INTRODUCTION: Skin aging involves both chronological aging influenced by human genetics and extrinsic aging mainly caused by UV radiation and smoking. Dermoscopy is a non-invasive diagnostic tool that provides accurate a...INTRODUCTION: Skin aging involves both chronological aging influenced by human genetics and extrinsic aging mainly caused by UV radiation and smoking. Dermoscopy is a non-invasive diagnostic tool that provides accurate aging assessment signs which may be invisible to the naked eye. This study aims to investigate and compare the dermoscopic features of facial photoaging in Moroccan females and males across various age groups. It also seeks to assess the impact of other factors associated with premature skin aging, notably smoking. METHODS: A descriptive and comparative study was conducted on 207 subjects with at least one hour of daily sun exposure. Participants were divided into three age groups: 35-49, 50-64, and 65+ years. RESULTS: In the group aged 35 to 49 years, a significant difference was observed between genders regarding yellowish discoloration, white lines, hypo-/hyperpigmented macules (P = 0.003) and deep wrinkles (P = 0.02). For subjects aged 50 to 64 years, males exhibited a significantly higher prevalence of yellowish discoloration and skin atrophy compared to females. However, females had a higher prevalence of superficial wrinkles (P = 0.02). In the group aged 65 years and older, significant differences were observed between females and males regarding white lines/skin atrophy, actinic keratosis, and senile comedones, all of which were more prevalent in males. CONCLUSION: Dermoscopy is a straightforward method for better assessing facial aging and detecting early signs of photoaging leading to ensure prevention of skin aging and to monitor the effectiveness of therapeutic applications.
AIM: Study the synergistic effects of noise-toluene co-exposure on hematological parameters, oxidative stress and pulmonary architecture in rats. METHODS: 24 male Wistar rats were divided into four groups: control, noise...AIM: Study the synergistic effects of noise-toluene co-exposure on hematological parameters, oxidative stress and pulmonary architecture in rats. METHODS: 24 male Wistar rats were divided into four groups: control, noise exposure, toluene exposure and co-exposure noise-toluene. Biological analyses were performed to determine hematological parameters and evaluate markers of oxidative stress. Histopathological sections were observed to assess pulmonary tissue damage and the degree of inflammatory response. RESULTS: Hematological analysis revealed a significant decrease in red blood cells (RBCs), accompanied by an increase in white blood cells (WBCs) and platelets. Histological examination of lung tissues revealed inflammation with alveolar wall damage and peribronchial immune cell infiltration in the co-exposed group, which correlated with increased vascular permeability and pulmonary edema. Exposure to toluene and noise resulted in significant disruption of the pulmonary tissue structure accompanied by oxidative stress. CONCLUSION: The results suggest that combined exposure to toluene and noise causes structural and functional changes in lung tissues and alterations in hematological parameters.
INTRODUCTION: Polycystic ovary syndrome (PCOS) is a common endocrine disorder affecting women worldwide, posing a major public health concern. This multifaceted condition significantly impairs quality of life (QOL) acros...INTRODUCTION: Polycystic ovary syndrome (PCOS) is a common endocrine disorder affecting women worldwide, posing a major public health concern. This multifaceted condition significantly impairs quality of life (QOL) across multiple domains. AIM: To assess QOL and eating disorders (EDs) in patients with PCOS. METHODS: A cross-sectional descriptive and comparative study was conducted on women with confirmed PCOS who were followed in the Endocrinology Department of Hedi Chaker Hospital, Sfax, Tunisia, and a targeted group of women with PCOS recruited through Google Forms. The PCOSQ-42 questionnaire for unmarried women, the PCOSQ-47 for married women, and the SCOFF questionnaire were used as assessment tools. Participants were divided into two groups: Group 1, consisting of French participants, and Group 2, consisting of Tunisian participants. RESULTS: A total of 71 French participants (Group 1) and 101 Tunisian participants (Group 2) were included in the study. All participants reported a compromised QOL. Among married women, the psychological well-being domain had the lowest score (2.86 ± 0.7), while the menstrual and fertility disorders domain was the most affected among unmarried women, with an average score of 2.84 ± 0.8. EDs were identified in 70.93% of participants, with a higher prevalence among unmarried women. A better QOL was observed among married women in Group 2 compared to their counterparts in Group 1. CONCLUSION: The findings reveal a high prevalence of impaired QOL and EDs in women with PCOS, with cultural and marital status differences warranting tailored interventions.
INTRODUCTION: The long-term effects of COVID-19 have been recognized as a significant public health issue, particularly for hospitalized patients who may experience persistent symptoms and lung complications. This study...INTRODUCTION: The long-term effects of COVID-19 have been recognized as a significant public health issue, particularly for hospitalized patients who may experience persistent symptoms and lung complications. This study aimed to determine the prevalence of persistent clinical symptoms and determine the predictive factors of persistent CT scan abnormalities (PCA) after COVID-19 pneumonia. METHODS: This was a longitudinal cohort study of patients followed up after being hospitalized for confirmed SARS-CoV-2 pneumonia. Patients were assessed for persistent clinical symptoms at one month and for PCA at four months. A logistic regression model was employed to assess the relationship between PCA and explanatory variables. RESULTS: A total of 240 patients were included. The sex ratio was 1.75, with a mean age of 57.6(± 11.5) years. The median length of stay was 10 [7-15] days. Initial CT scans revealed severe impairment in 23%. After one month, 75.8% had at least one persistent symptom. Hyperventilation syndrome was diagnosed in 15.4% of patients. At four-month follow-up, CT scan showed that 65% of patients had PCA. Factors associated with PCA, included age (p=0.001), initial dyspnea (p=0.021), length of hospital stay (p=0.001), an initial CT Severity Score (CTSS)≥ 50 (p=0.047), a low FEV1 (p=0.022), a low Total Lung capacity (TLC) (p=0.035) and impairment in DLCO (p=0.012). Logistic regression identified older age (OR=1.05 [1.02;1.08], p= 0.01), longer hospital stay (OR=1.12 [1.04;1.21], p= 0.003), and dyspnea (OR=3.11 [1.28;7.52],p= 0.012) as independent predictive factors of PCA. CONCLUSION: clinical and radiological long-term sequelae of COVID-19 are frequent, particularly in older patients, those with dyspnea, or with extended hospital stays.
INTRODUCTION: In Tunisia, where healthcare resources are often limited, nuclear imaging techniques are revolutionizing cardiac care. They provide critical information on myocardial perfusion, contractile function, and me...INTRODUCTION: In Tunisia, where healthcare resources are often limited, nuclear imaging techniques are revolutionizing cardiac care. They provide critical information on myocardial perfusion, contractile function, and metabolic processes, transforming the ischemic heart disease management. AIM: This study explores the essential role of isotopic examinations in assessing myocardial viability and evaluates their impact on therapeutic decision-making. METHODS: A prospective descriptive and analytical study was conducted on 40 patients for whom myocardial viability studies were indicated. All patients underwent isotopic examinations and coronary angiographies performed between January 2022 and June 2023. RESULTS: Myocardial viability scintigraphy (MVS) showed that 62.5% of myocardial territories were non-viable, while 37.5% were hibernating. These results perfectly matched those obtained by 18FDG PET-CT. MVS proved to be a highly reliable tool that significantly influenced therapeutic decisions. Revascularization was indicated in 40% of patients with viable myocardium, while medical treatment was prescribed for all patients with non-viable myocardium. During a follow-up period, a significant improvement in left ventricular ejection fraction (LVEF) was observed in the group of patients with hibernating myocardium treated with revascularization compared to those treated medically (p=0.02). Additionally, non-viable group had a higher mortality rate (12%) compared to viable group (6.7%). Survival rates were better in the group with viable lesions (93% vs 85%). CONCLUSIONS: This is the first prospective study conducted in Tunisia assessing the contribution of isotopic examinations in evaluating myocardial viability. The diagnostic value of MVS is comparable to metabolic imaging. Furthermore, nuclear imaging techniques can influence therapeutic management and provide information on long-term prognosis.
INTRODUCTION: Dental healthcare workers are at risk of being infected during their work due to exposure to blood. AIMS: To determine the prevalence of accidental exposure to blood and body fluids, to assess the knowledge...INTRODUCTION: Dental healthcare workers are at risk of being infected during their work due to exposure to blood. AIMS: To determine the prevalence of accidental exposure to blood and body fluids, to assess the knowledge, attitudes, and practices of these dental healthcare workers, and to identify factors associated with this exposure. METHODS: A cross-sectional hospital-based study was conducted between December 1st 2020 and June 1st 2021 in the dental services of five referrals hospitals. Dental healthcare workers present at the time of the study were recruited. Data were analyzed with R software. Multivariate analysis was used to determine factors associated with blood exposure, with their adjusted odds ratios and p-values. A p value < 0.05 was considered statistically significant. RESULTS: The frequency of accidental exposure to blood was 55% (95% CI: 47.9% - 67.2%), with needle stick injury (34.8%) being the main mechanism. Assessment of perceptions among victims revealed that those with average knowledge (84.6%), right attitudes (62.5%), and adequate practices (55.5%) were predominant. Factors statistically associated with accidental exposure were dental technician (adjusted Odds Ratio = 2.5; p = 0.02), length of employment greater than 10 years (adjusted Odds Ratio = 1.9; p < 0.01), insufficient knowledge (adjusted Odds Ratio = 2.5; p = 0.023), harmful attitudes (adjusted Odds Ratio = 3.5; p = 0.006), and inadequate practices (adjusted Odds Ratio =1.6; p = 0.008). CONCLUSION: There is a high rate of accidental exposure to blood in dental units. Efficient strategies to protect dental healthcare workers should be identified and implemented.
AIM: This study aimed to compare student success rates between the in-person and hybrid learning phases of the chronic Pain Certificate (CPC) at the Faculty of Medicine of Tunis (FMT), and to assess student satisfaction...AIM: This study aimed to compare student success rates between the in-person and hybrid learning phases of the chronic Pain Certificate (CPC) at the Faculty of Medicine of Tunis (FMT), and to assess student satisfaction with the hybrid model. Additionally, we evaluated the effects of platform modifications on students' satisfaction. METHOD: A retrospective analysis was conducted over five years (2018-2024) involving medical students enrolled in the CPC. Success and failure rates were compared between the in-person phase (2018-2020) and the hybrid phase (2020-2024). Student satisfaction was assessed through surveys. RESULTS: Among the 301 students included, 115 (38.2%) participated in the in-person phase, and 186 (61.8%) in the hybrid phase. The overall success rate was 81.39%. The success rate in the hybrid phase (84.4%) was higher than in the in-person phase (76.5%), though the difference was not statistically significant (p=0.08). Among 70 students who completed the satisfaction survey, self-rated knowledge on chronic pain increased significantly after the course (p=0.013). Satisfaction with the platform improved post-modification in several aspects, including interest in modules 1, 2, 3, and 5 (p=0.036, p=0.047, p=0.004, p=0.025, respectively), resource usefulness in modules 1, 3, 4, and 5 (p=0.004, p=0.002, p=0.012, p=0.018, respectively), and clarity of Module 3 resources (p=0.05). The estimated average preparation time decreased from 96.2 hours to 87.1 hours post-modification, though this change was not statistically significant (p=0.6). CONCLUSION: The integration of an online platform into the CPC at FMT was associated with improved student success rates and satisfaction.
Introduction . The flipped classroom (FC) integrates online content delivery with in-class activities focused on knowledge application, such as discussions and problem-solving. While increasingly prevalent in medical edu...Introduction . The flipped classroom (FC) integrates online content delivery with in-class activities focused on knowledge application, such as discussions and problem-solving. While increasingly prevalent in medical education field, the efficacy of FC remains a subject of debate. Objective . This protocol outlines a systematic review (SR) to examine the scope and methodological quality of studies on the FC teaching approach in medical education. Methods . The protocol was registered in PROSPERO (CRD420251008268) and adhered to the Preferred Reporting Items for SRs Protocols guidelines. A thorough literature search will be performed using Scopus, PubMed/Medline, the Cochrane Library, and Google Scholar. The review will consider comparative controlled studies that focus on FC in the medical learning field. Two independent reviewers will carry out a rigorous data extraction. The Medical Education Research Study Quality Instrument will be used to evaluate the study's quality. Synthetizing the findings of this SR will provide a thorough understanding of the impact of FC in academic performance and students' satisfaction in medical learning. Expected results . This qualitative summary will offer a narrative overview of the included papers, emphasizing interventions designed to evaluate the impact of FC. Results will be discussed according to the review's objectives, evaluating both study quality and consistency of findings, and will be clearly illustrated using tables and graphs. Conclusion . The SR developed from this protocol will undoubtedly provide evidence of the effectiveness of FC in medical education and will effectively contribute to increasing the present body of information on FC interventions for improving outcomes.
BACKGROUND: There is ongoing discussion regarding the terminology used when atrial fibrillation (AF) is present alongside either valvular heart disease (VHD) or non-valvular heart disease (NVHD). We conducted this meta-a...BACKGROUND: There is ongoing discussion regarding the terminology used when atrial fibrillation (AF) is present alongside either valvular heart disease (VHD) or non-valvular heart disease (NVHD). We conducted this meta-analysis to assess the effectiveness and safety of dabigatran compared to warfarin in AF patients with VHD and NVHD. METHODS AND RESULTS: Online databases were searched for eligible studies. Ten RCTs (22981 patients) were included. In NVHD subgroup, dabigatran 150 mg showed no statistically significantly difference in stroke (S) and systemic embolism (SE) (risk difference (RD) -0.01,95% confidence interval(CI):-0.01,0.0), and death (RD -0.00,95% CI -0.01,0.00) except for intracranial hemorrhage (ICH) (RD -0.01,95% CI -0.01,-0.01), and major bleeding (RD -0.02,95% CI -0.04,-0.00), similarly ,110 mg showed a low risk of ICH (RD -0.01,95% CI -0.01,-0.01), and no significant differences in S/SE and death compared to warfarin. In VHD subgroup, dabigatran showed no significant differences in S/SE (RD 0.02,95% CI -0.03,0.07), major bleeding (RD 0.01,95% CI -0.02,0.04), and death (RD -0.01,95% CI -0.04,0.01) compared to warfarin. In the catheter ablation subgroup, dabigatran reduced only groin hematoma (RD -0.02,95% CI -0.03,-0.00). CONCLUSION: Dabigatran 150 mg and 110 mg was superior to warfarin in AF patients with NVHD in reducing bleeding particularly ICH; However, no significant difference in reducing S/SE, and mortality. In catheter ablation, dabigatran reduced only groin hematoma. In the VHD subgroup, dabigatran did not show superiority or inferiority to warfarin; further studies are needed. "Non-valvular AF" should be replaced with "type II VHD" to distinguish it from other valvular heart diseases.
INTRODUCTION: The effect of Artificial Intelligence on scientific research is currently controversial (over-use, refusal). The objective of this scoping review was to summarize the impact of Generative Pre-Trained Bots (...INTRODUCTION: The effect of Artificial Intelligence on scientific research is currently controversial (over-use, refusal). The objective of this scoping review was to summarize the impact of Generative Pre-Trained Bots (ChatGPT) on medical research, for optimal use. METHODS: In accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, three electronic databases (MEDLINE, Web of Science, and Scopus) were searched for publications on the use of ChatGPT in medical research up to September 30, 2024. The inclusion criteria encompassed systematic reviews, meta-analyses, and reviews published in English or French. A synthesized and consensual perspective was then derived using the SWOT (Strengths, Weaknesses, Opportunities, and Threats) approach. RESULTS: Among the 120 articles identified during the study period, 33 publications were reviewed to describe the impact of ChatGPT on medical research skills. It emerged that ChatGPT was considered a tool for generating innovative ideas and analyzing "Big Data," helping researchers execute manually time-consuming processes. However, its responses may be accompanied by "hallucinations," posing a threat to the scientific integrity of medical research. CONCLUSION: ChatGPT serves as a valuable aid in medical research, particularly in its conceptualization and writing phases. However, its potential drawbacks, such as "hallucinations," highlight the need to strengthen young researchers' skills in the proper use of Artificial Intelligence.
INTRODUCTION: Scientific publication plays a vital role in sharing research outcomes, enhancing knowledge, and fostering academic careers. However, researchers in low-income countries like Tunisia often face significant...INTRODUCTION: Scientific publication plays a vital role in sharing research outcomes, enhancing knowledge, and fostering academic careers. However, researchers in low-income countries like Tunisia often face significant barriers, including limited access to funding, training, mentorship, and high-impact journals. These challenges can hinder their ability to publish effectively and at the right time. This study explored strategies for successful medical publication and examined the optimal timing for manuscript submission, 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 expert presentations, group discussions, and a review of relevant literature. RESULTS: Timing was highlighted as a key strategic factor: submitting a manuscript upon completion of data analysis, in response to a call for papers, ahead of a major scientific event, or when the topic is particularly relevant can significantly increase the visibility and impact of the publication. Scientific publication also plays a crucial role in academic recognition and career progression. Careful planning, strategic journal selection, and adherence to editorial and ethical standards were identified as essential elements for improving publication success. CONCLUSION: Knowing when to publish can make all the difference. Submitting a manuscript at the right time - whether it is shortly after completing data analysis, when the topic is gaining attention, or in response to a specific call for papers - can significantly increase a study's visibility and impact. However, timing alone is not enough. With the right training, thoughtful journal selection, and strong institutional support, researchers - especially those in low- and middle-income countries - can overcome many of the barriers they face and share their work more effectively with the global scientific community.
The Middle East, Mediterranean, and Africa (MEMA) region, encompassing 68 countries and 20% of the global population, contributes only 6% of the world's registered clinical trials. This editorial identifies eight key bar...The Middle East, Mediterranean, and Africa (MEMA) region, encompassing 68 countries and 20% of the global population, contributes only 6% of the world's registered clinical trials. This editorial identifies eight key barriers to clinical research in the region: (1) limited collaboration with high-income country (HIC) universities supporting low-income country (LIC) research, (2) insufficient specialized training programs, (3) inadequate laboratory and technological infrastructure, (4) lack of research methodology integration in medical curricula, (5) underdeveloped local institutional review boards, (6) insufficient and unsustainable funding, (7) limited technology transfer from HICs to LICs, and (8) migration of skilled professionals to HICs. These challenges hinder the region's research capacity and global contribution. Proposed solutions include fostering HIC-LMIC partnerships, enhancing training through scholarships and local research centers, improving infrastructure via international collaboration, and developing robust ethical review systems. By addressing these barriers, LMICs can increase their contribution to global clinical research, promoting equitable health outcomes.
Abdelaziz A, Abdelhedi Y, Abdelkrim M
… +102 more, Abdelmoula M, Abdelouahab F, Abdesalem M, Abid Y, Ajmi H, Barkous B, Ben Abdelaziz A, Ben Abdelkrim M, Ben Amor F, Ben Cheikh A, Ben Hadj Khelifa A, Ben Hmid W, Ben Khelifa M, Ben Khamsa J, Ben Lazreg N, Ben Mrad N, Ben Saad H, Ben Saida I, Ben Salem S, Ben Zouid B, Belazreg N, Belkacem M, Benzarti A, Benzarti H, Bercheche N, Besbes A, Bhiri S, Bouguila J, Bougrida M, Boumalleh F, Boumellah F, Bourahli M, Braham H, Braham N, Briki C, Chaabouni D, Chalghaf O, Charfedi E, Chekir R, Chibout N, Chabbou A, Daly S, Dahmani A, Dammak N, Derbel K, Dhraief S, Elleuch E, Elfani N, Elhreich A, Ferchichi S, Fakhfakh H, Fnina H, Gaddas M, Gallas S, Ghanmi M, Ghannouchi I, Guezguez F, Haddad N, Haddar A, Harzallah B, Hassad C, Hassine R, Hedhili S, Hentati H, Hizem R, Jguirim M, Kammoun R, Kechiche J, Ketata I, Khaldi S, Kchaou K, Khemiss M, Khemis M, Knaz H, Kramti A, Maalej M, Mannai A, Masmoudi K, Mel R, Metaouaa S, Molk M, Mougou S, Moussa A, Nouira A, Omezzine A, Rezigui S, Riahi A, Riahi Z, Rouatbi S, Saafi M, Sahli J, Sakly G, Sallem O, Sari A, Sayhi A, Seri F, Talbi I, Trabelsi H, Toure M, Yahyaoui A, Yacoub S, Zaalouni S
Abid A, Aissaoui L, Ayachi N
… +56 more, Ayed K, Azza E, Baazoug G, Barka M, Ben Abdallah A, Ben Ahmed K, Ben Elkilani O, Ben Fekih N, Ben Hamida O, Benlakhal R, Bedoui MH, Bettaieb A, Bint Mohamed T, Boudriga H, Charfi H, Charfi J, Chatti K, Cherif S, Chrfeddine S, Chtourou K, Dardouri T, Ezzine A, Frifita R, Ghannem R, Hajer L, Hamza F, Habechi C, Hsasna R, Jalel MK, Jardak I, Kasbi Y, Kacem K, Khadhraouia J, Lahdhiri H, Lamia Aissaoui L, Mazhoud A, Meddeb I, Mensi S, Mili M, Mhiri A, Mhiri C, Missaoui ZE, Mohamed Khaled J, Nouira M, Ouachem M, Rebah M, Romdhani M, Sakri H, Sayedi M, Sfar R, Slim I, Somai M, Teheni D, Trabelsi H, Yeddes I, Znati Jouini M
INTRODUCTION: Central pontine myelinolysis (CPM) is a rare condition that has been reported to occur in association with rapid correction of hyponatremia. Chronic hyperglycemia is an extremely rare cause of CPM with no o...INTRODUCTION: Central pontine myelinolysis (CPM) is a rare condition that has been reported to occur in association with rapid correction of hyponatremia. Chronic hyperglycemia is an extremely rare cause of CPM with no other metabolic disturbances. Our aim was to describe the case of a patient who presented with CPM associated with chronic hyperglycemia. OBSERVATION: We report the case of a 55-year-old male with a personal history of diabetes mellitus who presented, over two months, gait disorders, slurred speech, and dysphagia. All laboratory tests were within normal limits except for glycated hemoglobin level which was high at 12%. Calculated serum osmolality level was normal at 309.8 mOsm/kg. Brain magnetic resonance imaging was consistent with the diagnosis of CPM. Patient's medical condition improved by optimizing blood glucose levels, physical rehabilitation and speech therapy. CONCLUSION: This case highlights the hypothesis of chronic hyperglycemia being the direct cause of CPM. The underlying mechanism might be the toxicity of varying blood glucose levels towards the oligodendrocytes.
OBJECTIVE: Carcinomas of the external auditory canal (CEAC) are rare with poorly defined treatment guidelines. The aim of this study is to discuss the therapeutic management of patients with CEAC. METHODS: It was a retro...OBJECTIVE: Carcinomas of the external auditory canal (CEAC) are rare with poorly defined treatment guidelines. The aim of this study is to discuss the therapeutic management of patients with CEAC. METHODS: It was a retrospective study conducted over an 11-year period (2010-2021), including 8 patients with primary CEAC. Cases were recorded in terms of gender, age, symptoms, physical signs, radiological examinations, surgical methods and follow- up. RESULTS: Median age was 58 years with a sex ratio of 0.6. Main symptoms were hearing loss (n=6), otorrhea (n=4), otalgia (n=4), and peripheral facial palsy (n=2). According to the Pittsburgh classification, CEACs were classified as T1N0M0 in 3 cases, T4aN0M0 in 4 cases, and T4bN0M0 in one case. Surgery consisted of a local resection of the tumor in four cases. A lateral temporal bone resection with total ipsilateral parotidectomy and functional neck dissection was performed in three cases with, respectively, a resection of the ipsilateral pinna (2 cases) and of the temporomandibular joint (2 cases). Adjuvant radiotherapy was indicated in 4 cases. Exclusive radiation therapy was indicated in one case. Histopathological examination confirmed 5 cases of squamous cell carcinoma, 2 cases of basal cell carcinoma, and one case of adenoid cystic carcinoma. Surgical margins were negative in 5 cases. Follow-up was favorable without recurrence in six cases. In one case, a progressive disease with patient death was observed. CONCLUSIONS: Optimal treatment requires early diagnosis and careful imaging assessment of tumor extension to tailor treatment, which often includes surgery and radiotherapy.
BACKGROUND: Forearm shaft fractures are common among children. Elastic stable intramedullary nailing (ESIN) is generally considered the gold standard operative procedure. This study aimed to assess functional outcomes, a...BACKGROUND: Forearm shaft fractures are common among children. Elastic stable intramedullary nailing (ESIN) is generally considered the gold standard operative procedure. This study aimed to assess functional outcomes, axial alignment, bone healing, and complication rates in pediatric population. METHODS: This retrospective cohort study reviewed pediatric forearm fracture cases from January 2016 to December 2020 at Mouwasat Dammam Hospital, Saudi Arabia. The study included children aged 16 years and younger who were treated with elastic intramedullary nailing. Both clinical and radiological outcomes were assessed, along with the occurrence of complications. RESULTS: The study included 64 patients with a mean age of 8.3 years. In 60.93% of cases, both forearm bones were fractured, and in 60.09%, the fractures were located in the distal third of the forearm. Open reduction was needed in 20.03% of cases. None of the cases showed mean axial alignment values greater than 10°. The mean healing delay was 56.4 days, with a range of 38-73 days. The average time for nail removal was 4.5 months. From a clinical perspective, 92.18% of the cases (59 patients) had favorable outcomes. The complication rate was 23.43%. CONCLUSION: ESIN has proven to be an effective method for stabilizing forearm fractures, ensuring proper alignment, promoting high union rates, and delivering satisfactory functional results. Although complications are relatively common, serious complications remain rare.
INTRODUCTION: Polycystic Ovary Syndrome (PCOS) is a common cause of menstrual disorders, infertility, and hyperandrogenism, often associated with insulin resistance and an increased risk of metabolic disorders. This stud...INTRODUCTION: Polycystic Ovary Syndrome (PCOS) is a common cause of menstrual disorders, infertility, and hyperandrogenism, often associated with insulin resistance and an increased risk of metabolic disorders. This study aimed to assess the metabolic and nutritional characteristics of overweight women with PCOS. METHODS: This was a descriptive, cross-sectional, and retrospective case-control study that included 61 overweight women, divided into two groups: 31 women with PCOS and 30 controls without PCOS. Data were gathered through review of the patients' medical records. RESULTS: High blood pressure, type 2 diabetes, dyslipidemia, and metabolic syndrome were significantly more frequent in the PCOS group compared to the control group (p<0.001; p<0.001; p=0.002; and p=<00001, respectively). Eating disorders were more frequently observed in women with PCOS, with a significantly higher occurrence of binge eating behaviors in these patients compared to the control group (p=0.009). The intake of saturated fatty acids was higher in women with PCOS (p=0.01). Regarding micronutrients, intakes of vitamin C and vitamin B1 were significantly lower in PCOS patients (p=0.01 and p=0.04, respectively). However, significantly more prevalent nutrient deficiencies in omega-6 fatty acids (p=0.001), vitamin C (p=0.002), vitamin B1 (p=0.03), vitamin B3 (p=0.003), vitamin B6 (p=0.03), and iron (p=0.02) were noted in the PCOS group. CONCLUSIONS: Women with PCOS exhibit a higher occurrence of cardio-metabolic risk factors and multiple nutritional deficiencies. Early and personalized management is crucial to improve their long-term health outcomes and quality of life.
INTRODUCTION AND AIM: Child mortality is a critical indicator of public health. Identifying the causes and circumstances of death among children is the first step in preventing this tragedy. The purpose of this study was...INTRODUCTION AND AIM: Child mortality is a critical indicator of public health. Identifying the causes and circumstances of death among children is the first step in preventing this tragedy. The purpose of this study was to investigate and analyse the epidemiological, social, and forensic characteristics of children deaths in Tunisia over a 14-year period and identify the leading causes of death. METHODS: We conducted a transversal descriptive study in the Department of Forensic Medicine at Habib Bourguiba University Hospital of Sfax over 14 years (January 1 st, 2008-December 31st, 2021) including all forensic autopsies carried out on children. RESULTS: A total of 436 cases were examined with a male predominance (Sex ratio:1.5) and a mean age of 8 ± 6 years. Accidents were the most prevalent manner of death (70%) followed by natural deaths (16%), suicides (7%) and homicides (2%). A significant association between sex, age group and the manner of death (natural/violent deaths) was observed (p<0.001). The majority of accidents were due to road traffic accidents (48%), followed by drowning (20%). For suicidal deaths, hanging was the most common method (65%) followed by self-immolation (16%) and, finally, ingesting pesticides (13%). The most frequent method of homicide was sharp force. CONCLUSION: This study provides valuable data regarding child mortality patterns in Tunisia, which can help to implement adequate preventive measures.