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IntroductionNeurophobia, defined as a fear or aversion toward neuroscience and clinical neurology study, was first introduced by Dr. Ralph Jozefowicz in 1994. This study aimed to assess the prevalence and contributing factors of neurophobia among clinical-year medical students at Badr University in Cairo (BUC) and Helwan University. Given the high incidence of neurological disorders in Egypt, addressing neurophobia is crucial to encourage medical students to pursue neurology and help meet the country’s growing healthcare needs.MethodsA cross-sectional study was conducted on 1,235 clinical-year medical students from BUC and Helwan University. Quantitative data were collected using the Schon questionnaire and NeuroQ scale. Additionally, focus group discussions (FGDs) involving 62 students provided qualitative insights.ResultsNeurophobia was more prevalent among BUC students (47.7%) compared to Helwan students (26%). Male students reported higher levels of neurophobia, yet expressed greater confidence in neurology than female students. The perceived complexity of neuroanatomy (43.4%), lack of clinical exposure (52.5%), and excessive theoretical content (40.3%) were the main contributing factors. Early clinical exposure and more interactive teaching methods were strongly preferred by the students.ConclusionNeurophobia represents a major educational barrier and contributes to the global shortage of neurologists. A little is known regarding neurophobia among Egyptian medical students. Proposed solutions include adopting active learning strategies and reducing the time gap between neuroscience and neurology to enhance students’ confidence to reduce neurophobia among undergraduates. Yet, more studies are needed to reveal more about neurophobia prevalence, factors, and suggested plans to overcome.

Introduction: The identification of bladder detrusor muscle invasion in urothelial cancer is essential for prognosis and management. We studied the clinical, histological, and immunohistochemical expression of p16, p53, and Ki-67 in urothelial detrusor muscle-invasive bladder cancer (MIBC) and urothelial non-detrusor muscle-invasive bladder cancer (NMIBC) in Egyptian patients. Methods: Sixty-two bladder urothelial cancer cases obtained through TURBT were included and divided into two groups: (MIBC, stage T2) and NMIBC (T1). Tissue blocks were recut and re-examined microscopically; then, the immunostaining of p16, p53, and Ki-67 was performed to compare both groups and evaluate the 13% cut-off for Ki-67, 20% for p53, and p16 intensity in various conditions aided by telepathology technology. Results and conclusion: Hematuria was the main clinical first presentation, with no significant difference between either group. The mean age was 61.6 years, with male predominance (52 males and 10 females). The absence of papillary histological pattern was associated with a higher stage, including detrusor muscle invasion (p = 0.000). The overall average percent of p53 immunostaining was 12.9%, revealing no significant difference between MIBC and NMIBC when a cut-off of 20% was implicated. The Ki-67 expression was correlated with higher grade and muscle invasion; however, no association was found with the other two markers’ expression. The negative immunostaining of p16 was associated with low grade and NMIBC in the case of the preservation of the papillary pattern. We recommend further studies on the cut-off of widely used markers and more immunohistochemical and genetic studies on the p16(INK4A), taking into consideration the histological pattern of conventional carcinomas.

We would like to thank Harsanyi et al [...]