Evaluating the prevalence and risk factors for depression in patients with temporal lobe epilepsy with hippocampal sclerosis: A cross-sectional multicenter study.

BACKGROUND: Epilepsy frequently accompanies Major Depressive Disorder (MDD). Notably, people with temporal lobe epilepsy and hippocampal sclerosis may face an increased susceptibility to MDD, as evidence indicates the involvement of the limbic system in the development of emotional symptoms. OBJECTIVES: To determine the prevalence and predictors of depression in temporal lobe epilepsy with hippocampal sclerosis (TLE-HS) and compare them to those of other epilepsy types. METHODS: A sample of 293 epilepsy patients, including 159 non-TLE-HS and 134 TLE-HS, were recruited from three hospitals. Of these, 215 completed a two-section electronic survey. The first section collected demographic and epilepsy data, while the second used the Arabic version of the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E). RESULTS: Of 215 patients, 104 (48%) had TLE-HS-38 with right TLE-HS (37%), 56 with left TLE-HS (54%), and 10 with bilateral TLE-HS (10%). The prevalence and severity of depression was assessed with an NDDI-E score of 15 or higher identified 35 patients (16%) with MDD. Valproic acid and lamotrigine were associated with higher NDDI-E scores. No such associations were found for levetiracetam or carbamazepine. Polytherapy in TLE-HS showed a significant correlation with daily poor concentration. CONCLUSION: We explored the differences in depression prevalence between TLE-HS and other epilepsy types and concluded they are minimal but slightly higher in TLE-HS. Predictors of depression such as seizure frequency and disease duration influenced MDD prevalence in TLE-HS. Lamotrigine and valproate were linked to higher NDDI-E scores.

Acute extensive pulmonary embolism after mRNA SARS-CoV-2 immunization.

COVID-19 vaccines, a cornerstone of the fight against the disease have generally proven to be safe with most commonly reported side effects being mild and self-limiting. Uncommon severe adverse effects like thromboembolism have been reported during postmarketing surveillance. Viral-based vector vaccines have been most commonly implicated in these reports. Our report however portrays a case of a 26-year-old female who developed extensive pulmonary embolism following administration of the Pfizer- BNT162b2 mRNA COVID-19 vaccine. The patient did not have any risk factors for thromboembolism. She was admitted, put on enoxaparin, and given Altaplase thrombolytic therapy. Her condition improved and she was discharged on Apixaban. The Thrombophilia screen performed on the 6-month follow-up was negative and following the resolution of thrombosis, Apixaban was stopped. Our case highlights the importance of continued surveillance of uncommon adverse effects and the need for prompt diagnosis and management of such side effects.

Satisfaction Rate After Laser Correction of Presbyopia (Presbyond) Among Patients Aged 40 Years and Older in Taif, Saudi Arabia.

Background Presbyopia is a physiological condition arising due to the loss of accommodation within the crystalline lens. One of the most widely accepted theories of the mechanism of accommodation was that in response to ciliary muscle contraction, the crystalline lens thickness increases, the lens diameter decreases, and both the anterior and posterior curvature of the lens increase, resulting in an increase in lenticular power therefore, accommodation. A contrasting theory suggests that ciliary muscle contraction leads to a selective increase in equatorial zonular tension, with the lens equator moving toward the sclera and the equatorial diameter of the lens increasing. This results in a change of lens optical power. Until now, clinical approaches to correct presbyopia have included monovision, multifocality, and extended depth of focus, all three of which can be achieved surgically on the cornea or by lens surgery. Methods This was a cross-sectional study adopted among patients who had Presbyond surgery in Taif City, Saudi Arabia, and were aged 40 years and older. The data was collected by conducting phone interviews to increase the response rate with a prepared questionnaire that was studied to achieve equality between participants to determine whether they were satisfied or not about the results after this surgery. The contact information was retrieved based on hospital records about patients who underwent Presbyond surgery. Data was analyzed using IBM SPSS Statistics for Windows, Version 22 (Released 2013; IBM Corp., Armonk, New York, United States). The data was collected for the period beginning on the first of January 2019 until the first of February 2023. Results From the study findings, a significant number of participants (28.1%, n=25) reported experiencing complete improvement and returning to normal life within 1-30 days after surgery. A slightly larger percentage (39.2%, n=35) experienced this within 1-3 months. Most of the participants (80.9%, n=72) reported an overall improvement in their quality of life after the surgery. This included activities such as reading and using a mobile phone. This indicates that the surgery had a positive impact on their daily lives and activities. In terms of recommendations, a total of 49 (55.1%, n=49) participants stated that they were very likely to recommend refractive surgery to a family member or friend experiencing vision problems. The study found that the mean patients' satisfaction score after one month of surgery is 2.494 units higher than the mean satisfaction score before surgery. This difference was statistically significant (p < .001). Conclusion The majority of participants did not experience any problems during the surgery, and most were able to resume their normal activities within a relatively brief period of time. The surgery achieved its goals for the majority of participants, resulting in an improvement in their quality of life. However, some short-term discomfort or adjustment period was reported. Overall, the participants were satisfied with the surgery, with the majority being very likely to recommend it to others. There is room for improvement in addressing concerns such as blurred vision, the need for glasses, and dry eyes. The study also found that patient satisfaction increased significantly after one month of surgery, and the timing of complete improvement and perception of achieving surgical goals were strongly associated with perceived outcomes.