[Prevalence and correlates of major depressive episodes in Sousse primary care setting: assessment with Tunisian version of CIDI

Major depression is a mental disorder that is associated with high morbidity and significant mortality. It is common among primary care attenders. Few is known about major depression prevalence and associated factors, which would prevent general practitioners from diagnosing it in primary care centres and treating it adequately. To determine prevalence and correlates of major depressive episodes [MDE] in a representative sample of primary care attenders in the area of Sousse [Tunisia]. A random and representative sample of primary care attenders was obtained by a two-stage sampling procedure. First, 30 primary care centres [20 urban and 10 rural] were selected, with stratification according to residency location. Second, 1246 consenting participants were systematically recruited among those centres attenders. Participants were screened, by trained interviewers, with Tunisian version of " Composite International Diagnostic Interview " CIDI.2.1. After data entry in ishell program, MDE diagnosis was obtained according to ICD-10 criteria. Mean age in our sample was 43.4 +/- 17.62 years, with feminine [70.9%] and urban [67.8%] predominance. MDE was found in 26.4% of participants. Associated factors were female gender, marital statute of widowed or divorced and rural residency. This study provided data about high prevalence of MDE in the area of Sousse primary care centres and its correlated factors

Esophageal Involvement in Behcet's Disease

Esophageal involvement in Behcet's disease is very rare, and normally is observed as aphtosis and esophagitis, but serious complications such as erosions, perforations, and stenosis may occur. We carried out this prospective study to evaluate the prevalence of esophageal involvement in Behcet's disease and to establish if routine endoscopy and/or manometry are necessary. Twenty-three patients who fulfilled the diagnostic criteria of the international study group for Behcet's disease were enrolled. None were taking drugs or had disease that might produce esophageal abnormalities or alter any existing changes due to the Behcet's disease itself. Twenty- three patients underwent esophagogastroduodenoscopy by a single observer. Esophageal biopsies were performed in thirteen patients and esophageal manometry in twenty. At the beginning of the study, the disease activity was defined by the presence of more than one symptom related to Behcet's disease, and upon the classification of Behcet's disease. Of the twenty three patients enrolled two were excluded from final analysis because of the presence of hiatus hernia. Thus, 13 men and 8 women, ranging in age from 20 to 63 years with a mean age of 36.2 years were included. Ten patients (47.6%) had active disease and four (19%) complained of upper gastrointestinal symptoms at the time of the study. Fourteen patients had endoscopic, manometric and/or microscopic abnormalities. Esophageal manometry was performed in twenty patients and was abnormal in 7 cases (35%). Esophageal biopsies were done in 13 patients and revealed histopathological abnormalities in 5 cases. Microscopic findings showed vasculities in one case, and non-specific inflammatory infiltration mainly consisting of neutrophils in 4 cases. Our results suggest that the prevalence of esophageal involvement in Behcet's disease is rather high and occur even in asymptomatic patients, but that this usually does not result in specific abnormalities.