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This study aimed to investigated the relationship between the major Perspectives of balanced scorecard though A proposed Model to Merge Indicators of Social Responsibility within the Perspectives of the Balanced Score Card (BSC) and its Impact on strategic performance in three of nonprofit organizations which operate under super vision of “International Islamic Council for Dawah and Relief ”(IICDR): World assembly of Muslim youth (Cairo). General secretariat of International Islamic Council for Dawah and Relief. Kuwait Zakat House (Cairo). The five Perspectives of balanced scorecard (financial perspective, customer perspective, internal business perspective, learning and growth perspective, and social responsibility perspective) were explored in this study. It comes as a complement to other studies that have agreed to be the best measure to evaluate the strategic performance of nonprofit organizations is balanced scorecard measure. Where achieves a balance between financial and non-financial elements to measure performance. Kaplan and Norton inventory was used to collect data on the five Perspectives of balanced scorecard and obstacles of implementation in three of nonprofit organizations. A total of (100) usable survey were analyzed using sophisticated statistical techniques such as ANOVA, Path analysis, and structured equations models. The questionnaire was designed by the researcher under supervision of the main supervisor. Demographic information was also collected and was coded as follows: gender (male=1;female=2), age (less than 30 yrs. =1; 30-40 yrs. =2; 40-50 yrs. =3; more than 50 yrs. =4), career level (executive=1; department manager=2; general manager=3; other=4), experience (less than 5 yrs. =1; 5-10 yrs. =2; 11-15 yrs. =3; more than 15 yrs. =4), and education (high school=1; college graduate=2; diploma degree=3; master degree=3; ph. degree=3). Four major hypotheses were tested, the overall ANOVA and structured equation models indicates a significant statistical difference of adding Perspective of social responsibility within the Perspectives of the Balanced Score Card on (BSC) Perspectives (customer, internal operations, learning and growth, and finance perspective). Results showed statistically significant differences at the level indication (0.05) of adding Perspective of social responsibility within the Perspectives of the Balanced Score Card on (BSC) Perspectives (customer, internal operations, learning and growth, and finance perspective).

Background Unsafe injection practices are an occupational hazard among the nursing staff. Awareness of nurses’ staff members about safe injection practices may vary between different hospitals according to the policies adopted for staff training and systematic auditing. Aim To assess awareness and practice of safe injection among nursing staff in a Maternal and Child Hospital, Qassim Region, Saudi Arabia, and Beni-Suef University Hospital, Egypt. Methods A cross-sectional study using a structured questionnaire. Observations included 500 injections (250 from each hospital) from October to December 2017. Results The mean awareness total scores in both hospitals were 9.98 ± 1.76 and 11.12 ± 0.96 respectively with a significant difference among observed nurses (P = 0.001). The mean safe injection practice total score was 27.13 ± 3.11 and 27.39 ± 2.17. Past year safe injection training was received for 95% and 70% for observed Egyptian and Saudi group of nurses. The majority of nurses (98.8%) were aware of the importance of safe injection practices to minimize blood-borne diseases, and 95.2% of them were aware of the placement of sharps disposal box beside the place of injection procedure. Exposure to the past year needlestick injuries (NSIs) was higher among the observed Egyptian nurses (P = 0.001). Using appropriately stored and refilled disinfectants was done by 48.5% and 51.5% of the observed nurses. Needle separation from its syringe inside sharps disposal box and sharps disposal boxes near patient care areas were observed in 95.2% and 95.6% of both hospitals respectively. Conclusions and recommendation Nurses of both hospitals have good awareness and practice of injection safety. This might be attributed to the adoption of appropriate training courses. There is a need for continuous training sessions and auditing for nursing staff to ensure safe injection practices.

The anti-osteoporotic activity of ethanol extract from the Matricaria chamomilla L. flower was evaluated using steroid-induced osteoporosis in a rat model for the first time. Biochemical parameters such as serum calcium, phosphate, magnesium, creatinine, and alkaline phosphatase were assessed. At a 400 mg/kg body weight dose, the extract showed 54.01% and 27.73% reduction in serum calcium and phosphate ions serum levels, respectively. Meanwhile, it showed a 20% elevation in serum magnesium level, compared to the steroid-treated group. It also showed a significant decrease in creatinine and alkaline phosphatase levels, by 29.41% and 27.83%, respectively. The obtained results were further supported by biomechanical analyses, which revealed that a 400 mg/kg body weight dose of the flower extract increased bone strength and thickness. At the same time, it does not affect the bone length, compared to the diseased group. Histopathological examination revealed that the extract showed a significant increase in trabecular thickness, and it had restored the architecture of the cortical and trabecular structure with well-organized bone matrix. The possible inhibitory effect of the major phenolic compounds identified from the plant extract on cathepsin K was investigated using molecular docking. Rutin (4) had the best-fitting score within the active site, as evidenced by the free binding energy, (∆G = −54.19 Kcal/mol). ADMET/TOPKAT revealed that the examined compounds had variable pharmacodynamics and pharmacokinetic properties that could be improved to enhance the bioavailability during incorporation in various dosage forms. Thus, it can be concluded that this plant extract showed potential therapeutic benefits for osteoporosis.

Background: Genito-pelvic pain penetration disorder is a common and neglected problem that can affect a woman's quality of life. Aim of the study: Evaluate the effect of stretching versus breathing exercises on self-reported pain with penetration during sexual intercourse for women with genito-pelvic pain penetration disorder. Method: A quasi-experimental study was conducted on 150 women who were selected using a purposive sampling technique. Data was collected at the gynecology outpatient clinic at Zagazig University Hospital and a private clinic. The evaluation was performed via a structured interview questionnaire and the Marinoff Pain Intensity Scale before the start of the study and at the end of the intervention exercises. Results: The two groups showed a significant decrease (P Conclusion: The study concluded that stretching exercises have a significant role in reducing the self-reported pain intensity of penetration during sexual intercourse and pelvic floor muscle spasm for women with genito-pelvic pain penetration disorder.

OBJECTIVE Multimodal intraoperative neuromonitoring (IOM) using somatosensory-evoked potentials and motor-evoked potentials is a sensitive and specific tool for detecting intraoperative neurologic injury during spine surgery. This study aimed to evaluate the use of multimodal IOM in a lower-middle-income country (LMIC) during cervical and thoracic spine surgery in order to prevent and predict new postoperative neurologic deficits early on. This is the first report of multimodal IOM application in LMICs. METHODS The neurophysiologist raised the cutoff warning criteria of 50 patients who underwent surgery for different cervical and thoracic pathologies to decrease postoperative neurologic deficits. We retrospectively reviewed the medical charts and neuromonitoring traces of these patients followed by calculating the sensitivity, specificity, positive predictive value, and negative predictive value of combined IOM for postoperative neurologic deficit occurrence. RESULTS A significant relationship was found between the reversibility of alerts and the development of new postoperative deficits (P < 0.001). There was no relationship between the cause of alerts and the reversibility of those alerts after corrective measures were carried out (P = 0.455), or the frequency of alerts and the development of new deficits postoperatively (P = 0.578). Sensitivity, specificity, positive predictive value, and negative predictive value of combined somatosensory-evoked potential and motor-evoked potential monitoring were 100%, 80%, 62.5%, and 100%, respectively. CONCLUSION Because of the limited experience and the many technical difficulties faced in LMICs, we found that this cutoff limit resulted in more false-positive warnings but helped to avoid any false-negative results, thus enhancing the safety of surgery.

Introduction Primary malignant melanoma of the spinal cord (PSM) is a rare condition with limited evidence regarding its diagnosis (clinical and radiographic), management, and prognosis. Our aim was to report an extremely rare two cases of primary malignant melanoma of the spine one of them is sacral melanoma which represents the second reported case in the literature and to conduct a systematic review of the relevant literature. Methods The diagnosis and management of these cases were retrospectively reviewed. Using the PRISMA guideline, we conducted a systematic review of the literature to analyze different management strategies and the prognosis of such pathology. Results All two patients were operated on, and received gross total removal of their tumors, with extended follow up for tumor recurrences. One of the cases involved a sacral tumor, which was resected without adjuvant therapy. The other one was seen by oncology and received post-operative chemo- and radio- therapy. In addition to the aforementioned cases, we present a comprehensive review of the literature on PSM from 1950 to the present, demonstrating that PSM is a very rare tumor, with a limited counted number of cases reported worldwide. Conclusion In conclusion, we report an exceedingly rare two cases of primary malignant melanoma of the spine. Early surgical intervention is key to the management of these rare and aggressive tumors. GTR should be attempted if possible.

Histamine H3 receptors (H3Rs) are involved in several neuropsychiatric diseases including epilepsy. Therefore, the effects of H3R antagonist E177 (5 and 10 mg/kg, intraperitoneal (i.p.)) were evaluated on acute pentylenetetrazole (PTZ)-induced memory impairments, oxidative stress levels (glutathione (GSH), malondialdehyde (MDA), catalase (CAT), and superoxide dismutase (SOD)), various brain neurotransmitters (histamine (HA), acetylcholine (ACh), γ-aminobutyric acid (GABA)), and glutamate (Glu), acetylcholine esterase (AChE) activity, and c-fos protein expression in rats. E177 (5 and 10 mg/kg, i.p.) significantly prolonged step-through latency (STL) time in single-trial passive avoidance paradigm (STPAP), and shortened transfer latency time (TLT) in elevated plus maze paradigm (EPMP) (all P < 0.05). Moreover, and in the hippocampus of PTZ-treated animals, E177 mitigated abnormal levels of AChE activity, ACh and HA (all P < 0.05), but failed to modify brain levels of GABA and Glu. Furthermore, E177 alleviated hippocampal oxidative stress by significantly decreasing the elevated levels of MDA, and increasing the abnormally decreased level of GSH (all P < 0.05). Furthermore, E177 reduced elevated levels of hippocampal c-fos protein expression in hippocampal tissues of PTZ-treated animals (all P < 0.05). The observed results propose the potential of H3R antagonist E177 with an added advantage of avoiding cognitive impairment, emphasizing the H3Rs as a prospective target for future pharmacological management of epilepsy with associated memory impairments.