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Chakroun-Walha O, Karray R, Jerbi M, Affes H, Nasri A, Salem I, Issaoui F, Ben Dhaou M, Rekik N. Catheterized chicken for training on ultrasound-guided vascular access: A simple, cost-effective, and effective model. Afr J Emerg Med 2024; 14:91-95. [PMID: 38660415 PMCID: PMC11039968 DOI: 10.1016/j.afjem.2024.03.005] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 03/17/2024] [Accepted: 03/28/2024] [Indexed: 04/26/2024] Open
Abstract
Ultrasound-guided vascular access is a medical procedure that is becoming increasingly common in daily practice and is recommended to avoid iatrogenic complications. One of the procedures with a high-risk rate of complications is the vascular puncture. However, training on this technique can be challenging due to the limited availability of simulation models. We propose a simple, cost-effective, and effective ultrasound-guided vascular access simulation model that utilizes chicken breast and a urine catheter to address this need.
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Affiliation(s)
- Olfa Chakroun-Walha
- Emergency department, Habib Bourguiba university hospital, Sfax Medical School Simulation Center, Faculty of Medicine, Sfax university, Tunisia
| | - Rim Karray
- Emergency Department, Habib Bourguiba University Hospital, Faculty of Medicine, Sfax University, Tunisia
| | - Mouna Jerbi
- Emergency Department, Habib Bourguiba University Hospital, Faculty of Medicine, Sfax University, Tunisia
| | - Houcem Affes
- Emergency Department, Habib Bourguiba University Hospital, Faculty of Medicine, Sfax University, Tunisia
| | - Abdennour Nasri
- Emergency Department, Habib Bourguiba University Hospital, Faculty of Medicine, Sfax University, Tunisia
| | - Imen Salem
- Emergency Department, Habib Bourguiba University Hospital, Faculty of Medicine, Sfax University, Tunisia
| | - Fadhila Issaoui
- Emergency Department, Habib Bourguiba University Hospital, Faculty of Medicine, Sfax University, Tunisia
| | - Mahdi Ben Dhaou
- Sfax Medical School Simulation Center, Faculty of Medicine, Sfax University, Tunisia
| | - Noureddine Rekik
- Emergency Department, Habib Bourguiba University Hospital, Faculty of Medicine, Sfax University, Tunisia
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Nasri A, Jerbi M, Karray R, Snoussi H, Samet A, Talbi A, Ksentini H, Rejeb I, Chakroun-Walha O, Rekik N. Man-O-War simulator: a Low-cost manikin for training on chest tube management. Afr J Emerg Med 2023; 13:39-41. [PMID: 36864887 PMCID: PMC9970889 DOI: 10.1016/j.afjem.2023.01.004] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 01/14/2023] [Accepted: 01/15/2023] [Indexed: 02/19/2023] Open
Abstract
Simulation-based medical education is becoming a cornerstone in health education. Simulators are commonly expensive and not available in developing countries. We propose a very low-cost simulator that any educator can realize. We describe here the steps to follow to develop this proposed simulator.
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Affiliation(s)
- Abdennour Nasri
- Emergency department, Habib Bourguiba university hospital, Faculty of Medicine, Sfax university, Tunisia
| | - Mouna Jerbi
- Emergency department, Habib Bourguiba university hospital, Faculty of Medicine, Sfax university, Tunisia
| | - Rim Karray
- Emergency department, Habib Bourguiba university hospital, Faculty of Medicine, Sfax university, Tunisia
| | - Haifa Snoussi
- Emergency department, Habib Bourguiba university hospital, Faculty of Medicine, Sfax university, Tunisia
| | - Amal Samet
- Emergency department, Gabes university hospital, Faculty of Medicine; Sfax university, Tunisia
| | - Aziza Talbi
- Emergency department, Gabes university hospital, Faculty of Medicine; Sfax university, Tunisia
| | - Hana Ksentini
- Emergency department, Habib Bourguiba university hospital, Faculty of Medicine, Sfax university, Tunisia
| | - Imen Rejeb
- Gabes university hospital, Faculty of Medicine, Sfax university, Tunisia
| | - Olfa Chakroun-Walha
- Emergency department, Habib Bourguiba university hospital, Faculty of Medicine, Sfax university, Tunisia
- Corresponding author.
| | - Noureddine Rekik
- Emergency department, Habib Bourguiba university hospital, Faculty of Medicine, Sfax university, Tunisia
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Cheffi N, Chakroun-Walha O, Sellami R, Ouali R, Mnif D, Guermazi F, Issaoui F, Lajmi M, Benamar B, Damak J, Rekik N, Masmoudi J. Validation of the Hamilton Depression Rating Scale (HDRS) in the Tunisian dialect. Public Health 2021; 202:100-105. [PMID: 34936977 DOI: 10.1016/j.puhe.2021.11.003] [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: 02/11/2021] [Revised: 10/23/2021] [Accepted: 11/05/2021] [Indexed: 01/18/2023]
Abstract
OBJECTIVES The Hamilton Depression Rating Scale (HDRS) is one of the most frequently used depression assessment scales. In Tunisia, psychiatrists commonly use this scale in a Tunisian dialect. However, to the best of our knowledge, this scale has never been validated in Tunisia. This study aims to investigate the reliability and the validity of the HDRS among Tunisian patients who have been hospitalised for a suicide attempt. A secondary objective is to describe the sociodemographic characteristics of the study population. STUDY DESIGN This is a cross-sectional study performed in the emergency department. METHODS Patients who were hospitalised for a suicide attempt were eligible for inclusion in this study. The Tunisian version of the HDRS was developed using a forward-backward translation procedure. Psychometric properties of the Tunisian version of the HDRS were tested, including (i) construct validity with a confirmatory one-factor analysis; (ii) internal validity with Pearson correlations and Cronbach alpha coefficients; and (iii) external validity by correlations with the Patient Health Quality-9 (PHQ-9) scale. We used the Receiver-Operating Characteristic (ROC) curve to analyse the correlation between the total HDRS score and the presence of depression according to the PHQ-9. RESULTS In total, 101 participants were enrolled in this study. The principal component analysis (PCA) type factor analysis with varimax rotation found a high-grade correlation between HDRS individual items and the total score. The total variance, explained by five factors, was 64.4%. Cronbach's standardised alpha coefficient was 0.86 for the overall scale. Correlations between the total HDRS score and the PHQ-9 score, and its various items, were significant. The ROC curve analysis showed good sensitivity (80.8%) and specificity (91.1%). CONCLUSION The Tunisian version of the HDRS is an acceptable instrument to screen depression in individuals who have attempted suicide.
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Affiliation(s)
- N Cheffi
- Department of Psychiatry A, University Hospital Hédi Chaker Sfax, Tunisia
| | - O Chakroun-Walha
- Emergency Department, University Hospital Habib Bourguiba Sfax, Tunisia.
| | - R Sellami
- Department of Psychiatry A, University Hospital Hédi Chaker Sfax, Tunisia
| | - R Ouali
- Department of Psychiatry A, University Hospital Hédi Chaker Sfax, Tunisia
| | - D Mnif
- Department of Psychiatry A, University Hospital Hédi Chaker Sfax, Tunisia
| | - F Guermazi
- Department of Psychiatry A, University Hospital Hédi Chaker Sfax, Tunisia
| | - F Issaoui
- Emergency Department, University Hospital Habib Bourguiba Sfax, Tunisia
| | - M Lajmi
- Emergency Department, University Hospital Habib Bourguiba Sfax, Tunisia
| | - B Benamar
- Emergency Department, University Hospital Habib Bourguiba Sfax, Tunisia
| | - J Damak
- Department of Community Health and Epidemiology, University Hospital Hedi Chaker Sfax, Tunisia
| | - N Rekik
- Emergency Department, University Hospital Habib Bourguiba Sfax, Tunisia
| | - J Masmoudi
- Department of Psychiatry A, University Hospital Hédi Chaker Sfax, Tunisia
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Bahloul M, Kharrat S, Chtara K, Hafdhi M, Turki O, Baccouche N, Ammar R, Kallel N, Hsairi M, Chakroun-Walha O, Hamida CB, Chelly H, Mahfoudh KB, Karoui A, Karray H, Rekik N, Bouaziz M. Clinical characteristics and outcomes of critically ill COVID-19 patients in Sfax, Tunisia. Acute Crit Care 2021; 37:84-93. [PMID: 34380191 PMCID: PMC8918704 DOI: 10.4266/acc.2021.00129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 04/11/2021] [Indexed: 12/15/2022] Open
Abstract
Background Africa, like the rest of the world, has been impacted by the coronavirus disease 2019 (COVID-19) pandemic. However, only a few studies covering this subject in Africa have been published. Methods We conducted a retrospective study of critically ill adult COVID-19 patients—all of whom had a confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection—admitted to the intensive care unit (ICU) of Habib Bourguiba University Hospital (Sfax, Tunisia). Results A total of 96 patients were admitted into our ICU for respiratory distress due to COVID-19 infection. Mean age was 62.4±12.8 years and median age was 64 years. Mean arterial oxygen tension (PaO2)/fractional inspired oxygen (FiO2) ratio was 105±60 and ≤300 in all cases but one. Oxygen support was required for all patients (100%) and invasive mechanical ventilation for 38 (40%). Prone positioning was applied in 67 patients (70%). Within the study period, 47 of the 96 patients died (49%). Multivariate analysis showed that the factors associated with poor outcome were the development of acute renal failure (odds ratio [OR], 6.7; 95% confidence interval [CI], 1.75–25.9), the use of mechanical ventilation (OR, 5.8; 95% CI, 1.54–22.0), and serum cholinesterase (SChE) activity lower than 5,000 UI/L (OR, 5.0; 95% CI, 1.34–19). Conclusions In this retrospective cohort study of critically ill patients admitted to the ICU in Sfax, Tunisia, for acute respiratory failure following COVID-19 infection, the mortality rate was high. The development of acute renal failure, the use of mechanical ventilation, and SChE activity lower than 5,000 UI/L were associated with a poor outcome.
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Affiliation(s)
- Mabrouk Bahloul
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Sana Kharrat
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Kamilia Chtara
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Malek Hafdhi
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Olfa Turki
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Najeh Baccouche
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Rania Ammar
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Nozha Kallel
- Department of Radiology, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Majdi Hsairi
- Department of Anesthesiology, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Olfa Chakroun-Walha
- Department of Emergency Medicine, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Chokri Ben Hamida
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Hedi Chelly
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | | | - Abelhamid Karoui
- Department of Anesthesiology, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Hela Karray
- Department of Microbiology, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Noureddine Rekik
- Department of Emergency Medicine, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Mounir Bouaziz
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
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Chakroun-Walha O, Samet A, Ben Abdallah M, Benmansour S, Issaoui F, Rebai M, Ben Messaoud K, Benali C, Mokni W, Nasri A, Rejeb I, Rekik N. Stroke knowledge among emergency centre visitors: A cross-sectional multicenter survey. Afr J Emerg Med 2021; 11:10-14. [PMID: 33318912 PMCID: PMC7724164 DOI: 10.1016/j.afjem.2020.10.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 10/14/2020] [Accepted: 10/26/2020] [Indexed: 01/18/2023] Open
Abstract
INTRODUCTION Stroke is a public health problem worldwide. Community stroke knowledge is crucial to guide the prevention approach. We aimed to evaluate the level of stroke knowledge among the visitors to Emergency Centres (ECs) in the southern region of Tunisia concerning factors of risk, symptoms, and treatment of stroke. METHODS A multicenter cross-sectional survey about stroke knowledge; conducted in five ECs for 10 days. All the visitors to these ECs were invited to participate in this survey. In each center, one investigator had to conduct the questionnaire. We used the stroke knowledge test (SKT). RESULTS We enrolled 839 participants aged at 44 ± 7 years and with an M/F sex-ratio at 0.9. Relatives and mass media were the most reported sources of information about stroke. In 32.3% of cases, the participants had a university schooling level. The upper quartile had an SKT score of 55% or over (n = 247; 29.4%). The SKT score was significantly higher in young, female participants, in rural centers, with a university level of schooling and with no reported chronic diseases. Receiving information about stroke through the medium of television or via relatives was an independent predictor of a high SKT score compared with other knowledge sources. CONCLUSION This study emphasises the urgent need for improving the population's knowledge about stroke in Tunisia. These findings may reflect the lack of government policies for education and training on stroke. A national educating program is necessary to implement to increase stroke knowledge.
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Chakroun-Walha O, Issaoui F, Nasri A, Bradai H, Farroukh A, Karray R, Jerbi M, Rekik N. Early severity predictors of snakebite envenomation in the southern region of Tunisia: a multivariate analysis. J Acute Dis 2021. [DOI: 10.4103/2221-6189.312155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
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Chakroun-Walha O, Walha A, Bradai H, Nasri A, Karray R, Jerbi M, Trabelsi R, Rekik N. Frailty screening of Tunisian older adults: feasibility and usefulness in the Emergency Department. Afr J Emerg Med 2020; 10:229-233. [PMID: 33299754 PMCID: PMC7700987 DOI: 10.1016/j.afjem.2020.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 07/03/2020] [Accepted: 07/29/2020] [Indexed: 11/28/2022] Open
Abstract
Introduction Frail older adults are at an increased risk for adverse outcomes after an Emergency Department (ED) visit. Several tools exist for the screening of frailty among these patients. However, no tool has been validated in Tunisia. This study aims to evaluate the usefulness of frailty screening in predicting the outcome of older adults presenting to the ED. Methods This is a prospective, monocentric study. We evaluated the eligible patients at the ED and after their discharge. Follow-up phone calls were scheduled at 1, 2, 3, and 6 months after the ED visit. All patients aged 65 years or older; and visiting the ED during the inclusion period were involved. We used the ADL index and ISAR scale for assessing frailty. Results We enrolled 184 patients; they were living alone in 25% of cases. Half of them had medical care insurance. The ADL index was maximum (6 = total dependency) in 20% of cases. The ISAR score was above 1 point in 38%. Unplanned hospitalizations have accounted for 34%. In univariate analysis, the ADL index and ISAR score were statistically higher in the group of “unplanned hospitalization”. In multivariate analysis, the ISAR score and ADL index have not been associated with unplanned hospitalization. Conclusion Our results did not demonstrate the relevance of the ISAR or ADL scales in predicting the mortality or the need for unplanned hospitalization in multivariate analysis. This study did indicate an increased mortality in the “frail” patients in the univariate analysis. Further studies with larger samples and different tools are necessary.
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Chakroun-Walha O, Jmal M, Dammak M, Rekik N. Successful treatment of hepatic hydrothorax: A case report. J Acute Dis 2020. [DOI: 10.4103/2221-6189.283891] [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: 11/04/2022] Open
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Chakroun-Walha O, Weli M, Jerbi M, Maalej B, Gargouri L, Rekik N, Mahfoudh A. An unusual case of pediatric acute nicotine poisoning due to a dermal exposure. J Acute Dis 2019. [DOI: 10.4103/2221-6189.250378] [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: 11/04/2022] Open
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10
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Chakroun-Walha O, Samet A, Jerbi M, Nasri A, Talbi A, Kanoun H, Souissi B, Chtara K, Bouaziz M, Ksibi H, Rekik N. Benefits of the tranexamic acid in head trauma with no extracranial bleeding: a prospective follow-up of 180 patients. Eur J Trauma Emerg Surg 2018; 45:719-726. [PMID: 29922895 DOI: 10.1007/s00068-018-0974-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [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: 03/15/2018] [Accepted: 06/12/2018] [Indexed: 01/29/2023]
Abstract
INTRODUCTION Tranexamic acid (TXA) is one of the debated therapies in the management of traumatic brain injury (TBI). We conducted this study to evaluate the benefits of TXA in TBI on the mortality and its safety in these patients. METHODS This was a prospective randomized open-label trial including all patients, aged at 18 years or older, hospitalized in the emergency room during a 13-month period, for TBI. After the realization of the body CT scan, the patients were included if they had intracranial bleeding, and were then randomized according to their medical file number to receive or not the TXA. The eligibility criteria were based on the uncertainty principle, patients with significant extracranial bleeding were excluded since there was evidence that TXA improve their outcome. RESULTS We enrolled 180 patients aged at 42 ± 20 years, with an 88% men-proportion. Subarachnoid haemorrhage was the most frequent lesion in the brain CT-scan (67.5%). After randomization, 96 patients were in the TXA group (53%). Demographic data, clinical, biological and radiological features were statistically comparable in the two groups of patients ('TXA' and 'noTXA'). The needs of transfusion or neurosurgery, the mortality rate, the in-hospital length of stay and the dependency at 28-post-traumatic day were similar in the two groups of patients. However, pulmonary embolism was statistically more frequent in 'TXA' group (11.5 versus 2.4%, p = 0.02). CONCLUSION TXA is an interesting treatment in haemorrhagic shock. Its efficiency in head trauma is still debated and controversial. Its impact on the mortality and the needs of transfusion or surgery were not demonstrated in this study. Nevertheless, its safety worth to be studied in larger samples as we found a higher rate of pulmonary embolism in the treated group.
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Affiliation(s)
- Olfa Chakroun-Walha
- Emergency Department, University Hospital Habib Bourguiba, Service des urgences et SAMU04 SFAX, Route EL Aïn Km 0,5, 3029, Sfax, Tunisia.
| | - Amal Samet
- Emergency Department, University Hospital Habib Bourguiba, Service des urgences et SAMU04 SFAX, Route EL Aïn Km 0,5, 3029, Sfax, Tunisia
| | - Mouna Jerbi
- Emergency Department, University Hospital Habib Bourguiba, Service des urgences et SAMU04 SFAX, Route EL Aïn Km 0,5, 3029, Sfax, Tunisia
| | - Abdennour Nasri
- Emergency Department, University Hospital Habib Bourguiba, Service des urgences et SAMU04 SFAX, Route EL Aïn Km 0,5, 3029, Sfax, Tunisia
| | - Aziza Talbi
- Emergency Department, University Hospital Habib Bourguiba, Service des urgences et SAMU04 SFAX, Route EL Aïn Km 0,5, 3029, Sfax, Tunisia
| | - Hassen Kanoun
- Emergency Department, University Hospital Habib Bourguiba, Service des urgences et SAMU04 SFAX, Route EL Aïn Km 0,5, 3029, Sfax, Tunisia
| | - Basma Souissi
- Radiology Department, University Hospital Habib Bourguiba, Sfax, Tunisia
| | - Kamilia Chtara
- Intensive Care Unit, University Hospital Habib Bourguiba, Sfax, Tunisia
| | - Mounir Bouaziz
- Intensive Care Unit, University Hospital Habib Bourguiba, Sfax, Tunisia
| | - Hichem Ksibi
- Emergency Department, University Hospital Habib Bourguiba, Service des urgences et SAMU04 SFAX, Route EL Aïn Km 0,5, 3029, Sfax, Tunisia
| | - Noureddine Rekik
- Emergency Department, University Hospital Habib Bourguiba, Service des urgences et SAMU04 SFAX, Route EL Aïn Km 0,5, 3029, Sfax, Tunisia
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Chakroun-Walha O, Karray R, Jerbi M, Nasri A, Issaoui F, Amine BR, Bahloul M, Bouaziz M, Ksibi H, Rekik N. Update on the Epidemiology of Scorpion Envenomation in the South of Tunisia. Wilderness Environ Med 2018; 29:29-35. [DOI: 10.1016/j.wem.2017.09.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 09/20/2017] [Accepted: 09/22/2017] [Indexed: 01/18/2023]
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Chakroun-Walha O, Karray R, Jerbi M, Ben Rebeh A, Jammeli C, Bahloul M, Ammar R, Chabchoub I, Bouaziz M, Nasri A, Rekik N. Value of troponin levels in the diagnosis of cardiac dysfunction in moderate scorpion envenomation. Hum Exp Toxicol 2017; 37:580-586. [DOI: 10.1177/0960327117722822] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Context: Cardiac dysfunction is one of the most serious consequences of scorpion envenomation. The best tool to evaluate cardiac function is echocardiography, but it is not available at all emergency departments. Many studies aimed to describe biological predictive factors of cardiac dysfunction in scorpion envenomation. Troponin is one of these biomarkers but its correlation with myocarditis is not well established. The aim of this study was to evaluate correlation between troponin levels and cardiac dysfunction in moderate scorpion envenomation. Methods: A retrospective monocentric study including patients admitted in the emergency department for moderate scorpion envenomation with troponin measurement during their early management. On arrival, an electrocardiogram and a chest X-ray were realized for all patients. Results: We enrolled 132 patients with a mean age at 31.3 ± 24.4 years and a 1.35 sex-ratio. All patients had moderate systemic manifestations. There were 28 patients with clinical manifestations of cardiac dysfunction without life-threatening troubles (21.2%). Troponin was undetectable in 69 patients (56%). The mean value of troponin level (pg/ml) was higher in patients with clinical manifestations of left ventricular dysfunction (1.80 ± 3.8 vs. 0.11 ± 0.5; p = 0.02). Troponin levels were significantly higher in patients with positive T wave on electrocardiogram. Conclusion: In patients with moderate scorpion envenomation with positive T wave, high values of troponin suggest the presence of cardiac dysfunction.
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Affiliation(s)
- O Chakroun-Walha
- Emergency Department, University Hospital Habib Bourguiba Sfax, Sfax, Tunisia
| | - R Karray
- Emergency Department, University Hospital Habib Bourguiba Sfax, Sfax, Tunisia
| | - M Jerbi
- Emergency Department, University Hospital Habib Bourguiba Sfax, Sfax, Tunisia
| | - A Ben Rebeh
- Emergency Department, University Hospital Habib Bourguiba Sfax, Sfax, Tunisia
| | - C Jammeli
- Emergency Department, University Hospital Habib Bourguiba Sfax, Sfax, Tunisia
| | - M Bahloul
- Intensive Care Unit, University Hospital Habib Bourguiba Sfax, Sfax, Tunisia
| | - R Ammar
- Intensive Care Unit, University Hospital Habib Bourguiba Sfax, Sfax, Tunisia
| | - I Chabchoub
- Paediatric Department, University Hospital Hedi Chaker Sfax, Sfax, Tunisia
| | - M Bouaziz
- Intensive Care Unit, University Hospital Habib Bourguiba Sfax, Sfax, Tunisia
| | - A Nasri
- Emergency Department, University Hospital Habib Bourguiba Sfax, Sfax, Tunisia
| | - N Rekik
- Emergency Department, University Hospital Habib Bourguiba Sfax, Sfax, Tunisia
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Karray R, Chakroun-Walha O, Souissi B, Rekik N. Conservative management for acute renal rupture in blunt trauma. J Acute Dis 2017. [DOI: 10.4103/2221-6189.219623] [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: 11/04/2022] Open
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Chakroun-Walha O, Rejeb I, Boujelben M, Chaari A, Ksibi H, Kammoun L, Chaari A, Bouaziz M, Rekik N. Epidemiological features of stress hyperglycemia in elderly at emergency department. Tunis Med 2016; 94:140-144. [PMID: 27532531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
UNLABELLED Background : Stress hyperglycemia among patients having an acute pathology is frequently described in recent studies. AIMS The objectives of this work were to describe epidemiologic features of elderly patients hospitalized in the emergency department and having a hyperglycemia due to stress. METHODS A retrospective chart review identified patients older than 65 years with obtained serum glucose levels. Patients with diabetes were excluded. Two levels of serum glucose were considered (>6,9 mmol/l and ≤ 6,9 mmol/l). RESULTS We included 165. There were 94 patients with high level of serum glucose level (56,9%). Multivariate analysis found that only cardio-vascular pathologies were more predictive of having stress hyperglycemia (p=0,014, odds-ratio=2,8, IC=1,2-6,4). There were no correlation between serum glucose levels and mortality. CONCLUSION Stress hyperglycemia is a fairly common disorder but underestimated in emergency department. Its impact on the prognosis of elderly patients remains to be studied.
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