Academic self-efficacy (ASE), influenced by various sociodemographic, lifestyle, and psychological factors, is a critical determinant of academic performance in medical students. In Egypt, the medical education system underwent recent drastic changes. Therefore, we aim to explore the effects of these changes on the variables above and, subsequently, on ASE among a national sample of Egyptian medical students. We conducted a cross-sectional study across 30 Egyptian medical colleges using a validated electronic Arabic survey to evaluate sociodemographic, lifestyle behaviors, psychological factors, and ASE. Categorical variables were described using frequencies and percentages, while Continuous variables were summarized as mean and standard deviation. Bivariate analysis with post-hoc testing, Pearson’s correlation coefficient, and multivariate linear regression were employed to assess the associations between the study variables and ASE. Data analysis was performed using R Statistical Software. A total of 1446 participants were included, with a mean age of 20.59 ± 1.68. Of these, 61.5% (n = 890) were Females, while 94.3% (n = 1363) were single. ASE was significantly associated with certain financial status, smoking, sleeping hours, breakfast patterns, diet changes, and fluids. Stress, anxiety, and depression were associated with and correlated to poor ASE. Only depression, oversleeping, and smoking were significant predictors of worse ASE. Multiple variables are significantly associated with, correlated to, or predictors of ASE after the recent reform in the Egyptian medical education system. Subsequently, targeted interventions to specific sociodemographic, lifestyle, and psychological factors can be adopted and assessed through future longitudinal pre-post interventional studies.

Background: Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) remain major public health issues. Although the primary and secondary prevention of RHD through appropriate management of bacterial pharyngitis and ARF are well-described in the literature, few studies address the knowledge, attitude, and practice (KAP) of developing countries. We aimed to evaluate the KAP of the frontline physicians in Egyptian university hospitals regarding pharyngitis and ARF. Methods: We employed a cross-sectional design between September 1st, 2022, and January 31st, 2023 using a self-administered questionnaire in 21 Egyptian universities. The questionnaire was developed based on previous studies and recent guidelines and included four domains: sociodemographic data, knowledge, attitude, and practice regarding pharyngitis and ARF. We utilized both online (Google Forms) and paper surveys. Frontline physicians, including interns, residents, and assistant lecturers, were conveniently invited to participate. Furthermore, with the help of participating phycisians in recruiting their colleagues, we utilized the snowball method. Data were analyzed using IBM SPSS version 27 software. Results: The final analysis included 629 participants, of whom 372 (59.1%) were males and 257 (40.9%) had direct contact with ARF patients. Most participants (61.5%) had a fair knowledge level while 69.5% had a fair level of practice regarding ARF and pharyngitis. Higher satisfactory knowledge levels were noted regarding pharyngitis (17.1% vs. 11.3%; p-value: 0.036) and ARF (26.8% vs. 18%; p-value: 0.008) among physicians dealing directly with ARF cases compared to physicians in departments not dealing directly with ARF cases. Physicians in Cairo region universities had significantly higher levels of satisfactory knowledge about ARF compared to Delta and Upper Egypt region universities (p = 0.014). Delta region universities showed significantly lower levels of practice compared to Cairo and Upper Egypt region universities (p = 0.027). The most frequently recognized barriers against health promotion were low socioeconomic status (90.3%) and lack of adequate public education (85.8%). Conclusions: Despite the fair knowledge and practice levels towards bacterial pharyngitis and ARF among participants, many gaps were still identified that might contribute to RHD prevalence. Educational interventions should be implemented by updating the local guidelines in Egypt for diagnosis and management based on the most recent guidelines.

Idiopathic premature ventricular contractions (PVCs) can occur in up to 40% of children with structurally normal hearts. The study aims to assess the impact of high-burden idiopathic PVCs on children in comparison with adults in terms of symptoms, distribution of origin, management strategies, and safety considerations. This is a single-center retrospective cohort study that included patients with frequent PVCs (> 10% burden in Holter monitoring) and categorized by age into adult group (≥ 18 years) and pediatric group. Data encompassed demographic profiles, clinical symptoms, echocardiographic findings, electrocardiographic analyses, and one-year follow-up management. A total of 224 PVC cases were collected during a 2-year study (120 children and 104 adults). Syncope occurred significantly more in children than adults (15.8% vs. 0.9%, p = 0.003). In children, the right ventricular outflow tract (RVOT) free wall was the predominant site (48 patients; 40%), while the septal RVOT was most common in adults (35 patients; 33.7%). Pediatric cases exhibited significantly higher PVCs originating from the outflow tract (92.5% vs. 69.2%; p = 0.001). Nevertheless, there were no significant differences between groups regarding the safety, acute, and one-year outcomes of RF ablation. Age disparities were evident in syncope incidence and PVC origin, with no variance in PVC-induced myopathy prevalence or the safety and outcomes of RF catheter ablation between children and adults.

Background: Sepsis-associated encephalopathy (SAE) is a common complication of sepsis, contributing to poor outcomes and increased mortality. Early detection remains challenging due to the absence of observable direct brain injury. Transcranial Doppler (TCD) ultrasonography provides a non-invasive, bedside tool for assessing cerebral hemodynamics and may help identify patients at risk. SAE was defined as new-onset delirium (positive CAM-ICU) or unexplained coma (GCS < 8) not attributable to structural or metabolic causes. This study aimed to evaluate the role of TCD in predicting the incidence and prognosis of SAE in septic patients admitted to the ICU. Methods: This prospective cohort study included 93 patients with sepsis. Demographic, clinical, and laboratory data were recorded upon admission. Daily TCD was performed for seven consecutive days to measure the pulsatility index (PI) and resistive index (RI). Neurological dysfunction was assessed daily using the Confusion Assessment Method for the ICU (CAM-ICU) and the Glasgow Coma Scale (GCS). Results: A total of 93 patients were included, of whom 44 (47.3%) developed SAE. SAE patients showed greater illness severity, with higher median SOFA (6 [5–7] vs. 5 [3–6], p < 0.001) and APACHE II (14 [12–17] vs. 11 [9–14], p < 0.001) scores, and higher 28-day mortality (61.4% vs. 22.4%, p < 0.001). The median PI and RI were consistently higher in SAE patients across all study days, while the mean flow velocity (mFV) was lower. PI on day 1 had the best accuracy for predicting SAE, with a cutoff ≥ 1.30 (AUC: 0.963, sensitivity 95.45%, specificity 100%). RI on day 3 was also highly predictive (AUC: 0.971, cutoff ≥ 0.67, sensitivity 95.45%, specificity 95.92%). Conclusions: In this sample of septic patients, PI and RI are strong predictors of SAE, with PI serving as a reliable early indicator of both SAE and mortality. Trial Preregistration The study was registered in the Pan African Clinical Trials Registry: PACTR202410707982429, date: 7/10/2024.

Pediatric stroke is a life-threatening emergency condition characterized by a wide range of presentations, which frequently delays the diagnosis and intervention. This study aimed to evaluate the clinical presentation, diagnostic approaches, and outcomes of pediatric patients presenting with suspected stroke in emergency settings. A systematic search was conducted in PubMed, Embase, Cochrane Library, Scopus, and Web of Science for studies published up to May 2024. Nineteen peer-reviewed studies investigating pediatric stroke in emergency settings were included. A qualitative synthesis was performed, and meta-analysis was conducted when appropriate. The risk of bias was assessed using the NIH Quality Assessment Tool for Observational Cohort and Case Series Studies. Out of 2,958 identified records, 19 studies (13 cohort studies and 6 case series) met the inclusion criteria, with 8 eligible for meta-analysis. The pooled mortality rate was 19.2% (95% CI: 8.1%–30.4%), while intubation and ICU admission were required in 21.6% (95% CI: 10.9%–32.3%) and 37.6% (95% CI: 18%–57.2%) of cases, respectively. The average hospital stay was 11.12 days (95% CI: 8.58–13.65). CT was more frequently used (80.71%) than MRI (35.86%) for neuroimaging. The mean time from symptom onset to diagnosis was 9.95 h. Variability in prehospital management and diagnostic accuracy was noted across studies. Migraines (19.39%) and seizures (12.75%) were the most common non-stroke diagnoses reported. Pediatric stroke remains underrecognized and frequently misdiagnosed in emergency settings. Delays in diagnosis, reliance on CT over MRI, and inconsistent triage practices contribute to suboptimal outcomes. Standardized, pediatric-specific stroke protocols emphasizing early recognition, appropriate imaging, and timely intervention are urgently needed to improve patient care and outcomes.

Background: Telemedicine offers a variety of medical services and facilitates the delivery of care, particularly in developing countries. In Egypt, there is limited evidence regarding the knowledge, attitudes, and perceptions of medical students and interns, representing a key segment of the future healthcare workforce. Objective: We aimed to assess awareness, attitudes, and practice intentions toward telemedicine among Egyptian medical students and interns, and to identify factors associated with positive attitudes toward its future clinical use. Methods: A multicenter cross-sectional study was conducted across 16 Egyptian medical universities using a structured questionnaire developed from previous studies and assessed for content and face validity. Proportionate quota sampling was applied, and multivariable logistic regression was used to identify factors associated with positive attitudes. Results: A total of 900 respondents were included in the analysis (51% males; mean age 21 ± 2 years). Overall, 556 (62%) were aware of telemedicine, among whom 76.3% demonstrated a positive attitude. High levels of internet access (89.2%) and digital comfort (83.9%) were reported; however, only 25% had prior telemedicine experience, and 19% attended related training. In multivariable analysis, digital comfort (AOR = 1.93; 95% CI: 1.06–3.49; p = 0.029) and prior telemedicine experience (AOR = 2.19; 95% CI: 1.35–3.55; p = 0.001) were significant positive predictors, while residence in Upper Egypt was negatively associated (AOR = 0.19; 95% CI: 0.08–0.44; p < 0.001). Conclusion: Despite generally favorable attitudes toward telemedicine, important disparities persist in awareness, exposure, and practical readiness among Egyptian medical students and interns. The observed awareness-practice gaps highlight the need for structured telemedicine education, digital health training, and competency-based integration within undergraduate medical curricula.