Exogenous lipoid pneumonia caused by Nigella sativa oil - A case report

Introduction: Exogenous lipoid pneumonia [ELP] is an uncommon and chronic infiltrative pulmonary process secondary to continued aspiration of exogenous lipids. Nigella sativa, or the black cumin seed, is a herb used in traditional medicine in many Middle Eastern and Asian countries to treat a broad array of diseases

Objective: The purpose of the present case report is to reveal the role of the abuse of N. sativa seed oil [black cumin seed oil], as an exceptional cause of ELP, which has not been, to our knowledge, previously documented

Case report: A 50-year-old man was evaluated for a 6-month history of cough, sputum and progressively worsening dyspnea on exertion. His medical history included long-term smoking. We questioned the patient specifically about use of any traditional herbal medicinal products. He acknowledged that he had been taking one tablespoon [15 ml] of N. sativa oil at bedtime since 8 months [8 bottles of 500 ml] for the purposes of tonification. Exogenous lipid pneumonia was suspected. Physical examination found bilateral crackles of the lung bases. Lung function tests were normal. The chest radiograph showed thoracic distension and bilateral basal interstitial disease. Computed tomography [CT] of the chest was performed, and revealed infiltrative lung disease affecting the posterobasal segments of the right and left lower lobes, honeycomb fibrosis was seen at the bases of both lungs. Routine blood tests were normal. Sputum and blood culture were sterile. We performed bronchoscopy with transbronchial biopsies and bronchoalveolar lavage. The color of the lavage liquid was blakish with fat globules on the fluid surface. It contained 220,000 cells/ml. Differential cell count showed 87% macrophages, 13% lymphocytes; stains and cultures for infectious agents were negative. The patient was advised to stop taking N. sativa oil. The only treatment that was instituted was N-acetylcysteine. A clinically significant change in symptoms and chest radiograph was observed. The patient has remained stable 18 months after the diagnosis

Goals for oral health in Tunisia 2020

In 1981, the World Health Organization [WHO] together with the F‚d‚ration Dentaire Internationale [FDI] set global dental health goals for the year 2000 within the global strategy of health for all. In 1999, a team of experts drew up new goals to be achieved by 2020, which aimed to facilitate specific oral health policy development for each country. These goals are more general and have to be adapted to local circumstances. This paper aimed to adapt the WHO/FDI/IADR's Global goals for oral health 2020 to Tunisia and draw up new national goals and targets for Tunisia based on previous national oral health surveys

Anatomical study of feral queen's reproductive systems in Iraq

The present study is carried out to investigate some morphometric aspects of reproductive organs in Iraqi feral cats. Forty six female genital specimens from sexually mature queens were trapped during the period from December 2008 to December 2009.The specimens were classified into pregnant and non pregnant. The non pregnant were further classified into reproductive systems with or without obvious pathological changes. During the entire period, the results showed that the means of length, width and thickness of right and left ovaries were 9.8 x 5.03 x3.95 mm and 9.56 x4.8 x3.05 mm respectively, with no significant variation [p >/= 0.05] between the dimensions of right and left ovaries or between dimensions of the different seasons. The means of length of right and left uterine tubes were 54.4 and 55.7 mm respectively, with no significant variation [p >/= 0.05] between the dimensions of right and left uterine tubes or between dimension of different seasons. The means of length and diameter of right and left uterine horns were 48.44 x 5.41 mm and 54.43 x 5.14mm, with significant variation [P

[Intrathoracic goiters]

True intrathoracic goitres without any connexion with the cervical gland are rare. They present as tumours of the upper mediastinum. Mediastinal CT scan is the investigation of choice. Treatment is exclusively surgical because of the risk of mediastinal compression. In this report we describe a case of goitre which was diagnosed fortuitously in a 45 years old patient. Treatment was surgical with a left anterolateral thoracotomy

[Pulmonary hpertension in patent ductus arteriosus [about 4 cases]]

Pulmonary hypertension constitutes major problem in the natural evolution of patent ductus arteriosus. We report 4 cases of patients presenting a patent ductus arteriosus with pulmonary hypertension. There were one male and three females. The average age was of 9.5 +/- 6.4 years with age range 4 to 16 years. In 4 cases, the left to right shunt was important and associated to pulmonary hypertension. The diameter of the canal varied between communication between the aorta and the pulmonary artery. In the two other cases, the length of canal was respectively 5 and 10 mm. All patients had benefited from a surgical closure of the ductus arteriosus. The aftermath of surgery was simples in all patients. We insist on the importance of the systematic closure of every ductus arteriosus, closure as prematurely indicated as the canal is wide and the shunt consequently important

[Unusual technique of closure of patent ductus arteriosus]

Patent ductus arteriosus is a very common congenital heart disease. Surgery closure usually makes after the first year of the life. It is usually section and suture, which is a simple and safe act. We report a case of endoaortic closure of ductus arteriosus without cardiopulmonary bypass in a 144 year old girl

[Sternal osteomyelitis: an exceptional osteo-articular lesion in inflammatory bowel disease: a case study]

Primary sternal osteomyelitis is a rare condition. It's association with ulcerative colitis is exceptional. We report a case of a 34 years old woman with multiple extra-intestinal manifestations presenting sternal osteomyelitis successfully treated with combined surgical intervention and intravenous antibiotics

Ataxia telangietasia [about 11 cases]

Ataxia telangiectasia [AT] is an autosomal recessive disorder, caracterized by progressive cerebellar ataxia, oculocutaneos telangiectasia, immunological abnormalities and increased susceptibility of malignancies. Our study objectives are to provide the last data in genetic, clinical and therapeutic fields concerning AT in order to help our doctors to establish the diagnosis in the first stages and so participite to the diagnosis of the primary immunodeficiency diseases. Our 11 patients are from 7 families and the consanguinity was found in 8 cases. The median age of diagnosis is about 7 years and 7 months. The clinical study had found out eight cases of manifest ataxia, nine times bulbar telangiectasias and eight cases of bronchectasias. On the immunological side, the serum IgA deficiency was found 5 times and one case had showed lymphopenia. The taking in charge consisted in infectious episodes treatement and continuous antibiotic prophylaxis, IGIV infusion was used only four times. The course of our patients was characterized by regression of infectious signs in five cases and the death of five others. One patient had never been seen again. Our set was charactezed by the heterogenecity of the features. In one hand we had severe form with a very soon start and in the other hand we had a mild clinical form with a late start

[Primary immunodeficiency in children in Casablanca: a 73 cases report]

Primary immunodeficiencies [PID] seem to have two particularities in the Maghreb countries: a higher frequency than in the occidental countries and a higher proportion of deficiency of HLA class II antigens. Patients and method: a four-year study reports 73 PID cases between 1997 March and 2001 February in the Clinical Immunology Unit of the Casablanca Children Hospital. These 73 cases were diagnosed, according to the WHO criteria, among 358 children with recurrent and/or severe infections. They had an immunological assessment: tuberculin IDR, blood cells, serum immunoglobulin A G and M, lymphocytes classes. we found 18 combined immunodeficiency including 5 deficiencies of HLA class II antigens, 18 antibody defects, 17 complex immunodeficiencies including 11 ataxia-telangiectasia syndromes, 13 PID associated to an other disorder including 4 hyper IgM syndrome, 6 phagocyte disorders and one complement defect. Because of their high cost, the intravenous immunoglobulins were used in only 29 children and the bone marrow transplantation is not available in our country. Twenty six children died in this study. Comments: as in Tunisia, our study confirms the high frequency of combined and complex PID in comparison to the occidental studies, and we have to develop the PID diagnostic and treatment resources in our country

Atraumatic restorative treatment and glass ionomer sealants in Tunisian children: survival after 3 years

We evaluated the survival rates of atraumatic restorative treatment restorations and of glass ionomer sealants after 3 years of usage in primary and permanent teeth in Tunisian children aged 3-15 years attending rural schools, and assessed the presence or absence of dental caries in the restored teeth. After an initial survey of 1949 children, 242 were selected and agreed to undergo treatment. The loss to follow-up after 3 years was about 40%. Of those evaluated, 45.73% of one-surface ART restorations in permanent teeth had survived, 54.96% of one-surface sealants in permanent teeth had survived and 27.85% of one-surface ART restorations in primary teeth had survived. Caries was found in only 19 teeth after 3 years