ABSTRACT
Background: A polymorphism upstream of interleukin [IL]-28B was recently identified to be associated with a 2-fold difference in sustained virologic response [SVR] to pegylated interferon-alpha and ribavirin therapy in a large cohort of treatment-naive, adherent patients with chronic hepatitis C [CHC] virus genotype 1 [HCV-1] infection
Aim: We sought to confirm the polymorphism's clinical relevance by intention-to-treat analysis evaluating on-treatment virologic response and SVR
Methods: We perform a prospective study in gastroenterology unitof tunis'military hospital in collaboration with immunology unit, military center of blood transfusion and laboratory of biochemistry of childrens' hospital of Tunis. HCV patients were genotyped as CC, CT or TT at the polymorphic site rs12979860 and TT, TG or GG at the polymorphic site rs8099917. Viral kinetics and rates of rapid virologic response [RVR, week 4] and SVR were compared by IL-28B type in a tunisian population
Results: 154 patients including 80 healthy blood donors[sexratio: 1, mean age: 40.35 +/- 10.15 years] and 74 patients treated for CHC [39 men and 35 women; mean age = 51.7 +/- 9.4 years] were enrolled. 35.6% of patients were genotyped as CC at the polymorphic site rs12979860 and 69.1% as TT at the polymorphic site rs8099917. The CC IL-28B type at rs12979860 was associated with a greater likelihood of SVR [77% vs 31.9%; p<0.001; OR: 7.11 [2.37-21.35]] compared with CT and TT. The CC IL-28B type at rs12979860 wasn't associated with improved of rapid virologic response [RVR]. In a multivariate logistic regression model, the rs12979860 CC genotype predicted SVR [p<0.001; OR: 7.11 IC95% [2.37-21.35]]. The TT IL-28B type at rs 8099917 wasn't associated with improved RVR and SVR compared with TG and GG
Conclusion: In treatment-naive HCV patients treated with pegylated interferon and ribavirin, a polymorphism upstream CC at the site rs12979860 of IL-28B is associated with increased sustained virologic response and effectively predicts treatment outcome
ABSTRACT
Background: Medical writing is a coded language; its purpose is to convey a scientific message. In pathology, specialty involving the study of cell and tissue, quantitative and qualitative production of medical doctoral theses and their thematic focus has not been studied
The aim of this study was to analyze the pathology theses on the level of form, the background and methodology
Methods: Descriptive retrospective study of medical doctoral theses in the specialty "Pathology", listed in the catalog of theses of the library of the Faculty of Medicine of Tunis and supported between 2000 and 2010. Each thesis has been subject of a direct reading, systematic and thorough
Results: The study involved 189 pathology theses. The average overall productivity per academic pathologist was 5.5 theses. Gastrointestinal pathology was the most studied theme [24.9%]. Tumor pathology was addressed in 74.1% of the theses. The IMRAD structure was respected in 57.7% of theses; by assistant professor than by associate professor and professor [p = 0.005]. The summary was structured in 88.3% of theses, comparably with the grade of the thesis director [p = 0.5] and with the grade of PhD student [p = 0.08]. The transcript of references did not meet the recommendations of Vancouver in 87.8% of theses and irrespective of the rank of director of thesis [p = 0.2]
Conclusion: The pathology theses presented some shortcomings, particularly in the quality of medical writing. To remedy this problem, our faculty should increase efforts to improve the quality of scientific work, in order to have a better view of medical research in Tunisia
ABSTRACT
Exertional heat stroke is defined as hyperthermia associated with neurological signs related to intense physical activity performed in a hot environment. This is a medical emergency and life-threatening. In this study, we investigated four cases of exertional heat stroke hospitalized at the military hospital in Tunis [Tunisia] to describe the clinical, therapeutic and preventive characteristics and factors favoring this disease. Four young soldiers, 23 to 44 years older, have developed Exertional heat stroke after Intense and prolonged exercise. Exercises were performed in May and June, in high ambient temperature, high humidity and lack of wind. Three soldiers were in battle dress, a backpack and their weapon. Our four subjects had overweight, were not sufficiently trained and were highly motivated. Insufficient hydration and a diet rich in carbohydrates were noted. Upon hospitalization, patients were febrile and had neurological disorders, neuromuscular disorders, rhabdomyolysis and hemoconcentration. The medical care consisted of a rehydration and oxygen
ABSTRACT
Background: The need for a scientific evaluation of the work life quality has become today evident to all
Aim: This study aims to evaluate the short-term impact of the workload on the quality of life of employed Tunisian women.
Methods:A cross-sectional survey on a representative sample of 394 women working in the sectors of textile, shoe-manufacturing and administration was conducted between 2009 and 2010. The quality of life was assessed using the 36-item Short Form Health Survey questionnaire [SF-36]
Results: The overall quality of life score was 67.2 +/- 15.2. There was an uneven weathering of the different SF-36 scales. Vitality scale was the most affected with a score below 50. Quality of life of employed women differed significantly depending on the activity sector [p
Conclusion: The quality of life in employed women was correlated with the workload. The use of SF-36 to measure the quality of life is useful for the evaluation of work life quality
ABSTRACT
Background: Endoscopic polypectomy is the technique of choice for resection of colorectal polyps and has a major interest in the prevention of colorectal cancer. The aim of this study was to evaluate the technique, results and tolerance of colonic polypectomy
Methods: We conducted a retrospective study including 200 consecutive patients with colorectal polyps and who underwent therapeutic endoscopic polypectomy, performed at the endoscopy unit of the Military Hospital in Tunis, between December 2008 and December 2012
Results: Hundred and forty men and 60 women were included. The average age was 58.5 +/- 14.5 years. The polyp was unique in more than half of cases. The most frequent location was the sigmoid colon [30.5%]. Approximately, [1/4] of the polyps was larger than 10 mm. According to the Paris endoscopic classification, 78% of polyps were sessile [Is]. Seventy-two percent of polyps were adenomas. Twenty five per cent of them contained a villous component, 40% were advanced adenomas and 3% malignant adenomas. Regarding polypectomy, 232 polyps [64%] were treated by the cold forceps, 68 polyps [18.5%] by the diathermic snare and 63 [17.5%] by a mucosal resection. Thirty-one percent of polypectomy were fragmented. The evaluation of the efficacy of treatment among adenomas and potentially malignant tumors, had identified 36% of treatment failure. The common independent predictive factor of fragmented resection and treatment failure were the size >/= 10 mm [p <10[-3]]. Among a total of 363 polypectomies, 23 [6.3%] were complicated, by 11 procedural bleeding, 11 micro-perforations and 1 delayed hemorrhage. The common independent predictive factor of these complications was the size >/= 10 mm [p <10[-3]]. During following, there were 12 residual polyps [6%], 36 new polyps [18%] and 6 colorectal cancers [3%]. The only independent predictive factor of an unfavorable course was the multiplicity of polyps. The colorectal polyps-free survival was 90.2% at 12 months and 88.4% at 24 months
Conclusion: The evaluation of colorectal polypectomy in our series had confirmed the effectiveness and the low morbidity of this practice. The polyp size was the only independent predictive factor of both treatment failure and complications
ABSTRACT
Background: In front of the considerable impact of the viral hepatitis C, the prevention is more than ever a priority, based essentially on the screening
Aim: We realized an epidemiological study in a population of young recruits with the aim of considering prevalence of anti-hepatitis C Virus [anti-HCV] antibodies, describing its epidemiological evolution and establishing a cartography of the viral hepatitis C in Tunisia
Methods: Epidemiological retrospective study of prevalence was realized from the data of the screening of anti-HCV antibodies from 2003 till 2012 of all the young recruits suggested to be incorporated for the national service or suggested to be recruited as career soldier. The study was exhaustive concerning 175 322 young and healthy male adults aged between 20 and 30 years old, originating from all parts of Tunisia. The screening was realized by third and fourth generation ELISA tests then validated by Immunoblot
Results: The prevalence was 0.11% and the confirmed prevalence was 0.07%. The positive subjects were mainly between 20 and 25 years old [82.32%] and 91.05% were detected within the framework of their incorporations to the national service. The lowest prevalence was 0.07% in 2004, and the highest was 0.17% in 2011, without a significant tendency in the increase or in the decrease during the period of study [r = 0.857 ; p = 0.564]. The screening of anti-VHC antibodies had an unequal geographical distribution according to a North-South decreasing gradient. The highest proportions were registered in the North-West [23.23%] and the District of Tunis [22.73%], contrary to the South-East which was weakly affected [3.54%]. The governorates with the highest proportions were Tunis [19.19%], Bizerte [11.62%] and Jendouba [8.59%], the governorates of Monastir and Tataouine were weakly affected [0.51%]
Conclusion: Prevalence of anti-HCV antibodies in the young and male Tunisian population was weak, stable without significant tendency in the increase or in the decrease from 2003 till 2012, characterized by an unequal geographical distribution according to a North-South decreasing gradient
ABSTRACT
ENT cancers due to their location and treatment encompass a number of physical symptoms related to swallowing and communication disorders. To evaluate flight capacity of aircrew personnel with ENT cancer and consequences on fitness and waiver criteria. Case 1: A 52 years old smoker pilot whish present laryngeal epidermoid carcinoma staged T3M0N0 and treated by total laryngectomy with curative radio-therapy [70Gy]. Metastasis occurred on lumgth and death heaped after acute respiratory failure. Case 2: A 55 years old mechanic whish had rhinopharyngeal undifferentiated carcinoma staged T4N2M0 and treated with radiochemotherapy with favourable follow-up. Inability for flight was proclaimed because of severe psychological impact. Case 3: Concerned a vesiculograpillary carcinoma of thyroid gland occurring in a 46 years old helicopter pilot. After total thyroidectomy and iodine treatment, the patient has obtained complete fitness to flight. Fitness to flight can be controversed in ENT cancer occurs. Epidemio-clinical paraclinical, functionnel and operational criterias must be considered when wainer to be proclaimed