Search

Background: This study aimed to assess the epidemiological, clinical, and therapeutic aspects and prognosis of juvenile nasopharyngeal carcinoma in Tunis country. Materials and Methods: This study included 68 patients, younger than 18 years of age. All the patients had a clinical and para-clinical tumoral assessment. The study of survival and prognostic factors was done after a descriptive analysis. These prognostic factors were studied through uni and multivariate analysis. Results: The median age was 14.7 years and the sex ratio was 2 male to 1 female. The average time to first consultation was 4 months. Rhinological signs were the most frequent symptom for consultation (n= 41). The T3-T4 tumors accounted for 78% of patients and there was a lymph node invasion stage N2-N3 in 63% of cases. Non-metastatic patients had radiotherapy associated with chemotherapy in 97% of cases. Metastatic patients received hypofractionated radiotherapy on bone metastasis, and first-line chemotherapy followed by radiotherapy on the primitive tumor and lymph node areas in case of good response to chemotherapy (n= 2). The mean follow-up was 94 months; 78% of these patients were alive and in complete remission, 19% were in therapeutic failure, and 16% of them had metachronous metastases. The five-year-overall survival was 95%. Hyposialia and skin dystrophy were the most frequent late complications. In univariate analyses, significant prognostic factors were cranial nerve invasion, intracranial invasion, and infra-temporal fossa invasion. In multivariate analysis, the most parsimonious model associated extension to the infratemporal fossa, endo-cranial extension, and initial therapeutic modality (treatment failures were less frequent with neoadjuvant chemotherapy (p= 0.22)). Conclusion: Treatment of nasopharyngeal carcinoma in children consists of chemotherapy and radiotherapy. Synchronous or metachronous metastases are common in this patient population. Modern radiotherapy techniques, including conformal radiotherapy with intensity modulation, are promising and could overcome toxicities in long-term survivors. [ABSTRACT FROM AUTHOR]

For many years, mental health has been hidden behind a veil of shame and prejudice. In 2017, studies claimed that 10.7% of the global population suffered from mental health disorders. Recently, people started seeking relaxing treatment through technology, which enhanced and expanded mental health care, especially during the COVID-19 pandemic, where the use of mental health forums, websites, and applications has increased by 95%. However, these solutions still have many limits, as existing mental health technologies are not meant for everyone. In this work, an up-to-date literature review on state-of-the-art of mental health and healthcare solutions is provided. Then, we focus on Arab-speaking patients and propose an intelligent tool for mental health intent recognition. The proposed system uses the concepts of intent recognition to make mental health diagnoses based on a bidirectional encoder representations from transformers (BERT) model and the International Neuropsychiatric Interview (MINI). Experiments are conducted using a dataset collected at the Military Hospital of Tunis in Tunisia. Results show excellent performance of the proposed system (the accuracy is over 92%, the precision, recall, and F1 scores are over 94%) in mental health patient diagnosis for five aspects (depression, suicidality, panic disorder, social phobia, and adjustment disorder). In addition, the tool was tested and evaluated by medical staff at the Military Hospital of Tunis, who found it very interesting to help decision-making and prioritizing patient appointment scheduling, especially with a high number of treated patients every day. [ABSTRACT FROM AUTHOR]

Paediatric radiotherapy in African countries faces many challenges mainly due to socio-economic issues and scarcity of dedicated paediatric radiation oncologists. The IAEA is promoting paediatric radiation oncology through short fellowships programs within the framework of RAF6055 project. The Tunisian pilot experience integrated these fellows from French speaking countries into a 6-week Masterclass dedicated to paediatric radiotherapy. The program aimed to promote effective collaboration between African LMIC to improve the quality of paediatric radiotherapy practices. Sessionswere organized by the Radiation Oncology Department of Abderrahmen Mami Teaching Hospital, under the auspices of the Tunisian Society of Radiation Oncology (STOR) and Faculty of Medicine of Tunis. Participants included Tunisian residents, African radiation oncologists involved in childhood cancer care, medical physicists and RTT's. The training program course materiel and practicum covered indications, techniques of irradiation and contouring workshops in most frequent childhood cancers. Courses were given by international and national experts in paediatric radiotherapy. Sessions were live-streamed in order to widen the knowledge access. Weekly contouring workshops were organized using an online platform (Proknow Elekta®) and aimed to learn the guidelines and best practices proposed by the experts and further integrate them into daily practice. A thirty-item survey was distributed to participants to evaluate the program's efficiency and impact on their clinical practice. A total of 35 participants attended the training program mainly from north and west Africa. Clinical areas covered by the program were considered relevant to learning objectives by 86.7% of participants. Overall organisation, including course quality, allocated time, dedicated technical material and expert's availability, was satisfying according to 93.3% of attendees. All participants reported a substantial benefit of the training program in term of updating knowledge and improving technical skills in paediatric radiotherapy. Strengthening collaboration between African countries through targeted training programs is an accessible cost-effective strategy to improve childhood cancer care. Every effort should be made to promote these programs and support the role of existing paediatric radiation oncologists in these regions. [ABSTRACT FROM AUTHOR]