21 research outputs found
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 0â40 and 40â100 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 haâ1 compared to Newly Cultivated AR (NC-AR) with 25.13 Mg haâ1. However, the SOCS decreased after a long period of cultivation in CL from 43.00 Mg haâ1 (Newly Cultivated CL: NC-CL) to 32.19 Mg haâ1 (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 Ă©tiologique du diabĂšte insipide central: Ă propos de 41 cas
La survenue d'un syndrome polyuro-polydipsiqueavec des urines hypotoniques nĂ©cessite une stratĂ©gie diagnostique rigoureuse. Le but de cette Ă©tude Ă©tait dâĂ©tudier les modalitĂ©s de diagnostic du diabĂšte insipide central. A travers une Ă©tude rĂ©trospective de 41 cas de diabĂšte insipide central(DIC) colligĂ©s au service dâEndocrinologie Ă lâhĂŽpital de la Rabta de Tunis, allant de lâannĂ©e 1990 Ă lâan 2013,nous avons relevĂ© les circonstances de dĂ©couverte du DIC, les anomalies du bilan antĂ©-hypophysaire etde lâimagerie hypophysaire. Le DIC Ă©tait post opĂ©ratoire chez 20 patients. La diurĂšse moyenne de 24 heures Ă©tait significativement plus Ă©levĂ©e chez les patients ayant un DIC en dehors dâun contexte chirurgical. LâĂ©preuve de restriction hydrique Ă©tait concluante chez tous les patients qui en ont bĂ©nĂ©ficiĂ©. En dehors dâun contexte neurochirurgical, les causes infiltratives Ă©taient retrouvĂ©es chez 6 patientset les causes tumorales chez 6 patients. Le DIC Ă©tait associĂ© Ă une selle turcique vide dans 1 cas et idiopathique chez 3 malades. Lâimagerie par rĂ©sonnance magnĂ©tique hypothalamo-hypophysaire et le bilan antĂ©-hypophysaire sont systĂ©matiques en dehors dâun contexte de chirurgie hypophysaire et dâune polydipsie primaire Ă©vidente. 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
: Lâobjectif de notre Ă©tude Ă©tait dâĂ©valuer 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,
hospitalisĂ©s au service dâendocrinologie de lâhĂŽpital 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
diabÚte. Résultats : Le score moyen obtenu par nos patients en réponse au
questionnaire Ă©tait de 4,9/10 (extrĂȘmes de 1 Ă 9). Le score Ă©tait infĂ©rieur Ă 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 socioĂ©conomique (p = 0,009) et le fait de nâavoir jamais bĂ©nĂ©ficiĂ©
dâune sĂ©ance dâĂ©ducation thĂ©rapeutique visant Ă prĂ©venir la survenue de lĂ©sions du pied
(p =
0,032). Conclusion : Nos résultats révÚlent que la pratique
des soins des pieds par les diabétiques à haut risque podologique est trÚs insuffisante.
Des mesures préventives et éducatives en matiÚre de soins de pieds sont urgentes afin
dâamĂ©liorer 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 9.4âÎŒg/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 Bâcell 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 HippelâLindau Disease with Bilateral Pheochromocytoma and Ectopic Hypersecretion of Intact Parathyroid Hormone in an Adolescent Girl
Von HippelâLindau 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 HippelâLindau 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 HippelâLindau 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 âunsatisfactoryâ level of knowledge (score < 10/20) were compared with subjects whose level of knowledge was âsatisfactoryâ 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 âunsatisfactoryâ in 21 patients (23%). After univariate analysis, an âunsatisfactoryâ 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 âunsatisfactoryâ level of knowledge (respectively p = 0.03 and 0.03; adjusted OR [95% confidence interval] = 7.3 [1.2â43.5] and 13.7 [1.3â143.3]). 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 Cushingâs syndrome: prevalence, associated factors, and outcome after remission
Objective. The prognosis of Cushingâs 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 ± 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 ± 35.3 mm vs. 42.1 ± 15.5 mm (p < 0.05); 14.6 ± 28.7 mg/l vs. 6.7 ± 8 mg/l (p = 0.02); 1.3 ± 0.7g/l vs. 0.9 ± 0.4 g/l (p = 0.01), respectively.Conclusion: Inflammation increases in dialysis patient. It deserves the nephrologist’s consideration in order to minimize its harmful effects. The monitoring of inflammation markers must be integrated into the nephrologist’s medical practice