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Implementation of simulation training in the Intensive Care Units (ICU) during the COVID-19 pandemic: A scoping review. 在 COVID-19 大流行期间在重症监护病房 (ICU) 实施模拟培训:范围综述。
Tunisie Medicale Pub Date : 2024-08-05 DOI: 10.62438/tunismed.v102i8.4972
Hajer Nouira, Oussama Jaoued, Islem Ouanes, Maissa Jrad, Soumaya Chtioui, Rim Gharbi, Mohamed Fekih Hassen, Habiba Ben Sik Ali, Souheil Elatrous
{"title":"Implementation of simulation training in the Intensive Care Units (ICU) during the COVID-19 pandemic: A scoping review.","authors":"Hajer Nouira, Oussama Jaoued, Islem Ouanes, Maissa Jrad, Soumaya Chtioui, Rim Gharbi, Mohamed Fekih Hassen, Habiba Ben Sik Ali, Souheil Elatrous","doi":"10.62438/tunismed.v102i8.4972","DOIUrl":"10.62438/tunismed.v102i8.4972","url":null,"abstract":"<p><strong>Introduction: </strong>In response to the important influx of critically ill patients as well as resources limitation, simulation would be a tool ensuring the continuum of medical training.</p><p><strong>Aim: </strong>To assess the impact of simulation training on both education and performance related to protocol development during COVID-19 pandemic, in critical care.</p><p><strong>Methods: </strong>This scoping review was written in accordance with the PRISMA Guideline. Data sources and studies were identified by searching \"MEDLINE\", \"Cochrane library\" databases and \"Clinical trial.gov\". Study inclusion adhered to the PICO criteria: Population, Intervention, Comparison, and Outcomes. The Kirkpatrick Model, is a tool for evaluating the level of impact of training results according to four levels Results: The search algorithm yielded sixteen articles of which eight were meeting criteria for inclusion and finally seven were available. The number of participants ranged from 12 to 108 with a median of 61 (IQR: 8-76). The length of intervention ranged from 12 min to three hours with a median of 38 min (IQR: 12-135). Studies reported that incorporating simulation yields a more pronounced impact compared to theoretical and clinical training alone in enhancing knowledge and confidence. Regarding the role of simulation in protocol development, results have shown that in the pre-test, all the participants failed donning and doffing Personal Protective Equipment (PPE), the mean cognitive load was high (7.43±0.9 points) and the performance was low (2.5±0.8) while in the post-test, 100% of participants were successful in donning the PPE, the mean of the cognitive load decreased (4.1±1.4 points), and the performance substantially increased (7.9±1.1). In addition, five studies showed behavioral changes after training and thus the simulation reached Kirkpatrick level three.</p><p><strong>Conclusion: </strong>Results supported the impact of simulation, in critical care, as an effective method to enhance knowledge and confidence, and to improve protocol development during pandemics such as COVID-19.</p>","PeriodicalId":38818,"journal":{"name":"Tunisie Medicale","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11358777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Tuberculous Meningitis Genetic predisposition: Understanding cellular interactions, molecular mechanisms and genetic dimensions. 结核性脑膜炎的遗传易感性:了解细胞相互作用、分子机制和遗传因素。
Tunisie Medicale Pub Date : 2024-08-05 DOI: 10.62438/tunismed.v102i8.4816
Jean Claude Majambere, Sanae Zaidi, Abderrahmane Errami, Latifa Marih, Kamal Marhoum El Filali, Ahmed Aziz Bousfiha, Ahd Oulad Lahsen
{"title":"Tuberculous Meningitis Genetic predisposition: Understanding cellular interactions, molecular mechanisms and genetic dimensions.","authors":"Jean Claude Majambere, Sanae Zaidi, Abderrahmane Errami, Latifa Marih, Kamal Marhoum El Filali, Ahmed Aziz Bousfiha, Ahd Oulad Lahsen","doi":"10.62438/tunismed.v102i8.4816","DOIUrl":"10.62438/tunismed.v102i8.4816","url":null,"abstract":"<p><p>Tuberculous meningitis, a severe form of tuberculosis caused by Mycobacterium tuberculosis (BK), remains a major public health challenge worldwide. In addition to the complex mechanisms of the innate and adaptive immune response against Mycobacterium tuberculosis, there is a crucial genetic dimension to consider. Individuals with specific genetic variations may have altered immune responses that make them more susceptible to this form of tuberculosis. Genetic mutations in genes encoding surface receptors, adaptor proteins, kinases, transcription factors, nucleic receptors and other molecules involved in cellular interactions and molecular mechanisms have been associated with susceptibility to TB. Understanding the molecular mechanisms of immune interactions in host response to Mycobacterium tuberculosis is crucial to understanding the genetic dimension in susceptibility to tuberculosis, particularly its dreaded form of tuberculous meningitis. The aim of this update is to explore in details the key interactions between the main players in innate and adaptive immunity during infection with Mycobacterium tuberculosis, with particular emphasis on the genetic factors associated with susceptibility to tuberculosis, especially its dreaded form of tuberculous meningitis.</p>","PeriodicalId":38818,"journal":{"name":"Tunisie Medicale","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11387960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Epidemiological profile of dermatophytes at the parasitology-mycology laboratory at Mohammed VI University Hospital in Oujda. 乌季达穆罕默德六世大学医院寄生虫学-霉菌学实验室的皮癣菌流行病学概况。
Tunisie Medicale Pub Date : 2024-08-05 DOI: 10.62438/tunismed.v102i8.4862
Mohammed Lahmer, Oussama Grari, Soufiane Beyyoudh, Abdessamad Amrani, Ismail Faiz, Aziza Hami
{"title":"Epidemiological profile of dermatophytes at the parasitology-mycology laboratory at Mohammed VI University Hospital in Oujda.","authors":"Mohammed Lahmer, Oussama Grari, Soufiane Beyyoudh, Abdessamad Amrani, Ismail Faiz, Aziza Hami","doi":"10.62438/tunismed.v102i8.4862","DOIUrl":"10.62438/tunismed.v102i8.4862","url":null,"abstract":"<p><strong>Background: </strong>dermatophytoses are a current fungal infection, caused by keratinophilic fungi (dermatophytes) able to invade the nails, hair and skin of humans and animals.</p><p><strong>Aim: </strong>the aim of this study was to establish the epidemiological and mycological profile of dermatophytes isolated in the parasitology-mycology laboratory of the Mohammed VI University Hospital in Oujda.</p><p><strong>Methods: </strong>this is a 48-month retrospective study from January 2019 to December 2022.The study includes samples taken or sent to our parasitology-mycology laboratory for mycological study. A direct examination and culture were performed on each biological specimen. Species identification was based on macroscopic and microscopic colony criteria.</p><p><strong>Results: </strong>in the present report we reviewed 950 mycological samples. Dermatophytes were isolated in 505 (53.15%) cases. The most common infections were tinea unguium (n=353; 69.90%), followed by tinea corporis (n=123; 5.74%) and tinea capitis (n=29; 5.98%). Trichophyton rubrum was the most frequently incriminated species.</p><p><strong>Conclusion: </strong>dermatophytes are the most frequent mycoses in humans. They are generally benign and often develop in a chronic and frequently recurrent pattern. Mycological examination is essential. It confirms the fungal origin and isolates the species responsible, in order to identify the source of contamination and implement an appropriate treatment.</p>","PeriodicalId":38818,"journal":{"name":"Tunisie Medicale","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11390008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Infective endocarditis secondary to a hemodialysis catheter revealed by subarachnoid hemorrhage: Case report. 蛛网膜下腔出血显示血液透析导管继发感染性心内膜炎:病例报告。
Tunisie Medicale Pub Date : 2024-08-05 DOI: 10.62438/tunismed.v102i8.5022
Mahmoud Marzouk, Fathia Mghaieth, Nader Baffoun
{"title":"Infective endocarditis secondary to a hemodialysis catheter revealed by subarachnoid hemorrhage: Case report.","authors":"Mahmoud Marzouk, Fathia Mghaieth, Nader Baffoun","doi":"10.62438/tunismed.v102i8.5022","DOIUrl":"10.62438/tunismed.v102i8.5022","url":null,"abstract":"<p><strong>Introduction: </strong>Endocarditis associated with medical care is a rare and serious entity. The risk of occurrence is increased in hemodialysis patients due to the immunosuppression and the multiplicity of vascular accesses of different kinds. The mode of revelation can be variable given the diversity of symptoms it causes. Herein, we describe the case of endocarditis associated with medical care in a patient with renal failure who presents with neurological symptoms.</p><p><strong>Observation: </strong>A 38-year-old patient with a history of kidney disease in the hemodialysis stage presented to the emergency room with altered neurological status in the context of fever. The patient's condition requires airway control, sedation, and vasopressor medication. Brain imaging revealed Fisher 4 subarachnoid hemorrhage with brain turgor. Transthoracic and transesophageal cardiac ultrasound exploration revealed infective mitro-aortic endocarditis with trigonal abscess fistulized in the left ventricle and destruction of the aortic valve with massive regurgitation. The additional imaging in a second step did not highlight any images of mycotic aneurysm. The indication for early surgery was not approved given the hemodynamic instability and the poor intracerebral hemodynamics demonstrated by transcranial doppler ultrasound. The initial outcome under antibiotic treatment and renal replacement was favorable. But the subsequent course was fatal due to septic shock with multiple organ failure.</p><p><strong>Conclusion: </strong>The diagnosis of infective endocarditis should always be considered in hemodialysis patients presenting in a septic state with signs of systemic involvement. It is a source of mortality in these debilitated patients.</p>","PeriodicalId":38818,"journal":{"name":"Tunisie Medicale","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11390058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Malaria screening: what is the contribution of molecular biology? 疟疾筛查:分子生物学的贡献是什么?
Tunisie Medicale Pub Date : 2024-08-05 DOI: 10.62438/tunismed.v102i8.4949
Sameh Belgacem, Mohamed Bettaieb, Najoua Houas, Saoussen Chouchène, Maha Mastouri, Hamouda Babba
{"title":"Malaria screening: what is the contribution of molecular biology?","authors":"Sameh Belgacem, Mohamed Bettaieb, Najoua Houas, Saoussen Chouchène, Maha Mastouri, Hamouda Babba","doi":"10.62438/tunismed.v102i8.4949","DOIUrl":"10.62438/tunismed.v102i8.4949","url":null,"abstract":"<p><strong>Introduction: </strong>According to the World Health Organization, Microscopy is the gold standard for diagnosing malaria. However, the performance of this examination depends on the experience of the microscopist and the level of parasitemia. Thus, molecular biology detection of malaria could be an alternative technique.</p><p><strong>Aim: </strong>evaluate the contribution of molecular biology in detecting imported malaria.</p><p><strong>Methods: </strong>This was a descriptive, prospective study, including all students, from the Monastir region, and foreigners, from countries endemic to malaria. The study period was from September 2020 to April 2021. Each subject was screened for malaria by three methods: direct microscopic detection of Plasmodium, detection of plasmodial antigens, and detection of plasmodial DNA by nested PCR.</p><p><strong>Results: </strong>Among the 127 subjects screened, only one had a positive microscopic examination for Plasmodium falciparum. Among the 126 subjects with a negative microscopic examination, twelve students had a positive nested PCR result, i.e. 9.5%. Molecular sequencing allowed the identification of ten isolates of Plasmodium falciparum, one Plasmodium malariae and one Plasmodium ovale. Our study showed that the results of nested PCR agreed with those of microscopy in 90.6% of cases.</p><p><strong>Conclusion: </strong>Nested PCR seems more sensitive for the detection of low parasitemias. Hence the importance of including molecular biology as a malaria screening tool to ensure better detection of imported cases.</p>","PeriodicalId":38818,"journal":{"name":"Tunisie Medicale","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11390060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Sarcopenia prevalence and risk factors in obese Tunisian adults. 突尼斯肥胖成年人的 "肌少症 "患病率和风险因素。
Tunisie Medicale Pub Date : 2024-08-05 DOI: 10.62438/tunismed.v102i8.4965
Olfa Berriche, Rim Rachdi, Chaima Ammar, Rym Ben Othman, Amel Gamoudi, Henda Jamoussi
{"title":"Sarcopenia prevalence and risk factors in obese Tunisian adults.","authors":"Olfa Berriche, Rim Rachdi, Chaima Ammar, Rym Ben Othman, Amel Gamoudi, Henda Jamoussi","doi":"10.62438/tunismed.v102i8.4965","DOIUrl":"10.62438/tunismed.v102i8.4965","url":null,"abstract":"<p><strong>Introduction: </strong>Sarcopenia is a clinical condition defined as low skeletal muscle mass and function. It has been identified and described as a geriatric syndrome, but it may arise in individuals with obesity at any age.</p><p><strong>Aim: </strong>screen for sarcopenia in obese adults and identify the nutritional, clinical and biological risk factors associated with the development of sarcopenic obesity (SO+).</p><p><strong>Methods: </strong>Descriptive cross-sectional study, including 53 obese patients. Screening for sarcopenia has been established according to pathological thresholds proposed by the European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO).</p><p><strong>Results: </strong>Mean age was 44.34±13.51 years. Prevalence of Sarcopenia was 7.5% (SO+). The average intakes of calorie, lipids and saturated fatty acids were higher in SO+. A statistically significant relationship was found between low skeletal muscle mass (SMM/W) and the average intake of vitamin PP (p=0.014) and vitamin B9 (p=0.009). Mean BMI (45.86 kg/m² for SO+ versus 39.29 kg/m² for SO-; p=0.03) and mean visceral fat (16.55 l for SO+, versus 10.93 l for SO-; p=0.043) were significantly higher in SO+. A statistically significant relationship was found between insulin resistance and low (SMM/W), as attested by mean insulinemia (28.81 µIU/mL for low SMM/W, versus 14.48 µIU/mL for normal SMM/W; p=0.004) and HOMA index (7.94 for low SMM/W, versus 3.49 for normal SMM/W; p=0.002), which were higher in cases of low (SMM/W).</p><p><strong>Conclusion: </strong>We recommend promoting a balanced, low-energy-density diet to improve insulin sensibility and thus reduce the risk of sarcopenia. Regular physical activity is also strongly recommended.</p>","PeriodicalId":38818,"journal":{"name":"Tunisie Medicale","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11390009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Transitioning to Insulin Analogs in Tunisian Children with Type 1 Diabetes: Efficacy and Safety. 突尼斯 1 型糖尿病儿童向胰岛素类似物过渡:疗效与安全性
Tunisie Medicale Pub Date : 2024-08-05 DOI: 10.62438/tunismed.v102i8.4435
Asma Marzouk, Mariem Lajili, Ilyes Ben Yahya, Rahma Thebti, Saad Ayeb, Asma Bouaziz
{"title":"Transitioning to Insulin Analogs in Tunisian Children with Type 1 Diabetes: Efficacy and Safety.","authors":"Asma Marzouk, Mariem Lajili, Ilyes Ben Yahya, Rahma Thebti, Saad Ayeb, Asma Bouaziz","doi":"10.62438/tunismed.v102i8.4435","DOIUrl":"10.62438/tunismed.v102i8.4435","url":null,"abstract":"<p><strong>Introduction: </strong>there is a lack of research evaluating the impact of therapeutic switching from human insulin to analogues, particularly in paediatric populations from low- and middle-income countries.</p><p><strong>Aim: </strong>The study aimed to retrospectively assess the effectiveness and safety of transitioning from human insulin to insulin analogs in Tunisian children with diabetes.</p><p><strong>Methods: </strong>This retrospective descriptive study included children with type 1 diabetes who changed their insulin therapy protocol after at least one year of treatment with human insulin. Clinical, therapeutic, and glycaemic homeostasis parameters were assessed following the transition from human insulin (NPH + rapid-acting insulin) to the Basal-Bolus insulin analog- protocol.</p><p><strong>Results: </strong>The study included 60 patients. Following the switch, all patients showed a significant reduction in mean fasting blood glucose levels (11.11 mmol/l vs. 8.62 mmol/l; p=0.024). Glycated haemoglobin A1C levels decreased notably in children who adhered to their diet (from 9.93% to 8.38%; p=0.06) and/or engaged in regular physical activity (from 10.40% to 8.61%; p=0.043). The average number of hypoglycemic events per year decreased from 4.03 events/year to 2.36 events/year (p=0.006), along with a decrease in the rate of patients hospitalized for acid-ketotic decompensation (from 27% to 10%; p=0.001). Financial constraints led to 82% of patients reusing microfine needles ≥2 times per day, and 12% were compelled to revert to the initial insulin therapy protocol due to a lack of access to self-financed microfine needles or discontinued social coverage.</p><p><strong>Conclusions: </strong>Although insulin analogues offer clear benefits, their use poses challenges as a therapeutic choice for children with diabetes in low- to middle-income countries. These challenges hinder the achievement of optimal glycemic control goals.</p>","PeriodicalId":38818,"journal":{"name":"Tunisie Medicale","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11390061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Deadly cerebral ischemia due to carotid stenosis following a facial shot with a pellet gun: An autopsy case report. 面部中弹后颈动脉狭窄导致致命性脑缺血:尸检病例报告。
Tunisie Medicale Pub Date : 2024-08-05 DOI: 10.62438/tunismed.v102i8.5045
Sarra Ben Abderrahim, Fatma Daoud, Elyes Turki, Raja Ghzel, Malek Zribi
{"title":"Deadly cerebral ischemia due to carotid stenosis following a facial shot with a pellet gun: An autopsy case report.","authors":"Sarra Ben Abderrahim, Fatma Daoud, Elyes Turki, Raja Ghzel, Malek Zribi","doi":"10.62438/tunismed.v102i8.5045","DOIUrl":"10.62438/tunismed.v102i8.5045","url":null,"abstract":"<p><strong>Introduction: </strong>Facial gunshot wounds have devastating functional and aesthetic consequences for the patient. If associated with penetrating craniocerebral injuries, the prognosis is rather compromised even with appropriate medical and surgical treatment. Chop-off injuries with penetrating wounds constitute a challenging situation for the facial reconstructive surgeon in facial trauma.</p><p><strong>Observation: </strong>This case involved a 49-year-old man who sustained an accidental facial shot from a pellet gun. Radiological and clinical investigations revealed complex ballistic trauma to the maxillofacial region, with projectiles reaching the base of the skull. One of the projectiles migrated via the carotid canal towards a cerebral artery, leading to obstruction of the artery with cerebral infarction. An autopsy was performed which evaluated that the shooting distance was compatible with a long distance, causing the dispersion of lead grains with the absence of a wad inside the trauma site.</p><p><strong>Conclusion: </strong>In some cases of facial gunshot wounds, despite a complex and extensive lesion assessment, death may occur due to a neurological complication rather than sustaining hemodynamic shock, depending on the trajectory of the projectiles.</p>","PeriodicalId":38818,"journal":{"name":"Tunisie Medicale","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11387958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Malignant Otitis Externa: A persistent challenge. 恶性外耳道炎:持续的挑战
Tunisie Medicale Pub Date : 2024-08-05 DOI: 10.62438/tunismed.v102i8.4867
Mayssa Khribi, Wed El Abed, Khalil Gnaba
{"title":"Malignant Otitis Externa: A persistent challenge.","authors":"Mayssa Khribi, Wed El Abed, Khalil Gnaba","doi":"10.62438/tunismed.v102i8.4867","DOIUrl":"10.62438/tunismed.v102i8.4867","url":null,"abstract":"<p><strong>Introduction: </strong>Although rare, Malignant otitis externa is responsible for a high morbidity and could sometimes be fatal. The management of this condition is still challenging.</p><p><strong>Aim: </strong>To analyse the clinical, microbiological and radiological profile of malignant otitis externa, and the management of this condition.</p><p><strong>Methods: </strong>A descriptive, cross-sectional study was conducted at ENT Department of Kairouan's hospital including 38 patients hospitalised and treated for malignant otitis externa from January 2013 to August 2021.</p><p><strong>Results: </strong>The mean age of patients was 67.7 ± 12.9 years (35-98). All patients presented with continuous otalgia that resists to usual analgesics. Otorrhea was noticed in 76.3% of cases, facial palsy in 2 cases (5.3%) and dysphonia in one case (2.6%). Pseudomonas Aeruginosa was the main responsible pathogen (42%). Concomitant bacterial and fungal infection was noticed in 6.4% of the cases. First-line intravenous antibiotherapy used was mainly based on an association of Cephalosporins and Fluoroquinolones. Complete remission was noticed in 30 patients (79%). However, 8 cases of recurrences (21%) and 2 cases of deaths (5.2%) were noticed in our series. The mean follow-up was 4.6±6.3 (1-26 months).</p><p><strong>Conclusions: </strong>Pseudomonas Aeruginosa remains the main responsible pathogen for malignant otitis externa. Nevertheless, fungal infections are rising because of the overuse of antibiotics. Antibiotherapy should be adapted to culture results and resistance profile of pathogens in hospital. Practionners should be aware of the possibility of concomitant fungal infection, especially in the case of unfavorable evolution.</p>","PeriodicalId":38818,"journal":{"name":"Tunisie Medicale","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11390007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Study of peripartum cardiomyopathy in a context with limited resources: case of the region of Zinder, Niger. 在资源有限的情况下研究围产期心肌病:尼日尔津德尔地区的案例。
Tunisie Medicale Pub Date : 2024-08-05 DOI: 10.62438/tunismed.v102i8.4635
Aziz Abdoul Garba, Traore Solo, Hassane Moussa Diongole, Abassi Ibrahim M Awalou, Daou Mamane, Souleymane Brah
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