Mental Health Services in Egypt

This paper begins with a historical perspective on mental health care from ancient Egypt to modern times. Current mental health services are described including epidemiological information, the structure of services, and methods of service delivery. Contrasts are made between urban and rural community care systems. The changing demographics of institutional care are analyzed in detail and future plans for psychiatric services are discussed. The recent development of comprehensive interdisciplinary model of service and the founding of a training center for this model is described

Electro-Convulsive Therapy (ECT): an Egyptian perspective

The world celebrated 68 years of electroconvulsive therapy (ECT) recently. Whilst ECT has stood the test of time for nearly six decades. stigma remains one of the main issues that needs to be addressed. ECT is a technically advanced and effective treatment that is often misunderstood and maligned not only by the lay public but by psychiatrists as well. One of the main causes of stigma is the nomenclature which needs to be changed since shock and convulsion are absent when giving modified ECT.Based on the evidence derived from randomized controlled trials and extensive clinical experience for nearly 70 years, ECT is presently the most effective treatment for certain psychiatric disorders. The most transient memory disturbance is a moderate price for what can be achieved, as the benefit to risk ratio of ECT is usually favorable.The economic aspects of ECT use in Egypt, as well as the problem of ECT training, are discussed in this paper.The ethical aspects of ECT are reviewed as well as the discrepancies between developed and developing countries in its application, which needs to be addressed from a transcultural perspective. Keywords: Electroconvulsive Therapy, Developing Countries, Stigma, Transcultural aspects > South African Psychiatry Review Vol. 10 (1) 2007: pp 22-2

Evaluation of Peripheral Vascular Calcification and Serum Magnesium Level in a Group of Egyptian Hemodialysis Patients

Introduction: Vascular calcification is a risk factor for cardiovascular mortality in the general population. It is highly prevalent in end stage renal disease (ESRD) patients. Low magnesium (Mg) levels have been reported to have a strong association with vascular calcification in hemodialysis (HD) patients. The aims of this study were to evaluate the prevalence of vascular calcification and its relation to serum Mg concentration in a group of Egyptian HD patients. Methods: We studied 65 stable patients undergoing maintenance HD for more than 6 months. Vascular calcification was evaluated using hand roentgenography. Serum Mg, phosphorus, corrected calcium and intact parathyroid hormone (iPTH) levels were compared between patients with and without vascular calcification. Results: The study included 41 male and 24 female patients, aged 43-70 years. Vascular calcification was present in 38.5% of the patients. Mean serum Mg level was 2.88 ± 0.51 mg/dl. Male gender was more common in patients with vascular calcification, and they had significantly longer HD duration and significantly higher serum phosphorus and iPTH levels. Serum Mg level was significantly lower in patients with vascular calcification (2.36 ± 0.26 mg/dl vs.3.21 ± 0.32 mg/dl, p = 0.001). Serum Mg concentration remained as independent negative predictor of hand-artery vascular calcification after adjustment for age, gender, duration of HD, serum phosphorus and iPTH levels. Conclusion: Vascular calcification is common in the study population and is associated with a lower serum Mg level. High or sustained-normal Mg levels may have a protective role against the development of vascular calcification in HD patients. Keywords: hemodialysis; magnesium; renal failure; vascular calcificatio

Inclusive fitness maximization: an axiomatic approach

Kin selection theorists argue that evolution in social contexts will lead organisms to behave as if maximizing their inclusive, as opposed to personal, fitness. The inclusive fitness concept allows biologists to treat organisms as akin to rational agents seeking to maximize a utility function. Here we develop this idea and place it on a firm footing by employing a standard decision-theoretic methodology. We show how the principle of inclusive fitness maximization and a related principle of quasi-inclusive fitness maximization can be derived from axioms on an individual’s ‘as if preferences’ (binary choices). Our results help integrate evolutionary theory and rational choice theory, help draw out the behavioural implications of inclusive fitness maximization, and point to a possible way in which evolution could lead organisms to implement it

Multifocal necrotizing fasciitis following Hirshsprung’s disease surgery away from the surgical wound site

Necrotizing fasciitis (NF) is a life-threatening infection with rapidly progressive necrosis. Escherichia coli is rarely reported as causative agent of type 2 NF. NF typically arises in a single area usually secondary to penetrating injury. NF was only reported as a postoperative complication of Hirshsprung’s disease in one report, where the causative agent was Pseudomonas aeruginosa. We here present a case of synchronous multifocal NF in a 7-month Hirshsprung’s disease patient after abdominal Soave procedure. The patient presented with constipation and had a colosotomy undergone at the splenic flexure through a left transverse supraumbilical incision during neonatal period. At the age of 7 months and after preoperative preparation, abdominal Soave procedure was performed through a Pfannestiel incision. Few days following operation he had fever, tachycardia, and pain. Local examination showed red edematous areas at both flanks away from the wounds. Shortly afterwards skin became dark, tense, and started to slough. At this stage the clinical diagnosis of NF was raised and surgical debridement was done. Blood and tissue cultures were positive for E. coli. Five days later the patient had another debridement due to necrotic wound edges. Vacuum assisted closure therapy with Aquacel Ag dressings was fitted and changed every 48 h. Eighteen days later split thickness skin-graft was carried out. The patient was discharged home; 10 days later he is doing fine on follow-up.Keywords: complication of swave procedure, Hirshsprung’s disease, necrotizing fasciiti

Anterior abdominal wall ectopic testes: A report of two cases

Undescended testis (UDT) is a common anomaly of the male reproductive system  affecting about 2% to 4% of male infants more commonly preterms. If the testis remains in the line of normal descent, it is classified as an UDT. If it is not in the line of  normal descent, it is termed an ectopic testis. Common sites of ectopic testes are  perineal, transverse ectopia, pubopenile and femoral. To the best of our knowledge only two cases of anterior abdominal wall ectopic testis have been reported in the literature.  We present here two cases of anterior abdominal wall testis,  one of which was  associated with indirect inguinal hernia.Keywords: anomalies of the testis, ectopic testis, empty scrotu

The role of endoscopic ultrasound elastography in diagnosis of pancreatic lesions

Objective: To evaluate the accuracy of elastography in differentiating benign from malignant pancreatic masses for patients.Design: A prospective, consecutive, studySetting: Kasr Alini hospital department of internal Medicine , university of Cairo, Egypt.Subjects: Thirty patients had a solid-appearing pancreatic mass at conventional ultrasound, EUS and CT abdomen were included in the study.Results: A total of 30 patients were included in the study. The age of the Patients ranged between 38 and 70 years with a mean value of 54± 8.6 Years. The study included 22 (73.3%) males and eight (26.7%) females. The mean size of pancreatic masses was 35.6 ± 11.8 mm. The final diagnosis were pancreatic adenocarcinoma (n =25) papillary adenocarcinoma (n =1), papillary adenoma (n =2) and chronic pancreatitis ( n =2). The strain ratio was significantly higher among patient with pancreatic malignant tumour compare with those with inflammatory masses. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy for elastograpgy to Differentiate malignant from benign pancreatic masses were: 88%, 80%, 95.6%, 57.14% and 86% respectively (area under receiver operating curve 0 .974).Conclusion: EUS elastography is a useful tool for differentiating malignant from benign pancreatic masses through objective evaluation of tissue stiffness

Optimum PID Controller with Fuzzy Self-Tuning for DC Servo Motor

DC motors are simple and controllable, making them a popular choice for various applications. However, the speed and load characteristics of DC motors can change, making it difficult to control them effectively. This paper proposes an optimum PID controller with fuzzy self-tuning for DC servo motors. The controller uses two steps to adjust the PID gains: The ACS algorithm is employed to identify the optimal PID gains in the first step. A fuzzy logic (FLC) controller is employed in the second stage to further fine-tune the gains. The FLC considers two cost functions: the first function is the sum of the squares of the error between the controlled output and reference input. The second function is a mathematical expression that specifies the required characteristics of the system response. The fuzzy self-tune then uses a set of rules to adjust the PID gains in response to changes in the system. The rules are based on the two cost functions designed to maintain the optimum PID gains for various operating settings. The outcomes of the two functions are: Kp = 5.2381, Ki = 7.0427, and Kd = 0.49468, with rising time = 0.2503, overshoot = 2.5079, and settling time = 10.4824 in the first cost function. The second cost function outcomes are Kp = 8.1381; Ki = 8.6427; and Kd = 0.49468. The FST-PID controller's performance is evaluated using Matlab-Simulink. The proposed controller was tested on a DC servo motor, and the results showed good performance in both steady-state and transient responses. The controller also maintained the optimum PID gains in the event of changes or disturbances. So, the motor's speed can effectively control under a variety of conditions

Effects of aqueous leaves extract of Ocimum gratissimum on blood glucose levels of streptozocininduced diabetic wistar rats

The hypoglycemic effects of aqueous leaves extract of Ocimum gratisimum was investigated in streptozocin-induced diabetic rats. A single administration of the extract at the doses of 250, 500 and 1000 mg/kg body weight was done. The aqueous extract at the dose of 500 mg/kg significantly lowered blood glucose level (

Removal Of Methylene Blue By Adsorption Of Water Hyacinth Derived Active Carbon Embedded With Cobalt Nanoparticles

In this research, active carbon-based catalyst synthesis and characterization were tested for potential catalysts to be used in dye removal of methylene blue (MB). Water hyacinth is one of the major problems that is facing humankind and especially here in Egypt. One of the implications of industrial activities is environmental pollution. Dyes used in the production of textiles, paper, and clothes are one of the major pollutants. The waste of those dyes discharged into water supplies without treatment or with ineffective treatment harmfully impacts the environment. In this research, the treatment is implemented using active carbon-based catalysts using embedded nanoparticles. This leads to a huge increase in the adsorbent\u27s surface area, also increasing the adsorbent efficiency. The activated carbon was derived from water hyacinth that grows near the Nile River. Water hyacinth has many practical uses as it can absorb heavy metals like lead and dyes. Water hyacinth was converted into activated carbon through carbonization. Different dyes were used with different contact times in fixed conditions