ANALYSIS OF THE SPORTING BEHAVIOR OF THE JUNIOR ARABIC FENCERS DURING THE QUARANTINE AND CURFEW PERIOD DUE TO THE COVID-19 PANDEMIC

The aim of the current research is to investigate and analyzing behavior of the Arab Fencers during COVID-19 pandemic restrictions. The study has utilized a descriptive survey that covers 120 fencers from eight Arab countries. The Arab Fencing Association was a major mediator for distributing the developed electronic questionnaire to the fencers and clubs. The statistical results obtained from the questionnaire showed that curfew periods have harmed the training conditions for the fencers and consequently on their sporting behavior. Moreover, the periodical contact between the coaches and the players has contributed significantly to maintaining athletic behavior, physical skills, psychological stability, and commitment to ethics and traditions. The study recommends that it's important to continue the current successful approach by providing encouragement and support for the fencers, to maintain their mental and physical skills. Also, special alternative training programs should be developed and prepared for the fencers to be ready for the post-pandemic. Finally, it is necessary to conduct researches that tackle the negative psychological and social impacts of the COVID-19 pandemic. © (2023). All Rights Reserved.

COVID 19 Vaccine and Cancer: A Prospective Study of 186 Cases

Introduction: Vaccination against SARS-CoV-2 is currently recommended. Cancer patients are considered a priority. In Tunisia, these patients were included on the vaccination platform as priorities. The only contraindication to this vaccine is neutropenia. Objectives: The objective of this work was to study the acceptability and adherence of the COVID 19 vaccine in cancer patients. Methods: This is a prospective study including cancer patients undergoing chemotherapy. The study was carried out at the medical department of oncology at Habib Bourguiba hospital in Sfax between March 2021 and June 2021. Results: 186 patients were included including 38 men and 148 women. The average age was 52 years old [24-72 years old]. The site of the tumor was mammary in 61.3% of cases, recto-colic in 11.3%, and at the cavum in 3.8%. The tumor was localized in 52.7% and metastatic in 47.3% of cases. The chemotherapy was neoadjuvant in 9.1% of cases, adjuvant in 44.1% of cases and palliative in 46.2%. Administration of targeted therapies was observed in 25.3% of patients. Ten patients (5.3%) have a COVID infection during their treatment. Ninety-nine patients (53.2%) accepted the vaccine. Sixty-nine patients (37.1%) refused and eighteen patients (9.7%) were hesitant. Thirty patients (16.1%) were enrolled at the vaccine registration site. Twenty patients (10.7%) had the SARS-CoV-2 vaccine. The tolerance of the vaccination was good. Conclusion: It is important to vaccinate all cancer patients under chemotherapy given the severity of the COVID-19 infection and this after checking the blood count. In our series, 53.2% of patients agreed to have the COVID19 vaccine. This rate was higher than that described in the literature which is 37.4%. This can be explained by the awareness of patients through the vaccination brochures.

Polyarthrite rhumatoïde et Covid-19

Introduction Les rhumatismes inflammatoires chroniques et notamment la polyarthrite rhumatoïde (PR), nécessitent une attention particulière au cours de la pandémie COVID-19 (CV-19). L’objectif de notre étude était de détecter une infection CV-19 chez des patientes suivies pour PR, d’évaluer l’impact de cette infection sur leur maladie et leur volonté de se faire vacciner. Patients et méthodes Il s’agit d’une étude transversale incluant 51 patientes atteintes de PR au sein d’un service de Rhumatologie sur une période de 2 mois (juillet et août 2021). À travers un questionnaire-patient, nous avons cherché à évaluer l’impact de la pandémie sur les patientes présentant une PR, notamment concernant l’activité de la maladie, le maintien du suivi médical et du traitement, l’application des mesures de prévention et la vaccination. Résultats L’âge moyen était de 54,2±10,4 ans. La durée moyenne d’évolution de la maladie était 10,2±6,9 ans. Quarante patientes avaient une PR séropositive. Toutes les patientes étaient sous traitement de fond parmi lesquelles 33 % étaient sous biothérapie. Onze patientes avaient attrapé l’infection à CV-19 dont une est décédée. Quatre-vingt-deux % avaient une forme légère, 9 % une forme modérée et 9 % une forme grave. Vingt-deux patientes avaient au moins un sujet atteint par le CV-19 dans la famille. Un test PCR était le moyen de confirmation pour 7 patientes. Les signes cliniques présentés par ces patientes étaient : fièvre, céphalées, vertiges, asthénie, toux, anosmie, agueusie, diarrhées, épigastralgies, douleur thoracique et dyspnée. Soixante-trois % d’entre eux gardant des séquelles type d’arthralgies, radiculalgies, orteil Covid, hypoacousie, hyposmie, toux, asthénie. Concernant l’activité de leur PR au cours de l’infection, 36 % avaient une aggravation ;18 % présentaient une poussée et 27 % gardaient un état stationnaire. Au cours de la période pandémique, 12 patientes ont arrêté leur traitement de fond ;12 patientes ont raté leur rendez-vous de consultation et 9 patientes ont déclaré la survenue de poussées plus fréquentes. Concernant la vaccination, 14 patientes ne voulaient pas faire le vaccin pour plusieurs raisons : peur d’effets indésirables dans 50 % des cas, peur d’aggravation de la PR (50 %), inefficacité du vaccin (28 %), peur d’interaction avec leur traitement (28 %), peur des vaccins en général (28 %), non recommandé par un médecin (14 %), manque de confiance envers les labos pharmaceutiques (14 %), croyances religieuses (7 %). Parmi les sujets vaccinés, 21 patientes ont déjà reçu une dose complète. Seize % des patientes ont présenté une poussée après le vaccin et 53 % des patientes ont déclarées la survenue d’effets indésirables type : douleur au niveau du site d’injection, asthénie, fièvre, céphalées, vertiges, arthralgies. Pour les mesures de prévention, 88 % portaient leur masque dans les lieux publics, 92 % lavaient leurs mains régulièrement, 90 % gardaient une distance de sécurité et 74 % évitaient les espaces encombrés. Conclusion Les sujets atteints de PR ne sont pas épargnés de l’infection COVID-19. Cette pandémie a influencé la qualité de leur prise en charge. Un certain nombre de patients ne sont pas encore convaincu par la vaccination et ne prennent pas les mesures de précaution nécessaires. C’est pourquoi, il faut les sensibiliser.

Impact of covid 19 pandemic on Tunisian spa patients: Psychological state and treatment adherence

Background: The challenge posed by the COVID-19 pandemic may represent an overwhelmingly stressful event for ankylosing spondylitis (SpA) patients and impact their treatment adherence. In response to the COVID-19 pandemic, Tunisia, have adopted community containment to manage the spread of the virus. However, COVID-19 restrictions can alter psychological wellbeing and limit access to treatment for SpA patients. Objectives: This study aimed to evaluate the impact of COVID-19 pandemic on psychological health and treatment adherence on Tunisian SpA patients. Methods: This is a cross sectional study including patients with SpA (ASAS criteria). A survey comprising questions about adherence to stay home warnings;the obligation to go outside for work;satisfaction with the medical support or information received for COVID-19;showing up to medical check-ups, proper use of the medications;medications that the patient stopped taking. Anxious and depressive symptoms were assessed using the Arabic version of Hospital Anxiety and Depression Scale (HADS) questionnaire. Results: We included thirty patients. the average age was: 39,7 years-old and the sex ratio was: 13,3. 75 % of patients were married. The SpA was axial in 25%, peripheral in 20%, and both in 55 %. Most patients had a moderate activity and the mean activity scores were: BASDAI = 2.60, ASDAScrp:2.65 38% of patients were on biologics, 36 % on sulfasalazine and NSAIDs and 26 % on NSAIDs only. It seemed that significant number of patients strictly adhered to stay home warnings (> 89%) only 11% were obliged to go out for work during general lockdown while only 24 % adhered to it after general lockdown. Most of the patient 78 % were not satisfied with the medical support or information about COVID 19. 88% of patients requested information from TV while 10 % requested it from social media and 2 % from relatives and friends working in health care field. After the outbreak, 23% of the patients who had a scheduled chek-up visit attended the appointment as it was before.The remaining either 'did not want to come' (43%), wanted to come but could not contact anyone in the hospital (11%), was advised to postpone their visits (10%), or couldn't find means of transport (13%).A significant number of patients decreased or skipped their dose (69%), while only 13% continued their medications and 16%stopped taking NSAIDs. Biological DMARDs(anti-TNF agents) were the most frequent drugs which patients decreased their dose, skipped or stopped taking 33%. sulfasalazine and NSAIDs were least likely 17% to be skipped or stopped. 43% of patients Had a HADS anxiety level more than or equal to 11: 87 % women and 13 % men. The highest anxiety scores were found among patients aged less than 45 years old (87%) married with children .32% of patients had a HADS depression level more than or equal to 11: 54 % women and 44 % men. the highest depression scores were found among patients aged less than 45 years old married with children. No significant relationship was found between anxiety and depression levels regarding biologic treatment. Conclusion: Our results suggest that patients with SpA were less likely to comply strictly to 'stay home' restrictions, most probably due to the male predominance and relatively younger age. Additionally, we noticed that SpA patients treated with anti-TNF agents were the patients that regular drug use had been considerably disrupted. COVID 19 pandemic has heightened the need to care for patients with SpA in an increasingly virtual environment. Additionally, we found that being female, having a lower level of education, having a child, living in a crowded family is correlated to higher levels of anxiety and depression.

Thrombocytopaenia in pregnancy: the importance of differential diagnosis during the COVID-19 pandemic

Since the beginning of the COVID-19 pandemic, an optimal management of vulnerable patients, such as pregnant women, has been regarded as a challenge for healthcare professionals. Although thrombocytopaenia is considered a minor criterion for admission within an intensive care unit, a low platelet count has been observed in COVID-19 patients, including a pregnant woman, who developed severe pulmonary complications. Furthermore, thrombocytopaenia has been proposed as a potential biomarker in order to identify cases at high-risk complications. Nevertheless, thrombocytopaenia is a relatively frequent condition observed in pregnancy. In this context, a differential diagnosis is essential for the correct management of COVID-19 pregnant women.