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Abstract Background Polycystic ovary syndrome (PCOS) is a complex endocrine disorder affecting women of reproductive age, and it has emerged as a significant global public health issue. This study aimed to investigate the effects of web-based health education on nursing students’ knowledge, adaptive healthy measures, and attitudes toward PCOS. Methods A two-group randomized controlled trial (RCT) with pre-test and immediate post-test assessments was conducted. Study participants were recruited using a simple random sampling method from the Faculty of Nursing, Mansoura University, Egypt. A questionnaire consisting of six sections was developed to collect data, which was analyzed with the SPSS 23.0 using Student’s t-test, Pearson’s correlation test, and chi-square test analysis of variance. Results The analysis revealed a significant increase in knowledge scores post-intervention, with the web-based learning groups (32.2 ± 10.5) outperforming the traditional learning group (22.1 ± 10.2), with (p

In this study, we obtain solitary wave solutions and other exact wave solutions for Davey–Stewartson equation (DSE), which explains how waves move through water with a finite depth while being affected by gravity and surface tension. The study is conducted with the aid of the modified extended mapping method (MEMM). A variety of distinct traveling wave solutions are furnished. The obtained solutions comprise dark, bright, and singular solitary wave solutions. Additionally, Jacobi elliptic function solutions, exponential wave solutions, singular periodic wave solutions, rational wave solutions, and periodic wave solutions are also offered. To help readers physically grasp the acquired solutions, graphical representations of some of the extracted solutions are provided.

Background: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy, as compression of the median nerve in the carpal tunnel under the flexor retinaculum; it is more frequent in middle aged women and mostly occurs bilateral. Objectives: Prospective case control study of Evaluation of ultrasound and color Doppler accuracy in diagnosis of carpel tunnel syndrome. Patients and methods: Prospective –case control clinical study was conducted during the time period from august 2019 to June 2020. Thirty subjects were included in the study (60 wrists) 20 were females and 10 males. They were referred to the radiology department at south valley university hospital from orthopaedic and rheumatology departments of south valley university hospital for ultrasound examination of the carpal tunnel after taking oral consent. Results: Out of 30 wrists with CTS, 5 (16.7%) of them had detected intraneural abnormal hypervasculature in Color duplex and power duplex of median nerve. In case of control group, only one wrist had detected intraneural abnormal hypervasculature in color and power duplex of median nerve. The significant cut off value for CSA of the median nerve in ultrasound (p-value 9mm2 with a sensitivity of93%, specificity32%and at quadratus level is >8mm2 with sensitivity84.31%, specificity78.5%. Conclusion: From all above discussed results we will establish and recommend a scheme for diagnosis of CTS based on ultrasound. Lastly this study used US with Doppler study to diagnose CTS ,US is easy ,rapid ,less costly and more comfortable method to patients suspected CTS and so it can be preliminary in diagnosis of CTS and grading.

Rheumatoid arthritis (RA) is a chronic, systemic inflammatory disease. Left atrial (LA) dysfunction is strongly linked to cardiovascular diseases, and the early detection of LA function in patients with RA is vital. Real-time three-dimensional echocardiography (RT-3DE) offers a noninvasive method to assess the structure and function of the LA.

PurposeAmong Bruton's tyrosine kinase inhibitors, acalabrutinib has greater selectivity than ibrutinib, which we hypothesized would improve continuous therapy tolerability. We conducted an open-label, randomized, noninferiority, phase III trial comparing acalabrutinib and ibrutinib in patients with chronic lymphocytic leukemia (CLL).MethodsPatients with previously treated CLL with centrally confirmed del(17)(p13.1) or del(11)(q22.3) were randomly assigned to oral acalabrutinib 100 mg twice daily or ibrutinib 420 mg once daily until progression or unacceptable toxicity. The primary end point was independent review committee-assessed noninferiority of progression-free survival (PFS).ResultsOverall, 533 patients (acalabrutinib, n = 268; ibrutinib, n = 265) were randomly assigned. At the data cutoff, 124 (46.3%) acalabrutinib patients and 109 (41.1%) ibrutinib patients remained on treatment. After a median follow-up of 40.9 months, acalabrutinib was determined to be noninferior to ibrutinib with a median PFS of 38.4 months in both arms (95% CI acalabrutinib, 33.0 to 38.6 and ibrutinib, 33.0 to 41.6; hazard ratio: 1.00; 95% CI, 0.79 to 1.27). All-grade atrial fibrillation/atrial flutter incidence was significantly lower with acalabrutinib versus ibrutinib (9.4% v 16.0%; P = .02); among other selected secondary end points, grade 3 or higher infections (30.8% v 30.0%) and Richter transformations (3.8% v 4.9%) were comparable between groups and median overall survival was not reached in either arm (hazard ratio, 0.82; 95% CI, 0.59 to 1.15), with 63 (23.5%) deaths with acalabrutinib and 73 (27.5%) with ibrutinib. Treatment discontinuations because of adverse events occurred in 14.7% of acalabrutinib-treated patients and 21.3% of ibrutinib-treated patients.ConclusionIn this first direct comparison of less versus more selective Bruton's tyrosine kinase inhibitors in CLL, acalabrutinib demonstrated noninferior PFS with fewer cardiovascular adverse events.

Abstract Background IgG4-related disease (IgG4-RD) is a progressive and sometimes fatal disease that rarely affects pediatric age group. It may affect the orbits, lacrimal and salivary glands, pancreas, kidneys, peritoneum and other organs. Lung and pleura are not commonly reported in IgG4-RD. We here present a rare case of pediatric IgG4-RD with rare involvement of pericardium, pleura and lungs. Case presentation A 13-year-old girl presented with intrathoracic IgG4-RD with pleuropericardial involvement. She showed initial improvement on prednisolone. Azathioprine and then mycophenolate failed to control relapses during steroid tapering. Her last relapse was treated by rituximab however, the patient developed acute fatal massive hemoptysis. Conclusions Pediatric IgG4-RD is a rare entity with pericardio-pulmonary affection as the rare of the rare. Usual treatment of prednisolone and steroid sparing agents should be used, with rituximab used as a rescue therapy, but fatal complications may occur.

Background: Worldwide, diabetes mellitus [DM] continues to be a major source of morbidity and mortality and is a critical public health issue. Diabetic foot ulcers are significant sources of distress and discomfort for many diabetic patients, with frequent resistance to treatment.Aim of the work: This study's objective was to assess the frequency of microbes that cause diabetic foot ulcers, in order to reduce morbidities associated with this condition. Patients and methods: One hundred diabetic patients with infected foot ulcers who were undergoing surgery in the outpatient clinic at Al-Azhar University Hospital in New Damietta were included in this study. Samples were obtained from each patient for microbiological testing and antibiotic sensitivity.Results: The most found organism was staphylococcus aureus [19%] among gram-positive and E. coli [13%] among gram-negative, and longer diabetes duration and T1DM were significant risk factors for microbial growth.Conclusion: From the results of the study we can conclude that the most found organism was staphylococcus aureus among gram-positive and E. coli among gram-negative. Longer diabetes duration and T1DM were significant risk factors for microbial growth.

Background: The radiologic pulmonary inflammatory index (PII) may be used as an early predictor of inflammation as laboratory assessments in COVID-19 cases. The purpose of this study was tocompare the clinical and radiological features between cases of COVID-19 necessitating admittance to the intensive care unit (ICU) and those who did not, and to correlate the PII with other inflammatory markers and outcomes. Patients and methods: 72 patients consecutively admitted with confirmed COVID-19. Their electronic records were retrospectively revised and the demographic, clinical, laboratory (complete blood count, C- reactive protein, D dimer, and serum ferritin), High resolution computed tomography (HRCT) data, PII, and the outcomes of the patients were analyzed. Results: They were 50/50%, males/females, with mean age 47.1 ± 16.8 years. During their stay, 15.3% necessitated ICU admittance, 68% cured and discharged, 9 cases referred and 6.9% died. The baseline lesions identified were ground-glass opacification recognized in (93%), higher PII and >3 lobes affection was considerably recorded in those who required ICU admittance (P= 0.041 and 0.013). There was a mild positive correlation between PII with age (r=0.264, P=0.031) and other prognostic inflammatory indicators as ferritin (r=0.225, P=0.048), D Dimer (r=0.271, P=0.043), and serum creatinine. Conclusions: The use of PII together with clinical and laboratory data may be valuable in defining the inflammatory state of COVID-19. This may allow clinicians to avoid the progression of the illness and improve the cure rates by proper early intervention.

Purpose: To evaluate current practice patterns for Egyptian ophthalmologists in the diagnosis of diabetic retinopathy (DR) and explore potential implications of these approaches on management. Methods: Cross-sectional survey conducted in Egypt amongst practicing ophthalmologists. Results: The study had 203 responses (~6% of all Egyptian ophthalmologists). A majority of respondents were general ophthalmologists (78.2%), practicing for five to ten years (41.9%). In patients with DR and no diabetic macular edema (DME), 33.0% of respondents would use FA in patients with mild DR, 44.3% in patients with moderate DR and 51.2% in patients with severe non-proliferative diabetic retinopathy (NPDR). Color imaging (CI) was used by less than 1% as the sole imaging modality for any level of DR. Approximately 70% of respondents used fluorescein angiography (FA) to grade and base treatment decisions for DR, either alone or in conjunction with dilated eye exams and/or CI. Given the known more severe appearance of DR on FA than on standard color imaging upon which treatment guidelines are based, use of FA as the primary modality over a one-year period could result in PRP that would otherwise not be suggested in approximately 78,820 eyes at an additional cost of $10.1 million US dollars. These numbers are projected to double by 2045. Conclusion: Given that FA detects significantly greater pathology than CI, and that treatment and follow-up recommendations are based on CI, its use as the primary imaging modality in DR grading may result in apparently significantly higher DR severity, with subsequently increased procedures and associated costs.

Background: Previous abdominal surgery usually lead to adhesion formation, which considered as a contraindication of laparoscopic cholecystectomy (LC). However, it had been reported that, careful adhesiolysis could be performed and thus LC becomes feasible. Aim of the work: To assess the feasibility and outcome of laparoscopic cholecystectomy in patients with previous upper abdominal surgery. Patients and Methods: This study included 30 patients, who were presented by symptomatic gallstones. All participants assessed clinically. Then, a full lab profile was performed. Finally, abdominal ultrasound was done and if there was a dilatation of common bile duct, patients were submitted to magnetic resonance cholangiopancreatography. Both intra-and postoperative data were collected and any complications were documented.Results: 26 patients (86.7%) had chronic calcular cholecystitis, two had acute calcular cholecystitis and two had mucocele of gallbladder. Adhesions were grade 1 in 13.3%, grade 2 in 46.7%, grade 3 in 20% and grade 4 in 20.0%. Adhesiolysis was needed in twenty patients (66.7%). Intraoperative complications were reported in nine patients (40%). Bleeding reported in six patients and preformation of the gall bladder in three patients (10%). Three patients (10%) were converted to open surgery. Postoperatively, 12 patients (26.7%) had complications [3, 1, 2, 1 and 5 for port site wound infection, bile leakage, bleeding, and chest infection respectively). Post operative pain was mild in half of patients and moderate in other half. Conclusion: laparoscopic cholecystectomy after previous abdominal operations is relatively feasible and relatively safe, as nearly one third of patients had difficulties and complications.