Background: During the ongoing COVID-19 crisis, healthcare organizations are still fighting to retain nursing staff by reducing intense workload and sustaining workplace justice in order to avoid nursing staff burnout, turnover, and alienation. Aim: This research aimed to identify the influence of perceived organizational injustice on workplace alienation among nursing staff during COVID-19. Design: A descriptive, correlational research design was utilized to achieve the aim of the study. Settings: It was conducted in intensive care units (ICUs) and inpatient wards for males and females at Tanta Main University Hospital and Al-Minshawi General Hospital. Subjects: It contained a convenience sampling of 508 nursing staff. Tools: It compromised two instruments; the first tool, entitled perceived organizational injustice, which included socio-demographic data of nursing staff and four dimensions of distributive, procedural, informational, and interpersonal injustice (20 items). The second tool, entitled workplace alienation factors, contained three factors of powerlessness, self-estrangement, and meaninglessness (29 items). Results: This research showed that the overall nursing staff's perceptions of organizational injustice and workplace alienation were significantly high. The dimensions of organizational injustice were positively correlated with all the factors of workplace alienation. Conclusion: It verified that the dimensions of organizational injustice were discovered to have a substantial impact on the predicted variance of workplace alienation among nursing staff. Recommendations: This research recommended that hospital administrators need to state a clear grievance procedure, as well as nursing researchers, need to conduct a longitudinal study or qualitative study to assess the consequences of organizational injustice and workplace alienation.

Background Myocardial injury in conditions other than coronary artery disease (CAD), known as type 2 myocardial infarction, is mostly related to mismatch between myocardial oxygen supply and demand. Cirrhotic patients with acute upper gastrointestinal bleeding (UGIB) are usually hemodynamically unstable. Hypovolemia, hypotension, and decreased oxygen-carrying capacity as consequences of UGIB may precipitate subclinical heart failure and myocardial injury. Aim of work Assessment of the prevalence and potential risk factors of myocardial injury in patients with liver cirrhosis with acute UGIB. Patients and methods The study was conducted on 132 patients diagnosed with liver cirrhosis presenting by UGIT bleeding at Mansoura University Hospitals during one year. Patients were divided into 2 groups: group 1 (76 patients) with myocardial injury or ischemic heart disease and group 2 (60 patients) without. Results The incidence of myocardial injury in this study (elevated troponin levels above cutoff value and/or ECG changes) was 55% of patients. Troponin I was positive in 25% of patients. ECG ischemic changes were found in 36.3% of patients in the form of ST-segment deviation or T-wave inversion. On univariate analysis, predictors of myocardial injury in patients with UGIB included MELD score and variceal source of GI bleeding. On multivariate analysis variceal source of GI bleeding is an independent predictor of myocardial injury. Variceal bleeding was found in 95 % of the ischemic group versus 63% in the other group. Conclusion More than half of the study patients presented with UGIB have suffered from unnoticed subclinical myocardial injury. Variceal source of GI bleeding was found to be an independent predictor of myocardial injury.

Background: Paternalistic leadership is a style of leadership in which the leader merges strict discipline with the empathy of a paternal figure and moral character in a personalized climate to enable nurses perform more effectively and efficiently and help them reduce cynical behaviour toward the hospital. Aim of the study: Compare influence of head nurses' paternalistic leadership on hospital cynicism and job performance among intensive care nurses at Tanta Main University Hospitals and EL-Mehalla General Hospital. Subjects and Method: Research design: A descriptive, comparative, via cross-sectional research design was used. Subjects: Available nurses working at Tanta Main University Hospitals' ICUs (n=295) and EL-Mehalla General Hospital (n=301). Tools: Three tools were used for data collection: Paternalistic Leadership Scale, Organizational Cynicism Scale and Nurses' job Performance Observational Checklist. Results: The majority of nurses perceived a high level of paternalistic leadership from the head nurses at Tanta Main Hospital compared to the minority of nurses at El-Mahalla General Hospital. The majority of nurses perceived a low level of hospital cynicism at Tanta Main Hospital, while above half of nurses perceived a moderate level at El-Mahalla General Hospital. The majority of nurses at Tanta Main Hospital had a satisfactory level of job performance contrary to slightly more than half of nurses at El-Mahalla GeneralHospital. Conclusion: There was a significant influence of head nurses' paternalistic leadership on hospital cynicism at both setting (Tanta Main and El-Mahalla General Hospital). Also, head nurses' paternalistic leadership affects nurses' job performance at Tanta Main Hospital. However, there was no relation between head nurses' paternalistic leadership and nurses' job performance at El-Mahalla General Hospital. Recommendation:Develop training program for head nurses to improve leadership practices in order to reduce cynicism and improve staff performance.