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Abstract Background Musculoskeletal ultrasound is a useful, noninvasive tool to detect anatomical damage in the hyaline cartilage, synovial tissue, and tendons of individuals with asymptomatic hyperuricemia. This study aimed to determine the frequency of musculoskeletal ultrasonographic findings related to hyperuricemia among CKD patients and its relation to chronic musculoskeletal pain and their quality of life. Results Double contour (DC) was found in12%,18%, and 22% of the knee, ankle, and 1st MTPs joints, respectively. Hyper-echoic cloud was present in 2% and 6% of the knee and 1st MTPs, respectively. Synovitis was seen in 8%, 4%, and 16% of the knee, ankle, and 1st MTPs joints, respectively. Patellar tendon showed enthesopathy in 14% and tophus in 8% of cases. Tibialis posterior tenosynovitis was in 2% and peroneii tenosynovitis in 2%. Achilles tendon showed calcific foci in 24%, enthesopathy in 20%, and tophi in 4%. First MTPs showed erosion in 10% and tophi in 4%. There were statistically significant relations of pain index to DC, synovial thickening at the knee and at ankle joint. There were statistically significant relations of serum uric acid level to DC.There were statistically significant correlations of serum uric acid level to the 36-Item Short Form Survey (SF-36). Conclusions Untreated hyperuricemia might cause musculoskeletal ultrasonographic changes that could cause chronic musculoskeletal pain and decrease quality of life in chronic kidney disease patients.

Abstract Background DEXA scan could be unavailable at some health centers, and radiologic examination of the mandible and oral cavity is considered more commonly used radiologic test that can predict, diagnose, or even follow-up on any defect in bone mineralization. The aim of this study was to elucidate the ability of panoramic radiograph to detect osteoporosis in rheumatoid arthritis patients and correlate panoramic mandibular index with RA disease activity and severity parameters. Results The sensitivity of panoramic mandibular index for diagnosis of osteoporosis was 96% in group Ι (primary OP) and 70% in group ΙΙ (RA patients). The positive predictive value of PMI was 67% in group Ι and 55% in group ΙΙ. The negative predictive value of PMI was 34% in group Ι and was 46% in group ΙΙ. The cutoff value of PMI for diagnosis of OP was ≤ 0.31 in group Ι and ≤ 0.17 in group ΙΙ. In group I, there were significant correlations between panoramic mandibular index and patient’s ages, weights, T score at L1-4, T score at femoral neck, and T score at forearm while there were insignificant correlations between PMI and patients’ heights. In group ΙΙ, there were significant correlations between PMI, patients’ ages, weights, disease durations, SHARP score, ESR, RF, T score at L1-4, T score at femoral neck, and T score at forearm, while there were insignificant correlations between PMI and patients’ heights, DAS, and CRP. Conclusions Panoramic radiography could have a potential usability in the diagnosis of osteoporosis in rheumatoid arthritis patients regardless of displaying insignificant correlation with disease activity.

Abstract Background Lower limb deformities could affect child's quality of life and may worsen with time. This work aims to study the prevalence of lower limb deformities among primary school students in our governorate. Methods This cross-sectional descriptive study was carried out on 4689 students attending 12 public primary schools during the academic year 2019–2020.Complete clinical examination was done for picking of cases of genu varum, genu valgum, genu recurvatum, flat foot, pes cavus, hallux valgus, in-toeing, and lower limb discrepancy, and x-ray on both feet, pelvis, and full-length lower limb was requested. Results This cross-sectional descriptive study included 4689 students. The prevalence of lower limb (LL) deformities was 16.61%. One hundred twenty-three (2.62%) children had a positive history of musculoskeletal pain, 0.09% had genu varum, 0.11% had genu valgum, 0.75% had Genu recurvatum, 0.03% had LL discrepancy, 13.86% had flexible flat foot, 1.22% had rigid flat foot, 0.23% had pes cavus, 1.04 % had in-toeing, 0.06% had hallux varus, and 0.11% had hallux valgus. Conclusions Lower limb deformities are a considerable problem in primary school students that need early diagnosis because it could affect child’s future, health, and career. Further studies are needed to investigate spinal deformity, vit D level, calcium level, foot wear, and school bag weight as hidden factors.

BackgroundMisinformation is often disseminated through social media, where information is spread rapidly and easily. Misinformation affects many patients' decisions to follow a treatment prescribed by health professionals (HPs). For example, chronic patients (eg, those with diabetes) may not follow their prescribed treatment plans. During the recent pandemic, misinformed people rejected COVID-19 vaccines and public health measures, such as masking and physical distancing, and used unproven treatments. ObjectiveThis study investigated the impact of health-threatening misinformation on the practices of health care professionals in the United Kingdom, especially during the outbreaks of diseases where a great amount of health-threatening misinformation is produced and released. The study examined the misinformation surrounding the COVID-19 outbreak to determine how it may have impacted practitioners' perceptions of misinformation and how that may have influenced their practice. In particular, this study explored the answers to the following questions: How do HPs react when they learn that a patient has been misinformed? What misinformation do they believe has the greatest impact on medical practice? What aspects of change and intervention in HPs' practice are in response to misinformation? MethodsThis research followed a qualitative approach to collect rich data from a smaller subset of health care practitioners working in the United Kingdom. Data were collected through 1-to-1 online interviews with 13 health practitioners, including junior and senior physicians and nurses in the United Kingdom. ResultsResearch findings indicated that HPs view misinformation in different ways according to the scenario in which it occurs. Some HPs consider it to be an acute incident exacerbated by the pandemic, while others see it as an ongoing phenomenon (always present) and address it as part of their daily work. HPs are developing pathways for dealing with misinformation. Two main pathways were identified: first, to educate the patient through coaching, advising, or patronizing and, second, to devote resources, such as time and effort, to facilitate 2-way communication between the patient and the health care provider through listening and talking to them. ConclusionsHPs do not receive the confidence they deserve from patients. The lack of trust in health care practitioners has been attributed to several factors, including (1) trusting alternative sources of information (eg, social media) (2) patients' doubts about HPs' experience (eg, a junior doctor with limited experience), and (3) limited time and availability for patients, especially during the pandemic. There are 2 dimensions of trust: patient-HP trust and patient-information trust. There are 2 necessary actions to address the issue of lack of trust in these dimensions: (1) building trust and (2) maintaining trust. The main recommendations of the HPs are to listen to patients, give them more time, and seek evidence-based resources.

Objective This study aimed to highlight the diagnostic value of musculoskeletal ultrasonography (US) in the evaluation of inflammatory changes in the shoulders of rheumatoid arthritis (RA) patients and to correlate those findings with the clinical, laboratory, and radiological parameters of the disease activity. Patients and methods This study included 40 RA patients diagnosed according to the 2010 American College of Rheumatology/European League Against Rheumatism classification criteria for RA. In addition, 20 age-matched and sex-matched healthy individuals were included. US assessment was performed bilaterally in RA patient's shoulder and unilaterally in controls. All US examinations were carried out using LOGIQ P6 PRO machine equipped with 6–8 MHz broadband multifrequency linear transducer. Result US on shoulders detected that 21 (52.5%) RA patients studied had erosions, 18 (45%) RA patients had synovitis, 21 (52.5%) RA patients had tenosynovitis, seven (17.5%) RA patients had bursitis, and 18 (45%) RA patients had rotator cuff tendinopathy. There was a significant relation between US-detected erosion in RA patients and disease duration (P = 0.037) and rheumatoid factor (RF) level (P = 0.02), whereas there was no significant relation between US-detected erosion in RA patients and shoulder pain (P = 0.185), Disease activity score 28 (DAS28) (P = 0.163), erythrocyte sedimentation rate (P = 0.519), and C-reactive protein levels (P = 0.561). There was a significant relation between US-detected tenosynovitis in RA patients and shoulder pain (P = 0.025). There was no significant relation between US-detected bursitis in RA patients and disease duration (P = 0.970), shoulder pain (P = 0.907), DAS28 (P = 0.471), erythrocyte sedimentation rate (P = 0.220), and RF levels (P = 0.755), whereas there was a significant relation between US-detected bursitis in RA patients and C-reactive protein (P = 0.036). Conclusion US became a problem-solving approach and the tool of choice for cases with shoulder problem, and can provide an accurate answer to many clinical questions and give an accurate diagnosis of different pathological abnormalities encountered.

This article reports the findings from a review of the scholarly literature concerning women leaders in education. The PRISMA approach was used to review the contemporary evidence (2014-2024) and 30 articles were identified that fully met the inclusion and exclusion criteria set for the review. A thematic analysis of the selected articles was undertaken, and five main themes emerged. Results suggest that the under-representation of women in leadership roles and the barriers that women face in securing leadership positions remain dominant within the contemporary evidential base. The review findings suggest that women are still likely to encounter complex, inter-related discriminatory challenges when seeking a leadership post. The review findings also highlight that such challenges are well documented in evidence spanning over 30 years. Finally, the article suggests that the use of more sophisticated methodological approaches, including more longitudinal research studies of women leaders (both aspiring and in post), would add significant value to the knowledge base.

Participation in authentic research in the field and online through Community and Citizen Science (CCS) has shown to bring learning benefits to volunteers. In online CCS, available platforms present distinct features, ranging from scaffolding the process of data collection, to supporting data analysis and enabling volunteers to initiate their own studies. What is yet not well understood is how best to design CCS programmes that are educational, inclusive, and accessible by diverse volunteers, including young people and those with limited prior science experiences who are rather few in CCS. In this study, we interviewed 31 young people, aged 7-20 years old, who used iNaturalist, an online biodiversity monitoring platform, and identified how different forms of participation online and in the field facilitated (or inhibited) certain forms of learning, as defined by the Environmental Science Agency framework. Findings revealed that iNaturalist enabled participation of young people including those with limited science experiences and facilitated science learning such as the development of science competence and understanding. A blended learning framework for biodiversity monitoring in CCS is presented as a means to support the development of hybrid, educational, and inclusive CCS programmes for young people.

Background: The second wave of the COVID-19 pandemic presented significant challenges to healthcare systems worldwide. This retrospective cohort study aimed to investigate incidence and type of medication errors among patients isolated in an Egyptian general hospital during the early months of 2021. Methods: A total of 468 patient records were reviewed for medication errors. Data collection included patient demographics, comorbidities, admission details, and clinical pharmacist data. Medication errors were categorized based on ordering, administration, and monitoring processes. Statistical analysis included descriptive statistics, and visual representations of key variables. Results: A total of 934 medication errors were found with a prevalence of 42 per 100 patient days and almost 2 errors per patient. All participants experienced drug therapy problems, with the most prevalent issues related to dosing regimen (31%), needs drugs (27%), and monitoring (18%). The main drugs involved in medication errors were anticoagulants (17.6%), antibiotics (12.3%), corticosteroids (10%) and antiviral drugs (9%). Conclusion: This study highlights the very high incidence of medication errors among COVID-19 patients during the second wave of the pandemic. The main issues were related to "dosing regimen", "needs a drug" and "needs monitoring". Also, the main drug groups involved in theses errors were anticoagulants and antibiotics, followed by corticosteroids and antiviral drugs. Recommendations: Addressing medication errors, especially in critical care settings, is crucial for improving patient safety and outcomes. Future interventions should focus on enhancing healthcare professionals' knowledge and communication, particularly in high-stress environments like ICUs. These findings can guide healthcare practice improvements and enhance patient care during pandemics and other healthcare crises. [ABSTRACT FROM AUTHOR]

Background: A significant proportion of individuals, including those who were hospitalized, through the global pandemic of the novel 2019 coronavirus disease (COVID-19), experienced residual symptoms following acute COVID-19 infection. Accordingly, it has impacted the patient's Health-Related Quality of Life (HRQoL) resulting in negative effects on one or more domains of their quality of life. Objective: To assess the HRQoL of COVID-19 patients discharged from Ain Shams University Isolation Hospitals, 2021. Methods: We conducted a cross-sectional study including a total of 550 adults discharged from Ain Shams University Isolation Hospitals. Data was collected using a phone-based interview questionnaire including questions about socio-demographic characteristics, clinical information, and Short-form 8 (SF-8) to assess the 8 domains of HRQoL; general health, physical functioning, Role physical, bodily pain, vitality, social functioning, mental health, and role emotional. Univariate analysis was done to investigate the relationship between the study variables and the total mean score of HRQoL. Results: Participants' mean age was 53.71 ± 13.17, and 53.1% of them were females. We found that 63.5% had co-morbidities. The mean of the total days of hospital stay was 12.37 ± 7.22 and about fifth was admitted to the intensive care unit (ICU) (22.2%). The mean of the total score of the 8 items of SF-8 in discharged patients was 69.96 ± 23.31. The Role physical domain was more affected among the other domains (51.55±40.03). The following variables were significantly associated with lower mean of the total score of HRQoL as: age≥50, female gender, having co-morbidities, length of hospital stay and ICU admission. Conclusion and Recommendation: COVID-19 is associated with negative effect on HRQoL of hospitalized COVID-19 patients especially the physical domain. Follow up service after COVID infection is recommended, especially for people with existing comorbid conditions. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to explore correlations between the presence of depression, clinical scores, and ultrasonographic (US) grading in osteoarthritis (OA) patients and to clarify if depressive symptoms might cause a discrepancy between US findings and clinical scores. Material and Methods: Two hundred patients with primary knee OA and 100 healthy hospital volunteers of the same age and sex not complaining of knee troubles participated in this study. We evaluated depressive symptoms in all participants using the Beck Depression Inventory (BDI) scale. Thorough clinical examination was performed, including assessment using the Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) for disability. All patients underwent US examination of their affected knees. Results: Depression was detected in 60 patients with knee OA (30%) and in 5 controls (5%). The mean of BDI score was 12.8±12.2 in OA patients and 5.8±3.2 in controls, and this difference was statistically significant (p=0.03). Correlations of BDI with both body mass index (BMI) (p=0.04) and Numerical Rating Scale of Pain (NRSP) score (p=0.006) were significant, while correlations of BDI with both the ages of our patients (p=0.74) and their disease duration (p=0.88) were insignificant. There were statistically significant correlations between patients' disease duration and US measurements regarding osteophyte length, lateral femoral cartilage thickness, medial femoral cartilage thickness, and thickness of the quadriceps tendon despite of the presence of insignificant correlations between disease duration and both the effusion volume and volume of Baker's cysts. There were statistically significant correlations between patients' disease duration and US measurements except for effusion volume and volume of Baker's cysts. There were statistically significant correlations between the NRSP score in OA patients and BDI (p=0.006) and all US measurements apart from lateral femoral cartilage thickness, medial femoral cartilage thickness, and thickness of quadriceps tendon. There were statistically significant correlations between BDI in OA patients and the WOMAC (p=0.005), Kellgren-Lawrence (KL) grading (p=0.034), and US grading (p=0.041). Conclusion: The presence of knee effusion, Baker's cysts, osteophytes, and high BMI have a great impact on the pain and disability associated with OA. Higher clinical scores, radiographic scores, and US scores correlate with the emergence of depression in OA patients. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to evaluate the effect of one dose of intra-articular injection of (PRP) in the knee joint on a specific osteoarthritis (OA) serum biomarker of cartilage degeneration, Collagen 2-1 (Coll2-1), over a short period of 3 months. The aim extended to clarify the effect of PRP on the functional status of the osteoarthritic knee joint. Material and Methods: Sixty patients with primary unilateral knee OA were enrolled in this study. They were subdivided according to Kellgren-Lawrence grading scale (KL) into (Group I): including patients with KL grade < 3 and (Group ΙΙ): including patients with KL grade ≥3. Patients were asked to complete the Western Ontario and McMaster Universities Arthritis Index (WOMAC) Score. PRP was prepared and injected immediately into the affected knee. Serum Coll2-1 (S.Coll2-1) concentration was measured by enzyme-linked immunosorbent assay (ELISA) kit pre and 3 months after PRP injection. Results: Significant reduction in S.Coll2-1 concentration in primary knee OA patients; (p<0.001) and (p<0.05) in group Ι and group ΙΙ respectively as well as significant improvements in WOMAC total and WOMAC sub-scores values were noted after single intra-articular PRP injection with maximal functional improvements were achieved after 3 months (p<0.001). Mild cases experienced favorable results with no remarkable adverse reactions were observed. Conclusion: Reduction in specific OA biomarker S.Coll2-1 following intra-articular PRP injection emphasize that PRP could be a promising safe and tolerable effective therapeutic option which improves function from basal states in primary knee OA patients. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate the relations between calreticulin (CRT) serum level and both disease activity and severity parameters in juvenile idiopathic arthritis (JIA). Material and Methods: In this study, 60 children with JIA and 50 age-and-sex-matched healthy subjects were enrolled. The assessment of the disease activity was done using juvenile arthritis disease activity score 27 (JADAS-27). The assessment of disease severity was done via gray-scale ultrasonography (US) and power Doppler US (PDUS). Enzyme-linked immunosorbent assay (ELISA) was used to assay the serum level of human CRT. Results: The mean serum CRT levels in JIA patients was 8.6±1.2 ng/mL and showed a highly significant increase (p=0.001) as compared to the mean serum levels in the controls (5.02±0.77 ng/mL). There were statistically significant positive correlations between the serum CRT levels and disease duration, tender joint count, swollen joint count, visual analog scale, erythrocyte sedimentation rate, JADAS-27, C-reactive protein, rheumatoid factor titer, and ultrasonographic grading for synovitis and neovascularization. Conclusion: Elevated serum CRT levels in JIA patients and its correlations with JIA disease activity and severity parameters signified that CRT might be used as a novel biomarker for disease activity and severity in JIA. [ABSTRACT FROM AUTHOR]