Systemic sarcoidosis complicated of acute renal failure: about 12 cases

The sarcoidosis is a systemic granulomatosis affecting most frequently the lungs and the mediastinum. An acute renal failure reveals exceptionally this disease. It's a retrospective study implicating 12 cases of  sarcoidosis complicated of acute renal failure. The aim of this study is to determine epidemiological, clinical, biological and histological profile in these cases and then to indicate the interest to consider the diagnosis of sarcoidosis in cases of unexplained renal failure. Extra-renal complications, therapeutic modalities and the outcome were determined in all patients. Our series involved 12 women with an  average age of 40 years. Biological investigations showed an abnormal normocalcemia in 7 cases, a  hypercalcemia in 5 cases, a hypercalciuria in 10 cases and polyclonal hypergammaglobulinemia in 7 cases. An acute renal failure was found in all patients with a median creatinin of 520 umol/L. For all patients, the renal echography was normaln however, the kidney biopsy showed tubulo-interstitial nephritis. The extra-renal signs highlighting pulmonary interstitial syndrome in 5 cases, a sicca syndrome in 4 cases, mediastinal lymph nodes in 2 cases, a  lymphocytic alveolitis in 3 cases, an anterior granulomatous uveitis in 2 cases and a polyarthritis in 5 cases. Five patients benefited of hemodialysis. The treatment consisted of corticosteroid in all cases. The follow up was marked by complete resolution of clinical and biological signs. The diagnosis of renal sarcoidosis must be done quickly to prevent renal failure.Key words: Sarcoidosis, acute renal failure, interstitial nephritis, granulom

Vers une reconfiguration des territoires en Tunisie au temps de la décentralisation et de la communalisation intégrale

International audienceThe issue of socio-spatial inequalities was the burning point of the 2010-2011 mobilisation which led to the establishment of the Second Republic in Tunisia. Access to services and equipment, to employment, and more generally the right to development were among the popular claims of inland regions along with calls to new policy. Hence, the entirety of these evolutions put territories at the centre of transformations with the emergence of a new dynamic which set a political consensus around the implementation of an effective decentralisation on the one hand and an integral and immediate communalisation of territory on the other hand. However, more recently, we witness a movement which calls for a rethinking of the commitment towards decentralisation and regionalisation on account of risks of intensified tribal and regional tensions, whose demonstrations have been on the rise since 2011.La question des inégalités socio-spatiales a été au cœur de la mobilisation de 2010-2011 qui a conduit à l'instauration de la deuxième République tunisienne. L'accès aux services et aux équipements, à l'emploi et plus généralement le « droit au développement » ont été parmi les revendications populaires des régions de l'intérieur, au même titre que les appels au renouveau politique. Ainsi, l'ensemble de ces évolutions a mis les territoires au centre des transformations, avec l'émergence d'une nouvelle dynamique favorisant l'apparition d'un consensus politique sur la mise en place d'une décentralisation effective d'une part et la communalisation intégrale et immédiate du territoire d'autre part. Ce consensus laisse la place progressivement à un positionnement différencié des acteurs politiques, dont certains appellent à repenser l'engage-ment vers la décentralisation et la régionalisation, mettant en avant les risques d'exacerbation des tensions tribales ou régionales, dont les manifestations se sont multipliées depuis 2011

Herbal therapy for hemorrhoids: An Overview of Medicinal Plants Affecting Hemorrhoids

Hemorrhoids are one of the most common rectal diseases that affect millions of people in the world and cause many medical and socio-economic problems. The resulting pain is very severe and incurs exorbitant costs for the patient and the government. This study aimed to review the medicinal plants that affect hemorrhoids. Complete databases searched for in those articles were Google Scholar, SID, Scopus, PubMed, Science Direct, and WOS search engines. The search was done for articles published that included the search term containing, medicinal plants and hemorrhoids in their title. This study focused on published articles and papers from 1991 to 2022.The results showed medicinal plants Aloe vera, Trigonella foenum-graecum L, Nigella sativa L, Curcuma longa L, Cocos nucifera L, Solanum nigrum L., Alhagi persarum Boiss & Buhse, Plantago lanceolata L, Achillea santolina, Malva neglecta Wallr,  Rubus fruticosus L  have effects like anti-bleeding, analgesic, anti-inflammatory,  and wound-healing, and with hemorrhoid-healing effect. Generally, the investigated traditional Iranian edible plants are rich in different types of chemical compounds and have special benefits in the prevention and treatment of diseases.Keywords: Medicinal plants; Hemorrhoids; Diseases; Remedy Drugs 

Green Synthesis of Zn(OH)₂/ZnO-Based Bionanocomposite using Pomegranate Peels and Its Application in the Degradation of Bacterial Biofilm

The ability and potency of bacterial species to form biofilms, which show antibiotic resistance thereby avoiding antibiotic surfaces, is a major cause of prolonged infections. Various advanced approaches have been employed to prevent or damage bacterial biofilms, formed by a variety of bacterial strains, to help prevent the associated infectious disease. In this context, zinc-based nanostructures have been recognized as a potential antibiotic agent against a broad spectrum of bacterial communities. As a result, a sustainable and green synthesis method was adapted in the present study to synthesize a Zn(OH)(2)/ZnO-based bionanocomposite, in which aqueous extracts of waste pomegranate peels (Punica granatum) were employed as a natural bioreducing agent to prepare the bionanocomposite at room temperature. Furthermore, FT-IR, XRD, DLS, UV-Visible, PL spectroscopy, FE-SEM, and TEM were used to characterize the green route synthesized a Zn(OH)(2)/ZnO bionanocomposite. The average crystallite size was determined using the Scherrer relation to be 38 nm, and the DLS results indicated that the Zn(OH)(2)/ZnO bionanocomposite had a hydrodynamic size of 170 nm. On the other hand, optical properties investigated through UV-Vis and PL spectroscopy explored the energy bandgap between 2.80 and 4.46 eV, corresponding to the three absorption edges, and it covered the blue spectrum when the sample was excited at 370 nm. Furthermore, the impact of this green route synthesized a Zn(OH)(2)/ZnO bionanocomposite on the biofilm degradation efficiency of the pathogenic bacterial strain Bacillus subtilis PF_1 using the Congored method was investigated. The Congored assay clearly explored the biofilm degradation efficiency in the presence of a 50 mg/mL and 75 mg/mL concentration of the Zn(OH)(2)/ZnO bionanocomposite against the bacterial strain Bacillus subtilis PF_1 grown for 24 h. This study can be further applied to the preparation of bionanocomposites following a low-cost green synthesis approach, and thus prepared nanostructures can be exploited as advanced antimicrobial agents, which could be of great interest to prevent various infectious diseases

Critical Behavior of La0.8Ca0.2Mn1−xCoxO3 Perovskite (0.1 ≤ x ≤ 0.3)

The critical properties of La0.8Ca0.2Mn1−xCoxO3 (x = 0, 0.1, 0.2 and 0.3) compounds were investigated by analysis of the magnetic measurements in the vicinity of their critical temperature. Arrott plots revealed that the paramagnetic PM-ferromagnetic (FM) phase transition for the sample with x = 0 is a first order transition, while it is a second order transition for all doped compounds. The critical exponents β, γ and δ were evaluated using modified Arrott plots (MAP) and the Kouvel-Fisher method (KF). The reliability of the evaluated critical exponents was confirmed by the Widom scaling relation and the universal scaling hypothesis. The values of the critical exponents for the doped compounds were consistent with the 3D-Heisenberg model for magnetic interactions. For x = 0.1, the estimated critical components are found inconsistent with any known universality class. In addition, the local exponent n was determined from the magnetic entropy change and found to be sensitive to the magnetic field in the entire studied temperature range.This work has been supported by the Tunisian Ministry of Scientific Research and Technology and Institute Neel at Grenobl

Prevalence and practice of oestrogen use among the male gym participants

BackgroundOestrogen is the primary female sex hormone and has important functions in both female and male physiology. Recently oestrogen abuse among male gym participants had raised as it is considered to enhance gym performance and breast size. AimsThis study assesses the prevalence of oestrogen use among male gym patrons in Saudi Arabia, their practice related to oestrogen abuse, and the profiles of users. Methods A cross-sectional study was conducted from February 2017 to May 2017 and included 4,860 male gym patrons. The participants were given a questionnaire with a total of 19 questions regarding socioeconomic information, knowledge and practices related to oestrogen, and lifestyle habits.Results The participants had a mean age of 28.6+6.2 years, 6.1 per cent of them abused oestrogen, and the most common forms used were ethinylestradiol (0.03mg) and drospirenone (3mg). Furthermore, 80.7 per cent of the users used it before exercise only. Breast enlargement was the main reason for oestrogen use, and local drug stores were the main source. Compared to non-users, oestrogen users were older (P=0.322), reported lower incomes (P=0.395), were more likely to be active smokers (P=0.597), and had a longer duration of gym participation (P < 0.001).ConclusionThe results indicate that 6.1 per cent of the surveyed male participants abused a combination of oestrogen and progesterone for breast enlargement, which was significantly more likely among males who had longer durations of gym participation

Global, regional, and national burden of colorectal cancer and its risk factors, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Funding: F Carvalho and E Fernandes acknowledge support from Fundação para a Ciência e a Tecnologia, I.P. (FCT), in the scope of the project UIDP/04378/2020 and UIDB/04378/2020 of the Research Unit on Applied Molecular Biosciences UCIBIO and the project LA/P/0140/2020 of the Associate Laboratory Institute for Health and Bioeconomy i4HB; FCT/MCTES through the project UIDB/50006/2020. J Conde acknowledges the European Research Council Starting Grant (ERC-StG-2019-848325). V M Costa acknowledges the grant SFRH/BHD/110001/2015, received by Portuguese national funds through Fundação para a Ciência e Tecnologia (FCT), IP, under the Norma Transitória DL57/2016/CP1334/CT0006.proofepub_ahead_of_prin

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10&nbsp;years; 78.2% included were male with a median age of 37&nbsp;years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020