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32 results on '"Mouelhi L"'

1. Prevalence and risk factors for vitamin D deficiency in Crohn disease patients: A Tunisian study.

Author

Ayadi S, Ayari M, Bahlous A, Zaimi Y, Bel Hadj Mabrouk E, Mouelhi L, and Debbeche R

Subjects
Humans, Adult, Prevalence, Prospective Studies, Vitamin D, Risk Factors, Crohn Disease complications, Vitamin D Deficiency
Abstract

Introduction: Vitamin D plays a role in regulating the immune response through an immunomodulatory effect, and is probably involved in the pathophysiology of Crohn's disease (CD)., Aim: to assess vitamin D status in patients with CD as well as in healthy controls and to determine associated factors of vitamin D deficiency in patients with CD., Methods: We conducted a prospective study over 18 months, including CD patients with age and sex matched with healthy controls. Suboptimal vitamin D status was defined by vitamin D serum level < 30 ng/ml, vitamin insufficiency by vitamin D serum level between 10 and 30 ng/ml and vitamin deficiency serum level < 10 ng/ml., Results: We included 77 subjects (52 patients with CD and 25 controls) with mean age of 38 years± 11. Most patients and controls had suboptimal levels of vitamin D (98% and 96% respectively) including vitamin D deficiency in 75% and 67%, respectively and vitamin D insufficiency in 25% and 33%, respectively. In univariate analysis, vitamin D deficiency was associated with disease flare-up (p=0.001), anemia (p=0.002), hypo-albuminemia (p=0.002), elevated C-reactive protein (CRP) (p=0.003), Crohn's Disease Activity Index (CDAI) (p<0.001), ileal location (p=0.04) and immunosuppressive therapy (p=0.01). In multivariate analysis, only CDAI was significantly associated with vitamin D deficiency (p=0.003, OR=9.33)., Conclusion: Vitamin D deficiency is common in Tunisian CD patients as well as in controls and is associated with disease activity.

Published
2023

2. Unexpected isolated hepatic tuberculosis discovered during laparoscopic cholecystectomy: A case report.

Author

Ayadi S, Fares F, Blel A, Zaimi Y, Mensi A, Mouelhi L, and Debbeche R

Subjects
Female, Humans, Middle Aged, Abdomen, Abdominal Pain etiology, Biopsy, Cholecystectomy, Laparoscopic, Tuberculosis, Hepatic complications
Abstract

Isolated hepatic tuberculosis is a rare form of extrapulmonary tuberculosis. We report an exceptional case of a 51-year-old female patient complaining from right upper abdominal quadrant pain, who underwent laparoscopic surgery for millimetric gallbladder polyps. Preoperative ultrasound hepatic morphology and biochemical hepatic tests revealed no abnormalities. There were no clinical patterns for an active tuberculosis. During surgery time, scattered sub-centimeter whitish nodular lesions were discovered on the upper surface of the liver. Although gallbladder pathological examination did not reveal any significant abnormalities, per surgery hepatic biopsy indicated the presence of a giant cell granuloma with caseous necrosis highly suggestive of hepatic tuberculosis. Treatment by anti-bacillary drugs according to local standard protocol was conducted with favorable outcomes. Therefore, diagnosis of hepatic tuberculosis may be considered in endemic countries in totally asymptomatic patients or complaining from unexplained and isolated abdominal pain, in absence of any morphologic or biochemical hepatic abnormalities.

Published
2023

3. 2022 TUNISIAN NATIONAL CONGRESS OF MEDICINE ABSTRACTS.

Author

Yacoub A, Ayadi A, Ayed W, Ayari S, Chebbi S, Magroun I, Ben Afia L, Mersni M, Mechergui N, Brahim D, Ben Said H, Bahri G, Youssef I, Ladhari N, Mziou N, Grassa A, M'rad M, Khessairi N, Krir A, Chihaoui M, Mahjoub S, Bahlous A, Jridi M, Cherif Y, Derbal S, Chebbi D, Hentati O, Ben Dahmen F, Abdallah M, Hamdi I, Sahli F, Ouerdani Y, Mnekbi Y, Abaza H, Ajmi M, Guedria A, Randaline A, Ben Abid H, Gaddour N, Maatouk A, Zemni I, Gara A, Kacem M, Maatouk I, Ben Fredj M, Abroug H, Ben Nasrallah C, Dhouib W, Bouanene I, Sriha A, Mahmoudi M, Gharbi G, Khsiba A, Azouz M, Ben Mohamed A, Yakoubi M, Medhioub M, Hamzaoui L, Azouz M, Ben Attig Y, Hamdi S, Essid R, Ben Jemia E, Rezgui B, Boudaya MS, Hassine H, Dabbabi H, Fradi Y, Cherif D, Lassoued I, Yacoub H, Kchir H, Maamouri N, Khairi W, Ben Ammar H, Abaza H, Chelbi E, Merhaben S, Neffati W, Ajmi M, Tarchalla S, Boughzala S, Gazzeh M, Gara S, Labidi A, Touati H, Nefzi AM, Ben Mustpha N, Fekih M, Serghini M, Boubaker J, Zouiten L, Driss A, Meddeb N, Driss I, Walha S, Ben Said H, Bel Hadj Mabrouk E, Zaimi Y, Mensi A, Trad N, Ayadi S, Said Y, Mouelhi L, Dabbèche R, Belfkih H, Bani M, Moussa A, Souissi S, Trabelsi Werchfeni B, Chelly S, Ezzi O, Ammar A, Besbes M, Njah M, Mahjoub M, Ghali H, Neffati A, Bhiri S, Bannour R, Ayadi S, Khouya FE, Kamel A, Hariz E, Aidani S, Kefacha S, Ben Cheikh A, Said H, Dogui S, Atig A, Gara A, Ezzar S, Ben Fradj M, Bouanène I, M'kadmi H, Farhati M, Dakhli N, Nalouti K, Chanoufi MB, Abouda SH, Louati C, Zaaimi Y, Dabbeche R, Hermi A, Saadi A, Mokaddem S, Boussaffa H, Bellali M, Zaghbib S, Ayed H, Bouzouita A, Derouiche A, Allouche M, Chakroun M, Ben Slama R, Gannoun N, Kacem I, Tlili G, Kahloul M, Belhadj Chabbah N, Douma F, Bouhoula M, Chouchene A, Aloui A, Maoua M, Brahem A, Kalboussi H, El Maalel O, Chatti S, Jaidane M, Naija W, Mrizek N, Sellami I, Feki A, Hrairi A, Kotti N, Baklouti S, Jmal Hammami K, Masmoudi ML, Hajjaji M, Naaroura A, Ben Amar J, Ouertani H, Ben Moussa O, Zaibi H, Aouina H, Ben Jemaa S, Gassara Z, Ezzeddine M, Kallel MH, Fourati H, Akrout R, Kallel H, Ayari M, Chehaider A, Souli F, Abdelaali I, Ziedi H, Boughzala C, Haouari W, Chelli M, Soltani M, Trabelsi H, Sahli H, Hamdaoui R, Masmoudi Y, Halouani A, Triki A, Ben Amor A, Makni C, Eloillaf M, Riahi S, Tlili R, Jmal L, Belhaj Ammar L, Nsibi S, Jmal A, Boukhzar R, Somai M, Daoud F, Rachdi I, Ben Dhaou B, Aydi Z, Boussema F, Frikha H, Hammami R, Ben Cheikh S, Chourabi S, Bokri E, Elloumi D, Hasni N, Hamza S, Berriche O, Dalhoum M, Jamoussi H, Kallel L, Mtira A, Sghaier Z, Ghezal MA, Fitouri S, Rhimi S, Omri N, Rouiss S, Soua A, Ben Slimene D, Mjendel I, Ferchichi I, Zmerli R, Belhadj Mabrouk E, Debbeche R, Makhloufi M, Chouchane A, Sridi C, Chelly F, Gaddour A, Kacem I, Chatti S, Mrizak N, Elloumi H, Debbabi H, Ben Azouz S, Marouani R, Cheikh I, Ben Said M, Kallel M, Amdouni A, Rejaibi N, Aouadi L, Zaouche K, Khouya FE, Aidani S, Khefacha S, Jelleli N, Sakly A, Zakhama W, Binous MY, Ben Said H, Bouallegue E, Jemmali S, Abcha S, Wahab H, Hmida A, Mabrouk I, Mabrouk M, Elleuch M, Mrad M, Ben Safta N, Medhioub A, Ghanem M, Boughoula K, Ben Slimane B, Ben Abdallah H, Bouali R, Bizid S, Abdelli MN, Ben Nejma Y, Bellakhal S, Antit S, Bourguiba R, Zakhama L, Douggui MH, Bahloul E, Dhouib F, Turki H, Sabbah M, Baghdadi S, Trad D, Bellil N, Bibani N, Elloumi H, Gargouri D, Ben Said M, Hamdaoui R, Chokri R, Kacem M, Ben Rejeb M, Miladi A, Kooli J, Touati S, Trabelsi S, Klila M, Rejeb H, Kammoun H, Akrout I, Greb D, Ben Abdelghaffar H, Hassene H, Fekih L, Smadhi H, Megdiche MA, Ksouri J, Kasdalli H, Hayder A, Gattoussi M, Chérif L, Ben Saida F, Gueldich M, Ben Jemaa H, Dammak A, Frikha I, Saidani A, Ben Amar J, Aissi W, Chatti AB, Naceur I, Ben Achour T, Said F, Khanfir M, Lamloum M, Ben Ghorbel I, Houman M, Cherif T, Ben Mansour A, Daghfous H, Slim A, Ben Saad S, Tritar F, Naffeti W, Abdellatif J, Ben Fredj M, Selmi M, Kbir GH, Maatouk M, Jedidi L, Taamallah F, Ben Moussa M, Halouani L, Rejeb S, Khalffalah N, Ben Ammar J, Hedhli S, Azouz MM, Chatti S, Athimni Z, Bouhoula M, Elmaalel O, Mrizak N, Maalej M, Kammoun R, Gargouri F, Sallemi S, Haddar A, Masmoudi K, Oussaifi A, Sahli A, Bhouri M, Hmaissi R, Friha M, Cherif H, Baya C, Triki M, Yangui F, Charfi MR, Ben Hamida HY, Karoui S, Aouini F, Hajlaoui A, Jlassi H, Sabbah M, Fendri MN, Kammoun N, Fehri S, Nouagui H, Harzalli A, Snène H, Belakhal S, Ben Hassine L, Labbene I, Jouini M, Kalboussi S, Ayedi Y, Harizi C, Skhiri A, Fakhfakh R, Jelleli B, Belkahla A, Fejjeri M, Zeddini M, Mahjoub S, Nouira M, Frih N, Debiche S, Blibech H, Belhaj S, Mehiri N, Ben Salah N, Louzir B, Kooli J, Bahri R, Chaka A, Abdenneji S, Majdoub Fehri S, Hammadi J, Dorgham D, Hriz N, Kwas H, Issaoui N, Jaafoura S, Bellali H, Shimi M, Belhaj Mabrouk E, Sellami R, Ketata I, Medi W, Mahjoub M, Ben Yacoub S, Ben Chaabene A, Touil E, Ben Ayed H, Ben Miled S, El Zine E, Khouni H, Ben Kadhi S, Maatoug J, Boulma R, Rezgui R, Boudokhane M, Jomni T, Chamekh S, Aissa S, Touhiri E, Jlaiel N, Oueslati B, Maaroufi N, Aouadi S, Belkhir S, Daghfous H, Merhaben S, Dhaouadi N, Ounaes Y, Chaker K, Yaich S, Marrak M, Bibi M, Mrad Dali K, Sellami A, Nouira Y, Sellami S, Anane I, Trabelsi H, Ennaifer R, Benzarti Z, Bouchabou B, Hemdani N, Nakhli A, Cherif Y, Abdelkef M, Derbel K, Barkous B, Yahiaoui A, Sayhi A, Guezguez F, Rouatbi S, Racil H, Ksouri C, Znegui T, Maazaoui S, Touil A, Habibech S, Chaouech N, Ben Hmid O, Ismail S, Chouaieb H, Chatti M, Guediri N, Belhadj Mohamed M, Bennasrallah C, Bouzid Y, Zaouali F, Toumia M, El Khemiri N, El Khemiri A, Sfar H, Farhati S, Ben Chehida F, Yamoun R, Braham N, Hamdi Y, Ben Mansour A, Mtir M, Ayari M, Toumia M, Rouis S, Sakly H, Nakhli R, Ben Garouia H, Chebil D, Hannachi H, Merzougui L, Samet S, Hrairi A, Mnif I, Hentati O, Bouzgarrou L, Souissi D, Boujdaria R, Kadoussi R, Rejeb H, Ben Limem I, Ben Salah I, Greb D, Ben Abdelghaffar H, Smadhi H, Laatiri H, Manoubi SA, Gharbaoui M, Hmandi O, Zhioua M, Taboubi F, Hamza Y, Hannach W, Jaziri H, Gharbi R, Hammami A, Dahmani W, Ben Ameur W, Ksiaa M, Ben Slama A, Brahem A, Elleuch N, Jmaa A, Kort I, Jlass S, Benabderrahim S, Turki E, Belhaj A, Kebsi D, Ben Khelil M, Rmadi N, Gamaoun H, Alaya Youzbechi F, Brahim T, Boujnah S, Abid N, Gader N, Kalboussi S, Ben Sassi S, Loukil M, Ghrairi H, Ben Said N, Mrad O, Ferjaoui M, Hedhli L, Ben Kaab B, Berriche A, Charfi R, Mourali O, Smichi I, Bel Haj Kacem L, Ksentini M, Aloui R, Ferchichi L, Nasraoui H, Maoua M, Chérif F, Belil Y, Ayed MA, Alloulou Y, Belhadj S, Daghfous J, Mehiri N, Louzir B, Abbes A, Ghrab A, Chermiti A, Akacha A, Mejri O, Debbiche A, Yahiaoui C, Binous M, Tissaoui A, Mekni K, El Fekih C, Said MA, Chtioui S, Mestiri S, Smaoui H, Ben Hamida S, Haddar A, Mrizek N, Gares N, Zaibi A, Bouazizi N, Gallas S, Lachhab A, Belhadj M, Hadj Salem N, Garrouch A, Mezgar Z, Khrouf M, Abbassi H, Souissi D, Hamra I, Ben Mustapha N, Abessi I, Boubaker F, Bouchareb S, ElOmma Mrabet H, Touil I, Boussoffara L, Knani J, Boudawara N, Alaya W, Sfar MH, Fekih S, Snène H, Boudawara N, Gargouri I, Benzarti W, Knaz A, Abdelghani A, Aissa S, Hayouni A, Mejri I, Kacem M, Mhamdi S, Daboussi S, Aichaouia C, Moatemri Z, Chaachou A, Fsili R, Ben Ghezala H, Ben Jazia A, and Brahmi N

Published
2023

4. 46th Medical Maghrebian Congress. November 9-10, 2018. Tunis.

Author

Alami Aroussi A, Fouad A, Omrane A, Razzak A, Aissa A, Akkad A, Amraoui A, Aouam A, Arfaoui A, Belkouchi A, Ben Chaaben A, Ben Cheikh A, Ben Khélifa A, Ben Mabrouk A, Benhima A, Bezza A, Bezzine A, Bourrahouat A, Chaieb A, Chakib A, Chetoui A, Daoudi A, Ech-Chenbouli A, Gaaliche A, Hassani A, Kassimi A, Khachane A, Labidi A, Lalaoui A, Masrar A, McHachi A, Nakhli A, Ouakaa A, Siati A, Toumi A, Zaouali A, Condé AY, Haggui A, Belaguid A, El Hangouche AJ, Gharbi A, Mahfoudh A, Bouzouita A, Aissaoui A, Ben Hamouda A, Hedhli A, Ammous A, Bahlous A, Ben Halima A, Belhadj A, Bezzine A, Blel A, Brahem A, Banasr A, Meherzi A, Saadi A, Sellami A, Turki A, Ben Miled A, Ben Slama A, Daib A, Zommiti A, Chadly A, Jmaa A, Mtiraoui A, Ksentini A, Methnani A, Zehani A, Kessantini A, Farah A, Mankai A, Mellouli A, Zaouali A, Touil A, Hssine A, Ben Safta A, Derouiche A, Jmal A, Ferjani A, Djobbi A, Dridi A, Aridhi A, Bahdoudi A, Ben Amara A, Benzarti A, Ben Slama AY, Oueslati A, Soltani A, Chadli A, Aloui A, Belghuith Sriha A, Bouden A, Laabidi A, Mensi A, Ouakaa A, Sabbek A, Zribi A, Green A, Ben Nasr A, Azaiez A, Yeades A, Belhaj A, Mediouni A, Sammoud A, Slim A, Amine B, Chelly B, Jatik B, Lmimouni B, Daouahi B, Ben Khelifa B, Louzir B, Dorra A, Dhahri B, Ben Nasrallah C, Chefchaouni C, Konzi C, Loussaief C, Makni C, Dziri C, Bouguerra C, Kays C, Zedini C, Dhouha C, Mohamed C, Aichaouia C, Dhieb C, Fofana D, Gargouri D, Chebil D, Issaoui D, Gouiaa D, Brahim D, Essid D, Jarraya D, Trad D, Ben Hmida E, Sboui E, Ben Brahim E, Baati E, Talbi E, Chaari E, Hammami E, Ghazouani E, Ayari F, Ben Hariz F, Bennaoui F, Chebbi F, Chigr F, Guemira F, Harrar F, Benmoula FZ, Ouali FZ, Maoulainine FMR, Bouden F, Fdhila F, Améziani F, Bouhaouala F, Charfi F, Chermiti Ben Abdallah F, Hammemi F, Jarraya F, Khanchel F, Ourda F, Sellami F, Trabelsi F, Yangui F, Fekih Romdhane F, Mellouli F, Nacef Jomli F, Mghaieth F, Draiss G, Elamine G, Kablouti G, Touzani G, Manzeki GB, Garali G, Drissi G, Besbes G, Abaza H, Azzouz H, Said Latiri H, Rejeb H, Ben Ammar H, Ben Brahim H, Ben Jeddi H, Ben Mahjouba H, Besbes H, Dabbebi H, Douik H, El Haoury H, Elannaz H, Elloumi H, Hachim H, Iraqi H, Kalboussi H, Khadhraoui H, Khouni H, Mamad H, Metjaouel H, Naoui H, Zargouni H, Elmalki HO, Feki H, Haouala H, Jaafoura H, Drissa H, Mizouni H, Kamoun H, Ouerda H, Zaibi H, Chiha H, Kamoun H, Saibi H, Skhiri H, Boussaffa H, Majed H, Blibech H, Daami H, Harzallah H, Rkain H, Ben Massoud H, Jaziri H, Ben Said H, Ayed H, Harrabi H, Chaabouni H, Ladida Debbache H, Harbi H, Yacoub H, Abroug H, Ghali H, Kchir H, Msaad H, Ghali H, Manai H, Riahi H, Bousselmi H, Limem H, Aouina H, Jerraya H, Ben Ayed H, Chahed H, Snéne H, Lahlou Amine I, Nouiser I, Ait Sab I, Chelly I, Elboukhani I, Ghanmi I, Kallala I, Kooli I, Bouasker I, Fetni I, Bachouch I, Bouguecha I, Chaabani I, Gazzeh I, Samaali I, Youssef I, Zemni I, Bachouche I, Youssef I, Bouannene I, Kasraoui I, Laouini I, Mahjoubi I, Maoudoud I, Riahi I, Selmi I, Tka I, Hadj Khalifa I, Mejri I, Béjia I, Bellagha J, Boubaker J, Daghfous J, Dammak J, Hleli J, Ben Amar J, Jedidi J, Marrakchi J, Kaoutar K, Arjouni K, Ben Helel K, Benouhoud K, Rjeb K, Imene K, Samoud K, El Jeri K, Abid K, Chaker K, Abid K, Bouzghaîa K, Kamoun K, Zitouna K, Oughlani K, Lassoued K, Letaif K, Hakim K, Cherif Alami L, Benhmidoune L, Boumhil L, Bouzgarrou L, Dhidah L, Ifrine L, Kallel L, Merzougui L, Errguig L, Mouelhi L, Sahli L, Maoua M, Rejeb M, Ben Rejeb M, Bouchrik M, Bouhoula M, Bourrous M, Bouskraoui M, El Belhadji M, El Belhadji M, Essakhi M, Essid M, Gharbaoui M, Haboub M, Iken M, Krifa M, Lagrine M, Leboyer M, Najimi M, Rahoui M, Sabbah M, Sbihi M, Zouine M, Chefchaouni MC, Gharbi MH, El Fakiri MM, Tagajdid MR, Shimi M, Touaibia M, Jguirim M, Barsaoui M, Belghith M, Ben Jmaa M, Koubaa M, Tbini M, Boughdir M, Ben Salah M, Ben Fraj M, Ben Halima M, Ben Khalifa M, Bousleh M, Limam M, Mabrouk M, Mallouli M, Rebeii M, Ayari M, Belhadj M, Ben Hmida M, Boughattas M, Drissa M, El Ghardallou M, Fejjeri M, Hamza M, Jaidane M, Jrad M, Kacem M, Mersni M, Mjid M, Sabbah M, Serghini M, Triki M, Ben Abbes M, Boussaid M, Gharbi M, Hafi M, Slama M, Trigui M, Taoueb M, Chakroun M, Ben Cheikh M, Chebbi M, Hadj Taieb M, Kacem M, Ben Khelil M, Hammami M, Khalfallah M, Ksiaa M, Mechri M, Mrad M, Sboui M, Bani M, Hajri M, Mellouli M, Allouche M, Mesrati MA, Mseddi MA, Amri M, Bejaoui M, Bellali M, Ben Amor M, Ben Dhieb M, Ben Moussa M, Chebil M, Cherif M, Fourati M, Kahloul M, Khaled M, Machghoul M, Mansour M, Abdesslem MM, Ben Chehida MA, Chaouch MA, Essid MA, Meddeb MA, Gharbi MC, Elleuch MH, Loueslati MH, Sboui MM, Mhiri MN, Kilani MO, Ben Slama MR, Charfi MR, Nakhli MS, Mourali MS, El Asli MS, Lamouchi MT, Cherti M, Khadhraoui M, Bibi M, Hamdoun M, Kassis M, Touzi M, Ben Khaled M, Fekih M, Khemiri M, Ouederni M, Hchicha M, Kassis M, Ben Attia M, Yahyaoui M, Ben Azaiez M, Bousnina M, Ben Jemaa M, Ben Yahia M, Daghfous M, Haj Slimen M, Assidi M, Belhadj N, Ben Mustapha N, El Idrissislitine N, Hikki N, Kchir N, Mars N, Meddeb N, Ouni N, Rada N, Rezg N, Trabelsi N, Bouafia N, Haloui N, Benfenatki N, Bergaoui N, Yomn N, Ben Mustapha N, Maamouri N, Mehiri N, Siala N, Beltaief N, Aridhi N, Sidaoui N, Walid N, Mechergui N, Mnif N, Ben Chekaya N, Bellil N, Dhouib N, Achour N, Kaabar N, Mrizak N, Mnif N, Chaouech N, Hasni N, Issaoui N, Ati N, Balloumi N, Haj Salem N, Ladhari N, Akif N, Liani N, Hajji N, Trad N, Elleuch N, Marzouki NEH, Larbi N, M'barek N, Rebai N, Bibani N, Ben Salah N, Belmaachi O, Elmaalel O, Jlassi O, Mihoub O, Ben Zaid O, Bouallègue O, Bousnina O, Bouyahia O, El Maalel O, Fendri O, Azzabi O, Borgi O, Ghdes O, Ben Rejeb O, Rachid R, Abi R, Bahiri R, Boulma R, Elkhayat R, Habbal R, Rachid R, Tamouza R, Jomli R, Ben Abdallah R, Smaoui R, Debbeche R, Fakhfakh R, El Kamel R, Gargouri R, Jouini R, Nouira R, Fessi R, Bannour R, Ben Rabeh R, Kacem R, Khmakhem R, Ben Younes R, Karray R, Cheikh R, Ben Malek R, Ben Slama R, Kouki R, Baati R, Bechraoui R, Fakhfakh R, Fradi R, Lahiani R, Ridha R, Zainine R, Kallel R, Rostom S, Ben Abdallah S, Ben Hammamia S, Benchérifa S, Benkirane S, Chatti S, El Guedri S, El Oussaoui S, Elkochri S, Elmoussaoui S, Enbili S, Gara S, Haouet S, Khammeri S, Khefecha S, Khtrouche S, Macheghoul S, Mallouli S, Rharrit S, Skouri S, Helali S, Boulehmi S, Abid S, Naouar S, Zelfani S, Ben Amar S, Ajmi S, Braiek S, Yahiaoui S, Ghezaiel S, Ben Toumia S, Thabeti S, Daboussi S, Ben Abderahman S, Rhaiem S, Ben Rhouma S, Rekaya S, Haddad S, Kammoun S, Merai S, Mhamdi S, Ben Ali R, Gaaloul S, Ouali S, Taleb S, Zrour S, Hamdi S, Zaghdoudi S, Ammari S, Ben Abderrahim S, Karaa S, Maazaoui S, Saidani S, Stambouli S, Mokadem S, Boudiche S, Zaghbib S, Ayedi S, Jardek S, Bouselmi S, Chtourou S, Manoubi S, Bahri S, Halioui S, Jrad S, Mazigh S, Ouerghi S, Toujani S, Fenniche S, Aboudrar S, Meriem Amari S, Karouia S, Bourgou S, Halayem S, Rammeh S, Yaïch S, Ben Nasrallah S, Chouchane S, Ftini S, Makni S, Manoubi S, Miri S, Saadi S, Manoubi SA, Khalfallah T, Mechergui T, Dakka T, Barhoumi T, M'rad TEB, Ajmi T, Dorra T, Ouali U, Hannachi W, Ferjaoui W, Aissi W, Dahmani W, Dhouib W, Koubaa W, Zhir W, Gheriani W, Arfa W, Dougaz W, Sahnoun W, Naija W, Sami Y, Bouteraa Y, Elhamdaoui Y, Hama Y, Ouahchi Y, Guebsi Y, Nouira Y, Daly Y, Mahjoubi Y, Mejdoub Y, Mosbahi Y, Said Y, Zaimi Y, Zgueb Y, Dridi Y, Mesbahi Y, Gharbi Y, Hellal Y, Hechmi Z, Zid Z, Elmouatassim Z, Ghorbel Z, Habbadi Z, Marrakchi Z, Hidouri Z, Abbes Z, Ouhachi Z, Khessairi Z, Khlayfia Z, Mahjoubi Z, and Moatemri Z

Subjects
Africa, Northern epidemiology, Anatomy education, Education, Medical history, Education, Medical methods, Education, Medical organization & administration, History, 21st Century, Humans, Internship and Residency standards, Internship and Residency trends, Job Satisfaction, Pathology, Clinical education, Tunisia epidemiology, Education, Medical trends, Medicine methods, Medicine organization & administration, Medicine trends
Published
2019

5. Chilaiditi's sign (or syndrome).

Author

Daboussi O, Mouelhi L, Zaimi Y, Houissa F, El Jery K, Khedher S, Salem M, Said Y, Dabbeche R, and Najjar T

Subjects
Abdominal Pain diagnosis, Abdominal Pain etiology, Aged, 80 and over, Chilaiditi Syndrome complications, Colonography, Computed Tomographic, Humans, Male, Radiography, Thoracic, Vomiting diagnosis, Vomiting etiology, Chilaiditi Syndrome diagnosis
Published
2017

6. Hepatic hydrothorax: About a hospital serie of 63 cases.

Author

Mouelhi L, Daboussi O, Cheffi N, El Jery K, Said Y, Khedher S, Salem M, Dabbèche R, Houissa F, and Najjar T

Subjects
Adult, Aged, Aged, 80 and over, Ascites etiology, Case-Control Studies, Female, Hepatitis C complications, Humans, Hydrothorax epidemiology, Male, Middle Aged, Pleural Effusion etiology, Prevalence, Retrospective Studies, Tunisia epidemiology, Young Adult, Hydrothorax etiology, Liver Cirrhosis complications
Abstract

Background: Hepatic hydrothorax is a less common complication of cirrhosis with an estimated prevalence of 10- 15%. In the vast majority of cases, ascites are also present but significant pleural effusion may develop in patients without ascites. Hepatic hydrothorax is associated with cirrhosis whatever its etiology. The prognosis of hepatic hydrothorax remains unclear and is closely related to available therapeutic options. The aim of our study is to determine the prevalence of hydrothorax in cirrhotic patients, detail its clinical and therapeutic characteristics, and study the evolutive profile of cirrhotic patients with hydrothorax by comparing it to those without hydrothorax. We also search predictive factors of development of this complication in cirrhotic patients., Methods: We conduct a retrospective and case-control study including 63 cirrhotic patients with hepatic hydrothorax hospitalized in gastroenterology department of Charles Nicolle hospital of Tunis, during a period of fiveteen years, from January 2000 to January 2015., Results: The prevalence of hydrothorax was 14.5%. The mean age was 62 ± 14 years (range, 22- 86 years). The sex ratio H/F was 1.52. Hepatic hydrothorax was symptomatic in 35 patients. It was right-sided in 60%, left-sided in 24% and bilateral in 16% of cases. Hydrothorax was on average size abundance in 54% of cases. It was transsudatif in 52.5% of cases. Hepatitis C was the most frequent cause of cirrhosis (54%). Our results show that hepatic hydrothorax was present with important ascites in 35 patients. Hydrothorax was significantly related to Child-Pugh C severity of cirrhosis (p=0.0001). Hydrothorax occurence was significantly associated with a low level of albumin (p=0.001), an important hyponatremia (p=0.001) and a low prothrombin rate (p=0.02). A therapeutic thoracentesis was performed in 57% of cases. Diuretics based on spironolactone and furosemide were indicated in 30 patients. Evolution was favorable in 19 patients. Refractory hepatic hydrothorax was present in 31 patients. Death, in the days which follow the hospitalisation, was in 13 patients. The 5-years survival rate was 60%. The mean survival time of patients with hepatic hydrothorax was 8.41 years against 10.75 years at patients without hepatic hydrothorax., Conclusion: Hepatic hydrothorax is a common complication in our study. The improvement of the prognosis of our patients would require a better therapeutic management and especially the possibility of orthotopic liver transplantation which is the optimal therapeutic option for patients with hepatic hydrothorax.

Published
2016

7. Predictive scores of early mortality from variceal gastrointestinal bleeding in cirrhotic patients.

Author

Mouelhi L, Ayadi H, Zaimi Y, Daboussi O, Salem M, Debbech R, Houissa F, and Najjar T

Subjects
Female, Gastrointestinal Hemorrhage etiology, Humans, Male, Middle Aged, Mortality, Premature, Predictive Value of Tests, Prognosis, ROC Curve, Retrospective Studies, Severity of Illness Index, Esophageal and Gastric Varices complications, Gastrointestinal Hemorrhage mortality, Liver Cirrhosis complications
Abstract

Introduction: The variceal bleeding, main complication of portal hypertension during cirrhosis, is associated with high early mortality riskestimated between 15 and 20%. This highlights the necessity of predictive models that allow identifying high-risk patients raising the issue of amore aggressive therapeutic care., Objective: To assess the performance of four scores for the prediction of cirrhotic patients' high early mortality risk due to digestive hemorrhageand to compare them to the Child-Pugh reference score., Methods: We collected 87 cirrhotic patients admitted to the Gastroenterology Department of Charles Nicolle Hospital for a high digestivehemorrhage by rupture of gastric or esophageal varicose veins., Results: 56 men and 31 women were included in this study. The average value of Rockall, Glasgow Blatchford, MELD and MELD-Na scores,was respectively equal to 6.19, 10.91, and 17.6 and at 20. Early mortality was 30%. The average value of all the scores was significantly higherwith the prematurely deceased patients (p<0.001). The MELD-Na score had higher sensitivity and specificity for the prediction of prematuremortality compared to the other scores but without statistical significantly difference (Area under the ROC curve: MELD-Na=0.867, p<0.001;Child-Pugh=0.809, p<0.001; Rockall=0.777, p=0.001; Glasgow-Blatchford=0.761, p<0.001; MELD=0.838, p<0.001). The predictive value of thecut-off MELD-Na score was equal to 19 with a sensitivity of 70% and a specificity of 82%., Conclusion: The studied four scores had a good predictive value of early mortality risk by varicose digestive hemorrhage with cirrhotic patients.

Published
2016

8. Abstracts of the Maghreb Medical Congress 2015.

Author

Dahmeni A, Bouchekoua M, Aloui D, Trabelsi S, Khaled S, Gara S, Herbegue B, Chetoui A, Sellami S, Slama I, Antit S, Boussabah E, Thameur M, Zakhama L, Benyoussef S, Guemira F, Bellil N, Gargouri D, Masmoudi N, Elloumi H, Bibani N, Trad D, Kharrat J, Tounsi I, Fakhfakh N, Kallel A, Hadj Salah N, Belhadj S, Ladab S, Kallell K, Ayadi I, Frikha S, Messaoud M, Belhaj S, Triki H, Kallel K, BenHamida S, Ghribi I, Belkhamsa A, Ben Hamida M, Cheikh I, Hamdi B, Maazaoui S, Berraies A, Sakly H, Blibech H, Ammar J, Hamzaoui A, Belaazri S, Lamine F, Baidada A, Kharbach A, Mensi A, Ben Mohammed A, Khedher S, Mouelhi L, Houissa F, Najjar T, BenJemàa R, Oukaa-Kchaou A, Ben Mefteh I, Ayachi A, Morjène I, Trabelsi H, Mourali M, Maghrebi H, Barka M, Haddad A, Jlassi A, Makni A, Daghfous A, Rebai W, Fteriche F, Chebbi F, Ksantini F, Ammous A, Jouini M, Kacem MJ, Ben Safta Z, Cherif M, Zaafouri H, Bouhafa A, Ben Maamer A, Ben Khelifa M, Daboussi O, El Jeri K, Said Y, Salem M, Dabbech R, Hadidane M, Triki A, Henchiri H, Driss M, Ben Hassouna J, Hechiche M, Dhieb T, Rahal K, Lamghari J, Khaiz D, Ghaddou Y, Avala P, El Hattabi K, Bensardi FZ, Lefriyekh MR, Fadil A, Zerouali NO, Benahmed I, Karrou M, Benjaout K, Marouf R, Alloubi I, Achouri L, Slimene M, Laamouri B, Jendoubi M, Satouri L, Ghoul F, Reziga H, Malek M, Makni MK, Baba A, Derbel AM, Sellami L, Zili M, Khelifa R, Benahmed I, Benjaout K, Alloubi I, Maarouf R, Youssef A, Amdouni B, Gharrad M, Saadaoui M, Mbarki M, Rezigua H, Shimi C, Semlani J, Amhajer S, Ghouda H, Imane Z, Gaouzi M, Kriouile Y, Attia M, Ben Amor A, Banneni S, Dimassi K, Triki A, Gara MF, Amdouni B, Bennasser L, Magherbi H, Jallouli I, Harabi S, Kbeili S, Derbel M, Gassara H, Louati D, and Chaabene K

Published
2016

9. [Viral B reactivation: Risk factors and prevention].

Author

Mouelhi L, Houissa F, Mekki H, and Najjar T

Subjects
Humans, Risk Factors, Secondary Prevention methods, Hepatitis B prevention & control, Hepatitis B virology, Hepatitis B virus physiology, Virus Activation
Abstract

Background: The viral B reactivation is associated to deadly serious forms. There exist populations suffering this risk yet with a possibility of prevention through a pre-emptive treatment., Purposes: Establishing the diagnosis of a viral B reactivation. Identifying the patients with risk of exposure to viral B reactivation and implementing the means of prevention of viral reactivation., Methods: literature review, Results: the diagnosis of reactivation is not consensual. It is evoked facing a fast increase of aminotransferases with the ALAT superior to 5-10 times normal or superior to 3 times the basic value, an ascension of the HBV DNA within the serum, a reappearance of anti Hbc of IgM type with, most often, a weak title and /or a reversion Hbs. The reactivation depends on the type of treatment and of the viral B status. It was described under chemotherapy concerning the solid tumors particularly that of the breast, in haematology and increases with the resort to monoclonal antibody (anti-CD20). Under anti-TNFα a reactivation is possible within a variable deadline from the 1st to the 12th perfusion. Besides the type of treatment, the risk is more important with the patients Ag Hbs positive and correlated with the viremia. However, the patients having an occult hepatitis B or even a recovered from hepatitis are equally exposed to the risk of reactivation., Conclusion: viral reactivation is frequent since the larger use of immunosuppressive therapy, anti-TNFα and monoclonal antibody. The determination of the initial viral B status by a serology is indispensable. In order to indicate either surveillance or a preemptive treatment.

Published
2015

10. [Efficiency of endoscopic treatment with intra gastric balloon in severe to morbid obesity].

Author

Houissa F, Trabelsi S, Hadj Brahim K, Mouelhi L, Bouzaidi S, Salem M, Mekki H, El Jery K, Said Y, Kheder S, Debbech R, and Najjar T

Subjects
Adolescent, Adult, Female, Humans, Male, Middle Aged, Obesity, Morbid epidemiology, Retrospective Studies, Severity of Illness Index, Treatment Outcome, Weight Loss, Young Adult, Endoscopy, Gastrointestinal methods, Gastric Balloon, Obesity, Morbid surgery
Abstract

Background: Obesity raises such a healthcare matter throughout the world. Its management is not only complex but also most often multidisciplinary. The medico-dietary treatment is of inconstant efficiency and the surgical treatment, though more efficient, presents a considerable morbidity-death rate. The endoscopic treatment through intra-gastric balloon avails a seducing alternative namely accounting for surgery preparation., Aim: To assess the efficiency of the endoscopic treatment through gastric balloon, both in the short and long term, and this is accounting for weight loss as well as tolerance., Methods: We have carried out a retrospective study including the patients suffering from severe to morbid obesity and who had a gastric balloon implemented in our Endoscopy Unit between November 2005 and December 2007., Results: Twenty one patients were included. The average age was 32,19 ± 12,65 years with extremes of 16 and 52 years. Fifteen patients suffered from morbid obesity. The patients' average weight was 134, 52 ± 26,46 kg (extremes 88 and 194 kg). Some co-morbidity was found out with 15 patients. Te balloon implementation (Héliosphère®) was carried out with no incidents in all patients. Six months after the balloon implementation, the average weight loss was 17,5% and the average loss of over weigh was 37%. In biological level, we noted a normalisation of fasting glycaemia in 28,6 % of cases, of the cholesterolemia in 100 %, of the triglyceridemia in 33,33%, of the uraemia in 42,8% and hepatic tests in 50 % of the cases. The metabolic syndrome disappeared in 28,57 % of cases. The assessment after a 5-year-period was marked by the need to surgical treatment in 4 patients and this is due to the loss of efficiency of endoscopic treatment. A bad tolerance of gastric balloon was observed in 34 % of the cases, dominated by sicknesses. Only one patient presented incoercible sicknesses with ionic troubles as well as deshydrating requiring the precocious extraction of the balloon after 48 hours of its implementation., Conclusion: The endoscopic treatment through intra gastric balloon is well tolerated but efficiently limited in time. It might be recommended in preparation for a surgical treatment or in case of contre- indication or surgery refusal.

Published
2014

12. [Primitive pancreatic Cell B lymphoma: a case report].

Author

Houissa F, Bouslama K, Bouzaidi S, Debbeche R, Mouelhi L, Salem M, Mezlini A, and Najjar T

Subjects
Aged, Endosonography, Female, Humans, Image-Guided Biopsy, Lymphoma, B-Cell pathology, Pancreas pathology, Pancreatic Neoplasms pathology, Lymphoma, B-Cell diagnosis, Pancreatic Neoplasms diagnosis
Published
2013

13. Gastric Xanthelasma: an uncommon lesion.

Author

Houissa F, Bouslama K, Debbeche R, Mouelhi L, Bouzaidi S, Salem M, and Najjar T

Subjects
Adult, Aged, Female, Humans, Male, Middle Aged, Stomach Diseases diagnosis, Xanthomatosis diagnosis
Published
2013

14. Internal iliac vein thrombosis: a rare and multifactor complication in Crohn's disease.

Author

Houissa F, Haddad W, Debbech R, Mouelhi L, Bouzaidi S, and Najjar T

Subjects
Adult, Crohn Disease diagnostic imaging, Female, Humans, Iliac Vein diagnostic imaging, Radiography, Venous Thrombosis diagnostic imaging, Venous Thrombosis pathology, Crohn Disease complications, Iliac Vein pathology, Venous Thrombosis etiology
Published
2013

15. Median arcuate ligament syndrome: a rare cause of recurrent abdominal pain.

Author

Houissa F, Dachraoui A, Mouelhi L, Bouzaidi S, Debbech R, and Najjar T

Subjects
Abdominal Pain diagnostic imaging, Celiac Artery diagnostic imaging, Constriction, Pathologic diagnostic imaging, Female, Humans, Median Arcuate Ligament Syndrome, Middle Aged, Radionuclide Angiography, Recurrence, Syndrome, Tomography, Emission-Computed, Abdominal Pain etiology, Celiac Artery abnormalities, Constriction, Pathologic complications
Published
2013

16. [Factors predicting mortality in infected hospitalized cirrhotics patients: about 97 cases].

Author

Houissa F, Mouelhi L, Amouri N, Salem M, Bouzaidi S, Debbeche R, and Najjar T

Subjects
Adult, Aged, Aged, 80 and over, Cohort Studies, Female, Hospitalization statistics & numerical data, Humans, Infections complications, Infections therapy, Liver Cirrhosis complications, Liver Cirrhosis therapy, Male, Middle Aged, Prognosis, Retrospective Studies, Risk Factors, Survival Analysis, Young Adult, Infections diagnosis, Infections mortality, Liver Cirrhosis diagnosis, Liver Cirrhosis mortality
Abstract

Background: Infections are frequent in cirrhotic patients. They are potentially severe, modifying pejoratively the natural history of the cirrhosis and are suppliers of a heavy mortality., Aim: To determine the predictive factors of hospital mortality in cirrhotic infected patients., Methods: We conducted a retrospective study including 97 cirrhotic patients hospitalized in the department of gastroenterology of Charles Nicolle's hospital, for a first infectious episode and not having received antibiotics in the previous 15 days. Clinico-biological, bacteriological, therapeutic and evolutionary data were collected. Scores were adopted and calculated such as the score of Child-Pugh, the score MELD (The Model for End-Stage Liver Disease) and the score SOFA (Sequential Organ Failure Assessment). These data allowed a descriptive study and an uni and multi-varied analysis., Results: The median age of the studied population was of 59 ± 12 years with a sex ratio of 0.83. The diabetes was the comorbidity most frequently associated with the cirrhosis (26.8 % of the cases) Viral aetiology of the cirrhosis was dominant (3/4 of the cases) especially the virus C (62.5 % of the cases). The clinical presentation of the infection was polymorphic with presence of symptoms connected to the infection and the other connected to the progression of the liver disease. The fever was absent in 3/4 of the cases. The identified infections were, in order of frequency, urinary, infection of ascite, bronchopulmonary, cutaneous and gynecological. The responsible germs were especially bacilli gram negative of intestinal origin. The estimated scores of gravity were: a score of Child-Pugh C in 60 % of the cases, an average score MELD in 18±8 points and a score average SOFA in 8 ± 4 points. Multivariate study found that only encephalopathy, bilirubin level more than 40 μmol/l and creatinin level more than 120 μmol/l was independent factors predicting mortality., Conclusion: Infection in cirrhotic patients was a severe and mortal complication. The hepatic encephalopathy, the hyper bilirubinemia and the renal failure are predictive of the hospital mortality. The use of the scores of gravity: Child-Pugh, MELD and SOFA would an important help for the decision to admit in intensive care unit any infected cirrhotic patient.

Published
2012

17. [Exsudative ascites revealing Hashimoto's disease and primary biliary cirrhosis].

Author

Mouelhi L, Abbes L, Belhadj Ali I, Houissa F, Mekki H, Ben Rjeb M, Bouzaidi S, Salem M, Debbeche R, Khedher A, and Najjar T

Subjects
Aged, Ascites pathology, Diagnosis, Differential, Exudates and Transudates, Female, Hashimoto Disease complications, Humans, Liver Cirrhosis, Biliary complications, Ascites diagnosis, Hashimoto Disease diagnosis, Liver Cirrhosis, Biliary diagnosis
Published
2011

18. [Autoimmune hepatitis type 1 triggered by cytomegalovirus infection. One rare case report].

Author

Mouelhi L, Debbeche R, Salem M, Bouzaidi S, Mekki H, Houissa F, Said Y, Moussa A, Rejeb MB, Trabelsi S, and Najjar T

Subjects
Adolescent, Adrenal Cortex Hormones therapeutic use, Antiviral Agents therapeutic use, Cytomegalovirus Infections diagnosis, Cytomegalovirus Infections drug therapy, Female, Hepatitis, Autoimmune drug therapy, Humans, Immunosuppressive Agents therapeutic use, Cytomegalovirus Infections complications, Hepatitis, Autoimmune virology
Abstract

Background: Autoimmune hepatitis is chronic and uncommon disease. The pathogenesis is a complex process. Several triggers for autoimmune hepatitis particularly viral herpesviridae infection, which may induce the development of autoimmunity in predisposed individuals., Aim: Report a new case., Case Report: We report a case of 17-year- woman presented with autoimmune triggered by cytomegalovirus infection. Cytomegalovirus induced autoimmune hepatitis has not been reported previously. Evolution was favourable under antiviral treatment, corticosteroid and azathioprine.

Published
2010

19. Correlation between liver biopsy and fibrotest in the evaluation of hepatic fibrosis in patients with chronic hepatitis C.

Author

Said Y, Salem M, Mouelhi L, Mekki H, Houissa F, Ben Rejeb M, Moussa A, Trabelsi S, Debbeche R, Bouzaidi S, and Najjar T

Subjects
Biomarkers blood, Biopsy, Female, Humans, Liver pathology, Liver Cirrhosis blood, Liver Cirrhosis pathology, Male, Multivariate Analysis, Predictive Value of Tests, Prospective Studies, ROC Curve, Risk Factors, Algorithms, Hepatitis C, Chronic complications, Liver Cirrhosis diagnosis
Abstract

Aim: To assess the diagnostic value of Fibrotest in comparison with liver biopsy, for the evaluation of hepatic fibrosis in patients with chronic hepatitis C., Methods: This prospective study included in 2 years (2006-2007), consecutive patients with chronic hepatitis C naive to treatment. Fibrotest and liver biopsy were performed. Receiver operating characteristics (ROC) curves , the sensitivity, specificity, positive and negative predictive values were used to assess the diagnostic value of Fibrotest in comparison with the METAVIR classification., Results: We recruited a total of 65 patients: 28 males and 37 females (mean age: 50 years); 92% of the patients had genotype 1. The histological fibrosis results were: 3.1% F0; 24.6% F1; 32.3% F2; 29.2% F3 and 10.8 % F4. The diagnostic value of Fibrotest in the detection of significant fibrosis (F2-F4) was 0. 87. A score > 0.5 has a sensitivity of 85. 1%, a specificity of 72. 2%, a positive predictive value of 88. 9%,and a negative predictive value of 65%. The diagnostic value of Fibrotest in the detection of cirrhosis (F4) was 0. 85. There were 13/65 cases of discordance (20%) for fibrosis, 4 cases were attributable to biopsy and 6 cases to Fibrotest. The discordance was unexplained in 3 cases. the size of biopsy< 15 mm [OR=2. 82, 95% CI, 1. 3-6. 07; p = 0. 008] and the stage of fibrosis F0, F1, F2 [OR =3. 35 , 95% CI, 1. 1-10. 2; p=0. 03] were considered as risk factors of discordance in multivariate analysis., Conclusion: This prospective study confirmed the good diagnostic value of Fibrotest as compared with the histological analysis of liver biopsy.

Published
2010

20. [Nephrogenic ascites: an exceptional diagnosis. About one case].

Author

Debbeche R, Mekki H, Houissa F, Moussa A, Bouzaidi S, Trabelsi S, Said Y, Mouelhi L, Salem M, and Najjar T

Subjects
Adult, Ascites diagnosis, Humans, Male, Ascites etiology, Kidney Failure, Chronic complications
Abstract

Background: Nephrogenic ascites is a clinical entity that manifests as refractory and exsudative ascites with unknown etiology in patients with end stage renal disease and often undergoing hemodialysis. This entity presents in practice many diagnostic and therapeutic difficulties., Aim: The aim of this study is to focus on these difficulties through a new observation., Case Report: We report one case of nephrogenic ascites in chronic renal failure related to an idiopathic neurologic bladder. It's a 38 years old patient on hemodialysis for three years who consulted for exsudative ascites with a low rate of leucocytes., Conclusion: We conclude that nephrogenic ascites is rare. Its diagnosis is an exclusion diagnosis based on exclusion of other causes of ascites, particularly exsudative forms with low leucocytes rate. Its management is based essentially on renal transplantation and its prognosis is very poor.

Published
2010

21. Transverse myelitis associated with chronic viral hepatitis C.

Author

Mouelhi L, Mekki H, Houissa F, Debbeche R, Ben Rejeb M, Bouzaidi S, Trabelsi S, Salem M, and Najjar T

Subjects
Hepatitis C, Chronic diagnosis, Humans, Male, Middle Aged, Hepatitis C, Chronic complications, Myelitis, Transverse virology
Abstract

Background: HCV infection could cause several extra hepatic diseases including mixed cryoglobulinemia. Peripheral neuropathy is the most common complication of mixed cryoglobulinemia. In addition to cryoglobulinemia's neuropathy, transverse myelitis had been related to HCV infection., Aim: But causality of this association is not clearly established., Case Report: A 55-year-old man presented with motor deficiency in lower extremities and urinary retention. Neurological exams showed a spastic paraparesis and proprioceptive ataxia. Spinal MRI revealed a contrast enhancing signal abnormality within the spinal cord extending from Levels C3 to C5. Serology hepatitis C and viremia were positive. Clinical diagnosis of acute demyelinating sensorimotor polyneuropathy associated to chronic hepatitis C was etablished., Conclusion: Screening of HCV infection must be done in patients with transverse myelitis and no clear aetiology.

Published
2010

22. Evaluation of nutritional status in patients with liver cirrhosis.

Author

Houissa F, Salem M, Debbeche R, Mouelhi L, Bouzaidi S, Ben Rejeb M, Mekki H, Moussa A, Said Y, Trabelsi S, and Najjar T

Subjects
Female, Humans, Male, Malnutrition etiology, Middle Aged, Prospective Studies, Liver Cirrhosis complications, Malnutrition diagnosis, Nutritional Status
Abstract

Background: Malnutrition is a frequently reported complication in patients with liver cirrhosis. It has a high clinical and economic impact reflected by an increased morbidity and prolonged hospital stay., Aim: This preliminary prospective study aimed to determine the prevalence of malnutrition in hospitalized cirrhotic patients and to investigate whether biological and anthropometric parameters are a valuable tool for identifying malnutrition in these patients., Methods: The nutritional status of 44 consecutive cirrhotic patients (21 men, 23 women) was assessed according to the anthropometric measurements and biochemical analysis. The diagnosis of malnutrition was based on diminished values of Mid arm muscle circumference (MAMC) and/or Triceps skinfold thikness (TST) below the 5th percentile or less than 60%., Results: The aetiology of cirrhosis was viral hepatitis in 29 patients (66%). Cirrhosis was classified Child Pugh A, B or C in respectively 9, 26 and 9 patients; 37 patients (84%) have mild or tense ascite. In this study, malnutrition was found in 35 patients (79.5%), whereas 9 patients has a good nutritional status. TST and MAMC less than 60% was found in respectively 72% and 25% of patients. No significant statistical difference in epidemiological characteristics was found between malnourished and well-nourished patients. TST and MAMC decreased significantly according to the Child score (p = 0.014 and 0.032 respectively; a positive correlation was found between these two parameters and the severity of cirrhosis., Conclusion: In this study, the high prevalence of denutrition was associated with the severity of cirrhosis. Anthropometric parameters are valuable tools for malnutrition diagnosis.

Published
2010

23. [Ulcerative colitis and schizophrenia: fortuitous association or etiopathogenic link?].

Author

Ennaifer R, Rafrafi R, Mouelhi L, Houissa F, Bouzaidi S, Trabelsi S, El Hechmi Z, and Najjar T

Subjects
Adult, Female, Humans, Colitis, Ulcerative complications, Schizophrenia complications
Abstract

Background: Ulcerative colitis is a chronic inflammatory bowel disease with multiple pathogenic factors. Psychiatric disorder have frequently been associated to ulcerative colitis, the most frequent being depression and anxiety, whereas schizophrenia is unusual., Aim: Report a new case of ulcerative colitis associated topsychiatric disorder., Case-Report: We report the case of a 42-year-old woman with ulcerative colitis associated with schizophrenia. Although the two diagnoses were concomitant, on questioning, she revealed that digestive symptoms began before psychiatric disorders., Conclusion: Few cases of schizophrenia associated with ulcerative colitis have been reported in the literature. We discuss epidemiological, etiopathogenic and therapeutic links between the two diseases.

Published
2009

24. [Thrombosis in inflammatory bowel disease: mechanisms and risk factors].

Author

Mouelhi L, Mekki H, Debbeche R, Salem M, and Najjar T

Subjects
Humans, Risk Factors, Inflammatory Bowel Diseases complications, Thrombosis etiology
Abstract

Background: Thromboembolic manifestations are frequent in patients with inflammatory bowel disease., Aims: To explaim the mechanisms of thromboembolic manifestations in inflammatory bowel disease., Methods: Literature review., Results: Risk factors of thrombosis in inflammatory bowel disease are acquired or genetic. The most important factors are thrombocytosis, increased of activation of platelets and hyperhomocysteinemia. Other factors such factor V leiden, antithrombin III and antiphospholipid antibodies are observed in inflammatory bowel disease patients but not always correlated with thromboembolic manifestations., Conclusion: The mechanisms of thrombosis in inflammatory bowel disease are complex are intricate.

Published
2009

25. [Association Budd Chiari syndrome, antiphospholipid syndrome and Grave's disease].

Author

Mouelhi L, Chaieb M, Debbeche R, Salem M, Sfar I, Trabelsi S, Gorgi Y, and Najjar T

Subjects
Adult, Antibodies, Anticardiolipin immunology, Antiphospholipid Syndrome diagnosis, Antiphospholipid Syndrome drug therapy, Antiphospholipid Syndrome immunology, Biomarkers blood, Budd-Chiari Syndrome diagnosis, Budd-Chiari Syndrome drug therapy, Budd-Chiari Syndrome immunology, Fatal Outcome, Graves Disease diagnosis, Graves Disease drug therapy, Graves Disease immunology, Humans, Immunologic Factors immunology, Male, Antiphospholipid Syndrome complications, Budd-Chiari Syndrome complications, Graves Disease complications
Abstract

Background: Antiphospholipid syndrome is revealed by Budd Chiari syndrome in 5% of the cases. Antiphospholipid syndrome is characterized by venous or arterial thrombosis, foetal loss and positivity of antiphospholipid antibodies, namely lupus anticoagulant, anticardiolipin antibodies and anti-beta2-glycoprotein I. Anticardiolipin antibodies was reported in auto-immune thyroid disorders, particularly in Grave's disease. Antiphospholipid syndrome associated to Grave's disease was reported in only three cases., Aim: To describe a case report of association of Grave's disease and antiphospholipid syndrome., Observation: We report the first case of Grave's disease associated with antiphospholipid syndrome, revealed by Budd Chiari syndrome., Conclusion: Our observation is particular by the fact that it is about a patient presenting a Grave's disease associated with antiphospholipid syndrome revealed by Budd Chiari syndrome. This triple association has never been reported in literature. Although association between antiphospholipid syndrome and Grave's disease was previously described, further studies evaluating the coexistence of these two affections in the same patient would be useful.

Published
2009

26. [Impact of esophageal manometry before antireflux surgery].

Author

Mouelhi L, Ghrib B, Ben Yedder J, Debbeche R, Krichene A, Salem M, Abdesselem M, Zaouche A, and Najjar T

Subjects
Adult, Aged, Aged, 80 and over, Female, Humans, Male, Manometry, Middle Aged, Prospective Studies, Retrospective Studies, Esophagus physiopathology, Gastroesophageal Reflux physiopathology, Gastroesophageal Reflux surgery, Preoperative Care
Abstract

Background: Esophageal hypomotility is frequent in patients with gastroesophageal reflux disease (GERD)., Aims: To precise the frequency and the patterns of esophageal manometric abnormalities in GERD patients referred before antireflux surgery, to determine the frequency of post-operative dysphagia and to look for associated factors with high risk of dysphagia, with special interest on pre-operative esophageal manometric study., Methods: We conducted a retrospective study based on patients having anti-reflux surgery and pre-operative esophageal manometry. Post-operative dysphagia was prospectively assessed during the follow-up., Results: We studied 33 patients (mean age: 46 years; sex-ratio: 0.4). Pre-operative esophageal manometry was abnormal in 1/3 of cases, with a high prevalence of non specific motor disorders and hypomotility. Nor epidemiological, clinical or pHmetric factor was associated with the risk of motor esophageal abnormalities. Postoperative dysphagia was noted in 21% of the cases, with any correlation with results of pre-operative manometry., Conclusion: Esophageal hypomotility is frequent in patients with GERD; and not associated with a higher risk of post-operative dysphagia after anti-reflux surgery.

Published
2008

27. [Auto-immune serological disorders in chronic viral C hepatitis: prevalence and clinical significance].

Author

Mouelhi L, Debbeche R, Sfar I, Salem M, Bouzaidi S, Trabelsi S, Gorgi Y, and Najjar T

Subjects
Autoantibodies blood, Autoimmune Diseases blood, Hematologic Diseases blood, Hematologic Diseases immunology, Humans, Prevalence, Autoimmune Diseases epidemiology, Autoimmune Diseases etiology, Hematologic Diseases epidemiology, Hematologic Diseases etiology, Hepatitis C, Chronic complications
Abstract

Background: Hepatitis C viral (HCV) infection has been shown to lead to auto-immune phenomena., Aims: We review the prevalence of serological auto-immune disorders associated to HCV infection and to clarify their clinical significance., Methods: Literature review., Results: The serological immune response to HCV infection may include the development of cryoglobulinemia, rheumatoid factor, anticardiolipin, antinuclear, anti-liver-kidney-microsome 1 and anti-smooth muscle antibodies. Serological auto-immune manifestations were explained by the lymphotropism of HCV and the polyclonal activation of B cells. Interferon-based treatment of HCV infection may precipitate or exacerbate the associated auto-immune disease., Conclusion: In patients with serological auto-immune disorders associated with HCV infection, a very careful analysis of clinical and biological features is needed. Application of classification criteria of systemic auto-immune diseases and testing more specific antibodies can resolve this point.

Published
2008

28. Endoscopic ultrasonography versus helical CT in diagnosis and staging of pancreatic cancer.

Author

Jemaa Y, Houissa F, Trabelsi S, Moussa A, Belhouchet H, Mouelhi L, Bouraoui M, Bouzaidi S, Debbeche R, Ben Yedder J, Salem M, and Najjar T

Subjects
Female, Humans, Male, Middle Aged, Neoplasm Staging, Pancreatic Neoplasms pathology, Retrospective Studies, Endosonography, Pancreatic Neoplasms diagnosis, Tomography, Spiral Computed
Abstract

Aim: Compare the performances of EUS to helical CT in the diagnosis and staging of pancreatic adenocarcinoma., Methods: Forty two consecutive patients (mean age 63 years; 25 men, 17 women) who had surgical exploration and histologically proved pancreatic cancer were retrospectively included. All our patients underwent with endoscopic ultrasonography (EUS) and helical computed tomography (helical CT). Data analysis compared helical CT, EUS with the surgical data with or without histological study in diagnosis, staging and resectability of pancreatic cancer. Surgical findings were used as gold standard., Results: For positive diagnosis EUS was more sensitive 100% (CI:93-100) than helical CT 88% (CI:77-95). But helical CT was more specific 89% (CI:64-98) than EUS 83% (CI:58-96) for small tumors whose diameter is below 2.5 cm in witch EUS was more sensitive in their detection (100% versus 83%). In evaluating venous involvement EUS was more sensitive than helical CT (96% versus 50%; p<0.05), while CT was more specific (81% versus 75%; p<0.05). Regarding lymph nodes invasion, the two imaging technique had the same sensibility (56%) with better specificity for helical CT (83% versus 75%; p<0.05). The accuracy of EUS in identifying the T and N stages were 80% and 67% respectively, while helical CT have an accuracy of 50% and 71% respectively. EUS and helical CT correctly identified all resectable tumors while EUS was more accurate than helical CT in detecting non resectable tumors 94% versus 69%., Conclusion: EUS remains superior to helical CT in positive diagnosis of pancreatic adenocarcinoma especially for small tumors and also for the diagnosis of venous invasion and in identifying non resectable tumors. The two techniques have the same accuracy in the detection of lymph node involvement.

Published
2008

29. [Usefulness of endoscopic ultrasonography for diagnosis between multivesicular hydatic cyst and serous cystadenoma of the pancreas. Case report].

Author

Trabelsi S, Moussa A, Cherif I, Jemaa Y, Mouelhi L, Sebai F, and Najjar T

Subjects
Adult, Diagnosis, Differential, Humans, Male, Cystadenoma, Serous diagnostic imaging, Echinococcosis diagnostic imaging, Endosonography, Pancreatic Diseases diagnostic imaging, Pancreatic Diseases parasitology, Pancreatic Neoplasms diagnostic imaging
Abstract

Hydatid cyst of the pancreas is very rare. However, it should be suspected in every case of pancreatic cyst, especially in hydatid countries where hydatic cyst disease is endemic. In the paper we report the first case of a multivesicular hydatid cyst of the pancreas explored by endoscopic ultrasonography. Endoscopic ultrasonography is very reliable in the investigation of pancreatic cystic tumors. However it did not allow us to define semiological criteria capable of permitting a differential diagnosis between a hydatid cyst and serous cystadenoma. Per-echoendoscopic transduodenal puncture might improve the efficiency of this procedure with of hydatid cysts of the head of the pancreas.

Published
2005

30. [Ligation of oropharyngeal mucosa: a rare complication of ligation of esophageal varices. Two case reports].

Author

Kochlef A, Mouelhi L, Kharrat J, Romani M, Kilani A, Bel Hadj N, and Ghorbei A

Subjects
Adult, Humans, Ligation adverse effects, Male, Pharyngeal Diseases pathology, Esophageal and Gastric Varices therapy, Mouth Mucosa pathology, Pharyngeal Diseases etiology
Abstract

The eradication of oesophageal varices by binding became the best traitment for the bleeding by rupture of the verices. She tends to substitute the sclerosis because of her fast delay of eradication and her fewer complications and gravity. The incidence of complications after the binding vary between 3.3 and 11%. The most frequent complication is the appearance of oesophageal ulcers that sometimes causes bleeding. A dysphagia can happen within a few hours after the binding. Infections are rare. We report two cases of pharyngeal mucosae binding occurring during the binding of the varices.

Published
2002

31. [Duplicate principal bile ducts. Two case reports].

Author

Kharrat J, Elloumi H, Mouelhi L, Belhadj N, Ben Khelifa H, and Ghorbal A

Subjects
Aged, Bile Ducts surgery, Diagnosis, Differential, Female, Humans, Male, Bile Ducts pathology, Cholangiopancreatography, Endoscopic Retrograde
Abstract

The duplicity of the way biliaire main is a rare abnormality. We report two observations revealed by episodes of angiocholite. The degrades cholangiopancreatography endoscopy allowed to wear diagnosis and to practise a therapeutic gesture.

Published
2001

32. [Esophageal cancer with esophagotracheal fistula. Treatment by esophageal prosthesis. Report of two cases].

Author

Kharrat J, Elloumi H, Belhadj N, Kochlef A, Mouelhi L, Romani M, Kilani A, and Ghorbel A

Subjects
Adult, Aged, Female, Humans, Palliative Care, Tracheoesophageal Fistula etiology, Esophageal Neoplasms complications, Prosthesis Implantation, Tracheoesophageal Fistula surgery
Abstract

Esophageal cancer has a bad prognosis because of late diagnosis. The rate of Survival is very low. Palliative treatment is frequently made. The aim of the treatment is to allow feeding, and treat some complications likes breathing troubles. We report two cases of esotracheal fistulae secondary to esophageal cancer. The esophageal fistula was successfully treated by esotracheal prosthesis.

Published
2001

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