Background: The prevalence of electronic cigarette (e-cigarette) use is rising among health profession students, challenging the assumption that high health literacy is a protective factor against nicotine use. Understanding the motivations behind this trend is crucial for public health policy. Objective: To assess the prevalence, reasons for use, and perceived consequences of e-cigarette use among medical students and house officers. Methods: A cross-sectional study was conducted involving 144 current e-cigarette users recruited from the Faculty of Medicine, Cairo University. Participants completed a structured questionnaire covering sociodemographic data, vaping history, and the Short Form Vaping Consequences Questionnaire (S-VCQ). Results: The mean age of participants was 21.6 years, with a male predominance (90.3%). The majority (over 65%) were former cigarette smokers. The two most cited reasons for vaping were "recreation" (reported by 61.1% of the total cohort) and "as a method to quit cigarette smoking" (57.6%). Academic stress was a major trigger, with "exams" identified as the primary circumstance increasing vaping consumption (49.3%). High nicotine concentration usage (+20 mg/ml) was common (54.2%). On the S-VCQ, participants scored highest on "Positive Reinforcement" (mean score ~7.28), indicating they perceive vaping as pleasurable and socially beneficial. Conclusion: A significant proportion of medical trainees use e-cigarettes as a harm-reduction strategy or stress-coping mechanism during exams. Despite their medical training, these students remain heavily dependent on nicotine. Medical curricula must address the specific "cessation paradox" and stress triggers driving vaping in this population

Objectives: Managing type 1 diabetes in young adults involves distinct difficulties, especially when associated with depression, which contributes to difficulty in achieving glycemic control. The study focused on evaluating the effects of a virtual diabetes care program on Depression. Methods: A total of one hundred and thirty-two students from Assiut University diagnosed with type 1 diabetes who met the eligibility requirements were randomly assigned to either the intervention or control group. The intervention group consisted of university students with type 1 diabetes who participated in the virtual diabetes care program. The control group included university students with type1 diabetes and provided routine, usual care at the students' clinic of Assiut University. Both groups were assessed for Depression (via online designed questionnaire) and HbA1c at baseline and after six months. Results: After six months, the mean score on the CES-D scale did not differ statistically significantly between the two groups. There was a significant rise in depression symptoms among male patients in the control group (P = 0.038) after 6 months, but the virtual diabetes care program participants showed a slight, insignificant decrease in depressive symptoms. Conclusion: The virtual group attendance and mobile app usage were associated with preliminary results of improvement in depression in males. Longterm exposure to the virtual diabetes care program should be investigated in young adults with T1DM, focusing on the reasons for the gender differences in response to the program.

Metabolic dysfunction-associated steatotic liver disease (MASLD), previously termed non-alcoholic fatty liver disease (NAFLD), shares pathophysiological links with heart failure with preserved ejection fraction (HFpEF), but their clinical association remains underexplored. This systematic review and meta-analysis evaluates the association between MASLD and clinically diagnosed HFpEF and trying to quantify the magnitude of this association across available clinical studies. This review was registered on PROSPERO (CRD42025644064), we systematically searched PubMed, Embase, and Scopus (from inception to February 2025) for studies reporting clinical HFpEF prevalence in MASLD versus non-MASLD cohorts, using the following search terms: (“metabolic associated fatty liver disease” OR “MAFLD” OR “metabolic dysfunction associated steatotic liver disease” OR “MASLD” OR “non-alcoholic fatty liver disease” OR “NAFLD”) AND (“heart failure with preserved ejection fraction” OR “HFpEF” OR “diastolic heart failure” OR “preserved ejection fraction”) Pooled odds ratios (ORs) and 95

Background smart phones devices have become utilized in our daily life and it is now a common practice especially in the medical field. Nomophobia or-No Mobile PHOBIA-which is the fear of feeling uncomfortable without a cell phone is one of the negative aspects of mobile phones that has illustrated a massive increase over the past years. Aim Assess the prevalence of nomophobia among health acre providers and assess its relation to mental health as well as self-esteem. Methods 137 participants were assessed for nomophobia level using nomophobia questionnaire as well as self-esteem and mental health, as well as their sociodemographic characters, the correlation between nomophobia level and different factors was assessed. Results All the participants involved in the study (n=137) had nomophobia 100%, most of the participants had moderate nomophobia 59.85% (n=82) and 16.79% (n=23) had severe nomophobia and 23.36% (n=32) had mild nomophobia, there was a significant weak negative correlation between nomophobia level and self-esteem as well as mental health. Conclusion Nomophobia is a prevalent contemporary health concern that requires immediate care and management approaches.

Dementia is a global health challenge affecting both patients and their caregivers, with family members often bearing the primary caregiving burden. In Egypt, where research on caregiver mental health is limited, interventions addressing caregiver burden and anxiety is critical. To determine the effect of a psychoeducation and skill-based multimodal intervention on caregiver burden and anxiety. A randomized controlled trial (RCT) involving 84 family caregivers. Participants were assigned to either the intervention group (n = 42), which received structured psychoeducation and skill-based training over six biweekly sessions, or the control group (n = 42), which received routine outpatient care. Caregiver burden and anxiety were assessed using the Zarit Burden Interview (ZBI) and the Generalized Anxiety Disorder Scale (GAD-7). Behavioral and psychological symptoms of dementia were evaluated using the Neuropsychiatric Inventory Questionnaire (NPI-Q). The sample consisted predominantly of women (79

Background: Over the past few years, gestational diabetes mellitus has become more common. According to earlier research, gestational diabetes mellitus is linked to higher uric acid levels, and gestational hyperuricemia is linked to poor maternal and neonatal outcomes. Aim and objectives: To assess the influence of elevated uric acid >5 mg/dl on pregnancy outcomes such as neonatal weight, respiratory distress, preterm delivery, neonatal intensive care unit admission, premature membrane rupture, oligohydramnios, cesarean section, and intensive care admission for mothers. Setting and methods: It is a prospective cohort study, carried out at obstetric/family medicine outpatient clinics, Cairo University Hospitals on 221 pregnant females with gestational diabetes mellitus in their third trimester of pregnancy, selected by random sampling, performed structured interviews, and tested for serum uric acid level and were separated into two groups, those with elevated uric acid >5 mg/dl (121) and those without elevated uric acid ⩽5 mg/dl (100) patients and then followed up until delivery in Cairo University Hospitals for collecting pregnancy outcome data. Results: There were statistically significant differences between the antepartum uric acid and neonatal complications, maternal complications, preterm, macrosomia, neonatal intensive care unit admission, premature rupture of membranes, oligohydramnios, and cesarean section between both groups. Conclusions: This study showed that elevated serum uric acid >5 mg/dl can predict the incidence of maternal and neonatal problems in gestational diabetes mellitus including preterm, macrosomia, neonatal intensive care unit admission, premature rupture of membranes, oligohydramnios, and cesarean section.

Background: Non-steroidal anti-inflammatory drugs (NSAIDs) are common cause of acute kidney injury, but chronic kidney disease (CKD) risk of NSAIDs is controversial. Prior systematic reviews are outdated with some methodological flaws. We conducted this systematic review to clarify the association between chronic NSAIDs use and occurrence and/or progression of CKD. Methods: MEDLINE, Cochrane Library, Web of Science and Science direct were searched for observational and interventional studies from inception to May 2023. Qualitative synthesis was performed. The meta-analysis used pooled odds ratios (OR) and hazard ratios (HR) to estimate the association between chronic NSAID use and CKD occurrence or progression. Results: Forty studies with a total of 1757118 participants were included in the systematic review; of them 39 studies were suitable for meta-analysis. 56% of our included studies were recent, published within the last 10 years. The meta-analysis revealed a significant association between chronic NSAIDs use and CKD occurrence and progression. The pooled odds ratio was 1.24 (95% CI: 1.11-1.39, p <0.001, I-2 = 91.21%), and the pooled hazard ratio was 1.50 (95% CI: 1.31-1.7, p <0.001, I-2 = 90.77%). The pooled hazard ratio (HR) for individuals with no CKD at baseline was 1.31 (95% CI, 1.26-1.40), while for those with preexisting CKD, the HR was significantly higher at 1.67 (95% CI, 1.38-2.02). The HR for individuals with no specific chronic disease was 1.6 (95% CI, 1.32-1.94). For populations with diabetes mellitus (DM) and/or hypertension (HTN), the HR was 1.35 (95% CI, 1.27-1.43), and for those with rheumatic disease, the HR was 1.36 (95% CI, 0.88-2.10). Conclusions: Long-term NSAID use increases the risk of chronic kidney disease (CKD) occurrence and progression, especially in individuals with pre-existing CKD, who have a 67% risk compared to the general population's 60%. A patient-centered approach for safe and effective pain management is crucial, with special caution for those with pre-existing CKD.

Background Autism spectrum disorder (ASD) manifests in early childhood and significantly impairs social and communicative functions. Parents of children with ASD typically experience higher levels of stress compared to parents of children with other disabilities or health issues. This study investigates how a home-based early intervention known as the Portage program influences parenting stress and improves family awareness by using the Parental Stress Scale (PSS), and Family Awareness Scale. We enrolled 41 children diagnosed with ASD and their parents in this study. The median age of the children was 4 years, with a predominance of males (80%). We measured changes in parenting stress and family awareness as primary outcomes, with the children's behavior as a secondary outcome. Results Post-intervention assessments showed statistically significant improvements in parenting stress and family awareness (P < 0.001). Additionally, notable improvements were observed in the children's social, language, self-help, cognitive, and motor skills, as well as general developmental age and ratio. Conclusions A 3-month engagement with the Portage program markedly reduced stress among parents and increased family awareness regarding ASD. Significant advancements were also noted in multiple developmental domains of the children involved.

Assessing core clinical competencies in practice is challenging yet crucial. Family medicine offers opportunities to assess multiple competencies in a safe supervised environment. A robust system can integrate workplace-based assessment methods with detailed milestones and entrustable professional activities to formatively engage students and offer them constructive tutor feedback.

BackgroundThe COVID-19 pandemic is an unprecedented international health crisis, which has invoked massive consequence on healthcare workers' mental health and wellbeing. This study aimed to detect the prevalence of anxiety, depression, and burnout among house officers amid the COVID-19 pandemic in Egypt to assess the effect of this pandemic on their mental health.ResultsA total of 254 house officers were included in this study, and their responses were analyzed. Anxiety, burnout, and depression were reported among 35%, 32%, and 22% of participants, respectively. Multivariate regression analysis found that higher levels of overall worry were associated with anxiety, but not depression or burnout. Having a good personal protective equipment attitude was a significant predictor of both anxiety and burnout. Participants with depression had a higher likelihood of also having a burnout, but a lower likelihood of having anxiety. Overall worry related to the pandemic, depression, and clinical burnout status were all significantly associated with anxiety.ConclusionsThe study found that anxiety, depression, and burnout are highly prevalent among house officers, who are newly graduated medical professionals. These findings suggest the need for specific programs to address the wellbeing of these individuals during the COVID-19 pandemic.

Objectives The current study explores the level of perceived social stigma and associated psychological challenges among healthcare workers during the second wave of the COVID-19 pandemic in Egypt. Methods This was a cross-sectional study of 150 healthcare workers at Cairo University hospitals that were confirmed positive for COVID-19 infection. Participants were interviewed for assessment of perceived COVID-19-related stigma and associated psychological symptoms using the Patient Health Questionnaire for depression, the Generalized Anxiety Disorder Assessment for anxiety, and the Post-Traumatic Stress Disorder Checklist for post-traumatic stress symptoms. Results Two-thirds of participants perceived moderate-to-severe COVID-19-related stigma. Depression, anxiety, and post-traumatic stress symptoms were observed at varying levels in 58.0%, 38.0%, and 11.3% of participants, respectively. Female sex and occupation as a nurse were significantly associated with the total perceived COVID-19-related stigma score. COVID-19-related stigma perception significantly correlated with depression, anxiety, and post-traumatic stress. Conclusion Perceived social stigma prevails among healthcare workers and is associated with numerous psychological disturbances.

Abstract Background Coronavirus disease 2019 (COVID-19) struck the world by surprise by the rising numbers that required prompt governmental and hospital staff reaction to the ongoing crisis. A robust preparedness and personal protective equipment (PPE) were yet to be regarded as our best plan. Methods A survey study was conducted on 254 Egyptian house officers using an anonymous web-based questionnaire that was filled using Google Forms after obtaining online informed consent. Results The mean age of the participants was 25 years. Only 28.74% of the house officers were categorized as having a good preparedness, while 85.83% of them have a good PPE attitude. The preparedness and willingness were significantly associated with the overall worry related to the pandemic (P value = 0.012). Fear of contracting COVID-19 infection negatively affected their preparedness by 60% (odds ratio (OR) 0.40, 95% confidence interval (CI), 0.17–0.93, P value = 0.034). The House officers with family members at-risk for severe COVID-19 were less likely to be prepared and willing by 70% (OR 0.30, 95% CI 0.15–0.60, P value = 0.001). The house officers with good preparedness and willingness to deal with COVID-19 seemed to have a good PPE attitude (OR 11.48, 95% CI 2.43-54.34, P value = 0.002). Conclusion A significant number of house officers expressed low levels of preparedness, while most of them have a good PPE attitude.

1 Department of Family Medicine, Cairo University, Egypt 2 Department of Psychiatry, Cairo University, Egypt Abstract: Background: Enuresis is a common presentation among school children. The most common type is primary mono-symptomatic nocturnal enuresis (PMNE). Children suffering from enuresis have at least one psychological or psychiatric problem such as attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder ODD. Objective: This study aimed at evaluating the frequency and association between (PMNE) and disruptive behavioral disorders in children and young adolescents. Methods: A case-control study conducted at family medicine and child psychiatry clinics at the Center of Social and Preventive care. A total number of 110 children diagnosed with PMNE were assessed for disruptive behavioral disorders using Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) and Conners Parent Rating Scale-48 items (CPRS-48). Findings were compared with a matched group of 110 children without enuresis. Children and parents were interviewed and diagnosis was confirmed by a child psychiatrist. Results: The frequency of disruptive behavioral disorders was higher among cases than controls. The frequencies of ADHD, ODD, and conduct disorder in the case group (57%, 36%, and 30%, respectively) were significantly higher compared to the control group (23%, 11.8%, and 8.2%, respectively). ADHD-I (predominantly inattentive type) showed the highest prevalence among ADHD subtypes (n=31, 28%). The odds of children having ADHD were 4.5 which are significantly higher for children with PMNE than those without PMNE [OR: 4.56, 95% CI (2.54-8.18)]. Comparing cases and controls, the odds ratio for conduct disorder and ODD are [OR: 4.8, 95% CI (2.17-10.65)] and [OR: 4.1, 95% CI (2.04-8.24)], respectively. Conclusion: There is a significant association between PMNE and disruptive behavioral disorders in children and young adolescents.

Introduction: The COVID-19 pandemic has rapidly become a major worldwide health problem. Understanding the negative psychological sequalae on working physicians either front liners or not, can reserve psychological resilience for future disease outbreaks. Aim of the study: to explore the degree of anxiety and perceived stress in junior and mid senior physicians working at Cairo University Hospitals amid the COVID 19 pandemic. Methodology: This was an online based cross-sectional study done from April to May 2021. A total of 208 physicians working at Cairo University hospitals were asked to fill in Google forms including sociodemographic and clinical data beside two reliable tools to assess anxiety using the generalized anxiety disorder questionnaire (GAD) and perceived stress using the perceived stress scale (PSS). The individual domains and the total scores were calculated then compared with the different sociodemographic and clinical characteristics. Results: Most of the participants were females (66.3%), single (66.8%), not previously infected with COVID-19 (63.5%) and not included in the care of COVID 19 patients (64.9%). The mean GAD total score was 8.99±5.58 with 57.7% of the participants suffering mild to moderate anxiety. The mean PSS score was 20.76±5.3 with 80.3% found to have moderate stress. Except for the relation between gender and perceived stress (p value= 0.003), and the relation between psychiatric illness and perceived stress (p value=0.026), there was no statistical significance between anxiety and perceived stress from one side and sociodemographic and clinical data from the other side. Conclusion: Anxiety and perceived stress among physicians during the COVID-19 pandemic is considered high regardless of the different sociodemographic and clinical characteristics. Key words: COVID-19 pandemic, anxiety, perceived stress, physicians

BACKGROUND: Fibrocystic changes (FCCs) of the breast are a common breast condition. Mastalgia is the most common symptom of FCC; it usually causes fear of breast cancer and has negative effects on the quality of life. AIM: The objective of the research was to establish the effect of cosupplementation of omega-3 plus Vitamin E on mastalgia in FCC patients, to evaluate its effect with that of Vitamin E only, and to determine the effect of omega-3 plus Vitamin E versus Vitamin E only on the radiological findings in FCC patients. METHODS: This randomized controlled trial was conducted on 120 FCC patients with mastalgia. The participants were randomly assigned into three groups: Omega-3 plus Vitamin E group, Vitamin E only group, and control group. The new breast pain chart was used to assess the severity of mastalgia in the three groups before, through, and after intervention. Radiological assessment was done before and after the intervention. RESULTS: After 3 months of the intervention, there was a statistically significant difference between the three groups regarding radiological results with p > 0.05 and, after the 3rd month of interventions, there was a statistically significant difference between the groups regarding the new pain score with p > 0.001. The median of the new pain score premenstrual was 4.8, 2, and 2.5 in control, omega-3 plus Vitamin E, and Vitamin E only, respectively, but this difference was insignificant between the last two groups (p < 0.996). CONCLUSION: This study showed that Vitamin E and Vitamin E plus omega-3 were effective in relieving mastalgia in FCC patients. However, the addition of omega-3 was ineffective.

Abstract: Background: With the continuity of the COVD-19 pandemic and the rapid emergency remote teaching, Assessment was considered problematic. Objective structured clinical examination (OSCE) to assess the core skills required for the family physician is mandatory despite the circumstances. Objectives: This paper is to describe the experience of planning and conducting a virtual OSCE during the COVID-19 pandemic. Methods: Students enrolled in the professional family medicine diploma were the participants of the study. A suggested set-up of the virtual OSCE exam using the ZOOM meeting application was approved by the diploma council. Pilot Mock was done after orientation and preparation. Exam was conducted on parallel 2 sets of stations, each set is composed from 4 stations, facilitated by 3 coordinators and 1 assistant host in the ZOOM session. Each session included 10 students, 4 examiners. Coordinators (hosts) assigned assessors and role players in the designated (virtual) breakout rooms with the candidate, instructions displayed all through the station on the white board of this room. Results: Pilot Mock was conducted, and the feedback was improved in the actual exam setting. Nearly 18 examinee, 8 assessors and 3 moderators and administrate commenced the actual exam. Almost 87.5 % of the assessors were satisfied with the exam. The correlation of the virtual OSCE to written assessment was 0.52 which shows acceptable concurrent validity. Conclusion: Virtual OSCE is still an early version of a method for assessing the clinical skills remotely that needs logistics and further study.

Background: Evaluating gender-specific effects of COVID-19 is important to develop effective therapeutic strategies. The aim of this study was to explore gender difference in perceived symptoms and laboratory investigations in suspected and confirmed cases. Methods: This is a retrospective study that included data from suspected COVID-19 patients during the first wave of the pandemic. Participants using the phone triaging system at Kasralainy outpatient clinics were included. The analyzed data included patient history and results of nasopharyngeal swab and laboratory data. Results: Out of 440 COVID-19 suspected cases, 56.36% were females. The perceived COVID-19 symptoms showed no significant gender difference in suspected cases while in confirmed cases females were 4 times more likely to complain of cough [OR (95% CI) 3.92 (1.316–11.68), P-value .014] and 5 times more likely to experience loss of smell or taste [OR (95% CI) 4.84 (1.62–14.43), P-value .005]. Laboratory markers revealed high levels of aspartate aminotransferase, alanine aminotransferase, blood urea, serum creatinine, creatine kinase, and serum ferritin in males and this was statistically significant ( P-value <.001) in suspected and confirmed cases. Females confirmed with COVID-19 were 80%, 97%, and 97% less likely to have high levels of ALT, creatin kinase, and serum ferritin [OR (95% CI) 0.20 (0.07–0.54), 0.07 (0.01–0.38), and 0.07 (0.01–0.90), P-value .002, .002, and .041, respectively]. Conclusion: Gender differences were found in laboratory markers in COVID-19 suspected and confirmed cases and in perceived symptoms in confirmed cases.

BACKGROUND:Defensive medicine has great impact on medical practice and population health. It may provide enhanced quality of services with good explanations to patients resulting in increased satisfaction. On the other hand, it might include unnecessary investigations, prescription of unnecessary treatments which may be expensive or dangerous for patients. AIM OF WORK:This study aims to evaluate awareness and practice of defensive medicine among junior doctors in Cairo University Hospital. METHODS:This cross-sectional study includes 261 junior physicians by interviewing them using a structured questionnaire. RESULTS:Defensive medicine practice is highly affected by sociodemographic characteristics of study population. Almost half the female doctors are always giving extra details about the medication use (56%) P < 0.001. Around 90% of both specialties have not been involved in medical litigation. CONCLUSIONS:Defensive medicine is highly prevalent among junior physicians. Following clinical standards and fear of legal actions by patients are considered main causes of practice of defensive medicine.

We conduct this study to investigate the prevalence of dMMR, BRAFV600E mutation and nuclear BetaCatenin among Egyptian CRC cases and correlate results with clinico-pathological parameters and survival.Immunohistochemical assessment of MMR, BRAF and Beta-Catenin was carried out on 83 CRC cases.dMMR, BRAFV600E mutation and nuclear Beta-Catenin expression were identified in (48.2%), (20.5%)and(4.8%)of cases. For MMR and BRAF, none of the clinicopathologic parameters were significantlycorrelated with their status. Despite that the 5-year PFS was slightly better in dMMR tumors than pMMRtumors; yet, the statistical difference could not be verified. BRAF mutation had no prognostic impact onOS and PFS. The smaller number of Beta-Catenin positive tumors precluded the drawing of definitiveconclusion concerning its prognostic role.

Purpose of the study: how to shift from face-to-face clinical training into technology enhanced training during Covid 19 pandemic.Study design: Online trainer simulation with pre-prepared case scenarios and case discussion was our designed interventional training using Zoom application.Results: Regarding trainee’s feedback to the zoom training, 85% of them thought that it was useful. More than 75% of them recommended this online training for future trainees. More than 80% of the trainers were satisfied with the online training experience. More than 75% of them thought that this was a beneficial experience for the participating house officers. Although two-third of the trainers perceived the training to be mildly and moderately overloading, yet more than 80% of them were satisfied with this training experience and about three-fourth of them preferred it on face-to-face training. They suggested increasing the time of the session to allow for more feedback and discussion.Conclusion: Technology enhanced training is a good way of training that can improve many aspects of clinical family medicine skills as communication skills, patient-centred approach, clinical reasoning, and construction of management plan. It can be applied in other specialties especially in crisis times. In the future, it can be used as blended method of training beside face to face training in the clinics so they can complement each other.