BackgroundThis is a cross-sectional study carried out in the Obstetrics and Gynecology Department at Kasr Al- Ainy Cairo University Hospitals.MethodsOne thousand female patients in the child bearing period (age 18-45 yrs) were included in this study. These females were non-pregnant and non-menstruating with no douching or intercourse for at least 2–3 days, no use of antibiotics, anti-protozoal or steroids for the past 15 days complaining of vaginal discharge with or without itching, burning sensation or both. Vaginal swabs were obtained from all patients for examination by direct wet mount examination, Giemsa staining, Modified Diamond culture and latex agglutination test Kalon) to detect the presence of Trichomonas vaginalis infection.ResultsThe prevalence of trichomonas infection was 50 cases, latex agglutination test detected 50 positive cases, 30 of which were also positive by culture, and only 10 were detected both by Giemsa staining and by wet mount.The wet mount, Giemsa staining and Kalon latex test had sensitivities of 33.3, 33.3% and 100% respectively while their specificities were 100%, 100% and 97.9% respectively.ConclusionScreening tests should be done routinely to depict cases of T. vaginalis infection and should be included in the control programs of sexually transmitted infections. Although wet mount is not a sensitive method for diagnosis of T. vaginalis yet, it is a good positive one. Staining is only useful when there is heavy T. vaginalis infection.Latex agglutination is a highly sensitive, simple, rapid and cost effective test. It provides results within 2-3 minutes and it has the potential for use in screening and diagnosis of T. vaginalis infection.

Aims Oesophageal fistula represents a rare but dreadful complication of atrial fibrillation catheter ablation. Data on its incidence, management and outcome are sparse. Methods and results This international multicenter registry investigates the characteristics of oesophageal fistulae after treatment of atrial fibrillation by catheter ablation. A total of 553,729 catheter ablation procedures (radiofrequency: 62.9%, cryoballoon: 36.2%, other modalities: 0.9%) were performed at 214 centers in 35 countries. In 78 centers 138 patients (0.025%, radiofrequency: 0.038%, cryoballoon: 0.0015% (p<0.0001)) were diagnosed with an oesophageal fistula. Periprocedural data were available for 118 patients (85.5%). Following catheter ablation, the median time to symptoms and the median time to diagnosis were 18 (7.75, 25; range: 0-60) days and 21 (15, 29.5; range: 2-63) days, respectively. The median time from symptom onset to oesophageal fistula diagnosis was 3 (1, 9; range: 0-42) days. The most common initial symptom was fever (59.3%). The diagnosis was established by chest computed tomography in 80.2% of patients. Oesophageal surgery was performed in 47.4% and direct endoscopic treatment in 19.8%, and conservative treatment in 32.8% of patients. The overall mortality was 65.8%. Mortality following surgical (51.9%) or endoscopic treatment (56.5%) was significantly lower as compared to conservative management (89.5%) (odds ratio 7.463 (2.414, 23.072) p<0.001). Conclusions Oesophageal fistula after catheter ablation of atrial fibrillation is rare and occurs mostly with the use of radiofrequency energy rather than cryoenergy. Mortality without surgical or endoscopic intervention is exceedingly high.

BACKGROUND: Patient safety culture is a relatively new focus where little is known about its current status in Egypt’s teaching hospitals, mainly intensive care units (ICUs). Therefore, the authors of this study attempted to assess the patient safety culture dimensions from the nurses’ perspective. METHODS: An exploratory cross-sectional study was conducted in two ICUs (pediatric ICU and adult ICU) at the University Hospital over 3 months from October till December 2018. Sixty nurses were interviewed using the Hospital Survey on Patient Safety Culture. RESULTS: The current study findings revealed an average positive response to individual items ranging from 6% to 51%. The “Organizational learning” dimension had the highest average percent positive patient safety dimension score (51%) among all respondents, while the “Frequency of events reported” dimension had the lowest one (6%). No statistically significant difference was reported between the pediatric and adult ICUs for all mean scores except for the “Non-punitive response to error” dimension which was reported to be greater in the pediatric intensive care unit (PICU) compared to adult ICU (P < 0.005). The overall patient safety grade was rated acceptable by 47.5% of the interviewed nurses. CONCLUSION: The current study shows that patient safety is fragile in ICUs, and more effort is recommended to increase the awareness of health care providers. Also, hospital managers need to enhance the performance and practices of patient safety within a non-punitive reporting environment.

AIM: The researchers conducted the study to assess intensive care units (ICUs) preparedness in Cairo University Hospitals to deal efficiently and effectively with COVID-19 upcoming waves. METHODS: An exploratory cross-sectional study was conducted at Cairo University Intensive Care Units 6 pediatric ICUs, and 2 adult ICUs in the period from the end of February to the first week of March, 2020; almost 2 weeks after the appearance of the first case of COVID-19 in Egypt by hand-delivered questionnaire method with one of the ICU staff members who were available and have time to take part in the study. WHO checklist for hospital readiness was used; this checklist based on current knowledge and available evidence on the COVID-19 pandemic for WHO’s Regional Office for the Eastern Mediterranean Region. The WHO has developed the checklist to help hospital managers prepare for COVID-19 patient management by optimizing each hospital’s capacities. The list composed of 10 key components: (1) Leadership and coordination; (2) operational support, logistics and supply management; (3) information; (4) communication; (5) human resources; (6) continuity of essential services and surge capacity; (7) rapid identification; (8) diagnosis; (9) isolation and case management; and (10) infection prevention and control. RESULTS: The overall preparedness in both pediatric and adult ICUs was 54%. Overall, adult ICUs were more prepared than pediatric ICUs, especially in communication; continuity of essential services and surge capacity; rapid identification; diagnosis; isolation; and case management. Both of them were comparable regarding operational support, logistics and supply management; human resources; and infection prevention and control, while information component was lower in both types but reached critical values 10% in adult ones. CONCLUSION: The current study demonstrated the intermediate readiness of ICUs at initial outbreak; further assessment during different phases of pandemic is required. Continues education of HCWs and active communication should be established.

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The perspectives of healthcare professionals on antibiotic stewardship programs (ASPs) should be explored. Any antibiotic stewardship strategy must be individualized based on patient needs, prescription habits, and local resources. The current study aimed to explore the perspectives of healthcare providers on antibiotics stewardship and their awareness of these perspectives. Furthermore, potential barriers to the application of ASPs should be identified and addressed. This exploratory cross-sectional study utilized a qualitative method to evaluate critical care physicians, pediatricians, and clinical pharmacists (n = 43). The mean age of the physicians was 32 ± 1.5 years. Among them, approximately two-thirds (66%) were women. A thematic content analysis was performed to examine the responses of the participants and to prioritize the recommendations for and barriers to the implementation of ASPs from the perspective of healthcare providers. According to the interviewees, the primary obstacles include lack of time in implementation and monitoring and lack of awareness of the need for ASPs. All respondents recommended the implementation of supervised and continuous trainings. In conclusion, the abovementioned barriers must be adequately addressed to facilitate the implementation of ASPs.

BACKGROUND: Little is known about the extent of Egyptians’ awareness regarding the relationship between nutrition and cardiovascular health. AIM: This study seeks to evaluate people’s awareness through an online cross-sectional survey to determine the knowledge gaps. METHODS: This cross-sectional study was conducted through an online survey using a convenience sampling technique. The participation required being an adult Egyptian (≥18 years old). A pre-tested electronic-questionnaire included three sections: Socio-demographic data, a self-reported history of chronic and cardiac diseases, and 15 questions addressing dietary risk factors and protective factors. Six hundred and thirty-two participants completed the questionnaire. RESULTS: The mean age was 28 ± 8 years. More than 80% of the participants were males. Of 632 participants, 233 had poor awareness. The median knowledge percent score was 62 with interquartile range (52, 71). About 85.4% of the participants were ready to change their eating habits and follow a healthy diet to maintain their health. The participants were interested in knowing more about healthy food and how to prepare healthy balanced meals (71.7% and 62.2%, respectively). Females, university-educated, employed, and Upper Egypt residents demonstrated deep awareness (p-value = 0.02, 0.011, 0.05, and 0.012, respectively). Intriguingly, friends and social media were the primary sources of nutritional knowledge. CONCLUSION: The participants’ knowledge is poor regarding the relation between nutrition and cardiovascular health. This study emphasizes the urgent need to raise public awareness as a precaution against cardiovascular diseases.

BACKGROUND: Exposure of health care workers to COVID-19 virus and its consequences together with fear of being infected and died or passing the infection to their families creates negative emotions with high stress in the working environment that impact their physiological and psychological health. AIM: The objectives of the study were to explore the different stress coping strategies that reduce stress among physicians in Egypt during the COVID-19 pandemic. METHODS: A qualitative study conducted among critical care medicine physicians (n = 32) who are working in two isolation hospitals where COVID-19-confirmed patients are being treated. Semi-structured audiotaped interviews with open-ended questions for up to 45 min were conducted from March 20, 2020, to April 15, 2020. Data processing was performed based on thematic content analysis. RESULTS: The enrolled physicians (n = 32) were 35 ± 1.5 years old and about two-thirds of them were women (66%). Thematic analysis revealed that knowledge of the disease together with training of physicians on providing care in a healthy work environment, where adequate personal protective equipment are available, was important factors in reducing stress. Personal coping strategies, including psychological adjustment, spiritual interventions, and support systems, were mostly used among the interviewees. CONCLUSION: Different stress-reducing strategies were recommended by participants, and these strategies focused mainly on safety and support. Implementing and promoting these strategies by organizations and individual physicians are expected to reduce their stress and consequently promote productivity and endurance throughout the current pandemic.