Kafrelsheikh University

This research experimentally and numerically investigates the feasibility of using low-cost timber plates to enhance the shear behavior of reinforced concrete (RC) beams. Seven simply supported beams with a shear span-to-depth ratio (a/d) of 1.8 were tested under three-point bending, including one control specimen and six strengthened beams. Two strengthening techniques, externally bonded (EB) and near-surface mounted (NSM), were examined using three attachment methods: epoxy only, 10 mm diameter anchor bolts only, and a combination of both. A 3D finite element model (FEM) was developed in ABAQUS V2017 to evaluate the influence of increasing the a/d ratio from 1.8 to 3.1 on the ultimate load, stiffness, and toughness of the strengthened beams. results showed that timber plates, regardless of the strengthening technique, effectively restricted the propagation of the main shear crack and diverted it into multiple secondary cracks. Externally bonded specimens achieved higher ultimate loads than NSM specimens due to the absence of groove-induced reductions in the concrete section. The use of anchor bolts, either alone or in combination with epoxy, prevented debonding and produced the highest ultimate loads, reaching 91 kN and 92 kN, respectively, representing increases of 21.3 % and 22.7 % over the control beam. Both attachment methods also exhibited stiffness improvements of 10.8 % compared to the control beam. Numerical analysis indicated that increasing the a/d ratio from 1.8 to 3.1 led to reductions in stiffness of 43 %-47 %, ultimate load of 18 %-30 %, and toughness of 7 %-30 %. • The shear behavior of RC beams strengthened with timber plates was investigated. • Two strengthening techniques were considered: external strengthening and NSM technique. • Three different attaching methods were used: epoxy alone, anchor bolts alone, or a combination of both. • A Finite element model was developed to examine the effect of the shear span-to-depth ratio. • Using anchor bolts alone or in combination with epoxy exhibited the highest ultimate load.

Type 2 diabetes mellitus (T2DM) is a growing concern in the Arab world, with university students increasingly at risk due to lifestyle factors. This study aims to assess T2DM risk, knowledge, and beliefs among university students aged ≥ 18 years in Egypt, Saudi Arabia, and Yemen. A multinational, cross-sectional study was conducted from January to April 2025 among university students aged ≥ 18 years in Egypt (lower-middle-income), Saudi Arabia (high-income), and Yemen (low-income). A multistage, stratified purposive sampling technique was used to recruit students equally from medical and non-medical faculties in at least three universities per country. Data were collected via structured, interview-based questionnaires consisting of four components: (1) socio-demographic and anthropometric data; (2) the Diabetes Knowledge Questionnaire-18 (DKQ-18); (3) the Health Belief Model Scale (HBMS); and (4) the validated Arabic version of the Australian type 2 diabetes risk assessment tool (AUSDRISK). Among 2787 university students, the mean age was 21.0 years, with the majority being female (74.9%), and enrolled in medical faculties (58.2%). Diabetes knowledge was significantly higher in Egyptians (72.6% with good knowledge) compared to Saudis (63.9%) and Yemenis (59.8%) (p < 0.001). Health beliefs followed a similar trend, while diabetes risk was significantly higher among Yemeni students (22.0% with severe risk; p < 0.001). Multiple regression analysis revealed that a higher academic year was a positive predictor of both diabetes knowledge (β = 0.155, p < 0.001) and health beliefs (β = 0.152, p < 0.001), and was negatively associated with diabetes risk (β = − 0.061, p < 0.001). Medical faculty enrollment was also positively associated with knowledge (β = − 0.411 for non-medical faculty, p < 0.001) and beliefs (β = − 0.228 for non-medical faculties, p < 0.001). Parental education and income were positively associated with knowledge and beliefs. Specifically, father’s higher education predicted greater knowledge (β = 0.047, p < 0.001), and household income was a significant predictor of both knowledge (β = 0.042, p < 0.001) and beliefs (p < 0.001). In contrast, diabetes risk was independently associated with male gender (β = 0.305, p < 0.001), older age (β = 0.123, p < 0.001), higher BMI (β = 0.284, p < 0.001), and Yemeni nationality (β = 0.080, p < 0.001). Marked differences in diabetes risk, knowledge, and beliefs were observed among students from the three countries. Interventions targeting high-risk groups are essential to improve diabetes awareness and prevention in young adults. Countries like Yemen may benefit from urgent preventive measures, while countries with moderate risk profiles may focus on health promotion and sustained education to avert future disease burdens.

The optimal long-term antithrombotic strategy after apparently successful catheter ablation of atrial fibrillation (AF) remains uncertain, particularly in patients who meet conventional guideline thresholds for oral anticoagulation (OAC). To compare continuation versus cessation strategies of long-term OAC after successful AF ablation and to quantify net clinical benefit (NCB) integrating thromboembolic and bleeding outcomes. We searched PubMed, Cochrane CENTRAL, and Embase from inception through February 2026 for randomized and comparative observational studies evaluating long-term OAC continuation versus cessation (no OAC and/or switch to aspirin) after successful AF ablation. Risk of bias was assessed using RoB2 for randomized trials and a modified Newcastle-Ottawa Scale (NOS) for observational studies. Random-effects meta-analyses used a restricted maximum likelihood estimator with Hartung-Knapp adjustment. NCB was calculated as: thromboembolic event rate - (1.5 × major bleeding rate). Six studies met the inclusion criteria (four randomized trials and two observational cohorts). Stroke/transient ischemic attack (TIA) events were reported in six studies and were not significantly different between OAC continuation and cessation strategies (OR 0.69; 95% CI 0.24-1.99; p = 0.49). Systemic embolism (three studies) did not differ between groups (p = 0.12). Major bleeding (five studies) was numerically higher with continued OAC but not statistically significant (OR 2.07; 95% CI 0.88-4.86; p = 0.09). In NCB analysis, continued OAC yielded more negative or near-neutral NCB values, whereas, the cessation strategies were less negative or marginally positive; the fixed-effect risk difference in NCB (continued OAC vs cessation) was +0.00067 (95% CI -0.00279 to +0.00413). This meta-analysis suggests that after successful AF ablation, continuing OAC does not significantly reduce stroke risk compared to cessation or switching to aspirin, but it may increase major bleeding. While NCB trends favor cessation, the low absolute event rates and the risk of silent AF recurrence necessitate caution.

Medical students frequently experience health problems but often resort to self-medication instead of consulting a doctor. This practice may be influenced by various factors and is associated with serious health risks. This study aimed to assess the prevalence, predictors, and contributing factors for self-medication during illness among medical students in Egypt. A cross-sectional study was conducted among 1,128 medical students from seven public universities across three regions of Egypt. Data on self-medication practices, self-reported reasons, and associated factors were collected using an online survey distributed through university-affiliated channels. Binary logistic regression analysis was used to identify factors associated with self-medication for illness. Self-medication for illness during the past year was reported by 66.6% of participants. In univariate analysis, significant predictors included older age (Crude Odds Ratio (COR) = 1.55, 95% CI: 1.21, 1.99), advancing academic year (COR range: 1.69–2.60 vs. first-year students), having a part-time job (COR = 1.68, 95% CI: 1.04, 2.73), and having a chronic illness (COR = 1.75, 95% CI: 1.11, 2.76). Self-medication was also associated with confidence in self-diagnosis (COR = 1.66, 95% CI: 1.28, 2.16), barriers to healthcare access (COR = 1.55, 95% CI: 1.21, 2.00), discrimination in healthcare settings (COR = 1.40, 95% CI: 1.01, 1.95), and delaying healthcare-seeking (COR = 1.77, 95% CI: 1.32, 2.38). In multivariable analysis, significant predictors included advancing academic year (Adjusted Odds Ratio (AOR) = 1.71, 2.26, 95% CI: 1.14, 4.03), confidence in self-diagnosis (AOR = 1.63, 95% CI: 1.25, 2.13), delaying healthcare-seeking (AOR = 1.54, 95% CI: 1.13, 2.10), and experiencing barriers to healthcare access (AOR = 1.31, 95% CI: 1.00, 1.72). The most common self-reported reasons for self-medication was lack of time (43.4%) and convenience (42.5%). A substantial proportion of Egyptian medical students rely on self-medication during illness, influenced by academic progression, confidence in self-diagnosis, and healthcare access barriers. Addressing these factors is crucial to promoting safer healthcare-seeking behaviors among future physicians. Not applicable.

A man in his early 50 s presented with a 7-day history of progressive, symmetrical weakness that began in the lower limbs and ascended to involve the upper limbs. His symptoms were accompanied by distal paresthesia and complete areflexia. Three weeks prior to presentation, he experienced a self-limiting febrile illness associated with dark urine and elevated transaminase levels, which resolved spontaneously. On admission, laboratory investigations demonstrated elevated liver enzyme levels and positive anti–hepatitis E virus Immunoglobulin M antibodies, confirming acute hepatitis E virus infection. Nerve conduction studies were consistent with the acute inflammatory demyelinating polyneuropathy variant of Guillain–Barré syndrome. The patient was treated with intravenous immunoglobulin (0.4 g/kg/day for 5 days) and was closely monitored for respiratory and autonomic complications. Gradual neurological improvement was observed, along with normalization of liver function tests. To the best our knowledge, this case represents the first documented occurrence of hepatitis E virus-associated Guillain–Barré syndrome in Egypt after a careful review of the literature. It underscores the importance of considering hepatitis E virus infection in the differential diagnosis of Guillain–Barré syndrome, particularly in patients presenting with elevated liver enzymes or a recent history of hepatitis in hepatitis E virus-endemic regions. Early recognition and prompt initiation of immunotherapy may improve neurological recovery and clinical outcomes in this rare but clinically significant association.

Lumbar disc prolapse (LDP) is a significant cause of low back pain and radiculopathy. While both Microlumbar Discectomy (MLD) and Microendoscopic Discectomy (MED) are established minimally invasive treatments, comparative data for double-level LDP is limited. This study aimed to compare the efficacy and safety of MED versus MLD for patients with double-level lumbar disc prolapse. This randomized controlled trial included 50 patients with double-level LDP who failed 8 weeks of conservative treatment, randomized equally into two groups: MED group (n = 25) who underwent tubular microendoscopic interlaminar discectomy and MLD group (n = 25) who underwent standard microlumbar discectomy. Patients were followed for one year postoperatively. Primary outcomes included Visual Analogue Scale (VAS) scores for back and leg pain. Secondary outcomes encompassed Oswestry Disability Index (ODI), operative time, blood loss, wound length, hospital stay, return to work, and postoperative complications. Both MED and MLD significantly improved pain and disability. The MED group demonstrated statistically lower VAS scores for back pain at one month (2.1 ± 0.73 vs. 2.7 ± 0.84, p = 0.012), and consistently lower VAS scores for both back and leg pain at 6 and 12 months postoperatively. Operative time was significantly longer for MED (103 ± 15.6 mins vs. 73 ± 14.9 mins, p < 0.001). However, MED was associated with significantly less blood loss (49.9 ± 10.1 mL vs. 87.2 ± 26.2 mL, p < 0.001), smaller wound length (2.3 ± 0.4 cm vs. 4.7 ± 0.5 cm, p < 0.001), shorter hospital stay (1.1 ± 0.61 days vs. 1.7 ± 0.58 days, p = 0.007), and earlier return to work (39.4 ± 7.24 days vs. 43.1 ± 3.6 days, p = 0.029). Both microendoscopic and microlumbar discectomy are effective and safe for double-level lumbar disc prolapse. Microendoscopic discectomy offers superior short-term pain relief, reduced invasiveness, shorter hospital stays, and earlier returns to work, despite a longer operative time. These benefits suggest MED as a favorable option for patients with double-level LDP