Epidiological study of depressive disorders among patient attending outpatient clinics of Assiut University Hospital

Depression is a common mental health problem, seen frequently in general medical settings. Primary care physicians are more likely to see patients with depression than with any other disorder except hypertension. To estimate the percentage of depressive disorders among patients attending outpatient clinics of Assiut University Hospitals, and to study the possible risk factors underlying these depressive disorders. This cross-sectional study was conducted during one year period from June 1[st] 2006 to May 31[st] 2007. 2034 subjects aged 15 and above were screened for depression using Beck Depression Inventory [BDI] scale. Subjects who scored 4 or more were further evaluated through psychiatric sheet especially prepared for the present work. Psychiatric diagnosis was made on the basis of DSM-IV TR criteria. Patients were also subjected to Suicidality sheet of the MINI plus and Sheehan Disability Scale. Depression was found in 202 subjects representing 8.8% of the whole sample, with 167 patients [82.7%] were classified as having major depressive disorders, 28 patients [13.9%] were assessed to have depressive disorder NOS [26 patients [12.9%] with minor depression and only 2 patients [1%] with postpartum depression], 5 patients [2.5%] were diagnosed with dysthymic disorder and finally 2 patients [1%] with bipolar disorder, depressive episode. Depression was significantly higher among female subjects, highly educated and literate individuals, non-working males and among divorced/widowed/separated individuals. Depressive disorders were also significantly higher among patients with Dcertain medical conditions [e.g. malignancy, disfiguring conditions, autoimmune conditions, renal diseases and hepatic diseases] and among those who had more medical conditions. The degree of impairment is significantly higher among patients with moderate and severe depression and particularly in patients with severe depression with psychotic features. Suicidality is significantly higher among patients with severe depression and particularly among patients with severe depression with psychotic features. Depression is a common mental health problem, seen frequently in general medical settings and necessitates close psychiatric attention and management

Colonic bilharzioma - dramatic complication of schistosomiasis: report of ten cases

Bilharzioma implies a localized mass of fibrous and inflammatory tissue, which usually contains many eggs, frequently involving serosa and mesentery. Bilharzioma is probably caused by reaction to numerous eggs produced by one or more pair of worms in a single site. The aim of this study is to present the management of a group of patients had colonic bilharzioma presented with abdominal masses and intestinal obstruction. Ten patients presented with abdominal masses and intestinal obstruction. Complete blood count, urinalysis, stool analysis, and abdominal ultrasonography done in all the patients of the study. Barium enema done in 5 patients. Abdominal computed tomography done in 6 patients. All the patients of the study had been subjected to laparotomy. There were 7 males and 3 females, their ages ranged from 8 to 42 years [mean 14.2 years]. All the patients had abdominal pain [100%], 6 patients presented with abdominal mass [60%], and 4 patients presented with intestinal obstruction [40%]. There was microcytic hypochromic anemia in 9 patients [90%] and leukocytosis with eosinophilia in 7 patients [70%]. Abdominal US revealed presence of lymphoma versus teratoma in 6 patients [60%] and signs of intestinal obstruction in 4 patients [40%]. Barium enema revealed presence of multiple polyps throughout rectosigmoid colon, with loss of haustrations and spasm of descending colon in 3 cases. CoIonic wall thickening with narrowing and rigidity of the ascending colon in 2 cases. Abdominal CT revealed presence of colonic wall masses suggestive of lymphoma in 6 cases. In laparotomy, there were 4 rectosigrnoid bilharzioma, bilharzioma of the transverse colon down to the upper rectum in 3 patients and ascending colonic bilharzioma in 3 cases. Histopathology confirmed presence of bilharzial granuloma in all surgical specimens. Always consider bilharzioma in differential diagnosis of abdominal masses and intestinal obstruction, especially in countries where it is endemic. Rectal examination is an important and integral part of abdominal examination in such cases and biopsy is a must in presence of palpable nodules

Colonic bilharzioma; surgical intervention versus conservative treatment

Bilharzioma implies a localized mass of fibrous and inflammatory tissue, which usually contains many eggs, frequently involving serosa and mesentery. Bilharzioma is probably caused by reaction to numerous eggs produced by one or more pair of worms in a single site. The aim of this study is to compare between surgical intervention and conservative treatment in a group of patients had colonic bilharzioma presented with abdominal masses and intestinal obstruction. Ten patients presented with abdominal masses and intestinal obstruction. Complete blood count, urine analysis and stool analysis done to all the patients of the study. Abdominal ultrasonogiaphy done in all the patients of the study. Abdominal computed tomography done in 6 patients. Barium enema done in 5 patients. All the patients of the study had been subjected to laparotomy. There were 7 males and 3 females, their ages ranged from 8 to 42 years [mean 14.2 years]. All the patients had abdominal pain [100%], 6 patients presented with abdominal mass [60%], and 4 patients presented with intestinal obstruction [40%]. There was microcytic hypachromic anemia in 9 patients [90%] and leukocytosis with eosinophilia in 7 patients [70%]. Abdominal US revealed presence of lymphoma versus teratoma in 6 patients [60%] and signs of intestinal obstruction in 4 patients [40%]. Barium enema revealed presence of multiple polyps throughout rectosigmoid colon, with loss of haustrations and spasm of descending colon in 3 cases. Colonic wall thickening with narrowing and rigidity of the ascending colon in 2 cases. Abdominal CT revealed presence of colonic wall masses suggestive of lymphoma in 6 cases. In laparotomy, there were 4 rectosigmoid bilharzioma, bilharzioma of the transverse colon down to the upper rectum in 3 patients and ascending colonic bilharzioma in 3 cases. Histopathology confirmed presence of bilharzial granuloma in all surgical specimens. Always consider bilharzioma in differential diagnosis of abdominal masses and intestinal obstruction, especially in countries where it is endemic.Biopsy is a must as clinical examination laboratory and radiological methods are not diagnostic