Pub Date : 2024-02-05DOI: 10.62438/tunismed.v102i2.4679
Rihab Moncer, Ines Loubiri, Sarra Melki, Sinene Frigui, Walid Ouannes, Ahmed Ben Abdelaziz, Sonia Jemni
Introduction: Considering the growing global need and the complexity of health conditions, an intensive rehabilitation in inpatient departments is fundamental. Yet, in Tunisia, the distribution of Inpatient Rehabilitation Facilities is not illustrated.
Aim: To perform an update concerning the rehabilitation's beds-ratio /1000 Tunisian-inhabitants in 2023.
Methods: Data were collected from the Tunisian Ministry of Health, the Eastern Mediterranean Regional Office, and the National Institute of Statistics websites.
Results: The findings revealed a total number of rehabilitations' beds 132 among a total of 20000 hospital beds with a rehabilitations' beds-ratio equal to 0.01/1000 inhabitants. Only three Inpatient Rehabilitation Facilities were identified in Tunisia covering the Greater Tunis, North East, and Center east districts. There was inequity of distribution since the beds ratio is 1.07/1000 in the North east, 0.02/1000 in the Greater Tunis and 0 in the North West and the South of Tunisia.
Conclusion: This update highlighted the alarmingly low rehabilitation's beds-ratio in Tunisia, coupled to a significant regional disparity. Increasing beds in the existing Inpatient Rehabilitation Facilities and extending outpatient rehabilitation departments with inpatient units might be considered urgent solutions.
{"title":"An update on the access to inpatient rehabilitation facilities across Tunisia in 2023.","authors":"Rihab Moncer, Ines Loubiri, Sarra Melki, Sinene Frigui, Walid Ouannes, Ahmed Ben Abdelaziz, Sonia Jemni","doi":"10.62438/tunismed.v102i2.4679","DOIUrl":"https://doi.org/10.62438/tunismed.v102i2.4679","url":null,"abstract":"<p><strong>Introduction: </strong>Considering the growing global need and the complexity of health conditions, an intensive rehabilitation in inpatient departments is fundamental. Yet, in Tunisia, the distribution of Inpatient Rehabilitation Facilities is not illustrated.</p><p><strong>Aim: </strong>To perform an update concerning the rehabilitation's beds-ratio /1000 Tunisian-inhabitants in 2023.</p><p><strong>Methods: </strong>Data were collected from the Tunisian Ministry of Health, the Eastern Mediterranean Regional Office, and the National Institute of Statistics websites.</p><p><strong>Results: </strong>The findings revealed a total number of rehabilitations' beds 132 among a total of 20000 hospital beds with a rehabilitations' beds-ratio equal to 0.01/1000 inhabitants. Only three Inpatient Rehabilitation Facilities were identified in Tunisia covering the Greater Tunis, North East, and Center east districts. There was inequity of distribution since the beds ratio is 1.07/1000 in the North east, 0.02/1000 in the Greater Tunis and 0 in the North West and the South of Tunisia.</p><p><strong>Conclusion: </strong>This update highlighted the alarmingly low rehabilitation's beds-ratio in Tunisia, coupled to a significant regional disparity. Increasing beds in the existing Inpatient Rehabilitation Facilities and extending outpatient rehabilitation departments with inpatient units might be considered urgent solutions.</p>","PeriodicalId":38818,"journal":{"name":"Tunisie Medicale","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140866696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-05DOI: 10.62438/tunismed.v102i2.4746
Emna Labbène, Maha Mahmoud, Linda Marrakchi-Kacem, Mohamed Ben Hamouda
Introduction: Although glioblastoma (GBM) has a very poor prognosis, overall survival (OS) in treated patients shows great difference varying from few days to several months. Identifying factors explaining this difference would improve management of patient treatment.
Aim: To determine the relevance of diffusion restriction in newly diagnosed treatment-naïve GBM patients.
Methods: Preoperative magnetic resonance scans of 33 patients with GBM were reviewed. Regions of interest including all the T2 hyperintense lesion were drawn on diffusion weighted B0 images and transferred to the apparent diffusion coefficient (ADC) map. For each patient, a histogram displaying the ADC values within in the regions of interest was generated. Volumetric parameters including tumor regions with restricted diffusion, parameters derived from histogram and mean ADC value of the tumor were calculated. Their relationship with OS was analyzed.
Results: Patients with mean ADC value < 1415x10-6 mm2/s had a significantly shorter OS (p=0.021). Among volumetric parameters, the percentage of volume within T2 lesion with a normalized ADC value <1.5 times that in white matter was significantly associated with OS (p=0.0045). Patients with a percentage>23.92% had a shorter OS. Among parameters derived from histogram, the 50th percentile showed a trend towards significance for OS (p=0.055) with patients living longer when having higher values of 50th percentile. A difference in OS was observed between patients according to ADC peak of histogram but this difference did not reach statistical significance (p=0.0959).
Conclusion: Diffusion magnetic resonance imaging may provide useful information for predicting GBM prognosis.
简介虽然胶质母细胞瘤(GBM)的预后很差,但治疗后患者的总生存期(OS)却有很大差异,从几天到几个月不等。目的:确定弥散限制与新诊断的治疗无效 GBM 患者的相关性:方法:对33例GBM患者的术前磁共振扫描进行回顾。在弥散加权 B0 图像上绘制包括所有 T2 高浓病灶在内的感兴趣区,并将其转入表观弥散系数(ADC)图。为每位患者生成直方图,显示感兴趣区内的 ADC 值。计算包括扩散受限的肿瘤区域在内的容积参数、直方图得出的参数以及肿瘤的平均 ADC 值。分析了它们与 OS 的关系:结果:平均ADC值小于1415x10-6 mm2/s的患者的OS明显较短(P=0.021)。在容积参数中,T2病灶内容积百分比归一化ADC值为23.92%的患者OS较短。在直方图得出的参数中,第50百分位数对OS有显著影响趋势(p=0.055),第50百分位数值越高的患者寿命越长。根据直方图的 ADC 峰值,观察到不同患者的 OS 存在差异,但这种差异未达到统计学意义(P=0.0959):结论:弥散磁共振成像可为预测 GBM 的预后提供有用信息。
{"title":"Prognostic value of preoperative diffusion restriction in glioblastoma.","authors":"Emna Labbène, Maha Mahmoud, Linda Marrakchi-Kacem, Mohamed Ben Hamouda","doi":"10.62438/tunismed.v102i2.4746","DOIUrl":"https://doi.org/10.62438/tunismed.v102i2.4746","url":null,"abstract":"<p><strong>Introduction: </strong>Although glioblastoma (GBM) has a very poor prognosis, overall survival (OS) in treated patients shows great difference varying from few days to several months. Identifying factors explaining this difference would improve management of patient treatment.</p><p><strong>Aim: </strong>To determine the relevance of diffusion restriction in newly diagnosed treatment-naïve GBM patients.</p><p><strong>Methods: </strong>Preoperative magnetic resonance scans of 33 patients with GBM were reviewed. Regions of interest including all the T2 hyperintense lesion were drawn on diffusion weighted B0 images and transferred to the apparent diffusion coefficient (ADC) map. For each patient, a histogram displaying the ADC values within in the regions of interest was generated. Volumetric parameters including tumor regions with restricted diffusion, parameters derived from histogram and mean ADC value of the tumor were calculated. Their relationship with OS was analyzed.</p><p><strong>Results: </strong>Patients with mean ADC value < 1415x10-6 mm2/s had a significantly shorter OS (p=0.021). Among volumetric parameters, the percentage of volume within T2 lesion with a normalized ADC value <1.5 times that in white matter was significantly associated with OS (p=0.0045). Patients with a percentage>23.92% had a shorter OS. Among parameters derived from histogram, the 50th percentile showed a trend towards significance for OS (p=0.055) with patients living longer when having higher values of 50th percentile. A difference in OS was observed between patients according to ADC peak of histogram but this difference did not reach statistical significance (p=0.0959).</p><p><strong>Conclusion: </strong>Diffusion magnetic resonance imaging may provide useful information for predicting GBM prognosis.</p>","PeriodicalId":38818,"journal":{"name":"Tunisie Medicale","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140855477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-05DOI: 10.62438/tunismed.v102i2.4617
Rihem Kouada, Khaled Annabi, Amal Mosbahi, Tasnim Masmoudi, Mohamed Ben Dhiab
Introduction: Transformed progressively into a transit country towards Europe but also as a host, Tunisia has seen a diversification of migratory movements since the 2011 revolution, as well as the profiles of migrants who face multiple difficulties that can have an impact on their health.
Aim: This update aimed to expose the situation of migrants in Tunisia regarding access to healthcare, and to raise the ethical issues that result from it.
Results: Providing care to vulnerable individuals, especially migrants, compels us to reevaluate our practices and question ourselves. Ethical questioning is constant to determine how to do well and not harm. The reflection on this more humane "social medicine" comprehending the patient in its entirety, is only in its beginnings. The critical health status of the poorest populations and their extreme vulnerability do not only call for adapted and specific care measures but also a more comprehensive questioning of social ties and the place that our society grants to the weakest and excluded.
Conclusion: Migration must be considered as a central issue of the ethics of the health of a population in order to provide quality care without prejudice.
{"title":"Access to healthcare for migrants in Tunisia in 2023-2024: Current situation and ethical challenges.","authors":"Rihem Kouada, Khaled Annabi, Amal Mosbahi, Tasnim Masmoudi, Mohamed Ben Dhiab","doi":"10.62438/tunismed.v102i2.4617","DOIUrl":"https://doi.org/10.62438/tunismed.v102i2.4617","url":null,"abstract":"<p><strong>Introduction: </strong>Transformed progressively into a transit country towards Europe but also as a host, Tunisia has seen a diversification of migratory movements since the 2011 revolution, as well as the profiles of migrants who face multiple difficulties that can have an impact on their health.</p><p><strong>Aim: </strong>This update aimed to expose the situation of migrants in Tunisia regarding access to healthcare, and to raise the ethical issues that result from it.</p><p><strong>Results: </strong>Providing care to vulnerable individuals, especially migrants, compels us to reevaluate our practices and question ourselves. Ethical questioning is constant to determine how to do well and not harm. The reflection on this more humane \"social medicine\" comprehending the patient in its entirety, is only in its beginnings. The critical health status of the poorest populations and their extreme vulnerability do not only call for adapted and specific care measures but also a more comprehensive questioning of social ties and the place that our society grants to the weakest and excluded.</p><p><strong>Conclusion: </strong>Migration must be considered as a central issue of the ethics of the health of a population in order to provide quality care without prejudice.</p>","PeriodicalId":38818,"journal":{"name":"Tunisie Medicale","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140858226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Pemphigus is a therapeutically challenging disease with high morbidity and economic burden. First-line prescription of rituximab remains limited in Tunisia due to its high cost. Systemic steroids remain the standard of care but are associated with a major risk of morbidities and higher treatment costs.
Aim: To assess the direct medical costs of pemphigus in Tunisia.
Methods: Retrospective estimation of direct medical costs during the 18 months following the diagnosis using the "bottom-up approach" in the Dermatology Department of Hedi Chaker Hospital, Sfax, Tunisia.
Results: Total medical costs were estimated at 38745.7 €, with an average cost of 1 210 € per patient and per year: paraclinical investigations (46%), medical treatment (30%), hospitalization (21%) and outpatient visits (3%). The average cost was the highest in the age group of 15-24 years (1553 €). Treatment costs related to corticosteroid-induced morbidity were estimated at 1208 €.
Conclusions: The management of pemphigus in Tunisia needs to be adapted to take into account the health economic analysis in order to reduce overall disease costs and the burden of steroid-induced morbidities.
{"title":"Direct medical cost related to the management of pemphigus: A pilot Tunisian study.","authors":"Faten Hayder, Emna Bahloul, Sourour Yaich, Sana Turki, Khadija Sellami, Noureddine Litaiem, Hatem Masmoudi, Manel Turki, Hamida Turki","doi":"10.62438/tunismed.v102i2.4651","DOIUrl":"https://doi.org/10.62438/tunismed.v102i2.4651","url":null,"abstract":"<p><strong>Introduction: </strong>Pemphigus is a therapeutically challenging disease with high morbidity and economic burden. First-line prescription of rituximab remains limited in Tunisia due to its high cost. Systemic steroids remain the standard of care but are associated with a major risk of morbidities and higher treatment costs.</p><p><strong>Aim: </strong>To assess the direct medical costs of pemphigus in Tunisia.</p><p><strong>Methods: </strong>Retrospective estimation of direct medical costs during the 18 months following the diagnosis using the \"bottom-up approach\" in the Dermatology Department of Hedi Chaker Hospital, Sfax, Tunisia.</p><p><strong>Results: </strong>Total medical costs were estimated at 38745.7 €, with an average cost of 1 210 € per patient and per year: paraclinical investigations (46%), medical treatment (30%), hospitalization (21%) and outpatient visits (3%). The average cost was the highest in the age group of 15-24 years (1553 €). Treatment costs related to corticosteroid-induced morbidity were estimated at 1208 €.</p><p><strong>Conclusions: </strong>The management of pemphigus in Tunisia needs to be adapted to take into account the health economic analysis in order to reduce overall disease costs and the burden of steroid-induced morbidities.</p>","PeriodicalId":38818,"journal":{"name":"Tunisie Medicale","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140871568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-05DOI: 10.62438/tunismed.v102i2.4760
Sana Dorgham, Mohamed Amine Selmene, Mourad Zaraa, Ahmed Amine Lahmar, Hedi Annabi, Sabri Mahjoub
Introduction: Proximal femur fractures are one of the most common injuries in older adults representing a serious health condition in developed as well as developing countries.
Aim: This study aimed to assess the hospitalization costs of the proximal femur fracture.
Methods: We conducted a prospective descriptive study spread over six months about patients hospitalized and operated on for proximal femur fractures. In order to estimate the cost we referred to the nomenclature of professional acts and the prices set by the Ministry of Public Health and the Ministry of Finance.
Results: The study included 100 patients, 55 females and 45 males with an average age of 76 years. The average hospital length of stay was 5 days. The preoperative stay was at a mean of three days. The average total hospitalization cost for these fractures was 2877 Tunisian Dinars depending on the type of fracture and surgical treatment. The main components of the costs were hospital stay costs and human resources costs 40%, cost of the implant 25.9%, cost of consumables 12%, operating cost 10%, cost of additional examinations 9% and cost of medications 2%.
Conclusion: Proximal femur fractures represent an important cause of health resource consumption. To reduce the cost of hospital care, we recommend limiting the length of hospital stay as much as possible, investing in total hip and hemi-arthroplasties and adapting economical behavior taking into account the cost of consumables.
{"title":"Proximal femur fracture: Direct medical costs of hospital treatment.","authors":"Sana Dorgham, Mohamed Amine Selmene, Mourad Zaraa, Ahmed Amine Lahmar, Hedi Annabi, Sabri Mahjoub","doi":"10.62438/tunismed.v102i2.4760","DOIUrl":"https://doi.org/10.62438/tunismed.v102i2.4760","url":null,"abstract":"<p><strong>Introduction: </strong>Proximal femur fractures are one of the most common injuries in older adults representing a serious health condition in developed as well as developing countries.</p><p><strong>Aim: </strong>This study aimed to assess the hospitalization costs of the proximal femur fracture.</p><p><strong>Methods: </strong>We conducted a prospective descriptive study spread over six months about patients hospitalized and operated on for proximal femur fractures. In order to estimate the cost we referred to the nomenclature of professional acts and the prices set by the Ministry of Public Health and the Ministry of Finance.</p><p><strong>Results: </strong>The study included 100 patients, 55 females and 45 males with an average age of 76 years. The average hospital length of stay was 5 days. The preoperative stay was at a mean of three days. The average total hospitalization cost for these fractures was 2877 Tunisian Dinars depending on the type of fracture and surgical treatment. The main components of the costs were hospital stay costs and human resources costs 40%, cost of the implant 25.9%, cost of consumables 12%, operating cost 10%, cost of additional examinations 9% and cost of medications 2%.</p><p><strong>Conclusion: </strong>Proximal femur fractures represent an important cause of health resource consumption. To reduce the cost of hospital care, we recommend limiting the length of hospital stay as much as possible, investing in total hip and hemi-arthroplasties and adapting economical behavior taking into account the cost of consumables.</p>","PeriodicalId":38818,"journal":{"name":"Tunisie Medicale","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140863607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"\"La Tunisie Médicale\" Towards greater editorial visibility and academic recognition.","authors":"Ahmed Ben Abdelaziz","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":38818,"journal":{"name":"Tunisie Medicale","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140858809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-05DOI: 10.62438/tunismed.v102i2.4449
Mohamed Slim Werda, Fatma Cheikhrouhou, Zeineb Ben Zina, Fattouma Makni, Ali Ayadi
Introduction: Chronic blepharitis is a common cause of eye irritation and dryness. They are often treated without regard to causal factors such as parasites which are rarely mentioned.
Aim: To describe the role of Demodex in the pathogenesis of chronic blepharitis, to analyze the epidemiological, clinical, diagnostic and therapeutic particularities.
Methods: This is a prospective, case-control study conducted in the mycology parasitology department at the Habib Bourguiba university hospital in Sfax covering 100 cases with chronic blepharitis and 87 control cases. Clinical examination and eyelash removal were performed with direct examination for qualitative and quantitative analysis, before and after treatment.
Results: Demodex was significantly more found in patients than in controls (48% vs 13.8%). The quantitative analysis showed a significant difference between the two groups with 52.1% of Demodex (+++) for patients versus 8.3% for controls. Demodex blepharitis were treated with yellow oxid mercure ophthalmic ointment with a good outcome in 81,3%.
Conclusion: Although it is admitted to be a saprophyte of the skin, a large number of arguments argues for the incrimination of Demodex in the etiopathogenesis of chronic blepharitis, hence the interest of eyelashes examination and a parasitic research in front of any chronic blepharitis resistant to usual treatments. In case of positive research, a specific treatment should be prescribed. Its effectiveness is another argument for the etiological diagnosis.
{"title":"Chronic blepharitis due to Demodex: A prospective study in Sfax (Tunisia).","authors":"Mohamed Slim Werda, Fatma Cheikhrouhou, Zeineb Ben Zina, Fattouma Makni, Ali Ayadi","doi":"10.62438/tunismed.v102i2.4449","DOIUrl":"https://doi.org/10.62438/tunismed.v102i2.4449","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic blepharitis is a common cause of eye irritation and dryness. They are often treated without regard to causal factors such as parasites which are rarely mentioned.</p><p><strong>Aim: </strong>To describe the role of Demodex in the pathogenesis of chronic blepharitis, to analyze the epidemiological, clinical, diagnostic and therapeutic particularities.</p><p><strong>Methods: </strong>This is a prospective, case-control study conducted in the mycology parasitology department at the Habib Bourguiba university hospital in Sfax covering 100 cases with chronic blepharitis and 87 control cases. Clinical examination and eyelash removal were performed with direct examination for qualitative and quantitative analysis, before and after treatment.</p><p><strong>Results: </strong>Demodex was significantly more found in patients than in controls (48% vs 13.8%). The quantitative analysis showed a significant difference between the two groups with 52.1% of Demodex (+++) for patients versus 8.3% for controls. Demodex blepharitis were treated with yellow oxid mercure ophthalmic ointment with a good outcome in 81,3%.</p><p><strong>Conclusion: </strong>Although it is admitted to be a saprophyte of the skin, a large number of arguments argues for the incrimination of Demodex in the etiopathogenesis of chronic blepharitis, hence the interest of eyelashes examination and a parasitic research in front of any chronic blepharitis resistant to usual treatments. In case of positive research, a specific treatment should be prescribed. Its effectiveness is another argument for the etiological diagnosis.</p>","PeriodicalId":38818,"journal":{"name":"Tunisie Medicale","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140868339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Eighty-five per cent of uterine inversions are puerperal. Non-puerperal uterine inversion is usually caused by tumours that exert a traction force on the fundus of the uterus. This causes the uterus to be partially or completely inverted. It is commonly related to benign tumours like submucosal leiomyomas. Nevertheless, malignancies are an infrequent association.
Case presentation: We report a case of a 35-year-old female patient, medically and surgically free, gravida0 para0, complaining of menometrorrhagia associated with pelvic pain for 2 years. A suprapubic ultrasound scan showed an enlarged, globular uterus with a heterogeneous, undefined mass of 49 mm in size. MRI scan showed the appearance of a U-shaped uterine cavity and a thickened inverted uterine fundus with an endometrial infiltrating mass of 25 mm. Intraoperative exploration showed uterine inversion involving the ovaries; the fallopian tubes and the round ligaments and a necrotic intracavitary mass. The malignancy of the tumor was confirmed through anatomopathological examination as Adenosarcoma.
Conclusions: Uterine inversion is rare outside the puerperal period, and malignant etiology must not be overlooked. Therefore, comprehensive care with meticulous etiological investigation is crucial.
{"title":"Nonpuerperal uterine inversion caused by an adenosarcoma: A case report.","authors":"Cyrine Belghith, Ghada Abdelmoula, Mariem Garci, Zeineb Ghali, Saoussam Armi, Mehdi Makni, Fatma Dhieb, Miriam Boumediene, Myriam Jrad, Nabil Mathlouthi, Olfa Slimani","doi":"10.62438/tunismed.v102i2.4352","DOIUrl":"https://doi.org/10.62438/tunismed.v102i2.4352","url":null,"abstract":"<p><strong>Introduction: </strong>Eighty-five per cent of uterine inversions are puerperal. Non-puerperal uterine inversion is usually caused by tumours that exert a traction force on the fundus of the uterus. This causes the uterus to be partially or completely inverted. It is commonly related to benign tumours like submucosal leiomyomas. Nevertheless, malignancies are an infrequent association.</p><p><strong>Case presentation: </strong>We report a case of a 35-year-old female patient, medically and surgically free, gravida0 para0, complaining of menometrorrhagia associated with pelvic pain for 2 years. A suprapubic ultrasound scan showed an enlarged, globular uterus with a heterogeneous, undefined mass of 49 mm in size. MRI scan showed the appearance of a U-shaped uterine cavity and a thickened inverted uterine fundus with an endometrial infiltrating mass of 25 mm. Intraoperative exploration showed uterine inversion involving the ovaries; the fallopian tubes and the round ligaments and a necrotic intracavitary mass. The malignancy of the tumor was confirmed through anatomopathological examination as Adenosarcoma.</p><p><strong>Conclusions: </strong>Uterine inversion is rare outside the puerperal period, and malignant etiology must not be overlooked. Therefore, comprehensive care with meticulous etiological investigation is crucial.</p>","PeriodicalId":38818,"journal":{"name":"Tunisie Medicale","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140867800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-05DOI: 10.62438/tunismed.v102i2.4815
Amr Chaabeni, Amine Kalai, Jaouher Dhouibi, Helmi Ben Saad, Anis Jellad
Introduction: To enhance players' performance and implement effective injury prevention protocols and surveillance programs in football, it is essential to conduct epidemiological studies. Since significant disparities in injury rates across various football competitions were reported, it is important to characterize injuries in the context of the African cup of nation (AFCON) competition.
Aim: To determine the incidence and factors associated with injuries among African footballers during the 2024 AFCON competition, which will be held in Ivory Coast from January 13 to February 11, 2024.
Methods: Two expert physician in sports medicine will perform an analytical study (i.e.; a video-based analysis) of the 52 matches that will be played during the 2024 AFCON. The following parameters will be noted: i) Injury incidence, ii) Characteristics of injured players such as age, on-field position, and player league continent, iii) Characteristics ofinjuries such as mechanism, body location, moment of injury in terms of the minute of play and the round of the match, place of the injury in term of stadium zone, replacement consequent to the injury, absence next match, re-injury, recurrence of the injury with the same location during the competition, referee decision, and stoppage time for on-field injury, and iv) Characteristics of matches such as the match' schedule, ambient temperature, humidity, and wind speed.
Conclusion: This study will allow enriching the existing literature with additional data regarding the injuries and the players' characteristics in the African context.
{"title":"Designing a study on footballers' injuries in the 2024 African cup of nations competition (Ivory Coast).","authors":"Amr Chaabeni, Amine Kalai, Jaouher Dhouibi, Helmi Ben Saad, Anis Jellad","doi":"10.62438/tunismed.v102i2.4815","DOIUrl":"https://doi.org/10.62438/tunismed.v102i2.4815","url":null,"abstract":"<p><strong>Introduction: </strong>To enhance players' performance and implement effective injury prevention protocols and surveillance programs in football, it is essential to conduct epidemiological studies. Since significant disparities in injury rates across various football competitions were reported, it is important to characterize injuries in the context of the African cup of nation (AFCON) competition.</p><p><strong>Aim: </strong>To determine the incidence and factors associated with injuries among African footballers during the 2024 AFCON competition, which will be held in Ivory Coast from January 13 to February 11, 2024.</p><p><strong>Methods: </strong>Two expert physician in sports medicine will perform an analytical study (i.e.; a video-based analysis) of the 52 matches that will be played during the 2024 AFCON. The following parameters will be noted: i) Injury incidence, ii) Characteristics of injured players such as age, on-field position, and player league continent, iii) Characteristics ofinjuries such as mechanism, body location, moment of injury in terms of the minute of play and the round of the match, place of the injury in term of stadium zone, replacement consequent to the injury, absence next match, re-injury, recurrence of the injury with the same location during the competition, referee decision, and stoppage time for on-field injury, and iv) Characteristics of matches such as the match' schedule, ambient temperature, humidity, and wind speed.</p><p><strong>Conclusion: </strong>This study will allow enriching the existing literature with additional data regarding the injuries and the players' characteristics in the African context.</p>","PeriodicalId":38818,"journal":{"name":"Tunisie Medicale","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140852173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}