Tunisie Medicale最新文献

{"title":"Knowledge of Parents toward their Children's Oral Health: A Survey in Monastir, Tunisia.","authors":"Yamina Elelmi, Chayma Ben Arbia, Fatma Masmoudi, Ahlem Baaziz","doi":"10.62438/tunismed.v103i10.5657","DOIUrl":"https://doi.org/10.62438/tunismed.v103i10.5657","url":null,"abstract":"<p><strong>Introduction: </strong>The establishment and preservation of optimal oral health in children are largely contingent upon the active participation of their parents and caregivers. These primary figures are instrumental in shaping children's preventive practices and facilitating necessary treatment, highlighting a critical interface for health interventions. The aim of the study was to evaluate the knowledge of parents in Monastir city, Tunisia, toward their children's oral health care and prevention of tooth decay and to determine the influence of parental socio-demographic variables on knowledge.</p><p><strong>Methods: </strong>A cross-sectional study was conducted in the pediatrician's waiting room in Monastir, Tunisia. Ethical Clearance was obtained. The sample was made up of 195 parents. The questionnaire was completed to obtain information regarding demographic and education variables, knowledge about oral health prevention, parents', children's oral hygiene habits, and risk behaviors. The data collected were subjected to statistical analysis using the Pearson chi-square test and the ANOVA test.</p><p><strong>Results: </strong>Sixty-three percent of parents who participated in the study had an insufficient knowledge score (score<50%). The mean knowledge score among mothers was slightly greater than fathers. The parents having fewer than three children have better knowledge, and the parents with one child have better scores. Similar results with a higher educational level were statistically significant. The majority of parents recognized many preventive dental aspects like the number of daily brushings, the nature of toothbrush of the child's dental, effective brushing time, and caries as an infectious disease. However, it was revealed that there was limited knowledge among parents about the importance of early oral health prevention.</p><p><strong>Conclusion: </strong>The oral health knowledge among the participants was relatively low. Parents should get better education in oral health knowledge in order to influence their children to gain better oral health.</p>","PeriodicalId":38818,"journal":{"name":"Tunisie Medicale","volume":"103 10","pages":"1474-1479"},"PeriodicalIF":0.0,"publicationDate":"2025-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When to Publish? Perspectives of North African researchers in the medical field.","authors":"Rihem Dahmane, Rym Fakhfakh, Meriem Gaddas, Imen Ben Saida, Helmi Ben Saad","doi":"10.62438/tunismed.v103i10.6173","DOIUrl":"https://doi.org/10.62438/tunismed.v103i10.6173","url":null,"abstract":"<p><strong>Introduction: </strong>Scientific publication plays a vital role in sharing research outcomes, enhancing knowledge, and fostering academic careers. However, researchers in low-income countries like Tunisia often face significant barriers, including limited access to funding, training, mentorship, and high-impact journals. These challenges can hinder their ability to publish effectively and at the right time. This study explored strategies for successful medical publication and examined the optimal timing for manuscript submission, drawing on the experiences of Tunisian researchers.</p><p><strong>Methods: </strong>This perspective-based study combines a comprehensive literature review with expert-facilitated group discussions. A research session held at the Faculty of Medicine of Sousse (Tunisia) brought together 44 participants from diverse medical specialties. The session included expert presentations, group discussions, and a review of relevant literature.</p><p><strong>Results: </strong>Timing was highlighted as a key strategic factor: submitting a manuscript upon completion of data analysis, in response to a call for papers, ahead of a major scientific event, or when the topic is particularly relevant can significantly increase the visibility and impact of the publication. Scientific publication also plays a crucial role in academic recognition and career progression. Careful planning, strategic journal selection, and adherence to editorial and ethical standards were identified as essential elements for improving publication success.</p><p><strong>Conclusion: </strong>Knowing when to publish can make all the difference. Submitting a manuscript at the right time - whether it is shortly after completing data analysis, when the topic is gaining attention, or in response to a specific call for papers - can significantly increase a study's visibility and impact. However, timing alone is not enough. With the right training, thoughtful journal selection, and strong institutional support, researchers - especially those in low- and middle-income countries - can overcome many of the barriers they face and share their work more effectively with the global scientific community.</p>","PeriodicalId":38818,"journal":{"name":"Tunisie Medicale","volume":"103 10","pages":"1356-1361"},"PeriodicalIF":0.0,"publicationDate":"2025-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Analysis of Dietary Habits and Nutritional Profiles: Sidi Ali Ben Aoun vs. Grand Tunis.","authors":"Rym Ben Othman, Zahwa Bouguerra, Ramla Mizouri, Rim Rachdi, Faten Mahjoub, Olfa Berriche, Henda Jamoussi","doi":"10.62438/tunismed.v103i10.5906","DOIUrl":"https://doi.org/10.62438/tunismed.v103i10.5906","url":null,"abstract":"<p><strong>Introduction: </strong>Tunisia is affected by the nutritional and dietary transition.</p><p><strong>Aim: </strong>To compare dietary habits and nutritional profiles between a rural agricultural area Sidi Ali Ben Aoun and an urban area Grand Tunis.</p><p><strong>Methods: </strong>This is a comparative cross-sectional study conducted on a sample of 220 participants, including 110 from Ben Aoun and 110 from Grand Tunis. Data were collected based on a pre-established questionnaire about dietary lifestyle and habits survey. Validated scores were used: Alimentary Diversity of Households (SDAM), the Food Consumption Assessment score (SCAM), MEDI-LITE and IPAQ.</p><p><strong>Results: </strong>The mean age was 37.2±15.3 years for the urban population versus 38.7±13.8 years for the rural population (p=0.43). In the rural population, males were 54.5% vs 48.2%; p=0.34. The occurrence of non-communicable diseases was lower in Ben Aoun (p<0.001). The adopted diet in the region of Ben Aoun aligned with the principles of the Mediterranean diet (MEDI-LITE score was 13.2±1.76 versus 7.35±2.65 in Grand Tunis, p<0.001). Both studied regions had a similar level of food security as assessed by the SDAM (p=0.006). However, household dietary diversity was more present in the rural region: the average SCAM was 11.4±0.79 in the rural group compared to 10±1.31 in the urban group (p<0.001).</p><p><strong>Conclusion: </strong>The rural region (Sidi Ali Ben Aoun) was characterized by a healthier and more diverse diet compared to the urban region (Grand Tunis).</p>","PeriodicalId":38818,"journal":{"name":"Tunisie Medicale","volume":"103 10","pages":"1488-1494"},"PeriodicalIF":0.0,"publicationDate":"2025-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis and management of esthesioneuroblastoma.","authors":"Malika El Omri, Linda Mosbah, Maroua Naouar, Mouna Bellakhdher, Monia Ghammem, Jihene Houas, Abir Meherzi, Wassim Kermani, Moncef Mokni, Mohamed Abdelkefi","doi":"10.62438/tunismed.v103i10.5572","DOIUrl":"https://doi.org/10.62438/tunismed.v103i10.5572","url":null,"abstract":"<p><strong>Introduction: </strong>Esthesioneuroblastoma (ENB), also known as olfactory neuroblastoma, is a rare malignant tumor that develops in the nasal cavity. It accounts for only 1.2% of malignant nasosinus tumor and arises from the olfactory epithelium.</p><p><strong>Methods: </strong>This retrospective study presents olfactory neuroblastoma cases treated in our ENT department over a period of 36 years, from January 1986 to December 2023.</p><p><strong>Results: </strong>The study results indicate that the series consisted of 10 cases of olfactory neuroblastoma, with seven females and three males, and a mean age of 40 years. Based on the Kadish classification, 6 cases were classified as stage B, 3 as stage C, and 1 as stage D. Of the 8 patients who underwent surgery, 6 patients also received radiotherapy, while 2 cases were inoperable. After surgery followed by radiotherapy, complete remission was observed in 3 cases. Tumor progression was observed in 2 cases, after 8 and 3 months respectively and tumour recurrence was observed in one patient.</p><p><strong>Conclusion: </strong>Although the imaging features of olfactory neuroblastoma are non-specific, there are patterns of disease that should strongly suggest and stage this disorder. This is fundamental for surgical planning.</p>","PeriodicalId":38818,"journal":{"name":"Tunisie Medicale","volume":"103 10","pages":"1495-1500"},"PeriodicalIF":0.0,"publicationDate":"2025-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A decade of Non-Small Cell Lung Cancer management: threats and opportunities in resource-limited setting.","authors":"Nesrine Mejri, Ahmed Anas Haouari, Myriam Saadi, Yosra Berrazaga, Seif Haddeoui, Lilia Ghorbel, Hamouda Boussen, Haifa Rachdi, Yosr Hamdi","doi":"10.62438/tunismed.v103i10.6140","DOIUrl":"https://doi.org/10.62438/tunismed.v103i10.6140","url":null,"abstract":"<p><strong>Introduction: </strong>Non-small cell lung cancer (NSCLC) poses significant public health challenges in Tunisia.This study analyzes patient characteristics, management, and outcomes to identify improvement areas.</p><p><strong>Methods: </strong>This retrospective multicenter study included 924 patients diagnosed with NSCLC between 2013 and 2022. The study reviewed clinical data, pathology reports, surgical records, radiation therapy summaries, and imaging findings. The study also examined trends in management features by dividing the study period into 2012-2017 vs 2018-2022.</p><p><strong>Results: </strong>Median age was 60 years, with 78.7% being male, and the average tobacco consumption was 58 pack-years. Advanced-stage disease was highly prevalent, with 91% of patients presenting at stages III or IV. The median overall survival for the entire population was 32 months, varying significantly by disease stage: 52 months for stage I, 48 months for stage II, 22 months for stage III, and 14 months for stage IV. In advanced NSCLC, survival was notably higher among patients treated with targeted therapy (44 months) and immunotherapy (20 months) compared to chemotherapy alone (9 months). Over time, there was a significant increase in multidisciplinary discussions and biomarker testing rates; however, access to concurrent chemoradiation decreased. Despite some improvement, access to targeted therapy and immunotherapy remained limited. Among tested patients, a driver mutation was identified in 45.5%, but only 54% received targeted therapy. Furthermore, only 9.8% of advanced-stage patients received immunotherapy.</p><p><strong>Conclusion: </strong>This study serves as a baseline for future studies and highlights critical gaps in NSCLC care in Tunisia, emphasizing the need for strategic directions to enhance outcomes.</p>","PeriodicalId":38818,"journal":{"name":"Tunisie Medicale","volume":"103 10","pages":"1466-1473"},"PeriodicalIF":0.0,"publicationDate":"2025-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating public private partnerships in the healthcare sector: Scoping review.","authors":"Khadija Salim, Amina Idrissi Azami, Belabbes Sanae","doi":"10.62438/tunismed.v103i10.6153","DOIUrl":"https://doi.org/10.62438/tunismed.v103i10.6153","url":null,"abstract":"<p><strong>Introduction: </strong>Governments faced efficiency crises in healthcare between the 1980s and 1990s, leading to the adoption of Public-Private Partnerships (PPPs) as innovative solutions. This study explores evaluation methodologies, criteria, and research gaps in the healthcare sector.</p><p><strong>Methods: </strong>The study utilized Arksey and O'Malley's framework to conduct a scoping review of public-private partnerships in the health sector, identifying gaps, suggesting new research directions, and clarifying complex concepts using various databases and dictionaries.</p><p><strong>Results: </strong>A study screened 21 255 papers for inclusion in an analysis, resulting in 26 studies selected for final review. The aim was to understand the contribution of Public-Private Partnerships (PPPs) to healthcare service quality, operational efficiency, and accessibility. The studies were categorized into four: access to quality care, strengthening health programs, improving communication, information, and awareness, and strengthening leadership and financial management. The studies were conducted in various countries, including Africa, Europe, Asia, North America, and South America.</p><p><strong>Discussion: </strong>Public-private partnerships (PPPs) play a crucial role in the healthcare sector, improving efficiency and quality. They provide greater access to healthcare, especially for lowincome populations, and reduce financial burdens. However, their success depends on effective governance, accountability, and equitable cost-sharing arrangements. Effective communication and promotion are essential for PPP success. Resilient strategies are needed to overcome service disruptions and ensure transparency.</p>","PeriodicalId":38818,"journal":{"name":"Tunisie Medicale","volume":"103 10","pages":"1501-1510"},"PeriodicalIF":0.0,"publicationDate":"2025-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Breastfeeding and Work in Tunisia: A Challenge to Overcome].","authors":"Zahra Marrakchi","doi":"10.62438/tunismed.v103i9.6489","DOIUrl":"https://doi.org/10.62438/tunismed.v103i9.6489","url":null,"abstract":"<p><p>.</p>","PeriodicalId":38818,"journal":{"name":"Tunisie Medicale","volume":"103 10","pages":"1354-1355"},"PeriodicalIF":0.0,"publicationDate":"2025-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of flipped classroom in medical education: Protocol study of a systematic review.","authors":"Mariem Gaddour, Nedra Feni, Rihab Moncer, Rim Ghammem, Sonia Jemni, Helmi Ben Saad","doi":"10.62438/tunismed.v103i10.6330","DOIUrl":"https://doi.org/10.62438/tunismed.v103i10.6330","url":null,"abstract":"<p><p>Introduction . The flipped classroom (FC) integrates online content delivery with in-class activities focused on knowledge application, such as discussions and problem-solving. While increasingly prevalent in medical education field, the efficacy of FC remains a subject of debate. Objective . This protocol outlines a systematic review (SR) to examine the scope and methodological quality of studies on the FC teaching approach in medical education. Methods . The protocol was registered in PROSPERO (CRD420251008268) and adhered to the Preferred Reporting Items for SRs Protocols guidelines. A thorough literature search will be performed using Scopus, PubMed/Medline, the Cochrane Library, and Google Scholar. The review will consider comparative controlled studies that focus on FC in the medical learning field. Two independent reviewers will carry out a rigorous data extraction. The Medical Education Research Study Quality Instrument will be used to evaluate the study's quality. Synthetizing the findings of this SR will provide a thorough understanding of the impact of FC in academic performance and students' satisfaction in medical learning. Expected results . This qualitative summary will offer a narrative overview of the included papers, emphasizing interventions designed to evaluate the impact of FC. Results will be discussed according to the review's objectives, evaluating both study quality and consistency of findings, and will be clearly illustrated using tables and graphs. Conclusion . The SR developed from this protocol will undoubtedly provide evidence of the effectiveness of FC in medical education and will effectively contribute to increasing the present body of information on FC interventions for improving outcomes.</p>","PeriodicalId":38818,"journal":{"name":"Tunisie Medicale","volume":"103 10","pages":"1393-1397"},"PeriodicalIF":0.0,"publicationDate":"2025-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of CDX2 immunohistochemical marker in colorectal adenocarcinoma « CDX2 in colorectal adenocarcinoma ».","authors":"Sarra Ben Rejeb, Dhouha Bacha, Haifa Rachdi, Khadija Bellil","doi":"10.62438/tunismed.v103i10.6093","DOIUrl":"https://doi.org/10.62438/tunismed.v103i10.6093","url":null,"abstract":"<p><strong>Introduction: </strong>Caudal-type homeobox transcription factor 2 (CDX2), a marker of intestinal differentiation, has shown potential as a prognostic biomarker in colorectal cancer(CRC). Its loss is associated with aggressive disease features and poor survival, yet its routine clinical use remains limited. In this study, we aimed to explore the immunohistochemical expression of CDX2 in sporadic colorectal adenocarcinomas and to assess its prognostic significance.</p><p><strong>Methods: </strong>This was a retrospective longitudinal study including patients with sporadic colorectal adenocarcinoma. CDX2 expression was assessed via automated immunohistochemistry on formalin-fixed, paraffin-embedded sections using monoclonal antibody CDX2-DAK (Dako, Glostrup, Denmark). Only nuclear staining was considered positive. Clinicopathological data, including tumor stage, differentiation, and survival, were collected over a 36-month median follow-up. Statistical analysis was performed using SPSS version 20 (p < 0.05).</p><p><strong>Results: </strong>Thirty cases were included with a mean age of 57 ± 2 years and a male-to-female ratio of 1.7. CDX2 expression was observed in 80% (24/30) of tumors. Its loss was significantly associated with poor differentiation (p=0.04),lymph node involvement (p=0.0027), advanced stage (p=0.043), and reduced overall survival (p=0.0024). Loss of CDX2 expression combined with pT4 stage identified a high-risk subgroup with worse disease-free and overall survival. Tumors were predominantly colonic (80%), with 90% adenocarcinomas and 10% mucinous carcinomas.</p><p><strong>Conclusions: </strong>CDX2 loss is a robust prognostic indicator in CRC, particularly when combined with pT4 stage, highlighting its potential for risk stratification and treatment planning. Larger, prospective studies are needed to standardize CDX2 assessment and validate its clinical utility in colorectal adenocarcinoma.</p>","PeriodicalId":38818,"journal":{"name":"Tunisie Medicale","volume":"103 10","pages":"1460-1465"},"PeriodicalIF":0.0,"publicationDate":"2025-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dermoscopic assessment of facial photoaging skin among north Morroccans.","authors":"Nadia Handous, Ouiame El Jouari, Karima Sammoud, Adil Najdi, Salim Gallouj","doi":"10.62438/tunismed.v103i10.5821","DOIUrl":"https://doi.org/10.62438/tunismed.v103i10.5821","url":null,"abstract":"<p><strong>Introduction: </strong>Skin aging involves both chronological aging influenced by human genetics and extrinsic aging mainly caused by UV radiation and smoking. Dermoscopy is a non-invasive diagnostic tool that provides accurate aging assessment signs which may be invisible to the naked eye. This study aims to investigate and compare the dermoscopic features of facial photoaging in Moroccan females and males across various age groups. It also seeks to assess the impact of other factors associated with premature skin aging, notably smoking.</p><p><strong>Methods: </strong>A descriptive and comparative study was conducted on 207 subjects with at least one hour of daily sun exposure. Participants were divided into three age groups: 35-49, 50-64, and 65+ years.</p><p><strong>Results: </strong>In the group aged 35 to 49 years, a significant difference was observed between genders regarding yellowish discoloration, white lines, hypo-/hyperpigmented macules (P = 0.003) and deep wrinkles (P = 0.02). For subjects aged 50 to 64 years, males exhibited a significantly higher prevalence of yellowish discoloration and skin atrophy compared to females. However, females had a higher prevalence of superficial wrinkles (P = 0.02). In the group aged 65 years and older, significant differences were observed between females and males regarding white lines/skin atrophy, actinic keratosis, and senile comedones, all of which were more prevalent in males.</p><p><strong>Conclusion: </strong>Dermoscopy is a straightforward method for better assessing facial aging and detecting early signs of photoaging leading to ensure prevention of skin aging and to monitor the effectiveness of therapeutic applications.</p>","PeriodicalId":38818,"journal":{"name":"Tunisie Medicale","volume":"103 10","pages":"1438-1443"},"PeriodicalIF":0.0,"publicationDate":"2025-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}