Migraine and tension-type headache among undergraduate medical, dental and pharmaceutical students of University of Aleppo: a cross-sectional study

Introduction

Headache disorders are among the most common 10 causes of disability worldwide according to the global burden of disease survey 2010. Headache is also wildly common among universities students when compared with other populations. The purpose of this study is to assess headache prevalence among Aleppo University medical, dental and pharmaceutical undergraduate students.

Methods

A questionnaire-based cross-sectional study was conducted among medical, dental and pharmaceutical students at Aleppo University, Syria. We determined the type of headache according to the International Classification of Headache Disorder-III. The total number of participants was 2068. A χ² test was used to evaluate the association between the categorical outcomes. P<0.05 was considered significant.

Results

Out of 2068 participants, 1604 (77.6%) were medical students, 205 (9.9%) were dental students and 259 (12.5%) were pharmaceutical students. The effect on daily activities was higher in chronic tension headache (96.7%) and migraine without aura (94.6%) than migraine with aura (91.3) and episodic tension headache (85.1%). Out of 1191 who had a headache, only 188 (15.9%) had a medical consultation.

Conclusions

There was no a statistically significant difference in prevalence of tension headache and migraine according to faculties. There was a statistically significant difference in patients with migraine according to academic year, living with family and smoking. The effect on daily activities was higher in chronic tension-type headache and migraine without aura. There is a significant lack of medical consultation among students and most of them took over the counter analgesics depending on personal choice.

Current status of cutaneous leishmaniasis in Aleppo, Syrian Arab Republic

Cutaneous leishmaniasis has been endemic in Aleppo, Syria, for generations. Recently there has been a clear increase in the incidence of the disease, and more patients have shown a lack of response to antimonials. We report the results of a survey, undertaken over the period 2-17 January 1995, at a general hospital in Aleppo, of all patients presenting with cutaneous leishmaniasis. Patients were grouped according to the stage of their disease, and surgical biopsies were carried out for histopathological investigation. Patients who were unresponsive to treatment and proceeded to chronicity were predominantly children aged under 15 years with facial lesions. Histopathological examination showed that the inflammatory changes had reached the upper layers of the subcutaneous tissues in 10 of the 25 chronic cases (40%) and three of the four acute cases (75%). These levels of the skin are not directly reached by the antimonials administered intralesionally. The inadequacy of the intralesional method alone and technical errors in administration are discussed.

A randomized trial comparing a pentavalent antimonial drug and recombinant interferon-gamma in the local treatment of cutaneous leishmaniasis

In a randomized prospective trial N-methyl-glucamine antimoniate (Glucantime) and human recombinant interferon-gamma were infiltrated around lesions of cutaneous leishmaniasis caused by Leishmania tropica in Syria. A previous trial had shown that intradermal application of interferon-gamma promoted the healing of similar lesions in the study area. Twenty patients with 38 lesions received 1-3 ml Glucantime and 20 patients with 37 lesions received 25 micrograms of interferon-gamma intradermally once weekly for 5 consecutive weeks. While all lesions treated with Glucantime were free of parasites after the third injection, only 69% of those treated with interferon-gamma were parasitologically cured by week 10. Within 10 weeks, lesions treated with Glucantime healed completely in 29/38, and partially in 9/38, cases, whereas 1/37 and 13/37 lesions treated with interferon-gamma healed completely and partially, respectively. Perilesional application of Glucantime was highly effective and superior to interferon-gamma for treatment of cutaneous leishmaniasis caused by L. tropica.

Effects of intradermal gamma-interferon in cutaneous leishmaniasis

The clinical and immunological evolution of lesions in cutaneous leishmaniasis was assessed after treatment with human recombinant gamma interferon (rIFN-gamma). 3 weeks after rIFN-gamma treatment of lesions due to Leishmania braziliensis guyanensis, 12/13 had become smaller compared with 6/13 control lesions; only 4 treated lesions were free of parasites. 9 of 13 L tropica lesions treated with rIFN-gamma resolved completely within 4-8 weeks of treatment. An acute inflammatory reaction around treated lesions was more common in lesions due to L tropica. There were no other local or systemic adverse reactions. Histological and immunohistochemical studies indicate that local application of rIFN-gamma enhances cell-mediated immune responses and thus promotes healing of cutaneous leishmaniasis.