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Boudabbous M, Issa AB, Feki I, Gdoura H, Chtourou L, Moalla M, Sallemi R, Mnif L, Amouri A, Masmoudi J, Tahri N. Alexithymia impairs quality of life in irritable bowel syndrome. Future Sci OA 2023; 9:FSO881. [PMID: 37753356 PMCID: PMC10518833 DOI: 10.2144/fsoa-2023-0068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 06/27/2023] [Indexed: 09/28/2023] Open
Abstract
Aim Our objectives were to compare the frequency of alexithymia and the alteration of quality of life in irritable bowel syndrome (IBS) and to determine the factors associated with alexithymia and quality of life deterioration. Method This is a comparative study which collected 80 IBS patients and 80 controls. Results Quality of life was impaired in 75% of patients vs 37.5% (p < 0.0001). The prevalence of alexithymia was 50% in patients vs 1.2% (p < 0.0001). In multivariate analysis, an impaired quality of life was associated with alexithymia (p = 0.003). The factors associated with impaired quality of life were anxiety and alexithymia. Conclusion Alexithymia was present in half of patients with IBS and its was associated with impaired quality of life.
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Affiliation(s)
- Mona Boudabbous
- Gastroenterology Department, Hédi Chaker Hospital, Sfax, TUNISIA
- Sfax university of medicine, Tunisia
| | | | - Ines Feki
- Phsychiatric Department, Hédi Chaker Hospital, Sfax, TUNISIA
- Sfax university of medicine, Tunisia
| | - Héla Gdoura
- Gastroenterology Department, Hédi Chaker Hospital, Sfax, TUNISIA
- Sfax university of medicine, Tunisia
| | - Lassad Chtourou
- Gastroenterology Department, Hédi Chaker Hospital, Sfax, TUNISIA
- Sfax university of medicine, Tunisia
| | - Manel Moalla
- Gastroenterology Department, Hédi Chaker Hospital, Sfax, TUNISIA
- Sfax university of medicine, Tunisia
| | - Rim Sallemi
- Phsychiatric Department, Hédi Chaker Hospital, Sfax, TUNISIA
- Sfax university of medicine, Tunisia
| | - leila Mnif
- Gastroenterology Department, Hédi Chaker Hospital, Sfax, TUNISIA
- Sfax university of medicine, Tunisia
| | - Ali Amouri
- Gastroenterology Department, Hédi Chaker Hospital, Sfax, TUNISIA
- Sfax university of medicine, Tunisia
| | - Jaweher Masmoudi
- Phsychiatric Department, Hédi Chaker Hospital, Sfax, TUNISIA
- Sfax university of medicine, Tunisia
| | - Nabil Tahri
- Gastroenterology Department, Hédi Chaker Hospital, Sfax, TUNISIA
- Sfax university of medicine, Tunisia
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2
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Boudabbous M, Bouzid F, Agrebi I, Gdoura H, Chtourou L, Moalla M, Mnif L, Amouri A, Kammoun K, Tahri N. Screening for renal impairment in viral hepatopathy B: it is time to begin. Future Sci OA 2023; 9:FSO886. [PMID: 37752918 PMCID: PMC10518828 DOI: 10.2144/fsoa-2023-0019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 06/12/2023] [Indexed: 09/28/2023] Open
Abstract
Aim The aim of this study was to assess the value of routine screening for renal damage in cases of B viral infection, by looking for proteinuria and elevated creatinemia. Materials & methods We investigate the frequency and associated factors of renal impairment in patients with viral B hepatopathy. Results Pathological albuminuria was confirmed in 44.73%. The chronic kidney disease with slightly decreased filtration rate was found in 21.05%. In multivariate analysis, only BMI was an independent factor for pathological albuminuria (p = 0.013) and only age was an independent predictor of chronic kidney disease (p = 0.056). Conclusion Urine dipstick and creatinemia are useful for routine screening in viral B hepatopathy especially in the elderly and overweight.
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Affiliation(s)
- Mona Boudabbous
- Gastroenterology Department, Hédi Chaker Hospital, Sfax, Tunisia
- Department medecine B, Medecin Sfax University, Sfax university, Sfax, Tunisia
| | - Fatma Bouzid
- Department medecine B, Medecin Sfax University, Sfax university, Sfax, Tunisia
| | - Ikram Agrebi
- Nephrology Department, Hédi Chaker Hospital, Sfax, Tunisia
- Department medecine B, Medecin Sfax University, Sfax university, Sfax, Tunisia
| | - Héla Gdoura
- Gastroenterology Department, Hédi Chaker Hospital, Sfax, Tunisia
- Department medecine B, Medecin Sfax University, Sfax university, Sfax, Tunisia
| | - Lassad Chtourou
- Gastroenterology Department, Hédi Chaker Hospital, Sfax, Tunisia
- Department medecine B, Medecin Sfax University, Sfax university, Sfax, Tunisia
| | - Manel Moalla
- Gastroenterology Department, Hédi Chaker Hospital, Sfax, Tunisia
- Department medecine B, Medecin Sfax University, Sfax university, Sfax, Tunisia
| | - Leila Mnif
- Gastroenterology Department, Hédi Chaker Hospital, Sfax, Tunisia
- Department medecine B, Medecin Sfax University, Sfax university, Sfax, Tunisia
| | - Ali Amouri
- Gastroenterology Department, Hédi Chaker Hospital, Sfax, Tunisia
- Department medecine B, Medecin Sfax University, Sfax university, Sfax, Tunisia
| | - Khaoula Kammoun
- Nephrology Department, Hédi Chaker Hospital, Sfax, Tunisia
- Department medecine B, Medecin Sfax University, Sfax university, Sfax, Tunisia
| | - N Tahri
- Gastroenterology Department, Hédi Chaker Hospital, Sfax, Tunisia
- Department medecine B, Medecin Sfax University, Sfax university, Sfax, Tunisia
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3
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Boudabbous M, Charfi N, Gdoura H, Chtourou L, Moalla M, Mnif L, Amouri A, Maalej M, Tahri N. A survey to explore the psychological and professional impact of change imposed by COVID-19. Future Sci OA 2023; 9:FSO879. [PMID: 37621849 PMCID: PMC10445553 DOI: 10.2144/fsoa-2023-0057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 06/02/2023] [Indexed: 08/26/2023] Open
Abstract
Aim Staff of a department underwent a change following the COVID-19 pandemic. The objective of this study was to assess the psychological and professional impact of this change. Materials & methods This is cross-sectional study, including all department staff conducted from 15 July 2021 to 15 August 2021. Results All the staff concerned (n = 36) participated. Only 9.37% declared that they understood the change. The main problem encountered by participants was poor communication (86.2%). More than 75% among participants had a demotivation and 54.5% had resisted. The main cause of resistance was quality of organization (42.4%). Conclusion Our study illustrates the difficulties encountered by actors involved in organizational change and the high risk of their resistance.
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Affiliation(s)
- Mona Boudabbous
- Gastroenterology Departement, Hédi Chaker Hospital, Sfax, Tunisia
- Medecin B Departement, Medecin Sfax University, Sfax University, Sfax, Tunisia
| | - Nada Charfi
- Psychiatry C Departement, Hédi Chaker Hospital, Sfax, Tunisia
- Medecin B Departement, Medecin Sfax University, Sfax University, Sfax, Tunisia
| | - Héla Gdoura
- Gastroenterology Departement, Hédi Chaker Hospital, Sfax, Tunisia
- Medecin B Departement, Medecin Sfax University, Sfax University, Sfax, Tunisia
| | - Lassad Chtourou
- Gastroenterology Departement, Hédi Chaker Hospital, Sfax, Tunisia
- Medecin B Departement, Medecin Sfax University, Sfax University, Sfax, Tunisia
| | - Manel Moalla
- Gastroenterology Departement, Hédi Chaker Hospital, Sfax, Tunisia
- Medecin B Departement, Medecin Sfax University, Sfax University, Sfax, Tunisia
| | - Leila Mnif
- Gastroenterology Departement, Hédi Chaker Hospital, Sfax, Tunisia
- Medecin B Departement, Medecin Sfax University, Sfax University, Sfax, Tunisia
| | - Ali Amouri
- Gastroenterology Departement, Hédi Chaker Hospital, Sfax, Tunisia
- Medecin B Departement, Medecin Sfax University, Sfax University, Sfax, Tunisia
| | - Mohamed Maalej
- Psychiatry C Departement, Hédi Chaker Hospital, Sfax, Tunisia
- Medecin B Departement, Medecin Sfax University, Sfax University, Sfax, Tunisia
| | - Nabil Tahri
- Gastroenterology Departement, Hédi Chaker Hospital, Sfax, Tunisia
- Medecin B Departement, Medecin Sfax University, Sfax University, Sfax, Tunisia
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Khsiba A, Moalla M, Abid N, Douggaz A, Mahmoudi M, Mohamed AB, Yakoubi M, Medhioub M, Hamzaoui L, Chelbi E, Azzouz MM. A rare case of gastric metastasis originating from primary lung adenocarcinoma: a case report. Future Sci OA 2023; 9:FSO869. [PMID: 37485447 PMCID: PMC10357402 DOI: 10.2144/fsoa-2022-0083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 05/15/2023] [Indexed: 07/25/2023] Open
Abstract
Unlike liver and lung, the stomach is rarely a metastatic location for cancers. We report a case of a 62-year-old man known to have lung adenocarcinoma poorly differentiated presented with melena 1 month after diagnosis. Upper endoscopy revealed an ulcerated tumor in the prepyloric antrum. The diagnosis of gastric metastasis from pulmonary cancer was confirmed by the immunohistochemical staining for the thyroid transcriptional factor-1 and the pattern cytokeratine CK7+/CK20-. In conclusion, gastric metastasis from primary lung cancer is a rare phenomenon that every clinician must keep in mind.
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Affiliation(s)
- Amal Khsiba
- Gastroenterology Department, Mohamed Taher Maamouri Hospital, Nabeul, Tunisia
| | - Manel Moalla
- Gastroenterology Department, Mohamed Taher Maamouri Hospital, Nabeul, Tunisia
| | - Narjes Abid
- Pulmonology Department, Mohamed Taher Maamouri Hospital, Nabeul, Tunisia
| | - Amel Douggaz
- Pathology Department, Mohamed Taher Maamouri Hospital, Nabeul, Tunisia
| | - Moufida Mahmoudi
- Gastroenterology Department, Mohamed Taher Maamouri Hospital, Nabeul, Tunisia
| | - Asma Ben Mohamed
- Gastroenterology Department, Mohamed Taher Maamouri Hospital, Nabeul, Tunisia
| | - Manel Yakoubi
- Gastroenterology Department, Mohamed Taher Maamouri Hospital, Nabeul, Tunisia
| | - Mouna Medhioub
- Gastroenterology Department, Mohamed Taher Maamouri Hospital, Nabeul, Tunisia
| | - Lamine Hamzaoui
- Gastroenterology Department, Mohamed Taher Maamouri Hospital, Nabeul, Tunisia
| | - Emna Chelbi
- Pathology Department, Mohamed Taher Maamouri Hospital, Nabeul, Tunisia
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Moalla M, Elleuch N, Dahmani W, Hammami A, Ameur WB, Slama AB, Brahem A, Ajmi S, Ksiaa M, Jaziri H, Jmaa A. Predictive factors of recurrence in spontaneous bacterial peritonitis in Tunisian patients with cirrhosis. Future Sci OA 2023; 9:FSO857. [PMID: 37180608 PMCID: PMC10167715 DOI: 10.2144/fsoa-2023-0016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 03/30/2023] [Indexed: 05/16/2023] Open
Abstract
Introduction Recurrent spontaneous bacterial peritonitis (SBP) in patients with cirrhosis is associated with poor prognosis. Aim To assess the prevalence and the risk factors for recurrence and to evaluate its impact on the prognosis. Materials & methods We conducted a retrospective study including patients with cirrhosis having a first episode of SBP. Results A recurrence of SBP was identified in 43.4% of the patients who survived after a first episode of SBP. The mean time to onset of the first SBP recurrence from the first episode was 32 days. Recurrence factors were endoscopic hypertensive signs, a positive ascites culture, diarrhea and the MELD score. Conclusion There was no impact on survival of recurrent SBP compared with the first SBP episode.
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Affiliation(s)
- Manel Moalla
- Department of gastroenterology, Sahloul University Hospital, Sousse, 4054, Tunisia
| | - Nour Elleuch
- Department of gastroenterology, Sahloul University Hospital, Sousse, 4054, Tunisia
| | - Wafa Dahmani
- Department of gastroenterology, Sahloul University Hospital, Sousse, 4054, Tunisia
| | - Aya Hammami
- Department of gastroenterology, Sahloul University Hospital, Sousse, 4054, Tunisia
| | - Wafa Ben Ameur
- Department of gastroenterology, Sahloul University Hospital, Sousse, 4054, Tunisia
| | - Aida Ben Slama
- Department of gastroenterology, Sahloul University Hospital, Sousse, 4054, Tunisia
| | - Ahlem Brahem
- Department of gastroenterology, Sahloul University Hospital, Sousse, 4054, Tunisia
| | - Salem Ajmi
- Department of gastroenterology, Sahloul University Hospital, Sousse, 4054, Tunisia
| | - Mehdi Ksiaa
- Department of gastroenterology, Sahloul University Hospital, Sousse, 4054, Tunisia
| | - Hanen Jaziri
- Department of gastroenterology, Sahloul University Hospital, Sousse, 4054, Tunisia
| | - Ali Jmaa
- Department of gastroenterology, Sahloul University Hospital, Sousse, 4054, Tunisia
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Moalla M, Khsiba A, Mahmoudi M, Bouzaidi K, Chelbi E, Mohamed AB, Yakoubi M, Medhioub M, Hamzaoui L, Azzouz MM. Multifocal nodular lesions in fatty liver mimicking neoplastic disease: a case report. Future Sci OA 2023; 9:FSO848. [PMID: 37090491 PMCID: PMC10116373 DOI: 10.2144/fsoa-2022-0084] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 03/16/2023] [Indexed: 03/30/2023] Open
Abstract
Usually, fatty hepatic infiltration is diffuse and homogeneous. However, in some cases, it can be localized simulating benign or malignant tumors. We present a case of a 61-year-old female patient with family history of malignancy: sister with lung cancer, an other sister with colon cancer and a mother with breast cancer; who presented with multiple hepatic nodules at the ultrasonography images. CT scan and MRI were not sufficient to pose a certain diagnosis which was later confirmed by liver biopsy.
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7
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Chtourou L, Moalla M, Gdoura H, Smaoui H, Khrouf O, Kallel R, Mnif L, Amouri A, Boudabbous M, Tahri N. Clinical and therapeutic features of Plummer-Vinson syndrome in a Tunisian population: a case series. Pan Afr Med J 2023; 44:21. [PMID: 37013208 PMCID: PMC10066618 DOI: 10.11604/pamj.2023.44.21.35809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 01/01/2023] [Indexed: 04/05/2023] Open
Abstract
Plummer Vinson syndrome (PVS) is a rare entity and most publications are case or series of cases. Thus, we report a series from southern Tunisia. Our aim was to analyse the epidemiological and clinical characteristics, the therapeutic modalities as well as the evolution of this pathology. Thus we carried out a retrospective study from 2009 until 2019. For each patient with PVS, we collected the epidemiological, clinical, paraclinical data and therapeutic modalities. A total of 23 patients were enrolled with a median age of 49.52 years [18-82 years] and a clear female predominance (M/F=2/21). The median duration of dysphagia was 42 months [4-92 months]. Moderate microcytic hypochromic anemia was noted in 16 patients. The anemia was without obvious cause in 60.8% (n=14) of cases. The main endoscopic finding was a diaphragm in the cervical area. Treatment was based on iron supplementation followed by endoscopic dilatation with Savary dilators in 90.9% (n=20) and balloons for 9.1% of patients (n=2). Dysphagia recurred in 5 patients after a median of 26.6 months [2-60 months]. Three cases of PVS were complicated by esophageal squamous cell carcinoma. In conclusion, our series confirms that PVS affects mostly women. Anemia is frequently noted in these patients. Treatment is based on endoscopic dilatation which is often an easy and risk-free procedure and iron supplementation.
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Affiliation(s)
- Lassaad Chtourou
- Department of Gastroenterology and Hepatology, Hedi Chaker University Hospital, Sfax 3089, Tunisia
- Sfax Medical School, University of Sfax, Sfax 3029, Tunisia
- Corresponding author: Lassaad Chtourou, Department of Gastroenterology and Hepatology, Hedi Chaker University Hospital, Sfax 3089, Sfax Medical School, University of Sfax, Sfax 3029, Tunisia.
| | - Manel Moalla
- Department of Gastroenterology and Hepatology, Hedi Chaker University Hospital, Sfax 3089, Tunisia
- Sfax Medical School, University of Sfax, Sfax 3029, Tunisia
| | - Hela Gdoura
- Department of Gastroenterology and Hepatology, Hedi Chaker University Hospital, Sfax 3089, Tunisia
- Sfax Medical School, University of Sfax, Sfax 3029, Tunisia
| | - Hend Smaoui
- Department of Gastroenterology and Hepatology, Hedi Chaker University Hospital, Sfax 3089, Tunisia
- Sfax Medical School, University of Sfax, Sfax 3029, Tunisia
| | - Ons Khrouf
- Department of Gastroenterology and Hepatology, Hedi Chaker University Hospital, Sfax 3089, Tunisia
- Sfax Medical School, University of Sfax, Sfax 3029, Tunisia
| | - Roua Kallel
- Department of Gastroenterology and Hepatology, Hedi Chaker University Hospital, Sfax 3089, Tunisia
- Sfax Medical School, University of Sfax, Sfax 3029, Tunisia
| | - Leila Mnif
- Department of Gastroenterology and Hepatology, Hedi Chaker University Hospital, Sfax 3089, Tunisia
- Sfax Medical School, University of Sfax, Sfax 3029, Tunisia
| | - Ali Amouri
- Department of Gastroenterology and Hepatology, Hedi Chaker University Hospital, Sfax 3089, Tunisia
- Sfax Medical School, University of Sfax, Sfax 3029, Tunisia
| | - Mona Boudabbous
- Department of Gastroenterology and Hepatology, Hedi Chaker University Hospital, Sfax 3089, Tunisia
- Sfax Medical School, University of Sfax, Sfax 3029, Tunisia
| | - Nabil Tahri
- Department of Gastroenterology and Hepatology, Hedi Chaker University Hospital, Sfax 3089, Tunisia
- Sfax Medical School, University of Sfax, Sfax 3029, Tunisia
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Gdoura H, Barkia B, Chtourou L, Moalla M, Leila M, Amouri A, Boudabbous M, Tahri N. Ulcère œsophagien révélant une œsophagite à éosinophile : à propos d’un cas. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.10.280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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9
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Gdoura H, Abdelmoula A, Chtourou L, Moalla M, Mnif L, Amouri A, Boudabbous M, Tahri N. Faut-il rechercher systématiquement maladie cœliaque au cours des maladies inflammatoires chroniques de l’intestin ? À propos de deux cas. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.10.289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Dghaies HF, Moalla M, Ben Nessib D, Triki W, Maatallah K, Kaffel D, Hamdi W. 18 Does overweight enhance foot disorders in patients with juvenile idiopathic arthritis? Rheumatology (Oxford) 2022; 61:keac496.014. [PMCID: PMC9539168 DOI: 10.1093/rheumatology/keac496.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background Objectives Methods Results Conclusion
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Affiliation(s)
| | - M Moalla
- Kassab Institute of Orthopaedics, Tunisia
| | | | - W Triki
- Kassab Institute of Orthopaedics, Tunisia
| | | | - Dh Kaffel
- Kassab Institute of Orthopaedics, Tunisia
| | - W Hamdi
- Kassab Institute of Orthopaedics, Tunisia
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11
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Kharrat L, Ferjani H, Moalla M, Triki W, Ben Nessib D, Maatallah K, Kaffel D, Hamdi W. 22 Monitoring of juvenile idiopathic arthritis: don’t miss the foot deformities! Rheumatology (Oxford) 2022. [PMCID: PMC9538990 DOI: 10.1093/rheumatology/keac496.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background Foot deformities seem to be frequent in children with Juvenile Idiopathic Arthritis (JIA) [1,2]. These deformities can deeply affect the child’s activity and alter his quality of life. Objectives To study the association between disease activity and foot deformities in JIA patients. Methods We conducted a cross-sectional study including patients meeting the International League of Associations for Rheumatology (ILAR) 2001 criteria for JIA. For each patient, we collected the following data: age, disease duration, tender joint count (TJC), swollen joint count (SJC), Patient Global Assessment (PGA), Visual Analogic Scale (VAS), and therapeutic management. Disease activity was assessed using the Juvenile Arthritis Disease Activity score (JADAS). Foot deformities were assessed using an optical podoscope. C-reactive protein (CRP) and Erythrocyte sedimentation rate (ERS) levels were measured. Statistical analysis was performed using SPSS software. Results We included 35 patients. Forty-three percent of the patients were boys (n = 15). The mean age was 12.2 ± 3.61 years. The mean disease duration was 4.1 ± 3.29 years. The mean PGA and the mean VAS were 3.4 ± 3.02 and 3.37 ± 2.92, respectively. The mean TJC and the mean SJC were 1.48 ± 1.69 and 0.61 ± 0.77, respectively. The mean CRP and ESR were 7.51 ± 11.85 mg/l and 18.88 ± 15.53 mm, respectively. Twenty-four patients were under non-steroidal anti-inflammatory drugs (69%), 12 patients were under methotrexate (34%), and 5 patients were under TNFα inhibitor (14%). The mean JADAS was 7.58 ± 6.3. Seventeen percent of the patients had the inactive disease (n = 6). Foot deformities were found in 80% of the patients (n = 28). They were flatfoot in 40% (n = 14) and pes cavus in 46% (n = 16). These deformities were bilateral in 18 cases (51%). Hallux valgus was present in 14% of the cases (n = 5). Foot deformities were associated to a higher PGA (4.04 ± 3.01 vs 0.86 ± 1.2, p< 10–3), VAS (3.93 ± 2.94 vs 1.14 ± 1.46, p = 0.022), CRP level (8.84 ± 13.1 vs 2.79 ± 2.5 mg/l, p = 0.039), and higher JADAS (9.12 ± 6.25 vs 2.08 ± 1.93, p< 10–3). Conclusion Our study showed that foot deformities are common in JIA. Interestingly, these deformities are associated with a higher CRP level and a higher disease activity. These results suggest that an early screening of foot deformities is advisable in patients with active disease. References 1. Truckenbrodt H, Häfner R, von Altenbockum C. Functional joint analysis of the foot in juvenile chronic arthritis. Clin Exp Rheumatol. 1994; 12 Suppl 10: S91-96. 2. Gschwend N, Ivosevic-Radovanovic D. [The child’s foot in juvenile polyarthritis (cP)]. Orthopade. 1986; 15(3):212–9.
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Affiliation(s)
- L Kharrat
- Rheumatology Department, Kassab Orthopedics Institute, Ksar Saïd, Tunisia,Faculty of Medicine, University Tunis el Manar, Tunisia
| | - H Ferjani
- Rheumatology Department, Kassab Orthopedics Institute, Ksar Saïd, Tunisia,Faculty of Medicine, University Tunis el Manar, Tunisia
| | - M Moalla
- Rheumatology Department, Kassab Orthopedics Institute, Ksar Saïd, Tunisia,Faculty of Medicine, University Tunis el Manar, Tunisia
| | - W Triki
- Rheumatology Department, Kassab Orthopedics Institute, Ksar Saïd, Tunisia,Faculty of Medicine, University Tunis el Manar, Tunisia
| | - D Ben Nessib
- Rheumatology Department, Kassab Orthopedics Institute, Ksar Saïd, Tunisia,Faculty of Medicine, University Tunis el Manar, Tunisia
| | - K Maatallah
- Rheumatology Department, Kassab Orthopedics Institute, Ksar Saïd, Tunisia,Faculty of Medicine, University Tunis el Manar, Tunisia
| | - D Kaffel
- Rheumatology Department, Kassab Orthopedics Institute, Ksar Saïd, Tunisia,Faculty of Medicine, University Tunis el Manar, Tunisia
| | - W Hamdi
- Rheumatology Department, Kassab Orthopedics Institute, Ksar Saïd, Tunisia,Faculty of Medicine, University Tunis el Manar, Tunisia
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12
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Ferjani H, Kharrat L, Moalla M, Triki W, Ben Nessib D, Maatallah K, Kaffel D, Hamdi W. 21 Disease activity and body mass index in juvenile idiopathic arthritis: is the truth revealed? Rheumatology (Oxford) 2022. [PMCID: PMC9539183 DOI: 10.1093/rheumatology/keac496.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background Objective Methods Results Conclusion
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Affiliation(s)
- H Ferjani
- Rheumatology Department, Kassab Orthopedics Institute, Ksar Saïd, Tunisia,Faculty of Medicine, University Tunis el Manar, Tunisia
| | - L Kharrat
- Rheumatology Department, Kassab Orthopedics Institute, Ksar Saïd, Tunisia,Faculty of Medicine, University Tunis el Manar, Tunisia
| | - M Moalla
- Rheumatology Department, Kassab Orthopedics Institute, Ksar Saïd, Tunisia,Faculty of Medicine, University Tunis el Manar, Tunisia
| | - W Triki
- Rheumatology Department, Kassab Orthopedics Institute, Ksar Saïd, Tunisia,Faculty of Medicine, University Tunis el Manar, Tunisia
| | - D Ben Nessib
- Rheumatology Department, Kassab Orthopedics Institute, Ksar Saïd, Tunisia,Faculty of Medicine, University Tunis el Manar, Tunisia
| | - K Maatallah
- Rheumatology Department, Kassab Orthopedics Institute, Ksar Saïd, Tunisia,Faculty of Medicine, University Tunis el Manar, Tunisia
| | - D Kaffel
- Rheumatology Department, Kassab Orthopedics Institute, Ksar Saïd, Tunisia,Faculty of Medicine, University Tunis el Manar, Tunisia
| | - W Hamdi
- Rheumatology Department, Kassab Orthopedics Institute, Ksar Saïd, Tunisia,Faculty of Medicine, University Tunis el Manar, Tunisia
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Khsiba A, Moalla M, Nechi S, Bani A, Elloumi A, Jemal S, Azouz MM, Medhioub M, Hamzaoui L. Fatal invasive gastric mucormycosis: Two case reports. Clin Case Rep 2022; 10:e6330. [PMID: 36172336 PMCID: PMC9468655 DOI: 10.1002/ccr3.6330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/27/2022] [Accepted: 08/25/2022] [Indexed: 11/22/2022] Open
Abstract
Mucormycosis is a fungal infection affecting most commonly immunocompromised patients. Hereby, we report two cases: the first one is about a 61‐year‐old female with diabetes who presented with vomiting. The upper gastrointestinal endoscopy showed a budding grayish process which corresponded to an invasive mucormycosis in histology. As laboratory tests showed renal dysfunction, conventional amphotericin B was started at low doses since liposomal form was unavailable in Tunisia. Evolution was marked by a worsening of renal function leading to drug therapy withdrawal. Total gastrectomy was delayed because of a pulmonary embolism and was practiced 2 months later. The patient passed away 10 days after surgery. The second patient was a 59‐year‐old man who presented with vomiting and fast worsening of general state. At admission, he had a septic shock. Explorations revealed an invasive gastric mucormycosis. He died few days after admission. Thus, prompt diagnosis of mucormycosis and rapid initiation of treatment based on amphotericin B and surgical debridement is necessary to improve prognosis.
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Affiliation(s)
- Amal Khsiba
- Department of Gastroenterology Mohamed Taher Maamouri Hospital Nabeul Tunisia
| | - Manel Moalla
- Department of Gastroenterology Mohamed Taher Maamouri Hospital Nabeul Tunisia
| | - Salwa Nechi
- Department of Cytology Mohamed Taher Maamouri Hospital Nabeul Tunisia
| | - Amina Bani
- Department of Cytology Mohamed Taher Maamouri Hospital Nabeul Tunisia
| | - Aicha Elloumi
- Parasitology and Entomology Laboratory La Rabta Hospital Tunis Tunisia
| | - Sana Jemal
- Parasitology and Entomology Laboratory La Rabta Hospital Tunis Tunisia
| | | | - Mouna Medhioub
- Department of Gastroenterology Mohamed Taher Maamouri Hospital Nabeul Tunisia
| | - Lamine Hamzaoui
- Department of Gastroenterology Mohamed Taher Maamouri Hospital Nabeul Tunisia
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Chtourou L, Moalla M, Mnif B, Smaoui H, Gdoura H, Boudabous M, Mnif L, Amouri A, Hammami A, Tahri N. Prevalence of Helicobacter pylori resistance to clarithromycin in Tunisia. J Med Microbiol 2022; 71. [PMID: 36006691 DOI: 10.1099/jmm.0.001561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background. Helicobacter pylori (H. pylori) resistance to clarithromycin is increasing worldwide. Data on the prevalence of H. pylori resistance are limited in Tunisia.Gap statement. Given that H. pylori resistance to clarithromycin has not been studied in Tunisia since 2010, there was a need to determinate its prevalence and the principal mutations implicated in this resistance.Aim. The aims were to define the prevalence of H. pylori infection among symptomatic patients and to determinate the level of clarithromycin resistance among these patients and the main mutations conferring this resistance.Methods. We conducted a cross-sectional study from March 2017 to February 2020 in the Hepato-Gastroenterology Department of Hedi Chaker University Hospital in Sfax that included 124 Tunisian patients who underwent gastroduodenal endoscopy with biopsies. Mutations conferring resistance to clarithromycin were detected using the Allplex H. pylori and ClariR PCR Assay.Results. Out of 124 biopsies, 101 (81.5 2 %) were PCR-positive for H. pylori. Mutations conferring resistance to clarithromycin were detected in 30/95 (31.6 %) of patients. The rate of primary resistance was 25.3 % and of secondary resistance 62.5 %. The most frequently detected mutation was A2143G (86, 90%) followed by A2142G (11, 36%). Seven patients had a double mutation A2143G-A2142G. The factors independently associated with resistance to clarithromycin were diabetes, high blood pressure, the presence of a bulbar ulcer on endoscopy and the presence of gastric atrophy on histology.Conclusion. Detection of more than 25 % of strains with clarithromycin resistance mutations makes the H. pylori first-line treatment with clarithromycin questionable in our setting, and a review of empirical treatment of H. pylori is urgently needed.
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Affiliation(s)
- Lassaad Chtourou
- Department of Gastroenterology and Hepatology, Hedi Chaker University Hospital, Sfax, Tunisia.,Sfax Medical School, University of Sfax, Sfax, Tunisia
| | - Manel Moalla
- Department of Gastroenterology and Hepatology, Hedi Chaker University Hospital, Sfax, Tunisia.,Sfax Medical School, University of Sfax, Sfax, Tunisia
| | - Basma Mnif
- Sfax Medical School, University of Sfax, Sfax, Tunisia.,Department of Microbiology, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Hend Smaoui
- Department of Gastroenterology and Hepatology, Hedi Chaker University Hospital, Sfax, Tunisia.,Sfax Medical School, University of Sfax, Sfax, Tunisia
| | - Hela Gdoura
- Department of Gastroenterology and Hepatology, Hedi Chaker University Hospital, Sfax, Tunisia.,Sfax Medical School, University of Sfax, Sfax, Tunisia
| | - Mona Boudabous
- Department of Gastroenterology and Hepatology, Hedi Chaker University Hospital, Sfax, Tunisia.,Sfax Medical School, University of Sfax, Sfax, Tunisia
| | - Leila Mnif
- Department of Gastroenterology and Hepatology, Hedi Chaker University Hospital, Sfax, Tunisia.,Sfax Medical School, University of Sfax, Sfax, Tunisia
| | - Ali Amouri
- Department of Gastroenterology and Hepatology, Hedi Chaker University Hospital, Sfax, Tunisia.,Sfax Medical School, University of Sfax, Sfax, Tunisia
| | - Adnene Hammami
- Sfax Medical School, University of Sfax, Sfax, Tunisia.,Department of Microbiology, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Nabil Tahri
- Department of Gastroenterology and Hepatology, Hedi Chaker University Hospital, Sfax, Tunisia.,Sfax Medical School, University of Sfax, Sfax, Tunisia
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Moalla M, Lansari R, Saida R, Bergaoui E, Larnaout A, Melki W. Assessment of anxiety related to Covid-19 in the elderly in Tunisia. Eur Psychiatry 2022. [PMCID: PMC9564634 DOI: 10.1192/j.eurpsy.2022.782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction The COVID-19 pandemic has several risks particularly in the elderly, such a high death rate and severe forms.The risk also involves significant psychological distress especially anxiety. Objectives Assessment of anxiety symptoms due to COVID 19 in elderly subjects in Tunisia. Methods A cross-sectional descriptive study on a sample of 50 people aged between 65 and over. Data was collected using a questionnaire and a COVID Anxiety Rating Scale “Fear of COVID-19 Scale”. Results We found that most subjects agreed or strongly agreed that they were afraid of Corona and that 54% agreed or strongly agreed that they felt uncomfortable thinking about the Corona. Physical symptoms like having sweaty hands, or having palpitations related to the fear of having the disease were reported by 24% of the subjects. Almost half of the respondents (46%) were afraid of losing their lives due to Corona. Most subjects (66%) reported that they became nervous or anxious when viewing information posted on social media on Corona. Insomnia related to worries about having COVID was reported in 12% of subjects. We were able to retain that most of the subjects (68%) had a mild level of anxiety and that 30% of the subjects had a moderate level. No subject had severe anxiety. Conclusions Low to moderate level of fear due to the COVID 19 pandemic was observed among Tunisian elderly according to this study. This leads us to conclude that assessment of anxiety particularly in seniors should be more systematic. Disclosure No significant relationships.
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Moalla M, Mahmoud I, Ben Tekaya A, Rouached L, Bouden S, Tekaya R, Gorgi Y, Abdelmoula L, Saidane O, Sfar I. AB0351 IMPACT OF FCGR2A, FCGR3A AND FCGR3B POLYMORPHISM ON RITUXIMAB EFFICACY IN RHEUMATOID ARTHRITIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundIdentifying reliable biomarkers of response to biologics in rheumatoid arthritis (RA) is necessary to improve responsiveness, preserve functions and structure of joints, as well as to reduce treatment’s cost. Single nucleotide polymorphisms (SNP’s) of Fc-gamma receptors genes (FCGRs), by inducing a variation of receptors’ affinity to Fc fragment of Gamma immunoglobulin, might influence the efficacy of therapeutic monoclonal antibodies by modifying their clearance.ObjectivesThe aim of this study was to investigate whether FCGR2A, FCGR3A and FCGR3B SNP’s were predictive factors of response to rituximab (RTX) in Tunisian RA patients.MethodsA cross-sectional, observational and analytic multicentric cohort study was conducted in a group of patients suffering from RA treated with RTX. Treatment outcome was evaluated after 6 months, using DAS28 variation from baseline and EULAR response criteria. R131H-FCGR2A, F158V-FCGR3A and NA1/NA2-FCGR3B SNPs were studied using PCR-SSP and direct sequencing process.ResultsThirty-four patients were enrolled with a sexe ratio M/F=5/29. The mean age at inclusion was 54,24±11,78 years [29-77]. All patients received at least one cs-DMARDS priorly to the prescription of RTX. Concomitant treatment with methotrexate was pursued in 77,3% of patients. As shown in Table 1, an association, that tend to signification, was found between R/R FCGR2A receptors and a greater variation in DAS28 score (p=0,053). This association was also found using EULAR criteria, since all patients with R/R genotypes had a good or moderate response to RTX but was not significative (p=0,131).Table 1.Correlation of FCGR SNPs with response to rituximab at 6 months of treatmentGenetic studyΔDAS28CRPpΔDAS28ESRpEULAR (R-) (n=7)EULAR (R+) (n=27)PFCGR2A R131H*0,1380,7610,301GenotypesRR2,53±1,560,0531,83±0,750,4800(0)7 (100)0,131HH2,05±2,510,8682,29±1,640,6831 (33,3)2 (66,7)0,576RH1,09±1,360,062,00±1,730,8556 (25)18(75)0,324AllelesR1,45±1,520,8681,96±1,490,6836 (0,194)25(0,806)0,576H1,17±1,430,0532,1±1,600,4807 (0,259)20(0,741)0,131FCGR3A F158V*0,4280,8730,370GenotypesFF1,35±1,570,8601,91±1,860,7052 (16,7)10(83,3)0,676VV0,95±0,980,2882,85±0,320,6371 (10)9(90)0,324FV2,06±1,830,2371,84±1,5114 (33,3)8(66,7)0,175AllelesF1,72±1,700,2881,87±1,560,6376 (0,25)18(0,75)0,324V1,56±1,570,8602,13±1,330,7055(0,227)17(0,773)0,676FCGR3B NA1/NA2*0,2170,4850,645GenotypesNA1NA12,29±1,810,092,13±1,080,7152(22,2)7 (78,8)0,888NA2NA20,79±1,300,3290,60,3432 (33,3)4 (66,7)0,395NA1NA21,23±1,360,3912,28±2,070,3453 (15,8)16(84,2)0,436AllelesNA21,15±1,330,091,95±1,950,7155 (0,20)20(0,80)0,888NA11,60±1,580,3292,19±1,450,3435 (0,179)23(0,821)0,395DAS: disease activity score,ΔDAS: mean variation of DAS at 6 months, *:Comparison of the global distribution of the 3 genotypes,**: p while comparing the prevalence of R/R genotype to R/H and H/H genotypes,R+: good or moderate EULAR response,R-: bad EULAR responseConclusionThe low affinity receptor R/R FcgRIIa might be predictive of good response in RA patients treated with RTX. More studies need to be conducted in larger cohorts to confirm this association, with the aim of identifying reliable biomarkers of response to biologics to improve responsiveness, preserve joints functions and structure, as well as reduce treatment’s cost.Disclosure of InterestsNone declared
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Moalla M, Lansari R, Saida R, Zrelli M, Larnaout A, Melki W. Assessment of worries and attitudes towards the COVID-19 pandemic and the vaccine among Tunisian elderly. Eur Psychiatry 2022. [PMCID: PMC9566784 DOI: 10.1192/j.eurpsy.2022.1275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction The COVID-19 pandemic poses a threat particularly to the elderly. Although the current vaccination strategy is recognized as an adequate measure to reduce mortality, it still raises concerns about its efficacy and safety. Objectives Assessment of worries and attitudes among Tunisian elderly towards the pandemic. Methods A descriptive cross-sectional study on a sample of 50 consultants in a geriatric service, aged between 65 years and over. A questionnaire was formulated based on the recommendations of WHO and INEAS. Results The average age of our population is 74.6 years. The participants were mainly female, retired (76%) and with low educational attainment. Most of the elderly reported that they respected the wearing of the mask in public (90%) and washing their hands regularly (92%). Social distancing was respected by only 44% of the participants. Concerning the vaccine registration, we noted that 48% of the subjects expressed their willingness to register on the Evax.tn platform. On the other hand, 15 people expressed their refusal to receive the anti-Covid vaccine. We noted that only 22% had a dose of the Covid-19 vaccine. Only 4% of the respondents did not have concerns about new variants of the virus. About half (52%) of the subjects expressed significant concern about an increased risk of virulence and mortality due to the new variant. Vaccination was considered ineffective by most of the participants (70%). Conclusions Addressing worries about vaccine would be an important step to accept it among Tunisian elderly. Adequate information strategy is essential to change attitudes during the pandemic. Disclosure No significant relationships.
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Bergaoui E, Zrelli M, Staali N, Moalla M, Lansari R, Melki W. Bipolar disorder and grey matter heterotopia : a case report. Eur Psychiatry 2022. [PMCID: PMC9567415 DOI: 10.1192/j.eurpsy.2022.1634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction The grey matter heterotopias are a relatively common group of conditions characterized by interruption of normal neuronal migration from near the ventricle to the cortex. Subependymal grey matter heterotopia, also known as periventricular heterotopia, is the most common form. Objectives To search a link between bipolar disorder and grey matter heterotopia Methods A case report of a woman with grey matter heterotopia who is diagnosed as bipolar Results
A 34 year old woman was admitted at Razi psychiatric hospital 3 months after childbirth. She was agitated, logorrheic with multiple projects and insomniac. The diagnosis was a manic episod with a marked score of 28/44 at The Bech-Rafaelsen Mania Scale (MAS). The patient was treated with 4 mg of risperidone and 1000 mg of sodium valproate with partial remission after two weeks. One month after her discharge, she had depressive mood, asthenia, anhedonia and insomnia. She had a score of 19 at Hamilton Depression Rating Scale (HDRS). She was switched from risperidone to olanzapine 15mg/j with partial remission after two weeks. In front of persistent symptoms with labile mood, she took lithium 1000 mg/j. She was complaining of a headache and a fluctuating heaviness of the right upper limb. At brain imaging, she had periventricular nodular heterotopia. The patient was adressed to neurology department. Conclusions Grey matter heterotopia can cause a variety of neuropsychiatrc symptoms which can lead to diagnosis difficulties. Therefore, in front of atypical symptoms or drug-resistance, patients should be referred for brain imaging. Disclosure No significant relationships.
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Moalla M, Moalla M, Boudabous M, Tahri N. Ischemic colitis related to antipsychotics : A rare and serious entity to know. Eur Psychiatry 2022. [PMCID: PMC9567738 DOI: 10.1192/j.eurpsy.2022.1861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Ischemic colitis is a rare condition. It represents 3 to 10% of lower digestive hemorrhages. It preferentially affects the subject over the age of 50 with predisposing factors. Rare cases have been reported in young subjects with the use of cocaine, combined hormones or antipsychotics. Objectives This work aimed to study the potential side effects of antipsychotics Methods We report a case of ischemic colitis associated with antipsychotics. Results A 27-year-old patient, followed for 2 years for schizophrenia treated with antipsychotics (chlorpromazine and haloperidol) and an antiparkinsonian (Biperiden), consulted in the emergency room for rectorragies progressing for 3 days. The examination revealed the installation of diffuse abdominal pain associated with early postprandial vomiting which preceded the 7-day rectal bleeding. The physical examination revealed ascites without edema of the lower extremities. The stools were normal-colored on digital rectal examination. The biological workup revealed anemia and a biological inflammatory syndrome. The abdomino-pelvic scanner showed thickening of the entire colonic wall with signs of recent bleeding. The rectosigmoidoscopy showed an ecchymotic aspect of the sigmoid with less pronounced involvement of the rectum. Pathologic examination of the colonic biopsies concluded with ischemic colitis, showing hemorrhagic suffisions with numerous fibrinous thrombi of the vessels. The course was marked by the onset of multi-organ failure with acute renal failure, a picture of disseminated intravascular coagulation (DIC) and alveolar hemorrhage. Despite the resuscitation, the patient died 2 days after admission. Conclusions Ischemic colitis is a rare side effect of antipsychotics. Although rare, this entity should be evoked and diagnosed in time. Disclosure No significant relationships.
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Bergaoui E, Zrelli M, Staali N, Moalla M, Lansari R, Larnaout A, Melki W. Gender disparities in a psychiatric department in Tunisia. Eur Psychiatry 2022. [PMCID: PMC9567927 DOI: 10.1192/j.eurpsy.2022.2240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction
Gender disparities exist regarding prevalence, symptomatology and risk factors of mental disorders. In Tunisia, there is only one hospital dedicated entirely to mental health which is Razi hospital.
Objectives
The aim of the present study was to assess gender based mental health disparities in a psychiatric department and its related factors.
Methods
A cross sectional and comparative survey was conducted between March and April 2021 in the department of psychiatry D of Razi Hospital including 70 patients with a sex ratio= 1.
Results
The participants were aged between 17 and 68. Men had higher rate of celibacy: 80% of men against 48.57% of women (p=0.009). A total of 11.42% of women were illiterate against 2.85% of men, 48% of men were unemployed against 62.85% of women. There was a significant difference between gender and use of cigarettes, cannabis and alcohol (p<0.001). The diagnosis was mood disorders for 35.42% of women and 17.14% of men and schizophrenia for 57.14% of women and 77.14% of men. Gender and modality of hospitalization were significantly associated (p=0.046): 14% of women were involuntary hospitalized against 40% of men. Time between symptoms onset and consulting is 3.5 years (±5.67) for women and 1.77 (±4.75) for men. The mean number of admissions for women is 1.59 and for men 4.2 (p=0.009).
Conclusions
Onset of mental disorders for women is 3 to 4 years later than men. They have better premorbid functionning and better social networks.Gender disparities are not only determined biologically but also socially.
Disclosure
No significant relationships.
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Zrelli M, Bergaoui E, Staali N, Moalla M, Lansari R, Larnaout A, Melki W. Capgras syndrome and poor facial emotion recognition. Eur Psychiatry 2022. [PMCID: PMC9567116 DOI: 10.1192/j.eurpsy.2022.1989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Capgras syndrome is a disorder of personal identification characterized by the delusional belief that one or more persons close to the subject have been replaced by physically identical doubles. Objectives To deepen our knowledge of the Capgras syndrome Methods A case report about a Capgras syndrome. Results We report the case of a 46-year-old female patient who was admitted in February 2021 for incoherent speech and behavior disorder against her family members. Three years ago, she started to have hypochondriacal concerns. A week before her admission, she threatened her husband with a knife and she was convinced that her daughters were dead and that they had been replaced by clowns. She had a Capgras delusion with a hallucinatory and interpretative mechanism against her daughters, she reported olfactory and cenesthetic hallucinations. Biological explorations and brain CT were normal. The PANNS scale showed a positive scale of 36, a negative scale of 39, the general psychopathology scale of 53. She had a total score of 30/40 on The Penn emotion recognition test. The patient had difficulty in recognizing low intensity emotions (0 or 1) and 50% of the false responses were for the neutral emotion with responses tending towards anger first and then sadness. Conclusions
Capgras syndrome remains poorly described in the literature and the hypotheses concerning its origin often oscillate between neuropsychological and psychodynamic. With the recent advances in neuroscience, it would be interesting to deepen its physiopathology in order to place it in a more modern nosological framework. Disclosure No significant relationships.
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Bergaoui E, Zrelli M, Staali N, Moalla M, Lansari R, Larnaout A, Melki W. Rural-urban differences in accessing mental health care in Tunisia. Eur Psychiatry 2022. [PMCID: PMC9567248 DOI: 10.1192/j.eurpsy.2022.1616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Despite improvement of mental health outcomes over the last years in Tunisia, there are still striking rural-urban mental health inequalities. Objectives The aim of this study is to evaluate the rural-urban differences in accessing mental health care among patients with psychiatric disorders Methods A cross sectional and descriptive survey was conducted between March and April 2021 in the department of psychiatry D of Razi Hospital including 70 patients admitted or treated as outpatients. The sex ratio was 1. Results
The participants were aged between 17 and 68. About 11.42% came from rural areas. In these areas, 75% percent had low income versus 30.64% in urban areas. (p=0.047) The percentage of celibacy in urban areas was 68.85% versus 37.5% in rural areas (p=0.042) No significant difference was observed between the level of education and living in rural or urban areas. There was no association between rural or urban origin and number of admissions or treatment adherence or use of cannabis. The mean time between symptoms onset and consulting was 8.51 years in rural areas versus 2 years in urban areas. Moreover, time between symptoms onset and admission was significantly associated with rural or urban origin (p=0.045). The mean duration was 13,33 years (±10) in rural areas versus 3.12 years (±4.13). Conclusions Families living in urban areas had better income and would come to psychiatric hospital earlier. Therefore, we should help patients in rural areas access to mental health facilities for a better medical care. Disclosure No significant relationships.
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Zrelli M, Bergaoui E, Staali N, Moalla M, Melki W. Misdiagnosis and therapeutic impasse in psychiatry. Eur Psychiatry 2022. [PMCID: PMC9567169 DOI: 10.1192/j.eurpsy.2022.1833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction
We frequently receive patients with atypical psychiatric symptoms admitted in our department after consulting other psychiatrists and triying several treatments.
Objectives
To highlight the factors of misdiagnosis in patients of our department.
Methods
We recruited 70 patients during their appointment or during their hospital admission in our department between March and April 2021. We collected the patients’ socio-demographic and clinical data using a pre-designed questionnaire.
Results
Patients were aged between 17 and 68 years with a sex ratio (M/F) of 1. Mood disorders accounted for 24.6% of disorders (N=17) whereas schizophrenia 66.7% (N=46). Patients resided in urban areas in 88.6% of cases (N=69). The average number of hospitalizations was 2.7 with extremes ranging from 0 to 14. The average time between the onset of the symptoms and the first consultation was 1 year. The mean time from onset to hospitalization was 4.37 years. The rate of consulting a psychiatrist prior to admission was 42.8%. The diagnosis was corrected during the follow-up of the patients in 24.3% of cases. Conventional neuroleptics were prescribed as first-line treatment in 42.85% of cases. Due to poor tolerance or ineffectiveness of the treatment, 31.42% of patients had to change treatment.
Conclusions
Patients, who were desperate to find an adequate treatment for their disorders, put a lot of hope in the Razi psychiatric hospital. But after several years of evolution of their disease, we are faced with a therapeutic impasse. Raising awareness of mental illnesses is necessary for an early and adequate treatment.
Disclosure
No significant relationships.
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Bergaoui E, Zrelli M, Staali N, Moalla M, Lansari R, Larnaout A, Melki W. Women’s access to mental health care in Tunisia. Eur Psychiatry 2022. [PMCID: PMC9568217 DOI: 10.1192/j.eurpsy.2022.2202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Introduction Tunisia is viewed as an advanced country in terms of women’s rights in the Arab world. However, women are more exposed than men to many specific risk factors which greatly contribute to threaten their mental health. Objectives The main objective of this study was to find out the sociodemographic and clinical profiles of women admitted in Razi psychiatric hospital and their access to mental health services. Methods A cross sectional and descriptive survey was conducted between March and April 2021 in the department of psychiatry D of Razi Hospital including 40 female inpatients. Results The majority of patients had low (37.1%) to moderate (61.9%) socio economic status, with primary education (40%), secondary education (20%) and higher education (28.6%). The majority was unemployed (68.8%). A significant difference was observed between adherence to treatment and family support (p=0.04). It was mainly the father or the husband who was taking care of the patient in 50% of cases. The first psychiatric consultation was 2.68 years after having symptoms. Hospitalization was about 4.94 years later. Twenty five percent of them have seen a tradipractioner before consulting. About 46.87% of patients had conflicts with a member of her family and 15.62% of them were victims of either domestic or family violence. The main diagnoses were mood disorders (31.4%) and schizophrenia (42.9%) Time between symptoms onset and hospitalisation was significantly associated with socioeconomic status (p=0.047) and cultural beliefs (p=0.026). Conclusions The protection of women’s mental health is not only a medical challenge but also a cultural and political one. Disclosure No significant relationships.
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Moalla M, Larnaout A, Skhiri D, Lansari R, Staali N, Melki W. Role of nurses in the initiation and the monitoring of Lithium. Eur Psychiatry 2022. [PMCID: PMC9565090 DOI: 10.1192/j.eurpsy.2022.470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Introduction Lithium is the oldest known treatment of bipolar disorders and remains the gold standard. Nevertheless, it remains difficult to handle, largely due to its narrow therapeutic index and its long-term side effects. Thus, it requires special initiation and monitoring measures. Objectives This study aims to assess nurses’ knowledge and attitudes regarding lithium. A protocol on Lithium initiation and monitoring will be established. Methods This is a descriptive study including 20 nurses in a psychiatry department conducted from January to May 2021 based on an self-assessment questionnaire that was established to assess nurses’ knowledge about Lithium, its side effects, initiation and monitoring. Results None of the recruited nurses had any training regarding the use of lithium. The vast majority of subject (85%) said that lithium’s dosage must be individualized and adaptable to each patient throughout a specific blood test. 90% recognized renal failure as the most common contraindication of lithium. Complete Blood Count (CBC), and renal check-up were the only tests recognized as necessary by all the sample subjects. 90% answered that lithium is toxic and 65% answered that it is fatal. In case of toxicity by lithium all subjects (100%) agreed to call the responsible doctor of the patient, 25% of them chose it as a unique measure and 75% thought it was necessary to stop the lithium immediately as well. Conclusions Lithium is considered as a double-edged sword largely due to its narrow therapeutic index. Nevertheless, nurses are undertrained when it comes to its use and manipulation. Disclosure No significant relationships.
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Moalla M, Staali N, Bergaoui E, Zrelli M, Melki W. Post-ictal psychosis syndrome : A case report. Eur Psychiatry 2022. [PMCID: PMC9564619 DOI: 10.1192/j.eurpsy.2022.1146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction
Psychiatric comorbidity is prevalent among patients with epilepsy. Post-ictal psychosis syndrome (PIP) is a recent entity important to know. It belongs to the group of epileptic psychoses. The clinical presentation is often atypical, and symptoms are usually related to seizures.
Objectives
This work aimed to study the particularities of PIP.
Methods
It is a case report of PIP, involving a patient hospitalized in psychiatry department.
Results
We report the case of a 45-year-old woman, with medical history of generalized epilepsy which was stabilized under antiepileptic treatment (phenobarbital 150 mg/day). The patient was hospitalized for psychomotor instability and inconsistent speech after having experienced a generalized tonic-clonic seizure in the context of discontinuation of treatment. Psychiatric assessment revealed a hostility, a reluctance , a persecution delirium and auditory and visual hallucinations. A series of examinations have been carried out ; Neurological examination revealed no anomaly , a computed Tomography Scan of the Brain was normal. A lombar puncture was normal. A covid-19 infection was eliminated. The usual antiepileptic medication was reintroduced to the patient (Phenobarbital 150 mg/day),in association to benzodiazepines (clonazepam 4 mg/day). After 72 hours of treatment, psychiatric symptoms improved. The patient returned to its baseline condition after 7 days. A similar episode was reported two months earlier in the same circumstances with a similar symptomatology and a spontaneous resolution within 7 days.
Conclusions
PPI syndrome, regardless of its good short-term prognosis, can potentially evolve into other psychiatric disorders of less good prognosis. Thus, this syndrome should be managed in collaboration with neurology and psychiatry.
Disclosure
No significant relationships.
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Elleuch N, Moalla M, Mahmoud S, Hammami A, Jaziri H, Ameur WB, Dahmani W, Slama AB, Brahem A, Ajmi S, Ksiaa M, Jmaa A. Spectrum of acute hepatitis and its clinical outcome in a central region in Tunisia. Pan Afr Med J 2021; 40:53. [PMID: 34795833 PMCID: PMC8571919 DOI: 10.11604/pamj.2021.40.53.25725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 09/03/2021] [Indexed: 11/23/2022] Open
Abstract
Introduction given the lack of studies on acute hepatitis (AH) in Tunisia, we carried out this study to find the etiological spectrum and clinical profile of AH and to investigate the impact of viral etiology on the outcomes of AH. Methods retrospective descriptive study collecting all patients with AH from 2010 to 2017. The data were compared between two groups (viral AH and non-viral AH). Results one hundred and three patient´s files were included. The average age of our patients was 30.15 years. An etiology was found in 92 patients (89.3%). The viral etiology was found in 70 patients (76.1%). Hepatitis A virus (HAV), hepatitis B virus (HBV), hepatitis C virus (HCV) and cytomegalovirus (CMV) were in the cause in 52, 16, 1 and 1 patient respectively. Elsewhere, it was toxic hepatitis in 10 patients (10.9%) including 7 of drug-related AH. Budd-Chiari syndrome and autoimmune hepatitis with acute onset were reported in 3 (3.3%) and 7 (7.6%) patients, respectively. Patients with viral AH were younger than those with non-viral AH (p = 10-3). There was more recourse to hospitalization for non-viral AH. Patients with viral AH had a higher mean aminotransferase (ALT) level than those with non-viral AH. The liver damage was more severe in the non-viral AH group with lower PT. There was more severe form, more transition to chronicity and more deaths in the non-viral AH group. Conclusion: the results found in our study concerning the distribution of the etiologies of AH as well as their evolutionary aspects are consistent with the data in the literature.
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Affiliation(s)
- Nour Elleuch
- Department of Gastroenterology, Sahloul Hospital, Sousse, Tunisia
| | - Manel Moalla
- Department of Gastroenterology, Sahloul Hospital, Sousse, Tunisia
| | - Sana Mahmoud
- Department of Gastroenterology, Sahloul Hospital, Sousse, Tunisia
| | - Aya Hammami
- Department of Gastroenterology, Sahloul Hospital, Sousse, Tunisia
| | - Hanen Jaziri
- Department of Gastroenterology, Sahloul Hospital, Sousse, Tunisia
| | - Wafa Ben Ameur
- Department of Gastroenterology, Sahloul Hospital, Sousse, Tunisia
| | - Wafa Dahmani
- Department of Gastroenterology, Sahloul Hospital, Sousse, Tunisia
| | - Aida Ben Slama
- Department of Gastroenterology, Sahloul Hospital, Sousse, Tunisia
| | - Ahlem Brahem
- Department of Gastroenterology, Sahloul Hospital, Sousse, Tunisia
| | - Salem Ajmi
- Department of Gastroenterology, Sahloul Hospital, Sousse, Tunisia
| | - Mehdi Ksiaa
- Department of Gastroenterology, Sahloul Hospital, Sousse, Tunisia
| | - Ali Jmaa
- Department of Gastroenterology, Sahloul Hospital, Sousse, Tunisia
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Mnif-Feki M, Safi W, Bougacha-Elleuch N, Abid G, Moalla M, Elleuch M, Ben Salah DH, Rekik N, Belguith N, Abdelhedi F, Kammoun T, Hachicha M, Charfi N, Mnif F, Kammoun H, Hadj Kacem H, Hadj-Kacem F, Abid M. Occurrence of Hypopituitarism in Tunisian Turner Syndrome patients: familial versus sporadic cases. Gynecol Endocrinol 2021; 37:848-852. [PMID: 34124982 DOI: 10.1080/09513590.2021.1939298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVE To explore unusual association between Turner Syndrome (TS) and Hypopituitarism in a Tunisian cohort. METHODS We reported 6 patients with TS associated to Hypopituitarism, including three familial cases except the fourth sister who showed only a TS phenotype. Biochemical analysis, resonance magnetic imaging and cytogenetic analyses were performed. RESULTS The average age of our patients was 17.2 years (11-31 years). They were all referred for short stature and pubertal delay, except for the fourth sister who presented spontaneous puberty with the integrity of the pituitary axis and the presence of an X ring chromosome. Karyotype analysis showed monosomy in 3 cases and a mosaic TS in the 3 remaining cases, including one patient with abnormal X chromosome structure. Somatotropic and corticotropic deficiencies were confirmed in 2 sporadic cases while the gonadotropic and thyrotropic axes were spared. In contrast; familial cases were consistently affected by the integrity of the corticotropic axis. MRI showed pituitary hypoplasia in all familial cases and pituitary stalk interruption syndrome in only one sporadic case. No correlation was found between the chromosome formula and the anterior pituitary involvement. CONCLUSION Co-segregation of congenital Hypopituitarism with pituitary hypoplasia and X chromosome aberrations could imply a molecular anomaly of transcription factors responsible for the differentiation and development of pituitary cells such as PROP1, POUF1, Hesx1, Lhx3, Lhx4. The etiopathogenic link between X chromosome abnormalities and the occurrence of Hypopituitarism remains unclear; however, the progress of molecular biology may clarify the interrelation between transcription factors and sex chromosome segregation abnormalities.
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Affiliation(s)
- M Mnif-Feki
- Endocrinology-Diabetology Department, CHU Hédi Chaker, Sfax, Tunisia
| | - W Safi
- Endocrinology-Diabetology Department, CHU Hédi Chaker, Sfax, Tunisia
| | - N Bougacha-Elleuch
- Laboratory of Molecular and Functional Genetics, Faculty of Sciences of Sfax, Sfax University, TUNISIA
| | - G Abid
- Department of Medical Imaging, Auxerre Hospital Center, Auxerre, France
| | - M Moalla
- Laboratory of Molecular and Cellular Screening Processes, Center of Biotechnology of Sfax, Sfax, Tunisia
| | - M Elleuch
- Endocrinology-Diabetology Department, CHU Hédi Chaker, Sfax, Tunisia
| | - D H Ben Salah
- Endocrinology-Diabetology Department, CHU Hédi Chaker, Sfax, Tunisia
| | - N Rekik
- Endocrinology-Diabetology Department, CHU Hédi Chaker, Sfax, Tunisia
| | - N Belguith
- Genetic Department, Medicine CHU Hédi Chaker, Sfax, Tunisia
| | - F Abdelhedi
- Genetic Department, Medicine CHU Hédi Chaker, Sfax, Tunisia
| | - T Kammoun
- Pediatric Department, CHU Hédi Chaker, Sfax, Tunisia
| | - M Hachicha
- Pediatric Department, CHU Hédi Chaker, Sfax, Tunisia
| | - N Charfi
- Endocrinology-Diabetology Department, CHU Hédi Chaker, Sfax, Tunisia
| | - F Mnif
- Endocrinology-Diabetology Department, CHU Hédi Chaker, Sfax, Tunisia
| | - H Kammoun
- Genetic Department, Medicine CHU Hédi Chaker, Sfax, Tunisia
| | - H Hadj Kacem
- Department of Applied Biology, College of Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - F Hadj-Kacem
- Endocrinology-Diabetology Department, CHU Hédi Chaker, Sfax, Tunisia
| | - M Abid
- Endocrinology-Diabetology Department, CHU Hédi Chaker, Sfax, Tunisia
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Ferjani H, Moalla M, Maatallah K, Ben Nessib D, Triki W, Kaffel D, Hamdi W. AB0520 PUBIC SYMPHYSIS INVOLVEMENT IN NON-RADIOGRAPHIC SPONDYLARTHRITIS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.4147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Structural change within pubic symphysis (PS) occurs in 20–25% of patients with spondylarthritis (SpA). It occurs in all developmental stages, even in the early stages of the disease. Changes in the symphysis can sometimes precede spine and sacroiliac involvement. Radiological findings in PS were poorly described in the SpA, especially on its non-radiographic form (nr-axSpA).Objectives:We aimed in this study to evaluate pubic symphyseal features in patients with a confirmed diagnosis of nr-axSpA and to assess the correlation of these changes with clinical and imaging features of nr-axSpA in these patients. We also focused on the relationship between parity and radiographic changes in pubic symphysis (PS).Methods:We retrospectively reviewed the data of 40 patients diagnosed with nr-axSpA according to the ASAS criteria. Radiological-morphological changes of PS were assessed in pelvic radiography by two distinct rheumatologists. Grading symphysial involvement was made as follow: scores ranged from 0-4 per reading: grade 0 = normal; grade 1 = subtle irregularity and/or subchondral sclerosis, grade 2 = clear erosions, 3 = marked sclerosis, grade 4 = ankylosis.For all patients, we calculated the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the BASRI (Bath Ankylosing Spondylitis Radiology Index).For all patients, we recorded the sacroiliac changes showed by the previous pelvic radiography and/or the pelvic scanner and/or by magnetic resonance imaging (MRI).Results:We enrolled forty patients with a sex-ratio H/F=1/3. Mean age of patients at diagnosis was 39,9 +/- 10,8 [17-59]. Forty percent of patients had peripheral enthesitis, and 45% had peripheral arthritis. BASDAI mean score was 4,63 +/- 0,9 [0-8,6]. HLA B-27 was present in 32,3% of cases. We noted radiographic changes in PS in 37,5% (15 patients): grade 1 (n=1), grade 2 (n=10), grade 3 (n=3) and grade 4 (n=1). There was not a significant difference between the sex group (p=0,85). A comparison of 2 groups (women with 3 children or more and women with less than 3 children) concluded that childbirth did not modify PS changes (p=0,9). Also, PS changes did not differ with age (p=0,5). There was no correlation between the BASRI value with the presence of PS changes nor with its grades (p=0,5 and p=0,89, respectively). Also, disease activity did not influence the PS involvement (p=0,4). Radiological findings in PS was not correlated with the sacroiliac features found on MRI or pelvic CT scan (p=0,59 and p=0,1).Conclusion:In SpA criteria, PS changes were not considered. It can be an additional help in making the diagnosis. Interestingly, pubic symphysis may exist without sacroiliitis.Disclosure of Interests:None declared.
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Kacem M, Mami H, Sellami S, Moalla M, Frej SB, Bouzid R. Clozapine-induced parotitis: A case study. Eur Psychiatry 2021. [PMCID: PMC9475681 DOI: 10.1192/j.eurpsy.2021.1433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Clozapine is the drug of choice for patients with an unsatisfactory response to classic antipsychotic treatment. Little is known about the involvement of clozapine in the development of parotid disease. Objectives Identify the clinical characteristics of Clozapine-induced parotitis through a case and literature review. Methods We report the case of a patient with a refractory schizoaffective disorder, bipolar type and who developed recurrent parotitis while taking clozapine. We conducted a literature review based on a PubMed search of articles published on this subject with the following keywords: ‘parotitis clozapine’. Results Miss W., 34 years old, suffers from a severe schizoaffective disorder that has been diagnosed for several years. She has received various psychotropic medications. She suffered from frequent relapses that required recurrent hospital admissions. One year ago, a diagnosis of treatment-resistant schizoaffective disorder was made. The decision to introduce clozapine, associated with mood stabilizer treatment, was made on the basis of her treatment refractory symptoms. She experienced considerable sialorrhea after beginning clozapine treatment. Miss W. developed bilateral recurrent swelling over both temporal-mandibular areas after 6 months of treatment. It often appears after eating and lasts from 4 to 6 hours. There was no change in white blood cell count and she was afebrile. An otolaryngologist was consulted and a diagnosis of clozapine-induced parotitis was suggested. A spasmolytic and an anticholinergic treatment were prescribed and clozapine was continued. Conclusions This iatrogenic effect of clozapine must be recognized by clinicians in order to be better prevented.
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Sellami S, Mami H, Moalla M, Oumaya M, Bouzid R. Lorazepam causing drug-induced liver injury : Rare entity. Eur Psychiatry 2021. [PMCID: PMC9479962 DOI: 10.1192/j.eurpsy.2021.2046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
IntroductionLorazepam is a benzodiazepine derivative that is globally used for the therapy of anxiety and insomnia.ObjectivesThe objective of our work was to show that Lorazepam can be a cause of unexpected liver injury even though it is a rare entity.MethodsWe reported the case of a patient who had a Drug-Induced Liver Injury (DILI) under Lorazepam. We performed a literature review based on a PubMed search with the following keywords: “Lorazepam,DILI”.ResultsA 20 year-old-Tunisian woman was hospitalized in the psychiatry department of the hospital of Nabeul in Tunisia for a brief psychotic episode.She had a DILI under Olanzapine, Chlorpromazine and Lorazepam, which conducted us to interrupt her treatments except for the Lorazepam(5mg/day). The hepatic tests went back to normal even under Lorazepam. Few days later, the liver enzymes increased again to reach very high levels. Extensive workup was negative for other causes of liver injury, including viral hepatitis A, B, C and E.; capillary electrophoresis of serum proteins was normal; Exhaustive immunological tests were performed searching for auto immune hepatitis(anti-smooth muscle antibodies, anti-LKM1, anti-LC1, anti-SLA/LP) primary biliary cholangitis(anti-mitochondrial antibodies, anti-GP210, anti-sp100) and other antibodies like antinuclear antibodies were negative. Liver biopsy showed polymorphic inflammatory infiltrate including some eosinophilic polynuclear cells and rare vaguely epitheloid macrophages, with necrotico-inflammatory foci in the lobules, all of which were consistent with DILI. Lorazepam was discontinued and within 10 days her liver enzymes decreased and completely normalized.ConclusionsLorazepam, with an unknown action mechanism, can be a cause of DILI.DisclosureNo significant relationships.
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Mahmoud I, Moalla M, Ben Tekaya A, Bouden S, Tekaya R, Saidane O, Sfar I, Gorgi Y, Abdelmoula L. AB0307 DOES FCGR2A, FCGR3A AND FCGR3B POLYMORPHISM CAN PREDICT ANTI-DRUG ANTIBODIES APPARITION IN RHEUMATOID ARTHRITIS PATIENTS TREATED WITH TNF-BLOCKERS? Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.4540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Fc gamma receptors (FcγRs) play a major role in the regulation of humoral immune responses. Single-nucleotide polymorphisms (SNPs) of FCGR2A and FCGR3A and FCGR3B can impact the expression level, IgG affinity and function of the CD32 and CD16 FcγRs in response to their engagement by the Fc fragment of IgG. It was described in patient treated for rheumatoid arthritis (RA), that such a polymorphism may influence patients response to TNF-blockers.Objectives:In this study, we aimed to investigate whether the FCGR2A H131R (rs1801274), FCGR3A F158V (rs396991), and FCGR3B NA1/NA2 polymorphisms can be involved in the genesis of anti-drug-antibody ADAb to anti-TNF therapy in RA patients under etanercept (ETA), adalimumab (ADL) and infliximab (INF).Methods:We included 47 patients treated for RA under TNF-blockers. To assess the association between the FCGR2A H131R (rs1801274), FCGR3A F158V (rs396991), and FCGR3B NA1/NA2 polymorphisms and immunogenicity of TNF-blockers, we used allele contrast, the recessive model, the dominant model, and the homozygote contrast. Quantitative measurements of the ADAbs was carried out by a commercial enzyme-linked immunosorbent assay (ELISA) kit (Promonitor)®after 6 months of treatment.Results:We involved 18 patients treated with ETA, 13 patients with ADL and 16 under INF. None of the patients under ETA has developed ADAb and respectively 1 and 7 patients developed immunogenicity with ADL and INF. We excluded patients under ETA from statistical study since they didn’t develop ADAb.A significant association was revealed between FCGR2A H131R polymorphism and immunogenicity of INF and ADL (table 1).Table 1.Association between FCGR2A polymorphism and immunogenicity to INF and ADLFCGR2A association with ADAb (n=29, crude analysis)GenotypeADAb=0ADAb=1OR (95% CI)P-valueH/H1 (4.8%)3 (37.5%)1.000.031H/R-R/R20 (95.2%)5 (62.5%)0.08 (0.01-0.98)There weren’t significant associations between ADAb’s development and FCGR3A F158V and FCGR3B NA1/NA2 polymorphism.Conclusion:FCGR2A R allele carriers show less susceptibility to develop ADAb to ADL and INF with follow-up times of 6 months. Our results provide an explanation for controversies in the relationships between FCGR2A H131R polymorphism and TNF-blockers response. Further studies with larger population of RA patients should be undertaken to confirm this hypothesis.References:NoneDisclosure of Interests:None declared
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Mahmoud I, Moalla M, Ben Tekaya A, Bouden S, Tekaya R, Saidane O, Abdelmoula L. AB0945 CONTRIBUTION OF MICROBIOLOGICAL AND ANATOMOPATHOLOGICAL EXAMINATIONS IN THE DIAGNOSIS OF SPONTANEOUS PYOGENIC SPONDYLODISCITIS IN ADULTS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.6272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Pyogenic spondylodiscitis (SPD) is a serious infection of an intervertebral disc and/or adjacent vertebrae, that remains a topical problem in rheumatological practice. Early diagnosis and treatment are the only guarantees of a favorable outcome. Clinicians must strive to isolate the responsible bacteria in order to adapt the treatment, and thus reduce the risk of resistance and complications due to SPD itself, but also to the multiplication of probabilistic treatments.Objectives:Our aim was to study the contribution of the different microbiological and anatomopathological examinations in the diagnosis of pyogenic SPD.Methods:It was a descriptive study in a single rheumatology department. Data were collected retrospectively from observations of patients hospitalized in the past 20 years who have been diagnosed with pyogenic SPD. We excluded cases of tuberculous and brucellar SPD from our study because of their completely different histological and microbiological profiles.Results:Twenty-two cases of pyogenic SPD were collected (14M/ 8F). The mean age of the population was 55.9 years [29,80]. A bacteriological survey including at least one cytobacteriological examination of the urine (CBEU), chest X-rays and blood cultures allowed the identification of the bacteria in 16 cases (73%). The most common site were bacteria was identified was blood culture in 7 cases, skin sample and urine collection in 2 cases each. Disco-vertebral puncture and biopsy (DVPB) was performed in 19 patients when there was no bacteria identification and/or when diagnosis of infectious SPD persisted doubtful. On histopathological examination, were described: an infiltrate and/or inflammatory changes without specificity signs in 7 patients and an appearance of chronic pyogenic SPD very likely in 12 patients. Bacteriological study of DVPB fluid or paravertebral abscesses sample helped to isolate bacteria in 4 patients. DVPB or abscesses puncture were contributing by histological and/or bacteriological examination in 12 patients (63%).Infecting bacteria was identified in 14 patients (64%). Gram-negative bacilli (GNB) and staphylococcus aureus were the most frequent germs (7 cases each) including 2 cases of co-infection. GNBs were represented by: Escherichia Coli and Enterobacter Cloacae in 2 cases each, Proteus Mirabilis, Serratia Marcescens and Klebsiella oxytoca in 1 case each. Clostridium clostridioforme and Lactococcus cremoris were isolated in 1 case each. For patients whose etiological investigation remained negative, SPD diagnosis was retained based on imaging (MRI) guided by anamnestic, clinico-biological and histopathological arguments.Conclusion:SPD is a rare condition that needs to be treated rapidly. Once the diagnosis is suspected, bacteria must be isolated before starting any antibiotic therapy. Simple and non-invasive exams as blood cultures, CBUE and chest rays, should be undertaken first. In fact, these simple exams allowed a germ identification in 73% cases in our study. If doubt persist, DVPB could be contributive to the diagnosis.References:NoneDisclosure of Interests:None declared
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Moalla M, Maalej M, Nada C, Sellami R, Ben Thabet J, Zouari L, Maalej M. Sleep disorders, depression and anxiety among medicine university students in Sfax. Eur Psychiatry 2020. [DOI: 10.1016/j.eurpsy.2016.01.704] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
IntroductionSleep symptoms, depression and anxiety often coexist and tertiary students are a population group that are increasingly recognised to be at risk. However the rates of these conditions in the tunisian population are poorly understood.AimThe aim of this study was to evaluate sleep quality among medicine students during exam periods and identify correlations with anxiety and depression.MethodsThis is a descriptive and analytical cross-sectional study. It involved students of medicine University of Sfax during the period of exams. Each student filled out demographic questionnaire, the Pittsburgh Sleep Quality Index (PSQI) to assess the quality of sleep and Hospital Anxiety and Depression scale (HAD) to screen for anxiety and depressive disorders.ResultsThe average age was 22.27 years. The sex ratio M/F was 0.66. The students were single in 96.7% of cases. The average score of PSQI was 6.67 ± 3.23. According to the PSQI, 53.3% of students had poor sleep quality. The anxiety score ranged from 0 to 7 with an average of 8.37. The depression score ranged from 0 to 16 with an average of 7.47. Anxiety and depressive symptoms were present in 26.7% of students. The PSQI score was significantly correlated with anxiety (p <0.01) and depression scores (P = 0.019).ConclusionAnxiety and depressive symptoms are common among students during exam periods. They are associated with poor quality sleep. The establishment of a helpline for students during exam time, with psychologists and psychiatrists, would help them better manage this difficult period.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Chtourou L, Moalla M, Torjmen F, Gdoura H, Boudabous M, Amouri A, Mnif L, Tahri N. Manifestations hépatobiliaires au cours des maladies inflammatoires chroniques de l’intestin. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.10.250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Bellabah A, Benkirane A, Ibrahimi A, Nakhli A, Sair A, Nakhli A, Essaid A, Blel A, Ibrahimi A, Lahchaichi A, Ben Slama A, Ouni A, Amouri A, Jemaa A, Cherif A, Khsiba A, Hssine A, Djobbi A, Guedich A, Laabidi A, Mensi A, Ouakaa A, Sriha A, Choukri A, Green A, Belkhamsa A, Hammami A, Bourigua A, Filali A, Belabeh A, Ouakaa A, Sentissi A, Ait Errami A, Nadi A, Filankembo A, Lamine A, Badre W, Ben Kaab B, Ben Slimane B, S B, Hasnaoui B, Bouchabou B, Bouguerra C, Baccouche C, Ayadi C, Bennasrallah C, Benajah D, Gargouri D, Zehi D, Issaoui D, Cherif D, Ben Ghachem D, Trad D, Bouaiti E, Boutouria E, Bel Hadj Mabrouk E, Chalbi E, Aait E, Bouhamou F, Haddad F, Lairani F, Saffar F, Torjmen F, Haj Kacem F, Hamdane F, Chabib FZ, Elrhaoussi FZ, Moumayez FZ, Loukil F, Ahmed Djouldé Diallo F, Aissaoui F, Ajana F, Chabib F, Hamdoun F, Moumayez F, Hamdane F, Haddad F, Bennani Kella G, Bennani G, Abid H, Cheikhani H, Ouazzani H, Romdhane H, Seddik H, Sghir H, Debbabi H, Ben Jeddi H, Garraoui H, Letaief H, Kchir H, Elloumi H, Hammami H, Jaziri H, Ben Abdallah H, Chaabouni H, Ben Romdhane H, Yacoub H, Ben Jeddi H, Elloumi H, Gdoura H, Kchir H, Sahli H, Loghmari H, Bouguerra H, Maghrebi H, Ben Nejma H, Jlassi H, Elloumi H, Fourati H, Alaoui H, Ismail H, Benelbarhdadi I, Cohen I, Errabih I, Koti I, Doghri I, Cohen I, Elhidaoui I, Haraki I, Cheikh I, Abdelaali I, Jemni I, Bouennene I, Akoch I, H I, Boubaker J, Krati K, Eljery K, Temani K, Bellil K, Chabbouh K, Boughoula K, Ouazzani L, Ben Yaghlene L, Kallel L, A L, Hamzaoui L, Chtourou L, Ben Farhat L, Bouabid L, Mnif L, Mouelhi L, Safer L, Zouiten Mekki L, Bourehma M, El Akbari M, El Khayari M, Elyousfi M, Firwana M, Lahlali M, Tahiri M, Mestouri M, Abdelwahed M, Ben Hamida M, Ben Chaabane M, Moalla M, Yakoubi M, Sabbah M, Serghini M, Amri M, Ben Abbes M, Ben Cheikh M, Ghribi M, Hafi M, El Khayari M, Ben Abdelwahed M, Ksiaa M, Essid M, Zakhama M, Yousfi M, Sabbah M, Ayari M, Belhadj M, Cheickh M, Kacem M, Horma Alaoui M, Abid M, Bennour MA, Ghanem M, Loghmari MH, Douggui MH, Azouz MM, Abdelli MN, Boudabous M, Feki M, Fekih M, Kacem M, Mahmoudi M, Boudabbous M, Figuigui M, Medhioub M, Safer M, Azzouz M, Yakoubi M, Abbes M, Amri M, El Abkari M, Aqodad N, Azib N, Bellil N, Benhoumane N, Benzoubbeir N, Elkhabiz N, Hemdani N, Lahmidani N, Abdelli N, Ben Chaabane N, Tahri N, Azib N, Benhoummane N, Ben Jaafar N, Ben Mustapha N, Maamouri N, Elkhabiz N, Bellil N, Hannachi N, Hemdani N, Ben Alaya N, Bibani N, Trad N, Elleuch N, Lahmidani N, Kharmach O, Bahri O, Bousnina O, Gharbi O, Kharmach O, Benjira R, Ennaifer R, Dabbèche R, Jouini R, Zgolli R, Baklouti R, Bouali Mohamed R, Marouani R, Kallel R, Ennaifer R, Berrag S, El Yazal S, Jiddi S, Mechhour S, Morabit S, Oubaha S, Sentissi S, Bouaziz S, Soua S, Hachicha S, Elaboudi S, Ajmi S, Mallat S, Bouchoucha S, Mrabti S, Ben Slama S, Hamdi S, Laabidi S, Ayadi S, Hidri S, Bizid S, Ben Hamida S, Zertiti S, Ben Amor S, Nsibi S, Bellakhal S, Bahja S, Jomni T, Hliwa W, Rebai W, Ben Mansour W, Ben Othmen W, Dhouib W, Hammoumi W, Zaatour W, Bouhlel W, Feki W, Triki W, Said Y, Zaimi Y, Gorgi Y, Bouhnoun Z, Samlani Z, Hamidi Z, Mnif Z, Ben Safta Z. Oral communication and poster abstracts of the 22nd National Congress of Gastroenterology joint to the 4th Maghrebian Congress of Gastroenterology. December 2018. Tunis Med 2018; 96:932-1007. [PMID: 31131873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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Boudabous M, Moalla M, Gdoura H, Chtourou L, Amouri A, Mnif L, Tahri N. La tuberculose péritonéale : un défit diagnostique toujours d’actualité. À propos d’une série récente. Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.10.143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Moalla M, Feki I, Sellami R, Ktata A, Feki S, Masmoudi J. Screening for depressive symptoms among adolescent consulting in emergency. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
IntroductionAmongst adolescents, depression is a common mental health problem. Adolescent depression is associated with distress, functional impairment and difficulties in relationships with peers and family members. Depressive symptoms, even if sub-threshold to meet diagnostic criteria for a depressive disorder, are also risk factors for these difficulties. Adolescents rarely consult for their psychological distress. Emergency departments, which are often used by adolescents in this context, constitute a privileged place to detect this suffering.ObjectivesThe objective of this study was to estimate the prevalence and correlates of psychological distress among adolescents seen in emergency department.MethodsOur study was a transversal type, descriptive and analytic. It was conducted with 106 adolescents consulting in emergency department. All adolescents completed a sociodemographic data and the Adolescent Depression Rating Scale (ADRS), a screening questionnaire for depression.ResultsThe study included 106 adolescents. All of them consult for a somatic complain and none of them goes to the emergency department for a psychiatric reason. The mean age was 16.34 ± 2.54 (12→19 years). Sex ratio (♂/♀) = 0.89. The ADRS score was considered normal (score < 4) for 54.7% of the sample (n = 58) and 45.3% of adolescents (n = 48) had depressive symptoms (score ≥ 4). Depression was significantly correlated to bad school results (P = 10−3), tobacco use (P = 0.014), personal psychiatric history (P = 10−3) and family problems (P = 10−3).ConclusionDepressive symptoms are frequent among adolescents. Their consultations within emergency department provide a potential opportunity for their identification and for signposting to appropriate specialist services.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Sellami R, Moalla M, Affes L, Feki I, Mnif F, Abid M, Masmoudi J. Body shape perception among obese Tunisian women. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.1864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
IntroductionIn today's societies, pressures from the idea of thinness are omnipresent and lead to a corporal dissatisfaction with an excessive preoccupation of the body's image. Obese persons are often targets of stigmatization and are vulnerable to negative feeling about their physical appearance.AimsTo evaluate the worries towards the weight and the shape of the body among obese women.MethodsOur study was a transversal study, descriptive and analytic. A total of 42 obese women were included. Obesity was defined by body mass index (BMI) ≥ 30 and divided into 3 classes: class I: moderate obesity (30 ≤ BMI ≤ 34.9); class II: severe obesity (35 ≤ BMI ≤ 39.9); class III: morbid obesity (BMI≥40). Patients were studied by mean of body shape questionnaire (BSQ-34) (Considering score BSQ < 80 lack of altered body image perception and score > 140 excessive preoccupation).ResultsThe mean age of participants was 33.6 years. The average BMI was 37.42 kg/m2 (30.45–56.26 kg/m2). Third (35%) of women had a high educational level, 41.4% were inactive, and 70.8% had an average socioeconomic level.The average BSQ score was 108.31 (47–188). The majority of women (78.1%) had excessive preoccupation about their body image. The BSQ score was correlated to morbid obesity (P = 0.014). Women aged between 20 and 3 years were significantly more preoccupied about their body image (P = 0.046).ConclusionMajority of obese women were preoccupied about their body image. Young women and those having morbid obesity seemed more preoccupied about their body image.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Sellami R, Moalla M, Affes L, Feki I, Mnif F, Abid M, Masmoudi J. Sexual dysfunction in obese women. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.1689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
IntroductionThe increasing prevalence of obesity represents a major public health problem, with can effect on physical and emotional well-being and psychosocial function. Somatic and psychological dysfunctions, such as infertility, osteoarthritis, social disabilities caused by stigmatization, sleeping problems or apnea, are also known to follow obesity. Sexual dysfunction (SD) may also be related to obesity, but is rarely mentioned, and may cause concern for the affected individual and partner, constituting a great problem.ObjectivesThe aim of this study was to identify the frequency of SD among obese women.MethodsOur study concerned 42 obese married women consulting in endocrinology department. Obesity was defined by body mass index (BMI) ≥30. All participants assessed a sociodemographic data and the “Female Sexual Function Index” (FSFI). FSFI is a 19-item multidimensional self-reporting measure that quantifies six domains of female sexual dysfunction (FSD), including desire, arousal, lubrication, orgasm, satisfaction, and pain. Score ≤26 indicate the presence of FSD.ResultsThe mean age was 33.6 years (20 → 47 years). The mean total score of FSFI was 22.5 (3.2 → 32.6). The percentage of SD among obese women was 68.2%. FSFI score was correlated to ancient obesity (P = 0.026; r = 0.347) and waist circumference (P = 0.007; r = 0.412). High socio-economic level was correlated to desire and satisfaction (P = 0.021 and P = 0.048 respectively). Women with high educational level have better blurbification (P = 0.005). FSFI score was not correlated to BMI or obesity class.ConclusionAlmost two-thirds of obese women have sexual dysfunctions. Women with ancient obesity and higher waist circumference seemed to have better sexual functions.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Moalla M, Feki I, Ktata A, Sellami R, Triqui D, Baati I, Abida I, Masmoudi J. Attachment representations in a population of elderly subjects. Eur Psychiatry 2016. [DOI: 10.1016/j.eurpsy.2016.01.421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
IntroductionAccording to attachment theory, attachment relationships have a lasting impact on the functioning of the individual. If this impact has been much studied in children, few studies have been conducted in the elderly.ObjectivesExplore the representations of attachment in a population of elderly subjects.MethodsThe sample consists of 90 consultants over the age of 65. Each participant filled out demographic questionnaire, Relationship Scale Questionnaire (RSQ): questionnaire of 13 items, each item rated from 1 to 5, a lower score attests a more secure attachment and Adult Attachment Questionnaire: a categorical scale of 3 statements. Statement 1 corresponds to secure attachment style, 2 to avoidant attachment style and 3 to anxious-ambivalent attachment style.ResultsThe age of participants ranged from 65 to 95 years with an average of 68.14. The sex ratio M:F was 0.8. The RSQ Score ranged from 16 to 56 with an average of 37.27. Of the participants, 72.2% have secure attachment style, 24.4% have an avoidant attachment style and 3.3% have an anxious-ambivalent attachment style. The study of correlations showed strong correlation between the two scales (P = 0.00) and the RSQ score was significantly associated with poor satisfaction of married life (P = 0.025), presence of psychological trauma in childhood (P = 0.016) and a separation experience (P = 0.029).ConclusionOur study highlights the importance of early childhood experiences that may impact late adult life. These finding are in accordance with attachment theory.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Moalla M, Feki I, Boudabbous J, Masmoudi J, Jaoua A. Impact of Pregnancy On Eating Behaviors. Eur Psychiatry 2015. [DOI: 10.1016/s0924-9338(15)31037-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Moalla M, Feki I, Baati I, Masmoui J, Jaoua A. Alcohol Abuse, Impulsivity and Suicide Attempts in Bipolar Disorders. Eur Psychiatry 2015. [DOI: 10.1016/s0924-9338(15)30348-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Moalla M, Baratin D, Giard M, Vanhems P. Incidence of Methicillin-Resistant Staphylococcus aureus Nosocomial Infections in Intensive Care Units in Lyon University Hospitals, France, 2003-2006. Infect Control Hosp Epidemiol 2015; 29:454-6. [DOI: 10.1086/533547] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
We describe the trends in the incidence of methicillin-resistant Staphylococcus aureus nosocomial infection in intensive care units in Lyon hospitals from January 1, 2003, through December 31, 2006. The incidence rate decreased from 1.77 cases per 100 ICU patients in 2003 to 1.16 cases per 100 ICU patients in 2006, a reduction of 38.0% (P = .05).
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Troudi M, Cherni L, Ben Ammar Gaaied A, Moalla M. Un estimateur de distributions ajusté pour une aide à la décision de la neutralité génétique des populations. Ing Rech Biomed 2012. [DOI: 10.1016/j.irbm.2011.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Meddeb N, Hamza S, Moalla M, Siala M, Sellami S. [Patelar metastasis of primary lung cancer]. Rev Pneumol Clin 2003; 59:176-178. [PMID: 13130206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Patellar metastasis is uncommon. The clinical presentation is often misleading, suggestive of septic arthritis or meniscal disorder after knee trauma. We report the case of a 71-year-old patient who developed knee pain aggravated by movement with pseudo-blockage which was found to be related to a secondary localization of a primary lung cancer. Low blood flow in the patella probably explains why patellar metastasis is so rare.
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Affiliation(s)
- N Meddeb
- Service de Rhumatologie, Hôpital La Rabta, Tunis 1006, Tunisie.
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Abstract
Osteoid osteoma of the acetabulum can be expected to cause nonspecific symptoms of hip inflammation. In a sixteen year old girl, investigation by routine radiographs and a bone scan suggested a focus of inflammation with a nidus and sclerosis of the acetabulum and overgrowth of the head and neck of the femur. Removal of the lesion by an anterior approach with dislocation of the hip gave excellent results when seen after three years with a normal gait and normal hip motion.
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Affiliation(s)
- S Karray
- National Orthopaedic Institute Mohamed Kassab, Tunis-Mannouba, Tunisia
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Boussen K, Mabrouk J, Ben Mami N, Moalla M, Ben Abdallah N, Ben Ammar H, Ben Maiz H. [Collagenous colitis with antinuclear antibodies and chronic neutropenia]. Presse Med 1992; 21:1039. [PMID: 1387220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
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