Attitudes toward Help-seeking Counseling, Stigma in Arab context: A Systematic Literature Review

@#Researchers have found that most citizens of the Arab world are reluctant to look out for assistance from psychologists and counselors because of negative help-seeking attitudes. This article is a systematic review study, intends to explore the factors that affect attitudes toward counselling among citizens of the Arab region. Besides, this study is procured based on the definitions of attitudes toward psychological help-seeking, various factors affecting the attitudes, and suggestions to deal with obstacles. Electronic database was used to search for appropriate reading materials and hence, a total of 11 articles were found. Findings from different journal sources indicated that stigma, fear of self-disclosing, traditional healing methods, mental Illness conceptualization, culture and family, and religious leaders are still considered major barriers and discussed systematically. Finally, implications and suggestions for future interventional study conclude this article

Endovascular versus open surgical reconstruction in long segment superficial femoral artery occlusive disease

Background: The concept of endovascular intervention has been well supported by the continuous advance in technology in long segment [superficial femoral artery] SFA occlusions. The rapid evolution of stent design, deployment approaches and adjunctive therapy made the practice of [percutaneous transluminal angioplasty] PTA safer and more predictable and has reduced superficial femoral artey surgery

Objectives: To compare the safety and effectiveness of endovascular treatment versus open surgical bypass in treatment of superficial femoral artery occlusive disease

Patients and Methods: This prospective study included 30 patients presenting to the Vascular Department in Cairo University Hospitals with femoropopliteal occlusive disease for whom percutaneous transluminal angioplasty with or without stenting was done for 15 cases. Femoropopliteal bypass surgery with saphenous or synthetic graft was done for 15 cases between March 2017 and January 2018. The procedure, possible complications, benefits, risks and other alternative interventions were all explained to the patients and an informed consent was obtained

Results: In endovascular cases: 1/15[6.66%] cases, developed small haematoma at the site of puncture which resolved by conservative management. After 6 months follow up,6/15 cases [40%] had intact pedal pulsation, 6/15 cases [40%] had popliteal pulsation with marked improvement of their complaints [disappearance of rest pain in 3 cases, the other 3 cases which had gangrene, line of demarcation appeared]. 1/15 case [6.66%] showed popliteal pulse at 3 months follow up which disappeared at 6 months but the patient had good circulation with improvement of rest pain. So, successful cases were 13/15[86.66%] at 6 months follow up. 2 /15 cases[13.33%] showed occlusion, by Duplex 1 case of them showed occlusion of stent and 1 case showed return to original occlusion. In open surgical cases: Postoperative wound infection at groin incision developed in 3/15[20%] cases, 2 cases of them were managed conservatively by IV antibiotic and repeated dressing, and one developed secondary haemorrhage in which ligation of femoral artery was done and the limb became gangrenous and Above knee amputation was done. After 6 months follow up, 5/15 cases [33.33%] had intact pedal pulsation, 7/15 cases [46.66%] had popliteal pulsation with marked improvement of their complaints. Disappearance of rest pain occurred in 3 cases, while 3 cases which had gangrene, line of demarcation appeared and 1 case which had non healing ulcer, healing of ulcer started to occur. So successful cases 12/15[80%] at 6 months follow up. Thus, 3/15 cases [20%] failed, 1 case developed wound infection at groin incision followed by secondary haemorrhage in which ligation of the graft was done, the limb was worsen ended in above knee amputation. The other 2 cases showed occlusion of graft, 1 case ended in above knee amputation, the other below knee amputation was done in which the stump became gangrenous followed by above knee amputation

Conclusion: Percutaneous transluminal angioplasty [PTA] has obtained a definite place in the management of peripheral arterial occlusive disease of the lower limb. It was widely accepted as a first line of treatment for many patients with SFA occlusive disease. The low complication rate and relatively non-invasive nature of PTA made it an increasing popular intervention

Parathyroid hormone in pediatric patients with b-thalassemia major and its relation to bone mineral density; a case control study

Background: Thalassemia syndromes are heterogeneous groups of inherited anemias. Its treatment depends on recurrent blood transfusion with a problem of iron overload, which leads to multiple endocrinopathies including hypoparathyroid. The aim of the study is to estimate the level of serum parathyroid hormone and its relation to bone mineral density in transfusion dependent beta-thalassemia major children

Subjects and methods: We measured serum calcium, phosphorus and parathyroid hormone in a sample of pediatric patients with thalassemia, compared them with age and sex matched healthy control. Measurement of bone mineral density by dual-energy X-ray absorptiometry was done in 2 sites: lumbar spine [L2-L4] in the anteroposterior position and left femur neck using Lunar Densitometry in osteoporosis Unit Ain Shams University Hospital for thalassemia patients

Results: Thalassemic patients had significantly higher alkaline phosphatase and lower bone mineral density

Conclusion: Osteopenia in b-thalassemia major patients is multifactorial and is mainly predisposed by defective function of the parathyroid gland and excessive iron deposition

Assessment of executive functions in chronic hepatitis c virus infected patients

Chronic infection with HCV is one of the most important causes of chronic liver disease, which can progress to cirrhosis and hepatocellular carcinoma [HCC]. It is well established that advanced forms of the disease .are accompanied by overt and global cognitive deficits [hepatic encephalopathy] but now there is a growing evidence that the alterations in cerebral function in patients with chronic HCV infection may appear long before the development of severe liver cirrhosis, it has been hypothesized that it is related to a direct effect of HCV on the brain; or the neurotoxic effect of HCV-related systemic inflammation. The purpose of the study was to assess the possible existence of executive dysfunction in chronic HCV infected patients without cirrhosis. case control study. 100 elderly patients aged 60 years and above, 50 patients are HCV positive [cases] and 50 patients are HCV negative [controls] both groups have no liver cirrhosis. All participants were subjected to the following: Diagnosis of HCV by detection of HCV ab using ELISA technique, non invasive assessment of liver cirrhosis using abdominal ultrasound, and evaluation of executive functions using 5 neuropsychological tests [block design, digit span backwards, animal verbal fluency, clock drawing, and EXIT 25]. The study showed that there is a significant difference between cases and controls regarding Exit 25 and Digit span backwards tests scores indicating affection of the phonological loop component of working memory among HCV positive patients. Executive functions are affected in patients with chronic HCV infection without liver cirrhosis

Prevalence of HBV and HCV infection among multi-transfused Egyptian thalassemic patients

Though regular blood transfusion improves the overall survival of patients with p-thalassemia, it carries a definite risk of infection with blood-borne viruses. The present study was carried out to estimate the real frequency of hepatitis B virus [HBV] and hepatitis C virus [HCV] among Egyptian P-thalassemic patients, and determine the infection-associated risk factors in these patients. A prospective study conducted in a university hospital from January 2009 to January 2010. Two hundred patients with p-thalassemia major were enrolled in this study. Using enzyme-linked immunoabsorbent assay [EEISA], their sera were tested for hepatitis B surface antigen [HBsAg], antibody to hepatitis C core antigen [anti-HBc], and HCV antibody [HCV Ab]. The positive HCV Ab results were confirmed by second generation recombinant immunoblot assay [RIBA]. The study sample consisted of 111 males and 89 females, with a median age of 13 years. Eighty-one [40.5%] patients were HCV Ab positive by ELISA and 39 [19.5] were anti-HCV positive By RIBA; 58 [29.0%] were HBsAg positive and 13 [6.5%] were anti-HBc positive. Older age, an increased number of transfusion units, and HBsAg seropositivity were significantly associated with a higher prevalence of HCV and HBV. The prevalence of HCV and HBV infections are very high among Egyptian p-thalassemic patients, which calls for a critical look into the prevailing transfusion practices and adoption of stricter donor selection criteria to decrease the incidence rate of both HCV and HBV infections effectively. Furthermore, there is a compressing need for the use of more specific and sensitive methods for HCV testing in Mansoura University Hospitals

Social phobia among secondary school students: a comparative study between Egypt and Saudi Arabia

To assess the prevalence and Risk factors of social phobia [SP] among Arab secondary school students in Egypt, and Kingdom of Saudi Arabia [KSA]. This study was conducted in 2 Cities belonging to 2 Arab Countries, Cairo [Egypt], Abha [KSA]. In Cairo Adolescents were enrolled from schools of Al-Azhar Secondary schools. On the other hand, those in Abha [KSA] were enrolled through the primary care service of the school health programs in both areas. The study sample from each city comprised 400 adolescents [200 boys and 200 girls]. Study tools included the social phobia inventory and the social phobia Risk Factors Questionnaire. Prevalence of SP is higher in Cairo [13%], followed by that in Abha [9.8%]. Differences were statistically significant [p=0.044]. In Cairo only, risk factors for SP included being a female [p=0.038], or being a first born child] [p=0.036]. Moreover, in all study settings, other risk factors included punishment by parents or teachers, either physically by battering, or psychologically by humiliation, having a positive family history of mental disorder or frequent marital conflict among parents. SP is a common mental disorder among Arab secondary school children. Its prevalence is highest among Egyptian School children, where it affects more girls than boys. Risk factors include physical or psychological child punishment or abuse, having a positive family history of mental disorder and parental marital conflict. Physical and/or emotional punishment should be avoided. School health programs should include screening for SP. Diagnosed cases should be referred for psychiatric and behavioral management

Psychiatric, psychological and behavioral problem in Egyptian and Saudi adolescent orphans: a comparative study

To determine psychiatric, behavioral andpsychological problems in Egyptian and Saudi adolescent living in orphanages in a comparative study. 50 Saudi adolescent orphans [25 boys and 25 girls] and 50 Egyptian adolescent orphans [25 boys and 25 girls], 50 controls Saudi and 50 controls Egyptian psychiatrically free adolescent were also randomly selected. Psychiatric and psychological assessment using: complete psychiatric sheet, psychometry for psychopathy and aggression, ego strength, rigidity, locus of control, and SAKS which included Sexual Deviation, Relation with others, Negative attitude toward institutions, and Abnormal Behaviour. [44%] of girls and [44%] of boys showed Attention Deficit Disorder [ADD]. Also,[40%] of Egyptian boys and girls showed ADD. There was a statistically significant difference between orphans and controls Saudi girls regarding all items of psychological assessment. Orphans and control Saudi boys showed a statistically significant difference for ego strength, psychopathy, sexual deviation, and negative attitude toward home, abnormal behaviour and relation with others. There was a statistically significant difference between orphans and controls Egyptian girls and boys regarding all items of psychological assessment except for locus of control. Egyptian and Saudi orphan boys differed in all items of psychological assessment except for rigidity. Egyptian and Saudi orphan girls differed in for ego strength, sexual deviation, and negative attitude toward home, abnormal behaviour and relation with others. Saudi and Egyptian adolescent orphans showed psychiatric, psychological and behavioural problems, ADHD was the highest psychiatric diagnosis in both Saudi and Egyptian orphans, Orphans had disturbances in ego strength, psychopathy, sexual deviation, locus of control, negative attitude toward others, abnormal behavior and relation with others. There was cultural related difference in psychometric assessment for orphans

Adherence to medications in a group of Bahraini and Egyptian patients with bipolar mood disorder

The aim of this study was to identify predictors of non-adherence to medications in a group of bipolar mood disorder patients as well as the trans-cultural differences in non-adherence among them. Participants were 51 Bahraini and 53 Egyptians patients with bipolar mood disorder who had been prescribed medications within the past 12 months. Treatment adherence was evaluated by self-report of these patients. There was a distinction between intentional non-adherence [e.g., alteration of medication regimen to fit one's needs] and unintentional non-adherence than developing manic episodes for getfuiness]. No cultural group differences in intentional non-adherence were suggested. Egyptian patients reported significantly more unintentional non-adherence than Bahraini patients. however, once other predictors were entered into the model, cultural difference did not remain a significant predictor. After controlling for cultural factor and medication type, intentional non-adherence was associated with perceiving medication as less important, concerns about the side effects of medications and the stigma associated with medications. Unintentional non-adherence was associated with co-morbidity of drug abuse and development of manic episodes. results suggest no cultural difference in terms of barriers to adherence to medications. Interventions to increase adherence the bipolar patients. Drug education and information about the illness and its co-morbidity with drug abuse might help the patients and families

Prevalence study of psychiatric morbidity in a sample of adolescents in secondary schools in new Damietta City-Egypt

Few studies have estimated the psychiatric morbidity among adolescents in secondary schools in Egypt. The objectives of this study were to describe such disorders, identify those students with problems, and evaluate the relationship between their problems and some variables related to them. From September 2008 till April 2009. The study was done on 542 students [263 male [48.5%1 and 279 female [51.5%J], age range 15-18 years; those in urban 333 [61.4%] while in rural area 209 [38.61 with exclusion of deaf and blind. The researcher used Child and Adolescent behavior checklist, General health Questionnaire [GHQ], Clinical interview. Students with+ve score on GHQ were clinically interviewed, and the diagnosis of psychiatric disorders were done according to the diagnostic and statistically manual of mental disorder fourth version revised version [DSM IV TR]. About [22%] of Secondary school adolescents suffers from one or more of the psychiatric disorders as follows; Depression 21.4%, ADHD 15.9%, GAD 12.6% Adjustment disorder 12.6%, OCD 9.5%, conduct disorder 6.3%, Oppositional deviant dis. 5.6%, Separation anxiety dis. and Motor tics 4.8%, nocturnal enuresis 3.9%, social phobia 2.7%, no one complained of drug abuse or psychotic dis. The following socio demographic risk factors are statistically correlated to the psychiatric morbidity, age, sex, number of brothers, economic status and place of living. The mental health of Secondary school adolescents should be assessed, as they may be at risk for mental health problems. Preventive and therapeutic interventions are recommended

Cognitive dysfunctionin among schizophernic: first episode versus chronic patients

To compare the cognitive functioning of a sample of patients experiencing their first episode of schizophrenia with that of patients with an established schizophrenia illness. Thirty patients who were experiencing their first episode of schizophrenia. Thirty patients with an established schizophrenia illness and thirty control subjects volunteered to undergo the procedures. The cases were recruited from psychological medicine hospital [Kuwait]. All patients met DSM-IV criteria for diagnosing schizophrenia [group II, III]. All the three groups underwent Wechsler Adult Intelligence Scale [WAIS], Wisconsin Card Sorting Test [WCST]. Wechsler Memory Scale [WMS] and Positive and Negative Symptom Scale [PANSS], this related only to group II and III [patients groups]. Socio demographic characteristics of study sample showed that the mean age in years in group I is 27.77, in group II is 24.87and in group III is 31.37 the study revealed cognitive impairment in the early first-episode schizophrenia either IQ, memory or executive function, the study showed no relation between these cognitive deficits and the demographic variables, in both groups II and III with cognitive deficits. These results support the findings of previous studies suggesting that first-episode patients demonstrate cognitive impairments similar to those of patients with an established schizophrenia illness

Quality of life and coping among caregivers of diabetic and epileptic children in Kuwait: a comparative study

To compare the quality of life and coping capacity among primary care givers of Insulin Dependent Diabetes Mellitus [IDDM] children and epileptic ones. The study included 40 primary care givers of children with IDDM and 40 caregivers of children with benign childhood generalized absence seizures. The care givers of both diseased children were subjected to World Health Organization Quality of Life Brief scale [WHO QoL Brief] and Abdel Basset Coping Scale. There are statistically significant differences between the two groups in all domains of WHO QOL Brief and coping scores including total, active coping, emotional, emotional based cognitive processes indicating that quality of life and coping abilities are better for caregivers of diabetic children than those of epileptic ones. Also there is statistically significant correlation between those having IDDM boy, higher educational level of the caregivers and lower scoring on quality of life and coping capacity. In care givers of epileptic children significant correlation noted between duration, frequency of seizure, number of antiepileptic drugs, having an epileptic girl, higher educational and occupational status of care givers and poor quality of life and impaired coping capacity. Caregivers of epileptic children have poor quality of life and impaired coping capacity than those of IDDM children. This may increase the need for educational and psychological support to improve the quality of life and alleviate burden experienced by family having diabetic and epileptic child, especially family having an epileptic child

study on the ages of union of epiphyses at the elbow, wrist, hand, knee, ankle, and foot regions in a sample of Egyptian population in the East of Delta on the beginning of the 21st century

In the present work, 765 X-ray photographs for males and 450 for females from a sample of clinically healthy Egyptian population in the east of Delta, in the age range of 9-25 years, were examined for epiphyseal union in the regions of the elbow, wrist, hand, knee, ankle, and foot. The epiphysis was considered united if there was complete obliteration of the diaphyseo-epiphyseal space, and non- united if there was no or partial obliteration of diaphyseo- epiphyseal space. The results showed that epiphyseal union occurs over a range of 4-6 years in males and 4-5 years in females, and the union was 1-2 years earlier in females than in males. Comparison of results of the present study with results of other studies performed earlier or in other localities demonstrated the existence of differences in age timing and sequence of union of the studied epiphyses. The differences were more marked on comparing the present study with a study performed on Bengalis than with a study performed on Caucasians. This raises the importance of developing and updating the standards of ages of epiphyseal union for each locality to achieve more accuracy of age estimation by examining bone epiphyses. Examining more than one epiphysis for age estimation is also recommended

Lead enhances neutrophil apoptosis in albino rats

The present work was conducted to study the effect of lead, after in vivo and in vitro exposure, on neutrophil apoptosis in albino rats. For the in vivo study, adult female albino rats, with body weight range of 150-250 g, were randomized into test and control groups, 20 rats/group. Test groups were treated with lead acetate solution in distilled water by intraperitoneal injection at two dose levels [20 mg/kg body weight or 40 mg/kg body weight for either 4 weeks or 12 weeks for each dose level]. Control groups were treated with distilled water by intraperitoneal injection for either 4 weeks or 12 weeks. For the in vitro study, neutrophil cultures were prepared from 20 rats and each test culture was divided into two subdivisions and incubated for 24 hours with lead acetate at 2 concentrations, 20 or 40 mmol/ml cell culture. Control cultures were prepared from other 20 rats. Apoptosis was assessed morphologically by light microscope using Giemsa stain, fluorescence microscope using acridine orange stain and by assessment of DNA fragmentation by agarose gel electrophoresis

Lead modulates T lymphocyte functions in albino rats

The present work was performed to study the effects of subchronic and chronic in vivo exposure to lead on some parameters of T lymphocyte functions; namely, interferon-gamma [IFN-gamma] production and mitogen blastogenesis in albino rats. Adult female albino rats, with body weight range of 150-250 g, were randomized into test and control groups, 20 rats/group. Test groups were treated with lead acetate solution in distilled water by intraperitoneal injection at two dose levels [20 mg/kg body weight or 40 mg/kg body weight for either 4 weeks or 12 weeks for each dose level]. Control groups were treated with distilled water by intraperitoneal injection for either 4 weeks or 12 weeks. The results showed that lead exerted immunomodulatory effects on the studied immune parameters. It decreased gamma-IFN serum levels and enhanced blastogen transformation of lymphocytes in a dose and time-dependent manner. These results showed that lead differently affects T cell subpopulations. Dysregulation of the immune function may be the end result

Plasma leptin levels in glucocorticoid treated patients and in simple obesity

Plasma leptin in relation to other hormones [cortisol and insulin] was studied in 50 women [26 on corticosteroid therapy and 24 with simple obesity] in addition to 10 healthy lean age matched females served as controls. Plasma leptin levels were significantly higher in both corticosteroid treated patients and those with simple obesity compared with the controls. Plasma leptin levels were significantly correlated with body mass index [BMI], serum levels of cortisol and insulin. Patients treated with corticosteroids showed a higher mean value of plasma leptin levels than those with simple obesity in spite of the higher BMI in the latter group. Also, the group of patients who received prednisone therapy in a dose of >/20 mg/day showed significantly higher leptin levels than the group receiving lower doses of prednisone [<20 mg/day] in spite of the higher BMI in the latter group