Short and Long-Term Effect of Land Use and Management on Soil Organic Carbon Stock in Semi-Desert Areas of North Africa-Tunisia

Soil organic carbon (SOC) plays an important role in the global C cycle, as well as in the maintenance and improvement of the soil quality. Over time, special attention has been paid to it in the study of the SOC reserves worldwide; however, reduced attention has been given to assessing the spatial patterns of SOC stock (SOCS) in semi-desert ecosystems. In this line, there are no conclusive studies in drylands of Africa affected by aeolian processes (semi-desert conditions) mainly due to the complexity of sample collection, and this is especially significant in some soil types such as Arenosols (AR) and Calcisols (CL). This study evaluated the spatial variability of SOC and SOCS in AR and CL with woody crops in relation to land use and management (old plantations > 100 years: centenary olive grove; new plantations < 12 years: young olive grove, almond, and pistachio) in semi-desert conditions. For this purpose, 16 soil profiles (for 0–40 and 40–100 cm depth) were selected and studied in an experimental area of Menzel Chaker-Sfax in southeastern Tunisia (North Africa). The main results indicated that the SOCS on average was higher in Old Cultivated AR (OC-AR) with 41.16 Mg ha−1 compared to Newly Cultivated AR (NC-AR) with 25.13 Mg ha−1. However, the SOCS decreased after a long period of cultivation in CL from 43.00 Mg ha−1 (Newly Cultivated CL: NC-CL) to 32.19 Mg ha−1 (Old Cultivated CL: OC-CL). This indicates that in the long term, CL has more capacity to store SOC than AR, and that in the short term, AR is more sensitive to land management than CL

Diagnostic étiologique du diabète insipide central: à propos de 41 cas

La survenue d'un syndrome polyuro-polydipsiqueavec des urines hypotoniques nécessite une stratégie diagnostique rigoureuse. Le but de cette étude était d’étudier les modalités de diagnostic du diabète insipide central. A travers une étude rétrospective de 41 cas de diabète insipide central(DIC) colligés au service d’Endocrinologie à l’hôpital de la Rabta de Tunis, allant de l’année 1990 à l’an 2013,nous avons relevé les circonstances de découverte du DIC, les anomalies du bilan anté-hypophysaire etde l’imagerie hypophysaire. Le DIC était post opératoire chez 20 patients. La diurèse moyenne de 24 heures était significativement plus élevée chez les patients ayant un DIC en dehors d’un contexte chirurgical. L’épreuve de restriction hydrique était concluante chez tous les patients qui en ont bénéficié. En dehors d’un contexte neurochirurgical, les causes infiltratives étaient retrouvées chez 6 patientset les causes tumorales chez 6 patients. Le DIC était associé à une selle turcique vide dans 1 cas et idiopathique chez 3 malades. L’imagerie par résonnance magnétique hypothalamo-hypophysaire et le bilan anté-hypophysaire sont systématiques en dehors d’un contexte de chirurgie hypophysaire et d’une polydipsie primaire évidente. The Pan African Medical Journal 2016;2

Pratique des soins des pieds chez les diabétiques à haut risque podologique dans un centre hospitalo-universitaire

Les lésions du pied chez le diabétique sont associées à une importante morbimortalité. Leur prévention passe en particulier par des soins appropriés des pieds. Objectif : L’objectif de notre étude était d’évaluer la pratique des soins des pieds par les diabétiques à haut risque podologique dans un centre hospitalo-universitaire de Tunis. Méthodes : Cinquante-deux diabétiques à haut risque podologique, hospitalisés au service d’endocrinologie de l’hôpital La Rabta de Tunis entre Janvier 2014 et Mai 2014, ont répondu à un questionnaire évaluant leur pratique des soins des pieds. Un score global allant de 0 à 10 a été établi. Nous avons considéré comme étant à haut risque podologique les diabétiques dont le grade de risque podologique était de 1, 2 ou 3 selon la classification du groupe international de travail sur le pied diabétique (IWGDF). Les patients ayant une pratique de soins de pieds insatisfaisante (score < 5) ont été comparés à ceux ayant une pratique satisfaisante (score ≥ 5) en fonction de différents facteurs sociodémographiques et liés au diabète. Résultats : Le score moyen obtenu par nos patients en réponse au questionnaire était de 4,9/10 (extrêmes de 1 à 9). Le score était inférieur à 5 chez 42,3 % des patients entre 5 et 7 chez 40,4 % des patients et supérieur à 7 chez 17,3 % des patients. Les facteurs associés à une pratique insatisfaisante des soins des pieds étaient le bas niveau socioéconomique (p = 0,009) et le fait de n’avoir jamais bénéficié d’une séance d’éducation thérapeutique visant à prévenir la survenue de lésions du pied (p = 0,032). Conclusion : Nos résultats révèlent que la pratique des soins des pieds par les diabétiques à haut risque podologique est très insuffisante. Des mesures préventives et éducatives en matière de soins de pieds sont urgentes afin d’améliorer le pronostic podologique de ces patients

Late-Onset Isolated Corticotrope Deficiency in a Woman with Down Syndrome

Isolated corticotrope deficiency is a rare cause of secondary adrenocortical insufficiency. Its occurrence in patients with Down syndrome is exceptional. Herein, we report a case of an isolated corticotrope deficiency diagnosed at the age of 33 years in a woman with Down syndrome and discuss its possible mechanisms. A 33-year-old woman with Down syndrome was referred to our department for the investigation of low blood pressure. She complained of asthenia, dizziness, and palpitation with arterial hypotension for the past 4 years. The thyroid function was normal and anti-thyroperoxidase antibodies were negative. The peak of cortisol level in response to the insulin-induced hypoglycemia test was 9.4 μg/dl. ACTH level was normal, indicating corticotrope deficiency. Other pituitary hormones were normal. Magnetic resonance imaging scan revealed a partially empty sella turcica. Genetic analysis showed no mutations and no copy number variants of the TBX19 and NFKB2 genes. The mechanism of isolated corticotrope deficiency is unclear, but it may be induced by autoimmune mechanism in similar to other disorders of patients with Down syndrome

A diffuse large B‐cell thyroid lymphoma presented as a compressive goiter in a young woman with no evidence of Hashimoto's thyroiditis

Abstract Thyroid lymphoma should be suspected in case of rapid enlargement of the thyroid gland even in a young patient with no history of Hashimoto thyroiditis. The confirmation is based on histopathology and immunohistochemistry

A Case of Von Hippel–Lindau Disease with Bilateral Pheochromocytoma and Ectopic Hypersecretion of Intact Parathyroid Hormone in an Adolescent Girl

Von Hippel–Lindau disease is an autosomal dominant inherited syndrome predisposing to a variety of highly vascularised tumors in different organs. Although bilateral pheochromocytoma was reported in patients with von Hippel–Lindau disease, the coexistence of primary hyperparathyroidism is not a common condition. We report an observation of a primary hyperparathyroidism secondary to an ectopic secretion of intact parathyroid hormone in a 17-year-old girl with von Hippel–Lindau disease and bilateral pheochromocytoma. She presented with a newly diagnosed diabetes mellitus and a severe arterial hypertension. Blood tests disclosed hypercalcemia with increased intact PTH level. Cervical ultrasound and sestamibi scintigraphy were normal. Twenty-four-hour urinary normetanephrine level was highly elevated pointing to a catecholamine-secreting tumor. The abdominal computed tomography showed bilateral adrenal masses. MIBG scintigraphy exhibited a high accumulation of the tracer in both adrenal tumors. Genetic testing revealed a mutation of the VHL gene. The patient underwent a bilateral adrenalectomy. The postoperative outcome was marked by normalization of blood pressure, blood glucose, calcium, and PTH levels. In our case, the elevation of intact PTH and its spontaneous normalization after surgical treatment of pheochromocytomas confirms its ectopic secretion

Factors associated with knowledge level in adult type 1 diabetic patients

Background: The objective of the study is to determine the factors associated with the level of knowledge of Tunisian type 1 diabetic (T1D) patients in adulthood. Methods: This is a cross-sectional study including 93 T1D patients over 18 years old. The knowledge assessment was carried out by a questionnaire rated out of 20 points. The subjects with an „unsatisfactory” level of knowledge (score &lt; 10/20) were compared with subjects whose level of knowledge was „satisfactory” according to their socio-demographic, clinical, and paraclinical characteristics. Results: The mean age of the patients was 37.2 ± 12.4 years. The level of knowledge was „unsatisfactory” in 21 patients (23%). After univariate analysis, an „unsatisfactory” level of knowledge was associated with a low level of education (p = 0.001), a poor socioeconomic level (p = 0.03), a poor glycemic control (p = 0.003) and the absence of self-monitoring (p = 0.002). After multivariate analysis, only a low level of education and a lack of practice of self-monitoring were associated with an „unsatisfactory” level of knowledge (respectively p = 0.03 and 0.03; adjusted OR [95% confidence interval] = 7.3 [1.2–43.5] and 13.7 [1.3–143.3]). Conclusions: The factors independently associated with the level of knowledge in adult T1D patients are the level of education and the practice of self-monitoring. This encourages better tailoring of educational messages to patients with low levels of education and suggests that a better level of knowledge ensures better self-management of diabetes. However, the relationship with the quality of glycemic control remains uncertain

Metabolic disorders during endogenous Cushing’s syndrome: prevalence, associated factors, and outcome after remission

Objective. The prognosis of Cushing’s syndrome (CS) is related to a higher cardiovascular morbidity and mortality. This study aimed to determine the prevalence of metabolic disorders in patients with CS, the associated factors, and the rate of remission of these disorders after the remission from CS

The inflammatory profile of chronic kidney disease patients

Background: Chronic kidney disease is a worldwide public health issue which is associated with an increased risk of end-stage renal failure and cardiovascular disease. Systemic inflammation exists during chronic renal failure. Recent researches have highlighted the pivotal role of inflammation between renal and cardiovascular disease. The aim of our study is to determine the inflammatory profile of the patient suffering from chronic kidney disease and the influence of hemodialysis on this profile.Methods: We carried out a cross sectional study on 93 patients in the Nephrology Department at Hedi Chaker University Hospital, Sfax, South of Tunisia. Among those patients, 72 patients underwent hemodialysis and 21 patients had chronic kidney disease at stage 3. Clinical data and antecedents were collected. Biological samples were taken after informing the patients and taking their consent. Biological data consisted in lipid profile, albumin rate, hemoglobin rate, uric acid concentration and the usual markers of inflammation noting sedimentation rate, C - reactive protein and orosomucoid.Results: Hemodialysis group of the 72 patients had mean hemodialysis vintage of 54.6 &plusmn; 43 months. The inflammatory profile was worse in hemodialysis patients compared to chronic kidney disease patients. Both sedimentation rate, C - reactive protein and orosomucoid were higher in hemodialysis group than in chronic kidney disease group with 71 &plusmn; 35.3 mm vs. 42.1 &plusmn; 15.5 mm (p &lt; 0.05); 14.6 &plusmn; 28.7 mg/l vs. 6.7 &plusmn; 8 mg/l (p = 0.02); 1.3 &plusmn; 0.7g/l vs. 0.9 &plusmn; 0.4 g/l (p = 0.01), respectively.Conclusion: Inflammation increases in dialysis patient. It deserves the nephrologist&rsquo;s consideration in order to minimize its harmful effects. The monitoring of inflammation markers must be integrated into the nephrologist&rsquo;s medical practice