BACKGROUND: Integrated Management of Childhood Illness (IMCI) is a cost-effective strategy that improves the quality of care provided to under – five children. Alexandria was the first governorate that applied the Integrated Management of Childhood Illness guidelines in Egypt. The aim of this study was to assess the degree of primary health care physicians’ adherence and attitude towards those guidelines after 17 years of application.METHODS: This cross-sectional study was carried out on a representative sample from the primary health care facilities in Alexandria from which physicians using IMCI guidelines were included in the study. The sample units were chosen randomly from all districts of Alexandria. Observational checklists were developed to assess the degree of adherence of physicians based on the guidelines booklet.RESULTS: The highest adherence score reported was that of writing disease classification (100%). As regards infants aged up to 2 months, the highest physicians’ adherence score reported was that of jaundice and possible bacterial infection assessment (100 % and 95% respectively). And in spite of its importance, only 85.7% of physicians were complied with weight assessment and its plotting in the growth curve. For children aged from 2 months up to 5 years physicians were generally well complied with the guidelines especially for assessment of dangerous signs and possible bacterial infection. CONCLUSION: Despite being applied for years, IMCI guidelines still show certain areas of poor adherence, an issue that need further investigation in order to maximize physicians’ adherence and achieve the best of their performance.

Background: Dementia is a global health challenge affecting both patients and their caregivers, with family members often bearing the primary caregiving burden. In Egypt, where research on caregiver mental health is limited, interventions addressing caregiver burden and anxiety is critical. Aim: To determine the effect of a psychoeducation and skill-based multimodal intervention on caregiver burden and anxiety. Methods: A randomized controlled trial (RCT) involving 84 family caregivers. Participants were assigned to either the intervention group (n = 42), which received structured psychoeducation and skill-based training over six biweekly sessions, or the control group (n = 42), which received routine outpatient care. Caregiver burden and anxiety were assessed using the Zarit Burden Interview (ZBI) and the Generalized Anxiety Disorder Scale (GAD-7). Behavioral and psychological symptoms of dementia were evaluated using the Neuropsychiatric Inventory Questionnaire (NPI-Q). Results: The sample consisted predominantly of women (79% in the intervention group, 69% in the control group), with daughters forming the largest caregiver subgroup (66.6% and 52.4%, respectively). The mean age of caregivers was 39.2 ± 4.2 years. After three months, caregivers in the intervention group exhibited a significant reduction in burden (ZBI median score: 24 vs. 34, p < 0.0001) and anxiety (GAD-7 mean score: 6.15 vs. 9.4, p < 0.0001) compared to the control group, however, NPI-Q scores remained unchanged. Conclusion: A structured psychoeducation and skill-based intervention significantly reduces caregiver burden and anxiety. Implementing such programs in Egypt could improve the well-being of caregivers and individuals with dementia.

Hypertension is a common chronic disease amenable to control by adopting relevant lifestyle modifications and/or appropriate medication. The aim of the study was to assess the effect of patient centered approach on self-reported health related quality of life (HRQoL) in patients with essential hypertension attending Internal Medicine outpatient clinic in Zagazig University hospital. This single blinded randomized controlled clinical trial was conducted in Zagazig university internal medicine outpatient clinic on 112 non complicated apparently healthy essential hypertensive patients without comorbidities from 45 to 65 years old randomly allocated into two groups (intervention and control 1:1). Data for this study was collected by social, biological and SF-12v2 questionnaire for both groups. Then management of the intervention group according to the patient centered approach for nine months while patients within control group received classic disease centered approach. The patients within intervention group were given an individualized medical care and tailored patient education program about essential hypertension. The outcome of disease was assessed by measuring change in blood pressure control and health related quality of life within the two groups. It has been found that patients with essential hypertension within both groups reported deteriorated HRQoL yet there was no statistically significant difference between both groups regarding HRQoL at the start of the study. By the end of the study, there was a statistically significant difference between the two study groups regarding blood pressure control and self reported health related quality of life where patients within intervention group reported statistically significant improvement in both variables. In conclusion, the patient centered approach is better than the disease centered approach in management of patients with essential hypertension.

Background: Infertility can have an extravagated impact on the psychological wellbeing of the couple and subsequently affect the marital relationship and the quality of life. Objective: To screen for depression in infertile female attending infertility clinic and to determine the severity of depression in relation to duration of infertility and other socio-demographic characteristics in an Egyptian setting. Methods: This cross-sectional descriptive study was conducted from June 2014 to December 2014 in the infertility clinic in Kasr Al-Ainy hospital. Three hundred infertile females were screened for depression using the Arabic version of the Patient Heath Questionnaire (PHQ-9). Results: According to (PHQ-9), 62.3% of the studied infertile females suffer from moderate to severe depression. The score of PHQ-9 was inversely proportionate to both the duration of marriage (P value=0.038, person correlation:-0.12) and duration of infertility (P value=0.025, person correlation: -0.13) and was directly proportionate to age of studied females (P value =0.032, person correlation: 0.124), their educational level (P value =0.000, person correlation: 0.312) and number of trial of assisted reproductive technique (P value=0.001, person correlation: 0.189), and these data were statistically significant. Conclusion: A large percentage of Egyptian infertile females suffer from depression. And this highlights the challenging need for providing individualized bio-psychosocial care for all infertile Egyptian females.

Background: Videoconferencing technology reduces time and costs between remote locations, fill gaps in teaching services, enables meetings that would not be possible due to prohibitive travel costs, and improves access to learning Aim: To explore the effectiveness of the theoretical module of PDFM (Professional Diploma of Family Medicine) in Sudan delivered via distant learning compared to that of PDFM in Egypt delivered via conventional learning by comparing the achievement level in the post-theoretical-module exam and the results of the exam analysis. Methods: This comparative study was conducted from November 2014 to April 2015. In PDFM Egypt and Sudan, the theoretical part was delivered via face-to face learning and synchronous videoconference respectively. The same exam was used to assess candidates' knowledge in PDFM in Egypt and Sudan at the same time. Item analysis was done to obtain item and test statistics. Also, candidates' feedback was assessed using a Web-based questionnaire Results: Thirty-two candidates (84.2%) passed the exam of PDFM in Egypt while 77 candidates (86.5%) passed it in Sudan. The reliability co-efficient of the exam in Egypt and Sudan were 0.9188 and 0.8140 respectively. There was no significant difference between the discrimination index of the exam (p value=0.074), while there was significant difference between the difficulty index; 70% of the exam questions were considered easy in PDFM Sudan compared to 40% in PDFM Egypt. Conclusion: Synchronous videoconferencing can be used to expand educational capacity and international cooperation between academic institutions in developing countries, a particular priority in the growing field of Family Medicine.