La Tunisie Medicale[JOURNAL]
Sun
200 papers
How to Publish? Strategies for successful medical publication drawing on the experiences of North African researchers.
Fakhfakh R, Gaddas M, Dahmane R … +2 more , Ben Saida I, Ben Saad H
Tunis Med · 2025 Nov · PMID 41949950 · Publisher ↗
BACKGROUND: Publication is crucial for disseminating research findings and advancing scientific knowledge. However, medical researchers in developing countries face significant challenges in publishing their work due to...
BACKGROUND: Publication is crucial for disseminating research findings and advancing scientific knowledge. However, medical researchers in developing countries face significant challenges in publishing their work due to limited resources, mentorship, and access to high-impact journals. This study aimed to identify strategies for successful medical publication, drawing on the experiences of Tunisian researchers. METHODS: This perspective-based study combines a comprehensive literature review with expert-facilitated group discussions. A research session held at the Faculty of Medicine of Sousse (Tunisia) brought together 44 participants from diverse medical specialties. The session included group discussions and expert presentations to explore strategies for successful medical publication. RESULTS: Key strategies for successful publication were identified, including defining the target manuscript, choosing the appropriate journal, preparing a structured manuscript, ensuring clear and concise writing, following journal-specific guidelines, and adhering to ethical considerations. Other important aspects, such as identifying authorship, avoiding predatory journals, disclosure of conflicts, acknowledgements, cover letters, and responses to peer reviews, were often neglected in the feedback of Tunisian researchers. CONCLUSION: Strengthening the publishing capacity of researchers in developing countries requires targeted training programs and institutional support. By implementing best practices in manuscript preparation and submission, researchers can enhance their chances of publication in high-quality medical journals.
The University of Jendouba's Comprehensive Digital Framework for Research Ethics Management: An Integrated System with Real-Time Verification, Surprise Audits, and Public Access through QR Codes and DOIs.
Dergaa I, Dhahbi W, Guelmemi N … +3 more , Ben Jebli M, Jridi M, Sebai H
Tunis Med · 2025 Nov · PMID 41949949 · Publisher ↗
The University of Jendouba is implementing a novel digital framework to transform how Institutional Review Board (IRB) approvals are managed, with phased deployment commenced on June 13th, 2025, tackling pressing global...
The University of Jendouba is implementing a novel digital framework to transform how Institutional Review Board (IRB) approvals are managed, with phased deployment commenced on June 13th, 2025, tackling pressing global issues in research integrity and transparency. Built on international standards like the Declaration of Helsinki and Good Clinical Practice (GCP), this system employs advanced tools such as QR codes and Digital Object Identifiers (DOIs) to enable real-time verification and public access to approved protocols. Crucially, the system extends its oversight beyond IRB approvals, monitoring the entire research process to ensure ethical compliance from the initial protocol submission through to the final publication of results. This framework addresses critical challenges, including the falsification of IRB approvals, data manipulation, and undisclosed changes to research protocols. It features automated compliance checks, risk-based evaluations of protocols, and real-time tracking of research activities to ensure studies adhere to their approved plans. Additionally, surprise audits and continuous oversight mechanisms are in place to detect and prevent unethical practices at every stage of the research process. As the first system of its kind in North Africa, this platform aligns with both local and international research ethics guidelines, fostering collaboration and standardization across disciplines. It also integrates blockchain technology and connects with global ethics databases to enhance transparency and trust in research outcomes.
Effects of 16:8 intermittent fasting on inflammatory markers and oxidative stress in obese women.
Jamoussi H, Dhieb N, Karmous I … +8 more , Mahjoub F, Ben Chaabene A, Gamoudi A, Kacem A, Feki M, Ben Ahmed M, Talbi E, Ben Othman R
Tunis Med · 2025 Dec · PMID 41949948 · Publisher ↗
BACKGROUND: The efficiency of intermittent fasting (IF) in promoting weight loss and improving metabolic parameters in obese individuals has been demonstrated. This study aims to evaluate the impact of intermittent fasti...
BACKGROUND: The efficiency of intermittent fasting (IF) in promoting weight loss and improving metabolic parameters in obese individuals has been demonstrated. This study aims to evaluate the impact of intermittent fasting on inflammatory and oxidative stress parameters compared to continuous caloric restriction (CCR), three months after intervention. METHODS: Over three months, we enrolled obese women practicing intermittent fasting (16/8) and compared them to a group following continuous caloric restriction. Anthropometric characteristics were measured using a bioelectrical impedance meter, and biological parameters, including inflammatory markers (hs-CRP and interleukin-6) and oxidative stress markers (8-hydroxyguanosine and 8-isoprostaglandin F2α), were evaluated before and after the intervention. RESULTS: The mean age and initial body mass index (BMI) were 35.5±9.13 years and 38.3±4.8 kg/m² in the IF group, and 36.3±9.27 years and 36.8±4.3 kg/m² in the CCR group, respectively. Weight loss was statistically significant in both groups. However, no effect was observed on inflammatory markers (hs-CRP and interleukin-6) in either group. Similarly, regarding oxidative stress markers, the changes in plasma concentrations of 8-OHdG (from 78.3±50.2 pg/ml to 85.7±39.3 pg/ml in the CCR group and from 81.7±26.8 pg/ml to 92.3±36.3 pg/ml in the IF group) and 8-iso-PGF2α (from 240±176 pg/ml to 194±146 pg/ml in the CCR group and from 194±153 pg/ml to 184±176 pg/ml in the IF group) were not statistically significant. CONCLUSION: Despite its positive effects on weight and metabolic parameters, intermittent fasting has not demonstrated efficacy in reducing inflammation and oxidative stress in obese women.
Plasma progastrin levels in patients with oral squamous cellcarcinoma - a cross-sectional study.
Kumar M, V A, Kumaravel S … +2 more , Kannan R, Narayanan A
Tunis Med · 2025 Dec · PMID 41949947 · Publisher ↗
INTRODUCTION: Progastrin, is over-expressed in human colorectal tumor cells and also directly targets the ß-catenin/Tcf4 oncogenic pathway, The association between Wnt/ß-catenin pathway and cancer is not merely restricte...
INTRODUCTION: Progastrin, is over-expressed in human colorectal tumor cells and also directly targets the ß-catenin/Tcf4 oncogenic pathway, The association between Wnt/ß-catenin pathway and cancer is not merely restricted to colorectal cancer as disruption of this pathway results in epithelial mesenchymal transition in oral carcinogenesis. As therole of progastrin in subjects with Oral cancer(OC) is less explored, this study was contemplated to assess the role of plasma progastrin levels in subjects with various stages of oral squamous cell carcinoma. METHODS: The present study was a cross-sectional study done among 60 subjects who were divided into two study groups: Group OC (n=30) who have histologically confirmed oral squamous cell carcinomaand Group C (n=30) who were healthy controls. 10ml of blood samples were drawn from the study subjects and plasma was analysed for progastrin peptide. RESULTS: The present study demonstrated that the mean plasma progastrin levels (hPG80) were significantly elevated in Group OC (20.51 pM/L) when compared to the control (9.9 pM/L). No significant difference in Plasma level of progastrin between well, moderate and poorly differentiated OC and withincreasing staging of OC. CONCLUSION: The present study showed increased levels of plasma progastrin in subject with oral squamous cell carcinoma when compared to the control, highlighting the potential of using plasma progastrin levels as a biomarker for early detection of oral malignancies.
Assessing Medical Knowledge Gaps on Transfusion Incidents and Preventive Strategies.
Ghachem I, Kaabar Y, Kaab N … +4 more , Tounsi H, Skouri W, Ghachem I, Bachali A
Tunis Med · 2025 Dec · PMID 41949946 · Publisher ↗
INTRODUCTION: Blood transfusion (BT) is a life-saving therapy not devoid of risks. Reporting transfusion adverse events (TAEs) is a key element of hemovigilance, guaranteeing patient safety. However, it remains insuffici...
INTRODUCTION: Blood transfusion (BT) is a life-saving therapy not devoid of risks. Reporting transfusion adverse events (TAEs) is a key element of hemovigilance, guaranteeing patient safety. However, it remains insufficient due to a lack of knowledge among medical staff regarding the recognition and management of TAEs. The aim of this study was to assess physicians' knowledge of TAEs and their ability to manage them. METHODS: An observational study was carried out in 2024 among 96 physicians practicing in Tunisian transfusion services, via an anonymous 25-question questionnaire assessing recognition, management and reporting of TAEs. RESULTS: A total of 96 participants responded to the questionnaire, of which 46% (n=44) were residents, 38% (n=37) interns, and 16% (n=15) senior physicians working in transfusion departments. Among the respondents, 51% had received prior training in transfusion therapy. Only 15% of participants obtained more than half of the answers correct. The knowledge assessment revealed that 41.6% of physicians incorrectly believed TAEs were systematically associated with stable blood products. Furthermore, only 12.5% of physicians reported TAEs exclusively when they were classified as serious. Confusion between transfusion-related acute lung injury (TRALI) and cardiogenic pulmonary edema was observed in a significant proportion of participants. CONCLUSION: This study underscores a notable lack of knowledge among medical staff regarding transfusion events. Targeted, ongoing training programs are essential to address these gaps and enhance patient safety.
Optimising Brain Metastases Management in Resource-Limited Settings: Experience with Hypofractionated Stereotactic Radiotherapy at the Salah Azaiez Institute.
Ayadi H, Mousli A, Attia N … +10 more , Ghorbel A, Ben Zid K, Yousfi A, Ben Salem L, Besbes M, Mahjoubi K, Yahyaoui S, Zarraa S, Abidi R, Nasr C
Tunis Med · 2025 Dec · PMID 41949945 · Publisher ↗
INTRODUCTION: Radiotherapy remains a cornerstone in the palliative management of brain metastases (BM), a highly technical and evolving fieldtreatment is increasingly personalized. Stereotactic radiotherapy (SRT) has eme...
INTRODUCTION: Radiotherapy remains a cornerstone in the palliative management of brain metastases (BM), a highly technical and evolving fieldtreatment is increasingly personalized. Stereotactic radiotherapy (SRT) has emerged as a precise and effective alternative to whole-brain radiotherapy (WBRT), offering better neurocognitive preservation and improved local control. This study aims to evaluate the efficacy and tolerance of SRT in the management of BM at the Salah Azaiez Institute. METHODOLOGY: We conducted a single-center, retrospective, analyticalstudy in the radiotherapy department of the Salah Azaiez Institute between 2015 and 2022. Treatment planning was performed using the iPlan (BrainLab) and Eclipse (Varian) systems, utilizing the Conical Cone and AAA 13.7 algorithms, respectively. Techniques such as Dynamic Conformal Arc (DCA) and Volumetric Modulated Arc Therapy (VMAT) were employed. The ClinaciX (Varian), equipped with a Multi-Leaf Collimator (MLC), enabled precise beam modulation. Hypofractionated SRT was administered in three fractions of 9 Gy or five fractions of 5-6 Gy at the 80% isodose line depending of the lesion volume and site. RESULTS: A total of 45 patients (25 men, 20 women; median age: 57 years) were included. The primary tumors were predominantly bronchopulmonary carcinoma (60%) and breast cancer (17.8%). Solitary BM was observed in 66.6% of cases, while 33.4% had 2-3 lesions. BM presented synchronously in 35.5% and metachronously in 64.5% of cases. Two patients (4.44%) had prior prophylactic cranial irradiation for small-cell lung cancer. BM were treated in situ in 66.7% of cases. In the remaining 33.3%, stereotactic radiotherapy was performed....( abstract truncated at 250 words).
Factors associated with pharmaco resistance in major depressive disorder.
Ben Othman S, Mami H, Krir MW … +3 more , Ghorbel O, Abdelghaffar W, Oumaya A
Tunis Med · 2025 Dec · PMID 41949944 · Publisher ↗
BACKGROUND: Depressive disorder is a common psychiatric disorder that represents a major public health problem. The failure of pharmacological treatment remains frequent, resulting in significant socio-professional disab...
BACKGROUND: Depressive disorder is a common psychiatric disorder that represents a major public health problem. The failure of pharmacological treatment remains frequent, resulting in significant socio-professional disability and high economic costs. The objective of our work was to specify the rates of resistance and remission under antidepressants and to determine the factors associated with drug resistance in this disorder. METHODS: It was a prospective, longitudinal, analytical study conducted in the psychiatry department of the Military Hospital of Tunis in patients consulting for a depressive disorder. The participants were put on antidepressants with a regular evaluation of the response to the treatment through the Hamilton depression scale. The absence of response after two successive antidepressants was considered as resistance to antidepressant treatment. RESULTS: Our study included 80 patients, of whom 13 were excluded and 67 completed the study. The mean age of the final sample was 42.2 years with a slight male majority of 56.7%. The resistance rate was 28.4%. There was a significant association of the resistant character of the depression with the following factors: severity of the depressive episode (p<0.001), duration of the depressive symptomatology (p=0.026), belonging to a military family (p=0.009), presence of a non-addictive psychiatric comorbidity (p=0.005), particularly an anxiety disorder (p=0.003) and the presence of a post-traumatic stress disorder (p=0.007). CONCLUSION: This study underlines the importance of early and adequate management of resistant depression, which remains frequent. There are many predictive factors that must be detected at an early stage in order to adapt therapeutic strategies.
Self-medication with analgesics in rheumatology: Frequency and associated factors.
Bouden S, Abid Y, Rouached L … +5 more , Ben Tekaya A, Mahmoud I, Tekaya R, Saidane O, Abdelmoula L
Tunis Med · 2025 Dec · PMID 41949943 · Publisher ↗
INTRODUCTION: Analgesics are commonly used to relieve pain, but their consumption requires vigilance due to the possibility of interactions and the occurrence of adverse side effects from misuse however, they are often s...
INTRODUCTION: Analgesics are commonly used to relieve pain, but their consumption requires vigilance due to the possibility of interactions and the occurrence of adverse side effects from misuse however, they are often self-medicated. AIM: to determine the frequency of self-medication with analgesics in the rheumatology setting and its associated factors. METHODS: In this context, we conducted a descriptive and analytical cross-sectional study, concerning 150 patients followed at the rheumatology department of the Charles Nicolle Hospital in Tunis, from March 2023 to June 2023. RESULTS: The average age of patients was 51 years with extremes ranging from 15 to 82 years, with a female predominance. Concerning the pathologies for which our patients were followed in rheumatology, 81 patients had inflammatory pathologies and 69 patients with degenerative pathologies. Rheumatoid arthritiswas the most frequent pathology. The average pain using the visual analog scale (VAS) ranged from 5 to 8. Self-medication was a very common practice in our population with a prevalence of 60.7%. Paracetamol was the most used molecule (39%), followed by NSAIDs (38%). Only 10 patients (6,7%) reported learning about the drug before self-medication. Factors that were significantly associated with self-medication were: older age (p=0,02), female sex (p=0,05), high pain score (p=0,01), unemployment (p=0,003), and the presence of degenerative pathology (p<0,001). CONCLUSION: Self-medication was a very common practice in our population and health professionals must be aware of its frequency, in order to educate patients and promote responsible self-medication behaviors.
Contribution of the seric cytokeartin fragment 21.1 (cyf 21.1) as a tumor marker in a population of algerien women with breast cancer undergoing chemotherapy.
Sedoud Z, Hellal Y, Benafla R … +2 more , Deghima S, Djenouhat K
Tunis Med · 2025 Dec · PMID 41949942 · Publisher ↗
In Algeria, breast cancer accounts for 37.8% of new cancer cases in women. It is an epithelial cell tumor in most cases. CA15-3 (carbohydrate antigen) is the marker of choice for therapeutic monitoring, although ASCO (th...
In Algeria, breast cancer accounts for 37.8% of new cancer cases in women. It is an epithelial cell tumor in most cases. CA15-3 (carbohydrate antigen) is the marker of choice for therapeutic monitoring, although ASCO (the American Society of Clinical Oncology) does not recommend its routine use, preferring CYFRA21.1 (cytokeratin19 fragment) to assess response to treatment. The aim of this study was to estimate the degree of correlation between these two biological markers as a function of tumour histological type and the presence or absence of metastases. In a prospective descriptive study, sera from 110 breast cancer patients (mean age 49 ± 7.23 years) were measured using the electrochemiluminescence (ECL) technique to assess CYFRA 21.1 and CA 15.3 levels. Comparison of CA15.3 and CYFRA21.1 levels between patients and controls (79 controls) showed a highly significant association (p<0.0001) between these two markers and breast cancer. The significant correlation between CA15.3 and CYFRA21.1 (r=0.245; P< 0.0001) suggests that reliance on CYF 21.1 for monitoring breast cancer patients undergoing chemotherapy is possible. The results show a good correlation between the two markers, especially for the two histological types luminal a and luminal b+HER2 (r=0.602 ; p<0.0001, r=0.505 ;p< 0.0001 respectively). This study also assessed the correlation between CA15.3 and CYFRA21.1 levels in patients with and without metastases. A significant correlation was also found between CA15.3 and CYFRA 21.1 in the presence of metastases (r=0.472, p<0.0001). A multi-marker approach could provide a more comprehensive assessment of tumor burden and response to treatment.
The carriage of intestinal parasites among food handlers: Current status in Tunisia and contribution of surveillance.
Siala E, Cherif I, Zallega N … +2 more , Bouratbine A, Aoun K
Tunis Med · 2025 Dec · PMID 41949941 · Publisher ↗
Food handlers are a significant source of intestinal parasite transmission. The aim of this study was to establish the prevalence of intestinal parasite carriage among food handlers and to track its evolution. A retrospe...
Food handlers are a significant source of intestinal parasite transmission. The aim of this study was to establish the prevalence of intestinal parasite carriage among food handlers and to track its evolution. A retrospective study was conducted between 2019 and 2024 among food handlers in the framework of screening for intestinal parasitosis. A stool sample was collected from each individual and analyzed by direct microscopy and concentration using the Ritchie method. A total of 3866 individuals were included in the study, among whom 425 (11%) revealed carriers of intestinal parasites. This prevalence was significantly lower than that reported in a similar survey between the 1998-2008 period (13.5%, p<10-3). The rate of intestinal parasites was higher among private sector employees (12.6% vs. 10.6% in the public sector), without significant difference. Protozoa were predominant (98.3%) compared to helminths (1.7%). Directly transmitted pathogenic or potentially pathogenic species accounted for 76.3% of diagnosed parasites. Blastocystis sp. was the most prevalent parasite (40.5%). Dientamoeba fragilis, Giardia intestinalis and Entamoeba histolytica/dispar accounted for 27.5%, 3.8% and 3.5% of identified parasites, respectively. Nearly one-third (30.6%) of infected individuals were polyparasitized. Despite its decrease, the prevalence of intestinal parasitosis remains high among food handlers. The surveillance of this population should be strengthened through frequent screening, more stool samples and the implementation of sensitive techniques.
STOPBANG versus NOSAS in screening patients with severe obstructive sleep apnea.
Ben Jemia E, Trimech S, Ouertani H … +4 more , Rejaibi S, Hedhli H, Ben Amar J, Zaibi H
Tunis Med · 2025 Dec · PMID 41949940 · Publisher ↗
INTRODUCTION: Obstructive sleep apnea (OSA) is a prevalent sleep disorder characterized by repeated upper airway obstruction during sleep. It can lead to significant health risks, and early detection is essential for eff...
INTRODUCTION: Obstructive sleep apnea (OSA) is a prevalent sleep disorder characterized by repeated upper airway obstruction during sleep. It can lead to significant health risks, and early detection is essential for effective management. AIM: To evaluate the diagnostic performance of STOP-BANG and NoSAS questionnaires in identifying severe OSA. METHOD: Patients with confirmed sleep disorders by ventilator polygraphy were enrolled in this cross-sectional study conducted over 18 months in the Pneumonology department of Charles Nicolle Hospital of Tunis. All participants completed STOP-BANG and NoSAS questionnaires. RESULTS: A total of 172 patients diagnosed with OSA were enrolled, with a mean age of 54.4 years. OSA severity was classified as mild in 63 patients (36.6%), moderate in 45 patients (26.2%), and severe (apnea-hypopnea index ≥30/h) in 64 patients (37.2%). Severe OSA was significantly associated with male (p=0.04), older age (p=0.019), higher BMI (p<0.001), larger neck circumference (p<0.001), and greater fatigue (p=0.037). STOP-Bang and NoSAS scores demonstrated high discriminative value, with areas under the curve (AUC) of 0.61 and 0.64, respectively. STOP-BANG score showed higher sensitivity (65.2%) compared to NoSAS (34.8%), while NoSAS exhibited superior specificity (85.6% vs 53.8%). Positive predictive values were comparable between scores, but NoSAS had a slightly higher negative predictive value (82.9% vs 81.5%). CONCLUSION: These findings suggest that while STOP-BANG is more sensitive for identifying severe OSA, NoSAS offers better specificity, making it a valuable tool for screening in specific populations. Combining both scores may enhance diagnostic accuracy and improve early detection of severe OSA, thereby optimizing patient outcomes.
Antifungal Activity of Leaves and Cones Extracts of Pinus halepensis in Tlemcen North-West of Algeria.
Bensalah-Boukenadel F, Benariba N, Borsali F … +1 more , Beghdad MC
Tunis Med · 2025 Dec · PMID 41949939 · Publisher ↗
BACKGROUND: plants represent an exhaustible source of chemical molecules with a diverse biological activity. In this context, our study deal with the antifungal effect of aqueous extracts of Pinus halepensis leaves and c...
BACKGROUND: plants represent an exhaustible source of chemical molecules with a diverse biological activity. In this context, our study deal with the antifungal effect of aqueous extracts of Pinus halepensis leaves and cones as well as bioactive substance (gallic acid) on pathogenic fungi namely: Trichophyton rubrum, Microsporum canis, and Candida albicans. METHODS: methods involving direct contact and diffusion on agar plates were used. Antifungal testing was performed using aqueous extracts Results: the studied strains were sensitive to aqueous extracts of P. halepensis leaves and cones..The aqueous extract of P. halepensis leaves and cones of 200 mg/ml had a good antifungal activity as the percent inhibitions were respectively: 62% and 58% on T. rubrum, 80% and 65% on M. canis. The effect of the gallic acid is less significant in on both dermatophytes. The C. albicans strain was particularly sensitive to the extracts of P. halepensis leaves with inhibition areas of 18 mm diameter. CONCLUSION: these results indicate that extracts of P. halepensis may constitute an alternative solution for treatment of mycosis dermatosis and using an in vivo study as a perspective.
Relationship between Charlson Comorbidity Index and Obstructive Sleep Apnea severity indicators in a Tunisian cohort.
Ben Hmida L, Moussa I, Jallouli NL … +3 more , Mrassi H, Sahnoun I, Douik El Gharbi L
Tunis Med · 2025 Dec · PMID 41949938 · Publisher ↗
INTRODUCTION: Obstructive sleep apnea (OSA) is a recognized cardiovascular risk factor, associated with increased morbidity and mortality. Charlson comorbidity index (CCI) is widely used to measure comorbidities in chron...
INTRODUCTION: Obstructive sleep apnea (OSA) is a recognized cardiovascular risk factor, associated with increased morbidity and mortality. Charlson comorbidity index (CCI) is widely used to measure comorbidities in chronic conditions. OBJECTIVE: This study aimed to evaluate the CCI as a potential screening tool for severe OSA by assessing its association with OSA severity predictors. METHODS: A retrospective study was conducted at a pneumology department, including OSA patients. The CCI was assessed and its median CCI calculated. Patients were divided to two groups: Group1 including patients with CCI greater than or equal to the median, and group2 below the median. RESULTS: Median CCI was 3±1.6. Statistical analysis showed a significant association between a CCI greater than or equal to 3 and age (63 vs 47 years; p<0.001), Stop Bang score (5 vs 4; p=0.003), diastolic blood pressure (80 vs 70 mmHg; p=0.023), glycemia (7 vs 5 mmol/l; p=0.0001), arterial oxygen pressure (82 vs 86 mmHg; p=0.009), desaturation index (32 vs 28/h; p=0.022), minimal nocturnal pulse oxygen saturation (76 vs 78%; p=0.005), and nocturnal pulse oxygen saturation below 90% (17 vs 13%; p=0.02). No significant association was noted between the CCI and Epworth score, Pichot score, body mass index, apnea hypopnea index, mean duration of hypopnea or apnea, and mean nocturnal oxygen saturation. The CCI demonstrated sensitivity of 66% and specificity of 49% at a cutoff of 2.5 (AUC = 0.6, p<0.001). CONCLUSION: The CCI showed a significant but modest ability to identify severe OSA, with variable associations across OSA severity predictors.
The household financial burden of Diabetes Mellitus and its effect on adherence and beliefs abouts medicines among patients followed in primary care settings in a Sousse governorate, Tunisia.
Amara A, Douss N, Ben Saad OK … +10 more , Aissa I, Guetet M, Ach T, Guiga A, Bannour R, Sahli J, Mellouli M, ELghardellou M, Zeddini C, Mtiraoui A
Tunis Med · 2025 Dec · PMID 41949937 · Publisher ↗
BACKGROUND: Diabetes Mellitus (DM) represents a significant public health challenge on a global scale, with rising prevalence rates and substantial economic burdens. The current study aimed to measure DM related Out-of-P...
BACKGROUND: Diabetes Mellitus (DM) represents a significant public health challenge on a global scale, with rising prevalence rates and substantial economic burdens. The current study aimed to measure DM related Out-of-Pocket Costs among Tunisian patients and its effect on adherence to treatment and beliefs about medicines. METHODS: A cross-sectional study was conducted from May to July 2023 in basic health facilities in Sousse governorate, Tunisia. For data collection, we used the Arabic version of self-report scale "The Cost for Patients Questionnaire" in order to measure Health-Related Out-of-Pocket Costs. Assessment of patients' adherence to diabetes medications was made using the eight-item Morisky Medication Adherence Scale (MMAS-8). The third part included a self-reported questionnaire to measure patients' perceptions of medication; the Beliefs about Medicines Questionnaire (BMQ-specific). RESULTS: A total of 273 patients responded to the questionnaire from 8 Basic Health Center (BHC) in Sousse. The mean age of the patients was 60 ± 11,3 years, with extremes ranging from 28 to 86 years and Females predominance, with a sex ratio equal to 0.73. The study revealed that the median duration of diabetes among patients was 6 years, with (IQR) of [3-15] years. Among the respondents, 39.3% reported having paid employment, with a median salary equal to 600 Tunisian Dinars and (IQR) of [250-900]. Patients had a median direct medical cost of 75 TND (IQR: [20-170]). The median indirect medical cost for patients was 8 TND (IQR: [2.7-19.75]). Which gives a total of annual cost of 94.59 USD....( abstract truncated at 250 words).
Tunisian Validation of the Dysarthria Clinical Evaluation Battery.
Abdelhadi R, Messelmani M, Chaker E … +6 more , Souissi S, Soussi S, Beldi S, Derbali H, Mansour M, Zaouali J
Tunis Med · 2025 Dec · PMID 41949936 · Publisher ↗
BACKGROUND: Dysarthria is defined as a motor speech disorder that can cause major communication problems. Meticulous assessment of this disorder is crucial for adequate therapeutic follow-up. AIM: To Provide tunisian spe...
BACKGROUND: Dysarthria is defined as a motor speech disorder that can cause major communication problems. Meticulous assessment of this disorder is crucial for adequate therapeutic follow-up. AIM: To Provide tunisian speech therapists with an almost complete tool for the evaluation of dysarthria. METHODS: A single-center study adapted and validated the Dysarthria Clinical Evaluation Battery BECD 2019 in 135 dysarthric patients and 135 adult controls at different stages. RESULTS: Comparison of scores between all samples showed significance, hence the sensitivity of the tool. Construct validity was carried out with the help of expert neurologists and speech therapists. Cronbach's alpha coefficient revealed a value of 0.7, indicating good internal consistency of the scale. The ROC curves of the different tests guided us in leaving the same threshold scores of the original battery. CONCLUSION: Our study provided a dysarthria assessment tool, adapted to the Tunisian context, promoting a standardized clinical evaluation in order to harmonize communication amongclinicians.
Risk factors of hypothyroidism after hemithyroidectomy.
Jeridi L, Rejeb E, Romdhane N … +4 more , Zoghlami I, Nefzaoui S, Hriga I, Mbarek C
Tunis Med · 2025 Dec · PMID 41949935 · Publisher ↗
INTRODUCTION: Hemithyroidectomy has been increasingly applied in patients with thyroid diseases. Although patients are expected to maintain normal thyroid function after hemithyroidectomy, some patients may develop hypot...
INTRODUCTION: Hemithyroidectomy has been increasingly applied in patients with thyroid diseases. Although patients are expected to maintain normal thyroid function after hemithyroidectomy, some patients may develop hypothyroidism, which requires thyroid-hormone substitution. Our aim was to identify the risk factors of postoperative hypothyroidism after hemithyroidectomy. METHODS: We conducted a retrospective, analytical and descriptive study including all patients who underwent hemithyroidectomy between 2017 and 2022, with a minimum follow up of 12 months. Hypothyroidism was defined as a postoperative serum thyroid-stimulating hormone (TSH) level higher than 5 mIU/L. Collected and analyzed data included age, sex, personal history of hyperthyroidism, family history of thyroid pathology, preoperative and postoperative TSH, nodule size, side and volume of resected and remaining lobesand definitive histological diagnosis. RESULTS: A total of 190 patients were included. Mean age of patients was 45.95 years [13;79]. The sex ratio (M/F) was 0.091. Of the 190 patients studied, 30 (15.79%) developed hypothyroidism after surgery. Among these patients 2 cases showed signs of clinical hypothyroidism such as constipation and asthenia. The mean duration of diagnosis after surgery was 3.75 months [1;12]. The personal history of hyperthyroidism, preoperative TSH greater than 1.9, remaining lobe volume less than 3.8 cm3 and the presence of lymphocytic thyroiditis on definitive pathological examination were associated with a significantly increased risk of hypothyroidism after Hemithyroidectomy (p< 0.01). CONCLUSION: Preoperative TSH level greater than 1.9, remaining lobe volume less than 3.8 cm3 and the presence of lymphocytic thyroiditis on pathological examination justify postoperative TSH monitoring up to 12 months after surgery.
Non-Invasive Ventilation in Hypercapnic Acute Respiratory Failure : Hospital Outcomes And Home Follow-Up.
Khemakhem R, Wadhane I, Gargouri R … +4 more , Abid H, Msaad S, Kallel N, Kammoun S
Tunis Med · 2025 Dec · PMID 41949934 · Publisher ↗
INTRODUCTION: Non-invasive ventilation (NIV) is beneficial in hypercapnic acute respiratory Failure (ARF) for enhancing alveolar ventilation and reducing the need for intubation. Follow- Up care is essential for effectiv...
INTRODUCTION: Non-invasive ventilation (NIV) is beneficial in hypercapnic acute respiratory Failure (ARF) for enhancing alveolar ventilation and reducing the need for intubation. Follow- Up care is essential for effective management. Our study aims to identify best practices for acute NIV and home follow-up. METHODS: Observation al study of hospitalized patients with hypercapnic ARF treated with NIV In the Pneumology Department. RESULTS: We included 64 patients with a sexratioof1.3.The meanage was 66.66±2years. Respiratory pathologies were dominated by chronic obstructive pulmonary disease (45.3%, n=29),obesity-hypoventilation syndrome(17.18%,n=11),and bronchiectasis (15.8%,n=10). On admission,all patients were in respiratory acidosis(pH=7.32±0.04,PaCO2=67.87±11 mmHg,PaO2=55.56±10mmHg).The mean to talduration of NIVuse was7.21days±2.7. Three groups were defined:group1(G1:46.8%, n=30)(including patients discharged without Home NIV),group2(G2:26.6%,n=17)including patients discharged on long-term NIV, and group3(G2:26.6%,n=17)including patients with adelayed indication for NIV. Recurrence of ARF was noted in26.56% of patients(n=17).Themortality ratewas7.8%(n=5). CONCLUSION: A protocol for monitoring and prescribing NIV at home is needed to improve Quality of life and survival and prevent ARF recurrence.
Falls in rheumatoid arthritis: Prevalence and associated factors.
Makhlouf Y, Mahjoub S, Boussaa H … +8 more , Miladi S, Souebni L, Ouenniche K, Kassab S, Chekili S, Ben Abdelghani K, Fazaa A, Laatar A
Tunis Med · 2025 Dec · PMID 41949933 · Publisher ↗
OBJECTIVE: to assess the frequency of falls and identify its associated factors in rheumatoid arthritis (RA)patients. METHODS: we conducted a cross-sectional study includingRA patients according to the ACR EULAR criteria...
OBJECTIVE: to assess the frequency of falls and identify its associated factors in rheumatoid arthritis (RA)patients. METHODS: we conducted a cross-sectional study includingRA patients according to the ACR EULAR criteria 2010. Sociodemographic and disease-related data were collected. Fall risk and balance disorders were evaluated respectively according to the Timed Up and Go Test (TUG) and the Berge Balance Scale (BBS). Foot disability was assessed using the Foot Function Index (FFI). RESULTS: Fifty patients were included. The mean age was 58 years [30-88] with a gender ratio of 0.25. The average disease duration was 11 years [1-47]. Previous falls were found in 25% of the patients, resulting in fractures in 6.3% of them. Only three patients reported a history of fall in the last year with recurrent falls reaching 12.5%. There was a statistically significant association between the occurrence of falls and a prolonged TUG score (p= 0.041) as well as a history of vertigo (p<0.05). Similarly, the risk of falls was more frequent in female RA patients with a prolonged disease duration but without reaching a significant threshold (p=0.05). CONCLUSION: the study highlighted the frequent risk of falls in patients with RA. Factors associated with fall occurrence involved the number of falls, and a history of vertigo.
Predictive factors for treatment in diabetic macular edema.
Chaabani L, Nefzi D, Kalou M … +1 more , Jaklouti A
Tunis Med · 2025 Dec · PMID 41949932 · Publisher ↗
BACKGROUND: Diabetic macular edema represents the primary cause of blindness in individuals under the age of 50 and in those with diabetes. Treatment success is influenced by numerous factors.Our objective was to identif...
BACKGROUND: Diabetic macular edema represents the primary cause of blindness in individuals under the age of 50 and in those with diabetes. Treatment success is influenced by numerous factors.Our objective was to identify factors affecting anatomical and functional responses to DME treatment. METHODS: This retrospective study included 95 eyes of 54 patients treated for diabetic macular edema in our Ophthalmology Department at the Regional Hospital of Kasserine, Tunisia, between January 2016 and January 2018.Statistical analysis was done in 3 steps: a univariate analysis, then a bivariate analysis and finally, we performed a multivariate analysis with a logistic regression. Analysis was performed using the statistical software "SPSS 20.0". RESULTS: The multivariate analysis selected one principal factor: poor initial acuity as the only predictive factor of poor functional response to treatment with OR=35,763. The independent variables associated with a poor anatomical response to treatment were dyslipidemia (OR = 0.923), diabetic nephropathy (OR = 4.46), and proliferative diabetic retinopathy (OR = 0.063). CONCLUSION: The treatment of diabetic macular edema is associated with high costs and a variable response from one patient to another, justifying better definition of the predictive factors for treatment. The results of other future studies will probably give answer for this question.
Early maladaptive schemas in substance use disorder: A case-control study.
Laabidi S, Hajri A, Karmous A … +4 more , Bougacha D, Maamri A, Khelifa E, Zalila H
Tunis Med · 2025 Dec · PMID 41949931 · Publisher ↗
INTRODUCTION: Early maladaptive schemas have been increasingly implicated in the development of numerous psychopathological conditions. However, research examining their association with substance use disorders remains l...
INTRODUCTION: Early maladaptive schemas have been increasingly implicated in the development of numerous psychopathological conditions. However, research examining their association with substance use disorders remains limited. AIM: We aimed to identify and evaluate the activation levels of early maladaptive schemas in individuals diagnosed with a substance use disorder in comparison to a healthy control group. METHODS: We conducted a cross-sectional, analytic, and case-control study over four months (December 2023 - April 2024). Our investigation included 50 subjects with a substance use disorder who presented to the outpatient department or the Tanit Center of RAZI HospitalControl subjects were recruited from the Manouba dispensary. The two groups were compared using Young Schemas Questionnaire scores. RESULTS: The mean age of patients was 33.7 years. The sex ratio was 3.17. The most frequently used substances were cannabis (74%) and alcohol (54%). Subjects diagnosed with a substance use disorderhad significantly higher mean scores compared with controls for emotional deprivation (p<10⁻³), abandonment (p<10⁻³), distrust (p<10⁻³), social isolation (p<10⁻³), defectiveness (p<10⁻³),dependence (p<10⁻³), subjugation (p<10⁻³), emotional inhibition (p<10⁻³),insufficient self-control (p<10⁻³), as well as for the total score of Young's Short Form Schema Questionnaire (p<10⁻³). CONCLUSION: The findings of this study highlight the link between maladaptive early schemas and substance use disorders, reinforcing the validity of the schema model. These results have important clinical implications, suggesting that therapeutic approaches that address and modify early maladaptive schemas may be effective in preventing and treating addiction.
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