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Sameh Msaad,1 Nouha Ketata,2 Nesrine Kammoun,3 Rahma Gargouri,1 Rim Khemakhem,1 Sourour Abid,1 Saeb Bader,1 Sabrine Efidha,4 Narjes Abid,5 Jamel El Ghoul,6 Imen Sahnoun,4 Hazem Altalaa,1 Jihen Jdidi,2 Mohamed Jlidi,7 Nadia Keskes Boudaouara,8 Imen Gargouri,9 Najla Bahloul,1 Samy Kammoun1 1Department of Respiratory and Sleep Medicine, Hedi Chaker University Hospital of Sfax, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia; 2Department of Preventive Medicine, Hedi Chaker University Hospital of Sfax, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia; 3Tunisian Occupational Health and Safety Institute, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia; 4Department of Pneumology, Abderrahman Mami University Hospital of Ariana, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia; 5Department of Pneumology, Mohamed Taher Maamouri University Hospital of Nabeul, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia; 6Department of Pneumology, Habib Bourguiba University Hospital of Medenine, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia; 7Orthopedics and Traumatology Department, Mohamed Taher Maâmouri University Hospital of Nabeul, Faculty of Medicine of Tunis, University of Tunis EL Manar, Tunis, Tunisia; 8Department of Pneumology, Taher Sfar University Hospital of Mahdia, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia; 9Department of Pneumology, Farhat Hached University Hospital of Sousse, Faculty of Medicine of Sousse, University of Sousse, Sousse, TunisiaCorrespondence: Sameh Msaad, Tel +216 94 977 355, Email pneumo1972@gmail.comBackground: Sleep quality and disturbances have gained heightened scholarly attention due to their well-established association with both mental and physical health. This study aims to assess sleep-wake habits and disturbances in Tunisian adults.Methodology: This cross-sectional study employed an online questionnaire to assess 3074 adults ≥ 18 years. Primary outcomes, including sleep quality, daytime vigilance, mood, and subjective well-being, were measured using validated questionnaires [the Pittsburgh Sleep Quality Index (PSQI), the Insomnia Severity Index (ISI), the Epworth Sleepiness Scale (ESS), the Patient Health Questionnaire (PHQ)-9, and the World Health Organisation-Five Well-Being Index (WHO-5)].Results: Less than two-thirds (n= 1941; 63.1%) of participants were females and the mean age was 36.25± 13.56. The prevalence of poor sleep quality was 53.8% when defined as a PSQI > 5. The prevalence of insomnia, short sleep duration, long sleep duration, EDS, severe depression, and poor well-being were 14.5%, 34.7%, 12.3%, 32.4%, 7.4%, and 40.2%, respectively. Some factors were associated with an increased likelihood of poor sleep quality, including female gender, chronic hypnotics use, internet use close to bedtime, daily time spent on the internet > 3 hours, smoking, university- level education, nocturnal work, severe depression, impaired well-being status, insomnia, and EDS.Conclusion: The high prevalence of sleep-wake disturbances among Tunisian adults emphasizes the need for an appropriate screening strategy for high-risk groups. Individuals with unhealthy habits and routines were significantly more likely to experience these kinds of disturbances. Consequently, there is a pressing need for educational programs on sleep to foster healthier sleep patterns.Keywords: sleep, wake habits, sleep quality, insomnia, excessive daytime sleepiness, prevalence, risk factors

Introduction: COVID-19 affected humankind worldwide in different aspects of life. Survivors still report the effects of the pandemic on daily life, physical health, and mental health. Objectives: To assess effects of the pandemic on the mood and the quality of life of the survivors. Methods: We conducted a prospective cohort study including 121 Tunisian COVID-19 inpatients who had been discharged alive from hospital. Each enrolled patient was asked about the period before the hospital stay, and the 6-9 month-period after hospital discharge, using several scales: the validated Arabic version of "Patient Health Questionnaire" (PHQ-9) to screen for depressive symptoms, and "EuroQol five-dimension three-level" (EQ-5D-3L) to assess the quality of life. Results: The median age of participants was 59 years, with extreme values ranging from 18 to 80. Among them, 51.2% were females. As compared with baseline statue of patients, the depressive dimension assessed through PHQ was significantly impaired (7.05 vs 1.12; p<0.001). The different dimensions of the EQ-5D-3L showed significant deterioration in mean scores (mobility:1.09 vs 1.31, p<0.001;  selfcare:1 vs 1.11, p=0.001; daily activities:1.09 vs 1.49, p<0.001; pain and disturbance: 1.17 vs1.49, p<0.0005 and anxiety and depression: 1.07 vs 1.57, p<0.001). Depressive symptoms were 10 times more frequent in post-COVID (57.9% vs 5.7%). The post-COVID PHQ-9 score was correlated with the post-COVID EQ-5D-3L score (p=0.033). Conclusions: This study points out the long-term impact of the COVID infection. Therefore, the clinician should screen for possible psychological distress even after resolution of the disease, in order to guarantee a better quality of life. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

After having conducted an investigation about landfill in Beni Mellal city, Medical and Pharmaceutical Wastes (MPWs) are unloaded mixed with household and similar wastes. The objective of the present study is to analyze the management system of medical and pharmaceutical wastes at the level of Beni Mellal city in order to ameliorate the quality of collecting and handling these wastes and consequently minimizing the management costs vis a vis this service. First of all, we have created database concerning the location of health centers (HC). After, we have conducted a survey with the help of a questionnaire in different public and private health centers. Then we have carried out a research on MPWs in Dustbins existing around the health centers. We have also made an analysis of the management system of MPWs inside The Regional Hospital Center (RHC) in Beni Mellal. Afterwards, we have made a comparison between some hospital centers in Morocco when it comes to the management costs of MPWs.Based on the results obtained; we have suggested some solutions to master the management system of MPWs in addition to the scenarios for optimizing the costs linked with this service.

Chronic obstructive pulmonary disease (COPD) can lead to major alterations in the patient's quality of life. Our objectives were to assess the quality of life in a population of COPD patients in stable condition and to analyse the correlations between quality of life expressed by the St George's respiratory questionnaire (SGRQ), forced expiratory volume in 1 second (FEV1) and the BODE index. This study was a prospective study concerning 70 outpatients treated for COPD. Quality of life was assessed using the French version of the SGRQ. The study population was predominantly male (97%) with a mean age of 63 years. The average total SGRQ score was 2049 (SD 523). The difficulties expressed by our patients mainly concerned the domain of 'activity', followed by 'impact of the disease' and 'symptoms'.The correlation between FEV1 (percentage of predicted value) and the total SGRQ score and its different domains revealed a significant relationship with all parameters, but this correlation was weak with a correlation coefficient (r) between -0.43 and -0.28.In contrast, the BODE index was more strongly correlated with the quality of life (r between 0.44 and 0.60). In conclusion, FEV1 is correlated with health-related quality of life measured by the SGRQ, but the multidimensional BODE index is more reliable for assessing the impact of COPD on quality of life. [ABSTRACT FROM AUTHOR]

Introduction: There are no clear data about the incidence and the prophylactic strategies of arterial and venous thromboembolic events (TE) in COVID-19 ambulatory patients. Thus, we conducted this study to analyze thromboembolic complications in this setting and to assess thromboprophylaxis management and outcomes in the real life., Patients and Methods: This is an observational study including Covid-19 ambulatory patients. We assessed incidence of venous and arterial TE events as well as thromboprophylaxis outcomes and hemorrhagic complications. We defined high risk thrombo-embolic factor according to the Belgian guidelines which are the only guidelines that described thromboprophylaxis in COVID-19 ambulatory patients., Results: We included 2089 patients with a mean age of 43±16 years. The incidence of 30 days venous and arterial TE complications in our cohort was 1%. Venous thromboembolic complications occurred in 0.8% and arterial thromboembolic complications occurred in 0.3%.We noted at least one high-risk TE factor in 18.5% of patients but thromboprophylaxis was prescribed in 22.5% of the cases, LMWH in 18.1%, and Rivaroxaban in 3.7%. Hemorrhagic events occurred in eight patients (0.3%): five patients showed minor hemorrhagic events and three patients showed major ones (0.14%)., Conclusions: Our study showed that the incidence of thromboembolic complications is very low in COVID-19 ambulatory patients. Paradoxically, there is an over prescription of thrombo-prophylaxis in this population., Competing Interests: The authors have declared that no competing interests exist.