was given as a loading dose 1 μg/kg over 10 min before induction followed by an infusion at 0.5 μg/kg/h during the surgery. Group M: Magnesium sulphate was given as loading dose of 50 mg/kg over 10 min followed by an infusion at 15 mg/kg/h during the surgery. The systolic, diastolic and mean arterial blood pressures, in addition to the amount of blood loss were measured at specific timepoints. Data were described in terms of mean ± standard deviation, median, frequencies, 95% confidence of interval of mean and percentages.Results:Mean bleeding score was lower in Group D than Group M (1.36 ± 0.48 vs. 3.05 ± 0.65, respectively; P = 0.002). Mean blood loss was lower in Group D (157.43 ± 48.79 ml vs.299.47 ± 77.28 ml in Group M; P < 0.001)Heart rate, mean arterial pressure, fentanyl requirements, end-tidal sevoflurane concentration, and extubation and emergence times were lower, while incidence of bradycardia and hypotension were higher in Group D.Conclusions:During transsphenoidal pituitary resection, dexmedetomidine, compared to magnesium, is associated with lower blood loss and better operating conditions but with more hypotension and bradycardia

Chlorantraniliprole and indoxacarb insecticides exhibit good efficiency for control lepidopteran pests. The current study is a comprehensive analysis of the effect of lethal and sublethal concentrations of these insecticides on Spodoptera littoralis (Boisduval) (Lepidoptera: Noctuidae) by using the leaf dipping technique. The LC 50 values ranged from 0.06 to 1.07 mg/L, and 0.005 to 0.81 mg/L for chlorantraniliprole and indoxacarb, respectively. Our results showed that the treatment of the 2nd instar larvae with LC 50 concentrations of these insecticides significantly increased the length of larval and pupal duration as well as pupal weight in most cases. While, no significant differences have been found in the percentage of hatchability except for LC 50 equivalent of indoxacarb. Female behavior regarding calling activity decreased by 50-60% following exposure to the LC 50 concentration of both insecticides. Gas chromatography analysis results showed that both insecticides lowered pheromone titer except at chlorantraniliprole LC 50 equivalent for (Z,E)-9,12-tetradecadien-l-ol acetate, and indoxacarb LC 10 equivalent for (Z)-9-tetradecenyl acetate. Additionally, the activity of mixed-function oxidases and glutathione S-transferase were elevated relative to control. The carboxylesterase activity significantly increased when assayed with both chlorantraniliprole concentrations and indoxacarb LC 10 equivalent. These results indicate that chlorantraniliprole and indoxacarb could be effective for S. littoralis control.

Background Early postoperative ambulation and reduction of hospital stay necessitate efficient postoperative analgesia. Quadrates Lumborum Block (QLB) has been described to provide adequate postoperative analgesia after abdominal surgery. This randomized comparative trial was designed to compare the duration of analgesia provided by two different QLB approaches; the posterior QLB (QLB-2) and transmuscular QLB (QLB-3) in patients undergoing surgical repair of unilateral inguinal hernia. Methods Forty patients, aged from 18 to 50 years, ASA physical status I or II, scheduled for unilateral inguinal hernia repair were enrolled. At the end of the surgical procedure and before recovery from general anesthesia, Patients were randomly assigned into two groups to receive either posterior QLB (Group QLB-2) or transmuscular QLB (Group QLB-3) using 20 ml 0.25% bupivacaine. Duration of analgesia, postoperative VAS and postoperative opioid consumption were recorded. Results Duration of block was significantly longer in QLB-3 group when compared to QLB-2 group (20.1 + 6.2 h versus 12.0 + 4.8 respectively) with P value of < 0.001. A statistically significant lower VAS score was recorded in QLB-3 group immediately and 12 h postoperative. QLB-3 group showed a statistically significant delayed time of first analgesic request and less postoperative morphine consumption with P value of < 0.001 and 0.001 respectively. Conclusions Ultrasound guided postsurgical transmuscular approach of QLB (QLB-3) using 20 ml 0.25% bupivacaine produces more postoperative analgesic effect and less postoperative opioid consumption when compared to posterior QLB approach (QLB-2) in patients underwent unilateral inguinal hernia repair under general anesthesia. Trial registration ClinicalTrials.gov identifier: NCT03526731- on 16 May 2018.

Fipronil and emamectin benzoate (EMB) are effective insecticides for controlling cotton leafworm, Spodoptera littoralis. Fipronil works by blocking gamma-amino butyric acid (GABA) gated chloride. In contrast, EMB is activating GABA transporters. The objectives of our study were to assess relative toxicity of the technical fipronil and EMB alone and in mixture against S. littoralis. In addition, the GABA content was simultaneously determined using HPLC. Technical fipronil and EMB and their mixtures were applied topically to the fourth-instar larvae, and their LD50 values were estimated after 48 h. Results demonstrated that the LD50 for EMB applied alone was 0.751 ng/larva which was much less than for fipronil 7.271 ng/larva. Each of the two insecticides alone showed a significant decrease in GABA content at LD10, LD25, and LD50 doses, while their mixtures induced GABA levels. The highest potentiation was observed when both insecticides were in a mixture at the ratio of LD10:LD10 which was associated with higher increase in GABA levels. Moreover, the weight of the alive larvae was less than that was in the untreated control. However, all mixtures exhibited potentiation effect, except for the mixture of fipronil at LD50 with EMB at LD10, LD25, and LD50 that had antagonistic effect correlated with the lowest decrease in GABA level. Results suggested that lower doses of both insecticides in a binary mixture had potentiation effect against S. littoralis. This mixture could be used in combination as field application for successful and effective control of S. littoralis and would also help in managing insecticide resistance.