Burden of non-communicable diseases in Tunisia, 1990-2017: results from the global burden of disease study

Introduction: non-communicable diseases (NCDs) are the leading cause of mortality and disability worldwide especially in developing countries such as Tunisia. We aimed to describe the national burden of non-communicable diseases in 2017 and to analyze disability-adjusted life year trends from 1990 to 2017 in Tunisia by cause and gender. Methods: we used Joinpoint regression analysis to assess trends of the age standardized disability-adjusted life year rate from 1990 to 2017 and to determine average annual percentage change. Results: non-communicable diseases accounted for 87.7% of total disability-adjusted life year in Tunisia in 2017. The five leading causes of this rate in Tunisia in 2017 were cardiovascular diseases, musculoskeletal disorders, neoplasms, mental disorders and neurological disorders. The trend of disability-adjusted life year rate of non-communicable diseases decreased significantly from 23403.2 per 100.000 (95% CI: 20830.2-26285.8) in 1990 to 18454.6 (95% CI: 15611.3-21555.4) in 2017, with a change of -0.9%; p=0.00. The decrease of the age standardized disability-adjusted life year rate concerned mainly cardiovascular diseases and neoplasms secondly. This decrease was more important in female (change=-1.1, p=0.00) in comparison to males (change=-0.7, p=0.00). On the other hand, the increase of the standardized disability-adjusted life year rate was related to musculoskeletal disorders, diabetes, kidney disorders and substance use disorders with a significant annual percentage change of 0.1%, 0.2% and 1.3% (p=0.00) respectively. Conclusion: the implementation of the national strategy is the key solution to mitigate the impact of non-communicable diseases in Tunisia

Patients’ experiences and satisfaction with health care in the Salah Azaiez Institute of Cancer in Tunisia in 2020

Measurement of patient-centered care is a key step to ensure quality of care improvement. The aims of this study were to evaluate the experience of hospitalized patients of Salah Azaiez Institute (SAI) of Cancer of Tunisia in 2020 and to analyze factors associated to the global satisfaction. It was a cross-sectional study. The used questionnaire was derived from the Picker patient questionnaire. Factors associated to the global satisfaction were assessed using Chi-squared and Fisher’s exact tests. The present study concerned 200 inpatients of the SAI. The Cronbach’s α of the patient experience test (PPE-15) was of 0.82 indicating a good internal consistency. According to results of this study, only 38.5% of the patients were satisfied with their hospitalization. Perception of the quality of the received treatment was good to excellent for 57.0%. Regarding the global organization, 56.5% of the patients found it intermediate and 21.5% perceived it as bad. The highest scores among patient experience dimensions concerned the coordination of healthcare, the respect for patient preference and the physical comfort. However, lowest scores were attributed to the involvement of family and friends, the information and patient education and the emotional support. Unlike socio-demographic factors, patient experience and its dimensions was strongly associated to the global satisfaction. Further studies are recommended to explore patient experience dimensions and other determinants of patient satisfaction in Tunisia. Experience Framework This article is associated with the Policy & Measurement lens of The Beryl Institute Experience Framework. (https://www.theberylinstitute.org/ExperienceFramework). Access other PXJ articles related to this lens. Access other resources related to this lens

Angiomyolipome épithélioïde rénal mimant un carcinome rénal

L’angiomyolipome épithélioide est une forme rare d’angiomyolipome à potentiel malin, considéré récemment par l’OMS comme une entité à part dans la classification des tumeurs rénales. Cette lésion pose un problème dans le diagnostic différentiel avec les carcinomes à cellules claires. Il n’y a pas de critère spécifique clinique ou radiologique caractérisant cette tumeur. L’immunohistochimie en révélant la positivité des cellules épithélioide au marqueur HMB45 est essentielle au diagnostic. Le traitement doit être discuté en concertation pluridisciplinaire.Pan African Medical Journal 2016; 2

Chemical analysis of different parts of date palm (Phoenix dactylifera L.) using ultimate, proximate and thermo-gravimetric techniques for energy production

The objective of the study was to analyze chemical structure of date palm ( Phoenix dactylifera L.) by employing ultimate, proximate and thermo-gravimetric techniques. Samples from different anatomical parts of date palm, namely trunk, frond base, frond midrib, leaflets, coir, fruit stem, date stone, and fruit empty bunches were considered for the experiments. Based on the findings in this work palm leaflet samples gave the highest amount of extractives content (32.9%), followed by date palm stone specimens with 31.5%. Cellulose content values of 32.8% and 47.5% were obtained for date palm stone and palm coir samples, respectively. Overall the hemicellulose contents of all samples were relatively similar to those of typical wood or non-wood lignocellulosic materials with the two exceptions of palm coir and palm leaflets. Both palm coir and palm leaflet specimens had 12.6% and 16.1% hemicellulose content. Volatile matter values of 74.3% and 87.5% were determined for leaflets and fruit empty bunch samples. The ash content of the samples ranged from 1.4% for date stone to 15.2% for palm leaflet samples. The thermal decomposition was completed below a temperature of 500 °C with an exception of those samples taken from palm leaflets. Taken together the data indicate that date palm stone and palm coir revealed could be more viable for renewable energy production than the other specimens considered in this work.Peer reviewedNatural Resource Ecology and Managemen

Biomatrix from Stipa tenacissima L. and its Application in Fiberboard Using Date Palm Rachis as Filler

International audienceThe present study investigated the preparation of biomatrices from Stipa tenacissima L. and its valorization for fiberboard application. Resins were produced by extracting lignin from the Stipa tenacissima L. black liquor by soda process and combining it with glyoxal as crosslinking agent to produce lignin-glyoxal-resin (LGR). The matrix was characterized by several methods, such as FTIR and ATG/ATD, and then mixed with date palm rachis as reinforcing fibers in different proportions of 30 and 50% (w/w with respect to the matrix) to produce biodegradable composite materials. Then, their thermal and mechanical properties were determined, using differential scanning calorimetry (DSC) and dynamic mechanical analysis (DMA). The results obtained show that date palm rachis particles were effective in enhancing the thermo-mechanical properties of the thermoset matrix

Preparation of sodium carboxymethylcelluloses from rachis date aplm and their valorisation as sizing agents of cotton yarn

International audienc

Study of flocculation performance of sodium carboxy methylcellulose

International audienc

Preparation and application of Tunisian phosphogypsum as fillers in papermaking made from Prunus amygdalus and Tamarisk sp.

International audienceLarge mineral fillers have long been used in papermaking for many reasons. The finish of the writing and printing paper depends on using the fillers as internal or surface treatments. During this study, Tamarisk sp. and Prunus amygdalus pulp-filled papers with raw phosphogypsum (PG) and calcined PG (CPG) at different percentages were studied. First, the prepared minerals (treated and untreated ones) were characterized by different analytical methods such as SEM and EDS. Subsequently, different handsheets with a basis weight 60 g−2 were prepared on a Rapid Khöten sheet former following the standard method. The added amounts of PG and CPG fillers were included from 0% to 15% based on the pulp. The effects of incorporation as well as the quality fillers into physical and optical properties were assessed. It can be deduced that the incorporation of CPG at 800 °C improved filler retention by as high as 92%, and the optical properties of the filled paper was strikingly enhanced, while the strength properties were practically negatively influenced. It was clear that calcinationstepsreduce the fiber–filler–fiber bond. Thus, results are in accordance with the SEM observation, which confirmed the obtained physical properties

Preparation and Characterization of Carboxymethyl Cellulose with a High Degree of Substitution from Agricultural Wastes

This paper describes the use of agricultural wastes for the preparation of carboxymethylcellulose (CMC) with a high degree of substitution using two methods: the classic and a microwave-assisted method. A series of CMC samples with degrees of substitution from 0.43 to 2.83 were prepared from cellulose extracted from almond shells, almond stems, and fig stems by a one-step carboxymethylation reaction. The highest degree of substitution was 2.83, which corresponded to CMC from fig stems when butanol was used as a solvent. This CMC was easily dissolved in water and thus would provide many opportunities for diverse applications. The obtained CMCs were characterized using different tools. Different CMC films were prepared using the casting method and were characterized by the determination of their mechanical properties. The obtained results can be considered promising; they demonstrate the potential of using cellulose derivatives for the production of transparent and strong films

Cellulose Nanofibers from Schinus molle: Preparation and Characterization

International audienceSchinus molle (SM) was investigated as a primary source of cellulose with the aim of discovering resources to generate cellulose nanofibers (CNF). The SM was put through a soda pulping process to purify the cellulose, and then, the fiber was treated with an enzymatic treatment. Then, a twin-screw extruder and/or masuko were utilized to help with fiber delamination during the nanofibrillation process. After the enzymatic treatment, the twin-screw extruder and masuko treatment give a yield of 49.6 and 50.2%, respectively. The optical and atomic force microscopy, morfi, and polymerization degrees of prepared cellulosic materials were established. The pulp fibers, collected following each treatment stage, demonstrated that fiber characteristics such as length and crystallinity varied according to the used treatment (mechanical or enzymatic treatment). Obviously, the enzymic treatment resulted in shorter fibers and an increased degree of polymerization. However, the CNF obtained after enzymatic and extrusion treatment was achieved, and it gave 19 nm as the arithmetic width and a Young’s modulus of 8.63 GPa