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85 results on '"Meriam Sabbah"'

1. Serra doria procedure as an alternative treatment for end stage achalasia. A case report

Author

Haithem Zaafouri, Mona Cherif, Nizar Khedhiri, Meriam Sabbah, Taha Sabri, and Anis Ben Maamer

Subjects
Achalasia, End stage, Carioplasty, Serra doria, Case report, Science (General), Q1-390, Social sciences (General), H1-99
Abstract

The standard of care for achalasia is laparoscopic Heller's cardiomyotomy. This procedure achieves satisfactory and long-standing results in over 85 % of patients. However, disease progression occurs in some patients leading to end-stage achalasia, occasionally requiring oesophagectomy. In a recent systematic review and meta-analysis of 1307 patients who underwent oesophagectomy for end-stage achalasia, the pooled prevalence of pneumonia, anastomotic leakage and mortality were 10 %, 7 % and 2 %, respectively. We present a Serra Doria procedure as an alternative ‘esophagus-preserving’ procedure in a 58-year-old female patient with end-stage achalasia. This advancement highlights the crucial role of personalized care and the ongoing research necessary to enhance outcomes for those suffering from this challenging condition.

Published
2024
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2. Comparison between signet-ring cell carcinoma and non-signet-ring cell carcinoma of the stomach: clinicopathological parameters, epidemiological data, outcome, and prognosis—a cohort study of 123 patients from a non-endemic country

Author

Haithem Zaafouri, Raja Jouini, Nizar Khedhiri, Fatma Khanchel, Mona Cherif, Meryam Mesbahi, Aziz Daghmouri, Wiem Mahmoudi, Soumaya Akremi, Meriam Sabbah, Yazid Benzarti, Dhafer Hadded, Dalila Gargouri, Mourad Ben Bader, and Anis Ben Maamer

Subjects
Gastric cancer, Adenocarcinoma, Signet-ring cell carcinoma, Non-signet-ring cell carcinoma, Prognosis, Surgery, RD1-811, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Abstract Background Signet-ring cell carcinoma of the stomach (SRCC) is a particular gastric cancer entity. Its incidence is increasing. Its diagnosis is pathological; it corresponds to adenocarcinoma with a majority of signet-ring cells component (> 50%). These histological features give it its aggressiveness characteristics. This has repercussions on the prognostic level and implications for the alternatives of therapy, especially since some authors suggest a potential chemoresistance. This survey aimed to identify the epidemiological, pathological, therapeutic, and prognostic characteristics of SRCC as a separate disease entity. Methods This was a retrospective study of 123 patients admitted for gastric adenocarcinoma to Habib Thameur Hospital in Tunis over 11 years from January 2006 to December 2016. A comparative study was performed between 2 groups: the SRCC group with 62 patients and the non-SRCC (non-signet-ring cell carcinoma of the stomach) with 61 patients. Results The prevalence of SRCC in our series was 50%. SRCC affected significantly younger patients (55 vs 62 years; p = 0.004). The infiltrative character was more common in SRCC tumors (30.6 vs 14.8%; p = 0.060), whereas the budding character was more often noted in non-SRCC tumors (78.7 vs 58.1%; p = 0.039). There was no significant difference in tumor localization between both groups. Linitis plastica was noted in 14 patients with SRCC against a single patient with non-SRCC (p = 0.001). The tumor size was more important in the non-SRCC group (6.84 vs 6.39 cm; p = 0.551). Peritoneal carcinomatosis was noted in 4.3% of cases in the SRCC group versus 2.2% of cases in the NSRCC group (p = 0.570). Total gastrectomy was more often performed in the SRCC group (87 vs 56%; p = 0.001). Resection was more often curative in the non-SRCC group (84.4 vs 78.3%; p = 0.063). Postoperative chemotherapy was more commonly indicated in the SRCC group (67.4 vs 53.3%; p = 0.339). Tumor recurrence was more common in the non-SRCC group (35.7 vs 32%; p = 0.776). The most common type of recurrence was peritoneal carcinomatosis in the SRCC group (62.5%) and hepatic metastasis in the non-SRCC group (60%; p = 0.096). The overall 5-year survival in the SRCC group was lower than in the non-SRCC group, with no statistically significant difference (47.1 vs 51.5%; p = 0.715). The overall survival was more important for SRCC in early cancer (100 vs 80%; p = 0.408), whereas it was higher for non-SRCC in advanced cancer (48.1 vs 41.9%; p = 0.635). Conclusion Apart from its epidemiological and pathological features, SRCC seems to have a worse prognosis. Indeed, it is diagnosed at a more advanced stage and has a worse prognosis in advanced cancer than non-SRCC. It is therefore to be considered as a particular entity of gastric adenocarcinoma requiring a specific therapeutic protocol where the place of chemotherapy remains to be more investigated.

Published
2022
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3. Sporadic Burkitt lymphoma presenting with peritoneal lymphomatosis

Author

Meriam Sabbah, Abdelwahab Nakhli, Nawel Bellil, Fatma Khanchel, Dhafer Haddad, and Chiraz Chammakhi

Subjects
ascites, Burkitt, chemotherapy, lymphoma, Medicine, Medicine (General), R5-920
Abstract

Abstract Burkitt lymphoma (BL) is a highly aggressive non‐Hodgkin B‐cell lymphoma. It has a doubling time of 24 h. Fortunately, it is highly sensitive to aggressive chemotherapy. Sporadic BL often affects the mesenteric and retroperitoneal lymph nodes. Extra‐nodal involvement includes the ileocecal area, stomach, kidneys, gonads, and central nervous system. Peritoneal lymphomatosis is a rare presentation. We report a case of BL presenting with peritoneal lymphomatosis to emphasize the importance of early histological diagnosis of any peritoneal thickening.

Published
2022
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4. An unusual case of diffuse large B‐cell lymphoma complicating a Crohn's disease

Author

Meriam Sabbah, Fatma Ben Farhat, Nawel Bellil, Fatma Khanchel, Asma Ouakaa, and Dalila Gargouri

Subjects
Crohns disease, gastroenterology and hepatology, lymphoma, oncology, Medicine, Medicine (General), R5-920
Abstract

Abstract Clinicians should keep in mind that Crohn's disease may be complicated by neoplasia such as adenocarcinomas or lymphomas, especially if the disease duration is long and the patient is under immunosuppressive therapy.

Published
2020
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5. Gastrointestinal bleeding as an initial manifestation of gastric lipoma: Case report and review of the literature

Author

Meriam Sabbah, Abdelwahab Nakhli, Imen Helal, Nawel Bellil, Asma Ouakaa, and Dalila Gargouri

Subjects
endoscopy, gastrointestinal bleeding, Lipoma, stomach, Medicine, Medicine (General), R5-920
Abstract

Abstract Gastric lipoma should be considered as a rare differential diagnosis in patients presenting with gastrointestinal bleeding. Diagnosis is mainly done by radiologic and endoscopic findings. It presents characteristic pathognomonic endoscopic signs.

Published
2020
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6. Primary gastric squamous cell carcinoma with a bilio‐gastric fistula and Krukenberg syndrome

Author

Meriam Sabbah, Ghada Gharbi, Nawel Bellil, Imen Helal, Chiraz Chamakhi, and Dalila Gargouri

Subjects
fistula, ovarian metastases, Primary squamous cell carcinoma, stomach, Medicine, Medicine (General), R5-920
Abstract

Abstract Primary squamous cell carcinoma of the stomach is a rare type of gastric malignancies. Diagnosis criteria are well defined but diagnosis is generally late being made at an advanced stage with metastases explaining its poor diagnosis.

Published
2021
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7. Predictors of failure of endoscopic retrograde pancreatocholangiography during common bile duct stones

Author

Meriam Sabbah, Abdelwahab Nakhli, Nawel Bellil, Asma Ouakaa, Norsaf Bibani, Dorra Trad, Héla Elloumi, and Dalila Gargouri

Subjects
Evidence-based medicine, Internal medicine, Laboratory medicine, Surgery, Common bile duct, Lithiasis, Science (General), Q1-390, Social sciences (General), H1-99
Abstract

Introduction: Endoscopic retrograde cholangiopancreatography associated with sphincterotomy and stone extraction with balloon or Dormia basket represents the gold standard for the management of common bile duct stones. The aim of our study were to investigate the predictors of failure of standard endoscopic techniques during the management of common bile duct stones. Methods: A retrospective study including all endoscopic retrograde cholangiopancreatography for common bile duct stones between January 2014 and December 2017 was conducted. First line treatment was based on endoscopic retrograde cholangiopancreatography with endoscopic sphincterotomy and balloon or Dormia extraction. Second line endoscopic treatment was based on macrodilatation of Oddi sphincter, mechanical lithotripsy, biliary stent or nasobiliary drain placement. Predictors of failure of standard endoscopic techniques were sought by uni and multivariate analysis (SPSS software, p significant if < 0.05). Results: One hundred eighty one patients (mean age 64 years and sex ratio M/W = 0.4) were included. Main indications for endoscopic retrograde cholangiopancreatography were residual or recurrent lithiasis (67.4%, n = 122). Cholangiography revealed multiple stones in 53 patients with an average size of 12.5mm [3–40]. The success rate of first line treatment was 61.9%. Independent predictors of failure of standard endoscopic techniques (failure of papillary cannulation or stone extraction) according to multivariate analysis were: an age greater than 65 years OR 0.516 [0.272–0.979], an intra-diverticular papilla OR 0.179 [0.035–0.914], a common bile duct diameter greater than 15 mm OR 0.161 [0.068–0.385] and a stenosis of the common bile duct OR 0.068 [0.008–0.605]. The success rate of the second line treatment was 73%. Conclusion: Endoscopic retrograde cholangiopancreatography results in a successful clearance of the common bile duct in almost two-thirds of patients. In case of predictors of failure, alternative techniques can increase this rate.

Published
2020
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8. Prognostic significance of poorly cohesive gastric carcinoma in Tunisian patients

Author

Raja Jouini, Fatma Khanchel, Meriam Sabbah, Imen Helal, Abdessalem Gharsallah, Marwa Ferchichi, Dhafer Hadded, Haithem Zaafouri, Ehsen Ben Brahim, Anis Ben Maamer, and Aschraf Chadli Debbiche

Subjects
Biological sciences, Health sciences, Pathology, Abdominal surgery, Cancer surgery, Gastric cancer, Science (General), Q1-390, Social sciences (General), H1-99
Abstract

Background: While the incidence of gastric cancer has decreased worldwide in recent decades, the incidence of poorly cohesive carcinoma (PCC) is rising. The prognostic significance of gastric PCC remains a subject of debate. Objective: To analyze the prognosis of gastric PCC in a Tunisian cohort. Methods: A total of 122 gastric adenocarcinoma patients who underwent curative gastrectomy from 2001 to 2014 at Habib Thameur hospital in Tunis, Tunisia were included. The clinicopathological parameters and prognosis of PCC were analyzed in comparison with non PCC (NPCC). Results: Sixty one patients (50%) presented PCC. Patients were younger in PCC group (p = 0,001). There was no difference in sex distribution between the two groups. PCC was more likely to be stage T4 (55.7% vs 34.4%; p = 0.033), N3 (67.8% vs 30%; p < 0.001) and have a higher metastatic lymph node ratio (p < 0.001). Hepatic metastases were more frequent in NPCC group (p = 0.031) whereas peritoneal carcinomatosis was more common in PCC group (p = 0.004). Perineural invasion was more frequent in PCC group (p = 0.001). Resection margins were more often positive in PCC group (31.1% vs 9.8%; p = 0.004). There was no difference in recurrence rate between the 2 groups (p = 0.348). The 5-year survival was similar in the NPCC and PCC (respectively 43% vs 23 %; p = 0.247). Survival rates were also comparable in early stage (100% vs 80% respectively for PCC and NPCC; p = 0.527) as well as for advanced stage (16% vs 35% respectively for PCC and NPCC; p = 0.538). PCC was not a prognostic factor for survival. Interestingly, advanced age, adjacent structures invasion, positive resection margins were specific prognostic factors for PCC. Conclusion: In our study PCC was not a prognostic factor for survival. Advanced age, adjacent structures invasion and positive resection margins were specific prognostic features for this histological subtype.

Published
2020
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10. An unusual case of diffuse large B‐cell lymphoma complicating a Crohn's disease

Author

N Bellil, Asma Ouakaa, Dalila Gargouri, Fatma Ben Farhat, Meriam Sabbah, and Fatma Khanchel

Subjects
medicine.medical_specialty, Medicine (General), Disease duration, Case Report, lymphoma, Disease, Case Reports, 030204 cardiovascular system & hematology, gastroenterology and hepatology, 03 medical and health sciences, 0302 clinical medicine, R5-920, medicine, Crohn's disease, Unusual case, business.industry, General Medicine, Crohns disease, medicine.disease, Dermatology, digestive system diseases, Lymphoma, 030220 oncology & carcinogenesis, oncology, Medicine, business, Diffuse large B-cell lymphoma
Abstract

Clinicians should keep in mind that Crohn's disease may be complicated by neoplasia such as adenocarcinomas or lymphomas, especially if the disease duration is long and the patient is under immunosuppressive therapy.

Published
2020

11. Global multi-stakeholder endorsement of the MAFLD definition

Author

Nahum Méndez-Sánchez, Elisabetta Bugianesi, Robert G Gish, Frank Lammert, Herbert Tilg, Mindie H Nguyen, Shiv K Sarin, Núria Fabrellas, Shira Zelber-Sagi, Jian-Gao Fan, Gamal Shiha, Giovanni Targher, Ming-Hua Zheng, Wah-Kheong Chan, Shlomo Vinker, Takumi Kawaguchi, Laurent Castera, Yusuf Yilmaz, Marko Korenjak, C Wendy Spearman, Mehmet Ungan, Melissa Palmer, Mortada El-Shabrawi, Hans-Juergen Gruss, Jean-François Dufour, Anil Dhawan, Heiner Wedemeyer, Jacob George, Luca Valenti, Yasser Fouad, Manuel Romero‐Gomez, Mohammed Eslam, Maria Lorena Abate, Bahaa Abbas, Ahmed Amr Abbassy, Waleed Abd El Ghany, Amira Abd Elkhalek, Emad Abd ElMajeed, Mohammad Abdalgaber, Mohamed AbdAllah, Marwa Abdallah, Nourhan Abdallah, Shereen Abdelaleem, Yasser Abdelghani, Wael Abdelghany, Safaa Mohamed Abdelhalim, Wafaa Abdelhamid, Nehal Abdelhamid, Nadia A. Abdelkader, Elsayed Abdelkreem, Aly Mohamed Abdelmohsen, Awny Ali Abdelrahman, Sherief M Abd-elsalam, Doaa Abdeltawab, Abdulbaset Abduh, Nada Abdulhakam, Maheeba Abdulla, Navid Abedpoor, Ludovico Abenavoli, Fredrik Åberg, Omala Ablack, Mostafa Abo elftouh, Yousry Esam-Eldin Abo-Amer, Ashraf Aboubkr, Alaa Aboud, Amr M. Abouelnaga, Galal A. Aboufarrag, Ashraf Aboutaleb, Leticia Abundis, Gupse Adalı, Enrique Adames, Leon Adams, Danjuma Adda, Noor Adel, Nada Adel, Muhammad Adel Sayed, Taiba Jibril Afaa, Nawal Afredj, Gulnara Aghayeva, Alessio Aghemo, Carlos A. Aguilar-Salinas, Golo Ahlenstiel, Walid Ahmady, Wafaa Ahmed, Amira Ahmed, Samah Nasser Ahmed, Heba Mostafa Ahmed, Rasha Ahmed, Elmar Aigner, Mesut Akarsu, Maisam Akroush, Umit Akyuz, Mamun Al Mahtab, Tahani Al Qadiri, Yusriya Al Rawahi, Razzaq AL rubaee, Muna Al Saffar, Shahinul Alam, Zaid Al-Ani, Agustín Albillos, Mohamed Alboraie, Said Al-Busafi, Mohamed Al-Emam, Jawaher Alharthi, Kareem Ali, Basma Abdelmoez Ali, Mohammad Ali, Raja Affendi Raja Ali, Anna Alisi, Ali Raad AL-Khafaji, Maryam Alkhatry, Rocio Aller, Yahya Almansoury, Khalid Al-Naamani, Alaa Alnakeeb, Anna Alonso, Saleh A. Alqahtani, Leina Alrabadi, Khalid Alswat, Mahir Altaher, Turki Altamimi, Jose Altamirano, Mario R. Alvares-da-Silva, Elsragy Adel M. Aly, Amgad Alzahaby, Ahmed Alzamzamy, Keisuke Amano, Maysa A. Amer, Mona A. Amin, Sayed A. Amin, Ashraf A. Amir, Javier Ampuero, Noha Anas, Pietro Andreone, Soa Fy Andriamandimby, Mahmoud Anees, Peltec Angela, Manal Antonios, Wael Arafat, Jose Moreno Araya, Juan Armendariz-Borunda, Matthew J. Armstrong, Hassan Ashktorab, Patricia Aspichueta, Fathia Assal, Mira Atef, Dina Attia, Hoda Atwa, Reham Awad, Mohyeldeen Abd Elaziz Awad, Sally Awny, Obafemi Awolowo, Yaw Asante Awuku, Ibrahim Ayada, Than Than Aye, Sherif Ayman, Hedy Ayman, Hesham Ayoub, Hosny M. Azmy, Romiro P. Babaran, Omneya Badreldin, Ahmed Badry, İbrahim Halil Bahçecioğlu, Amira Bahour, Jiajia Bai, Yasemin Balaban, Muthuswamy Balasubramanyam, Khaled Bamakhrama, Jesus M Banales, Babu Bangaru, Jianfeng Bao, Jorge Suazo Barahona, Salma Barakat, Sandra Maria Barbalho, Bikwa Barbra, Beatriz Barranco, Francisco Barrera, Ulrich Baumann, Shamardan Bazeed, Eva Bech, Aourarh Benayad, Andreas Benesic, David Bernstein, Fernando Bessone, Susie Birney, Cyrille Bisseye, Martin Blake, Bilal Bobat, Leonilde Bonfrate, Dmitry S Bordin, Francisco Bosques-Padilla, Jerome Boursier, Boushab Mohamed Boushab, David Bowen, Patricia Medina Bravo, Paul N Brennan, Bisi Bright, Ilse Broekaert, Xabier Buque, Diego Burgos-Santamaría, Julio Burman, Luca Busetto, Chris D. Byrne, Patricia Anne I. Cabral-Prodigalidad, Guillermo Cabrera-Alvarez, Wei Cai, Francesca Cainelli, Ali Riza Caliskan, Ali Canbay, Ana Cano-Contreras, Hai-Xia Cao, Zhujun Cao, Andres Carrion, Francesca Carubbi, Teresa Casanovas, Marlen Ivón Castellanos Fernández, Jin Chai, Siew Pheng Chan, Phunchai Charatcharoenwitthaya, Norberto Chavez-Tapia, Kazuaki Chayama, Jinjun Chen, Lin Chen, Zhong-Wei Chen, Huiting Chen, Sui-Dan Chen, Qiang Chen, Yaxi Chen, Gang Chen, En-Quang Chen, Fei Chen, Pei-Jer Chen, Robert Cheng, Wendy Cheng, Jack Tan Wei Chieh, Imad Chokr, Evangelos Cholongitas, Ashok Choudhury, Abhijit Chowdhury, Evaristus Sunday Chukwudike, Stefano Ciardullo, Michelle Clayton, Karine Clement, Marie Michelle Cloa, Cecilia Coccia, Cristina Collazos, Massimo Colombo, Arif Mansur Cosar, Helma Pinchemel Cotrim, Joris Couillerot, Alioune Coulibaly, Gonzalo Crespo, Javier Crespo, Maria Cruells, Ian Homer Y. Cua, Hesham K. Dabbous, George N Dalekos, Patricia D'Alia, Li Dan, Viet Hang Dao, Mostafa Darwish, Christian Datz, Milagros B Davalos-Moscol, Heba Dawoud, Blanca Olaechea de Careaga, Robert de Knegt, Victor de Ledinghen, Janaka de Silva, Nabil Debzi, Marie Decraecker, Elvira Del Pozo, Teresa C Delgado, Manuel Delgado-Blanco, Łukasz Dembiński, Adilson Depina, Moutaz Derbala, Hailemichael Desalegn, Christèle Desbois-Mouthon, Mahmoud Desoky, Anouk Dev, Agostino Di Ciaula, Moisés Diago, Ibrahima Diallo, Luis Antonio Díaz, Melisa Dirchwolf, Paola Dongiovanni, Andrriy Dorofeyev, Xiaoguang Dou, Mark W. Douglas, Michael Doulberis, Cecil K. Dovia, Adam Doyle, Ivana Dragojević, Joost PH Drenth, Xuefei Duan, Audrius Dulskas, Dan L Dumitrascu, Oliver Duncan, Vincent Dusabejambo, Rev. Shem N.A. Dwawhi, Sho Eiketsu, Doaa El Amrousy, Ahmed El Deeb, Ghada El Deriny, Hesham Salah El Din, Salwa El Kamshishy, Mohamed El Kassas, Maissa El Raziky, Osama A Elagamy, Wafaa Elakel, Dina Elalfy, Hanaa Elaraby, Heba ElAwady, Reda Elbadawy, Hanaa Hassan Eldash, Manal S. Eldefrawy, Carol Lezama Elecharri, Amel Elfaramawy, Mohammed Elfatih, Mahmoud Elfiky, Mohamed Elgamsy, Mohamed Elgendy, Mohamed A. El-Guindi, Nagi Elhussieny, Ahmed Maher Eliwa, Zeineb Elkabbany, Hesham El-Khayat, Nehal M. El-Koofy, Alaa Elmetwalli, Amr Elrabat, Fathiya El-Raey, Fatma Elrashdy, Medhat Elsahhar, Esraa M. Elsaid, Shimaa Elsayed, Hany Elsayed, Aly Elsayed, Amr M. Elsayed, Hamdy Elsayed, Magdy El-Serafy, Ahmed M. Elsharkawy, Reem Yehia Elsheemy, Eman Elsayed Elshemy, Sara Elsherbini, Naglaa Eltoukhy, Reda Elwakil, Ola Emad, Shaimaa Emad, Mohamed Embabi, Ilkay Ergenç, Tatiana Ermolova, Gamal Esmat, Doaa M. Esmat, Enrique Carrera Estupiñan, Said Ettair, Tcaciuc Eugen, Mohammed Ezz-Eldin, Lidia Patricia Valdivieso Falcón, Yu-Chen Fan, Samah Fandari, Mahmoud Farag, Taghreed Mohamed Farahat, Eman M. Fares, Michael Fares, Eduardo Fassio, Hayam Fathy, Dina Fathy, Wael Fathy, Soheir Fayed, Dan Feng, Gong Feng, Miguel Fernández-Bermejo, Cristina Targa Ferreira, Javier Díaz Ferrer, Alastair Forbes, Rabab Fouad, Hanan M. Fouad, Tove Frisch, Hideki Fujii, Shuhei Fukunaga, Shinya Fukunishi, Hacer Fulya, Masato Furuhashi, Yasmine Gaber, Augusto Jose G. Galang, Jacqueline Cordova Gallardo, Rocío Galloso, Mahmoud Gamal, Reham Gamal, Hadeel Gamal, Jian Gan, Anar Ganbold, Xin Gao, George Garas, Tony Garba, Miren García-Cortes, Carmelo García-Monzón, Javier García-Samaniego, Amalia Gastaldelli, Manuel Gatica, Elizabeth Gatley, Tamar Gegeshidze, Bin Geng, Hasmik Ghazinyan, Salma Ghoneem, Luca Giacomelli, Gianluigi Giannelli, Edoardo G. Giannini, Matthew Giefer, Pere Ginès, Marcos Girala, Pablo J Giraudi, George Boon-Bee Goh, Ahmed Ali Gomaa, Benbingdi Gong, Dina Hilda C. Gonzales, Humberto C. Gonzalez, Maria Saraí Gonzalez-Huezo, Isabel Graupera, Ivica Grgurevic, Henning Grønbæk, Xuelian Gu, Lin Guan, Ibrahima Gueye, Alice Nanelin Guingané, Ozen Oz Gul, Cuma Bulent Gul, Qing Guo, Pramendra Prasad Gupta, Ahmet Gurakar, Juan Carlos Restrepo Gutierrez, Ghada Habib, Azaa Hafez, Emilia Hagman, Eman Halawa, Osama Hamdy, Abd Elkhalek Hamed, Dina H. Hamed, Saeed Hamid, Waseem Hamoudi, Yu Han, James Haridy, Hanan Haridy, David C H Harris Harris, Michael Hart, Fuad Hasan, Almoutaz Hashim, Israa Hassan, Ayman Hassan, Essam Ali Hassan, Adel Ahmed Hassan, Magda Shehata Hassan, Fetouh Hassanin, Alshymaa Hassnine, John Willy Haukeland, Amr Ismael M. Hawal, Jinfan He, Qiong He, Yong He, Fang-Ping He, Mona Hegazy, Adham Hegazy, Osama Henegil, Nelia Hernández, Manuel Hernández-Guerra, Fatima Higuera-de-la-Tijera, Ibrahim Hindy, Keisuke Hirota, Lee Chi Ho, Alexander Hodge, Mohamed Hosny, Xin Hou, Jiao-Feng Huang, Yan Huang, Zhifeng Huang, Yuan Huang, Ang Huang, Xiao-Ping Huang, Sheng Hui-ping, Bela Hunyady, Mennatallah A. Hussein, Osama Hussein, Shahinaz Mahmoud Hussien, Luis Ibáñez-Samaniego, Jamal Ibdah, Luqman Ibrahim, Miada Ibrahim, Ibrahim Ibrahim, Maria E. Icaza-Chávez, Sahar Idelbi, Ramazan Idilman Idilman, Mayumi Ikeda, Giuseppe Indolfi, Federica Invernizzi, Iram Irshad, Hasan Mohamed Ali Isa, Natacha Jreige Iskandar, Abdulrahman Ismaiel, Mariam Ismail, Zulkifli Ismail, Faisal Ismail, Hideki Iwamoto, Kathryn Jack, Rachael Jacob, Fuad Jafarov, Wasim Jafri, Helen Jahshan, Prasun K Jalal, Ligita Jancoriene, Martin Janicko, Hiruni Jayasena, Meryem Jefferies, Vivekanand Jha, Fanpu Ji, Yaqiu Ji, Jidong Jia, Changtao Jiang, Ni Jiang, Zong-zhe Jiang, Xing Jin, Yi Jin, Xu Jing, Qian Jingyu, Maia Jinjolava, FX Himawan Haryanto Jong, Alina Jucov, Ibecheole Julius, Mona Kaddah, Yoshihiro Kamada, Abobakr kamal, Enas Mohamed Kamal, Ashraf Sayed Kamel, Jia-Horng Kao, Maja Karin, Thomas Karlas, Mohammad Kashwaa, Leolin Katsidzira, Eda Kaya, M.Azzam Kayasseh, Bernadette Keenan, Caglayan Keklikkiran, William Keml, Deia K. Khalaf, Rofida Khalefa, Sherin Khamis, Doaa Khater, Hamed khattab, Anatoly Khavkin, Olga Khlynova, Nabil Khmis, Nazarii Kobyliak, Apostolos Koffas, Kazuhiko Koike, Kenneth Y.Y. Kok, Tomas Koller, Narcisse Patrice Komas, Nataliya V. Korochanskaya, Yannoula Koulla, Shunji Koya, Colleen Kraft, Bledar Kraja, Marcin Krawczyk, Mohammad Shafi Kuchay, Anand V Kulkarni, Ashish Kumar, Manoj Kumar, Sulaiman Lakoh, Philip Lam, Ling Lan, Naomi F. Lange, Kamran Bagheri Lankarani, Nicolas Lanthier, Kateryna Lapshyna, Sameh A. Lashen, Konang Nguieguia Justine Laure, Leonid Lazebnik, Didier Lebrec, Samuel S. Lee, Way Seah Lee, Yeong Yeh Lee, Diana Julie Leeming, Nathalie Carvalho Leite, Roberto Leon, Cosmas Rinaldi Adithya Lesmana, Junfeng Li, Qiong Li, Jun Li, Yang-Yang Li, Yufang Li, Lei Li, Min Li, Yiling li, Huiqing Liang, Tang Lijuan, Seng Gee Lim, Lee-Ling Lim, Shumei Lin, Han-Chieh Lin, Rita Lin, Rania Lithy, Yaru Liu, Yuanyuan Liu, Xin Liu, Wen-Yue Liu, Shourong Liu, Ken Liu, Tian Liu, Amedeo Lonardo, Mariana Bravo López, Eva López-Benages, Patricio Lopez-Jaramillo, Huimin Lu, Lun Gen Lu, Yan Lu, John Lubel, Rashid Lui, Iulianna Lupasco, Elena Luzina, Xiao-Hui Lv, Kate Lynch, Hong-Lei Ma, Mariana Verdelho Machado, Nonso Maduka, Katerina Madzharova, Russellini Magdaong, Sanjiv Mahadeva, Amel Mahfouz, Nik Ritza Kosai Nik Mahmood, Eman Mahmoud, Mohamed Mahrous, Rakhi Maiwall, Ammar Majeed, Avik Majumdar, Loey Mak, Madiha M Maklouf, Reza Malekzadeh, Claudia Mandato, Alessandra Mangia, Jake Mann, Hala Hussien Mansour, Abdellah Mansouri, Alessandro Mantovani, Jun qian Mao, Flor Maramag, Giulio Marchesini, Claude Marcus, Rui António Rocha Tato Marinho, Maria L Martinez-Chantar, Antonieta A. Soares Martins, Rana Marwan, Karen Frances Mason, Ghadeer Masoud, Mohamed Naguib Massoud, Maria Amalia Matamoros, Rosa Martín Mateos, Asmaa Mawed, Jean Claude Mbanya, Charles Mbendi, Lone McColaugh, Duncan McLeod, Juan Francisco Rivera Medina, Ahmed Megahed, Mai Mehrez, Iqbal Memon, Shahin Merat, Randy Mercado, Ahmed Mesbah, Taoufik Meskini, Mayada Metwally, Rasha Metwaly, Lei Miao, Eileen Micah, Luca Miele, Vladimir Milivojevic, Tamara Milovanovic, Yvonne L. Mina, Milan Mishkovik, Amal Mishriki, Tim Mitchell, Alshaimaa Mohamed, Mona Mohamed, Sofain Mohamed, Shady Mohammed, Ahmed Mohammed, Viswanathan Mohan, Sara Mohie, Aalaa Mokhtar, Reham Moniem, Mabel Segura Montilla, Jose Antonio Orozco Morales, María María Sánchez Morata, Jose Maria Moreno-Planas, Silvia Morise, Sherif Mosaad, Mohamed Moselhy, Alaa Mohamed Mostafa, Ebraheem Mostafa, Nezha Mouane, Nasser Mousa, Hamdy Mahfouz Moustafa, Abeer Msherif, Kate Muller, Christopher Munoz, Ana Beatriz Muñoz-Urribarri, Omar Alfaro Murillo, Feisul Idzwan Mustapha, Emir Muzurović, Yehia Nabil, Shaymaa Nafady, Ayu Nagamatsu, Atsushi Nakajima, Dan Nakano, Yuemin Nan, Fabio Nascimbeni, Mirella S. Naseef, Nagwa Nashat, Taran Natalia, Francesco Negro, Alexander V. 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J, Rockey, D, Rodriguez, M, Rodriguez Hernandez, H, Roman, E, Romeiro, F, Romeo, S, Rosales-Zabal, J, Roshdi, G, Rosso, N, Ruf, A, Ruiz, P, Runes, N, Ruzzenente, A, Ryan, M, Saad, A, Sabbagh, E, Sabbah, M, Saber, S, Sabrey, R, Sabry, R, Saeed, M, Said, D, Said, E, Sakr, M, Salah, Y, Salama, R, Salama, A, Saleh, H, Saleh, A, Salem, A, Salifou, A, Salih, A, Salman, A, Samouda, H, Sanai, F, Sanchez-Avila, J, Sanker, L, Sano, T, Sanz, M, Saparbu, T, Sawhney, R, Sayed, F, Sayed, S, Sayed, A, Sayed, M, Sebastiani, G, Secadas, L, Sediqi, K, Seif, S, Semida, N, Senates, E, Serban, E, Serfaty, L, Seto, W, Sghaier, I, Sha, M, Shabaan, H, Shalaby, L, Shaltout, I, Sharara, A, Sharma, V, Shawa, I, Shawkat, A, Shawky, N, Shehata, O, Sheils, S, Shewaye, A, Shi, G, Shi, J, Shimose, S, Shirono, T, Shou, L, Shrestha, A, Shui, G, Sievert, W, Sigurdardottir, S, Sira, M, Siradj, R, Sison, C, Smyth, L, Soliman, R, Sollano, J, Sombie, R, Sonderup, M, Sood, S, Soriano, G, Stedman, C, Stefanyuk, O, Stimac, D, Strasser, S, Strnad, P, Stuart, K, Su, W, Su, M, Sumida, Y, Sumie, S, Sun, D, Sun, J, Suzuki, H, Svegliati-Baroni, G, Swar, M, Taharboucht, S, Taher, Z, Takamura, S, Tan, L, Tan, S, Tanwandee, T, Tarek, S, Tatiana, G, Tavaglione, F, Tecson, G, Tee, H, Teschke, R, Tharwat, M, Thong, V, Thursz, M, Tine, T, Tiribelli, C, Tolmane, I, Tong, J, Tongo, M, Torkie, M, Torre, A, Torres, E, Trajkovska, M, Treeprasertsuk, S, Tsutsumi, T, Tu, T, Tur, J, Turan, D, Turcan, S, Turkina, S, Tutar, E, Tzeuton, C, Ugiagbe, R, Uygun, A, Vacca, M, Vajro, P, Van der Poorten, D, Van Kleef, L, Vashakidze, E, Velazquez, C, Velazquez, M, Vento, S, Verhoeven, V, Vespasiani-Gentilucci, U, Vethakkan, S, Vilaseca, J, Vitek, L, Volkanovska, A, Wallace, M, Wan, W, Wang, Y, Wang, X, Wang, C, Wang, M, Wangchuk, P, Weltman, M, White, M, Wiegand, J, Wifi, M, Wigg, A, Wilhelmi, M, William, R, Wittenburg, H, Wu, S, Wubeneh, A, Xia, H, Xiao, J, Xiao, X, Xiaofeng, W, Xiong, W, Xu, L, Xu, J, Xu, W, Xu, K, Xu, Y, Xu, S, Xu, M, Xu, A, Xu, C, Yan, H, Yang, J, Yang, R, Yang, Y, Yang, Q, Yang, N, Yao, J, Yara, J, Yaras, S, Yilmaz, N, Younes, R, Younes, H, Young, S, Youssef, F, Yu, Y, Yu, M, Yuan, J, Yue, Z, Yuen, M, Yun, W, Yurukova, N, Zakaria, S, Zaky, S, Zaldastanishvili, M, Zapata, R, Zare, N, Zerem, E, Zeriban, N, Zeshuai, X, Zhang, H, Zhang, X, Zhang, Y, Zhang, W, Zhang, Z, Zhao, J, Zhao, R, Zhao, H, Zheng, C, Zheng, Y, Zheng, R, Zheng, T, Zheng, K, Zhou, X, Zhou, Y, Zhou, H, Zhou, L, Zhu, L, Zhu, Y, Zhu, P, Ziada, E, Ziring, D, Ziyi, L, Zou, S, Zou, Z, Zou, H, Zuart Ruiz, R, and Global Multi-Stakeholder Consensus on the Redefinition of Fatty Liver Disease

Subjects
Renal disorders Radboud Institute for Molecular Life Sciences [Radboudumc 11], Hepatology, Non-alcoholic Fatty Liver Disease, NAFLD, consensu, Gastroenterology, MAFLD, definition, Humans, MAFLD, NAFLD, Human medicine
Abstract

Contains fulltext : 252162.pdf (Publisher’s version ) (Closed access)

Published
2022
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12. Effect of low dose albumin administration in spontaneous bacterial peritonitis on renal function and survival

Author

Dalila Gargouri, Meriam Sabbah, Héla Elloumi, Jamel Kharrat, Norsaf Bibani, Asma Ouakaa, Nour Elleuch, and Dorra Trad

Subjects
Adult, Liver Cirrhosis, Male, medicine.medical_specialty, Hepatorenal Syndrome, Cirrhosis, Renal function, Kaplan-Meier Estimate, Peritonitis, Protective Agents, Gastroenterology, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Spontaneous bacterial peritonitis, Hepatorenal syndrome, Albumins, Internal medicine, Ascites, medicine, Humans, Infusions, Parenteral, Aged, Retrospective Studies, Aged, 80 and over, Creatinine, Dose-Response Relationship, Drug, business.industry, Albumin, Bacterial Infections, Middle Aged, Hepatitis B, medicine.disease, Anti-Bacterial Agents, Treatment Outcome, chemistry, 030220 oncology & carcinogenesis, Drug Therapy, Combination, Female, 030211 gastroenterology & hepatology, medicine.symptom, business
Abstract

Background and Study Aims Current guidelines favour albumin administration during spontaneous bacterial peritonitis (SBP). However, its use is limited in clinical practice and low doses are preferred. The aim of our study was to determine the effect of low dose albumin perfusion during SBP on mortality and prevention of hepatorenal syndrome (HRS) in cirrhotic patients. Patients and methods A retrospective study including consecutive patients with SBP hospitalized from 2002 to 2015 was performed. All patients were treated by intravenous empiric antibiotics associated with albumin infusion (30 g/day the first and third day) irrespective of patient's weight. The diagnosis of HRS was assessed according to the International Ascites Club criteria. The survival, the frequency of HRS and any disturbance in renal function were recorded. Results Fourty nine patients (sex ratio = 0.81, mean age 60.6 years [23–89]) were included. Main cause of cirrhosis was hepatitis B and C in 42.9% of cases. 63.3% were of Child Pugh C score%. The first line intravenous antibiotic treatment was based on cefotaxime in 87.8% of cases, followed by ofloxacin in 6.1% of cases. The outcome was favourable in 85.7% of cases. HRS was observed in 9 patients (18.3%) within 18 months [1–55]. Otherwise, 10 patients (20.4%) experienced an increase in creatinine level despite of albumin perfusion. The immediate mortality was 4%, and the six months survival was of 81.8%. Conclusion Despite even a low dose administration of albumin during SBP, renal dysfunction and HRS occurred less than described in literature. These results associated with cost considerations could suggest to use such an intervention during SBP or to select high risk patients who must receive albumin perfusion during SBP.

Published
2019
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13. Gastric Polyps: A 10-Year Analysis Of 18496 Upper Endoscopies

Author

Norsaf Bibani, Asma Ouakaa, Dalila Gargouri, N Bellil, Dorra Trad, Haythem Yacoub, and Meriam Sabbah

Subjects
medicine.medical_specialty, Gastric Polyp, Internal medicine, otorhinolaryngologic diseases, medicine, digestive system, Gastroenterology, digestive system diseases
Abstract

Background/Aims: Gastric polyps (GPs) are usually asymptomatic lesions of the upper gastrointestinal tract observed in 1-3% of esophagogastroduodenoscopies (EGD). The majority of polyps are benign. The aim of this study was to precise the frequency of different types of gastric polyps in our population, and to analyze their possible association with other factors.Materials and Methods: A total of 18496 consecutive patients undergoing EGD over a ten-year period (between 2007 and 2018) in a tertiary hospital were retrospectively reviewed. Eighty-six patients diagnosed with gastric polyps were analysed. Demographics, medical history of the patients, and indication for gastroscopy were collected. Morphological, histological characteristics of polyps, and therapeutic management data were also collected.Results: GPs were found in 86 out of 18496 (0.46%) reviewed EGD, corresponding to a total of 141 polyps. There were 64 female (74.4%) and 22 male patients (25.6%) with a sex ratio (M/F) of 0.34. The average age was 58.1 years. One hundred and forty one polyps were included, and histopathology was obtained on 127 GPs. The most common location was the fundus (59.6%) and 48.9% were smaller than 5 mm. The polyp was unique in 75.6% of cases. According to Paris classification, 80% of the polyps were sessile (Is). Hyperplastic polyps were the most common (55.9%) were hyperplastic polyps, followed by sporadic fundic gland polyps in 23 patients (18.1%), 7 (5.5%) were adenomas, and 4 (3.1%) were neuroendocrine tumors type 1. The following factors were associated with hyperplastic polyps: anemia (p= 0.022), single polyp (p= 0.025) and size ≥ 5mm (p= 0.048). Comparing hyperplastic polyps biopsies to resected polyps, no difference was found in the evolutionary profile of the 2 groups. A size less than 10 mm (p=0.013) was associated with fundic gland polyps. Sixty polyps (47.2%) were treated by cold forceps, 19 (15%) treated by a mucosal resection and 15 (11.8%) with diathermic snare. Five procedural bleeding incidents were observed (3.9%). Only the use of anticoagulant treatment was associated with a high bleeding risk (p= 0.005). The comparative histological study between specimens of biopsied GPs and endoscopic polypectomy led to an overall agreement of 95.3%.Conclusion: In our study, the GPs frequency was 0.36%. Hyperplastic polyps and fundic gland are the most common gastric polyps in our country. The high frequency of Helicobacter pylori infection in our patients and in our area may explain the high frequency of HP.

Published
2021
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14. Gastric cancer revealed by a pathologic fracture due to bone metastasis

Author

Chammakhi C, N Bellil, Benzarti Z, Meriam Sabbah, N Bibani, and Gargouri D

Subjects
Pathology, medicine.medical_specialty, Text mining, business.industry, Pathologic fracture, digestive, oral, and skin physiology, Medicine, Bone metastasis, Cancer, business, medicine.disease, digestive system diseases
Abstract

Gastric cancer rarely disseminates to the bone. Initial clinical presentation of bone metastasis without any preceding gastrointestinal symptoms in gastric cancer patient is also extremely infrequent. Herein, we report an original case of gastric cancer revealed by a pathologic fracture due to bone metastasis.

Published
2021
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15. Primary gastric squamous cell carcinoma with a bilio‐gastric fistula and Krukenberg syndrome

Author

N Bellil, Chiraz Chamakhi, Meriam Sabbah, Imen Helal, Ghada Gharbi, and Dalila Gargouri

Subjects
medicine.medical_specialty, Medicine (General), Fistula, Case Report, Case Reports, 030204 cardiovascular system & hematology, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, R5-920, ovarian metastases, Internal medicine, medicine, fistula, Basal cell, business.industry, Stomach, Advanced stage, digestive, oral, and skin physiology, General Medicine, medicine.disease, Gastric Squamous Cell Carcinoma, stomatognathic diseases, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Primary squamous cell carcinoma, Medicine, business, stomach
Abstract

Primary squamous cell carcinoma of the stomach is a rare type of gastric malignancies. Diagnosis criteria are well defined but diagnosis is generally late being made at an advanced stage with metastases explaining its poor diagnosis.

Published
2021

17. Predictors of failure of endoscopic retrograde pancreatocholangiography during common bile duct stones

Author

N Bellil, Héla Elloumi, Meriam Sabbah, A Nakhli, Dorra Trad, Dalila Gargouri, Norsaf Bibani, and Asma Ouakaa

Subjects
0301 basic medicine, medicine.medical_specialty, Evidence-based medicine, medicine.medical_treatment, Common bile duct, Lithotripsy, Lithiasis, Balloon, 03 medical and health sciences, ERCP, 0302 clinical medicine, Cholangiography, medicine, lcsh:Social sciences (General), lcsh:Science (General), Internal medicine, Multidisciplinary, Endoscopic retrograde cholangiopancreatography, medicine.diagnostic_test, business.industry, medicine.disease, Laboratory medicine, Surgery, Major duodenal papilla, Stenosis, 030104 developmental biology, medicine.anatomical_structure, Sphincter, lcsh:H1-99, business, 030217 neurology & neurosurgery, Research Article, lcsh:Q1-390
Abstract

Introduction Endoscopic retrograde cholangiopancreatography associated with sphincterotomy and stone extraction with balloon or Dormia basket represents the gold standard for the management of common bile duct stones. The aim of our study were to investigate the predictors of failure of standard endoscopic techniques during the management of common bile duct stones. Methods A retrospective study including all endoscopic retrograde cholangiopancreatography for common bile duct stones between January 2014 and December 2017 was conducted. First line treatment was based on endoscopic retrograde cholangiopancreatography with endoscopic sphincterotomy and balloon or Dormia extraction. Second line endoscopic treatment was based on macrodilatation of Oddi sphincter, mechanical lithotripsy, biliary stent or nasobiliary drain placement. Predictors of failure of standard endoscopic techniques were sought by uni and multivariate analysis (SPSS software, p significant if < 0.05). Results One hundred eighty one patients (mean age 64 years and sex ratio M/W = 0.4) were included. Main indications for endoscopic retrograde cholangiopancreatography were residual or recurrent lithiasis (67.4%, n = 122). Cholangiography revealed multiple stones in 53 patients with an average size of 12.5mm [3–40]. The success rate of first line treatment was 61.9%. Independent predictors of failure of standard endoscopic techniques (failure of papillary cannulation or stone extraction) according to multivariate analysis were: an age greater than 65 years OR 0.516 [0.272–0.979], an intra-diverticular papilla OR 0.179 [0.035–0.914], a common bile duct diameter greater than 15 mm OR 0.161 [0.068–0.385] and a stenosis of the common bile duct OR 0.068 [0.008–0.605]. The success rate of the second line treatment was 73%. Conclusion Endoscopic retrograde cholangiopancreatography results in a successful clearance of the common bile duct in almost two-thirds of patients. In case of predictors of failure, alternative techniques can increase this rate., Evidence-based medicine; Internal medicine; Laboratory medicine; Surgery; Common bile duct, Lithiasis, ERCP

Published
2020

18. Duplication of the inferior vena cava: Case report and review of the literature

Author

Dhafer Haddad, Meriam Sabbah, Norsaf Bibani, Dalila Gargouri, Khaoula Chabbouh, fatma dieb, maroua ben ali, and N Bellil

Subjects
medicine.medical_specialty, business.industry, medicine.disease, Inferior vena cava, digestive system diseases, Bowel obstruction, medicine.anatomical_structure, medicine.vein, Gene duplication, cardiovascular system, Medicine, Abdomen, cardiovascular diseases, Radiology, business
Abstract

A 33-year-old man was admitted to the hospital for bowel obstruction secondary to fistulizing and stenosing Crohn's disease. A computerized tomography scan of abdomen showed a duplication of the inferior vena cava.

Published
2020
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19. Nomenclature and definition of metabolic-associated fatty liver disease: a consensus from the Middle East and north Africa

Author

Necati Örmeci, Fuad Al-Ali, Yousef Ajlouni, Maryam Al Khatry, Khalid Alswat, Abd Elkhalek Hamed, Almoutaz Hashim, Mustapha Benazzouz, Waseem Hamoudi, Nawel Afredj, Reham Soliman, Mohsen Salama, Gamal Shiha, Yasser Fouad, Amir Anushiravani, Imam Waked, Moutaz Derbala, Said A. Al-Busafi, Dina Attia, Ala I. Sharara, Salma Barakat, Nazir Ibrahim, Khaled Bamakhrama, Mohamed Sharaf-Eldin, Meriam Sabbah, and Samy Zaky

Subjects
medicine.medical_specialty, Consensus, MEDLINE, Type 2 diabetes, Disease, 03 medical and health sciences, Middle East, 0302 clinical medicine, Africa, Northern, Non-alcoholic Fatty Liver Disease, Risk Factors, Diabetes mellitus, Terminology as Topic, Health care, medicine, Global health, Prevalence, Humans, Intensive care medicine, Hepatology, business.industry, Fatty liver, Gastroenterology, medicine.disease, Obesity, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, business
Abstract

With the increasing prevalence of obesity and type 2 diabetes, fatty liver disease associated with metabolic dysfunction is a global health problem, especially because it is one of the earliest consequences of obesity and it precedes diabetes development. Fatty liver disease associated with metabolic dysfunction is of particular concern in the Middle East and north Africa, where its prevalence is greater than that in the rest of the world. Despite the magnitude of the problem, no regional guidelines have been developed to address this disease. This Review describes suggestions of redefining fatty liver disease associated with metabolic dysfunction, including its terminology and criteria for diagnosis. Experts have raised serious concerns on the current nomenclature, which labels the disease as non-alcoholic fatty liver disease (NAFLD), and its diagnostic criteria. The panel reached a consensus that the disease should be renamed as metabolic-associated fatty liver disease (MAFLD) and that the disease should be diagnosed by positive criteria. The aim is now to work with authorities across the region to implement these proposed changes and reflect them in health-care policy and to improve health care for patients in this region.

Published
2020

20. Prognostic significance of poorly cohesive gastric carcinoma in Tunisian patients

Author

Anis Ben Maamer, Meriam Sabbah, Haithem Zaafouri, Fatma Khanchel, Ehsen Ben Brahim, Marwa Ferchichi, Aschraf Chadli Debbiche, Raja Jouini, Imen Helal, Dhafer Hadded, and Abdessalem Gharsallah

Subjects
0301 basic medicine, medicine.medical_specialty, Survival, Abdominal surgery, macromolecular substances, Gastroenterology, Article, 03 medical and health sciences, 0302 clinical medicine, Poorly cohesive carcinoma, Poorly Cohesive Gastric Carcinoma, Cancer surgery, Internal medicine, Pathology, Medicine, Stage (cooking), lcsh:Social sciences (General), lcsh:Science (General), Multidisciplinary, business.industry, Incidence (epidemiology), Cancer, Health sciences, medicine.disease, Prognosis, Biological sciences, 030104 developmental biology, Cohort, bacteria, lcsh:H1-99, business, Gastric cancer, 030217 neurology & neurosurgery, Biomedical sciences, lcsh:Q1-390
Abstract

Background While the incidence of gastric cancer has decreased worldwide in recent decades, the incidence of poorly cohesive carcinoma (PCC) is rising. The prognostic significance of gastric PCC remains a subject of debate. Objective To analyze the prognosis of gastric PCC in a Tunisian cohort. Methods A total of 122 gastric adenocarcinoma patients who underwent curative gastrectomy from 2001 to 2014 at Habib Thameur hospital in Tunis, Tunisia were included. The clinicopathological parameters and prognosis of PCC were analyzed in comparison with non PCC (NPCC). Results Sixty one patients (50%) presented PCC. Patients were younger in PCC group (p = 0,001). There was no difference in sex distribution between the two groups. PCC was more likely to be stage T4 (55.7% vs 34.4%; p = 0.033), N3 (67.8% vs 30%; p < 0.001) and have a higher metastatic lymph node ratio (p < 0.001). Hepatic metastases were more frequent in NPCC group (p = 0.031) whereas peritoneal carcinomatosis was more common in PCC group (p = 0.004). Perineural invasion was more frequent in PCC group (p = 0.001). Resection margins were more often positive in PCC group (31.1% vs 9.8%; p = 0.004). There was no difference in recurrence rate between the 2 groups (p = 0.348). The 5-year survival was similar in the NPCC and PCC (respectively 43% vs 23 %; p = 0.247). Survival rates were also comparable in early stage (100% vs 80% respectively for PCC and NPCC; p = 0.527) as well as for advanced stage (16% vs 35% respectively for PCC and NPCC; p = 0.538). PCC was not a prognostic factor for survival. Interestingly, advanced age, adjacent structures invasion, positive resection margins were specific prognostic factors for PCC. Conclusion In our study PCC was not a prognostic factor for survival. Advanced age, adjacent structures invasion and positive resection margins were specific prognostic features for this histological subtype., Biological sciences; Health sciences; Pathology; Abdominal surgery; Cancer surgery; Gastric cancer, Poorly cohesive carcinoma, Prognosis, Survival.

Published
2020

21. P226 Does faecal Calprotectin help differentiate inflammatory from fibrous stenosis in Crohn’s disease?

Author

N Bellil, Dalila Gargouri, Meriam Sabbah, Aïda Bouratbine, N Bibani, Karim Aoun, F Ben Farhat, and M. Ben Abid

Subjects
Leukocyte L1 Antigen Complex, medicine.medical_specialty, Crohn's disease, Fibrous stenosis, business.industry, Gastroenterology, Inflammation, Azathioprine, General Medicine, medicine.disease, Faecal calprotectin, Infliximab, Diarrhea, Internal medicine, medicine, medicine.symptom, business, medicine.drug
Abstract

Background Digestive stenosis is the most common complication of Crohn’s disease. It can be either inflammatory or fibrous. The clinical, biological and especially morphological characteristics of the stenosis can help differentiate inflammatory stenosis from fibrous stenosis. The aim of our study was to evaluate the performance of fecal calprotectin (FC), a marker of intestinal inflammation, in identifying the type of stenosis. Methods A prospective study including all patients followed for Crohn’s disease in the Gastroenterology Department of Habib Thameur Hospital over a 6-month period from July 2020 to December 2020 was performed. Clinical, biological, endoscopic and radiological data were collected. The inflammatory nature of the stenosis was mainly retained according to radiological activity signs objectified by cross-sectional imaging. All patients were given a FC assay at the time of inclusion. FC was dosed by using the Bulhmann® FCAL ELISA technique. The statistical study was carried out using the SPSS software version 22.0 (p value significant if lower than 0.05). Results Fifty patients were included in our study (mean age 40.54 years [18–67] and sex ratio (M/F) = 1.77). The average evolution time of the disease was 8 years [6 months- 27 years]. The disease was ileal in 16 patients, colic in 4 patients and ileocolic in 30. Twenty patients (40%) had an intestinal stenosis whose location was: ileocaecal anastomosis (n=9), ileal (n=8) and colic (n=3). Multiple stenoses (colic and ileal) were noted in 3 patients. Fifteen patients were on medical treatment at the time of inclusion: 7 patients were on Infliximab, 5 were on azathioprine and 3 were on 5ASA. Digestive symptoms such as diarrhoea or subocclusive syndromes were noted in 7 patients. A biological inflammatory syndrome (CRP >10mg/L) was noted in 8 patients. Of the 20 stenoses included, 8 were of the inflammatory type (40%). In the presence of stenosis, the mean level of FC was 224.9 μg/g. A high level of FC was associated with the inflammatory type of stenosis (p Conclusion According to our study, FC is a good marker of intestinal inflammation allowing to differentiate an inflammatory from a fibrous stenosis during Crohn’s disease better than the usual biological markers. These results should be confirmed by larger studies.

Published
2021
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22. P231 Work productivity loss in perianal crohn’s disease

Author

N Bellil, Asma Ouakaa, Meriam Sabbah, N Bibani, D Trad, Dalila Gargouri, and H Jlassi

Subjects
Perianal Crohn's disease, Crohn's disease, medicine.medical_specialty, Work productivity, business.industry, Depreciation, Gastroenterology, General Medicine, medicine.disease, Internal medicine, Disease remission, Presenteeism, medicine, Absenteeism, business
Abstract

Background Few data exist on the socio-professional impact in patients with perianal Crohn’s disease, probably because the patient-doctor relationship is mainly focused on obtaining clinical, biological and endoscopic remission of the Crohn’s disease (CD). Our study aimed to evaluate the impacts of perianal Crohn’s disease on work productivity. Methods A prospective cross-sectional study including patients with CD followed in the Gastroenterology department between July and August 2020 was performed. Professional impact was assessed using Work Productivity and Activity Impairment questionnaire (WPAI) which is composed of 6 questions evaluating during the last seven days preceding the interview with the patient, the absenteeism, the presenteeism, the total decrease in productivity and the decrease in daily activities for health reasons. The results are multiplied by 100, expressed as a percentage of time lost. A higher percentage indicates greater depreciation and less productivity. Professional impact was compared in patients with perianal Crohn’s disease and controls without perianal symptoms. Results Thirty two patients were included. The mean age was 38.28 years [18–60] and the sex ratio was 1. Perianal manifestations were observed in 15 patients (44% of cases). Thirteen patients (41%) were in paid employment at the time of inclusion. CD was responsible for an average absenteeism of 30% ± 10.4% [0–80%] of the working time during the last seven days. An average percentage of work impairment defining the presenteeism was noted to be 52% ± 28% [0–80%] of working time. The overall average decline in productivity was estimated at 56% ± 22% [0–97%]. CD was responsible for an average restriction of 45% ± 33% [0–100%] of usual daily activities. By comparing the professional impact according to the presence or not of anoperineal lesions (APL), an association between the mean rate of activity restriction and the presence of APL (p = 0.04) was objectified. However, no significant association was noted in the other dimensions of the WPAI questionnaire. Conclusion According to our study, it appears that Crohn’s disease is a source of reduced work productivity especially in case of perianal manifestation. These results should be confirmed by larger studies.

Published
2021
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25. P205 Influencing factors of Sleep quality in patients with Crohn’s Disease

Author

Dalila Gargouri, D Trad, Asma Ouakaa, H Jlassi, N Bellil, Meriam Sabbah, and N Bibani

Subjects
Crohn's disease, medicine.medical_specialty, Sleep quality, business.industry, Gastroenterology, General Medicine, medicine.disease, Hospital Anxiety and Depression Scale, Sleep in non-human animals, Quality of life (healthcare), medicine, Insomnia, Anxiety, In patient, medicine.symptom, Psychiatry, business
Abstract

Background Sleep is considered vital for the health and quality of life of individuals. Recently, studies have suggested that sleep disturbances are common in people with Crohn’s disease (CD) and in the majority of cases are related to disease activity.The aim of our study was to determine the prevalence of insomnia in patients with CD and to identify the influencing factors. Methods A prospective cross-sectional study including patients with CD followed in the department between July and August 2020 was carried out. Epidemiological and clinical data have been collected. Self-report questionnaires were given to patients. Insomnia was assessed using the Insomnia Severity Index (ISI) which provides a valid index of the overall severity of insomnia. A score between 0 and 7 indicates the absence of insomnia; between 8 and 14 a mild infra-clinical insomnia; between 15 and 21 moderate clinical insomnia, and between 22 and 28 severe insomnia. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS) questionnaire which is a scale of 14 items rated from 0 to 3. Seven questions are related to anxiety and seven to depression. Fatigue was screened for using the Fatigue Severity Scale (FSS) which has 9 questions rated from one to seven. Significant fatigue was defined by a score greater than or equal to 5.5. Statistical analysis was performed by SPSS 21 software (p significant if less than 0.05). Results Thirty two patients with a mean age of 38.28 years [18–60 years] and a sex ratio equal to 1 were enrolled. Mean duration of the disease was 10.56 years [1–40 years]. At the time of inclusion, the average Harvey Bradshaw (HAB) score was 5.14 [1–14]. Mean insomnia score was 12.62 [0–26]. The insomnia severity index showed mild insomnia in 4 patients (12.5%), moderate insomnia in 7 patients (22%) and severe insomnia in 8 patients (25%). The HADS score revealed obvious depression in 19% of patients, doubtful depression in 25% of patients. 56% of patients had no symptoms of depression. Likewise, anxiety was objectified in 22% of patients and doubtful anxiety in 37% of patients. 41% of patients had no symptoms of anxiety. The mean fatigue score was 3.75 ± 1.9 [range 1–9]. A fatigue score greater than or equal to 5.5 was observed in 3 cases (9%). A significant positive correlation was found between the insomnia severity score and the depression score (r = 0.4, p = 0.035) as well as the fatigue severity score (r: 0.36, p = 0.04). Conclusion Our study shows that insomnia is very common in patients with CD. The factors associated with these sleep disturbances were depression and fatigue. Gastroenterologist and psychologist should join forces to evaluate emotional as well as sleep disturbances for a better global CD management.

Published
2021
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26. P537 Anemia in Crohn’s Disease: Response to treatment and risk of recurrence

Author

G Gharbi, B Nawel, Dalila Gargouri, Meriam Sabbah, Asma Ouakaa, N Bibani, Héla Elloumi, and D Trad

Subjects
medicine.medical_specialty, Crohn's disease, business.industry, Anemia, Gastroenterology, General Medicine, Iron deficiency, medicine.disease, Response to treatment, Crohn's Disease Activity Index, Pallor, Hypocholesterolemia, Iron-deficiency anemia, Internal medicine, medicine, medicine.symptom, business
Abstract

Background Anemia is common in Crohn’s Disease (CD). Iron deficiency and inflammation are the most common etiologies. The aim of our study is to assess the response of patients with CD to anemia treatment , as well as the predisposing factors for recurrence after treatment. Methods This is a retrospective study including patients with CD complicated by anemia, treated in the gastroenterology department between January 2015 and December 2019. Iron deficiency anemia is defined by a ferritin level Results Fifty-four patients were included with a M / F sex ratio of 1.3. The mean age was 40.5 years old with a mean age at diagnosis of CD of 29 years old. Patients had ileal or ileocolic involvement in 82.2% of cases and pure colonic involvement in 16.7%. The main symptoms of anemia were asthenia (64.8%) and mucocutaneous pallor (42.6%). Severe anemia was noted in 64.8% of patients. The factors statistically associated with severe anemia were: the number of relapses before the diagnosis of anemia (p= 0.012), an active disease (p = 00.024) assessed by the CDAI score, the presence of a deficiency syndrome, in particular hypocholesterolemia (p= 0.007) and hypocalcemia (p= 0.006). The anemia was inflammatory in 44.4% of patients, iron deficiency in 31.7%, mixed in 20.4% and vitamin B12 deficiency in 16.7% of them. Treatment of anemia depending on the etiology was effective in 72% of patients. The response was partial in 24% of cases. Only 4% of patients did not respond to treatment. The predictive factors of a poor response to anemia treatment were: the disease duration (p= 0.05), an active disease at the time of diagnosis of anemia (p= 0.025) and an extended ileal resection (p= 0.005). Patients with inflammatory anemia responded better to treatment (p= 0.006). A longer duration of iron suplementation (p = 0.02), as well as the route of administration (IV) (p= 0.014) were correlated with a better response to therapy in case of iron deficiency anemia. Recurrence of anemia was observed in 84.3% of patients with a mean time after anemia correction of 11.5 months. Serum ferritin levels Conclusion Even after treatment, recurrence of anemia is common especially in patients followed for CD with ileal involvement. A clinical-biological remission, a sufficient duration of iron treatment and the control of the response to treatment by the dosage of the ferritin level even after the correction of the anemia is necessary in order to avoid this recurrence and thus ensure a better quality of life .

Published
2021
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28. Hepatitis B and C viral infections screening in a Tunisian IBD population under immunosuppressive therapies

Author

Norsaf Bbani, Asma Ouakaa, Dalila Gargouri, Haythem Yacoub, Meriam Sabbah, N Bellil, Héla Elloumi, and Dorra Trad

Subjects
Adult, Male, Gynecology, medicine.medical_specialty, education.field_of_study, Tunisia, business.industry, Population, General Medicine, Hepatitis C, Middle Aged, Hepatitis B, Inflammatory Bowel Diseases, medicine.disease, Prevalence, medicine, Humans, Mass Screening, Female, education, business, Immunosuppressive Agents
Abstract

Antecedentes: Los farmacos inmunosupresores se han convertido en un pilar de la terapia para las enfermedades inflamatorias del intestino (EII). Estos tratamientos exponen al riesgo de reactivacion de la hepatitis B y C. Objetivo: El objetivo de este estudio fue evaluar la prevalencia de los virus de la hepatitis B y C en pacientes tunecinos con EII que reciben tratamientos inmunosupresores. Materiales y metodos: Los pacientes con enfermedad inflamatoria intestinal fueron reclutados consecutivamente durante un periodo de 2 anos (2017-2018). Se evaluo la prevalencia de las hepatitis virales B y C, asi como la presentacion, el tratamiento y los resultados clinicos, biologicos y virologicos. Tambien se analizaron los factores asociados a la hepatitis B y C (software SPSS, valor de p

Published
2020
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29. Prognostic factors of survival during hepatocellular carcinoma

Author

Norsaf, Bibani, Dorra, Trad, Meriam, Sabbah, Asma, Ouakaa, Héla, Elloumi, Dalila, Gargouri, and Jamel, Kharrat

Subjects
Adult, Aged, 80 and over, Liver Cirrhosis, Male, Carcinoma, Hepatocellular, Liver Neoplasms, Kaplan-Meier Estimate, Middle Aged, Hepatitis B, Prognosis, Hepatitis C, Survival Analysis, Survival Rate, Treatment Outcome, Humans, Female, Aged, Retrospective Studies
Abstract

Despite advances in diagnostic and therapeutic means,mortality of hepatocellular carcinoma (HCC) on liver cirrhosis remainsheavy in the absence of curative treatment.To evaluate survival and to identify prognostic factors during HCC.A mono centric retrospective study over a period of13 years (January 2002-October 2015), including all patients with HHConcirrhotic liver was performed. Survival analysis was performed accordingto the Kaplan-Meier method. The prognostic factors of survival weredetermined by the Log Rank test.Ninety four patients wereincluded (meanage 66.18 years, sexratio 1.65). Cirrhosiswassecondary to hepatitis B or C in 73.6%). Twentytwo patients responded to the MILAN criteria. Cirrhosiswasrated Child A,B and C in 30.9%, 46.8% and 22.3% of patients, respectively. A Curativetreatment was possible for only 10 patients (11.2%). In our study, meansurvival was 15.1 months and overall survival at 1 year and 2 years were25.5% and 21.3%, respectively. Nine factors associated with shortersurvival were identified : a Child-Pugh stage B or C; the absence ofscreening; an AFP level of400ng / ml; the existence of vascularthrombosis; a CHC evolved according to the classification of Milan; anOKUDA III score; CLIP score ≥ 3; a BCLC stage C or D; palliative orsymptomatic treatment.Although the best treatment of HCC remainspreventive, theuse of new prognostic scores couldimprove the management of patientsifintegrated in therapeuticalgorithms.

Published
2018

30. Gastric trichobezoar revealed by epigastric mass

Author

Norsaf Bibani, Asma Ouakaa, Meriam Sabbah, Dalila Gargouri, and Dorra Trad

Subjects
medicine.medical_specialty, business.industry, Stomach, General Medicine, Gastroenterology, Bezoars, Internal medicine, Epigastric mass, Gastroscopy, medicine, Humans, Female, business, Child
Published
2018

31. Atypical hyperplastic polyp

Author

Dorra Trad, Imen Helal, Meriam Sabbah, Raja Jouini, and Asma Ouakaa

Subjects
Pathology, medicine.medical_specialty, Hyperplastic Polyp, business.industry, Medicine, General Medicine, business
Published
2019
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36. Known, new and emerging risk factors of hepatocellular carcinoma (review)

Author

Meriam Sabbah, Jamel Kharrat, Dorra Trad, Norsaf Bibani, Asma Ouakaa, Dalila Gargouri, and Héla Elloumi

Subjects
Oncology, medicine.medical_specialty, Carcinoma, Hepatocellular, Prevalence, Malignancy, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Internal medicine, medicine, Humans, Risk factor, neoplasms, business.industry, Liver Neoplasms, General Medicine, Hepatitis C, Hepatitis B, medicine.disease, digestive system diseases, 030220 oncology & carcinogenesis, Hepatocellular carcinoma, 030211 gastroenterology & hepatology, Liver cancer, business, Risk assessment
Abstract

Summary Hepatocellular carcinoma (HCC) is the commonest primary cancer of the liver and is a leading cause of cancer-related death worldwide. And despite effective treatment of hepatitis B and C infection which is the prominent factor associated with HCC, the prevalence of this malignancy continues to rise probably due to other factors. So that, identifying risk factor of HCC is essential and effective surveillance programs are necessary in order to maximize patient outcomes. This article summarizes the known, new and emerging risk factors of HCC.

Published
2017

37. Ascending Cholangitis secondary to migrated embolization coil of gastroduodenal artery pseudo-aneurysm a case report

Author

Dhafer Haddad, Meriam Sabbah, Haithem Zaafouri, Anis Hasnaoui, Anis Ben Maamer, Jamel Kharrat, Ahmed Bouhafa, and Sonia Essghaeir

Subjects
Male, medicine.medical_specialty, Cholangitis, Hemobilia, Case Report, Aneurysm, Ruptured, Gastroduodenal artery, Embolization coil, 03 medical and health sciences, 0302 clinical medicine, Foreign-Body Migration, Blood vessel prosthesis, medicine.artery, medicine, Humans, Pseudo-aneurysm, Ascending cholangitis, Cholangiopancreatography, Endoscopic Retrograde, Common Bile Duct, Endoscopic retrograde cholangiopancreatography, Common bile duct, medicine.diagnostic_test, business.industry, Bile duct, Stomach, Haemobilia, Angiography, General Medicine, Middle Aged, medicine.disease, Embolization, Therapeutic, Surgery, Blood Vessel Prosthesis, medicine.anatomical_structure, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Radiology, business, Aneurysm, False
Abstract

Background Gastroduodenalartery (GDA) pseudo-aneurysms are very rare. Their clinical importance lies in the eventuality of rupture, causing bleeding and ultimately exsanguination. Case presentation We report the case of a man, with prior history of biliary surgery, presenting with haemobilia secondary to a rupture of GDA pseudo-aneurysm eroding the main bile duct. The patient was treated with coil embolization. This technique is considered to be safe. However, on the long term, some complications may occur. In our case, the patient presented with cholangitis subsequent to coil migration in the lower bile duct. This situation was managed using endoscopic retrograde cholangiopancreatography (ERCP) allowing coil extraction with favorable evolution. Conclusions GDA pseudo-aneurysms are very rare. Bleeding, secondary to the rupture of these lesions, is a serious complication that could lead to death. Diagnosis and treatment of ruptured GDA pseudo-aneurysms rely on angiography. This method is considered to be safe. Cholangitis secondary to coil migration in the main bile duct is exceedingly rare,but remains an eventuality that physicians should be cognizant of.

Published
2017

44. Hepatic Tuberculosis of Pseudotumor Form

Author

Meriam, Sabbah, primary, Norsaf, Bibani, additional, Dorra, Trad, additional, Asma, Ouakaa, additional, Hela, Elloumi, additional, Dalila, Gargouri, additional, Ahlem, Lahmar, additional, and Jamel, Kharrat, additional

Published
2018
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46. Systematic gastric biopsy in iron deficiency anaemia

Author

Meriam Sabbah, Héla Elloumi, Dalila Gargouri, Jamel Kharrat, Achraf Debbiche, Norsaf Bibani, Asma Ouakaa, and Dorra Trad

Subjects
Adult, Male, 030213 general clinical medicine, medicine.medical_specialty, Adolescent, Autoimmune Gastritis, Atrophic gastritis, Biopsy, Chronic gastritis, Gastroenterology, Helicobacter Infections, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Internal medicine, medicine, Carcinoma, Prevalence, Humans, Prospective Studies, Villous atrophy, Aged, Aged, 80 and over, Metaplasia, biology, medicine.diagnostic_test, Anemia, Iron-Deficiency, Helicobacter pylori, business.industry, Intestinal metaplasia, Middle Aged, medicine.disease, biology.organism_classification, Gastric Mucosa, Gastritis, 030211 gastroenterology & hepatology, Female, business
Abstract

Background and study aims Gastric biopsies are recommended in patients with iron deficiency anaemia to identify atrophic gastritis. However, in practice, only duodenal biopsies are routinely performed. The aim of our study was to determine the value of gastric biopsies in iron deficiency anaemia. Patients and methods A prospective study including all patients referred for gastrointestinal endoscopy for iron deficiency anaemia from May 2008 to September 2014 was performed. All patients having endoscopic lesions which may explain occult bleeding were excluded, as well as patients using non-steroidal anti-inflammatory drugs or anticoagulation treatment. Two fundic biopsies, two antral biopsies, and one biopsy from the lesser curve were taken in all patients. Following entities were particularly looked for: chronic gastritis, Helicobacter pylori infection, intestinal metaplasia, endocrine hyperplasia and villous atrophy. In cases where intestinal metaplasia was present in the fundus and associated with endocrine hyperplasia and glandular atrophy, immunohistochemical study was performed to confirm autoimmune gastritis. Results One hundred seventy-seven patients (mean age 50 years, range: 15–90) were included. Chronic gastritis was found in 149 cases (84%). Infection by Helicobacter pylori was found in 107 cases (60%). Fundic intestinal metaplasia was observed in 25 patients (14%) and was associated with Helicobacter pylori infection in 52% of cases. Atrophic gastritis was observed in 14 cases (8%) and autoimmune gastritis was confirmed in 5 cases by immunohistochemical study. One patient had on gastric biopsy a carcinoma with signet ring cells. Conclusion Intestinal metaplasia was frequently observed and was mostly related to Helicobacter pylori infection. These patients require monitoring, especially if they are young because it represents a pre neoplastic condition. However, in our study autoimmune gastritis often described in the literature in case of iron deficiency anaemia was rarely seen raising the question of relative cost-efficiency of fundic biopsies during iron deficiency anaemia.

Published
2016

47. Cholestatic hepatitis due to Ecballium elaterium ingestion

Author

Bizid S, Baha Ben Slimene, G. Mohamed, Abdelli N, Bouali R, Hatem Ben Abdallah, Meriam Sabbah, and Issam Msakni

Subjects
Adult, Male, medicine.medical_specialty, Cholagogues and Choleretics, Treatment outcome, Histamine Antagonists, Gastroenterology, Internal medicine, medicine, Ingestion, Humans, Emergency Treatment, Past medical history, Hepatology, biology, Traditional medicine, business.industry, Ursodeoxycholic Acid, food and beverages, Jaundice, biology.organism_classification, Ecballium elaterium, Ocular toxicity, Cucurbitaceae, Jaundice, Obstructive, Treatment Outcome, Cholestatic hepatitis, Drug Therapy, Combination, medicine.symptom, Chemical and Drug Induced Liver Injury, business, Phytotherapy
Abstract

Ecballium elaterium is an herbaceous plant belonging to the Cucurbitaceae family. This plant is fairly common in the Mediterranean regions. It is frequently consumed in infusion, mixture of fruit or even in aerosol in cases of fever or flu. This plant is known for its respiratory and ocular toxicity. Hepatotoxicity has never been described in the literature. We report a case of acute cholestatic hepatitis due to Ecballium elaterium in a 39 years old patient, with no past medical history.

Published
2014

48. Gastric polyps: a 10-year analysis of 18,496 upper endoscopies

Author

Haythem Yacoub, Norsaf Bibani, Mériam Sabbah, Nawel Bellil, Asma Ouakaa, Dorra Trad, and Dalila Gargouri

Subjects
Stomach, Polyp, Polypectomy, Endoscopic mucosal resection, Diseases of the digestive system. Gastroenterology, RC799-869
Abstract

Abstract Background/aims Gastric polyps (GPs) are usually asymptomatic lesions of the upper gastrointestinal tract observed in 1–3% of esophagogastroduodenoscopies (EGD). Most GPs are benign. The aim of this study was to precise the frequency of different types of gastric polyps in our population, and to analyze their possible association with other factors. Materials and methods A total of 18,496 consecutive patients undergoing EGD over a 10-year period (between 2007 and 2018) in a tertiary hospital were retrospectively reviewed. Eighty-six patients diagnosed with gastric polyps were analysed. Demographics, medical history of the patients, and indication for gastroscopy were collected. Morphological, histological characteristics of polyps, and therapeutic management data were also collected. Results GPs were found in 86 out of 18,496 (0.46%) reviewed EGD, corresponding to a total of 141 polyps. There were 64 female (74.4%) and 22 male patients (25.6%) with a sex ratio (M/F) of 0.34. The average age was 58.1 years. One hundred and forty one polyps were included, and histopathology was obtained on 127 GPs. The most common location was the fundus (59.6%) and 48.9% were smaller than 5 mm. The polyp was unique in 75.6% of cases. According to Paris classification, 80% of the polyps were sessile (Is). Hyperplastic polyps were the most common (55.9%), followed by sporadic fundic gland polyps observed in 23 patients (18.1%), 7 (5.5%) were adenomas and 4 (3.1%) were neuroendocrine tumors type 1. The following factors were associated with hyperplastic polyps: anemia (p = 0.022), single polyp (p = 0.025) and size ≥ 5 mm (p = 0.048). Comparing hyperplastic polyps’ biopsies to resected polyps, no difference was found in the evolutionary profile of the 2 groups. A size less than 10 mm (p = 0.013) was associated with fundic gland polyps. Sixty polyps (47.2%) were treated by cold forceps, 19 (15%) treated by a mucosal resection and 15 (11.8%) with diathermic snare. Five procedural bleeding incidents were observed (3.9%). Only the use of anticoagulant treatment was associated with a high bleeding risk (p = 0.005). The comparative histological study between specimens of biopsied GPs and endoscopic polypectomy led to an overall agreement of 95.3%. Conclusion In our study, the GPs frequency was 0.36%. Hyperplastic polyps and fundic gland are the most common in our country. The high frequency of Helicobacter pylori infection in our patients and in our area may explain the high frequency of HP.

Published
2022
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