Retroperitoneal Abscess: A Rare Localization of Tubercular Infection

Incidence of tuberculosis infection has considerably increased during the past 20 years due to the HIV pandemic and continues to be one of the most prevalent and deadly infections worldwide. Extrapulmonary tuberculosis lacks specific clinical manifestation and can mimic many diseases. It can invade neighbouring tissue and form a big cyst with manifesting clinical symptoms. We describe a rare case of 31-year-old immunocompetent man affected by a retroperitoneal abscess secondary to tubercular infection. Exploratory laparotomy and histopathological examinations of tissue were required for achieving diagnosis of tuberculosis. No pulmonary or spinal involvement was identified. The patient was successfully treated with standard four-drug antitubercular therapy

Primary resistance to clarithromycin, metronidazole and amoxicillin of Helicobacter pylori isolated from Tunisian patients with peptic ulcers and gastritis: a prospective multicentre study

<p>Abstract</p> <p>Background</p> <p>The frequency of primary resistance to antibiotics in H. pylori isolates is increasing worldwide. In Tunisia, there are limited data regarding the pattern of H. pylori antibiotic primary resistance.</p> <p>Aim</p> <p>To evaluate the primary resistance of H. pylori to clarithromycin, metronidazole and amoxicillin and to detect the mutations involved in clarithromycin resistance.</p> <p>Materials and methods</p> <p>273 strains isolated from adults and children were enrolled. The primary resistance to clarithromycin, metronidazole and amoxicillin was evaluated by means of E-test minimal inhibitory concentration (MIC). The real-time PCR using Scorpion primers was performed in all cases to assess clarithromycin primary resistance and point mutations involved.</p> <p>Results</p> <p>No resistance to amoxicillin was detected. For adults, resistance to clarithromycin and metronidazole was found respectively in 14.6% and 56.8%, and respectively in 18.8% and 25% in children. Overall, the rates of global primary resistance to clarithromycin and metronidazole in Tunisia were respectively determined in 15.4% and 51.3%.</p> <p>By the use of Scorpion PCR, the A2143G was the most frequent point mutation observed (88.1%), followed by the A2142G (11.9%); the A2142C was not found and 18 of 42 patients (42.8%) were infected by both the resistant and the susceptible genotype.</p> <p>The association of clarithromycin resistance with gender was not statistically significant, but metronidazole resistant strains were isolated more frequently in females (67.8%) than in males (32.2%) and the difference was significant. As for gastroduodenal diseases, the difference between strains isolated from patients with peptic ulceration and those with non peptic ulceration was not statistically significant. When about the distribution of resistant strains to clarithromycin and metronidazole between the three Tunisian cities (Tunis, Menzel Bourguiba and Mahdia), the difference was not statistically significant.</p> <p>Conclusion</p> <p>Local data regarding the primary resistance of H. pylori to clarithromycin, metronidazole and amoxicillin and the main genetic mutation involved in clarithromycin resistance in vivo (A2143G) are necessary to prove a clear need for a periodic evaluation of antibiotic consumption and new therapeutic strategies in Tunisia in order to avoid the emergence of resistant strains.</p

Tolllike receptor 4 (TLR4) polymorphisms in Tunisian patients with Crohn's disease: genotype-phenotype correlation

<p>Abstract</p> <p>Background</p> <p>The immune responses to bacterial products through the pattern recognition receptor (PRR) play a pivotal role in pathogenesis of Crohn's disease. A recent study described an association between CD and some gene coding for bacterial receptor like NOD2/CARD15 gene and TLR4. In this study, we sought to determine whether TLR4 gene was associated with Crohn's disease (CD) among the Tunisian population and its correlation with clinical manifestation of the disease.</p> <p>Methods</p> <p>90 patients with CD and 80 healthy individuals are genotyped for the <it>Asp299Gly </it>and <it>Thr399Ile </it>polymorphisms by restriction fragment length polymorphism analysis.</p> <p>Results</p> <p>The allele and genotype frequency of the TLR4 polymorphisms did not differ between patients and controls. The genotype-phenotype correlation permitted to show that the <it>Thr399Ile </it>polymorphism was associated with early onset disease.</p> <p>Conclusion</p> <p>this study reported the absence of association between CD and TLR4 gene in the Tunisian population, but this gene could play a role in clinical expression of the disease.</p

: Journée d’études:Littérature tunisienne et révolution

La troisième table ronde, « Écrire et éditer depuis 2011 », a réuni Azza Filali et Abdelaziz Belkhodja autour de la modératrice Elisabeth Daldoul. Dans une intervention toute en poésie, l’écrivaine Azza Filali a défendu le droit de la littérature à rester en retrait, en décalage par rapport aux faits. L’écriture n’a pas pour mission d’expliquer le réel, mais de le transfigurer en captant l’essence de l’événement. C’est ce qui garantit sa liberté à l’égard des idées et des hommes. La liberté d’expression n’a donc pas véritablement modifié la façon d’écrire de l’écrivaine, l’imaginaire étant, selon elle, toujours libre. Abdelaziz Belkhodja, écrivain et éditeur (éditions Appolonia), a insisté sur le rôle croissant de l’écrit de façon plus large depuis 2011. Il a joué un rôle fédérateur par le biais d’internet ; le besoin de se réapproprier l’histoire et de réécrire les bases politiques et constitutionnelles a entrainé un retour aux textes fondamentaux. La révolution tunisienne a fait renaître la nécessité de l’écrit, sous des formes et des structures nouvelles. Les débats ont permis de poursuivre cette réflexion sur l’écrit et ses lecteurs. Selon Azza Filali, les bouleversements politiques n’ont pas provoqué un regain de la lecture et les formats et médias actuels font perdre à l’écrit sa dignité. D’autres ont soutenu qu’il fallait considérer la lecture dans ses nouvelles pratiques qui se rattachent à des textes plus courts. Enfin, la salle et les intervenants ont débattu du rôle des réseaux culturels étatiques et de l’enseignement dans le développement d’une lecture comme forme d’interaction et de socialisation