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La Tunisie Médicale

Rami Rhaiem, Amine Makni, Houcine Maghrebi, Alia Zehani, Amine Daghfous, Zoubaier Ben Safta
BACKGROUND: Nodular lymphoid hyperplasia (NLH) of the gastrointestinal (GI) tract is a rare condition in adults. It is usually asymptomatic. Few complications have been described. AIM:   We report an unusual clinical presentation of focal lymphoid hyperplasia of the GI. CASE REPORT: A 23-year-old female patient presented with a fistulizingdisease of the terminal ileum and the caecum complicated with an abscess of the lower right quadrant if the abdomen...
June 2017: La Tunisie Médicale
Mounira El Euch, Wifak Bani, Madiha Mahfoudhi, Fatima Jaziri, Khaoula Ben Abdelghani, Sami Turki, Taïeb Ben Abdallah
BACKGROUND: Lung damage during amyopathic dermatomyositis (ADM) associated with auto antibodies anti MDA-5 is serious. We report a rare observation of a severe ADM associated to anti MDA-5 antibodies complicated with diffuse interstitial lung disease (ILD) rapidly extensive and fatal. OBSERVATION: We report the observation of a Tunisian adult who was admitted for ADM. The anti MDA-5 antibodies were detected. He developed an ILD rapidly extensive to fibrosis. Corticosteroids were unefficient and he deceded of pneumomediastin and refractory respiratory distress...
June 2017: La Tunisie Médicale
Mohamed Amine Bani, Alia Zehani, Ines Chelly, Aida Khadhar, Slim Haouet, Nidhameddine Kchir
No abstract text is available yet for this article.
June 2017: La Tunisie Médicale
Alia Zehani, Ines Chelly, Jihene Marrakchi, Ezzeddine Chouat, Ghazi Besbes, Slim Haouet, Nidhameddine Kchir
A 57 year-old, male presented with a chronic unilateral nasal obstruction and epistaxis. Intranasal endoscopy showed multiple polypoid lesions. The computed tomography exam revealed a heterogeneous mass that occupied the right nasal cavity with osteolysis of the middle and lower cone causing fluid retention of the right maxillary sinus. He underwent resection of these lesions. Pathological examination revealed malignant transformation of nasal inverted papilloma into sarcomatoid carcinoma. This case report highlights the importance of considering malignant transformation in the differential diagnosis of polypoid lesions...
June 2017: La Tunisie Médicale
Mouna Ben Kilani, Soufia Naccache, Rami Tlili, Dorra Mbarek, Salma Longo, Youssef Ben Ameur, Mohamed Rachid Boujnah
Class Ic antiarrythmic overdose is associated with a relatively high mortality. We presenta case report regarding a suicidal intoxication of an 18-year old female with a medical history of Wolff-Parkinson-White syndrome. The preliminary examination highlighted a profound cardiovascular collapse. The electrocardiogram showed a PR interval extended to 360 ms. The QRS complexes were enlarged to 360 ms with a right bundle brunch block appearance associated with left posterior hemibloc. There were repolarization abnormalities such as elevation of the J-point, convex ST segment and biphasic T wave in the right precordial leads ("Brugada-Like ECG pattern")...
June 2017: La Tunisie Médicale
Houda Lajmi, Wassim Hmaied, Wady Ben Jalel, Khaoula Ben Romdhane, Zied Chelly, Lamia El Fekih
Backgroud: The fronto-ethmoidal mucocele is a benign condition leading commonly to limited eye movement or ocular pain but it could also induce visual acuity impairment by compressing the optic nerve Aim: To discuss, through a case report, different ophthalmologic manifestations of the fronto-ethmoidalmucocele. Reported case: A 46-years-old man with no general history consulted for a bilateral ocular redness and itching. He reported, however, a mild protrusion of his left globe evolving for oneyear. The clinical examination revealed a unilateral proptosis in the left eye with a discrete limitation of theadduction...
June 2017: La Tunisie Médicale
Rami Rhaiem, Houcine Maghrebi, Wael Rebai, Amine Makni, R Ksantini, Zoubaier Ben Safta
BACKGROUND: Laparoscopic gastric band (LAGB) has gained popularity among the surgical community since its first description in the early 90'. Actually, it is the third most practiced bariatric procedure in the world. The mean advantage of LAGB is a low rate of early postoperative morbidity. These satisfactory early results are in complete opposition with relatively high long term morbidity and a high rate of weight loss failure. AIM: Long term morbidity, weight loss and life quality index after LAGB were analyzed...
June 2017: La Tunisie Médicale
Dhouha Bacha, Zeineb Mzoughi, Oussama Belkacem, Salsabil Rejaibi, Ahlem Lahmar, Lassad Gharbi, Saadia Bouraoui
BACKGROUND: Extracapsular extension of nodal metastasis has recently emerged as an important prognostic factor in different malignancies. In colorectal cancer (CRC), only a limited number of studies have been published and its prognostic value has not yet been completely established. AIMS: To assess the incidence of extracapsular invasion (ECI) in lymph node (LN) metastasis in colorectal adenocarcinoma and to investigate the correlation between this parameter and other clinico-pathological factors...
June 2017: La Tunisie Médicale
Ines Ayedi, Hamed Chaabouni, Malek Akrout, Tahia Boudawara, Nabil Toumi, Afef Khanfir, Mounir Frikha
Cardiac metastases are rare. They are found in one to 10% of autopsies of patients withmalignant neoplasm. Adenocarcinoma represents the most common histologicaltype. The most common neoplasms that metastasize to the heart are lung andbreast cancers, melanoma, mesothelioma and lymphoma. However, Cardiacinvolvement is unusual in Hepatic, cutaneous and gastric cancer. We reportedthese three primary localizations in our cases.
June 2017: La Tunisie Médicale
Mehdi Ben Khelil, Majed Kamel, Sana Lahmar, Ali Mrabet, Nabiha Borsali Falfoul, Moncef Hamdoun
OBJECTIVE: Assess Death Certificates accuracy (DCs) issued by a teaching emergency department in Tunis. METHODS: It is a descriptive study. We included all death certificates issued in the Emergency Department of a teaching Hospital in Tunis over 17 months period (October 2013 - March 2014). Twenty-one errors have been predefined and classified as "Editing errors" or "Medical analysis error" then as major or minor errors. RESULTS: 757 certificates were studied; all DCs had at least three errors with an average number of errors of 6...
June 2017: La Tunisie Médicale
Latifa Mohammadi, Noria Harir, Mohamed Brahimi, Soraya Moulessehoul, Mohamed Amine Bekadja
BACKGROUND: Multiple Myeloma (MM) represent about 1 to 2% of cancers and 15% of all hematological malignancies. It is characterized by malignant proliferation of plasmocytes in bone marrow and an excess of secreted monoclonal immunoglobulins (Ig) Objective: Describe the epidemiological, clinical, biological and prognosis of patients with MM treated with autologous peripheral hematopoietic stem cell transplantation (APHSCT) in the Algerian West. METHODS: It is a retrospective descriptive study covering all MM patients treated with APHSCT over a period of 7 years (2008-2015) at service of Haematology and Cell Therapy of the EHU "1er November 1954 of Oran, Algeria...
June 2017: La Tunisie Médicale
Omar Toumi, Mohamed Ali Chaouch, Abdesslem Ghedira, Ibtissem Korbi, Mohamed Nasr, Faouzi Noomene, Khadija Zouari, Randa Salem, Badii Hamida, Mondher Golli
INTRODUCTION: Congenital bile duct cysts (CBDC) is a rare congenital malformation. It results from an anomaly of the biliopancreatic junction (AJBP). This condition is often diagnosed at a young age. Although, it can be asymptomatic and discovered only at an advanced age. The aim of our work was to describe the diagnosis, therapeutic and evolutionary aspects of BVCD through a series of 11 cases diagnosed in adult cases. METHODS: This is a descriptive, retrospective and monocentric study...
June 2017: La Tunisie Médicale
Chawki Jebali, Lotfi Boukadida, Ali Ousgi, Wael Chaabene, Borhen Shili, Mohamed Amin Naggara, Riadh Boukef
INTRODUCTION: Inhaled nitrous oxide (MEOPA) ensures short-term analgesia of a patient in spontaneous ventilation through a mask. It ensures analgesic coverage during the painful gesture while saving to the patient the phenomena of memorization. AIM: To study the efficacy and safety of the use of MEOPA during the make stitches. METHODS: Randomized double blind prospective study including any patient aged > 16 years admitted to the emergency for make stitches during a period of 3 months...
June 2017: La Tunisie Médicale
Mehdi Ben Khelil, Mona Mlika, Nidhal Haj Salem, Ali Chadly, Ahmed Banasr, Moncef Hamdoun
BACKGROUND: Job satisfaction is a key element in managing human resources despite the scope of practice. It is intimately linked to motivation but acts independently. AIM: To evaluate the degree of job satisfaction of the teaching physicians practicing in the hospitals of Tunis. METHODS: It was a descriptive study including a sample of 75 teaching physicians practicing in Tunis hospitals, selected randomly and anonymously with a 1:20 scale with a matching based on the grade and the speciality...
June 2017: La Tunisie Médicale
Alia Zehani, Sarra Aloui, Ines Chelly, Slim Haouet, Nidhameddine Kchir
BACKGROUND: Neuroendocrine tumors (NETs) of the gastrointestinal tract are a heterogeneous group of tumors which have different malignant potential and evolution. The World Health Organization (WHO) has set up a new classification of gastrointestinal NETs in 2010. However, it does not evaluate the risk of malignancy for each tumor. AIM: To evaluate the prognostic impact of the WHO classification in 2010 by reclassifying the tumor according to new recommendations and to identify histoprognostic factors to better predict changes...
June 2017: La Tunisie Médicale
Mona Mlika, Mehdi Ben Khelil, Moncef Hamdoun, Faouzi Mezni
The role of the pathologist has been highlighted by the medias since the recent years and the Tunisian law system suffers from a huge and there are no rules or jury verdicts concerning the e responsability  of the doctors in general with emphasis on pathologists. One might think that the lack of laws benefits to the pathologist, on the other hand, we can consider this as dangerous either for the patients or the pathologists. This lack of laws makes the judge dependant on the expert view. Other countries like European ones and the United States, has available data furnished by the insurance bodies that enrich the jury verdicts and the different laws that are available...
June 2017: La Tunisie Médicale
Mohamed Amine Bani, Besma Laabidi, Faten Gargouri, Nada Mansouri, Ammar Bouziani, Issam Msakni
No abstract text is available yet for this article.
May 2017: La Tunisie Médicale
Ibtissem Oueslati, Karima Khiari, Emna Elfaleh, Nadia Znaidi, Nadia Mchirgui, Soumaya Rammeh, Néjib Ben Abdallah
No abstract text is available yet for this article.
May 2017: La Tunisie Médicale
Meriem Haloua, Younes Houmada, Youssef Alaoui Lamrani, Moustapha Maaroufi, Siham Tizniti, Meryem Boubbou
The neuropathic osteoarthropathy are ectopic ossifications, developed near the joints, secondary to a process of neo-osteogenesis in the case of central neurological lesions and rarely peripheral lesions. We report the case of two patients aged of 7 years and 35 years, for whom the CT scan allowed us to make the positive diagnosis, and an accurate preoperative assessment, by studying the seat, the vessels and nerves, allowing an adapted and precocious management. We propose an update of neuropathic osteoarthropathy based on data from the literature...
May 2017: La Tunisie Médicale
Alia Zehani, Ines Smichi, Jihene Marrakchi, Ghazi Besbes, Slim Haouet, Nidhameddine Kchir
Mucormycosis is a rare and acute fungal infection which is frequently lethal, usually observed in non-controlled diabetic patients. The infection usually begins in the nose but it can invade the lung, the digestive tract, and the skin. Rhinocerebral mucormycosis accounts for 40 to 49% of mucormycosis cases. We report the case of a 44-year-old diabetic man, presenting with rhinocerebral mucormycosis. Our patient was treated by an association of amphotericin B and surgical debridement.
May 2017: La Tunisie Médicale
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