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Abstract Introduction Cervical cancer presents a significant global public health challenge, particularly affecting low- and middle-income countries like Egypt. Despite the availability of effective screening methods such as Pap smears and HPV testing, the incidence of cervical cancer remains high in Egypt. Health literacy, which refers to the ability to access, understand, and utilize basic health information and services to make informed decisions, is crucial in influencing individuals’ health behaviors, including their participation in cancer screening programs. Objectives To examine the correlation between health literacy levels and cervical cancer screening behaviors among women. Methods This study employed a multi-site cross-sectional research design from September 2023 to January 2024. The research was conducted at four primary health care (PHC) facilities in the Damanhur district of Egypt. Three hundred fifty women participated in the study, completing a comprehensive questionnaire that included a Woman’s Social and Health Form, a Cervical Cancer Knowledge Scale, a Cervical Cancer Screening Behaviors Scale, and a Health Literacy Scale (HLS-SF12). Results The study revealed significant relationships between the importance of health literacy (HL) in understanding cervical cancer (CC) knowledge and screening behaviors among Egyptian women. A positive correlation was found between Knowledge and HL (r = 0.507, p

Abstract Background In Egypt, despite the presence of numerous approved osteoporosis medications and many dual-energy X-ray absorptiometry scan facilities, only a small percentage of patients at high risk of sustaining a fragility fracture receive treatment. This significant “treatment gap” puts the highest-risk individuals at risk for developing fragility fractures. The aim of this study was to highlight patients at high risk of experiencing fragility fractures in the catchment area of Helwan University Hospitals by establishing a fracture liaison service and examining how they received their osteoporosis management and utilization of services. Purpose (1) To determine the treatment gap for men and postmenopausal women who have experienced a fragility fracture and (2) to look into the traits and risk factors for fractures of patients who show up with an index fragility fracture. Results This study included 28 individuals with fragility fractures, with 60.7% being female and 39.3% being male. The average age was 68.75 (SD ± 8.93) years. Twenty-five percent of males and 62% of postmenopausal women had an increased 10-year fracture risk [not including bone mineral density (BMD)]. A total of 83.3% of males and 62.6% of postmenopausal women did not get any osteoporosis medicines, despite being eligible for therapy. The Fracture Risk Assessment Tool score and BMD measurements at the hip and spine showed a significant correlation. Fracture risk was significantly correlated with falls, sarcopenia, and functional disability. Conclusion In the Helwan University Hospitals catchment area, there exists a significant treatment gap for older adults in Egypt. The discrepancy appears to be linked to inadequate patient education and a poor diagnosis rate for osteoporosis.

Abstract Background Spiritual leadership emphasizes that nurses encounter situations that require compassion, empathy, and a deep understanding of the human experience. Passion can drive nurses' motivation, engagement, and commitment to patient care. Altruism is a core value in nursing that involves selfless concern for the well-being of others. Spiritual leadership might be an essential organizational resource in enhancing followers’ inspiring vision, compassion for others, and passion for their work. Aim of the study To investigate the role of spiritual leadership in the relationship between altruism and passion for work among nurse colleagues. Subjects & method A multicenter descriptive, cross-sectional research study was conducted at six Nursing Egyptian faculties affiliated with Alexandria, Port-Said, Fayoum, Damanhur, Assiut, and Sohag Universities, with 391 nurse colleagues. Data collection tools Personal and Job-related Data Questionnaire, Spiritual Leadership Questionnaire (SLQ), Passion Scale, and 9- Self-Report Altruism Scale (9- SRA) were utilized to collect data. Results The current study verified that nurse colleagues had high levels of perceived spiritual leadership, passion, and altruism (50.9, 47.6, and 40.2, respectively). The results revealed noteworthy positive correlations between spiritual leadership, passion, and altruism (r = 0.644, 0.519, & 0.509). Furthermore, mediation analysis highlighted that spiritual leadership could mediate the effect of altruism on the passion level. Conclusion This study delivers valued insights into the crucial role of spiritual leadership in augmenting nurse colleagues’ altruistic tendencies and passion. Recommendations Cultivating workplace spirituality on a daily agenda is a key component of management that requires spiritual competencies from nurse leaders. These competencies ultimately enhance passion for work, performance, and altruistic behaviors.

Abstract Background Stroke stands as a major cause of morbidity and mortality worldwide. The recommended treatment for eligible patients within the initial 4.5-h window is intravenous recombinant tissue plasminogen activator (IV rt-PA). This study explored the factors influencing functional outcome following IV rt-PA treatment in a group of Egyptian patients with acute ischemic stroke (AIS). We included sixty patients diagnosed with AIS who met the criteria for IV rt-PA therapy. Data were collected and statistically analyzed, we established correlations with functional outcomes as measured by the modified Rankin Scale (mRS) and National Institute of Health Stroke Scale (NIHSS) 3-month post-treatment. Results Of the 60 patients, 40 (66.67%) exhibited a favorable functional outcome, while 20 (33.33%) experienced a less favorable outcome. Poor functional outcome was associated with atrial fibrillation [p value

Abstract Background Monkeypox has emerged as a global health concern, necessitating preventive measures and awareness among healthcare students. Understanding nursing students’ fears, concerns, and preventive practices regarding Monkeypox can help improve preparedness and response strategies. Aim This study aimed to assess the levels of fear, concerns, and preventive practices related to monkeypox among nursing students at Beni Suef University, Egypt, during the 2024–2025 academic year. Methods A cross-sectional descriptive design was employed, involving 505 nursing students systematically randomized recruited. Data collection utilized three validated tools: the Monkeypox Fear Scale, Monkeypox Concern Scale, and Monkeypox Preventive Practices Scale. Reliability was confirmed with Cronbach’s alpha values ranging from 0.87 to 0.94. Data analysis included descriptive statistics, Spearman correlation, and multiple linear regression using SPSS Version 23. Results Most (56.2%) students rarely worried about Monkeypox infection, though 49.2% reported anxiety influenced by media coverage. High preventive practices were noted, with 60.6% frequently practicing hygiene measures. A strong positive correlation between Monkeypox concern and fear (r = 0.646, p

Abstract Hypervitaminosis D leads to toxic effects, including hypercalcemia, which can cause severe damage to various organs. Fetuin-A, a glycoprotein with anti-inflammatory properties, may protect tissues from such damage. This study explores the role of Fetuin-A in mitigating hypervitaminosis D-induced damage in renal, hepatic, and cardiac tissues. The objectives of this study were to: (1) Assess the extent of tissue damage from high-dose vitamin D in a murine model by examining the histopathological changes in liver, kidney and heart. (2) Investigate Fetuin-A's protective effect against this damage. Thirty-six albino rats were divided into four groups: (1) control, (2) vitamin D toxicity, (3) Fetuin-A + vitamin D, and (4) Fetuin-A only. Vitamin D was administered subcutaneously at 250 μg/20 g/day for 3 days. Fetuin-A was given at 100 μl/20 g, starting 7 days before vitamin D treatment. Histopathological analysis of liver, kidney, and heart tissues was performed using H&E and Alizarin Red staining and findings were analysed statistically. Vitamin D toxicity caused significant tissue damage, including apoptosis, inflammation, and calcification in the liver, kidneys, and heart. Pre-treatment with Fetuin-A reduced calcification and inflammation, preserving tissue architecture. Fetuin-A-only rats showed no damage or calcification. Fetuin-A provided statistically significant protection against vitamin D-induced damage, reducing oxidative stress and calcification in affected organs. These findings suggest Fetuin-A could be a potential therapeutic agent for hypervitaminosis D.

Background/Objectives: Hemophilia A is an X-linked recessive illness produced by a deficiency of coagulation factor VIII. This study aimed to evaluate serum vitamin D in hemophilic pediatric patients and its correlation with joint health and quality of life. Methods: This case-control study was performed on ninety children under the age of 18 years old and separated into two groups: study group of 45 children with hemophilia A and control group of 45 healthy children at an outpatient pediatric hematology clinic at the Beni-Suef University hospitals. Results: Serum vitamin D levels were significantly lower in hemophilia A patients than in controls (p < 0.001). The level of serum vitamin D was deficient in 38 (84.4%), insufficient in 4 (8.8%) and sufficient in 3 (6.6%) in the study group while deficient in 8 (17.7%), insufficient in 16 (35.5%) and sufficient in 21 (46.6%) in the control group. Total hemophilia joint health score (HJHS) had a significant negative correlation with serum total calcium (R = −0.31, p = 0.038) and serum vitamin D level (R = −0.974, p < 0.001) while also positively correlated with alkaline phosphatase (R = 0.834, p < 0.001). A quality-of-life index that is specific to total hemophilia (Haemo-Qol/Haem-A-QoL) had a significant positive correlation with total hemophilia joint health score (HJHS) (R = 0.934, p < 0.001) and negatively correlated with serum vitamin D level (R = −0.924, p-value lower than 0.001), alkaline phosphatase (R = 0.842, p < 0.001), and severity of hemophilia (R = 0.67, p < 0.001). Conclusions: patients with hemophilia A had lower vitamin D levels than healthy controls. The severity of vitamin D deficiency is related positively to (HJHS) hemophilia and quality of life hemophilia cases according to Haemo-QoL.

Abstract Background Depression is the most common psychiatric disorder in older adults, even though it is commonly misdiagnosed and undertreated, leading to exacerbations of preexisting medical conditions and even a higher mortality rate. In the present systematic review with meta-analysis, we quantify the magnitude of depression and its associated risk factors among the older adult population in Egypt. Methods A thorough literature search was performed from 2010 up to October 2023. The results were presented as proportions or risk difference with a 95% confidence interval (CI) calculated using the random effects model. A sensitivity analysis was performed to examine the robustness of the results. Results Our study included 14 articles with 5857 older adults published between 2011 and 2023. All the included studies assessed depression in geriatrics using the Geriatric Depression Scale. Of the 14 studies, 5 were for community-dwelling older adults, 3 were for older adults attending primary health care (PHC) centers, 2 were for hospitalized older adults, 3 were for residing in geriatric homes, and one for residing in geriatric homes, hospitalized older adults, and community-dwelling older adults. The overall prevalence of depression among Egyptian geriatrics was 64.6%. The pooled prevalence of depression was 59.6%, 67.0%, 67.0%, and 62.0% for community-dwelling older adults, older adults people attending PHC, hospitalized older adults, and older adults residing in geriatric homes, respectively. Older adults with chronic illness, female sex, and low-income elders and elders who were not employed had a higher risk for depression with pooled risk differences of 34.9%, 17.8%, 23.8%, and 15.1% (P

Abstract Background Diabetes mellitus (DM) is a global epidemic disease affecting millions each year. Recent studies have suggested novel biomarkers that are linked to DM. This study aimed to measure the levels of fibroblast growth factor-21 (FGF-21) and adiponectin in the blood of patients with type 2 DM and to assess the variations in their levels in response to the type of treatments. The possible correlations with several biochemical parameters and the diagnostic potential of FGF-21 and adiponectin as biomarkers for DM were also investigated. Eighty subjects were classified into control, Type 2 DM patients who were treated with metformin, Type 2 DM patients who were treated with metformin + oral hypoglycemic agents (OHAs), and Type 2 DM patients who were treated with insulin + metformin + OHAs. Results The metformin + OHAs group and the insulin + metformin + OHAs group had higher levels of FGF-21 when compared to the control group. The metformin + OHAs also had significantly higher adiponectin levels when compared to the control or metformin groups. The serum levels of FGF-21 in the diabetic subjects were negatively correlated with LDL, direct bilirubin, albumin, and insulin levels and positively correlated with the duration of DM. However, the serum levels of adiponectin in the diabetic subjects were negatively correlated with weight while positively correlated with potassium levels. Remarkably, FGF-21 and adiponectin were effective biomarkers for diagnosing DM with a specificity of 100% and 90% and sensitivity of 52.3% and 64.5%, respectively. Conclusion These findings suggest that FGF-21 and adiponectin play crucial roles in DM diagnosis and prognosis and that their levels change depending on the treatment type.

Introduction Smartphones have significantly increased digital engagement among young people due to their ease of use and constant internet access. Nomophobia and the fear of missing out are associated with mobile and internet use, potentially impacting students’ mental health and academic performance. Objectives To provide the prevalence of nomophobia and fear of missing out while shedding light on the role of psychological alienation between them. Methods A multisite descriptive correlational study was conducted among 1,273 undergraduate nursing students at six Egyptian universities: North Sinai, South Sinai, Port-Said, Suez Canal, Suez, and Damanhur University, Egypt. From June 2023 to November 15, 2023, the students were surveyed using questionnaires on nomophobia, fear of missing out, and psychological alienation. Results Nursing students experienced moderate to severe levels of nomophobia (37.4%–45.3%) and psychological alienation (45.8%–55.4%). There was a significant positive correlation between nomophobia and fear of missing out ( r = .908, p

Decades of conflict, political instability, and limited infrastructure left Somalia facing significant challenges to offer consistent and equitable health services, especially for child vaccination. Recent data reveals alarming vaccination gaps, with 60% of children receiving no vaccinations, and only 11% completing required vaccines. Despite global support, an estimated 1.15 million children remain unvaccinated, half of them reside in inaccessible areas controlled by non-state armed actors. In this context, the Far-Reaching Integrated Delivery (FARID) project was initiated since October 2022 across 10 districts of Galmudug and Hirshabelle state in Somalia. Employing the ‘Health Camp’ model, FARID addresses social, structural, and gender barriers, adapting to ever-changing context of inaccessible regions by providing mobile health facilities and outreach health and nutrition services, including child vaccination. This approach effectively reached previously unreached population in Somalia’s most difficult-to-reach areas. Implemented in phases, the project immunized 51,168 children (0–23 months) who had not received any prior vaccinations (23,753 boys and 27,415 girls), screened and treated 14,158 malnourished children (0–59 months) and vaccinated 11,672 pregnant women during March–December 2023. The project’s success hinges on intensive community engagement, local partnerships, innovation in mapping and data management, and delivery of integrated services tailored to population needs. The project underscores the critical role of local community-based organizations and clan elders in reaching inaccessible populations through humanitarian negotiation amidst security challenges. The project has achieved significant milestones aligned with national health strategic plans, including progress towards universal health coverage and improved immunization access in Somalia’s most challenging regions.

Abstract Background The field of long COVID research is rapidly evolving, however, tools to assess and monitor symptoms and recovery of the disease are limited. The objective of the present study was to develop a new patient-reported outcomes instrument, the Symptoms Evolution of Long COVID‑19 (SE-LC19), and establish its content validity. Methods The 40-item SE-LC19 instrument was developed based on patient-relevant empirical evidence from scientific literature and clinical guidelines that reported symptoms specific to long COVID. A 2-part mixed-method approach was employed. Part 1: Qualitative interviews with a purposive sample of 41 patients with confirmed long COVID were conducted for the content validation of SE-LC19. During cognitive debriefing interviews, patients were asked to describe their understanding of the instrument’s instructions, specific symptoms, response options, and recall period to ensure its relevance and comprehensiveness. Five clinicians of different medical specialties who regularly treated patients with long COVID were also interviewed to obtain their clinical expert opinions on SE-LC19. Part 2: Exploratory Rasch Measurement Theory (RMT) analysis was conducted to evaluate the psychometric properties of the SE-LC19 data collected during the interviews. Results Overall, patients reported that the instructions, questions, recall period, and response options for SE-LC19 were comprehensive and relevant. Minor conceptual gaps reported by patients captured nuances in the experience of some symptoms that could be considered in future studies. Some patients suggested a revision of the recall period from 24 h to 7 days to be able to capture more symptoms given the waxing and waning nature of some symptoms. Clinicians found the instrument comprehensive with minimal suggestions regarding its content. Exploratory RMT analyses provided evidence that the SE-LC19 questionnaire performed as intended. Conclusion The present mixed-methods study in patients with confirmed long COVID supports the content validity and applicability of the SE-LC19 instrument to evaluate the symptoms of patients with long COVID. Further research is warranted to explore the psychometric properties of the instrument and refine a meaningful and robust patient-relevant endpoint for use in different settings such as clinical trials and clinical practice to track the onset, severity, and recovery of long COVID.

Abstract Introduction This study aimed to assess the effects of a monoclonal antibody (mAb) combination on symptoms, daily function, and overall health-related quality of life. Methods We analyzed patient-reported outcomes data from symptomatic outpatients in a phase 1/2/3 trial. Patients with confirmed SARS-CoV-2 infection and ≥ 1 risk factor for severe COVID-19 received mAb treatment (casirivimab plus imdevimab 1200 mg) or placebo. Prespecified exploratory assessments included time to sustained symptoms resolution, usual health, and return to usual activities (assessed daily for 29 days). The trial was conducted from September 2020 to February 2021, prior to widespread COVID-19 vaccination programs and Omicron-lineage variants against which casirivimab + imdevimab is not active. Results In this analysis 736 outpatients received mAb and 1341 received placebo. Median time to sustained symptoms resolution was consistently shorter with mAb versus placebo (≥ 2 consecutive days: 14 vs 17 days, [nominal p = 0.0017]; ≥ 3 consecutive days: 17 vs 21 days, [nominal p = 0.0046]). Median time to sustained return to usual health and usual activities were both consistently shorter with mAb versus placebo (≥ 2 consecutive days: 12 vs 15 days [nominal p = 0.0001] and 9 vs 11 days [nominal p = 0.0001], respectively; ≥ 3 consecutive days: 14 vs 18 days [nominal p = 0.0003] and 10 vs 13 days [nominal p = 0.0041], respectively). Conclusions mAb treatment against susceptible SARS-CoV-2 strains improved how patients feel and function, as evidenced by shortened time to sustained symptoms resolution and return to usual health and activities. Future studies are warranted to assess the patient experience with next generation mAbs. ClinicalTrials.gov Registration number, NCT04425629; Submission date June 11, 2020.

Background: The recurring psychological, behavioural, and physical symptoms of premenstrual tension syndrome (PTS) are related to the luteal phase of the menstrual cycle. Its development may be influenced by hormonal influences. Objectives: To investigate the effects of catecholamines on PTS and possible improvements upon using pharmacological treatments. Patients and methods: After agreement of participants and ethical committee approval, this randomized controlled trial enrolled 60 obese women with PTS who were split into younger (18-39 years) and older (40-48 years) age groups in comparison to an age-matched healthy control group. All of the study participants' serum levels of adrenaline (epinephrine), and norepinephrine were measured. Utilizing pertinent rating scales, a few psychosomatic PTS symptoms (headache, backache, and stomach bloating) were also assessed. Results: Compared to the control group, obese women with PTS had significantly higher serum levels of adrenaline, and noradrenaline (p

Abstract Background Analysis of free DNA molecules shed from tumour cells in plasma of patients referred as circulating tumour DNA (ctDNA) with reference to physiological circulating cell-free DNA (cfDNA) is nowadays exploited as liquid biopsy and is considered a new emerging promising biomarker for diagnosis, selection of proper treatment, and prognosis of cancer. DNA integrity index (DII) is assessed by calculating the ratio between the concentration of long cfDNA strands released from tumour cells (ALU247) and the short strands released from normal cells (ALU115). The aim of the current study was to evaluate DII as a potential diagnostic and prognostic biomarker of NSCLC. Methods Our study included 48 NSCLC patients diagnosed as primary NSCLC before starting treatment, 30 COPD patients diagnosed clinically, radiologically, and subjected to chest high-resolution computerized tomography, and 40 healthy controls. cfDNA concentration and DII were measured by quantitative real-time polymerase chain reaction (qPCR). Results ALU115, ALU247, and DII were significantly higher in NSCLC compared to COPD patients (p

Author(s): Mohamed Hussein Ramadan Atta (corresponding author) [1,2]; Sally Mohammed Farghaly Abdelaliem [3]; Amany Anwar Saeed Alabdullah [4]; Ghada Ahmed Ghazi [5] 1. Introduction Depression is a common emotion-based illness [...], Background: Depressive disorders are prevalent mental health conditions that significantly impair individuals' social functioning and communication competence. These challenges can exacerbate depressive symptoms, creating a vicious cycle that hinders recovery and overall well-being. Despite the growing recognition of the impact of depressive disorders on social functioning and communication competence, there remains a significant gap in effective interventions addressing these specific areas. Aims: This research aims to investigate the effect of interpersonal effectiveness skill training on social functioning and communication competence among clients with depressive disorder. Design: A quasiexperimental research design. Setting: The research procedure was carried out in the outpatient clinic of Alexandria University Hospital. Subjects: The study group, which included 42 males and 18 females, and the control group had the same number of patients. Tools: After the preliminary assessment of depression, three instruments were used to collect data: a structured interview schedule that gathered sociodemographic and clinical information, the Scale of Communication Competence, and the Social Functioning Scale. Results: The study group showed a positive difference in their social functioning and communication competence score compared with the control group. Implication: The findings of this study have significant implications for the treatment and support of clients with depressive disorder by incorporating structured skill-building programs into therapeutic regimens for individuals with depressive disorders. Conclusion: IESTI can enhance patients with depression's ability to communicate competently and function socially.

Introduction: Joint positioning can impact nerve function. Few studies have explored the effects of ankle positions on deep peroneal nerve conduction. This cross-sectional study investigated the influence of different ankle joint positions on the deep peroneal nerve’s distal motor and sensory onset latencies. Materials and Methods: A total of 31 healthy adults (23.4±3.9 years old) underwent a deep peroneal nerve conduction study. Distal motor and sensory onset latencies were measured at neutral (0°), dorsiflexion (20°) and plantar flexion (40°) ankle positions. Results: Changing ankle position significantly affected distal motor (P=0.001) and sensory onset latencies (P=0.001). Latencies were shortest in dorsiflexion (motor: 3.8±0.46; sensory: 2.4±0.2 ms), followed by neutral (motor: 4.2±0.5; sensory: 2.6±0.3 ms) and most prolonged in plantar flexion (motor: 5±0.6; sensory: 3.3±0.2 ms). Conclusion: Ankle position impacts deep peroneal nerve conduction. Dorsiflexion and neutral positions reduced distal motor and sensory latencies compared to plantar flexion. These findings provide preliminary evidence that may help optimize ankle positioning in electrodiagnostic testing. Further blinded research with larger, more diverse samples is warranted.