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Background: Intracranial aneurysms are life threatening and disabling vascular lesions. The majority of aneurysms are located at branching points along the proximal arterial tree, suggesting that haemodynamic factors play significant role in aneurysms formation. Aim: The aim of the work was to evaluate the efficacy, safety, clinical and radiological outcome of endovascular management of anterior communicating artery aneurysms. Patients and Methods: This study was a prospective study conducted on 20 patients with anterior communicating artery aneurysms at Neurosurgery Departments – Tanta University hospitals between February 2021 and April 2022. Results: Successful Endovascular treatment was achieved in 19 patients. 17 patients had good recovery (Glasgo outcome scale 5), 1 patient had moderate disability (GOS 4), no patients severely disabled (GOS 3), and 1 patient died (GOS 1). According to hunt and hess grading (5 patients before EVT), 10 patients with grade 1, 5 patients with grade 2 and 5 patients with grade 3 and all patients were with the same grading after ETV without deterioration. Conclusion: In this thesis, EVT was an effective and safe technique for treatment without any treatment related morbidity or mortality. Despite our good angiographic and clinical outcome either postoperatively or during early follow up period, still longer angiographic and clinical follow up is mandatory in all cases since initial total obliteration is not a guarantee for permanent obliteration.

Presently, Gulf Cooperation Council countries are lagging in the generation of real-world data and use of real-world evidence for patient-centered care compared with the global average. In a collaborative effort, experts from multiple domains of the healthcare environment from the Gulf Cooperation Council countries came together to present their views and recommended key action points for the generation of robust real-world data and leveraging real-world evidence in the countries. The opinions of the experts are presented, along with existing barriers to the effective generation of real-world evidence in the countries. The Gulf Cooperation Council countries are undergoing transformative changes paving the way for improved healthcare measures; however, the challenges in generating reliable, robust, accessible, and secure real-world evidence are persistent. Hence, ongoing public-private engagements, as well as collaborations between regulators, policymakers, healthcare professionals, insurance and pharmaceutical companies, and patients, are warranted. A few notable examples of real-world evidence studies highlighting the benefits of real-world evidence for gaining valuable insights into patient-centric decision making are also discussed. The actionable steps identified for successful real-world evidence generation would provide long-term, real-world evidence-based patient-centric benefits for the countries.

Why do rumors make it difficult for subordinates to follow their bosses' orders? How do managers keep rumors from having a negative impact? Are workplace ostracism and psychological contract violations breaches motivated by organizational cynicism and/ or negative rumors? Is there a connection between optimistic rumors and the fulfillment of psychological contracts? a sample of (327) academics from Egypt's private universities were surveyed. 'a four-part questionnaire that evaluates the study' axes (workplace ostracism, positive and/ or negative rumors prevalence, organizational cynicism and psychological contract violation).

Background; Vertical shear fractures of the medial malleolus occur through supination–adduction loading of the talus onto the articular surface of the medial malleolus, Aim and objectives; to assess the radiological and functional outcomes of open reduction and internal fixation with antiglide plate of vertical shear medial malleolus fracture, Subjects and methods; This prospective case series study was carried out at the Orthopedics Departments of Al-Azhar University and Health Insurance Hospitals. The study included 22 patients with antiglide plating of vertical medial malleolus fracture. The duration of the study ranged from 6-12 months, Result; Number of patients with Antiglide plate for medial malleolus Management in the study population was 9 (40.91%). Number of patients with Antiglide plate for medial malleolus & Semitubular Plate of lateral malleolus Management in the study population was 13 (59%), Conclusion; Surgical management of vertical shear of medial malleolus fracture gave excellent anatomical reduction and rigid fixation to restore articular congruity, help to facilitate early mobilization and hence to achieve optimal ankle function. The antiglide plate fixation is readily available and cost significantly less than a precountoured anatomicspecific type of fixation.

Why do some managers fail to direct their subordinates correctly while some may succeed? Why subordinates may respond to the permanent-orientations and/or daily-directions while others do not? How learning approaches effect on managers’ behavior and self-management theory? Are all these challenges considered meta-management? This research is empirical research which methodically providing an answer to these questions. The answer presenting in a diagnostic and an epistemologically analytical method about Antropogogy (Pedagogy to Andragogy) with Cybergogy directing and Heutagogy-Self-determined). The managers' failure in practicing the function of direction and the failure of subordinates to respond to permanent-orientations and/or daily-directions is due to the lack of awareness of self-management theory, adult personality theory, the deficiency in adopting Cybergogy-social media directing and anthropogogy (Andragogy and Heutagogy) self-directed based learning approaches, and the lack of awareness of what is Meta-HRM.

BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is a common liver disease affecting nearly 25% of adults worldwide with related risk factors including obesity, metabolic, and inflammatory diseases. Many therapeutic remedies of natural or synthetic properties were used. AIM: This study aimed to investigate and compare the effects of ginger/rosuvastatin (ROSU) on the liver of rats with induced NAFLD. MATERIALS AND METHODS: Forty adult male albino rats were used in this study and divided into four equal subgroups, Group I, control received the standard rat chow diet and given normal saline (1 ml/kg/day), Group II, high-fat diet (HFD) group, Group III, received HFD+ ROSU (15 mg/kg/day), and Group IV, HFD+ Zingiber officinale (10% W/V) for 6 weeks. At the end of our experiment, the rats were sacrificed then blood samples were collected for biochemical analysis of lipid profiles and liver enzymes, liver specimen was prepared for light and electron microscopic examination, and measurement of tissue level of malondialdehyde. RESULTS: NAFLD caused degenerative changes and lipid deposition in liver cells as evidenced by microscopic results and laboratory tests. Treatment with ginger/ROSU alleviated those changes. CONCLUSION: Ginger and ROSU could ameliorate liver functions in NAFLD and ginger effect is superior to ROSU.

Is organizational favoritism a phenomenon or a real problem? Is (organizational Favouritism-(nepotism-cronyism)-(ONC): widespread in the higher education sector like other sectors? What is the effect of (emotional exhaustion) on social capital? What effects of psychological detachment and organizational integrity on that relationship? Will studying this benefit the competitive landscape of the higher education sector in Egypt? How do managers detect and treat these organizational gaps such as organizational-(favouritism and emotional exhaustion) and enhance a role of psychological detachment and organizational integrity in enhancing social capital? a sample of (412) managers and employees from higher education sector in Egypt were surveyed. a seven-part questionnaire evaluating the study's axes (behavioral integrity, organizational nepotism-cronyism, psychological detachment, emotional exhaustion and unitarism social capital). This research study relationship of organizational nepotism-cronyism as independent variable and unitarism social capital as dependent variable and study impacts of emotional exhaustion as an intermediate variable on this relationship. Finally, study the impact of psychological detachment as the first moderator variable and behavioral integrity as a second moderator variable on this relationship. The study reached some results related to these variables, in addition to providing some recommendations related to raising the efficiency of the education sector and overcoming these obstacles and regulatory gaps in a way that strengthens the higher education sector, universities, institutes, and Egyptian educational institutions

Background The liver biopsy is an essential element of evaluating progression of liver disease in children with Progressive Familial Intrahepatic Cholestasis (PFIC) and Allagille Syndrome (AGS). Several noninvasive techniques, including radiological imaging and blood biomarkers assay, can be used to evaluate liver stiffness. Objectives To identify whether liver Transient elastography (FibroScan) and AST/PLT Ratio Index (APRI) could be reliable tools to assess the degree of fibrosis prior to partial biliary diversion (PBD). Methods A prospective cohort in which all patients with PFIC and AGS who underwent PBD from July 2019 to July 2021 were included. Preoperative liver functions, pelvic-abdominal ultrasonography and FibroScan assessments were performed while intraoperative liver biopsy was obtained. Results Eight patients with chronic cholestatic liver disease who were candidates for PBD due to intractable pruritus were enrolled, including PFIC (n = 6; 75%), and AGS (n = 2; 25%). The liver FibroScan results were similar to the liver biopsy histopathological assessment in 87.5% of cases. APRI ranged from 0.1 to 3.2 (median = 1.2). In four cases (50%), APRI was consistent with histological evaluation of liver samples. The FibroScan results were in concordance with APRI results in three patients (37.5%). Conclusion The current cohort demonstrated that fibroScan was consistent with histopathology in 87.5% of patients, highlighting its value in determining the degree of liver fibrosis prior to surgery, whereas the APRI was only consistent with histopathology in half of cases.

Secondary hyperparathyroidism (SHPT) is linked to obesity. Bariatric surgery may be associated with calcium and vitamin D deficiencies leading to SHPT. This study aimed to detect the prevalence of SHPT before and after bariatric surgery.This prospective study assessed the prevalence of SHPT after sleeve gastrectomy (SG, n = 38) compared to one-anastomosis gastric bypass (OAGB, n = 86). All patients were followed up for 2 years. Bone mineral density (BMD) was assessed using dual-energy X-ray absorptiometry.Of the 124 patients, 71 (57.3%) were females, and 53 (42.7%) were males, with a mean age of 37.5 ± 8.8 years. Before surgery, 23 patients (18.5%) suffered from SHPT, and 40 (32.3%) had vitamin D deficiency. The prevalence of SHPT increased to 29.8% after 1 year and 36.3% after 2 years. SHPT was associated with lower levels of vitamin D and calcium and higher reduction of BMD in the hip but not in the spine. After 2 years, SHPT was associated with a significantly lower T-score in the hip. SHPT and vitamin D deficiency were significantly more common in patients subjected to OAGB compared to SG (p = 0.003, and p 0.001, respectively). There is a strong negative correlation between vitamin D levels and parathormone levels before and after surgery.Prevalence of SHPT is high in obese patients seeking bariatric surgery, especially with lower vitamin D levels. Bariatric surgery increases the prevalence of SHPT up to 2 years. Gastric bypass is associated with a higher risk of developing SHPT compared to SG.

The SRQR information for the paper titled: ‘Because people here are ignorant’: The failure of a community intervention to prevent mycetoma in Sudan

Immunostimulatory and antiproliferative therapies have been widely used for the treatment of multiple warts. Recently, anti-HPV activity of ionic contra viral therapy (ICVT) which is comprised of combined digoxin and furosemide has been demonstrated.To evaluate and compare the effectiveness and safety of intralesional injection of Candida antigen, vitamin D3, and combined digoxin and furosemide in the treatment of multiple warts.Seventy-five patients with numerous warts were randomly assigned to one of three equal groups: Candida antigen, vitamin D3, or a combination of digoxin and furosemide. In the Candida antigen group, injections into the biggest wart were done. In the vitamin D3 and combined digoxin/furosemide groups, the agent was injected into each wart with a maximum of five injected warts. Injections were repeated every 2 weeks until clearance or for a total of five sessions.There was a statistically significant difference in the overall therapeutic response among the studied groups in favor of the intralesional Candida antigen group (60%), followed by the vitamin D3 group (48%) and the ionic contraviral therapy group (28%) (p = 0.02). However, the difference between both Candida antigen and vitamin D groups was not significant (p = 0.59).Intralesional Candida antigen immunotherapy and vitamin D3 antiproliferative therapy are significantly more effective than ICVT.Short follow-up period and relatively small sample size.

There is paucity of studies that discussed the role of peritoneal dialysis (PD) in managing end stage renal disease (ESRD) in sickle cell disease (SCD) patients. The present study compares the outcome of SCD-ESRD patients treated with hemodialysis (HD) or PD. Sixty incident ESRD patients were allotted to HD, (HD group, n=40) or PD, (PD group, n=20). Causes and severity of renal injury were assessed at the time of initiating dialysis. The primary outcome was hospital mortality at 5 years, and secondary outcomes were infection rates, incidents of vasoocclusive crisis (VOC) and acute chest syndrome (ACS), response to erythropoietic agents and improvement of cardiac function. No statistically significant differences were observed between groups in regard to patients’ characteristics. The survival at 5 years was significantly better in the patients treated with PD when compared to HD (75.0% vs. 57.5%, p=0.026). Infectious complications (15% vs 35%, p

El objetivo de este estudio es analizar comparatísticamente el empeño compartido de Carlos Muñiz y Tawfīq Al-Ḥakīm en criticar el autoritarismo del régimen político que afectó la vida social y política de sus respectivos países. El protagonista en ambas obras está comparado con el insecto (grillo-cucaracha) debido a su mediocridad, ya que tanto al hombre como al insecto nadie les hace caso, a pesar de sus repetidos gritos. Esta estrategia de recurrir al reino de los insectos para proyectar sus críticas hacia las dimensiones política y social ha sido un recurso de camuflaje para escapar del aparto censor del régimen dictatorial.

تستهدف الدراسة تحليل واختبار العلاقة بين متغيرات السياسة النقدية والفقر في مصر خلال الفترة (1990-2019)، وذلك من خلال بناء نموذجين للفقر المعتدل والمدقع، وباستخدام أسلوب التكامل المشترك ونموذج متجه تصحيح الخطأ (VECM) Vector Error Correction وجدت الدراسة تأثيراً معنوياً لمتغيرات السياسة النقدية على الفقر يتوقف على شدة الفقر: ففي الأجل الطويل يكون تأثير عرض النقود ومعدل التضخم سلبياً ومعنوي إحصائياً على الفقر المعتدل والمدقع، بينما يكون تأثير معدل الصرف الحقيقي إيجابياً ومعنوي إحصائياً، أما في الأجل القصير يتغير أثر بعض هذه المتغيرات ويكون بعضها غير معنوي إحصائياً. وبالتالي يجب على صانع السياسة النقدية التركيز على آثارها طويلة الأجل، واحتواء التضخم واستقرار معدل الصرف لتحسين ظروف الفقراء في الأجل الطويل، مما قد يسهم في خفض الإنفاق العام وضبط أوضاع المالية العامة. أما بالنسبة لتأثير الفقر على المتغيرات النقدية فقد وجدت الدراسة للفقر المعتدل تأثيراً سلبياً ومعنوي إحصائياً على معدل التضخم ومعدل الفائدة ومعدل الصرف الحقيقي في الأجل القصير، ويتحول إلى تأثيراً إيجابياً في الأجل الطول، أما الفقر المدقع فَوُجِدَ له تأثيراً إيجابياً ومعنوي إحصائياً على معدل التضخم وعرض النقود ومعدل الصرف الحقيقي في الأجل الطويل، وعلى معدل الصرف الحقيقي فقط في الأجل القصير.

Purpose: Severe pruritus caused by progressive familial intrahepatic cholestasis (PFIC) and Alagille syndrome (AGS) is refractory to medical treatment. Surgical interruption of the enterohepatic circulation is considered the mainstay of alleviating distressing symptoms and delaying cirrhosis. This study aims to evaluate the short-term effect of partial external biliary diversion (PEBD) on pruritus, liver disease progression, patient’s growth, and quality of life.Methods: This prospective cohort study enrolled children with PFIC and AGS from July 2019 to July 2021, whose guardians consented to the PEBD procedure. A standard surgical approach was performed by a single surgeon. Outcomes were measured subjectively and objectively pre- and post-procedure using the pruritus 5-D itching score, Paediatric Quality of Life Inventory scale (PedsQL), growth parameters, bile acids level, and liver function tests. Patients’ follow-up period ranged from 6 to 12 months.Results: Seven patients had PEBD procedure; five with PFIC and two with AGS. A significant improvement was detected in the 5-D itching score (p-value < 0.001), PedsQL (p-value < 0.001), and bile acids level (p-value 0.013). The preexisting growth failure was ameliorated. The downward trend in the bilirubin level was not significant. No influential difference in the other liver function tests occurred. No intra-operative complications encountered. Only one case had a post-operative stoma prolapse which was managed surgically.Conclusion: PEBD procedure could be considered as an effective and safe treatment options for intractable pruritus in patients with PFIC or AGS, providing preserved synthetic liver functions.Research Ethics committee approval: MD110-2019 on 28/12/2019

One of the most significant illnesses associated with gluten is celiac disease, which encompasses many conditions. It is generally recognized that neurological manifestations can occur either at the time of the disease onset or as the illness continues to develop. One of the main clinical presentations of celiac disease is headache, either in the form of migraine or in an unspecific form. Migraine pathophysiology is intricate and still poorly understood. Several mechanisms involving the gut-brain axis have been proposed to explain this association. These include the interaction of chronic inflammation with inflammatory and vasoactive mediators, the modulation of the intestinal immune environment of the microbiota, and the dysfunction of the autonomic nervous system. However, further research is required to fully comprehend the fundamental mechanisms and pathways at play. This review aims to give a narrative summary of the literature on celiac disease's neurological symptoms, particularly migraines, and to assess any potential associations to dysbiosis, an imbalance in the microbiome.

PurposeOman has a rich built heritage due to its strategic location, making its history full of events, which resulted in remarkable cultural and social heritage. The government works on preserving the built environment through the adaptive reuse strategy of abandoned buildings or sites, which is considered a comprehensive approach to sustainability. The adaptive reuse process often involves complex factors especially through decision-making, which influence the success of the generated project. The research aims at proposing an assessment strategy that offers guidelines that can help to achieve comprehensive adaptive reuse.Design/methodology/approachThis paper analyzes and assesses adaptive reuse interventions of selected five heritage projects in Oman. The assessment was conducted based on semi-structured interviews with stakeholders and local community representatives, as well as onsite observations, documentation and relevant data analyses.FindingsThe results display that a comprehensive sustainable management plan for adaptive reuse projects is essential to ensure the success of the new uses in promoting the local economy, enhancing social values, preserving the cultural identity and adapting to the local environment.Originality/valueThis contribution proposes a comprehensive strategy for assessing the adaptive reuse projects' performance that can be used as a checklist for achieving more social, cultural, environmental and economic benefits. This strategy can be further developed by extending to include more categories.

Ovarian cancer is one of the most common causes of mortality in women and is frequently diagnosed at an advanced stage. Ovarian cancer has a high recurrence rate, with most cases being peritoneal metastasis. The standard treatment of peritoneal metastasis is systemic chemotherapy, but naturally, the peritoneum is poorly vascularized, making this standard of treatment frequently ineffective. Hence, pressurized intraperitoneal aerosol chemotherapy (PIPAC) introduced a new type of intraperitoneal chemotherapy (IPC) in November 2011. Positive feedback on its feasibility, tolerance, and efficacy has encouraged medical communities worldwide to adopt PIPAC as a new drug delivery technique. This study's objective is to review previously conducted research on the efficacy of PIPAC treatment for peritoneal metastasis from ovarian cancer.

Phosphodiesterase type 5 (PDE5) inhibitors are frequently used for erectile dysfunction (ED) as the first line of treatment. This medication was initially developed to treat muscle spasms and pulmonary hypertension. The United States Food and Drug Administration (FDA) approved its usage for treating ED. Sildenafil, tadalafil, vardenafil, and avanafil are PDE5 inhibitors. The decrease of cyclic guanosine monophosphate (cGMP) in smooth muscle cells caused by sildenafil causes smooth muscle relaxation and penile erection. Vasodilation of the blood vessels reduces perfusion and blood flow to the optic nerve and eye. Several incidences of non-arteritic anterior ischemic optic neuropathy (NAION) have been recorded in sildenafil users, among other ocular complications. The onset of NAION is usually sudden and painless, and it is associated with any pattern of visual field loss. Possible symptoms include poor visual acuity, diminished color vision, a visual field defect, or hemorrhages in the form of flames. Nevertheless, NAION pathogenesis is still a mystery. Most visual effects are reversible weeks after the medication is stopped, and NAION does not seem to cause a permanent blindness. A small cup-to-disc ratio (disc at risk) and underlying systemic illnesses, such as hypertension, increase the risk of developing NAION. An early indicator of cardiovascular disease is ED. NAION diagnosis is challenging due to a lack of confirmatory diagnostic evidences. Normal visual acuity does not exclude NAION from being a possibility. In order to evaluate visual outcomes in NAION, data on both visual acuity (VA) and the full peripheral visual field are needed. Treatment with steroids did not seem to improve visual results.

PurposeThe study aims to analyze the development of Omani heritage legislation against the UNESCO World Heritage Convention (WHC), 1972 and WHC Operational Guidelines (WHC-OGs) to predict the possible effects of the recent developments on the management of the World Heritage Site in Oman.Design/methodology/approachThis study discusses the development of the heritage protection legislation in Sultanate of Oman since 1970; it analyses the Omani Cultural Heritage Law 35/2019 against the recommendations of the UNESCO WHC as well as the requirements of the World Heritage Operational Guidelines. Moreover, the research investigates the possible effects of the recent heritage legislation developments on the management of Bahla Fort and Oasis in Oman, which is the first Omani World Heritage Site and the only site with special management regulations.FindingsThe paper outlines the effects of both the Omani Cultural Heritage Law 35/2019 and the Special Management Regulations 81/2019 on the implementation of the Bahla Management Plan. Additionally, the research establishes how the customization of heritage legislation as a special heritage management regulation facilitates the implementation of national legislation to solve specific local problems.Originality/valueThe study establishes the significance of developing comprehensive legislation to protect and manage the rich Omani cultural heritage and World Heritage Sites in alignment with the WHC and the WHC-OGs.

Background: Dysfunction of the coronary microcirculation may be one of the factors responsible for persistent anginal symptoms. Noninvasive as well as invasive modes for assessing microcirculation have yielded inconsistent results. Aim of work: To determine the usefulness of coronary sinus filling time (CSFT) for assessment of microcirculatory transit time in the coronary circulation. Subjects and methods: A case-control study carried out in the Cardiology Department, Zagazig University Hospital on 57 patients divided into three groups: Group A included diabetics with angina, Group B included non-diabetics with angina, and Group C included control group. All patients were subjected to complete history taking, general examination and local cardiac examination. 12 Lead ECG, stress ECG (treadmill test), transthoracic echocardiography and coronary angiography were done. Results: regarding CSFT in group A the mean was 5.247 ± 0.562, in group B the mean was 4.635 ± 0.224 sec and in group C the mean was 3.295 ± 0.525 sec. There were significant difference between group A and control group (P < 0.001), between group B and control group (P < 0.001) and between group A and group B (P < 0.001). There were statistically significant relation between prolongation of coronary sinus filling time and presence of comorbid hypertension (P < 0.001), dyslipidemia (P < 0.05), Family History of CAD (P < 0.001) and obesity (P < 0.05). Conclusion: The coronary sinus filling time is a useful method for assessment of microcirculatory transit time in the coronary circulation. The prolongation of coronary sinus filling time is significantly associated with the presence of diabetes mellitus.

Background: Type 2 diabetes is a global public health crisis that threatens the economies of all nations, particularly developing countries. Hyperprolactinemia may reflect neuroendocrine stress reaction to acute coronary syndromes, which induces acute endothelial dysfunction, insulin resistance, and induction of vascular immune reactions; thus, prolonged hyperprolactinemia lead to arteriosclerosis, augmentation of arterial stiffness, and hypertension. Objective: To assess role of prolactin as a cardiovascular risk in type 2 diabetes mellitus patients in Zagazig University Hospitals. Patients and Methods: This study was performed in Clinical Pathology, Cardiology and Internal Medicine Departments Zagazig University Hospitals in the period between July and October 2019. Approval for study was obtained from research administration and research ethics committee, Faculty of Medicine Zagazig University. Results: Regarding prolactin level, there was a statistically significant increase on comparing group 1 with group 2, 3 and 4 (P= 0.016, P

Objective: The main objective of this study was to develop atorvastatin calcium (ATR) as an oral drug delivery system for a P-glycoprotein (P-gp) substrate drug using different pharmaceutical excipients that inhibit P-glycoprotein and evaluate the influence of nanocrystals on the dissolution characteristics and bioavailability compared to the plain drug. Methods: A nanosuspension was prepared by Solvent-antisolvent precipitation method using a solvent containing stabilizer that act as a p-gp inhibitor dissolved in distilled water as polyethylene glycol 300, polyethylene glycol 400 (PEG 300, PEG 400), tween 20 and tween 80 while the solvent selected for atorvastatin calcium was methanol. The concentrations were as follows: PEG 300 and 400 = 0.25% w/v, tween 20 and 80 = 0.75% v/v. Nanocrystals were extracted from the suspension and characterized. Results: Particle size of the drug was 1307±127.79 nm while the formulas prepared ranged from 223±17.67 to 887±58.12 nm. Pure ATR had a saturated solubility of 0.059±0.005 mg/ml and the prepared nanocrystals ranged from 0.32±0.021 to 0.88±0.019 mg/ml. The Percentage of drug released of plain atorvastatin calcium reached 41.49% while the formula ranged from 44.32 to 61.5%. Both XRD and SEM discussed the degree of crystallinity as follows: F1

Background: The Intensive care units acquired weakness detected in 30 to 50% of ICU patients leading to high morbidity and complication, family engaging family in early mobility process that reported benefits including reduced ICU-acquired weakness, improved functional recovery within the hospital, improved walking distance at hospital discharge and reduced hospital length of stay. This study aimed to Determine the effect of family involvement in patient care on preventing intensive care units acquired weakness. Methods: Quasi experimental research was conducted in surgical and general ICUs in the main Mansoura university and emergency hospitals, which included 60 adult newly ICU admitted patients. Tools: Three tools were used to collect the data of this study namely “Intensive care unit acquired weakness assessment”, “Early progressive mobility protocol” and “Patients’ family satisfaction with early mobility protocol involvement”. Results: Only 6.7% of the intervention group had a weakness at the end of the study with no significant difference (0.150) was found in muscle strength from the start and end of the study. While about a third of the control group (26.7%) had a weakness at the end of the study. A statistically significant difference (0.038) in muscle strength was found between intervention and control group. Furthermore, About two-thirds (70%) of patients' family members of the intervention group were satisfied by giving them a role in participation in their patient care. Conclusion: Critically ill patients whose families were involved in their mobility protocol had less intensive care units acquired weakness rates than those who were not. Recommendation: Evaluation of muscle strength should be a routine part of ICU examination. Family centered care concept should be adopted in ICUs by allocating them in daily activities involvement with enough support and cooperation

BackgroundIntralesional immunotherapy has been effectively used in the treatment of warts; however, comparative studies between different antigens are limited.ObjectiveTo evaluate the efficacy and safety of intralesional measles, mumps, and rubella (MMR) vaccine compared with intralesional Candida antigen for the treatment of multiple common and plantar warts.MethodsSixty-eight adult patients with multiple common and plantar warts were randomly assigned into two groups, each containing 34 patients. The first group received intralesional MMR vaccine, while the second group received intralesional Candida antigen. Each treatment was injected into the largest wart at 2-week intervals until complete clearance or for a maximum of 5 sessions.ResultsThe overall therapeutic response was higher in the Candida antigen group (73.5%) compared with the MMR group (67.7%); however, the difference was not statistically significant. Complete clearance of common warts was higher in the Candida antigen group, while that of plantar warts was higher in the MMR group. Adverse effects were transient and well tolerated in both groups. No recurrence was detected during the 6-month follow-up period.ConclusionIntralesional MMR and intralesional Candida antigen showed comparable efficacy and safety in the treatment of common and plantar warts.