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

Strategy for improving extracellular lipolytic activities by a novel thermotolerant Staphylococcus sp. strain

<p>Abstract</p> <p>Background</p> <p>Extracellular bacterial lipases received much attention for their substrate specificity and their ability to function under extreme environments (pH, temperature...). Many staphylococci produced lipases which were released into the culture medium. Reports of extracellular thermostable lipases from <it>Staphylococcus </it>sp. and active in alkaline conditions are not previously described.</p> <p>Results</p> <p>This study focused on novel strategies to increase extracellular lipolytic enzyme production by a novel <it>Staphylococcus </it>sp. strain ESW. The microorganism needed neutral or alkaline pH values between 7.0 and 12.0 for growth. For pH values outside this range, cell growth seemed to be significantly inhibited. <it>Staphylococcus </it>sp. culture was able to grow within a wide temperature range (from 30 to 55°C). The presence of oils in the culture medium leaded to improvements in cells growth and lipolytic enzyme activity. On the other hand, although chemical surfactants leaded to an almost complete inhibition of growth and lipolytic enzyme production, their addition along the culture could affect the location of the enzyme. In addition, our results showed that this novel <it>Staphylococcus </it>sp. strain produced biosurfactants simultaneously with lipolytic activity, when soapstock (The main co-product of the vegetable oil refining industry), was used as the sole carbon source.</p> <p>Conclusion</p> <p>A simultaneous biosurfactant and extracellular lipolytic enzymes produced bacterial strain with potential application in soap stock treatment</p

A newly high alkaline lipase: an ideal choice for application in detergent formulations

<p>Abstract</p> <p>Background</p> <p>Bacterial lipases received much attention for their substrate specificity and their ability to function in extreme environments (pH, temperature...). Many staphylococci produced lipases which were released into the culture medium. Reports of thermostable lipases from <it>Staphylococcus </it>sp. and active in alkaline conditions are not previously described.</p> <p>Results</p> <p>A newly soil-isolated <it>Staphylococcus </it>sp. strain ESW secretes an induced lipase in the culture medium. The effects of temperature, pH and various components in a detergent on the activity and stability of <it>Staphylococcus </it>sp. lipase (SL1) were studied in a preliminary evaluation for use in detergent formulation solutions. The enzyme was highly active over a wide range of pH from 9.0 to 13.0, with an optimum at pH 12.0. The relative activity at pH 13.0 was about 60% of that obtained at pH 12.0. It exhibited maximal activity at 60°C. This novel lipase, showed extreme stability towards non-ionic and anionic surfactants after pre-incubation for 1 h at 40°C, and relative stability towards oxidizing agents. Additionally, the crude enzyme showed excellent stability and compatibility with various commercial solid and liquid detergents.</p> <p>Conclusions</p> <p>These properties added to the high activity in high alkaline pH make this novel lipase an ideal choice for application in detergent formulations.</p

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

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

Browder and semi-Browder operators and perturbation function

This paper is devoted to the investigation of the stability of closed densely de¯ned semi-Browder and Browder operators on Banach spaces. Our approach consists to introduce the concepts of a perturbation function and a coperturbation function in order to deduce the stability under strictly singular and cosingular operator perturbations. Further, our results are used to show the invariance of Browder's spectru

Hyperthyroidism: A rare cause of pulmonary embolism: Report of two cases

Several disorders of coagulation and fibrinolysis have been widely reported in patients with hyperthyroidism. Most reports have focused on only the venous thromboembolism risk, and few of them have studied specifically the association between hyperthyroidism and pulmonary embolism (PE). We report two cases of Graves′ disease complicated by PE. The first patient is a 32 year-old man, and the second patient is a 23-year-old female. PE was suspected on the basis of pulmonary hypertension in patient one, and clinical presentation in the other patient. The first patient had also right heart failure. PE was confirmed in both patients by a lung perfusion-ventilation scan test. Thrombophilia screen revealed normal findings in the first patient and an elevation in coagulation factor VIII in the second one. Both patients received heparin, followed by oral anticoagulant therapy. In addition, they were treated with radioactive iodine resulting in partial recovery from hyperthyroidismforpatient oneand clinical euthyroidism for patient two.The former died of acute heart failure secondary to a chest infection, while the later was lost to follow-up. In conclusion, hyperthyroidism is associated with increased risk of venous thromboembolism, including PE. Potential mechanisms involved in this association include endothelial dysfunction, decreased fibrinolytic activity, and increased coagulation factors levels. Thyroid evaluation is recommended in patients with unprovoked venous thromboembolic events. Conversely, the diagnosis of venous thromboembolism should be considered in patients with hyperthyroidism, particularly if additional prothrombotic risk factors are present

Case report: Management challenges of late diagnosed 17‐alpha hydroxylase deficiency

Abstract Herein we report the intriguing case of a 42‐year‐old woman presenting with grade three hypertension, severe hypokalemia and primary amenorrhea, which revealed to be the complete form of 17 alphahydroxylase deficiency. We also discuss the challenging therapeutic approach as well as the outcomes and the follow‐up of this patient