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Papers by ahmed baki

Journal of Pharmaceutical Policy and Practice

Background Psychological morbidity has been documented in medical and pharmaceutical undergraduat... more Background Psychological morbidity has been documented in medical and pharmaceutical undergraduate students in different countries around the world. In this study, we examined the impact of coronavirus disease 2019 (COVID-19) home quarantine on the depressive psychological aspects of last-grade pharmacy students. Methods A cross-sectional study was conducted by the Department of Clinical Pharmacy, Faculty of Pharmacy, Deraya University, Egypt. Two hundred and sixty-eight last-grade pharmacy students were included in this study, and they completed a self-administered, pre-designed, anonymous questionnaire. The main outcome measures were the Hamilton Depression Rating Scale (HRS) and Patient Health Questionnaire-9 (PHQ-9), which were measured to screen for the symptoms of psychological depression and determine the degree of depression severity between the beginning and the end of the COVID-19 home quarantine period. Data entry and analysis were done using the Statistical Package for S...

Middle East Current Psychiatry

Background Medical students are at high risk of developing depressive symptoms rather than their ... more Background Medical students are at high risk of developing depressive symptoms rather than their age-matched group as medical education is stressful and medical students have psychological and academic stressors. The study aimed to estimate the prevalence of depressive symptoms and the most important correlates associated with it among Assiut University Medical Students in the academic year 2019–2020. It is a cross sectional study conducted among 766 medical students at Assiut University in the academic year 2019–2020, screening for depressive symptoms was by patient health questionnaire-9 (PHQ-9). Results The mean age of students was 21.27 ± 1.9, 55.5% of them have depressive symptoms. Female students had statistically significantly higher percent of depressive symptoms compared with males (58.9% vs 51.2%), there was statistically significant lower mean socio-economic score among students having depressive symptoms compared to students with no depressive symptoms (5.73 ± 2.46 and 6...

Journal of Clinical Images and Medical Case Reports, 2021

Background: Acne vulgaris is a common skin disease which has a major impact on quality of life an... more Background: Acne vulgaris is a common skin disease which has a major impact on quality of life and common psychiatric co-morbidities. Objective: was to assess Quality Of Life (QOL) and depression in Egyptian acne patients and the effect of acne variables such as clinical severity, disease duration, type of treatment and presence of complications on patients’ psychometric using objective scales. Patients and methods: Four hundred acne patients and one hundred healthy participants as controls were included in the study. The patients were subjected to clinical examination with assessment of acne severity by Global Acne Grading Scale (GAGS) and patient selffulfillment of 2 psychometric questionnaires: Cardiff Acne Disability Index (CADI) and Beck depression inventory (BDI). Results: There was significant impairment of QOL in Egyptian acne patients. Impairment of QOL was significantly correlated with acne severity and its complications. Moreover, increase in depression scores was also fo...

Neurophysiologie Clinique, 2021

OBJECTIVE The aim of the present study was to explore the impact of acute and chronic nicotine co... more OBJECTIVE The aim of the present study was to explore the impact of acute and chronic nicotine consumption on measures of intracortical inhibition and facilitation. METHODS This study involved 50 chronic heavy cigarette smokers and 40 healthy subjects matched for age, sex and educational level, with no history of chronic nicotine intake. Intracortical inhibition and facilitation were assessed using transcranial magnetic stimulation (TMS) measures of motor threshold (MT), short- and long-interval intra-cortical inhibition (SICI, LICI), cortical silent period (CSP) and intra-cortical facilitation (ICF). Basal serum levels of cotinine were measured in the healthy group and at ½ and 2 h after smoking a single cigarette in the chronic smokers. RESULTS There was enhanced SICI and reduced ICF in smokers (independent of time after smoking) compared with non-smokers. The former suggests a chronic effect of increased nicotine levels on GABA-A neurotransmission whereas the latter suggests an additional effect on glutamatergic transmission. There were no significant differences between smokers and non-smokers in other TMS parameters. There was a significant negative correlation between cotinine levels at ½ h after smoking and SICI at 3 ms ISI (P < 0.001). There were no significant differences in any of the neurophysiological measures between smokers at ½ h versus 2 h after smoking a single cigarette. CONCLUSION Chronic nicotine consumption enhances SICI, and reduces ICF, supporting the hypothesis that nicotine acts as a neuromodulator of GABA-A and glutamate neurotransmission.

Basic and Clinical Neuroscience Journal, 2021

Background& Objectives: In this research, we investigated any possible effect of receiving Hyperb... more Background& Objectives: In this research, we investigated any possible effect of receiving Hyperbaric oxygen therapy (HBOT) or Risperidone on the autism core symptoms in children diagnosed as autism spectrum disorder (ASD). Methods: A randomized, controlled clinical trial, in Minia and Assiut University hospitals in Egypt with three parallel groups. One hundred and eighty children with autism, ages 5–8 years, divided into equal three groups, Group1 (G1): (N=60) received 40 sessions of (HBOT) within two months. Group2 (G2): (N=60) received Risperidone (0.25 mg daily for children under 20 kg; 0.5 mg daily for children equal to or over 20 kg) for six months. Group3 (G3): (N=60) control group received a placebo for six months. Assessment of their Childhood Autism Rating Scale (CARS) and Autism Treatment Evaluation Checklist (ATEC) scores was done at the beginning of the study (baseline) and after one year. Results: The mean total CARS, total ATEC, and ATEC subscales scores were signific...

Scientific Reports, 2021

High frequency repetitive transcranial magnetic stimulation (HF-rTMS) over the left dorsolateral ... more High frequency repetitive transcranial magnetic stimulation (HF-rTMS) over the left dorsolateral prefrontal cortex (L-DLPFC) is a widely applied treatment protocol for chronic smoking and major depressive disorder. However, no previous study has measured the effects of rTMS on both nicotine consumption and anxiety/depression in the same volunteers despite the relationship between them. The aim of this work was to evaluate the efficacy of 10 daily sessions of HF-rTMS over the L-DLPFC in chronic cigarette smokers’ addiction and investigate the possible beneficial effects of this treatment procedure on symptoms of depression and anxiety in the same subjects. The study included 40 treatment-seeking nicotine-dependent cigarette smokers. Onset/duration of smoking, number of cigarettes/day, Fagerstrom Test of Nicotine Dependence (FTND), Tobacco Craving Questionnaire-Short Form (TCQ-SF), Hamilton depression and anxiety scales (HAM-D and HAM-A) were recorded. Participants were randomly assig...

The Egyptian Journal of Neurology, Psychiatry and Neurosurgery, 2020

Background Depression and anxiety are non-motor symptoms of Parkinson’s disease (PD) that are oft... more Background Depression and anxiety are non-motor symptoms of Parkinson’s disease (PD) that are often overlooked and underrated. This study aimed to highlight the frequency and risk factors of depression and anxiety among subjects with PD. Methods Sixty-four patients with PD who were diagnosed according to United Kingdom Parkinson’s Disease Society (UKPDS) Brain Bank Criteria and 50 sex- and age-matched healthy control subjects are evaluated for depression and anxiety. PD severity and staging were assessed using Unified Parkinson’s Disease Rating Scale (UPDRS) and Hoehn and Yahr scale. Depression and anxiety were diagnosed using DSM-IV TR criteria and scored using Hamilton Depression and Hamilton Anxiety Rating Scales (HAM-D and HAM-A). The World Health Organization Quality of Life (WHOQOL)-BREF was used to assess impact of depression and anxiety on quality of life. Results 31.25% of patients with PD had depression while 40.6% of patients had anxiety disorder. Depression was higher in...

Middle East Current Psychiatry, 2020

Background: Several studies using event-related potential (ERP) methods have reported a relations... more Background: Several studies using event-related potential (ERP) methods have reported a relationship between the cognitive dysfunction of patients with psychosis and P300 latency and amplitude. P300 follow-up studies in patients with schizophrenia receiving antipsychotic treatment revealed that the P300 amplitudes were increased while other studies showed limited changes in the P300 amplitude even after antipsychotics use. Results: We found that at the first presentation, all patients' groups have significantly lower amplitude and more prolonged latency of P300 than controls. All the first-episode psychosis patients showed a significant improvement of P300 amplitude mean scores after 1 year, but with no significant change in the P300 latency. There was an inverse correlation between the patients' PANSS scores and their P300 latency and amplitude values. Conclusion: P300 amplitude and latency might be of clinical value in the evaluation of cognitive functions in the first-episode psychosis patients. The abnormalities in P300 may be improved with continuous control of psychotic symptoms with psychotropic medications.

Progress in Neuro-Psychopharmacology and Biological Psychiatry, 2020

In this study, we first investigated interleukin-1 beta (IL-1β) and IL-1 receptor antagonist (IL-... more In this study, we first investigated interleukin-1 beta (IL-1β) and IL-1 receptor antagonist (IL-1RA) levels in a cohort of Egyptian children with autism spectrum disorder (ASD) and in healthy controls. Second, we examined the single-nucleotide polymorphisms (SNPs) at positions -31 and - 511 of the IL-1β gene promoter and IL1RA and assessed the association between IL1B and IL1RA polymorphisms with ASD. We examined IL1β promoter polymorphism at -511 (IL-1β-511) and - 31 (IL-1β-31) and IL1RA gene polymorphism in 80 children with ASD and 60 healthy children. The children with ASD had significantly higher levels of IL-1β and IL-1RA than the controls. The children with ASD also had significantly higher frequencies of homozygous (CC) and heterozygous (TC) genotype variants of IL-1β-511, and IL-1RA than the controls. Moreover, the frequency of the IL-1β-511 allele (C) was higher in the ASD group than in the controls (p = .001). The homozygous and heterozygous variants of IL-1RA allele II were also significantly higher in the ASD group than in the control group. There was no significant association between the IL-1β-31 genotype and autism classes. However, there were significant differences in the distribution of the IL-1RA heterogeneous genotype and allele II among children with severe autism. The inflammatory role of cytokines has been implicated in a variety of neuropsychiatric pathologies, including autism. Our data show alterations in the IL-1β system, with abnormally increased serum levels of IL-1β and IL-1RA in the children with ASD. Further, polymorphisms in the IL-1β-511 and IL-1RA genotype variants correlated positively with autism severity and behavioral abnormalities. IL-1β-511 and IL-1RA gene polymorphisms could impact ASD risk and may be used as potential biomarkers of ASD. Variations in the IL-1β and IL-1RA systems may have a role in the pathophysiology of ASD.

The Egyptian Journal of Neurology, Psychiatry and Neurosurgery, 2020

Background: Post-stroke depression (PSD) has worse functional outcomes and quality of life. Despi... more Background: Post-stroke depression (PSD) has worse functional outcomes and quality of life. Despite the extensive literature on this topic, there is no agreement on the frequency or risk factors for post-stroke depression. Objectives: To establish the frequency and risk factors of post-stroke depression and its impact on quality of life. Patients and methods: One hundred three stroke patients were recruited from the outpatient clinic of Qena University Hospital who satisfied the WHO definition for stroke, together with a control group of 50 age-and sexmatched healthy volunteers. A complete history, neurological examination, and CT brain were obtained for each patient. DSM-IV TR criteria were used for diagnosis of depressive disorders which was scored with the Hamilton depression rating scale (HAM-D); Barthel Index (BI), and quality of life were also measured. Results: Thirty-eight (36.9%) stroke patients had PSD which was significantly higher than in the normal population (control group 12%). Statistically significant risk factors for PSD included low educational level, low socioeconomic status, smoking, and post-stroke functional impairment. Post-stroke depression has an impact on quality of life. Conclusion: Post-stroke depression is a relatively common complication of stroke and can affect the quality of life. Low educational level and socioeconomic status, as well as smoking and functional impairments, were considered as risk factors for the occurrence of post-stroke depression. Early detection of predictors of post-stroke depression may improve the outcome of stroke and prevent the psychiatric consequences.

Middle East Current Psychiatry, 2020

Background This study was performed for clinical study of suicide including risk factors in psych... more Background This study was performed for clinical study of suicide including risk factors in psychiatric patients admitted in psychiatric unit of Assiut University Hospital (AUH). Results We found that frequency of suicidal attempts is more in MDD (major depressive disorder), bipolar disorders followed by schizophrenia. And frequency of suicidal attempts in patients with multiple previous attempts before this one was higher in patients with mood disorders (53.8%) than psychotic and substance-induced disorders (32.3%, 13.8% respectively), with statistically significant difference in patients with MDD as well as there was significant treatment outcome on suicidal behavior. Conclusion The frequency of suicidal attempts is more in MDD (major depressive disorder), bipolar disorders followed by schizophrenia. There was significant severity of suicidal behavior in patients with psychotic disorders in comparison to patients with substance-induced disorder or mood disorders.

Journal of Current Medical Research and Practice, 2017

Aim Psoriasis is an immune-mediated genetically determined common dermatological disorder. Psoria... more Aim Psoriasis is an immune-mediated genetically determined common dermatological disorder. Psoriasis has the potential for significant psychological and social morbidity. Depression is the most common psychiatric disorder associated with psoriasis. The aim of this study was to evaluate depression among patients with psoriasis attending Assiut University Hospital. Patients and methods This was a cross-sectional study consisting of 100 patients with psoriasis who met the inclusion criteria. All eligible patients were subjected to the following tools: beck depression inventory, psoriasis disability index, and short form-36 quality of life questionnaire. Results and conclusion The results show that depression is highly significant among patients with psoriasis. The overall prevalence of depression was 76% among patients with psoriasis, and 60% of the patients presented with moderate and severe depression. There was a significant negative correlation between depression and quality of life. There was a significant positive correlation between depression and duration of psoriasis. Female sex and long duration of the disease were found to be risk factors for the occurrence of depression among patients with psoriasis.

Journal of Affective Disorders, 2019

Repetitive transcranial magnetic stimulation (rTMS) is an emerging treatment for neuropsychiatric... more Repetitive transcranial magnetic stimulation (rTMS) is an emerging treatment for neuropsychiatric disorders. Patients in rTMS treatment typically receive concomitant psychotropic medications, which affect neuronal excitability and plasticity and may interact to affect rTMS treatment outcomes. A greater understanding of these drug effects may have considerable implications for optimizing multi-modal treatment of psychiatric patients, and elucidating the mechanism(s) of action (MOA) of rTMS. Method: We summarized the empirical literature that tests how psychotropic drugs affect cortical excitability and plasticity, using varied experimental TMS paradigms. Results: Glutamate antagonists robustly attenuate plasticity, largely without changes in excitability per se; antiepileptic drugs show the opposite pattern of effects, while calcium channel blockers attenuate plasticity. Benzodiazepines have moderate and variable effects on plasticity, and negligible effects on excitability. Antidepressants with potent 5HT transporter inhibition reduce both excitability and alter plasticity, while antidepressants with other MOAs generally lack either effect. Catecholaminergic drugs, cholinergic agents and lithium have minimal effects on excitability but exhibit robust and complex, non-linear effects in TMS plasticity paradigms. Limitations: These effects remain largely untested in sustained treatment protocols, nor in clinical populations. In addition, how these medications impact clinical response to rTMS remains largely unknown. Conclusions: Psychotropic medications exert robust and varied effects on cortical excitability and plasticity. We encourage the field to more directly and fully investigate clinical pharmaco-TMS studies to improve outcomes. 1.2. TMS measures of cortical excitability and plasticity Single-or multiple pulse TMS is a valuable experimental probe of cortical excitability and plasticity (Ziemann et al., 2008). Neural excitability is typically defined as the threshold for neuronal action

Middle East Current Psychiatry, 2017

Middle East Current Psychiatry, 2017

Background Epilepsy is a common and chronic brain disorder that affects about 50 million people w... more Background Epilepsy is a common and chronic brain disorder that affects about 50 million people worldwide. The majority of the affected population lives in the low-income regions of the world. Stigma and social marginalization are common to persons with epilepsy. Purpose The aim of the present study was to evaluate the factors, including personality and psychological illnesses, likely to be influential in enhancing the social stigma of epilepsy. Methods Data were collected from 102 epileptic adults recruited from the Epilepsy Clinic of Assiut University Hospital in Egypt, with 52 healthy adults included as controls. Clinical information about seizures was obtained from neurologists, and other information was collected from self-completed questionnaires, including those measuring stigma scales. Results Overall, 65.7% of the people with epilepsy felt stigmatized by their condition and in 17.6% of these the stigma was severe. Multivariate analysis identified experiences of actual discrimination from society; more introverted personalities had a higher degree of depression and anxiety with a low self-esteem, and all dimensions of Quality of Life-36 questionnaire short form were negatively correlated with the social stigma of epilepsy. Conclusion Factors suggested to have an impact on stigma of epilepsy include seizure-related aspects such as seizure type, frequency, duration of illness, type and number of medications, and EEG changes, and individual-related aspects such as age, sex, residence, occupational status, marital status, educational level, age at seizure onset, and the affection of the quality of life.

Journal of autism and developmental disorders, Jan 7, 2017

The aim of our study was to evaluate the frequencies of myeloid dendritic cells (mDCs) and plasma... more The aim of our study was to evaluate the frequencies of myeloid dendritic cells (mDCs) and plasmacytoid dendritic cells (pDCs) in children with ASD. Subjects were 32 children with ASD and 30 healthy children as controls. The numbers of mDCs and pDCs and the expression of CD86 and CD80 on the entire DCs were detected by flow cytometry. ASD children had significantly higher percentages of mDCs and pDCs when compared to controls. We found significant inverse relationships between serum 25-hydroxyvitamin D levels and the frequencies of mDCs and pDCs in autistic children. Our data suggested that DCs could play a role in the clinical course of ASD. The relationship of DCs to immune disorders in ASD remains to be determined.

Journal of Child Psychology and Psychiatry, 2016

Autism spectrum disorder (ASD) is a frequent developmental disorder characterized by pervasive de... more Autism spectrum disorder (ASD) is a frequent developmental disorder characterized by pervasive deficits in social interaction, impairment in verbal and nonverbal communication, and stereotyped patterns of interests and activities. It has been previously reported that there is vitamin D deficiency in autistic children; however, there is a lack of randomized controlled trials of vitamin D supplementation in ASD children. This study is a double-blinded, randomized clinical trial (RCT) that was conducted on 109 children with ASD (85 boys and 24 girls; aged 3-10 years). The aim of this study was to assess the effects of vitamin D supplementation on the core symptoms of autism in children. ASD patients were randomized to receive vitamin D3 or placebo for 4 months. The serum levels of 25-hydroxycholecalciferol (25 (OH)D) were measured at the beginning and at the end of the study. The autism severity and social maturity of the children were assessed by the Childhood Autism Rating Scale (CARS), Aberrant Behavior Checklist (ABC), Social Responsiveness Scale (SRS), and the Autism Treatment Evaluation Checklist (ATEC). UMIN-CTR Study Design: trial number: UMIN000020281. Supplementation of vitamin D was well tolerated by the ASD children. The daily doses used in the therapy group was 300 IU vitamin D3/kg/day, not to exceed 5,000 IU/day. The autism symptoms of the children improved significantly, following 4-month vitamin D3 supplementation, but not in the placebo group. This study demonstrates the efficacy and tolerability of high doses of vitamin D3 in children with ASD. This study is the first double-blinded RCT proving the efficacy of vitamin D3 in ASD patients. Depending on the parameters measured in the study, oral vitamin D supplementation may safely improve signs and symptoms of ASD and could be recommended for children with ASD. At this stage, this study is a single RCT with a small number of patients, and a great deal of additional wide-scale studies are needed to critically validate the efficacy of vitamin D in ASD.

Egyptian Journal of Psychiatry, 2013

Background Depression is a common mental health problem observed frequently in general medical se... more Background Depression is a common mental health problem observed frequently in general medical setting. Aim The aim of this study was to identify possible demographic and clinical risk factors for depressive disorders among patients attending outpatient clinics of Assiut University Hospitals. Methods A cross-sectional study was conducted during a 1-year period from 1 June 2006 to 31 May 2007; 2304 patients aged 15 years and above were screened for depression using the Beck Depression Inventory. Patients who scored 4 or more were further evaluated through a psychiatric sheet especially prepared for the present work. Psychiatric diagnosis of patients was based on the Diagnostic and Statistical Manual of Mental Disorders, 4th ed.-text revision criteria. Medical/surgical diagnoses were confirmed by appropriate investigations, and information about the possible risk factors were obtained. Patients were also screened using the suicidality sheet and scored using the Sheehan Disability Scale. Results Depression was found in 202 patients, representing 8.8% of the entire sample. Depression was significantly higher among female patients, highly educated and literate individuals, nonworking male patients and among divorced/widowed/separated individuals. Patients with malignancy, disfiguring conditions, autoimmune conditions, renal diseases, and hepatic diseases were at a higher risk of developing depressive disorders. Patients with two or more medical/surgical conditions were at a high risk of developing depressive disorders (25.9 and 17.1%, respectively). Depressive disorders were significantly high among patients on dialysis (42.9%), radiotherapy (40%), chemotherapy (38.5%), steroids (28.9%), interferon (25%), and digoxin (21.9%). Depressive disorders were more prevalent among patients with a duration of medical illness of 24 months or more. The degree of impairment is significantly higher among patients with moderate and severe depression, particularly in patients having severe depression with psychotic features. Suicidality is significantly higher among patients with severe depression, particularly among patients having severe depression with psychotic features. Conclusion Patients attending outpatient clinics might be at a high risk for depressive disorders, especially those with certain medical conditions, with more than two medical diseases, and receiving specific treatment modalities. These patients need close psychiatric attention for early detection of depressive disorders and proper management.

Nutritional Neuroscience, 2015

Objectives: Autism spectrum disorder (ASD) is a developmental disorder characterized by pervasive... more Objectives: Autism spectrum disorder (ASD) is a developmental disorder characterized by pervasive deficits in social interaction, impairment in verbal and nonverbal communication, and stereotyped patterns of interests and activities. Vitamin-D deficiency was previously reported in autistic children. However, the data on the relationship between vitamin D deficiency and the severity of autism are limited. Methods We performed a case-controlled cross-sectional analysis conducted on 122 ASD children, to assess their vitamin D status compared to controls and the relationship between vitamin D deficiency and the severity of autism. We also conducted an open trial of vitamin D supplementation in ASD children. Results Fifty-seven percent of the patients in the present study had vitamin D deficiency, and 30% had vitamin D insufficiency. The mean 25-OHD levels in patients with severe autism were significantly lower than those in patients with mild/moderate autism. Serum 25-OHD levels had significant negative correlations with Childhood Autism Rating Scale (CARS) scores. Of the ASD group, 106 patients with low-serum 25-OHD levels

Asian Journal of Psychiatry, 2013

The aim of this study was to evaluate and explore the clinical, neuropsychiatric status and EEG p... more The aim of this study was to evaluate and explore the clinical, neuropsychiatric status and EEG pattern in a series of children with Williams-Beuren syndrome (WBS) in Assiut, Upper Egypt. We aimed to provide a comprehensive data comparable to what has been published, to enable us to make comparisons across different cultural areas. This will contribute to a better definition of the neuropsychiatric features that may be specific to WBS that allows early and better detection and management of those children. A series of 17 WBS children patients who consulted at our hospital were evaluated. The patients were assessed mainly for clinical, neurological, psychiatric and EEG status. We performed FISH for all patients. All patients had a deletion of the long arm of chromosome 7 (7q 11.23). All had elfin facies. Neurological examination revealed hypotonia in 25% of patients and rigidity (12.50%), brisk deep tendon reflexes (25%), abnormal plantar response (12.50%). Cerebellar and extrapyramidal signs were frequent: dysmetria (31.25%), dysdiadochokinesia (31.25%) and ataxia (18.75%). Epileptic seizures were present in 31.25% of patients and ADHD (37.5%). Autism was present in one patient. EEG abnormalities were present in 31.25%. Congenital cardiopathies were present in 62.50%. Our data showed that WBS children had multi-systemic clinical complications and the management of those patients requires the pediatrician to understand the natural course of this condition, awareness of potential medical problems, and periodic baseline clinical, neuropsychiatric evaluations, monitoring, and rapid intervention to improve the medical care for patients who have WBS.

Journal of Pharmaceutical Policy and Practice

Background Psychological morbidity has been documented in medical and pharmaceutical undergraduat... more Background Psychological morbidity has been documented in medical and pharmaceutical undergraduate students in different countries around the world. In this study, we examined the impact of coronavirus disease 2019 (COVID-19) home quarantine on the depressive psychological aspects of last-grade pharmacy students. Methods A cross-sectional study was conducted by the Department of Clinical Pharmacy, Faculty of Pharmacy, Deraya University, Egypt. Two hundred and sixty-eight last-grade pharmacy students were included in this study, and they completed a self-administered, pre-designed, anonymous questionnaire. The main outcome measures were the Hamilton Depression Rating Scale (HRS) and Patient Health Questionnaire-9 (PHQ-9), which were measured to screen for the symptoms of psychological depression and determine the degree of depression severity between the beginning and the end of the COVID-19 home quarantine period. Data entry and analysis were done using the Statistical Package for S...

Middle East Current Psychiatry

Background Medical students are at high risk of developing depressive symptoms rather than their ... more Background Medical students are at high risk of developing depressive symptoms rather than their age-matched group as medical education is stressful and medical students have psychological and academic stressors. The study aimed to estimate the prevalence of depressive symptoms and the most important correlates associated with it among Assiut University Medical Students in the academic year 2019–2020. It is a cross sectional study conducted among 766 medical students at Assiut University in the academic year 2019–2020, screening for depressive symptoms was by patient health questionnaire-9 (PHQ-9). Results The mean age of students was 21.27 ± 1.9, 55.5% of them have depressive symptoms. Female students had statistically significantly higher percent of depressive symptoms compared with males (58.9% vs 51.2%), there was statistically significant lower mean socio-economic score among students having depressive symptoms compared to students with no depressive symptoms (5.73 ± 2.46 and 6...

Journal of Clinical Images and Medical Case Reports, 2021

Background: Acne vulgaris is a common skin disease which has a major impact on quality of life an... more Background: Acne vulgaris is a common skin disease which has a major impact on quality of life and common psychiatric co-morbidities. Objective: was to assess Quality Of Life (QOL) and depression in Egyptian acne patients and the effect of acne variables such as clinical severity, disease duration, type of treatment and presence of complications on patients’ psychometric using objective scales. Patients and methods: Four hundred acne patients and one hundred healthy participants as controls were included in the study. The patients were subjected to clinical examination with assessment of acne severity by Global Acne Grading Scale (GAGS) and patient selffulfillment of 2 psychometric questionnaires: Cardiff Acne Disability Index (CADI) and Beck depression inventory (BDI). Results: There was significant impairment of QOL in Egyptian acne patients. Impairment of QOL was significantly correlated with acne severity and its complications. Moreover, increase in depression scores was also fo...

Neurophysiologie Clinique, 2021

OBJECTIVE The aim of the present study was to explore the impact of acute and chronic nicotine co... more OBJECTIVE The aim of the present study was to explore the impact of acute and chronic nicotine consumption on measures of intracortical inhibition and facilitation. METHODS This study involved 50 chronic heavy cigarette smokers and 40 healthy subjects matched for age, sex and educational level, with no history of chronic nicotine intake. Intracortical inhibition and facilitation were assessed using transcranial magnetic stimulation (TMS) measures of motor threshold (MT), short- and long-interval intra-cortical inhibition (SICI, LICI), cortical silent period (CSP) and intra-cortical facilitation (ICF). Basal serum levels of cotinine were measured in the healthy group and at ½ and 2 h after smoking a single cigarette in the chronic smokers. RESULTS There was enhanced SICI and reduced ICF in smokers (independent of time after smoking) compared with non-smokers. The former suggests a chronic effect of increased nicotine levels on GABA-A neurotransmission whereas the latter suggests an additional effect on glutamatergic transmission. There were no significant differences between smokers and non-smokers in other TMS parameters. There was a significant negative correlation between cotinine levels at ½ h after smoking and SICI at 3 ms ISI (P < 0.001). There were no significant differences in any of the neurophysiological measures between smokers at ½ h versus 2 h after smoking a single cigarette. CONCLUSION Chronic nicotine consumption enhances SICI, and reduces ICF, supporting the hypothesis that nicotine acts as a neuromodulator of GABA-A and glutamate neurotransmission.

Basic and Clinical Neuroscience Journal, 2021

Background& Objectives: In this research, we investigated any possible effect of receiving Hyperb... more Background& Objectives: In this research, we investigated any possible effect of receiving Hyperbaric oxygen therapy (HBOT) or Risperidone on the autism core symptoms in children diagnosed as autism spectrum disorder (ASD). Methods: A randomized, controlled clinical trial, in Minia and Assiut University hospitals in Egypt with three parallel groups. One hundred and eighty children with autism, ages 5–8 years, divided into equal three groups, Group1 (G1): (N=60) received 40 sessions of (HBOT) within two months. Group2 (G2): (N=60) received Risperidone (0.25 mg daily for children under 20 kg; 0.5 mg daily for children equal to or over 20 kg) for six months. Group3 (G3): (N=60) control group received a placebo for six months. Assessment of their Childhood Autism Rating Scale (CARS) and Autism Treatment Evaluation Checklist (ATEC) scores was done at the beginning of the study (baseline) and after one year. Results: The mean total CARS, total ATEC, and ATEC subscales scores were signific...

Scientific Reports, 2021

High frequency repetitive transcranial magnetic stimulation (HF-rTMS) over the left dorsolateral ... more High frequency repetitive transcranial magnetic stimulation (HF-rTMS) over the left dorsolateral prefrontal cortex (L-DLPFC) is a widely applied treatment protocol for chronic smoking and major depressive disorder. However, no previous study has measured the effects of rTMS on both nicotine consumption and anxiety/depression in the same volunteers despite the relationship between them. The aim of this work was to evaluate the efficacy of 10 daily sessions of HF-rTMS over the L-DLPFC in chronic cigarette smokers’ addiction and investigate the possible beneficial effects of this treatment procedure on symptoms of depression and anxiety in the same subjects. The study included 40 treatment-seeking nicotine-dependent cigarette smokers. Onset/duration of smoking, number of cigarettes/day, Fagerstrom Test of Nicotine Dependence (FTND), Tobacco Craving Questionnaire-Short Form (TCQ-SF), Hamilton depression and anxiety scales (HAM-D and HAM-A) were recorded. Participants were randomly assig...

The Egyptian Journal of Neurology, Psychiatry and Neurosurgery, 2020

Background Depression and anxiety are non-motor symptoms of Parkinson’s disease (PD) that are oft... more Background Depression and anxiety are non-motor symptoms of Parkinson’s disease (PD) that are often overlooked and underrated. This study aimed to highlight the frequency and risk factors of depression and anxiety among subjects with PD. Methods Sixty-four patients with PD who were diagnosed according to United Kingdom Parkinson’s Disease Society (UKPDS) Brain Bank Criteria and 50 sex- and age-matched healthy control subjects are evaluated for depression and anxiety. PD severity and staging were assessed using Unified Parkinson’s Disease Rating Scale (UPDRS) and Hoehn and Yahr scale. Depression and anxiety were diagnosed using DSM-IV TR criteria and scored using Hamilton Depression and Hamilton Anxiety Rating Scales (HAM-D and HAM-A). The World Health Organization Quality of Life (WHOQOL)-BREF was used to assess impact of depression and anxiety on quality of life. Results 31.25% of patients with PD had depression while 40.6% of patients had anxiety disorder. Depression was higher in...

Middle East Current Psychiatry, 2020

Background: Several studies using event-related potential (ERP) methods have reported a relations... more Background: Several studies using event-related potential (ERP) methods have reported a relationship between the cognitive dysfunction of patients with psychosis and P300 latency and amplitude. P300 follow-up studies in patients with schizophrenia receiving antipsychotic treatment revealed that the P300 amplitudes were increased while other studies showed limited changes in the P300 amplitude even after antipsychotics use. Results: We found that at the first presentation, all patients' groups have significantly lower amplitude and more prolonged latency of P300 than controls. All the first-episode psychosis patients showed a significant improvement of P300 amplitude mean scores after 1 year, but with no significant change in the P300 latency. There was an inverse correlation between the patients' PANSS scores and their P300 latency and amplitude values. Conclusion: P300 amplitude and latency might be of clinical value in the evaluation of cognitive functions in the first-episode psychosis patients. The abnormalities in P300 may be improved with continuous control of psychotic symptoms with psychotropic medications.

Progress in Neuro-Psychopharmacology and Biological Psychiatry, 2020

In this study, we first investigated interleukin-1 beta (IL-1β) and IL-1 receptor antagonist (IL-... more In this study, we first investigated interleukin-1 beta (IL-1β) and IL-1 receptor antagonist (IL-1RA) levels in a cohort of Egyptian children with autism spectrum disorder (ASD) and in healthy controls. Second, we examined the single-nucleotide polymorphisms (SNPs) at positions -31 and - 511 of the IL-1β gene promoter and IL1RA and assessed the association between IL1B and IL1RA polymorphisms with ASD. We examined IL1β promoter polymorphism at -511 (IL-1β-511) and - 31 (IL-1β-31) and IL1RA gene polymorphism in 80 children with ASD and 60 healthy children. The children with ASD had significantly higher levels of IL-1β and IL-1RA than the controls. The children with ASD also had significantly higher frequencies of homozygous (CC) and heterozygous (TC) genotype variants of IL-1β-511, and IL-1RA than the controls. Moreover, the frequency of the IL-1β-511 allele (C) was higher in the ASD group than in the controls (p = .001). The homozygous and heterozygous variants of IL-1RA allele II were also significantly higher in the ASD group than in the control group. There was no significant association between the IL-1β-31 genotype and autism classes. However, there were significant differences in the distribution of the IL-1RA heterogeneous genotype and allele II among children with severe autism. The inflammatory role of cytokines has been implicated in a variety of neuropsychiatric pathologies, including autism. Our data show alterations in the IL-1β system, with abnormally increased serum levels of IL-1β and IL-1RA in the children with ASD. Further, polymorphisms in the IL-1β-511 and IL-1RA genotype variants correlated positively with autism severity and behavioral abnormalities. IL-1β-511 and IL-1RA gene polymorphisms could impact ASD risk and may be used as potential biomarkers of ASD. Variations in the IL-1β and IL-1RA systems may have a role in the pathophysiology of ASD.

The Egyptian Journal of Neurology, Psychiatry and Neurosurgery, 2020

Background: Post-stroke depression (PSD) has worse functional outcomes and quality of life. Despi... more Background: Post-stroke depression (PSD) has worse functional outcomes and quality of life. Despite the extensive literature on this topic, there is no agreement on the frequency or risk factors for post-stroke depression. Objectives: To establish the frequency and risk factors of post-stroke depression and its impact on quality of life. Patients and methods: One hundred three stroke patients were recruited from the outpatient clinic of Qena University Hospital who satisfied the WHO definition for stroke, together with a control group of 50 age-and sexmatched healthy volunteers. A complete history, neurological examination, and CT brain were obtained for each patient. DSM-IV TR criteria were used for diagnosis of depressive disorders which was scored with the Hamilton depression rating scale (HAM-D); Barthel Index (BI), and quality of life were also measured. Results: Thirty-eight (36.9%) stroke patients had PSD which was significantly higher than in the normal population (control group 12%). Statistically significant risk factors for PSD included low educational level, low socioeconomic status, smoking, and post-stroke functional impairment. Post-stroke depression has an impact on quality of life. Conclusion: Post-stroke depression is a relatively common complication of stroke and can affect the quality of life. Low educational level and socioeconomic status, as well as smoking and functional impairments, were considered as risk factors for the occurrence of post-stroke depression. Early detection of predictors of post-stroke depression may improve the outcome of stroke and prevent the psychiatric consequences.

Middle East Current Psychiatry, 2020

Background This study was performed for clinical study of suicide including risk factors in psych... more Background This study was performed for clinical study of suicide including risk factors in psychiatric patients admitted in psychiatric unit of Assiut University Hospital (AUH). Results We found that frequency of suicidal attempts is more in MDD (major depressive disorder), bipolar disorders followed by schizophrenia. And frequency of suicidal attempts in patients with multiple previous attempts before this one was higher in patients with mood disorders (53.8%) than psychotic and substance-induced disorders (32.3%, 13.8% respectively), with statistically significant difference in patients with MDD as well as there was significant treatment outcome on suicidal behavior. Conclusion The frequency of suicidal attempts is more in MDD (major depressive disorder), bipolar disorders followed by schizophrenia. There was significant severity of suicidal behavior in patients with psychotic disorders in comparison to patients with substance-induced disorder or mood disorders.

Journal of Current Medical Research and Practice, 2017

Aim Psoriasis is an immune-mediated genetically determined common dermatological disorder. Psoria... more Aim Psoriasis is an immune-mediated genetically determined common dermatological disorder. Psoriasis has the potential for significant psychological and social morbidity. Depression is the most common psychiatric disorder associated with psoriasis. The aim of this study was to evaluate depression among patients with psoriasis attending Assiut University Hospital. Patients and methods This was a cross-sectional study consisting of 100 patients with psoriasis who met the inclusion criteria. All eligible patients were subjected to the following tools: beck depression inventory, psoriasis disability index, and short form-36 quality of life questionnaire. Results and conclusion The results show that depression is highly significant among patients with psoriasis. The overall prevalence of depression was 76% among patients with psoriasis, and 60% of the patients presented with moderate and severe depression. There was a significant negative correlation between depression and quality of life. There was a significant positive correlation between depression and duration of psoriasis. Female sex and long duration of the disease were found to be risk factors for the occurrence of depression among patients with psoriasis.

Journal of Affective Disorders, 2019

Repetitive transcranial magnetic stimulation (rTMS) is an emerging treatment for neuropsychiatric... more Repetitive transcranial magnetic stimulation (rTMS) is an emerging treatment for neuropsychiatric disorders. Patients in rTMS treatment typically receive concomitant psychotropic medications, which affect neuronal excitability and plasticity and may interact to affect rTMS treatment outcomes. A greater understanding of these drug effects may have considerable implications for optimizing multi-modal treatment of psychiatric patients, and elucidating the mechanism(s) of action (MOA) of rTMS. Method: We summarized the empirical literature that tests how psychotropic drugs affect cortical excitability and plasticity, using varied experimental TMS paradigms. Results: Glutamate antagonists robustly attenuate plasticity, largely without changes in excitability per se; antiepileptic drugs show the opposite pattern of effects, while calcium channel blockers attenuate plasticity. Benzodiazepines have moderate and variable effects on plasticity, and negligible effects on excitability. Antidepressants with potent 5HT transporter inhibition reduce both excitability and alter plasticity, while antidepressants with other MOAs generally lack either effect. Catecholaminergic drugs, cholinergic agents and lithium have minimal effects on excitability but exhibit robust and complex, non-linear effects in TMS plasticity paradigms. Limitations: These effects remain largely untested in sustained treatment protocols, nor in clinical populations. In addition, how these medications impact clinical response to rTMS remains largely unknown. Conclusions: Psychotropic medications exert robust and varied effects on cortical excitability and plasticity. We encourage the field to more directly and fully investigate clinical pharmaco-TMS studies to improve outcomes. 1.2. TMS measures of cortical excitability and plasticity Single-or multiple pulse TMS is a valuable experimental probe of cortical excitability and plasticity (Ziemann et al., 2008). Neural excitability is typically defined as the threshold for neuronal action

Middle East Current Psychiatry, 2017

Middle East Current Psychiatry, 2017

Background Epilepsy is a common and chronic brain disorder that affects about 50 million people w... more Background Epilepsy is a common and chronic brain disorder that affects about 50 million people worldwide. The majority of the affected population lives in the low-income regions of the world. Stigma and social marginalization are common to persons with epilepsy. Purpose The aim of the present study was to evaluate the factors, including personality and psychological illnesses, likely to be influential in enhancing the social stigma of epilepsy. Methods Data were collected from 102 epileptic adults recruited from the Epilepsy Clinic of Assiut University Hospital in Egypt, with 52 healthy adults included as controls. Clinical information about seizures was obtained from neurologists, and other information was collected from self-completed questionnaires, including those measuring stigma scales. Results Overall, 65.7% of the people with epilepsy felt stigmatized by their condition and in 17.6% of these the stigma was severe. Multivariate analysis identified experiences of actual discrimination from society; more introverted personalities had a higher degree of depression and anxiety with a low self-esteem, and all dimensions of Quality of Life-36 questionnaire short form were negatively correlated with the social stigma of epilepsy. Conclusion Factors suggested to have an impact on stigma of epilepsy include seizure-related aspects such as seizure type, frequency, duration of illness, type and number of medications, and EEG changes, and individual-related aspects such as age, sex, residence, occupational status, marital status, educational level, age at seizure onset, and the affection of the quality of life.

Journal of autism and developmental disorders, Jan 7, 2017

The aim of our study was to evaluate the frequencies of myeloid dendritic cells (mDCs) and plasma... more The aim of our study was to evaluate the frequencies of myeloid dendritic cells (mDCs) and plasmacytoid dendritic cells (pDCs) in children with ASD. Subjects were 32 children with ASD and 30 healthy children as controls. The numbers of mDCs and pDCs and the expression of CD86 and CD80 on the entire DCs were detected by flow cytometry. ASD children had significantly higher percentages of mDCs and pDCs when compared to controls. We found significant inverse relationships between serum 25-hydroxyvitamin D levels and the frequencies of mDCs and pDCs in autistic children. Our data suggested that DCs could play a role in the clinical course of ASD. The relationship of DCs to immune disorders in ASD remains to be determined.

Journal of Child Psychology and Psychiatry, 2016

Autism spectrum disorder (ASD) is a frequent developmental disorder characterized by pervasive de... more Autism spectrum disorder (ASD) is a frequent developmental disorder characterized by pervasive deficits in social interaction, impairment in verbal and nonverbal communication, and stereotyped patterns of interests and activities. It has been previously reported that there is vitamin D deficiency in autistic children; however, there is a lack of randomized controlled trials of vitamin D supplementation in ASD children. This study is a double-blinded, randomized clinical trial (RCT) that was conducted on 109 children with ASD (85 boys and 24 girls; aged 3-10 years). The aim of this study was to assess the effects of vitamin D supplementation on the core symptoms of autism in children. ASD patients were randomized to receive vitamin D3 or placebo for 4 months. The serum levels of 25-hydroxycholecalciferol (25 (OH)D) were measured at the beginning and at the end of the study. The autism severity and social maturity of the children were assessed by the Childhood Autism Rating Scale (CARS), Aberrant Behavior Checklist (ABC), Social Responsiveness Scale (SRS), and the Autism Treatment Evaluation Checklist (ATEC). UMIN-CTR Study Design: trial number: UMIN000020281. Supplementation of vitamin D was well tolerated by the ASD children. The daily doses used in the therapy group was 300 IU vitamin D3/kg/day, not to exceed 5,000 IU/day. The autism symptoms of the children improved significantly, following 4-month vitamin D3 supplementation, but not in the placebo group. This study demonstrates the efficacy and tolerability of high doses of vitamin D3 in children with ASD. This study is the first double-blinded RCT proving the efficacy of vitamin D3 in ASD patients. Depending on the parameters measured in the study, oral vitamin D supplementation may safely improve signs and symptoms of ASD and could be recommended for children with ASD. At this stage, this study is a single RCT with a small number of patients, and a great deal of additional wide-scale studies are needed to critically validate the efficacy of vitamin D in ASD.

Egyptian Journal of Psychiatry, 2013

Background Depression is a common mental health problem observed frequently in general medical se... more Background Depression is a common mental health problem observed frequently in general medical setting. Aim The aim of this study was to identify possible demographic and clinical risk factors for depressive disorders among patients attending outpatient clinics of Assiut University Hospitals. Methods A cross-sectional study was conducted during a 1-year period from 1 June 2006 to 31 May 2007; 2304 patients aged 15 years and above were screened for depression using the Beck Depression Inventory. Patients who scored 4 or more were further evaluated through a psychiatric sheet especially prepared for the present work. Psychiatric diagnosis of patients was based on the Diagnostic and Statistical Manual of Mental Disorders, 4th ed.-text revision criteria. Medical/surgical diagnoses were confirmed by appropriate investigations, and information about the possible risk factors were obtained. Patients were also screened using the suicidality sheet and scored using the Sheehan Disability Scale. Results Depression was found in 202 patients, representing 8.8% of the entire sample. Depression was significantly higher among female patients, highly educated and literate individuals, nonworking male patients and among divorced/widowed/separated individuals. Patients with malignancy, disfiguring conditions, autoimmune conditions, renal diseases, and hepatic diseases were at a higher risk of developing depressive disorders. Patients with two or more medical/surgical conditions were at a high risk of developing depressive disorders (25.9 and 17.1%, respectively). Depressive disorders were significantly high among patients on dialysis (42.9%), radiotherapy (40%), chemotherapy (38.5%), steroids (28.9%), interferon (25%), and digoxin (21.9%). Depressive disorders were more prevalent among patients with a duration of medical illness of 24 months or more. The degree of impairment is significantly higher among patients with moderate and severe depression, particularly in patients having severe depression with psychotic features. Suicidality is significantly higher among patients with severe depression, particularly among patients having severe depression with psychotic features. Conclusion Patients attending outpatient clinics might be at a high risk for depressive disorders, especially those with certain medical conditions, with more than two medical diseases, and receiving specific treatment modalities. These patients need close psychiatric attention for early detection of depressive disorders and proper management.

Nutritional Neuroscience, 2015

Objectives: Autism spectrum disorder (ASD) is a developmental disorder characterized by pervasive... more Objectives: Autism spectrum disorder (ASD) is a developmental disorder characterized by pervasive deficits in social interaction, impairment in verbal and nonverbal communication, and stereotyped patterns of interests and activities. Vitamin-D deficiency was previously reported in autistic children. However, the data on the relationship between vitamin D deficiency and the severity of autism are limited. Methods We performed a case-controlled cross-sectional analysis conducted on 122 ASD children, to assess their vitamin D status compared to controls and the relationship between vitamin D deficiency and the severity of autism. We also conducted an open trial of vitamin D supplementation in ASD children. Results Fifty-seven percent of the patients in the present study had vitamin D deficiency, and 30% had vitamin D insufficiency. The mean 25-OHD levels in patients with severe autism were significantly lower than those in patients with mild/moderate autism. Serum 25-OHD levels had significant negative correlations with Childhood Autism Rating Scale (CARS) scores. Of the ASD group, 106 patients with low-serum 25-OHD levels

Asian Journal of Psychiatry, 2013

The aim of this study was to evaluate and explore the clinical, neuropsychiatric status and EEG p... more The aim of this study was to evaluate and explore the clinical, neuropsychiatric status and EEG pattern in a series of children with Williams-Beuren syndrome (WBS) in Assiut, Upper Egypt. We aimed to provide a comprehensive data comparable to what has been published, to enable us to make comparisons across different cultural areas. This will contribute to a better definition of the neuropsychiatric features that may be specific to WBS that allows early and better detection and management of those children. A series of 17 WBS children patients who consulted at our hospital were evaluated. The patients were assessed mainly for clinical, neurological, psychiatric and EEG status. We performed FISH for all patients. All patients had a deletion of the long arm of chromosome 7 (7q 11.23). All had elfin facies. Neurological examination revealed hypotonia in 25% of patients and rigidity (12.50%), brisk deep tendon reflexes (25%), abnormal plantar response (12.50%). Cerebellar and extrapyramidal signs were frequent: dysmetria (31.25%), dysdiadochokinesia (31.25%) and ataxia (18.75%). Epileptic seizures were present in 31.25% of patients and ADHD (37.5%). Autism was present in one patient. EEG abnormalities were present in 31.25%. Congenital cardiopathies were present in 62.50%. Our data showed that WBS children had multi-systemic clinical complications and the management of those patients requires the pediatrician to understand the natural course of this condition, awareness of potential medical problems, and periodic baseline clinical, neuropsychiatric evaluations, monitoring, and rapid intervention to improve the medical care for patients who have WBS.