[Intestinal parasites in food handlers region of Tunis: 8502 study stool samples [1998-2008]]

The food handlers control is one of the major measures of the National program against intestinal parasitoses in Tunisia. The collected data allow regular updates of the prevalence and profile of the involved parasitic species and note possible evolutions in time. From 1998 to 2008, 8502 stool samples of food handlers working in Tunis area were examined in the laboratory of Parasitology, Pasteur Institute of Tunis. The mean prevalence of intestinal parasites was 13.5% [1152 positive samples]. The protozoa were the most detected parasites [93% of the species observed]. Among the pathogenic or potentially pathogenic parasites, Dientamoeba fragilis [15.5%] and Giardia intestinalis [7.6%] were the most frequently encountered. Entamoeba [E.] histolytica/dispar was diagnosed in 41 subjects [a prevalence of 0.5%]. Hymenolepis nana was the most frequent helminth [4.5% of the whole parasites]. Therapeutic failures were noticed in 43.8% of infection by this cestode because of the lack of the appropr iate antihelminthic. The identification using PCR of cysts and/or vegetative forms of E. histolytica/dispar revealed the exclusive presence of E. dispar

[Primary Hypothyroidism subject of age: about 71 cases]

We report in this work a retrospective study of 71 patients older than 65 years who presented with primary hypothyroidism and were hospitalised. These patients represent 8.5% of all our hypothyroid patients. In our group, hypothyroidism was characterized by a female preponderance [72% of our cases] and by its atypical clinical presentation and the marked paucity of its clinical symptoms. The most frequent signs include physical asthenia [79%], weight increase [32%], cutaneo-mucosal signs [49.3%]. Anaemia and hyperlipidemia were the most frequent biological signs encountered [50% and 43% respectively] with hyponatremia found in 15% of the cases. Cardiovascular complications were present in 8 cases [11%]. A myxoedematous coma was present 3 patients [4%] and myopathy was seen in only one female patient. The aetiologies in our elderly patients were mainly auto-immune thyroiditis found in 74,6% of the cases and post-radiation hypothyroidism in 18.3%. Substitutive treatment was started during hospitalisation and the patients had thereafter a clinical and electrocardiographic follow-up to avoid ischemic coronary complications. The mean substitutive dose of L-thyroxine was 166 micro g/day