[Attention deficit hyperactivity disorder at schools in Sfax-Tunisia]

Background: Frequency, social impact, the negative effects of ADHD on personal development, make it a public health problem. Tunisian existing data confirm its frequency and severity in clinical population. The absence of data in student population has led us to develop this work. The objectives of our study were to study epidemiological profile of ADHD in school population

Methods: The analysis involved a cross-sectional descriptive study conducted from April 2008 to October 2008 using a representative randomized multistage sample of schoolchildren between 6 and 12 years old. Measurement was performed in two stages first the parents and teachers of each children filled Conners questionnaire separately then students with the score in subscales inattention, hyperactivity with impulsivity higher than 70 were selected for psychiatric interview. Psychiatric interview was intended to confirm or refute the diagnosis of ADHD. The diagnoses were made according to DSM IV-TR. To study the possible associated factors with the disorder they were compared in children with ADHD and children without the disorder taken as controls

Results: A total of 51 students out of 513 had ADHD. Prevalence was found to be 9,94%. For the study of factors associated with ADHD were found in males, neonatal hospitalization, psychiatric and family history of ADHD and the existence of a family dysfunctionment

Conclusion: Our prevalence is similar to the majority of those reported by studies conducted through the same methodology as ours. The etiology of ADHD is not unequivocal. The disorder appears to be multifactorial

[Emotional disorders and inflammatory bowel disease]

The co-occurrence of emotional disorders [alexithymia, depression and anxiety] and inflammatory bowel disease [IBD] is reported in the literature. There are several possible explanations for this co morbidity. To evaluate the prevalence of alexithymia, anxiety and depression among patients with IBD and to compare them with a control group of healthy individuals and to discuss the relation between emotional disorders and IBD. We built a case - control study of 50 patients with IBD [ulcerative colitis [UC] and Crohn's disease [CD]]. The control group compounded 50 subjects without IBD and paired according sex, age, and school level. Alexithymia was assessed with the 20-item version of the Toronto Alexithymia Scale [TAS -20]. Participants completed the Hospital Anxiety and Depression Scale [HADS], which is a 14-item self-report scale providing separate subscale scores for anxiety [HADS-A] and depression [HADS-D]. Among the group of patients, the rates of anxiety, depression and alexithymia were, respectively, 52%, 44% and 54%. In this group, there were significantly more anxious, depressed, and alexithymic subjects than in the control group [p respectively, 0, 007, 0, 015 and 0, 002]. The anxiety and the depression were more frequent among patients who had active disease or symptoms than those in remission [p respectively, 0, 011 and 0, 035]. The comorbidity of emotional disorders and IBD seems to be frequent. Therefore, clinicians should look for those disorders in patients with IBD, by using specific scales. The adjunction of emotional disorder treatment, if needed, would allow optimizing the management of MICI

[ 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

[Adolescent's hospital morbidity in Sfax-Tunisia]

Adolescents present specific sanitary needs, linked to the physical and psychological mutations that occur during this vulnerable period of life. These needs remain little known in Tunisia. But: To describe epidemiological profile of morbidity of teenagers hospitalized in Hedi Chaker's hospital center of Sfax, during a period of 5 years, between 2003 and 2007. Data exploitation of the descriptive survey of morbidity and mortality of hospitalized adolescents. During the study, 2963 adolescents of 10 to 19 years have been hospitalized [5.1% of total of hospitalizations]. Paediatrics received 36.9% of adolescents. Paediatrics, haematology and infectious diseases's services received 58.5% of them. According to the groups of diagnosis, genitourinary and endocrine's diseases, dominate for girls, whereas infectious and parasitic diseases and tumors touched more boys. Diabetes, signs and general symptoms, leukaemia and anaemia, were the most frequent pathologies. Taking care of teenagers is often parcelled out on several hospitable services. Therefore, the improvement of the greeting services, in order to answer the teenager's relational needs home a temporary solution, while hoping, the setting up of units or specific services of adolescents that showed evidence of their utility for the development of the medicine of the teenagers in the industrialized countries

[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%

Sanitary's indicators of the university hospital hedi chaker of sfax in 2002

The objective of this work was to present the main results of this investigation during the year 2002 and to describe the profile of the hospital morbidity. In the setting of the epidemiologic supervision, the Community Medicine and Epidemiology service in Sfax leads a continuous descriptive study of the hospital morbidity and mortality. The average age of the hospitalized was 32, 10 years. The sex-ratio was estimated at 0, 94. The socio-economic level was relatively low. The chronic pathologies come in head and are dominated by the chronic renal failure, schizophrenia and diabetes. The profile of morbidity reflects an epidemiological transition phenomenon and call to a backing of the ambulatory handling and the development of specific services capable to make decrease the needs of hospitalizations