Trauma records in Egyptian hospitals are widely suspected to be inadequate for developing a practical and useful trauma registry, which is critical for informing both primary and secondary prevention. We reviewed archived paper records of trauma patients admitted to the Beni-Suef University Hospital in Upper Egypt for completeness in four domains: demographic data including contact information, administrative data tracking patients from admission to discharge, clinical data including vital signs and Glasgow Coma Scale scores, and data describing the causal traumatic event (mechanism of injury, activity at the time of injury, and location/setting). The majority of the 539 medical records included in the study had significant deficiencies in the four reviewed domains. Overall, 74.3% of demographic fields, 66.5% of administrative fields, 55.0% of clinical fields, and just 19.9% of fields detailing the causal event were found to be completed. Critically, oxygen saturation, arrival time, and contact information were reported in only 7.6%, 25.8%, and 43.6% of the records, respectively. Less than a fourth of the records provided any details about the cause of trauma. Accordingly, the current, paper-based medical record system at Beni-Suef University Hospital is insufficient for the development of a practical trauma registry. More efforts are needed to develop efficient and comprehensive documentation of trauma data in order to inform and improve patient care.

Background Numerous trauma scoring systems have been developed in an attempt to accurately and efficiently predict the prognosis of emergent trauma cases. However, it has been questioned as to whether the accuracy and pragmatism of such systems still hold in lower-resource settings that exist in many hospitals in lower- and middle-income countries (LMICs). In this study, it was hypothesized that the physiologically-based Revised Trauma Score (RTS), Mechanism/Glasgow Coma Scale/Age/Pressure (MGAP) score, and Glasgow Coma Scale/Age/Pressure (GAP) score would be effective at predicting mortality outcomes using clinical data at presentation in a representative LMIC hospital in Upper Egypt. Methods This was a retrospective analysis of the medical records of trauma patients at Beni-Suef University Hospital. Medical records of all trauma patients admitted to the hospital over the 8-month period from January to August 2016 were reviewed. For each case, the RTS, MGAP, and GAP scores were calculated using clinical data at presentation, and mortality prediction was correlated to the actual in-hospital outcome. Results The Area Under the Receiver Operating Characteristic (AUROC) was calculated to be 0.879, 0.890, and 0.881 for the MGAP, GAP, and RTS respectively, with all three scores showing good discriminatory ability. With regards to prevalence-dependent statistics, all three scores demonstrated efficacy in ruling out mortality upon presentation with negative predictive values > 95%, while the MGAP score best captured the mortality subgroup with a sensitivity of 94%. Adjustment of cutoff scores showed a steep trade-off between optimizing the positive predictive values versus the sensitivities. Conclusion The RTS, MGAP, and GAP all showed good discriminatory capabilities per AUROC. Given the relative simplicity and potentially added clinical benefit in capturing critically ill patients, the MGAP score should be further studied for stratifying risk of incoming trauma patients to the emergency department, allowing for more efficacious triage of patients in lower-resource healthcare settings.

Patient safety and medical errors are one of the major challenges that health systems in all countries are grappling with to minimize and reduce the damage caused by them. An organizational culture of safety affects employees" attitudes, beliefs, perceptions, and values related to safe practice as well as their behaviors and level of engagement. The objective of the current study was to determine the barriers for nurses" reporting of medical errors. This was an exploratory descriptive qualitative study, conducted from March 2020 to July 2020 in the all departments and intensive care units (ICUs) in Beni-Suef University Hospital. In-depth interviews were held with twelve nurses. When barriers to error reporting were examined, the three areas identified from the data were: (The nurses" perceptions of error, Fear and, Barriers related to the system). This work may provide a road map for just culture implementation. Future qualitative and quantitative research should explore effects of just culture on safety reporting patterns and specific events such reducing medication errors or risk-taking behaviors.

Background. Knee arthroplasty surgeries are in ever-increasing demand. With unicompartmental knee arthroplasty (UKA), patients may benefit from a higher range of flexion and a better Knee Society Score (KSS). Aim. In this study, we compared the short-term clinical outcomes of total knee arthroplasty (TKA) and UKA using the patient-specific templating (PST) technique. Methods. Two groups of 20 knees each were divided into UKA and TKA groups depending on the Oxford criteria of UKA. Only patients with medial compartmental osteoarthritis were included. KSS, functional knee score (FKS), and ROF were assessed preoperatively and at 6 months postoperatively. Results. The TKA group has shown a significant improvement compared to the UKA group in KSS (MD = 39.35 vs. 31.2, respectively, p = 0.003 ). Both TKA and UKA have shown no significant difference concerning both the FKS (MD = 32 and 31.75, respectively, p = 0.926 ) and ROF (MD = 10.25 and 7.25, respectively, p = 0.072 ). Discussion. The higher improvement of KSS in the TKA group can be attributed to the fact that patients in the TKA had significantly worse KSS preoperatively. Also, the small improvement in ROF in the UKA group might be related to their wider preoperative ROF. Conclusion. Preoperatively, the TKA group had lower KSS and ROF compared to UKA. The improvement of KSS from preoperative to postoperative was more significant in TKA. However, the TKA group has shown less range of flexion postoperatively.

Background: Subacromial impingement syndrome is a common disorder about the shoulder. Patients presented by shoulder pain and impaired activity of daily living. Patients can be treated conservatively and if failed surgical intervention is indicated which could be open or arthroscopically with variable results. Aim and objective: This study was conducted to compare effectiveness and benefits between arthroscopic and open subacromial decompression in treatment of subacromial impingement syndrome. Method: The study was approved by the local ethics committee, and a written consent was obtained for each subject, and included 60 patients; 30 patients was treated by arthroscopic subacromial decompression and the other 30 were treated by open surgery. Patients were followed for a period of one year. Results: Functional outcome was assessed using the American shoulder and elbow surgeons' score. The arthroscopic group (A) had significant high score in first three months after operation than the open group (B). And after 6 months the significance between the two groups decreased till one year after operation at which there was no significance. Conclusion: Our results revealed that arthroscopic subacromial decompression for subacromial impingement syndrome were effective and safe than open surgery.