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Biological maturity status significantly influences success in handball, impacting an athlete’s performance and overall development. This study aimed to examine the anthropometric and physical performance variables concerning age and maturity status, establishing reference values for physical performance among Tunisian players. A total of 560 handball players (309 males and 251 females aged 13–19 years) were categorized based on maturity status: early (n = 98), average (n = 262), and late (n = 200), determined through Mirwald and colleagues’ equations. Anthropometric, physical fitness, and physiological data were collected for reference value creation. Our findings revealed significantly higher anthropometric parameters (p = 0.003) in late-maturing athletes compared to their early-maturing counterparts. Post-pubertal athletes showed significantly superior (p = 0.002) jumping ability, change of direction, and aerobic performance compared to their pre-pubertal peers. Additionally, male athletes outperformed females in both fitness (p = 0.001) and aerobic (p = 0.001) performance. A notable age-by-maturity interaction emerged for most performance outcomes (η2 ranging from 0.011 to 0.084), highlighting increased sex-specific differences as athletes progressed in age. Percentile values are provided for males and females, offering valuable insights for coaches and sports scientists to design personalized training programs. Understanding a player’s performance relative to these percentiles allows trainers to tailor workouts, addressing specific strengths and weaknesses for enhanced development and competitiveness.

Abstract The study investigated the antifungal and phytochemical properties of three forest plants (Eucalyptus globulus, Pistacia lentiscus, and Juniperus phoenicea) against apple diseases caused by Colletotrichum gloeosporioides and Alternaria alternata. The determination of the total polyphenol and flavonoid contents in the three aqueous extracts of studied plants showed that E. globulus exhibited the highest contents than those of P. lentiscus and J. phoenicea. Furthermore, the three studied extracts showed very appreciable antioxidant activity with decreasing order: E. globulus, P. lentiscus, and J. phoenicea. The phytochemical analysis showed different common phenolic acids in the three studied plants namely: quinic acid, gallic acid, chlorogenic acid, and caffeoylquinic acid as well as other flavonoids mainly quercetin and catechin. The results of the current study demonstrated that the fungistatic activity of E. globulus EO (4 and 2 µl/ml) seemed to be the most effective under laboratory conditions with an inhibition zone diameter above 16 mm. However, the poisoned food technique indicated that the aqueous extract (80%) and the essential oil (4 µl/ml) of E. globulus exhibited the highest mycelial growth (> 67%) and spore germination (> 99%) inhibition. Preventive treatments with essential oils (4 µl/ml) and aqueous extracts (80%) applied to apple fruits inoculated with A. alternata and C. gloeosporioides resulted in the lowest lesion diameter ( 85.45%) and protective potentials (> 84.92%). The results suggest that E. globulus has a brilliant future in the management of anthracnose and Alternaria rot of apple and provide a basis for further studies on its effects under field conditions.

This study aims to evaluate the effect of diclofenac addition to the preservation solution Celsior on liver graft preservation. Liver from Wistar rats were cold flushed in situ, harvested, and then stored in Celsior solution (24 h, 4[degrees]C) supplemented or not with 50 mg/L of diclofenac sodium salt. Reperfusion was performed (120 min, 37[degrees]C) using the isolated perfusion rat liver model. Perfusate samples were collected to evaluate transaminases' activities after cold storage and by the end of reperfusion. To evaluate liver function, bile flow, hepatic clearance of bromosulfophthalein, and vascular resistance were assessed. Diclofenac scavenging property (DPPH assay) as well as oxidative stress parameters (SOD and MPO activities and the concentration of glutathione, conjugated dienes, MDA, and carbonylated proteins) were measured. Transcription factors (PPAR-[gamma] and NF-kB), inflammation (COX-2, IL-6, HMGB- 1, and TLR-4), as well as apoptosis markers (Bcl-2 and Bax) were determined by quantitative RT-PCR. Enriching the preservation solution Celsior with diclofenac sodium salt attenuated liver injuries and improved graft function. Oxidative stress, inflammation, and apoptosis were significantly reduced in Celsior + Diclo solution. Also, diclofenac activated PPAR-[gamma] and inhibited NF-kB transcription factors. To decrease graft damage and improve transplant recovery, diclofenac sodium salt may be a promising additive to preservation solution. Key words: diclofenac, organ preservation solution, cold ischemia/reperfusion injury, inflammation, 1. Introduction Organ preservation is a crucial feature for a successful transplantation procedure (Petrenko et al. 2019). To ensure optimal graft preservation, two requirements are needed: hypothermia and a preservation [...]

INTRODUCTION: Disorders of sexual development (DSD) are a heterogeneous group of genital defects affecting chromosomal, gonadal and anatomical sex. 46,XY DSD is a subset of DSD which covers a wide range of phenotypes in which 46,XY gonadal dysgenesis (GD) is the most severe form. In this study, we report on the clinical and molecular cytogenetic findings of a study on a Tunisian girl with the syndromic form of 46,XY DSD. METHODS: This case was a phenotypic female patient having several congenital anomalies including growth retardation. Karyotype, fluorescence in situ hybridization and array Comparative Genome Hybridization (array CGH) were performed. RESULTS: The proband exhibited a de-novo 46,X,der(Y) karyotype. Array CGH revealed a pathogenic 27.5Mb gain of an Xp21.2 chromosome segment leading to Xp functional disomy. No deletion was observed in the Y-chromosome. The duplicated region encompassed the NR0B1 (DAX1) and MAGEB genes, located within the dosage sensitive sex (DSS) reversal locus, known as promote genes responsible for human sex reversal and testis repression. The extra-dosage and interactions of these genes with different specific genes could result in the impairment of the male sex pathway. Over-dosage of KAL1 and IL1RAPL1 genes fall within the somatic features observed in the patient. DISCUSSION AND CONCLUSION: To the best of our knowledge, we report on the fourth case of Xp21.2-pter duplication within Xp;Yp translocation associated with XY GD. Our findings suggest that when duplicated, the NR0B1 and MAGEB genes could be a major cause of XY GD. Therefore, we emphasize the usefulness of a combined cytogenetic approach in order to provide an accurate genetic diagnosis for those patients having syndromic XY DSD in a clinical setting.

Background: Pulmonary alveolar proteinosis is a very rare diffuse lung disease characterized by the accumulation of amorphous and periodic acid Schiff-positive lipoproteinaceous material in the alveolar spaces due to impaired surfactant clearance by alveolar macrophages. Three main types were identified: Autoimmune, secondary and congenital. Pulmonary alveolar proteinosis has been previously reported to be associated with several systemic auto-immune diseases. Accordingly, we present the first case report of pulmonary alveolar proteinosis associated with myasthenia gravis. Case: A 27-year-old female patient, ex-smoker, developed a dyspnea on exertion in 2020. The chest X-ray detected diffuse symmetric alveolar opacities. Pulmonary infection was ruled out, particularly COVID-19 infection. The chest scan revealed the “crazy paving” pattern. The bronchoalveolar lavage showed a rosy liquid with granular acellular eosinophilic material Periodic acid-Schiff positive. According to the lung biopsy results, she was diagnosed with pulmonary alveolar proteinosis. The granulocyte macrophage colony-stimulating factor autoantibodies were negative. Nine months later, she was diagnosed with bulbar seronegative myasthenia gravis, confirmed with the electroneuromyography with repetitive nerve stimulation showing significant amplitude decrement of the trapezius and spinal muscles. She was treated with pyridostigmine, oral corticosteroids and azathioprine. Given the worsening respiratory condition of the patient, a bilateral whole lung lavage was performed with a partial resolution of symptoms. Thus, this previously unreported association was treated successfully with rituximab, including improvement of dyspnea, diplopia and muscle fatigability at six months of follow-up. Conclusions: This case emphasizes on the possible association of auto-immune disease to PAP, which could worsen the disease course, as the specific treatment does not exist yet. Hence, further studies are needed to establish clear-cut guidelines for PAP management, particularly when associated to auto-immune diseases.

Background: Pulmonary alveolar proteinosis (PAP) is a very rare diffuse lung disease characterized by the accumulation of amorphous and periodic acid Schiff-positive lipoproteinaceous material in the alveolar spaces due to impaired surfactant clearance by alveolar macrophages. Three main types were identified: Autoimmune, secondary and congenital. PAP has been previously reported to be associated with several systemic auto-immune diseases. Accordingly, we present the first case report of PAP associated with myasthenia gravis. Case: A 27-year-old female patient, ex-smoker, developed a dyspnea on exertion in 2020. The chest X-ray detected diffuse symmetric alveolar opacities. Pulmonary infection was ruled out, particularly Coronavirus disease 2019. The chest scan revealed the “crazy paving” pattern. The bronchoalveolar lavage showed a rosy liquid with granular acellular eosinophilic material Periodic acid-Schiff positive. According to the lung biopsy results, she was diagnosed with PAP. The granulocyte macrophage colony-stimulating factor autoantibodies were negative. Nine months later, she was diagnosed with bulbar seronegative myasthenia gravis, confirmed with the electroneuromyography with repetitive nerve stimulation showing significant amplitude decrement of the trapezius and spinal muscles. She was treated with pyridostigmine, oral corticosteroids and azathioprine. Given the worsening respiratory condition of the patient, a bilateral whole lung lavage was performed with a partial resolution of symptoms. Thus, this previously unreported association was treated successfully with rituximab, including improvement of dyspnea, diplopia and muscle fatigability at six months of follow-up. Conclusions: This case emphasizes on the possible association of auto-immune disease to PAP, which could worsen the disease course, as the specific treatment does not exist yet. Hence, further studies are needed to establish clear-cut guidelines for PAP management, particularly when associated to auto-immune diseases.

The Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) syndrome can be potentially life-threatening. The diagnosis is sometimes difficult since the clinical manifestations may be incomplete or non-specific. Insulinoma is a rare functioning neuroendocrine tumor (NET) of the pancreas. Medical therapy may be needed when surgery is contraindicated, delayed or refused. Diazoxide is widely used to control hypoglycemia in patients with insulinoma. We report a clinical case of an insulinoma in a 85-year-old patient treated with diazoxide with a fatal outcome due to a delayed diagnosis of a DRESS syndrome. This is the first case of DRESS syndrome reported after using diazoxide for insulinoma treatment in our knowledge.

Purpose To identify plasma alterations in lipid species in patients with chronic obstructive pulmonary disease (COPD), as well as, relationships with smoking status, oxidative and inflammatory markers. Methods Plasma was obtained from 100 patients with COPD and 120 healthy controls. Pulmonary function was assessed by plethysmography. Serum levels of IL-6 and TNF-[alpha] were determined by ELISA. Oxidative stress parameters were measured using standard methods. Lipids were extracted then analyzed by Matrix-Assisted Laser Desorption and Ionization Time-Of-Flight Mass Spectrometry (MALDI-TOF-TOF-MS). Results More than 40 lipid compounds were identified within plasma samples. Among these 19 lipid species including plasmalogens (PC O-), phosphatidylcholines (PC), and triglycerides (TG) were significantly altered in COPD. A decreased expression of PC O- (36:1, 36:2, 36:3, 36:4, 38:4, 38:5) species was found in patients with different severities compared to healthy controls. There was also a decrease in PC (34:3, 36:0, 36:4, 36:5, 40:6, 40:7) species in COPD patients. PC (34:3) levels were positively correlated with disease progression and pulmonary function decline (forced expiratory volume in 1 s (FEV.sub.1)) (r = 0.84, p < 0.001) and inversely correlated with thiobarbituric acid-reactive substances (TBARS) (r = - 0.77, p < 0.001). TG (50:0, 50:1, 52:1, 52:2, 52:3, 52:4, 54:4) species were altered in COPD patients and in those with advanced disease stages. Significant correlations between FEV.sub.1, TBARS, peroxynitrite, and TG (52:3) were found among COPD patients (r = - 0.69; r = 0.86; r = 0.77, p < 0.001, respectively). Conclusion PC (34:3) and TG (52:3) could be potential lipid signatures of COPD that correlate with altered pulmonary function and oxidative status., Author(s): Amel Ben Anes [sup.1], Hela Ben Nasr [sup.1] [sup.2], Zouhair Tabka [sup.1], Oussama Tabka [sup.1], Monia Zaouali [sup.1], Karim Chahed [sup.1] [sup.3] Author Affiliations: (1) grid.7900.e, 0000 0001 2114 [...]

Abstract Background Reduced forced vital capacity (FVC) is a risk factor of all-cause mortality; however, the prevalence and determinants of reduced FVC are not available for the Tunisian population. This study investigated the association of reduced FVC with risk factors and health variables in an urban population of subjects aged ≥ 40 years and living in the city of Sousse in Tunisia. Methods A cross-sectional survey was performed using data from the Tunisian Burden of Obstructive Lung Disease (BOLD) study. We defined reduced FVC as a post-bronchodilator FVC below the lower limit of normal using National Health and Nutrition Examination Survey (NHANES) values and Global Lung Function Initiative 2012 equations (GLI 2012) and determined the relation between this finding and the potential risk factors (demographic and socioeconomic factors and the presence of chronic diseases), using multivariable regression analysis. Results The prevalence of reduced FVC was 26.6% (176/661) when using NHANES values for white Americans and 14.2% (94/661) using the GLI 2012 equations. Compared to people with normal FVC, those with a reduced FVC were significantly older, taller, had a lower body mass index (BMI), more respiratory symptoms and a higher prevalence of heart disease and hypertension. Multivariable analysis showed that reduced FVC was essentially driven by exposure to biomass smoke for heating, a number of schooling years lower than or equal to 6 years, a childhood history of hunger for a lack of money, aging and height. Conclusions The prevalence of reduced FVC is associated with a poor socioeconomic status aging and height.

Introduction Insulin is the basic medical therapy to manage type 1 diabetes and is also a cornerstone of treatment of type 2 diabetes as insulinopenia belongs to its natural history. However, insulintherapy is associated with many challenges especially psychological difficulties such as patient’s acceptance and compliance, which may lead to metabolic and psychological disorders. Objectives The aim of our study was to determine the association between insulintherapy and depression. Methods A cross sectional analytic study was conducted from October 2019 to October 2020 among a group of diabetic patients followed in the Endocrinology Department of Taher Sfar University Hospital in Mahdia, Tunisia. “DSM-V diagnosis criteria for depression screening” and “Hamilton score scale” were used to evaluate the severity of depression. Results A total of 260 patients were recruited in our study. The mean age was of 57.36±15.4 years with extremities ranging from 20 to 91 years. The sex ratio M/F was situated at 0.59. The mean diabetes duration was of 10.92 years. The majority of patients had type 2 diabetes (92.3%). The micro vascular long-term complications of diabetes were the most frequent (67.7%): neuropathy (39%), retinopathy (37%) and nephropathy (24%). According to the “DSM-V diagnosis criteria”, 15% of the study population suffered from a Major Depressive disorder (MDD). Hamilton score scale showed that thirty-eight patients had severe depression symptoms (14.6%). Insulintherapy was associated with MDD and depression severity (19.1% vs 10.1% ; p=0,041 and 20% vs 8.4% ; p

Introduction Schizoaffective Disorder is frequently associated with somatic and addictive comorbidities. This association can change the expression of the disease as well as its prognosis. In addition, this association can affect many functional and psychosocial aspects that can lead to impaired quality of life (QOL) and overall functioning of patients. Objectives the aims of this work were to study the impact of somatic and addictive comorbidities on QOL and global functioning of patients followed for schizoaffective disorder. Methods This is a cross-sectional study carried out at the psychiatric consultation of the University Hospital of Mahdia for a period of 6 months. The evaluation of the QOL was made using a generic instrument for measuring quality of life: the SF-36 in its version in literary Arabic using the Global Evaluation of Functioning scale . Results fifty-two patients with schizoaffective disorder were included in the study. The age of the patients varied from 29 to 62 years with an average of 38 years. The sex ratio (M/F) was 1.6. Singles accounted for 46.2%. Somatic comorbidities were found in 30.8% of patients. Diabetes ranked first (13.5%) followed by arterial hypertension (9.6%) then epilepsy (3.8%). Addictive comorbidities were noted in 63.5% of patients. Tobacco, alcohol and Cannabis were the most consumed substances with respective rates of 57.7; 28.8 and 13.5%. The evaluation of the QoL of the patients revealed that 80.8% of the patients had scores attesting to an altered QoL. Regarding the evaluation of global functioning by EGF, (65.4%) of patients had a score of less than 70 attesting to an impairment of global functioning. The analytical study of correlation between the dimensions of the SF-36 and somatic comorbidities found that dimension D1 (physical activity) is significantly influenced by somatic comorbidities (10-4). The deterioration in the global functioning of the patients was not correlated with the presence of somatic comorbidities (p=0.28). The change in QoL was not correlated with the consumption of psychoactive substances (0.32 for alcohol and p=0.23 for drug addiction). Conclusions It is accepted that the objectives of the management of patients suffering from schizoaffective disorder go beyond the remission of clinical symptoms to the improvement of QoL and socio-professional functioning. Larger-scale work is needed to study the influence of comorbidities associated with schizoaffective disorder on these dimensions. Disclosure of Interest None Declared

Introduction Neoplastic disease affects all aspects of life. People with cancer may experience a variety of emotions and reactions to their new reality that may be mild or intense, transitory or permanent. Objectives The aim of our study was to assess the psychological distress of patients with breast cancer. Methods Cross-sectional descriptive study including patients followed for breast cancer at the outpatient medical oncology consultation of Hadj Ali Soua regional hospital from January to March 2021. We used the “Hospital Anxiety and Depression Scale (HAD-S)” for the assessment of anxiety and depression. Results Fifteen patients were included with a mean age of 49.87 ± 8.48 years and a mean age at diagnosis of 46.73 ± 7.55 years. At the TNM classification, 66.6% of the patients had a T1 or T2 at the time of diagnosis and 80% had an N0. All patients received a surgical intervention which was conservative in 53.3% of cases. No patient underwent breast reconstruction. Chemotherapy and hormone therapy were prescribed in 86.7% of patients. The mean anxiety and depression scores according to the HAD-S were 9.53 and 4.93, respectively. The majority of our patients had no depressive symptoms (80%) against only 2 patients (13.33%) with depressive symptoms. On the other hand, most of our patients were anxious: 6 patients (40%) showed probably clinically relevant levels of anxiety (score of 11 or higher) and 5 patients showed possibly clinically relevant levels of anxiety (scores of 8 or higher) (33,33%). Conclusions Our study revealed a high prevalence of psychological distress. The presence of clinical psychologists in the medical oncology department and the training of nursing staff in psycho-oncology are essential for the overall care of patients with cancer. Disclosure of Interest None Declared

Introduction Long COVID is a condition characterized by long-term health problems persisting or appearing after the typical recovery period of COVID-19. Physical symptoms such as respiratory, neurological and musculoskeletal complaints were initially described in the foreground. A little after, psychological disorders have been widely reported. Objectives The aim of this study was to screen for somatic and anxio-depressive disorders of Long COVID. Methods A cross sectional descriptive study included the patients consulting within a minimum of 1 month after a COVID-19 infection. It was conducted at Taher Sfar university hospital of Mahdia over a period of one year from March 2020 to March 2021. A questionnaire and physical examination were used to look for physical symptoms and the Hospital Anxiety and Depression scale (HAD) was used to screen for anxio-depressive disorders. Results We recruited 137 patients. The median age was of 60 years with a sex ratio M/F at 0.073. Obesity was the most frequent comorbidity (36%) followed by diabetes (35%) and hypertension (32%). More than a quarter of patients was hospitalized (30%) during the acute phase, while the others (70%) were confined at home. The median stay duration at home or hospital was of 10 days with extremes ranging from 0 to 21 days. The most frequent post-COVID symptoms were dyspnea, mood disorders, myalgia, arthralgia, dry cough, sleep disorders and anorexia in 45%, 30%, 30%, 20%, 16%, 15% and 14% of cases, respectively. Pulmonary auscultation was normal in 86% of our patients, for the others we noted crackles, ronchi and wheezing among 9%, 1% and 1% of patients. The median oxygen saturation was 97% with a range from 93 to 99%. The majority of our patients (120) had saturation more than 95% in ambient air. The median HAD score was situated at 19 [8, 33]. Anxio-depressive disorders were present 61% of cases. A severe depression was noted among 24% of patients. and a severe anxiety among 28% of them. Conclusions Our study highlighted a high prevalence of anxio-depressive disorders (62%) which exeeds the prevalence described in the literature. The systematic use of the HAD scale among consultants could be the explanation. Thus, psychological screening and support should be considered when managing patients having a history of COVID-19 infection. Citizens should comply with the relevant legal provisions making vaccination compulsory as it was found that COVID-19 vaccination reduced long COVID risk. Disclosure of Interest None Declared

Introduction Breast cancer is the most frequently encountered malignant tumor among women in Tunisia and in the world. The quality of sexual life of patients with breast cancer is impaired by multifactorial mechanisms. Objectives The aim of our study was to determine the factors associated with sexual disorders in patients followed for breast cancer. Methods Cross-sectional analytic study including patients followed for breast cancer at the outpatient medical oncology consultation of Hadj Ali Soua regional hospital from January to March 2021. We collected sociodemographic and clinical data with an assessment of sexuality (FSFI), marital satisfaction (MAT), psychological profile (HAD) and quality of life (SF36). Results Fifteen patients were included with a mean age of 49.87 ± 8.48 years and a mean age at diagnosis of 46.73 ± 7.55 years. At the TNM classification, 66.6% of the patients had a T1 or T2 at the time of diagnosis and 80% had an N0. All patients received a surgical intervention, which was conservative in 53.3% of cases. No patient underwent breast reconstruction. Chemotherapy and hormone therapy were prescribed in 86.7% of patients. The mean score of the FSFI questionnaire in our study was 17.25. Eleven patients (73.3%) had an FSFI score below 26.55. We found negative correlations between age and FSFI score (r=-0.622; p=0.013). We noted statistically significant negative correlations between FSFI and HAD-D (r=-0.606; p=0.017) and FSFI and HAD-a (r=-0.707; p=0.01) as well as significant correlations between FSFI and the following items: RE (r=0.84p=0.000), SF (r=0.684 p=0.005), GH (r=0.671 p=0.006) and MCS (r=0.788 p=0.000). Conclusions Focusing on a small sample of patients followed for breast cancer, our study provides an assessment of the sexual function in its various areas and shows how sexuality is deeply intertwined with other sections of medical management. Disclosure of Interest None Declared

Introduction Menopause is a special period for women which can have both physical and psychological consequences. Objectives The aim of our study was to assess the impact of menopause on women’s quality of life. Methods A cross-sectional descriptive study conducted on menopausal women consulting at the basic health center in réjiche over a period from 12 september to 12 october 2022. The impact of menopause on the mental health of women was assessed by the menopause rating scale (MRS). Results A total of 83 women were incluted in our study. The mean age was 61.89±11.03 years. The median age of menopause was 45 years (50-43). The majority of women (90.4%) were married and five women (6%) lived alone. Twenty-six women were professionally active and more than half were sedentary (54.2%). The comorbidities were dominated by arterial hypertension (50.6%). The mean BMI was 30.6±4.75 Kg/m². All the women had a variable psychological impact (from minor to very strong). The median score of the psychological scale was 10 (13-7): median scores for depressed mood, anxiety and physical and intellectual fatigue equal to 3 (4-1), each and median score for irritability equal to 2 (4-1). Physical and mental fatigue was the most common psychological symptom in 88% of cases followed by irritability in 86.7% of patients. Depressive and anxious symptoms were noted in 85.5% and 84.3% of cases, respectively. Psychological impact was severe in 33.7% of patients (strong or very strong symptoms). Conclusions Focusing on a small sample of menopausal patients, our study revealed a high prevalence of psychological distress during menopause which requires early adequate assessment and treatment. Disclosure of Interest None Declared

Introduction Schizophrenia, a chronic and complex psychiatric pathology, can be isolated. However, it can be associated with other comorbidities and thus be accompanied by addictive behaviors that complicate their management. Objectives The objectives of our study were to estimate the prevalence and identify the characteristics of addictive behaviors in patients with schizophrenia. Methods A retrospective study of 151 patients with schizophrenia hospitalized in the psychiatry department of Taher Sfar University Hospital in Mahdia from January 2017 to December 2021. Results The mean age of the patients was 39.8 ± 11.23 years, with a predominance of the 36-45 age group (38.4%). All patients were male. Three quarters of the patients (75.5%) were users of psychoactive substances (PAS): nearly three quarters (72.8%) were addicted to tobacco, more than one third (39.7%) were addicted to alcohol, more than one quarter (29.1%) were addicted to cannabis and nearly one quarter (26.5%) were addicted to other PAS. In more than half of the cases (54.4%), the age of onset of substance use was between 16 and 25 years. The use of PAS preceded the onset of schizophrenia in 62.3% of cases. The relationship with the entourage was marked by hetero-aggressiveness in 77.5% of patients, withdrawal from the entourage in 16.6% of patients and conflict in 5.3% of patients. The impact on the relationship with oneself was marked by self-aggressiveness in 18.5% of patients. Concerning the professional impact, three quarters of the patients (76.1%) had to stop working. The majority of patients (84.1%) continued their usual treatment, while 15.2% of patients stopped it. Only one patient required an increase in dose. Conclusions Subjects suffering from schizophrenia are particularly vulnerable to addictions, mainly to tobacco and alcohol. They are thus a group more at risk of the deleterious effects of psychoactive substances and of the aggravation of the clinical and psychosocial evolution of their psychiatric disorders. Measures for early detection and treatment of their addictive behaviors even before the onset of schizophrenia should be proposed. Disclosure of Interest None Declared

Introduction The assessment of quality of life is an essential complement to medical care. Some studies have shown that young women are more vulnerable to the disease impact and have a greater worsening of their quality of life. Objectives The aim of our study was to assess the quality of life of patients with breast cancer. Methods Cross-sectional descriptive study including patients followed for breast cancer at the outpatient medical oncology consultation of Hadj Ali Soua regional hospital from January to March 2021. We applied the 36-Item Short Form Survey SF-36. Results Fifteen patients were included with a mean age of 49.87 ± 8.48 years and a mean age at diagnosis of 46.73 ± 7.55 years. At the TNM classification, 66.6% of the patients had a T1 or T2 at the time of diagnosis and 80% had an N0. All patients received a surgical intervention, which was conservative in 53.3% of cases. No patient underwent breast reconstruction. Chemotherapy and hormone therapy were prescribed in 86.7% of patients. There was unequal impairment of different areas of the SF-36 questionnaire. The physical component was the most affected with a mean physical score (PCS) of 62.64; the RP score (limitations due to physical condition) was the lowest with a mean of 45 and the score of the item “Life and relations with others” was the best with a mean of 77.5. Conclusions The quality of life in relation to breast cancer in our population was at the medium rating, with moderately high scores. Sustainable improvement of the quality of life of women with breast cancer is a priority issue among the treatment objectives. Further studies are needed to assess the impact on the spouse, which is inseparable from the couple. Disclosure of Interest None Declared

Introduction The association of an addictive disorder (harmful use, abuse or dependence) with a schizophrenic disorder is the rule. Genetic vulnerability and social and economic factors are common to both disorders. Objectives determine the impact of addictive behavior on patients suffering from schizophrenia. Methods A descriptive and analytical retrospective study of 150 patients with schizophrenia hospitalized in the psychiatry department of Taher Sfar University Hospital in Mahdia from January 2017 to December 2021. Results The average age of the patients was 39.8 ± 11.23 years with a predominance of the age group 36-45 years (38.4%). All of the patients were male. Three quarters of the patients (75.5%) were consumers of psychoactive substances (PSA): nearly three quarters (72.8%) were dependent on tobacco, more than a third (39.7%) were dependent on alcohol, more than a quarter (29.1%) dependent on cannabis and almost a quarter (26.5%) dependent on other SPAs. Criminal history, suicide attempts and hospitalization in psychiatry were significantly more frequent in patients who consumed SPA than those who did not consume (39.5% vs 8.1%; p=0.008, 17.5% vs 2.7%; p=0.02, 89.5 % vs 75.7%; p=0.03, respectively). Patients who consumed SPA had significantly more positive signs of schizophrenia (51.8% vs 10.8%; p=0.001) and were significantly less observant to treatment (55.3% vs 16.3%; p=0.001) than those who did not consume. Hetero-aggressiveness, self-aggressiveness and job change were significantly more frequent in patients with addictive behaviors than those without addiction (86.8% vs 48.7%; p=0.001, 23.7% vs 2.7%; p= 0.004, 14.9% vs 0%; p=0.015, respectively). Multivariate analysis revealed that criminal history, hetero-aggressiveness, predominant positive symptomatology and work stoppage were the factors independently associated with SPA consumption in patients with schizophrenia in our study (β=14.7 95% CI 3.23–67.01, p=0.001, β=0.099, 95% CI 0.03–0.31, p=0.001, β=7.18, 95% CI 2.09–24.67, p=0.002, β=5.24 95% CI 1.27–21.7; p=0.02, respectively). Conclusions According to our study, addictive comorbidities concern three quarters of our patients. They expose them to a higher risk of legal problems, hetero-aggressiveness, predominance of positive signs and instability at work. These results encourage the development of methods for early diagnostic identification of addictive behavior comorbid with schizophrenia as well as integrated care combining psychiatric and addictological care. Disclosure of Interest None Declared

Introduction Various psychiatric disorders were reported during the long COVID. The most frequently cited by physicians included the insomnia, the anxio-depressive disorders and the post-traumatic stress disorder. These symptoms would have a negative impact on the quality of life as well as on the socio-professional and economic efficiency. Objectives The aim of this study was to determine the associated factors to anxio-depressive disorders during long COVID. Methods A cross sectional analytic study was conducted at Taher Sfar university hospital of Mahdia over a period of one year (from March 2020 to March 2021). It included patients consulting within at least 1 month after a COVID-19 documented infection. We used the Hospital Anxiety and Depression scale (HAD) to screen for anxio-depressive disorders. Results We recruited 137 patients in the study. The median age was situated at 60 years, ranging from 17 to 82 years. The sex ratio M/F was 0.073. The median HAD score was 19 [8, 33]. Anxio-depressive disorders were present in 61% of cases. There was no statistically significant association between anxio-depressive disorders and post COVID symptoms except arthralgia and myalgia (38.6% vs 13.5; p=0,006 and 26.8% vs 5.4%; p=0.007, respectively). After the multivariate analysis, only arthralgia during long COVID was associated with the anxio-depressive disorders (95% CI 1.489 to 30.25, p=0.01). Conclusions Arthralgia is a frequent symptom sometimes underestimated and in others overtreated. As it seems to be significantly associated with anxio-depressive disorders in the post covid period, physicians should pay attention to the history of a viral documented or probable infection and to psychiatric symptoms’ screening. Our results should however be confirmed by multicenter studies with larger sample size. Disclosure of Interest None Declared

Introduction Breast cancer is the leading cancer in women in developed and developing countries. Treatment strategies can affect sexuality in the short or long term. Objectives The aim of our study was to assess sexuality and martial satisfaction in patients followed for breast cancer. Methods Cross-sectional descriptive study including patients followed for breast cancer at the outpatient medical oncology consultation of Hadj Ali Soua regional hospital from January to March 2021. We passed the Female Sexual Function Index (FSFI) and the martial adjustment test (MAT). Results Fifteen patients were included with a mean age of 49.87 ± 8.48 years and a mean age at diagnosis of 46.73 ± 7.55 years. At the TNM classification, 66.6% of the patients had a T1 or T2 at the time of diagnosis and 80% had an N0. All patients received a surgical intervention, which was conservative in 53.3% of cases. No patient underwent breast reconstruction. Chemotherapy and hormone therapy were prescribed in 86.7% of patients. Radiotherapy and targeted therapy were prescribed in 12 and 2 case, respectively. Amenorrhea, hot flushes and vaginal dryness were noted in 98.7%, 26.7% and 7.6% of patients, respectively. Sexual disorders were found in 53.3% of cases, which settled in a chronic mode in 75% of cases and progressed in a continuous mode in half of cases. The assessment of physical and erotic life was revealed to be neat in 73.3% of the patients. The mean score of the FSFI questionnaire was 17.25 [2.6-31.9]. Eleven patients (73.3%) had sexual dysfunction. A low marital satisfaction was found in 34% of cases. Conclusions The medical consultation to identify sexuality disorders in correlation with the martial dissatisfaction in women followed for new breast cancer is crucial allowing a better management of this pathology. Disclosure of Interest None Declared

Introduction: Both exercise and pre-meal metformin could lower postprandial glucose and lipid profiles. Aims: To explore whether pre-meal metformin administration is superior to metformin administration with the meal in reducing postprandial lipid and glucose metabolism, and whether its combination with exercise confer superior benefits in metabolic syndrome patients. Materials and Methods: In a randomized crossover design, 15 metabolic syndrome patients were assigned to 6 sequences including 3 experimental conditions: metformin administration with a test meal (met-meal), metformin administration 30 min prior to a test meal (pre-meal-met) with or without an exercise bout designed to expend 700 Kcal at 60% VO 2 peak performed the evening just before pre-meal-met condition. Only 13 participants (3 males, 10 females; age: 46 ± 9.86, HbA1c: 6.23 ± 0.36) were included in the final analysis. Results: Postprandial triglyceridemia was unaffected by any condition (all P > .05). However, both pre-meal-met (−7.1%, P = .009) and pre-meal-metx (−8.2%, P = .013) significantly reduced total cholesterol AUC with no significant differences between the two latter condition ( P = .616). Similarly, LDL-cholesterol levels were significantly lower during both pre-meal-met (−10.1%, P = .013) and pre-meal-metx (−10.7%, P = .021) compared to met-meal with no difference between latter conditions ( P = .822). Plasma glucose AUC was significantly reduced by pre-meal-metx compared to both pre-meal-met (−7.5%, P = .045) and met-meal (−8%, P = .03). Insulin AUC was significantly lower during pre-meal-metx compared to met-meal (−36.4%, P = .044). Conclusions: Metformin administration 30 minutes prior to meal seems to exert favorable effects on postprandial TC and LDL-Cholesterol levels compared to its administration with meal. Addition of one exercise bout only improved postprandial glycemia and insulinemia. Trial registry: Pan African clinical trial registry, Identifier PACTR202203690920424.