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Misoprostol, a synthetic analogue of prostaglandin E1, is commonly used in gynecology, particularly in combination with mifepristone for elective abortion. Although its use is widespread, the potential teratogenic effects of misoprostol in cases of failed medical abortion have not been sufficiently explored in the medical literature. Severe congenital malformations, although rare, have been reported, raising concerns about the impact of this drug on fetal development. We present a rare case of femoral agenesis observed in a woman who experienced a failed medical abortion with Misoprostol (Cytotec®), highlighting the need for a better understanding of the risks associated with fetal exposure to this drug and the implementation of rigorous follow-up measures after its use.

Background Hydatidosis of the thoracic wall differs from other hydatid localizations in its pathophysiology, diagnostic, and therapeutic management. It is a little-studied entity. The objectives of our work were to describe its surgical management and to analyze the factors that may influence recurrence and mortality. Methods A retrospective, descriptive, longitudinal, and multicenter study on four university hospital surgical centers of Tunis, from January 1995 to December 2022 including operated hydatid cysts of the thoracic wall. Overall survival (OS) and cumulative recurrence rates were calculated. Univariate and multivariable Cox regression analyses were performed to identify recurrence and mortality risk factors. Results Forty-nine patients were included. The mean age was 41 ± 17 years [8-76]. The main presenting sign was thoracic parietal swelling (n=22). Chest ultrasound and CT scan showed multivesicular formation in 17 and 33 cases, respectively. Muscle involvement was in the intercostal (n=4), paravertebral (n=13), and pectoralis major (n=3) muscles. Bone involvement was vertebral (n=11), costal (n=12), costo-vertebral (n=21) and sternal (n=2). A posterolateral thoracotomy was performed (n=20). Surgical excision at various levels of the chest wall with spinal stabilization (n=15) was performed. Sixty-three percent of the patients received antiparasitic medical treatment. Recurrence occurred in 37% of cases. Four patients died from hydatidosis-related complications. Factors could be independently associated with recurrence such as male gender, and vertebral involvement. The presence of a visceral hydatid cyst located at a distance from the parietal lesion at the time of diagnosis and the occurrence of postoperative infectious complications could increase mortality. Conclusions Chest wall hydatidosis represents a rare medical condition where surgery remains the preferred treatment modality. However, it carries a substantial burden of morbidity and mortality, influenced by various factors. Further large-scale studies are necessary to gain a deeper understanding of these factors and to optimize management strategies accordingly.

Abstract The thrust of the study was to determine the chemical composition of the essential oils extracted from Thymus pallescens de Noé and Cymbogon citratus Stapf. as well as to evaluate their efficacy in controlling Sitophilus zeamais Motschulsky and Tribolium castaneum (Herbst) in either single or combined populations. Carvacrol (56.04%) and geraniol (20.86%) were identified as the major constituents of T. pallescens and C. citratus respectively. The tested essential oils showed pronounced insecticidal activity against the pest species in relation with the applied doses. T. pallescens EO had the highest efficacy and S. zeamais was found to be more susceptible to both individual and combined treatments. With reference to the contact and fumigation assessments, T. pallescens EO effectuated corrected mortality rates ranging from 42.5–100% to 25–100% in S. zeamais with corresponding lethal concentration (LC50) values of 17.7 µl/ml and 15µL/L air respectively. Whereas, the T. pallescens EO exhibited corrected mortality rates of 42.5–100% and 20–100% with corresponding LC50 values of 18.1 µl/ml and 15.5 µL/L air against T. castaneum in contact and fumigation assessments, respectively. The corrected mortality rates increased for both insect species when using combination treatments, with significant increases in the LC50 values, ranging from 8.59 to 49.9% for both pest species. Analysis of energy biomarkers in the treated insects indicate significantly increased protein and carbohydrate contents and decreased lipids levels. The study therefore demonstrated the bio-insecticidal toxicity of the EOs from T. pallescens and C. citratus against two important maize post-harvest pests, concurrently revealing significant positive and negative insecticidal activity gradients in relation to single or combined populations.

Experimental Myocardial infarction (MI) using ligation procedure induces cardiac dysfunction, high level of ROS, inflammation, apoptosis, fibrosis and cardiomyocyte (CM) loss. AAV overexpressing human Trx-2, specifically in CM mitochondria improves mouse cardiac function, reduces the size of cardiac infarct, increases the expression of cardiac anti-inflammatory markers, reduces apoptosis and oxidative stress. However, it does not increase CM proliferation.

Abstract Dental fluorosis (DF) is a prevalent developmental defect of tooth enamel caused by exposure to excessive fluoride, with the severity dependent on various factors. This study aimed to investigate the association between DF and a specific genetic polymorphism (rs412777) in the COL1A2 gene among a Tunisian population. A case-control study was conducted from July to November 2022, involving a total of 95 participants including 51 cases and 44 controls. Dental examinations and genetic analysis were performed to assess the relationship between the COL1A2 gene polymorphism and DF. The results of allelic distribution revealed that A allele carriers were significantly protected against (DF) when compared to those with the C allele (C vs. A, p = 0.001; OR = 0.375 (0.207–0.672)). This suggests a strong correlation between the presence of the C allele and the risk of developing DF. Additionally, significant association between the CC genotype of rs412777 and an increased risk of DF was found under both codominant and dominant genetic models (P = 0.002 and P

Introduction Lung cancer (LC) is the most common cause of cancer-related deaths worldwide. Its early detection can be achieved with a CT scan. Two large randomised trials proved the efficacy of low-dose CT (LDCT)-based lung cancer screening (LCS) in high-risk populations. The decrease in specific mortality is 20%–25%.Nonetheless, implementing LCS on a large scale faces obstacles due to the low number of thoracic radiologists and CT scans available for the eligible population and the high frequency of false-positive screening results and the long period of indeterminacy of nodules that can reach up to 24 months, which is a source of prolonged anxiety and multiple costly examinations with possible side effects.Deep learning, an artificial intelligence solution has shown promising results in retrospective trials detecting lung nodules and characterising them. However, until now no prospective studies have demonstrated their importance in a real-life setting.Methods and analysis This open-label randomised controlled study focuses on LCS for patients aged 50–80 years, who smoked more than 20 pack-years, whether active or quit smoking less than 15 years ago. Its objective is to determine whether assisting a multidisciplinary team (MDT) with a 3D convolutional network-based analysis of screening chest CT scans accelerates the definitive classification of nodules into malignant or benign. 2722 patients will be included with the aim to demonstrate a 3-month reduction in the delay between lung nodule detection and its definitive classification into benign or malignant.Ethics and dissemination The sponsor of this study is the University Hospital of Nice. The study was approved for France by the ethical committee CPP (Comités de Protection des Personnes) Sud-Ouest et outre-mer III (No. 2022-A01543-40) and the Agence Nationale du Medicament et des produits de Santé (Ministry of Health) in December 2023. The findings of the trial will be disseminated through peer-reviewed journals and national and international conference presentations.Trial registration number NCT05704920.

Antimicrobial residues in animal-derived foods have become a major source of concern around the world. Oxytetracycline (OTC), one of these antibiotics that belongs to the tetracycline family should be detected in these matrices. Nanostructured metal oxides have attracted a lot of scientific attention due to their special characteristics that can be exploited for creating innovative nanodevices. Therefore, in the present study, we report the fabrication of cobalt-doped ZnO/GO nanocomposites for OTC sensors using a simple and environmentally friendly method that does not require toxic solvents. Contact angle measurements, X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), X-ray photoelectron spectroscopy (XPS) and UV–Vis were used to confirm the successful fabrication of the Co–ZnO/GO nanocomposite and to determine the surface area, Structural, morphological features, chemical composition and purity of the nanocomposite. The electrochemical and electrocatalytic properties were recorded using cyclic voltammetry (CV), electrochemical impedance spectroscopy, and differential pulse voltammetry (DPV). Optimizing parameters such as scan rate, pH value, deposition time, and deposition potential, we achieve a wide linear concentration range from 10−12 M to 10−7 M, with an impressive detection limit of 1.6 10−13 M.Notably, our sensor exhibits remarkable selectivity, demonstrating its usefulness for the detection of oxytetracycline traces in real milk samples. These results emphasize the novelty and practical significance of our work and provide a promising avenue for the development of sensitive and selective electrochemical sensing platforms in various fields.

Valproic acid holds a prominent position as the primary therapeutic option for epilepsy cases. The utilization of antiepileptic agents like valproic acid has been linked to disturbances in sleep architecture. Although scant, there exists a subset of studies that allude to the potential manifestation of sleep apnea as an adverse effect of valproic acid administration. In this context, we present a case report of a 76-year-old man with a past medical history of arterial hypertension, atrial fibrillation, and obstructive sleep apnea syndrome treated with continuous positive airway pressure since 2020. Following the commencement of valproic acid treatment for vascular epilepsy, obstructive sleep apnea evolved toward to central sleep apnea. This case exemplifies the need for a heightened awareness of the multifaceted implications of valproic acid therapy on sleep patterns.

Low-grade fibromyxoid sarcoma (LGFMS) is a rare, low-grade malignant soft tissue tumor that is often mistaken for benign or more rarely malignant tumor types. Commonly, this tumor affects young adults and typically arises in the deep proximal extremities or trunk with frequent recurrences and can metastasize to the lungs many years late. Visceral LGFMS is extremely rare. Only a few cases of primary LGFMS of the lung have been reported. Here, we present the clinical, gross, microscopic, and immunohistochemical characteristics of Evans tumor occurring in the lung with a review of the literature and discuss the differential diagnosis in this exceptional localization.

Pneumocystis jirovecii pneumonia, typically an opportunistic infection, is commonly associated with risk factors such as low CD4+ lymphocyte count, underlying malignancies, organ transplantation, or immunosuppressive medications. However, occurrences in healthy individuals without known risk factors are exceptionally rare and sparsely documented. In our retrospective analysis of a 42-year-old male without past medical history at Abderrahmane Mami Hospital, Tunisia, Pneumocystis jirovecii pneumonia was diagnosed. The patient presented with fever, productive cough, hemoptysis, and a decline in general health. Clinical examination revealed fever and hypoxemia, and imaging studies demonstrated bilateral necrotic alveolar opacities. Despite empirical antibiotics, nonresponse necessitated bronchoscopy, confirming Pneumocystis jirovecii . Treatment with oral Sulfamethoxazole-Trimethoprim yielded excellent outcomes. This case highlights the potential occurrence of Pneumocystis jirovecii pneumonia in immunocompetent individuals, underscoring the importance of direct microbiological methods in assessing suggestive clinical and radiological features.

Abstract Background The COVID-19 pandemic has presented various challenges, one of which is the discovery that after the acute episode, around 30% of patients experience persistent symptoms or develop new ones, now known as long COVID. This new disease has significant social and financial impacts. The objective is to determine the prevalence of long COVID in the Tunisian population and identify its predictive factors. Methods This was a cross-sectional study conducted among Tunisians who were infected with COVID-19 between March 2020 and February 2022. An online self-administered questionnaire was distributed through social media, radio, and television channels over the course of one month (February 2022). Long COVID was defined as the persistence of existing symptoms or the development of new symptoms within three months after onset, lasting for at least two months, and with no differential diagnosis. We performed univariate and multivariate analyses using binary stepwise logistic regression with a significance level set at 5%. Results A total of 1911 patients participated in our study, and the prevalence of long COVID was 46.5%. The two most frequent categories were general and neurological post-COVID syndrome, with a prevalence of 36.7% each. The most commonly observed symptoms were fatigue (63.7%) and memory problems (49.1%). In the multivariate analysis, the predictive factors for long COVID were female gender and age of 60 years or older, while complete anti-COVID vaccination was found to be a protective factor. Conclusions Our study found that complete vaccination was a protective factor against long COVID, while female gender and age of 60 years or older were identified as the main risk factors. These findings are consistent with studies conducted on other ethnic groups. However, many aspects of long COVID remain unclear, including its underlying mechanisms, the identification of which could guide the development of potential effective treatments.

Background: Venous thromboembolism (VTE) is a common and potentially fatal complication in patients with lung cancer. This study aimed to develop and validate a risk score for early prediction of VTE in these patients. Methods: Four hundred and one patients with lung cancer from three pulmonology departments hospitalized between January 2011 and December 2021 were retrospectively assessed. The population was divided into two groups: a Development Group (182 patients) and a validation group (199 patients). In the development group, the risk score system was developed, via univariate and multivariate analyses, based on demographic and clinicopathological variables; it was then validated in the validation group. Results: The incidence of VTE was 26.8% in the development group. It was 25.8%, and 27.6% in the internal and external validation groups, respectively. Hemoglobin level Conclusions: This risk score requires prospective validation studies on a nationwide scale in order to use it as a valid tool for the prevention of VTE in lung cancer.

Pulmonary alveolar proteinosis (PAP) is an uncommon disease characterized by the excessive accumulation of lipoprotein material in the alveoli. No uniform treatment existed. However, whole lung lavage (WLL) remains the main treatment. We report the case of a 33-year-old non-smoking man, with no reported history of medical problems, who complained of dyspnea on exertion and cough for over 5 years. A CT scan revealed diffuse pulmonary interstitial infiltrates. Bronchoalveolar lavage was milky. WLL was planned, and the procedure was repeated 70 times and a total of 3,5 liters of saline serum was instilled and 2,8 liters of milky liquid was removed. The operation procedure was interrupted because of acute pulmonary edema. The patient was transferred to the intensive care unit for acute respiratory distress syndrome. He received 3 days of noninvasive ventilation and regression of supplemental oxygen. Faced with the seriousness of the complication it was decided not to perform a third wash and to monitor the patient functionally and radiologically. Currently, after one year of the lung wash the patient is stable functionally and radiologically. We presented a rare complication of a WLL in a patient with PAP. Physicians should evaluate the patient carefully before suggesting WLL, which is an invasive procedure requiring general anesthesia for a pathology that may evolve spontaneously favorably.

Objective: To examine the sociodemographic factors and determine the prevalence of overweight and obesity among students in their early adolescent years. Method: The cross-sectional study was conducted at four governmental intermediate schools located in Al-Nasiriya city of Thi-Qar Governorate in Iraq from January 2 to February 15, 2021, and comprised students of either gender aged 12-14 years. Data was gathered using a self-designed questionnaire. Body mass index was calculated after measuring the subjects’ weight in kilograms on a properly calibrated digital scale and their height in centimetres on an appropriate tape meter scale. Data was analysed using SPSS 23. Results: Of the 218 subjects, 124(56.88%) were girls and 94(43.12%) were boys. Overall, 100(45.87%) subjects were aged 13 years. There were 71(32.56%) overweight and 30(13.76%) obese subjects. Age and gender were significantly associated with body mass index (p

Pulmonary actinomycosis is a rare anaerobic infection with non specific clinical and radiographic presentations that delay diagnosis. Throughout literature, a significant number of misdiagnosed cases have been reported. The diagnosis is substantially based on histopathological pattern.We describe the cases of two patients evaluated and treated in pulmonary department 1 of Abderrahmane Mami hospital of Tunisia with a diagnosis of pulmonary actinomycosis. There are two men. The first patient had hypertension and chronic obstructive pulmonary disease and the second one underwent surgery for bronchiectasis. Clinical presentation was consistent with productive cough, hemoptysis, and deterioration of general status. The medical examination was non-specific. The chest X-ray revealed an apical opacity, excavated in the first case and retractable in the second one. Biology showed an inflammatory syndrome. Bronchoscopy was performed in the two cases and showed lesions mimicking lung malignancy. Diagnosis is confirmed by histopathological examinations of surgical specimens in the two cases. Both patients were received antibiotic therapy. The results were excellent with a favorable clinical course and no deaths.This study highlights the misleading patterns of actinomycosis to prompt accurate diagnosis and earlier treatment, thus improving the outcome. Given either its low culture yield or the limited use of new molecular diagnostic tools in routine clinical practice, histological examination of lung tissue specimens is crucial to get the correct diagnosis.

This study was conducted to assess the effectiveness of a health education program on mothers' knowledge and practices related to amebiasis. Pre‑ and post‑I and II‑tests were used, along with a two‑group quasi‑experimental design. The study included a convenience sample of 120 mothers, including 60 from the study and 60 from the control group. Out of the entire number of PHCs in Wasit Governorate, seven were used for the study. A three‑part structured questionnaire tests mothers' knowledge of the illness and attitudes about it. The results of this study indicated that there is statistically significant difference between the study and control groups during the post‑test I and post‑test II periods (t=14.968, P=.000 and t=13.731, P=.000, respectively). Data from the study group during the pre‑test period of 31.17(9.14) revealed that (70%) of mothers had bad practices connected to Entameba Histolytica among children. According to the post‑test I results, 47.4 (9.48) respondents, or 70%, identified good practices. The main finding showed that, after the educational program was implemented, mothers' knowledge and practice of amebiasis dramatically increased, with pre‑post implementation differences that are statistically significant.

Abstract Drug‐induced tubulointerstitial nephritis is an uncommon complication in patients on anti‐tuberculosis therapy that can lead to permanent kidney damage. Rifampicin is the most offending drug. We report a case of a 41‐years old man being treated for pulmonary tuberculosis and presenting with tubulointerstitial nephritis associated with rifampicin. We focus on diagnosis features and therapeutic challenges.

Pulmonary granular cells tumors (CGT) are rare tumors, that derive from Schwann cells. In the tracheobronchial and pulmonary tree, they remain a diagnostic challenge. There are no well-established criteria to differentiate between benign, atypical, and malignant GCT. Moreover, its real frequency in the respiratory tract is still unknown. Here, we represent 2 cases of bronchial and lung GCTs. We aim to highlight the frequency of all clinicopathological characteristics of this rare tumor in the tracheobronchial and pulmonary tree location based on our cases and the available literature in a large systematic review.

As the descendants of stars with masses less than 8 M _⊙ on the main sequence, white dwarfs provide a unique way to constrain planetary occurrence around intermediate-mass stars (spectral types BAF) that are otherwise difficult to measure with radial-velocity or transit surveys. We update the analysis of more than 250 ultraviolet spectra of hot (13,000 K < T _eff < 30,000 K), young (less than 800 Myr) white dwarfs collected by the Hubble Space Telescope, which reveals that more than 40% of all white dwarfs show photospheric silicon and sometimes carbon, signposts for the presence of remnant planetary systems. However, the fraction of white dwarfs with metals significantly decreases for massive white dwarfs ( M _WD > 0.8 M _⊙ ), descendants of stars with masses greater than 3.5 M _⊙ on the main sequence, as just ${11}_{-4}^{+6}$ % exhibit metal pollution. In contrast, 44% ± 6% of a subset of white dwarfs ( M _WD < 0.7 M _⊙ ) unbiased by the effects of radiative levitation are actively accreting planetary debris. While the population of massive white dwarfs is expected to be influenced by the outcome of binary evolution, we do not find merger remnants to broadly affect our sample. We connect our measured occurrence rates of metal pollution on massive white dwarfs to empirical constraints of planetary formation and survival around stars with masses greater than 3.5 M _⊙ on the main sequence.