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Abstract Introduction Addressing acquired laryngotracheal stenosis presents a complex healthcare dilemma. Results We present a case series of 48 acquired post-intubation laryngotracheal stenosis cases managed within our Department of ENT Surgery at Farhat Hached Tunisia. Diagnosis relied on imaging and endoscopic findings. Among these cases, 28 exhibited tracheal stenosis, with 60% falling into grade 2–3 severity. Management approaches included sole endoscopic dilation for 17 patients, surgical intervention for 19 patients, and T-tube placement for 10 patients. Conclusions The management of laryngotracheal stenosis poses a challenge for ENT surgeons. Prevention is paramount, encompassing various measures such as employing high-volume, high tracheostomy, and extended intubation practices.

Abstract Background The diffuse sclerosing variant of papillary thyroid carcinoma is a rare pathologic entity. It is characterized by a tendency for rapid growth and a higher incidence of cervical lymph node and distant metastases. We report an unusual presentation of diffuse sclerosing variant of papillary thyroid carcinoma presented as a single thyroid mass of a small size. Case presentation We experienced a case of a diffuse sclerosing variant of papillary thyroid carcinoma in a 30-year-old woman. The preoperative findings on the cytology and ultrasound were suggestive of a malignant thyroid nodule. This case was confirmed by surgical excision. The management included surgery, radioiodine ablation, and suppressive levothyroxine therapy. Conclusions We would like to highlight that an early diagnosis associated with an appropriate management leads to a good prognosis.

Abstract Otogenic cerebral sinovenous thrombosis is an intracranial complication secondary to otogenic disease; it is rare but could be a life‐threatening condition. Its management is always challenging. This study aimed to focus on clinical features, on diagnosis of this pathology and to review the most controversial aspect of management of otogenic cerebral sinovenous thrombosis. We reviewed retrospectively 10 inpatients treated with cerebral sinus thrombosis secondary to otitis between 1995 and 2020. Ten inpatients (eight males and two females) with ages ranging from 11 to 77 years were diagnosed with ontogenesis sinus thrombosis. The most commonly reported symptoms were headaches and otalgia. Five patients had mastoiditis, and 7 of the 10 patients had other concurrent complications: cerebellar abscess (three patients) and extradural empyema in two patients, retropharyngeal abscess in one patient, and meningitis in one patient. All patients were treated with broad‐spectrum antibiotherapy, anticoagulation was used to treat nine patients, and surgery was required in nine patients. Nine patients had satisfactory resolution of their symptoms, but one patient had sequel as permanent loss of visual acuity. Because of the inconspicuous clinical presentation, and the probability of a fatal evolution, suspicion is essential for a proper diagnosis and suitable treatment.

Abstract Background Distinct virulence factors of H. pylori have been described: the vaculating cytotoxin (vacA), the cytotoxin associated gene (cagA), the induced by contact with epithelium factor Antigen (iceA gene) and the outer membrane protein oipA. In Tunisia, there are no data regarding the pattern of H. pylori genotypes; therefore, this prospective and multicentre study was the first to be done in Tunisia and aimed to investigate the prevalence of the vacA, cagA, iceA and oipA genotypes of H. pylori isolates from Tunisian patients with peptic ulceration, gastric cancer, MALT lymphoma and gastritis. Methods H. pylori was cultured from endoscopic biopsies obtained from 281 Tunisian patients. The vacA alleles, cagA, iceA and oipA genotypes were determined by PCR. Results The vacA s1m1, s1m2 and s2m2 were respectively found in 10.7%, 12.5% and 45.6% of strains. The s2m1 genotype was not detected in our study. The cagA was found in 61.6% of isolates. The iceA1 and the iceA2 genotypes were respectively isolated in 60.2% and in 16% of strains. The oipA genotype was detected in 90.8% of strains. Considering the vacA and iceA genotypes, the presence of multiple H. pylori strains in a single biopsy specimen was found respectively in 31.4% and 23.8%. The comparison between strains isolated from antrum and fundus showed that Tunisian patients were infected with two or more strains of different cagA, vacA, iceA and oipA genotypes and the discordance was respectively in 9.6%, 4.6%, 8.9% and 8.5% of strains. Conclusion Our results showed that in 46% (131 strains among 281), the H. pylori strains were highly virulent in relation of the three or four virulent factors they could carry. These finding were described before in the literature. Tunisian patients were colonized by one or multiple strains of H. pylori in the same time in relation of presence of vacA m1/m2 and iceA1/iceA2 in the same biopsy. The discordance between strains isolated from antrum and fundus was high, and it is in favour of multicolonization.

The objective of this article is to evaluate, through an experimental and numerical study, the effect of the addition of isooctane on the performance and Nox emissions of a spark–ignition engine four different mixtures in addition to gasoline were tested in a spark–ignition engine using the DIN70020 standard at full load. The tests were conducted by adding 10, 20, 30, and 40% isooctane by volume to unleaded commercial gasoline. This practice makes a significant contribution to improving engine performance, increasing fuel efficiency, and reducing pollutant emissions. As a result, the addition of isooctane is establishing itself as a standard in the manufacture of premium fuels, providing not only an improved driving experience but also preserving the health of the engine. Extensive studies have been conducted to explore the potential of isooctane as a fuel in this regard. NOx emissions were reduced by adding a proportion of isooctane to unleaded commercial gasoline for all fuel blends, which could be explained by the high vaporization enthalpy of isooctane. This reduces the maximum temperature reached in the cylinder and thus reduces nitrogen oxide (NOx) emissions. A significant reduction in emissions of approximately 5% is achieved for the I10 blend (10% isooctane + 90% unleaded commercial gasoline) with the maintenance of engine performance (torque and power). This experimental study is confirmed by a numerical simulation using the DIESL-RK software with an average convergence of results that varies from 0.47% to 5.01%. [ABSTRACT FROM AUTHOR]

Introduction: Addressing acquired laryngotracheal stenosis presents a complex healthcare dilemma. Results: We present a case series of 48 acquired post-intubation laryngotracheal stenosis cases managed within our Department of ENT Surgery at Farhat Hached Tunisia. Diagnosis relied on imaging and endoscopic findings. Among these cases, 28 exhibited tracheal stenosis, with 60% falling into grade 2–3 severity. Management approaches included sole endoscopic dilation for 17 patients, surgical intervention for 19 patients, and T-tube placement for 10 patients. Conclusions: The management of laryngotracheal stenosis poses a challenge for ENT surgeons. Prevention is paramount, encompassing various measures such as employing high-volume, high tracheostomy, and extended intubation practices. [ABSTRACT FROM AUTHOR]