Screening for psychological distress among High School Graduates Accepted for Enrollment at Alexandria Faculty of Medicine: Academic year 2016/2017

Background: Mental and psychological health of adolescents in general and prospective medical students in particular is a priority area to investigate as it affects wellbeing of the future doctors.Objectives: The current research was conducted to screen first year medical students accepted for enrollment at Alexandria Faculty of Medicine to identify those with a high probability of having psychological distress before the start of academic courses as well as explore the sources of stress among them.Methods: A cross sectional survey of 779 high school graduates accepted for admission to Alexandria Faculty of medicine was conducted. Participants were approached on the days of obligatory pre-enrollment medical examination. The translated Arabic version of DASS 21 questionnaire was used to screen students for three negative emotional symptoms namely depression, anxiety and stress. Inquiry about age, sex, residency and type of high school was added.Results: More than a tenth of studied medical students (12.6%) suffered from severe or profound stress and 29.1% of them had mild to moderate stress. Moreover, one fifth (20%) of studied students were severely anxious and less than one third (29.3%) had mild to moderate anxiety. Severe and profound depression was diagnosed among 14.3% of students whereas, 18.7% them were moderately depressed. No association was found between any of studied negative emotional symptoms and the students’ educational background or their residency.Conclusion: Nearly half of the prospective medical students might have some sort of psychological distress before starting their study in the Faculty of Medicine. They should be investigated to verify diagnosis and start intervention to minimize its adverse effects on academic performance and advancement at the faculty. Stress management courses should be considered for all medical students.Keywords: Psychological distress, Prospective medical students, Adolescents’ psychological health, Depression, Anxiety, Stres

“ The Effect of Technology on Outdoor Furniture “

There is no doubt that technological development in all its scientific fields seeks the effective truth in meeting human needs and in all scientific, technical and applied aspects. The areas that have been greatly affected by advanced technology and techniques, and furniture is an integral and inherent element of architecture, and its design depends a lot on its function and the space in which it will be placed, and from this becomes clear the importance of outdoor furniture, used for gardens, streets and external public places, which is subject to conditions in manufacturing that take into account factors Several of them are: durability, the ability to withstand the natural factors of the site in which it will be placed, suitability for the function for which it was designed, and be environmentally friendly. The research problem is that the traditional outdoor furniture has become not fulfilling the requirements of the modern era, and the research aims to clarify some types of smart outdoor furniture. Versatile, as each piece of furniture can perform more than one function, and it is solar powered A need for special electronic equipment, as it relies in its design on integrating sensors and a data processor in its parts that are connected within central networks, and it is also made of smart materials, and one of the most important features of these materials is the ability to take variable reactions to meet performance needs Its functional purpose, to achieve comfort, safety and well-being for members of society, while shedding light on some types of traditional furniture, then presenting some types of smart furniture with a brief explanation of the characteristics and advantages of each, and in the end the conclusions and recommendations

Influence of Advanced Technologies in The Design of Modern Facades “

Architectural and interior design has been influenced by the enormous technological evolution of the world. Designers have begun to use the latest technologies available in the design and implementation of architectural products, particularly in the design of building interfaces, which rely mainly on technology in all its formal and functional aspects.The problem of research is the paucity of comprehensive and technology-oriented intellectual and applied studies in the design of building interfaces. Research aims to illustrate the impact of advanced techniques as a key variable in the design of functional as well as formal interfaces. To achieve the objective of research, research has relied on explaining and clarifying the types of vocabulary. Glass has been instrumental and influential in the design of facades. The evolution of the concept of glass use has been of great importance and influence to modern architects in trying to adapt external facades and solve their problems, as these materials have features that are not available from other ores. They have the capacity to acquire and distribute the greatest amount of light and rays in the directions required by the utility of design, as well as to reach the upper limit in terms of design. (Aesthetic) and functional for use in the design of external interfaces, with examples of modern interfaces tailored to advanced techniques, and concluded with theoretical and applied conclusions and recommendations.Research problem:The research problem is represented in the lack of comprehensive intellectual and applied studies directed towards the impact of technology in the design of the external facades of buildings.Research goal:The research aims to clarify the impact of advanced technologies as a key variable in the design of external interfaces in terms of the functional aspect of the interfaces as well as the formality.research importance:Emphasizing the role of technological progress and how to take advantage of modern technological methods and apply them in architecture, interior and exterior desig

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance.

Investment in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing in Africa over the past year has led to a major increase in the number of sequences that have been generated and used to track the pandemic on the continent, a number that now exceeds 100,000 genomes. Our results show an increase in the number of African countries that are able to sequence domestically and highlight that local sequencing enables faster turnaround times and more-regular routine surveillance. Despite limitations of low testing proportions, findings from this genomic surveillance study underscore the heterogeneous nature of the pandemic and illuminate the distinct dispersal dynamics of variants of concern-particularly Alpha, Beta, Delta, and Omicron-on the continent. Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve while the continent faces many emerging and reemerging infectious disease threats. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Another indication for a transanal pull-through: surgical management of rectal atresia—a case report

Abstract Background Rectal atresia is a very rare cause of neonatal intestinal obstruction. It has some distinctive anatomical and physiological specifications. The management is controversial with many described operative techniques. In this case report, we described our patient that we operated according to the transanal pull-through technique. We discussed the advantages and disadvantages of this technique and what makes it a suitable option for this population of patient. Case presentation A full-term male patient presented at 36 h of life for a pneumoperitoneum. Because of his well-placed, normally appearing anus, the diagnosis of rectal atresia was delayed. The patient was operated then according to the transanal pull-through technique with good follow-up results. Conclusion Transanal pull-through is a safe, easy. and a potentially reproducible option for managing rectal atresia. It should be considered for managing future cases. More cases should be done before drawing big conclusions. </jats:sec