Elevated uric acid in gestational diabetes and its risk on pregnancy outcomes.

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.

Perception of COVID-19-related stigma and associated psychological challenges among healthcare workers at Cairo University hospitals.

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.

Gender Difference in Perceived Symptoms and Laboratory Investigations in Suspected and Confirmed COVID-19 Cases: A Retrospective 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.

House Officers' Choice of Family Medicine Specialty amid the Implementation of the New Universal Health Insurance Law.

BACKGROUND: The new Egyptian Universal Health Insurance Law is introduced through family-oriented primary health care. Increasing the number of recent graduates who specialized in family medicine is considered a national need to overcome family physicians' shortage. AIM: To explore the factors affecting the house officers' choice of Family Medicine as a future career amid the implementation of the new Universal Health Insurance Law in Egypt. METHODS: This is a cross-sectional study conducted on house officers during their training in Cairo university hospitals from the first of March 2020 to February 2021. The researchers offered an anonymous self-administered questionnaire to all house officers at the beginning of their 2-week family medicine training (1170 house officers). RESULTS: A total of 1052 completed the questionnaire (response rate 90%). Family medicine as a specialty was considered by 53.6% (n = 564) of participants, while only 23.4% (n = 246) of participants had an obvious intention to choose family medicine. Multivariate (adjusted) logistic regression model revealed that factors significantly associated with intention to choose family medicine were marital status, knowledge about governmental advantages for family medicine offered to the specialized recent graduates, and previously encountered with family practice as customers. CONCLUSIONS: The choice of family medicine specialty is increasing among house officers. This could be attributed to the growing interest in family medicine in Egypt, especially after implementing the new insurance law's first phase in several Egyptian governorates.

Defensive Medicine Practice in Different Specialties among Junior Physicians in KasrAlAiny Hospitals, Egypt.

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.