Effect of different frequencies of repetitive transcranial magnetic stimulation on motor function recovery after acute ischemic stroke

Although there is some early evidence showing the value of repetitive transcranial magnetic stimulation [rTMS] in stroke rehabilitation, the therapeutic effect of high-frequency rTMS, has not been established. The aim of this study is to investigate the effect of different frequencies of rTMS on motor cortical excitability on the affected and non affected hemisphere and to detect the best frequency used to enhance motor recovery in acute stroke patients. Forty eight patients with acute ischemic stroke of middle cerebral artery territory participated in the study [24] males and [24] females. The patients were randomly classified into three groups: Group 1 [included sixteen patients who received real rTMS with 3Hz]. Group 2 [included sixteen patients who received real rTMS with 10 Hz]. Group 3 [included sixteen patients who received sham rTMS with 3 Hz] for five consecutive days. Otherwise, patients continued their medical treatment. Each patient underwent complete neurological examination, CT and/or MRI of the brain, motor disability and functional ability, EEG and neurophysiological assessment before and after rTMS sessions. There was significant improvement in patients who received real rTMS in comparison to the sham rTMS group regarding motor power recovery and all stroke scales scores. The improvement was concomitantly associated with cortical excitability changes. High-frequency rTMS provides a fast, effective, painless, non invasive treatment for motor disorders during the rehabilitation of acute stroke patients

Differential aspects of consultation-liaison psychiatry in a Saudi hospital. I: referral pattern and clinical indices

Consultation-liaison psychiatry has emerged as an important sub-specialty in the general hospital setting during recent years as a result of psychiatric acute wards moving into these hospitals. This has inspired the need for better structured research to establish its relevance and effectiveness. We, therefore, carried out a prospective cohort study at King Fahad General Hospital. We report the interaction of sociodemographic, clinical and diagnostic factors, time lag of referral and diagnostic ability of referring physicians. A total of 206 patients were referred over a period of 6 months. Sensitivity and specificity of the diagnostic skills of the referring doctors were found to be generally poor, particularly for anxiety

Differential aspects of consultation-liaison psychiatry in a Saudi hospital. II: knowledge and attitudes of physicians and patients

To assess the attitude and knowledge of physicians and patients towards psychiatry, we asked 115 referring doctors and 188 referred patients to complete questionnaires. We examined the results along with the referral rates to try to identify factors that may affect a consultation-liaison psychiatry service. Generally, knowledge was poor and attitudes towards psychiatry negative in both groups. This negatively influenced the referral rates and reflected the lack of integration of psychiatry and medicine at the training level. This is an indication that psychiatrists need to work in collaboration with hospital doctors to integrate psychiatry into medicine at all levels and emphasizes the priority of education of hospital staff, patients and the community in consultation-liaison psychiatry

Effect of natural solubilizers on the solubility and dissolution of aceclofenac

Aceclofenac, an insoluble anti-inflammatory drug, was incorporated in solid dispersions using different carriers; namely, hen, fish and rabbit gallbladder contents as natural solubilizers and polysorbate 80, sodium lauryl sulfate, sodium deoxycholate and lecithin/sodium deoxycholate [1:1] mixture as synthetic solubilizers. The solubility and dissolution of aceclofenac were investigated at pH 1.2 and 7.4 as a function of the solubilizer concentration [0-2% w/w] in the prepared solid dispersion. At pH 1.2, in a concentration of 2% w/w solubilizer, the drug solubility and dissolution were improved. The solubility increased from 1.24 mg/ml to 11.65 and 11.5 mg/ml when using hen bile and polysorbate 80, respectively. Dissolution was found to be a function of solubility, especially in case of natural solubilizers and polysorbate 80. Simple and/or mixed micellar solubilization was the main mechanism suggested for the increased solubility and dissolution of the drug. The results were confirmed by surface tension measurements of the aqueous solutions of the plain drug and its solid dispersions. Differential scanning calorimetry [DSC] and infrared spectroscopy [IR] studies suggested the possible interactions between aceclofenac and some of the used solubilizers

Neural maturation of breast and formula fed infants

Human milk provides infants with a full complement of all polyunsaturated fatty acids, including docosahexaenoic acid [DHA] and arachidonic acid [AA]. Formula milks contain only the precursors of DHA and AA, and linoleic acid and hence formula fed infants must synthesize their own DHA and AA. This work aimed at evaluating the hypothesis that the method of feeding; whether breast feeding or formula feeding in early infancy affects subsequent neurodevelopment and achievement of optimum brain function [Visual system, auditory and Sensory system]. The present study includes 53 infants [at the age of one year +/- I month], 30 infants were exclusively breast fed and 23 infants were exclusively formula fed. Each infant was subjected to a full neurological examination and neurophysiological studies including, flash Visual Evoked Potentials [FVEPs], Auditory Brainstem Evoked Potentials [ABEPs], and Somatosensory Evoked Potentials [SSEPs]. There was significant prolongation in the P100 wave latency of FVEP in formula fed infants [96.4 +/- 9.0] compared with breast-fed infants [90.2 +/- 8.5]. There was a significant prolongation of absolute latency of wave I with subsequent prolongation of wave Ill and wave V in formula-fed infants group compared with breast fed infants group. Meanwhile, there was no significant differences between the two groups as regards to interpeak latencies. There was significant prolongation in interpeak latencies between cortical and Erb's components in formula fed infants compared with breast fed infants. There was no significant correlation between sex, consanguinity, sibbling number, order of birth, parental educational level, age of supplementation of foods, social level, head circumference, anterior fontanel and different variables of evoked potentials. VEP, BAEP and SSEP are more mature in breast fed infants relative to formula fed infants at one year of age. Consequently we can speculate that breast milk helps earlier development and maturation of some aspects of the nervous system than milk formulas

Study of certain epidemiological differentials associated with infertility

This study aimed to assess certain epidemiological differentials affecting the female infertility. The subjects of the study were 512 women; half of them were cases of infertile women and the others were the control normal fertile women. The case and control groups have the same life style nearly. The advanced age, high body mass index, low educational level, positive family history of infertility and consanguinity are more prevalent among infertile women than fertile ones. Also, the delayed age of marriage, increased frequency of intercourse per week, deep dyspareunia, history of lower genital tract infection, history of PID and history of pelvic or abdominal operation are more prevalent among infertile women than fertile ones

Improvement of dissolution of terfenadine by recrystalliza-tion

Trials to recrystallize terfenadine [an antihistaminic drug] from alcoholic solution of Tween 80, polyethylene glycol [PEG] and polyvinyl pyrrolidone [PVP] were carried out. The prepared crystals were investigated by means of x-ray diffraction, differential-scanning calorimetry [DSC], IR spectroscopy as well as spectroscopy and dissolution studies. Marked enhancement in the drug dissolution rate from the formed crystals was observed. The enhancement was found to be a function of the polymer molecular weight as well as its solution concentration. X-ray diffraction, DSC and IR studies revealed different polymorphic and /or pseudopolymorphic forms of the drug

Benzodiazepines in developing countries: not for damnation yet

Since their introduction in the 1960s, benzodiazepines [BZDs], have readily gained a wide popularity and become one the most widely prescribed psychiatric drugs. However, they have recently come under a critical reappraisal, on account of their potential harm if abused, or dependence with long term use. Consequently, many psychiatrists have become over reluctant to prescribe these drugs, to the extent that many patients, even those severely anxious, who will never live normally without BZDs, or a similar substitute have been refused to them. We studied 400 case notes of patients diagnosed as suffering from anxiety or a related disorder in two different hospitals to find out the pattern of BZD prescriptions in Saudi Arabia. We found that the pattern is inconsistent and varies significantly between the two hospitals, and not necessarily for medical reasons. We highlight the danger of such attitudes, and the place of BZDs in developing countries

pattern of admission to Jeddah Psychiatric Hospital

We studied all the case notes of patients admitted to Jeddah Psychiatric Hospital in a period of 1 year, aiming at delineating the pattern of admission and the related sociocultural factors. In spite of the difficulties and drawbacks inherent in such retrospective studies on hospital populations, few, but albeit, significant intrasample differences emerged due to sex. In contrast to the universal excess of females among psychiatric patients, we found males always outnumbering females with a ratio of 2 to 1 as out-patients and in-patients. Females were also found to have a better chance of getting married in the presence of mental illness, but showed higher rates of divorce. Other significant differences due to sex were the length of stay in hospital per index admission and the nature of symptoms prevailing in the period immediately before admission

Availability of piprofen from tropical vehicles

Films of ethyl cellulose [EC], hydroxy propyl methyl cellulose [HPMC] and mixture of them were investigated as a transdermal delivery system for pirprofen in comparison with Pluronic F 127 and carboxy methyl cellulose [CMC] gels. The results were given in details