Mental health literacy and help-seeking behaviour among Egyptian undergraduates: a cross-sectional national study.

BACKGROUND: Mental health literacy (MHL) and help-seeking behaviors are pivotal in managing mental well-being, especially among Egyptian undergraduates. Despite the importance and prevalent psychological distress in this group, limited research has addressed MHL and associated behaviors in Egypt. This study aimed to assess the levels of MHL and help-seeking behavior among Egyptian university students. METHODS: A cross-sectional study was conducted across ten Egyptian universities during the academic year 2022-2023. A convenience sample of 1740 students was obtained through online questionnaires distributed via social media platforms. The survey comprised demographic characteristics, the Mental Health Literacy Scale (MHLS), and the General Help Seeking Behavior Questionnaire (GHSPQ). RESULTS: Among 1740 Egyptian undergraduates, medical students scored higher in recognizing disorders (p < 0.05), while non-medical students excelled in attitudes (p < 0.05). A strong correlation was observed between attitudes toward mental illness and total mental health literacy (coefficients of 0.664 and 0.657). Univariate analysis indicated a significant association with professional help-seeking (OR = 1.023). Females, individuals aged 21 or above, and non-medical students were more likely to seek mental health information (OR = 1.42, 1.82, 1.55 respectively). Help-seeking behavior for emotional problems was more inclined towards intimate partners, whereas suicidal thoughts prompted seeking professional help. CONCLUSION: The findings advocate for comprehensive mental health education, particularly in rural areas, and emphasis on the role of personal relationships in mental well-being. Implementing these insights could foster improved mental health outcomes and reduce related stigma in Egypt.

Factors affecting work productivity and activity impairment among chronic obstructive pulmonary disease patients.

Chronic obstructive pulmonary disease (COPD) can negatively affect patients' employment and work-life activities with a significant indirect economic impact. The current study aimed to measure unemployment, work productivity, activity impairment, and their associated factors among COPD patients. A cross-sectional study was conducted in the Chest outpatient clinic, Mansoura University Hospital, Egypt. COPD patients completed an interviewer-administered questionnaire including sociodemographic, occupational data, clinical history, medical research council (mMRC) dyspnea scale, the COPD assessment test (CAT), and work productivity and activity impairment Questionnaire (WPAI-COPD). A total 140 patients were included in the study and 22.1% of them gave up their jobs because of their COPD. Due to COPD, the mean percentage of daily activity impairment was 39.8 among all patients. The mean percentages of absenteeism, presenteeism, and overall work impairment among the 84 working patients were 0.07, 24.4, and 24.5. The CAT score was the significant predictor of all components of WPAI. In conclusion, COPD causes early retirement, high work productivity loss, and impaired daily activities. Higher CAT scores and increased disease severity significantly increase absenteeism, presenteeism, overall work, and activity impairment. Thus, timely diagnosis of COPD with appropriate management can help improve outcomes and lower the disease burden and economic impact.

Assessing self-stigma levels and associated factors among substance use disorder patients at two selected psychiatric hospitals in Egypt: a cross-sectional study.

BACKGROUND: Substance use disorder is a growing problem worldwide, and the stigma associated with it remains a significant barrier to treatment and recovery. This study aimed to assess the perceived stigma among individuals with substance use disorders and its correlation with their socio-demographic characteristics and clinical history Parameters. METHODS: A cross-sectional study was conducted among 552 patients with substance use disorders admitted to the outpatient clinics of Mansoura University Hospital, Addiction Treatment Unit of the Psychiatry Department, and Port Said Mental Hospital, Addiction Department. Participants completed a self-administered questionnaire, which included demographic information, clinical history parameters, and the Perceived Stigma of Substance Abuse Scale (PSAS). RESULTS: The study found that almost half of the participants were aged 29 or younger, married, and had a median stigma score of 20. The vast majority of participants were male, had no previous legal problems, and had a median stigma score of 19. The most common type of substance used was opioids, and more than half of the participants were still using drugs. The highest mean stigma scores were for the items "Most people think less of a person who has been in treatment for substance use" and "Most employers will pass over the application of someone who has been treated for substance use in favor of another applicant." The perceived stigma score was significantly correlated with the severity of use but not with age or duration of use. CONCLUSION: Our study investigates self-stigma in substance use disorder (SUD), revealing its variance across demographics and clinical groups. We found that self-stigma correlates with use severity and possibly decreases with abstinence. Notably, societal bias contributes significantly to self-stigma, necessitating societal interventions. The impact of self-stigma on patient well-being highlights the need for personalized treatments and stigma reduction strategies.

Effect of a waste management intervention program on knowledge, attitude, and practice (KAP) of nurses and housekeepers: a quasi-experimental study, Egypt.

BACKGROUND: Improper healthcare waste management practice is alarming in developing countries because resources are inadequate and waste management is often delegated to poorly educated and untrained laborers. This study aimed to compare the pre-KAP versus post-KAP towards the waste management program for nurses and housekeepers. In addition, it aimed to explore possible factors affecting the pre- and post-KAP in Mansoura Emergency University Hospital, Egypt. SUBJECTS AND METHODS: One hundred thirty-three newly employed nurses, housekeepers, and those who need refreshment training as nominated by head nurses and link occupational health and safety nurses in the hospital were recruited for the study. The study's intervention included multiple training sessions using a PowerPoint presentation in Arabic with appropriate illustrations followed by an open discussion. An Arabic self-administered questionnaire containing demographic and occupational history, knowledge (27 questions), attitude (10 questions), and practice (9 questions) was used pre- and post-intervention. RESULTS: The overall KAP scores among the studied healthcare workers were significantly higher after the intervention. The pre- and post-knowledge scores were significantly different with respect to education, job description, and duration of employment (p < 0.05). The post-attitude scores were significantly different with respect to education and job description only (p < 0.05). The total pre-practice scores were significantly different with respect to education and job description (p < 0.05). However, the post-practice scores were significantly different with respect to sex, age, education, and job description (p < 0.05). CONCLUSION: There was a significant improvement in the KAP scores post-intervention. The post-knowledge and attitude scores were significantly better in nurses and participants with a higher education. The post-practice score was significantly better for females, participants with an age ≥ 30 years, higher education, and nursing jobs. The combination of training and supervision was crucial for the success of waste management programs. Higher education levels are required for housekeepers to be capable of gaining better knowledge, follow rules, and be ready for any challenges in the future.

Prevalence of gastro-oesophageal reflux disease, and its associated risk factors among medical students: a nation-based cross-sectional study.

BACKGROUND: Gastroesophageal reflux disease (GERD) is a common digestive problem in adults particularly medical students, who are one of the most vulnerable groups. Many variables, including lifestyle changes and psychological stress, increase the prevalence of GERD among undergraduate medical students. Therefore, this study aims to assess the prevalence, and risk factors of GERD, and its relationship with perceived stress among medical students in Egypt. METHODS: In November and December of 2022, a cross-sectional descriptive study with an analytical component was carried out among medical students from six different universities. An online self-reported questionnaire was used to collect data. The questionnaire included data on sociodemographic characteristics, risk factors, lifestyle, the Arabic version of GerdQ, and the Arabic version of Cohen's Perceived Stress Scale (PSS). RESULTS: The questionnaire was filled out by 964 medical students, the majority of whom were female (64%). Overall, 17.1% of participants reported symptoms of GERD. Logistic regression showed that smoking, high perceived stress, and a family history of GERD were the independent predictors of having GERD symptoms, with odds ratios of 4.1, 3.9, and 2.2, respectively. CONCLUSION: GERD is a frequent condition among Egyptian medical students, affecting around one-fifth of them. In the fight against GERD, university-based smoking cessation and stress management programs may be influential.

Cardiovascular risk factors among train drivers, Mansoura, Egypt.

Cardiovascular risk factors and diseases are the most prevalent health conditions in train drivers. A comparative cross-sectional study was carried out to estimate the prevalence of some cardiovascular risk factors among train drivers. A pre-designed questionnaire was used to collect socio-demographic and occupational data. Physical activity and dietary habits were assessed, psychological distress was measured. Out of 100 recruited train drivers, 62% had obesity, 46% were hypertensive, 72.8% had dyslipidemia, and 71% had mild and/or moderate level of psychological distress. Being a train driver is independently associated with the likelihood of having obesity (AOR = 14.2) and psychological distress (AOR = 6.6). The prevalence of various cardiovascular risk factors was significantly higher among train drivers than the comparison group. Being a train driver is independently associated with obesity and psychological distress.

Vitamin D receptor gene polymorphism and polycystic ovary syndrome susceptibility.

BACKGROUND: Polycystic ovary syndrome (PCOS) is the most common endocrinopathy in women. This study was designed to investigate the associations of vitamin D receptor (VDR) gene variants with PCOS risk and the severity of the disease phenotype among Egyptian women. METHODS: In this study, 185 women with PCOS and 207 fertile women as controls were recruited. Cases were divided into phenotype groups based on their clinical and paraclinical features. Clinical and laboratory data were measured in the patient and control groups. All individuals were genotyped for nine single-nucleotide polymorphisms (SNPs) located across the VDR gene using TaqMan allelic discrimination real-time polymerase chain reaction. RESULTS: Women with PCOS were significantly (P ≤ 0.001) higher body mass index (BMI) (22.77 ± 2.5) than controls (21.68 ± 1.85 kg/m2). Women with PCOS had significantly higher anti-Mullerian hormone, prolactin, luteinizing hormone (LH), LH/follicle-stimulating hormone (FSH), free testosterone, total testosterone, and dehydroepiandrosterone sulfate levels than the control group (P ≤ 0.001). The level of FSH was significantly lower in women with PCOS than in the control group (P ≤ 0.001). Analysis of the VDR rs4516035, rs2107301, rs1544410 (BsmI), and rs731236 (TaqI) SNPs showed a significant association with PCOS phenotype A. Furthermore, rs2228570 (FokI), rs3782905, rs7975232 (ApaI), and rs739837 SNPs showed a significant association with PCOS phenotype C. Furthermore, rs11568820 SNP showed a significant association with PCOS phenotype D (P < 0.05). CONCLUSIONS: The findings of this study indicate that variations in the VDR gene were associated with an increased risk of PCOS in Egyptian women.

Peroxisome proliferator-activated receptor γ Pro12 ala polymorphism and risk of cerebral stroke in type 2 diabetes mellitus egyptian patients.

Objectives: This study aimed to analyze the association of the peroxisome proliferator activated receptor gamma (PPARγ) P12A (rs1801282) polymorphism with development of cerebral stroke in patients with type 2 diabetes mellitus. Methods: We included 224 patients with diabetes, they were categorized into116 patients with ischemic stroke (IS) and 108 without IS, in addition to 148 healthy controls in this study. respectively. Anthropometric parameters and laboratory tests were measured. The polymorphism was detected by a PCR-RFLP method. Results: A12 allele and A12 containing genotypes show significant higher percentage in patients with diabetes and IS in comparison to diabetes patients without IS (9.1 vs. 4.2%,16.4 vs7.4%; P = 0.044,0.044) with OR of 2.29 and 2. 449 respectively (95% CI: 1.024-5.115, 1.024-5.856) but does not withstand Bonferroni correction. Conclusion: A12 containing genotypes and A12 allele are not associated with IR, diabetes and risk of IS development, however, significant higher BMI were observed in A12 allele carriers in the studied patients with diabetes as well as those with IS.

Perceived benefits of cochlear implants by parents: expectations, decision-making process, and barriers to care.

BACKGROUND: Identifying predictive factors of the cochlear implant outcomes in pediatric patients is critical in guiding tailored rehabilitation programs. The study aimed to assess cochlear implant outcomes, identify predictors, and highlight decision-making factors and barriers to quality care. METHODS: This cross-sectional study included parents of children who received unilateral cochlear implants for bilateral severe- to- deep sensorineural hearing loss. Inclusion criteria were age ≤ 5 years and intelligence quotient (IQ) Scores ≥ 85, A pre-designed structured questionnaire was used to collect data from parents/guardians of the children attending follow-up. The Arabic validated Glasgow Children Benefit Inventory score was used to assess the health-related quality of life (QOL) after intervention. RESULTS: The quality of life (QOL) score (outcome) after surgery was positive in all cases. Multivariate analysis showed that the site of operation (Bahtim hospital and Ain Shams Hospital [AOR(95% confidence interval CI), 5.7 (1.4-23), 5 (1.4-17.9), p = 0.015, 0.013, respectively]), education of the father (university/postgraduate [AOR (95% CI): 5 (1.4-17.9), p = 0.013]), the parents' expectation that their child would be able to participate in regular classroom activities [AOR (95% CI): 8.9 (3.7-21.3), p < 0.001], and history of Attention deficit/hyperactivity disorder (ADHD), perinatal hypoxia, and low birth weight [AOR (95% CI): 2.5 (1.2-5.1), 3.7 (1.7-8.1), 4.7 (2.1-10.5), p = 0.013, 0.001, ≤ 0.001, respectively] are significant independent predictors of good outcome. CONCLUSION: All parents expressed a positive change in their child's QOL. Almost all parents of children with cochlear implants face many barriers in obtaining quality healthcare services for their children. Parents, especially those with lower schooling, should receive good counselling to increase their confidence in their children's capabilities and maximize benefits of regular follow-up. Improving the quality of healthcare centers is recommended.

Translation, validation and cultural adaptation of the Arabic version of the HIV knowledge questionnaire (HIV-Kq-18).

BACKGROUND: Although the number of new HIV infections is declining in most regions of the world, the Middle East is one of the regions with a rapidly growing HIV epidemic, with Egypt having the fastest-growing epidemic, with a 76 percent increase in the number of cases. One of the major factors contributing to this trend is the general public's lack of knowledge about the disease. The HIV Knowledge Questionnaire-18 (HIV-KQ-18) is one of the most widely used instruments for assessing HIV/AIDS knowledge and has been translated into several languages. This study examined the validity of the Arabic version of the HIV-18-KQ as well as its adaptation among Arab undergraduates. METHODS: The HIV-18-KQ was both forward and back-translated. The translation was reviewed by an expert committee of eight experts. The final version was created and distributed to undergraduates from five Arabic countries: Egypt, Sudan, Yemen, Jordan, and Algeria. The validity of the Arabic version of the HIV-18-KQ was evaluated using internal consistency and construct validity. Internal consistency was tested using the Kuder-Richardson formula 20 (KR-20), and construct validity was evaluated using an exploratory factor analysis with a polychoric correlation matrix. RESULTS: The majority of the translated items were easy to understand. The Arabic HIV-18-KQ was deemed culturally appropriate by the expert committee. This study included 1745 university students, including 956 (54.5%) males and 798 (45.5%) females, with 33.4% from Egypt. Based on the acceleration factor approach to interpreting the scree plot in the factor analysis, it was preferable to use only one factor, which is consistent with the original version of HIV-45-KQ. The KR-20 value was 0.73, indicating good internal reliability. CONCLUSION: This study demonstrates that the Arabic version of the HIV-18-KQ is a valid and reliable tool for assessing HIV-related knowledge in Arabic-speaking countries.

TRANSLATION, ADAPTATION, AND VALIDATION OF AN ARABIC VERSION OF HUMAN RESOURCE PRACTICES SCALE AMONG NURSES.

Background and Purpose: Nursing human resource practices (HRP) have a unique role in healthcare organizations. Nevertheless, there is no valid and reliable Arabic tool measuring nursing HRP has been published. The present study aimed to translate, culturally adapt and validate the HRP scale into the Arabic language among nurses. Methods: A methodological study was applied in a sample of 328 nurses from 16 hospitals in Port-Said, Egypt. Results: The scale had good content and concurrent validity. Confirmatory factor analysis showed a better fit for the second-order. Cronbach's alpha was 0.95, and the intra-class correlation coefficient was 0.91 for the total scale showed good reliability. Conclusion: The scale application is recommended in clinical and research settings to assess HRP among Arabic nurses.

Pattern, barriers, and predictors of mental health care utilization among Egyptian undergraduates: a cross-sectional multi-centre study.

BACKGROUND: Mental health disorders are a major public health concern especially among undergraduates, globally and within Egypt. Most individuals suffering from mental illnesses either do not seek care at all or seek it only after a large delay. It is therefore critical to identify the barriers that prevent them from seeking professional help to solve the problem from its roots. Thus, the objectives of the study were to assess the prevalence of psychological distress, the need for professional mental health care, and the barriers to seeking available services among undergraduate students in Egypt. METHODS: A proportionate allocation technique was used to recruit 3240 undergraduates from 21 universities. Symptoms of psychological distress were evaluated using the Arabic General Health Questionnaire (AGHQ-28) and a score of above nine was used to identify positive cases. The pattern for utilization of mental health care was assessed using a multi-choice question and barriers to mental health care were assessed using the Barriers to Access to Care Evaluation (BACE- 30) tool. Logistic regression was adopted to identify the predictors of psychological distress and seeking professional health care. RESULTS: The prevalence of psychological distress was 64.7% and the need for professional mental health care was 90.3% of those with psychological distress. The top barrier to receiving professional mental health services was wanting to solve the problem on their own. Logistic regression revealed that female sex, living away from family and positive family history of mental disorders were independent predictors of psychological distress. Students from urban backgrounds were more likely to seek help than students from rural ones. While age above 20 and positive family history of mental disorders were independent predictors for seeking professional help. There is no significant difference between medical and non-medical students in terms of psychological distress. CONCLUSION: The findings of the study showed there is a high prevalence of psychological distress and a lot of instrumental and attitudinal related barriers to seeking mental health care and highlighted the urgent need to develop interventions and preventive strategies to address the mental health of university students.

Effects of Emotional Intelligence Training on Symptom Severity in Patients With Depressive Disorders.

Depressive disorders affect individual's thoughts, feelings, and social interactions. Enhancing emotional competencies of depressed individuals may alleviate their suffering. Purpose: This study aimed to compare depression severity and emotional intelligence before and after emotional intelligence training in patients with depressive disorders. Methods: A nonrandomized trial (one-group pretest-posttest) research design was applied to 69 patients purposively recruited. The patients' sociodemographic and clinical data were collected. The Beck Depression Inventory-II and Trait Emotional Intelligence Questionnaire-Short Form were completed before and immediately after an 8-weeks of focused weekly group training. Results: A significant improvement in the scores of well-being, self-control, emotionality, and sociability; total emotional intelligence scores; and total depression scores was perceived after training (Z = 5.601, 4.398, 5.686, and 3.516; 4.943; and 2.387, respectively). Implications for Nursing Practice: As emotional intelligence can be learned; it may be a target for interventions when dealing with patients with depressive disorders by strengthening their emotional intelligence.

The Practice of Breastfeeding in Public and its Associated Factors Among Egyptian Mothers.

Introduction: The practice of breastfeeding in public (BFP) is associated with the perceived social norms. No sufficient knowledge is available regarding this practice, the attitudes related, and the significant associated factors in Egypt. Aim: To assess the prevalence of BFP, attitudes, barriers, and enabling factors. Methods: A cross-sectional study was conducted in Dakahlia Governorate, Egypt, including breastfeeding mothers whose babies were ≤12 months of age. A predesigned validated interviewer-administered questionnaire was used to collect data. Results: The study included 400 participants, 72.8% of them had practiced breastfeeding in public at least once. Regression analysis showed that being urban, high socioeconomic standard, having babies who were of normal birthweight and not the first in order were significant predictors of higher prevalence of BFP. Also, positive mother's attitude and having a family member who also practiced BFP were independent significant predictors. Finally, mothers who practiced breastfeeding in public are less likely to have supportive families' attitude. The most common causes of not practicing BFP is men's presence (94%), followed by husband disagreement (78.5%), absence of breast cover (69.3%), or feeling embarrassed (63.2%). Conclusion: Breastfeeding in public is a frequent practice among the studied mothers. Underlying factors associated with BFP can help guide tailored health education message to nursing mothers. Privacy was the keyword behind not practicing BFP.

Efficacy, Safety and Quality of Life of Oxybutynin versus Aluminum Chloride Hexahydrate in Treating Primary Palmar Hyperhidrosis.

Background: Palmar hyperhidrosis is characterized by excessive sweating beyond the physiological needs of the patient's body and the most frequent form is primary or essential. Different treatments protocols have been proposed to control or decrease sweating. Aims and Objectives: This study aimed to compare the efficacy and safety of oral oxybutynin versus topical aluminum chloride hexahydrate (ACH) in treating primary palmar hyperhidrosis. Also, to assess quality of life (QOL) as a measure of improvement of hyperhidrosis state. Materials and Methods: Patients were randomized using the block randomization with sealed envelope method into two treatment groups; oral oxybutynin group and topical ACH group. Hyperhidrosis Disease Severity Scale (HDSS) was used as a primary outcome measure to assess the efficacy of the drug in both groups. Clinical grading and the QOL were used as secondary outcome measures. The safety was evaluated by recording side effects in the follow-up visits. Results: HDSS, clinical grading and QOL score showed a statistically significant improvement in the oral oxybutynin groups. One week after stoppage of treatment, the symptoms recurred again in both groups with return of HDSS and QOL scores to pretreatment levels. The most common side effects were dry mouth (65.8%) and itching (65.0%) for oral oxybutynin group and topical ACH group; respectively. Conclusion: Treatment of primary palmar hyperhidrosis with oxybutynin is a good initial alternative for treatment given that it gives better results and much more improvement in QOL when compared to topical ACH. QOL questionnaire and clinical grading should also be considered as useful tools in the assessment of response to treatment.

Personal protective equipment used by obstetricians and obstetric nurses during the COVID-19 pandemic in Mansoura, Egypt.

Background: This study was done to describe the pattern of personal protective equipment (PPE) use, associated factors, and adverse events among obstetricians and obstetric nurses in obstetrics & gynecology departments.  Methods: A cross sectional study was conducted in Obstetrics & Gynecology departments in three hospitals (physician & nurses n=252) using an online Google form including demographic and occupational health data, type of available personal protective equipment during usual care, CS and emergency labor, infection control measures and hazards of full PPE use. Results Full PPE use was 37.7% during CS and 34.9% during emergency labor. The significant predictors of wearing full PPE during CS were daily work hours > 8 hours and receiving formal training about PPE use. During CS & emergency labor most of HCws used sterile gloves and sterile fluid resistant gowns and surgical mask.to less extent used face shields or tight fitting googles and one tenth (11.8%) only used N95. The most common health effects of full PPE use was sense of heat (79.5%) .Conclusion: During the COVID-19 pandemic more vigorous respiratory (N95 mask) and eye protection is required during aerosol-generating procedures. Formal training is an evident predictor for full PPE use.

Presenteeism and associated factors among railway train drivers.

Background: Presenteeism is an emerging work-related health problem among train drivers. It is more serious than absenteeism, as it accounts for higher productivity losses and may increase the risk of occupational accidents. Train drivers have high rates of mental and physical health conditions that may put them at high risk of presenteeism. Methods: A comparative cross-sectional study was conducted on 100 train drivers working in Mansoura railway station and 100 administrative employees working in the Faculty of Medicine, Mansoura university as a comparison group to estimate the prevalence of presenteeism and its associated factors among train drivers working in Mansoura railway station, Egypt. A questionnaire was used to collect socio-demographic, occupational and medical data. The Kessler Psychological Distress Scale (K10) was used to measure non-specific psychological distress. The Stanford Presenteeism Scale (SPS-6) was used to assess productivity loss related to sickness presenteeism. Results: The prevalence of presenteeism was significantly higher among train drivers (76%) compared to the comparison group (31%). All participants (100%) with psychological distress reported presenteeism. Being a train driver (adjusted odds ratio [AOR]=5.4) and having hypertension (AOR=4.03) are independent predictors for presenteeism. Conclusions: The prevalence of presenteeism and its associated risk factors were significantly higher among train drivers than the comparison group. There is an urgent need for the railway industry to understand the factors that may contribute to presenteeism.

Long-term follow-up of living liver donors: A single-center experience.

Living donors are healthy individuals who are exposed to a major surgical procedure during which a major part of their liver is resected. Data on the long-term consequences of living liver donation are scarce. This study examined clinical, laboratory, and long-term health-related quality of life (HRQoL) in 237 living liver donors and 239 matched controls during 48-168 months of postdonation follow-up. We used the 36-item short-form health survey (SF-36), version 1. The scores for the four following subscales were higher in nondonors than in donors: physical functioning (p = 0.009), role limitations due to physical health (p = 0.002), energy/fatigue (p < 0.001), and bodily pain (p < 0.001). The scores on the eight subscales of the SF-36 were higher in donors with living recipients than in donors whose recipients died (p < 0.001). Our results suggest that living donor right hepatectomy is safe and results in a postdonation HRQoL similar to that of nondonors in those donors whose recipients are healthy, whereas donors whose recipients die have a lower HRQoL that is significantly negatively correlated with the time since recipient death and improves over time.

Amenorrhea, premenstrual tension syndrome, and dysmenorrhea among women of reproductive age on hemodialysis: A national study in Egypt.

BACKGROUND AND AIM: The current literature concerning the reproductive health of end stage renal disease (ESRD) females is scarce, outdated, and largely unknown in women living in developing countries. This study aims to estimate the prevalence of menstrual abnormalities and their associated factors among ESRD women in reproductive age undergoing chronic hemodialysis (HD) in Egypt. METHODS: Thirty-five dialysis centers were selected by simple random sampling to represent the different regions of Egypt. Non-pregnant women in the reproductive age (15-50 years) receiving dialysis at the participating centers completed a questionnaire about their menstrual health during a routine hemodialysis session. Their responses were verified by reviewing the medical records and assessing their clinical data. RESULTS: Out of the 472 women, 32.6% had amenorrhea. Menstrual irregularities were reported in 37% of the menstruating women. Premenstrual tension syndrome (PMS) was reported in 70% while dysmenorrhea in 58%. Amenorrhea was more prevalent in non-working women who started hemodialysis after the age of 30. PMS was more encountered in women with hypertension or in those with obstructive uropathy or autoimmune disease as a cause of ESRD. Dysmenorrhea was more prevalent among patients with autoimmune disease or chronic hepatitis C virus and those who started dialysis after the age of 30. CONCLUSION: Secondary amenorrhea, dysmenorrhea, and PMS are common among premenopausal women with ESRD on dialysis. Several factors including socio-economic factors, cause of ESRD, and hypertension contribute to these disorders. Future studies are needed to understand the underlying pathophysiologic mechanisms and management of these abnormalities.

Effect of a tailored multidimensional intervention on the care burden among family caregivers of stroke survivors: a randomised controlled trial.

OBJECTIVES: To evaluate the effectiveness of a tailored multidimensional intervention in reducing the care burden of family caregivers of stroke survivors. This intervention considered caregivers' perceived needs and incorporated three evidence-based dimensions (psychoeducation, skill-building and peer support). DESIGN: A prospective randomised control trial. SETTING: A community-based study conducted in Egypt. PARTICIPANTS: A total of 110 caregivers aged ≥18 years who cared for a survivor within 6 months of stroke, with modified Rankin Scale scores of 3-5, and without other physical disabilities or terminal illnesses were recruited between December 2019 and May 2020. Participants were assigned to the intervention group (IG; n=55) and control group (CG; n=55) through open-label, parallel 1:1 randomisation. INTERVENTION: The IG was provided with tailored multidimensional interventions for 6 months until November 2020, including three home visits, six home-based telephone calls and one peer-support session. The CG received simple educational instructions at a single visit. OUTCOME: The participants completed the Zarit Burden Interview (primary outcome) and the WHO Quality of Life-BREF (secondary outcome) before the intervention (T0), at 3 months (T1) and at 6 months (T2). RESULTS: No differences were observed between the characteristics of the groups at baseline (T0). The independent t-test showed no significant differences in the care burden and Quality of Life (QoL) at T1 and T2 between the groups. The intervention had no significant effect on the outcomes between or within groups over time, as shown by the repeated-measures analysis of variance. However, the group and time interaction had significant main effects on caregivers' QoL (psychological and social domains). CONCLUSION: The main results showed that participants in the IG did not experience an improvement in the main outcomes. Nevertheless, the improvement in the psychological and social domains may have been attributed to our intervention. TRIAL REGISTRATION NUMBER: NCT04211662.