16 results on '"Rim Karray"'
Search Results
2. Man-O-War simulator: a Low-cost manikin for training on chest tube management
- Author
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Abdennour Nasri, Mouna Jerbi, Rim Karray, Haifa Snoussi, Amal Samet, Aziza Talbi, Hana Ksentini, Imen Rejeb, Olfa Chakroun-Walha, and Noureddine Rekik
- Subjects
Simulator ,Chest tube ,Management ,Health education ,Low-cost ,Medicine ,Medicine (General) ,R5-920 - Abstract
Simulation-based medical education is becoming a cornerstone in health education. Simulators are commonly expensive and not available in developing countries.We propose a very low-cost simulator that any educator can realize. We describe here the steps to follow to develop this proposed simulator.
- Published
- 2023
- Full Text
- View/download PDF
3. Evidence of SARS-CoV-2 symptomatic reinfection in four healthcare professionals from the same hospital despite the presence of antibodies
- Author
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Saba Gargouri, Amal Souissi, Nabil Abid, Amel Chtourou, Lamia Feki-Berrajah, Rim Karray, Hana Kossentini, Ikhlass Ben Ayed, Fatma Abdelmoula, Olfa Chakroun, Abdennour Nasri, Adnène Hammami, Noureddine Rekik, Saber Masmoudi, Hela Karray-Hakim, and Ahmed Rebai
- Subjects
Coronavirus disease 2019 ,SARS-CoV-2 ,Reinfection ,Healthcare professional ,Infectious and parasitic diseases ,RC109-216 - Abstract
Objectives: Since the onset of the COVID-19 pandemic, cases of reinfection with SARS-CoV-2 have been reported, raising additional public health concerns. SARS-CoV-2 reinfection was assessed in healthcare workers (HCWs) in Tunisia because they are at the greatest exposure to infection by different variants. Methods: We conducted whole-genome sequencing of the viral RNA from clinical specimens collected during the initial infection and the suspected reinfection from 4 HCWs, who were working at the Habib Bourguiba University Hospital (Sfax, Tunisia) and retested positive for SARS-CoV-2 through reverse transcriptase–polymerase chain reaction (RT-PCR) after recovery from a first infection. A total of 8 viral RNAs from the patients’ respiratory specimens were obtained, which allowed us to characterize the differences between viral genomes from initial infection and positive retest.The serology status for total Ig, IgG, and IgM against SARS-CoV-2 was also determined and followed after the first infection. Results: We confirmed through whole-genome sequencing of the viral samples that all 4 cases experienced a reinfection event. The interval between the 2 infection events ranged between 45 and 141 days, and symptoms were milder in the second infection for 2 patients and more severe for the remaining 2 patients. Reinfection occurred in all 4 patients despite the presence of antibodies in 3 of them. Conclusion: This study adds to the rapidly growing evidence of COVID-19 reinfection, where viral sequences were used to confirm infection by distinct isolates of SARS-CoV-2 in HCWs. These findings suggest that individuals who are exposed to different SARS-CoV-2 variants might not acquire sufficiently protective immunity through natural infection and emphasize the necessity of their vaccination and the regular follow-up of their immune status both in quantitative and qualitative terms.
- Published
- 2022
- Full Text
- View/download PDF
4. Early severity predictors of snakebite envenomation in the southern region of Tunisia: a multivariate analysis
- Author
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Olfa Chakroun-Walha, Fadhila Issaoui, Abdennour Nasri, Haifa Bradai, Ayman Farroukh, Rim Karray, Mouna Jerbi, and Noureddine Rekik
- Subjects
snakebite envenomation ,outcomes ,emergency department ,severity predictors ,tunisia ,Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
Objective: To identify the early predictors of severe envenomation in the southern region of Tunisia. Methods: It was a retrospective monocentric study including consecutive patients admitted to the emergency department for snakebite envenomation. Snakebite envenomation was defined by a history of snakebite. Predictors of severe envenomation were determined by univariate and multivariate analyses. Results: Our sample consisted of 109 patients aged 30 (20-44) years with a 1.1:1 sex-ratio (56 males and 53 females). During the 24-hour surveillance period, 25 patients developed severe envenomation (22.9%). The in-hospital mortality rate was 4.6% (n=5). The independent predictors of severe snakebite envenomation were leucocyte count over 11 550/mm3 (OR: 18.7, 95% CI: 3.3-107.8), creatine kinase over 155 IU/L (OR: 6.16, 95% CI: 1.1-35.6), and/or tourniquet before arrival to the ED (OR: 32.14, 95% CI: 3.5-295.9). Conclusions: This study emphasizes the importance of early evaluation of snakebite envenomation. Further studies are required to approve a severity scale proper to snakebite envenomation in Tunisia.
- Published
- 2021
- Full Text
- View/download PDF
5. Frailty screening of Tunisian older adults: feasibility and usefulness in the Emergency Department
- Author
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Olfa Chakroun-Walha, Adel Walha, Haifa Bradai, Abdennour Nasri, Rim Karray, Mouna Jerbi, Rahma Trabelsi, and Noureddine Rekik
- Subjects
ADL index ,Elderly ,Emergency Department ,ISAR scale ,Outcomes ,Medicine ,Medicine (General) ,R5-920 - Abstract
Introduction: Frail older adults are at an increased risk for adverse outcomes after an Emergency Department (ED) visit. Several tools exist for the screening of frailty among these patients. However, no tool has been validated in Tunisia. This study aims to evaluate the usefulness of frailty screening in predicting the outcome of older adults presenting to the ED. Methods: This is a prospective, monocentric study. We evaluated the eligible patients at the ED and after their discharge. Follow-up phone calls were scheduled at 1, 2, 3, and 6 months after the ED visit. All patients aged 65 years or older; and visiting the ED during the inclusion period were involved. We used the ADL index and ISAR scale for assessing frailty. Results: We enrolled 184 patients; they were living alone in 25% of cases. Half of them had medical care insurance. The ADL index was maximum (6 = total dependency) in 20% of cases. The ISAR score was above 1 point in 38%. Unplanned hospitalizations have accounted for 34%. In univariate analysis, the ADL index and ISAR score were statistically higher in the group of “unplanned hospitalization”. In multivariate analysis, the ISAR score and ADL index have not been associated with unplanned hospitalization. Conclusion: Our results did not demonstrate the relevance of the ISAR or ADL scales in predicting the mortality or the need for unplanned hospitalization in multivariate analysis. This study did indicate an increased mortality in the “frail” patients in the univariate analysis. Further studies with larger samples and different tools are necessary.
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- 2020
- Full Text
- View/download PDF
6. Une cause exceptionnelle des péritonites: une perforation iléale par un corps étranger lors de la réduction d'une hernie inguinale
- Author
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Mohamed Moez Kammoun, Rim Karray, Kais Regaieg, Mabrouk Bahloul, and Mounir Bouaziz
- Subjects
péritonite secondaire ,hernie ,corps étranger ,réanimation ,choc septique ,Medicine - Abstract
La péritonite secondaire est fréquemment rapportée dans la littérature. Les causes sont multiples. Nous rapportons un cas d'une perforation iléale par une cause exceptionnelle. Il s'agit d'une perforation iléale par un corps étranger lors de la réduction d'une hernie inguinale, responsable d'une péritonite grave avec tableau de défaillance multiviscérale.
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- 2018
- Full Text
- View/download PDF
7. Conservative management for acute renal rupture in blunt trauma
- Author
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Rim Karray, Olfa Chakroun-Walha, Basma Souissi, and Noureddine Rekik
- Subjects
Blunt trauma ,Renal rupture ,Emergency ,Imaging ,Conservative management ,Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
Renal injuries are commonly reported in blunt abdominal trauma and are usually associated to other abdominal injuries. Renal rupture may be misdiagnosed and its management, especially in severe lesions, is still controversial. We describe the case of renal rupture diagnosed in the Emergency Department and conservatively managed. The outcome was good thanks to the early diagnosis and the management of the renal trauma. Conservative management in renal rupture is possible in stable patients provided that the imaging is early done.
- Published
- 2017
- Full Text
- View/download PDF
8. Outcomes in chloralose poisoning: A multivariate analysis of a retrospective cohort in an emergency department
- Author
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Abdennour Nasri, Rim Karray, Mouna Jerbi, Haifa Snoussi, Leila Chaari, Adel Chaari, Olfa Chakroun-Walha, and Noureddine Rekik
- Subjects
Health, Toxicology and Mutagenesis ,Toxicology - Published
- 2023
9. Early severity predictors of snakebite envenomation in the southern region of Tunisia: a multivariate analysis
- Author
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Noureddine Rekik, Rim Karray, Haifa Bradai, Ayman Farroukh, Mouna Jerbi, Olfa Chakroun-Walha, Abdennour Nasri, and Fadhila Issaoui
- Subjects
Tourniquet ,medicine.medical_specialty ,Multivariate analysis ,business.industry ,RC86-88.9 ,Mortality rate ,Medical emergencies. Critical care. Intensive care. First aid ,General Medicine ,Emergency department ,Internal medicine ,Medicine ,Envenomation ,business ,snakebite envenomation ,outcomes ,emergency department ,severity predictors ,tunisia - Abstract
Objective: To identify the early predictors of severe envenomation in the southern region of Tunisia. Methods: It was a retrospective monocentric study including consecutive patients admitted to the emergency department for snakebite envenomation. Snakebite envenomation was defined by a history of snakebite. Predictors of severe envenomation were determined by univariate and multivariate analyses. Results: Our sample consisted of 109 patients aged 30 (20-44) years with a 1.1:1 sex-ratio (56 males and 53 females). During the 24-hour surveillance period, 25 patients developed severe envenomation (22.9%). The in-hospital mortality rate was 4.6% (n=5). The independent predictors of severe snakebite envenomation were leucocyte count over 11 550/mm3 (OR: 18.7, 95% CI: 3.3-107.8), creatine kinase over 155 IU/L (OR: 6.16, 95% CI: 1.1-35.6), and/or tourniquet before arrival to the ED (OR: 32.14, 95% CI: 3.5-295.9). Conclusions: This study emphasizes the importance of early evaluation of snakebite envenomation. Further studies are required to approve a severity scale proper to snakebite envenomation in Tunisia.
- Published
- 2021
10. Frailty screening of Tunisian older adults: feasibility and usefulness in the Emergency Department
- Author
-
Abdennour Nasri, Rahma Trabelsi, Haifa Bradai, Mouna Jerbi, Noureddine Rekik, Olfa Chakroun-Walha, Rim Karray, and Adel Walha
- Subjects
ADL index ,medicine.medical_specialty ,Multivariate analysis ,Adverse outcomes ,Frail Older Adults ,lcsh:Medicine ,Outcomes ,Medical care ,03 medical and health sciences ,Elderly ,0302 clinical medicine ,Geochemistry and Petrology ,Medicine ,030212 general & internal medicine ,lcsh:R5-920 ,Univariate analysis ,business.industry ,lcsh:R ,ISAR scale ,030208 emergency & critical care medicine ,Emergency Department ,Emergency department ,Increased risk ,Emergency medicine ,Emergency Medicine ,Original Article ,lcsh:Medicine (General) ,business ,human activities ,Gerontology - Abstract
Introduction Frail older adults are at an increased risk for adverse outcomes after an Emergency Department (ED) visit. Several tools exist for the screening of frailty among these patients. However, no tool has been validated in Tunisia. This study aims to evaluate the usefulness of frailty screening in predicting the outcome of older adults presenting to the ED. Methods This is a prospective, monocentric study. We evaluated the eligible patients at the ED and after their discharge. Follow-up phone calls were scheduled at 1, 2, 3, and 6 months after the ED visit. All patients aged 65 years or older; and visiting the ED during the inclusion period were involved. We used the ADL index and ISAR scale for assessing frailty. Results We enrolled 184 patients; they were living alone in 25% of cases. Half of them had medical care insurance. The ADL index was maximum (6 = total dependency) in 20% of cases. The ISAR score was above 1 point in 38%. Unplanned hospitalizations have accounted for 34%. In univariate analysis, the ADL index and ISAR score were statistically higher in the group of “unplanned hospitalization”. In multivariate analysis, the ISAR score and ADL index have not been associated with unplanned hospitalization. Conclusion Our results did not demonstrate the relevance of the ISAR or ADL scales in predicting the mortality or the need for unplanned hospitalization in multivariate analysis. This study did indicate an increased mortality in the “frail” patients in the univariate analysis. Further studies with larger samples and different tools are necessary.
- Published
- 2020
11. Evidence of SARS-CoV-2 Symptomatic Reinfection in Four Health Care Professionals from the Same Hospital Despite the Presence of Antibodies
- Author
-
Saba Gargouri, Amal Souissi, Nabil Abid, Amel Chtourou, Lamia Feki-Berrajah, Rim Karray, Hana Kossentini, Ikhlass Ben Ayed, Fatma Abdelmoula, Olfa Chakroun, Abdennour Nasri, Adnène Hammami, Noureddine Rekik, Saber Masmoudi, Hela Karray-Hakim, and Ahmed Rebai
- Subjects
Microbiology (medical) ,Infectious Diseases ,Healthcare professional ,Coronavirus disease 2019 ,SARS-CoV-2 ,Reinfection ,General Medicine ,Article - Abstract
Objectives Since the onset of the COVID-19 pandemic, cases of reinfection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been reported, raising additional public health concerns. SARS-CoV-2 reinfection was assessed in healthcare workers in Tunisia, as they are at the greatest exposure to infection by different variants. Methods We conducted whole-genome sequencing of the viral RNA from clinical specimens at the initial infection and suspected second infection from four healthcare workers, working at the Habib Bourguiba University Hospital (Sfax, Tunisia), who were retested positive for SARS-CoV-2 by RT-PCR after recovery from a first infection. A total of 8 viral RNAs from the patients’ respiratory specimens were obtained, which allowed us to characterize the differences between viral genomes from initial infection and positive retest. The serology status for total Ig, IgG, and IgM against SARS-CoV-2 was also determined and followed after the first infection. Results We confirmed by whole-genome sequencing of the viral samples that all four cases experienced a reinfection event. The interval between the two infection events ranged from 45 to 141 days and symptoms were milder in the second infection for two patients and more severe for the two remaining cases. Reinfection occurred for all four cases, despite the presence of antibodies for three of them. Conclusion This study adds to the rapidly growing evidence of COVID-19 reinfection, where viral sequences were used to confirm infection by distinct isolates of SARS-CoV-2 in healthcare workers. These findings suggest that individuals, who are exposed to different SARS-CoV-2 variants, might not acquire sufficiently protective immunity through natural infection and emphasis the necessity of their vaccination and the regular follow-up of their immune status both in quantitative and qualitative terms.
- Published
- 2022
12. Post-traumatic symptoms in patients with acute coronary syndrome: Maybe an outcome predictor after the ED visit!
- Author
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Noureddine Rekik, Sirine Bouzid, Amine Abdelhedi, Kais Bouzid, Mouna Benamor, Feres Benamira, Rim Karray, Mouna Jerbi, Abdennour Nasri, and Olfa Chakroun-Walha
- Subjects
Stress Disorders, Post-Traumatic ,Chest Pain ,Emergency Medicine ,Humans ,General Medicine ,Prospective Studies ,Acute Coronary Syndrome ,Emergency Service, Hospital - Abstract
We aimed to assess the patients' experience of threat during management of an acute coronary syndrome (ACS) in the Emergency Department (ED) and to analyze the impact of this acute stress on day-30 outcomes.This is a prospective study.We included patients with ACS in the ED. After discharge, the perceived stress (Perceived Stress Scale (PSS); Visual Analogic Scale (VAS) in stress evaluation; Patient Health Questionnaire (PHQ); and Posttraumatic Stress Disorder Checklist Scale (PCLS) were used.35 patients have developed PTSD on day-30 (31.8%). The independent predictors of developing PTSD at day-30 were high PSS score on admission (OR = 1.4; CI = 1.1-1.8; p = 0.004) and/or elevated PHQ-9 score at day-30 (OR = 1.5; CI = 1.2-1.9; p0.001). The recurrence of the chest pain was more frequent in the PTSD group of patients. Patients with PTSD symptoms were more likely to report a non-therapeutic adherence to their cardiovascular medication.Stress management in EDs should become a systematic step in the management of patients with ACS. This study emphasizes the importance of multidisciplinary follow-up and early screening of patients at risk of PTSD to improve their outcomes after discharge.
- Published
- 2021
13. Update on the Epidemiology of Scorpion Envenomation in the South of Tunisia
- Author
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Hichem Ksibi, Fadhila Issaoui, Olfa Chakroun-Walha, Noureddine Rekik, Mabrouk Bahloul, Abdennour Nasri, Ben Rebeh Amine, Mouna Jerbi, Rim Karray, and Mounir Bouaziz
- Subjects
Adult ,Male ,medicine.medical_specialty ,Poor prognosis ,Tunisia ,animal structures ,Adolescent ,030231 tropical medicine ,Scorpion ,complex mixtures ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,biology.animal ,Epidemiology ,Humans ,Medicine ,Child ,Envenomation ,Aged ,Retrospective Studies ,Aged, 80 and over ,Scorpion Stings ,biology ,business.industry ,Mortality rate ,Public Health, Environmental and Occupational Health ,Infant ,030208 emergency & critical care medicine ,Retrospective cohort study ,Emergency department ,Middle Aged ,Sting ,Child, Preschool ,Emergency medicine ,Emergency Medicine ,Female ,Emergency Service, Hospital ,business - Abstract
Introduction Scorpion envenomation is still a frequent occurance in tropical and subtropical regions. In Tunisia, multiple studies on scorpion envenoming have contributed to an improved understanding of cardiac dysfunction and factors predictive of poor prognosis. These previous studies have contributed to the current standardized management of envenomed patients. However, the epidemiology of scorpion envenoming in Tunisia has not been updated for more than 10 years. The aim of this study was to report an update of the epidemiological features of scorpion envenomation in the southern region of Tunisia. Methods This is a retrospective monocentric study including all patients admitted in the emergency room for scorpion envenomation. Cases were collected from emergency medical files during a 3-year period (2013–2015). The diagnosis of scorpion envenomation was made by history of a scorpion sting. All files in which scorpion envenomation was not certain were excluded. Data are presented as mean±SD with range or percentages, as appropriate. Results We enrolled 282 patients aged 27.4±22.8 years with a 1:1 sex ratio. During surveillance in the emergency room, 39 patients developed cardiac dysfunction. Overall, 42 patients (14.9%) were at stage 3 of severity, and 240 patients (85.1%) had moderate scorpion envenomation (stage 2). Only 1 patient died a few hours after admission. In the remaining cases, the outcome was good. Our results show the improvement in mortality rates even in severe presentations. Conclusion This study found that the outcome of scorpion-stung patients has clearly improved. This enhancement can be explained by early medical consultation and standardized management of patients with predictive factors for cardiac dysfunction.
- Published
- 2018
14. Une cause exceptionnelle des péritonites: une perforation iléale par un corps étranger lors de la réduction d’une hernie inguinale
- Author
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Kais Regaieg, Mounir Bouaziz, Mabrouk Bahloul, Mohamed Moez Kammoun, and Rim Karray
- Subjects
medicine.medical_specialty ,Resuscitation ,Ileal Perforation ,medicine.medical_treatment ,resuscitation ,Peritonitis ,Case Report ,hernie ,030230 surgery ,choc septique ,hernia ,03 medical and health sciences ,Secondary peritonitis ,0302 clinical medicine ,réanimation ,medicine ,Hernia ,030212 general & internal medicine ,Reduction (orthopedic surgery) ,Septic shock ,business.industry ,General Medicine ,medicine.disease ,foreign body ,Surgery ,Péritonite secondaire ,Inguinal hernia ,corps étranger ,septic shock ,Foreign body ,business - Abstract
La péritonite secondaire est fréquemment rapportée dans la littérature. Les causes sont multiples. Nous rapportons un cas d'une perforation iléale par une cause exceptionnelle. Il s'agit d'une perforation iléale par un corps étranger lors de la réduction d'une hernie inguinale, responsable d'une péritonite grave avec tableau de défaillance multiviscérale.
- Published
- 2018
15. Value of troponin levels in the diagnosis of cardiac dysfunction in moderate scorpion envenomation
- Author
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Mounir Bouaziz, Mouna Jerbi, Rim Karray, Imen Chabchoub, Abdennour Nasri, Olfa Chakroun-Walha, Noureddine Rekik, Rania Ammar, A Ben Rebeh, Mabrouk Bahloul, and C Jammeli
- Subjects
Cardiac function curve ,Adult ,Male ,medicine.medical_specialty ,Myocarditis ,Adolescent ,Health, Toxicology and Mutagenesis ,Scorpion ,Context (language use) ,030204 cardiovascular system & hematology ,Toxicology ,03 medical and health sciences ,Ventricular Dysfunction, Left ,Young Adult ,0302 clinical medicine ,biology.animal ,Internal medicine ,medicine ,Humans ,Envenomation ,Child ,Retrospective Studies ,Scorpion Stings ,biology ,business.industry ,030208 emergency & critical care medicine ,Retrospective cohort study ,General Medicine ,Emergency department ,Middle Aged ,medicine.disease ,Troponin ,biology.protein ,Cardiology ,Female ,business ,Emergency Service, Hospital ,Biomarkers - Abstract
Context: Cardiac dysfunction is one of the most serious consequences of scorpion envenomation. The best tool to evaluate cardiac function is echocardiography, but it is not available at all emergency departments. Many studies aimed to describe biological predictive factors of cardiac dysfunction in scorpion envenomation. Troponin is one of these biomarkers but its correlation with myocarditis is not well established. The aim of this study was to evaluate correlation between troponin levels and cardiac dysfunction in moderate scorpion envenomation. Methods: A retrospective monocentric study including patients admitted in the emergency department for moderate scorpion envenomation with troponin measurement during their early management. On arrival, an electrocardiogram and a chest X-ray were realized for all patients. Results: We enrolled 132 patients with a mean age at 31.3 ± 24.4 years and a 1.35 sex-ratio. All patients had moderate systemic manifestations. There were 28 patients with clinical manifestations of cardiac dysfunction without life-threatening troubles (21.2%). Troponin was undetectable in 69 patients (56%). The mean value of troponin level (pg/ml) was higher in patients with clinical manifestations of left ventricular dysfunction (1.80 ± 3.8 vs. 0.11 ± 0.5; p = 0.02). Troponin levels were significantly higher in patients with positive T wave on electrocardiogram. Conclusion: In patients with moderate scorpion envenomation with positive T wave, high values of troponin suggest the presence of cardiac dysfunction.
- Published
- 2017
16. Conservative management for acute renal rupture in blunt trauma
- Author
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Basma Souissi, Noureddine Rekik, Olfa Chakroun-Walha, and Rim Karray
- Subjects
medicine.medical_specialty ,Conservative management ,business.industry ,General surgery ,Renal rupture ,lcsh:Medical emergencies. Critical care. Intensive care. First aid ,lcsh:RC86-88.9 ,General Medicine ,Emergency department ,urologic and male genital diseases ,medicine.disease ,Imaging ,Blunt ,Abdominal trauma ,Blunt trauma ,Emergency ,medicine ,business - Abstract
Renal injuries are commonly reported in blunt abdominal trauma and are usually associated to other abdominal injuries. Renal rupture may be misdiagnosed and its management, especially in severe lesions, is still controversial. We describe the case of renal rupture diagnosed in the Emergency Department and conservatively managed. The outcome was good thanks to the early diagnosis and the management of the renal trauma. Conservative management in renal rupture is possible in stable patients provided that the imaging is early done.
- Published
- 2017
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