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Imposter syndrome (IS) and low self-esteem (SE) are common issues affecting medical students that can impact their well-being and development. This study aimed to assess the prevalence and factors associated with IS and SE among medical students at Jazan University, Saudi Arabia. In this cross-sectional study, 523 medical students in years 2–6 at Jazan University, Saudi Arabia, completed validated questionnaires on IS (Young Imposter Scale) and SE (Rosenberg Self-Esteem Scale). Sociodemographic factors were also collected. Descriptive statistics and logistic regression analyses were used to analyze IS and SE prevalence and correlates. Five hundred twenty-three students with a mean age of 22.09 ± 1.933 participated. The prevalence of low SE and positive IS was 17.6% and 24.3%, respectively. IS and SE had a significant negative correlation (p<0.001). Several sociodemographic factors were associated with increased IS, including 2nd and 4th-year students, forced study choice, and a grade point average (GPA) of 3.0–3.49 (P<0.05). Paternal education beyond high school was associated with lower IS (P<0.05). Logistic regression analyses confirmed that 2nd-year students had a 3.88 times higher odds ratio (OR) (95% confidence interval (CI); 2.19–6.88), and 4th-year students had a 2.37 times higher OR (95% CI; 1.40–4.02) of IS than other years. For SE, advanced academic years, forced study choice, 7+ hours of sleep, and a GPA above 3.5 were associated with higher levels (P<0.05). Negative self-appraisals were associated with lower SE, while positive attitudes were associated with higher SE (P<0.05). Our study reveals that IS and low SE are prevalent among Jazan University, Saudi Arabia, medical students. Therefore, intervention courses that address these issues in medical education at Jazan University, Saudi Arabia, may be necessary to support medical students’ well-being and academic success.

Background Understanding the factors that influence clinical outcomes of COVID-19 and the safety of various vaccines is important to inform public health strategies, particularly in diverse communities. This study aimed to assess the factors affecting the clinical outcomes of COVID-19 and vaccination safety among the Egyptian population. Methods In a retrospective study, we examined 1597 patients who tested positive for COVID-19. Among them, 1280 patients had received the vaccination, while 317 patients had not. We collected data from medical records, which included clinical characteristics, comorbidities, disease severity, type of vaccination, and adverse hematological effects postvaccination. We calculated the relative risk, odds ratio, and 95% confidence intervals (CIs). Results Among the 1,597 COVID-19 cases, 74.1% were mild, 24.8% were moderate, and 1.1% were severe. Significant factors for moderate/severe cases included male sex (RR 0.78, 95% CI 0.64–0.95), cardiovascular diseases (RR 1.86, 95% CI 1.32–2.64), respiratory diseases (RR 1.40, 95% CI 1.08–1.82), diabetes mellitus (RR 1.41, 95% CI 1.07–1.86), and previous COVID-19 infection (RR 1.22, 95% CI 1.02–1.46). Vaccination reduced the severity risk, with BBIBP-CorV (Sinopharm) showing a significant protective effect (OR 0.78, 95% CI 0.62–0.98). Clinical presentations varied, with 97.6% having an oxygen saturation ≥ 92%. Logistic regression indicated that male sex and BBIBP-CorV (Sinopharm) vaccination were protective factors. Linear regression revealed that the male sex increased hemoglobin and leucocyte counts, whereas BBIBP-CorV (Sinopharm) decreased leucocyte and platelet counts. Conclusion Vaccination, particularly with BBIBP-CorV (Sinopharm), significantly reduces COVID-19 severity among Egyptians, despite various clinical presentations and hematological effects. Clinical trial number Not applicable.

This study aimed to estimate the national prevalence of developmental delays (DDs) and their determinants among Egyptian children aged 6 to 12 years. Such estimation is a prerequisite step toward the application of Life Skill Education (LSE) programs that will potentiate children's future capabilities. Vineland Adaptive Behavior Scales\" was used as a reliable and diagnostic test for DDs screening during this national cross sectional study. Gross motor (GM), fine motor (FM), daily living skills, communication, and socialization skills were assessed. The multivariate logistic regression analysis was used to identify factors associated with DDs. The Adjusted Odds Ratio (AOR) with a 95% Confidence Interval was estimated to indicate the strength of association. A p-value of <0.05 was used to declare statistical significance. Out of the 20324 surveyed school-aged children, 7.4% were found to have at least one delay. Communication deficits were the most common (6.4%) followed by delay in daily living skills (2.0%). The final model of logistic regression had a good fit for seven variables out of the sociodemographic, epidemiological characteristics, maternal and perinatal problems that were associated with a higher likelihood of at least one DD: Children suffering from any convulsions (AOR = 4.32; 95% CI: 3.18-5.88), male gender (AOR = 1.86; 95% CI: 1.65-2.09), birth weight less than 2.5 kg (AOR = 1.77; 95% CI: 1.40-2.24), history of maternal health problem during pregnancy (AOR = 1.64; 95% CI:1.34-2.01), children staying in an incubator for more than two days (AOR = 1.57, 95% CI: 1.29-1.91), having less educated fathers (AOR = 1.55, 95% CI: 1.24-1.95) and belonging to the middle social class (AOR = 1.40, 95% CI: 1.24-1.58). The identified types and determinants for each DD are allowing for the implementation of tailored programs for school children's life skills promotion for achieving the most sustainable effects on children's biological and psychological health and well-being.

Background Shivering is known to be a frequent complication in patients undergoing surgery under neuraxial anesthesia with incidence of 40–70%. Although many pharmacological agents have been used to treat or prevent postspinal anesthesia shivering (PSAS), the ideal treatment wasn’t found. This study evaluated the efficacy of paracetamol and dexamethasone to prevent PSAS in patients undergoing lower abdominal and lower limb surgeries. Methods Three hundred patients scheduled for surgeries under spinal anesthesia (SA) were allocated into three equal groups to receive a single preoperative dose of oral paracetamol 1 g (P group), dexamethasone 8 mg intravenous infusion (IVI) in 100 ml normal saline (D group) or placebo (C group), 2 h preoperatively, in a randomized, double-blind trial. The primary endpoint was the incidence of clinically significant PSAS. Secondary endpoints included shivering score, the change in hemodynamics, adverse events (e.g., nausea, vomiting and pruritis) and patients` satisfaction. Results Clinically significant PSAS was recorded as (15%) in P group, (40%) in D group and (77%) in C group ( P  < 0.001). The mean blood pressure values obtained over a 5-25 min observation period were significantly higher in the D group ( P  < 0.001). Core temperature 90 min after SA was significantly lower in the 3 groups compared to prespinal values ( P  < 0.001). Nausea, vomiting and pruritis were significantly higher in the C group ( P  < 0.001). P and D groups were superior to C group regarding the patients’ satisfaction score ( P  < 0.001). Conclusion Paracetamol and dexamethasone were effective in prevention of PSAS in patients undergoing lower abdominal and lower limb surgeries compared to placebo controls. Trial registration ClinicalTrials.gov Identifier: NCT03679065 / Registered 20 September 2018 - Retrospectively registered, http://www.ClinicalTrial.gov .

Background The prevalence of autism spectrum disorder (ASD), a common developmental disorder, has surged in recent years. Accordingly, the identification and early management of possible risk factors can diminish ASD incidence. Aim To determine the prevalence and severity of idiopathic ASD in Egyptian children aged 12 months to 12 years, and to identify the epidemiological, sociodemographic, and environmental risk factors contributing to this disorder. Methods This study comprised 41,640 children from the main eight geographic areas in Egypt. It was conducted through four phases: household screening, facility-based screening for high-risk children, diagnosis confirmation, and risk factor assessment. Results The prevalence of ASD as confirmed by the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and the Childhood Autism Rating Scale (CARS) was 1.1% (455 out of 41,640), with significant geographic variability. Urban areas had a significantly higher prevalence than rural areas. Children aged 3–6 years showed the highest prevalence at 1.5%. Boys were four times more affected than girls, with prevalence rates of 1.7% and 0.4%, respectively. Significant risk factors included: a history of convulsions (AOR = 4.7; 95% CI: 3.3–6.79), low birth weight (AOR = 2.08; 95% CI: 1.54–2.79), prolonged  stays in neonatal intensive care unit (NICU) longer than two days (AOR = 1.91; 95% CI: 1.46–2.49) and maternal health problems during pregnancy (AOR = 1.66; 95% CI:1.36–1.95). Regarding severity, 45% of diagnosed children had moderate ASD, 39% had severe ASD, and 16% had mild ASD. Female gender and older age were significant predictors of greater ASD severity. Conclusion ASD prevalence in Egypt is comparable to other Middle Eastern countries. Policymakers should utilize these findings to design targeted public health interventions aimed at early detection, management, and prevention of ASD progression.

Early detection of COVID-19 improves the chance of recovery and helps identify high-risk patients. Our study aimed to statistically predict the time to improvement with the admission data of COVID-19 patients. Methods : Our prospective cohort study occurred between January and September 2022 at Alexandria University Hospital’s outpatient clinic and isolation department. We enrolled 43 patients after assessing their eligibility and collecting their baseline data. Results : The mean age was 34.8 years (± 12.3). Most of them were females (65.1%). The mean of oxygen saturation was 95.2% (± 2.8). We used linear regression to predict how long it would take to improve [time to improvement (days) = 1.186*P (mmol/L) + 0.010*IL-10 (pg/mL)]. Its diagnostic performance was 0.723 (95% CI: 0.552–0.894), and it was accurate at predicting improvement within a week but not at longer delays; additionally, its positive and negative predictive values were 56.3% and 85.2%, respectively. Conclusion : We recommend monitoring phosphorus and interleukin-10 levels. The time-to-improvement delay negatively correlated with a reduction in baseline oxygen saturation upon admission. Additionally, for every 0.84 meq/L increase in phosphorus or 100 pg/mL increase in interleukin-10, there was a 1-day delay provided that the other was constant, with a coefficient of determination of 85.9%.

Nonalcoholic fatty liver disease (NAFLD) is a possible risk factor for chronic kidney disease (CKD). Renal resistive index (RRI) which is a ratio of peak systolic and end diastolic velocity can test arterial stiffness and endothelial renal dysfunction. The aim of the work is to detect the relation between NAFLD and RRI as an indicator of early renal affection and its relation to the disease severity. This study included 150 subjects divided into 3 groups: patients with NASH, simple steatosis, and control group (50 patients each). All patients were subjected to full history taking, clinical examination, laboratory investigations, abdominal ultrasound examination, and RRI measurement. 6.0% of NASH patients had significant fibrosis by NAFLD fibrosis score. RRI was significantly higher in NASH patients with fibrosis (mean = 0.74) than NASH patients without fibrosis (mean = 0.65) and patients with simple steatosis (mean = 0.63). It was the lowest in normal controls (mean = 0.61). There were significant correlations between RRI and age, BMI, serum lipids, liver enzymes, and NAFLD fibrosis score. Multiple linear regression analysis found that age and serum cholesterol were significant independent factors of increased RRI (p < 0.0001). RRI showed low diagnostic performance in differentiation between NASH and simple steatosis using ROC curve. RRI was significantly higher in NASH patients with and without hepatic fibrosis. RRI correlates significantly with NAFLD fibrosis score. RRI can be used as an indicator of early renal affection in patients with NAFLD.

Several compounds obtained from plants have potential insecticidal, growth deterrent or repellent characteristics. The control of hard ticks by non-chemical substances was targeted in this study. The effect of 36 materials on in-vitro ticks was studied, including 2 absolute controls (water only or absolute ethyl alcohol only), 6 conventionally used spinosad preparations (aqueous solutions), 12 Nigella sativa (N. sativa) preparations (aqueous and alcoholic solutions), and 12 Thyme preparations (aqueous and alcoholic solutions). The engorged ticks were tested in-vitro for mortality and oviposition ability using the studied materials. The final mortality after 48 hours of application in N. sativa aqueous preparations began from 10.0% concentration, 1.0% to 100% by concentration preparations ≥10%. In addition, N. sativa alcoholic preparations began from 50.0% concentration, 2 % to 100% by concentration ≥5%. Meanwhile, Thyme aqueous and alcoholic preparations began from 70.0% concentration, 5% to 90% by concentration 10-20%. Additionally, spinosad aqueous preparations and both of control preparations (Water and Alcohol) resulted in no mortality. All differences were statistically significant. The oviposition was stopped in N. sativa (aqueous ≥10% and alcoholic ≥5%) and in spinosad (aqueous≥25%). The aqoues dilution of the used matters killed B. annulatus larvae beginning from the concentration 5%. Nigella sativa alcohol 20% was the best of studied preparations being the lowest concentration (20%) that could achieve the highest lethal (100%) effect in shortest time (12 hours). Moreover, Thyme oil and spinosad could not kill 100% of adult but did on larvae.

This study aimed to provide a national estimate of the prevalence of the high risk of autism spectrum disorder (ASD) and their determinants. A national screening survey was conducted for 41,640 Egyptian children aged 1 to 12 years in two phases. Tools used were Vineland's Adaptive Behavior Scales, Modified Checklist for Autism in Toddlers, Gilliam Autism Rating scale, and Denver II Developmental screening test. The overall prevalence of children at high risk of ASD was 3.3% (95% CI:3.1%–3.5%). Children living without mothers in homes, suffered from convulsions (AOR = 3.67; 95%CI:2.8–4.8), a history of cyanosis after birth (AOR = 1.87; 95% CI:1.35–2.59) or history of LBW babies (AOR = 1.53; 95% CI:1.23–1.89) carried higher odds of being at high risk of ASD.

Background Community perspectives on organ donation legislation, aligned with ethical and medical standards, shape the trajectory of donation practices. This study assessed public awareness and acceptance levels of the seven key articles governing organ donation under Egyptian law, focusing on how these perceptions influence willingness to donate. And identified the demographic and socioeconomic determinants. The study explored the relationship between awareness and willingness. It analyzed public perceptions of highly visible and lesser-known legal articles to identify disparities in understanding and acceptance. Methods A cross-sectional study was conducted among 2743 participants aged 20–70 years, focusing on seven legal articles covering aspects such as donation eligibility, death verification, non-relative donations, government-funded transplants for the underprivileged, living donor restrictions, penalties for illegal transplants, and severe punishments for unauthorized procedures. Results Awareness and acceptance of 4–6 articles were reported by 36.9% and 43.7% of participants respectively. The highest awareness for state-funded transplants and the greatest acceptance for cross-national donation eligibility were observed. Factors influencing awareness included individuals aged (≤ 25 years, educated individuals and Group D participants. Willingness to donate, expressed by 78.4% of participants, correlated positively with awareness (OR = 6.48) and acceptance (OR = 9.69) of all seven articles (p < 0.001). Logistic regression model showed that higher awareness and acceptance increased willingness, while higher socioeconomic status (OR = 0.22 for Group A, p < 0.001) reduced it. Conclusion Disparities in awareness and acceptance across different demographics and specific legal provisions highlight areas for targeted interventions. Addressing public skepticism about state-funded transplants and improving awareness of niche laws, such as cross-national donations, can enhance trust and participation in organ donation programs, thereby enhancing community support for ethical donation practices.