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Background: Unintended pregnancies may be mistimed or unwanted. It represents 40% of all pregnancies, and it had multiple risky health outcomes. It is essential to understand the factors affecting unintended pregnancies and their consequences to develop strategies that help prevent them. The present study is conducted to identify the prevalence, determinants, and outcomes of unintended pregnancies in Sohag district, Egypt. Methods: A cross-sectional study was conducted in Sohag district, 2016. Five hundred fifty-four ever married women aged 18-49 years whose last pregnancy was in the 3 years preceding the data collection date were randomly selected from rural and urban localities. Data were collected through home visits using a validated questionnaire. In this study, Sohag city represents the urban place, while Tunis and El-Sheikh Makram villages represent the rural places. Results: Nearly one third (30.7%) of the study sample had an unintended pregnancy within the last 3 years from the time of interview. Regression analysis showed that young women < 30 (OR = 2.24, 95% CI 1.12-4.48, p = 0.02), young husbands ≤ 30 (OR = 5.44, 95% CI 1.14-26.11, p = 0.03), women working for cash (OR = 6.16, 95% CI 3.15-13. 92, p < 0.0001), monthly income ≤ 1200 LE (OR = 34, 95% CI 6.41-187.52, p < 0.0001), and spacing < 24 months (OR = 8.79, 95% CI 4.33-17.80, p < 0.0001) were risk factors for mistimed pregnancy. On the other hand, women working for cash (OR = 11.43, 95% CI 3.22-40.62, p < 0.0001), living children ≥ 5 (OR = 11.45, 95% CI 2. 84-46.07, p = 0.001), and the woman's perception of her family size as higher than the ideal (OR = 394.8, 95% CI 97.36-1601.17, p < 0.0001) were risk factors for unwanted pregnancy. Mistimed and unwanted pregnancies were significantly associated with late start of antenatal care (ANC), low birth weight (LBW), and no breastfeeding. In addition, unwanted pregnancies were associated with more pregnancy complications. Conclusions and recommendations: Unintended pregnancy represents a public health problem in Sohag. Therefore, improving services in rural areas and improving the economic level and effective use of family planning methods could reduce the risks associated with the unintended pregnancy.

Summary Background Risk of mortality following surgery in patients across Africa is twice as high as the global average. Most of these deaths occur on hospital wards after the surgery itself. We aimed to assess whether enhanced postoperative surveillance of adult surgical patients at high risk of postoperative morbidity or mortality in Africa could reduce 30-day in-hospital mortality. Methods We did a two-arm, open-label, cluster-randomised trial of hospitals (clusters) across Africa. Hospitals were eligible if they provided surgery with an overnight postoperative admission. Hospitals were randomly assigned through minimisation in recruitment blocks (1:1) to provide patients with either a package of enhanced postoperative surveillance interventions (admitting the patient to higher care ward, increasing the frequency of postoperative nursing observations, assigning the patient to a bed in view of the nursing station, allowing family members to stay in the ward, and placing a postoperative surveillance guide at the bedside) for those at high risk (ie, with African Surgical Outcomes Study Surgical Risk Calculator scores ≥10) and usual care for those at low risk (intervention group), or for all patients to receive usual postoperative care (control group). Health-care providers and participants were not masked, but data assessors were. The primary outcome was 30-day in-hospital mortality of patients at low and high risk, measured at the participant level. All analyses were done as allocated (by cluster) in all patients with available data. This trial is registered with ClinicalTrials.gov , NCT03853824 . Findings Between May 3, 2019, and July 27, 2020, 594 eligible hospitals indicated a desire to participate across 33 African countries; 332 (56%) were able to recruit participants and were included in analyses. We allocated 160 hospitals (13 275 patients) to provide enhanced postoperative surveillance and 172 hospitals (15 617 patients) to provide standard care. The mean age of participants was 37·1 years (SD 15·5) and 20 039 (69·4%) of 28 892 patients were women. 30-day in-hospital mortality occurred in 169 (1·3%) of 12 970 patients with mortality data in the intervention group and in 193 (1·3%) of 15 242 patients with mortality data in the control group (relative risk 0·96, 95% CI 0·69–1·33; p=0·79). 45 (0·2%) of 22 031 patients at low risk and 309 (5·6%) of 5500 patients at high risk died. No harms associated with either intervention were reported. Interpretation This intervention package did not decrease 30-day in-hospital mortality among surgical patients in Africa at high risk of postoperative morbidity or mortality. Further research is needed to develop interventions that prevent death from surgical complications in resource-limited hospitals across Africa. Funding Bill & Melinda Gates Foundation and the World Federati...

Purpose. To study the relation between the serum 25-hydroxyl vitamin D (OH D) level and the occurrence of age-related cataract in a case-control study. Patients and Methods. 325 cataract patients and 385 control individuals of both sexes were examined for the 25-OH D level using the chemiluminescent microparticle immunoassay (CMIA) technology. Results. Mean 25-OH D level in cataract patients was 7.6 ± 5.5 ± 11.2 ng/mL and median was 5.6 (2.6–31.9), while in the control group, mean 25-OH D level was 18.5 ± 9.6 ng/mL and median was 17.8 (3.4–37.8) (p value < 0.001). There was a statistically significant difference among the different types of cataracts with the lowest level in nuclear cataract. Conclusion. 25-OH D levels in all enrolled individuals were below the reference levels with a severe deficiency in cataract patients. These results might highlight the role of deficiency of 25-OH D in age-related cataract patients.

Background: Upper respiratory tract infections (URTIs) are considered to be the most common reason for children's visits to outpatient clinics. The emergence and spread of resistance related to the irrational use of antibiotics is a major global public health problem. Aim of the work: This study aimed to assess parents' knowledge, attitude, and practice (KAP) regarding the use of antibiotics in URTIs in children. Methodology: A cross-sectional study wascarried out among parents(N=800) of children who were attending the maternal and child health center in Sohag city and the family medicine unit in Elmahamdaelbahria village in the period from 1 st July 2016 till 31 th May 2017.Results:Our results revealed that females were about 62.6%, those not sharing in labor force were 55.9 %, and urban parents were about58.8%. The mean age of parents was 33 years old.There is a statistically highly significant difference between mother & father in mean scoresof knowledge, attitude, practice; they were lower in fathers. Also, there is statistically significant difference between parents with different ages in practice score. There are highly statistically significant differences between mothers who were sharing and not sharing in labor force in Attitude, Practice scores.Conclusion:Parents with loweducational level, rural residence, low income and with two children or less have lack of knowledge ,inappropriate beliefs andpractices so they are vulnerable for misusing antibiotics for their children.

Purpose Diabetes is a documented risk factor for peripheral neuropathy. It was reported that associated hypertension could increase this risk. The present study aimed to assess the effect of hypertension and diabetes on median nerve using high-resolution ultrasound. Methods The study includes 50 hypertensive patients (HTN group), 50 diabetic patients (DM group), 50 patients with coexisting diabetes and hypertension (HTN + DM group) and 50 healthy controls. Median nerve affection in the studied groups was studied by vibration perception thresholds (VPT). The median nerve cross-sectional area was determined at the nerve cross-sectional area of the median nerve at the carpal tunnel by high-resolution ultrasound. Clinical symptoms were assessed using Toronto Clinical Severity Score (TCSS). Results There was significantly higher median nerve CSA in all patient groups in comparison to controls. HTN + DM group had significantly higher median nerve CSA when compared with DM group. Patients with peripheral neuropathy in HTN + DM and DM groups had significantly higher median nerve CSA than patients without. Using ROC curve analysis, it was shown that median CSA could successfully distinguish patients with peripheral neuropathy from patients without in HTN + DM group [AUC (95% CI): 0.71 (0.54–0.89)] and in DM group [AUC (95% CI): 0.86 (0.72–0.99)]. Conclusion Hypertensive patients with and without diabetes have significantly higher median nerve CSA when compared with controls.

Bariatric surgeries involvement in treating comorbid obesity is growing fast. Since it was first approved as a treatment for those who had previously failed to reduce weight through conventional ways, the usage of bariatric surgery has significantly increased. The body mass index is frequently used in clinical practise to identify obesity, which is generally understood to mean having a significant quantity of harmful body fat (BMI). Since the BMI's creation, numerous studies involving sizable populations have shown a J-shaped relationship between the BMI and risk of morbidity or mortality, with a BMI greater than 30 kg/m2 (the definition of obesity in many guidelines) being undeniably linked to an elevated risk of morbidity or mortality. A severe and rapidly expanding global health hazard is the prevalence of morbid obesity. While some people can lose additional weight by making lifestyle changes, participating in exercise programmes, and following diet plans, bariatric surgery is still the treatment of choice for many patients who don't react to other forms of therapy. In terms of weight loss and comorbidity alleviation, bariatric procedures have produced excellent results. However, some issues with bariatric surgery have been reported, including anastomotic leakage, stenosis, haemorrhage, weight regain, and nutritional inadequacies. Due to the Roux-en-Y gastric bypass's poor absorption capabilities (RYGB), ND is an expected complication. Sleeve gastrectomy (SG) and other restraint-inducing operations are also linked to ND. The purpose of this review of the research is to present and discuss the nutritional effects of bariatric procedures and the currently available treatment alternatives.