Background The coronavirus disease 2019 (COVID‐19) pandemic directly affects the psychological well‐being of critical care nurses. Several studies had investigated the psychological impact of the pandemic on nurses caring for patients with COVID‐19, but few were conducted to identify the predictors of this impact. Aims The objective of this study is to identify the predictors of critical care nurses' stress, anxiety, and depression in response to the COVID‐19 pandemic. Design A cross‐sectional survey was conducted in five intensive care units in five hospitals in Alexandria, Egypt. Methods An online questionnaire was distributed. It included socio‐demographic and work‐related data and the depression, anxiety, and stress scale scores of the nurses under study. A multiple linear regression model was developed to identify the predictors of critical care nurses' stress, anxiety, and depression in response to the COVID‐19 pandemic. Results Two hundred (64%) of 308 nurses completed the electronic questionnaire. Significant predictors of stress included the number of infected colleagues (P < .001) and availability of hospital resources (P = .01). Significant predictors of anxiety were age, gender, satisfactory income (P < .001), years of experience, time spent caring for patients with COVID‐19 (P = .04), continuous training, number of infected colleagues (P = .01), and availability of hospital resources (P = .02). Finally, significant predictors of depression included gender, history of physical problems (P = .04), educational attainment, availability of hospital resources, history of psychological problems (P < .001), and number of infected colleagues (P = .001). Conclusion The hospital's lack of human and physical resources and the number of colleagues infected with COVID‐19 were the strongest predictors of stress, anxiety, and depression among nurses. Relevance to clinical practice Identifying the predictors of stress, anxiety, and depression among nurses who care for patients with COVID‐19 is a vital step in developing mental health promotion strategies to support nurses during this pandemic.

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Background: The aim of the present study was to assess the prevalence of self-medication among undergraduate medical students in Alexandria Faculty of Medicine and recognize the patterns and the attitude of students towards intake. Methods: A cross-sectional study was conducted among undergraduate medical students attending Alexandria Faculty of Medicine from both national and international programs during the period of June 2013 until October 2013. A self-administrated, semi-constructed questionnaire was used to assess the practice of self-medication among 408 students who were randomly selected using a stratified random sample technique. Results: Self-medication was reported by 208 (52.7%) students, with no significant difference between males and females. The highest percentage of self-medication was reported among those who have completed six years of academic study and the lowest was reported among those who have completed two years of academic study. There was a statistically significant association between educational stage (preclinical and clinical) practice of self-medication. Most common medications involved were analgesic and anti-inflammatory followed by decongestants, antimicrobials and antihistaminic drugs. 309 (78.8%) students believed that self-medication is acceptable. Conclusion: The present study demonstrated that self-medication is practiced by more than half of undergraduate medical students in the Faculty of Medicine - Alexandria University. Acquiring medical knowledge seems to be associated with the practice of self-medication. Therefore, more attention should be paid to medical curricula to raise awareness and limit the hazardous effects of this phenomenon

Aims and objectives To investigate the effect of reverse Trendelenburg position versus semi‐recumbent position on respiratory parameters of obese critically ill patients. Background Reverse Trendelenburg position is recommended for obese patients; however, the effect among critically ill patients, especially those on mechanical ventilation, has limited study. Design Randomised, controlled pretest, repeated post‐test trial with two parallel groups. Methods The study started from 13 January 2020–12 March 2020. Adult critically ill patients with a body mass index ≥30 were randomly assigned by computer‐generated randomisation to either reverse Trendelenburg position group (intervention) or semi‐recumbent position group (active comparator control). Outcome measures were ventilation parameters (dynamic compliance, partial pressure of arterial carbon dioxide and minute volume) and oxygenation parameters (hypoxaemic index and partial pressure of arterial oxygen). Measures were assessed immediately before positioning and after positioning in 10 minutes, 20 minutes and 30 minutes. CONSORT checklist was used to report the current study. Settings Four general intensive care units. Results One hundred and ten patients (55 patients in each group) completed the study. The reverse Trendelenburg position group had a higher improvement than the semi‐recumbent position group as estimated by mean differences in their dynamic compliance, minute volume, partial pressure of carbon dioxide, partial pressure of oxygen and hypoxaemic index. Conclusion Reverse Trendelenburg position improves obese patients’ respiratory parameters more than semi‐recumbent position. Relevance to clinical practice This study directs nurses to use the reverse Trendelenburg position, which is an important position for enhancing the parameters of ventilation and oxygenation of obese mechanically ventilated patients.

Background Mechanical ventilation increases stress and anxiety of critically ill patients and subsequently physiological parameters of these patients. Peppermint inhalation reduces stress and improves physiological parameters in many studies, but none of these studies used peppermint inhalation yet for mechanically ventilated patients. Methods Randomized placebo controlled trial. Data for this study were collected from 1 June to 12 September 2022. Patients who were conscious on mechanical ventilation via endotracheal tube were randomly assigned to two groups. The intervention group received peppermint inhalation intervention, and the placebo group received almond inhalation intervention. Patients in both groups were assessed for their smell ability by Sniffin Sticks-test before starting the interventions. CONSORT checklist was used to report the study. This study was conducted in six intensive care units. Results A total of 52 patients in the intervention group and 54 patients in the placebo group completed the study. Pain score was significantly decreased in the intervention group after starting the intervention in comparison to the placebo group. There was a strong positive correlation between Sniffin Sticks-test score and the decrease in pain score after inhalation of peppermint. Conclusion/ Implications for practice: Inhalation of mechanically ventilated patients to peppermint decreases pain score. The effectiveness of peppermint inhalation is correlated to the smell ability of the patients. Trial registration: The identification number of the registered trial to the Clinical Trials Online Registry is: NCTXXXXXXX.