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According to the criteria adopted by Ciriaci and colleagues in the survey published on proceedings of the International Conference on “Human Capital and Employment in the European and Mediterranean Area” Bologna, 10-11 March 2011 the souhern Italy graduates migration choices are directly connected with the following variables: i) unemployement rate of the residency area, ii) unemployment rate of the chosen education area, iv) scientific prestige of the centre. The migration trend considered from south to north considered as target migration areas the Italian central-northern regions: Lazio, Tuscany, Umbria, Marche, Emilia-Romagna, Liguria, Valle d‟Aosta, Piedmont, Lombardy, Trentino A.A., Friuli Venezia-Giulia, Veneto. The southern regions are Campania, Abruzzi, Molise, Puglia, Basilicata, Calabria, Sicily and Sardinia, which comprise the so-called „Mezzogiorno‟.

Gharib Fawi Mohamed1, Taher Abd El-Raheem1, Nayel Abd El-Hamed Zaky2, Mohammed Abdal Abbas1, Islam Gad Elrap Ahmed1,

1Department of neuropsychiatry, Sohag University, Sohag, Egypt 2Department of internal medicine, Sohag University, Sohag, Egypt

Background: peripheral Neuropathy (PN) is a well-known complication of chronic renal failure (CRF). The frequency of PN in patients with CRF has declined owing to improvement in the modalities and techniques of dialysis and uremic neuropathy can be considered as an indicator of inadequate treatment by dialysis Aim of the work: is to quantitively determine the electrophysiological changes in both peripheral and central nervous system in CRF and to determine the differences between CRF patients on dialysis and
those who don’t start dialysis yet regarding neuropathy and cognitive impairment.
Materials and Methodology: we studied two groups of patients from the dialysis unit in Sohag faculty medicine, in addition to a control group. Group I is patients with CRF, who recently diagnosed and where the decision of dialysis was taken (10 pts). Group II is on dialysis for more than one year (10 pts). All
patients were subjected to full clinical assessment relevant to the peripheral neuropathy, laboratory evaluation, abdominal ultrasonography, nerve conduction studies, electromyography, mini-mental state examination and P30
Neuropathy is found in 75% of patients. NCS show that both motor and sensory fibers were affected and both axonal degeneration and demyelination were present. Neurophysiological abnormalities and cognitive impairment in group Ι were more than at group II
This study clearly demonstrated that neuropathy is very common in CRF patients and neurophysiological abnormalities in group Ι were more common than in group ΙΙ. This show the importance of hemodialysis in reduction of uremic neuropathy and its sensory symptoms

A 50-year-old Nigerian man was admitted for generalized non febrile seizures. Two weeks before his GP prescribed antimalaric prophilaxis with clorochine for a planned trip in his home country. He suffered of a minor stroke 2 years before with no residual disability. He had also history of arterial hypertension treated with ace inhibitors and aspirin. At admission he was treated with lorazepam i.v. for a second generalized crisis at admission, and started carbamazepine 1000 per day. No other critical events were found during in hospital staying. A CT scan demonstrated the known subcortical right hemispheric hypodensity with no sulcal effacement or swelling features. Three months later carbamazepine was gradually intterrupted. After few months a new trip to Lagos was planned and chosen an antimalaric prophilaxis with Proguanil/Atovaquone (Malarone). The drug was well tolerated and no side effects were detected.

Take home message:
while choosing antimalaric prophilaxis a medical history of stroke and TIA may encourage the use of non epileptogenic drugs.

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