Egyptian students’ guardians knowledge, attitude and predictors of negative attitude of epilepsy in Assiut city

AbstractBackgroundEpilepsy is very prevalent in Egypt, approaching 6.98 per 1000 population. This study was designed to assess the knowledge and attitudes towards epilepsy among guardians of Egyptian high school students.MethodsA cross-sectional study was made among guardians (parents/guardians) of high school students in Assiut city, Egypt. A 15-item questionnaire was self-administered by 1257 students’ guardians who were randomly selected.ResultsAll recruited parents/guardians of high school students had heard about epilepsy. Families with a patient with epilepsy (PWE) had significantly better information about epilepsy and its aetiology than other families. The predictors of negative attitudes towards PWE were: age group ranging from 40 to 49years, no work, skilled work, male sex and incorrect knowledge.ConclusionHaving a patient with epilepsy is a predictor to having greater knowledge and a better attitude towards epilepsy. However, people still have a concept that PWE are stigmatized and are different from others. Raising awareness about epilepsy and its aetiology will increase the knowledge and improve the attitudes towards PWE

Population-based study of acquired cerebellar ataxia in Al-Kharga district, New Valley, Egypt

Wafaa MA Farghaly1, Hamdy N El-Tallawy1, Ghaydaa A Shehata1, Tarek A Rageh1, Nabil Abdel Hakeem2, Noha M Abo-Elfetoh11Department of Neurology and Psychiatry, Assiut University, Assiut, Egypt; 2Al Azhar University, Assiut Branch, EgyptBackground: The aim of this research was to determine the prevalence and etiology of acquired ataxia in Al-Kharga district, New Valley, Egypt.Methods: A population-based study of acquired ataxia was conducted in a defined geographical region with a total population of 62,583. A door-to-door survey was used to identify cases of acquired cerebellar ataxia. Patients with acquired cerebellar ataxia at any age and of both genders were included. Cases of known inherited cerebellar ataxia, acquired neurological disorders with ataxia as a minor feature, or pure acquired sensory ataxia, were excluded.Results: We identified 17 cases of acquired ataxia, of which eight were vascular, six were an ataxic cerebral palsy subtype, and three involved postencephalitic ataxia. The crude prevalence rate for acquired ataxia was 27.16/100,000 (95% confidence interval [CI]: 14.3–40.1). The mean age of the patients at interview was 31.8 (range 4–72) years, with a male to female ratio of 2.1:1. The most frequent presenting complaint was disturbance of gait (90.7%). The majority (92%) were ambulatory, but only 9.3% were independently self-caring.Conclusion: This population-based study provides an insight into acquired cerebellar ataxia within a defined region, and may inform decisions about the rational use of health care resources for patients with acquired cerebellar ataxia. The most common causes of acquired cerebellar ataxia in this region were cerebrovascular injury and cerebral palsy.Keywords: acquired cerebellar ataxia, prevalence, subtypes, Egyp

Pre- and in-hospital delays in the use of thrombolytic therapy for patients with acute ischemic stroke in rural and urban Egypt

BackgroundReducing pre- and in-hospital delays plays an important role in increasing the rate of intravenous thrombolysis (IVT) in patients with acute ischemic stroke. In Egypt, the IVT rate has increased steadily but is still far away from an ideal rate.AimThe study aimed to investigate the factors associated with pre- and in-hospital delays of IVT among patients with acute ischemic stroke coming from urban and rural communities.MethodsThis prospective, multicenter, observational cohort study was conducted from January 2018 to January 2019. Patients with acute ischemic stroke, who did not receive IVT, were included in the study. Patients were recruited from three large university stroke centers in Egypt, Assiut (south of Egypt), Tanta (north of Egypt), both serving urban and rural patients, and the University Hospital in Cairo (capital city), only serving an urban community. All participants underwent the National Institutes of Health Stroke Scale and full neurological assessment, urgent laboratory investigations, and computed tomography or magnetic resonance imaging to confirm the stroke diagnosis. The patients were subjected to a structured questionnaire that was designed to determine the parameters and time metrics for the pre- and in-hospital delays among patients from rural and urban regions.ResultsA total of 618 patients were included in the study, of which 364 patients (58.9%) lived in rural regions and 254 (41.1%) in urban regions. General demographic characteristics were similar between both groups. Approximately 73.3% of patients who arrived within the therapeutic time window were urban patients. The time from symptom onset till hospital arrival (onset to door time, ODT) was significantly longer among rural patients (738 ± 690 min) than urban patients (360 ± 342 min). Delayed onset to alarm time (OAT), initial misdiagnosis, and presentation to non-stroke-ready hospitals were the most common causes of pre-hospital delay and were significantly higher in rural patients. For patients arriving within the time window, the most common causes of in-hospital delays were prolonged laboratory investigations and imaging duration.ConclusionThe limited availability of stroke-ready hospitals in rural Egypt leads to delays in stroke management, with subsequent treatment inequality of rural patients with acute stroke

Neuropsychological effects of antiepileptic drugs (carbamazepine versus valproate) in adult males with epilepsy

Ghaydaa A Shehata,1 Abd El-aziz M Bateh,2 Sherifa A Hamed,1 Tarek A Rageh,1 Yaser B Elsorogy11Department of Neurology and Psychiatry, Faculty of Medicine, Assiut University, Egypt; 2Department of Psychology, Faculty of Arts, Banha University, EgyptPurpose: To evaluate the effect of antiepileptic drugs (AEDs) on cognition and behavior in adult epileptic males controlled on treatment with conventional antiepileptic medications. Methods: Cognitive, mood, behavior and personality traits were assessed in 45 epileptic patients treated with carbamazepine and/or valproate and free of seizures for ≥1 year. Thirty-four newly diagnosed or untreated patients with epilepsy and 58 matched healthy subjects were also included for comparison. A battery of psychometric tests was utilized including Stanford-Binet (4th edition), Beck Inventory for Depression, Aggressive Scale and Eysenck Personality Questionnaire.Results: Compared to matched control subjects, treated and untreated epileptic patients had poor performance in different cognitive and behavioral functions testing. Treated patients had worse scores in memory for digits forward and backward, total short-term memory, extroversion and psychosis. The duration of AEDs intake was correlated with memory of objects (r = -0.323; P = 0.030), bead memory (r = -0.314; P = 0.036) and total nonverbal short-term memory (r = -0.346; P = 0.020). Treated and untreated epileptic patients had poor performance of similar extent in behavioral functions testing (depression, aggression and neurosis). The dose of AEDs was correlated with testing scores for neurosis (r = 0.307; P = 0.040), verbal aggression (r = 0.483; P = 0.001) and nonverbal aggression (r = 0.526; P = 0.000), and duration of drug intake was correlated with scores for depression (r = 0.384; P = 0.009), psychosis (r = 0.586; P = 0.0001) and nonverbal aggression (r = 0.300; P = 0.045).Conclusions: This study provides support for the notion that AEDs can impair performance in cognition, mood and behavior. Duration of drug intake and the number of the utilized AEDs are the main confounding variables. This study did not provide clues on how to exclude the effect of epilepsy itself and psychosocial variables as additional important confounding variables.Keywords: cognition, behavior, mood, personality traits, epilepsy, AED

Wiedza, postawa i zasady postępowania pielęgniarek wobec chorych na padaczkę

Background: This work handled three aspects: to assess the nurses’ knowledge and practice with regard to patients with epilepsy, to study the outcome of training of nurses regarding epilepsy. Material and methods: The study conducted at the Department of Neurology at Assiut University Hospital. Data collected from all nurses (n = 35) working at the Department of Neurology. The following tools were used for data collection; a pre-/post-test questionnaire sheet for the assessment of the nurses’ knowledge of epilepsy, an observation checklist sheet for nurses, and the patient’s assessment sheet to assess the nurses’ practice. The work involved nine sessions, each about 30 minutes long, applied to teach nurses about all data necessary for the patients with epilepsy. Results: A good improvement in the mean knowledge and practice scores observed following the implementation of the designed nursing protocol. A significant decrease in complication rate which resulted from bad practice during fit following the implementation of the designed nursing protocol. A reduction in seizure-related complications reported after the training of nurses with the designed nursing protocol which acts as an additional advantage. Conclusion: Improving the nurses’ knowledge and practice with regard to patients with epilepsy will lead to the improvement the health and social conditions of patients with epilepsy.Wprowadzenie: Autorzy opracowania przeanalizowali stan wiedzy i praktykę pielęgniarek w odniesieniu do pacjentów z padaczką, a także wyniki odbytego przez pielęgniarki szkolenia na temat padaczki. Materiał i metody: Badanie przeprowadzono na Oddziale Neurologii Szpitala Uniwersyteckiego w Assiut. Dane zebrano od wszystkich pielęgniarek (n = 35) pracujących na oddziale. Do zbierania danych wykorzystano następujące narzędzia: kwestionariusz przed i po wprowadzeniu programu edukacyjnego służący do oceny stanu wiedzy pielęgniarek na temat padaczki, listę obserwacyjną dla pielęgniarek, formularz oceny stanu pacjenta w celu oceny praktyki pielęgniarek. Szkolenie przeprowadzono w dziewięciu 30-minutowych sesjach, w trakcie których pielęgniarki uzyskały wszelkie informacje potrzebne do opieki nad chorymi z padaczką. Wyniki: Zaobserwowano wyraźną poprawę średniej stanu wiedzy i wyników praktyki pielęgniarskiej po wdrożeniu programu opieki pielęgniarskiej, jak również znaczny spadek liczby powikłań spowodowanych nieprawidłowym postępowaniem z pacjentem podczas napadów padaczkowych. Ponadto stwierdzono zmniejszenie liczby zgłaszanych powikłań ponapadowych po wdrożeniu programu opieki pielęgniarskiej, co stanowi dodatkową jego zaletę. Wnioski: Poprawa stanu wiedzy oraz praktyki pielęgniarek w odniesieniu do chorych na padaczkę doprowadzi do poprawy stanu zdrowia i warunków życia osób z padaczką