Background The oropharyngeal dysphagia is an underestimated symptom with various causes in the geriatric population. Clinical presentation is often insidious and dysphagia symptoms are seldomly mentioned by elderly patients although causing many life-threatening complications. The aim of this work was to introduce an easy applicable tool to be used by the caregivers and general practitioners for screening of dysphagia in geriatrics for early detection of at risk individuals. Methods A sample of 200 Egyptian Arabic-speaking elderly patients (65 years or older) not complaining of dysphagia was recruited from nursing homes in Greater Cairo Area. They or their caregivers completed the designed screening tool, including; the designed questionnaires of dysphagia manifestations and eating habits. General, oral motor and bedside evaluation were also performed. In addition to filling in the EAT10 questionnaire and FEES that was performed for only suspected cases for the purpose of validation of the screening tool. Results The dysphagia manifestations questionnaire was significantly correlated with EAT 10 with p value of 0.001. It was correlated in some of its aspects with FEES showing quite reliability with p values’ range between 0.012 and 0.044. The Questionnaire of eating habits reliability of r- value of 0.568 slightly exceeding EAT10 reliability of r -value of 0.721 in the subjects under study. The cutoff point of total score of the dysphagia manifestations was > 5, with a sensitivity of 17.65% & a specificity of 94.20%. The cutoff point of total score of the bedside evaluation was ≤ 1 with a sensitivity of 66.9% & a specificity of 56.9%. Conclusion the use of this easy applicable screening tool managed to suspect and later on diagnose cases with oropharyngeal dysphagia in non-complaining aging subjects.

Background:The Swallowing Disturbance Questionnaire contains 15 items covering the common swallowing disturbances that appear in the oral and pharyngeal phases of swallowing. Aim: To evaluate the validity of an Arabic version of swallowing disturbance questionnaire in the screening of dysphagia resulting from various swallowing disorders to be used as an easily applicable self-reported questionnaire for early detection of dysphagic cases. Patients and Methods: Forty patients with different etiologies of oropharyngeal dysphagia were asked to fill in the generated Arabic version of Swallowing Disturbance Questionnaire in addition to filling in the Dysphagia Handicap Index to detect the concurrent validity. Flexible endoscopic evaluation of swallowing was carried out to all patients to confirm the presence of dysphagia. Results: Three questions related to laryngeal symptoms were excluded from the questionnaire as they showed low reliability (p value= 0.177). Cronbach's alpha coefficient of Arabic version of Swallowing Disturbance Questionnaire after removal of the three questions showed good reliability (p value=0.768) and excellent test retest reliability. It showed a good concurrent validity when it was compared against Dysphagia Handicap Index. The two questionnaires had the same findings in the scores of dysphagia within the study groups with higher scores in Post-Stroke cases. Arabic version of Swallowing Disturbance questionnaire had a cut off level of 10 with (55.26%) sensitivity and (50.0%) specificity. Conclusion:Given the proved validity of the Arabic version of Swallowing Disturbance questionnaire, the current study proposes its use to high-risk patients of swallowing problems.

Objective The aim of this study was to evaluate swallowing in early and late stage dementia cases referred to the swallowing clinic with oropharyngeal dysphagia in order to have a comprehensive view about their characteristic oropharyngeal dysphagia profile toward different food textures to address them in their rehabilitation program. Patients and Methods Fiber-optic endoscopic examination of swallowing (FEES) was conducted to evaluate formally the oropharyngeal stage of swallowing in 26 individuals diagnosed with early mild Alzheimer dementia and late severe Alzheimer dementia. The FEES protocol included symptoms of presentation, route of feeding, bedside evaluation using different textures followed by evaluation of the oral preparatory stage, and the pharyngeal stage through FEES. In addition to observing the ability of the patient to imitate various oromotor actions and ability to follow commands related to the oral phase of swallowing. Results For early stage dementia, all food consistencies were considered safe except for mixed consistencies, large volumes of thin liquids and jelly, while the safest consistencies to use with the late stage dementia cases for quality of life and pleasurable feeds were thickened liquids and jelly consistency. Conclusion Oropharyngeal dysphagia profiles in early stage Alzheimer dementia is different from late stage Alzheimer dementia indicating that the mechanism behind dysphagia is different in the two groups.

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Background COVID-19 is not only a health crisis; it has the potential to create devastating social, as well as economic crises. Health care practitioners are the category with the highest diffusion of the contagion. The aim was to determine the economic and emotional impact of the COVID-19 pandemic on phoniatricians in Egypt in an attempt to analyze this data to determine the magnitude of this effect and if it is age and/or location specific. Subjects and methods An online structured Google-free form survey composed of 49 questions was created and sent online to phoniatricians all over Egypt. The survey was divided into three sections about demographic, economical then emotional-related questions. The studied group was further subdivided into 2 groups according to age and location for comparison purposes. Results 82.5% of phoniatricians confirmed that the pandemic had a lot of negative impact on their practice. About 37.5% reduced their practices to urgent procedures and the same percentage closed their practice. The expenses of 56.3% exceeded their income. 91.2% had negative feelings when thinking about the pandemic. The economic problems have affected 71.3% of the participants emotionally. The pandemic had comparable negative impact on the economic and emotional aspects of both age groups. However, the younger age group suffered more from getting infected, and they thought more about career shift and was the group that needed psychological support during the pandemic. Outside Cairo organizations succeeded in providing the personal protective equipment to the phoniatricians in comparison to Cairo. Conclusion COVID-19 had a negative effect on the economical and emotional aspects of Egyptian phoniatricians’ lives. The pandemic economic burden was related to quarantine period, heath problems and getting infected, family requirements, and purchasing the protective equipment. The emotional burden was related most to the pandemic hazards and financial effect on the clients and chance of losing job. Few effects were age- and location-specific.