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Objectives The aims of this study were to estimate the incidence of the post-partum post-traumatic stress disorder (PP-PTSD) in primiparous women, and to determine the profile of women at risk of developing this disorder. Methods We conducted a descriptive, prospective and longitudinal study carried out at the maternity department of the Hedi Chaker Hospital, Sfax-Tunisia over a period of 15 months. At the first stage of the study, the Saint-Antoine pain questionnaire, the peri-traumatic dissociative experiences questionnaire and the peri-traumatic distress inventory were used respectively to assess the pain of delivery, the peri-traumatic dissociation and distress. At the second stage of the study, the questionnaires, perinatal post-traumatic stress disorder (PPQ), hospital anxiety and depression scale and the Edinburgh postnatal depression scale were used respectively for the PP-PTSD screening and the assessment of the post-partum anxious and depressive symptomatology. Results The study population consisted of 183 parturients at the first stage of the study and 150 parturients at the second stage of the study. The incidence of the PP-PTSD was 9.3 %. In the multivariate study, some factors studied were significantly associated with the development of PTSD-PP, including a history of therapeutic termination of pregnancy, a history of miscarriage, exposure to a stressful event during pregnancy, prenatal hospitalization of the mother, instrumental delivery, pain intensity especially in the affective component, peri-traumatic dissociation and avoidance of sexual intercourse for fear of a new pregnancy. However the skin to skin contact with the new-born immediately after delivery was a significant protective factor. Conclusion The psychological consequences associated with the first birth, particularly the PP-PTSD, are common. The Identification of women at risk and a systematic screening of postpartum post-traumatic stress symptoms are desirable.

Resume Introduction L’infection a VIH est de plus en plus caracterisee par la frequence des anomalies metaboliques en rapport avec la chronicite de l’infection et les effets secondaires des antiretroviraux. Objectif Decrire les caracteristiques epidemio-cliniques, biologiques et therapeutiques des personnes vivant avec le VIH (PVVIH) traitees par les antiretroviraux et determiner la prevalence du syndrome metabolique ainsi que les facteurs associes. Materiels et methodes Il s’agit d’une etude transversale descriptive et analytique portant sur toutes les PVVIH suivies au service des Maladies Infectieuses de l’hopital universitaire de Monastir, Tunisie et traitees pendant au moins 3 mois. Elles ont beneficie d’un bilan biologique systematique apres avoir signe un consentement eclaire. Le syndrome metabolique est defini selon les criteres de la Federation Internationale du Diabete (IDF) en 2005. Les PVVIH etaient reparties en deux groupes : Groupe A : PVVIH presentant un syndrome metabolique (n = 19) et groupe B : patient n’ayant pas de syndrome metabolique (n = 51). Resultats Notre etude avait inclus 70 PVVIH dont 19 (27,1 %) avaient un syndrome metabolique. L’âge moyen etait de 43,7 ans dans le groupe A et 36,7 ans dans le groupe B. Le sex-ratio etait comparable dans les deux groupes (p = 0,4). L’infection a VIH evoluait depuis 9,7 et 5,8 ans respectivement dans le groupe A et B, p = 0,017. L’indice de masse corporelle (IMC) etait significativement plus eleve dans le groupe A (26,4 vs 23,5 kg/m2, p = 0,008). Deux malades du groupe A (10,5 %) et 14 malades du groupe B (27,4 %) avaient un taux de CD4 Conclusion Le syndrome metabolique est une realite chez les PVVIH sous antiretroviraux. La recherche clinique des facteurs determinants du syndrome metabolique et la mise en place des mesures de lutte contre ces facteurs sont necessaires pour reduire la prevalence et les consequences du syndrome metabolique.

Resume Introduction La tigecycline est un nouvel antibiotique dont les indications validees restent limitees. En dehors d’autre alternative, cette molecule est de plus en plus utilisee hors AMM, avec de bons resultats. Objectif Ce travail a pour objectif de resumer les differentes utilisations hors AMM de la tigecycline, pour pouvoir y recourir en cas d’impasse therapeutique. Materiels et methode Cette etude consiste en une revue de la litterature, colligeant les differents articles rapportant des cas d’utilisation hors AMM de la tigecycline. On resume ainsi les differentes indications possibles de cette molecule en l’absence d’autres alternatives therapeutiques. Resultats La TG a ete prescrite hors AMM dans differentes indications avec des resultats parfois controverses. Le recours a la TG pour le traitement des pneumopathies a ete sujet d’etudes randomisees avec des resultats ayant un niveau de preuve respectable. Mais pour les autres indications, la litterature reste insuffisante pour supporter ces prescriptions. Les protocoles utilises etaient heterogenes et difficile a reproduire avec une tendance au recours a des doses elevees. Une surmortalite avec une incidence plus importante des effets indesirables a ete notee lors de la prescription de la TG hors AMM. Conclusion La TG reste une option valide pour la prise en charge des infections a germes multiresistants surtout au niveau des sites ou la diffusion des autres molecules reste douteuse. Mais elle doit etre reservee aux situations ou aucune autre alternative n’est possible.

Distinguishing sarcoidosis from pulmonary tuberculosis can be a great challenge to physicians, especially in Tunisia where there is high prevalence of tuberculosis. Both tuberculosis and sarcoidosis are granulomatous diseases; however, necrosis is commun in tuberculosis and less commun in sarcoidosis. The presence of necrosis may lead to an excessive diagnosis of tuberculosis. We present the case of a 48 years old female in which nasosinusal tuberculosis was retained face to granulomatous inflammation with little fields of necrosis. The patient was treated for many months without healing. The diagnosis was revised when evolutive pulmonary lesions were observed while the patient was under well conducted anti-tubercular treatment. Sarcoidosis was in fine retained with good response to corticosteroid therapy.

28 pages, 9 figures, 6 tables, supporting information https://doi.org/10.1029/2021JC017676.-- Data Availability Statement: SSS CCI datasets are freely available at https://catalogue.ceda.ac.uk/uuid/4ce685bff631459fb2a30faa699f3fc5. The PI-MEP MDB are freely available as NetCDF files at https://www.salinity-pimep.org/data/mdb.html; corresponding validation reports are available on https://www.salinity-pimep.org/reports/mdb.html. SMAP salinity data are produced by Remote Sensing Systems and sponsored by the NASA Ocean Salinity Science Team. Data are available at www.remss.com. Aquarius data are available at https://podaac.jpl.nasa.gov/dataset/AQUARIUS_L3_SSS_SMID_ANNUAL_V5. CATDS SSS are available at the CATDS Production Data Center (CPDC), www.catds.fr. ISAS and Glorys fields are taken from (https://catalogue.marine.copernicus.eu/; INSITU_GLO_TS_OA_REP_OBSERVATIONS_013_002 and GLOBAL-REANALYSIS-PHY-001-030 products, respectively). The GOSUD RV data set is available at https://doi.org/10.17882/39475, the ships of opportunity data set is available at http://www.legos.obs-mip.fr/observations/sss/datadelivery/dmdata. Argo data are taken from http://www.coriolis.eu.org/, Sea Surface Salinity (SSS) is an increasingly used Essential Ocean and Climate Variable. The Soil Moisture and Ocean Salinity (SMOS), Aquarius, and Soil Moisture Active Passive (SMAP) satellite missions all provide SSS measurements, with very different instrumental features leading to specific measurement characteristics. The Climate Change Initiative Salinity project (CCI + SSS) aims to produce a SSS Climate Data Record (CDR) that addresses well-established user needs based on those satellite measurements. To generate a homogeneous CDR, instrumental differences are carefully adjusted based on in-depth analysis of the measurements themselves, together with some limited use of independent reference data. An optimal interpolation in the time domain without temporal relaxation to reference data or spatial smoothing is applied. This allows preserving the original datasets variability. SSS CCI fields are well suited for monitoring weekly to interannual signals, at spatial scales ranging from 50 km to the basin scale. They display large year-to-year seasonal variations over the 2010–2019 decade, sometimes by more than ±0.4 over large regions. The robust standard deviation of the monthly CCI SSS minus in situ Argo salinities is 0.15 globally, while it is at least 0.20 with individual satellite SSS fields. r2 is 0.97, similar or better than with original datasets. The correlation with independent ship thermosalinographs SSS further highlights the CCI data set excellent performance, especially near land areas. During the SMOS-Aquarius period, when the representativity uncertainties are the largest, r2 is 0.84 with CCI while it is 0.48 with the Aquarius original data set. SSS CCI data are freely available and will be updated and extended as more satellite data become available, This study was funded by ESA CCI contract 4000123663/18/I-NB, With the institutional support of the ‘Severo OchoaCentre of Excellence’ accreditation (CEX2019-000928-S)

Clean Intermittent Catheterization (CIC) is the method of choice for bladder emptying in patients having bladder emptying disorders, acquired or pharmacologically induced, whether it is neurologically related or not. The aim of this study is to assess the theoretical and practical knowledge of general practitioners (GP) on CIC.Observational prospective study (anonymous online questionnaire) was conducted with 224 GP between March and April 2020. Each physician had to complete a questionnaire about the definition of CIC, its indications and usage, the indications of urine culture, antibiotic therapy, and the complications of this method of drainage.Only 18.3% of GP that took part in the study gave an exact definition of CIC. As to the importance of it, 67.9% responded that it protects the upper urinary tract and 37.1% that it prevents urinary tract infections (UTI). Fifty-two per cent of physicians were unaware of the regular frequency at which it should carry out a day. Fifty eight percent prescribed sterile gloves and 57.1% an antiseptic. UTI was considered as the main complication of CIC by 87.1% of physicians and 35.7% requested a systematic urine culture for patients under CIC. For patients with an asymptomatic bacteriuria, 65.6% of GP prescribed antibiotic therapy.GP need to improve their knowledge of SIP, its framework, indications, modalities, and the way to deal with colonization or urinary tract infection. This will improve the management of impacted patients.

Amylases were extracted from the ice plant (Mesembryanthemum crystallinum L.) and their effect on cake and bun qualities was studied. The amylolytic activity showed a good stability over a wide pH ranging from 2 to 10 with two pH optima: the first at pH 5 (Amy A) and the second at pH 8 (Amy B). This suggests that there are two amylases in M. crystallinum extracts. HPLC analysis of the hydrolysis products showed that these enzymes predominantly formed maltose and glucose. The extract containing AmyA and AmyB might be potentially beneficial to the baking industry. The incorporation of a M. crystallinum extract into cake and bun formulations was evaluated. Four different concentrations of the amylase extracts were used. At 0.01 and 2.76 × 10−3 U/g, respectively, for cakes and buns, a significant (P

Background: Tumor necrosis factor-alpha (TNF-alpha), a basic cytokine is an immunosuppressive agent used intensively in the treatment of systemic diseases. various side effects have been reported with the use of these powerful immunosuppressive drugs. In this case we report an autoimmune hepatitis an uncommon side effect of infliximab perfusion. Case: A 41-year-old man living with HIV on emtricitabine tenofovir and efavirenz for 6 years with good tolerance and undetectable viral load had been diagnosed as having a Crohn disease. He was referred for persistent increase in aminotransferase levels during infliximab therapy. After the 3rd infusion, serum aspartate Aminotransferase (AST) and alanine Aminotransferase (ALT) raised to 75 and 136 IU/L. After exhaustive etiological exams we retained autoimmune hepatitis. Two months after stopping infliximab aminotransferases were normal. Conclusion: Infliximab induced autoimmune hepatitis is an uncommon side effect. Clinicians should be aware of this risk and should perform aminotransferase level control when infliximab use.

Objectifs Les contusions sur rein pathologique est une entite rarement rencontree. Les lesions renales, congenitales ou acquises, peuvent modifier le tableau clinique, l’image radiologique et la prise en charge therapeutique. Notre objectif etait de determiner les particularites therapeutiques de cette entite rare. Methodes Il s’agit d’une etude retrospective, monocentrique portant sur 37 dossiers de patients hospitalises entre janvier 1992 et fevrier 2021 pour un traumatisme sur un rein pathologique. Tous les patients ont ete explores par une echographie renale et un uroscanner. Les lesions etaient classees selon la classification de l’American Association of Surgery of Trauma (AAST). Resultats Une contusion sur rein pathologique etait retrouvee chez 37 patients (18,22 %) sur un total de 203 hospitalises pour un traumatisme ferme du rein. Les anomalies sous-jacentes, representees dans le Tableau 1 , etaient dominees par la presence de lithiase urinaire et l’anomalie de la jonction pyelo-ureterale. Les lesions traumatiques retrouvees etaient de grade I et II dans respectivement 39 % et 33 % des cas ( Fig. 1 ). Un traitement non operatoire etait decide dans 15 cas, un drainage endoscopique des cavites dans 9 cas, percutanee dans 7 cas et une embolisation par radiologie interventionnelle dans 2 cas. Une nephrectomie d’hemostase en urgence etait realisee dans 4 cas (10,8 %). Le traitement des anomalies renales etait realise 3 mois apres le traumatisme ( Tableau 2 ). Le taux de nephrectomies etait de 29,7 %. Conclusion Les reins pathologiques sont habituellement plus susceptibles aux traumatismes. L’uroscanner est l’examen de choix pour etudier les lesions secondaires au traumatisme et la pathologie sous-jacente. Les contusions sont souvent benignes contrastant avec le taux de nephrectomie eleve de 29,7 % et qui est du dans la plupart des cas a l’uropathie sous-jacente.

Objectifs La biopsie prostatique est primordiale pour le diagnostic positif du cancer de la prostate. La morbidite de cet acte est surtout liee aux complications infectieuses et hemorragiques. L’effet de la biopsie prostatique sur les symptomes du bas appareil urinaire (SBAU) et la sexualite est peu etudie. L’objectif de notre etude etait d’etudier l’evolution des SBAU et de la sexualite apres biopsie de la prostate. Methodes Il s’agit d’une etude prospective incluant tous les patients ayant eu une biopsie prostatique entre juin 2019 et mars 2020. Les donnees collectees ont inclus les caracteristiques cliniques, le PSA, les donnees de l’IRM et l’examen anatomopathologique. Les SBAU ont ete evalues par le score IPSS avant et apres un delai de 1 mois de la biopsie. La fonction erectile a ete evaluee par le score IIEF-5 avant et apres un delai de 1 mois de la biopsie. L’analyse statistique a ete realisee par le logiciel SPSS version 20. Resultats Cent vingt-quatre patients ont ete inclus dans l’etude. L’âge moyen des patients etait de 69,7 ans (48–85). Trente-six patients etaient diabetiques (29,9 %) et 25 etaient hypertendus (20,2 %). Des SBAU etaient presents avant la biopsie chez 114 patients(91,9 %). Le score IPSS moyen des patients ayant des SBAU etait de 16,25 points (10–25). La fonction erectile etait normale chez 39 patients (31,5 %). Le score IIEF-5 moyen etait de 15,82. A 1 mois de la biopsie, on a note une aggravation significative du score IPSS avec un IPSS moyen de 19,82 (p = 0,001). Le score IIEF-5 moyen 1 mois apres la biopsie etait de 15,2 (p = 0,73). Une retention vesicale est survenue chez 12 patients apres la biopsie (9,7 %) avec un sevrage de la sonde reussi sous alphabloquants chez 11 patients (91 %). Soixante-douze pour cent des biopsies etaient positives. Conclusion Notre serie montre que la biopsie prostatique peut aggraver significativement les symptomes du bas appareil urinaire, en rapport probablement avec les phenomenes inflammatoires apres la biopsie. Toutefois, cet acte diagnostique ne semble pas affecter la fonction erectile des patients.