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Diabetes Mellitus (DM) causes global exhaustion, consumes economic resources, and has several risk factors. The bibliometric studies re-evaluate the research efforts on this illness using mathematical and statistical tools to indicate current research and future trends. This study examines KSA's DM research during 2010-2021. Data were acquired from Scopus and analyzed using VOSviewer and MS Excel. Several characteristics were examined to measure the quantity and quality of KSA-related DM articles. In total, 1,919 journal and conference papers were published. DM research included researchers from multidisciplinary sectors. Thirty-seven percent of them have ten or more scientific publications. Al-Daghri, N.M. (King Saud University) leads the pack. In total, 757 (39.44%) research projects got funding from 159 sources within and outside KSA. Memish, Z.A. is the most cited author. The Saudi Medical Journal has the most citations (1214). Al-Daghri, N.M. (KSU) collaborates the most. One hundred forty-one nations aided KSA's diabetes research. Egypt's High Institute of Public Health has the most scientific collaboration with KSA. Authors' and all Keywords analyses indicated a rich knowledge structure. Diabetes Care Journal has the most cocitations with 2,220 and a total link strength of 19,283, followed by The New England Journal of Medicine. The study results will be helpful to stakeholders to understand better the trends and performance of diabetes-related regional research, which will be beneficial. [ABSTRACT FROM AUTHOR]

Background Cooked dried beans are commonly consumed in many countries and are known in Egypt as Ful medames. Adding synthetic colors to keep the dishes more attractive may have toxic effects on the human body, as it may be unsafe to consume potentially microbial contaminated foods, especially when obtained from street vendors. Aim The aim of this study was to detect the types of artificial colors added to cooked faba bean (Ful medames) by street vendors in Egypt and highlight their health hazards and microbial hazards. Materials and methods A total of 100 convincing samples were collected from street vendors from four large Egyptian cities. The coloring agents were extracted and purified from samples using the hydrochloric acid extraction method followed by separation using ascending paper chromatography. Total bacterial counts, coliforms, Bacillus cereus, Staphylococcus aureus, and mold and yeast counts were used for microbial tests on 24 samples obtained from Cairo and Giza cities. Findings Artificial colors were detected in 46% of samples. From the total positive samples, sunset yellow, tartrazine, or both combined were identified in 26.1, 30.4, and 41.3%, respectively. Carmoisine was detected combined with tartrazine in only one sample. Giza and Cairo cities recorded the highest positive samples (64.3 and 42.9%, respectively), followed by Mansoura (10%). No added colors were detected in Mahala samples. Coliforms, mold, yeast, and bacillus were detected in most of the samples that were subjected to microbiological examination, whereas S. aureus was not found in any of the examined samples. Conclusion Overall, 46% of the examined samples from street vendors contained artificial colors, mainly tartrazine and sunset yellow, although the authorities of Egyptian standards do not allow any artificial additives to these types of food. Most positive samples were from more urban cities. Microbial contaminants found in the examined samples may be due to unhygienic approaches in such areas and lack of sanitary practices of street vendors. This also predisposes consumers to the risk of severe public health challenges. Recommendations The society should be made aware about the health hazards of the incessant usage of synthetic food colors. The public should be encouraged to add natural food coloring, such as carrots, through home cooking instead. Moreover, strict monitoring of street vendors for food safety regulation should be done by competent authorities. [ABSTRACT FROM AUTHOR]

Background There is an increasing evidence of an association between low vitamin-D levels and depression. Consequently, the present study aimed to investigate the serum levels of vitamin D in cases with major depressive disorder in Sohag Governorate in Upper Egypt. Also, we studied the correlation between serum vitamin-D level and different demographic and clinical variables in these patients. This study included 60 patients who attended our outpatient psychiatric clinic at Sohag University Hospital, who were diagnosed as major depressive disorder (group I) and a similar number (60) of age-matched and sex-matched controls (group II). The diagnosis was based on Diagnostic and statistical manual of mental disorders, 5th ed. criteria and verified by application of Quick Inventory of Depressive Symptomatology. A blood sample was taken from all participants for assessment of the levels of serum vitamin D. Results Patients with major depressive disorder have significantly lower serum vitamin-D levels than controls (mean±SD was 17.2±12.3 for patients and 33.4±24.2 for controls, P=0.001). About 58.33% of patients had deficient vitamin D, while 45% of controls had deficient vitamin D (P=0.022). There is a statistically significant negative correlation between the severity of depression and serum vitamin D. Conclusions Serum vitamin D was significantly lower in major depression patients than controls. In addition, it is evident to have a direct correlation with severity of symptom depression. [ABSTRACT FROM AUTHOR]

Background: During the coronavirus disease 2019 (COVID-19) pandemic, Egypt was among the minor epidemic areas. COVID-19 has wide variations in the clinical presentation manifesting as a heterogeneous disease severity varying from mild, moderate, and severe to critical illness. Objective: This study aimed to identify the potential clinical, radiological, and laboratory characteristics and prognosis of the COVID-19 patients obtained during the first peak of this pandemic at a University Hospital in Egypt, and to provide a reference for the pandemic management in the subsequent peaks. Patients and methods: A single-center prospective study was done on patients with COVID-19 admitted to Fayoum University Hospital during the period from May to July 2020. All patients had full medical history taking, clinical examination, laboratory assessment, oxygen-saturation monitoring, chest computed tomography (CT), and reverse transcriptase-PCR testing. All the patients were treated with the treatment protocol accredited by the Egyptian Ministry of Health and accordingly disease outcome was determined. Results: The study included 162 COVID-19 patients, 80 (49.4%) had mild cases, 40 (24.7%) had moderate cases, and 26 (16.0%) and 16 (9.9%) had severe and critical cases, respectively. The median CT-severity score was 10 (3.75–11.25). Significantly high serum levels of C-reactive protein, D-dimer, lactate dehydrogenase, and ferritin levels were observed in severe cases (P <0.01 for all) in comparison with mild/moderate cases. By comparing died cases with other severe cases, the proportion of cases with CURB 65 score (comorbidity, confusion, urea, respiratory rate, blood pressure, and 65 years of age or older score) more than or equal to 4, PaO2/FiO2 less than 300, hypoxemia less than 85%, higher levels of ferritin, D-dimer, alanine aminotransferase, aspartate aminotransferase, CT severity, and consolidation score were significantly higher in died cases than other severe cases. By regression analysis, among severe cases, predictors of death were the presence of comorbidity and increased consolidation size. Conclusion: All healthcare workers should understand the presentation of the disease, workup, and supportive care experienced from the first outbreak and offer an evidence-based management for succeeding outbreaks in our community. [ABSTRACT FROM AUTHOR]

Background: Intimate partner violence (IPV) is one of the world's most critical public health issues. Aims: The main aim of the study was (1) to examine the association between IPV and female Syrian refugees' mental health. We also wanted: (2) to assess the prevalence of IPV and its subtypes – controlling, emotional, physical, and sexual violence – among female Syrian refugees, (3) to evaluate the association between childhood maltreatment and IPV, and (4) examine IPV and risky behaviors. Settings and Design: This study is a descriptive cross-sectional study. A clinician interviewed (n = 289) female Syrian refugees seeking therapy in Egypt. Materials and Methods: Female Syrian refugees completed the following assessments: WHO Multi-Country Study on Women's Health and Domestic Violence Questionnaire, Beck Depression Inventory-II, Beck Anxiety Inventory (BAI), and Difficulties in Emotion Regulation Scale (DERS)-16. Results: Female Syrian refugees who had experienced IPV scored significantly higher on the BDI-II (U = 1799, P < 0.00), BAI (U = 2511.5, P < 0.00), and DERS (U = 1636, P < 0.00). In addition, 90.3% of them experienced psychological control, 91.3% emotional abuse, 39.4% physical violence, and 27% sexual violence by an intimate partner. Those who had experienced physical IPV were more likely to use substances (χ 2 = 5.8, P < 0.05), engage in binge eating (χ 2 = 17.5, P < 0.001), and have suicidal thoughts or behaviors (χ 2 = 5.1, P < 0.05). Conclusions: Female Syrian refugees with a history of IPV exhibited significantly worse mental health. There is an imperative need for mental health treatment and prevention strategies for female Syrian refugees. [ABSTRACT FROM AUTHOR]

Background: Workers in printing press are frequently exposed to various occupational health hazards, including physical, chemical, mechanical (ergonomic), biological, and psychological hazards while doing their jobs. Chemical and mechanical hazards pose a significant threat to the health and safety of printing press workers (PPWs). A hazardous working condition not only brings numerous health risks to the workers' health but also minimizes the enterprise's productivity. Recognizing these hazards and their consequences is the first step toward creating a safer and healthier work environment for this dedicated workforce. Aim: To assess occupational health hazards (OHHs) as reported by PPW. Design: A descriptive study design was utilized. Sample: A purposive sample of 299 was approached for the current study. Tools: Printing Press Workers Structured Questionnaire. Results: Workers at the printing press were exposed to different types of OHHs, 44.6% of PPWs were exposed to chemical hazards, 46.3% were exposed to mechanical hazards, 58.5% were exposed to accidents in the workplace, and 39.5% had work accidents due to machines. Regarding causes of chemical hazards, 61.5, 55.2, 89.0, and 57.2% of PPWs were always exposed in the workplace to dust, organic solvents, ink, and lead, respectively. As for the causes of mechanical hazards, 61.9% of the study sample always have work that requires carrying heavy objects, 63.9% have a job that always requires a fixed work situation, and 61.9% have work that requires vigorous effort or maximum range of motion. Additionally, 68.9% of the study sample always have work that requires pushing or pulling, and 68.9% always have jobs that require similar repetitive movements. There were highly statistically significant positive correlations between the work stage and chemical and mechanical hazards (P =0.00). Conclusion: PPWs faced various OHHs and health problems due to their work and environment. Over one-third were exposed to mild chemical hazards, almost half were exposed to moderate chemical hazards and less than one-fifth were exposed to high chemical hazards. Regarding mechanical hazards, over one-third of PPWs were exposed to mild mechanical hazards, another one-third were exposed to moderate mechanical hazards, and almost one-third were exposed to high mechanical hazards. Recommendations: Conduct training programs on safety and health measures to increase knowledge and awareness of printing workers to minimize OHHs. Also, ensure effective usage of personal protective equipment (PPE). [ABSTRACT FROM AUTHOR]

Background: Climate change poses a significant risk to the population's health. Nurses are the best group to take action against the health hazards caused by climate change. However, their knowledge and practice of this phenomenon is unknown. Aim: To assess the knowledge and practice of nurses toward climate change at Bahariya Oasis, Egypt. Design: A descriptive exploratory design was utilized to fulfill the aim of this study. Setting: The study was conducted at Bahariya Oasis, Giza Governorate, Egypt. Sample: All 213 nurses working at all available settings affiliated with the health sector were included in this study. Tools for data collection: I. Nurses' climate change knowledge questionnaire, and II. Nurses' self-reported practice checklist. Results: The current study results showed that 67.1% and 65.7% of nurses had correct incomplete knowledge regarding the definition and causes of climate change, respectively. 90.6% and 88.7% of nurses had incorrect knowledge about the effects of household items and high temperatures, respectively. 86.4% of nurses did not conduct awareness programs and instructions on preserving the environment. 68.5% of nurses used public transportation to get to work. Conclusion: Three-quarters of nurses had partially satisfactory knowledge, and the majority of them had poor practice regarding climate change. Recommendations: The current study recommended that nurses should receive continuous updating knowledge and training toward climate change. Further researches are recommended to find out knowledge and practice among nurses on a large scale for generalization. [ABSTRACT FROM AUTHOR]

Natural radioactive substances may be present in the environmental substances that have uses in pharmacy and medicine as health supplements. This paper presents natural radioactivity levels in some of the medicinal plants available in Egypt. Natural radionuclides such as 226Ra, 228Ra, and 40K were measured in medicinal plants samples collected from the local market in Qena, Upper Egypt. All measurements were performed with a gamma spectrometry with high-purity germanium detector. The radioactivity concentration ranged from 0.4 ± 0.2 to 21.0 ± 1.2 Bq/kg for 226Ra, from <0.3 to 42.3 ± 5.9 Bq/kg for 228Ra, and from 140 ± 6 Bq/kg to 1538 ± 54 Bq/kg for 40K. The total annual committed effective doses ranged from 0.003 to 0.073 mSvy−1 with an average value of 0.02 mSva−1. [ABSTRACT FROM AUTHOR]

Abstract: Sludge dewatering and treatment may cost as much as the wastewater treatment. Usually large proportion of the pollutants in wastewater is organic. They are attacked by saprophytic microorganisms, i.e. organisms that feed upon dead organic matter. Activity of organisms causes decomposition of organic matter and destroys them, where the bacteria convert the organic matter or other constituents in the wastewater to new cells, water, gases and other products. Demolition activities, including renovation/remodeling works and complete or selective removal/demolishing of existing structures either by man-made processes or by natural disasters, create an extensive amount of wastes. These demolition wastes are characterized as heterogeneous mixtures of building materials that are usually contaminated with chemicals and dirt. In developing countries, it is estimated that demolition wastes comprise 20% to 30% of the total annual solid wastes. In Egypt, the daily quantity of construction and demolition (C&D) waste has been estimated as 10 000 tones. That is equivalent to one third of the total daily municipal solid wastes generated per day in Egypt. The zabbaliin have since expanded their activities and now take the waste they collect back to their garbage villages where it is sorted into recyclable components: paper, plastics, rags, glass, metal and food. The food waste is fed to pigs and the other items are sold to recycling centers. This paper summarizes the wastewater and solid wastes management in Egypt now and future. [Copyright &y& Elsevier]

Background: In Egypt as elsewhere, patients with schizophrenia and their families confront unique obstacles. This study examined the views of important stakeholders' on the feasibility, approval, and obstacles of family intervention programs for schizophrenia in Egypt to address these issues. Objective: The aim of the study was to investigate the perspectives of stakeholders regarding the feasibility, acceptability, and obstacles associated with providing family intervention for schizophrenia in Egypt. Methods: The research took place at El-Maamoura Hospital in Alexandria and included a total of 37 participants. These participants were divided into seven focus groups, with 25 individuals being health professionals and the remaining 12 individuals being caregivers. Concurrently, data collection and analysis were carried out using the qualitative research method, employing the framework analysis to process the transcripts. Results: The participants highlighted the importance of families feeling accepted and well-informed regarding the nature of the illness. In conclusion, the participants suggested making changes to the intervention's content by incorporating details about the illness, providing emotional support, and including culturally appropriate coping mechanisms. Conclusion: In conclusion, it is determined by the study that before implementing family intervention for schizophrenia, it is crucial to make cultural adjustments to ensure its acceptability. The findings of the study offer valuable insights for the development and execution of family intervention programs for schizophrenia in Egypt. Implication for Clinical Practice: It is crucial to culturally adapt a modified family interventions to cater to the cultural requirements of families and healthcare professionals in Egypt, as this could potentially result in improved outcomes for patients diagnosed with schizophrenia and their families. [ABSTRACT FROM AUTHOR]

Background: Atraumatic care plays a significant role in reducing the noxious effect of hospitalization on children and their families. Providing atraumatic care should be a basic premise in pediatric nursing care. Aim: To evaluate the effect of an educational bundle on pediatric oncology nurses' knowledge and attitudes about the implementation of atraumatic care. Method: A quasi-experimental research design was used. The study was carried out at the Pediatric Oncology Department at Oncology Center Mansoura University. A convenient sample of 27 nurses was elected. A Structured Interview Questionnaire Sheet consisting of four parts was used for data collection. Results: Preintervention, 26.0% of the nurses had good total knowledge while postintervention and at follow-up this percentage increased to 77.8 and 70.3%, respectively. Moreover, 44.4% of the studied nurses had an overall supportive attitude preintervention but the percentage improved to 81.5% postintervention and 77.8% at follow-up. Conclusion: The educational bundle positively affected pediatric oncology nurses' knowledge and attitude postimplementation with good retention of knowledge and sustained holding supportive attitudes three months later. Recommendations: Scheduled regular update sessions and refreshment courses are strongly recommended to maintain and further improve the knowledge and attitudes of nurses over a longer period. [ABSTRACT FROM AUTHOR]

Background: Clinical education is an essential part of nursing education. It aims to prepare students to be able to provide safe and quality nursing care. However, despite its significance, it carries many difficulties for responsible nurse educators due to its unique nature. Aim: To determine the difficulties of clinical nursing education from nurse educators' perspectives. Design: A descriptive design was used. Setting: The current study was conducted at the Faculty of Nursing, Cairo University. Sample: A purposive sample consisting of 180 nurse educators who met the inclusion criteria were included in the study. Tools: (a) Nurse educator's characteristics sheet and (b) difficulties in clinical nursing education from perspectives of nurse educator's questionnaire. Results: The study results revealed that the difficulties from the perspectives of nurse educators included students/educator ratio (48.9%), availability of conference rooms (57.2%), availability of sufficient numbers of clinical settings (51.1%), availability of changing rooms for faculty staff members (48.9%), availability of needed supplies and equipment for training (45.0%), and overcrowding as a result of presence of students from other programs that result in lack of learning opportunities (46.7%). Conclusion: There are many difficulties in clinical nursing education from the perspective of nurse educators. On top of these difficulties were the increasing number of students and the lack of educational facilities in clinical settings. Recommendation: Faculty administration should plan carefully in relation to student/educator ratio as well as provide adequate facilities and resources to achieve educational objectives. [ABSTRACT FROM AUTHOR]

BACKGROUND: A headache is a very common condition that can have a significant impact on one's quality of life. It is one of the leading causes of years lived with disability worldwide.The objective of the study was to determine the prevalence of primary headache disability, its characteristics, risk factors and its impact on daily life. MATERIALS AND METHODS: A cross-sectional study was conducted in Fayoum governorate. The sample size was 1909 participants. A multistage random sample technique was used to select adults aged above 18 years. A self-structured questionnaire solicited information on sociodemographic characteristics, headache characteristics, and the headache disability index. SPSS v 22.0 was used for data analysis. RESULTS: Headaches caused complete disability in 19.5% of the study group, and 76.8% developed severe disability. Participants who reported that they had a headache more than once a week were; 44.5% had moderate pain and 40.2% had more intense pain. About 55% complained of attacks rather than continuous headache and were more likely to have a degree of complete disability, (P = 0.001). A statistically significant association was found between living in urban areas, working in professional occupations, complaining of severe headache in the form of an attack and seeking medical advice, with high scores of headache disability. CONCLUSION: Headache is a condition that affects the entire population in a way that causes high levels of disability. Good management is necessary for the reduction of the adverse effects of headaches on the health of the population. This should focus on raising public awareness by means of education and on the provision of basic healthcare. [ABSTRACT FROM AUTHOR]

Background Nurses play a critical and vital role in the delivery of patient care, they exposed to workplace hazards and violence, work overload, pain, exhaustionand fatigue which affect their health and social life. Aim Of the present study was aimed to assess nurses fatigue level causes and consequences. Research design A descriptive design was used to carry out this study. Setting The study was conducted in multispecialty private hospital in Cairo which is supervised by Ministry of Health; bed capacity approximately (n = 200 beds). Sample Convenient sample of all available nursing staff (n = 300) who are working during the period of data collection.Data collection tools: The current study data was collected using self-administered questionnaire titled Fatigue Severity Scale (FSS). Results The study subjects had high mean scores to all domains and total of fatigue consequences. Clarifying that the highest mean score (77.0 % and 76.6%) was regarding to fatigue and physical activities and Fatigue and lack of energy. Around half (47.3%) of nurses had moderate fatigue level. Also, (32.4%) of them had severe fatigue level. While, the least percentage (20.3%) of nurses had mild fatigue level. There was a highly statistical significant positive relation exists between the study subjects' perception of total fatigue level and their years of experiences, gender, current job position and current working unit (X2 = 15.99, P-Value = 0.00, X2 = 7.99, P-Value = 0.03 X2 = 5.94, P-Value = .015* and X2 = 10.38, P-Value = 0.04*) respectively. While, there is no statistically significant relation between the total fatigue level and their age and qualifications(X2 = 1.33, P-Value = 0.085, and X2 = 1.2 P-Value = 0.12) respectively. Conclusion Nurses had high mean scores to all domains and total of fatigue consequences. The highest mean score was regarding to fatigue and physical activities and, fatigue and lack of energy domains. Around half of nurses had a moderate level of fatigue, almost one third of them had a severe level of fatigue, while, the least percentage of them had mild level of fatigue. There was a highly statistically significant positive relation exists between nurses' perception of total fatigue level and their years of experiences, gender, current job position and current working unit. While, there is no statistically significant relation between the total fatigue level and their age and qualifications. Recommendations Unit managers should consider staff needs for monthly work scheduling and give the suitable break time during long hour shift and detect negative signs and symptoms of fatigue and how to support and manage nurses. Hospital administrators must encourage nurses to follow a healthy lifestyle, which includes a balanced diet, regular exercise, enough sleep, and stress management techniques and develop appropriate educational programs and preventive strategies for nurses to be able to control fatigue causes and consequences. [ABSTRACT FROM AUTHOR]

Background High-level noise exposure in the workplace is one of the most common hazards worldwide. Noise-induced hearing loss (NIHL) is one of the most common occupational disorders. However, little is known about printing press workers’ present level of knowledge and practices about NIHL. Aim To assess knowledge and practices of printing press workers toward NIHL in Giza Governorate. Design A descriptive design was used to fulfill the aim of this study. Setting The study was conducted at the book sector in Faisal, Giza Governorate, Egypt. Sample A purposive sample of 100 printing press workers was included in the study, who fulfilled the following inclusion criteria: technicians who were exposed to printing press machines, work experience of more than 6 months at the printing press, and exposure to noise for at least 8 h per day. Tools for data collection (a) Noise-Induced Hearing Loss Questionnaire for printing press workers and (b) reported practices checklist. Results The current study result showed that a statistically significant positive correlation was found between total knowledge and total practice scores, and a statistically significant positive correlation was found between the practices of printing press workers and their educational level. A highly statistically significant positive correlation was found between monthly income and workers’ practice. Conclusion More than three-quarters of printing press workers had an unsatisfactory level of knowledge, and the majority of them had an unsatisfactory level of practice. Recommendations The current study recommended that printing workers receive continuous training on safety guidelines and enforce standard safety practices to decrease the hazards of noise in the workplace. Further researches are recommended to find out knowledge and practice among printing press workers on a large scale for generalization. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to assess the public's perspectives and the health institutions' readiness for telehealth utilization in Egypt. Methods: A cross-sectional study design was employed, and data were collected from a convenient sample of 800 Egyptian citizens and 26 nursing administrators and information technology personnel from 16 governmental hospitals and 10 private hospitals between January and March 2022. The Egyptian community utilization of telehealth questionnaire and the telemedicine hospital readiness assessment were used to collect the data. Results: The results revealed that 35.1% of the general Egyptian population used telehealth services and 43% expressed willingness to use them in future. As perceived by the general Egyptian population, the most prevalent barriers to telehealth utilization were communication barriers (97.6%), lack of confidence in health professionals (77.6%), technological limitations (72.5%), the need for physical examination (25%), and privacy concerns (10%). Regarding hospital readiness, 42% of governmental hospitals were not taking any initiative to implement telehealth services, and 15.4% were at the beginner level, meaning that some steps had been taken. However, the hospital was still far from being able to implement telehealth services. In contrast, private hospitals were either at the beginner or advanced level. Conclusion: Although the use of telehealth services in Egypt has increased, there is a need to address the barriers to public utilization and improve hospitals' readiness to implement telehealth services to enhance public usage. [ABSTRACT FROM AUTHOR]

Background: Tuberculosis (TB) control depends on healthcare professionals 'knowledge, practice, and self-efficacy when managing high-risk groups. So the study aimed to evaluate the effectiveness of a structured educational program in improving nurses' knowledge, practice, and self-efficacy in caring for patients with TB. Material and Methods: A pre-test post-test quasi-experimental design was conducted on 36 nurses at Chest hospital Al Masah al Bahri in port said city and the Chest Hospital in Damietta City, Egypt. Data were collected using three self-administered questionnaires to assess knowledge, practice, and self-efficacy by using convenience sampling from March to August 2019. Data analyses were done by using a paired t-test, a Student t-test, and an F-test analysis of variance. Results: Based on data related to the two groups before and after the study in knowledge, practice (t = 8.27, p < 0.001), and self-efficacy (t = 28.91, p < 0.001), there was a significant difference between knowledge and overall knowledge scores (t=14, p < 0.001). Mean scores were significantly increased for practice items about the nursing role in medication, directed observed therapy, and the overall practice score; and for self-efficacy, which increased from 27.58 to 37.86 (p = <0.001). The results indicate that nurses' knowledge, practice, and self-efficacy were enhanced by the implementation of the educational program. Conclusions: There is scope for development in knowledge, practice, and self-efficacy using the educational program among nurses. Training programs must be implemented in quality control to aid nurses in realizing the significance of information in reducing disease and death and enhancing the quality of care. [ABSTRACT FROM AUTHOR]

Background Female'self-objectification (SO) is a cognitive process and could affect one's way of behaving and thinking positively or negatively. Rational emotive therapy (RET) brings to the spotlight and deals with those irrational beliefs or self-defeating thoughts as acquired by the SO. Aim It was aimed to examine the effectiveness of Rational emotive behavior therapy (REBT) on SO among Psychotic females. Design It utilized the quasi-experimental design. Setting It was conducted at inpatient of female's psychiatric unite of Psychiatry, Neurology and Neurosurgery hospital at Assiut University Hospital. Patients It involved 70 psychotic females, 35 participants were assigned to the experimental group and 35 participants to the control group. Tools The study's measures consisted of four scales involving: (1) Demographic and clinical data sheet, (2) SO Questionnaire, (3) Body shame (BSH) scale and (4) Body-esteem (BES) scale. Results There were statistically significant differences between experimental group and control group in relation to the two subscales of SO scale. Furthermore, the mean value of the body shame score of experimental group was statistically significant decreased after intervention in inverse to the control group. Besides, there were no statistically significant differences between the three subscales of BES for both groups. Conclusion Based on the results, the REBT approach to somewhat successfully reduces SO and BSH among psychotic females. Recommendations As an alternative to traditional psychoeducation and psychotherapies, REBT is used to help patients who struggle SO, BSH and low BES. [ABSTRACT FROM AUTHOR]

Background Hepatitis C virus (HCV) infection is the most challenging public health problem in Egypt where the prevalence is the highest in the world. Intrafamilial transmission of hepatitis C occurring between patients infected with HCV and their household members sharing the same house and living conditions. Preventive measures of hepatitis C are considered the first line of defense against HCV infection. Aim assess the intrafamilial transmission risk factors and preventive measures followed by household contacts of hepatitis C patients. Design A descriptive cross sectional research design was utilized. Setting The study was conducted at outpatient clinics of Liver Institute at Kafer-Elsheikh Governorate. Sample A simple random sample of 365 household contacts of hepatitis C patients was recruited for the current study. Tool Data was collected through one tool: A structured Interviewing Questionnaire for household contacts of hepatitis C patients which included three parts; part I-(a) Demographic data, (b) Medical history of household contacts, Part II (a) Household contacts knowledge about HCV (b) Hepatitis C risk factors, Part III: Preventive measures followed by household contact of hepatitis C patient: This part is self-reported practices. Results The study revealed that;56.7% of household contacts were males, 72.1% of them were living in rural areas, 75.60% were married, with a mean age ±SD 36.73±9.18 years old.44.1% obtained secondary education, 30.7% were employees, among this group hypertension and diabetes were the main chronic illness. 49.90% had moderate level of general knowledge about HCV infection, 71.50% had low level of knowledge about hepatitis C risk factors and 90.00% had a low level of preventive measures (self-reported practices) regarding HCV. There was no correlation between household contacts knowledge about HCV risk factors and their preventive measures(r=0.031 and P=0.549). Conclusion Almost half of household contacts mentioned that they knew intrafamilial risk factors while about half of this group have a misconception about intrafamilial risk factors, while majority of them stated that they knew sharing scissors and clippers as the main intrafamilial risk factors and less than one-fourth of them knew direct contact with infected blood and sharing of special equitoothbrushesth brushes. Household contacts applied some preventive measures such as; Cover the wound with a piece of cloth or gauze, disinfect the site with alcohol or antiseptic solution and frequent and proper hand washing. Recommendations Routine health assessment of household contacts knowledge regarding intrafamilial risk factors and preventive measures therefore health education sessions should be conducted to raise their awareness regarding HCV infection and further research should be conducted on larger samples of contacts. [ABSTRACT FROM AUTHOR]

Background Narrow-band ultraviolet B (NB-UVB) is a crucial and effective line of treatment for nonsegmental vitiligo. Objective To compare the effect of adding platelet-rich plasma (PRP) injections versus microneedling sessions on the response to NB-UVB in patients who stopped giving response or did not give response from the start. Patients and methods An intrapatient randomized comparative study including 30 patients with stable, nonsegmental vitiligo was performed. Three lesions were assessed in each participant and randomly allocated to undergo PRP injections or microneedling every 2 weeks for four sessions. The third lesion was left as a control. Throughout the study, all lesions were subjected to NB-UVB three times a week. Photographic assessment by an independent dermatologist and a patient satisfaction questionnaire were used to assess repigmentation. Results PRP injection showed better results than microneedling in terms of repigmentation, complications, and patient satisfaction. The mean percentages of repigmentation in PRP, microneedling-treated, and control lesions were 58.17±21.52, 24.5±18.77, and 15.17±13.49, respectively (P<0.001). The onset of repigmentation was earlier in the PRP-injected lesions compared with microneedling (3.97±1.607 and 7.8 ±2.683 weeks, respectively; P<0.001). Follicular repigmentation was the predominant pattern in PRP sites (50%). Conclusion PRP therapy is a secure and effective procedure that helps patients with vitiligo and speeds up their reaction to NB-UVB as well as supports and encourages their recall response. [ABSTRACT FROM AUTHOR]

Background Following coronary artery bypass graft (CABG), the main causes of postoperative morbidity and mortality are postoperative pulmonary complications, respiratory dysfunction, and arterial hypoxemia. Aim To evaluate the effect of postoperative incentive spirometry (IS) on dyspnea severity among patients undergoing CABG. Research hypothesis H1: there is a statistically significant improvement in dyspnea severity among patients undergoing CABG after using IS when compared with before use. Design A quasi-experimental (one group pretest-posttest) design was used in the current study. Setting This study was conducted at selected cardiothoracic care units and cardiothoracic ward affiliated to Cairo University Hospitals. Sample A convenient sample of 49 adult patients undergoing CABG was included. Tools Three tools were used to collect data: first, demographic characteristics and health relevant data; second, chest auscultation; and third, dyspnea severity score. Results There were statistically significant improvements found in the dyspnea severity score on first day, second day, and third day after using IS compared with before using spirometry among the patients. Moreover, there was significant improvement in chest auscultation before and after using spirometry. Half of the patients (53.1%) revealed regaining of normal breath sounds on the third day after using IS versus before using spirometry, where only 28.6% had normal breath sounds on the third day. Conclusion It can be concluded that postoperative IS decreased dyspnea severity and improved respiratory function among patients undergoing CABG. Recommendation Future trials may be carried out with adequate research grants with postoperative IS after major surgery and other respiratory diseases to improve dyspnea severity without medication. [ABSTRACT FROM AUTHOR]

Background Urinary tract infections (UTIs) are the most common bacterial infection during pregnancy. UTIs in pregnancy are associated with maternal as well as fetal morbidity. The aim of the current study was to assess the health profile of pregnant women with asymptomatic bacteriuria (ASB). Design A descriptive research design was adopted to obtain the stated aim. Sample A purposive sample of pregnant women with UTIs without symptoms throughout 1 year but the sample not less than 100 pregnant women was recruited. Setting The study was performed at woman's care clinic at Al Kasr Al Ainy University Hospital. Tools Two tools were utilized: (a) urine analysis record and (b) structured interviewing questionnaire schedule. Results The study findings showed that the mean age of the pregnant women with ASB was 29.00±5.48 years old. Overall, 26% of them could not read and write, and 96% of them were housewives. Regarding place of residence, 82% of the selected sample was from rural areas. Half of the selected sample was multigravida, whereas 55% of them were multipara. Overall, 61% of them had a history of abortion. Furthermore, 86% of the selected sample used new latrine toilet, and 61% had a previous history regarding infection. In addition, 63% of the selected sample used contraceptive methods, and 58% of them had previous normal vaginal delivery. Concerning trimester, 73% were in the third trimester. Conclusion The current study's findings revealed that age, cannot read and write, rural areas, housewives, usage of new latrine toilet, multigravida, multipara, history of abortion, normal vaginal delivery, usage of contraceptive methods, history of previous infection, and third trimester were represented the health profile of the pregnant women with ASB that might increase the incidence of a symptomatic bacteriuria infection. Recommendation Pregnant women should be made aware regarding personal hygiene through classes on motherhood. [ABSTRACT FROM AUTHOR]

Background Stroke care bundles are evidence-based practices in the management of acute ischemic stroke that are rapidly changing. Early detection of stroke symptoms and prompt treatments can result in a positive outcome. Specialized care in the emergency room during the acute phase and the first week in a neurological ICU or stroke unit for follow-up can enhance the overall prognosis. Aim To evaluate the effect of implementing an initial stroke care bundle on clinical outcomes among patients with acute ischemic stroke. Patients and methods A quasi-experimental research design was used. A convenient sample of 60 critically ill adult patients who were admitted to the emergency care unit and neurology ICU was included. The patients were tested using an initial stroke care bundle during 7 days of admission to the neurological ICU and then followed up another week in the medical ward and 2 weeks in the outpatient clinic. The data were collected using three tools developed by the researchers. Results There were highly statistically significant differences between the control and study groups regarding improving vital signs, neurological status, and hydration status on admission, third and seventh days after admission, and during 3-week follow-up. Moreover, patients with acute stroke who received the initial stroke care bundle had a statistically significant reduction in mortality rate, higher independence, and normal prefeeding assessment compared with those who received routine care on admission, 3 and 7 days after admission, and during 3-week follow-up. Conclusion Implementing an initial stroke care bundle can improve the prognosis of patients with acute ischemic stroke and decrease the number of deaths. Recommendation Recent stroke care bundle should be integrated into the management of patients with acute stroke to improve the patients' outcomes. [ABSTRACT FROM AUTHOR]

Background Inflammatory markers like interleukin-6 (IL-6) are linked to the worse outcome in coronavirus disease 2019 (COVID-19) cases. Other markers such as C-reactive protein are not as reliable as IL-6 in predicting respiratory failure. Aim To assess the function of IL-6 as a predictor of COVID-19 severity. Patients and methods A total of 50 severe and critical patients with PCR-confirmed COVID-19 were included. All enrolled patients followed the case definition for confirmed cases of Egyptian national protocol for COVID-19 issued by MOHP. Clinical assessment, imaging, and laboratory data were recorded at admission. Pulmonary function was evaluated by SpO2/FiO2 ratio. Outcomes included hospital stay, prognosis of the disease, complications, death rate, and discharge, which were recorded during the follow-up. Results The elevated IL-6 group showed a significantly higher critical rate (87.1%) than the normal IL-6 group (26.3%) (P<0.0001), and the improvement rate was higher in the normal IL-6 group (73.7%). Moreover, the death rate was significantly greater in the elevated IL-6 group (38.7%) than the normal IL-6 group (10.5%) (P=0.033). The cutoff value of IL-6 levels in prediction of severity and mortality of COVID-19 was assessed. Our receiver operating characteristic results revealed that IL-6 cutoff value is higher than 50.27 for severity and the cutoff value is greater than 120.83 for mortality. The sensitivity values of IL-6 for severity and mortality were 93.3 and 90.5%, respectively, and the specificity values were 90.0 and 86.7%, respectively. Conclusion Elevated levels of serum IL-6 in COVID-19-infected patients were related with a variety of adverse outcomes, including severe illness, mechanical ventilation, and acute respiratory distress syndrome. When it came to accurately predicting the severity and mortality of COVID-19, the optimum IL-6 cutoff levels were 50.27 and 120.83 pg/ml, respectively. [ABSTRACT FROM AUTHOR]

Context Existing literature is poor with epidemiological studies handling Egyptian paediatric patients diagnosed with inflammatory bowel disease (IBD). Herein, we describe the epidemiological and clinical features of paediatric IBD cases (PIBD) attending Mansoura University Children Hospital (MUCH). Aim To evaluate epidemiological and clinical data of (PIBD) in Egyptian children. Settings and design This retrospective study included the data of Thirty-nine paediatric patients (age<18 years) admitted to the gastroenterology ward of MUCH and divided into two groups; ulcerative colitis group (UC 32 cases) and Crohn disease group (CD 7 cases). Methods and material Data were retrospectively reviewed, including history, examination, biochemical, endoscopic, and pathological findings. Statistical analysis used: SPSS software (version 26 for macOS) to tabulate and analyse the collected data Results UC group had a mean age of 10.73 years compared to 13.2 years in the CD group (P=0.01). The prevalence of anoperineal disease significantly increased with CD. The age of symptom onset and diagnosis confirmation were insignificant between the same groups. Laboratory parameters were also comparable. Pancolitis and ileocolitis were the most common involvement patterns in the UC and CD groups, respectively. Pathologically, UC was distinguished by crypt abscess, while CD was distinguished by granulomas. Conclusions PIBD was related to the male sex, with early diagnosis and a low prevalence of the early-onset disease. Although it is crucial to exclude common infections causing similar manifestations, the paediatrician should consider the possibility of IBD. [ABSTRACT FROM AUTHOR]

Background DNA-methyltransferase 3 A (DNMT3A) plays an important role in DNA methylation. Its mutation is the commonest mutated epigenetic regulator in acute myeloid leukemia (AML). However, the relation between DNMT3 polymorphism and AML risk in Egyptian patients is still unknown. Objectives To detect the frequency of DNMT3A-448A>G (rs 1550117) single nucleotide polymorphism in a cohort of adult Egyptian patients with AML and normal controls matched by age, sex, and ethnicity and to assess its effect on the susceptibility of AML. Patients and methods PCR-restriction fragment length polymorphism was the genotyping method used to assess DNMT3A polymorphism in the present case–control study. Results The frequency of the wild (GG), mutant heterozygous (AG), and mutant homozygous (AA) genotypes among patients and controls were 47.90 versus 47.70%, 46.50 versus49.20%, and 5.60 versus 3.10%, respectively (P=0.763, 0.505, and 0.462, respectively), whereas the frequency of A allele was 28.87 versus 27.69% P=0.829. The patients with DNMT3A mutant types (AG, AA, and carrier of the variant Allele of the DNMT3A) were not associated with the risk of AML (odds ratio: 0.548, 0.516, and 0.934; 95% confidence interval: 0.094–3.206, 0.088–3.014, and 0.556-1.60, respectively). Conclusion DNMT3A-448A>G (rs 1550117) polymorphism conferred no risk to AML in our studied Egyptian patients. [ABSTRACT FROM AUTHOR]

Background Blended learning forms the natural evolution of learning in the contemporary time to cope with current challenges to meet the educational needs of students. Objectives To determine the factors that affect students' use of blended learning during coronavirus disease 2019 at Assiut University. Study design Descriptive cross-sectional. Settings Ten colleges that were selected by simple random sampling from each sector (medical and nonmedical). Participants One thousand six hundred forty university students. Patients and methods One tool divided into two parts: part I: student personal data; part II: scale to examine the factors influencing blended learning use. Results Lecturer's factor had the high moderate mean±SD 3.11±0.95, followed by technical support 3.00±0.99, while usability and information quality with low medium mean ±SD (2.87±0.99 and 2.87±0.96, respectively). Also, there was statistically significance differences between factors influencing blended learning use and college type, age of students, and class with P value of 0.000. Conclusion Factors of lecturers, technical support, and information quality had valuable effect on the university students' use of blended learning. Recommendation The university staff should encourage their students to use blended learning as a preferable approach for enhancing their interaction and communication skills. [ABSTRACT FROM AUTHOR]

Background Breast cancer is the most frequent cancer among women all over the world. Breast cancer risk increases with age and about a third of female breast cancers are diagnosed in patients aged older than 70 years. Elderly breast cancer patients are affected by poorer quality of life (QoL) compared with younger patients. Aim The current study aimed to assess QoL of elderly women with breast cancer who received chemotherapy at Cancer Institute, Sohag Governorate. Research questions What is the QoL of breast cancer elderly women who received chemotherapy at Sohag Cancer Institute? Design Cross-sectional descriptive design was utilized. Sample Purposive sample of 100 elderly women with breast cancer, who completed all cycles of chemotherapy 1-3 months at least from the last dose of chemotherapy. Setting This study was conducted at the oncology building at outpatient clinics for cancer patients follow-up at Sohag Cancer Institute. Tools (1) Structured interviewing questionnaire for demographic and medical data. (2) QoL scale to assess QoL issues relevant to breast cancer patients (Algamdi and Hanneman, 2016). Results The results revealed that selected breast cancer elderly women aged from 60 to 80 years with mean 63.47±4.87 years. Seventy-two percent of them could not read and write, and 62% of them lived in rural areas. Seventy-eight percent suffered from chronic diseases. The mean of social well-being domain was 2.98±0.56, the mean of emotional well-being domain was 2.32±1.34, the mean of physical well-being domain was 1.79±1.15, and the mean of total Functional Assessment of Cancer Therapy - Breast was 2.24±0.31. More than half of the women had poor QoL, more than one-third of them had fair QoL, and a minority had good QoL. Conclusion The current study concluded that 60% of the selected breast cancer elderly women had poor QoL, whereas 38% had fair QoL and only 2% had good QoL. Also, it revealed that more than half of women had poor physical, functional well-being, and additional concerns and about half of them had good social well-being. Recommendations The current study recommends use of QoL scale in elderly women with breast cancer in oncology outpatient clinics in different cancer institutes and conduction of health education programs and further research works for improving QoL in elderly women with breast cancer. [ABSTRACT FROM AUTHOR]

Background Discharge of preterm infants from neonatal intensive care unit (NICU) is a stressful experience for mothers as they will have to resume the full responsibility of their care for the first time, and without discharge preparation, it is even more stressful for them. Even though western research studies have showed positive effects of family-centered care (FCC) and parent/mother partnership programs for preterm mothers on maternal confidence in care provision and reflected on preterm health status, there is still a need to study its effectiveness in Arab countries. Aim To evaluate the effect of maternal partnership discharge program on mothers' knowledge and selected health outcomes of their preterm infants. [ABSTRACT FROM AUTHOR]

One of the most commonly used and effective lines of treatment in chronic skin diseases is phototherapy. A protocol of the Kasr Al-Ainy Phototherapy Unit has been proposed for the treatment of different dermatological diseases such as psoriasis, mycosis fungoides, and vitiligo based on the best current research-based guidelines and the experience of the phototherapy team. This protocol is the cornerstone of the everyday practice in Kasr Al-Ainy Phototherapy Unit and we believe dermatologists dealing with such diseases in their hospitals or clinics, can find it helpful and applicable to get better results with their patients. In part 1, the general measures of the protocol will be discussed. [ABSTRACT FROM AUTHOR]

Background: Vitiligo is a common depigmenting skin disorder characterized by white macules and patches accompanied by local melanocyte loss, caused by autoimmune destruction. Vitiligo is classified into two major forms: segmental vitiligo (SV) and non-segmental vitiligo (NSV). It was also found that the IFN-ȣ/CXCL10 axis is functionally required for both progression and maintenance of the disease. Chemokine 10 (CXCL10) is a pro-inflammatory chemokine which was found to be elevated in the serum of vitiligo patients. UVB has been found to be a useful therapy that results in rapid repigmentation in NSV patients. Objectives: To evaluate CXCL10 in vitiligo patients before and after narrow band UVB (NB-UVB) phototherapy, which if targeted could provide new insights for therapeutic intervention for vitiligo. Patients and Methods: The study included 25 active NSV patients who were able to comply with the study protocol in the Center of Excellence, Dermatology Outpatient Clinic, National Research Center, Egypt (February 2020–2021). All recruited patients were subjected to documentation of complete history. Dermatological assessment of vitiligo lesions, including vitiligo area score index (VASI) score, CXCL10 and extent of the disease were performed. A 3 mm punch biopsy from active vitiligo lesion (site of biopsy) was taken before and after treatment by NB-UVB, and then immunohistochemical staining was performed to evaluate expression of CXCL10. Results: After treatment by NB-UVB there was a significant decrease in VASI score, extent of the disease and CXCL10 expression. Conclusion: The decrease in CXCL10 levels could be attributed to the effect of NB-UVB which leads to decrease in IFN-γ level, necessary to release CXCL10 through its pathway resulting in repigmentation and decrease in the extent of the disease and VASI scores. [ABSTRACT FROM AUTHOR]

Background Nail changes including onychomycosis are clues to many systemic diseases. The prevalence of this disease is variable worldwide and in different patient groups. Objective To study the prevalence of onychomycosis among chronic liver disease (CLD) patients, the association of risk factors in that patient category with onychomycosis, the causative fungal species, and antifungal susceptibility of the most common species isolated. Patients and methods Six hundred and eighty patients with CLD were screened for nail abnormalities clinically suggestive of onychomycosis. Demographic data and risk factors associated with CLD were investigated. Samples were mycologically identified, and antifungal susceptibility was tested for the most common isolated species. Results Prevalence of onychomycosis among CLD patients was 9.4%. Advancing age, low platelet count, positive Hepatitis C virus (HCV) or Hepatitis B virus (HBV), and high alanine aminotransferase (ALT) level showed significant association with onychomycosis in CLD patients. Dermatophytes were the most common cause (57.7%) of onychomycosis in CLD patients. Terbinafine was the most potent antifungal, as 80% of dermatophytes were susceptible to it. Conclusion Patients with CLD are at risk of developing onychomycosis especially with the following risk factors: advancing age, decreased platelet count, testing positive for HCV or HBV, and high ALT. For onychomycosis in patients with CLD, dermatophytes were the most common cause, and terbinafine was the drug of choice in treatment. [ABSTRACT FROM AUTHOR]

BACKGROUND: Much research has found that smoking is one of the major risk factors for a variety of physical diseases and mental disorders; however, few studies have been conducted on smoking in Egypt. Furthermore, to the researcher's best knowledge, no study in Egypt has compiled data on smoking prevalence, motives, and levels of nicotine dependency. In order to fill in this gap, the current study has attempted to summarize the situation and construct an accurate picture of smoking in Egypt. MATERIALS AND METHODS: This cross-sectional study included 2000 Egyptian adults in Fayoum through a multistage cluster sampling technique. For data collection, the Socioeconomic Status Scale was deployed. In addition, Depression, Anxiety, Stress Scale (DASS), the Modified Reasons for Smoking Scale (MRSS), and Fagerstrom Test for Nicotine Dependence (FTND) were used. Data analysis performed using SPSS version 22.0. For qualitative data, Chi-square test was used to determine statistical significance. Bivariate Pearson correlation was used to test for the association between quantitative variables. RESULTS: Of the total sample of 2000 adults, 40.4% had anxiety and 24.3% had stress, and 19.5% showed severe to extremely severe level of depression. For MRSS, tension reduction or relaxation was found in 46.5% adults while 9.8% had high level of nicotine dependence. There was a statistically significant association between psychometric disorders, on one hand, and both smoking motivation and nicotine dependence, on the other (P < 0.001). The DASS score had a statistically significant correlation with age, smoking duration, nicotine dependence level, and MRSS subscales. CONCLUSION: Smoking is linked to psychological symptoms and shows a moderate to high level of nicotine dependence, with a higher level of dependency, smoking pleasure, stress reduction/relaxation, and hand-mouth movement as motives for smoking. Furthermore, there was a correlation between nicotine dependence, on one hand, and depression and stress on the other. [ABSTRACT FROM AUTHOR]

Background In spite of the achievements concerning patient rights and ethical problems in healthcare in Egypt, several problems still persist, including the unethical behavior of some healthcare workers, and patient understanding of the concepts of the patient rights. Aim To assess nurses' versus patient's awareness about patient's rights and nurses' compliance to these rights. Research design Comparative descriptive design. Setting The study was conducted in two types of hospitals in Egypt, three governmental hospitals (university hospital, health insurance hospital, and ministry of health hospital) and one of them private hospital. Study sample Two groups of the patients were included in the present study: a total of 400 nurses who provide direct care to patients (100 in each hospital), and a total of 400 patients who present at the time of the study (100 in each hospital). Tool There were three tools used for data collection: I. nurses' awareness toward patient rights' questionnaires, II. patient's awareness toward patient rights' questionnaires, and III. nurses' compliance to the patient's rights from patients' point-of-view questionnaire, these structured questionnaires were adopted by Said (2010) to assess nurses' versus patients' awareness toward the patient's rights and compliance of nurses to these rights. Results The results revealed that 60.75% of nurses had a high level of awareness to patients' rights and 34.23% of patients had good awareness toward their rights, in addition, there was a statistical significant difference in the compliances of nurses about patients' rights between private hospitals and governmental hospitals (P=0.001). Conclusion The study findings showed that there was a significant difference in nurses' compliance regarding patients' bill of rights in four hospitals, especially in governmental hospitals. Recommendations The study recommended that the concept of patients' rights should be given as a regular and specialized educational program and retraining and putting it as a course in curriculum. [ABSTRACT FROM AUTHOR]

Background Laparoscopy has been widely applied for colorectal cancer surgery. Many studies have demonstrated that laparoscopy is safe and feasible for colon cancer. Recently, several studies compared laparoscopic abdominoperineal resection (LAPR) and open abdominoperineal resection for rectal cancer, but the results may differ from each other. This study was conducted to evaluate the safety and oncological efficacy of LAPR compared with the conventional open procedure. Setting Gastro-Intestinal Surgical Center, Mansoura University, Egypt. Patients and methods This is a prospective randomized trial conducted in the period between January 2017 and March 2019. A total of 60 patients diagnosed with low rectal cancers were included in this study. Patients were randomly allocated into two groups: group A included 30 cases who underwent the open procedure, and group B included the other 30 cases who underwent the laparoscopic technique. Both groups were compared in terms of operative time, blood loss, pain control, hospital stay, as well as early and late complications. Results Our data showed that LAPR resulted in early return to bowel functions expressed as early nasogastric tube removal, oral intake, flatus passage, and less postoperative pain. Moreover, LAPR is associated with fewer postoperative complications, especially abdominal wound infections and paralytic ileus. Conclusion LAPR is a safe and feasible procedure that reduces postoperative complications and leads to faster postoperative recovery, lesser use of analgesia, and shorter hospital stay. In addition, LAPR is not inferior to open abdominoperineal resection in terms of oncological clearance as it offers better chance for harvesting more dissected lymph nodes. [ABSTRACT FROM AUTHOR]

Pressure ulcers represent a major health problem, particularly in critically ill patients whose nutritional status is negatively affected by illness. Therefore, careful assessment and monitoring of critically ill patients are important nursing considerations. Aim To assess the relationship between nutritional status and occurrence of pressure ulcers among adult critically ill patients. Research design A descriptive correlational research design was utilized in this study. Research questions 1-What is the nutritional status of adult critically ill patients at Cairo University Hospitals? 2-Is there a relationship between nutritional status and pressure-ulcer development among adult critically ill patients at Cairo University Hospitals? Setting Different ICUs affiliated to Cairo University Hospitals. Sample A purposive sample consisting of 90 patients was included. Tools of data collection Demographic and medical data sheet, Braden scale, and Derby nutritional score. Results Nearly two-thirds of the studied sample was not at risk of nutritional deficiency in different assessment times in percentages of 58.2, 55.6, 62.2, 66.6, and 61.1%, respectively. As well, nearly half of the patients were not at risk of developing pressure ulcers in different assessment times in percentages of 46.7, 46.7, and 56.3%, respectively. Pressure-ulcer development did not differ significantly in relation to sex and;Deg;BM;Deg;I (X2=1.875, P=0.759, X2=5.639, P=0.688). A negative significant statistical correlation was found between nutritional status and the risk of developing pressure ulcer (r=-0.761, P=0.000). Conclusion Nutritional status was negatively associated with pressure-ulcer development. Age, immobility, and sensory perceptual alteration represented significant determinants of patients' readiness for developing pressure ulcers. Recommendations Regular and careful assessment of critically ill patients' nutritional status, frequent skin assessment for prevention, early detection of pressure ulcers, availability of written guidelines, and booklets about early detection and management of pressure ulcers. [ABSTRACT FROM AUTHOR]

The Egyptian healthcare system has challenges in order to promote and maintain Egyptian human health and well-being. Healthcare reform is a program to modernize Egypt's healthcare system, with a goal of shifting the focus of healthcare away from a high reliance on vertical programs, inpatient care, and toward a more integrated, less expensive, quality, universally accessible, and sustainable healthcare system. The aim of this study was to assess healthcare reform as perceived by nursing staff in three selected hospitals. Research design A descriptive comparative research design. Sample A convenience sample of total (N=559) staff nurses classified as the following: n=224 at governmental hospital, n=290 at health insurance hospital, and n=45 at a private hospital at El Gharbia governorate. Results In terms of healthcare reform as perceived by nursing staff, a highly statistically significance difference was found among the three hospitals. In addition, nursing staff at health insurance hospitals had more positive perceptions toward healthcare reform than nursing staff in other hospitals. Recommendations Design workshops and nurses' training programs on healthcare reform rules, regulations, managerial skills, and duties during the reform process. As healthcare technology progresses, the quality and distribution of resources at practically all levels of care should increase. Finally, new nursing duties should be added to the job description in order for them to be more engaged in the centralized decision throughout healthcare reform. [ABSTRACT FROM AUTHOR]

Background Trauma continues to be a common problem affecting global health care systems. Accordingly, different types of trauma have been considered major causes of morbidity and mortality, with approximately five million deaths per year. Road traffic injuries, in particular, have been recognized by the WHO as the sixth leading cause of death in the eastern Mediterranean region. Developed countries have realized the importance of implementing registries across all health care systems to improve service quality. Unfortunately, Egypt has yet to establish a national trauma registry in its hospitals. Although data banks have been available in a few hospitals, they have been inconsistent. Purpose The present study aimed at developing a trauma registry for a major tertiary hospital in Cairo. Patients and methods To this end, data from 202 patients admitted to the emergency department of Ain Shams University Hospital owing to trauma were collected. Procedures and actions used were then described to create a trauma registry from January to December 2017. Results The collected data were statistically analyzed, after which the epidemiological distribution of the trauma patients was described. Accordingly, our results showed that among the included patients, 65% were men, whereas most were single, illiterate, and unemployed. Thereafter, statistics regarding trauma circumstances were generated. Conclusion In conclusion, the present study found that hospital trauma registries can be established, are essential for improving the quality of health care services, and should be used ubiquitously throughout the country's hospitals to establish a national registry. [ABSTRACT FROM AUTHOR]

Introduction Nurses are under such a tremendous amount of pressure during the COVID-19 pandemic that many have become concerned about their jobs and even intend to leave them. Aim The aim was to investigate the effect of fear of COVID-19 pandemic on work satisfaction and turnover intentions of nurses. Patients and methods A descriptive correlation research design was adopted. The study was conducted at all inpatient units (medical and surgical) and critical care units (N=15) of Damanhour National Medical Institute (nurses=210). Part I included questions related to demographic characteristics. Part II was the fear of COVID-1 9 Scale. Part III was the work satisfaction index (JSI). Part IV included two measures of turnover intention used to assess organizational and professional turnover intentions. Results The total score for the fear of COVID-19 scale was 19.01 (SD: 5.98), which was above the average. Fear of COVID-19 scale mean score was higher among nurses who had not attended COVID-19-related training than nurses who had attended the training (t=-2.349, P=0.020). Conclusion This study illuminates that the enhanced fear of COVID-19 pandemic among nurses increases their work dissatisfaction, in addition, to an increase in their organizational and professional turnover intentions. It is recommended to formulate COVID-19 training programs to enhance the capacity of nurses to effectively care for and manage coronavirus patients among healthcare organization. [ABSTRACT FROM AUTHOR]

Background Pulmonary affection in patients with thalassemia major (TM) is well established; however, a special pattern of disease has not yet been observed. Suggestions in preference of the role for transforming growth factor-β1 (TGF-β) superfamily members in the pathogenesis of airway obstructive diseases has arisen from previous genetic studies. Objectives We aimed to assess TGF-β1 serum level in the blood and its relation to pulmonary affection in children with TM. Patients and methods A total of 40 patients with β-TM were included, who were compared with 40 agematched and sex-matched normal children as a control group. Cases were subjected to clinical assessment for anthropometric measurements and respiratory examination, spirometry, and chest radiograph, whereas serum TGFβ1 was assessed in cases and control using a TGF-β1 capture enzyme-linked immunosorbent assay. Results Different patterns of pulmonary dysfunction in spirometry were found: 12 (30%) patients had obstructive pattern, seven (17.5%) patients had restrictive pattern, nine (22.5%) patients had mixed pattern, whereas 12 (30%) patients had normal pulmonary function. Moreover, a significant negative correlation between serum TGF-β1 and both forced expiratory volume in 1 s (r: −0.317, P<0.05) and forced vital capacity (r: −0.354, P<0.05) was found. Conclusion Inflammatory markers such as serum TGF-β1 may play a role in pulmonary affection in patients with thalassemia, either obstructive or restrictive pattern. There is a potential role of excess ferritin deposited in the airways, resulting in obstructive pulmonary pattern in pulmonary function tests. [ABSTRACT FROM AUTHOR]

Introduction and aim Acute mesenteric ischemia (AMI) is a life-threatening condition. This is an audit for the management of a cohort of patients with AMI, which was then compared with the World Society of Emergency Surgery recommendations. Patients and methods This is a prospective clinical audit, conducted at General Surgery Department, Assiut University Hospital, Egypt, during the period from December 2017 to September 2018. The audit was designed to match the recommendations of the World Society of Emergency Surgery. Results A total of 135 patients presented with suspicion of AMI to the emergency unit of the General Surgery Department by either clinical, laboratory, or radiological findings. Only 30 (22%) patients had final diagnosis of AMI and were audited. Median age was 55 years (interquartile range, 40–66). There were 22 (73.3%) males and eight (26.7%) females. Hypertension was the most prevalent risk factor (n=10, 33.3%). Etiology was arterial embolism in 13 (43.3%), arterial thrombosis in four (13.3%), venous thrombosis in 11 (36.6%), and was not identified in two patients. Management was surgical in 17 (56.6%), interventional radiology in two (6.7%), and noninterventional in 11 (36.6%) patients. Percentages of adherence to World Society of Emergency Surgery guidelines were as follows: 40% for recommendation 1, 60% for 2, 100% for 3, 100% for 8a, 43% for 8b, 100% for 9, 100% for 10, 0% for 11, 100% for 12, and 67% for 14. Conclusion This audit showed some discrepancies between our practices and World Society of Emergency Surgery recommendations. We advocate implementing changes in our practices and reauditing. [ABSTRACT FROM AUTHOR]

Introduction Colorectal cancer (CRC) is the world's third most common malignant neoplasm. In Egypt, a small incidence of CRC and a high proportion of young-onset disease is observed. Colonoscopy is commonly used for neoplastic colorectal screening. The aim of this work was to assess colonoscopy in high-risk groups as a screening and diagnostic method for early detection of CRC. Patients and methods The study included 200 patients, with age varying from 20 to 83 (mean: 53.42±15.50) years. They were presented to GIT Surgery Unit, Alexandria University Hospital, complaining of lower gastrointestinal tract symptoms and/or high risk of CRC over 9 months. Two professional endoscopists have performed 200 colonoscopies over 9 months. Results Total colonoscopy was done in 94% of cases, and the biopsies were tested. Colorectal polyps were observed in 54 (27%) patients. Of these polyps, the most common were adenomatous polyps (81.5%). Colonic masses were typically seen in males in 22 (11%) cases. Adenocarcinomas were the most common of these masses, accounting for 9% of all cases. A total of 14 (7%) patients reported inflammatory conditions. 6.7% of all cases were diagnosed as colitis. Eight cases were diverticulosis, and 10 cases were hemorrhoid. Conclusion There is an increased rate of detection of adenoma by using screening colonoscopy among endoscopists. Colonoscopy is a valuable screening and diagnostic tool for early detection of CRC. [ABSTRACT FROM AUTHOR]

Purpose The aim was to study the prevalence and related risk factors of dry eye disease (DED) in a random population sample from Cairo and upper Egypt. Materials and methods A clinic-based, cross-sectional, observational, multicenter study was conducted on eyes of healthy individuals accompanying ophthalmological patients coming for ocular examination in outpatient clinics of Ain Shams University Hospital and Al Watany Eye Hospital, Cairo; Saint Mary Hospital, Qena; and Aswan Eye center, Aswan, Egypt. Eyes were selected by systematic random sampling. Two questionnaires were used: the Ocular Surface Disease Index and another one covering medical history and risk factors for DED. External ocular examination, tear film break-up time, and Schirmer's tests were done. Diagnosis of DED was established on an Ocular Surface Disease Index score of 50 or above associated with at least one of DED symptoms together with either tear film break-up time of less than or equal to 5 s or Schirmer's test measurement of less than or equal to 10 mm. Results A total of 603 eyes were included; 290 of which were of male participants and 313 were of female ones. The age range was 18–94 years, with a mean age of 50.06±19.06 years. The prevalence of DED was 77.6% (468 eyes). There was a statistically highly significant difference in DED prevalence among all age groups (P<0.0001), with higher prevalence in age group of 41–50 years old, but the trend between consecutive age groups was not statistically significant (P=0.4747). Moreover, DED was statistically more common in females [86.9% of female participants versus 67.6% of male participants (P<0.0001)]. Blepharitis was found in 81% (379 eyes) and smoking in 43.8% (205 eyes). Moreover, 29.7% (139 eyes) of detected DED cases had associated dry mouth. Conclusion DED was quite common among our studied subjects, and most of them had associated blepharitis. Smoking was also a major risk factor. Moreover, DED was more common in female sex. There was a statistically significant difference in DED prevalence among the age groups. [ABSTRACT FROM AUTHOR]

Background: Patients with cancer experience a variety of physical and/or psychological symptoms. These symptoms may vary in terms of occurrence, severity, and distress and might occur as a result of the illness or the treatment. Aim: The aim of this study was to assess physical and psychological distressing symptoms among patients with cancer who receive radiotherapy. Research design: A descriptive exploratory research design was used to carry out this study. Setting: The study was conducted at the Radiotherapy Department of a university hospital affiliated to Cairo University, Egypt. Sample: A convenient sample of 250 patients who had cancer and undergoing radiotherapy was recruited for this study. Tools: Data were collected using two tools: Demographic and Clinical Characteristics Data Form and the Memorial Symptom Assessment Scale. Results: The study findings denoted that approximately half of the sample was male, and the mean age was 45.68±15.84 years, with range from 18 to 79 years. The most prevalent physical symptoms among the study participants were lack of energy (97.2%), followed by changes in skin (redness and skin pigmentation) and pain (96.8%). Feeling irritable (89.2%) and feeling sad (87.2%) were the two most frequent psychological symptoms. Moreover, there was a statistically significant relation between participants' sex, education, occupation, social status, cancer type, and cancer stage and total score of severity symptoms. Conclusion: This study concluded that patients with cancer undergoing radiotherapy experienced a variety of physical and psychological distressing symptoms. Mostly lack of energy, changes in skin, pain, and feeling drowsy were the physical symptoms, whereas feeling irritable and feeling sad were the two most frequent psychological symptoms. Recommendations; Nurses should assess frequency, severity, and level of distressing symptoms to provide quality nursing care to alleviate distressing symptoms. [ABSTRACT FROM AUTHOR]

Background Breast cancer is the most common site of cancer in women in Egypt as it accounts for ∼38.8% of total malignancies among Egyptian women; it is an important cause of mortality among women. For many women with early-stage breast cancer, a combination of partial mastectomy and radiation therapy − together referred to as breast-conserving therapy − is preferable to total mastectomy. Objective To focus on superior medial technique as an oncoplastic procedure for the management of breast cancer and to assess the technique clinically regarding oncological safety, surgical outcomes, and patient satisfaction. Patients and methods It was a prospective, analytical study that included 20 patients aiming to assess clinically the superior medial oncoplastic technique for lower and outer quadrant breast cancer regarding oncological safety and patient satisfaction. This study was conducted at Bahya Specialized Breast Cancer Hospital and Ain Shams University Hospitals. Results All the 20 patients underwent oncoplastic breast surgery which implied two major technical steps, excision of the tumor with a wide safety margin through a predesigned incision with frozen section examination for margins along with formal axillary dissection, followed by immediate reconstruction using superior medial technique. Breast cancer, like other cancers, occurs because of an interaction between an environmental (external) factor and a genetically susceptible host. Normal cells divide as many times as needed and stop. They attach to other cells and stay in place in tissues. Cells become cancerous when they lose their ability to stop dividing, to attach to other cells, to stay where they belong, and to die at the proper time. Conclusion This approach has enabled us to increase the number and extend the indications of breast-conserving surgery with wider margins offering safer oncologic control with more satisfactory cosmetic outcome. [ABSTRACT FROM AUTHOR]

Background: Breast cancer plays major public health in Egyptian women. In upper Egypt, There is an increase in the incidence of breast cancer compared to other Egyptian areas without know the reasons. In this study, we aimed to evaluate the potential of HER-2/neu status as one of the important markers to classify the women suffering from breast cancer in upper Egypt and monitoring the responsiveness to different therapies.Settings and Design: The present study was performed on 67 female breast cancer patients in the South Egypt Cancer Institute to evaluate HER-2/neu gene amplification and expression.Patients and Methods: Tissue samples were used for immunohistological analysis of endocrine receptors, HER-2/neu, and HER-2/neu gene amplification. In addition, the blood samples were also used to determine HER-2/neu gene expression.Statistical Analysis: All statistical analyses were performed using Chi-square test. The statistical difference is considered statistically significant at P < 0.05.Results: There was a statistically significant association between HER-2/neu gene expression and the age of patients. There is decrease in the level of HER-2/neu mRNA expression in group treated with chemotherapy and group treated with chemotherapy and radiotherapy compared to each group baseline level of HER-2/neu mRNA expression before treatment. On the contrary, the group treated with chemotherapy, radiotherapy, and hormonal therapy revealed increase on the level of HER-2/neu mRNA expression when compared with their baseline for the same patients before treatment.Conclusion: We need further studies on the large group of upper Egypt breast cancer patients to confirm that the level of HER-2/neu mRNA expression can be used as a marker for classified them and their response to different treatment. [ABSTRACT FROM AUTHOR]

Background: Dermatophytic fungi of genera Trichophyton and Microsporum are the most important fungal species causing tinea capitis. Choice of treatment for tinea capitis is determined by the species of fungus. Aim: The aim of the study was to investigate the most prevalent fungal species causing tinea capitis in children from Egypt and the most useful antifungal agent for treatment. Patients and Methods: A total of 100 patients diagnosed clinically with tinea capitis were included in the study. Samples were collected and sent to the microbiology and immunology laboratory for sample processing and fungal identification by routine laboratory techniques. A study of antifungal susceptibility to chosen antifungal medications (fluconazole, ketoconazole, clotrimazole, miconazole, amphotericin, caspofungin, itraconazole, terbinafine, and griseofulvin) was done by minimum inhibitory concentration technique. Results: Our analysis revealed that Microsporum canis is the most commonly isolated strain. Amphotericin was the most effective antifungal agent followed by terbinafine. The most sensitive strain to fluconazole and griseofulvin is Microsporum gypseum, while Microsporum audouinii was mostly responsive to terbinafine. Conclusion: Identification and evaluation of the antifungal susceptibility of the pathogenic species in a certain geographic region is important to achieve a good clinical response. [ABSTRACT FROM AUTHOR]

Background: Solid waste management has emerged as an important human and environmental health issue. Municipal solid waste workers (MSWWs) are potentially exposed to a variety of occupational biohazards and safety risks. The aim of this study was to describe health practices and safety measures adopted by workers in the main municipal company in Alexandria (Egypt) as well as the pattern of the encountered work related ill health. Methods: A cross-sectional study was conducted between January and April 2013. We interviewed and evaluated 346 workers serving in about 15 different solid waste management activities regarding personal hygiene, the practice of security and health care measures and the impact of solid waste management. Results: Poor personal hygiene and self-care, inadequate protective and safety measures for potentially hazardous exposure were described. Impact of solid waste management on health of MSWWs entailed high prevalence of gastrointestinal, respiratory, skin and musculoskeletal morbidities. Occurrence of accidents and needle stick injuries amounted to 46.5% and 32.7% respectively. The risk of work related health disorders was notably higher among workers directly exposed to solid waste when compared by a group of low exposure potential particularly for diarrhea (odds ratio [OR] = 2.2, 95% confidence interval [CI] = 1.2-3.8), vomiting (OR = 2.7, 95% CI = 1.1-6.6), abdominal colic (OR = 1.9, 95% CI = 1.1-3.2), dysentery (OR = 3.6, 95% CI = 1.3-10), dyspepsia (OR = 1.8, 95% CI = 1.1-3), low back/sciatic pain (OR = 3.5, 95% CI = 1.8-7), tinnitus (OR = 6.2, 95% CI = 0.3-122) and needle stick injury (OR = 3.4, 95% CI = 2.1-5.5). Conclusions: Workers exposed to solid waste exhibit significant increase in risk of ill health. Physician role and health education could be the key to assure the MSWWs health safety. [ABSTRACT FROM AUTHOR]

Background: We examined perceived health status and physical and psychological well being of 3,271 undergraduate students attending eleven faculties in a university in Egypt. Methods: During 2009-2010, participants completed a self administered questionnaire that gathered socio demographic, physical and psychological health data. Body mass index (BMI) was calculated from students' measured height and weight. Differences across these variables were computed by gender and participating faculties. Results: Whilst more females watched and rated their health favorably, they were more likely to feel psychosomatic/physical health problems, to have seen a medical practitioner or been ill that they had to stay in bed. Females were consistently more likely to feel burdened overall, and across several aspects apart from financial problems. Less females had 'normal' BMI, were satisfied with current weight, perceived their body image as 'just right', or were not worried about their shape. More males rated their quality of life favorably. About 25% of males and 32% of females were either overweight/obese. Exams, presentations, and the lack of time for studies were the frequently reported burdens. Comparisons of health/well being indicators across the participating faculties suggested some evidence of 'clustering': Favorable indicators would cluster at some faculties; and conversely, less favorable variables would cluster at other faculties. Conclusions: Generally, the levels of some health complaints and psychological problems/burdens are higher than in other countries. Increased vigilance of university administrators and leaders to monitoring the health and well being of their students, as well as their health needs is required if policy makers are to operate from a valid evidence base platform. Given cultural factors prevalent in the Eastern Mediterranean region generally, female students might require particular attention. The clustering effects suggest the need for local (faculty specific) health and well being profiles as basis and guidance for relevant health promotion programs in faculty/university settings. [ABSTRACT FROM AUTHOR]

Background: Chronic conditions like epilepsy in a child can affect his/her entire family. The failure of the family members to adapt adequately to the unique demands of this childhood chronic illness can be considered as an important risk factor for development of psychopathology. Objectives: The objectives of this study were to study the profile of parenting stress in parents of children with epilepsy and its correlates; and, to examine the correlates of psychopathology in these children. Material and Methods: Twenty three epileptic children and their families were subjected to Parenting Stress Index (PSI), Scores for indices such as The Children's Depression Inventory (CDI), Benton Visual Retention test, Spence anxiety scale for children, The Child Behavior Checklist (CBCL) and Wechsler Intelligence Scale for Children were calculated. Results: Mean verbal and performance IQ score was 94, while the mean total IQ score was 95. Mean scores for all Wechsler IQ Scores as well as Benton Visual retention test were within the average range. Means for total internalizing CBCL t scores (M, Mean=70; Standard Deviation, SD=4.4), total externalizing CBCL t scores (M=60, SD=9.6), and total behavior problems CBCL t scores (M=67, SD=5.2) were above the standard cut off levels of 65 for clinical behavioral problems. Mean score on CDI was 42 ± 2. Scores of the PSI equal to or higher than 85th percentile were considered pathologically high. Conclusion: The results of our study indicated that pediatric patients with epilepsy, specifically with intractable cases, are correlated with high levels of parental stress. [ABSTRACT FROM AUTHOR]