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Background: psoriatic arthritis (PsA) is a chronic, inflammatory, progressive joint disease. It has much psychosocial impact and affects quality of life (QOL) of the patients. Aim of the study: to determine the psychosocial impact of PsA on the patients and to define QOL of them. Patients and Methods: the study was conducted on 50 PsA patients, 68 psoriasis (Ps) patients, and 100 controls. A case-control, clinic-based study design was used in this research. An interviewing form and Middle Sex Hospital Questionnaire were used to survey the characteristics of the patients and controls. Severity of PsA was determined clinically. Also, the medical outcomes study 36-item short form (SF-36) was used to assess impact of the disease on the patient's QOL. Results: most (92.0%) of PsA patients had psychiatric symptoms. The disease had interfered with most of patients' personal feelings and relationships, daily activities, school/work, and leisure/sport. Majority (88.0%) of the patients had stigma feeling. Also, 40.0% and 60.0% of PsA patients had severe and mild forms, respectively. The differences between two forms of PsA regarding interference with school/work and presence of suicidal ideation were significant. The difference regarding presence of familial psychological stress was significant. The highly affected SF-36 domain scores were general health and physical limitation. The eight mean domain scores were significantly lower among PsA patients than controls. The mean domain scores of physical functioning, physical limitation, social functioning, emotional limitation, and mental health were significantly lower among patients with severe PsA than those with mild PsA. The eight mean domain scores were significantly lower among PsA patients than those with only Ps. Conclusions: the physical and psychosocial aspects of PsA may interact and influence one another. So, PsA has a great effect on the patients' QOL; disrupting physical and psychosocial aspects, and interfering with daily activities, school/work, and leisure/sport. QOL scores were significantly lower among PsA than only Ps patients.

Abstract:Background: Foot health problems are common in the elderly due to pathological changes in their feet. The aim of this study was to identify diabetic foot risk factors among the elderly at Zagazig City Subjects and methods; Analytic cross sectional study design was utilized. The study was conducted at Zagazig health insurance clinic for the elderly diabetic patients with purposive sample composed of (280) of the elderly diabetic patients. Tools, tool I, Interview questionnaire sheet composed of four parts (socio demographic characteristics, medical past &present history of diabetes, assessing patient foot care practice and assessment of risk factors of diabetic foot) and tool II, physical assessment of diabetic foot condition. Results it revealed that approximately one-half of the patients were 60-65 years old, only more than the third of studied patients had adequate foot care practice; the foot inspection revealed that the majority of them had abnormal foot and statistically significant relations between patients practice and their level of education, job type and income. The foot inspection revealed that the patients had no infection, no ulcer and no low blood flow had a higher percentage of normal examination. Conclusion The study found several factors associated with higher incidence of diabetic foot among the elderly diabetic patients including: low educational level, longer duration of diabetes, smoker, lack of foot care and poor footwear. Recommendations: Educate diabetic patients, about diabetic foot care practice through educational program to reduce the risk of complications.

Background: Gestational Diabetes Mellitus is considered to be a significant problem among pregnant women in Egypt. Aim: To evaluate the effect of educational protocol to improve pregnant women practices about gestational diabetes mellitus. Design: A quasi-experimental design was used. Setting: The outpatient diabetic clinic at Zagazig university hospital. Sample: A purposive sample of eighty pregnant diabetic women. Tools: Two tools were used in the study, Tool (1): Contained two parts; (1) demographic characteristics, (2) History about reproductive profile during pregnancy, Tool (2): Included two parts, assessment of knowledge of pregnant women about DM, and assessment of practice of pregnant women about DM. Results: The mean age of the pregnant women were 32.04 ± 9.36 years, also it was revealed that the total knowledge scores improved from 31.35% to 58.20%, with a highly significant difference (p=0.0044) for the participants, additionally, the overall increase in adequate practices improved from 56 to 78.5% after the implementation of the protocol sessions, with a significant difference (p=0.0106). Conclusion: The implementation of educational protocol for pregnant women was effective and enhanced their practices, and knowledge regarding the gestational diabetes mellitus. Recommendation: The study recommended that further studies for pregnant women with gestational diabetes mellitus should be applied in all health care centers.

Background: Old age is a period of transition when one has to deal not only with the physical aging, but also with the challenges affecting the mental and social well-being of the elderly. Aim: to assess the effect of social environment of elderly care homes on their psychosocial health in Helwan City. Research design: A descriptive correlational design. Setting: The study was carried out in four governmental elderly care homes in Helwan City. Subjects: One hundred elderly residents. Tool: A structured interview questionnaire consisted of five parts (Demographic characteristics of the elderly and data about the geriatric homes, history of chronic diseases and medication, elderly's satisfaction with geriatric home, elderly social relations in geriatric home, and assessment of psychosocial health of the elderly). Results: Half of the elderly were having fair relationship with their colleagues and family members and two thirds of them were having good relationship with their caregivers. About three quarters of the elderly had accepted psychological and social health. Highly statistically significant positive correlations were found between the scores of elderly psychological health, social health and their social relations scores. Conclusion: The present study revealed that there were highly statically significant positive correlations between the social environment of elderly care homes and their psychosocial health. Recommendations: Continuous assessment of social relations and psychosocial health of elderly residing in care homes. Developing and conducting programs to enhance social relations of elderly residents with specific focus on their psychosocial health.