Communication and the circulation of letters in the Eastern Desert of Egypt during the Roman Period

Over the past thirty years, excavations in Egypt’s Eastern Desert, which was home to important mining sites and the hub for long-distance trade between Rome and the Near and Far East, have turned up thousands of potsherds inscribed with Greek and much fewer with Latin. Most of these texts are private and official letters and they tend to date to the first three centuries of the current era. Studying this large corpus of material, which has not been studied in a synthetic manner before, reveals multiple aspects of life in Roman Egypt: for example, we see how letters were exchanged, who handled and delivered them, whence and to where they were delivered, what obstacles could prevent their delivery, and who communicated with whom, namely, the networks that were formed through epistolary communication. The Eastern Desert brought people of different cultures together, who came to this hardly habitable area generally for reasons of work and commercial interest. It was important to the Romans because of its mines of precious metals and stones, and for its access to the Red Sea trade route, which connected the Mediterranean to South Arabia, Southern Africa, and India. People stationed in the Eastern Desert needed to communicate, and communication required infrastructure. The present work has thus been conducted with particular focus on the circumstances that surrounded the process of the circulation of letters and goods in the Eastern Desert. Overall, this study attempts to reveal how epistolary communication was the underpinning of Roman commercial and military operations in a critical part of the Roman empire

Flexible bronchoscopy contribution in the approach of diagnosis and treatment of children’s respiratory diseases: the experience of a unique pediatric unit in Tunisia

Objective: Our study aimed at assessing the role of flexible bronchoscopy (FB) in improving diagnosis and management of children’s respiratory conditions in the pediatric unit of FB, newly created and unique in Tunisia.Methods: Retrospective study including all the FB achieved in our pediatric unit from 2009 to 2014.Results: We performed 365 FB in 333 patients aged 46 months on average (1 month - 15 years), often under conscious anesthesia (81.6%). FB was performed for diagnostic purposes in 341 cases and for therapeutic purposes in 24 cases. Eight anatomical abnormalities were revealed in 22 patients. An intraluminal bronchial obstruction was found in 71 FB, mainly due to a foreign body (n=36). A vascular anomaly was responsible for nine cases out of 17 extraluminal obstructions. Airways malacia was observed in 60 FB. Bronchoalveolar lavage was performed in 196 cases. It was determinant in 43.9% of the cases. FB was of great diagnostic value in 74.8% of the cases. It influenced the management of the patients in 58% of the cases. The FB for therapeutic purposes was beneficial in all cases. Few complications occurred (5.5%).Conclusion: FB is a safe tool providing precious diagnostic and/or therapeutic help for the clinician.Keywords: Flexible bronchoscopy, child, bronchoalveolar lavage, foreign body aspiration, pulmonary alveolar proteinosi

Cystic fibrosis in Tunisian children: a review of 32 children

Background: Cystic fibrosis is rare in Tunisia.Its diagnosis requires experienced specialists. Its prognosis is poor in developing countries.Objectives: To study the epidemiologic, clinical, genetic features and the therapeutic challenges of cystic fibrosis in Tunisian children.Methods: Covering a period of 21 years, this retrospective study included all patients with a definite diagnosis of cystic fibrosis from the Pediatrics Department B of The Children’s Hospital of Tunis.Results: Data from 32 children (14 boys and 18 girls) were collected. The diagnosis was made during the first year of life in 28 cases. Meconium ileus was found in 5 cases, respiratory manifestations in 22 cases, chronic diarrhea in 19 cases, faltering growth in 17 cases and a pseudo Barter syndrome in 2 cases. The sweat chloride test was positive in all cases. The most frequent mutation was F508del (56% of cases). Respiratory complications marked the outcome. Among our 32 patients, 15 patients (50%) died at an average age of 5 years and 3 months, mainly due to respiratory failure. The mean age of the surviving patients was 5 years.Conclusion: Cystic fibrosis prognosis is poor in our series compared to developed countries due to the longer diagnostic delay and the limited therapeutic options.Keywords: Cystic fibrosis, children, Tunisia

Flexible bronchoscopy contribution in the approach of diagnosis and treatment of children\u2019s respiratory diseases: the experience of a unique pediatric unit in Tunisia.

Objective: Our study aimed at assessing the role of flexible bronchoscopy (FB) in improving diagnosis and management of children\u2019s respiratory conditions in the pediatric unit of FB, newly created and unique in Tunisia. Methods: Retrospective study including all the FB achieved in our pediatric unit from 2009 to 2014. Results: We performed 365 FB in 333 patients aged 46 months on average (1 month - 15 years), often under conscious anesthesia (81.6%). FB was performed for diagnostic purposes in 341 cases and for therapeutic purposes in 24 cases. Eight anatomical abnormalities were revealed in 22 patients. An intraluminal bronchial obstruction was found in 71 FB, mainly due to a foreign body (n=36). A vascular anomaly was responsible for nine cases out of 17 extraluminal obstructions. Airways malacia was observed in 60 FB. Bronchoalveolar lavage was performed in 196 cases. It was determinant in 43.9% of the cases. FB was of great diagnostic value in 74.8% of the cases. It influenced the management of the patients in 58% of the cases. The FB for therapeutic purposes was beneficial in all cases. Few complications occurred (5.5%). Conclusion: FB is a safe tool providing precious diagnostic and/or therapeutic help for the clinician. Keywords

Acute Pesticide Poisoning in Children: A Review of 50 Cases

Background: Pesticide poisoning is very common in Tunisia. Various factors are involved in the analysis of the clinical presentations and the severity of this condition. Major factors are the chemical nature of the pesticides and the quantity entered the body. Methods: This is a retrospective study, reporting the pediatric cases that presented to us with signs and symptoms of pesticide poisoning. Fifty cases pesticide poisoning were admitted to the hospital between January 2013 and October 2016. Results: A total of 50 pediatric cases were included in this study with the mean age of 3 years and 4months. The poisoning was accidental in 49 cases and self-inflicted in one, with the mode being oral (N=45), respiratory (N=2) and cutaneous (N=3). The average duration of hospital care for these patients was 2 hours and 30 minutes (range: 30 min-24 hr). The clinical manifestations of poisoning noted were due to muscarinic and nicotinic receptors inhibition. Upon clinical examination, 29 patients had no pesticide in the gastric lavage fluid and urine and demonstrated no abnormal cholinesterase activity. The therapeutic management was mainly symptomatic with antidote medications prescribed (atropine and oxime). All patients had favorable outcomes and no death occurred. Conclusion: This study demonstrated the frequency of pesticide poisoning in a pediatric setting and the importance of early management. Optimal therapeutic approaches were evaluated, demonstrating that prevention still remains the best solution in such cases

Long-term outcome of Tunisian children with primary ciliary dyskinesia confirmed by transmission electron microscopy.

Background: Primary ciliary dyskinesia (PCD) is rare. Its diagnosis requires experienced specialists and expensive infrastructure. Its prognosis is variable. Objective: To study the long-term outcome of PCD in Tunisian children with ciliary ultra-structure defects detected by electron microscope. Methods: Covering a period of 20 years (1996-2015), this retrospective study included all patients with definite PCD (outer dynein arms (DA) defects and/or situs inversus) and presumed PCD (other ciliary ultra-structure defects). The clinical data and the investigations made were registered at diagnosis and during the follow-up. Results: Patients with a definite PCD (G1, n=7) were diagnosed earlier compared to those with a presumed PCD (G2, n=13) (2.5 vs. 9.3 years on average). At diagnosis, bronchiectasis was more frequent in G1 (3/7 vs. 4/13). The inner DA loss was constant in G1 and predominant in G2. The treatment adhesion was more often irregular in G2 (2/7 vs. 8/13). During a mean follow-up of 11 years, G1 showed less severe outcome (clubbing (0 vs. 3), bronchiectasis (3 vs. 11; more expanded in G2), proximal and distal airway obstruction (0/3 vs. 5/7), lobectomy (0 vs. 2), and death (0 vs. 2)). Conclusion: Precocious diagnosis and regular treatment may enhance the PCD prognosis

Cystic fibrosis in Tunisian children: a review of 32 children

Background: Cystic fibrosis is rare in Tunisia.Its diagnosis requires experienced specialists. Its prognosis is poor in developing countries. Objectives: To study the epidemiologic, clinical, genetic features and the therapeutic challenges of cystic fibrosis in Tunisian children. Methods: Covering a period of 21 years, this retrospective study included all patients with a definite diagnosis of cystic fibrosis from the Pediatrics Department B of The Children\u2019s Hospital of Tunis. Results: Data from 32 children (14 boys and 18 girls) were collected. The diagnosis was made during the first year of life in 28 cases. Meconium ileus was found in 5 cases, respiratory manifestations in 22 cases, chronic diarrhea in 19 cases, faltering growth in 17 cases and a pseudo Barter syndrome in 2 cases. The sweat chloride test was positive in all cases. The most frequent mutation was F508del (56% of cases). Respiratory complications marked the outcome. Among our 32 patients, 15 patients (50%) died at an average age of 5 years and 3 months, mainly due to respiratory failure. The mean age of the surviving patients was 5 years. Conclusion: Cystic fibrosis prognosis is poor in our series compared to developed countries due to the longer diagnostic delay and the limited therapeutic options

Awareness, knowledge, attitudes, and behaviors related to COVID-19 in Libya: a nation-wide online survey

Introduction: the World Health Organization declared the COVID-19 outbreak to be a global pandemic in March 2020. However, the pandemic cannot be ended overnight and more social distancing and other self-care measures are needed to protect our communities. Therefore, people´s awareness, knowledge, attitudes, and appropriate behaviors are instrumental to containing the pandemic. The aim of this study was to determine COVID-19 awareness, knowledge, attitudes, and related behaviors in Libya. Methods: a cross-sectional online survey was conducted from October 10 th to November 10th, 2020 in 24 cities in Libya. The participants were non-medical professionals who were living in Libya for at least 2 years and were at least 18 years old. Results: a total of 1018 participants completed the questionnaire, with ages ranging from 18-74 years (Mean ± SD = 33.49±13.24); nearly two-thirds were < 40, and 68.2% were females. Almost half of the participants considered the potential threat of COVID-19 to be low, and one in five reported that they were “Not worried at all” about getting COVID-19. In multivariate analyses, participants who were 40-49 years old, had master´s degrees or higher, and worked in the private sector reflected high mean scores for both knowledge and attitudes, while those who lived in the Eastern or Southern regions had lower mean attitude scores. Conclusion: the low levels of awareness as well as the attitudes and behaviors among the public in Libya are worrisome. This study highlighted profound gaps that may put Libyan communities at high risk of a COVID-19 explosion. Therefore, immediate action is needed to address public awareness and attitudes and to improve COVID-19 related behaviors among the Libyan public

Toxicity of the active fraction of Pergularia tomentosa and the aggregation pheromone phenylacetonitrile on Schistocerca gregaria fourth-instar nymph: effects on behavior and acetylcholinesterase activity

Chemical insecticides remain the most used approach in locust control although they present a serious menace to human health and the environment. The search for alternative control methods, efficient and environmentally friendly, has become indispensable. The aim of this work is to study the effect of the aggregation pheromone, phenylacetonitrile, alone or in combination with the active fraction of Pergularia tomentosa on Schistocerca gregaria fourth-instar nymph. Toxicity bioassays showed that the combination of phenylacetonitrile with the active fraction of P. tomentosa significantly increased nymph mortality. Results also showed that the aggregation pheromone caused significant mortality especially after 6 hours of exposure. The pheromone also caused neurotoxic effects on S. gregaria nymph due to the disturbance of the acetylcholinesterase activity. We also noted the presence of cannibalism phenomenon. Phenylacetonitrile seems to have an effect on phase ployphenism of S. gregaria imagos that exhibit specific traits to the solitarious phase