Cigarette Smoking Effect on Microhardness and Flexural Properties of Denture Base Resins

ABSTRACT Objective: To identify the tobacco effect on flexural properties and the microhardness of three acrylic resins. Material and Methods: Three resins were tested: two thermo-polymerizable acrylic resins (RMB 20 and BMS 014) and one autopolymerized acrylic resin. The 3-point bending and microhardness tests were carried out with a universal tensile-compression machine and a micro-Vickers hardness tester. The acrylic resin specimens have been exposed for 21 days to cigarette smoke in a smoking room. Their mechanical strength was compared to unexposed samples. Statistical analysis was performed using the data processing software SPSS Statistics 21.0. Results: The flexural properties of the resins were affected by cigarette smoke only in the case of Major Base 20® (drop in strength with p= 0.02; 0.6; 0.7 and in elastic modulus with p= 0.86; 0.74 and 0.85 for Major Base 20®, BMS 014® and Major Repair®). The cigarette smoke affected significantly microhardness for all groups (p<0.001). Conclusion: Cigarette smoking does not affect the flexural properties of the acrylic resin (BMS 014® and Major Repair® unlike Major Base 20®), but it does reduce the microhardness.

A Road Less Traveled: Endoscopic Retrograde Cholangiopancreatography in a Patient with Long-standing Achalasia and Sigmoid Esophagus / 대한소화기학회지

Endoscopic retrograde cholangiopancreatography in a patient with achalasia and sigmoid esophagus poses a unique technical challenge, as one must safely guide the side viewing duodenoscope across a severely distorted distal esophagus and non-relaxing lower esophageal sphincter. In such patients, the use of an overtube is a simple solution that allows the safe passage of a duodenoscope and the removal of common bile duct stones.

Novel RAB3GAP1 Mutation in the First Tunisian Family With Warburg Micro Syndrome

Background@#and Purpose Warburg Micro syndrome (WARBM) is a rare autosomal recessive genetic disease characterized by ocular, neurologic, and endocrine anomalies. WARBM is a phenotypically and genetically heterogeneous syndrome caused by mutations in RAB3GAP1, RAB3GAP2, RAB18, and TBC1D20. Here we present the clinical and genetic characterization of a consanguineous Tunisian family with a WARBM phenotype presenting two pathogenic variations, one of which is on RAB3GAP1. @*Methods@#We applied whole-exome sequencing (WES) to two affected young males presenting a WARBM-compatible phenotype. @*Results@#We reveal a new variation in RAB3GAP1 (NM_012233.3: c.297del, p.Gln99fs) and another variation in ABCD1 (NM_000033: c.896A>G, p.His299Arg). Each of these mutations, which in silico predictions concluded as being pathogenic variations, affects a critical protein region. Both affected males presented a WARBM-compatible phenotype, with severe intellectual disability, severe developmental delay, postnatal growth delay, postnatal microcephaly, congenital bilateral cataracts, general hypotonia, and a thin corpus callosum without a splenium. However, intrafamilial clinical heterogeneity was present, since only the oldest child had large ears, microphthalmia, foot deformities, and a genital anomaly, and only the youngest child had microcornea. Despite the mutation identified in ABCD1, our patients did not have any Xlinked symptoms of adrenoleukodystrophy disorder that are usually caused by ABCD1 mutations, which prompted our interest in clinical monitoring. @*Conclusions@#WES analysis of a consanguineous Tunisian family with WARBM revealed a novel variation in RAB3GAP1 (NM_012233.3: c.297del, p.Gln99fs) that is most likely pathogenic and allowed us to confirm the diagnosis of WARBM.

Clinical and Genetic Heterogeneity of Familial Early-Onset Diabetes: Case of Six Tunisian Patients Suspected of Maturity-Onset Diabetes of the Young 12

Background and objective: Maturity-onset diabetes of the young 12 (MODY12) is a form of early-onset type 2 diabetes, which is transmitted in an autosomal dominant mode. It has clinical features similar to MODY1 and MODY3. The aim of this study is to screen for mutations in ABCC8 gene in six Tunisian patients suspected of MODY12 using Sanger sequencing. Methods: Six probands, with diabetes in 2-3 generations and found previously negative for mutations in HNF1A, HNF4A, INS, IPF1 and NEUROD1, were screened for known mutations in ABCC8 gene using Sanger sequencing. A comparison of the clinical features of our patients with MODY12 cohorts of other studies was also performed using ANOVA test. Results: The six patients were diagnosed with overt diabetes (fasting glycemia: 12.85 ± 3.5 mmol/l, HbA1c: 12.51 ± 2.58%) at mean age of 25.16 ± 5.11 years. They had a BMI mean equal to 26.7 ± 5.9 kg/m2. The majority of the patients were initially treated with OHA or on diet. Some of them converted to insulin therapy. Although, the comparison of our cohort with other MODY12 cohorts showed no significant difference in age at diagnostic and HbA1c, molecular analysis showed only two synonymous non-pathological polymorphisms rs1799857 and rs1805036. Conclusion: Our study highlighted the clinical and genetic heterogeneity of familial earlyonset diabetes in the Tunisian population, which is concordant with previous studies Thus, the need for using nextgeneration sequencing technologies to determine the aetiology of these forms of diabetes.

Study of Physicochemicals Characteristics and Antioxidant Capacity of Cork Oak Acorns (Quercus suber L.) grown in Three Regions in Tunisia.

This study focuses on the valorization of the Tunisian cork oak acorns in minerals, bioactive compounds and antioxidants. It involved the study of physico-chemical characteristics of acorns from Quercus Suber. L, of three Tunisian northern regions: Sejnen, Nefza and Ain Drahem. The kernels and hulls of acorns were analyzed for their antioxidant capacity using DPPH free radical scavenging activity. The total phenolics, flavonoid and carotenoid contents were measured using standard methods. The multi-elemental analysis was performed by atomic emission spectrometry with inductively coupled plasma (ICP). Acorns exhibit a degree of organic matter and moisture varies according to the region and part of the studied plant. The ICP analysis shows the abundance of cork oak acorns in calcium, magnesium and especially in potassium (6.942 g.kg-1). Kernels have higher polyphenol contents (66 - 77 mg GAE.g-1). The radical scavenging activity of methanol extracts of cork oak acorns shows that the Sejnan kernels have significant antiradical activity with an IC50 in the order of 6.94 μg.mL-1. Analysis of sugars in the fruits by HPLC revealed the presence of fructose, galactose, sucrose and maltose. This plant can be used as an inexpensive source of natural antioxidants and mineral supplements of food.

Total Phenolic, Total Flavonoid, Tannin Content, and Antioxidant Capacity of Halimium halimifolium (Cistaceae).

This study was carried out to evaluate the phytochemical constituents and antioxidant potential of the leaves and flowers extracts of Halimium halimifolium in order to validate the medicinal potential of this herb. The antioxidant activity of alcoholic and aqueous extracts was evaluated using 2, 2-diphenyl-l-picrylhydrazyl (DPPH), 2, 2’-azinobis- (3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) and ferric reducing antioxidant power (FRAP) assays. The total polyphenol, flavonoid and tannin content were determined according respectively to Folin-Ciocalteu method, Zhishen method and Broadhurst method. The leaves of H. halimifolium had greater antioxidant activity than flowers by DPPH and ABTS assays. The ethanol extract of the leaves exhibited the better antioxidant activity by DPPH assay (IC50 = 1.19 μg.mL-1), the n-butanol by ABTS assays (IC50 = 1.73μg.mL-1). As opposed to FRAP method the flowers had greater antioxidant activity as leaves. Ethyl acetate extract exhibited better antioxidant activity (IC50 = 15.5 mmol Fe2+.g-1). The obtained results showed that the extracting solvent significantly influenced the antioxidant property estimations of Halimium halimifolium. The ethanol is a recommended solvent for extracting antioxidants from this plant. The antioxidant activity determined by DPPH, ABTS and FRAP demonstrated a linear relationship with their polyphenols, flavonoids and tannins content.

[Vulvovaginal trichomoniasis: epidemiology, clinical and parasitological characteristics]

Background: Trichomonas vaginalis infection is the most prevalent nonviral sexual transmitted infection. The World Health Organization estimates that its prevalence is 170 million cases worldwide each year. In women, he represents the third cause of vaginitis

Aim: to determine the prevalence, to evaluate predisposing factors and to study the clinical and parasitological characteristics of vulvovaginal trichomoniasis in a Tunisian population during a period of 18 months

Methods: This is a transversal study concerning 924 women. We administered a questionnaire to obtain information about the possible risk factors of vulvovaginal trichomoniasis. Vaginal swabs were collected with the help of sterile transportable cotton swabs, followed by microscopic examination. Data were statistically analyzed

Results: Trichomonas vaginalis infection was diagnosed in 3,5% of cases. The study various potential risk factors showed that trichomoniasis was significatively associated with multiple partners, long-term corticotherapy. However, the pregnancy was a protector factor

Conclusion: The research for factors allows not only to explain the appearance of this infection but also, and especially, to establish a disease prevention to avoid their second offense or, at best their arisen in women at risk

Assessment of MYCN amplification status in Tunisian neuroblastoma: CISH and MLPA combining approach

Background: Neuroblastoma [NB] shows a complex combination of genetic aberrations. Some of them represent poor genetic prognosis factors that require specific and intensive chemotherapy. MYCN amplification consists of the major bad outcome prognostic factor, it is indeed frequently observed in aggressive neuroblastomas. To date different methods are used for MYCN status detection

Objectives: The primary aim of our study was to provide a critical assessment of MYCN status using 2 molecular techniques CISH and MLPA. We also focused on the correlation between neuroblastoma genetic markers and patient's clinical course among 15 Tunisian patients

Methods: we developed a descriptive study that includes 15 pediatric Tunisian patients referred to our laboratory from 2004 to 2011. We reported the analysis of fresh and FFPE NB tumors tissues

Results:No significant correlation was found between COG grade and patients overall survival. Assessment of NMYC gene copy number by kappa statistic test revealed high concordance between CISH and MLPA tests [kappa coefficient = 0.02]

Conclusion: Despite misdiagnosing of MYCN status fewer than 5 copies, MLPA remains an effective molecular technique that enables a large panel of genomic aberrations screening. Thus combining CISH and MLPA is an effective molecular approach adopted in our laboratory. Our results allow pediatric oncologists to set up the first Neuroblastoma therapeutic strategy based on molecular markers in Tunisia

[Development and validation of a new HPLC method for determination of lamotrigine and clinical application]

Background: Lamotrigine is an effective anticonvulsant drug used in the treatment of epilepsy. It has a narrow therapeutic range, a large inter and intra-individual pharmacokinetic variability and some concentration-dependent side effects

Aim: The aim of this study was to develop and validate a new method for lamotrigine quantitation in plasma using HPLC with UV/visible detection

Methods: A rapid HPLC-UV method was developed for the determination of lamotrigine in plasma. All solvents used were HPLC grade

Results:After liquid-liquid extraction, chromatographic separation was achieved using an RP 18 [250 mm] column. The mobile phase was composed of acetonitrile and 0.1 M potassium dihyrogenophosphate [25/75] [v/v]. Barbital sodium was used as internal standard. This technique was linear over the 2 micro g/mL to 50 micro g/mL range [r= 0.99]. Detection and quantification limits were 0.07 micro g/mL and 0.21 micro g/mL, respectively. Within-day coefficient of variation [13.37 to 16%] and day-to-day coefficients of variation [15.68 to 16.63%] at three different concentrations. Under these conditions, each analysis required no longer than 10 min. We finally evaluated the plasma concentrations of lamotrigine in Tunisian patients treated with this drug

Conclusion: The results found are similar to those previously described and the developed method is repeatable and reproducible. It can be used for clinical applications

[Pharmacokinetik population of methotrexate in Tunisian population with acute lymphoblastic leukemia]

Background: The use of high dose of MTX in the treatment of the leukemia is actually better controlled by renal preparation, control of plasma concentrations and administration of folinic acid. However, High dose MTX has been proven to cause substantial toxicity and have high intra-and inter-patient variability. Population pharmacokinetic analysis is a useful tool for identification of sources of pharmacokinetic variability during anticancer drug development and can aid the design of alternative dosing regimens to enhance their efficacy and safety

Aim: The aim of our study is to developed and validate a population pharmacokinetics model of our population. We hereby describe the clinical covariates [age, sex and clearance of the creatinine] that influence MTX pharmacokinetic for predicting optimal dose to reduce MTX toxicity

Method: It is a prospective study achieved between January 2005 to January 2012 in the Service of Clinical Pharmacology. Including 273 patients treated for acute lymphocytic leukaemia 2582 plasma concentration was achieved. The data have been analyzed with Nonmem[copyright sign] software [non linear regression to mixed effect]

Results:The age of our patients varied from 2 to 23 years with an average of 13 years. The patients received high dose MTX therapy [1 to 8 g/m2] in 24 hours infusion every 15 days. Three compartiment models describe the pharmacokinetic of MTX. The most important covariables affecting the model were clearance of the creatinine, age and weight. We obtained a good correlation between the predicted and the observed concentrations

Conclusion: The development of population pharmacokinetics model of MTX allows us to propose a therapeutic diagram adapted to every patient according to its morphological and pharmacological features while taking in consideration the therapeutic objective

Epidemiology and medical cost of hospitalization due to rotavirus gastroenteritis among children under 5 years of age in the central-east of Tunisia

Data on the economic burden of rotavirus infection in Tunisia are needed to inform the decision to include rotavirus in routine childhood immunizations. This study aimed to describe the epidemiological profile of rotavirus disease in central-east Tunisia and to estimate its hospital cost. In the first stage - the prospective collection of epidemiological data - we enrolled all patients < 5 years old who were hospitalized for acute diarrhoea at 5 university paediatric departments in central-east Tunisia during the period 2009-2011. Rotavirus was responsible for 65 [23.3%] of the 279 cases enrolled. In the second stage, cost data were collected retrospectively using an activity-based costing method from the medical records of the children who were positively diagnosed with rotavirus. The average cost of care per child was TD 433 [SD 134]. This is a significant economic burden in Tunisia, where a safe and effective vaccine is available but not yet introduced to the immunization schedule

Exploitation des racines naturelles et artificielles en prothèse adjointe: cas cliniques

Les problèmes de rétention et d'instabilité sont les principales plaintes des prothèses amovibles partielles et complètes. Dans les prothèses complètes amovibles (CRP), la conservation des racines avec des chapes équipées d'attaches axiales ou avec une barre de conjonction est indiquée lorsque nous sommes en présence d'un nombre réduit de dents du rapport couronne / clinique racinaire est défavorable. La réduction de la couronne clinique permettra d'établir plus facilement une occlusion équilibrée et de résoudre le problème esthétique. Dans les prothèses partielles amovibles (PRP), la différence de compressibilité entre l'élément. Le ligament parodontal des dents restantes et les crêtes édentées fibro muqueuses est un piège pour éviter d'assurer la stabilité, le confort et la durabilité de la restauration prothétique et des structures anato- miques. Doté d'un accessoire, l'implant permet de proposer la conception prothétique la mieux adaptée pour contrôler les différents mouvements que l'on peut effectuer. Les prothèses amovibles sous-racines ou sous-implantaires sont comparables dans leurs avantages, inconvénients et principes biomécaniques. En effet, l'exploitation de racines naturelles ou d'implants favorise le traitement prothétique au niveau fonctionnel, psychologique et biologique

[Anemia caused by parasites]

Anemia is a major public health problem and concerns the World Health Organization. It is more common in developing countries particularly in South Asia and Africa. The causes of anemia are varied and parasites can cause it. We propose to study the anemia caused by parasites after a brief hematology and pathophysiology of anemia in general

Lower incidence of hypotension following spinal anesthesia with 6% hydroxyethyl starch preload compared to 9% saline solution in caesarean delivery

Hypotension is a common complication following spinal anesthesia for cesarean delivery. Techniques to prevent hypotension include preloading intravenous fluid. To compare the effect of two preloading regimens: 6% hydroxyethyl starch [HES] and 9‰ saline solution, to prevent hypotension after spinal anesthesia in cesarean delivery. 105 patients undergoing intrathecal anesthesia for elective cesarean delivery were randomized and allocated to receive a preload of 500 ml HES 130/0.4 [HES Group] or a preload of 1500 ml 9‰ saline solution [CR group]. Blood pressure and heart rate were recorded at baseline and after spinal anesthesia [every minute for the first 10 min, every 3 min for the next 10 min, and then every 5 min for the last 20 min]. The primary outcome was to compare the incidence of hypotension [defined as a 20% reduction in systolic arterial pressure from baseline] between the two preloading regimens. Vasopressor requirements [i.v. bolus of 6 mg ephedrine] were also compared. The incidence of hypotension was 87% in the CR group and 69% in the HES group [p= 0.028]. Ephedrine requirement, incidence of nausea, and/or vomiting and neonatal outcome did not significantly differ between the two groups. The incidence of hypotension was lower after preloading of 500 mL of HES 130/0.4 than preloading with 1500 mL of 9‰ saline solution

[Postpartum depression: prevalence and risk factors prospective study concerning 302 Tunisian parturients]

Depression is a common condition especially in the postpartum. It exposes mothers, newborns and couples for psychosocial complications. They were to estimate the prevalence of the depression in postpartum in a population of 302 Tunisian parturients and to identify its associated factors. Our study was prospective, in two stages: at the first week [T1], then between sixth and tenth week of the postpartum [T2]. The study was conducted at CHU Hédi Chaker in Sfax, Tunisia. We used the Arabic version and validated the Edinburgh Postnatal Depression Scale [EPDS] for screening for postpartum depression. We used the scale MSSS. "Maternity Social Support Scale"to assess the social and family support and the Azrin scale to evaluate the satisfaction of the conjugal relationship. An epidemiologic questionnaire was used to collect the sociodemographic and clinical data. At T1, 302 women were examined. At T2, 139 were reexamined [46% of the initial population]. In the first stage, the prevalence of the intense postpartum blues, according to EPDS, was 19,2%. In the second stage, the prevalence of the postnatal depression was 12, 9%. Factors associated with postpartum blues intense were the low socioeconomic status [p =0, 01], a lower educational level [p = 0,017], the poor marital relationship [p =0, 04], an insufficient social support [p ‹0,001], the difficulty to accept pregnancy [p =0,001], the presence of psychiatric the presence of psychiatric history [p =0,001], the prematurity [p =0,001] and an ill newborn birth [p =0,001]. Factors associated with the post natal depression were the low socioeconomic status [p =0,01], the poor marital relationship [p =0,034], difficulty with pregnancy [p =0,001] and the presence of psychiatric history [p =0,001]. Postpartum depressions are common. It seems to be the result of the interaction of several biological, psychological and social factors. This suggests the importance of screening for women having such risk factors to prevent the installation of this depression. This detection should be done early in postpartum or else in the later postnatal consultations. This allows an adequate treatment for the mothers, for the relationship mother-new born and later, for the psychological equilibrium of the child

[Prevalence of helicobacter pylori infection and gastroscopic finding in diabetic patients: case control study]

Current data on the prevalence of Helicobacter pylori infection in dyspeptic diabetic patients are contradictory in the literature. The aim was to assess the prevalence of Helicobacter pylori infection, gastroscopic lesions, and gastric histopathological lesions, in dyspeptic diabetic patients. It was a case-control study collecting 394 dyspeptic patients [194 diabetic and 200 nondiabetic patients]. The average age of patients was 47 years. 144 patients [47%] were male and 150 patients [53%] were female. The two patient groups were matched for age and sex. The prevalence of Helicobacter pylori infection was comparable between the two groups of patients [85% in diabetics versus 90% in the controls]. The frequency of gastroscopic lesions was 50% in diabetics and 55% in controls with no significant difference between the two groups. At histology, the prevalence of chronic gastritis, intestinal metaplasia, and gastric atrophy was 85%, 13% and 39% respectively in the group of diabetic patients. These results were comparable to those found in patients without diabetes. Our work shows no difference between diabetics and non-diabetics on the prevalence of Helicobacter pylori infection, gastroscopic, and gastric histopathological lesions