Rehabilitation Center Research Articles

Correlation of postural stability with pain, disability and quality of life among patients with sacroiliac joint dysfunction- A cross-sectional study

Context-Sacroiliac (SI) joint dysfunction accounts for altered postural stability which can cause a continuously intense pain level and range of disabilities. AimTo investigate the correlation of postural stability with pain, disability & QOL among sufferers of sacroiliac joint dysfunction. SettingThis cross-sectional research was undertaken at Rehabilitation Centre, Jamia Hamdard University. MethodA total of fifty participants were recruited using sample of convenience according to inclusion and exclusion criteria. After obtaining informed consent, three pain provocative tests and one motion palpation test were used to determine sacroiliac joint dysfunction. Humac balance master system (CSMi USB powered, Stoughton, USA), Visual analogue scale (VAS), modified Oswestry Disability Index (ODI) & WHO QOL-BREF (US version) were used to assess postural stability, pain, disability & Quality of life (QOL) respectively. Data analysis was done for correlation by SPSS version 24.0. ResultStrong positive correlations were found between reaction time, VAS (r = 0.791) and modified ODI score (r = 0.576) and weak positive correlations between eyes closed solid surface (ECSS) component of modified clinical test of sensory interaction & balance with VAS (r = 0.333) and with modified ODI score (r = 0.304) and eyes open foam surface (EOFS) component with environmental component of QOL (r = 0.287). There were negative correlations between reaction time, physical health (r = −0.413), psychological health (r = −0.375), social relations (r = −0.305), and environment (r = −0.379) parameters of QOL. ConclusionAccording to the findings of the study, there were positive correlations of reaction time with pain and disability and negative correlations with QOL. Awareness of clinicians regarding the altered postural stability can help in improvising the assessment and treatment protocols for patients of SI dysfunction.

Quality of life and mental health of patients with coronary heart disease

According to WHO, cardiovascular diseases are the leading cause of death in the world. The most common form of heart disease is coronary heart disease (CHD). IHD is the most acute medical problem in most countries of the world, including Russia, due to high morbidity, mortality, persistent and temporary disability among the most productive part of the population, which causes significant economic damage to modern society [1, 2, 3]. Target. To study factors influencing the quality of life and mental health of patients with coronary artery disease. Results. The prevalence of risk factors among patients with coronary artery disease is analyzed, the impact of the disease on the physical and emotional state of patients is considered, and the influence of rehabilitation measures that help improve the quality of life of patients with coronary artery disease is shown.Conclusion. To improve the quality of life of patients with coronary artery disease, it is necessary to develop new forms of rehabilitation assistance and methods of financial support, and create rehabilitation centers at the place of residence and work.

Etiology and evolution of anemia in patients submitted to cardiovascular surgery

Anemia is associated with increased mortality in patients undergoing major surgeries. The aim of this study is to evaluate the prevalence of anemia in the preoperative period of cardiovascular surgery, its postoperative incidence and its evolution during the first month in our setting. A prospective cohort study was carried out in which all patients undergoing central cardiovascular surgery operated during the period 09/01/2021-09/01/2022 in a university hospital were included. Clinical and laboratory follow-up was carried out prior to surgery, on the fifth and on the 30th postoperative day. Groups with and without preoperative anemia were compared. The prevalence of anemia in the preoperative period was 32.1%. The incidence of anemia in the postoperative period was 96% in the group of patients without previous anemia. One month after surgery, 73 and 90% of the patients, with and without preoperative anemia, respectively, remained anemic. Patients with preoperative anemia had less recovery of their hemoglobin values at one month. A trend towards higher mortality and a greater need for referral to post-hospital discharge rehabilitation centers was observed in those with preoperative anemia. In this work, a high prevalence and incidence of anemia in the perioperative period of cardiovascular surgeries was evidenced. As well as its subtreatment and high persistence during the month after surgery.

Towards efficient motor imagery interventions after lower-limb amputation

BackgroundThe therapeutic benefits of motor imagery (MI) are now well-established in different populations of persons suffering from central nervous system impairments. However, research on similar efficacy of MI interventions after amputation remains scarce, and experimental studies were primarily designed to explore the effects of MI after upper-limb amputations.ObjectivesThe present comparative study therefore aimed to assess the effects of MI on locomotion recovery following unilateral lower-limb amputation.MethodsNineteen participants were assigned either to a MI group (n = 9) or a control group (n = 10). In addition to the course of physical therapy, they respectively performed 10 min per day of locomotor MI training or neutral cognitive exercises, five days per week. Participants’ locomotion functions were assessed through two functional tasks: 10 m walking and the Timed Up and Go Test. Force of the amputated limb and functional level score reflecting the required assistance for walking were also measured. Evaluations were scheduled at the arrival at the rehabilitation center (right after amputation), after prosthesis fitting (three weeks later), and at the end of the rehabilitation program. A retention test was also programed after 6 weeks.ResultsWhile there was no additional effect of MI on pain management, data revealed an early positive impact of MI for the 10 m walking task during the pre-prosthetic phase, and greater performance during the Timed Up and Go Test during the prosthetic phase. Also, a lower proportion of participants still needed a walking aid after MI training. Finally, the force of the amputated limb was greater at the end of rehabilitation for the MI group.ConclusionTaken together, these data support the integration of MI within the course of physical therapy in persons suffering from lower-limb amputations.

Socratic guided feedback therapy after acquired brain injury: A multicenter randomized controlled trial to evaluate effects on self-awareness

ABSTRACT Impaired self-awareness after acquired brain injury (ABI) challenges neuropsychological rehabilitation. The current study aimed to compare the effects of Socratic Guided Feedback therapy to usual care in a multicenter randomized controlled trial with 64 participants with reduced self-awareness after ABI. The objectives were to study the effects on (1) self-awareness and (2) motivation for and participation in therapy, mood, quality of life, and social participation. Patients were recruited from rehabilitation centres in The Netherlands and Belgium. They were 50.8 (±16) years old and 2.7 months (±1.8) post-injury at baseline. Session duration ranged from 20–60 minutes and the number of sessions ranged from 1 to 162 sessions. Self-awareness increased over time in both groups. Between 9 and 12 months after baseline measurement, self-awareness (Patient Competency Rating Scale discrepancy score between patient and significant other) improved in the experimental group and deteriorated in care as usual. No significant differences were found on secondary outcome measures. In conclusion, Socratic Guided Feedback therapy is as effective as care as usual but provides a structure for therapists. We recommend further investigation of the added value of Socratic Guided Feedback therapy in later follow-up measurements, group therapy settings, and on other outcome domains such as caregiver burden.

Profile of paediatric occupational therapy practice in Eastern Mediterranean countries

Background Paediatric occupational therapy (OT) is considered the largest practice area in OT in several regions, including the Eastern Mediterranean (EM) countries. Aims/objectives This study aimed to establish a profile of paediatric occupational therapists in EM countries to identify theoretical models, assessments and interventions employed. It also investigated the therapists’ usage of evidence-based practice in their practice. Material and methods We conducted a cross-sectional survey using a questionnaire which was distributed electronically to occupational therapists working with children. Results The participants included 118 therapists. Majority of the participants were working at rehabilitation centres. The primary client groups were pre- and school-age children with autism spectrum disorder and cerebral palsy. The most frequently used assessments were sensory-related tools. Activities of daily living and play were the most often targeted interventional area. Participants highlighted some of the challenges faced in implementing evidence in their practice. Conclusion Paediatric occupational therapists are usually exposed to specific age groups and conditions. However, a lack of knowledge practice in some areas and challenges in others exist. Significance Within the EM region, knowledge regarding therapists’ practices is lacking. Actions should be taken to improve current practice and meet the current needs of clients, and utilise evidence-based practices.

Early rehabilitation after spinal cord injury: a scoping review protocol.

The objective of this scoping review is to identify the timings and types of early rehabilitation after spinal cord injury (SCI) that are documented in the literature, as well as identify possible research gaps in this field. Preclinical and clinical studies support the idea that early rehabilitation may be beneficial for patients with acute SCI. However, the timings and types of rehabilitation that should and could be used in the acute stage are still unclear. The first step towards such knowledge is to extensively review what is documented in the literature. This review will consider all papers focusing on early rehabilitation after SCI in adult humans or animals (<3 months' post-SCI for humans and other primates and <3 weeks' post-SCI for other animals). Interventions in the included papers must aim at sensorimotor or functional improvement and take place in a hospital or a rehabilitation center if they target human subjects. This review will include published and unpublished experimental and observational studies, research protocols, conference abstracts, systematic reviews, and guidelines. MEDLINE (PubMed), Scopus, Embase, PEDro, Web of Science Core Collection, CINAHL (EBSCOhost), Cochrane Database of Systematic Reviews, Cochrane CENTRAL, PROSPERO, ClinicalTrials.gov, and gray literature sources will be searched for eligible articles. No language or date limits will be applied. Two independent reviewers will perform study selection and data extraction, and the results will be presented according to the SCI type and severity. Open Science Framework https://osf.io/q45er.

Key lessons to improve care-factors contributing to delayed discharges and cost implications: medical conditions and rehabilitation delays at a tertiary rehabilitation center in Saudi Arabia.

Key lessons to improve care-factors contributing to delayed discharges and cost implications: medical conditions and rehabilitation delays at a tertiary rehabilitation center in Saudi Arabia.

Understanding physical exercise among individuals with substance use disorders using an integrated theoretical perspective of the health action process approach and theory of planned behavior.

Physical exercise is considered a useful non-pharmacological adjunctive treatment for promoting recovery from substance use disorders (SUD). However, adherence to physical exercise treatments is low, and little is known about what factors are associated with the initiation and maintenance of physical exercise behaviors. The aim of this study was to explore the psychosocial factors underlying these behaviors in individuals with SUD using an integrated theoretical model based on the health action process approach (HAPA) and the theory of planned behavior (TPB). A total of 1,197 individuals with SUDs (aged 37.20 ± 8.62 years) were recruited from 10 compulsory isolation drug rehabilitation centers in Zhejiang Province via convenience sampling according to a set of inclusion criteria. Self-reported data were collected to assess task self-efficacy (TSE), maintenance self-efficacy (MSE), recovery self-efficacy (RSE), outcome expectations (OE), action planning (AP), coping planning (CP), social support (SS), subjective norms (SN), attitude behavior (AB), behavioral intention (BI), perceived behavioral control (PBC), risk perception (RP), exercise stage, and exercise behavior in this integrated model. ANOVA and structural equation modeling (SEM) were used to evaluate this model. One-way ANOVA revealed that the majority of the moderating variables were significantly different in the exercise phase. Further SEM showed that the model fit the data and revealed several important relationships. TSE, RP, SS, AB, and SN were indirectly associated with physical exercise behavior in individuals with SUD through the BI in the SUD initiation stage. In addition, PBC was directly related to physical exercise behavior in individuals with SUD. In the maintenance stage, MSE, AP, CP and exercise behavior were significantly related. Moreover, AP and CP were mediators of BI and MSE. This study is the first attempt to integrate patterns of physical exercise behavior in individuals with SUD. The HAPA-TPB integration model provides a useful framework for identifying determinants of physical exercise behavioral intentions and behaviors in individuals with SUD and for explaining and predicting the initiation and maintenance of physical exercise behaviors in these individuals. Moreover, the model provides scientific guidance for the enhancement of physical exercise adherence in individuals with SUD.

Age is not a sole predictor of outcomes in octogenarians undergoing complex endovascular aortic repair

ObjectiveTo examine the perioperative, postoperative, and long-term outcomes of fenestrated/branched endovascular aneurysm repair (F/BEVAR) in octogenarians compared with nonoctogenarians. MethodsA multicenter, retrospective cohort study was conducted using the Vascular Quality Improvement database, which prospectively captures information on patients who undergo vascular surgery across 1021 academic and community hospitals in North America. All patients who underwent F/BEVAR endovascular aortic repair from 2012 to 2022 were included. Patients were stratified into two groups: those aged <80 years and those aged ≥80 years at the time of the procedure. The preoperative, intraoperative, and postoperative factors were compared between the two groups. The primary outcome was long-term all-cause mortality; secondary outcomes included aortic-specific mortality and aortic-specific reintervention. ResultsA total of 6007 patients (aged <80 years, n = 4860; aged ≥80 years, n = 1147) who had undergone F/BEVAR procedures were included. No significant difference was found in technical success, postoperative length of stay, length of intensive care unit stay, postoperative bowel ischemia, and spinal cord ischemia. After adjustment for baseline covariates, octogenarians were more likely to suffer from a postoperative complication (odds ratio [OR]: 1.16; [95% confidence interval (CI): 0.98-1.37], P < .001) and be discharged to a rehabilitation center (OR: 1.60; [95% CI: 1.27-2.00], P < .001) or nursing home (OR: 2.23; [95% CI: 1.64-3.01], P < .001). Five-year survival was lower in octogenarians (83% vs 71%, hazard ratio [HR]: 1.70; [95% CI: 1.46-2.0], P < .0001). Multivariate Cox proportional hazard analysis demonstrated that age was associated with increased all-cause mortality (HR: 1.72, [95% CI: 1.39-2.12], P < .001) and aortic-specific mortality (HR: 1.92, [95% CI: 1.04-3.68], P = .038). Crawford extent II aortic disease was associated with an increase in all-cause mortality (HR 1.49; [95% CI: 1.01-2.19], P < .001), aortic-specific mortality (HR: 5.05; [95% CI: 1.35-18.9], P = .016), and aortic-specific reintervention (HR: 1.91; [95% CI: 1.24-2.93], P = .003). Functional dependence was associated with increased all-cause mortality (HR: 2.90; [95% CI: 1.87-4.51], P < .001) and aortic-specific mortality (HR: 4.93; [95% CI: 1.69-14.4], P = .004). ConclusionsOur findings suggest that octogenarians do have a mildly increased mortality rate and rate of adverse events after F/BEVAR procedures. Despite this, when adjusted for other risk factors, age is on par with other medical comorbidities and therefore should not be a strict exclusion criterion for F/BEVAR procedures, rather considered in the global context of patient’s aortic anatomy, health, and functional status.

The Impact of Criminal Dangerousness on Criminal Penalties

The theory of criminal dangerousness emerged in modern penal policy and has been the focus of criminal legal studies to understand the reasons that drive criminals to commit crimes. The objective is to work to mitigate these reasons through the application of appropriate criminal sanctions adapted to the circumstances of each offender, to rehabilitate them and reintegrate them into society as responsible citizens. Criminal dangerousness is a psychological state or attribute closely associated with the offender, which indicates the possibility of committing another crime in the future. Without a doubt, this topic poses many challenges in terms of the personality, inclinations, emotions, and reactions of the individual, which are reflected in his outward behavior. Addressing the hidden criminal danger in the offender has been achieved through legal texts in which the legislator considers the presence or absence of criminal danger in the authors of the crimes. Additionally, judges have been given discretionary authority to consider the personality of the offender and reveal criminal dangers. Finally, the execution of criminal sanctions in reform and rehabilitation centers also contributes to effectively confronting criminal dangerousness.

Return to Work in Breast Cancer Patients following an Interdisciplinary Rehabilitation Program in a Community-Based Cancer Rehabilitation Center: A Pilot Study.

Despite curative treatment and discharge from acute hospital settings, breast cancer patients often have cancer- and treatment-related morbidity which impairs them from returning to work. Hence, the role of community-based return to work rehabilitation programs is important to help these patients transition back to work. This was a retrospective cohort study involving patients with breast cancer conducted at a community-based cancer rehabilitation center. Patients were involved in an interdisciplinary vocational rehabilitation program involving physiatrists, occupational therapists, physiotherapists and social workers. We recruited 63 patients for this study cohort, with 46 (73.0%) patients ≤ 60 years old. After undergoing the rehabilitation program, there were 37 (58.7%) participants who successfully returned to work. These participants returned to work at either within 6 months (27.0%), 12 months (29.7%) or 24 months (43.2%) after enrollment into the program, with a majority enrolling in white collar jobs. Multivariate regression analysis revealed that significant negative factors for return to work were advanced stage of cancer (p = 0.004), along with clinically significant fatigue, measured on the Brief Fatigue Inventory (p < 0.001). However, perceived work ability (p = 0.020) was found to be a positive factor.

A Survey on Speech Emotion Based Music Recommendation System

Psychological research has proven that music relieves stress, elevates mood, and is responsible for the release of “feel-good” chemicals like oxytocin, serotonin, and dopamine. It comes as no surprise that music has been a popular tool in rehabilitation centers and therapy for various disorders, thus with the interminably rising numbers of people facing mental health-related issues across the globe, addressing mental health concerns is more crucial than ever. Despite the existing music recommendation systems, there is a dearth of holistically curated algorithms that take care of the needs of users. Given that, an undeniable majority of people turn to music on a regular basis and that music has been proven to increase cognition, memory, and sleep quality while reducing anxiety, pain, and blood pressure, it is the need of the hour to fashion a product that extracts all the benefits of music in the most extensive and deployable method possible. Our project aims to ameliorate our users’ mental state by building a comprehensive mood-based music recommendation system called “Viby”. Keywords Language, Communication, Speech recognition, Interaction.

Resistant Escherichia coli isolated from wild mammals from two rescue and rehabilitation centers in Costa Rica: characterization and public health relevance

This study aimed to characterize the antimicrobial resistance (AMR) and virulence profiles of 67 Escherichia coli isolates obtained from faecal samples of 77 wild mammals from 19 different species, admitted in two rescue and rehabilitation centers in Costa Rica. It was possible to classify 48% (n = 32) of the isolates as multidrug-resistant, and while the highest resistance levels were found towards commonly prescribed antimicrobials, resistance to fluoroquinolones and third generation cephalosporins were also observed. Isolates obtained from samples of rehabilitated animals or animals treated with antibiotics were found to have significantly higher AMR levels, with the former also having a significant association with a multidrug-resistance profile. Additionally, the isolates displayed the capacity to produce α-haemolysins (n = 64, 96%), biofilms (n = 51, 76%) and protease (n = 21, 31%). Our results showed that AMR might be a widespread phenomenon within Costa Rican wildlife and that both free-ranging and rehabilitated wild mammals are potential carriers of bacteria with important resistance and virulence profiles. These results highlight the need to study potential sources of resistance determinants to wildlife, and to determine if wild animals can disseminate resistant bacteria in the environment, potentially posing a significant threat to public health and hindering the implementation of a “One Health” approach.

‘Dead birds flying': can north American rehabilitated raptors released into the wild mitigate anthropogenic mortality?

As the human footprint expands to meet societal energy needs, as do the impacts to wildlife. Raptors in particular are highly susceptible to anthropogenic caused mortality. Industry sectors are encouraged to offset these causes of mortality. Several options to mitigate these losses have been proposed, including raptor rehabilitation. However, its role as a conservation tool is untested. Currently no peer‐reviewed demographic analyses exist using post‐release data from rehabilitated raptors to evaluate its effectiveness at continental scales. Our objectives were to estimate annual survival of rehabilitated and wild raptors, and then use those estimates in demographic models to assess potential effects at individual and population levels. We hypothesized that rehabilitated raptors would survive similarly to their wild counterparts after an acclimation period, and that longer‐lived species (K‐selected) would benefit most from these releases. We used US Geological Survey Bird Banding Lab band‐recovery data (1974–2018) from 20 raptor species for modeling survival of rehabilitated individuals (n = 125 740) in comparison to wild birds (n = 1 913 352). Results from 17 species with adequate recovery data indicated that five species rehabilitated ≠ wild survival, two species had uncertain estimates, and 10 species rehabilitated ≈ wild survival by years two and three post‐release. We acquired admission (n = 69 707) and release (n = 25 740) data from 24 rehabilitation centers across the US (2012–2021). We integrated survival, fecundity and numbers of releases into demographic models. These models quantified the extent to which rehabilitated raptors may contribute to broader conservation efforts, especially in the context of individual take. All but two species, had measurable numbers of individuals added to the population regardless of the number of releases. The general pattern was for K‐selected species to yield larger benefits from rehabilitated supplementation to the population. These results provide evidence that rehabilitation may serve as mitigation tool to offset incidental take.

Improvements of complex post-traumatic stress disorder symptoms during a multimodal psychodynamic inpatient rehabilitation treatment – results of an observational single-centre pilot study

ABSTRACT Background: Complex post-traumatic stress disorder (CPTSD) describes chronic disturbances in self-organization (i.e. affect dysregulation; negative self-concept; severe difficulties in relationships) which are frequently observed in survivors of prolonged, repeated or multiple traumatic stressors. So far, evidence of psychodynamic treatment approaches for CPTSD is scarce. Methods: In this single-centre observational pilot study, symptom change during a 6-week psychodynamic inpatient treatment in a multimodal psychosomatic rehabilitation centre was evaluated using repeated measures analyses of variance (ANOVAs). Patients completed questionnaires on PTSD and CPTSD symptoms (ITQ), anxiety, depression and somatization (BSI-18), functional impairment (WHODAS) and epistemic trust, mistrust and credulity (ETMCQ) before (T1) and at the end of treatment (T2). A hierarchical linear regression analysis was calculated to identify factors associated with improved CPTSD symptoms. Results: A total of n = 50 patients with CPTSD were included in the study, of whom n = 40 (80%) completed treatment. Patients reported a significant reduction of CPTSD symptoms during treatment with a large effect size (−3.9 points; p < .001; η 2 = .36), as well as a significant reduction of psychological distress (p < .001; η 2 = .55) and functional impairment (p < .001; η 2 = .59). At the end of treatment, 41.0% of patients no longer fulfilled the diagnostic criteria for CPTSD. Changes in epistemic stance included improved epistemic trust (β = –.34, p = .026) and decreased epistemic credulity (β = .37, p = .017), which together with lower age (β = .43, p = .012) and lower depression levels at baseline (β = .35, p = .054) were significantly associated with baseline adjusted mean change of CPTSD symptoms during therapy and explained 48% of its variance. Discussion: In our study, patients reported a significant reduction of CPTSD symptoms and comorbid symptoms during a multimodal psychodynamic inpatient rehabilitation treatment. Improved epistemic trust may facilitate the establishment of a trusting therapeutic relationship, thus fostering an environment of openness for knowledge transfer (i.e. social learning) and the exploration of diverse viewpoints and perspectives in the therapeutic process.

Fidelity of family centered care model to early disability diagnosis and rehabilitation in the United Arab Emirates.

The role of parents in supporting early intervention for young children with disabilities is critical. Indeed, models of family centered care (FCC), which emphasis strong partnerships between health professionals and families in disability health services delivery are now widely associated with best practice. While FCC is consistently argued to be an appropriate model for disability service delivery, its utilization is limited primarily to Western countries such as Australia and the United States. Countries such as the United Arab Emirates (UAE) have prioritized early childhood development and are thus in search of best practices for delivery of early intervention for children and their families. The aim of this study was to explore the appropriateness of the FCC model in disability service delivery in the UAE. This study was conducted from the perspectives of health professionals who are involved in disability diagnosis, referral and ongoing support for families and children with disabilities. A total of 150 health professionals were recruited from health facilities, rehabilitation centers and schools in the Emirates of Abu Dhabi. The 27-item Measure of Process of Care for Service Providers (MPOC-SP) was used for data collection. The data were subjected to confirmatory factor analysis to confirm applicability of the model to this context. Multivariate analysis of variance and moderation analysis were also conducted, to ascertain the relationship between participants' satisfaction levels with their ability to diagnose, refer and provide on-going support and their likelihood of practicing key components of FCC. Computation of confirmatory factor analysis provided support for applicability of the MPOC-SP in the UAE context. Further inspection showed moderate to large correlations between the four components of FCC measured by MPOC-SP, providing further support for utilization of FCC in disability health service delivery in the UAE. The study concludes with a call to policymakers in the UAE to consider developing disability health policy based on key components of FCC. This could be supplemented by development of training modules on FCC to upskill health professionals involved in disability diagnosis and rehabilitation.

Developing a Pain Identification Model Using a Deep Learning Technique

In this study, the authors proposed a pain identification model using facial expressions. An image extraction technique was developed using the liquid neural network to extract diverse images from the video files. The authors used the DenseNet 201 and MobileNet V3 models to build a hybrid feature engineering technique. They applied quantization aware training to improve the efficiency of the models. The Prkachin and Solomon Pain Intensity score was used for the image classification. They fine-tuned the LightGBM model using the random search algorithm for identifying pain from the facial images. The authors used the Denver Intensity of Spontaneous Facial Action dataset to generalize the proposed model. The performance evaluation outlined the significant performance of the proposed model in identifying pain using the images. In addition, it demands limited computational resources to identify pain. Healthcare and rehabilitation centers can implement the proposed model to provide adequate services to disabled individuals.

Erectile Dysfunction as an Obesity-Related Condition in Elderly Men with Coronary Artery Disease.

Background: This cross-sectional study aimed to investigate the prevalence of erectile dysfunction (ED) in elderly men with overweight or obesity and coronary artery disease. Methods: Patients recruited in cardiac rehabilitation centers post-myocardial infarction provided demographic and anthropomorphic data. ED was assessed using the abbreviated International Index of Erectile Function 5 (IIEF-5) Questionnaire. Results: The study included 661 men with a mean age of 67.3 ± 5.57 years, a mean BMI of 27.9 ± 3.6 m/kg2, and a mean waist circumference of 98.9 ± 10.23 cm. Over 90% of men experienced ED, with similar proportions across BMI categories. The development of ED in men with a waist circumference of ≥100 cm had 3.74 times higher odds (OR 3.74; 95% CI: 1.0-13.7; p = 0.04) than in men with a waist circumference of <100 cm. Men with obesity and moderate-to-severe and severe ED were older compared to those without these disorders (67.1 ± 5.29 vs. 65.3 ± 4.35; p = 0.23). Conclusions: The prevalence of ED in men with coronary artery disease surpasses 90%. An increased body weight raises the risk of ED, with waist circumference proving to be a more reliable predictor of this risk compared to BMI. Physicians are encouraged to screen elderly patients with cardiovascular disease for ED and address obesity to enhance overall health.

Historical Perspectives on Disability in Egypt: Attitudes and Policies

This research paper examines the historical perspectives on disability in Egypt from ancient times to the modern era. The study uses a comparative approach to explore the attitudes and policies towards individuals with disabilities in different historical eras, including ancient Egypt, ancient Rome and Greece, ancient civilizations in China, India, and Persia, through the Islamic era, and the colonial period under French and British occupation. To conduct this research, a multi-disciplinary methodology was employed, including a review of historical literature and primary sources, as well as an analysis of art, architecture, and cultural artefacts. The research sheds light on the evolution of attitudes towards disability in Egypt, including the role of religion, philosophy, and social norms in shaping perceptions of disability. The study also examines policies and initiatives aimed at supporting individuals with disabilities throughout history, such as philanthropic organizations, schools, and rehabilitation centres. The research findings have significant implications for contemporary policies and practices concerning individuals with disabilities in Egypt and other countries. Understanding the historical context of disability in Egypt can inform current efforts to promote inclusion, accessibility, and human rights for people with disabilities. Keywords: disability, Egypt, attitudes, policies, historical perspective, comparative approach