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1. Unicystic ameloblastoma: Diagnostic challenges and uncommon treatment strategy: Case report.

Author

Ouertani H, Azouzi I, Gargouri F, Tlili K, Khrifi N, and Khattech MB

Abstract

Introduction: Unicystic ameloblastoma (UA) is frequently associated with an impacted tooth with a challenging diagnosis and decision making. The aim of this article is to emphasize a novel approach of treatment with tooth reimplantation after conservative treatment., Presentation of Case: A 7-year-old boy consulting with a chief complaint of swelling in the upper left front region. Intraoral examination revealed a non-tender swelling extending from 61 to 63. Radiographic examination showed a well-defined, unilocular radiolucency associated to tooth 21. Initial diagnosis was a dentigerous cyst and was treated conservatively (enucleation and tooth reimplantation). Final diagnosis was an UA, intraluminal form. After 6 years, no signs of recurrence were observed, and teeth 21 and 22 showed healthy root development., Discussion: UA is the least encountered variant of all types of ameloblastomas and more commonly affects the mandible's posterior region than the maxilla. Differential diagnosis in the presence of radiolucent images is a dilemma, especially when a tooth is impacted in association with the lesion. Decision-making can be challenging, particularly regarding the appropriateness of initial radical extensive surgery in children. We opted to a conservative treatment. This procedure resulted in fewer complications and preserved the permanent teeth and as much bone as possible to avoid aesthetic deformities., Conclusion: This case report focuses on a novel approach to the treatment of UA. This case report confirms that for UA conservative treatment is possible, with preservation of tooth and alveolar bone, particularly in young patients., Competing Interests: Declaration of competing interest None., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Published
2024
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2. Association of simple bone cyst and cemento-osseous dysplasia: A long-term follow-up.

Author

Hajjami F, Ouertani H, Brahem H, Mehrez H, Blouza I, and Khattech MB

Abstract

Cemento-osseous dysplasia (COD) is a non-neoplastic, usually asymptomatic condition characterized by the presence of amorphous cement-like calcifications located exclusively in the tooth-bearing regions of the jawbone. Simple bone cysts (SBCs) of the jaws are benign intraosseous cavities, empty or filled with serous, serohematic, or blood fluid. They are characterized by the absence of an epithelial lining. COD and SBCs are two distinct lesions of the jaws that have long been described separately in the literature; however, their co-occurrence remains rare and only a few cases have been reported illustrating this relationship. This association can be considered as a distinct entity since it presents specific epidemiological, clinical, and radiological data. The aim of this article was to report a new case of association between COD and SBC by illustrating a florid COD formation in mandibular SBC detected in a 31-year-old patient followed over a period of 11 years., Competing Interests: The authors declare that there is no conflict of interest regarding the publication of this article., (© 2023 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd.)

Published
2023
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3. Misdiagnosis asthma in adult, three rare causes.

Author

Zaibi H, Fessi R, Ben Jemia E, Ouertani H, Ben Amar J, and Aouina H

Subjects
Adult, Child, Humans, Cough, Diagnosis, Differential, Diagnostic Errors, Asthma, Pulmonary Eosinophilia
Abstract

Introduction: All that wheezes is not asthma. Although, asthma is the most common cause of wheeze and cough in children and adults, it is often attributed inappropriately to these symptoms from other causes., Aim: We illustrate through this manuscript three rare causes of wheeze in adults, misdiagnosis as asthma., Observations: The three reported cases were misdiagnosed as difficult-to-treat asthma. They were found as mimicking asthma. Final diagnoses were localized tracheobronchial amyloidosis, aortic arch anomalies, and idiopathic chronic eosinophilic pneumonia., Conclusion: Although asthma is a common cause of various respiratory symptoms, all that coughs and wheezes is not asthma. So before retaining the severe asthma diagnosis, we have to exclude various differential diagnoses, even the rarest ones. Several diagnostic tests have to be done to have the appropriate diagnosis.

Published
2023

4. Assessment of therapeutic compliance and its associated factors in tunisian adult asthmatic patients.

Author

Zaibi H, Allouche A, Ben Jemia E, Ouertani H, Ferchichi M, Ben Amar J, and Aouina H

Subjects
Humans, Adult, Cross-Sectional Studies, Health Care Costs, Hospitals, Medication Adherence, Asthma drug therapy, Asthma epidemiology
Abstract

Introduction: Despite therapeutic advances, morbidity attributed to asthma continues to increase. This seems partly to be due to poor adherence., Aim: To assess therapeutic adherence and the association between poor compliance and asthma control., Methods: We carried out a descriptive cross-sectional study on a sample of 150 asthmatics, followed in the pneumology department of Charles Nicolle hospital for more than 6 months. The survey took place over 1 month. The 4-item Morisky questionnaire (MMAS-4) was used to assess adherence to therapy., Results: Our patients had a median age of 44.2 years and a sex ratio of 0.47. Asthma was severe in 48% of cases and poorly controlled in 34% of cases. Adherence was poor in 66% of patients. Factors significantly associated with adherence were educationlevel (p=0.02), socio- economic status (p = 0.01), treatment cost (p= 0.02), its availability (p=0.04) and its free cost (p = 0.001), consultation waiting time (p=0.03) and knowledge on asthma (p=0,04). We retained in multivariate analyze two factors determining therapeutic adherence, which are socio-economic status (OR = 2.02 ; [1.2-6.26]) and participation in the therapeutic choice (OR = 1.2 ; 95% CI [2.02-4.25])., Conclusions: It appears that medication adherence is widely influenced by socio-economic status. So, improving these conditions would guarantee better treatment compliance.

Published
2023

5. 2022 TUNISIAN NATIONAL CONGRESS OF MEDICINE ABSTRACTS.

Author

Yacoub A, Ayadi A, Ayed W, Ayari S, Chebbi S, Magroun I, Ben Afia L, Mersni M, Mechergui N, Brahim D, Ben Said H, Bahri G, Youssef I, Ladhari N, Mziou N, Grassa A, M'rad M, Khessairi N, Krir A, Chihaoui M, Mahjoub S, Bahlous A, Jridi M, Cherif Y, Derbal S, Chebbi D, Hentati O, Ben Dahmen F, Abdallah M, Hamdi I, Sahli F, Ouerdani Y, Mnekbi Y, Abaza H, Ajmi M, Guedria A, Randaline A, Ben Abid H, Gaddour N, Maatouk A, Zemni I, Gara A, Kacem M, Maatouk I, Ben Fredj M, Abroug H, Ben Nasrallah C, Dhouib W, Bouanene I, Sriha A, Mahmoudi M, Gharbi G, Khsiba A, Azouz M, Ben Mohamed A, Yakoubi M, Medhioub M, Hamzaoui L, Azouz M, Ben Attig Y, Hamdi S, Essid R, Ben Jemia E, Rezgui B, Boudaya MS, Hassine H, Dabbabi H, Fradi Y, Cherif D, Lassoued I, Yacoub H, Kchir H, Maamouri N, Khairi W, Ben Ammar H, Abaza H, Chelbi E, Merhaben S, Neffati W, Ajmi M, Tarchalla S, Boughzala S, Gazzeh M, Gara S, Labidi A, Touati H, Nefzi AM, Ben Mustpha N, Fekih M, Serghini M, Boubaker J, Zouiten L, Driss A, Meddeb N, Driss I, Walha S, Ben Said H, Bel Hadj Mabrouk E, Zaimi Y, Mensi A, Trad N, Ayadi S, Said Y, Mouelhi L, Dabbèche R, Belfkih H, Bani M, Moussa A, Souissi S, Trabelsi Werchfeni B, Chelly S, Ezzi O, Ammar A, Besbes M, Njah M, Mahjoub M, Ghali H, Neffati A, Bhiri S, Bannour R, Ayadi S, Khouya FE, Kamel A, Hariz E, Aidani S, Kefacha S, Ben Cheikh A, Said H, Dogui S, Atig A, Gara A, Ezzar S, Ben Fradj M, Bouanène I, M'kadmi H, Farhati M, Dakhli N, Nalouti K, Chanoufi MB, Abouda SH, Louati C, Zaaimi Y, Dabbeche R, Hermi A, Saadi A, Mokaddem S, Boussaffa H, Bellali M, Zaghbib S, Ayed H, Bouzouita A, Derouiche A, Allouche M, Chakroun M, Ben Slama R, Gannoun N, Kacem I, Tlili G, Kahloul M, Belhadj Chabbah N, Douma F, Bouhoula M, Chouchene A, Aloui A, Maoua M, Brahem A, Kalboussi H, El Maalel O, Chatti S, Jaidane M, Naija W, Mrizek N, Sellami I, Feki A, Hrairi A, Kotti N, Baklouti S, Jmal Hammami K, Masmoudi ML, Hajjaji M, Naaroura A, Ben Amar J, Ouertani H, Ben Moussa O, Zaibi H, Aouina H, Ben Jemaa S, Gassara Z, Ezzeddine M, Kallel MH, Fourati H, Akrout R, Kallel H, Ayari M, Chehaider A, Souli F, Abdelaali I, Ziedi H, Boughzala C, Haouari W, Chelli M, Soltani M, Trabelsi H, Sahli H, Hamdaoui R, Masmoudi Y, Halouani A, Triki A, Ben Amor A, Makni C, Eloillaf M, Riahi S, Tlili R, Jmal L, Belhaj Ammar L, Nsibi S, Jmal A, Boukhzar R, Somai M, Daoud F, Rachdi I, Ben Dhaou B, Aydi Z, Boussema F, Frikha H, Hammami R, Ben Cheikh S, Chourabi S, Bokri E, Elloumi D, Hasni N, Hamza S, Berriche O, Dalhoum M, Jamoussi H, Kallel L, Mtira A, Sghaier Z, Ghezal MA, Fitouri S, Rhimi S, Omri N, Rouiss S, Soua A, Ben Slimene D, Mjendel I, Ferchichi I, Zmerli R, Belhadj Mabrouk E, Debbeche R, Makhloufi M, Chouchane A, Sridi C, Chelly F, Gaddour A, Kacem I, Chatti S, Mrizak N, Elloumi H, Debbabi H, Ben Azouz S, Marouani R, Cheikh I, Ben Said M, Kallel M, Amdouni A, Rejaibi N, Aouadi L, Zaouche K, Khouya FE, Aidani S, Khefacha S, Jelleli N, Sakly A, Zakhama W, Binous MY, Ben Said H, Bouallegue E, Jemmali S, Abcha S, Wahab H, Hmida A, Mabrouk I, Mabrouk M, Elleuch M, Mrad M, Ben Safta N, Medhioub A, Ghanem M, Boughoula K, Ben Slimane B, Ben Abdallah H, Bouali R, Bizid S, Abdelli MN, Ben Nejma Y, Bellakhal S, Antit S, Bourguiba R, Zakhama L, Douggui MH, Bahloul E, Dhouib F, Turki H, Sabbah M, Baghdadi S, Trad D, Bellil N, Bibani N, Elloumi H, Gargouri D, Ben Said M, Hamdaoui R, Chokri R, Kacem M, Ben Rejeb M, Miladi A, Kooli J, Touati S, Trabelsi S, Klila M, Rejeb H, Kammoun H, Akrout I, Greb D, Ben Abdelghaffar H, Hassene H, Fekih L, Smadhi H, Megdiche MA, Ksouri J, Kasdalli H, Hayder A, Gattoussi M, Chérif L, Ben Saida F, Gueldich M, Ben Jemaa H, Dammak A, Frikha I, Saidani A, Ben Amar J, Aissi W, Chatti AB, Naceur I, Ben Achour T, Said F, Khanfir M, Lamloum M, Ben Ghorbel I, Houman M, Cherif T, Ben Mansour A, Daghfous H, Slim A, Ben Saad S, Tritar F, Naffeti W, Abdellatif J, Ben Fredj M, Selmi M, Kbir GH, Maatouk M, Jedidi L, Taamallah F, Ben Moussa M, Halouani L, Rejeb S, Khalffalah N, Ben Ammar J, Hedhli S, Azouz MM, Chatti S, Athimni Z, Bouhoula M, Elmaalel O, Mrizak N, Maalej M, Kammoun R, Gargouri F, Sallemi S, Haddar A, Masmoudi K, Oussaifi A, Sahli A, Bhouri M, Hmaissi R, Friha M, Cherif H, Baya C, Triki M, Yangui F, Charfi MR, Ben Hamida HY, Karoui S, Aouini F, Hajlaoui A, Jlassi H, Sabbah M, Fendri MN, Kammoun N, Fehri S, Nouagui H, Harzalli A, Snène H, Belakhal S, Ben Hassine L, Labbene I, Jouini M, Kalboussi S, Ayedi Y, Harizi C, Skhiri A, Fakhfakh R, Jelleli B, Belkahla A, Fejjeri M, Zeddini M, Mahjoub S, Nouira M, Frih N, Debiche S, Blibech H, Belhaj S, Mehiri N, Ben Salah N, Louzir B, Kooli J, Bahri R, Chaka A, Abdenneji S, Majdoub Fehri S, Hammadi J, Dorgham D, Hriz N, Kwas H, Issaoui N, Jaafoura S, Bellali H, Shimi M, Belhaj Mabrouk E, Sellami R, Ketata I, Medi W, Mahjoub M, Ben Yacoub S, Ben Chaabene A, Touil E, Ben Ayed H, Ben Miled S, El Zine E, Khouni H, Ben Kadhi S, Maatoug J, Boulma R, Rezgui R, Boudokhane M, Jomni T, Chamekh S, Aissa S, Touhiri E, Jlaiel N, Oueslati B, Maaroufi N, Aouadi S, Belkhir S, Daghfous H, Merhaben S, Dhaouadi N, Ounaes Y, Chaker K, Yaich S, Marrak M, Bibi M, Mrad Dali K, Sellami A, Nouira Y, Sellami S, Anane I, Trabelsi H, Ennaifer R, Benzarti Z, Bouchabou B, Hemdani N, Nakhli A, Cherif Y, Abdelkef M, Derbel K, Barkous B, Yahiaoui A, Sayhi A, Guezguez F, Rouatbi S, Racil H, Ksouri C, Znegui T, Maazaoui S, Touil A, Habibech S, Chaouech N, Ben Hmid O, Ismail S, Chouaieb H, Chatti M, Guediri N, Belhadj Mohamed M, Bennasrallah C, Bouzid Y, Zaouali F, Toumia M, El Khemiri N, El Khemiri A, Sfar H, Farhati S, Ben Chehida F, Yamoun R, Braham N, Hamdi Y, Ben Mansour A, Mtir M, Ayari M, Toumia M, Rouis S, Sakly H, Nakhli R, Ben Garouia H, Chebil D, Hannachi H, Merzougui L, Samet S, Hrairi A, Mnif I, Hentati O, Bouzgarrou L, Souissi D, Boujdaria R, Kadoussi R, Rejeb H, Ben Limem I, Ben Salah I, Greb D, Ben Abdelghaffar H, Smadhi H, Laatiri H, Manoubi SA, Gharbaoui M, Hmandi O, Zhioua M, Taboubi F, Hamza Y, Hannach W, Jaziri H, Gharbi R, Hammami A, Dahmani W, Ben Ameur W, Ksiaa M, Ben Slama A, Brahem A, Elleuch N, Jmaa A, Kort I, Jlass S, Benabderrahim S, Turki E, Belhaj A, Kebsi D, Ben Khelil M, Rmadi N, Gamaoun H, Alaya Youzbechi F, Brahim T, Boujnah S, Abid N, Gader N, Kalboussi S, Ben Sassi S, Loukil M, Ghrairi H, Ben Said N, Mrad O, Ferjaoui M, Hedhli L, Ben Kaab B, Berriche A, Charfi R, Mourali O, Smichi I, Bel Haj Kacem L, Ksentini M, Aloui R, Ferchichi L, Nasraoui H, Maoua M, Chérif F, Belil Y, Ayed MA, Alloulou Y, Belhadj S, Daghfous J, Mehiri N, Louzir B, Abbes A, Ghrab A, Chermiti A, Akacha A, Mejri O, Debbiche A, Yahiaoui C, Binous M, Tissaoui A, Mekni K, El Fekih C, Said MA, Chtioui S, Mestiri S, Smaoui H, Ben Hamida S, Haddar A, Mrizek N, Gares N, Zaibi A, Bouazizi N, Gallas S, Lachhab A, Belhadj M, Hadj Salem N, Garrouch A, Mezgar Z, Khrouf M, Abbassi H, Souissi D, Hamra I, Ben Mustapha N, Abessi I, Boubaker F, Bouchareb S, ElOmma Mrabet H, Touil I, Boussoffara L, Knani J, Boudawara N, Alaya W, Sfar MH, Fekih S, Snène H, Boudawara N, Gargouri I, Benzarti W, Knaz A, Abdelghani A, Aissa S, Hayouni A, Mejri I, Kacem M, Mhamdi S, Daboussi S, Aichaouia C, Moatemri Z, Chaachou A, Fsili R, Ben Ghezala H, Ben Jazia A, and Brahmi N

Published
2023

6. Athrogenic indexes: Useful markers for predicting metabolic syndrome in axial spondyloarthritis.

Author

Slouma M, Ben Ali K, Kharrat L, Zouaoui C, Ouertani H, and Gharsallah I

Subjects
Biomarkers, Cholesterol, HDL, Cholesterol, LDL, Cross-Sectional Studies, Humans, Axial Spondyloarthritis, Metabolic Syndrome diagnosis, Metabolic Syndrome epidemiology
Abstract

Introduction: Metabolic syndrome is a pathological entity associated with a high risk of cardiovascular disease. Data regarding the frequency of this syndrome, lipid profile, and atherogenic index of plasma in patients with radiographic axial spondyloarthritis are scarce. We aim to determine the prevalence of metabolic syndrome in patients with spondyloarthritis. We also aim to determine discriminative values of atherogenic indexes between patients with and without metabolic syndrome., Methods: We conducted a cross-sectional study including 51 patients meeting the ASAS 2009 criteria for radiographic axial spondyloarthritis. We measured the following parameters: triglyceride (TG), high-density lipoproteins (HDL c ), low-density lipoprotein cholesterol (LDL c ), and total cholesterol (TC). We calculated TC/HDL c , TG/HDL c , LDL c /HDL c ratios, and atherogenic index of plasma (LogTG/HDL c )., Results: Metabolic syndrome was noted in 33% of cases. Patients with active disease had a higher body mass index (26.89±5.88 versus 23.63±4.47kg/m 2 , p=0.03), higher TG (1.41±0.64 versus 0.89±0.5mmol/L, p=0.05) and a lower HDL c level (1±0.28 versus 1.31±0.22mmol/L, p=0.01). However, the LogTG/HDL c and TG/HDL c were higher in patients under TNFα inhibitors. The ability of the TG/HDL c ratio and LogTG/HDL c to distinguish patients with or without metabolic syndrome were good at cut-offs of 1.33 and 0.22, respectively (specificity: 91.2% and sensitivity 70.6% for both ratios)., Conclusion: Our study showed that metabolic syndrome is frequent in patients with axial spondyloarthritis. Atherogenic indexes can be used for predicting metabolic syndrome in these patients., (Copyright © 2022 Sociedad Española de Arteriosclerosis. Publicado por Elsevier España, S.L.U. All rights reserved.)

Published
2022
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7. [Role and effectiveness of radioactive-iodine therapy for the treatment of Grave's disease].

Author

Sellem A, Elajmi W, Mhamed RB, Oueslati N, Ouertani H, and Hammami H

Subjects
Adult, Aged, Antithyroid Agents therapeutic use, Cross-Sectional Studies, Female, Graves Disease blood, Graves Disease epidemiology, Humans, Male, Middle Aged, Retrospective Studies, Thyroid Function Tests, Thyroid Hormones blood, Treatment Outcome, Young Adult, Graves Disease radiotherapy, Iodine Radioisotopes therapeutic use
Abstract

The treatment of Graves' disease is based on three therapies: medical treatment with synthetic antithyroid agents, surgery and radioactive-iodine therapy. The purpose of our study was to study the role and effectiveness of radioactive-iodine therapy for the treatment of Graves' disease. We conducted a retrospective, descriptive study of the epidemiological, clinical, paralclinical and therapeutic features of 54 patients with Graves' disease managed and treated with iodine-131 as well as of their short- and medium-term remission rate. The sex ratio was 0.45. The average age of patients was 38,33 ± 12.7 years. The most common functional signs were weight loss, tremors and palpitations. Mean FT4 was 54,51 ± 19,56 ng/dl (ranging from 8,90 and 100). Mean TSHus was 0,074 ± 0,29 µIU/ml. Synthetic antithyroid drugs were used in 49 patients; 83,67% of cases had persistent hyperthyroidism. Radioactive-iodine therapy was used as first-line therapy in 9,3% of cases and as second-line therapy in 90,7% of cases. Mean activity was 13,29 mCi ± 1,46 ranging from 10 to 15 mCi. The first assessment of hormonal status was performed after an average post-treatment period of 1,91 months; 29 patients (53,7%) achieved remission (eu- or hypo-thyroidism). After a 12 month-follow-up, patients' course was marked by remission in 88,88% of cases (euthyroidism in 14,8% and hypothyroidism in 74% of cases). Radioactive-iodine therapy is an effective treatment for Graves' disease. High radioactive iodine dose provides high remission rate., Competing Interests: Les auteurs ne déclarent aucun conflit d´intérêts., (Copyright: Ali Sellem et al.)

Published
2020
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8. The stigma of severe mental illness: Beliefs and experiences of Tunisian patients.

Author

Ouali U, Jouini L, Ouertani H, Jomli R, and Nacef F

Subjects
Adult, Cross-Sectional Studies, Female, Humans, Male, Quality of Life, Social Stigma, Mental Disorders epidemiology, Schizophrenia
Abstract

Background: Stigmatization of patients with mental illness is a worldwide phenomenon which can jeopardize help seeking and treatment adherence and contribute to low self-esteem and quality of life., Aim: To assess stigmatization as perceived and experienced by patients with severe mental illness in Tunisia., Methods: This is a cross-sectional descriptive study conducted at Razi Hospital La Manouba, Tunisia in clinically stabilized patients with bipolar disorder and schizophrenia followed at our outpatient clinic. Patients gave their opinion on a total of 31 statements related to stigma relevant to the Tunisian cultural context., Results: The study sample consisted of 105 patients with an average age of 38.3 years and a sex ratio of 1.5. Negative perceptions or experiences prevailed in 19 out of 31 statements, mostly referring to received and endorsed stigma.Study participants expressed apprehension about disclosure of mental illness, mainly due to fears about family reputation and job opportunities, however, a large majority actually disclosed their mental illness to their surroundings. Male participants had less positive opinions than women regarding former mental patients becoming teachers and experienced more stigma than women in the professional field., Conclusions: Besides actions towards public attitudes, patient-centered-approaches, both tailored to the Tunisian cultural context, are necessary to raise awareness of the public and to reduce endorsed stigma in this vulnerable group of the population.

Published
2020

9. Delay of insulin therapy in type 2 diabetics.

Author

El Arbi K, Zouaoui C, Zargni A, Merdani G, Jaïdane A, and Ouertani H

Subjects
Administration, Oral, Aged, Blood Glucose analysis, Blood Glucose metabolism, Cross-Sectional Studies, Diabetes Mellitus, Type 2 blood, Diabetes Mellitus, Type 2 epidemiology, Drug Administration Schedule, Female, Glycated Hemoglobin analysis, Glycated Hemoglobin metabolism, Humans, Male, Middle Aged, Retrospective Studies, Time Factors, Tunisia epidemiology, Diabetes Mellitus, Type 2 drug therapy, Hypoglycemic Agents administration & dosage, Insulin administration & dosage, Time-to-Treatment statistics & numerical data
Abstract

Type 2 diabetes (T2DM) is a progressive disease. Insulin appears early in the therapeutic intensification algorithm, but is still a last resort. This delay is frequent but its duration has been little studied in the Tunisian population. The main objective of this study was to identify and evaluate, in a specialized center, the delay in insulin therapy in type 2 diabetics. This was a retrospective, cross-sectional study of 140 patients. DT2 were included as oral antidiabetic agents, including at least one optimal dose sulfonamide, hospitalized for insulin therapy between January 1, 2014 and December 31, 2015. The delay in insulin therapy was defined by the succession of two HbA1c values ≥8% at least 3 months apart. Its duration, in months, calculated in 90 patients, corresponds to that passed between T0 where HbA1c ≥8% and T1 at the insulin initiation. Our population was 74 women and 66 men, mean age 58.2 ± 11.7 years. The average duration of diabetes was 10.3 ± 6.1 years; mean fasting glucose and HbA1c were 11.9 ± 3.6 mmol / l and 11.3 ± 2%, respectively. The delay in insulin therapy concerned all patients. Its average duration was 39 ± 29 months with extremes of 6 months to 10 years. Mean HbA1c increased significantly from 10 ± 1.5% to 11.2 ± 2% between T0 and T1 (p <10-3). A shift to insulin beyond three years was associated with the duration of diabetes (p = 0.03) and dyslipidemia (p = 0.04). Insulin therapy is late even in a specialized center. This therapeutic inertia is universal. Its causes should be better studied to be better mastered.

Published
2020

10. Mammary analogue secretory carcinoma: A case report.

Author

Hedhli F, Ouertani H, Gargouri F, Naija S, Casiraghi O, Valent A, and Khatteche B

Subjects
Anoctamin-1 analysis, Anoctamin-1 metabolism, Cheek pathology, Cytogenetic Analysis, Diagnosis, Differential, Female, Humans, Immunohistochemistry, In Situ Hybridization, Fluorescence, Mammaglobin A analysis, Mammaglobin A metabolism, Mammary Analogue Secretory Carcinoma genetics, Mammary Analogue Secretory Carcinoma surgery, Mouth Mucosa metabolism, Mouth Mucosa pathology, Neoplasm Proteins analysis, Neoplasm Proteins metabolism, Oncogene Proteins, Fusion analysis, Oncogene Proteins, Fusion genetics, S100 Proteins analysis, S100 Proteins metabolism, Tunisia, Mammary Analogue Secretory Carcinoma diagnosis
Abstract

Background: Mammary analogue secretory carcinoma is a rare new entity of low-grade malignant tumor of salivary glands. It shared the same histologic features and the chromosomal translocation t(12;15)(p13;q25) as secretory carcinoma of the breast., Aim: To highlight the diagnosis approaches and the attitude of management in a case of MASC which is the first case reported in Tunisia. Reported case: A case of MASC of the lower left jugal mucosa was reviewed for its microscopic and immunohistochemical features. Fluorescence in situ hybridization (FISH) for the ETV6-NTRK3 translocation was performed. Surgery was the only treatment required in this case. No signs of local or regional recurrence during the one-year follow-up were noticed., Commentaries: Secretory carcinoma was confused with other salivary gland tumors especially acinic cell carcinoma due to their morphological similarities, making diagnosis dilemma. Fluorescence in-situ hybridization (FISH) is the one definitive finding to confirm the diagnosis of MASC and to differentiate it from the other types of salivary gland tumor. At the present time, no specific therapy is available for patients with MASC.

Published
2020

11. Impact of sertraline on weight, waist circumference and glycemic control: A prospective clinical trial on depressive diabetic type 2 patients.

Author

Rachdi C, Damak R, Fekih Romdhane F, Ouertani H, and Cheour M

Subjects
Aged, Biomarkers blood, Blood Glucose metabolism, Body Mass Index, Depression diagnosis, Depression psychology, Diabetes Mellitus, Type 2 blood, Diabetes Mellitus, Type 2 diagnosis, Diabetes Mellitus, Type 2 physiopathology, Female, Glycated Hemoglobin metabolism, Humans, Male, Middle Aged, Prospective Studies, Sertraline adverse effects, Time Factors, Treatment Outcome, Tunisia, Antidepressive Agents therapeutic use, Blood Glucose drug effects, Depression drug therapy, Diabetes Mellitus, Type 2 drug therapy, Hypoglycemic Agents therapeutic use, Selective Serotonin Reuptake Inhibitors therapeutic use, Sertraline therapeutic use, Waist Circumference drug effects, Weight Loss drug effects
Abstract

Aim: Depression is prevalent in patients with type 2 diabetes. It may have a negative impact on the management of diabetes mellitus and could affect weight. The main aim of the investigation was to evaluate the effect of antidepressant treatment (sertraline) on anthropometric variables and glycemic control in depressed type 2 diabetic patients., Methods: Thirty three type 2 diabetic outpatients depressed received open-label sertraline therapy for up to 12 weeks. Clinical outcome measures included the 17-item Hamilton depression rating. Changes in the anthropometrics variables were evaluated by measuring weight, waist circumference and by calculating body mass index at three, six and 12 weeks of treatment. In addition, fasting, postprandial plasma glucose level, glycosylated hemoglobin-A 1C measures, lipid and renal profile were obtained before and during sertraline therapy., Results: Weight decreased significantly (-2kg; p=0.000) and body mass index decreased from 30.41kg/m 2 to 29.6kg/m 2 (p=0.000). Patients lost on average seven centimeters in waist circumference (p=0.000). We also observed a modest, non-significant reduction in fasting, postprandial and glycosylated hemoglobin. We observed a significant reduction in mean score according to the Hamilton depression scale (p=0.000) CONCLUSION: Our study results suggested that sertraline produced a benefic effect on weight, body mass index and waist circumference at 12-week follow up., (Copyright © 2018 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.)

Published
2019
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12. Methylenetetrahydrofolate Reductase (MTHFR) (C677T and A1298C) Polymorphisms and Vascular Complications in Patients with Type 2 Diabetes.

Author

Fekih-Mrissa N, Mrad M, Ibrahim H, Akremi I, Sayeh A, Jaidane A, Ouertani H, Zidi B, and Gritli N

Subjects
Adult, Diabetic Retinopathy epidemiology, Diabetic Retinopathy genetics, Female, Humans, Hypertension epidemiology, Hypertension genetics, Male, Middle Aged, Diabetes Mellitus, Type 2 epidemiology, Diabetes Mellitus, Type 2 genetics, Methylenetetrahydrofolate Reductase (NADPH2) genetics, Polymorphism, Single Nucleotide genetics, Vascular Diseases epidemiology, Vascular Diseases genetics
Abstract

Objectives: To assess whether 2 polymorphisms of the methylenetetrahydrofolate reductase (MTHFR) gene, C677T and A1298C, are risk factors for vascular complications in Tunisian patients with type 2 diabetes mellitus., Methods: The MTHFR polymorphisms were genotyped, and plasma homocysteine levels were evaluated in 160 Tunisian patients with type 2 diabetes mellitus., Results: Prevalence of the 2 heterozygous polymorphisms of the thermolabile MTHFR gene (CT and AC) was encountered more commonly in patients with diabetes mellitus than in the healthy controls (p<10 -3 ). Subjects with diabetes had significantly higher homocysteine (Hcy) levels than the control subjects; however, there was no statistical difference in plasma Hcy values between carriers of mutant genotypes (CT/TT for C677T and AC/CC for A1298C) and wild types (CC and AA) in patients with diabetes. Retinopathy was found to be a vascular complication in patients with either the 677CT or the 1298(AC+CC) genotype more commonly than in those with the wild-type genotypes (p=0.003; OR=3.2, 95% CI, 1.4 to 7.4; p<10 -3 ; OR=5.9, 95% CI, 2.7 to 13). Only patients who carry the A1298C mutation (AC+CC) are at risk for at least 1 complication (p=0.002). Double heterozygous mutants were at the greatest risk for retinopathy and for suffering at least 1 complication (p<10 -3 )., Conclusions: Studies involving a larger study population and various ethnic groups are required before ruling out the role of MTHFR gene in type 2 diabetes mellitus and in vascular complications., (Copyright © 2017 Diabetes Canada. Published by Elsevier Inc. All rights reserved.)

Published
2017
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13. Ridge augmentation with titanium mesh: A case report.

Author

Jegham H, Masmoudi R, Ouertani H, Blouza I, Turki S, and Khattech MB

Subjects
Adult, Bone Regeneration physiology, Dental Implants, Humans, Male, Osseointegration physiology, Surgical Mesh, Alveolar Ridge Augmentation instrumentation, Alveolar Ridge Augmentation methods, Bone Transplantation instrumentation, Bone Transplantation methods, Dental Implantation, Endosseous instrumentation, Dental Implantation, Endosseous methods, Guided Tissue Regeneration instrumentation, Guided Tissue Regeneration methods, Titanium chemistry
Abstract

Insufficient bone volume for dental implant placement in the maxillary anterior segment is a constant challenge in oral surgery. Several techniques have been suggested to reconstruct deficient alveolar ridges and to facilitate dental implant placement. These techniques include bone splitting osteotomy, distraction osteogenesis, inlay and onlay bone grafting. Guided bone regeneration (GBR) is also a promising alternative that increases the bone volume by the use of a subperiosteal barrier., Aim: The aim of this case was to demonstrate that the use of rigid titanium occlusive barrier is a reliable alternative to perform a lateral alveolar bone augmentation and treat localized ridge deformities before reaching an ideal implant placement., Observation: A 25-year-old healthy male was referred for implant placement in the maxillary central incisor. The alveolar bone width at the implant site 21 was less than 5mm. Hard tissue augmentation was accomplished using guided bone regeneration. A rigid titanium occlusive barrier was customized to desired shape of future alveolar ridge then secured with tent and fixing screws. Autogenous bone graft harvested with an auto-chip-maker adjacent to the surgical site were mixed with a xenograft and putted under the barrier. The wound was closed using a vestibular mucoperiosteal flap. At 4 months, the rigid barrier was removed, and a 7mm crestal width transversal bone was observed. At the same time, a fixture (4×10mm) was placed. A definitive ceramometal crown was completed after full osseointegration with periodical clinical maintenance. The exposure of the titanium mesh occurred in this case and was visible with a circular flap dehiscence at 1-month follow-up visit. This exposure did not affect the successful regenerative outcomes. After removal of the titanium mesh from the grafted defects, the space beneath the membrane enclosure was seen to be almost completely filled with new hard tissue covered by a thin layer of soft tissue. The postoperative follow-ups revealed that the implant was stable with excellent osseointegration and the buccal depression of the surgical area was reconstructed., Conclusion: The use of rigid titanium occlusive screwed barrier with autogenous and bovine bone graft might be a reliable technique for alveolar ridge reconstruction. This approach achieve excellent final esthetic outcome of the implant-supported restoration., (Published by Elsevier Masson SAS.)

Published
2017
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14. Survival and electrotransformation of Pseudomonas syringae strains under simulated cloud-like conditions.

Author

Blanchard LS, Monin A, Ouertani H, Touaibia L, Michel E, Buret F, Simonet P, Morris CE, and Demanèche S

Subjects
Biological Evolution, DNA, Bacterial metabolism, Electric Stimulation, Electroporation methods, Escherichia coli genetics, Ice, Lightning, Pseudomonas syringae growth & development, Weather, Adaptation, Physiological genetics, Gene Transfer, Horizontal genetics, Pseudomonas syringae genetics, Pseudomonas syringae metabolism
Abstract

To diversify their genetic material, and thereby allow adaptation to environmental disturbances and colonization of new ecological niches, bacteria use various evolutionary processes, including the acquisition of new genetic material by horizontal transfer mechanisms such as conjugation, transduction and transformation. Electrotransformation mediated by lightning-related electrical phenomena may constitute an additional gene-transfer mechanism occurring in nature. The presence in clouds of bacteria such as Pseudomonas syringae capable of forming ice nuclei that lead to precipitation, and that are likely to be involved in triggering lightning, led us to postulate that natural electrotransformation in clouds may contribute to the adaptive potential of these bacteria. Here, we quantify the survival rate of 10 P. syringae strains in liquid and icy media under such electrical pulses and their capacity to acquire exogenous DNA. In comparison to two other bacteria (Pseudomonas sp. N3 and Escherichia coli TOP10), P. syringae CC0094 appears to be best adapted for survival and for genetic electrotransformation under these conditions, which suggests that this bacterium would be able to survive and to get a boost in its adaptive potential while being transported in clouds and falling back to Earth with precipitation from storms., (© FEMS 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Published
2017
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15. Abstracts of the 40th National Congress of Medicine Tunis, 19-20 October 2017.

Author

Abdallah M, Abdelaziz A, Abdelaziz O, Abdelhedi N, Abdelkbir A, Abdelkefi M, Abdelmoula L, Abdennacir S, Abdennadher M, Abidi H, Abir Hakiri A, Abou El Makarim S, Abouda M, Achour W, Aichaouia C, Aissa A, Aissa Y, Aissi W, Ajroudi M, Allouche E, Aloui H, Aloui D, Amdouni F, Ammar Y, Ammara Y, Ammari S, Ammous A, Amous A, Amri A, Amri M, Amri R, Annabi H, Antit S, Aouadi S, Arfaoui A, Assadi A, Attia L, Attia M, Attia L, Ayadi I, Ayadi Dahmane I, Ayari A, Azzabi S, Azzouz H, B Mefteh N, B Salah C, Baccar H, Bachali A, Bahlouli M, Bahri G, Baïli H, Bani M, Bani W, Bani MA, Bassalah E, Bawandi R, Bayar M, Bchir N, Bechraoui R, Béji M, Beji R, Bel Haj Yahia D, Belakhel S, Belfkih H, Belgacem O, Belgacem N, Belhadj A, Beltaief N, Beltaief N, Ben Abbes M, Ben Abdelaziz A, Ben Ahmed I, Ben Aissia N, Ben Ali M, Ben Ammar H, Ben Ammou B, Ben Amor A, Ben Amor M, Benatta M, Ben Ayed N, Ben Ayoub W, Ben Charrada N, Ben Cheikh M, Ben Dahmen F, Ben Dhia M, Ben Fadhel S, Ben Farhat L, Ben Fredj Ismail F, Ben Hamida E, Ben Hamida Nouaili E, Ben Hammamia M, Ben Hamouda A, Ben Hassine L, Ben Hassouna A, Ben Hasssen A, Ben Hlima M, Ben Kaab B, Ben Mami N, Ben Mbarka F, Ben Mefteh N, Ben Kahla N, Ben Mrad M, Ben Mustapha N, Ben Nacer M, Ben Neticha K, Ben Othmen E, Ben Rhouma S, Ben Rhouma M, Ben Saadi S, Ben Safta A, Ben Safta Z, Ben Salah C, Ben Salah N, Ben Sassi S, Ben Sassi J, Ben Tekaya S, Ben Temime R, Ben Tkhayat A, Ben Tmim R, Ben Yahmed Y, Ben Youssef S, Ben Ali M, Ben Atta M, Ben Safta Z, Ben Salah M, Berrahal I, Besbes G, Bezdah L, Bezzine A, Bezzine A, Bokal Z, Borsali R, Bouasker I, Boubaker J, Bouchekoua M, Bouden F, Boudiche S, Boukhris I, Bouomrani S, Bouraoui S, Bouraoui S, Bourgou S, Boussabeh E, Bouzaidi K, Chaker K, Chaker L, Chaker A, Chaker F, Chaouech N, Charfi M, Charfi MR, Charfi F, Chatti L, Chebbi F, Chebbi W, Cheikh R, Cheikhrouhou S, Chekir J, Chelbi E, Chelly I, Chelly B, Chemakh M, Chenik S, Cheour M, Cheour M, Cherif E, Cherif Y, Cherif W, Cherni R, Chetoui A, Chihaoui M, Chiraz Aichaouia C, Dabousii S, Daghfous A, Daib A, Daib N, Damak R, Daoud N, Daoud Z, Daoued N, Debbabi H, Demni W, Denguir R, Derbel S, Derbel B, Dghaies S, Dhaouadi S, Dhilel I, Dimassi K, Dougaz A, Dougaz W, Douik H, Douik El Gharbi L, Dziri C, El Aoud S, El Hechmi Z, El Heni A, ELaoud S, Elfeleh E, Ellini S, Ellouz F, Elmoez Ben O, Ennaifer R, Ennaifer S, Essid M, Fadhloun N, Farhat M, Fekih M, Fourati M, Fteriche F, G Hali O, Galai S, Gara S, Garali G, Garbouge W, Garbouj W, Ghali O, Ghali F, Gharbi E, Gharbi R, Ghariani W, Gharsalli H, Ghaya Jmii G, Ghédira F, Ghédira A, Ghédira H, Ghériani A, Gouta EL, Guemira F, Guermazi E, Guesmi A, Hachem J, Haddad A, Hakim K, Hakiri A, Hamdi S, Hamed W, Hamrouni S, Hamza M, Haouet S, Hariz A, Hendaoui L, Hfaidh M, Hriz H, Hsairi M, Ichaoui H, Issaoui D, Jaafoura H, Jazi R, Jazia R, Jelassi H, Jerraya H, Jlassi H, Jmii G, Jouini M, Kâaniche M, Kacem M, Kadhraoui M, Kalai M, Kallel K, Kammoun O, Karoui M, Karouia S, Karrou M, Kchaou A, Kchaw R, Kchir N, Kchir H, Kechaou I, Kerrou M, Khaled S, Khalfallah N, Khalfallah M, Khalfallah R, Khamassi K, Kharrat M, Khelifa E, Khelil M, Khelil A, Khessairi N, Khezami MA, Khouni H, Kooli C, Korbsi B, Koubaa MA, Ksantini R, Ksentini A, Ksibi I, Ksibi J, Kwas H, Laabidi A, Labidi A, Ladhari N, Lafrem R, Lahiani R, Lajmi M, Lakhal J, Laribi M, Lassoued N, Lassoued K, Letaif F, Limaïem F, Maalej S, Maamouri N, Maaoui R, Maâtallah H, Maazaoui S, Maghrebi H, Mahfoudhi S, Mahjoubi Y, Mahjoubi S, Mahmoud I, Makhlouf T, Makni A, Mamou S, Mannoubi S, Maoui A, Marghli A, Marrakchi Z, Marrakchi J, Marzougui S, Marzouk I, Mathlouthi N, Mbarek K, Mbarek M, Meddeb S, Mediouni A, Mechergui N, Mejri I, Menjour MB, Messaoudi Y, Mestiri T, Methnani A, Mezghani I, Meziou O, Mezlini A, Mhamdi S, Mighri M, Miled S, Miri I, Mlayeh D, Moatemri Z, Mokaddem W, Mokni M, Mouhli N, Mourali MS, Mrabet A, Mrad F, Mrouki M, Msaad H, Msakni A, Msolli S, Mtimet S, Mzabi S, Mzoughi Z, Naffeti E, Najjar S, Nakhli A, Nechi S, Neffati E, Neji H, Nouira Y, Nouira R, Omar S, Ouali S, Ouannes Y, Ouarda F, Ouechtati W, Ouertani J, Ouertani J, Ouertani H, Oueslati A, Oueslati J, Oueslati I, Oueslati A, Rabai B, Rahali H, Rbia E, Rebai W, Regaïeg N, Rejeb O, Rhaiem W, Rhimi H, Riahi I, Ridha R, Robbena L, Rouached L, Rouis S, Safer M, Saffar K, Sahli H, Sahraoui G, Saidane O, Sakka D, Salah H, Sallami S, Salouage I, Samet A, Sammoud K, Sassi Mahfoudh A, Sayadi C, Sayhi A, Sebri T, Sedki Y, Sellami A, Serghini M, Sghaier I, Skouri W, Skouri W, Slama I, Slimane H, Slimani O, Souhail O, Souhir S, Souissi A, Souissi R, Taboubi A, Talbi G, Tbini M, Tborbi A, Tekaya R, Temessek H, Thameur M, Touati A, Touinsi H, Tounsi A, Tounsia H, Trabelsi S, Trabelsi S, Triki A, Triki M, Turki J, Turki K, Twinsi H, Walha Y, Wali J, Yacoub H, Yangui F, Yazidi M, Youssef I, Zaier A, Zainine R, Zakhama L, Zalila H, Zargouni H, Zehani A, Zeineb Z, Zemni I, Zghal M, Ziadi J, Zid Z, Znagui I, Zoghlami C, Zouaoui C, Zouari B, Zouiten L, and Zribi H

Published
2017

16. Case report of bacteremia due to Neisseria mucosa.

Author

Mechergui A, Achour W, Baaboura R, Ouertani H, Lakhal A, Torjemane L, Othman TB, and Hassen AB

Subjects
Bacteremia microbiology, Female, Hematopoietic Stem Cell Transplantation adverse effects, Humans, Immunocompromised Host, Middle Aged, Multiple Myeloma complications, Multiple Myeloma therapy, Neisseria mucosa classification, Neisseria mucosa genetics, Neisseriaceae Infections microbiology, Neutropenia complications, Bacteremia etiology, Neisseria mucosa pathogenicity, Neisseriaceae Infections etiology
Abstract

Neisseria mucosa, a Gram-negative diplococcus, is part of normal nasopharyngeal flora. We report a case of bacteremia caused by N. mucosa in a 50-year-old neutropenic patient suffering from non-secretory multiple myeloma stage IIIA. This case underscores that mostly nonpathogenic N. mucosa can cause bacteremia in neutropenic patients who developed mucositis after hematopoietic stem cell transplantation., (© 2013 APMIS. Published by John Wiley & Sons Ltd.)

Published
2014
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17. Association of HLA-DR-DQ polymorphisms with diabetes in Tunisian patients.

Author

Fekih Mrissa N, Mrad M, Ouertani H, Baatour M, Sayeh A, Nsiri B, Lamine K, Zidi B, and Gritli N

Subjects
Adolescent, Female, Humans, Male, Risk Factors, Tunisia, Alleles, Diabetes Mellitus, Type 1 genetics, HLA-DQ beta-Chains genetics, HLA-DRB1 Chains genetics, Haplotypes, Polymorphism, Genetic
Abstract

Objective: Type 1 diabetes (T1D) is a polygenic disease whose principal locus is the human leukocytes antigen (HLA) region. The aim of this study was to evaluate HLA DR-DQ alleles and to asses them as risk factors for type 1 diabetes in the Tunisian population., Materials and Methods: A total of 119 subjects with diabetes were tested for HLA class II alleles and compared with 292 healthy controls. HLA DRB1 and DQB1 alleles were genotyped using polymerase chain reaction sequence-specific primers (PCR-SSPs)., Results: The results revealed that the most susceptible haplotypes are the DRB1(*)03-DQB1(*)02 (pc<10(-3)) and DRB1(*)0401-DQB1(*)0302 (pc=0.001). (pc denotes Bonferroni corrected probability values.) The most protective haplotypes are DRB1(*)11-DQB1(*)03, DRB1(*)07-DQB1(*)02, and DRB1(*)13-DQB1(*)06 (pc=0.0026, pc=0.0065, and pc=0.02 respectively). Our results showed some particularities unique to Tunisians, there was a lack of a significant protective effect of the DRB1(*)15-DQB1(*)06 haplotype that usually is the dominant combination associated with protection in most other populations., Conclusion: Tunisian diabetic patients share the most susceptible and protective HLA haplotypes with Caucasians and those in neighbor Mediterranean countries. This is most likely explained by the history and admixture events of Tunisia and North Africa., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Published
2013
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18. [Association of renovascular hypertension and primary aldosteronism].

Author

Jaïdane A, Ouertani H, Dorai A, Zouaoui C, Ibrahim H, and Zidi B

Subjects
Adrenal Cortex Neoplasms complications, Adrenal Cortex Neoplasms diagnostic imaging, Adrenal Cortex Neoplasms surgery, Adrenalectomy, Adrenocortical Adenoma complications, Adrenocortical Adenoma diagnostic imaging, Adrenocortical Adenoma surgery, Adult, Humans, Hyperaldosteronism diagnostic imaging, Hyperaldosteronism etiology, Hyperaldosteronism surgery, Hypertension, Renovascular diagnostic imaging, Hypertension, Renovascular surgery, Male, Tomography, X-Ray Computed, Hyperaldosteronism complications, Hypertension, Renovascular etiology
Abstract

Introduction: Renal artery stenosis is rarely associated with Conn adenoma., Case Report: We report a 27-year-old male patient who presented in 2001 with a severe high blood pressure associated with hypokaliemia. Radiologic investigations showed a left renal artery stenosis with agenesis of left kidney. A left nephrectomy was performed and blood pressure returned to normal with a single antihypertensive drug. Five years later, the patient again presented with severe high blood pressure. Laboratory studies revealed a low serum potassium level at 2.8 mmol/L associated with high urinary potassium excretion (84 mmol/24h) and a very high aldosterone/renin ratio (>462). Abdominal CT scan demonstrated a right adrenal mass. The patient underwent a right adrenalectomy (adenoma). Blood pressure returned to normal with a single antihypertensive. Serum potassium levels as well as aldosterone/renin ratio normalized., Conclusion: We discussed whether the association between these two entities is merely fortuitous or conversely based on a causal relationship., (Copyright © 2012. Published by Elsevier SAS.)

Published
2012
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19. Paraganglioma of the nasal cavity.

Author

Zainine R, Sahtout S, Ouertani H, Sellami M, Beltaief N, and Besbes G

Subjects
Adult, Female, Humans, Magnetic Resonance Imaging, Nasal Cavity surgery, Nose Neoplasms surgery, Paraganglioma surgery, Tomography, X-Ray Computed, Nasal Cavity pathology, Nose Neoplasms pathology, Paraganglioma pathology
Published
2012

20. [CRP and micro-albumin: new markers of cardiovascular risk in type 2 diabetes].

Author

El Oudi M, Aouni Z, Ouertani H, Mazigh C, Nsiri B, Zidi B, and Machghoul S

Subjects
Biomarkers analysis, Female, Humans, Male, Middle Aged, Risk Factors, Albuminuria etiology, C-Reactive Protein analysis, Cardiovascular Diseases etiology, Diabetes Mellitus, Type 2 complications, Diabetes Mellitus, Type 2 metabolism, Diabetic Angiopathies etiology
Abstract

Introduction: Type 2 diabetes is a chronic disease associated to the presence of multiple risk factors. Among recently studied factors we cite PCR and micro-albumin., Objective: In the present study we intend to determine the correlation between urine albumin excretion rate, CRP levels and type of vascular complications in type 2 diabetes., Patients and Methods: We recruited 48 type 2 diabetic subjects subdivided into three groups according to the type of vascular complications (GI: type 2 diabetics without complications, GII: type 2 diabetics with microvascular complications and GIII: type 2 diabetics with macrovascular complications)., Results: We found a significant elevated levels of CRP and micro-albumin (P<0.05) when we compared diabetics with vascular complications to those without any complications. Diabetics with macrovascular complications have the highest levels of CRP and micro-albumin. Significant positive correlation was found between CRP and micro-albumin levels in a total group of diabetics (r=0.32; P<0.05)., Conclusion: The determination of CRP and microalbumin levels represents an interest in the screening of cardiovascular disease in type 2 diabetics., (Copyright © 2011 Elsevier Masson SAS. All rights reserved.)

Published
2011
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21. Effect of lipopenic and hypotensive treatment on homocysteine levels in type 2 diabetics.

Author

El Oudi M, Aouni Z, Ouertani H, Mazigh C, and Machghoul S

Subjects
Aged, Antihypertensive Agents adverse effects, Biomarkers blood, Case-Control Studies, Chi-Square Distribution, Diabetes Mellitus, Type 2 blood, Diabetes Mellitus, Type 2 complications, Female, Folic Acid blood, Humans, Hyperhomocysteinemia etiology, Hypolipidemic Agents adverse effects, Male, Middle Aged, Odds Ratio, Risk Assessment, Risk Factors, Time Factors, Treatment Outcome, Triglycerides blood, Vitamin B 12 blood, Antihypertensive Agents therapeutic use, Diabetes Mellitus, Type 2 drug therapy, Homocysteine blood, Hyperhomocysteinemia blood, Hypolipidemic Agents therapeutic use
Abstract

Aim: Evaluate the effect of lipopenic and hypotensive treatment on homocysteine levels., Methods: We recruited 145 type 2 diabetics and 130 control subjects. Thirty-seven diabetics had no complications, 54 had microvascular complications and 54 had macrovascular complications. We determined the parameters homocysteine of lipid, vitamin B12, triglycerides, and folates for all subjects. Associated treatments used one or more of the following drugs, statin, fibrate, angiotensin-converting enzyme inhibitor and beta-blockers., Results: Hyperhomocysteinemia was present in 35.6% of patients. Diabetics had elevated serum levels of triglycerides (P < 0.001), homocysteine (P < 0.01), folates (P < 0.01) and vitamin B12 (P < 0.001). A strong association was found between type 2 diabetes and hyperhomocysteinemia (P < 0.001). Diabetics with associated treatment had elevated homocysteine, vitamin B12 and folate levels when compared to diabetes-free controls. For diabetics with macrovascular complications, we found significant differences in homocysteine (P = 0.010) and folate (P = 0.014) between those taking associated drugs and those who did not. For diabetics with microvascular complications, a significant difference was found in folate only (P = 0.012)., Conclusion: Drugs used for hypertension and hyperlipidemia may have an effect on homocysteine levels, for this reason the interaction between drug action and homocysteine levels should be taken into consideration.

Published
2010
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22. [Hypothalamic-pituitary Langerhans cell histiocytosis in adults].

Author

Essais O, Jomaa R, Bougerra R, Marrakchi Z, Ben Salem L, Ouertani H, Chamakhi S, Neji S, Ben Slama C, and Zidi B

Subjects
Adult, Diabetes Insipidus etiology, Female, Humans, Histiocytosis, Langerhans-Cell diagnosis, Hypothalamic Diseases diagnosis, Pituitary Diseases diagnosis
Abstract

Introduction: Langerhans cell histiocytosis is a rare entity. Involvement of the pituitary region is frequently delayed and rarely studied., Cases: We report some clinical and paraclinical particularities of the disease in four women. Diabetes insipidus was the initial symptom in all cases, accompanied by panhypopituitarism at initial presentation in one woman. Hypopituitarism was diagnosed from 6 months to 4 years after the diabetes insipidus in the other cases, and systemic lesions appeared 3 to 6 years thereafter. Magnetic resonance imaging of the hypothalamic-pituitary axis found tumors in two patients and infundibular thickening in the other two. One patient also had a partially empty sella., Discussion: In adults, pituitary involvement seems to occur predominantly in women, and panhypopituitarism is possible at initial presentation. The clinical polymorphism of Langerhans cell histiocytosis makes this disease difficult and often slow to diagnose.

Published
2006
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23. [Factors influencing homocysteineamia in type 2 diabetic patients].

Author

Essais O, Bouzid C, Ouni Z, Ibrahim H, Ouertani H, Machghoul S, and Zidi B

Subjects
Diabetes Mellitus, Type 2 blood, Female, Folic Acid blood, Glycated Hemoglobin analysis, Homocysteine blood, Humans, Hypoglycemic Agents blood, Male, Metformin blood, Middle Aged, Obesity complications, Prospective Studies, Risk Factors, Vitamin B 12 blood, Vitamin B 12 Deficiency complications, Diabetes Mellitus, Type 2 complications, Hyperhomocysteinemia complications
Abstract

Previous studies have suggested that hyperhomocysteinaemia (Hcy) could be a strong and independent cardiovascular risk factor. Many factors could influence the serum concentration of Hcy such as vitamin B 12, folic acid, renal failure, hypothyroid status, ovarian failure and cancers. So the aim of our study was to evaluate the prevalence of hyperhomocysteinaemia among 54 type 2 diabetic patients and to study, its relationship with vitamin B12, folic acid and Metformin. Were excluded all patients with an evident cause of hyperhomocysteinaemia. Mean age of patients was 52.8 years. Mean Hcy was 11.7 + 6.9 micromol/l. The prevalence of hyperhomocysteinaemia was 27.8% in our group. There were eight (14%) patients with vitamin B12 deficiency and three among them had hyperhomocysteinaemia. There was no folic acid deficiency and no relationship with Metformin treatment. We suggest a wide screening of hyperhomocysteinaemia in type 2 diabetic patients and folic acid or vitamin B12 supplements if necessary.

Published
2006

24. [Hypopituitarism and antiphospholipid syndrome].

Author

Essaïs O, Ouertani H, Bouzid C, and Zidi B

Subjects
Adult, Female, Humans, Hypopituitarism etiology, Hypothalamus pathology, Magnetic Resonance Imaging, Pituitary Gland pathology, Pregnancy, Antiphospholipid Syndrome diagnosis, Hypopituitarism diagnosis, Puerperal Disorders diagnosis
Abstract

Endocrine disorders seen in antiphospholipid syndrome are rare. To date, these disorders have generally involved Addison's disease. Recently reports have appeared of a few cases of primary or secondary hypopituitarism associated with primary antiphospholipid syndrome. We report the case of a young female patient who presented neuroendocrine symptoms during the postpartum period associated with an antiphospholipid syndrome. Hormone assessment showed complete anterior hypopituitarism and antiphospholipid antibodies were positive. We discuss the clinical, biological and radiological features observed in our patient and compare results with cases reported in the literature. This case illustrates the importance of screening for antiphospholipid syndrome in the etiological work-up of hypopituitarism associated with a history of recurrent thrombosis.

Published
2003

26. [Psychopathological and psychotherapeutic approach to the first psychotic episode].

Author

Ouertani H, Taktak J, Bouattour M, Regaieg I, and Douki S

Subjects
Family psychology, Family Relations, Humans, Psychotherapy methods, Severity of Illness Index, Psychotic Disorders diagnosis, Psychotic Disorders psychology, Psychotic Disorders therapy
Abstract

The studies and research on the psychopathology of delusions are extremely numerous and varied and have resulted in the construction of psychoanalytic, systemic, cognitive and other explanatory models. All the theories stress the interaction between the subject and his/her environment, in particular when an initial psychotic episode emerges. In addition to their etiopathogenic interest, these models have the advantage of constituting specific therapeutic approaches, which indubitably increase the impact of treatment when associated with chemotherapy.

Published
1999

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