Cross-sectional, hospital-based analysis of headache types using ICHD-3 criteria in the Middle East, Asia, and Africa: the Head-MENAA study.

BACKGROUND: Headaches are frequent neurological disorders that are yet to be unveiled and treated comprehensively worldwide. Bearing in mind that the distribution of headache subtypes in neurology clinics (NC) is essential for planning appropriate diagnostic and therapeutic approaches, the primary goals of this multi-centric study are to carry out inter-regional comparisons by using current diagnostic criteria with evaluations of neurologists to delineate headache burden. METHODS: A cross-sectional study between April 1 and May 16, 2022 was conducted with the participation of 13 countries from the Middle East, Asia, and Africa. Patients were included in the study on a specific day each week during five consecutive weeks. All volunteers over the age of 18 and whose primary cause for admission was headache were examined. The patients admitted to NC or referred from emergency services/other services were evaluated by neurologists by means of the International Classification of Headache Disorders (ICHD-3) criteria. RESULTS: Among the 13,794 patients encountered in NC, headache was the primary complaint in 30.04%. The headache patients' mean age was 42.85 ± 14.89 (18-95 years), and 74.3% were female. According to the ICHD-3 criteria, 86.7% of the main group had primary headache disorders, 33.5% had secondary headaches, 4% had painful cranial neuropathies along with other facial and headaches, and 5.2% had headaches included in the appendix part showing some overlapping conditions. While the most common primary headache was migraine without aura (36.8%), the most common secondary headache was medication-overuse headache (MOH) (9.8%). Headaches attributed to COVID-19, its secondary complications, or vaccines continue to occur at rates of 1.2%-3.5% in current neurology practice. Pain severity was significantly lower in Ivory Coast and Sudan than in Türkiye, Turkish Republic of Northern Cyprus, Iran, Egypt, Senegal, Tatarstan, and Azerbaijan (p < 0.001). CONCLUSIONS: The study showed that migraine is still the most common motive for admissions to NC in different regions. Furthermore, MOH, an avoidable disorder, is the most common secondary headache type and appears to be a significant problem in all regions. Remarkably, pain perception differs between regions, and pain intensity is lower in Africa than in other regions.

Determining the anxiety of athletes during Covid-19 pandemic

Aim: The purpose of this study is to determine the state-trait anxiety of athletes during Covid-19 pandemic. Method: The study was performed by using survey method. The research population is composed of a total of 224 adult athletes (Xage=26.24±8.50) as 139 males (Xage=27.71±9.81) and 103 females ( Xage=24.25±5.72) engaged in individual and team sports in different branches in Marmara region (Istanbul, Kocaeli and Sakarya). The athletes have 13.73±8.65 years of experience in sports. "State-Trait Anxiety Inventory" developed by Spielberger et al. (1970) and adapted into Turkish by Oner and Le Compte (1983) and "Personal Information Questionnaire" prepared by the researchers were used as the data collection tool. Data were analyzed by using descriptive statistics, independent groups T-test, one-way variance (ANOVA) analysis and Pearson correlation analysis. Findings: State anxiety scores of athletes significantly differ by such conditions as being a national athlete, fear of Covid infection, damaged performance in Covid infection, doing exercise at home during Covid infection and weight change during Covid (p<.05) while they do not significantly differ by gender and monthly income perception (p>.05). Trait anxiety scores of athletes significantly differ by being a national athlete, fear of Covid infection, damaged performance in Covid infection, doing exercise at home during Covid infection, monthly income perception and weight change during Covid (p<.05) while they do not significantly differ by gender (p>.05). Moreover, significant negative relationship was established between state anxiety scores of athletes and the time of exercise during pandemic (p<.05) while no significant relation was found regarding age, year of sports and duration of sleep during pandemic (p>.05). Negative significant relationships were found between trait anxiety scores and age, year of sports, and time and day of exercise;positive significant relationships were found between trait anxiety and duration of sleep in pandemic period (p<.05). Conclusion: It has been concluded that state anxiety scores of athletes are over average, their trait anxiety scores are below average and state-trait anxiety scores differ by some demographic variables while they are in relation with some others.

Early-Responding Civil Society and a Late Coming State: Findings from Turkey during the Pandemic

By building on available literature and interview notes with the NGOs working mainly on refugees and irregular migrants, this study examines the experiences of civil society in Turkey in the first 6 months of the COVID-19 pandemic. One of the main findings is that NGOs responded quite early and with agility to the sufferings of people before the state entered into the field and implemented its own rules and methods to deal with the crisis. The study also reveals that the pandemic affected the focus of the NGOs, their services, finances, and working methods in the field. The organizations we examined adapted to a new online working environment which increased demand for their services and aggravated difficulties in assuring clients access to needed healthcare services. The study finds that relations with the local and central governments remain difficult, and during the pandemic, the NGOs were compelled to act very cautiously. While suffering from their society's political polarization, they report that xenophobia continues to rise and has been worsened by the impact of the pandemic. © 2021 Erhan Doǧan and H Deniz Genç, published by De Gruyter, Berlin/Boston.