Pediatric maxillofacial injuries are of special medico-legal implications as may involve serious esthetic and functional facial problems in addition being a common occurrence in poly-trauma pediatric patients with serious implications. Aim of the study was interpretation of pediatric maxillofacial injuries from the medico-legal point of view and epidemiological analysis over a 5-year period in Assiut University Hospitals, Egypt. Methods: observational descriptive hospital-based study includes 940 patients' medical records and radiographs of pediatric maxillofacial injured cases obtained from Trauma Unit of Assiut University Hospitals in the period of 1st January 2015 to 31st of December 2019.Results: The 5-year incidence of pediatric MF injuries was 28.4% of the total MF injuries. The mean age was 8.4 ±4.5 years, with more incidence in the age group 1 to 6 years, boys represent most of the cases (72.2%). The major cause of injury was falls from height (29.1%) followed by motor-cycle accidents (22%), the manner of injury was almost always accidental (94.6%). Most pediatric MF injuries were associated with other injuries (81.36%), while only 19.64% were isolated MF injuries. Conservative treatment was indicated in 64.4% of cases while 35.6% of the cases were received surgical treatment. There was statistically significant difference between age, sex and the cause of injury, between manner of injury and its cause, between treatment modality and different age groups of the cases. In addition, there was statistically significant relation between the mean duration of hospital stay from one side and the cause of injury and the treatment modality from the other side Conclusion: Falls from height is the main etiologic factor of Pediatric Maxillofacial injuries and younger male children are more involved. Accidental manner is the usual one. Mandibular fractures are the commonest followed by fracture maxilla. Conservative management is the commonest line of treatment especially with younger age.

Purpose: To compare the efficacy of local injection of both betamethasone and triamcinolone in the management of thyroid eye disease-related upper eyelid retraction with proptosis.
Methods: This prospective, double-blind, randomized clinical trial was conducted at Assiut University Hospital, Upper Egypt in the period between December 2021 and December 2023. The study included 45 patients (77 eyes) and was divided into: A (betamethasone) group and B (triamcinolone) group. The steroid was injected peri-levator (1 ml) and retrobulbar (1.5 ml). The injection was repeated every month for up to 5 injections if there was an improvement in margin reflex distance 1 (MRD1) and Hertel measurements. The injection was stopped if measurements reached the normal value or if 2 successive injections caused no improvement. The postinjection outcome was divided into; 1) effective if measurements reached the normal (MRD1 ≤4.5 mm and Hertel ≤18 mm); 2) partially effective if measurements were improved but did not reach the normal; and 3) ineffective if there was no improvement in measurements. The follow-up ranged from 6 to 20 months.
Results: In group A, the injection was effective in 35 eyes (89.74%) and partially effective in 4 eyes (10.26%). In group B, the injection was effective in 22 eyes (57.9%), partially effective in 8 eyes (21.05%) and ineffective in 8 eyes (21.05%). The mean injection number was significantly lower in group A than in group B; 2.54 ± 0.51 versus 3.74 ± 1.18.
Conclusions: This study’s results suggest that betamethasone is more effective with a small number of injections than triamcinolone in the management of thyroid eye disease-related upper eyelid retraction with proptosis.

Ulcerative colitis (UC) is a form of inflammatory bowel disease. Multiple disease relapses can impair the quality of life in UC patients and increase the risk of colitis-associated complications. Diet is known to play an important role in the complex pathogenesis of UC and many patients attribute their disease relapses to diet. This is an interesting work aimed to study the demographic and dietary profile of UC patients, assess their beliefs regarding the effect of nutrition on disease conditions, and study the effect of diet on disease severity. A crosssectional study was conducted at Al-Rajhi University Hospital, Assiut and included 70 patients diagnosed with UC. The mean age of studied patients was 35.63 ± 9.92 years and more than half of them were females. As regards socioeconomic level, 55.7% of patients were from the middle level, and 42.9% of patients were from the low socioeconomic level. The most frequently consumed food items were beans and cereals while meat, sea food and eggs were the least frequent. The majority of patients believed that nutrition was an important cause of the disease. There was a significant association between the fiber content of diet and disease severity. In conclusion, different dietary contents have a great effect on patients with UC. Patients consuming high fiber diets were found to have better disease outcomes with low disease severity. More than half of patients with high- fiber diet had mild disease and received conventional therapy

Introduction: Patient safety is a fundamental element in healthcare quality and a major challenge in achieving universal health coverage, especially in low- and middle-income countries. The first step to improve patient safety is to evaluate the safety culture in hospitals. This study aimed to investigate the patient safety culture among nurses and determine the factors affecting it. Methods: This cross-sectional study was conducted among 423 nurses working at tertiary care hospitals in the Al-Jouf region in Saudi Arabia. Results: The highest score for patient safety among nurses was for teamwork within units (16.41 ± 2.44). The lowest score was for nonpunitive response to errors (5.87 ± 1.92). In addition, 83% of the participants did not report any events in the past 12 months. More perception of patient safety was significantly higher among females than males in dimensions of teamwork within units, frequency of events reported, and staffing. Furthermore, teamwork within units, management support for patient safety, staffing, non-punitive response to errors, and handoffs and transitions were significantly higher among participants in direct contact with patients. The Hospital Survey on Patient Safety Culture (HSOPSC) scale is significantly higher among non-Saudi nurses, nurses with bachelor's education, nurses with less working hours per week, and those who had training on patient safety. Conclusion: The current study showed that the majority of the participants did not report any events in the past 12 months. The highest score for patient safety culture dimensions among nurses was for teamwork within units while the lowest score was for nonpunitive response to errors

Introduction

Death certification is a health indicator and a public health surveillance tool. High-quality death certificate ensures reliability of mortality statistics used to direct the arranging of health-related programs and leading assessments of research and proper healthcare outcomes. The World Health Organization (WHO) puts Egypt in the group of ‘low quality’ death registration data. The aim of this study was to evaluate the impact of composite training and audit intervention on accurate completion of death notification forms (DNFs) in Assiut University Children Hospital (AUCH) that has an average monthly mortality of 120 children’s deaths.

Methods

A Quasi-experimental study design was conducted among residents of AUCH. The intervention consisted of 1- Preparing training material with basic information on how to report causes of death according to WHO criteria and case scenarios extracted from the medical records of children who died at AUCH, 2- One hundred residents of the AUCH were trained in one day workshops in 4 groups, with a pre-post knowledge assessment questionnaire. 3- A weekly audit of a sample of 10–15 DNFs was done for six months with reporting of findings to quality assurance director of the hospital.

Results

Eighty- nine physicians completed the pre-post knowledge assessment with significant increase in knowledge score after the intervention (15.7 ± 3.2 vs. 11.9 ± 2.8). There was a significant decrease in the errors of reporting on the DNFs. The main improvement was in decrease from 90 to 18% in reporting the mechanism of death, and significant decline in writing cause of death in Arabic language only.

Conclusion

Accurate reporting of the medical cause of death can be achieved by educational intervention targeting physicians with institutionalizing of audit system for continuous quality improvement.