Patients and Relatives' Perspectives about Electroconvulsive Therapy (ECT) In Khartoum, Sudan

@#Lack of knowledge and inappropriate attitude towards electroconvulsive therapy (ECT) treatment may affect the outcome of psychiatric’s morbidity and mortality. However, less systematic studies have been done on this area. This study aimed to assess the patients’ and relatives’ perspectives, i.e. knowledge, attitude and compliance on ECT in Khartoum State, Sudan. This was an observational hospital-based study conducted among 103 psychiatric patients and their relatives respectively who visited the Taha Basher and Eltigani Elmahi psychiatric hospitals during 2016. Both the patients and their relative inquired about different criteria of knowledge and attitude towards ECT. The percentage of score was calculated based on their positive answers by selecting the most appropriate answer or by calculating the mean of many positive answers. All the data were collected through a pre-designed questionnaire, and further analyzed statistically. Male was represented 61 (59.2%) and the commonest age group of patients was 16-30 years. The overall score of knowledge towards ECT among patients and their relative was 54.9% and 59.4%, respectively. Acceptance on the use of ECT were agreed by 43.7% of patients and more than 70% of patients and their relatives believed giving ECT for emergency psychiatric cases. Psychiatrist was the most frequent source of information reported by both patients (73.8%) and relatives (67%). Male relatives showed significantly higher attitude of recommending ECT treatment (p=0.004) for other patients. Patients and their relatives were reported to have moderate and better knowledge and attitude towards the use of ECT, respectively.

Angioplasty and stenting of symptomatic vertebral artery stenosis. Clinical and angiographic follow-up of 206 cases from Northwest Iran.

Percutaneous transluminal angioplasty (PTA) has recently become a noteworthy treatment option for significant stenosis involving the vertebral artery (VA) in selected patients. We conducted a prospective study to evaluate the efficacy, safety and mid-term follow up results of 206 cases received PTA with or without stent implant to treat their symptomatic atherosclerotic VA stenosis in all segments (V1-V4). In a prospective mono-arm trial from October 2008 to July 2012 in a single center, 239 lesions affecting the intra or extracranial VA (171 in V1, 17 in V2, 14 in V3, 21 in V4 and 16 in combined segments) were treated by PTA with or without stent implant. Non-disabling stroke patients who had failed conservative medical treatment and had angiographic evidence of >50% stenosis in the dominant VA with clinical signs and symptoms of VB stenosis were included in this study. They were mean followed for 13.15±5.24 months after treatment. Overall, 206 patients underwent the procedure. A stent was implemented in 199 patients (96.6%). The periprocedural complication rate was 7.2%. The procedural (technical) success rate was 97.6%. Of the total 239 lesions, 223 were treated with stent implant. Clinical success was achieved in all 206 symptomatic patients after the procedure. Restenosis occurred in 15.9% after a mean 10.8 (6-24) months. Of those, 63.1% and 34.2% had mild and moderate stenosis that was treated medically, whereas one case (2.6%) with severe restenosis underwent balloon angioplasty. No deaths occurred during the follow-up period. The follow-up complication rate was 6.3%. TIA occurred in 4.4%, a minor stroke in 1.4% and a major stroke in one patient. The overall patient event-free survival was 92.4%. These results demonstrate the safety and feasibility of PTA with or without stent implant, with a high technical success rate, a low complication rate, a low restenosis rate and durable clinical success in patients with symptomatic VA stenosis. This approach seems to improve patients' immediate and mid-term clinical results. Randomized controlled trials are necessary to further validate this treatment option.

Polycystic ovary syndrome and migraine headache, is there any correlation?

BACKGROUND: To evaluate the role of some sex hormones in migraine headaches, the aim of this study was to assess the prevalence and characteristics of headache, especially migraine, in patients with polycystic ovary syndrome (PCO) compared with women without this disease. METHODS: One hundred and thirty-three women with PCO and 107 controls were interviewed by 2 neurologists experienced in headache diagnosis. The headache disorders were classified according to the International Headache Society criteria. The statistical significance was determined using the chi(2) test, and a p value of <0.05 was considered significant. RESULTS: Forty-five women (33.8%) of the 133 cases without PCO complained of headache. Of the PCO patients, 48 women (44.9%) suffered from headache. The prevalence of headache was not significantly higher among women with PCO (p = 0.85). The same results were found for migraine headache (p = 0.13). CONCLUSION: Migraine is not more frequent in women with PCO. It was concluded that male sex hormones and especially testosterone do not play an important role in the exacerbation of migraine headache.