Tunisie Medicale最新文献

Psychological impact of peri-implant fractures: A cross-sectional study. 种植体周围骨折的心理影响：横断面研究

Tunisie Medicale Pub Date : 2024-10-05 DOI: 10.62438/tunismed.v102i10.5068

Brahim Demnati, Zakaria Chabihi, El Mehdi Boumediane, Siham Dkhissi, Fahd Idarrha, Yassine Fath Elkhir, Mohamed Amine Benhima, Imad Abkari, Mohamed Rafai, Samir Ibn Moussa, Mohamed Rahmi

{"title":"Psychological impact of peri-implant fractures: A cross-sectional study.","authors":"Brahim Demnati, Zakaria Chabihi, El Mehdi Boumediane, Siham Dkhissi, Fahd Idarrha, Yassine Fath Elkhir, Mohamed Amine Benhima, Imad Abkari, Mohamed Rafai, Samir Ibn Moussa, Mohamed Rahmi","doi":"10.62438/tunismed.v102i10.5068","DOIUrl":"https://doi.org/10.62438/tunismed.v102i10.5068","url":null,"abstract":"Introduction: Peri-implant fractures (PIFs) are uncommon yet critical complications following orthopedic surgery. These complications can significantly impact a patient's psychological well-being and overall quality of life.Aim: This study aimed to investigate the psychological effects of PIFs.Methods: This was a cross-sectional study that involved 136 patients who underwent surgery for PIFs between 2018 and 2022. We utilized various validated scales and questionnaires such as Hospital Anxiety and Depression Scale (HADS), Perceived Stress Scale (PSS), Impact of Event Scale Revised (IES-R), 36-Item Short Form Survey (SF-36), and Brief COPE Inventory (BCI) to assess their psychological state.Result: The results revealed that patients with PIFs experienced higher levels of anxiety, depression, stress, and post-traumatic stress compared to the general population. Additionally, they reported lower physical and mental health. Factors such as the number of surgeries, treatment delay, post-operative pain levels, and complications significantly influenced their psychological outcomes. Notably, acceptance, positive reframing, and seeking emotional support were the most common coping mechanisms employed by these patients. Conversely, denial, substance use, and self blame were the least employed strategies.Conclusion: This study suggests that psychological interventions could significantly benefit patients with PIFs, potentially reducing their distress and improving their quality of life.","PeriodicalId":38818,"journal":{"name":"Tunisie Medicale","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509791","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}

引用次数: 0

Intravenous Leiomyomatosis of the Uterus: An Intriguing Case Revealed through Anatomopathological Examination. 子宫静脉内雷肌瘤病：通过解剖病理学检查发现的一个耐人寻味的病例

Tunisie Medicale Pub Date : 2024-10-05 DOI: 10.62438/tunismed.v102i10.5139

Khaoula Magdoud, Abir Karoui, Nadia Boujelbene, Rim Ben Hmid

{"title":"Intravenous Leiomyomatosis of the Uterus: An Intriguing Case Revealed through Anatomopathological Examination.","authors":"Khaoula Magdoud, Abir Karoui, Nadia Boujelbene, Rim Ben Hmid","doi":"10.62438/tunismed.v102i10.5139","DOIUrl":"https://doi.org/10.62438/tunismed.v102i10.5139","url":null,"abstract":"Introduction: Intravenous leiomyomatosis (IVL), a rare type of uterine leiomyoma (its incidence is about 0.25% to 0.40% of patients who present uterine fibroma), is characterized by the formation and growth of benign leiomyoma tissue within the vascular wall or lymphatic lumen. Herein, we presented a case of early stage of IVL successfully treated by surgical removal and a review of actual medical recommendations.Observation: A 49-year-old woman, gravida 2 para 2, presented to our department with hypogastric pain. On physical examination, a palpable mass in the hypogastrium was noted. Pelvic ultrasound showed a huge uterus with multiple heterogeneous leiomyomas. As the patient was symptomatic and as she had completed their family plan, the decision to perform a total abdominal hysterectomy with bilateral salpingo-oophorectomy was taken. On pathological examination, intravascular growth of benign smooth muscle cell was found within venous channels lined by endothelium. The diagnosis of IVL of the uterus without malignant transformation was confirmed. The patient was monitored for 14 months, and subsequent computed tomography did not reveal any evidence of tumor recurrence.Conclusion: IVL is a benign, rare and potentially lethal pathology. Clinical manifestations are nonspecific. IVL needs surgical treatment for diagnosis and therapeutic purposes. They require close and prolonged follow-up because of the high risk of recurrence.","PeriodicalId":38818,"journal":{"name":"Tunisie Medicale","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509773","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}

引用次数: 0

Performance of GPR score for non-invasive assessment of liver fibrosis in chronic hepatitis B Tunisian patients. 突尼斯慢性乙型肝炎患者肝纤维化无创评估的 GPR 评分性能。

Tunisie Medicale Pub Date : 2024-10-05 DOI: 10.62438/tunismed.v102i10.5091

Ikbel Ghachem, Lamine Hamzaoui, Asma Bachali, Chayma Rhimi, Mouna Medhioub, Moufida Mahmoudi, Amal Khsiba, Mohamed Msaddak Azouz

{"title":"Performance of GPR score for non-invasive assessment of liver fibrosis in chronic hepatitis B Tunisian patients.","authors":"Ikbel Ghachem, Lamine Hamzaoui, Asma Bachali, Chayma Rhimi, Mouna Medhioub, Moufida Mahmoudi, Amal Khsiba, Mohamed Msaddak Azouz","doi":"10.62438/tunismed.v102i10.5091","DOIUrl":"https://doi.org/10.62438/tunismed.v102i10.5091","url":null,"abstract":"Introduction: Several non-invasive tests (NIT) have been reported for predicting liver fibrosis to avoid percutaneous liver biopsy (PLB).Aim: To evaluate the performance of NIT in Tunisian patients with chronic hepatitis B (CHB).Methods: We calculated the ASAT/platelet ratio index (APRI), GGT-to-platelet ratio (GPR), Fibrosis-4 score (FIB-4), and RDW/platelet ratio (RPR). The accuracy of NIT was compared with the Metavir score for the detection of liver fibrosis stage using the area under the ROC curves (AUROC).Results: Seventy-seven CHB patients were included. For predicting significant fibrosis, the AUROC of GPR (0.81; CI95% [0.68-0.93]; P < 0.001) was significantly higher than that of RPR (0.67; CI95% [0.52-0.82]; P = 0.03) and FIB-4 (0.746; CI95% [0.61-0.88]; P = 0.002), but was similar to APRI (0.88; CI95% [0.79-0.97]; P < 0.001). For advanced fibrosis, the AUROC of GPR (0.93; CI95% [0.84-1]; P < 0.001) was higher than that of RPR (0.83; CI95% [0.69-0.97]; P < 0.001) and FIB-4 (0.88; CI95% [0.76-0.99]; P < 0.001), but similar to APRI (0.93; CI95% [0.87-0.99]; P < 0.001). For predicting cirrhosis, the AUROC of GPR (0.98; CI95% [0.95-1]; P < 0.001) was higher than that of APRI (0.95; CI95% [0.90-1]; P = 0.02), similar to RPR (0.99; CI95% [0.98-1]; P < 0.001) but lower than that of FIB-4 (1; CI95% [1-1]; P < 0.001). In multivariate analysis, APRI (OR = 3.78; P = 0.002) and FIB-4 (OR = 2.65; P = 0.01) were independent predictors of significant fibrosis. GPR was the only independent predictor of advanced fibrosis (OR = 4.64; P = 0.001) and FIB-4 was the independent predictor of cirrhosis (OR = 2.85; P < 0.001).Conclusion: GPR does not demonstrate significant advantages over APRI, FIB-4, and RPR in identifying liver fibrosis in patients with chronic hepatitis B (CHB).","PeriodicalId":38818,"journal":{"name":"Tunisie Medicale","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509776","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}

引用次数: 0

Challenges and Implications of Military Attacks on Hospitals: A Critical Analysis of International Legal Standards and the Pursuit of Accountability. 军事袭击医院的挑战和影响：对国际法律标准和追究责任的批判性分析》。

Tunisie Medicale Pub Date : 2024-10-05 DOI: 10.62438/tunismed.v102i10.5106

Meriem Gaddas, Helmi Ben Saad

引用次数: 0

Depression among Alopecia Areata Patients: Prevalence and associated factors in a Tunisian sample. 脱发患者中的抑郁症：突尼斯样本中的患病率和相关因素。

Tunisie Medicale Pub Date : 2024-10-05 DOI: 10.62438/tunismed.v102i10.5119

Nour Faouel, Nadia Ghariani, Amjed Ben Haouala, Soukaina Maghfour, Maha Lahoual, Sana Mokni, Ahmed Mhalla, Mohamed Denguezli

{"title":"Depression among Alopecia Areata Patients: Prevalence and associated factors in a Tunisian sample.","authors":"Nour Faouel, Nadia Ghariani, Amjed Ben Haouala, Soukaina Maghfour, Maha Lahoual, Sana Mokni, Ahmed Mhalla, Mohamed Denguezli","doi":"10.62438/tunismed.v102i10.5119","DOIUrl":"https://doi.org/10.62438/tunismed.v102i10.5119","url":null,"abstract":"Introduction Alopecia areata (AA) is a common, chronic inflammatory, non-scarring form of hair loss affecting 0.1-0.2% of the population. It is a psychosomatic disease involving a T-cell-mediated immune reaction against hair follicle antigens during the anagen phase. Psychiatric morbidity in dermatological patients can significantly affect their quality of life and disease progression. Identifying and addressing these comorbidities in AA patients is crucial. Aim This study aimed to estimate the prevalence of depression and its associated factors among patients diagnosed with alopecia areata (AA). Methods The present study is a cross-sectional, descriptive, and analytical study conducted at Farhat Hached Hospital in Sousse, Tunisia, during the period from August to December 2019. Participants were recruited from the Dermatology Outpatient Department. The questionnaire covered socio-demographic characteristics, personal and family history, AA history, clinical presentation, disease severity (SALT score), nail involvement, and depression assessment using the Hamilton Depression Scale (validated Arabic version). Results A total of 60 AA patients were enrolled, with a mean age of 37.6 ± 12.9 years. Females exhibited a predominant representation, with a male to female ratio (M/F) of 0.76. According to the Hamilton Depression Scale (HAM-D), 31 cases (51.7%) were depressed, with a mean depression scale score of 11.33 (±6.57 SD). The presence of depression was significantly associated with younger age (p=0.018), the presence of the eyelashes/eyebrows form (p=0.035), nail involvement (p= 0.03), and a poor response to treatment (p=0.004). Conclusion Our research highlights the importance of providing psychological support to alopecia areata patients.","PeriodicalId":38818,"journal":{"name":"Tunisie Medicale","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509864","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}

引用次数: 0

Diagnosis of esophageal varices: Correlation between non-invasive tests and digestive endoscopy. 食管静脉曲张的诊断：无创检验与消化内镜检查的相关性。

Tunisie Medicale Pub Date : 2024-10-05 DOI: 10.62438/tunismed.v102i10.5168

Asma Mensi, Amel Medhioub, Nouha Trad, Emna Bel Haj Mabrouk, Yosra Said, Radhouane Debbeche

{"title":"Diagnosis of esophageal varices: Correlation between non-invasive tests and digestive endoscopy.","authors":"Asma Mensi, Amel Medhioub, Nouha Trad, Emna Bel Haj Mabrouk, Yosra Said, Radhouane Debbeche","doi":"10.62438/tunismed.v102i10.5168","DOIUrl":"https://doi.org/10.62438/tunismed.v102i10.5168","url":null,"abstract":"Introduction: Esophageal variceal bleeding (EVB) is one of the main causes of mortality and morbidity in cirrhotic patients. Non-invasive tests (NIT) of liver fibrosis have been developed to predict the presence of esophageal varices (EV).Aim: To evaluate the performance of NIT of liver fibrosis such as liver transient elastography (TE) and serum scores in predicting EV.Methods: We conducted a retrospective collecting patients with chronic liver disease. TE and serum scores were evaluated for all patients and correlated with endoscopic data.Results: One hundred and fifty patients were included with an average age of 58.98 years and a sex ratio of 0.68. Sixty-seven patients were cirrhotic. Viral origin C was found in 72% of cases. Thirty-three patients had EV. NIT of liver fibrosis such as TE and serum scores were statistically correlated to the presence of EV. TE had the better performance for the prediction of EV with a Cut-off of 13.5 Kpa and AUC of 0.855. In multivariate analysis, TE, AST to ALT ratio and platelet count were independent predictors of EV.Conclusion: The performance of TE and serum scores in the diagnosis of EV and LEV was demonstrated. These results suggest that NIT of liver fibrosis make it possible to select patients who are candidates for gastroscopy.","PeriodicalId":38818,"journal":{"name":"Tunisie Medicale","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509865","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}

引用次数: 0

Factors influencing valproic acid trough levels in epileptic children. 影响癫痫儿童丙戊酸谷值水平的因素。

Tunisie Medicale Pub Date : 2024-10-05 DOI: 10.62438/tunismed.v102i10.4881

Khouloud Ferchichi, Rim Charfi, Syrine Ben Hammamia, Mouna Ben Sassi, Emna Gaies, Mouna Daldoul, Riadh Daghfous, Sameh Trabelsi

{"title":"Factors influencing valproic acid trough levels in epileptic children.","authors":"Khouloud Ferchichi, Rim Charfi, Syrine Ben Hammamia, Mouna Ben Sassi, Emna Gaies, Mouna Daldoul, Riadh Daghfous, Sameh Trabelsi","doi":"10.62438/tunismed.v102i10.4881","DOIUrl":"https://doi.org/10.62438/tunismed.v102i10.4881","url":null,"abstract":"Objective: In this study, we aimed to assess main factors influencing the Valproic Acid (V.Acid) plasma trough levels (C0) and to determine their degree of influence on V.Acid C0 in children with epilepsy who had Therapeutic Drug Monitoring (TDM).Methods: We conducted an observational study in the Department of Clinical Pharmacology including patients with generalized seizures' epilepsy aged between two and 18 years. Only the children that had benefited from at least two V.Acid C0 determinations were included. First, we assessed daily dose optimization, performed by the practitioners. Then we divided our population into two groups: group A with a final V.Acid C0 in the therapeutic range (TR) and group B with a final V. Acid C0 outside the TR to find out factors influencing V.Acid C0 journey.Results: We included 805 patients (2537 V.Acid C0). The median age was 6.24 years and the sex ratio (M/F) was 1.45. The median V.Acid normalized daily dose was 27.27mg/kg/day and the median V.Acid C0 was 57µg/mL. The children's first V.Acid C0 was in the TR in 59.4% and V.Acid daily dose optimization was performed by the practitioners in 72.3%. Comparing GroupA and B, we found that age and the number of V.Acid C0 determinations increases the chance to reach the TR by respectively 3.79% and 7.39%.Conclusion: Older children who benefit from higher number of performed V.Acid C0 were more likely to reach the TR. In children who beneficiate from a TDM of V.Acid, close follow-up is mandatory to reach and maintain therapeutic V.Acid C0.","PeriodicalId":38818,"journal":{"name":"Tunisie Medicale","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509868","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}

引用次数: 0

Impact of virtual reality on the perception of procedural pain in paediatric oncology. 虚拟现实对儿科肿瘤手术疼痛感的影响。

Tunisie Medicale Pub Date : 2024-10-05 DOI: 10.62438/tunismed.v102i10.4934

Elhem Jbebli, Yosra Jbeli, Rawia Ben Farhat, Samar Rhayem, Sarra Ben Ahmed, Rym Amdouni, Faten Fedhila Ben Ayed, Monia Khemiri

{"title":"Impact of virtual reality on the perception of procedural pain in paediatric oncology.","authors":"Elhem Jbebli, Yosra Jbeli, Rawia Ben Farhat, Samar Rhayem, Sarra Ben Ahmed, Rym Amdouni, Faten Fedhila Ben Ayed, Monia Khemiri","doi":"10.62438/tunismed.v102i10.4934","DOIUrl":"https://doi.org/10.62438/tunismed.v102i10.4934","url":null,"abstract":"Introduction: Virtual reality is being used more and more in the healthcare field, particularly during treatment. In the context of pain management, the question arises as to the effectiveness of using virtual reality during care in reducing the perception of procedural pain.Aim: To study the impact of using virtual reality on the perception of procedural pain and on the course of care in pediatric oncology.Methods: A quasi-experimental, matched-case-control study conducted at the pediatric oncology unit of the Tunis Children's Hospital over a three-month period. Each child had two nursing care : with and without the use of virtual reality.Results: Thirty-two children were enrolled. The sex ratio was 0.88. The edia nage was 96 ± 49 months. The care provided was peripheral venous line insertion (53%), blood sampling (32%) and port-a-catheter puncture (15%). The use of virtual reality significantly reduced heart rate (p<0.0001), respiratory rate (p<0.0001) and pain perception (p<0.0001). Workload was reduced, as evidenced by a drop in the duration of nursing care (p<0.0001) and in the number of people needed to carry out care (p<0.0001).Conclusions: Virtual reality is a good non-pharmacological alternative for procedural pain control in a pediatric oncology unit.","PeriodicalId":38818,"journal":{"name":"Tunisie Medicale","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509771","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}

引用次数: 0

Atypical presentation of systemic lupus erythematosus in a 16-year-old boy: Case report. 一名 16 岁男孩系统性红斑狼疮的非典型表现：病例报告。

Tunisie Medicale Pub Date : 2024-10-05 DOI: 10.62438/tunismed.v102i10.5065

Hela Sahbani, Marwa Bahri, Emna Azza, Yosr Ben Abdennebi, Lamia Aissaoui

引用次数: 0

Prevention of perioperative anxiety: Interest of audiovisual distraction. 预防围手术期焦虑：视听分散的兴趣

Tunisie Medicale Pub Date : 2024-10-05 DOI: 10.62438/tunismed.v102i10.4468

Faten Haddad, Sirine Rais, Hajer Arfaoui, Emna Kammoun, Skander Naimi, M'hamed Sami Mebazaa

{"title":"Prevention of perioperative anxiety: Interest of audiovisual distraction.","authors":"Faten Haddad, Sirine Rais, Hajer Arfaoui, Emna Kammoun, Skander Naimi, M'hamed Sami Mebazaa","doi":"10.62438/tunismed.v102i10.4468","DOIUrl":"https://doi.org/10.62438/tunismed.v102i10.4468","url":null,"abstract":"Introduction: Audiovisual distraction (AVD) is one of the non-pharmacological means of anxiety prevention. However, few studies have evaluated its perioperative effect in adults.Aim: To evaluate the contribution of audio-visual distraction in the prevention of perioperative anxiety in adult patients proposed for surgery under spinal anesthesia.Methods: This was a prospective randomized controlled study lasting three months from July 1, 2021. We included ASA I to III over 18 years patients, proposed for visceral or orthopedic surgery under spinal anesthesia. We didn't include patients operated in lateral or prone positions or with a history of anxiety disorders or communication difficulties. 90 patients were randomized into two groups: a control group T and a group A who had an AVD throughout the operation. The primary outcome was anxiety as assessed by the visual analogue scale (VAS).Results: Demographic characteristics, Amsterdam preoperative anxiety and information scale (APAIS) and pain levels were comparable between the two groups. During the surgery, 22 (48.9 %) patients in group T versus 3 (6.7 %) in group A required Midazolam (p < 0.001). Anxiety assessed by VAS at the end of the act was lower in group A (p < 0.001). The pain levels also were lower in patients who received AVD (p = 0.004). A patient satisfaction score (Iowa Satisfaction with Anesthesia Scale French version) ≥ 5.4 was more frequently observed in group A (p < 0.001).Conclusion: AVD reduced perioperative anxiety and decreased the use of midazolam during surgery performed under spinal anesthesia.","PeriodicalId":38818,"journal":{"name":"Tunisie Medicale","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509790","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}

引用次数: 0