L’ansa pancreatica: une cause rare de pancréatite aigue

L’ansa pancréatica est une voie de communication accessoire entre le canal de Wirsung et un conduit pancréatique accessoire ne présentant pas de jonction normale avec le premier. L’association entre cette variante anatomique et la pancréatite aigue dite idiopathique reste hypothétique. Nous rapportons l’observation d’un patient présentant des poussées de pancréatites récidivantes qui serait en rapport avec une Ansa pancréatica.Pan African Medical Journal 2012; 13:3

Rabies encephalitis in children: a resurgence of a fatal anthropozoonosis

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Rabies encephalitis in children: a resurgence of a fatal anthropozoonosis

Rabies is a ubiquitous fatal disease and its large wild life reservoir may precipitate a flare-up whenever stringent control is relaxed. It remains a serious public health challenge in the developing world. It is estimated that up to 40\u201360,000 cases of human rabies occur annually, mostly in rural areas of Africa and Asia, and with a particularly high incidence in young children (under the age of 15 years). Although Tunisia has implemented a national program against rabies since 1982, we are still recording one or two cases every year; in these cases, the victims generally did not consult after a dog bite and did not receive prophylaxis. We report in this article the case of an eleven year old child, who received post exposure prophylaxis and unfortunately developed fatal rabies

Volatile compounds and anatomical features of Opuntia sp. cladodes

The cactus pear is belongs to the Cactaceae family Opuntia. The cladodes are known as nopalitos, are frequently consumed and used in folk medicine due to their beneficial effects and phytochemical composition. Cactus in Tunisia is mostly localized in areas characterized by low quality soils and water scarcity. In this study we evaluate the amount of volatile compounds on the powder obtained from Opuntia microdasys Lehm. and macrorhiza Engelm. cladodes were investigated by HS-SPME-GC-MS and anatomical structure of cladodes was identify by light microscopy. The most important compound found in the cladodes of O. microdasys is limonene (11.20 %), while O.macrorhiza was mainly rich in camphor (49.10 %). The highest contents of phytochemicals compounds were found in the cladode of Opuntia microdasys. Light microscopy revealed the presence of a high number of calcium oxalate crystals in fresh cladodes

Epidemiology of heart failure and long-term follow-up outcomes in a north-African population: Results from the NAtional TUnisian REgistry of Heart Failure (NATURE-HF)

International audienceThe NATURE-HF registry was aimed to describe clinical epidemiology and 1-year outcomes of outpatients and inpatients with heart failure (HF). This is a prospective, multicenter, observational survey conducted in Tunisian Cardiology centers. A total of 2040 patients were included in the study. Of these, 1632 (80%) were outpatients with chronic HF (CHF). The mean hospital stay was 8.7 ± 8.2 days. The mortality rate during the initial hospitalization event for AHF was 7.4%. The all-cause 1-year mortality rate was 22.8% among AHF patients and 10.6% among CHF patients. Among CHF patients, the older age, diabetes, anemia, reduced EF, ischemic etiology, residual congestion and the absence of ACEI/ ARBs treatment were independent predictors of 1-year cumulative rates of rehospitalization and mortality. The female sex and the functional status were independent predictors of 1-year all-cause mortality and rehospitalization in AHF patients. This study confirmed that acute HF is still associated with a poor prognosis, while the mid-term outcomes in patients with chronic HF seems to be improved. Some differences across countries may be due to different clinical characteristics and differences in healthcare systems

Design and Rationale of the National Tunisian Registry of Heart Failure (NATURE-HF): Protocol for a Multicenter Registry Study

BackgroundThe frequency of heart failure (HF) in Tunisia is on the rise and has now become a public health concern. This is mainly due to an aging Tunisian population (Tunisia has one of the oldest populations in Africa as well as the highest life expectancy in the continent) and an increase in coronary artery disease and hypertension. However, no extensive data are available on demographic characteristics, prognosis, and quality of care of patients with HF in Tunisia (nor in North Africa). ObjectiveThe aim of this study was to analyze, follow, and evaluate patients with HF in a large nation-wide multicenter trial. MethodsA total of 1700 patients with HF diagnosed by the investigator will be included in the National Tunisian Registry of Heart Failure study (NATURE-HF). Patients must visit the cardiology clinic 1, 3, and 12 months after study inclusion. This follow-up is provided by the investigator. All data are collected via the DACIMA Clinical Suite web interface. ResultsAt the end of the study, we will note the occurrence of cardiovascular death (sudden death, coronary artery disease, refractory HF, stroke), death from any cause (cardiovascular and noncardiovascular), and the occurrence of a rehospitalization episode for an HF relapse during the follow-up period. Based on these data, we will evaluate the demographic characteristics of the study patients, the characteristics of pathological antecedents, and symptomatic and clinical features of HF. In addition, we will report the paraclinical examination findings such as the laboratory standard parameters and brain natriuretic peptides, electrocardiogram or 24-hour Holter monitoring, echocardiography, and coronarography. We will also provide a description of the therapeutic environment and therapeutic changes that occur during the 1-year follow-up of patients, adverse events following medical treatment and intervention during the 3- and 12-month follow-up, the evaluation of left ventricular ejection fraction during the 3- and 12-month follow-up, the overall rate of rehospitalization over the 1-year follow-up for an HF relapse, and the rate of rehospitalization during the first 3 months after inclusion into the study. ConclusionsThe NATURE-HF study will fill a significant gap in the dynamic landscape of HF care and research. It will provide unique and necessary data on the management and outcomes of patients with HF. This study will yield the largest contemporary longitudinal cohort of patients with HF in Tunisia. Trial RegistrationClinicalTrials.gov NCT03262675; https://clinicaltrials.gov/ct2/show/NCT03262675 International Registered Report Identifier (IRRID)DERR1-10.2196/1226