Mucocele geante de l’enfant

Les mucocèles sont des formations pseudo kystiques expansives des sinus de la face. Elles sont souvent diagnostiquées tardivement du fait de l’absence de signes spécifiques. Le bilan radiologique basé sur la TDM et ou l’IRM est essentiel pour confirmer le diagnostic et établir le bilan d’extension. Nous rapportons le cas d’un enfant âgé de 4 ans et 6mois traité d’une mucocèle géante éthmoïdo- maxillaire.Mots clés : mucocèle ; enfant ; TDM ; IRM ; chirurgieMucoceles are pseudo-cystic expansive formations of the sinuses. They are often diagnosed lately because of the lack of specific signs. CT and MRI are essential for the diagnosis and to evaluate the extension.We report a case of child with ethmoide-maxillary mucocèle treated in our department.Key words: mucocele; child; CT; MRI; surger

Molecular analysis of HBV genotypes and subgenotypes in the Central-East region of Tunisia

<p>Abstract</p> <p>Background</p> <p>In Tunisia, country of intermediate endemicity for Hepatitis B virus (HBV) infection, most molecular studies on the virus have been carried out in the North of the country and little is known about other regions. The aim of this study was to determine HBV genotype and subgenotypes in Central-East Tunisia. A total of 217 HBs antigen positive patients were enrolled and determination of genotype was investigated in 130 patients with detectable HBV DNA. HBV genotyping methods were: PCR-RFLP on the pre-S region, a PCR using type-specific primers in the S region (TSP-PCR) and partial sequencing in the pre-S region.</p> <p>Results</p> <p>Three genotypes (D, B and A) were detected by the PCR-RFLP method and two (D and A) with the TSP-PCR method, the concordance between the two methods was 93%. Sequencing and phylogenetic analysis of 32 strains, retrieved the same genotype (D and A) for samples with concordant results and genotype D for samples with discordant results. The sequences of discordant genotypes had a restriction site in the pre-S gene which led to erroneous result by the PCR-RFLP method. Thus, prevalence of genotype D and A was 96% and 4%, respectively. Phylogenetic analysis showed the predominance of two subgenotypes D1 (55%) and D7 (41%). Only one strain clustered with D3 subgenotype (3%).</p> <p>Conclusions</p> <p>Predominance of subgenotype D7 appears to occur in northern regions of Africa with transition to subgenotype D1 in the East of the continent. HBV genetic variability may lead to wrong results in rapid genotyping methods and sequence analysis is needed to clarify atypical results.</p

WR279,396, a Third Generation Aminoglycoside Ointment for the Treatment of Leishmania major Cutaneous Leishmaniasis: A Phase 2, Randomized, Double Blind, Placebo Controlled Study

Cutaneous leishmaniasis is due to a small parasite (Leishmania) that creates disfiguring sores, and affects more than one million persons (mainly children) each year. Treating lesions with a cream—instead of with injections as currently done—would greatly improve the well-being of affected patients. No cream formulation that would be efficient and would not create important skin irritation has been identified yet. Here, we tested a new cream formulation (WR279,396) containing paromomycin and gentamicin, two members of a well-known family of antibacterial antibiotics (aminoglycosides). Injectable paromomycin is efficient in other forms of the disease (visceral leishmaniasis). This was a carefully monitored study (phase 2) involving mainly children in Tunisia and France. The cream was applied twice a day for 20 days. The proportion of patients treated with the paromomycin-containing cream (active formulation) that cured (94%) was higher than that observed (71%) in patients treated with a cream that did not contain the active product (placebo formulation). Local irritation affected less than one-third of the patients and was usually mild. This new cream formulation was safe and effective in treating cutaneous leishmaniasis, thereby providing a new, simple, easily applicable, and inexpensive treatment for this neglected disease

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Dual Geochemical and isotopic approach to study the functioning of the Gabes South phreatic aquifer (south-eastern Tunisia).

International audienc

Up-scaling of crop productivity estimations using the AquaCrop model and GIS-based operations

International audienceCrop models are useful in evaluating management strategies and exploration of new practices, particularly in studies related to climate change and productivity assessment of agricultural systems. At field level, biophysical crop models are generally suitable in homogeneous environments when accurate input data and calibration parameters are available. However, their use at watershed level is limited, especially in hilly areas with great variability of soils, slope, and land use. Systematic method considering all terrain variabilities is time consuming since it requires high-resolution data and parameterization effort while geospatial models like SWAT, using simplified crop modules do not reflect the complexity of the simulated processes. In this work, an alternative methodology is proposed and tested in the hilly Mediterranean watershed of Kamech located in the Cap Bon Peninsula, Tunisia (N 36.88 degrees, E 10.88 degrees); it uses the FAO AquaCrop biophysical model to estimate production in selected fields and scale up the results to the watershed level. Maps of soil, slope, and land use are combined by a GIS tool to obtain a database of averaged field properties and occupations. Three categories of texture, depths, and slopes were considered to classify the 313 fields of the watershed into 27 soil classes and determine their respective area-weighting factor. The systematic method considering all fields and the proposed method considering the 27 representative fields were used to estimate the watershed production for dominant crops: wheat, barley, and faba bean. Results show a good correlation between both methods with values of relative RMSD in the range of 0.5-2% for biomass and 2-5% for grain yield. Decile-decile analysis showed that the proposed methodology simulated almost all the observed spatial variability of yield within the watershed suggesting its suitability for productivity assessment and prediction in hilly fragmented agricultural landscape