Defensive medicine practices as a result of malpractice claims and workplace physical violence: a cross-sectional study from Egypt.

Defensive medicine refers to practices motivated mainly by legal rather than medical purposes. Increased healthcare costs, overutilization of medical services, and potential harm to patients from unnecessary procedures are among its drawbacks. We performed this study to assess the prevalence of defensive medicine practices in Egypt and their associations with experiencing malpractice claims and workplace physical violence. We investigated 1797 physicians (68.1% male), with an average age of 36.8 ± 9.1 years, practicing in Egypt between January 14th and February 23rd, 2023. SPSS was used for statistical analysis. The majority reported engaging in defensive medicine practices. Specifically, 89.6% acknowledged avoiding high-risk procedures, 87.8% refrained from treating high-risk patients, 86.8% admitted to making unnecessary referrals, 84.9% acknowledged ordering unnecessary tests, 61.4% reported performing unnecessary procedures, and 56.4% disclosed prescribing unnecessary medications. Obstetricians and surgeons exhibited the highest rates of defensive medicine. Using linear regression analysis adjusted for age and sex, malpractice claims and workplace physical violence were associated with defensive medicine score (zero-100): ßs (95% CIs) = 5.05 (3.10, 6.99) and 5.60 (3.50, 7.71), respectively, (p values < 0.001). In conclusion, defensive medicine is deeply ingrained in the clinical routines of Egyptian physicians. Establishing a comprehensive national medical liability framework is required.

mHealth App Barriers, Usability, and Personalization: A Cross-Sectional Study from Egypt and Saudi Arabia.

Mobile health (mHealth) has emerged as a substantial segment of eHealth. Herein, we conducted a cross-sectional study to investigate mHealth app barriers, usability, and personalization in Egypt and Saudi Arabia. We used a Google survey to recruit participants from both countries between the 15th of September and the 15th of October 2022. Among 299 participants (247 from Egypt and 52 from Saudi Arabia), aged ≥ 18 years, 27.4% reported mHealth app use. In the age-, sex-, and country-adjusted regression models, age > 25 years: OR (95% CI) = 1.98 (1.11, 3.54), residing in Saudi Arabia: OR (95% CI) = 4.33 (2.22, 8.48), and physical activity: OR (95% CI) = 2.53 (1.44, 4.44) were associated with mHealth app use. The main mHealth app purposes were lifestyle promotion (35.4%), diet and nutrition (30.5%), and administrative services (13.4%). On a scale from 20 to 100, mHealth app usability scores were 46.3% (20−40), 7.3% (41−60), 31.7% (61−80), and 14.7% (81−100). According to 93.9% of users, mHealth app features were modifiable to meet personal health goals, while 37% stated that mHealth apps helped them set new personal health goals. In conclusion, age, residing in Saudi Arabia (compared to Egypt), and physical activity were positively associated with mHealth app use. mHealth app feature personalization and helping users set new personal health goals were largely reported, suggesting that mHealth has the potential to help put personalized healthcare into practice.

Maternal and neonatal risk factors for autism spectrum disorder: A case-control study from Egypt.

BACKGROUND: The prevalence of autism spectrum disorder (ASD) has been increasing steadily in Egypt and worldwide. Detecting risk factors for ASD could help initiate screening and risk prevention approaches. Herein, this study aimed to detect several maternal and neonatal risk factors for ASD in Egypt. METHODS: In this case-control study, mothers of children with ASD who were visiting Beni-Suef University Hospital in Egypt (n = 268) were compared to mothers of children without ASD attending one primary school with a kindergarten (n = 504) regarding their preconception, conception, and postconception characteristics. Data were collected using a self-administered questionnaire. The odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to investigate the possible associations between the collected data and the odds of ASD. RESULTS: In the multivariable-adjusted models, urban residence: OR (95% CI) = 2.33 (1.60-3.38), relative father: 2.63 (1.74-3.96), history of diabetes: 5.98 (1.99-17.97), previous abortion: 2.47 (1.20-13.38), assisted fertility: 4.01 (1.20-13.38), family history of ASD: 7.24 (2.00-26.24), multiple pregnancy: 11.60 (2.54-53.07), exposure to passive smoking during pregnancy: 2.95 (1.86-4.68), vaginal bleeding during pregnancy: 3.10 (1.44-6.67), hypertension with pregnancy: 3.64 (1.06-12.51), preterm labor: 2.64 (1.26-5.57), neonatal convulsions: 14.88 (5.01-44.20), and admission to neonatal intensive care unit 2.13: (1.21-3.74) were associated with the increased odds of ASD. On the other hand, the intake of vitamins during pregnancy: 0.09 (0.06-0.16) and C-section: 0.44 (0.27-0.70) were associated with the decreased odds of ASD. CONCLUSION: This study detected several maternal and neonatal risk factors for ASD in Egyptian children.

Violence against healthcare workers during the COVID-19 pandemic: a cross-sectional study from Egypt.

Workplace violence (WPV) is a serious endemic phenomenon in healthcare settings, and it has been escalating during the COVID-19 pandemic. In this cross-sectional study, healthcare workers (HCWs) (105 physicians and 104 nurses) working at two public hospitals accepting patients with COVID-19 in Egypt were included. Using a self-administered questionnaire distributed in January 2021, data about HCWs' sociodemographic and occupational characteristics and their exposure to psychological and physical WPV during the past six months were collected. The results showed that the prevalence of psychological and physical WPV was 42.6% and 9.6%, respectively. Relatives of patients were the perpetrators in most WPV incidents. HCWs did not report 57.3% of psychological and 10.0% of physical WPV incidents. Female sex, having physical contact with patients, and working rotational shifts were associated with the increased exposure to psychological and physical WPV. In conclusion, this study showed a high prevalence of WPV against HCWs in Egyptian public hospitals during the COVID-19 pandemic.

Public attitudes towards people who stutter in South Egypt.

PURPOSE: Stuttering is a multifactorial speech disorder with significant social and psychological consequences. There is a lack of knowledge about public attitudes towards people who stutter (PWS) and the factors that can determine such attitudes in underprivileged communities. This study aimed to assess the public attitudes in South Egypt towards PWS and compare our results with those stored in a reference database representing 180 different samples. METHODS: A multi-stage random sampling approach was used to recruit 650 people from Beni-Suef City in South Egypt. All participants were interviewed using the Arabic version of the Public Opinion Survey of Human Attributes-Stuttering (POSHA-S) after getting their informed consent. This instrument assesses people's Beliefs and Self Reactions towards PWS in addition to their sociodemographic characteristics. RESULTS: The Beliefs and Self Reactions subscores in addition to the Overall Stuttering Score of the Egyptian sample were remarkably lower than the median values of the reference database (12 versus 34), (-4 versus 2), and (4 versus 18), respectively. TV, radio, and films were the main sources of knowledge about stuttering. Egyptian participants who reported average to high income were more likely to have a positive attitude (≥50% of Overall Stuttering Score) towards PWS than their counterparts with low income (Odds Ratio = 1.57, 95% Confidence Interval: 1.08-2.28). CONCLUSION: People in South Egypt showed a less positive attitude towards PWS compared with other populations worldwide. Further studies should focus on changing the public attitudes towards PWS through awareness programs that consider the cultural perspectives of the society.

Psychological Impacts of the COVID-19 Pandemic on the Public in Egypt.

This study aimed to evaluate the prevalence of depression, anxiety, stress, and inadequate sleeping among the public in Egypt during the novel Corona Virus Disease (COVID-19) pandemic. An online snowball sampling approach was used to collect data from netizens in four Egyptian governorates between 16 and 30 April 2020. A semi-structured questionnaire was designed to assess sociodemographic characteristics, sleeping hours per day, and psychological disturbances (depression, anxiety, and stress) of participants using the Depression Anxiety Stress Scale-21. Out of 1629 participants, 48.1% were aged ≤ 30 years, 42.4% were men, and 20.0% were working in the health sector. The participants reported a high prevalence of depression (67.1%: mild to moderate 44.6% and severe to very severe 22.5%), anxiety (53.5%: mild to moderate 30.6% and severe to very severe 22.9%), stress (48.8%: mild to moderate 33.8% and severe to very severe 15.0%), and inadequate sleeping (< 6 h/day) 23.1%. Female sex, working in sectors other than the health sector, watching/reading COVID-19 news ≥ 2 h/day, and lack of emotional support from family and society were associated with a high prevalence of severe to very severe depression, anxiety, and stress. In conclusion, the psychological impacts of COVID-19 on the public in Egypt were enormous, therefore, providing psychological support and counsel is warranted.

Completeness of Medical Records of Trauma Patients Admitted to the Emergency Unit of a University Hospital, Upper Egypt.

Trauma records in Egyptian hospitals are widely suspected to be inadequate for developing a practical and useful trauma registry, which is critical for informing both primary and secondary prevention. We reviewed archived paper records of trauma patients admitted to the Beni-Suef University Hospital in Upper Egypt for completeness in four domains: demographic data including contact information, administrative data tracking patients from admission to discharge, clinical data including vital signs and Glasgow Coma Scale scores, and data describing the causal traumatic event (mechanism of injury, activity at the time of injury, and location/setting). The majority of the 539 medical records included in the study had significant deficiencies in the four reviewed domains. Overall, 74.3% of demographic fields, 66.5% of administrative fields, 55.0% of clinical fields, and just 19.9% of fields detailing the causal event were found to be completed. Critically, oxygen saturation, arrival time, and contact information were reported in only 7.6%, 25.8%, and 43.6% of the records, respectively. Less than a fourth of the records provided any details about the cause of trauma. Accordingly, the current, paper-based medical record system at Beni-Suef University Hospital is insufficient for the development of a practical trauma registry. More efforts are needed to develop efficient and comprehensive documentation of trauma data in order to inform and improve patient care.

Age-related differences in driving behaviors among non-professional drivers in Egypt.

PURPOSE: This study aimed to investigate whether young and old non-professional drivers in South Egypt have aberrant driving behaviors compared with their middle-aged counterparts. MATERIALS AND METHODS: In this cross-sectional study, a total of 1764 non-professional drivers aged ≥ 19 years, residing in Beni-Suef in South Egypt, and having ≥ one year of driving experience were randomly selected. All drivers were asked to fill out a self-administered questionnaire, including personal information, driving habits, and the Arabic version of the Driver Behavior Questionnaire which evaluates driving violations, errors, and lapses. RESULTS: This study included 560 young drivers (19-25 years), 850 middle-aged drivers (26-59 years), and 354 old drivers (≥ 60 years). Compared with middle-aged drivers, young drivers reported more non-use of the seatbelt, eating while driving, and driving while feeling drowsy. Old drivers, in contrast, showed more careful driving behaviors including fewer violations, errors, and lapses and less likelihood of driving while feeling sleepy. CONCLUSION: This study supports the conception that young drivers pose less careful driving habits. Initiating educational programs targeting young drivers to improve their driving habits and create a traffic safety culture in Egypt is highly warranted.

Pattern and quitting of tobacco smoking among Egyptian university students.

OBJECTIVES: University students are at high risk of practicing the smoking habit being exposed to smoking peers and easier cigarette availability. METHODS: This study aims to explore prevalence, attitude and pattern of tobacco smoking and quitting among Beni-Suef University students. A cross-sectional study was conducted from March to May 2019. A total of 4,599 students were selected by using randomized multi-stage sampling using self-administered questionnaire for data collection. RESULTS: The mean age of students found to be smokers was 20.8 ± 1.42 years. Males: Females' ratio was 2:1 (66 vs.34%). Prevalence of smoking was 17.4%. Students of non-medical and non-health colleges showed a significant high smoking rate (18.8 and 18.3% respectively) than students in health faculties (15.2%); p=0.017. Participants believed that they might smoke because of: peers' pressure (73.3%), stress (71.4%), imitating popular figures (61.7%) and availability of money (60.4%). Regarding smoking provinces; 86.1% did smoke in coffee-shops, 73.1% in university yards and only 16.87% used to smoke at home Regarding the attitudes of smokers and nonsmokers towards smoking; the acceptance of indoor smoking was significantly higher (85.6%) among smokers than non-smokers (6.42%); p=0.0001. Of note; 51.2% of smokers versus 86.3% of non-smokers agreed to ban smoking in public places (P=0.001). Majority of smokers (72.1%) had the desire to stop smoking while (57.8%) tried to stop smoking but failed. CONCLUSIONS: Smoking is becoming a habit among university students and initiative of a smoke free environment should be encouraged and subject and method.

Blastocystis spp. and Giardia intestinalis co-infection profile in children suffering from acute diarrhea.

Giardia intestinalis and Blastocystis spp. are two common zoonotic intestinal parasites responsible for the majority of diarrheic cases, especially in children. The study was planned to determine the impact role of both Giardia and Blastocystis co-infection in children up to 12 years old with acute diarrhea in Beni-Suef, Egypt. Also, to estimate the general prevalence rates and risk factors associated with intestinal parasitic infections. Stool samples collected from 125 children, within a period of 7 months, were examined using direct wet mount and trichrome stain in comparison to in vitro culture on Jones medium (for detecting Blastocystis spp.) and Immunochromatography techniques (for detecting Giardia). At least one type of intestinal parasites was harbored in 72% of the studied children, single infection constituted 37.6% while, 34.4% were polyparasitized children. The predominant parasites involved were Blastocystis spp.(53.6%), followed by Giardia intestinalis (27.2%). Co-infection between both parasites was recorded in 20% of cases. Two risk factors were significantly associated with higher risk of Giardia-Blastocystis co-infection including age category (5-7 years) and family size (≥ 6 members) by univariate analysis (P = 0.004, 0.009 respectively) and also by the multivariate model (OR = 0.526, 0.336). Abdominal pain was the only gastrointestinal manifestation associated with the co-infection using the univariate analysis (P = 0.0427). The present study detects a high prevalence of intestinal parasitic infection; in particular, Giardia-Blastocystis co-infection in diarrheic young children (up to 12 years) in Beni-Suef Governorate, Egypt and recommends further subtypes identification of both parasites.

Knowledge and attitudes about toxoplasmosis among female university students in Egypt.

AIM: This study aimed to assess toxoplasmosis-related knowledge, attitudes and preventive practices among female undergraduate students in Beni-Suef University, Egypt. SUBJECTS AND METHODS: A cross-sectional design with a multi-stage random sample of female Beni-Suef university students were recruited in this survey over a period of 8 weeks' duration using a self-administrated questionnaire. RESULTS: Among 1079 female students, only 35 (3.2%) had good knowledge. Female students of the Health Care faculty and students from rural areas had a significantly higher rate of good knowledge. The results also illustrated that most of the studied sample (63%) had a negative attitude. Nearly one-third of participants were convinced that toxoplasmosis shows symptoms and only (25.6%) agreed about the occurrence of toxoplasmosis infection during pregnancy. A significant positive correlation was found between the total knowledge score and the total attitude score of female students, indicating that students with better knowledge had more positive attitudes. Of the participants, 67.1% always ate fast food, while 70.7%, 72% and 78.2% of female students reported hand washing after gardening, cleaning areas where cats were and cooking with meat, respectively. CONCLUSION: Knowledge regarding toxoplasmosis was deficient among female students attending Beni-Suef University, and they had a negative attitude regarding toxoplasmosis. There was also a positive correlation between students' knowledge and their attitude toward toxoplasmosis infection. Many students avoided risk behaviors in the correct way, without realizing what they avoided. There is a critical need for efficient educational programs to raise the population's awareness regarding toxoplasmosis.

Menstrual disorders and medical counseling among schoolgirls in South Egypt: a cross-sectional study.

BACKGROUND: Menstrual disorders are common gynecological problems among adolescents, however, medical counseling for these disorders is not well documented in developing countries. OBJECTIVES: This study aimed to assess medical counseling for menstrual disorders among schoolgirls in Beni-Suef city in South Egypt. METHODS: Using a multi-stage random sampling, a total of 970 preparatory schoolgirls were included in this study. We used a self-administered questionnaire to detect the premenstrual and menstrual disorders as reported by the schoolgirls during the previous 6 months. Medical counseling for the menstrual disorders and other demographic characteristics were also surveyed. RESULTS: The mean age of the schoolgirls was 15.4 ± 0.8 years, age of menarche 13.2 ± 1.1 years and menstrual flow days 5.0 ± 1.3. During the past 6 months, 19.4% of the schoolgirls reported medical counseling for at least one menstrual symptom. Dysmenorrhea (89.2%), premenstrual fatigue (32.4%) and headache (31.1%) were the most often reported symptoms. After adjustment for personal and gynecological characters, abdominal bloating [odds ratio (OR) 3.66; 95% confidence interval (CI) 2.18-6.17], flow days >4 (OR 1.73; 95% CI 1.21-2.47), acne flare (OR 1.42; 95% CI 1.01-1.99), dysuria (OR 2.09; 95% CI 1.35-3.22) and facial hair (OR 6.89; 95% CI 3.47-13.69) were associated significantly with a higher likelihood of medical counseling. CONCLUSION: Menstrual disorders are highly prevalent among preparatory schoolgirls in Beni-Suef, however, there is a noticeable lack of the medical counseling for these disorders. Future research should focus on the barriers to medical counseling for menstrual disorders among adolescents.

Pattern and correlates of cyberbullying victimization among Egyptian university students in Beni-Suef, Egypt

BACKGROUND: The expansion of the online environment has unveiled many cyber risks and potentials for abuse such as cyberbullying. Cyberbullying carries many negative psychological impacts that affect mainly young people. AIM: The objective of our study is to explore the of cyberbullying victimization among Egyptian university students in Beni-Suef and investigate factors correlating with it. MATERIALS AND METHODS: In this cross-sectional study, a multi-stage random sampling was used to include a total of 6740 students from all grade levels in all faculties (n=28) of Beni-Suef University. After 4 focus group discussions, a self-administered questionnaire was designed for data collection. The questionnaire comprised three sections including questions about selected socio-demographic characteristics, exposure to cyberbullying in the past 6 months, and factors associated with victimization. RESULTS: Almost half of our students (48.2%) reported experiencing cyberbullying victimization in the past 6 months. Female students, students living in urban areas and those who spent more hours using the internet reported more exposure (p<0.001). Harassment was the main type stated by females (79.8%) while flaming was excessively reported by males (51.8%). Students responded mostly by anger (63.1%), hatred (23.2%) and sorrow (22.6%) towards the worst victimization incidents. CONCLUSION: Cyberbullying victimization is highly prevalent amongst university students in Beni-Suef and female students are more vulnerable to exposure, Implementing anti-cyberbullying programs tailored for university students will be a major step. Such programs should include anti-cyberbullying policies and materials, and provision of guidance for students, their parents and their teaching staff.

Hepatitis C virus in patients on regular hemodialysis in Beni-Suef Governorate, Egypt.

BACKGROUND: The prevalence of HCV infection among hemodialysis patients (HD) varies from country to country and from one center to another. Despite the existence of guidelines for a comprehensive infection control program, Egypt is one of the countries with high HCV prevalence. In Egypt, the prevalence of HCV in haemadalysis patients (2015) was 50.7%. OBJECTIVES: (1) To detect the prevalence of hepatitis C virus (HCV) infection and HCV seroconversion among all hemodialysis patients in Beni-Suef governorate, and (2) To detect factors associated with HCV seroconversion. MATERIALS AND METHODS: Multicenter retrospective medical records review design was conducted in 13 hemodialysis units in Beni-Suef governorate during May - June 2015; all ESRD (End stage renal disease) patients undergoing hemodialysis were included in the sample. A predesigned questionnaire was used. RESULTS: The prevalence of the HCV at begin of dialysis was 60.9% and the rate of HCV seroconversion was 9.7%. Univariate analysis confirmed that history of blood transfusion, the non-adherence to infection control guidelines, lack of isolation strategies and history of Shistosomiasis were significant risk factors for seroconversion. Meanwhile multivariate logistic regression analysis confirmed that history of blood transfusion, and history of shistosomiasis were significantly associated with HCV seroconversion. CONCLUSION: HCV infection still remains a predominant problem among patients on maintenance HD in Beni- Suef governorate History of blood transfusion and history of shistosomiasis were significant risk factors for acquiring HCV infection in these patients.

Prevalence of HIV among blood donors at Beni-Suef University Hospital Blood Bank, Egypt.

BACKGROUND: The prevalence rate of HIV among blood donors differs between countries and regions. The aim of this study was to determine the prevalence of HIV among blood donors in the Blood Bank of Beni-Suef University Hospital, Egypt, during the 5 years 2010-2014. MATERIALS AND METHODS: This is a retrospective, record-based study that involved the abstraction of data of all donors from registers at the Beni-Suef University Hospital Blood Bank during the period 2010-2014. Data were transformed onto data sheets and entered into a computer database. RESULTS: Of the 26 442 blood donors, 24 733 (93.5%) were male and 1709 (6.5%) were female. The mean age for the whole group was 29.88±7.6 (range=18-65) years. The prevalence of HIV was 0.1% (14 donors); of them, there were 13 (92.9%) male donors and one (7.1%) female donor, but this difference was not statistically significant (P=0.9). More than 50% (57.1%) of HIV-positive patients (8/14) were between 20 and 29 years of age and four (28.6%) were between 30 and 39 years of age, with no statistically significant difference (P=0.08). There were HIV-HCV coinfections in two donors (14.3%) (P=0.5). The highest percentage (35.7%) of HIV-positive donors (five donors) were of blood group B, with no significant difference (P=0.2). CONCLUSION AND RECOMMENDATIONS: The prevalence of HIV was low (0.1%) among blood donors in Beni-Suef, Egypt, with no significant differences for age or sex. The incidence of HIV-HCV coinfection was 14.3%. We recommend strengthening of the healthcare system by improving the screening facilities for HIV and other transfusion-transmissible infections.