48 results on '"L, Boughammoura"'
Search Results
2. Profil clinico-biologique et immunohématologique des patients atteints de β-thalassémie en Tunisie : à propos de 26 cas
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H. Amara, S. Jemni Yacoub, S. Abdelkefi, N. Souyeh, I. Jarrey, S. Belhedi, B. Houissa, L. Boughammoura, T. Chakroun, H. Romdhane, and M. Bouslama
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Gynecology ,Pediatrics ,medicine.medical_specialty ,business.industry ,Thalassemia ,Biochemistry (medical) ,Clinical Biochemistry ,medicine ,Hematology ,medicine.disease ,business - Abstract
Resume But de l’etude Etudier le profil clinico-biologique des patients β-thalassemiques dans notre region, reflet de la qualite de leur prise en charge. Patients et methodes Etude retrospective (2010–2011) portant sur 26 patients beta-thalassemiques suivis au service pediatrie du CHU Farhat-Hached de Sousse, Tunisie. Les donnees epidemiologiques, cliniques et biologiques ont ete recoltees a partir des dossiers medicaux et transfusionnels des malades. Le protocole transfusionnel adopte visait a maintenir un taux d’hemoglobine > 10 g/dL par des transfusions regulieres toutes les 3 a 4 semaines. Un traitement chelateur en fer dans le but de maintenir une ferritinemie Resultats L’âge moyen des patients lors du diagnostic etait de 15 mois. La repercussion clinique de l’anemie s’etait traduite par un retard staturo-ponderal chez 54 % des patients et par une dysmorphie faciale chez 23 %. Le besoin transfusionnel moyen etait estime a 311,02 mL/kg/an avec 6 cas d’hyperconsommation. Le suivi immunohematologique avait montre l’apparition d’une allo-immunisation anti-erythrocytaires chez un seul patient et de 4 cas d’auto-immunisation. La mauvaise observance du traitement chelateur etait de 62 % et etait a l’origine de 5 cas de complications cardiaques, 4 cas d’atteintes hepatiques et 14 cas de complications endocriniennes. Conclusion L’amelioration de la prise en charge therapeutique des enfants β-thalassemiques necessiterait un meilleur suivi du rendement transfusionnel, ainsi qu’une amelioration de l’observance au traitement chelateur.
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- 2014
3. Puberté précoce centrale : profils cliniques et thérapeutiques
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S. Alilech, N. Kahloun, N. Zouari, K. Ach, A. Tej, H. Marzouk, Amel Maaroufi, Y. Hasni, L. Boughammoura, J. Bouguila, and R. Kbeili
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Endocrinology ,Endocrinology, Diabetes and Metabolism ,General Medicine - Abstract
Introduction La puberte est dite precoce quand elle debute avant 8 ans chez les filles et avant 10 ans chez le garcon. Elle est dite centrale quand elle est due a une activation precoce de l’hypothalamus avec une augmentation precoce de la secretion des gonadotrophines. Patients et methodes Il s’agit d’une etude retrospective, descriptive, multicentrique collectant les cas de puberte precoce des services de pediatrie et d’endocrinologie de Sousse sur une periode de 17 ans allant de 2000 a 2017. Resultat Nous avons collige 31 cas dont 28 filles et 3 garcons. L’âge moyen de debut etait de 3,9 ± 2,6 ans. Le signe majeur motivant la consultation etait le developpement mammaire bilateral chez les filles, la pilosite pubienne chez les garcons. On avait constate une avance staturale (la taille moyenne +2,4 ± 1,4 DS) avec avance de l’âge osseux dans 71 % des cas. Le diagnostic confirme par un pic de LH au cour du test a la GnRH, le pic moyen etait de 35,9 UI/L. Chez les filles et 45,8 UI/L chez les garcons. L’IRM hypothalamo-hypophysaire avait confirme l’atteinte organique chez 23 % des cas : hamartome (3 cas), adenome hypophysaire (3 cas), une hydrocephalie (3 cas), une neurofibromatose (un cas) et un kyste pineal (un cas). Le traitement par agoniste de LHRH etait prescrit pour 21 enfants. Conclusion La puberte precoce serait a l’origine d’une petite taille adulte, avec tout le retentissement psychologique et metabolique, ce qui implique le recours aux agonistes de la gonadoliberine (GnRH).
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- 2018
4. Étude comparative de la protéine C-réactive et de la procalcitonine dans le diagnostic de sévérité des pyélonéphrites aiguës de l’enfant
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K. Limam, J. Bouguila, K. Chatti, L. Boughammoura, B. Charfeddine, M. Ben Rejeb, H. Essabbeh, I. Khalef, and A. S. Essoussi
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Gynecology ,medicine.medical_specialty ,business.industry ,medicine ,General Medicine ,business - Abstract
Resume Objectif L’objectif de ce travail est de comparer deux parametres biologiques, la proteine C-reactive (CRP) et la procalcitonine (PCT) dans la detection des lesions renales aigues confirmees par la scintigraphie au DMSA, dans les pyelonephrites aigues (PNA) chez l’enfant. Patients et methodes Etude prospective menee sur une annee, incluant les enfants presentant un premier episode de PNA. Tous les enfants ont eu un dosage de la PCT, la CRP et l’hemogramme. Resultats Parmi les 75 patients inclus, 33 avaient des lesions renales aigues (groupe A) et 42 enfants avaient une scintigraphie au DMSA normale (groupe B). Dans le groupe A, la valeur moyenne de la PCT etait plus elevee que dans le groupe B avec une difference significative (8,81 ng/mL versus 1,7 ng/mL, p = 0,01). Le calcul de l’air sous la courbe ROC de la CRP et de la PCT a trouve que la PCT a un seuil de 0,76 ng/mL etait plus performante dans la detection des lesions renales aigues par rapport a la CRP a un seuil de 70 mg/L avec une meilleure sensibilite, valeur predictive negative et indice de Youden (82 % versus 70 % ; 84 % versus 70 % et 0,58 versus 0,25). Conclusions Notre etude a confirme la bonne sensibilite et la bonne specificite du dosage de la PCT dans le diagnostic des lesions aigues du parenchyme renal des infections urinaires de l’enfant febrile.
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- 2013
5. Séroprévalence et facteurs de risque de l’infection par le virus herpès humain 8 dans le Centre-Est tunisien
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Jalel Boukadida, Asma Ferjani, N. Ben Fredj, H. Skouri, Mahjoub Aouni, S. Samoud, Naila Hannachi, A. Khlif, S. Soussi, and L. Boughammoura
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General Medicine - Abstract
Resume Objectif L’epidemiologie de l’infection par le virus herpes humain de type 8 (HHV8) est inconnue en Tunisie. Notre objectif est d’evaluer sa prevalence dans une population du Centre-Est tunisien, ainsi que chez des sujets a risque eleve de transmission virale sanguine ou sexuelle. Methodes Un effectif de 553 personnes a ete concerne : 116 donneurs de sang, 100 femmes enceintes, 100 enfants, 50 sujets ayant une infection sexuellement transmissible non infectes par le VIH et 50 autres infectes par le VIH, 107 sujets polytransfuses et 30 personnes ayant eu une greffe de rein. La technique de detection des anticorps anti-HHV8 etait l’immunofluorescence indirecte. Resultats La seroprevalence des IgG anti-HHV8 etait de 13,8 % chez les donneurs de sang, 13 % chez les femmes enceintes et 12 % chez les enfants. Dans la population saine adulte, il n’existait pas de difference de prevalence selon le sexe, les caracteristiques sociodemographiques, les antecedents chirurgicaux et les marqueurs serologiques d’hepatite B. La prevalence des IgG anti-HHV8 etait significativement elevee dans le groupe a risque sexuel (p Conclusion La prevalence du HHV8 est elevee dans le Centre-Est tunisien a l’instar des pays mediterraneens. L’infection parait s’acquerir tot dans l’enfance, probablement par voie salivaire. Le risque de transmission sanguine du virus, controverse dans la litterature, est clairement etabli dans cette etude effectuee en region endemique. Un depistage precoce de l’infection dans les populations a risque de sarcome de Kaposi parait necessaire dans nos regions.
- Published
- 2012
6. Syndrome des poumons rétractés chez un enfant atteint de lupus érythémateux
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R. Kebaili, S. Tilouche, S. Rouatbi, L. Boughammoura, N. Soyah, N. Khattat, and J. Bouguila
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Pathology ,medicine.medical_specialty ,business.industry ,Pediatrics, Perinatology and Child Health ,medicine ,Shrinking lung syndrome ,business ,Diaphragm (structural system) - Published
- 2012
7. Syndrome hépatopulmonaire : une complication de la maladie de Gaucher de type 1
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S. El Ajmi, Ahmed Sahloul Essoussi, Imene Chabchoub, B. Trimech, J. Bouguila, A. Tej, L. Boughammoura, and H. Rouatbi
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Pulmonary and Respiratory Medicine ,Gynecology ,medicine.medical_specialty ,Intrapulmonary shunts ,business.industry ,Medicine ,Lung scan ,business - Abstract
Resume La maladie de Gaucher est une maladie lysosomiale non exceptionnelle en Tunisie. Le type 1 est de loin le plus frequent. L’atteinte pulmonaire est consideree comme rare mais souvent grave. Elle peut avoir plusieurs mecanismes puisqu’il peut s’agir d’une atteinte interstitielle secondaire a l’infiltration par les cellules de Gaucher, d’une hypertension arterielle pulmonaire ou des shunts arterio-veineux intrapulmonaire. Nous rapportons une observation d’un syndrome hepatopulmonaire compliquant une maladie de Gaucher type 1 chez un enfant âge de 14 ans. Le diagnostic de la maladie de Gaucher a ete confirme a l’âge de deux ans par le dosage enzymatique de la β-glucosidase intraleucocytaire. L’enfant a presente une dyspnee d’aggravation progressive avec un hippocratisme digital et une cyanose peribuccale. Les gaz du sang arteriel a l’air ambiant ont montre une hypoxemie severe avec une pression arterielle en oxygene (PaO2) a 56,9 mmHg. Le diagnostic du syndrome hepatopulmonaire a ete confirme par la constatation d’un shunt intrapulmonaire a l’echographie cardiaque couplee a l’epreuve aux microbulles et la scintigraphie pulmonaire de perfusion aux macroagregats d’albumine. Le traitement enzymatique substitutif de la maladie de Gaucher etant indisponible pour notre patient, il a ete traite symptomatiquement par une oxygenotherapie a domicile. La severite du syndrome hepatopulmonaire nous incite a pratiquer regulierement un depistage precoce chez les enfants ayant une maladie hepatique chronique.
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- 2012
8. Digestive Malacoplakia in Children: Case Report
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A. Harbi, M. Mokni, L. Boughammoura, A. S. Essoussi, K. Brahim, J. Bouguila, and K. Skandrani
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Pathology ,medicine.medical_specialty ,Abdominal pain ,business.industry ,Case Report ,Histology ,Disease ,Malacoplakia ,medicine.disease ,Gastroenterology ,Chronic diarrhea ,Levofloxacin ,Internal medicine ,medicine ,Histopathology ,medicine.symptom ,business ,medicine.drug ,Rectal hemorrhage - Abstract
Malacoplakia is a form of chronic granulomatous inflammatory reaction that rarely affects the pediatric age group. The gastrointestinal system is the second most common site for the occurrence of malacoplakia. We report the case of a 9-year-old girl who was hospitalized for abdominal pain, chronic diarrhea, and rectal hemorrhage. The endoscopic examinations and histopathology confirmed the diagnosis of intestinal malacoplakia. We successfully treated her with oral levofloxacin. This disease does not have any specific clinical or biological signs, and the diagnosis is exclusively based on histology.
- Published
- 2011
9. Le risque infectieux viral chez le polytransfusé : séroprévalence de sept agents viraux dans le centre tunisien
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M. Tfifha, M. Marzouk, A. Khlif, H. Skouri, S. Soussi, Jalel Boukadida, Naila Hannachi, and L. Boughammoura
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Gynecology ,medicine.medical_specialty ,Blood donor ,business.industry ,Tropical medicine ,medicine ,virus diseases ,Infectious risk ,North africa ,business ,Pathology and Forensic Medicine ,Serology - Abstract
Nous avons etudie 107 patients polytransfuses (59 adultes et 48 enfants) et 160 temoins (100 donneurs de sang et 60 enfants n’ayant jamais ete transfuses). Des tests immunoenzymatiques ont ete utilises pour la detection de l’antigene HBs (Ag HBs), des anticorps diriges contre le virus de l’hepatite C (anti-VHC) et le virus de l’immunodeficience humaine (anti-VIH) et des anticorps de type IgG diriges contre le cytomegalovirus (IgG anti-CMV), le parvovirus B19 (IgG anti-PB19) et le virus de l’hepatite E (IgG anti-VHE). Les anticorps de type IgG diriges contre l’herpesvirus humain de type 8 (IgG anti-HHV8) ont ete detectes par immunofluorescence. Les prevalences de l’Ag HBs, des anti-VHC, des anti-VIH, des IgG anti-CMV, des IgG anti-PB19, des IgG anti-VHE et des anti-HHV8 dans le groupe polytransfuse etaient respectivement de 8,4, 4,7, 0, 86,9, 60,7, 28,9 et 47,6%; dans le groupe temoin ces memes prevalences etaient respectivement de 1,8, 0,6, 0, 86,2, 53,1, 10 et 12,5 %. La difference entre les deux groupes etait statistiquement significative pour l’Ag HBs (p = 0,01), l’anti-VHC (p = 0,03), les IgG anti-VHE (p < 10−4) et les IgG anti-HHV8 (p < 10−4). L’analyse de ces prevalences en fonction de l’âge a montre que l’association entre marqueurs serologiques des hepatites B et C avec la polytransfusion etait limitee au groupe des adultes. Dans le groupe des polytransfuses, l’infection par le HHV8 etait significativement plus importante chez les sujets nes avant la date de l’instauration de l’utilisation de produits sanguins deleucocytes chez les polytransfuses. Nos resultats corroborent les donnees de la litterature sur le risque de transmission transfusionnelle du VHE et du HHV8. La vaccination contre l’hepatite B et l’amelioration des tests de depistage ont un role important dans la reduction du risque de transmission des hepatites B et C chez les jeunes polytransfuses. Le risque residuel de transmission virale persiste pour plusieurs virus et necessite des efforts supplementaires en matiere de securite transfusionnelle.
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- 2011
10. Caractéristiques épidémiologiques et bactériologiques des bactéries uropathogènes isolées dans un milieu pédiatrique
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S. Tilouche, H. Mkaddemi, A. Ferjani, N. Hannechi, M. Marzouk, J. Boukadida, and L. Boughammoura
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Gynecology ,medicine.medical_specialty ,business.industry ,Pediatrics, Perinatology and Child Health ,medicine ,business ,Beta lactam antibiotics - Abstract
Resume L’infection urinaire (IU) de l’enfant est une pathologie grave qui necessite une prise en charge rapide et efficace. Les donnees bacteriologiques et epidemiologiques jouent un role determinant dans la prise en charge du patient. Nous rapportons une etude retrospective qui s’etale du 1er janvier au 31 aout 2009, ayant concerne les enfants hospitalises dans le service de pediatrie du CHU Farhat Hached de Sousse (Tunisie) pour IU. Notre serie a comporte 51 enfants avec un sex-ratio de 0,76, un âge moyen de 32 mois. La majorite des cas etait des pyelonephrites (94,1 %). Une pathologie est associee a l’IU dans 41,2 %. Trois cas de reflux vesico-ureteral ont ete notes. Le diagnostic d’IU a ete confirme par l’examen cytobacteriologique des urines (ECBU). Les enterobacteries etaient isolees dans 96,1 %. Escherichia coli vient au premier rang (80,4 %), suivi de Klebsiella pneumoniae (9,8 %) puis de Proteus mirabilis (5,9 %). E. coli etait resistante a l’amoxicilline dans 78 % des cas, a l’association amoxicilline-acide clavulanique dans 64,8 % des cas, aux cephalosporines de 3e generation (C3G) dans 5 % et au cotrimoxazole dans 51 %. Aucune souche de K. pneumoniae ou de P. mirabilis n’etait resistante aux C3G. L’IU de l’enfant est toujours une indication a la realisation en premiere intention d’un ECBU. Les resultats de cet examen sont tres importants compte tenu de la diversite des bacteries responsables et de la frequence grandissante de la resistance acquise aux antibiotiques.
- Published
- 2011
11. Maladie de Castleman localisée cervicale chez l’enfant
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I. Lahmer, M. Abdelkefi, J. Bouguila, M. Trimeche, A. Affissath, and L. Boughammoura
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Otorhinolaryngology ,Surgery - Abstract
Resume Introduction La maladie de Castleman est un syndrome lymphoproliferatif rare et benin. Sa localisation cervicale a ete rarement rapportee dans la litterature pediatrique. Observation Nous rapportons l’observation d’un garcon âge de 13 ans hospitalise pour exploration d’une tumefaction cervicale droite evoluant depuis trois mois. L’examen clinique a trouve une adenopathie lisse et mobile, au niveau du muscle sternocleidomastoidien profond. L’enfant a beneficie d’une exerese complete de la lesion dont l’etude histopathologique etait en faveur d’une maladie de Castleman dans sa forme hyaline vasculaire. Les suites operatoires etaient simples avec absence de recidive apres un recul d’un an. Discussion/conclusion La localisation cervicale de la maladie de Castleman localisee est souvent pauci-symptomatique et rarement evoquee devant une masse cervicale chez l’enfant. Le diagnostic de certitude est anatomopathologique. La maladie de Castleman localisee de type hyaline vasculaire est d’excellent pronostic apres exerese complete de la lesion.
- Published
- 2013
12. Schwannome de la base de la langue chez l’enfant
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L. Boughammoura, I. Khalef, M. BenAli, J. Bouguila, N. Soyah, and B. Sriha
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Gynecology ,medicine.medical_specialty ,Otorhinolaryngology ,Philosophy ,medicine ,Surgery ,General Medicine ,Oral Surgery - Abstract
Resume Introduction Le schwannome est une tumeur benigne du systeme nerveux peripherique de croissance tres lente. Sa localisation au niveau de la base de la langue est extremement rare et n’a ete rapportee dans la litterature qu’a deux reprises chez de tres jeunes patients. Observation Une patiente de 15 ans a ete hospitalisee en urgence pour hematemese de moyenne abondance. L’examen clinique a revele une tumefaction de la base de la langue a l’origine de ce saignement. Cette lesion evoluait depuis l’âge de trois ans sans qu’une prise en charge medicale n’ait ete effectuee. L’analyse post-exerese complete indiquait un schwannome de la base de la langue. Les suites postoperatoires ont ete simples et aucune recidive n’a ete detectee apres six mois. Discussion La particularite de cette observation etait le tres jeune âge de la patiente lors de l’apparition de la tumeur et sa localisation exceptionnelle a la base de la langue. Le pronostic est favorable en cas de lesion unique, apres exerese complete. Une neurofibromatose type 2 doit etre exclue, etant donne le risque de transformation maligne lie a cette maladie.
- Published
- 2013
13. [Clinico-biological and immunohaematological profile of patients with β-thalassemia in Tunisia: about 26 cases]
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H, Romdhane, H, Amara, S, Abdelkefi, N, Souyeh, T, Chakroun, I, Jarrey, M, Bouslama, S, Belhedi, B, Houissa, L, Boughammoura, and S, Jemni Yacoub
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Male ,Erythrocytes ,Tunisia ,Adolescent ,Hospital Departments ,Autoimmunity ,Pediatrics ,Hospitals, University ,Hemoglobins ,Humans ,Blood Transfusion ,Child ,Growth Disorders ,Quality of Health Care ,Retrospective Studies ,beta-Thalassemia ,Infant ,Transfusion Reaction ,Chelation Therapy ,Failure to Thrive ,Child, Preschool ,Face ,Ferritins ,Splenomegaly ,Patient Compliance ,Female - Abstract
To study the clinical and biological profile of β-thalassemic patients in our region, reflecting the quality of their care.A retrospective study (2010-2011) on 26 β-thalassemic patients followed in the pediatrics service at CHU Farhat Hached Sousse, Tunisia. Epidemiological, clinical and biological data were collected from medical records and transfusion files of patients. The transfusion protocol adopted was to maintain a hemoglobin level10g/dL by regular transfusions every 3-4 weeks. Iron chelation therapy, in order to maintain serum ferritin1500ng/mL, was introduced when serum ferritin exceeded 800-1000ng/mL.The mean age of patients at diagnosis was 15 months. The clinical impact of anemia had resulted in failure to thrive in 54% of patients and facial dysmorphism in 23%. The average transfusion requirement was estimated at 311.02mL/kg/year with 6 cases of hyperconsumption. The immunohaematological monitoring showed the appearance of anti-RBC alloimmunization in one patient and 4 cases of autoimmunization. Poor adherence of chelation therapy was 62% and causing 5 cases of cardiac complications, 4 cases of liver injury and 14 cases of endocrine complications.Improving the therapeutic care of β-thalassemic children requires better monitoring of transfusion recovery and improved adherence to chelation therapy.
- Published
- 2014
14. [Comparative study of C-reactive protein and procalcitonin in the severity diagnosis of pyelonephritis in children]
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J, Bouguila, I, Khalef, B, Charfeddine, M, Ben Rejeb, K, Chatti, K, Limam, H, Essabbeh, A S, Essoussi, and L, Boughammoura
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Calcitonin ,Male ,Adolescent ,Pyelonephritis ,Calcitonin Gene-Related Peptide ,Infant, Newborn ,Infant ,Sensitivity and Specificity ,Severity of Illness Index ,C-Reactive Protein ,Predictive Value of Tests ,Child, Preschool ,Humans ,Female ,Protein Precursors ,Child ,Radionuclide Imaging ,Succimer - Abstract
The aim of this study is to compare two biologic parameters; C-reactive protein (CRP) and procalcitonin (PCT) in the detection of acute renal lesions assessed by DMSA scintigraphy in the urinary tract infection in child.In a prospective study, serum PCT, CRP and leukocyte counts were measured for children admitted, between January and December 2010, with a first episode of febrile urinary tract infection.Seventy-five children were enrolled in the study. Thirty-three patients had renal lesions (group A) and 42 had a normal DMSA scintigraphy (group B). The mean PCT level was significantly higher in group A than in group B (8.81 ng/mL versus 1.7 ng/mL, P=0.01). In this study, using receiver operating characteristic (ROC) curve, we identified that the optimal cut-off value with ideal sensitivity and specificity for PCT in detection of renal lesions was 0.76 ng/mL and for CRP, it was 70 mg/L. The sensitivity, the negative predictive value and the indice of Youden of the cut-off value of PCT were significantly higher than CRP (82% versus 70%; 84% versus 70% and 0.58 versus 0.25).This study confirmed that the serum PCT level was more sensitive and specific than the CRP in the detection of renal lesions in the first urinary tract infection in child.
- Published
- 2012
15. [Tongue base schwannoma in a child]
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J, Bouguila, I, Khalef, M, BenAli, B, Sriha, N, Soyah, and L, Boughammoura
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Adolescent ,Tongue ,Age Factors ,Humans ,Female ,Hematemesis ,Neurilemmoma ,Tongue Neoplasms - Abstract
A schwannoma is a benign slow growing tumor originating from the peripheral nerve sheath. Its tongue base location is extremely rare, especially in very young patients.A 15-year-old female patient was admitted in emergency for moderate hematemesis. The clinical examination revealed swelling of the tongue base, causing the bleeding. This lesion had appeared when she was 3years of age and no treatment was done. A complete surgical excision was performed and the histopathological examination allowed diagnosing a tongue base schwannoma. The postoperative outcome was uneventful, and no recurrence was detected 6months after surgery.The particularities of this report are the patient's very young age and the tumor's tongue base location. The prognosis is usually good after complete excision, if there is only one tumor. Type 2 neurofibromatosis should be excluded, given the risk of malignant degeneration.
- Published
- 2011
16. [Hepatopulmonary syndrome: a complication of type 1 Gaucher disease]
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J, Bouguila, H, Rouatbi, A, Tej, I, Chabchoub, B, Trimech, S, El Ajmi, A S, Essoussi, and L, Boughammoura
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Male ,Gaucher Disease ,Adolescent ,Echocardiography ,Oxygen Inhalation Therapy ,Humans ,Technetium Tc 99m Aggregated Albumin ,Hepatopulmonary Syndrome - Abstract
Gaucher's disease is a not exceptional lysosomial disease in Tunisia. Type 1 is by far the most common one. Pulmonary involvement is considered to be rare in type 1 Gaucher's disease. Pulmonary hypertension, infiltration of the lungs with Gaucher cells, and severe hypoxemia due to intrapulmonary arterial-venous shunts, have been described in case reports and small case series. We reported the case of hepatopulmonary syndrome in a 14-year-old boy with type 1 Gaucher disease. The diagnosis of Gaucher disease was established, at 2 years age, by enzyme assay of leucocyte β-glucosidase. The patient presented dyspnoea, digital clubbing and cyanosis of the lips. The arterial blood gas found severe hypoxaemia with PaO(2) at 56.9 mmHg. The diagnosis of hepatopulmonary syndrome, in our patient, was confirmed by demonstration of the intrapulmonary shunting using contrast-enhanced echocardiography and the technetium-99m-labeled macroaggregated albumin. The patient was treated by symptomatic measure, long term oxygen therapy because the insufficiency of the enzyme replacement therapy. Screening for hypoxemia in children with liver disease should be considered.
- Published
- 2010
17. [Epidemiological and bacteriological characteristics of uropathogen bacteria isolated in a pediatric environment]
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A, Ferjani, H, Mkaddemi, S, Tilouche, M, Marzouk, N, Hannechi, L, Boughammoura, and J, Boukadida
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Male ,Bacteria ,Child, Preschool ,Urinary Tract Infections ,Humans ,Female ,Retrospective Studies - Abstract
Urinary tract infection (UTI) in children is a grave pathology, which requires a fast and effective care. Bacteriological and epidemiological data play a determining role in patient's care. We report a retrospective study, which spreads out from January 1st till August 31st, 2009, having concerned hospitalized children for urinary infection in pediatrics service of Farhat Hached teaching hospital in Sousse. Our series contained 51 children with a sex ratio of 0.76, an average age of 32 months. The majority of cases was pyelonephritis (94.1%). A pathology is associated with the urinary infection in 41.2%. Three cases of vesico-ureteral reflux were noted. The diagnosis of urinary infection was confirmed by cytobacteriological exam of urine (CBEU). Enterobacteriacea were isolated in 96.1%. Escherichia coli remains the most often isolated (80.4%), followed by Klebsiella pneumoniae (9.8%) then by Proteus mirabilis (5.9%). E. coli was resistant to amoxicillin in 78% of cases, to the association amoxicillin-clavulanic acid in 64,8%, to cephalosporins of 3(rd) generation (C3G) in 5% and to cotrimoxazole in 51%. No K. pneumoniae or P. mirabilis strain was resistant to C3G. UTI in children is always an indication for CBEU realization at first intention. The results of this exam are very important considering the diversity of the responsible bacteria and the growing frequency of acquired antibiotic resistance.
- Published
- 2010
18. [Seroprevalence and risk factors of human herpes virus 8 infection in Central-East Tunisia]
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N, Hannachi, N, Ben Fredj, S, Samoud, A, Ferjani, A, Khlif, L, Boughammoura, S, Soussi, M, Aouni, H, Skouri, and J, Boukadida
- Subjects
Adult ,Male ,Tunisia ,Adolescent ,Sexual Behavior ,Sexually Transmitted Diseases ,Infant ,Herpesviridae Infections ,Middle Aged ,Antibodies, Viral ,Young Adult ,Pregnancy ,Risk Factors ,Seroepidemiologic Studies ,Child, Preschool ,Herpesvirus 8, Human ,Humans ,Female ,Pregnancy Complications, Infectious ,Child - Abstract
Epidemiology of human herpesvirus 8 (HHV8) is still unknown in Tunisia. We aimed to assess the prevalence of HHV8 infection in adults and children from Central-East Tunisia and in patients with high risk of parenteral or sexual infection.We enrolled 553 subjects: 116 blood donors, 100 pregnant women, 100 children, 50 subjects with sexually transmitted infections with positive HIV serology and 50 other without HIV infection, 107 multitransfused patients and 30 kidney transplant patients. Antibodies against HHV8 were tested using a sensitive indirect immunofluorescence assay.The seroprevalence of HHV8 was found to be 13.8% in blood donors, 13% in pregnant women and 12% in children. In healthy adult population, no association was found between HHV8 seropositivity and sex, sociodemographic characteristics, parenteral risk factors or serological markers of hepatitis B. Rates of HHV8 infection were significantly higher in patients having high-risk sexual behavior with or without HIV infection (P10(-4)), in polytransfused patients (P10(-4)) and in patients with kidney transplantation (P=0.001).Our findings suggest that HHV8 infection is widespread in Central-East Tunisia such as in the Mediterranean area. HHV8 infection appears to be acquired early in life, probably through saliva. HHV8 transmission by blood transfusion, subject of controversy in literature, is well established in our study. Early screening of this infection should be considered in populations with high risk of Kaposi's sarcoma in our areas.
- Published
- 2010
19. [Viral infection risk in polytransfused adults: seroprevalence of seven viruses in central Tunisia]
- Author
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N, Hannachi, L, Boughammoura, M, Marzouk, M, Tfifha, A, Khlif, S, Soussi, H, Skouri, and J, Boukadida
- Subjects
Adult ,Male ,Risk ,Tunisia ,Adolescent ,Hepatitis, Viral, Human ,Blood Donors ,HIV Infections ,Antibodies, Viral ,Parvoviridae Infections ,Immunocompromised Host ,Young Adult ,Seroepidemiologic Studies ,Parvovirus B19, Human ,Humans ,Child ,Aged ,Aged, 80 and over ,Infant ,Transfusion Reaction ,Herpesviridae Infections ,Middle Aged ,Immunoglobulin M ,Child, Preschool ,Immunoglobulin G ,Female - Abstract
The aim of this study is to evaluate the prevalence of seven transfusion-transmitted viruses in polytransfused adults and children comparatively with a group of healthy control subjects. We studied 107 polytransfused patients (59 adults and 48 children) and 160 control subjects (100 blood donors and 60 children). Immunoenzymatic tests were used for detection of HBs antigen (HBs Ag), antibodies against hepatitis C Virus (anti-HCV), and human immunodeficiency virus (anti-HIV), and IgG antibodies against human cytomegalovirus (IgG anti-CMV), human parvovirus B19 (IgG anti-PB19), and hepatitis E virus (IgG anti-HEV). An immunofluorescent assay was performed for the detection of human herpesvirus 8 antibodies (anti-HHV8). Prevalence of HBs Ag, anti-HCV, anti-HIV, IgG anti-CMV, IgG anti-PB19, IgG anti-HEV, and anti-HHV8 in polytransfused group was 8.4, 4.7, 0, 86.9, 60.7, 28.9, and 47.6%, respectively, and 1.8, 0.6, 0, 86.2, 53.1, 10, and 12.5%, respectively, in the control group. The difference in prevalence between the two groups was statistically significant for HBs Ag (P = 0.01), anti-HCV (P = 0.03), IgG anti-HEV (P10(-4)), and IgG anti-HHV8 (P10(-4)). Categorization according to age showed that hepatitis B and C risk was limited in adult polytransfused group. HHV8 infection was higher in polytransfused subjects born before the use of leucocyte-depleted blood components. Our results corroborate literature data on the risk of HEV and HHV8 infection by blood transfusion. Hepatitis B vaccination and improvement in screening tests have an important role in reduction of hepatitis B and C risk in transfusion, especially in young polytransfused persons. However, a residual risk of transmitting viral infections persists, and efforts are needed to improve transfusion safety.
- Published
- 2010
20. Anticonvulsivant-induced dress syndrome in Children: two cases
- Author
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C. Ben Salem, Neila Fathallah, A. Mlika, H. Zayani, R. Slim, L. Boughammoura, and S. Larif
- Subjects
Pharmacology ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Betamethasone dipropionate ,medicine.disease ,Dermatology ,Interferon ,Erythematous plaque ,Skin biopsy ,Etiology ,Medicine ,Pharmacology (medical) ,medicine.symptom ,business ,Parakeratosis ,Isotretinoin ,medicine.drug ,Spongiosis - Abstract
August 2015 e53 Case Description: A woman in her 40S was diagnosed with the relapsing remitting form of MS. Four months after the first dose of interferon beta-1b (8 million units, one time weekly), the patient was seen in the dermatology clinic for evaluation of pruritus and multiple eczema-like lesions on the legs and bottom. Physical examination findings revealed erythematous nummular patches on the legs and bottom with linear excoriations (Figure 1). Involved skin biopsy revealed a mild epidermal hyperplasia with spongiosis and lymphocyte exocytosis, overlying parakeratosis and a perivascular lymphocytic dermal infiltrate including rare eosinophils. Interferon beta-1b was withdrawn, and the patient received 0.05% betamethasone dipropionate ointment. There was an improvement of the lesions. Two months later, interferon was readministrated and few days later the patient noted an aggravation of the previous lesions with development of new lesions. Interferon was definitely stopped. Discussion: In our case, the pathogenic role of the interferon beta-1b seems likely, because the lesions occurred during the course of treatment, regressed after withdrawing the treatment, reappeared after the reintroduction of interferon, and other evident etiologies of eczema were absent. Skin manifestations resulting from treatment with interferon beta-1b consist principally of injection-site reaction with lesions varying from sclerotic dermal plaques to erythematous plaques to cutaneous ulcers. The etiology of nummular eczema is multifactorial, involving allergic, environmental, emotional, and nutritional factors. Drugs such as isotretinoin, interferon alfa-2b and ribavirin are rarely reported to be a trigger factor. Conclusion: Physicians should be aware of this side effect induced by interferon beta-1b.
- Published
- 2015
21. P-340 – Manifestations respiratoires dans les déficits immunitaires primitives
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D. Zouari, A. Tej, L. Boughammoura, J. Bouguila, A. Mlika, S. Tilouche, N. Soyah, N. Kahloul, and R. Barbouche
- Subjects
Pediatrics, Perinatology and Child Health - Published
- 2015
22. SFP P-147 – Pneumonies nécrosantes chez l’enfant
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R. Kebaili, J. Bouguila, S. Tilouche, C. Moulahi, N. Soyah, L. Boughammoura, and A. Tej
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Pediatrics, Perinatology and Child Health - Abstract
Objectif rapporter une serie de 25 observations de pneumonies necrosantes (PN) et de decrire les particularites epidemiologiques, cliniques et evolutives. Materiel et methodes etude retrospective colligeant les enfants hospitalises entre 2000 et 2012 pour une PN. Resultat Nos patients etaient âges de 36,1 mois en moyenne, repartis en 15 garcons et 10 filles. Une augmentation du nombre des cas etait observee a partir de 2008. Le delai entre le debut de la symptomatologie et l’hospitalisation etait de 10,9 jours. Durant cette periode, 72% des malades avaient recu des antibiotiques et 48% des anti-inflammatoires non steroidiens. Le diagnostic de PN etait confirme par le scanner thoracique en revelant les images de condensation pulmonaire et de cavites de necrose. Une antibiotherapie intraveineuse etait instauree chez tous les patients avec un relai par voie orale. Trois patients ont necessite le drainage chirurgical. Une lobectomie etait effectuee chez une patiente. L’evolution etait favorable pour tous nos patients au prix d’une hospitalisation prolongee. Conclusion La PN est une complication rare et severe des pneumonies communautaires qui devient de plus en plus frequente chez l’enfant. Dans notre serie, l’evolution etait favorable au prix de certaines sequelles.
- Published
- 2014
23. Le débit expiré forcé 25-75 est une grandeur prédictive de l’augmentation du NO exhalé
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C. Aouichaoui, Zouhair Tabka, L. Boughammoura, and F. Chaieb
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Immunology and Allergy - Published
- 2013
24. Cervical unicentric Castleman's disease in children
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I. Lahmer, L. Boughammoura, A. Affissath, M. Trimeche, J. Bouguila, and M. Abdelkefi
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Male ,Pathology ,medicine.medical_specialty ,Adolescent ,Physical examination ,Disease ,Complete resection ,Lesion ,Neck Muscles ,medicine ,Humans ,Child ,Lymph node ,medicine.diagnostic_test ,business.industry ,Castleman Disease ,Castleman's disease ,Magnetic Resonance Imaging ,medicine.anatomical_structure ,Otorhinolaryngology ,Surgical excision ,Surgery ,Good prognosis ,medicine.symptom ,business ,Sternocleidomastoid muscle ,Neck - Abstract
Summary Introduction Unicentric Castleman's disease (CD) is a rare benign lymphoproliferative disorder. A cervical location has rarely been reported in the pediatric literature. Case report A 13-year-old boy presented with a mass in the right neck region of 3 months’ evolution. Clinical examination revealed a smooth mobile 5 cm node deep in the sternocleidomastoid muscle. The diagnosis of hyaline vascular type CD was confirmed by complete surgical excision and histopathologic examination. Postoperative course was simple, without recurrence over 1 year's follow-up. Discussion and conclusion Cervically located CD often shows few symptoms, and is rarely suggested by a cervical mass found in children. Definitive diagnosis is histopathological. The hyaline vascular type of unicentric CD has a good prognosis after complete resection of the lesion.
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25. Effect of diabetes self-management education on health-related quality of life of Tunisian children with type1 diabetes mellitus and their parents: A randomized controlled trial.
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Ben Abdesselem I, Kebaili R, Derbel K, Ben Said H, Boughammoura L, Rouatbi S, and Bouguila J
- Subjects
- Humans, Tunisia, Child, Male, Female, Adolescent, Follow-Up Studies, Diabetes Mellitus, Type 1 therapy, Diabetes Mellitus, Type 1 psychology, Quality of Life, Parents psychology, Self-Management education, Self-Management methods, Self-Management psychology, Patient Education as Topic methods
- Abstract
Aim: To assess the effect of diabetes self-management education (DSME) on health related quality of life (HRQoL) of Tunisian children/adolescents with type 1 diabetes mellitus and their parents., Methods: This monocentral study used a randomized controlled trial design, during five-month intervention and five-month follow-up and including 110 patients (54 in the DSME intervention group and 56 in the Individual Education by Pediatrician (IEP) control group) and their parents. Pediatric Generic Core Quality-of-Life Inventory 4.0-Scale (PedsQL4.0) evaluated HRQoL., Results: At baseline, both groups had similar clinical features and PedsQL4.0 scores (p>0.05). In DSME, clinical outcomes were significantly improved from baseline to follow-up (p<0.001), while in the IEP group, which received no intervention, these outcomes remained unchanged. During follow-up, DSME showed higher PedsQL4.0 scores in parents' proxy-report and children/adolescents self-report (p<0.001). According to parents' proxy-report, PedsQL4.0 scores were significantly higher during follow-up compared to baseline in DSME (p<0.001) while they remained the same in IEP (p>0.05). DSME had higher percentage of change in the PedsQL4.0 scores than IEP (p<0.01). The median change varied from -5.01% to 0% vs 5.41% to 36.36% in IEP and DSME, respectively., Conclusion: Encouraging healthcare professionals to incorporate these interventions could enhance the HRQoL of diabetic children and bolster their self-esteem.
- Published
- 2024
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26. Access to Care and Therapy for Kawasaki Disease in the Arab Countries: A Kawasaki Disease Arab Initiative (Kawarabi) Multicenter Survey.
- Author
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Alzyoud R, El-Kholy N, Arab Y, Choueiter N, Harahsheh AS, Aselan AS, Kotby A, Bouaziz A, Salih AF, Abushhaiwia A, Alahmadi F, Agha HM, Elmarsafawy HM, Alrabte H, Al-Saloos H, Boudiaf H, Hijazi I, Bouayed K, Al Senaidi KS, Boughammoura L, Jalal M, Ladj MS, Abu-Shukair ME, ElGanzoury MM, Hammadouche N, Elsamman N, Mouawad P, Boukari R, Benalikhoudja N, Jdour S, Abu Al-Saoud SY, Touri SN, Kammoun T, Fitouri Z, and Dahdah N
- Subjects
- Child, Humans, Infant, Child, Preschool, Immunoglobulins, Intravenous therapeutic use, Arabs, Health Services Accessibility, Mucocutaneous Lymph Node Syndrome diagnosis, Mucocutaneous Lymph Node Syndrome epidemiology, Mucocutaneous Lymph Node Syndrome therapy, Heart Diseases
- Abstract
Kawasaki Disease (KD) is still the most common acquired heart disease in children below the age of five years; it has been well described in the developed world; however, data from the Arab world are limited to case reports or single-center case series. In an effort of optimizing KD research in the Arab world, a group of physicians and researchers established the KD Arab Initiative (Kawarabi) in 2021, and published the first survey, which showed disparities in the availability of intravenous immunoglobulin (IVIG); this had prompted Kawarabi to assess the access to care and therapy of KD patients in Arab countries. A 32 structured questions survey was conducted in thirteen Arab countries and addressed KD patients' access to healthcare in urban and rural settings. The survey results showed that access to care was uniform across large, mid-size cities and rural areas in 7/13 (54%) countries, while in 6/13 (46%) countries, it was in favor of large and mid-size cities over rural areas. The quality of medical services received by children with KD in large cities was rated as excellent in 6/13 or good in 7/13 countries compared to fair in 4/13 or poor in 4/13 countries in rural areas. Availability of IVIG was limited (23%) in mid-size cities and almost impossible (23%) in rural areas. The KD patients in mid-size cities and rural areas have limited access to standard healthcare in the Arab world. This survey laid the foundation for future Kawarabi endeavors to improve the care of children with KD., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
- Published
- 2023
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27. Fulminant Encephalitis Caused by SARS-CoV-2 in a Two-Month-Old Infant.
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Abdelbari M, Tilouche S, Hannachi S, Bouguila J, Hannachi N, and Boughammoura L
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- Humans, Infant, SARS-CoV-2, COVID-19 complications, Encephalitis
- Published
- 2023
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28. Reversibility of pancreatic β-cells dysfunction after vitamin D and calcium supplementation: a pilot study in a population of obese and prepubescent North-African children.
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Gaddas M, Latiri I, Kebaili R, Kacem I, Jaballah N, Maatoug J, Salaani M, Boughammoura L, and Ben Saad H
- Subjects
- Blood Glucose metabolism, Child, Dietary Supplements, Female, Humans, Insulin, Male, Obesity, Pilot Projects, Vitamin D, Vitamins, Calcium, Insulin Resistance
- Abstract
The mechanisms of diabetogenesis in children remain largely obscure. This study aimed to determine the impact of vitamin D and calcium supplementation on pancreatic β-cells function in terms of insulin secretion and sensitivity. This was a quasi-experimental study involving 30 obese and prepubescent Tunisian children (57% boys). During three months, the children received calcium and vitamin D supplementation at therapeutic doses. An oral glucose tolerance test (OGTT) was performed at the beginning and at the end of the study. The following metabolic definitions were applied: i) hyperinsulinism: insulinemia sum > 300 μ UI/ml during OGTT, ii) insulin-resistance: homeostatic model assessment of insulin-resistance > 2, iii) normal glycaemic profile: normal plasma levels during OGTT without any spike, and iv) pancreatic β-cells dysfunction reversibility: disappearance of the aforementioned disorders. The means ± standard-deviation of age and body mass index were 10.87 ± 1.9 years, and 30.17 ± 4.99 kg/m
2 , respectively. All children were at the stage of hyperinsulinism associated with insulin-resistance. These disturbances were noted even in children having a normal glycaemic profile at OGTT. After calcium and vitamin D supplementation, glycaemic profile as well as insulin-secretion improved significantly ( p < 0.0001 ). Hyperinsulinism and insulin-resistance decreased significantly by 56.67% ( p < 0.0001 ) and 70.00% ( p < 0.0001 ), respectively. Complete reversibility of these two disorders was noted in 26.6% of children. To conclude, in obese and prepubescent children, vitamin D and calcium supplementation led to the reversibility of the pancreatic β-cells dysfunction.- Published
- 2022
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29. [Coronary artery aneurysm in Kawasaki disease and its risk factors : a retrospective study about 65 Tunisian children].
- Author
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Ajmi H, Ghorbel S, Ezzi O, Mabrouk S, Mansour K, Kahloul N, Chemli J, Zouari N, Mejaouel H, Boughammoura L, and Abroug S
- Subjects
- Adolescent, Child, Coronary Vessels, Female, Humans, Infant, Male, Retrospective Studies, Risk Factors, Coronary Aneurysm diagnostic imaging, Coronary Aneurysm epidemiology, Coronary Aneurysm etiology, Coronary Artery Disease complications, Coronary Artery Disease etiology, Mucocutaneous Lymph Node Syndrome complications, Mucocutaneous Lymph Node Syndrome diagnosis
- Abstract
Introduction: Kawasaki syndrome (KS) is a systemic vasculitis of unknown etiology that affects medium and small blood vessels. The aim of our study is to analyze coronary artery lesions in children with KS and their risk factors., Material and Methods: All children under the age of 15 years-old presenting KS and admitted in the pediatric department of three university hospital (Sahloul hospital, and Farhat Hached hospital of Sousse, Ibn El Jazzar hospital of Kairoun) from January 2000 to December 2018 were included., Results: Sixty-five patients were included in our study. The mean age at diagnosis was of 29.9 months [2-120 months] and the sex ratio was of 1.7. Echocardiography was performed in all patients. It showed coronary dilation in 37% of patients with coronary artery diameter of 4.2 mm on average [3.2-7mm]. The coronary aneurysm was small in 19 cases and medium in 5 cases. No giant aneurysm has been identified. In univariate analysis, the predictors of coronary artery lesions were male sex, atypical form, fever duration more than 10 days, hepatic cytolysis, thrombocytosis and anemia. In multivariate analysis, only the last four parameters were the predictive factors of the coronary artery involvement., Conclusion: Several risk factors can be used to determine which children are predisposed to develop coronary dilations. In case of patient with risk factors, intravenous immunoglobulins should be initiated early to avoid these serious complications., (Copyright © 2021 Elsevier Masson SAS. All rights reserved.)
- Published
- 2022
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30. Disseminated BCG infection revealing a severe combined immunodeficiency: A case report.
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Ben Belgacem H, Bouguila J, Tej A, Tilouche S, Kebaili R, Kahloul N, Barbouche MR, Soyah N, and Boughammoura L
- Abstract
Introduction: Bacillus Calmette Guerin (BCG) vaccine, which is administered to all newborns in Tunisia, can lead to serious complications ranging from local disease to disseminated disease in a group of patients with primary immunodeficiency diseases., Case Report: A 3-month-old boy presented with persistent fever, hepato-splenomegaly and multiple osteolytic lesions. He was diagnosed with severe combined immunodeficiency disease and disseminated BCG infection. Despite anti-tubercular therapy combined with intravenous immunoglobulin, the evolution was fatal., Conclusion: The case highlights the possible risk of such rare yet lethal complication of BCG vaccine. In suspected cases of primary immunodeficiency disease, inoculation of BCG should be postponed until appropriate screening tests exclude such diagnosis to prevent serious complications.
- Published
- 2022
31. Temporal and climate characteristics of respiratory syncytial virus bronchiolitis in neonates and children in Sousse, Tunisia, during a 13-year surveillance.
- Author
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Brini I, Bhiri S, Ijaz M, Bouguila J, Nouri-Merchaoui S, Boughammoura L, Sboui H, Hannachi N, and Boukadida J
- Subjects
- Child, Humans, Infant, Infant, Newborn, Male, Respiratory Syncytial Viruses, Seasons, Tunisia, Bronchiolitis, Respiratory Syncytial Virus Infections, Respiratory Tract Infections
- Abstract
This study established the correlation between respiratory syncytial virus (RSV) bronchiolitis and climate factors in the area of Sousse, Tunisia, during 13 years (2003-2015), from neonates and children <= 5 years old and hospitalized in Farhat Hached University-Hospital of Sousse. The meteorological data of Sousse including temperature, rainfall, and humidity were obtained. RSV detection was carried out with the direct immunofluorescence assay. The impact of climate factors on viral circulation was statistically analyzed. From 2003 to 2015, the total rate of RSV bronchiolitis accounted for 34.5% and peaked in 2007 and 2013. RSV infection was higher in male cases and pediatric environment (p<0.001) and was detected in 47.3% of hospitalizations in intensive care units. The epidemic of this pathogen started in October and peaked in January (41.6%). When the infectivity of RSV was at its maximum, the monthly average rainfall was high (31 mm) and the monthly average temperature and the monthly average humidity were at their minimum (11 °C and 66%, respectively). RSV activity was negatively correlated with temperature (r = - 0.78, p = 0.003) and humidity (r = - 0.62, p = 0.03). Regression analysis showed that the monthly average temperature fits into a linear model (R
2 = 61%, p < 0.01). No correlation between RSV activity and rainfall was observed (p = 0.48). The meteorological predictions of RSV outbreaks with specific Tunisian climate parameters will help in determining the optimal timing of appropriate preventive strategies. In the area of Sousse, preventive measures should be enhanced since October especially, when the temperature is around 11 °C and humidity is above 60%.- Published
- 2020
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32. Long term effect of a school based intervention to prevent chronic diseases in Tunisia, 2009-2015.
- Author
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Ghammam R, Maatoug J, Zammit N, Kebaili R, Boughammoura L, Al'Absi M, Lando H, and Ghannem H
- Subjects
- Case-Control Studies, Exercise, Female, Humans, Male, Noncommunicable Diseases epidemiology, Prevalence, Schools, Tunisia epidemiology, Chronic Disease epidemiology, Diet, Healthy, Health Promotion methods, Noncommunicable Diseases prevention & control, Program Evaluation methods
- Abstract
Background & Objectives: We aimed to evaluate the long term effect of school based intervention to prevent non- communicable disease risk factors., Methods: It was a quasi experimental study conducted during the period of 2009-2015. We involved school children aged from 11 to 16 years old. For the assessment of the program's effectiveness, subjects in both groups were examined at baseline, at the end of the 3-year intervention period and at the follow-up, one year after program's cessation., Results: In the intervention group, the prevalence of school children who reported to be eating 5 fruits and vegetable sdaily increased significantly from 30.0% at pre-assessment to 33.2% at post-assessment, one year after (p=0.02, p=0.41 respectively). For the control group, this prevalence had significantly decreased from 40.2% at baseline to 35.0% at post-intervention, at the follow up, this proportion increased to 44.5%(p=0.001, p<10
-3 respectively). Concerning smoking habits, we observed a decreasing trend in the intervention group from 5.7% at pre-assessment, to 4.8% at post-assessment and to 3.4% at the follow-up (p=0.19 and p=0.25 respectively). There was also a significant decrease in school children who did recommended physical activity in the same group., Conclusion: The present work showed that interventions promoting healthy lifestyles should be maintained. Developing countries should be encouraged and supported to design, conduct, and evaluate robust preventive interventions.- Published
- 2017
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33. Socio-demographic association of non communicable diseases' risk factors in a representative population of school children: a cross-sectional study in Sousse (Tunisia).
- Author
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El Ghardallou M, Maatoug J, Harrabi I, Fredj SB, Jihene S, Dendana E, Sana B, Zammit N, Boughammoura L, and Ghannem H
- Abstract
Introduction: A better understanding of socio-demographic characteristics of subgroups, which have a high risk to develop chronic diseases, is essential to develop more efficient interventional programs especially for youth. This study aimed to determine the association between clusters of non communicable diseases (NCDs') risk factors and the socio-demographic characteristics among a sample of Tunisian school children., Materials and Methods: We conducted, in 2013/2014, a cross-sectional study among a proportional and stratified school children sample, selected in 17 elementary public schools in Sousse (Tunisia). A cluster analysis was used to identify different NCDs risk factors clusters, based on tobacco use, physical inactivity, unhealthy diet, and excess weight. Subsequent χ2-tests were used to identify differences between the NCDs risk factors clusters in regards to socio-demographic characteristics., Results: Four clusters of NCDs risk factors were found: 1) Cluster 1: physical inactivity behavior with normal weight, 2) Cluster 2: physical inactivity behavior associated to excess weight, 3) Cluster 3: unhealthy diet associated to excess weight and low practice of physical activity, and 4) Cluster 4: smoking behavior with physical activity behavior. The pattern of cluster membership differed across sex (<10-3), school level, and socioeconomic level (<10-3) but there was no significant difference between clusters for mother's education levels and household tenure., Conclusion: This study can have important implications for health policy and practice. Indeed, it found that many subjects have simultaneous multiple NCDs risk factors which leads to identify groups at risk and implement integrated intervention program.
- Published
- 2016
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34. Report of the Tunisian Registry of Primary Immunodeficiencies: 25-Years of Experience (1988-2012).
- Author
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Mellouli F, Mustapha IB, Khaled MB, Besbes H, Ouederni M, Mekki N, Ali MB, Larguèche B, Hachicha M, Sfar T, Gueddiche N, Barsaoui S, Sammoud A, Boussetta K, Becher SB, Meherzi A, Guandoura N, Boughammoura L, Harbi A, Amri F, Bayoudh F, Jaballah NB, Tebib N, Bouaziz A, Mahfoudh A, Aloulou H, Mansour LB, Chabchoub I, Boussoffara R, Chemli J, Bouguila J, Hassayoun S, Hammami S, Habboul Z, Hamzaoui A, Ammar J, Barbouche MR, and Bejaoui M
- Subjects
- Age of Onset, Antibodies genetics, Complement System Proteins genetics, Consanguinity, Female, Humans, Immunologic Deficiency Syndromes classification, Immunologic Deficiency Syndromes mortality, Infant, Male, Prevalence, Survival Analysis, Tunisia, Antibodies metabolism, B-Lymphocytes physiology, Immunologic Deficiency Syndromes epidemiology, Registries, T-Lymphocytes physiology
- Abstract
Purpose: Primary immunodeficiencies (PIDs) are a large group of diseases characterized by susceptibility to not only recurrent infections but also autoimmune diseases and malignancies. The aim of this study was to describe and analyze the distribution, clinical features and eventual outcome of PID among Tunisian patients., Methods: We reviewed the record of 710 patients diagnosed with Primary Immunodeficiency Diseases (PIDs) from the registry of the Tunisian Referral Centre for PIDs over a 25-year period., Results: The male-to-female ratio was 1.4. The median age at the onset of symptoms was 6 months and at the time of diagnosis 2 years. The estimated prevalence was 4.3 per 100,000 populations. The consanguinity rate was found in 58.2 % of families. According to the International Union of Immunological Societies classification, spectrums of PIDs were as follows: combined T-cell and B-cell immunodeficiency disorders account for the most common category (28.6 %), followed by congenital defects of phagocyte (25.4 %), other well-defined immunodeficiency syndromes (22.7 %), predominant antibody deficiency diseases (17.7 %), diseases of immune dysregulation (4.8 %), defect of innate immunity (0.4 %) and complement deficiencies (0.4 %). Recurrent infections, particularly lower airway infections (62.3 %), presented the most common manifestation of PID patients. The overall mortality rate was 34.5 %, mainly observed with combined immunodeficiencies., Conclusion: The distribution of PIDs was different from that reported in Western countries, with a particularly high proportion of Combined Immunodeficiencies and phagocyte defects in number and/or function. More is needed to improve PID diagnosis and treatment in our country.
- Published
- 2015
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35. School-Based Intervention as a Component of a Comprehensive Community Program for Overweight and Obesity Prevention, Sousse, Tunisia, 2009-2014.
- Author
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Maatoug J, Msakni Z, Zammit N, Bhiri S, Harrabi I, Boughammoura L, Slama S, Larbi C, and Ghannem H
- Subjects
- Adolescent, Child, Energy Intake, Exercise physiology, Feeding Behavior psychology, Female, Health Education, Health Promotion methods, Humans, Longitudinal Studies, Male, Multivariate Analysis, Non-Randomized Controlled Trials as Topic, Outcome Assessment, Health Care statistics & numerical data, Program Evaluation, Protective Factors, Risk Factors, Surveys and Questionnaires, Tunisia, Vegetables, Comprehensive Health Care methods, Health Knowledge, Attitudes, Practice, Overweight prevention & control, Pediatric Obesity prevention & control, School Health Services trends
- Abstract
Introduction: Combating obesity at an early age, by improving physical activity and nutrition-related behaviors, is vital to the prevention of more critical health concerns in adulthood. This intervention study evaluated the effectiveness of a school-based component of a community behavioral intervention on overweight and obesity rates of adolescents in Sousse, Tunisia., Methods: A quasi-experimental school-based intervention was conducted with an intervention group (in Sousse Jawhara and Sousse Riadh) and a control group (in Sousse Msaken). The intervention (which was a physical activity and nutrition program) lasted 3 years, with data at preintervention collected during the 2009-2010 school year and at postintervention collected during the 2013-2014 school year. Descriptive statistics and multivariate analysis were used to determine the effect of the intervention on risk of excess weight., Results: Results showed a significant increase in fruit and vegetable intake by the intervention group (P = .04). The intervention group had an increase in students in the normal weight category (P = .03) and a decrease in students in the overweight category (P = .03).The intervention effect was a protective factor against excess weight for the participating schoolchildren (OR, 0.84; P = .02)., Conclusion: This study showed that a school-based intervention is successful in increasing healthy dietary habits and in reducing risk of excess weight. It also showed the importance of a multisectoral approach to provide an environment conducive to healthy behaviors for adolescents.
- Published
- 2015
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36. Baseline characteristics of a school based intervention to prevent non communicable diseases risk factors: Project "together in Health".
- Author
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Maatoug Maaloul J, Harrabi I, Ghammem R, Hmad S, Belkacem M, Slama S, Ben Mabrouk F, Boughammoura L, and Ghannem H
- Abstract
Background: Tobacco use, unhealthy diet, and physical inactivity are among the leading causes of the major non communicable diseases. So, prevention should take place early in childhood., Aim: In this paper, we will present an overview of project "Together in health" in schools, a component of a community based intervention. It consists on a school based intervention with the aim to improve knowledge, attitudes and behaviors concerning the main chronic disease risk factors such as unhealthy diet, physical inactivity and smoking., Methods: We conducted a quasi experimental design with intervention and control groups. The study concerned pupils of colleges of Sousse aged 11 to 16 years old in 7th and 9th grade. The pre-assessment concerned a randomized sample of schoolchildren. The proportional and stratified sample was composed of 4003 schoolchildren with 1929 and 2074 respectively in intervention and control groups. We used chi square test to compare percentages with 0.05 level of significance., Results: The sex ration was been 1 in the intervention group and 0.87 in control group. The mean age of our population was been 13.48±1.29 and 13.24±1.25 respectively in intervention and control groups with significant difference (p<10-3). Schoolchildren who reported practicing physical activity daily represented 19.1% and 12.7% respectively in intervention and control groups. Concerning eating habits, the schoolchildren reported frequency (number of days per week) of consuming various foods and beverages included respectively in the intervention and control group: vegetables 3.9 days/week and 4.81 days/week, fruits 5.41 days/week and 5.7 days/week, high fat food 2.49 days/week and 2.48 days/week, sweetened beverage 3.84 days/week and 3.3 days/week, sweets 4.33 days/week and 4.57 days/week. The proportion of irregular smokers was been respectively 6.8% and 2.2% among boys and girls in the intervention group and 11.3% and 0.9% in control group., Conclusion: Integrated and sustainable interventions against non communicable disease risk factors in this region are needed to prevent these diseases early in childhood.
- Published
- 2015
37. [Clinico-biological and immunohaematological profile of patients with β-thalassemia in Tunisia: about 26 cases].
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Romdhane H, Amara H, Abdelkefi S, Souyeh N, Chakroun T, Jarrey I, Bouslama M, Belhedi S, Houissa B, Boughammoura L, and Jemni Yacoub S
- Subjects
- Adolescent, Autoimmunity, Blood Transfusion statistics & numerical data, Chelation Therapy, Child, Child, Preschool, Erythrocytes immunology, Face abnormalities, Failure to Thrive etiology, Female, Ferritins blood, Growth Disorders etiology, Hemoglobins analysis, Hospital Departments statistics & numerical data, Hospitals, University statistics & numerical data, Humans, Infant, Male, Patient Compliance, Pediatrics, Quality of Health Care, Retrospective Studies, Splenomegaly etiology, Transfusion Reaction, Tunisia epidemiology, beta-Thalassemia blood, beta-Thalassemia complications, beta-Thalassemia immunology, beta-Thalassemia therapy, beta-Thalassemia epidemiology
- Abstract
Aim of the Study: To study the clinical and biological profile of β-thalassemic patients in our region, reflecting the quality of their care., Patients and Methods: A retrospective study (2010-2011) on 26 β-thalassemic patients followed in the pediatrics service at CHU Farhat Hached Sousse, Tunisia. Epidemiological, clinical and biological data were collected from medical records and transfusion files of patients. The transfusion protocol adopted was to maintain a hemoglobin level>10g/dL by regular transfusions every 3-4 weeks. Iron chelation therapy, in order to maintain serum ferritin<1500ng/mL, was introduced when serum ferritin exceeded 800-1000ng/mL., Results: The mean age of patients at diagnosis was 15 months. The clinical impact of anemia had resulted in failure to thrive in 54% of patients and facial dysmorphism in 23%. The average transfusion requirement was estimated at 311.02mL/kg/year with 6 cases of hyperconsumption. The immunohaematological monitoring showed the appearance of anti-RBC alloimmunization in one patient and 4 cases of autoimmunization. Poor adherence of chelation therapy was 62% and causing 5 cases of cardiac complications, 4 cases of liver injury and 14 cases of endocrine complications., Conclusion: Improving the therapeutic care of β-thalassemic children requires better monitoring of transfusion recovery and improved adherence to chelation therapy., (Copyright © 2014 Elsevier Masson SAS. All rights reserved.)
- Published
- 2014
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38. A 1,100-year-old founder effect mutation in IL12B gene is responsible for Mendelian susceptibility to mycobacterial disease in Tunisian patients.
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Ben-Mustapha I, Ben-Ali M, Mekki N, Patin E, Harmant C, Bouguila J, Elloumi-Zghal H, Harbi A, Béjaoui M, Boughammoura L, Chemli J, and Barbouche MR
- Subjects
- Adult, Alleles, BCG Vaccine therapeutic use, Child, Female, Genotype, Humans, Interleukin-12 Subunit p40 genetics, Male, Mycobacterium Infections immunology, Mycobacterium Infections microbiology, Mycobacterium Infections prevention & control, Mycobacterium bovis isolation & purification, Pedigree, Tunisia, Founder Effect, Genetic Predisposition to Disease, Interleukin-12 Subunit p40 deficiency, Mutation genetics, Mycobacterium Infections genetics
- Abstract
Mendelian susceptibility to mycobacterial disease (MSMD) is a rare disorder predisposing apparently healthy individuals to infections caused by weakly virulent mycobacteria such as bacille Calmette-Guerin (BCG), environmental mycobacteria, and poorly virulent Salmonella strains. IL-12p40 deficiency is the first reported human disease due to a cytokine gene defect and is one of the deficiencies that cause MSMD. Nine mutant alleles only have been identified in the IL12B gene, and three of them are recurrent mutations due to a founder effect in specific populations. IL-12p40 deficiency has been identified especially in countries where consanguinity is high and where BCG vaccination at birth is universal. We investigated, in such settings, the clinical, cellular, and molecular features of six IL-12p40-deficient Tunisian patients having the same mutation in IL12B gene (c.298_305del). We found that this mutation is inherited as a common founder mutation arousing ~1,100 years ago. This finding facilitates the development of a preventive approach by genetic counseling and prenatal diagnosis especially in affected families.
- Published
- 2014
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39. Cervical unicentric Castleman's disease in children.
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Bouguila J, Lahmer I, Abdelkefi M, Affissath A, Trimeche M, and Boughammoura L
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- Adolescent, Castleman Disease pathology, Humans, Magnetic Resonance Imaging, Male, Neck Muscles pathology, Castleman Disease surgery, Neck Muscles surgery
- Abstract
Introduction: Unicentric Castleman's disease (CD) is a rare benign lymphoproliferative disorder. A cervical location has rarely been reported in the pediatric literature., Case Report: A 13-year-old boy presented with a mass in the right neck region of 3 months' evolution. Clinical examination revealed a smooth mobile 5 cm node deep in the sternocleidomastoid muscle. The diagnosis of hyaline vascular type CD was confirmed by complete surgical excision and histopathologic examination. Postoperative course was simple, without recurrence over 1 year's follow-up., Discussion and Conclusion: Cervically located CD often shows few symptoms, and is rarely suggested by a cervical mass found in children. Definitive diagnosis is histopathological. The hyaline vascular type of unicentric CD has a good prognosis after complete resection of the lesion., (Copyright © 2013. Published by Elsevier Masson SAS.)
- Published
- 2013
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40. [Comparative study of C-reactive protein and procalcitonin in the severity diagnosis of pyelonephritis in children].
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Bouguila J, Khalef I, Charfeddine B, Ben Rejeb M, Chatti K, Limam K, Essabbeh H, Essoussi AS, and Boughammoura L
- Subjects
- Adolescent, Calcitonin Gene-Related Peptide, Child, Child, Preschool, Female, Humans, Infant, Infant, Newborn, Male, Predictive Value of Tests, Pyelonephritis blood, Radionuclide Imaging, Sensitivity and Specificity, Severity of Illness Index, Succimer, C-Reactive Protein analysis, Calcitonin blood, Protein Precursors blood, Pyelonephritis diagnosis
- Abstract
Objective: The aim of this study is to compare two biologic parameters; C-reactive protein (CRP) and procalcitonin (PCT) in the detection of acute renal lesions assessed by DMSA scintigraphy in the urinary tract infection in child., Design: In a prospective study, serum PCT, CRP and leukocyte counts were measured for children admitted, between January and December 2010, with a first episode of febrile urinary tract infection., Results: Seventy-five children were enrolled in the study. Thirty-three patients had renal lesions (group A) and 42 had a normal DMSA scintigraphy (group B). The mean PCT level was significantly higher in group A than in group B (8.81 ng/mL versus 1.7 ng/mL, P=0.01). In this study, using receiver operating characteristic (ROC) curve, we identified that the optimal cut-off value with ideal sensitivity and specificity for PCT in detection of renal lesions was 0.76 ng/mL and for CRP, it was 70 mg/L. The sensitivity, the negative predictive value and the indice of Youden of the cut-off value of PCT were significantly higher than CRP (82% versus 70%; 84% versus 70% and 0.58 versus 0.25)., Conclusions: This study confirmed that the serum PCT level was more sensitive and specific than the CRP in the detection of renal lesions in the first urinary tract infection in child., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)
- Published
- 2013
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41. Giant cell hepatitis with autoimmune hemolytic anemia in a nine month old infant.
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Bouguila J, Mabrouk S, Tilouche S, Bakir D, Trabelsi A, Hmila A, and Boughammoura L
- Abstract
Giant cell hepatitis (GCH) with autoimmune hemolytic anemia is a rare entity, limited to young children, with an unknown pathogenesis. We report the case of 9-mo old who presented with fever, diarrhea and jaundice four days before hospitalization. Physical examination found pallor, jaundice and hepatosplenomegaly. The laboratory workup showed serum total bilirubin at 101 μmol/L, conjugated bilirubin at 84 μmol/L, hemolytic anemia, thrombocytopenia and immunoglobulin G (IgG) and anti-C3d positive direct Coombs' test. The antinuclear, anti-smooth muscle and liver kidney microsomes 1 non-organ specific autoantibodies, antiendomisium antibodies were negative. Serological assays for viral hepatitis B and C, cytomegalovirus, herpes simplex and Epstein Barr virus were negative. The association of acute liver failure, Evan's syndrome, positive direct Coomb's test of mixed type (IgG and C3) and the absence of organ and non-organ specific autoantibodies suggested the diagnosis of GCH. The diagnosis was confirmed by a needle liver biopsy. The patient was treated by corticosteroids, immunomodulatory therapy and azathioprine but died with septicemia.
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- 2013
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42. [Tongue base schwannoma in a child].
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Bouguila J, Khalef I, BenAli M, Sriha B, Soyah N, and Boughammoura L
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- Adolescent, Age Factors, Female, Hematemesis diagnosis, Hematemesis etiology, Hematemesis surgery, Humans, Neurilemmoma complications, Neurilemmoma surgery, Tongue pathology, Tongue surgery, Tongue Neoplasms complications, Tongue Neoplasms surgery, Neurilemmoma diagnosis, Tongue Neoplasms diagnosis
- Abstract
Introduction: A schwannoma is a benign slow growing tumor originating from the peripheral nerve sheath. Its tongue base location is extremely rare, especially in very young patients., Case Report: A 15-year-old female patient was admitted in emergency for moderate hematemesis. The clinical examination revealed swelling of the tongue base, causing the bleeding. This lesion had appeared when she was 3years of age and no treatment was done. A complete surgical excision was performed and the histopathological examination allowed diagnosing a tongue base schwannoma. The postoperative outcome was uneventful, and no recurrence was detected 6months after surgery., Discussion: The particularities of this report are the patient's very young age and the tumor's tongue base location. The prognosis is usually good after complete excision, if there is only one tumor. Type 2 neurofibromatosis should be excluded, given the risk of malignant degeneration., (Copyright © 2012 Elsevier Masson SAS. All rights reserved.)
- Published
- 2013
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43. [Seroprevalence and risk factors of human herpes virus 8 infection in Central-East Tunisia].
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Hannachi N, Ben Fredj N, Samoud S, Ferjani A, Khlif A, Boughammoura L, Soussi S, Aouni M, Skouri H, and Boukadida J
- Subjects
- Adolescent, Adult, Antibodies, Viral blood, Child, Child, Preschool, Female, Herpesviridae Infections transmission, Humans, Infant, Male, Middle Aged, Pregnancy, Pregnancy Complications, Infectious epidemiology, Pregnancy Complications, Infectious etiology, Risk Factors, Seroepidemiologic Studies, Sexual Behavior physiology, Sexually Transmitted Diseases blood, Sexually Transmitted Diseases epidemiology, Sexually Transmitted Diseases etiology, Sexually Transmitted Diseases transmission, Tunisia epidemiology, Young Adult, Herpesviridae Infections epidemiology, Herpesviridae Infections etiology, Herpesvirus 8, Human immunology, Herpesvirus 8, Human isolation & purification
- Abstract
Objective: Epidemiology of human herpesvirus 8 (HHV8) is still unknown in Tunisia. We aimed to assess the prevalence of HHV8 infection in adults and children from Central-East Tunisia and in patients with high risk of parenteral or sexual infection., Methods: We enrolled 553 subjects: 116 blood donors, 100 pregnant women, 100 children, 50 subjects with sexually transmitted infections with positive HIV serology and 50 other without HIV infection, 107 multitransfused patients and 30 kidney transplant patients. Antibodies against HHV8 were tested using a sensitive indirect immunofluorescence assay., Results: The seroprevalence of HHV8 was found to be 13.8% in blood donors, 13% in pregnant women and 12% in children. In healthy adult population, no association was found between HHV8 seropositivity and sex, sociodemographic characteristics, parenteral risk factors or serological markers of hepatitis B. Rates of HHV8 infection were significantly higher in patients having high-risk sexual behavior with or without HIV infection (P<10(-4)), in polytransfused patients (P<10(-4)) and in patients with kidney transplantation (P=0.001)., Conclusion: Our findings suggest that HHV8 infection is widespread in Central-East Tunisia such as in the Mediterranean area. HHV8 infection appears to be acquired early in life, probably through saliva. HHV8 transmission by blood transfusion, subject of controversy in literature, is well established in our study. Early screening of this infection should be considered in populations with high risk of Kaposi's sarcoma in our areas., (Copyright © 2011 Elsevier Masson SAS. All rights reserved.)
- Published
- 2012
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44. [Hepatopulmonary syndrome: a complication of type 1 Gaucher disease].
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Bouguila J, Rouatbi H, Tej A, Chabchoub I, Trimech B, El Ajmi S, Essoussi AS, and Boughammoura L
- Subjects
- Adolescent, Echocardiography, Hepatopulmonary Syndrome diagnosis, Hepatopulmonary Syndrome etiology, Humans, Male, Oxygen Inhalation Therapy, Technetium Tc 99m Aggregated Albumin, Gaucher Disease complications, Hepatopulmonary Syndrome complications
- Abstract
Gaucher's disease is a not exceptional lysosomial disease in Tunisia. Type 1 is by far the most common one. Pulmonary involvement is considered to be rare in type 1 Gaucher's disease. Pulmonary hypertension, infiltration of the lungs with Gaucher cells, and severe hypoxemia due to intrapulmonary arterial-venous shunts, have been described in case reports and small case series. We reported the case of hepatopulmonary syndrome in a 14-year-old boy with type 1 Gaucher disease. The diagnosis of Gaucher disease was established, at 2 years age, by enzyme assay of leucocyte β-glucosidase. The patient presented dyspnoea, digital clubbing and cyanosis of the lips. The arterial blood gas found severe hypoxaemia with PaO(2) at 56.9 mmHg. The diagnosis of hepatopulmonary syndrome, in our patient, was confirmed by demonstration of the intrapulmonary shunting using contrast-enhanced echocardiography and the technetium-99m-labeled macroaggregated albumin. The patient was treated by symptomatic measure, long term oxygen therapy because the insufficiency of the enzyme replacement therapy. Screening for hypoxemia in children with liver disease should be considered., (Copyright © 2011 Elsevier Masson SAS. All rights reserved.)
- Published
- 2012
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45. Thyroid-related autoantibodies in Tunisian patients with type 1 diabetes.
- Author
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Sakly W, Mankaï A, Achour A, Thabet Y, Ouertani M, Boughammoura L, Harbi A, Chaieb L, Sfar MT, and Ghedira I
- Subjects
- Adolescent, Adult, Aged, Autoantibodies immunology, Child, Child, Preschool, Diabetes Mellitus, Type 1 blood, Female, Humans, Infant, Iodide Peroxidase immunology, Male, Middle Aged, Receptors, Thyrotropin immunology, Retrospective Studies, Thyroglobulin immunology, Tunisia, Autoantibodies blood, Diabetes Mellitus, Type 1 immunology, Thyroid Gland immunology
- Abstract
Aim: To evaluate, retrospectively, the frequency of antithyroid antibodies (ATA) in patients with type 1 diabetes (T1D)., Materials and Methods: Antithyroperoxidase antibodies (TPO-Ab), antithyroglobulin antibodies (TG-Ab), and antithyroid-stimulating hormone receptor antibodies (TSHR-Ab) were determined by enzyme-linked immunosorbent assay. Sera of 312 patients (166 children and 146 adults) with T1D were analyzed. Sera of 276 healthy subjects (87 children and 189 blood donors) served as controls., Results: Out of 312 patients with T1D, 44 (14%) had ATA (TPO-Ab or TG-Ab or TSHR-Ab). The frequency of ATA in patients with T1D was significantly higher than in the control group (14% vs. 2.8%; p<10(-5)). ATA were significantly more frequent in adult patients with T1D than in the blood donor group (20% vs. 1.6%; p<10(-8)). The frequency of ATA in adult patients was significantly higher than in pediatric patients (20% vs. 9%; p=0.006). The frequency of TPO-Ab and TG-Ab was significantly higher in patients with T1D than in the control group (13.5% vs. 2%; p<10(-8) and 7% vs. 2.2%, p=0.008), respectively. Out of 312 patients with T1D, only one had TSHR-Ab. The simultaneous presence of three autoantibodies was found in one patient with T1D., Conclusion: ATA were frequent in patients with T1D. Serological screening of autoimmune thyroid disease is suggested in patients with T1D.
- Published
- 2012
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46. [Viral infection risk in polytransfused adults: seroprevalence of seven viruses in central Tunisia].
- Author
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Hannachi N, Boughammoura L, Marzouk M, Tfifha M, Khlif A, Soussi S, Skouri H, and Boukadida J
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Antibodies, Viral blood, Blood Donors, Child, Child, Preschool, Female, HIV Infections blood, HIV Infections transmission, Hepatitis, Viral, Human blood, Hepatitis, Viral, Human transmission, Herpesviridae Infections blood, Herpesviridae Infections transmission, Humans, Immunocompromised Host, Immunoglobulin G blood, Immunoglobulin M blood, Infant, Male, Middle Aged, Parvoviridae Infections blood, Parvoviridae Infections transmission, Risk, Seroepidemiologic Studies, Tunisia epidemiology, Young Adult, HIV Infections epidemiology, Hepatitis, Viral, Human epidemiology, Herpesviridae Infections epidemiology, Parvoviridae Infections epidemiology, Parvovirus B19, Human immunology, Transfusion Reaction
- Abstract
The aim of this study is to evaluate the prevalence of seven transfusion-transmitted viruses in polytransfused adults and children comparatively with a group of healthy control subjects. We studied 107 polytransfused patients (59 adults and 48 children) and 160 control subjects (100 blood donors and 60 children). Immunoenzymatic tests were used for detection of HBs antigen (HBs Ag), antibodies against hepatitis C Virus (anti-HCV), and human immunodeficiency virus (anti-HIV), and IgG antibodies against human cytomegalovirus (IgG anti-CMV), human parvovirus B19 (IgG anti-PB19), and hepatitis E virus (IgG anti-HEV). An immunofluorescent assay was performed for the detection of human herpesvirus 8 antibodies (anti-HHV8). Prevalence of HBs Ag, anti-HCV, anti-HIV, IgG anti-CMV, IgG anti-PB19, IgG anti-HEV, and anti-HHV8 in polytransfused group was 8.4, 4.7, 0, 86.9, 60.7, 28.9, and 47.6%, respectively, and 1.8, 0.6, 0, 86.2, 53.1, 10, and 12.5%, respectively, in the control group. The difference in prevalence between the two groups was statistically significant for HBs Ag (P = 0.01), anti-HCV (P = 0.03), IgG anti-HEV (P < 10(-4)), and IgG anti-HHV8 (P < 10(-4)). Categorization according to age showed that hepatitis B and C risk was limited in adult polytransfused group. HHV8 infection was higher in polytransfused subjects born before the use of leucocyte-depleted blood components. Our results corroborate literature data on the risk of HEV and HHV8 infection by blood transfusion. Hepatitis B vaccination and improvement in screening tests have an important role in reduction of hepatitis B and C risk in transfusion, especially in young polytransfused persons. However, a residual risk of transmitting viral infections persists, and efforts are needed to improve transfusion safety.
- Published
- 2011
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47. [Epidemiological and bacteriological characteristics of uropathogen bacteria isolated in a pediatric environment].
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Ferjani A, Mkaddemi H, Tilouche S, Marzouk M, Hannechi N, Boughammoura L, and Boukadida J
- Subjects
- Bacteria isolation & purification, Child, Preschool, Female, Humans, Male, Retrospective Studies, Urinary Tract Infections epidemiology, Urinary Tract Infections microbiology
- Abstract
Urinary tract infection (UTI) in children is a grave pathology, which requires a fast and effective care. Bacteriological and epidemiological data play a determining role in patient's care. We report a retrospective study, which spreads out from January 1st till August 31st, 2009, having concerned hospitalized children for urinary infection in pediatrics service of Farhat Hached teaching hospital in Sousse. Our series contained 51 children with a sex ratio of 0.76, an average age of 32 months. The majority of cases was pyelonephritis (94.1%). A pathology is associated with the urinary infection in 41.2%. Three cases of vesico-ureteral reflux were noted. The diagnosis of urinary infection was confirmed by cytobacteriological exam of urine (CBEU). Enterobacteriacea were isolated in 96.1%. Escherichia coli remains the most often isolated (80.4%), followed by Klebsiella pneumoniae (9.8%) then by Proteus mirabilis (5.9%). E. coli was resistant to amoxicillin in 78% of cases, to the association amoxicillin-clavulanic acid in 64,8%, to cephalosporins of 3(rd) generation (C3G) in 5% and to cotrimoxazole in 51%. No K. pneumoniae or P. mirabilis strain was resistant to C3G. UTI in children is always an indication for CBEU realization at first intention. The results of this exam are very important considering the diversity of the responsible bacteria and the growing frequency of acquired antibiotic resistance., (Copyright © 2010 Elsevier Masson SAS. All rights reserved.)
- Published
- 2011
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48. Digestive malacoplakia in children: case report.
- Author
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Bouguila J, Brahim K, Mokni M, Skandrani K, Harbi A, Essoussi AS, and Boughammoura L
- Abstract
Malacoplakia is a form of chronic granulomatous inflammatory reaction that rarely affects the pediatric age group. The gastrointestinal system is the second most common site for the occurrence of malacoplakia. We report the case of a 9-year-old girl who was hospitalized for abdominal pain, chronic diarrhea, and rectal hemorrhage. The endoscopic examinations and histopathology confirmed the diagnosis of intestinal malacoplakia. We successfully treated her with oral levofloxacin. This disease does not have any specific clinical or biological signs, and the diagnosis is exclusively based on histology.
- Published
- 2011
- Full Text
- View/download PDF
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