Tunisie Medicale最新文献

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Introduction and aim: Status epilepticus (SE) in children is a critical condition that can be life-threatening. The objective of this study was to identify factors associated with the occurrence of SE after a first convulsive seizure in children.

Methods: A retrospective study was conducted at the pediatric department of BEN AROUS regional hospital between January 2015 and December 2019.

Results: A total of 300 patients admitted for a first epileptic seizure were included in this analysis. The mean age of the patients was 33 months. Seizures were generalized in 92.7%, with tonic-clonic seizures being the most common (54.8%). SE was diagnosed as inaugural in 29% of cases. Abnormalities in EEG were observed in 36.5% of cases, while MRI revealed abnormal results in 32.8% of patients. Factors associated with a risk of SE recurrence were age younger than 1 year (p = 0.003), neuromotor retardation (p = 0.001), EEG abnormalities (p < 0.001), MRI abnormalities (p = 0.001), and abrupte discontinuation of antiepileptic treatment (p < 0.001). Simple febrile seizure was identified as a protective factor (p = 0.038).

Conclusion: The study identified that age under 1 year, neuromotor delay, and abnormalities in EEG and MRI are significant risk factors for the recurrence of status epilepticus after a first epileptic seizure in children. These findings suggest targeted preventive strategies to improve the management and prognosis of these patients.

Non.

Introduction: Multiple sclerosis (MS) is a potentially disabling disease of the brain and spinal cord. Falls are a serious health concern for persons with MS (PwMS).

Aim: To determine the frequency and associated factors of falls in PwMS.

Methods: A cross-sectional study was conducted in the Physical Medicine and Rehabilitation and Neurological Departments at the Military Hospital of Tunis between July and December 2022. Participants meeting the inclusion criteria completed a survey focusing on the prevalence and related factors of falls. In addition to the survey and a thorough clinical and functional examination, we used the 12-item MS Walking Scale (MSWS-12), the Fall Efficacy Scale International (FES-I), the Short Physical Performance Battery (SPPB), and the 10-meter walk test for clinical assessment of balance. A baropodometric platform was employed for instrumental assessment.

Results: Thirty individuals with an average age of 33,6 [SD: 7,7], completed the survey with a mean Expanded Disability Status Scale = 2,5. Twenty-one patients reported falling at least once since the diagnosis. The MSWS-12 mean score was 61 % and the FES-I scored an average of 33.8. The average total score of the SPPB was 8. Total boli of corticosteroids prescribed during disease flare-ups (p=0,022), magnetic resonance imaging lesions of the basal ganglia (p=0,047), vestibular syndrome (p=0,048), MSWS-12 score (p=0,022), and the chair lift test of SPPB (p=0,018) were significantly associated with the prevalence of falling. No significant differences were observed for the instrumental assessment.

Conclusion: Falls are frequent in PwMS. MSWS-12, the FES-I, and the SPPB, can be used by clinicians to predict potential fallers of the PwMS.

Introduction: Severe pain is a therapeutic emergency that can be life-threatening by its location, its repercussions or the misdiagnosis it can cause.

Aim: To investigate the efficacy of analgesia by morphine versus that by low-dose ketamine in severe pain in emergency department.

Methods: We conducted a randomized open study. We included patients over 18 years-old who consulted for severe pain defined by numeric rating scale (NRS) ≥6. Patients of M group received a titration of 10 mg morphine while those of LDK group, received a bolus of 30 mg of ketamine. The primary endpoint was obtaining a NRS of less than 4 within 10 minutes.

Results: We included 120 patients, 66 in the M group and 54 in the LDK group. The mean baseline NRS was 8.8 ± 1.3 in the M group and 8.6 ± 1.4 in the LDK group (p₌ 0.7). At 10 minutes, the same number of patients in both groups achieved a NRS less than 4 (p = 0.09). However, the mean NRS was significantly lower in the LDK group (p = 0.008). More adverse effects were noted in the LDK group (p <10-3).

Conclusions: Low-dose ketamine appears to be non-inferior to morphine in achieving effective analgesia for severe pain in the emergency department.

Objective: The objective of this study was to assess the relationship between Body Mass Index (BMI), dietary habits, physical activity, and health perception among female university students in Morocco.

Methods: The study was conducted at a Moroccan university among female students from the Faculty of Sciences Ain-Chock in Casablanca. Participants were given a self-administered questionnaire that evaluated sociodemographic factors, dietary habits, food group consumption, physical activity, and self-assessed health status. Data collection took place from February 2023 through the end of April 2023.

Results: A total of 335 students aged 18 to 29 years participated in the survey. The study revealed that 72.5% of the participants were within the normal weight range (BMI 18.5-24.9 kg/m²), while 15.9% were classified as overweight and 3.9% as obese. Additionally, 47.9% of the participants engaged in physical activity, with 30.2% dedicating more than 45 minutes to their activities. The health perception was found to be related to weight classification, with poor health perception most commonly associated with the "18.5-25" BMI range (57.8%).

Conclusion: The study sheds light on the intricate interaction between weight, health, and lifestyle in Morocco. The frequency of normal-weight persons and active participation indicates university students' health awareness. The prevalence of overweight and obesity, on the other hand, need ongoing health measures. These findings help to build focused methods for promoting healthier lives in Morocco, utilizing educational institutions as health promotion platforms.

Non.

Aim: To determine the impact of a therapeutic patient education (TPE) program on the quality of life of coronary patients at the Sahloul University Hospital in Sousse.

Methods: an interventional study was conducted over a period of seven months from May 2022 to November 2022, with patients hospitalized in the cardiology department of the Sahloul University Hospital. Participants were divided into two groups, intervention and control. The task force benefited from a TPE program. The control group followed the usual consultations at the hospital. The health-related quality of life assessment was done three months after the end of the educational program, using the validated Tunisian version of SF-12.

Results: Of the 129 patients included, 38 followed the education program while 91 were in the control group. Sociodemographic characteristics revealed a male predominance in the study population, with a similar average age between the two groups. The main cardiovascular risk factors identified were smoking, hypertension and diabetes. This program has led to an improvement in the quality of life of patients. Thus, patients who participated in the TPE program had significantly higher scores than the control group in the headings of physical role, emotional role, body pain, social function, and physical health and mental health scores with statistically significant differences.

Conclusion: Our study highlights the crucial importance of therapeutic education in improving the health status and quality of life of coronary patients. It calls for its widespread integration into cardiovascular care protocols, highlighting its central role in a proactive and personalized approach to medical care.

Introduction: During a role-play simulation session, despite supporting observer learning, educators disagree about whether the learning outcomes of observers are like those of active participants.

Aim: Evaluation of the degree of knowledge acquisition by these two types of learners during the same role-play session.

Methods: We carried out a quasi-experimental pre-post intervention study to identify the learning outcomes among learners serving in observer (group 1) and active (group 2) roles during a role-play simulation session.

Results: The role play involved 29 learners. In both groups, 65% of learners improved their overall score. The median post-test score was significantly higher in both groups (p=0.0001). Likewise, learners in group 1 (p=0.023) and in group 2 (p=0.008) showed an improvement in the overall score in the within-group evaluation study. The between-group evaluation study showed no statistically significant difference in overall score improvement (p=0.58), number of learners improving (p=0.05) or percentage improvement (p=0.3).

Conclusion: Based on these findings, it is suggested that role-playing method is effective in achieving student-learning outcomes regardless of their status as active or observer.

Introduction: The benchmark of a medical thesis' success is often its acceptance for publication in an indexed journal.

Aim: To determine the publication rate of practice theses in the field of Cardiology at the Faculty of Medicine of Sousse (FMSo) in Tunisia and to identify predictive factors for successful publication.

Methods: We conducted a descriptive bibliometric analysis of Cardiology theses defended at FMSo from 2000 to 2019. Data were extracted from the theses' cover pages, abstracts, and conclusions. The publication status was ascertained via searches in "MEDLINE", "Scopus", and "Google Scholar". Predictive factors for publication were identified using multivariate analysis with a 90% Confidence Interval (CI).

Results: Of the 111 Cardiology theses defended at FMSo between 2000 and 2019, 36 were published yielding 42 scientific articles (publication rate of 32%). Notably, 86% of these articles were indexed in "MEDLINE" and/or "Scopus". In 79% of cases, doctoral candidates were co-authors of the resultant publications. Publication was significantly influenced by three factors: scientific mentorship by an Assistant or Associate Professor (aOR=3.021; 90%CI: 1.06-10.14; p=0.082), a prospective study design (aOR=2.536; 90%CI: 1.07-6.02; p=0.076), and a satisfactory quality of writing (aOR=2.384; 90%CI: 1.11-5.11; p=0.061).

Conclusion: The publication of Cardiology theses at FMSo was found to be associated with the prospective design of the study and the quality of writing. Thus, it is imperative to enhance the research methodology and scientific communication skills of medical thesis candidates and their mentors to facilitate the transition from academic dissertations to medical articles.