Background: The Lambda-Mu-Sigma (LMS) and Z score methods are important for assessment of growth and nutritional status. In Egypt, there is a lack of this tool for monitoring growth in preschool children.Objective: To develop LMS and Z score growth references for assessment of growth and nutritional status for Egyptian children from birth up to 5 years.Methods: A total of 27,537 children [13,888 boys (50.4%) and 13,649 girls (49.6%)] from birth up to 5 years were included in a multistage cross sectional randomized study from different Egyptian geographic districts to create LMS and Z score references for weight, length/height, and body mass index corresponding to age in addition to weight for length/height. Healthy term infants and children, exclusive breast feeding for at least 4 months and not suffering from any chronic diseases were included in this study. Children with dysmorphic features, preterm infants, admitted in neonatal or pediatric intensive care units and having any chronic diseases (hematological, cardiac, hepatic, and renal) were excluded. In addition any health condition that affects child growth including nutritional disorders was also excluded. Un-paired t-test was calculated to compare the means of weight for age, length/height for age, weight for length/height, and BMI for-age z scores of the Egyptian and WHO reference values.Results: Through detailed tables and graphs, LMS and Z scores for weight for age, length/height for age, weight for length/height, and BMI for age of both sexes were represented. Our findings showed no statistically significant difference between reference charts of WHO and Egyptian Z score charts (P > 0.05).Conclusion: This study provides the first reference for Egyptian children from birth up to 5 years based on Z score tool for assessment the growth and nutritional status in various clinical conditions and research, also allows comparison with references of other countries.

BackgroundWorkplace-based assessment (WBA) is a group of assessment approaches that assesses the trainees' performance through their observation and monitoring in real clinical settings and then provides them with constructive and relevant feedback. Many WBA tools are available, including the mini-clinical evaluation exercise (mini-CEX), direct observation of procedural skills (DOPS), case-based discussions, and multisource feedback (peers, seniors, and patients). A WBA can help medical students improve their clinical competencies and ensure that qualified physicians graduate. MethodsThis prospective study was done in the family medicine department at the Menoufia Faculty of Medicine in Egypt and passed through two phases. Phase I was introducing an orientation lecture for family medicine staff and a convenient sample of 21 family medicine postgraduates about WBA. Phase II was conducting a monthly mini-CEX and DOPS for the postgraduates. Finally, students' satisfaction with the WBA was assessed, and all collected data were analyzed via Statistical Package for Social Science (SPSS) version 23 (IBM Corp., Armonk, NY). ResultsA total of 105 feedback sheets were obtained. These feedback sheets were subdivided into 63 mini-CEX feedback sheets (21 sheets from each mini-CEX session for three sessions) and 42 DOPS feedback sheets (21 sheets from each DOPS session for two sessions), all of which were collected and analyzed. A significant improvement was detected in the mini-CEX and DOPS feedback scores of the postgraduates throughout the consecutive sessions (9.5 ± 2.7, 24.9 ± 2.5, 27.29 ± 1.5) (P < 0.001) for Mini-CEX and (6.1 ± 1.8 versus 9.0 ± 1.2) (P < 0.001) for DOPS. About 93% of the postgraduates recommended the application of WBA for their peers, and 86% of them requested to perform it again for other different clinical cases and procedures. ConclusionWorkplace-based assessment in the form of Mini-CEX and DOPS revealed its ability to improve clinical knowledge and skills among family medicine postgraduates who became motivated to undergo it again in search of improving their clinical performance and reducing their stresses related to final summative and objective structured clinical examinations (OSCEs).

Background: Refractive error is the powerlessness of the eye to light into focus on the retina resulting in nearsightedness (myopia), farsightedness (Hyperopia) or astigmatism. Uncorrected refractive error in children is connected with impaired quality of life, increased morbidity and reduced educational opportunities. Objectives: This study aims to assess the impact of refractive errors on the quality of life (QOL) of Primary Schools Children. Methods: This cross section study was conducted on 960 (6-12 years old) primary school children in the first, second and third grades attended Munshaat Sultan primary school , Menouf district, Menoufia, Egypt from 1st October 2016 to the end of December 2016. The participants were assessed through a questionnaire which includes (socio-demographic data and comprehensive history), general and visual examination. QOL of participants with refractive errors was assessed using semi structured questionnaire that consisted of 7 items .The reliability of questionnaires was tested using Cronbach's alpha which was 0.953. Results: Out of 960 students 232 (24.1%) had a significant refractive error of ±0.50 in one or both eyes. There was a highly statistically significant difference between participated children with and without error of refraction regarding socioeconomic status and all parameters of QOL (p value <0.001). Overall 45.5 % of students with error of refraction had poor QOL. Conclusion: Screening for refractive errors in primary school children is mandatory to start corrective measures at the early stage, and improve their quality of life.

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