Mental health disorders are increasingly being recognized as a major global challenge. In the Arabic-speaking Middle East and North Africa (MENA) region, this challenge is compounded by sociocultural stigma, political instability, and limited mental health infrastructure, all of which restrict access to effective care. While neurostimulation modalities such as electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS) have proven effective and are gaining traction, their use in the MENA region remains limited and underexplored. This narrative review aims to bridge critical gaps by examining knowledge levels, attitudes, perceptions, and the clinical application and accessibility of ECT and rTMS across Arabic-speaking countries. We searched multiple databases using keywords related to neurostimulation and psychiatry, covering all 22 Arabic-speaking MENA countries. Studies were included if they were published in English and were related to psychiatric applications of ECT or rTMS. Findings were categorized by geography and grouped into four thematic domains: knowledge, perception, availability, and clinical use. The findings revealed an uneven distribution of neurostimulation research and services across the region; ECT is more established than rTMS. Additionally, public awareness remains low, and high levels of stigma persist. Among clinicians, psychiatrists tend to support neurostimulation, while general medical staff show mixed opinions. rTMS is gaining clinical interest but remains limited in accessibility due to high costs and limited infrastructure. Although neurostimulation should be more widely implemented in psychiatry in the MENA region, it is still underrecognized and underused. Region-specific strategies addressing stigma, training gaps, and policy standardization are essential to optimize neurostimulation use and its public acceptance.

Parenting a child with a chronic disease presents significant emotional and psychological challenges, potentially impacting the mental well-being of family

Hirsutism is defined as a condition in which women develop excessive body hair in androgen-dependent areas, which include lips, chin, chest, abdomen, back, and femoral region. The link between hyperandrogenism and insulin resistance and/or hyperinsulinemia is well established. Polycystic ovary syndrome, as a form of hyperandrogenism, has been linked to several diseases, including type 2 diabetes mellitus and hirsutism. However, it is unknown how common hyperandrogenic problems are in women who receive exogenous insulin. Therefore, this study aims to assess the effect of insulin intake and other sociodemographic factors on the development of hirsutism among diabetic females. This case-control study was conducted in six regions of Saudi Arabia, including Al-Ahsa, Dammam, Qatif, Riyadh, Abha, and Jeddah, during the year 2022. The population was Saudi females who were diabetic, between the age of 18 and 65 years, and living in Saudi Arabia. The sample size was 186 participants. Of the participants, 48 had considerable hirsutism whereas 138 did not. The degree of hirsutism has been determined using the Ferriman and Gallwey scoring tool. A total of 186 diabetic females were included in the study. Among the females, 97 (52.2%) were on insulin therapy and 89 (47.8%) were on non-insulin therapies. Only hair distribution on the chin showed a significant difference between the study groups where 4.1% of cases on insulin showed complete cover with light or heavy hair on the chin compared to 3.4% of controls (P = 0.049). There was no significant difference regarding hirsutism score among the study patients according to insulin intake where the mean score was 5.4 ± 5.1 among cases on insulin versus 4.7 ± 5.1 for controls (P = 0.978). Adjusted logistic regression models showed an insignificant association between diabetic female hirsutism and insulin intake (OR = 1.1 and 1.0, respectively; P > 0.05). Many factors were examined to reveal their associations with hirsutism in diabetic females. Neither the type of diabetes nor insulin intake was significantly correlated with the development of hirsutism. On the other hand, age was found to be significantly associated with the development of hirsutism among age groups (<30, 30-49, and 50+; P = 0.49). It seemed that the prevalence of hirsutism decreases as age advances.