Hyperhomocysteinaemia in Behçet's Disease

Objectives. The aim of this study was to investigate if hyperhomocysteinaemia is a contributive risk factor for the pathogenesis and the activity of Behçet's disease (BD). Design and Methods. Fifty four patients fullfiling the criteria of the International Study Group for BD were enrolled. Fifty healthy volunteers matched for age and sex with the BD group were included as a negative control group. Patients, with any condition that might affect plasma homocysteine concentration, were excluded. Results. Mean serum homocysteine concentration was significantly higher in patients with BD than in the healthy controls (P < .001), in patients with active disease (P = .04), and in masculine gender (P = .05). There was no significant difference between homocysteine level and clinical involvement. Conclusions. We demonstrated that plasma total homocysteine level (tHcy) is increased in BD and correlated with disease activity. No association was found between homocysteine levels and clinical involvement

Detection of metallo-beta-lactamase producing Pseudomonas aeruginosa using a modified IMP-lysate assay

Since the increasing prevalence of carbapenem-resistant Pseudomonas aeruginosa spp., accurate detection of metallo-β-lactamase (MBL) such as blaVIM type enzyme producing isolates became very important. However, phenotypic MBL detection methods previously reported are not highly sensitive or highly specific. This study aimed to evaluate the performance of a modified IMP-lysate test, the doubledisk- synergy-test (DDST) and the combined-disk-test (CDT) for detecting MBL blaVIM gene in P. aeruginosa. The reference technique was PCR molecular test. The study used 12 blaVIM2 producer isolates, 13 MBL-negative controls which included 4 imipenem-susceptible strains and 9 imipenemresistant strains harbouring blaSHV-2a genes collected from two Tunisian hospitals and P. aeruginosa ATCC27853 and P. aeruginosa COL-1 as negative and positive controls respectively. CDT showed 100% of sensitivity. The highest level of specificity was shown by IMP-lysate test (76.92%). To evaluate efficiencies of methods, the study noted that the highest Youden Index (YI) was shown by IMP-lysate method (0.7), followed by DDST (0.6) than CDT (0.2). Since MBL-Etest and PCR were expensive and not adaptable for extension use in clinical microbiology laboratories, a modified IMP-lysate MBL hydrolytic activity can be chosen by laboratories with limited resources as an inexpensive, simple, and accurate test to detect . P. aeruginosa producing blaVIM enzyme.Key words: Metallo-beta-lactamase, VIM, phenotypic detection, pseudomonas aeruginosa

Co-existing sarcoidosis and Takayasu arteritis: report of a case

<p>Abstract</p> <p>Introduction</p> <p>Takayasu arteritis (TA) is a chronic vasculitis of unknown origin, affecting mainly the aorta and its main branches. As a result of the inflammation, stenosis, occlusion or dilatation of the involved vessels may occur and cause a wide range of symptoms. It has been described in association with various auto-immune disorders (mainly inflammatory digestive tract diseases). However, only few cases of TA associated with sarcoidosis have been reported, raising the question of an association by chance.</p> <p>Case report</p> <p>We report a case of a 34 year-old woman, with one year history of sarcoidosis, who presented with asymmetric high hypertension revealing inflammatory humeral, axillary and subclavian arteritis related to TA, successfully treated by steroid and immunosuppressive therapy(Methotrexate^R).</p> <p>Conclusion</p> <p>TA and sarcoidosis may be related, rising the hypothesis that TA or Takayasu arteritis-like granulomatous vasculitis may be, in fact, a complication of sarcoidosis.</p

Regionalization and Contribution to the Study of Reservoirs Sedimentation: Lakes of Cape Bon and the Tunisia Central

Sediment Transport and Morphodynamic

Interest of the therapeutic education in patients with type 2 diabetes observing the fast of Ramadan

AbstractThe fast of Ramadan is a dilemma for diabetic patients due to the complexity of the management of diabetes during this holy month and the multiple risks they face (hypoglycemia, etc.).ObjectivesEvaluate the impact of a structured protocol of therapeutic education in a sample of type 2 diabetes, who were authorized by their doctors to fast, on metabolic and anthropometric profiles.MethodsThis prospective study was conducted among 54 type 2 diabetic patients (28 men and 26 women) aged 36–65years, recruited from National Nutrition Institute. Patients were divided into two groups: the first group (n=26) received an education session one to two weeks before the month of Ramadan; the second group (n=28) did not have appropriate therapeutic education except therapeutic adjustments. All our diabetic patients benefited from anthropometric measurements, determination of body composition and metabolic assessment (HbA1c, cholesterol, triglycerides, etc.) before and after the month of Ramadan.ResultsThe fast was completed without complications in 25 diabetic patients educated group and 22 control patients.We found that weight loss was greater among educated diabetic patients (−1.05kg) than in controls (−0.58kg), but without statistical significance. Body composition has not undergone significant changes in both diabetic groups.Therapeutic education has led to a decline of 0.27% in HbA1c in the educated group while glycemic control in diabetic patients uneducated remained stable. Furthermore, we observed a better lipid profile in diabetic patients educated than those who did not have education.ConclusionOur results justify the interest of patient education centered on the month of Ramadan in all type 2 diabetic patients observing the fast of the holy month. This education should be continued during Ramadan in order to fulfill this religious rite safely

Salt intake in a group of Tunisian obeses

Background: Salt is directly related to hypertension and cardiovascular disease associated with it. As obesity facilitates the effect of salt, a quantification of obese salt intake is necessary.Methods: Our patients numbering 56 have been recruited in the consultation of the obesity unit. Patients were given a questionnaire about their knowledge concerning salt. Natriuresis of 24 h was quantified. The average amount of sodium consumed per day from foods was determined (SAL), the average amount of sodium consumed per day from table salt added to cooking and seasoning (SAC) and the average total amount of sodium consumed per day (STOQ).Results: The mean age of our patients was 44.31 ± 12.8 years. The average BMI of our patients was 37.12 ± 5.9 kg/m2. The average systolic blood pressure was 123.8 ± 14 mmHg and mean diastolic blood pressure was 76.45 ± 10.7 mmHg. The average amount of sodium consumed per day from food (SAL) was 1 915 ± 1038 mg. The average amount of sodium consumed per day from cooking salt (SAC) was 2487 ± 1663 mg. The total amount of sodium consumed per day (STOQ) was 4402 ± 1831 mg. This addition is equivalent to 11 ± 4.6 g of salt per day. The total sodium intake exceeded 2000 mg/day in 89.2% of patients. More than half (57%) of spontaneous sodium intake comes from salt added. The average natriuresis in our population is 158 ± 68 mmol/24 h, higher than the norm in 18% of cases. The majority (85%) of our patients have claimed that excess salt is bad to very bad for health.Conclusion: Our study showed the importance of salt consumption in obeses and especially table salt and yet the majority of our patients consider it to be harmful to health.It will be necessary to take into account the sodium intake when prescribing the diet.Keywords: Obesity, Salt, Sodium intake, Natriuresis 24

Nutritional risk factors for postmenopausal osteoporosis

Background: Osteoporosis is a bone disease that combines both a decrease in bone density and its internal architecture changes. Nutrition is one of the major determinants of osteoporosis.Aim: The purpose of our study was to identify nutritional risk factors of osteoporosis of two groups of osteoporotic women and witnesses.Methods: We conducted a comparative cross-sectional study including 60 postmenopausal women and screening for osteoporosis by a bone densitometry, recruited the outpatient service of Rheumatology of the Institute KASSAB.Results: We have identified excessive supply of saturated fatty acids (SFA) in the osteoporotic compared with controls (13.27% vs 10.23%, p= 0.002) and an inadequate intake of monounsaturated fatty acids (MUFA) (12.6% vs 16.16%, p=0.012).A low calcium intake is another factor of risk of osteoporosis (574.27 ± 336.9 mg/day vs 782.45 ± 340.54 mg/day; p= 0.021). This is explained by the low consumption of milk and milk products objectified in the osteoporotic group (p= 0.001). We also found a negative relationship between inadequate intakes of potassium and osteoporosis (2241.55 ±1049.85 mg/day vs 2988.17 ± 1146.52 mg/day; p= 0.011). This may be due to the low consumption in fruit and vegetables, sources of potassium, found in the osteoporotic group (p= 0.003).We found a significant increase in the consumption of the VVPO group in the osteoporotic toward women witness (2.23 ± 0.99 number of times/day vs 1.67 ± 0.76 number of times/day; p= 0.019). A high consumption of coffee appears also as a risk factor since the osteoporotic group consume almost twice than controls (p= 0.002).Conclusion: Nutritional risk factors of osteoporosis are all the most important that they are editable and can take their place in a prevention of public health policy.Keywords: Osteoporosis; Menopause; Risk factors; Nutritio

The potential of using E. coli as an indicator for the surveillance of antimicrobial resistance (AMR) in the environment

To understand the dynamics of antimicrobial resistance (AMR), in a One-Health perspective, surveillance play an important role. Monitoring systems already exist in the human health and livestock sectors, but there are no environmental monitoring programs. Therefore there is an urgent need to initiate environmental AMR monitoring programs nationally and globally, which will complement existing systems in different sectors. However, environmental programs should not only identify anthropogenic influences and levels of AMR, but they should also allow for identification of transmissions to and from human and animal populations. In the current review we therefore propose using antimicrobial resistant Escherichia coli as indicators for monitoring occurrence and levels of AMR in the environment, including wildlife.publishedVersio

Polymorphism of Interleukin 6 -174 G/C in Behcet Disease: Case Series and Review of Literature

To assess the association between polymorphisms of the IL-6 -174 G/C and Behçet's disease (BD) in Tunisian patients. DNA was extracted from blood samples taken from 43 Tunisian patients and 43 healthy controls. The polymorphisms were analyzed by PCR with the PCR-RFLP. No significant association was found between patients and controls concerning polymorphism of IL6 -174 G/C between the (allelic frequency: C (17.44 vs 8, 13%; P=0.17) et G (82,55 vs 91,86%; P= 0.21). Neither age of onset of BD nor sex appears to be influenced by allelic variation of SNP-174 G / C of IL6. Disease duration of BD was longer in patients having the form 174 G-allele. SNP -174G/C was more frequent in patients without significant association (32.5 vs 16,26% ; P=0.07). SNP -174 G/C was not associated with the HLA B51. Neither age of onset of BD nor sex appears to be influenced by SNP-174 G / C of IL6. Disease duration of BD was longer in the absence of the SNP-174 G/C IL6, with no significant difference (79.2 + / -45.095 vs.70.28 + / - 47.034 months, P=0.59). The polymorphism of IL6 -174 G/C does not modulate clinical expression of BD. The single nucleotide polymorphisms of the IL-6 do not appear to be associated with BD reconstruction