La Tunisie Medicale[JOURNAL]
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200 papers
Intra-articular infiltration of bupivacaine in arthroscopic knee surgery: Dexamethasone versus magnesium sulfate as adjuncts.
Arfaoui H, Haddad F, Mensi M … +3 more , Bel Haj Youssef A, Kammoun E, Mebazaa MS
Tunis Med · 2025 Aug · PMID 41832647 · Publisher ↗
INTRODUCTION: Knee arthroscopy is a common procedure in orthopedics due to its minimally invasive nature. However, it often leads to moderate to severe postoperative pain, especially within the first 24 hours. Several st...
INTRODUCTION: Knee arthroscopy is a common procedure in orthopedics due to its minimally invasive nature. However, it often leads to moderate to severe postoperative pain, especially within the first 24 hours. Several studies demonstrated the efficiency of intra-articular infiltration of analgesics but the optimal infiltration mixture remains a topic of debate. AIM: The aim of our study was to assess the analgesic role of Dexamethasone or Magnesium Sulfate as adjuncts to intra-articular Bupivacaine after knee arthroscopic surgery. METHODS: It was a prospective randomized double-blinded study including 75 adult patients classified according to the American Society of Anesthesiology (ASA) I-II and undergoing arthroscopic knee surgery under spinal analgesia. They were divided into three groups of 25 each. All patients received intra articular infiltration at the end of surgery: group B received 10 ml of saline solution with 10 ml of bupivacaine 0.5%, group D received 4 mg of dexamethasone in combination with bupivacaine and group Mg received 1.5 g of magnesium sulfate in combination with bupivacaine. Postoperative rescue analgesia was insured by a patient-controlled analgesia (PCA) morphine. The primary outcome was morphine consumption during the first 24 hours after surgery. RESULTS: The cumulative morphine dose was higher in group B compared to group D and Mg (p=0.001 and p<0.001, respectively). Group D and group Mg showed comparable cumulative morphine doses (p=0.52). At 24 hours postoperatively, static visual analog scale (VAS) scores were higher in the control group compared to group Mg and group D (p=0.004 and p=0.019, respectively). CONCLUSION: The addition of dexamethasone and magnesium sulfate to bupivacaine in intra-articular infiltration improves the quality of postoperative analgesia.
Evaluation of epidemiological, clinical and paraclinical data of Rheumatoid arthritis in Guinea: Registry year 2018 - 2022.
Condé K, Adjakou F, Barry A … +4 more , Bah A, Touré M, Kamissoko AB, Cissé FA
Tunis Med · 2025 Aug · PMID 41832646 · Publisher ↗
INTRODUCTION: Rheumatoid arthritis (RA) is a chronic, destructive inflammatory rheumatic disease reported in populations of African origin. The aim of this study was to evaluate the epidemiological, clinical and paraclin...
INTRODUCTION: Rheumatoid arthritis (RA) is a chronic, destructive inflammatory rheumatic disease reported in populations of African origin. The aim of this study was to evaluate the epidemiological, clinical and paraclinical data of RA in Guinea with a registry from 2018 - 2022. METHOD: This was a longitudinal, retrospective study conducted in the rheumatology department of CHU Ignace Deen between January 2018 and December 2022. The diagnosis of RA was based on the ACR and EULAR 2010 criteria. RESULTS: During the study period we collected 528 cases of RA out of 4213 observations (12.5%). There were 433 (82%) women with an average age of 47.3 years. The average number of painful joints was 8, ranging from 4 to 28, and the average number of swollen joints was 2 (ranging from 2 to 20). Rheumatoid factors were positive in 396 (75%) of cases, while anti-CCP antibodies were positive in 380 (72%) of patients. With DAS28, remission was noted in 53 (10%) of our patients, activity was low in 137 (26%) of cases, moderate in 259 (49%) and high in 79 (15%). Quality of life was assessed by the HAQ score, the mean value of which was 48 out of 60 (range 0 to 60). CONCLUSION: Rheumatoid arthritis is the most common form of arthritis in Guinea. It mainly affects housewives, with significant functional repercussions.
Lacrimal tract trauma: Epidemiological aspects and prognostic factors in a population of southern Tunisia.
Feki O, Rekik M, Kammoun S … +3 more , Sehli M, Kaibi I, Trigui A
Tunis Med · 2025 Aug · PMID 41832645 · Publisher ↗
Introduction . The epidemiology and management of lacrimal tract trauma (LTT) vary depending on the populations, the skills, and resources of the healthcare team. Aim . To examine the epidemiological and therapeutic aspe...
Introduction . The epidemiology and management of lacrimal tract trauma (LTT) vary depending on the populations, the skills, and resources of the healthcare team. Aim . To examine the epidemiological and therapeutic aspects of LTT and their prognostic factors in southern Tunisia. Methods . The study included 35 patients with LTT treated in the ophthalmology department of the Habib Bourguiba Hospital in Sfax. The postoperative result was evaluated functionally, anatomically, and aesthetically, and classified as good, average, or poor. Results . Patients were aged 28±18 years, with a sex ratio of 3.4. Domestic and road accidents and fights represented 93% of the causes of LTT. The lesions affected more frequently both the left side (71%) and the inferior canaliculus (74%). Most patients (91%) were operated on within the first 48 hours. The internal fragment was identified by the Bowman probe (in 83% of cases) and sutured in all patients with true monocanalicular intubation by mini-Monoka probe in 94% of cases. The post-operative result was good in 83% of patients. Younger age, loss of eyelid substance, delay in surgical intervention, and lacrimal suture without intubation were associated with unsatisfactory postoperative results. Conclusions . LTT affects mostly young male adults. Age under 20 years, post-traumatic operative delay above 48 hours, loss of eyelid substance, as well as suture of the wound without intubation are the main risk factors for a poor postoperative result. Good awareness and respect for the means of protection would make it possible to reduce LTT and their harmful impact.
Drug-Induced acute Pancreatitis: A Real-World Pharmacovigilance Study Using the Tunisian Databases.
Ben Hassine H, Boughanmi F, Lefi A … +3 more , Touati M, Korbi I, Noomen F
Tunis Med · 2025 Aug · PMID 41832644 · Publisher ↗
BACKGROUND: Acute pancreatitis (AP) is acute inflammatory process of the pancreas, commonly attributed to biliary or alcoholic causes. Drug-induced AP, although rare, is increasingly recognized as a potential etiology. H...
BACKGROUND: Acute pancreatitis (AP) is acute inflammatory process of the pancreas, commonly attributed to biliary or alcoholic causes. Drug-induced AP, although rare, is increasingly recognized as a potential etiology. However, there is limited literature on this topic. AIM: This study aims to review the epidemiological, clinical, radiological, and management characteristics of drug-induced AP based on data from Tunisian databases. METHODS: A retrospective study was conducted at the Department of Digestive and Visceral Surgery, spanning five years. Thirteen cases of drug-induced AP out of 1580 admitted patients with AP were analyzed. Data collection included clinical characteristics, diagnosis methods, therapeutic approaches, and outcomes. RESULTS: We report a series of 13 cases of drug-induced acute pancreatitis (AP). Due to the rarity of this event, our small sample size limits the statistical power of our findings. However, each case provides valuable insight into potential drug associations with AP. The mean age of affected patients was 55.62 years, with a male predominance (77%). Common symptoms included sudden onset epigastric abdominal pain (100% of cases) and elevated lipase levels (92.3%). Implicated medications included captopril (38.5%), atorvastatin (23.1%), azathioprine (23.1%), metformin, and olanzapine (7.7% each). Management involved pain management and proton pump inhibitors, with favorable outcomes in 84% of cases. CONCLUSION: Drug-induced pancreatitis is a recognized entity requiring multidisciplinary management. Early recognition and reporting of suspected cases are essential for improved pharmacovigilance.
50-Year Bibliometrics of International Scientific Biomedical Publications on "Parasitic Diseases": MEDLINE (1970-2019).
Babba O, Ben Abdelaziz A, Zanina Y … +4 more , Ghribi A, Gazzeh H, Khelil M, Ben Abdelaziz A
Tunis Med · 2025 Aug · PMID 41832643 · Publisher ↗
INTRODUCTION: The objective of this bibliometric study, spanning half a century of international biomedical research (1970-2019), on "parasitic diseases", was to describe the editorial profile; methodological and themati...
INTRODUCTION: The objective of this bibliometric study, spanning half a century of international biomedical research (1970-2019), on "parasitic diseases", was to describe the editorial profile; methodological and thematic of these scientific publications. METHODS: The data were collected from the MEDLINE database, through a documentary query based on the descriptor "Parasitic Diseases", and analyzed according to their main editorial characteristics (types of publication, scientific journals, etc.), methodological (country, parasitic diseases, etc.) and themes (key words), deduced particularly from the fields of its Medical Subjects Heading (MeSH), following a stratification into two periods: A (1970-1994) and B (1995-2019). "Highly Cited" papers were identified through Web of Science. RESULTS: A total of 337157 publications were identified (A: 110,062; B: 227095) and indexed by 20881 MeSH descriptors (A: 11 817; B: 19640). Published in 6470 scientific journals, these publications particularly covered the specialties of "Infectious Diseases" (37%), "Gastrology/Hepatology" (22%) and "Pediatrics" (20%). Conducted particularly in Brazil (2.6%), these studies were often "retrospective" (2.8%). The descriptor "Intestinal Diseases Parasitic" was the most explored thematic category (2.8%). In addition to "Malaria" (11.3%), the most studied diseases were "Echinococcosis" (2.9%), "Visceral Leishmaniasis" (2.7%) and "Toxoplasmosis" (2.5%). Bibliometric trends were characterized by an increase in "Reviews" (12.4% versus 7.5%), a switch from an "immunology" approach (24261 publications) to another "epidemiology" (70012 articles) and more focus on "Malaria Falciparum". Only 329 articles were qualified as "Highly Cited" (1‰). CONCLUSION: The bibliometric profile of international publications on "Parasitic Diseases", over the last half century, has been characterized by an explosion of synthetic studies, covering a broad spectrum of scientific journals, focused on low- or middle-income countries and centred on malaria.
Analysis of reliability between pharmacists when using the pediatric prescription optimization tool (GOPP Tool) in Ivorian hospital context.
Elisée D, Abrogoua DP
Tunis Med · 2025 Aug · PMID 41832642 · Publisher ↗
INTRODUCTION: Inappropriate prescriptions (IP) and omission of prescriptions (OP) are sources of adverse events in pediatrics. The pediatric prescription optimization grid (GOPP tool) was developed in the Ivorian pediatr...
INTRODUCTION: Inappropriate prescriptions (IP) and omission of prescriptions (OP) are sources of adverse events in pediatrics. The pediatric prescription optimization grid (GOPP tool) was developed in the Ivorian pediatric environment for the detection and management of IP and OP. Our aim was to analyze the reliability between pharmacists, when using the GOPP tool for the detection of IP and OP in the Ivorian hospital context. METHODS: A cross-sectional study with a descriptive aim was carried out. The treatments of 881 patients were analyzed using the GOPP tool by clinical pharmacists (reference group) for the detection of IP and OP. Thirty (30) cases with at least 1 IP or OP were selected. These cases were also examined independently using GOPP tool by ten (10) pharmacists and interns (evaluator group) having no prior experience with this tool. Inter-user reliability for PI and OP detection using the GOPP tool was determined using the kappa (κ) test of agreement. RESULT: The selected cases concerned patients with a median age of 25.5 months. The numbers of PI lines and OP detected by pharmacists in the "reference" group were 50 and 6, respectively. The median levels of agreement for PI and OP detection were judged as very good (Kappa=0.92) and good (Kappa=0.77), respectively. CONCLUSION: The GOPP tool is a reliable tool for the detection of PI and OP by pharmacists working in the Ivorian hospital context. Its use is relevant in routine for the pharmaceutical analysis of prescriptions in pediatric departments in Côte d'Ivoire.
Tuberculosis Meningo-encephalitis in Casablanca, Morocco.
Majambere JC, Aznag FZ, Marih L … +3 more , El Filali Marhoum K, Bousfiha AA, Oulad Lahsen A
Tunis Med · 2025 Aug · PMID 41832641 · Publisher ↗
INTRODUCTION: Neuromeningeal tuberculosis remains the most serious form of Mycobacterium tuberculosis infection. The wide clinical polymorphism and lack of specificity of radiological signs make diagnosis difficult and l...
INTRODUCTION: Neuromeningeal tuberculosis remains the most serious form of Mycobacterium tuberculosis infection. The wide clinical polymorphism and lack of specificity of radiological signs make diagnosis difficult and lead to delays in management. AIM: To describe the epidemiological profile of confirmed Tuberculous Meningo-encephalitis. METHODS: This is a monocentric, retrospective, descriptive and analytical study of patients followed for confirmed tuberculous Meningo-encephalitis in Infectious diseases department at the Ibn Rochd University Hospital in Casablanca between January 2015 and December 2018. Analytical and multivariate logistic regression analyses were performed to identify predictors of mortality and neurological sequelae. RESULTS: 90 patients were included, 58% were male with an average age of 38 years. The main risk factors were low socioeconomic status (90%) and recent tuberculosis contact was observed in 13.3%. Onset of symptoms was progressive (92.2%) with average evolution of 25.4 days. Predominant clinical signs were fever (97.4%), headache (70%) and stiff neck (58%). Clinical forms were Meningo-encephalitis (59.9%) and meningitis (36.8%). Predominant Brain radiological sign was leptomeningeal contrast (35%). Cerebrospinal fluid (CSF) abnormalities: White cells mean: 128 white cells/mm3 with lymphocytic predominance (79.1%); Proteinorachia mean: 1.27g/l, Glycorrachia mean: 0.32g/l (88%). Culture on Lowenstein positive in 85% and RT- Polymerase Chain Reaction (PCR) performed in 17.7% and positive in 87.5%. All patients had received standard antituberculosis drugs combining Isoniazid, Rifampicin, Pyrazinamide and Ethambutol. Evolution was favorable with symptom resolution patient rate of 62.5%, 10% mortality, 7.8% neurological sequelae. In multivariate analysis, delayed diagnosis, hydrocephalus and Meningo-encephalitis form were independently associated with mortality or neurological sequelae. CONCLUSION: Neuromeningeal tuberculosis in the form of tuberculous meningoencephalitis presents a clinical, biological and radiological polymorphism. Its prognosis depends on the earliness of the diagnosis and treatment.
The impact of socio-economic and demographic factors on non-communicable diseases in Morocco.
Lahmam H, Auajjar N, El Berri H … +9 more , Saeid N, Mekkaoui B, Benjeddou K, El Kari K, Mehdad S, Mounach S, Belakhel L, Attarassi B, Aguenaou H
Tunis Med · 2025 Aug · PMID 41832640 · Publisher ↗
INTRODUCTION: By 2030, non-communicable diseases (NCDs) are expected to overtake all other causes of death in Africa. The prevalence of NCDs and related risk factors are influenced by gender and socioeconomic disparities...
INTRODUCTION: By 2030, non-communicable diseases (NCDs) are expected to overtake all other causes of death in Africa. The prevalence of NCDs and related risk factors are influenced by gender and socioeconomic disparities. AIM: Thus, this study aimed to determine the impact of socio-economic and demographic factors on non-communicable diseases in Morocco. METHODS: Cross-sectional data were analysed from 4766 adults who participated in the 2017 STEPS survey in Morocco. Data collection included assessment of behavioural and biochemical risk factors. The Kolmogorov-Smirnov, Chi-square and the Kruskal-Wallis tests were performed. RESULTS: There was a significant difference between genders in NCDs. Men had higher rates of tobacco and alcohol use (21.2%, 13.9%, respectively, with a p <0.001)), while women had higher obesity prevalence (31.2% (p <0.001)). Individuals with no formal education showed the highest prevalence of hypertension (38.9%), diabetes (10.1%), and obesity (27.9%) compared to those having primary education or more. Adults aged 70 years or older showed higher prevalence of hypertension and diabetes than the other age groups. CONCLUSION: Morocco has a high prevalence of NCDs. The incidence of NCDs is significantly associated with sociodemographic and behavioral factors. A multisectoral and integrated strategy, focusing on sociodemographic and behavioral factors is necessary to prevent and control NCDs.
Application of the Health Belief Model (HBM) in Understanding the Relationship Between Anemia and Academic Performance Among Junior High School Students in Lhokseumawe City, Indonesia.
Akbar TIS, Sayuti M, Wahyuni H … +6 more , Siregar SR, Jannah CM, Maulana R, Ritchie NK, Sahira N, Farasha D
Tunis Med · 2025 Aug · PMID 41832639 · Publisher ↗
UNLABELLED: Indonesia ministry of health data shows that 21.7% of the population has anemia, with a prevalence of 26.4% in the 5-14-year age group and 18.4% in the 15-24-year age group (Hb <12.0 g/dL). The Health Belief...
UNLABELLED: Indonesia ministry of health data shows that 21.7% of the population has anemia, with a prevalence of 26.4% in the 5-14-year age group and 18.4% in the 15-24-year age group (Hb <12.0 g/dL). The Health Belief Model (HBM) is used to identify lifestyle patterns of anemic students and their risks to academic achievement. AIMS: This study examines the relationship between hemoglobin levels and academic achievement and assesses the relationship between the HBM construct and anemia. METHODOLOGY: This study is a cross-sectional study with a sample of 80 grade VIII students at SMP Negeri 1 Lhokseumawe. This study examines the relationship between hemoglobin levels and academic achievement and assesses the relationship between the HBM construct and anemia. RESULTS: Chi-square test showed a significant relationship (p<0.05) between anemia and academic achievement, where students with normal hemoglobin levels had better achievements than those with anemia. CONCLUSIONS: These findings confirm the impact of anemia on academic achievement, highlighting the importance of iron for brain function, concentration, and intelligence. The limited correlation of most HBM constructs with anemia suggests low student awareness, thus educational interventions are needed to improve preventive behavior.
The association of Maternal obesity with cesarean section and macrosomia outcomes among Moroccan women from the province of kenitra, Morocco.
Derdak M, Chakit M, El Ouardi M … +3 more , Belkhaoud M, Quyou A, Ouahidi ML
Tunis Med · 2025 Aug · PMID 41832638 · Publisher ↗
Introduction Obesity is a common problem with increasing prevalence and health consequences. In pregnant patients, its impact seems equally worrying affecting large population. Some obesity complications in pregnant wome...
Introduction Obesity is a common problem with increasing prevalence and health consequences. In pregnant patients, its impact seems equally worrying affecting large population. Some obesity complications in pregnant women have not been examined, in particular link with fetal macrosomia. Aim: The study aimed to assess the obesity factor associated with cesarean section and birth-weight infants. Methods In a retrospective study, 174 women were recorder in the period from 2021 to 2022 in the Hospital El Idrissi of Kenitra, Morocco. For each patient, age, newborn weight, number of grosses, body mass index (BMI) prepregnancy and before delivering were recorded, univariate and bivariate analyses was performed for all parameters. Results The occurrence of maternal complications during attempted vaginal delivery of a child weighing more than 4000 g is 6%. Risk factors for maternal complications, in addition to the child's birth weight (p=0.004, attributable risk (AR)=10%), are the mother's origin (p=0.04; AR=3%), a long duration of labor (p=0.02; AR=12%), and a cesarean section during labor (p=0.004; AR=17%). Multiparous patients who had already given birth vaginally to a macrosomic child had a reduced risk of maternal complications (p=0.03). The prevalence of obesity was 2% (p<0.001). Obesity was significantly associated with an increased risk of cesarean delivery and macrosomia (p<0.0001). The prevalence of macrosomia remained higher in the overweight group than in the normal weight group (aOR=2.01, 95% CI: 1.13-3.58, p<0.05). Conclusion The study shows a significant relationship between obesity and macrosomia outcome in Moroccan women.
Predictive factors of poor nutritional status in children and young adults on chronic hemodialysis: A single center experience.
Boussetta A, Abida N, Jellouli M … +1 more , Gargah T
Tunis Med · 2025 Aug · PMID 41832637 · Publisher ↗
UNLABELLED: Introduction-Aim: Children with kidney failure (KF) are prompt to undernutrition with subsequent growth failure. The aim of this study was to assess probable correlates of normalized protein catabolic rate (n...
UNLABELLED: Introduction-Aim: Children with kidney failure (KF) are prompt to undernutrition with subsequent growth failure. The aim of this study was to assess probable correlates of normalized protein catabolic rate (nPCR) in children on chronic hemodialysis (HD). METHODS: This prospective study included all 20-year-old or less patients undergoing chronic HD at our pediatric HD unit between 1st January 2024 and 30th April 2024. Patients included had been on HD for more than 3 months and were clinically stable. For each patient, baseline characteristics were recorded along with their echocardiogram findings. Mean nPCR was calculated and potential predictive factors were simultaneously evaluated. Our study included a univariate and a multivariate analysis. A p value less than 0.05 was considered statistically significant. RESULTS: A total of 40 patients were included with a mean age of 14.4 ± 3.7 years old and a sex-ratio M/F of 1.9. Twenty-two (55%) had a mean nPCR <1g/kg/day. A strong positive correlation between nPCR and the 3-months body mass index variation percentage was found with a correlation ratio of 0.82. On multivariate analysis, Patients with a single pool KT/V < 1.2 and those exhibiting left ventricular hypertrophy were more likely to have a nPCR value <1g/kg/day (OR: 7.2 and 11.1, 95% CI: 2.28 - 75.23 and 5.5-98,08, respectively). A first hour refill index > 1.7 ml/kg/h/% was also correlated with a low nPCR (Adjusted OR:5.5- 95% CI: 3.2-65.2). CONCLUSION: Pressure and volume control along with dialysis adequacy are promising factors in improving nutritional status and clinical outcomes in children with KF.
Epidemiological and Clinical Aspects of Early-Onset Colorectal Cancer: A Comparative Study of 180 Cases.
Hassine H, Krifa N, Sebei A … +9 more , Kchir H, Atri S, Jemai C, Hajji R, Ben Achour T, Cherif D, Yacoub H, Dabbebi H, Maamouri N
Tunis Med · 2025 Aug · PMID 41832636 · Publisher ↗
INTRODUCTION: The incidence of early-onset colorectal cancer (EO-CRC), defined as occurring before 50 years, is rising significantly. While genetic syndromes account for a minority of cases, the majority are sporadic and...
INTRODUCTION: The incidence of early-onset colorectal cancer (EO-CRC), defined as occurring before 50 years, is rising significantly. While genetic syndromes account for a minority of cases, the majority are sporadic and influenced by both genetic and environmental factors. This study aimed to identify the epidemiological and clinical characteristics of EO-CRC. METHODS: We conducted a single-center, retrospective, comparative study over seven years, including all patients diagnosed with colorectal cancer (CRC). Patients were classified into two groups: <50 years (G1) and ≥50 years (G2). Clinical data, tumor characteristics, and treatment strategies were compared. RESULTS: Among 180 patients, 26.1% were under 50 years (G1). No significant differences were observed in sex ratio, smoking, alcohol consumption, obesity, or family history of cancer. Both groups presented with bowel transit disorders and general health deterioration, but diarrhea (p = 0.015) and rectal bleeding (p = 0.026) were more frequent in G1. Rectal localization was significantly more common in G1 (p < 0.001). Histologically, EO-CRC was more often poorly differentiated, exhibited greater lymph node involvement, and was diagnosed at more advanced stages, though differences were not statistically significant. A curative approach was more frequently proposed in younger patients, without significant difference. CONCLUSION: EO-CRC represented over one-quarter of CRC cases in our cohort. It was predominantly rectal and frequently diagnosed at an advanced stage. These findings highlight the need for increased awareness, early diagnosis, and tailored management strategies for younger patients.
Bibliometrics of scientific biomedical publications on Primary Immunodeficiency Diseases in the Arab World (2020-2024).
Ben Abdelaziz A, Zanina Y, Bradai S … +3 more , Adaliy N, Khelil M, Ben Abdelaziz A
Tunis Med · 2025 Aug · PMID 41832635 · Publisher ↗
OBJECTIVE: Describing the editorial, methodological and thematic profile of scientific publications on Primary Immunodeficiency Diseases in the Arab World during the five-year period 2020-2024. METHODS: Based on the MeSH...
OBJECTIVE: Describing the editorial, methodological and thematic profile of scientific publications on Primary Immunodeficiency Diseases in the Arab World during the five-year period 2020-2024. METHODS: Based on the MeSH descriptor 'Primary Immunodeficiency Diseases' (PID), combined with the names of 22 Arab countries, this bibliometric study was conducted on MEDLINE, via Web of Science, analyzing all available bibliographic fields. The number of authors was limited to researchers from the Arab world who had co-authored at least two publications during the study period. Visualization of author and research topic clusters was carried out using VOS Viewer. RESULTS: During the five-year study period, 156 publications from the Arab world were indexed under the PID descriptor, published by 86 scientific journals, and tagged with 479 MeSH descriptors. These publications, often of the 'Case Reports' (19%) and 'Review Article' (15%) type, were mainly categorized under 'Immunology' (62%), "Pediatrics" (47%) and 'Genetics' (39%). They were published particularly by the Journal of Clinical Immunology (15%) and Frontiers in Immunology (12%). Among the 119 co-authors of these publications, from 12 countries, the most prolific were AL-HERZ (Kuwait), BOUSFIHA (Morocco) and ADELI (Qatar). These studies were often retrospective in nature, focused on children and the problem of "Severe Combined Immunodeficiency", particularly in Egypt, Saudi Arabia, Oman and Morocco. In addition to the 'Genetics' approach (39%), notably 'Genetic Predisposition To Disease' and 'Genetic Diseases Inborn', these publications also addressed "Immunology" (19%), including topics such as 'Immunologic Deficiency Syndromes' and 'Acquired Immunodeficiency Syndrome'. Visualization of these publications reveals collaboration between two sub-regions of the Arab world (Africa and Asia) with a strong focus on 'Hematopoietic Stem Cell Transplantation'. CONCLUSION: The bibliometric analysis of PID publications in the Arab world highlights a dynamic editorial landscape, diverse methodological approaches, and a wide thematic range. This stresses the need to network researchers, following a unified and interdisciplinary approach (bridging basic, clinical and public health sciences), and aligning with local epidemiological priorities.
Paraneoplastic Raynaud's phenomenon revealing lung adenocarcinoma.
Debiche S, Cherif H, Bachta T … +3 more , Mokadem S, Yangui F, Charfi MR
Tunis Med · 2025 Aug · PMID 41832634 · Publisher ↗
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Imaging of sinonasal inverted papillomas: A literature review.
Bouatay R, Koubaa J
Tunis Med · 2025 Aug · PMID 41832633 · Publisher ↗
The sinonasal inverted papilloma is a rare benign tumor which is distinguished from the other sinonasal tumors by some characteristics such as a slow developement, local aggressiveness, a high rate of recurrence after su...
The sinonasal inverted papilloma is a rare benign tumor which is distinguished from the other sinonasal tumors by some characteristics such as a slow developement, local aggressiveness, a high rate of recurrence after surgical resection and the possibility of malignant transformation. It should be considered in the presence of any unilateral polypoid symptomatology or lesion. Its treatment is surgical. In this update, we discuss the radiological specificities of sinonasal inverted papillomas as well as the contribution of imaging in the diagnosis and post-treatment monitoring of these tumors.
Thoughts and considerations on Elderly onset Rheumatoid Arthritis: A case-control study of a North African population.
Maatallah K, Cherif I, Ferjani H … +4 more , Triki W, Ben Nessib D, Kaffel D, Hamdi W
Tunis Med · 2025 Jun · PMID 41784254 · Publisher ↗
INTRODUCTION: Rheumatoid arthritis (RA) is the most common chronic inflammatory joint disease, and elderly onset RA starting after age 65 (EORA) is on the rise constituting approximately one-third of RA cases. AIM: To id...
INTRODUCTION: Rheumatoid arthritis (RA) is the most common chronic inflammatory joint disease, and elderly onset RA starting after age 65 (EORA) is on the rise constituting approximately one-third of RA cases. AIM: To identify the clinical and therapeutic specificities of EORA. METHODS: This was a cross-sectional case-control study of 224 RA patients (recruitment was done over a 30-month period between 2018 and 2021). Two groups were evaluated: Elderly onset rheumatoid arthritis (EORA): patients in whom the disease started after the age of 65 and the young-onset rheumatoid arthritis (YORA) control group: patients with disease onset before the age of 65. We collected the clinical characteristics and we compared the therapeutic modalities between both groups: Results: Our study included 59 patients in the EORA group and 165 patients in the YORA group. The onset of RA in both groups was predominantly progressive and polyarticular. However, in the EORA group, rhizomelic involvement and abrupt onset were significantly more frequent than in the YORA group, with respectively (ORa=4.8 CI=1.5-15.6; p-0.01) and (ORa=5.1 CI=1.8-14; p-0.01). Methotrexate (MTX) was the most frequently used background treatment in both groups. There was no significant difference between the two groups in the prescription of the other conventional DMARDs. Adverse events were more frequently found in the EORA group (ORa=4.7 CI=1.3-16.4, p-0.05) and consisted mainly of gastrointestinal intolerance. Rehabilitation was advocated in 6.7% of the EORA group versus 16.9% of the YORA group, with a significant difference (ORa=4.73 [1.36-16.47), p=0.02). CONCLUSION: In EORA patients, therapeutic modalities overlapped with those for young-onset RA. Therapeutic decisions should be carried out without depriving EORA patients with good biological age from advanced and auspicious treatment.
Epidemiology and sociodemographic determinants of Obesity in Moroccan Adult Population.
Mohtadi K, Khalidi H, Lebrazi H … +3 more , Kettani A, Taki H, Saile R
Tunis Med · 2025 Jun · PMID 41784253 · Publisher ↗
INTRODUCTION: Obesity and overweight result from excess fat, leading to health complications and a reduced life expectancy. This issue impact Morocco like all countries worldwide, due to several determinants such as diet...
INTRODUCTION: Obesity and overweight result from excess fat, leading to health complications and a reduced life expectancy. This issue impact Morocco like all countries worldwide, due to several determinants such as dietary changes, lifestyle choices, sedentary behavior and socioeconomic parameters. AIM: To evaluate the prevalence of overweight and obesity in Moroccan population, and their related socio-demographic factors. METHODS: Our study is a cross-sectional study carried out among adult subjects aged 18 years and above, who were selected using cluster sampling. Data collection was conducted using a questionnaire that included sociodemographic parameters such as age, sex, and marital status, educational level…as well as anthropometric measurements. The statistical analysis was performed using SPSS. RESULTS: The total number of participants was 731 (51.8% women and 48.2% males). The age group 20-29 years constitutes 25.6% of the studied population followed by 30-39 years with 19.4%. According to the BMI the overall prevalence of obesity was 20.7%, with a female predominance (80.10 %). The results indicated that BMI increases with age up to 59 years (p<0.0001). We revealed a strong association between numerous factors and obesity such as age, sex, age, marital status, occupational activity, education level and housing. CONCLUSION: Through our study, we found that the obesity was associated with a several sociodemographic factors such as: gender, age, marital status, occupational activity, education level and housing type and size with a female predominance. We suggest structural and supportive policies such as improving access to healthcare services that promotes healthy living and reduces obesity rates.
Enhanced Heart Failure Management: Impact of the therapeutic unit for heart failure (TUNI-HF) on mid-term prognosis.
Hermassi H, Ben Ayed H, Mahfoudhi H … +3 more , Hajlaoui N, Haggui A, Fehri W
Tunis Med · 2025 Jun · PMID 41784252 · Publisher ↗
BACKGROUND: Chronic heart failure (CHF) is a global and increasing problem responsible of uncontrolled rates of mortality and readmission. A therapeutic Unit of heart failure (TUNI-HF) was established to assume a treatme...
BACKGROUND: Chronic heart failure (CHF) is a global and increasing problem responsible of uncontrolled rates of mortality and readmission. A therapeutic Unit of heart failure (TUNI-HF) was established to assume a treatment optimization, comorbidities management and education in order to improve heart failure (HF) prognosis. AIM: This study aimed to describe the impact of the TUNI-HF on treatment optimization, mortality and readmission rates at 12 months in patients with heart failure with reduced ejection fraction (HFrEF). METHODS: A retrospective study was conducted in the military hospital of Tunis, Tunisia. Two groups were compared: Group "C" included patients followed from March 2018 for 12 months with usual care. Group "U" included patients followed from Mars 2021 for 12 months in the TUNI-HF. RESULTS: Groups "C" and "U" enrolled 108 and 110 patients respectively. At baseline, patients' characteristics were comparable. Prescription rates of guideline directed medical treatment (GDMT) at optimal doses were low in two groups. After 12 months, prescription rates of beta-blockers (BB) and mineralocorticoid receptor antagonist (MRA) were higher in group "U". In addition, optimal doses of BB, renin angiotensin aldosterone system inhibitors (RAASI) and MRA were more achieved in the same group "U". Loop diuretics were less prescribed in the group "U" and cardiac implantable devices rate was higher in the same group. Kaplan Meier analysis showed significantly lower rates of readmission and all-cause mortality rates in the group "U". CONCLUSION: The management of HF in a specialized unit, compared with usual care, was associated with a better treatment optimization and a reduction in mortality and readmission rates.
Determinants of quality of life among patients with breast cancer in Africa: A systematic review.
Lemmih H, Bakzaza B, Rachiq S … +1 more , Raoui SM
Tunis Med · 2025 Jun · PMID 41784251 · Publisher ↗
AIM: To detect and describe determinants influencing the quality of life among patients with breast cancer across Africa. METHODS: Applying the PRISMA methodology, we searched the PubMed, Scopus, and Web of Science datab...
AIM: To detect and describe determinants influencing the quality of life among patients with breast cancer across Africa. METHODS: Applying the PRISMA methodology, we searched the PubMed, Scopus, and Web of Science databases from inception through January 2024 using the following search terms: breast cancer, quality of life, and Africa. The studies selected aimed to identify the factors that impact the quality of life of African women with breast cancer. The methodological rigour of each publication was assessed using the Newcastle-Ottawa Scale, which was adjusted for both cohort and cross-sectional study designs. RESULTS: 22 studies were included in this systematic review, consisting of 15 (68%) cross-sectional studies and 7 (32%) prospective studies. These studies investigated more than 34 different determinants influencing the quality of life among breast cancer. Comorbidities, chemotherapy, anxiety, and depression generally reported poorer quality of life initially, though it often showed improvement over time. Research findings varied regarding how age, marital status, income, and treatment types influence the quality-of-life outcomes among patients with breast cancer in Africa. CONCLUSION: Breast cancer patients frequently experience a worse quality of life, particularly if they are receiving chemotherapy and have additional medical conditions. This situation highlights the importance of offering patients additional therapies to improve their overall quality of life, together with comprehensive psychological and social support.
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Ben Saida I, Kahloul M, Chrigui R … +3 more , Kacem I, Ben Saad H, Naija W
Tunis Med · 2025 Jun · PMID 41784250 · Publisher ↗
INTRODUCTION: Patient safety is a major concern in healthcare, particularly in intensive care units. While the room of errors (RoE) has proven to be an effective pedagogical tool for preventing medical errors, its applic...
INTRODUCTION: Patient safety is a major concern in healthcare, particularly in intensive care units. While the room of errors (RoE) has proven to be an effective pedagogical tool for preventing medical errors, its application in the initial medical training of healthcare professionals in Tunisia remains under-explored. AIMS: To i) Describe the methods used to implement a RoE in a Tunisian university setting, ii) Analyze the errors made by learners, and iii) Evaluate the impact of RoE on participants' knowledge and satisfaction. METHODS: This was a cross-sectional descriptive study conducted on May, 2024, at the simulation center of the Faculty of Medicine of Sousse (Tunisia), involving third-year students in the anesthesia and resuscitation section of the private university of health sciences in Tunisia (n=20), and first-year students of the second cycle of medical studies (n=11), who were completing their anesthesia and resuscitation medicine internship at Sahloul hospital (Sousse, Tunisia). RESULTS: Twenty-six students were included in the study. The median [interquartile range] of detected errors was 3.5 [3.0-5.0]. Pre- and post- tests showed an improvement in participants' theoretical knowledge regarding hemorrhagic shock after the debriefing session. Nevertheless, some gaps persisted, suggesting the need to delve deeper into certain points in future sessions. The evaluation results showed that the RoE was highly appreciated by most participants. CONCLUSION: RoE is an innovative and particularly effective pedagogical tool to promote a positive error culture and enhance patient safety.
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