[Continuous glucose monitoring in glimipiride plus metformin treated type 2 diabetic patients during Ramadan month]

Fasting during Ramadan may be a cause of poor glycaemic control in diabetic patients. To assess glucose excursions during Ramadan by using a continuous glucose monitoring system [CGMS]. The interstitial glucose level was recorded over 72 hours during Ramadan and three months later, in five type 2 diabetic patients, aged 56 +/- 5, treated with glimepiride and metformin. During Ramadan, four patients experienced at least one episode of low glucose level [<0.7 g/l] during the monitoring. The frequency of these episodes was 0.6 episode/d with an average duration of 36 mn / d. These episodes occurred in the morning in half of the cases and in the hour before breaking the fast in 37.5% of the cases. Four patients experienced at least one episode of high glucose level [>1.8 g/l], with an average duration of 403 mn /d and with a frequency of two episodes /d. More than half episodes [53] occurred after the breaking of the fast. After Ramadan, CGM records showed at least one episode of low glucose in two patients with an average duration of 58 mn /d and a frequency of 1.3 episodes/d. Three patients experienced at least one episode of high glucose level with an average duration of 525 mn /d and a frequency of 1.46 episodes/day. The blood glucose profile of our patients during Ramadan is characterized by important glycaemic excursions

Hypocalcaemia due to hypoparathyroidism in beta-thalassemia major: a study of a new case

To report a new case of hypoparathyroidism in a child with beta thalassemia major. We report a case of a 17-year-old Tunisian girl with transfusion-dependent thalassemia major presented with paresthesia and pubertal delay. Laboratory investigations showed hypocalcaemia and hyperphosphatemia. Parathyroid hormone level was low [2 ng/1, normal range: 12-72 ng/1] than expected for the degree of hypocalcaemia. Serum ferritin concentration was 1770ng/ml. The patient was started on oral daily calcium supplementation, Alfa calciferol and intensive iron chelation therapy. Follow-up after 6 and 12 months revealed normal Calcium and ECG showed QT intervalwithin normal range. Investigating calcium homeostasis at regular intervals and early management of any abnormality can preclude the occurrence of complications

[Disribition and prevalence of dyslipidemia in Tunisia: results of Tunisian national nutrition survey]

The aims of the study were to study the distribution of cholesterol and triglycerides and to assess the prevalence of dyslipemia in Tunisian adult population. The Tunisian National Nutrition Survey [TNNS] was a cross sectional study performed on a total of 7860 adult subjects and was conducted on1996-1997. The TNNS included 3087 adults over 20 years old. The mean values of cholesterol [CT] were more elevated in urban than rural area [p<0,001], and in females than in males [p<0.007]. The overall prevalence of hypercholesterolemia [CT >6, 2 mmol/l] was 8, 4% and that of hypertriglyceridemia [TG > 1, 70 mmol/l] was 21%. The prevalence of borderline high cholesterol [>-/ 5, 2 - < 6, 2 mmol/l] was 17%: These prevalences were more elevated in urban than rural areas [p<0,001] and increased with age in both genders [p<0,001]. The multiple adjusted odd ratio of the prevalence of hypercholesterolemia showed a positive correlation with female sex [OR 1.40 p <0, 01], high waist circumference [OR 2.51 in men and 3, 04 in women p <0001] and urban residency [OR1.35 p = 0, 03]. Our study showed the metabolic consequences of westernization style life in our country and should be the starter to preventive adequate policy

Molecular basis of pituitary development defects

Over the last twenty years, the progress made in molecular biology have led to the identification of many transcription factor genes, whose mutations has been reported as causes of familial hypopituitarism

Aim:Based on literature review, this study is intending to highlight the role of some transcription factors in the development of the anterior pituitary gland and to analyse the involvement of their dysfunction in some cases of congenital hypopituitarism

Methods: Litterature review

Results: These transcription factors are nuclear proteins expressed specifically in certain target cells, in order to control genes expression. Their role is fundamental in embryonic and foetal development, and particularly in embryonic and foetal development, and particularly in pituitary ontogenesis. Together, they direct the formation of anterior pituitary gland, the differentiation, the expansion and the definitive function of the five pituitary cell types. In this report, after introducing the different stages of anterior pituitary development and differentiation of its cell lines, we will briefly highlight the clinical phenotypes associated with alterations of different transcription factor genes in both murine models and humans

[Food intake and high density lipoprotein cholesterol levels changes during ramadan fasting in healthy young subjects]

During the holy month of Ramadan, it is obligatory for all adult healthy Muslims to abstain from food, drink and smo-king each day from dawn to sunset. The aims of our study were to evaluate the effects of Ramadan fasting on plasma lipids, lipoproteins and the change of food consumption in healthy subjects. Thirty young healthy and normal weighted adults [9 males and 21 females] were evaluated during three periods: 3 weeks before Ramadan [TO]: the 4th week of Ramadan [T1] and 3 weeks after the end of Ramadan [T2]. Main Clinical and biological parameters investigated were: body weight. blood glucose, plasma triglycerides [TG], plas-ma total cholesterol [TC], high density lipoprotein cholesterol [HDL-c] and. low density lipoprotein cholesterol [LDL-c] Body weight, and blood glucose were unchanged. There was a significant increase of the mean daily caloric intake, the lipids intake particularly mono-unsaturated and poly-unsatu-rated fatty acids [p < 0,001] and cholesterol intake [p<0.001] during Ramadan with a decrease of the meal frequency. There was also a significant increase of plasma total cholesterol and HDL-cholesterol. The most striking finding was a significant increase in the HDL-Cholesterol during Ramadan +20% [p<0,02]. This increase was lost after Ramadan. Fasting Ramadan affects beneficially serum lipoprotein metabolism in young adult healthy subjects with an increase of HDL-cho-lesterol