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Fadwa Lajili,1,2 Marwa Toumia,1,2 Adel Sekma,1,2 Khaoula Bel Haj Ali,1,2 Sarra Sassi,1,2 Asma Zorgati,3 Hajer Yaakoubi,3 Rym Youssef,3 Mohamed Habib Grissa,1,2 Kaouther Beltaief,1,2 Zied Mezgar,4 Mariem Khrouf,4 Ikram Chamtouri,5 Wahid Bouida,1,2 Hamdi Boubaker,1,2 Mohamed Amine Msolli,1,2 Zohra Dridi,6 Riadh Boukef,1,3 Semir Nouira1,2 1Research Laboratory LR12SP18, Monastir University, Monastir, 5019, Tunisia; 2Emergency Department, Fattouma Bourguiba University Hospital, Monastir, 5000, Tunisia; 3Emergency Department, Sahloul University Hospital, Sousse, 4011, Tunisia; 4Emergency Department, Farhat Hached University Hospital, Sousse, 4031, Tunisia; 5Department of Cardiology B, Fattouma Bourguiba University Hospital, Monastir, 5000, Tunisia; 6Department of Cardiology A, Fattouma Bourguiba University Hospital, Monastir, 5000, TunisiaCorrespondence: Semir Nouira, Emergency Department and Laboratory Research(LR12SP18), Fattouma Bourguiba University Hospital, Monastir, 5000, Tunisia, Tel +21673106046, Email semir.nouira.urg@gmail.comIntroduction: Identifying heart failure (HF) in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) can be challenging. Lung ultrasound sonography (LUS) B-lines quantification has recently gained a large place in the diagnosis of HF, but its diagnostic performance in AECOPD remains poorly studied.Purpose: This study aimed to assess the contribution of LUS B-lines score (LUS score) in the diagnosis of HF in AECOPD patients.Patients and methods: This is a prospective cross-sectional multicenter cohort study including patients admitted to the emergency department for AECOPD. All included patients underwent LUS. A lung ultrasound score (LUS score) based on B-lines calculation was assessed. A cardiac origin of dyspnea was retained for a LUS score greater than 15. HF diagnosis was based on clinical examination, pro-brain natriuretic peptide levels, and echocardiographic findings. The LUS score diagnostic performance was assessed by receiver operating characteristic (ROC) curve, sensitivity, specificity, and likelihood ratio at the best cutoffs.Results: We included 380 patients, mean age was 68± 11.6 years, sex ratio (M/F) 1.96. Patients were divided into two groups: the HF group [n=157 (41.4%)] and the non-HF group [n=223 (58.6%)]. Mean LUS score was higher in the HF group (26.8± 8.4 vs 15.3± 7.1; p< 0.001). The mean LUS score in the HF patients with reduced LVEF was 29.2± 8.7, and was 24.5± 7.6 in the HF patients with preserved LVEF. LUS score area under ROC curve for the diagnosis of HF was 0.71 [0.65– 0.76]. The best sensitivity (89% [85.9– 92,1]) was observed at the threshold of 5; the best specificity (85% [81.4– 88.6]) was observed at the threshold of 30. Correlation between LUS score and E/E’ ratio was good (R=0.46, p=0.0001).Conclusion: Our results suggest that LUS score could be helpful and should be considered in the diagnostic approach of HF in AECOPD patients, at least as a ruling in test.Keywords: chronic obstructive pulmonary disease, COPD, heart failure, dyspnea, lung ultrasound sonography

Kaouthar Beltaief,1,2 Mohamed Habib Grissa,1,2 Mohamed Amine Msolli,1,2 Nasri Bzeouich,1,2 Nizar Fredj,1,2 Adel Sakma,1,2 Hamdi Boubaker,1,2 Wahid Bouida,1,2 Riadh Boukef,1,3 Semir Nouira1,2 1Emergency Department, Fattouma Bourguiba University Hospital, 2Research Laboratory LR12SP18, University of Monastir, Monastir, 3Emergency Department, Sahloul University Hospital, Sousse, Tunisia Objective: The objective of this study was to compare the analgesic effect and tolerance profile of acupuncture versus intravenous (IV) titrated morphine in patients presenting to the emergency department (ED) with renal colic.Materials and methods: A total of 115 patients were randomized into two groups. Patients in the IV titrated-morphine group (n=61) received 0.1 mg/kg morphine every 5 minutes until pain score dropped by at least 50% of its baseline value. Patients in the acupuncture group (n=54) received an acupuncture session of 30 minutes following a prespecified protocol. The visual analog scale (VAS) was used to assess pain intensity at baseline and at 10, 20, 30, 45, and 60 minutes following the start of the treatment protocol. Possible treatment side effects were also recorded.Results: No significant differences were found between the two groups concerning age, sex, or baseline VAS score. From the 10th minute until the end of the intervention, acupuncture was associated with a deeper analgesic effect than titrated morphine (P

Hamdi Boubaker,1,2 Mohamed Habib Grissa,1,2 Kaouther Beltaief,1,2 Zohra Dridi,3 Mohamed Fadhel Najjar,4 Wahid Bouida,1,2 Riadh Boukef,5 Soudani Marghli,6 Semir Nouira1,2 1Department of Emergency, Fattouma Bourguiba University Hospital, 2Research Laboratory (LR12SP18), University of Monastir, 3Department of Cardiology, 4Department of Biochemistry, Fattouma Bourguiba University Hospital, Monastir, 5Department of Emergency, Sahloul University Hospital, Sousse, 6Department of Emergency, Tahar Sfar University Hospital, Mahdia, Tunisia Background: The goal of this study was to determine the value of systolic time intervals and their change during Valsalva maneuver (VM) in the diagnosis of left ventricular dysfunction (LVD) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods: We included 166 patients admitted to the emergency department for AECOPD. Measurement of systolic time intervals included electromechanical activation time (EMAT), left ventricular ejection time (LVET), and EMAT/LVET ratio. These were performed at baseline and during the first strain phase of the VM using a computerized phonoelectrocardiographic method. The diagnosis of LVD was determined on the basis of clinical examination, echocardiography, and brain natriuretic peptide. The values of systolic time intervals were compared between patients with and without LVD; their diagnostic performance was assessed using the area under receiver operating characteristic (ROC) curve.Results: Patients with LVD (n=95) had a significantly higher EMAT and lower LVET and EMAT/LVET ratio compared to patients without LVD (n=71); the area under ROC curve was 0.79, 0.88, and 0.90, respectively, for EMAT, LVET, and EMAT/LVET ratio. All baseline systolic time intervals changed significantly during VM in patients without LVD but they did not change in patients with LVD. The area under ROC curve increased to 0.84 and 0.93, ­respectively, for EMAT and EMAT/LVET ratio but did not change for LVET.Conclusion: Simple and noninvasive measurements of systolic time intervals combined with VM could be helpful to detect or rule out LVD in patients admitted to the emergency room for COPD excacerbation. The EMAT/LVET ratio seems to have the best diagnostic value. Keywords: chronic obstructive pulmonary disease, exacerbation, systolic time intervals, Valsalva maneuver

Modern research is focused on the discovery of new compounds that meet the requirements of modern construction. An example of low energy consumption is that buildings consume between 20% and 40% of energy. In this research, the effect of fiber addition on the properties of compacted earth bricks composed of clay and sand and fixed with cement is studied. Fiberglass or palm are used in different proportions (0% and 0.4%). This is done by studying the change in mechanical and thermal properties. The study focuses on clarifying the role of fiber type and the amount of compressive force applied to the soil. To change the properties of bricks. This is studied using experimental methods and systematization criteria. The results showed a decrease in density by 9.1%, with a decrease in water absorption by 8%, an increase in brick hardness by 42.7%, and a decrease in thermal conductivity by 22.2%. These results show that the addition of fiber improves mechanical and thermal properties. Which reduces energy consumption. The results are important because they explain the changes that occur in the earth block when palm fibers and glass are added and how they are used to improve earthen buildings.

Sulphur-nitrogen(SN) donor thiosemicarbazone ligand [(Z)-N-ethyl-2-(5-methyl-2-oxoindolin-3-ylidene)hydrazinecarbothioamide] and its Pt(II) complex were synthesized by condensation method. The compounds were structurally characterized by elemental analysis CHNS, FT-IR, and NMR analysis. The elemental analyses data for the compounds were in good agreement with the theoretical values. The melting point of the complex was higher than the ligand, as expected. The FT-IR spectral data reflect a bidentate bonding of thiosemicarbazone ligand to Pt(II) ion through thioketo sulfur and azomethine nitrogen. The docking results (theoretical results) of these compounds show that the binding energy between DNA and Pt(II) complex was found to be less than that of the Schiff base ligand (L) in the sense that it has higher stability at various stages and angles. The strength of docking between DNA and Pt(II) complex was also found to be that stronger than the Schiff base ligand (L).

In this article, we analyze the performance of five estimation methods for the long memory parameterd. The goal of our article is to construct a wavelet estimate for the fractional differencing parameter in nonstationary long memory processes that dominate the well-known estimate of Shimotsu and Phillips (2005). The simulation results show that the wavelet estimation method of Lee (2005) with several tapering techniques performs better under most cases in nonstationary long memory. The comparison is based on the empirical root mean squared error of each estimate. [ABSTRACT FROM PUBLISHER]