[Employment after spinal cord injury - about observations]

Spinal cord Injury management requires the collaboration of several structures of which the professional rehabilitation center located in La Manouba. This center contribute to the improvement of professional reintegration of spinal cord injured persons. to evaluate employment among spinal cord injured patients rebabilited in this center. a retrospective study of 34 patients with spinal cord injury [8 females and 26 males] mean aged 3005 years All patients had a professional training in the professional rehabilitation center after spinal cord injury 19 patients [55 8%] had a primary academic level and 14 patients [41 2%] had a secondary academic level. Before spinal cord injury, 27 patients [80%] were employed or had a school activity. Autonomy was satisfactory at 29 patients [88%]. After professional training, the rate of employment was 67.8%. Patients Aged> 30 years and those having a better functional autonomy had a better employment rate Sex, academic level and professional status before spinal cord injury have no influence on the employment rate. The rate of professional reintegration m spinal cord injured patients after professional rehabilitation is very satisfactory giving evidence of the efficiency of this rehabilitation It would be interesting to confirm this result by a prospective study

Microvascular complications in the type 2 diabetes: impact of the insulin therapy

When oral antidiabetics at optimal dosage have failed to maintain good diabetic control, insulin treatment has to be considered. The aim of this retrospective study is to evaluate over a 5 years period the incidence of progression in microvascular complications in 35 type 2 diabetes patients treated with insulin and compared to 35 controls treated with oral hypoglycemic agents. By 3-5 years, the "insulin" group had lower risks of progression in both complications: retinopathy [p=0,005] and neuropathy [p<0,05]. However, the incidence of progression in nephropathy was quite similar between the two groups. Our study confirms the long term results found in the literature about effects of insulin therapy on microvascular complications in diabetic patients

Metabolic control and alimentary contribution of type 2 diabetic during Ramadan under repaglinide

We studied 14 diabetic patients with type 2 diabetes [9 men and 5 women] in the aim to evaluate their metabolic control when treated with repaglinide while fasting during the month of Ramadan; their mean age was 50.6 +/- 2.2 year and their mean diabetes duration was 6.2 +/- 1. 3 years. We followed closely incidences of diurnal hypoglycemia and post prandial hyperglycemia. Mean glycosylated hemoglobin before Ramadan was 7.3 +/- 0.3% and none of our subjects had micro or macroangiopathy. During Ramadan, patients received repaglinide [l.l +/- 0.1mg at Iftar and 0.8 +/- 0.1mg at Shour] and metformine was continued in the 13 patients who were taking it prior to our study. Mean capillary glycemia at the end of the daily fasting was 1.32 +/- 1.06 g/l compared to 1.19 +/- 0.06 g/l for a mean fasting blood glucose before the month of Ramadan. Their mean postprandial 2H blood glucose after Iftar was 2. 15 +/- 0.17 g/l compared to 1.86 +/- 0.19 g/l for postprandial blood glucose after dinner. The mean blood glucose 2H after Shour was 1.76 +/- 0.20 g/l compared to 1.71 +/- 0.18 g/l for postprandial blood glucose after breakfast. The patients' weight remained stable; Fructosamine increased by 20.2 +/- 25.6 micro mol/l and glycosylated hemoglobin by 0.3 +/- 0.1%. Total food caloric intake and food composition remained unchanged. Only one event of clinical hypoglycemia occurred. Use of repaglinide during Ramadan decreases postprandial hyperglycemia without increasing the risk of diurnal hypoglycemia

[The diabetic diet of Tunisia: lived and recommendations]

Diet is essential for diabetes treatment. It must provide a balanced nutritional intake with adaptation to each patient. The aim of this study is to evaluate the spontaneous food consumption in a group of 150 type 2 diabetic Tunisian patients. Main food consumption abnormalities are an excessive caloric intake, an excess in glucid consumption, a saturated, fatty acids intake accounting for 26 +/- 6% of the lipid ration which is positively correlated with high LDL cholesterol levels [p=0,04], a ratio animal/vegetable proteins greater than I and an insufficiency in anti-oxidant vitamins. Thus, the qualitative analysis of the, food intake shows several anomalies which exposes our diabetic patients to a high cardiovascular risk; adapted recommendations appear to be necessary