Ahmed K. Ibrahim

A systematic review of studies of depression prevalence in university students

BACKGROUND Depression is a common health problem, ranking third after cardiac and respiratory diseases as a major cause of disability. There is evidence to suggest that university students are at higher risk of depression, despite being a socially advantaged population, but the reported rates have shown wide variability across settings. PURPOSE To explore the prevalence of depression in university students. METHOD PubMed, PsycINFO, BioMed Central and Medline were searched to identify studies published between 1990 and 2010 reporting on depression prevalence among university students. Searches used a combination of the terms depression, depressive symptoms, depressive disorders, prevalence, university students, college students, undergraduate students, adolescents and/or young adults. Studies were evaluated with a quality rating. RESULTS Twenty-four articles were identified that met the inclusion and exclusion criteria. Reported prevalence rates ranged from 10% to 85% with a weighted mean prevalence of 30.6%. CONCLUSIONS The results suggest that university students experience rates of depression that are substantially higher than those found in the general population. Study quality has not improved since 1990.

Assessment of serum 25-hydroxyvitamin d levels in children with atopic dermatitis: correlation with SCORAD index.

BackgroundAtopic dermatitis (AD) is a chronic inflammatory skin disorder with an immunologic basis. It may have negative medical and social impacts on a patient and his family. ObjectivesTo assess serum level of vitamin D among children with AD and determine its association with AD severity using the AD Scoring System Index. Study DesignA case-control study. Patients and MethodsTwenty-nine patients with AD in the age group between 2 and 12 years were enrolled in the study. The severity of the disease was determined by the AD scoring system. Thirty controls were recruited. Serum levels of 25-hydroxyvitamin D3 [25(OH)D3] were tested using commercial automated chemiluminescent microparticle immunoassay. ResultsThe mean value of vitamin D in children with AD was much lower than normal value, and there was a significant difference in the mean values of vitamin D between children with AD (5.4±1.9 ng/mL) and the controls (28.9±2.4 ng/mL). Serum 25(OH)D levels were found to be significantly higher in mild AD (14.6±3.5 ng/mL) compared with moderate (5.5±3.1 ng/mL) or severe AD (0.3±0.1 ng/mL); P<0.001. ConclusionPatients with AD have lower serum vitamin D levels than normal. Vitamin D deficiency might be related to the severity of AD.

Analysis of an Egyptian study on the socioeconomic distribution of depressive symptoms among undergraduates.

BackgroundWorldwide population surveys show that prevalence of mental disorders in developing countries was as common as in industrialized countries. College life is an important stage in every person’s life; unfortunately, it may be the time to experience depression for the first time. Latterly, there has been a steady increase in the number of university students diagnosed and treated as depressed patients. This paper presents the results of a study carried out on a representative sample of undergraduate students of an Egyptian University, which aimed to study the relationship between social factors and the occurrence of depression. It was assumed that the poorer the socio-economic background the higher the rates of depression.MethodData were collected in 2004 from students at Assiut University using the Zagazig Depression scale (ZDS) and an Egyptian socio-economic status measure. This analysis, based on a refined version of the ZDS used STATA (v. 10.1.). Descriptive statistics, univariate and multivariate regression models were used to test for associations with the dimensions of SES and depression.ResultThirty-seven percent of the students had symptoms scored above the threshold for moderate depression. In the fully adjusted model: faculty of study, father’s occupation, family income and number of persons per room were associated with depression in this sample.ConclusionThe high prevalence of depressive symptoms among Egyptian students found in this study call attention to the need for a student counseling service offering mental health support. This service should particularly discover an approach for low affluence students.

Fractional CO2laser versus intense pulsed light in treating striae distensae

Context: Striae distensae are linear atrophic dermal scars covered with flat atrophic epidermis. They may cause disfigurement, especially in females. Many factors may cause striae distensae such as steroids, obesity, and pregnancy. Although there is no standard treatment for striae; many topical applications, peeling, and light and laser systems have been tried. Aims: To evaluate and compare the efficacy of fractional CO2 laser with intense pulse light in treating striae distensae. Subjects and Methods: Forty patients with striae distensae were recruited. Twenty of them were treated by fractional CO2 laser and 20 were treated with intense pulse light. Length and width of the largest striae were measured pre- and post-treatment. Patient satisfaction was also evaluated and graded. Patients were photographed after each treatment session and photos were examined by a blinded physician who had no knowledge about the cases. Results: Both groups showed significant improvement after treatments (P < 0.05). Patients treated with fractional CO2 laser showed significant improvement after the fifth session compared with those treated with ten sessions of intense pulsed light (P < 0.05) in all parameters except in the length of striae (P > 0.05). Conclusions: The current study has provided supportive evidence to the effectiveness of both fractional CO2 laser and intense pulse light as treatments for striae distensae. Fractional CO2 laser was found to be more effective in the treatment of striae distensae compared with intense pulse light.

Reliability of a shortened version of the Zagazig Depression Scale and prevalence of depression in an Egyptian university student sample

BACKGROUND There is some evidence that university students are at higher risk of depression; but rates have been found to vary widely across different countries, and there have been few surveys in representative samples. This study was carried out to assess the reliability of the Arabic-language Zagazig Depression Scale (ZDS) in a sample of Egyptian university students and to use the ZDS to assess the prevalence of depression. METHODS The study was a cross-sectional survey of a representative sample of 988 undergraduate students from Assiut University, Egypt (response rate, 82.3%). Prevalence of depressive symptoms was assessed using the ZDS, a self-report Arabic-language version of the Hamilton Rating Scale, modeled on the Carroll Rating Scale for Depression. RESULTS Participants had a mean ZDS score of 17.8 (± 9.0) out of a possible maximum score of 46. Using the recommended cutoffs for the ZDS, 37.6% of the students were found to have at least moderate depression, with 71% exceeding the cutoff for mild depression. The internal consistency of the ZDS was excellent (Cronbach α = 0.904), as was the split-half correlation coefficient. CONCLUSION This survey revealed a worryingly high rate of depressive symptoms in a representative sample of Egyptian university students. The ZDS is a reliable and acceptable tool for assessing mental health in a university population.

Establishing the reliability and validity of the Zagazig Depression Scale in a UK student population: an online pilot study

BackgroundIt is thought that depressive disorders will be the second leading cause of disability worldwide by 2020. Recently, there is a steady increase in the number of university students diagnosed and treated as depression patients. It can be assumed that depression is a serious mental health problem for university students because it affects all age groups of the students either younger or older equally. The current study aims to establish the reliability and validity of the Zagazig Depression scale in a UK sample.MethodsThe study was a cross-sectional online survey. A sample of 133 out of 275 undergraduate students from a range of UK Universities in the academic year 2008-2009, aged 20.3 ± 6.3 years old were recruited. A modified back translated version of Zagazig Depression scale was used. In order to validate the Zagazig Depression scale, participants were asked to complete the Patient Health Questionnaire. Statistical analysis includes Kappa analysis, Cronbachs alpha, Spearmans correlation analysis, and Confirmatory Factor analysis.ResultsUsing the recommended cut-off of Zagazig Depression scale for possible minor depression it was found that 30.3% of the students have depression and higher percentage was identified according to the Patient Health Questionnaire (37.4%). Females were more depressed. The mean ZDS score was 8.3 ± 4.2. Rates of depression increase as students get older. The reliability of The ZDS was satisfactory (Cronbachs alpha was .894). For validity, ZDS score was strongly associated with PHQ, with no significant difference (p-value > 0.05), with strong positive correlation (r = +.8, p-value < 0.01).ConclusionThe strong, significant correlation between the PHQ and ZDS, along with high internal consistency of the ZDS as a whole provides evidence that ZDS is a reliable measure of depressive symptoms and is promising for the use of the translated ZDS in a large-scale cross-culture study.

Impact of reconstruction methods and pathological factors on survival after pancreaticoduodenectomy

Background: Surgery remains the mainstay of therapy for pancreatic head (PH) and periampullary carcinoma (PC) and provides the only chance of cure. Improvements of surgical technique, increased surgical experience and advances in anesthesia, intensive care and parenteral nutrition have substantially decreased surgical complications and increased survival. We evaluate the effects of reconstruction type, complications and pathological factors on survival and quality of life. Materials and Methods: This is a prospective study to evaluate the impact of various reconstruction methods of the pancreatic remnant after pancreaticoduodenectomy and the pathological characteristics of PC patients over 3.5 years. Patient characteristics and descriptive analysis in the three variable methods either with or without stent were compared with Chi-square test. Multivariate analysis was performed with the logistic regression analysis test and multinomial logistic regression analysis test. Survival rate was analyzed by use Kaplan-Meier test. Results: Forty-one consecutive patients with PC were enrolled. There were 23 men (56.1%) and 18 women (43.9%), with a median age of 56 years (16 to 70 years). There were 24 cases of PH cancer, eight cases of PC, four cases of distal CBD cancer and five cases of duodenal carcinoma. Nine patients underwent duct-to-mucosa pancreatico jejunostomy (PJ), 17 patients underwent telescoping pancreatico jejunostomy (PJ) and 15 patients pancreaticogastrostomy (PG). The pancreatic duct was stented in 30 patients while in 11 patients, the duct was not stented. The PJ duct-to-mucosa caused significantly less leakage, but longer operative and reconstructive times. Telescoping PJ was associated with the shortest hospital stay. There were 5 postoperative mortalities, while postoperative morbidities included pancreatic fistula-6 patients, delayed gastric emptying in-11, GI fistula-3, wound infection-12, burst abdomen-6 and pulmonary infection-2. Factors that predisposed to development of pancreatic leakage included male gender, preoperative albumin < 30g/dl, pre-operative hemoglobin < 10g/dl and non PJ-duct to mucosa type of reconstruction. The ampullary cancers presented at an earlier stage and had a better prognosis than pancreatic cancer and cholangiocarcinoma. Early stage (I and II), negative surgical margin, well and moderate differentiation and absence of lymph node involvement significantly predicted for longer survival. Conclusions: PJ duct-to-mucosa anastomosis was safe, caused least pancreatic leakage and least blood loss compared with the other methods of reconstruction and was associated with early return back to home and prolonged disease free and overall survival.

A pilot study on surgical trimming impact on severely overgrown claws in sheep: Behavioral, physiological, and ruminal function aspects

ABSTRACT Overgrown claws make walking painful, increase difficulty in finding food, and increase susceptibility to foot problems. This study highlights the effect of surgical claw trimming on the behavior, physiological indices, and ruminal activity of sheep. Twenty sheep that had severe claw overgrowth were divided into 2 groups: the trimmed group (T), subjected to the process of claw trimming, and the overgrown claw group, the control group (C). Claw morphometric measurements (toe length, claw height, sole length, sole width, heel height, dorsal hoof angle, fetlock angle, and dew claws length), gait analysis, behavioral patterns (feeding, rumination, drinking, standing, walking, and resting), hematological and blood biochemical indices (complete blood count, plasma cortisol, glucose, lactate, copper, and tumor necrosis factor–&agr; levels), and ruminal function tests (ruminal PH, and count and activity of ruminal fauna) were evaluated in both groups. The overgrown claw trimming improved sheep behavior, gait scoring, physiological indicators, and ruminal activity.

Breast cancer correlates in a cohort of breast screening program participants in Riyadh, KSA

BACKGROUND Breast cancer is the first cancer among females in the Kingdom of Saudi Arabia, accounting for 27.4% of all newly diagnosed female cancers in 2010. There are several risk factors affecting the incidence of breast cancer where some factors influence the risk more than the others. AIM We aimed to identify the different risk factors related to breast cancer among females participating in the breast-screening program in Riyadh, KSA. METHODS Based on data from phase-I of the breast-screening program, a case-control study was conducted on women living in Riyadh, KSA. A sample of 349 women (58 cases and 290 controls) was recruited to examine the different breast cancer correlates. Multivariate regression model was built to investigate the most important risk factors. RESULTS The mean age of cases was 48.5±7.1 years. Age at marriage, number of pregnancy, age at menopause, oral contraceptive pills, breast feeding and family history of breast cancer in first-degree relative were identified as the most important correlates among the studied cohort. CONCLUSIONS The findings of the current work suggested that age at marriage, age at menopause ⩾50 years and 1st degree family history of breast cancer were risk factors for breast cancer, while, age at menopause <50 years, number of pregnancies and practicing breast feeding were protective factors against breast cancer. There was no effect of body mass index or physical inactivity. Further studies are needed to explore the hereditary, familial and genetic background risk factors in Saudi population.

Reliability, Validity, and Sensitivity to Change Overtime of the Modified Melasma Area and Severity Index Score

BACKGROUND The new modified Melasma Area and Severity Index (mMASI) score, the recently used outcome measure for melasma, has not been tested to determine its sensitivity to change in melasma. OBJECTIVE To determine the reliability, validity, and sensitivity to change overtime of the mMASI score in assessment of the severity of melasma. METHODS Pearson correlation, Cronbach alpha, and intraclass correlation coefficient were calculated to assess the reliability of the mMASI score. Validity of the mMASI scale was carried out using Spearman correlation between mMASI total score (before and after treatment), clinical data, and patients responses. RESULTS The mMASI score showed excellent reliability and good validity for assessment of the severity of melasma. The authors also determined that the mMASI score demonstrated sensitivity to change over time. CONCLUSION An excellent degree of agreement between the mMSAI and MASI scores was revealed. The mMASI score is reliable, valid, and responsive to change in the assessment of severity of melasma. Moreover, the mMASI score was found to be easier to learn and perform and simpler in calculation compared with the MASI score. Overall, the mMASI score can effectively replace the MASI score.