Comparative effectiveness clinical trial of magnetic seizure therapy and electroconvulsive therapy in major depressive disorder.

BACKGROUND: Magnetic seizure therapy (MST) has demonstrated fewer cognitive side effects than electroconvulsive therapy (ECT) in antidepressant efficacy trials. However, there are no effectiveness trials examining antidepressant efficacy and cognitive side effects against ECT. The aims of this study were to evaluate the comparative effectiveness of MST vs ECT in major depressive disorder (MDD), and compare the cognitive side effects of MST and ECT. METHODS: In this open-label study, patients were assigned to either ECT or high-dose MST twice a week for 5 sessions based on the clinician's and the patient's decision-making. Efficacy was primarily assessed by the Hamilton Depression Rating Scale-21 (HAMD-21); cognitive side effects were assessed by time to reorientation (TRO) and cognitive battery. RESULTS: Sixty patients were enrolled. Efficacy was similar between those assigned to MST (n = 30) and ECT (n = 30). Post-treatment HAMD-21 mean scores were 12.33 after MST, 12.80 after bitemporal (BT) ECT (n = 15), and 27.93 after right unilateral (RUL) ECT (n = 15). Magnetic seizure therapy had a significantly faster TRO of 1.8 minutes (standard deviation [SD] = 0.37) compared with ECT (RUL: 18.9 minutes [SD = 8.25]; BT: 50.2 minutes [SD = 5.89]) and had fewer cognitive side effects. CONCLUSIONS: Magnetic seizure therapy was effective for the treatment of MDD in real-world clinical care, with fewer cognitive side effects than ECT. Future studies are warranted to replicate these findings.

Habitat characteristics for different freshwater snail species as determined biologically through macroinvertebrate information.

Macro-invertebrates including freshwater snails collected from 643 sites over 8 successive seasons among the River Nile, branches, main canals and certain drains in eight Egyptian Governorates. Thirteen snail species and one bivalve species were identified. The most distributed were Lanistus carinatus and Physa acuta while the most abundant were Cleopatra bulimoides and Physa acuta during the whole study. The sites that harbored each snail species in all the examined water-courses were grouped seasonally and their biological assessment was determined by their minimum and maximum total point similarity percentage to that of the corresponded reference site and mean of the total points. Habitats for most snail species attained minimum total point's similarity percentage less than 21% (very poor habitat) during autumn and winter then spring while during summer very poor habitat was harbored by only few snail species. P. acuta was the only survived snails in habitat which attained 0 as a minimum total point's similarity percentage during two seasons and L. carinatus and Succinea cleopatra during one season. With respect to medically important snails very poor sites constituted 23% of Biomphalaria alexandrina sites, 14% of Lymnaea natalensis and 9.4% of Bulinus truncatus sites. The studied macroinvertebrate matrices, total number of organisms, taxa richness, the Ephemeroptera, Plecoptera, and Trichoptera (EPT) index, ratio of EPT index to chironomidae, ratio of scraper to filtering collector, contribution of dominant macroinvertebrate major group, comparison revealed descending tolerances from B. alexanrina followed by L. natalensis then B. truncates, but Hilsenhoff Biotic Index (HBI) showed the same tolerance to organic pollution.

Chemical and biological assessment for Egyptian surface freshwater environment with reference to human activities.

The Egyptian freshwater was assessed in the River Nile, branches, main canals and certain drainages in eight Governorates, over eight successive seasons starting from spring 2008. Chemical assessment was made through ten parameters and the biological one was made through macro-invertebrates information. Results showed that means of Cd, Pb, Cu, Hg, Mn, Fe, Ni, Na, K & Ca varied in watercourses seasonally within somewhat narrow ranges, which may exceed the level of concern but with some elevations in branches, Rayahs and canals during certain seasons. Sites showed chemical levels over the permissible one or those gain total points < or = 6.3 according to the biological assessment indicate that very poor habitat or those of Hilsenhoff Biotic Index (HBI) equal to 7-10 indicate that organic pollution were observed in all the studied watercourses reflecting hazard non point source pollution. Damietta branch in the region of Damietta city characterized with elevations in the concentration of most chemicals examined. The percentages of sites that showed chemical level over the permissible one were 70.56% for K, 54.08% for Cu, 50.08% for Na, 22.08% for Cd, 11.36% for Fe, 5.6% for Pb, 1.92% for Ni, 1.12% for Mn, 0.16% for Ca and at last 0.0736% for Hg. The biological assessment was more able to define more polluted sites than did the chemical one. Human activity data revealed that each of the drains, Giza and Qalyubia canals showed the highest item conduction (animal or plant waste, macroscopic pollution and presence of bridges or barriers) and this was co parallel with their highest pollution recordation.

Impact of certain plants and synthetic molluscicides on some fresh water snails and fish.

The LC50 (78, 85 ppm) and LC90 (88, 135 ppm) of Anagalis arvensis and Calendula micrantha respectively against Biomphalaria alexandrina were higher than those of the non-target snails, Physa acuta, Planorbis planorbis, Helisoma duryi and Melanoides tuberculata. In contrast, the LC50 of Niclosamide (0.11 ppm) and Copper sulphate (CuSO4) (0.42 ppm) against B. alexandrina were lower than those of the non-target snails. The mortalities percentage among non-target snails ranged between 0.0 & 20% when sublethal concentrations of CuSO4 against B. alexandrina mixed with those of C. micrantha and between 0.0 & 40% when mixed with A. arvensis. Mortalities ranged between 0.0 & 50% when Niclosamide was mixed with each of A. arvensis and C. micrantha. A. arvensis induced 100% mortality on Oreochromis niloticus after 48 hrs exposure and after 24 hrs for Gambusia affinis. C. micrantha was non-toxic to the fish. The survival rate of O. niloticus and G. affinis after 48 hrs exposure to 0.11 ppm of Niclosamide were 83.3% & 100% respectively. These rates were 91.7% & 93.3% respectively when each of the two fish species was exposed to 0.42 ppm of CuSO4. Mixture of sub-lethal concentrations of A. arvensis against B. alexandrina and those of Niclosamide or CuSO4 at ratios 10:40 & 25:25 induced 66.6% mortalities on O. niloticus and 83.3% at 40:10. These mixtures caused 100% mortalities on G. affinis at all ratios. A. arvensis CuSO4 mixtures at 10:40 induced 83.3% & 40% mortalities on O. niloticus and G. affinis respectively and 100% mortalities on both fish species at ratios 25:25 & 40:10. A mixture of sub-lethal concentrations of C. micrantha against B. alexandrina and of Niclosamide or CuSO4 caused mortalities of O. niloticus between 0.0 & 33.3% and between 5% & 35% of G. affinis. The residue of Cu in O. niloticus were 4.69, 19.06 & 25.37 mg/1kgm fish after 24, 48 & 72 hrs exposure to LC0 of CuSO4 against B. alexandrina respectively.

Feeding ecology and food composition of the black carp Mylopharyngodon piceus and the grass carp Ctenopharyngodon idella inhabiting the fish pond of Al-Abbassa fish hatchery with emphasis given to vector snails.

Stomach contents of M. piceus and C. idella collected from earthen fish ponds at Al-Abbassa fish hatchery during different seasons were examined. Food items were analyzed by three methods; the numerical (N%) percentage of point assessment (P%) and frequency of occurrence (F%). A comparison of the different methods emphasized the importance of snails as the major food resources in the diet of M. piceus during all seasons. During winter, stomachs of the most fish samples collected from fish ponds were empty or had traces of food. The index of relative importance (I.R.I) indicated that snails were the major food category in the diet of M. piceus during summer, autumn and spring represented by 7331, 9696 and 11670 respectively. Plants were the main food item in the diet of C. idella during summer (4604), meanwhile they came 3rd in relative importance in the diet during autumn and spring. Artificial fish food came as the 2nd food item in the diet of M. piceus during summer (1398.9) and autumn (5896.3) but it completely absent in spring. It is considered the main food item in diet of C. idella during autumn (10384.3) and spring (6293.5) and being 3rd in summer (1395.5). The results showed that snails reached highest level in the diet of M. piceus during spring (about 80% of all diet, decreased during summer (about 70%) and reached lowest proportion in autumn (50%). Plants exhibited marked seasonal variation in abundance with maximum level during summer (about 41% of all diet decreased during spring (27%) and autumn (22%). Artificial fish food was the highest in the diet of M. piceus during autumn (39%), decreased in summer (22%) until disappeared during spring. It reached highest level in diet of C. idella during autumn (49%), decreased in spring (38%) and reached lowest proportion during summer (21 %).