Burden of Care, Depression, and Anxiety Among Family Caregivers of People With Dementia.

BACKGROUND: There are many challenges that entail caring for an individual with dementia, affecting not only the individual with the condition but also their caregivers. This can lead to increased burden, frustration, and depression among those taking care of them. A research gap exists concerning the care of people with dementia in Egypt, particularly regarding the mental health of caregivers. Limited studies have been conducted in Egypt, particularly focusing on the mental health of caregivers. This lack highlights the need to understand the prevalence and impact of caregiver burden in this population. OBJECTIVES: The research aimed to evaluate the burden of dementia, levels of depression, and anxiety among family caregivers of individuals with dementia. METHODS: A cross-sectional study was conducted at a geriatric unit clinic of a psychiatric hospital in Cairo University, Egypt. Caregiver burden, anxiety, and depression were assessed using questionnaires. These questionnaires included the Zarit Burden Interview (ZBI), Generalized Anxiety Disorder scale (GAD-7), and Patient Health Questionnaire-9 (PHQ-9), together with demographic data on the patients and caregivers. RESULTS: The majority of the 141 participants (73% (n = 103)) were female, mostly daughters, with an average age of 40 years. Approximately 50% (n = 71) of the subjects exhibited mild to moderate burden, whereas 30% (n = 43) showed moderate to severe burden. About 31% (n = 44) of the subjects exhibited symptoms of moderate depression, whereas 9% (n = 13) had symptoms of severe depression. Furthermore, almost 43% (n = 60) of caregivers exhibited a moderate level of anxiety. Furthermore, a significant association was seen between caregiver burden and the presence of anxiety and depression. CONCLUSION: This study showed a substantial burden in providing care, elevated levels of despair, and anxiety among caregivers of PWD. The findings highlight how important it is to develop targeted therapies and support systems in order to lessen the load on caregivers, advance their mental health, and improve overall care for both caregivers and their patients in Egypt. Policy-makers should prioritize investing in dementia-related support systems and services to empower caregivers and improve the quality of life for both caregivers and their patients.

Accuracy of the Traditional COVID-19 Phone Triaging System and Phone Triage-Driven Deep Learning Model.

OBJECTIVES: During the COVID-19 pandemic, a quick and reliable phone-triage system is critical for early care and efficient distribution of hospital resources. The study aimed to assess the accuracy of the traditional phone-triage system and phone triage-driven deep learning model in the prediction of positive COVID-19 patients. SETTING: This is a retrospective study conducted at the family medicine department, Cairo University. METHODS: The study included a dataset of 943 suspected COVID-19 patients from the phone triage during the first wave of the pandemic. The accuracy of the phone triaging system was assessed. PCR-dependent and phone triage-driven deep learning model for automated classifications of natural human responses was conducted. RESULTS: Based on the RT-PCR results, we found that myalgia, fever, and contact with a case with respiratory symptoms had the highest sensitivity among the symptoms/ risk factors that were asked during the phone calls (86.3%, 77.5%, and 75.1%, respectively). While immunodeficiency, smoking, and loss of smell or taste had the highest specificity (96.9%, 83.6%, and 74.0%, respectively). The positive predictive value (PPV) of phone triage was 48.4%. The classification accuracy achieved by the deep learning model was 66%, while the PPV was 70.5%. CONCLUSION: Phone triage and deep learning models are feasible and convenient tools for screening COVID-19 patients. Using the deep learning models for symptoms screening will help to provide the proper medical care as early as possible for those at a higher risk of developing severe illness paving the way for a more efficient allocation of the scanty health resources.

Barriers to Completing Therapy for Hepatitis C with Direct-Acting Antivirals: A Real-Life Experience from a Single Treatment Center in Egypt.

INTRODUCTION: Interferon-based therapies against the hepatitis C virus had a poor adherence profile. On the other hand, new direct-acting antivirals (DAAs) are orally administered medications, show high efficacy against the hepatitis C virus in addition to a high safety profile. Therefore, adherence to this treatment is expected to improve. Assessment for treatment adherence is mandatory to assess the feasibility of achieving viral hepatitis elimination. AIM: The study aims to assess the adherence rate and causes of non-adherence in Egyptian hepatitis C patients who received interferon-free treatment regimens. METHODS: Retrospective data analysis for 668 hepatitis C patient's records from August 2014 to October 2019 was done. Assessment of treatment adherence was done by revising the records and phone calls. However, 172 patients were excluded due to the absence of contact data. Rest of patients (n = 496) was categorized into 2 groups: Adherent (n = 432) and non-adherent (n = 64). For whom comparative analysis was done. RESULTS: The adherent group (87%) achieved 100 % sustained virological response after 12 weeks (SVR 12). Non-adherence was reported in 12.9% of patients. Low awareness was the main cause of non-adherence (43.75%). BMI was the only significant risk factor for poor adherence (P = .04). Other Patient demographics, clinical, and laboratory data didn't show any significant differences between both groups. CONCLUSION: Interferon-free regimens are tolerable. Raising awareness is mandatory for proper treatment adherence and, subsequently, good clinical outcomes.

Impact of Bariatric Surgery on Male Sexual Health: a Prospective Study.

BACKGROUND: Obesity is a worldwide prevalent problem which negatively affects most of the human body systems. Male sexual dysfunction is a frequent problem in obese individuals. Nowadays, bariatric surgery is the most successful way for the management of morbid obesity. Recent research has concluded that it has a significant improving effect on sexual function. AIM OF THE STUDY: This study aimed to assess the long-term effect of bariatric surgery on male sexual function. PATIENTS AND METHODS: Sixty-six male patients indicated for bariatric surgery were enrolled in this prospective study. Only forty-eight of them completed the study. Patients were invited to fill the International Index of Erectile Function (IIEF) questionnaire twice, preoperatively (T1) and 12 months postoperatively (T2). Simultaneously, patients' serum testosterone levels were assayed. RESULTS: At T2, the patients showed highly significant increase in the IIEF scores and the serum testosterone levels (p<0.001). Only weight and BMI were significant predictors of the IIEF scores. The same factors as well as the patients' age were predictors of the serum testosterone levels. CONCLUSION: Bariatric surgery improves male sexual health. It is associated with significant increase in IIEF score and serum testosterone levels.

Prevalence and Predictors of Self-Medication with Antifungal Drugs and Herbal Products Among University Students: A Cross-Sectional Study from Egypt.

BACKGROUND AND PURPOSE: Irrational use of drugs for self-medication (SM) is a worldwide public health problem which results in treatment failure, economic loss, and increased burden of morbidity and mortality. Thus, the purpose of this study was to explore SM with antifungal drugs and herbal products among university students in Egypt. METHODS: A cross-sectional sectional study was conducted over 7 months among 403 university students in Egypt. The students were invited to complete a self-administered questionnaire through an online Google form. Questionnaire items included socio-demographic characteristics of the students, practice of and attitude towards SM with antifungal drugs, and SM with herbal products. RESULTS: Prevalence of SM with antifungal drugs among students stood at 38.2%. The main reasons for SM with antifungal drugs were perceiving their health problem as being minimal, followed by having fears of a doctor's visit. About 73% of the students thought that SM was not a safe practice. Older age (AOR = 1.5, 95% CI= 1.3-1.8), affiliation to a private university (AOR = 3.7, 95% CI= 2.2-6.4), and being a medical student (AOR =2.4, 95% CI= 1.3-4.5) were the significant predictors of SM with antifungal drugs. A high prevalence of SM with herbal products (70.7%) was reported, with most students having used some form of herbal weight loss preparation (64%). Being a Cairo resident (AOR= 2.4, 95% CI =1.5-3.8, P<0.05) and being a medical student (AOR= 2.1, 95% CI =1.3-3.4, P<0.05) were the significant predictors of SM with herbal products. CONCLUSION: In the current study, SM was common among Egyptian university students. Providing counseling and public health education to university students with regards to SM is crucial. Implementing strict regulations and the full enforcement of excitant laws pertaining to the use of medication supplies is also needed. Herbal products should face the scrutiny of evidence-based medicine. Further studies are needed to evaluate the impact of SM among university students.