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Abstract Background Knowledge of the frequency of precipitating factors for acute heart failure (AHF) is important (either new-onset heart failure [NOHF] or worsening heart failure [WHF]), as this can guide strategies for prevention and treatment. Most data come only from Western Europe and North America; nevertheless, geographic differences do exist. We set out to study the prevalence of precipitating factors of AHF and their connection to patient characteristics and in-hospital and long-term mortality in patients from Egypt hospitalized for decompensated HF. Using the ESC-HF-LT Registry which is a prospective, multicenter, observational study of patients confessed to cardiology centers in the nations of Europe and the Mediterranean, patients presenting with AHF were recruited from 20 centers all over Egypt. Enrolling physicians were requested to report possible precipitants from among several predefined reasons. Results We included 1515 patients (mean age 60 ± 12 years, 69% males). The mean LVEF was 38 ± 11%. Seventy-seven percent of the total population had HFrEF, 9.8% had HFmrEF, and 13.3% had HFpEF. The commonly reported precipitating factors for AHF hospitalization among study population were as follows (in decreasing order of frequency): infection in 30.3% of patients, acute coronary syndrome/myocardial ischemia (ACS/MI) in 26%, anemia in 24.3%, uncontrolled hypertension in 24.2%, atrial fibrillation (AF) in 18.3%, renal dysfunction in 14.6%, and non-compliance in 6.5% of patients. HFpEF patients had significantly higher rates of AF, uncontrolled hypertension, and anemia as precipitants for acute decompensation. ACS/MI were significantly more frequent in patients with HFmrEF. WHF patients had significantly higher rates of infection and non-compliance, whereas new-onset HF patients showed significantly higher rates of ACS/MI and uncontrolled hypertension. One-year follow-up revealed that patients with HFrEF had a significantly higher rate of mortality compared to patients with HFmrEF and HFpEF (28.3%, 19.5, and 19.4%, P = 0.004). Patients with WHF had a significantly higher rates of 1-year mortality when compared to those with NOHF (30.0% vs. 20.3%, P

Background: The situation for medical education and healthcare in Sudan has been challenging for the recent years, and emigration of physicians is an ongoing problem threatening the healthcare system. We conducted this study to understand the future plans of medical students and their perceptions regarding their medical education and healthcare system., Method: We performed this cross-sectional study at five public and private Sudanese medical schools in November 2023. We distributed the questionnaire electronically through an Online Google Form via social media platforms, such as WhatsApp Messenger. Descriptive statistics were employed for the data analyses., Results: The mean age (±SD) of the students was 22.2 (±2.7) years, and females constituted 61.8% (397) of the study sample. About 18% of the students rated their medical training as excellent, and half of them (50%) said that it was good. Nearly half of the students believed the quality of healthcare services in hospitals was poor (46%) along with a shortage or severe shortage in its number (49%). A majority (58.4%) thought frequently or constantly about leaving Sudan after graduation. Reasons given for leaving included better personal lifestyle, avoiding conflict, advanced training, and better professional opportunities and salary. Leading motives for staying included the pull of friends and family and a sense of responsibility to the country., Conclusion: This study indicated the pressing need for comprehensive interventions to address the challenges faced by medical students in Sudan. The strong desire to emigrate increased by the current conflict, coupled with concerns about the healthcare system and medical education, poses a significant threat to the future of healthcare services in the region., Competing Interests: The authors declare no conflicts of interest regarding this study or its publication., (© 2025 The Author(s). Health Science Reports published by Wiley Periodicals LLC.)

Background: Dengue fever, a neglected tropical disease, exhibits a total seroprevalence of 27% in Sudan. During the recent outbreak, medical students actively participated in health education and community outreach programs. This study aims to assess the knowledge, attitude, and practice (KAP) of medical students regarding Dengue Fever (DF) during its current outbreak in Sudan., Design and Methods: We conducted a cross-sectional study involving medical students from more than 15 Sudanese universities, encompassing 11 states. Data collection took place between October 23 and November 10, 2023, utilizing a Google Form questionnaire. A convenient sampling technique was employed to reach students due to its accessibility and feasibility during the ongoing conflict in Sudan. Correlation and regression analyses were used to identify predictors of KAP and establish associations between KAP domains and socio-demographic factors., Results: Of 694 medical students, 11% reported a previous infection with DF. Among the participants, 58% demonstrated good knowledge, 74.1% exhibited a positive attitude, and less than half (46.7%) demonstrated good preventive practices. There was a positive correlation between knowledge and attitude levels with the practice level ( p  < 0.001). Gender, age, and previous DF infection emerged as significant predictors ( p  < 0.05) of the overall KAP level in multiple logistic regression., Conclusions: Our study revealed a commendable level of knowledge and attitude but a suboptimal level of practice regarding DF among medical students. This inadequacy in practice, particularly among medical students who are expected to set an example, is concerning and warrants further investigation., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

Increased COVID-19 vaccine hesitancy presents a major hurdle in global efforts to contain the COVID-19 pandemic. This study was designed to estimate the prevalence of adverse events after the first dose of the Covishield (AstraZeneca) vaccine among physicians in Bangladesh. A cross-sectional study was conducted using an online questionnaire for physicians ( n  = 916) in Bangladesh. Physicians who received at least one dose of the COVID-19 vaccine were included. The study was carried out from April 12 to May 31, 2021. More than 58% of respondents ( n  = 533) reported one or more adverse events. Soreness of the injected arm (71.9%), tiredness (56.1%), fever (54.4%), soreness of muscles (48.4%), headache (41.5%) and sleeping more than usual (26.8%) were the most commonly reported adverse events. Most vaccine-related reactogenicities were reported by the younger cohorts (<45 years). The majority of respondents reported severity of reactogenicity as "mild," experienced on the day of vaccination, and lasting for 1-3 days. The most common reactogenicity was pain at the injection site; the second most common was tiredness. Almost half (49.2%) of the physicians took acetaminophen (paracetamol) to minimize the effects of vaccine reactogenicity. Multivariate logistic regression analyses showed that physicians with diabetes and hypertension (OR = 2.729 95% CI: 1.282-5.089) and asthma with other comorbidities (OR = 1.885 95% CI: 1.001-3.551) had a significantly higher risk of vaccine-related reactogenicities than physicians without comorbidities. Further safety studies with larger cohorts are required to monitor vaccine safety and provide assurance to potential vaccine recipients., Competing Interests: The authors have no conflict of interest to declare., (© 2022 The Authors. FASEB BioAdvances published by the Federation of American Societies for Experimental Biology.)

Background: Acceptance of the COVID-19 vaccine by the target groups would play a crucial role in stemming the pandemic. Healthcare professionals (HCPs) are the priority group for vaccination due to them having the highest risk of exposure to infection. This survey aimed to assess their acceptance of COVID-19 vaccines in Bangladesh., Research Design and Methods: A cross-sectional survey using an online questionnaire was conducted between January 3 to 25, 2021, among HCPs (n = 834) in Bangladesh., Results: Less than 50% of HCPs would receive the vaccine against COVID-19 if available and 54% were willing to take the vaccine at some stage in the future. Female participants (OR:1.64;95%CI:1.172-2.297), respondents between 18-34 years old (OR:2.42; 95% CI:1.314-4.463), HCPs in the public sector (OR:2.09; 95% CI:1.521-2.878), and those who did not receive a flu vaccine in the previous year (OR:3.1; 95% CI:1.552-6.001) were more likely to delay vaccination., Conclusions: The study revealed that, if available, less than half of the HCPs would accept a COVID-19 vaccine in Bangladesh. To ensure the broader success of the vaccination drive, tailored strategies and vaccine promotion campaigns targeting HCPs and the general population are needed.

Introduction: Community orientation in medical education, which prepares medical students to become more effective practitioners, is now a global movement. Many medical schools around the world have adopted the concept as the main curricular framework in order to align learning programs with the needs of the community and the learner. Despite many changes over the past few decades, many improvements are still needed in medical education in Bangladesh. This study investigated medical students' perceptions of the community-based learning experiences incorporated into the Bachelor of Medicine, Bachelor of Surgery (MBBS) degree at Uttara Adhunik Medical College, Dhaka (UAMC), Bangladesh., Methods: A total of 135 students from three undergraduate year levels of the MBBS degree at UAMC, Dhaka, Bangladesh, undertook study tours (community-based teaching, CBT) as a part of a community medicine course and visited a medical college, two rural health centres and a meteorology centre in the Cox's Bazar district, 400 km from Dhaka city. A questionnaire was used to assess the perceptions of students regarding the administration, organisation and learning experiences of the study tours. Students were required to write reports, present their findings and answer questions in their examinations related to the study tours and CBT., Results: The majority of the students agreed or strongly agreed that the tour was a worthwhile (93%) and enjoyable (95%) learning experience that helped them to understand rural health issues (91%). More than half of the students reported that the study tours increased their awareness about common rural health problems (54%) and provided a wider exposure to medicine (61%). Only 41% of students reported that the study tour increased their interest in undertake training in a rural area. A substantial number of students also expressed their concerns about the planning, length, resources, finance and organisation of the study tours., Conclusions: Overall, the study tours had a positive effect, enhancing students' awareness and understanding of common rural health problems. As study tours failed to increase the motivation of the students (approximately 60%) to work in rural areas, CBT in the medical curriculum should be reviewed and implemented using effective and evidence-based models to promote interest among medical students to work in rural and underserved or unserved areas.