Mohamed Elzayat

BACKGROUND: Mental health disorders are a major public health concern especially among undergraduates, globally and within Egypt. Most individuals suffering from mental illnesses either do not seek care at all or seek it only after a large delay. It is therefore critical to identify the barriers that prevent them from seeking professional help to solve the problem from its roots. Thus, the objectives of the study were to assess the prevalence of psychological distress, the need for professional mental health care, and the barriers to seeking available services among undergraduate students in Egypt. METHODS: A proportionate allocation technique was used to recruit 3240 undergraduates from 21 universities. Symptoms of psychological distress were evaluated using the Arabic General Health Questionnaire (AGHQ-28) and a score of above nine was used to identify positive cases. The pattern for utilization of mental health care was assessed using a multi-choice question and barriers to mental health care were assessed using the Barriers to Access to Care Evaluation (BACE- 30) tool. Logistic regression was adopted to identify the predictors of psychological distress and seeking professional health care. RESULTS: The prevalence of psychological distress was 64.7% and the need for professional mental health care was 90.3% of those with psychological distress. The top barrier to receiving professional mental health services was wanting to solve the problem on their own. Logistic regression revealed that female sex, living away from family and positive family history of mental disorders were independent predictors of psychological distress. Students from urban backgrounds were more likely to seek help than students from rural ones. While age above 20 and positive family history of mental disorders were independent predictors for seeking professional help. There is no significant difference between medical and non-medical students in terms of psychological distress. CONCLUSION: The findings of the study showed there is a high prevalence of psychological distress and a lot of instrumental and attitudinal related barriers to seeking mental health care and highlighted the urgent need to develop interventions and preventive strategies to address the mental health of university students.

Introduction: Hip fractures are within the most injuries coming to the emergency department, and one of the highest operations done in the trauma section of the orthopedics department. Within this, hip fractures treatment can vary depending on where the fracture is situated within the femur, either intracapsular that requires a hip hemiarthroplasty or extracapsular with require in situ fixation, with each of these methods or any surgical procedure there are risks that can happen, in this case report, we are highlighting a rare complication of a hip fixation and how it was managed. Case Report: An 89-year-old lady presented to our emergency department with a 6-week history of left thigh pain and swelling. She sustained a left hip fracture 8 weeks before this presentation for which she had an uneventful surgery. On examination her left thigh was swollen, there was no pitting edema and her pulses were intact. A Doppler ultrasound showed a large pseudoaneurysm arising from the profunda femoris artery. A computed tomography angiogram was subsequently performed to confirm the diagnosis. The patient had a successful embolization of the pseudoaneurysm. This was confirmed with ultrasound 24 h later, which showed no refilling of the pseudoaneurysm. The patient was discharged home in good condition. Conclusion: Arterial vessel damage following hip fractures is very rare. It may be caused by the fracture itself or more commonly as a consequence of intertrochanteric fracture fixation. A high index of suspicion should be maintained as the symptoms can be non-specific and the diagnosis can be challenging.

BACKGROUND: Migraine is a common type of primary headache which is responsible for one-third of the headache cases. It's also considered the third highest neurological disease with disability in 2021, however, underdiagnosis of migraine remains a significant health problem. This study aims to assess the prevalence of hidden migraine identified by screening among the Arab general population, describe the characteristics of headache attacks, and assess disability and distress associated with migraine. METHODS: This cross-sectional study was conducted between April and June 2024 among the general population of eight Arab countries using a self-administered online questionnaire to collect sociodemographic data and medical history. The questionnaire also included the ten-item Kessler Psychological Distress Scale (K10), Migraine Screen Questionnaire (MS-Q), and Migraine Disability Assessment Questionnaire (MIDAS). RESULTS: A total of 2152 individuals completed the questionnaire with a median age of 24 (21-29). Among them 683 (31.7%) individuals were screened positive by MS-Q. Using regression analysis, the independent predictors for positive screening were being Saudi Arabian, having one or more diseases, and having severe psychological distress with adjusted odds ratios of 0.622, 0.282, and 1.329 respectively. Among positive cases, 667 (97.7%) reported having headaches in the past 3 months. Phonophobia (50.97%) and photophobia (49.33%) were the most common associated symptoms. Sleep disturbance (66.72%) and noise (63.87%) were the most common triggering factors while sleep (71.81%) and self-medication (68.52%) were the most common relieving factors. Only 25.34% reported having aura with the last attack. According to MIDAS scores, 459 (67.2%) positive cases had moderate or severe disabilities. Regression analysis identified being a housewife and having one or more diseases as the independent predictors of having moderate or severe disabilities with adjusted odds ratios of 0.228 and 0.523 respectively. CONCLUSION: Migraine is still underdiagnosed in Arab countries which causes significant disability among positive cases. Raising awareness about the importance of early migraine diagnosis is crucial for encouraging the general population to seek medical advice once they have symptoms.