Pub Date : 2024-01-05DOI: 10.62438/tunismed.v102i1.4723
Yosra Raddaoui, Ahmed Ben Amara, Aymen Noamen, Saoussen Antit, Youssef Hajri, Jamila Habli, Hassen Ibn Hadj Amor, Youssef Ben Youssef, Lilia Zakhama, Wafa Fehri
Research problem: Hypertension is a multifactorial disease that affects approximately one third of the Tunisian adult population. It is a major risk factor for stroke and cardiovascular disease. Environmental and psychosocial factors play an important role in hypertension onset and control. The prevalence of depression among hypertensive patients is 26, 8% and its presence is associated with increased risk of cardiovascular related morbi-mortality. Our study aims to evaluate the role of depression in blood pressure control among ambulatory hypertensive patients. Investigative process: This study is a cross-sectional, multicentric and descriptive study. We intend to include three hundred and two patients. A 24-hour ambulatory blood pressure monitor will be used to evaluate blood pressure control. Depression will be assessed by the 9-item Patient Health Questionnaire (PHQ-9) in Tunisian dialect. Clinical, socio-environmental, psychosocial and therapeutic and prognosis data will be collected from medical records. Patients will be classified into two groups: Controlled versus non-controlled hypertension. PHQ-9 scores will be then compared between the two cohorts.
Research plan: Ethical considerations will be undertaken and respected. All patients should express an informed oral consent before enrollment. This trial will run for three months from the 15th August 2022.
{"title":"Role of depression in blood pressure control. A cross-sectional multicentric study.","authors":"Yosra Raddaoui, Ahmed Ben Amara, Aymen Noamen, Saoussen Antit, Youssef Hajri, Jamila Habli, Hassen Ibn Hadj Amor, Youssef Ben Youssef, Lilia Zakhama, Wafa Fehri","doi":"10.62438/tunismed.v102i1.4723","DOIUrl":"10.62438/tunismed.v102i1.4723","url":null,"abstract":"<p><strong>Research problem: </strong>Hypertension is a multifactorial disease that affects approximately one third of the Tunisian adult population. It is a major risk factor for stroke and cardiovascular disease. Environmental and psychosocial factors play an important role in hypertension onset and control. The prevalence of depression among hypertensive patients is 26, 8% and its presence is associated with increased risk of cardiovascular related morbi-mortality. Our study aims to evaluate the role of depression in blood pressure control among ambulatory hypertensive patients. Investigative process: This study is a cross-sectional, multicentric and descriptive study. We intend to include three hundred and two patients. A 24-hour ambulatory blood pressure monitor will be used to evaluate blood pressure control. Depression will be assessed by the 9-item Patient Health Questionnaire (PHQ-9) in Tunisian dialect. Clinical, socio-environmental, psychosocial and therapeutic and prognosis data will be collected from medical records. Patients will be classified into two groups: Controlled versus non-controlled hypertension. PHQ-9 scores will be then compared between the two cohorts.</p><p><strong>Research plan: </strong>Ethical considerations will be undertaken and respected. All patients should express an informed oral consent before enrollment. This trial will run for three months from the 15th August 2022.</p><p><strong>Trial registration: </strong>NCT05516173.</p>","PeriodicalId":38818,"journal":{"name":"Tunisie Medicale","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11261507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140307264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-05DOI: 10.62438/tunismed.v102i1.4689
Imen Turki, Mouna Mnif, Chekib Zedini
Introduction: Type 2 Diabetes Mellitus (T2DM) is a chronic non-communicable disease with major impact on health in general and quality of life (QoL) in particular. The ultimate goal of all health interventions is to reduce the burden of this disease.
Aim: To evaluate the effect of therapeutic education program on the QoL among patients with T2DM.
Methods: Between May 2021 and July 2022, 320 outpatients were enrolled in a randomized controlled trial in Sfax, Tunisia. The experimental group received the therapeutic education program, whereas the control group received only standard care. For data collection, the Arabic version of the Diabetes Quality of Life (DQoL-Arabic) questionnaire was used.
Results: In total, 263 patients completed the intervention, 132 in the experimental group and 131 in the control group. In terms of the main baseline characteristics, the two groups were comparable. After the intervention, there was a significant difference in all domains of QoL scores (median [interquartile]) between the experimental and control groups: satisfaction (3.14 [2.64-3.36] vs. 3.57 [3.43-3.71], p<0.001, respectively), impact (2.09 [1.91-2.36] vs. 2.45 [2.27 2.64], p<0.001, respectively) and worries (2.50 [2.25-2.75] vs. 3.00 [2.75 3.14], p<0.001, respectively). The QoL improves over time in the experimental group (3.01 [2.79-3.17] vs. 2.59 [2.21-2.80], p<0.001, respectively) and remains comparable in the control group (2.99 [2.81-3.14] vs. 3.01 [2.81-3.15], p=0.724, respectively).
Conclusions: The benefits of implementing an educational program among patients with T2DM are observed in terms of all QoL domains.
引言2 型糖尿病(T2DM)是一种慢性非传染性疾病,对总体健康,特别是生活质量(QoL)有重大影响。目的:评估治疗教育计划对 T2DM 患者生活质量的影响:2021年5月至2022年7月,突尼斯斯法克斯的一项随机对照试验招募了320名门诊患者。实验组接受治疗教育计划,而对照组只接受标准护理。数据收集采用阿拉伯语版糖尿病生活质量(DQoL-Arabic)问卷:共有 263 名患者完成了干预,其中实验组 132 人,对照组 131 人。就主要基线特征而言,两组具有可比性。干预结束后,实验组和对照组在所有 QoL 领域的得分(中位数[四分位数之间])均有显著差异:满意度(3.14 [2.64-3.36] vs. 3.57 [3.43-3.71],pConclusions):在 T2DM 患者中实施教育计划的益处体现在所有 QoL 领域。
{"title":"The effect of therapeutic education program on quality of life among type 2 diabetic North-African patients: a randomized controlled trial.","authors":"Imen Turki, Mouna Mnif, Chekib Zedini","doi":"10.62438/tunismed.v102i1.4689","DOIUrl":"10.62438/tunismed.v102i1.4689","url":null,"abstract":"<p><strong>Introduction: </strong>Type 2 Diabetes Mellitus (T2DM) is a chronic non-communicable disease with major impact on health in general and quality of life (QoL) in particular. The ultimate goal of all health interventions is to reduce the burden of this disease.</p><p><strong>Aim: </strong>To evaluate the effect of therapeutic education program on the QoL among patients with T2DM.</p><p><strong>Methods: </strong>Between May 2021 and July 2022, 320 outpatients were enrolled in a randomized controlled trial in Sfax, Tunisia. The experimental group received the therapeutic education program, whereas the control group received only standard care. For data collection, the Arabic version of the Diabetes Quality of Life (DQoL-Arabic) questionnaire was used.</p><p><strong>Results: </strong>In total, 263 patients completed the intervention, 132 in the experimental group and 131 in the control group. In terms of the main baseline characteristics, the two groups were comparable. After the intervention, there was a significant difference in all domains of QoL scores (median [interquartile]) between the experimental and control groups: satisfaction (3.14 [2.64-3.36] vs. 3.57 [3.43-3.71], p<0.001, respectively), impact (2.09 [1.91-2.36] vs. 2.45 [2.27 2.64], p<0.001, respectively) and worries (2.50 [2.25-2.75] vs. 3.00 [2.75 3.14], p<0.001, respectively). The QoL improves over time in the experimental group (3.01 [2.79-3.17] vs. 2.59 [2.21-2.80], p<0.001, respectively) and remains comparable in the control group (2.99 [2.81-3.14] vs. 3.01 [2.81-3.15], p=0.724, respectively).</p><p><strong>Conclusions: </strong>The benefits of implementing an educational program among patients with T2DM are observed in terms of all QoL domains.</p>","PeriodicalId":38818,"journal":{"name":"Tunisie Medicale","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140307265","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 : 2024-01-05DOI: 10.62438/tunismed.v102i1.4503
Mohamed Hbibi, Mounira El Alaoui El Hanafi, Zakaria Kasmi, Hind Ouair, Sarra Benmiloud, Fatima Ailal, Moustapha Hida, Ahmed Aziz Bousfiha
Autoimmune cytopenias are defined by autoantibodies' immune destruction of one or more blood elements. Most often it is autoimmune hemolytic anemia or immune thrombocytopenia or both that define Evans syndrome. It may be secondary to infection or to underlying pathology such as systemic autoimmune disease or primary immunodeficiency, especially when it becomes chronic over several years. Primary Immunodeficiencies or inborn errors of immunity (IEI) are no longer defined solely by infections: autoimmunity is part of the clinical features of several of these diseases. It is dominated by autoimmune cytopenias, in particular, immune thrombocytopenia (ITP) and autoimmune hemolytic anaemia (AIHA). The challenges for the clinician are the situations where autoimmune cytopenias are chronic, recurrent and/or refractory to the various long-term therapeutic options. Most of these therapies are similar in action and generally consist of non-mediated immune suppression or modulation. In these situations, primary Immunodeficiencies must be diagnosed as soon as possible to allow the initiation of a targeted treatment and to avoid several ineffective therapeutic lines.
{"title":"Autoimmune cytopenias in children: When to think of primary immunodeficiency?","authors":"Mohamed Hbibi, Mounira El Alaoui El Hanafi, Zakaria Kasmi, Hind Ouair, Sarra Benmiloud, Fatima Ailal, Moustapha Hida, Ahmed Aziz Bousfiha","doi":"10.62438/tunismed.v102i1.4503","DOIUrl":"10.62438/tunismed.v102i1.4503","url":null,"abstract":"<p><p>Autoimmune cytopenias are defined by autoantibodies' immune destruction of one or more blood elements. Most often it is autoimmune hemolytic anemia or immune thrombocytopenia or both that define Evans syndrome. It may be secondary to infection or to underlying pathology such as systemic autoimmune disease or primary immunodeficiency, especially when it becomes chronic over several years. Primary Immunodeficiencies or inborn errors of immunity (IEI) are no longer defined solely by infections: autoimmunity is part of the clinical features of several of these diseases. It is dominated by autoimmune cytopenias, in particular, immune thrombocytopenia (ITP) and autoimmune hemolytic anaemia (AIHA). The challenges for the clinician are the situations where autoimmune cytopenias are chronic, recurrent and/or refractory to the various long-term therapeutic options. Most of these therapies are similar in action and generally consist of non-mediated immune suppression or modulation. In these situations, primary Immunodeficiencies must be diagnosed as soon as possible to allow the initiation of a targeted treatment and to avoid several ineffective therapeutic lines.</p>","PeriodicalId":38818,"journal":{"name":"Tunisie Medicale","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11261479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140307256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-05DOI: 10.62438/tunismed.v102i1.4521
Fatma Tritar, Soumaya Ben Saad, Mariem Ferchichi, Amani Ben Mansour, Azza Slim, Othman Neffati, Hedia Bellili, Leila Slim, Hafaoua Daghfous
Introduction-aim: The emergence of multidrug resistant tuberculosis (MDR-TB) is a threat to global public health. The aim of our study was to determine risk factors for treatment failure in MDR-TB.
Methods: Retrospective study conducted between January 2000 and March 2019 including patients with MDR-TB. Characteristics of patients with therapeutic failure were compared to cured ones. Logistic regression analysis was used to identify risk factors for treatment failure.
Results: Our study included 140 patients aged of 42±13 years (18-80). Fifty-seven percent of patients had treatment success and 12% had treatment failure. In multivariate logistic regression analysis, treatment failure was associated with age over 45 years (OR=1.05; 95%CI, 1.024-7.736;p=0.014), primary education level and illiteracy (OR=5.022; 95%CI, 1.316-19.161;p=0,018), history of incarceration (OR=3.291; 95%CI, 1.291-21.083;p=0.016), undernutrition (OR=4.544; 95%CI, 2.304-54.231;p=0,027), extensive TB (OR=6.406; 95%CI, 1.761-23.922; p=0.038), initial high grade positive smears (OR=1.210; 95%CI, 1.187-32.657; p=0.045), positive smear culture at 90 days of treatment (OR=6.871, 95%CI, 3.824-23.541; p=0.003), poor adherence (OR=6.110; 95%CI, 2.740-12.450; p=0.021) and occurrence of psychiatric adverse events (OR=3.644 95%CI, 2.560- 27.268; p=0.041).
Conclusion: Therapeutic education, nutritional and psychological support and close follow-up are strongly recommended to optimize the prognosis of MDR-TB.
{"title":"Risk factors for treatment failure in multidrug resistant tuberculosis in Tunisia: An analytic study.","authors":"Fatma Tritar, Soumaya Ben Saad, Mariem Ferchichi, Amani Ben Mansour, Azza Slim, Othman Neffati, Hedia Bellili, Leila Slim, Hafaoua Daghfous","doi":"10.62438/tunismed.v102i1.4521","DOIUrl":"10.62438/tunismed.v102i1.4521","url":null,"abstract":"<p><strong>Introduction-aim: </strong>The emergence of multidrug resistant tuberculosis (MDR-TB) is a threat to global public health. The aim of our study was to determine risk factors for treatment failure in MDR-TB.</p><p><strong>Methods: </strong>Retrospective study conducted between January 2000 and March 2019 including patients with MDR-TB. Characteristics of patients with therapeutic failure were compared to cured ones. Logistic regression analysis was used to identify risk factors for treatment failure.</p><p><strong>Results: </strong>Our study included 140 patients aged of 42±13 years (18-80). Fifty-seven percent of patients had treatment success and 12% had treatment failure. In multivariate logistic regression analysis, treatment failure was associated with age over 45 years (OR=1.05; 95%CI, 1.024-7.736;p=0.014), primary education level and illiteracy (OR=5.022; 95%CI, 1.316-19.161;p=0,018), history of incarceration (OR=3.291; 95%CI, 1.291-21.083;p=0.016), undernutrition (OR=4.544; 95%CI, 2.304-54.231;p=0,027), extensive TB (OR=6.406; 95%CI, 1.761-23.922; p=0.038), initial high grade positive smears (OR=1.210; 95%CI, 1.187-32.657; p=0.045), positive smear culture at 90 days of treatment (OR=6.871, 95%CI, 3.824-23.541; p=0.003), poor adherence (OR=6.110; 95%CI, 2.740-12.450; p=0.021) and occurrence of psychiatric adverse events (OR=3.644 95%CI, 2.560- 27.268; p=0.041).</p><p><strong>Conclusion: </strong>Therapeutic education, nutritional and psychological support and close follow-up are strongly recommended to optimize the prognosis of MDR-TB.</p>","PeriodicalId":38818,"journal":{"name":"Tunisie Medicale","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11261501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140307263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Pediatric end-stage renal disease is a rare but severe condition that causes numerous complications and impairs the quality of life of children. Kidney transplantation is the therapy of choice in pediatric end-stage renal disease.
Aim: Our study aimed to identify the predictive factors of renal graft failure after kidney transplantation in Tunisian children and young adults.
Methods: We conducted a retrospective bicentric study of children and young adults (age≤20 years) who had undergone renal transplantation between 1989 and 2019 in Tunisia. We analyzed long-term survival rates and complications after pediatric kidney transplantation and searched for predictive parameters for graft dysfunction. We used a univariate and a multivariate analysis to identify predictive factors of graft survival.
Results: A total of 112 patients underwent 115 kidney transplantations. Graft failure occurred in 30% of the cases. The overall 1-, 3-, 5- and 10-year graft survival rates were 92%, 89.1%, 85.9% and 74.5% respectively. The following parameters strongly influenced graft survival: immunosuppressive regimen including an association other than Mycophenolate mofetil- tacrolimus and corticosteroids (p=0.002), year of transplant (p<0.0001 for 1987-2000), deceased donor (p = 0.039), underlying etiology of end-stage renal disease (p=0.045), occurrence of acute or chronic rejection (p<0.001), a urine protein greater than 0.3 g/l per day (p=0.002), post-transplant urologic complications (p=0.002), five-year creatinine level>1.28 mg/dl (p<0.001). The overall 1-, 3-, 5- and 10-year patients survival rates were 97%, 95%, 90.2% and 84.4% respectively.
Conclusions: Our study identified several predictive factors of graft failure in Tunisian children and young adults undergoing renal transplantation.
{"title":"Predictive Factors of Renal Graft Failure in Tunisian Children and young adults: A Retrospective Study.","authors":"Abir Boussetta, Manel Jellouli, Tahar Gargah, Meriem Hajji, Hafedh Hedri, Ezzeddine Abderrahim","doi":"10.62438/tunismed.v102i1.4328","DOIUrl":"10.62438/tunismed.v102i1.4328","url":null,"abstract":"<p><strong>Introduction: </strong>Pediatric end-stage renal disease is a rare but severe condition that causes numerous complications and impairs the quality of life of children. Kidney transplantation is the therapy of choice in pediatric end-stage renal disease.</p><p><strong>Aim: </strong>Our study aimed to identify the predictive factors of renal graft failure after kidney transplantation in Tunisian children and young adults.</p><p><strong>Methods: </strong>We conducted a retrospective bicentric study of children and young adults (age≤20 years) who had undergone renal transplantation between 1989 and 2019 in Tunisia. We analyzed long-term survival rates and complications after pediatric kidney transplantation and searched for predictive parameters for graft dysfunction. We used a univariate and a multivariate analysis to identify predictive factors of graft survival.</p><p><strong>Results: </strong>A total of 112 patients underwent 115 kidney transplantations. Graft failure occurred in 30% of the cases. The overall 1-, 3-, 5- and 10-year graft survival rates were 92%, 89.1%, 85.9% and 74.5% respectively. The following parameters strongly influenced graft survival: immunosuppressive regimen including an association other than Mycophenolate mofetil- tacrolimus and corticosteroids (p=0.002), year of transplant (p<0.0001 for 1987-2000), deceased donor (p = 0.039), underlying etiology of end-stage renal disease (p=0.045), occurrence of acute or chronic rejection (p<0.001), a urine protein greater than 0.3 g/l per day (p=0.002), post-transplant urologic complications (p=0.002), five-year creatinine level>1.28 mg/dl (p<0.001). The overall 1-, 3-, 5- and 10-year patients survival rates were 97%, 95%, 90.2% and 84.4% respectively.</p><p><strong>Conclusions: </strong>Our study identified several predictive factors of graft failure in Tunisian children and young adults undergoing renal transplantation.</p>","PeriodicalId":38818,"journal":{"name":"Tunisie Medicale","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140307261","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: Meningitis is a potentially life threatening illness. It requires prompt diagnosis and treatment. Recurrent meningitis needs detailed investigations to identify the underlying cause.
Observation: We report a case of recurrent pneumococcal meningitis in a 9-year-old boy with an underlying congenital skull base abnormality. Brain computed tomography (CT) scan showed no obvious skull base defects. A magnetic resonance imaging (MRI) of the brain revealed a dehiscence of the cribriform plate with encephalomeningocele. The patient underwent an endoscopic repair of the bony defect and had not developed any new infections ever since.
Conclusion: This case highlights the need to investigate recurrent bacterial meningitis with CT scan and MRI of the brain and skull base. Repair of these congenital skull base defects are mandatory to prevent the recurrence of meningitis.
{"title":"Cribriform plate dehiscence with encephalomeningocele revealed by recurrent meningitis: A case report.","authors":"Najla Soyah, Hajer Ben Belgacem, Donia Brahem, Nadia Mama, Raoudha Kebaili, Samia Tilouche, Marwa Abdelberi, Nesrine Jaballah, Jihene Bouguila, Lamia Boughamoura","doi":"10.62438/tunismed.v102i1.4587","DOIUrl":"10.62438/tunismed.v102i1.4587","url":null,"abstract":"<p><strong>Introduction: </strong>Meningitis is a potentially life threatening illness. It requires prompt diagnosis and treatment. Recurrent meningitis needs detailed investigations to identify the underlying cause.</p><p><strong>Observation: </strong>We report a case of recurrent pneumococcal meningitis in a 9-year-old boy with an underlying congenital skull base abnormality. Brain computed tomography (CT) scan showed no obvious skull base defects. A magnetic resonance imaging (MRI) of the brain revealed a dehiscence of the cribriform plate with encephalomeningocele. The patient underwent an endoscopic repair of the bony defect and had not developed any new infections ever since.</p><p><strong>Conclusion: </strong>This case highlights the need to investigate recurrent bacterial meningitis with CT scan and MRI of the brain and skull base. Repair of these congenital skull base defects are mandatory to prevent the recurrence of meningitis.</p>","PeriodicalId":38818,"journal":{"name":"Tunisie Medicale","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140307257","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: Third molars are the most commonly concerned teeth with the impaction. Impacted third molar (ITM) can be associated to various clinical pathologies Aim: To determine the prevalence of ITM, its pattern and associated affections in Tunisian patients.
Methods: The study reviewed panoramic radiographs of patients consulting the Fattouma Bourguiba University Hospital, Monastir (Tunisia). Orthopantomograms were analyzed to define the prevalence of ITM; its angulation, depth and relation with the anterior border of mandibular ramus. Associated pathologies were also assessed.
Results: Seven hundred and thirty patients were included (286 men and 444 women). The age ranged from 19 to 89 years. Half of the patients (50.3%) showed at least one ITM. The total number of ITM was 881 with a statistical difference between arches (respectively 34.3% and 65.7% in the maxilla and in the mandible). The most common number of ITM was two (35.4%). Level C of impaction was observed more frequently in the maxilla and level A in the mandible. The most common angulation was the vertical one for both arches. Seventy six percent of ITM were presented with class II in relation with the anterior border of mandibular ramus. There was no significant difference in the frequency of impaction between gender and sides. The number of ITM associated with pathological conditions was 199 (22.6%). The most frequently observed pathology was the distal caries on the second molars (11.7%) followed by the caries of the third molars (5.2%).
Conclusion: The prevalence of ITM among Tunisian patients was high.
{"title":"Prevalence of impacted third molars: a radiographic study among a North African population.","authors":"Sinda Yacoub, Nouha Dammak, Soumaya Zaalouni, Mohamed Amine Hrizi, Mohamed Ben Khelifa","doi":"10.62438/tunismed.v102i1.4461","DOIUrl":"10.62438/tunismed.v102i1.4461","url":null,"abstract":"<p><strong>Introduction: </strong>Third molars are the most commonly concerned teeth with the impaction. Impacted third molar (ITM) can be associated to various clinical pathologies Aim: To determine the prevalence of ITM, its pattern and associated affections in Tunisian patients.</p><p><strong>Methods: </strong>The study reviewed panoramic radiographs of patients consulting the Fattouma Bourguiba University Hospital, Monastir (Tunisia). Orthopantomograms were analyzed to define the prevalence of ITM; its angulation, depth and relation with the anterior border of mandibular ramus. Associated pathologies were also assessed.</p><p><strong>Results: </strong>Seven hundred and thirty patients were included (286 men and 444 women). The age ranged from 19 to 89 years. Half of the patients (50.3%) showed at least one ITM. The total number of ITM was 881 with a statistical difference between arches (respectively 34.3% and 65.7% in the maxilla and in the mandible). The most common number of ITM was two (35.4%). Level C of impaction was observed more frequently in the maxilla and level A in the mandible. The most common angulation was the vertical one for both arches. Seventy six percent of ITM were presented with class II in relation with the anterior border of mandibular ramus. There was no significant difference in the frequency of impaction between gender and sides. The number of ITM associated with pathological conditions was 199 (22.6%). The most frequently observed pathology was the distal caries on the second molars (11.7%) followed by the caries of the third molars (5.2%).</p><p><strong>Conclusion: </strong>The prevalence of ITM among Tunisian patients was high.</p>","PeriodicalId":38818,"journal":{"name":"Tunisie Medicale","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11261499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140307262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Non-alcoholic fatty liver disease (NAFLD) is the most common cause of liver failure, fibrosis, cirrhosis, and liver cancer, which can eventually lead to death.
Aim: To investigate the effects of high-intensity interval training (HIIT) and iranian propolis extract on serum levels of transient receptor potential cation channel subfamily V member 4 (TRPV4) and cytochrome P450 2E1 (CYP2E1) proteins in patients with NAFLD.
Methods: Thirty-two patients with NAFLD (mean±standard deviation of age: 45.1±3.6 years; body mass index: 30.0±3.6 kg/m2) were assigned in a randomized control trial to one of the following groups: HIIT (n=8), propolis supplement (n=8), propolis + HIIT (n=8), and controls (n=8). The subjects participated in eight weeks of HIIT (one bout of 1-min intervals at 80-95% of the maximal heart-rate, interspersed by two min at 50-55% of the reserve heart-rate). The Propolis supplement was taken three times a day by the patients in the form of 50 mg tablet after the main meals. Body composition, liver injury test (eg; Alanine- and Aspartate- aminotransferase levels), liver ultrasound and serum levels of TRPV4 and CYP2E1 were measured before and after intervention. One-way analysis of variance was used to compare post-tests among the groups.
Results: HIIT significantly reduced serum levels of TRPV4 protein (p=0.001). The reduction in CYP2E1 was not significant in HIIT group (p=0.075). Propolis consumption had no significant effect on serum levels of CYP2E1 protein (p=0.059), and TRPV4 (p=0.072). There was a significant decrease in TRPV4 and CYP2E1 in the HIIT (p=0.001) and propolis supplement (p=0.032) groups.
Conclusion: HIIT and propolis supplementation can be used to reduce TRPV4 and CYP2E1, which in turn reduces oxidative stress and inflammation in patients with NAFLD.
{"title":"The effects of high-intensity interval training and Iranian propolis extract on serum levels of TRPV4 and CYP2E1 proteins in patients with nonalcoholic fatty liver.","authors":"Khadijeh Irandoust, Mahsa Gholamhosseini, Rasool Samimi, Ismail Dergaa, Helmi Ben Saad, Mortez Taheri","doi":"10.62438/tunismed.v102i1.4669","DOIUrl":"10.62438/tunismed.v102i1.4669","url":null,"abstract":"<p><strong>Introduction: </strong>Non-alcoholic fatty liver disease (NAFLD) is the most common cause of liver failure, fibrosis, cirrhosis, and liver cancer, which can eventually lead to death.</p><p><strong>Aim: </strong>To investigate the effects of high-intensity interval training (HIIT) and iranian propolis extract on serum levels of transient receptor potential cation channel subfamily V member 4 (TRPV4) and cytochrome P450 2E1 (CYP2E1) proteins in patients with NAFLD.</p><p><strong>Methods: </strong>Thirty-two patients with NAFLD (mean±standard deviation of age: 45.1±3.6 years; body mass index: 30.0±3.6 kg/m2) were assigned in a randomized control trial to one of the following groups: HIIT (n=8), propolis supplement (n=8), propolis + HIIT (n=8), and controls (n=8). The subjects participated in eight weeks of HIIT (one bout of 1-min intervals at 80-95% of the maximal heart-rate, interspersed by two min at 50-55% of the reserve heart-rate). The Propolis supplement was taken three times a day by the patients in the form of 50 mg tablet after the main meals. Body composition, liver injury test (eg; Alanine- and Aspartate- aminotransferase levels), liver ultrasound and serum levels of TRPV4 and CYP2E1 were measured before and after intervention. One-way analysis of variance was used to compare post-tests among the groups.</p><p><strong>Results: </strong>HIIT significantly reduced serum levels of TRPV4 protein (p=0.001). The reduction in CYP2E1 was not significant in HIIT group (p=0.075). Propolis consumption had no significant effect on serum levels of CYP2E1 protein (p=0.059), and TRPV4 (p=0.072). There was a significant decrease in TRPV4 and CYP2E1 in the HIIT (p=0.001) and propolis supplement (p=0.032) groups.</p><p><strong>Conclusion: </strong>HIIT and propolis supplementation can be used to reduce TRPV4 and CYP2E1, which in turn reduces oxidative stress and inflammation in patients with NAFLD.</p>","PeriodicalId":38818,"journal":{"name":"Tunisie Medicale","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11261517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140307266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-05DOI: 10.62438/tunismed.v102i1.4649
Hassen Teyeb, Monji Marzougui, Olfa Bouallegue, Houyem Said Latiri
Introduction: Public primary healthcare facilities, the cornerstone of the Tunisian health system, were impacted by the Covid 19 crisis as all health systems in the world.
Aim: This study aims to assess this impact of the pandemic.
Methods: We analyzed the budgetary evolution of the basic healthcare group (BHG) of Medenine and Djerba between 2019 and 2020. Similarly, we examined the evolution of all the activities of BHG of Medenine. This analysis was also completed by a semi-structured questioning with a regional expert.
Results: Our results showed an increase in expenditure, a decrease in revenue (12.4% for GSB of Medenine and 10.8% for BHG of Djerba), and an accumulation of outstanding payment. BHG's activities have been affected by the pandemic. We showed that stomatology and vaccine activities were well maintained during the pandemic. However, we noted a regression in the number of patients and some illnesses. Activity related to child health and health education has significantly decreased. This impact has had and will have repercussions on the epidemiological state of the population. Despite the intervention of the regional management in terms of organization, training and strengthening of equipment and human resources, the pandemic has generally impacted the operation process of these establishments, which are already facing several challenges.
Conclusion: We recommend above all to activate the already existing opportunities to replenish the financial resources of primary healthcare facilities, to improve work environment and continuous professional development and to computerize the data and its analysis according to a scientific approach.
{"title":"Impact of Covid 19 on Primary healthcare in Tunisia.","authors":"Hassen Teyeb, Monji Marzougui, Olfa Bouallegue, Houyem Said Latiri","doi":"10.62438/tunismed.v102i1.4649","DOIUrl":"10.62438/tunismed.v102i1.4649","url":null,"abstract":"<p><strong>Introduction: </strong>Public primary healthcare facilities, the cornerstone of the Tunisian health system, were impacted by the Covid 19 crisis as all health systems in the world.</p><p><strong>Aim: </strong>This study aims to assess this impact of the pandemic.</p><p><strong>Methods: </strong>We analyzed the budgetary evolution of the basic healthcare group (BHG) of Medenine and Djerba between 2019 and 2020. Similarly, we examined the evolution of all the activities of BHG of Medenine. This analysis was also completed by a semi-structured questioning with a regional expert.</p><p><strong>Results: </strong>Our results showed an increase in expenditure, a decrease in revenue (12.4% for GSB of Medenine and 10.8% for BHG of Djerba), and an accumulation of outstanding payment. BHG's activities have been affected by the pandemic. We showed that stomatology and vaccine activities were well maintained during the pandemic. However, we noted a regression in the number of patients and some illnesses. Activity related to child health and health education has significantly decreased. This impact has had and will have repercussions on the epidemiological state of the population. Despite the intervention of the regional management in terms of organization, training and strengthening of equipment and human resources, the pandemic has generally impacted the operation process of these establishments, which are already facing several challenges.</p><p><strong>Conclusion: </strong>We recommend above all to activate the already existing opportunities to replenish the financial resources of primary healthcare facilities, to improve work environment and continuous professional development and to computerize the data and its analysis according to a scientific approach.</p>","PeriodicalId":38818,"journal":{"name":"Tunisie Medicale","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140307258","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 : 2024-01-05DOI: 10.62438/tunismed.v102i1.4564
Mejda Bouladi, Amal Ben Othmen, Miladi Sawssen, Merieme Kalou, Ahmed Laater, Lamia El Fekih
Introduction: Anti-tumor necrosis factor α (anti-TNF α) agents are an effective treatment for a variety of inflammatory and autoimmune diseases. In ophthalmology anti-TNF α began to emerge as a possible therapy for non-infectious uveitis, paradoxically their administration may result in the onset or recurrence of inflammatory eye disease such as uveitis. We reported a case of new onset of bilateral anterior and intermediate uveitis in a patient with rheumatoid arthritis (RA) while being treated with infliximab and we performed a review of literature.
Observation: A 25-year-old female with RA under infliximab, presented with bilateral blurred vision. Anterior segment examination demonstrated retrodescmetic fine precipates, 1+ cells in the anterior chamber on both eyes. The fundus examination was difficult because of the vitritis. Fluorescein angiography demonstrated mild optic disc edema, and bilateral diffuse peripheral fern leaf cappilaritis. Optical coherence tomography showed severe cystoid macular edema bilaterally. The diagnosis of bilateral anterior and intermediate uveitis caused by infliximab was retained after exclusion of infectious and autoimmune aetiologies. She was treated with corticosteroid with good visual outcome.
Conclusion: In our case, new onset of uveitis may be considered as paradoxical effect of anti-TNF α therapy. Rheumatologists and ophthalmologists should be aware of this effect. Careful monitoring of patients under infliximab is necessary for appropriate diagnosis and early treatment.
{"title":"New onset of uveitis during infliximab treatment: A case report.","authors":"Mejda Bouladi, Amal Ben Othmen, Miladi Sawssen, Merieme Kalou, Ahmed Laater, Lamia El Fekih","doi":"10.62438/tunismed.v102i1.4564","DOIUrl":"10.62438/tunismed.v102i1.4564","url":null,"abstract":"<p><strong>Introduction: </strong>Anti-tumor necrosis factor α (anti-TNF α) agents are an effective treatment for a variety of inflammatory and autoimmune diseases. In ophthalmology anti-TNF α began to emerge as a possible therapy for non-infectious uveitis, paradoxically their administration may result in the onset or recurrence of inflammatory eye disease such as uveitis. We reported a case of new onset of bilateral anterior and intermediate uveitis in a patient with rheumatoid arthritis (RA) while being treated with infliximab and we performed a review of literature.</p><p><strong>Observation: </strong>A 25-year-old female with RA under infliximab, presented with bilateral blurred vision. Anterior segment examination demonstrated retrodescmetic fine precipates, 1+ cells in the anterior chamber on both eyes. The fundus examination was difficult because of the vitritis. Fluorescein angiography demonstrated mild optic disc edema, and bilateral diffuse peripheral fern leaf cappilaritis. Optical coherence tomography showed severe cystoid macular edema bilaterally. The diagnosis of bilateral anterior and intermediate uveitis caused by infliximab was retained after exclusion of infectious and autoimmune aetiologies. She was treated with corticosteroid with good visual outcome.</p><p><strong>Conclusion: </strong>In our case, new onset of uveitis may be considered as paradoxical effect of anti-TNF α therapy. Rheumatologists and ophthalmologists should be aware of this effect. Careful monitoring of patients under infliximab is necessary for appropriate diagnosis and early treatment.</p>","PeriodicalId":38818,"journal":{"name":"Tunisie Medicale","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140307260","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}