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Objective: Surgery is the mainstay of hepatic cystic echinococcosis (HCE). The conservative surgery of HCE carries a non-negligible risk of recurrence and significant morbidity, dominated by Deep Surgical Site Infections (DSSI). To address these issues, we have improved and standardized this technique, which could reduce complications and achieve better postoperative outcomes. Patients and methods: We conducted a prospective study from June 2017 to June 2022 involving of patient operated using a standardized open technique for uncomplicated HCE at Habib Bourguiba University Hospital, Sfax, Tunisia. The aim was to obtain results at least similar to radical management in terms of DSSI. Patients with large cystobiliary fistulas or patients with complicated cysts were excluded. Results: Fifty patients with 106 cysts were operated using the standardized technique comprising of liver mobilization, intraoperative ultrasound, systematic methylene blue injection to detect cystobiliary fistulas and omentoplasty. The median age of the patients was 44(semi-interquartile range: 16) years. The main symptom described by the patient was pain in 43 cases (86%). An abnormal liver test was found in 20 cases (40%). On imaging studies, the cyst had a median size of 7.4(3.0) cm. Cyst of the hepatic dome accounted for 38 cases (35.8%) with most cysts being situated in the right hemi-liver. Visual inspection of the cavity and Methylene blue testing allowed for the discovery of 57 cysts (53.7%) that had cystobiliary fistulas that were sutured. Omentoplasty was performed in 77 cysts (72.6%). Postoperatively, only 2 cases (1.9%) developed a DSSI in the form of an external bile leak with resolved with conservative management. No case of recurrence was found after a median follow-up of 24 months. Conclusion: The standardized conservative surgical technique, in selected patients, shows promise in reducing DSSI rates and overall morbidity, and achieve as equally good result as radical management. Author summary: This study addresses the treatment of hepatic cystic echinococcosis (HCE), a serious health concern in many parts of the world. Surgery has been the mainstay of the management which could be conservative or radical. Conservative surgery has high recurrence rates and complications as opposed to radical surgery. Through a prospective study, we showed that an improved and standardized a surgical technique of the conservative approach could achieve postoperative outcomes as good as the radical management. The standardized approach significantly reduced Deep Surgical Site Infections (DSSI) as well as overall morbidity rates in patients. This was achieved through various adjuncts such as methylene blue test, liver detachment, and omentoplasty. [ABSTRACT FROM AUTHOR]

This work focuses on the relationship between governance and inclusive economic growth in Tunisia over the period 1996-2017. The Inclusive Growth Index is based on appropriate indicators from Mckinley (2010). The composite index was constructed on a weighted score for each year from 1996 to 2017. The sum of all indicator scores for each year provides the inclusive composite index for the year. In this case, by applying the technique of Principal Component Analysis (PCA) we have constructed an aggregate indicator of governance. The index was also constructed based on a number of structural and political changes in the Tunisian economy in terms of inclusive growth in relation to these changes. To conclude, the results of VECM clearly show the existence of a relationship between governance and inclusive economic growth in Tunisia. [ABSTRACT FROM AUTHOR]

This paper aims to assess the impact of industrial policy instruments on international competitiveness and in particular on the competitiveness of the manufacturing sector in Tunisia. From a non-stationary panel model composed of 13 Tunisian manufacturing sectors during the period 1995-2016, we show the existence of a long-term cointegration relationship between manufacturing exports and its determinants. The results show that spending on research and development and tertiary education has a positive effect on exports. Hence, it is necessary for the public authorities to intervene within the framework of industrial policy to promote technological innovation and higher education. [ABSTRACT FROM AUTHOR]

In all the economies of the world, Economic Growth presents a good indicator of development, and so it is always necessary to examine the factors influencing this growth. Many recent studies show that one of the factors that influence economic growth is ICT services. We will show in this paper that ICT services have an impact on economic growth in African countries. In fact, working on a panel of 28 African countries, we were able to identify through the Solow and Swan (1956) and Mankiw, Romer and Weill (1992) models, that ICT services exports haves a positive and statistically significant effect on economic growth. [ABSTRACT FROM AUTHOR]

The object of this work consists in analyzing economic growth in African countries. We have three main results that were generated from this work. First, we explain how industrial development can achieve strong and sustained economic growth in African countries. Secondly, concerning economic performances, the African countries achieved a great improvement during the last decade and show very important potential. They should strengthen reforms in a process of structural transformation focused on the development of the manufacturing sector. Finally, on using a panel model for two samples of 4 North African countries and 26 Sub-Saharan African countries covering the period (1982-2009), we confirmed the positive and statistically significant effect of industrialization on sustained economic growth. [ABSTRACT FROM AUTHOR]

The World Health Organization declared on March 11, 2020 that the COVID-19 epidemic has become a pandemic. In Tunisia, the Ministry of Health has recommended enhanced preventive hygiene measures to contain and limit the spread of the virus. Following the entry of Tunisia into phase 4 of the COVID-19 epidemic, the Tunisian Association of Surgery proposed recommendations related to surgical activity. Surgical emergencies must be treated urgently and without delay. Non-tumor pathologies which require surgery in an elective situation and for which the risk of aggravation or complication is considered low shoud be postponed. For digestive tumor pathology, and apart from complicated forms, neoadjuvant treatment is highly recommended in the context of multidisciplinary concertation staff.

Introduction: Pancreatic localization of hydatid disease is atypical and extremely rare; it accounts for less than 1% of cases. Preoperative diagnosis may be difficult regarding the absence of clinical or radiological signs., Materials and Methods: We report a retrospective study of twelve cases of hydatid cyst of the pancreas over a period of 30 years (1980 to 2010). By means of our study we try to clarify clinical manifestation, radiological features and therapeutic modalities., Results: The twelve patients consisted on eight men and four women with an average age of 25.8 years. Abdominal pain was the most frequent clinical signs. Jaundice was noted in 4 cases and abdominal mass in 2 cases. Hydatid serology, practiced in 7 cases was positive in 6 cases. Abdominal ultrasound, practiced in 11 cases, completed in 7 cases by abdominal computed tomography (CT), showed cystic lesions in 10 cases, in 7 cases the cystic lesion was dependent of the pancreas. All patients were operated by median laparotomy. Partial cystectomy was performed in six cases, cystic punture in one case, pancreaticoduodenectomy one case, distal spleno pancreatectomy in 2 cases, distal pancreatectomy in one case and trans-duodenal puncture of the cyst in 2 cases with pancreatico-duodenal anastomosis in one case., Conclusion: Hydatid cyst of the pancreas is extremely rare even in endemic countries, it should be considered in the differential diagnosis of cystic lesions of the pancreas. Ultrasound and CT coupled with hydatid serology could be helpful for the diagnosis. Surgery remains the treatment of choice in pancreatic hydatid cysts.

The aim of the present study was to investigate the effects of voluntary maximal leg strength training on peak power output (Wpeak), vertical jump performance, and field performances in junior soccer players. Twenty-two male soccer players participated in this investigation and were divided into 2 groups: A resistance training group (RTG; age 17 +/- 0.3 years) and a control group (CG; age 17 +/- 0.5 years). Before and after the training sessions (twice a week for 2 months), Wpeak was determined by means of a cycling force-velocity test. Squat jump (SJ), countermovement jump (CMJ), and 5-jump test (5-JT) performances were assessed. Kinematics analyses were made using a video camera during a 40-m sprint running test and the following running velocities were calculated: The first step after the start (V(first step)), the first 5 m (V(first 5 meters)), and between the 35 m and 40 m (V(max)). Back half squat exercises were performed to determine 1-repetition maximum (1-RM). Leg and thigh muscle volume and mean thigh cross-sectional area (CSA) were assessed by anthropometry. The resistance training group showed improvement in Wpeak (p < 0.05), jump performances (SJ, p < 0.05 and 5-JT, p < 0.001), 1-RM (p < 0.001) and all sprint running calculated velocities (p < 0.05 for both V(first step) and V(first 5 meters), p < 0.01 for V(max)). Both typical force-velocity relationships and mechanical parabolic curves between power and velocity increased after the strength training program. Leg and thigh muscle volume and CSA of RTG remained unchanged after strength training. Back half squat exercises, including adapted heavy loads and only 2 training sessions per week, improved athletic performance in junior soccer players. These specific dynamic constant external resistance exercises are highly recommended as part of an annual training program for junior soccer players.

Pancreas divisum is the most frequent congenital disease of the pancreas. It results from the failure of the dorsal and ventral pancreatic ducts to fuse. It is responsible primarily for recurrent acute pancreatitis, chronic abdominal pain, and chronic pancreatitis. It is diagnosed today by MRI. Treatment is recommended only for symptomatic patients. Endoscopic sphincterotomy is the main treatment, and its results are good for most patients with recurrent acute pancreatitis. Surgical sphincteroplasty is indicated if endoscopic treatment fails.