Wafaa Y Abdel Wahed | Fayoum University (original) (raw)
Papers by Wafaa Y Abdel Wahed
Medicina clínica, Mar 1, 2024
Minerva respiratory medicine, Nov 30, 2023
Alexandria journal of medicine, Dec 17, 2023
Egyptian Journal of Chest Diseases and Tuberculosis/Egyptian Journal of Chest Diseases and Tuberculosis, Jul 1, 2024
BMC Psychiatry, Apr 14, 2023
Background The methodological choice of aggregated estimates for meta-analysis may be notable for... more Background The methodological choice of aggregated estimates for meta-analysis may be notable for some common drawbacks, including variations in the cutoff values of depression, and lower statistical power for analyzing the associated factors. The study aimed to refine the precision of previous findings on the prevalence of depressive symptoms among medical students, through gathering individual participant data (IPD) as identified from our previous reviews. Material and methods In the present study, we searched MEDLINE, EMBASE, PsycINFO, WanFang, Scielo and LILACS to identify published systematic reviews and meta-analyses up to March 2018, then individual data was requested for further analysis (PROSPERO registration: CRD42018091917). The participants' age, sex, year of study, scores for depressive symptoms, and other predictor variables were requested. To pool the prevalence from the included studies, random-effects model (two-step method) was used. Multiple linear regression was used to examine the associated factors on the depression z-scores (one-step method). Results Of the 249 studies, the datasets of 34 studies were included. The crude prevalence was 19.4% (95% CI: 18.8%, 19.9%) by one-step method and the pooled prevalence was 18.1% (95% CI: 14.1%, 22.1%) by two-step method. Multiple linear regression revealed that being a female, older age, and senior year of study were significantly associated with the z-score. Conclusion The pooled prevalence of depressive symptoms from the Individual Participant Data (IPD) meta-analysis was lower than the previous meta-analyses using aggregated data. Age, sex, and year of study were significantly associated with the depression z-score. IPD meta-analysis may provide a more accurate estimation of disease burden, and allow verification of associated factors.
Background: The structural damage of RA usually develops within the first two years of disease an... more Background: The structural damage of RA usually develops within the first two years of disease and the risk of joint destruction is still difficult to predict 1 Objectives: To assess predictive value of the clinical, laboratory and echosonographic parameters activity of early RA in progression of structural damage in DMARDs/glucocorticoid naïve patients in the first 6 months. Methods: Sixty-five pts. (56 females, mean age 53±14.1 years) with early RA (EULAR/ACR 2010 criteria) and symptoms duration of £1 years. (mean duration of 3.6 months) were included during the 2012-14 years. and followed up 6 months. Patients were DMARDs/glicocorticoid naïve and had no X-ray visible structural damage. The ESR, CRP, RF, ACPA and MMP3 were measured. DAS28 index was calculated. US assessment was performed blindly to patient's medical history, on the same day when early RA diagnosis was established and repeated after 6 months, using 18MHz linear probe by ESAOTE My Lab 70 machine. Presence of bone erosions and Power Doppler (PD) signal, were recorded at each hand's joint, as well as at MTP1-5 joints of both side, according to OMERACT US group definition. The semi quantitative method (0-3) was applied for assessing US synovitis and total Power Doppler joint score (TPDJs)/ pts. was calculated. Results: Fifty-nine pts. had finding of US bone erosions at baseline visit and 62 pts had it after 6 months. The significant increase of bone erosions and significant decrease of TPDJs/pts were found after follow-up (2.2. vs. 3.1 respectively; 10. vs. 4.5 respectively; Wilcoxon test: p<0.001). There was no statistical significant difference between the groups of pts. with (42 pts.) and without (23 pts.) new (!1) US bone erosion after 6 months regarding value of ESR (41. vs. 39; p=0.973), CRP (18. vs. 11; p=0.255), RF (82. vs. 114; p=0.652), ACPA (184. vs. 319; p=0.784) MMP3 (110. vs. 83; p=0.245), DAS28 (5.7. vs. 5.3; p=0.269), total number of bone erosions (2. vs. 2; p=0.06) and TPDJs/pts (10. vs. 12; p=0.831). Univariant logistic regression analysis showed significant predictive value for US bone erosions finding at baseline visit OR 0.68 (0.48-0.98), p=0.04 for progression of structural damage after 6 months of follow up but not for value of:
Annals of the Rheumatic Diseases, Jun 1, 2015
ABSTRACT Abstract Background Chronic low back pain is a common painful medical problem which has ... more ABSTRACT Abstract Background Chronic low back pain is a common painful medical problem which has significant socioeconomic impact. Conventional pharmacological therapy usually associated with adverse effects. Mesotherapy is a minimally invasive technique done by subcutaneous injections of drugs, plant extracts, homeopathic agents, or other bioactive substance [1]. Objectives To evaluate the value of mesotherapy, either by traditional drugs or by bee venom, as a therapeutic modality for management of chronic low back pain and compare it versus conventional systemic administration of nonsteroidal anti-inflammatory drugs and corticosteroids for patients with chronic low back pain. Methods A randomized controlled clinical trial with three parallel arms carried out at the Department of Rheumatology and Rehabilitation -Faculty of Medicine, Fayoum University in Egypt.The study was assessed and approved by the Faculty of Medicine Fayoum University Ethics Committee and has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki. One hundred and twenty (120) patients (both sexes) aged 19– 65 years and suffering from back pain since more than 3 months and reported a current pain intensity >60 on a 100mm visual analogic scale. Patients are randomly allocated to be divided to three main groups: Group I: 40 patients received drug therapy according to the following protocol: ketoprofen 150 mg /day orally for 12 days + methylprednisolone (MP) intramuscularly 40 mg/day for the first 4 days, then 20mg/day for 3 days, then 20 mg/day at alternate days + esomeprazole 20 mg/die for 12 days. Group II: 40 patients received: 2% lidocaine (1 mL) + ketoprofen 100 mg (2 mL) + MP 40 mg (1 mL) at day 1 and 4, then 2% lidocaine (1 mL) + ketoprofen 100 mg (2mL) + MP 20 mg (0.5 mL) day 7, 10, and 13, five repeated injections. Group III: 40 patients received (0.5 mL) diluted purified bee venom + 2% lidocaine (0.5 mL) twice weekly for three weeks. Pain intensity and functional disability were assessed at baseline (T0), at the end of treatment (T1), and 6 months thereafter (T2) by using visual analogic scale (VAS) and Roland-Morris disability questionnaire (RMDQ). Results In the three groups, VAS and RMDQ values were significantly reduced at the end of drug treatment and after 6 months, in comparison with baseline. there was no significant difference in mean basal VAS and RMDQ scores between three groups, at the end of treatment (T1) but mean VAS and RMDQ scores level in group II showed significant decrease than G I and G III (p value <0.05). At T3, the mean VAS and RMDQ scores showed further decrease in GII in comparison with GI and GIII. Figure View larger version: In a new window Download as PowerPoint Slide Conclusions Mesotherapy by using conventional drugs; NSAIDs and corticosteroids or by bee venom is an effective and well-tolerated method for managing low back pain in the short-term, and may be a valid alternative to conventional therapy in the treatment of low back pain with corticosteroids and NSAIDs. References Costantino C, Marangio E and Coruzzi G: Mesotherapy versus Systemic Therapy in the Treatment of Acute Low Back Pain: A Randomized Trial. Evid Based Complement Alternat Med. 2011; 2011. pii: 317183. doi: 10.1155/2011/317183. Epub 2010 Sep 1. Acknowledgements Abdelwahab Khalil Abdelwahab, Sera Plant, Egyptien serum and vaccine company (VACSERA) Disclosure of Interest None declared
The Egyptian Journal of Hospital Medicine, Oct 1, 2022
Background: Postpartum depression (PPD) is a major depressive disorder with possible long-term co... more Background: Postpartum depression (PPD) is a major depressive disorder with possible long-term consequences on the mother and her infant. Objective: The aim of the current study is to assess the proportion of postpartum depression and its contributing factors among women who give birth and seek medical care at Fayoum University Hospitals. Patients and methods: A cross-sectional study was conducted on 400 postpartum women (1-6 months following delivery) who visited Obstetrics-Gynecology, Family Planning, Family Medicine, and Pediatric Clinics at Fayoum University Hospital (FUH) in Fayoum Governorate, Egypt. For data collection, the Arabic version of the Edinburgh Postnatal Depression Scale (EPDS) was used for PPD screening, socio-demographic characteristics of the participants were collected by a pre-designed structured questionnaire. Results: PPD was found in 39.5% of the studied women. The multivariate analysis showed that postpartum depression was significantly associated with the educational level, with higher levels of education associated with a decreased likelihood of depression with odds ratio (OR) 0.437 (95% confidence interval [95%CI] 0.248-0.768). Female residents of rural areas were more likely to be depressed than females of urban areas, having OR 1.8 (95%CI 1.10-2.98). The female sex of the infant was shown to be a risk factor for PPD with OR 1.76 (95%CI 1.12-2.75), and the women who were not employed had a reduced risk of depression than those who were employed, with OR 0.384 (95%CI 0.233-0.632). Conclusion: PPD is a considerable and existing problem among the study group. Many factors may cause PPD to occur. Early detection of such factors can help in early detection of postpartum depression.
Current Drug Safety, Sep 17, 2018
Different combinations of Direct Antiviral Agents (DAAs) have been used against different hepatit... more Different combinations of Direct Antiviral Agents (DAAs) have been used against different hepatitis C virus (HCV) genotypes and in different types of patients. Despite being effective and characterized by a very low rate of adverse effects in clinical trials, few data are available on adverse events in real life studies. The aim of this study was to identify the incidence and pattern of Adverse Drug Reactions (ADRs) caused by DAAs; daclatasvir and sofosbuvir and their combination with ribavirin and to assess the causality and the severity of the reported ADRs. A prospective observational study was conducted over six months in treatment HCV center at Health Insurance Hospital in Fayoum Governorate, Egypt. A pre-tested, interviewed structured questionnaire was used by authors to gather required data from enrolled 345 patients regarding demographic, co-morbidity and ADRs. Causality and severity of ADRs were assessed Results: According to our data we have found that 75.7% (261out of 345) patients reported 36 different ADRs involving different systems, of these 1.2% experienced serious adverse events (SAEs), including three deaths (0.9%). A majority of ADRs were more significantly reported with ribavirin containing regimen. Out of 345 patients, 23.5% have comorbidities. Among them, 92.6% reported ADRs. Causality assessment of ADRs by WHO-UMC criteria revealed that 38.89% were probable while 61.11% were possible. new antiviral drugs require careful follow-up of any significant adverse event that may occur and can affect adherence. Special population as the elderly and those with comorbidities should always be managed with caution to avoid development of serious side effects.
The Journal of the Egyptian Public Health Association, Jan 7, 2019
Background: Chickenpox infection acquired during pregnancy is a serious condition. There may be c... more Background: Chickenpox infection acquired during pregnancy is a serious condition. There may be congenital malformations and neonatal varicella syndrome with significant morbidity and mortality. Egypt has no routine varicella-zoster vaccination program. Objective: To assess the immune status against varicella-zoster virus (VZV) antibodies among a group of pregnant women and to study the relationship between VZV seroprevalence and some sociodemographic characteristics. Subjects and methods: A descriptive cross-sectional study was conducted on a group of pregnant women (n = 333) attending antenatal care (ANC) clinic at Fayoum University Hospital. Serologic testing for VZV was performed using ELISA through the years 2016-2017. Results: VZV seroprevalence was detected in 294 (88.3%) of the 333 recruited pregnant women. Older age > 25 years old was significantly associated with low percent of VZV-negative antibodies (6.7% in versus 17.4% in younger age, OR (95%CI) 0.34 (0.17-0.70)), also having more than one child was significantly associated with a low percent of VZV-negative antibodies (8.2% versus 16.1% among participants with no children or having one child, OR 0.34 (0.17-0.70)). Conclusions: Despite the absence of a routine VZV vaccination program in Egypt, VZV immunity was high among pregnant women, but less than that reported in many developed countries. We recommend targeted vaccination for women in the reproductive age especially young and primipara. Trial registration: Ethical Committee Registration number R67 session 42: date 12/11/2017(retrospectively registered).
Journal of Dermatological Treatment, Mar 30, 2016
The aim of this study is to evaluate four drug regimens for treatment of scabies as regard their ... more The aim of this study is to evaluate four drug regimens for treatment of scabies as regard their efficacy, acceptability and cost effectiveness. Two hundred cases with ordinary scabies were randomized into four groups. First group received ivermectin 200 μg/kg body weight single oral dose, repeated after one week. The second received benzyl benzoate 20% cream. The third received permethrin 2.5%-5% lotion, whereas the fourth group received 5-10% sulfur ointment. Topical treatments were applied for five consecutive nights. Patients were followed up for two weeks for cure rate and adverse effects. At the end of the study, permethrin provided a significant efficacy of 88% and acceptability in 100% of cases, but had higher cost to treat one case (20.25 LE). Ivermectin provided efficacy and acceptability rates of 84% and 96%, respectively, and had a cheaper cost (9.5 LE). Benzyl benzoate provided 80% for both rates and was the cheapest drug. Sulfur ointment provided the least rates, and it was the most expensive. Treatment choice will depend on the age, the general condition of cases, patient compliance to topical treatment and his ability to stick to its roles, and the economic condition of the patient.
Alexandria journal of medicine, Mar 1, 2017
Background: Mental health issues are increasing in severity and number on college campuses. Impro... more Background: Mental health issues are increasing in severity and number on college campuses. Improving adolescent mental well-being remains a challenge for most societies. Objectives: The objectives of this study was to study the prevalence of psychological mood disorders and its association with some factors. Methods: A cross-sectional-questionnaire based study was conducted among medical students in Fayoum University. Propensity to Psychological mood disorders was assessed by using a short version Depression, Anxiety and Stress Scale-21 (DASS-21), along with a pretested Sociodemographic questionnaire. Results: A total of 442 students participated in the study with the mean age of 20.15 ± 1.9 years. Overall, the prevalence of stress, anxiety and depression with various degrees was 62.4%, 64.3%, and 60.8% among studied sample respectively. Higher stress and anxiety scores were significantly associated with female sex, older age, and BMI P 25 kg/m 2. Higher depression score was associated with increasing age, low socioeconomic standard and among students from other governorates. Conclusion: A substantial proportion of medical students are suffering from depression, stress, and anxiety. Female sex, increasing age, overweight and obesity are significant associated factors. Further studies need to be carried to identify other associated factors related to academic medical education.
Journal of Community Health, Jul 7, 2020
Healthcare workers (HCWs) are at the frontline defense against the coronavirus disease 2019 (COVI... more Healthcare workers (HCWs) are at the frontline defense against the coronavirus disease 2019 (COVID-19) pandemic. Inadequate knowledge and incorrect attitudes among HCWs can directly influence practices and lead to delayed diagnosis, poor infection control practice, and spread of disease. This study aimed to assess the knowledge, perception, and attitude of the Egyptian HCWs towards the COVID-19 disease. A descriptive cross-sectional study was conducted in Egypt, among 407 HCWs using a self-administered questionnaire. The mean correct answer rate was 80.4% with a mean knowledge score of 18.5 ± 2.7 out of 24. A positive correlation between knowledge and attitude scores was detected (r = 0.215, p < 0.001). About 83.1% of our participants reported that they were afraid of being infected with COVID-19, and 89.2% stated that they were more susceptible to COVID-19 infection as compared to others. Unavailability of personal protective equipment (PPE), fear of transmitting the disease to their families, and social stigma were the most frequently reported reasons for increased risk perception. The overall knowledge level of HCWs was generally good especially among physicians. A positive attitude was detected among allied health professionals more than physicians. Risk perception was high among HCWs. Causes of increased risk perception need to considered by the government and the Egyptian Ministry of Health.
The Egyptian Journal of Hospital Medicine, Oct 1, 2022
Background: Physicians' attitude towards mental illness is crucial in providing the service and i... more Background: Physicians' attitude towards mental illness is crucial in providing the service and in the feasibility of integrating mental health in primary health care (PHC). Objective: This cross-sectional study aimed to assess PHC physicians' attitudes toward mental illness and integrating mental health services into PHC facilities Material and Methods: This is a cross-sectional study conducted on 105 primary health care physicians in Fayoum governorate, Egypt. For data collection, a self-administered questionnaire was used. It covers three themes: the basic characteristics of the physicians, their attitude towards mental illness using the Mental Illness Clinicians' Attitudes Scale version 4 (MICA 4). and their attitude towards integrating mental health into PHC. Results: The mean MICA score was 44.4 ± 8.1 out of 96. A significant positive attitude was found among those younger than 40 years, females, urban residents, those with no postgraduate degree, and those working in an urban PHC facility. The mean score of attitude towards integrating mental health in PHC was 7.02 ± 2.03 out of 15. The majority of respondents (87.6%) believe in the necessity of integrating mental health in PHC. Conclusion: Physicians' attitude was generally positive regarding mental illness and mental health integration in PHC. Further research is required to identify obstacles in integrating mental health in PHC.
The Egyptian Journal of Medical Microbiology, Oct 1, 2022
Background: Throughout unexplained cases of pneumonia, a new human coronavirus first found in Wuh... more Background: Throughout unexplained cases of pneumonia, a new human coronavirus first found in Wuhan, China in December 2019 had spread worldwide. Viral loads from respiratory samples were measured and considered an indication of active virus replication and used for monitoring severe viral respiratory tract infections routinely. Objective: is to evaluate if the nasopharyngeal viral load has any link with known clinical parameters at disease progression in cases infected with (SARS-CoV-2) during the early three months (May, June, July /2020) of the epidemic in Fayoum University Hospitals. Methodology: Nasopharyngeal swabs were taken from cases with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and viral loads were detected by real-time Reversed transcriptase polymerase chain reaction (RT-PCR) according to cycle threshold (Ct) where high viral load means Ct value <25, moderate viral load; Ct value is from 25 to 35 and low viral load means Ct value >35. Results: Moderate and high NP viral load were significantly higher in patients with fever, upper respiratory tract symptoms, bone aches, and vomiting. High levels of both CRP (p=0.021) and CT findings (p=0.005) were significantly associated with moderate and high viral load. There were significant differences between viral loads groups as regards the occupation of HCWs (p=0.005). Conclusion: SARS-CoV-2 viral load were high in the nasopharynx at the early phase of infection; also high viral load were noticed more in HCWs.
Egyptian Rheumatology and Rehabilitation, Oct 22, 2020
Background: To study the most common rheumatologic manifestations of hepatitis C viral (HCV) infe... more Background: To study the most common rheumatologic manifestations of hepatitis C viral (HCV) infection in Egyptian patients and associated risk factors with assessment the effect of current therapies on these manifestations. A prospective study was carried out to HCV patients attending the tropical medicine department referred to rheumatology department, over a year. A total of 204 hepatitis C virus treatment-naïve patients aged 21-71 years old suffering from rheumatologic manifestations were recruited, and history taking, general and musculoskeletal examination, laboratory and serological investigations, imaging, and liver fibrosis findings were assessed: baseline, end of treatment, and 12 weeks later, either sofosbuvir/ribavirin or sofosbuvir/simeprevir regimens and through three consecutive visits: joint activity and functional scores were taken. Results: Common observed rheumatologic manifestations were fibromyalgia (74.5%), arthralgia (73.5%), Raynaud's phenomenon (54.9%), peripheral neuropathy (29.4%),chronic fatigue syndrome and purpura (24.5%), arthritis (16.7%), Sicca symptoms and skin ulcers (9.8%), and vasculitic CNS involvement (5.9%), mostly seen in females. VAS and FAS scales have improved across visits (p value < 0.001) with lowered number and percentage of arthralgia (tender joint counts), arthritis (swollen joint counts), improvement of fibromyalgia, purpura, peripheral neuropathy, anemia, and thrombocytopenia (p < 0.001). Common reported risk factors were barber shaving (52 %), dental procedures (44.1%), and surgical interventions (36.3%). Non-reactive cases shown by HCV-PCR response increased at the end of study reaching 62%. The percent of improvement was significantly higher in patients receiving sofosbuvir/simeprevir regimen (100%) versus sofosbuvir/ribavirin (58.2%). Conclusion: Direct antiviral drugs seem to improve the rheumatic extra-hepatic manifestations of HCV patients and lowering viremia level especially sofosbuvir/simeprevir regimen in hepatitis C treatment-naïve patients.
Nursing Open
AimTo assess the effect of parental and peer support on children's self‐esteem during the iso... more AimTo assess the effect of parental and peer support on children's self‐esteem during the isolation period in COVID‐19‐infected children is the main objective of this study.DesignThis is a descriptive cross‐sectional study. One hundred ninety children with a confirmed diagnosis of COVID‐19 were included.MethodsA survey questionnaire to assess family and children's demographic characteristics was used for this study. A 13‐item scale to assess parental support during the isolation period and a 10‐item scale to assess peers' support during the isolation period were evaluated. Along with it, a 10‐item scale to assess self‐esteem during the isolation period was also measured.ResultsHome isolation was associated with higher parental and peer support scores than hospital isolation. The mean age of study participants was 13.23 ± 4.05 years; 52.6% were isolated at home versus 47.4% in hospital isolation. Phone calling and WhatsApp/messenger chat were methods of communication for ...
Idiopathic interstitial pneumonias, 2018
Idiopathic Pulmonary Fibrosis is chronic and progressive condition. The hallmark symptom is breat... more Idiopathic Pulmonary Fibrosis is chronic and progressive condition. The hallmark symptom is breathlessness, which progressively limits the ability of patients to carry out routine activities. IPF affects an individual’s sense of wellbeing, with anxiety, depression and fatigue often accompanying exertional limitation, leading to a loss of health status. Neurocognitive dysfunction, a significant and extraordinary complication of IPF, influences patients’ career, family, and social life and reduces quality of life to some extent, these defects in general intellectual function and executive function were strongly linked to the degree of hypoxia but the mechanisms responsible for this dysfunction have not been elucidated. Our aim is to investigate presence of cognitive deficits and depression in patients with IPF. Methodology: 100 persons with IPF were enrolled, and 50 healthy persons as control. Depression was evaluated using Beck depression inventory (BDI). The cognitive examination assessed by Mini-Mental State Exam (MMSE), Controlled Oral Word Association Test (COWT) and Trial Making Part B (TMPB). Results: All cases had depressive symptoms: 9% had moderate depression, 52% had severe depression and 39% had extreme depression. There was a significant association between depression and hypoxia. There was a significant differences between MMSS in cases compared to control. As regards MMSS and TMTB scores showed significant association with pulmonary arterial hypertension. Conclusion: Depression is common and neurocognitive dysfunction is a significant complication of IPF.
International Journal of Medicine in Developing Countries, 2017
Background: Patient satisfaction is an important commonly used indicator for measuring the qualit... more Background: Patient satisfaction is an important commonly used indicator for measuring the quality in healthcare. It affects clinical outcomes, patient retention, and medical malpractice claims. Methodology: This cross-sectional health service research is conducted at the Radiology Department in Fayoum University Hospital (FUH). Pretested structured exit interview questionnaire was used to assess patients' satisfaction about the services introduced in the radiology department. Results: The overall patient satisfaction level towards radiological services was 75%. Lowest satisfaction levels were reported towards the following items; receiving sufficient information on how to prepare for the examination 29.3%, the efficiency of registration process 24.0%, length of time waiting in reception area 21.3%, confidentiality, and privacy of the service 34.7%. On the other hand, 98% of participants were satisfied with the experience of staff. Younger age patients, those with lower education level and who are outpatients were more satisfied with radiological service at FUH than the older age patients, those with higher educational level and who are outpatients. Conclusion: The majority of participants were satisfied with the radiological services. Young age, lower education level and who are outpatients other than inpatients were the factors associated with patient satisfaction.
The Egyptian Journal of Hospital Medicine
Background: Breaking bad news (BBN) is challenging for patients and physicians. Physicians are us... more Background: Breaking bad news (BBN) is challenging for patients and physicians. Physicians are usually poorly trained or untrained at all in BBN despite the existence of consensus protocols for BBN. Objective: This study aimed to assess physicians' knowledge, attitude, and practice (KAP) regarding SPIKES protocol for BBN. Patients and Methods: This is a cross-sectional multicenter study carried out on 395 physicians of different specialties and workplaces in Fayoum Governorate, Egypt. Data were collected through a self-administered questionnaire consisting of three sections of questions about physicians: the background characteristics questions, questions assessing their knowledge regarding BBN, and questions assessing their attitude regarding SPIKES protocol for BBN. The attitude was assessed using the BBN attitude scale (BBNAS). Results: Only 24% of physicians ever received training on BBN and 10% knew about SPIKES protocol. Bad experience after BBN was reported by 52% of physicians. Most (75%) physicians preferred BBN to the patient's family rather than the patient. Physicians' agreement level with the SPIKES strategy was very high (91.8%). Agreement to the SPIKES protocol steps was statistically significantly higher among men, younger and older age groups (≤ 30 and > 40 years of age) physicians, psychologists and oncologists, and those who received previous training on BBN. Conclusion: The majority of physicians highly agreed with the SPIKES strategy for BBN, but they lacked essential knowledge for BBN. Specific training and standardized protocols in this regard deem to be necessary during medical school study and continuous professional development.
Medicina clínica, Mar 1, 2024
Minerva respiratory medicine, Nov 30, 2023
Alexandria journal of medicine, Dec 17, 2023
Egyptian Journal of Chest Diseases and Tuberculosis/Egyptian Journal of Chest Diseases and Tuberculosis, Jul 1, 2024
BMC Psychiatry, Apr 14, 2023
Background The methodological choice of aggregated estimates for meta-analysis may be notable for... more Background The methodological choice of aggregated estimates for meta-analysis may be notable for some common drawbacks, including variations in the cutoff values of depression, and lower statistical power for analyzing the associated factors. The study aimed to refine the precision of previous findings on the prevalence of depressive symptoms among medical students, through gathering individual participant data (IPD) as identified from our previous reviews. Material and methods In the present study, we searched MEDLINE, EMBASE, PsycINFO, WanFang, Scielo and LILACS to identify published systematic reviews and meta-analyses up to March 2018, then individual data was requested for further analysis (PROSPERO registration: CRD42018091917). The participants' age, sex, year of study, scores for depressive symptoms, and other predictor variables were requested. To pool the prevalence from the included studies, random-effects model (two-step method) was used. Multiple linear regression was used to examine the associated factors on the depression z-scores (one-step method). Results Of the 249 studies, the datasets of 34 studies were included. The crude prevalence was 19.4% (95% CI: 18.8%, 19.9%) by one-step method and the pooled prevalence was 18.1% (95% CI: 14.1%, 22.1%) by two-step method. Multiple linear regression revealed that being a female, older age, and senior year of study were significantly associated with the z-score. Conclusion The pooled prevalence of depressive symptoms from the Individual Participant Data (IPD) meta-analysis was lower than the previous meta-analyses using aggregated data. Age, sex, and year of study were significantly associated with the depression z-score. IPD meta-analysis may provide a more accurate estimation of disease burden, and allow verification of associated factors.
Background: The structural damage of RA usually develops within the first two years of disease an... more Background: The structural damage of RA usually develops within the first two years of disease and the risk of joint destruction is still difficult to predict 1 Objectives: To assess predictive value of the clinical, laboratory and echosonographic parameters activity of early RA in progression of structural damage in DMARDs/glucocorticoid naïve patients in the first 6 months. Methods: Sixty-five pts. (56 females, mean age 53±14.1 years) with early RA (EULAR/ACR 2010 criteria) and symptoms duration of £1 years. (mean duration of 3.6 months) were included during the 2012-14 years. and followed up 6 months. Patients were DMARDs/glicocorticoid naïve and had no X-ray visible structural damage. The ESR, CRP, RF, ACPA and MMP3 were measured. DAS28 index was calculated. US assessment was performed blindly to patient's medical history, on the same day when early RA diagnosis was established and repeated after 6 months, using 18MHz linear probe by ESAOTE My Lab 70 machine. Presence of bone erosions and Power Doppler (PD) signal, were recorded at each hand's joint, as well as at MTP1-5 joints of both side, according to OMERACT US group definition. The semi quantitative method (0-3) was applied for assessing US synovitis and total Power Doppler joint score (TPDJs)/ pts. was calculated. Results: Fifty-nine pts. had finding of US bone erosions at baseline visit and 62 pts had it after 6 months. The significant increase of bone erosions and significant decrease of TPDJs/pts were found after follow-up (2.2. vs. 3.1 respectively; 10. vs. 4.5 respectively; Wilcoxon test: p<0.001). There was no statistical significant difference between the groups of pts. with (42 pts.) and without (23 pts.) new (!1) US bone erosion after 6 months regarding value of ESR (41. vs. 39; p=0.973), CRP (18. vs. 11; p=0.255), RF (82. vs. 114; p=0.652), ACPA (184. vs. 319; p=0.784) MMP3 (110. vs. 83; p=0.245), DAS28 (5.7. vs. 5.3; p=0.269), total number of bone erosions (2. vs. 2; p=0.06) and TPDJs/pts (10. vs. 12; p=0.831). Univariant logistic regression analysis showed significant predictive value for US bone erosions finding at baseline visit OR 0.68 (0.48-0.98), p=0.04 for progression of structural damage after 6 months of follow up but not for value of:
Annals of the Rheumatic Diseases, Jun 1, 2015
ABSTRACT Abstract Background Chronic low back pain is a common painful medical problem which has ... more ABSTRACT Abstract Background Chronic low back pain is a common painful medical problem which has significant socioeconomic impact. Conventional pharmacological therapy usually associated with adverse effects. Mesotherapy is a minimally invasive technique done by subcutaneous injections of drugs, plant extracts, homeopathic agents, or other bioactive substance [1]. Objectives To evaluate the value of mesotherapy, either by traditional drugs or by bee venom, as a therapeutic modality for management of chronic low back pain and compare it versus conventional systemic administration of nonsteroidal anti-inflammatory drugs and corticosteroids for patients with chronic low back pain. Methods A randomized controlled clinical trial with three parallel arms carried out at the Department of Rheumatology and Rehabilitation -Faculty of Medicine, Fayoum University in Egypt.The study was assessed and approved by the Faculty of Medicine Fayoum University Ethics Committee and has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki. One hundred and twenty (120) patients (both sexes) aged 19– 65 years and suffering from back pain since more than 3 months and reported a current pain intensity >60 on a 100mm visual analogic scale. Patients are randomly allocated to be divided to three main groups: Group I: 40 patients received drug therapy according to the following protocol: ketoprofen 150 mg /day orally for 12 days + methylprednisolone (MP) intramuscularly 40 mg/day for the first 4 days, then 20mg/day for 3 days, then 20 mg/day at alternate days + esomeprazole 20 mg/die for 12 days. Group II: 40 patients received: 2% lidocaine (1 mL) + ketoprofen 100 mg (2 mL) + MP 40 mg (1 mL) at day 1 and 4, then 2% lidocaine (1 mL) + ketoprofen 100 mg (2mL) + MP 20 mg (0.5 mL) day 7, 10, and 13, five repeated injections. Group III: 40 patients received (0.5 mL) diluted purified bee venom + 2% lidocaine (0.5 mL) twice weekly for three weeks. Pain intensity and functional disability were assessed at baseline (T0), at the end of treatment (T1), and 6 months thereafter (T2) by using visual analogic scale (VAS) and Roland-Morris disability questionnaire (RMDQ). Results In the three groups, VAS and RMDQ values were significantly reduced at the end of drug treatment and after 6 months, in comparison with baseline. there was no significant difference in mean basal VAS and RMDQ scores between three groups, at the end of treatment (T1) but mean VAS and RMDQ scores level in group II showed significant decrease than G I and G III (p value <0.05). At T3, the mean VAS and RMDQ scores showed further decrease in GII in comparison with GI and GIII. Figure View larger version: In a new window Download as PowerPoint Slide Conclusions Mesotherapy by using conventional drugs; NSAIDs and corticosteroids or by bee venom is an effective and well-tolerated method for managing low back pain in the short-term, and may be a valid alternative to conventional therapy in the treatment of low back pain with corticosteroids and NSAIDs. References Costantino C, Marangio E and Coruzzi G: Mesotherapy versus Systemic Therapy in the Treatment of Acute Low Back Pain: A Randomized Trial. Evid Based Complement Alternat Med. 2011; 2011. pii: 317183. doi: 10.1155/2011/317183. Epub 2010 Sep 1. Acknowledgements Abdelwahab Khalil Abdelwahab, Sera Plant, Egyptien serum and vaccine company (VACSERA) Disclosure of Interest None declared
The Egyptian Journal of Hospital Medicine, Oct 1, 2022
Background: Postpartum depression (PPD) is a major depressive disorder with possible long-term co... more Background: Postpartum depression (PPD) is a major depressive disorder with possible long-term consequences on the mother and her infant. Objective: The aim of the current study is to assess the proportion of postpartum depression and its contributing factors among women who give birth and seek medical care at Fayoum University Hospitals. Patients and methods: A cross-sectional study was conducted on 400 postpartum women (1-6 months following delivery) who visited Obstetrics-Gynecology, Family Planning, Family Medicine, and Pediatric Clinics at Fayoum University Hospital (FUH) in Fayoum Governorate, Egypt. For data collection, the Arabic version of the Edinburgh Postnatal Depression Scale (EPDS) was used for PPD screening, socio-demographic characteristics of the participants were collected by a pre-designed structured questionnaire. Results: PPD was found in 39.5% of the studied women. The multivariate analysis showed that postpartum depression was significantly associated with the educational level, with higher levels of education associated with a decreased likelihood of depression with odds ratio (OR) 0.437 (95% confidence interval [95%CI] 0.248-0.768). Female residents of rural areas were more likely to be depressed than females of urban areas, having OR 1.8 (95%CI 1.10-2.98). The female sex of the infant was shown to be a risk factor for PPD with OR 1.76 (95%CI 1.12-2.75), and the women who were not employed had a reduced risk of depression than those who were employed, with OR 0.384 (95%CI 0.233-0.632). Conclusion: PPD is a considerable and existing problem among the study group. Many factors may cause PPD to occur. Early detection of such factors can help in early detection of postpartum depression.
Current Drug Safety, Sep 17, 2018
Different combinations of Direct Antiviral Agents (DAAs) have been used against different hepatit... more Different combinations of Direct Antiviral Agents (DAAs) have been used against different hepatitis C virus (HCV) genotypes and in different types of patients. Despite being effective and characterized by a very low rate of adverse effects in clinical trials, few data are available on adverse events in real life studies. The aim of this study was to identify the incidence and pattern of Adverse Drug Reactions (ADRs) caused by DAAs; daclatasvir and sofosbuvir and their combination with ribavirin and to assess the causality and the severity of the reported ADRs. A prospective observational study was conducted over six months in treatment HCV center at Health Insurance Hospital in Fayoum Governorate, Egypt. A pre-tested, interviewed structured questionnaire was used by authors to gather required data from enrolled 345 patients regarding demographic, co-morbidity and ADRs. Causality and severity of ADRs were assessed Results: According to our data we have found that 75.7% (261out of 345) patients reported 36 different ADRs involving different systems, of these 1.2% experienced serious adverse events (SAEs), including three deaths (0.9%). A majority of ADRs were more significantly reported with ribavirin containing regimen. Out of 345 patients, 23.5% have comorbidities. Among them, 92.6% reported ADRs. Causality assessment of ADRs by WHO-UMC criteria revealed that 38.89% were probable while 61.11% were possible. new antiviral drugs require careful follow-up of any significant adverse event that may occur and can affect adherence. Special population as the elderly and those with comorbidities should always be managed with caution to avoid development of serious side effects.
The Journal of the Egyptian Public Health Association, Jan 7, 2019
Background: Chickenpox infection acquired during pregnancy is a serious condition. There may be c... more Background: Chickenpox infection acquired during pregnancy is a serious condition. There may be congenital malformations and neonatal varicella syndrome with significant morbidity and mortality. Egypt has no routine varicella-zoster vaccination program. Objective: To assess the immune status against varicella-zoster virus (VZV) antibodies among a group of pregnant women and to study the relationship between VZV seroprevalence and some sociodemographic characteristics. Subjects and methods: A descriptive cross-sectional study was conducted on a group of pregnant women (n = 333) attending antenatal care (ANC) clinic at Fayoum University Hospital. Serologic testing for VZV was performed using ELISA through the years 2016-2017. Results: VZV seroprevalence was detected in 294 (88.3%) of the 333 recruited pregnant women. Older age > 25 years old was significantly associated with low percent of VZV-negative antibodies (6.7% in versus 17.4% in younger age, OR (95%CI) 0.34 (0.17-0.70)), also having more than one child was significantly associated with a low percent of VZV-negative antibodies (8.2% versus 16.1% among participants with no children or having one child, OR 0.34 (0.17-0.70)). Conclusions: Despite the absence of a routine VZV vaccination program in Egypt, VZV immunity was high among pregnant women, but less than that reported in many developed countries. We recommend targeted vaccination for women in the reproductive age especially young and primipara. Trial registration: Ethical Committee Registration number R67 session 42: date 12/11/2017(retrospectively registered).
Journal of Dermatological Treatment, Mar 30, 2016
The aim of this study is to evaluate four drug regimens for treatment of scabies as regard their ... more The aim of this study is to evaluate four drug regimens for treatment of scabies as regard their efficacy, acceptability and cost effectiveness. Two hundred cases with ordinary scabies were randomized into four groups. First group received ivermectin 200 μg/kg body weight single oral dose, repeated after one week. The second received benzyl benzoate 20% cream. The third received permethrin 2.5%-5% lotion, whereas the fourth group received 5-10% sulfur ointment. Topical treatments were applied for five consecutive nights. Patients were followed up for two weeks for cure rate and adverse effects. At the end of the study, permethrin provided a significant efficacy of 88% and acceptability in 100% of cases, but had higher cost to treat one case (20.25 LE). Ivermectin provided efficacy and acceptability rates of 84% and 96%, respectively, and had a cheaper cost (9.5 LE). Benzyl benzoate provided 80% for both rates and was the cheapest drug. Sulfur ointment provided the least rates, and it was the most expensive. Treatment choice will depend on the age, the general condition of cases, patient compliance to topical treatment and his ability to stick to its roles, and the economic condition of the patient.
Alexandria journal of medicine, Mar 1, 2017
Background: Mental health issues are increasing in severity and number on college campuses. Impro... more Background: Mental health issues are increasing in severity and number on college campuses. Improving adolescent mental well-being remains a challenge for most societies. Objectives: The objectives of this study was to study the prevalence of psychological mood disorders and its association with some factors. Methods: A cross-sectional-questionnaire based study was conducted among medical students in Fayoum University. Propensity to Psychological mood disorders was assessed by using a short version Depression, Anxiety and Stress Scale-21 (DASS-21), along with a pretested Sociodemographic questionnaire. Results: A total of 442 students participated in the study with the mean age of 20.15 ± 1.9 years. Overall, the prevalence of stress, anxiety and depression with various degrees was 62.4%, 64.3%, and 60.8% among studied sample respectively. Higher stress and anxiety scores were significantly associated with female sex, older age, and BMI P 25 kg/m 2. Higher depression score was associated with increasing age, low socioeconomic standard and among students from other governorates. Conclusion: A substantial proportion of medical students are suffering from depression, stress, and anxiety. Female sex, increasing age, overweight and obesity are significant associated factors. Further studies need to be carried to identify other associated factors related to academic medical education.
Journal of Community Health, Jul 7, 2020
Healthcare workers (HCWs) are at the frontline defense against the coronavirus disease 2019 (COVI... more Healthcare workers (HCWs) are at the frontline defense against the coronavirus disease 2019 (COVID-19) pandemic. Inadequate knowledge and incorrect attitudes among HCWs can directly influence practices and lead to delayed diagnosis, poor infection control practice, and spread of disease. This study aimed to assess the knowledge, perception, and attitude of the Egyptian HCWs towards the COVID-19 disease. A descriptive cross-sectional study was conducted in Egypt, among 407 HCWs using a self-administered questionnaire. The mean correct answer rate was 80.4% with a mean knowledge score of 18.5 ± 2.7 out of 24. A positive correlation between knowledge and attitude scores was detected (r = 0.215, p < 0.001). About 83.1% of our participants reported that they were afraid of being infected with COVID-19, and 89.2% stated that they were more susceptible to COVID-19 infection as compared to others. Unavailability of personal protective equipment (PPE), fear of transmitting the disease to their families, and social stigma were the most frequently reported reasons for increased risk perception. The overall knowledge level of HCWs was generally good especially among physicians. A positive attitude was detected among allied health professionals more than physicians. Risk perception was high among HCWs. Causes of increased risk perception need to considered by the government and the Egyptian Ministry of Health.
The Egyptian Journal of Hospital Medicine, Oct 1, 2022
Background: Physicians' attitude towards mental illness is crucial in providing the service and i... more Background: Physicians' attitude towards mental illness is crucial in providing the service and in the feasibility of integrating mental health in primary health care (PHC). Objective: This cross-sectional study aimed to assess PHC physicians' attitudes toward mental illness and integrating mental health services into PHC facilities Material and Methods: This is a cross-sectional study conducted on 105 primary health care physicians in Fayoum governorate, Egypt. For data collection, a self-administered questionnaire was used. It covers three themes: the basic characteristics of the physicians, their attitude towards mental illness using the Mental Illness Clinicians' Attitudes Scale version 4 (MICA 4). and their attitude towards integrating mental health into PHC. Results: The mean MICA score was 44.4 ± 8.1 out of 96. A significant positive attitude was found among those younger than 40 years, females, urban residents, those with no postgraduate degree, and those working in an urban PHC facility. The mean score of attitude towards integrating mental health in PHC was 7.02 ± 2.03 out of 15. The majority of respondents (87.6%) believe in the necessity of integrating mental health in PHC. Conclusion: Physicians' attitude was generally positive regarding mental illness and mental health integration in PHC. Further research is required to identify obstacles in integrating mental health in PHC.
The Egyptian Journal of Medical Microbiology, Oct 1, 2022
Background: Throughout unexplained cases of pneumonia, a new human coronavirus first found in Wuh... more Background: Throughout unexplained cases of pneumonia, a new human coronavirus first found in Wuhan, China in December 2019 had spread worldwide. Viral loads from respiratory samples were measured and considered an indication of active virus replication and used for monitoring severe viral respiratory tract infections routinely. Objective: is to evaluate if the nasopharyngeal viral load has any link with known clinical parameters at disease progression in cases infected with (SARS-CoV-2) during the early three months (May, June, July /2020) of the epidemic in Fayoum University Hospitals. Methodology: Nasopharyngeal swabs were taken from cases with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and viral loads were detected by real-time Reversed transcriptase polymerase chain reaction (RT-PCR) according to cycle threshold (Ct) where high viral load means Ct value <25, moderate viral load; Ct value is from 25 to 35 and low viral load means Ct value >35. Results: Moderate and high NP viral load were significantly higher in patients with fever, upper respiratory tract symptoms, bone aches, and vomiting. High levels of both CRP (p=0.021) and CT findings (p=0.005) were significantly associated with moderate and high viral load. There were significant differences between viral loads groups as regards the occupation of HCWs (p=0.005). Conclusion: SARS-CoV-2 viral load were high in the nasopharynx at the early phase of infection; also high viral load were noticed more in HCWs.
Egyptian Rheumatology and Rehabilitation, Oct 22, 2020
Background: To study the most common rheumatologic manifestations of hepatitis C viral (HCV) infe... more Background: To study the most common rheumatologic manifestations of hepatitis C viral (HCV) infection in Egyptian patients and associated risk factors with assessment the effect of current therapies on these manifestations. A prospective study was carried out to HCV patients attending the tropical medicine department referred to rheumatology department, over a year. A total of 204 hepatitis C virus treatment-naïve patients aged 21-71 years old suffering from rheumatologic manifestations were recruited, and history taking, general and musculoskeletal examination, laboratory and serological investigations, imaging, and liver fibrosis findings were assessed: baseline, end of treatment, and 12 weeks later, either sofosbuvir/ribavirin or sofosbuvir/simeprevir regimens and through three consecutive visits: joint activity and functional scores were taken. Results: Common observed rheumatologic manifestations were fibromyalgia (74.5%), arthralgia (73.5%), Raynaud's phenomenon (54.9%), peripheral neuropathy (29.4%),chronic fatigue syndrome and purpura (24.5%), arthritis (16.7%), Sicca symptoms and skin ulcers (9.8%), and vasculitic CNS involvement (5.9%), mostly seen in females. VAS and FAS scales have improved across visits (p value < 0.001) with lowered number and percentage of arthralgia (tender joint counts), arthritis (swollen joint counts), improvement of fibromyalgia, purpura, peripheral neuropathy, anemia, and thrombocytopenia (p < 0.001). Common reported risk factors were barber shaving (52 %), dental procedures (44.1%), and surgical interventions (36.3%). Non-reactive cases shown by HCV-PCR response increased at the end of study reaching 62%. The percent of improvement was significantly higher in patients receiving sofosbuvir/simeprevir regimen (100%) versus sofosbuvir/ribavirin (58.2%). Conclusion: Direct antiviral drugs seem to improve the rheumatic extra-hepatic manifestations of HCV patients and lowering viremia level especially sofosbuvir/simeprevir regimen in hepatitis C treatment-naïve patients.
Nursing Open
AimTo assess the effect of parental and peer support on children's self‐esteem during the iso... more AimTo assess the effect of parental and peer support on children's self‐esteem during the isolation period in COVID‐19‐infected children is the main objective of this study.DesignThis is a descriptive cross‐sectional study. One hundred ninety children with a confirmed diagnosis of COVID‐19 were included.MethodsA survey questionnaire to assess family and children's demographic characteristics was used for this study. A 13‐item scale to assess parental support during the isolation period and a 10‐item scale to assess peers' support during the isolation period were evaluated. Along with it, a 10‐item scale to assess self‐esteem during the isolation period was also measured.ResultsHome isolation was associated with higher parental and peer support scores than hospital isolation. The mean age of study participants was 13.23 ± 4.05 years; 52.6% were isolated at home versus 47.4% in hospital isolation. Phone calling and WhatsApp/messenger chat were methods of communication for ...
Idiopathic interstitial pneumonias, 2018
Idiopathic Pulmonary Fibrosis is chronic and progressive condition. The hallmark symptom is breat... more Idiopathic Pulmonary Fibrosis is chronic and progressive condition. The hallmark symptom is breathlessness, which progressively limits the ability of patients to carry out routine activities. IPF affects an individual’s sense of wellbeing, with anxiety, depression and fatigue often accompanying exertional limitation, leading to a loss of health status. Neurocognitive dysfunction, a significant and extraordinary complication of IPF, influences patients’ career, family, and social life and reduces quality of life to some extent, these defects in general intellectual function and executive function were strongly linked to the degree of hypoxia but the mechanisms responsible for this dysfunction have not been elucidated. Our aim is to investigate presence of cognitive deficits and depression in patients with IPF. Methodology: 100 persons with IPF were enrolled, and 50 healthy persons as control. Depression was evaluated using Beck depression inventory (BDI). The cognitive examination assessed by Mini-Mental State Exam (MMSE), Controlled Oral Word Association Test (COWT) and Trial Making Part B (TMPB). Results: All cases had depressive symptoms: 9% had moderate depression, 52% had severe depression and 39% had extreme depression. There was a significant association between depression and hypoxia. There was a significant differences between MMSS in cases compared to control. As regards MMSS and TMTB scores showed significant association with pulmonary arterial hypertension. Conclusion: Depression is common and neurocognitive dysfunction is a significant complication of IPF.
International Journal of Medicine in Developing Countries, 2017
Background: Patient satisfaction is an important commonly used indicator for measuring the qualit... more Background: Patient satisfaction is an important commonly used indicator for measuring the quality in healthcare. It affects clinical outcomes, patient retention, and medical malpractice claims. Methodology: This cross-sectional health service research is conducted at the Radiology Department in Fayoum University Hospital (FUH). Pretested structured exit interview questionnaire was used to assess patients' satisfaction about the services introduced in the radiology department. Results: The overall patient satisfaction level towards radiological services was 75%. Lowest satisfaction levels were reported towards the following items; receiving sufficient information on how to prepare for the examination 29.3%, the efficiency of registration process 24.0%, length of time waiting in reception area 21.3%, confidentiality, and privacy of the service 34.7%. On the other hand, 98% of participants were satisfied with the experience of staff. Younger age patients, those with lower education level and who are outpatients were more satisfied with radiological service at FUH than the older age patients, those with higher educational level and who are outpatients. Conclusion: The majority of participants were satisfied with the radiological services. Young age, lower education level and who are outpatients other than inpatients were the factors associated with patient satisfaction.
The Egyptian Journal of Hospital Medicine
Background: Breaking bad news (BBN) is challenging for patients and physicians. Physicians are us... more Background: Breaking bad news (BBN) is challenging for patients and physicians. Physicians are usually poorly trained or untrained at all in BBN despite the existence of consensus protocols for BBN. Objective: This study aimed to assess physicians' knowledge, attitude, and practice (KAP) regarding SPIKES protocol for BBN. Patients and Methods: This is a cross-sectional multicenter study carried out on 395 physicians of different specialties and workplaces in Fayoum Governorate, Egypt. Data were collected through a self-administered questionnaire consisting of three sections of questions about physicians: the background characteristics questions, questions assessing their knowledge regarding BBN, and questions assessing their attitude regarding SPIKES protocol for BBN. The attitude was assessed using the BBN attitude scale (BBNAS). Results: Only 24% of physicians ever received training on BBN and 10% knew about SPIKES protocol. Bad experience after BBN was reported by 52% of physicians. Most (75%) physicians preferred BBN to the patient's family rather than the patient. Physicians' agreement level with the SPIKES strategy was very high (91.8%). Agreement to the SPIKES protocol steps was statistically significantly higher among men, younger and older age groups (≤ 30 and > 40 years of age) physicians, psychologists and oncologists, and those who received previous training on BBN. Conclusion: The majority of physicians highly agreed with the SPIKES strategy for BBN, but they lacked essential knowledge for BBN. Specific training and standardized protocols in this regard deem to be necessary during medical school study and continuous professional development.