Sheehan's syndrome with pancytopenia: a case report and review of the literature

<p>Abstract</p> <p>Introduction</p> <p>Sheehan's syndrome is defined by varying degrees of anterior pituitary deficiency due to postpartum ischemic necrosis of the pituitary gland after massive bleeding. It is a rare disorder in western countries and even in Tunisia. Hematologic abnormalities such as normochromic anemia have been reported in these patients. However, pancytopenia is rarely observed.</p> <p>Case presentation</p> <p>We describe the case of a 48-year-old Tunisian woman with features of hypopituitarism. Laboratory tests showed pancytopenia that was completely reversed after adequate hormone replacement.</p> <p>Conclusion</p> <p>Clinicians should consider the possibility of hypopituitarism as a cause of pancytopenia. This is an original case report that is of interest to hematologists, who should be aware of Sheehan's syndrome as a treatable etiology of pancytopenia for women.</p

Prévalence et facteurs de risque du surpoids et de l’obésité dans une population d’enfants scolarisés en milieu urbain à Sfax, Tunisie

Introduction: L'objectif de ce travail etait d'étudier la prévalence du surpoids et de l'obésité chez un  groupe d'enfants d'âge scolaire, habitant la ville de Sfax en Tunisie, et identifier les facteurs favorisant la prise pondérale. Méthodes: Il s'agossait d'une enquête descriptive transversale était réalisée en 2011 sur un échantillon représentatif d'élèves recrutés dans 11 écoles primaires publiques. Des informations  concernant les caractéristiques sociodémographiques, les habitudes alimentaires et le comportement sédentaire pour chaque élève ont été précisées au moyen d'un questionnaire. Résultats: Nous avons colligé 1529 élèves, âgés entre 9 et 12 ans et se répartissant en 787 garçons (51,14%) et 747 filles (48,86%). Selon les seuils de  référence de l'IOTF, la fréquence de l'obésité était de 2,4% et celle du surpoids était de 6,3%. L'obésité était significativement associée à l'obésité parentale, un niveau socioéconomique élevé, la prise de plus de deux goûters par jour et à l'activité sédentaire. Conclusion: L'identification des facteurs de risque du surpoids et de l'obésité infantile permettrait de dépister les enfants à risques afin de leur proposer des mesures de prévention adaptées. Ces mesures de prévention devraient inclure non seulement des approches individuelles, mais aussi l'environnement social et physique de l'enfant. Key words: Enfant, obésité, surpoids, facteurs de risque, milieu scolair

Adrenocortical Secreting Mass in a Patient with Gardner's Syndrome: A Case Report

Gardner's syndrome (GS) is a dysplasia characterized by neoformations of the intestine, soft tissue, and osseous tissue. Endocrine neoplasms have occasionally been reported in association with GS. Adrenal masses in GS are rare, and few have displayed clinical manifestations. In the current paper, The authors report a 37-year-old male patient with GS including familial adenomatous polyposis (FAP) and mandible osteoma who presented with an incidental adrenal mass. Computerized tomography adrenal scan identified bilateral masses. Functional analyses showed a hormonal secretion pattern consistent with pre-Cushing's syndrome. Other extraintestinal manifestations were hypertrophy of the pigmented layer of the retina and histiocytofibroma in the right leg. This paper describes a rare association of adrenocortical secreting mass in an old male patient with Gardner syndrome

Isolation and characterization of halophilic bacteria producing exopolymers with emulsifuing and antioxidant activities

Halophilic bacteria are considered a great source of new strains producing novel exopolymers with functional properties. In this work we isolated ten halophilic strains producing exopolymers from different hypersaline environments in Morocco. Phenotypic characterization showed that the strains were moderately halophilic, mesophilic and neutrophilic with the ability to produce some hydrolytic enzymes. Strains identification based on 16S rRNA gene sequences comparison showed that nine strains, designed as N1, N2, N5, N7, N8, N9, N10, N11 and N12 belong to Halomonas genus and one strain, designed as N4, to Marinobacter genus. The majority of the strains showed high levels of exopolymer production. The study of emulsifying and antioxidant activities revealed that all the polymers have an interesting emulsifying and antioxidant activities with the polymer from Marinobacter sp. N4 forming the highest and most stable emulsions and exhibiting the best antioxidant activity in comparison with other exopolymers produced by Halomonas strains. The obtained results demonstrate the great potential of exopolymers from halophilic bacteria to be applied as emulsifying and antioxidant agents in food, cosmetics and oil industries

Obésité, activité physique et temps de sédentarité chez des adolescents scolarisés, âgés de 15 à 18 ans de la ville de Sfax (Tunisie)

Introduction: Le but de notre étude était d'évaluer la prévalence du surpoids et de l'obésité chez des adolescents scolarisés dans la ville de Sfax mais aussi, d'étudier son association avec le temps de sédentarité et l'activité physique (AP). Méthodes: La population étudiée était composée de 1695 adolescents âgés de 15-18 ans. Tous les participants avait rempli un questionnaire porté sur leurs activités physiques et temps de sédentarité, donné lors d'un entretien direct. Le niveau d'AP était évalué avec l'International Physical Activity Questionnaire (IPAQ) version courte. Résultats: Notre étude comportait 43,7% de garçons et 56,3% de filles. L'âge moyen était de 16,78 ± 1, 1 an. Dans notre échantillon, 23,4% des adolescents étaient en surpoids ou obèses. Le score de l'IPAQ nous a montré que le niveau d'AP de nos participants était faible dans 6,4%, modéré dans 65,4% et élevé dans 28,2% des cas. Nos résultats avaient démontré que l'augmentation du temps de sédentarité (plus de 2 h / jour) est associée à une augmentation significative de l'indice de masse corporelle (IMC) et du tour de taille (TT) (P &lt;0,001). Alors qu'un niveau d'AP élevé et/ou la participation aux séances d'AP structurées dans le cadre scolaire et hors scolaire est accompagnée par une diminution significative de l'IMC et du TT (P &lt;0,001). Conclusion: Nos résultats apportent une preuve supplémentaire sur la nécessité de promouvoir la vie active chez les jeunes Tunisiens.Pan African Medical Journal. 2015; 2

Leydig Cell Tumor Associated with Testicular Adrenal Rest Tumors in a Patient with Congenital Adrenal Hyperplasia due to 11β-Hydroxylase Deficiency

Congenital adrenal hyperplasia (CAH) describes a group of inherited autosomal recessive disorders characterized by enzyme defects in the steroidogenic pathways that lead to the biosynthesis of cortisol, aldosterone, and androgens. Chronic excessive adrenocorticotropic hormone (ACTH) stimulation may result in hyperplasia of ACTH-sensitive tissues in adrenal glands and other sites such as the testes, causing testicular masses known as testicular adrenal rest tumors (TARTs). Leydig cell tumors (LCTs) are make up a very small number of all testicular tumors and can be difficult to distinguish from TARTs. This distinction is interesting because LCTs and TARTs require different therapeutic approaches. Hereby, we present an unusual case of a 19-year-old patient with CAH due to 11β-hydroxylase deficiency, who presented with TARTs and an epididymal Leydig cell tumor

Neurological Characteristics of Allgrove Syndrome: A Case Series

Purpose Allgrove syndrome, also known as “triple A” syndrome, is characterized by adrenal insufficiency, achalasia, and alacrimia. When neurological signs are also present, the condition is referred to as “4 A” syndrome. Methods We conducted a retrospective analysis of three patients with 4 A syndrome confirmed genetically. A complete neurological exam was carried out by an experimented neurologist. Results Herein, we describe the neurological characteristics often associated with this condition, through the clinical and electrophysiological analysis of three patients. All patients exhibited a mutation in AAAS, the gene coding for ALADIN. While these individuals presented with the classic features of triple-A syndrome, neurological symptoms were not prominent. Conclusion The neurological manifestations of Allgrove syndrome have historically been overlooked and inadequately explored. Due to the condition’s rarity and substantial phenotypic heterogeneity, only recently have a variety of symptoms been recognized and described

Marinobacter maroccanus sp. nov., a moderately halophilic bacterium isolated from a saline soil.

During the taxonomic investigation of exopolymer producing halophilic bacteria, a rod shaped, motile, Gram-stain-negative, aerobic, halophilic bacterium, designated strain N4T, was isolated from a natural saline soil located in the northern Morocco. The optimal growth of the isolate was at 30-37 ºC and at pH 6.0-9.0, in the presence of 5-7% (w/v) NaCl. Useful tests for the phenotypic differentiation of strain N4T from other Marinobacter species included α-chymotrypsin and α-glucosidase activities and the carbohydrate assimilation profile. The major fatty acids detected in strain N4T were C18:1 ω9c, C16:0, and C16:1 ω7c/C15:0 iso 2-OH. Sequence analysis of the 16S rRNA indicated that strain N4T belonged to the genus Marinobacter and was closely related to Marinobacter adhaerens NC17506T (99.04%), Marinobacter salsuginis SD-14BT (98.97%), and Marinobacter flavimaris SW-145T (98.36%). Phylogenetic analysis of the rpoD gene sequence also showed that the nearest neighbours of strain N4T were M. adhaerens (90.63%) and M. salsuginis (91.13%). Strain N4T showed 87.98% similarity in the average nucleotide identity (ANI) with M. flavimaris and M. salsuginis, and 87.47% with M. adhaerens. In the in-silico genome-to-genome distance (GGD), strain N4T showed DNA-DNA hybridization (DDH) values of 33.30% with M. adhaerens, 34.60% with M. flavimaris and 34.70% with M. salsuginis. DNA G+C content of N4T was 57.3 mol%. Based on the results of phenotypic characterization, phylogenetic analysis and genome comparison, strain N4T represents a novel species of the genus Marinobacter, for which the name Marinobacter maroccanus sp. nov. is proposed. The type strain is N4T (=CECT 9525T=LMG 30466T)