[Epidemiology of domestic accidents of young children in Tunis: impact of health professionals training on data collection quality]

In Tunisia, several studies on domestic injuries have been carried out on children attending care facilities. Nevertheless, there is a lack of data on incidence and kinds of child domestic injuries amongst general population because of absence of a reliable data collect system. To estimate the incidence and kinds of domestic injuries through a prospective survey "here-there" within two cohorts of young children attending two mother and child protection centers [MCPC] in Tunis during the three first years of their life and to analyze the importance of health professional training in improving data collect. A prospective study "here-there" was carried out on two cohorts of children in two mother and child protection centers [MCPC] between January 2007 and December 2009. Only children aged less than 3 months at their first contact with the centers were included and followed up until age of 3 years. In the MCPC2 [cohort2], health personnel have been trained on data collection importance related to child domestic accident and asked to monitor accidents by calling parents while a phone line got available for this aim. In the MCPC1, health personnel was asked to work as they used to do and to collect data on child domestic injuries when children attend the center. 192/435 domestic accidents were recorded within cohort 2 vs only 1/686 within cohort 1. Annual incidence rate was 14.7% for the cohort 2. The kinds of accidents were: falls 78.2% [falls from high plans 84.6%], injuries15.1% [injury by cutting things 58.6%], burns 5.7% [burns by hot liquid 54.5%], intoxications 1%. In terms of damages, we recorded 4 cases of broken bones [thighbone, elbow, handwrist], stitches in 11 cases, broken teeth in 3 cases and nail pulled out in one case. No death was recorded. Training impact on accident prevention was not studied. Child domestic accidents are relatively frequent. Health personnel training allows to improve data. The kinds of recorded accidents indicate the need to educate parents on best practices towards strengthening prevention

[ retrospective study of 339 ICSI cycles: assessment of the two first years of activity of the assisted reproductive technology's center of Aziza Othmana's hospital]

Intracytoplasmic sperm injection [ICSI] is a micro-manipulation-assisted fertilization, whereby one spermatozoon is injected into the oocyte cytoplasm. Initially, ICSI was the treatment of choice for male factor infertility. However, because of the high fertilization and pregnancy rates achieved with this technique, the scope of the procedure has been widened to include couples with other causes of infertility. The aim of this study was to study the progression of the activity of the assisted reproductive technology's center of Aziza Othmana's Hospital and the ICSI results during the first two years. Our study included 269 infertile couples who underwent 339 ICSI cycles between 1st May 2001 and 30 April 2003. Cycles with no oocytes obtained at the follicular aspiration and women aged over 40 years were excluded from this study. The number of ICSI cycles progressed in our center: 150 ICSI cycles in the 1st year, 189 ICSI cycles in the 2nd year. The mean number of picked-up oocytes was 8,8 +/- 5,6. The fertilization rate was 62. The mean number of transferred embryos was 3,1 +/- 1,5. The pregnancy rate per transfer was 32,4%. The miscarriage rate was 28,4%. The take home baby rate was 67,9%. The number of couples undergoing ICSI cycles in our center is increasing. The fertilization rates and pregnancy rates in our center are similar to those published in the literature

[Validation of the Tunisian versions of bath ankylosing spondylitis functional index [BASFI] and disease activity index [BASDAI]]

The Bath Ankylosing Spondylitis Functional Index [BASFI] and the Bath Ankylosing Spondylitis Disease Activity [BASDAI] are the most commonly used instruments to evaluate respectively functioning and disease activity in ankylosing spondylitis [AS]. The aim of this study was to translate, adapt and validate these instruments into the Tunisian language. The studied population consisted of 68 AS patients [59 males and 9 females]. Their mean age was 37.9 years [range: 18-76]. The mean disease duration was 13.6 years [range: 1-40].After translation and retranslation the BASFI and BASDAI questionnaires were administrated to the patients and tested for reliability, internal consistency and construct validity. The reproducibility of the indices BASFI and BASFAI was good, the intraclass correlation coefficient for reliability was 0.96 [CCI: 0.93-0.97] for the BASFI and 0.93 [CCI: 0.90 -0.97] for the BASDAI, and the coefficient of internal consistency [Cronbach's alpha] was 0.91 for BASFI and 0.90 for BASDAI. Concerning construct validity, both questionnaires were significantly correlated to each other, to the disease-specific instruments [BASG-s, BASMI, BASRI, ASQoL] and to all domains of the SF-36. The Tunisian versions of the BASFI and the BASDAI preserve the metrological properties of the original versions and were easy to use for the assessment of disease status in ankylosing spondylitis

Prevalence of benign prostatic hyperplasia in general practice and practical approach of the Tunisian general practitioner [Prevapt study]

Benign prostatic hyperplasia [BPH] is one of the most common conditions associated with ageing in men. BPH presents as lower urinary tract symptoms [LUTS]. The aim of this study is to assess the prevalence of LUTS suggestive of BPH in 50 years or older men in general medicine and to evaluate the management of these patients by general practitioners. This cross-sectional, prospective, multi-centre epidemiological survey, included all men with an IPSS [international prostatic symptoms score] > 8. The management by general practitioners was analysed including complementary examinations and treatment. Among 4602 outpatients recruited by 88 general practitioners, 434 patients had an IPSS > 8 and were included in the study. The prevalence of LUTS/ BPH was 16.1%. The prevalence showed a linear increase with age. The prevalence was 7% at the age 50-59 years, 17.4% at the age 60-69 years and 33.4% in 70 years and over men. LUTS were the main reason of consulting general practitioner in 45.4% of cases. 72.6% of patients were with moderate symptoms [IPSS 8-19] and 26.4% of patients were with severe symptoms [IPSS 20-35]. Quality-of-life score was 0-2 in 10.3% of patients, 3-4 in 52.2% of patients and 5-6 in 37.5% of cases. The management by general practitioner was then a watchful waiting in 14.7% of cases, to refer the patient to an urologist in 13.7% of cases, to ask for complementary examinations in 71.6% of cases and to treat in 73.4% of cases. Only 37.4% of patients with suspect prostate malignancy were referred to the urologist. In cases of treatment alpha blocker was the treatment choice in 77% of the cases. LUTS/ BPH are frequent in Tunisia. It occurs in one third of men over 60 years and one fifth of men over 70 years. With the progressive ageing of Tunisian population, this pathology may constitute a public health problem. It is therefore urgent to elaborate recommendations concerning the management of this disease, specifying the role to play by the urologist and the general practitioner