[ causes of death of the women in age of procreation at the hospitals of Sfax]

To study the principal causes of death of the women dead at an age ranging between 15 and 49 years old and having been hospitalized in a public medical structures of the gouvernorat of Sfax. Retrospective study concerning all the included deaths between 1999 and 2007. The study was related to 728 deaths, which correspond to an average of 80.88 deaths FAR per year. Public highway accidents were the major cause of death [83 cases, 11.4% of the causes of death] followed by the burns [37 cases, 5%] and the cerebral vascular accidents [31 cases, 4.25%]. The classification of the causes of death according to groups of pathologies showed the prevalence of the cardio- vascular diseases [18.7%], the external causes of death [18.2%], cancers [11.6%] and the causes related to the pregnancy and the childbirth [8.5%]. The maternal death rate was of 56.91 per 100000. The cause of maternal death was directly related to the pregnancy in 67.74% of the cases. The immediate causes were prevailed by the hemorrhagic causes [27.5%]. The death was avoidable in 48.83% of the cases and the failures were related to the woman in 60% of the cases. The prevention of new practices of life [female nicotinism, obesity, bad food habits, lack of vigilance in traffic] and a better practice of the primary and secondary prevention in medicine could decrease the premature death rates in Tunisia

[Evaluation of knowledge of fibromyalgia in Tunisia]

Fibromyalgia is a chronic, non inflammatory, pain syndrome, characterized by widespread musculoskeletal pain and excessive fatigue. Although it is considered like being the second pathology met in ambulatory rheumatology practice, it is again, poorly understood by medical and scientific community. Value the level of knowledge, attitudes and practices of Tunisian physicians, general practitioners concerning fibromyalgia. It was about a cross-sectional survey using questionnaire, achieved by a representative sample of Tunisian physicians, general practitioners. These last, answered a questionnaire previously used in France, in Portugal and in Russia, valuing their knowledge on fibromyalgia, their attitudes and practice in the face of patients suffering from fibromyalgia. Fibromyalgia was recognized as a clinical entity by 26.7% of our physicians. Each general practitioner followed an average of 5.7 patients. The diagnosis of fibromyalgia was made based on widespread pain that persists more than 3 months, sensitive to NSAIDs, for 48% of general practitioners, or on tenderness that occurs in precise, localized areas of the body [trigger points] according to 54% among them. Main symptoms of Fibromyalgia were known with various degrees: pains [87.9%], excessive fatigue [85.7%], muscular weakness [78%], sleeping troubles [65.9%] and psychological disturbance [68.1%]. Knowledge of physicians about attitudes and practices in front of cases of fibromyalgia were limited. Knowledge of this disease is still mysterious and not well know. General practitioners are aware of fibromyolgia which not included in the program during that training in the medical school. In consequence, our institution, our medical schools in Tunisia should teach this disease to our student and during post graduate courses

[Fibromyalgia prevalence in Tunisia]

To estimate fibromyalgia [FM] prevalence in Tunisia Data on a cross-section of 1000 individuals aged 15 years or older living in Sfax were collected by interviewers using the London Fibromyalgia Epidemiology Study - Screening Questionnaire [LFES- SQ]. The sampling was realized by empirical poll and respecting quota according to delegation, rural or urban environment, sex and age according to the demographic national data. The positive screened subjects were invited to be examined to confirm or exclude the FM by applying the 1999 ACR criteria. The questionnaire was administered to a second group of 252 volunteers, all were afterward examined. This allowed 10 study specificity and sensibility of the questionnaire and allowed to calculate the FM prevalence. 159 subjects were screened positive, only 141 were examined. The specialized exam allowed confirming the diagnosis of FM in 67 subjects. FM prevalence is different according to sex, age, study level and socio-economic level. Two hundred and fifty two volunteers answered the questionnaire then all examined. The questionnaire specificity was 90.8% and the sensibility 79;4%. FM prevalence in Tunisia, calculated by Bayes theorem, is estimated between 8.27% and 12.3%. FM prevalence in Tunisia is estimated at least at 8.27%