Purpose The outbreak of COVID-19 erupted in December 2019 in Wuhan, China. In a few weeks, it progressed rapidly into a global pandemic which resulted in an overwhelming burden on health care systems, medical resources and staff. Spine surgeons as health care providers are no exception. In this study, we try to highlight the impact of the crisis on spine surgeons in terms of knowledge, attitude, practice and socioeconomic burden. Methods This was global, multicentric cross-sectional study on 781 spine surgeons that utilized an Internet-based validated questionnaire to evaluate knowledge about COVID-19, availability of personal protective equipment, future perceptions, effect of this crisis on practice and psychological distress. Univariate and multivariate ordinal logistic regression analyses were used to evaluate the predictors for the degree of COVID-19 effect on practice. Results Overall, 20.2%, 52% and 27.8% of the participants were affected minimally, intermediately and hugely by COVID-19, respectively. Older ages (β = 0.33, 95% CI 0.11-0.56), orthopedic spine surgeons (β = 0.30, 95% CI 0.01-0.61) and those who work in the private sector (β = 0.05, 95% CI 0.19-0.61) were the most affected by COVID-19. Those who work in university hospitals (β = − 0.36, 95% CI 0.00 to − 0.71) were affected the least. The availability of N95 masks (47%) and disposable eye protectors or face shields (39.4%) was significantly associated with lower psychological stress (p = 0.01). Only 6.9%, 3.7% and 5% had mild, moderate and severe mental distress, respectively. Conclusion While it is important to recognize the short-term impact of COVID-19 pandemic on the practice of spine surgery, predicting where we will be standing in 6-12 months remains difficult and unknown. The COVID-19 crisis will probably have an unexpected long-term impact on lives and economies.

Numerous blood biomarkers are altered in COVID-19 patients; however, no early biochemical markers are currently being used in clinical practice to predict COVID-19 severity. COVID-19, the most recent pandemic, is caused by the SRS-CoV-2 coronavirus.  The study was aimed to identify patient groups with a high and low risk of developing COVID-19 using a cluster analysis of several biomarkers. 137 women with confirmed SARS CoV-2 RNA testing were collected and analyzed for biochemical profiles. Two-dimensional automated hierarchy clustering of all biomarkers was applied, and patients were sorted into classes. Biochemistry marker variations (Ferritin, lactate dehydrogenase LDH, D-dimer, and C- reactive protein CRP) have split COVID-19 patients into two groups(severe cases and non-severe cases groups). Ferritin, lactate dehydrogenase LDH, D-dimer and CRP were markedly increased in COVID-19 patients in the first group (severe cases). Our findings imply that early measured levels of (Ferritin, lactate dehydrogenase LDH, D-dimer, and C- reactive protein CRP) are linked to a decreased probability of COVID-19 severity. Elevated levels of this biomarker may predict COVID severity development.

Purpose: The outbreak of COVID-19 erupted in December 2019 in Wuhan-China. In a few weeks it progressed rapidly into a global pandemic which resulted in an overwhelming burden on health care systems, medical resources and staff.Spine surgeons as health care providers are no exception. In this study we try to highlight the impact of the crisis on spine surgeons in terms of knowledge, attitude, practice and socioeconomic BurdenMethods: This was global, multi-centric cross-sectional study on 781 spine surgeons that utilized an internet-based validated questionnaire to evaluate knowledge about COVID-19, availability of personal protective equipment (PEE), future perceptions, effect of this crisis on practice and psychological distress. Univariate and multivariate ordinal logistic regression analyses were used to evaluate the predictors for the degree of COVID-19 effect on practice. Results: Overall, 20.2%, 52%, and 27.8% of the participants were affected minimally, intermediately, and hugely by COVID-19, respectively. Older ages (β= 0.33, 95% CI 0.11 to 0.56), orthopedic spine surgeons (β=0.30, 95% CI 0.01 to 0.61) and those who work in the private sector (β=0.05, 95% CI 0.19 to 0.61) were the most affected by COVID-19. Those who work in university hospitals (β=-0.36, 95% CI 0.00 to -0.71) were affected the least. The availability of N95 masks (47%) and disposable eye protectors or face shields (39.4%) was significantly associated with lower psychological stress (p=0.01). Only (6.9%), (3.7%), and (5%) had mild, moderate and severe mental distress, respectively.Conclusion: While it is important to recognize the short-term impact of COVID-19 pandemic on the practice of spine surgery, predicting where we will be standing in 6-12 months remains difficult and unknown. The COVID-19 crisis will probably have an unexpected long-term impact on lives and economies.

Background and Objectives: The frequency of Brucellosis is expanding in the Middle East particularly in Iraq. Spondylitis is the most incessant difficulty, yet it is hard to analyze in light of the fact that its clinical side effects are vague. The cross-sectional study was conducted to evaluate abnormal serum protein electrophoresis patience living with brucellar spondylitis and it is related to the disease. This study shares out the distribution of protein pattern in Brucellar spondylitis patients. Methods: The current study included a total number of 40 voluntary subjects covers of 25 cases and 15 controls. Total serum protein was determined using the biuret method, serum albumin was determined using bromocresol green method, Serum protein electrophoresis was determined using SAS-MX serum protein gel. Results: Total proteins, Alpha 1 Globulin, and Gamma Globulin were significantly increased in Brucellar spondylitis when compared to controls. Ratio Albumin/Gamma was significantly decreased in Brucellar spondylitis compared to control. Albumin, Alpha 2 Globulin, and Beta Globulin did not appear significant difference. According to the multivariable regression analysis the level of Alpha 1 Globulin was highly related to total protein in Brucellar spondylitis. The cluster analysis showed that the investigated parameters organized into four clusters in the serum of patients with Brucellar spondylitis. Conclusion: we conclude that Total proteins, Alpha 1 Globulin, and Gamma Globulin have altered in patients Brucellar spondylitis when compared to control, Also Alpha 1 Globulin was associated with total protein in the studied cases.