[Using mesenchymal stem cells for the treatment of non-obstructive azoospermia]

Approximately 15% of couples of reproductive age are infertile. Among patients with infertility, nearly 10-15% have azoospermia. The current treatment methods of non-obstructive azoospermia, in particular the use of mesenchymal stem cells, and the comparative analysis of the cost-effectiveness of different methods are discussed in the article.

Evaluation of tuberculosis control programme in Khartoum State for the year 2006

Background: Tuberculosis (TB) is among the top ten causes of global mortality. Sudan is among the countries with high TB prevalence; with an estimated incidence of 90/100,000 smear-positive cases. In 1993, the Khartoum State tuberculosis control programme was established. Since its establishment, however, the programme has never been adequately assessed. Aim: To evaluate and describe the tuberculosis control programme in Khartoum State, Sudan in 2006; to find out if the programme achieved its global targeted goals; and to identify the challenges and needs for performing a good standard tuberculosis control programme. Methods: A descriptive cross-sectional and retrospective study design was used. The study population was tuberculosis control departments at the levels of the state (n = 1), localities (n = 7), health areas (n = 19) and health facilities (n = 42). Records review and group interviews were used to collect the required data. Results: The study found that the TB control programme in Khartoum State achieved a 77.2% case detection rate of the smear-postive cases, and 73.5% treatment success rate, and a case fatality rate of 2.2%, treatment failure rate of 2.2%, and default rate of 14.1%. There was no system to detect the prevalence of MDR-TB (multi-drug resistant TB) or HIV (human immunodeficiency virus) among the TB cases. The programme was not well implemented at locality or health area levels. Conversely, drugs and laboratory supply systems were functioning well. Conclusions: The tuberculosis control programme in Khartoum State is centralized, not updated, and does not achieve the targeted goals.

Some characteristics of the psychiatric population attending a primary care centre in Kuwait

This study examined the sociodemographic correlates of psychiatric illness in a primary care centre in Kuwait. A total of 164 psychiatric patients seen over a 3-year period formed the experimental group while 165 nonpsychiatric patients attending the same centre formed the control group. Results showed significant differences in basic demographic variables of the 2 groups. The psychiatric patients were significantly more likely to be single, unskilled, young, less educated and living alone or in an overcrowded household and to report more recent life events than controls. The absence of family and social support, lacking a meaningful job and chronicity of illness were significantly correlated with poor treatment response. Possible interpretations of the results were discussed in the cultural context of our patients. The fact that 57% of the psychiatric patients had been ill for more than 6 months prior to consultation highlights the importance of orientation of primary care practitioners to the psychiatric aetiology of somatic presentation of many of their patients.

The profile of parasucide repeaters in Kuwait

A one-year cohort of 92 parasuicides was followed up at 6 monthly intervals for a period of 2 years since their index parasuicide to study the outcome and evaluate the level of social readjustment. One male patient died of suicide (1.1%) and 18 (19.6%) individuals repeated parasuicide using self-poisoning. The rate of repeated parasuicidal behaviour in this investigation was considerably higher than that reported in comparable studies from developing countries but similar to that from a number of western European cities. The data indicated that the probability of further episodes of parasuicidal behaviour increased in the few months after the index episode. Although the repeaters and non-repeaters were essentially similar in most of their sociodemographic characteristics, the former were a distinctive group in many respects. The factors found to be significantly associated with subsequent parasuicide included self-poisoning by prescribed drugs at the index parasuicide, previous parasuicidal behaviour prior to the index, occupational status of a housewife, past history of depression and/or dependence and precipitating life events in the family environment. Contrary to our hypothesized theory, none of the types of attitudes received by the patients from their family members at the index parasuicide related to outcome. The global level of social readjustment of non-repeaters was about three times higher than that of repeaters of parasuicide. The implications of these findings for future policy making were discussed with respect to prevention of parasuicide.

The correlates of hypochondriasis in depressed patients

Of 100 inpatients with depressive illness, fifty-three had evidence of depressed mood prior to their hypochondriacal symptoms, sixteen had the opposite sequence of development and thirty-one had no hypochondriacal symptoms. Comparisons of the three groups revealed some differences that would suggest a less severe depressed mood in association with hypochondriacal symptoms. Whether hypochondriasis preceded or followed depressed mood did not make any other difference to the total clinical picture. This should not be taken to imply that treatment and prognosis are the same in hypochondriacal and nonhypochondriacal depressions.

Psychosocial profile of the parasuicidal patient in Kuwait

A consecutive sample of 92 parasuicides aged 14-44 years (mean age +/- standard deviation, 22.9 +/- 5.6) was seen during the period December 1984-November 1985 at Kuwait's main teaching general hospital (catchment area 449000 population). Self-poisoning accounted for 85.9%. Their sociodemographic characteristics were consistent with contemporary trends of parasuicidal behaviour reported in other countries. The structure of the Kuwaiti population is quite special. The majority (58.3%) are expatriates mostly males at the working age group while the minority (41.7%) are Kuwaiti nationals. Family discord was the dominant antecedent life event in Kuwaitis. On the other hand, non-Kuwaiti Arabs and non-Arab expatriates reported an excess of work-related problems as precipitating factors. Non-Arab females resorted to more violent methods than other females. Acute situational distress was the most common diagnosis while depression was present in about 25% of the total sample. The attitudes of family members of the parasuicidal patients were discussed in the light of the socio-cultural perspective. Attention to possible preventive measures is suggested. Parasuicide (Kreitman et al 1970) is a topic which has stimulated considerable research in recent years. A wealth of information has become available on the subject and its patterns in different cultures and various countries (WHO 1974). In the "Arab World" a few studies have dealt with parasuicide. El-Islam (1974) studied the characteristics of hospital referred parasuicide in Qatar and indicated that intergenerational conflict was the commonest precipitating life event.(ABSTRACT TRUNCATED AT 250 WORDS)

The WHO collaborative study on strategies for extending mental health care, II: The development of new research methods

Teams in seven developing countries under sponsorship of the World Health Organization have been carrying out collaborative operational research on providing mental health care through primary health care services. New techniques of identifying mental disorders in children and adults have been developed and tested. Methods of assessing the skills and attitudes of health workers toward mental health work and of gauging community attitudes toward mental illness have also been developed. Results have been directly applied in planning better mental health care. The authors conclude that cross-cultural collaborative research is effective in improving mental health care for those in greatest need.