Effect on Ziziphus jujuba Mill. fruit powders embedded on physicochemical properties, biological activities, and rheologic quality of cake

Abstract This study aimed to improve the effects on the physical, textural, and rheological characteristics of cake supplied with Ziziphus jujuba fruit powder at rates of 0%, 3%, 5%, and 10%. The Physicochemical and antioxidant as well as the antibacterial activity and sensory qualities of Z. jujuba fruits were also investigated. The highest levels reached the values of 245.15 mg GAE/g DW (phenol) and 180.23 mg RE/g DW (flavonoids). Pulp extracts were also subjected to HPLC analysis in order to identify and quantify the sugar composition. This technique allowed us to identify Mahdia as the richest provenance especially in glucose (136.51%) and sucrose (113.28%) contents. The antioxidant activities investigated using DPPH assay decreased slightly from 175 μg/mL (Sfax) to 55 μg/mL (Mahdia). Furthermore, the antibacterial activity indicated that the S. aureus was the most inhibited especially by Sfax powder extracts (from 12 to 20 mm). Our results showed that the incorporation of Z. jujuba powder ameliorated the physicochemical and rheological characteristics (humidity, gluten yield, tenacity, falling time, and configuration) of the dough. Sensory analysis showed that consumer scores were increased with the increasing supplementation powder levels. Highest scores attributed to the cake supplied with 3% jujube powder collected from Mahdia provenance and confirmed that Ziziphus fruit could be advised a part of our diet. These results could validate a novel method to conserve Z. jujuba fruits in order to avoid their soilages for a long period

Place des gestes associés à l’ostéotomie de Scarf dans le traitement de l’hallux valgus

Devant la multiplicité des techniques proposées pour le traitement de l'hallux valgus, nous proposons d'évaluer l'ostéotomie Scarf associée ou non à une ostéotomie phalangienne et/ou une ostéotomie Weil. Il s'agit d'une étude rétrospective de 29 patients, dont un cas bilatéral, opérés entre 2011 et 2016 par une ostéotomie de Scarf du premier rayon avec un geste associé dans 80% des cas. Les résultats ont été analysés selon la satisfaction des patients, l'indice de Groulier et les mesures radiologiques. Le score global de Groulier donnait une bonne évaluation objective du résultat prenant en compte les données radiologiques et anatomiques qui influencent le résultat final en cas d'insuffisance de correction. Le recul moyen était de 3 ans et 5 mois. Une diminution significative du valgus phalangien (de 34,17% à 16,1%), du métatarsus varus (de 15,13% à 9,93%) et de l'angle articulaire distal métatarsien (de 17,63% à 12,73%) étaient retrouvés. Les patients sont satisfaits et très satisfaits dans 83% des cas. Les complications sont dominées par l'hypo-correction dans 13,3% des cas et nous n'avons noté aucun cas de pseudarthrose ou de nécrose de la tête de M1. Nos résultats sont comparables à ceux de la littérature. Nous insistons sur le caractère surtout fonctionnel de la chirurgie de l'hallux valgus qu'il convient d'intégrer dans une correction globale de l'avant-pied. L'ostéotomie de Scarf nécessite une technique rigoureuse, elle est fiable par ses résultats et présente comme limite les grosses déformations surtout de l'angle articulaire distal métatarsien

Chronic myeloid leukemia patients in Tunisia: epidemiology and outcome in the imatinib era (a multicentric experience).

International audienceData are limited in developing countries regarding the clinicopathologic features and response to therapy of chronic myeloid leukemia (CML) in the era of imatinib (IM). The objective of this study is to report on the clinicoepidemiologic features of CML in Tunisia, to evaluate the long-term outcome of patients in chronic (CP) or accelerated phase (AP) treated with IM 400 mg daily as frontline therapy, and to determine imatinib's efficacy and safety. From October 2002 to December 2014, 410 CML patients were treated with IM in six Tunisian departments of hematology. Response (hematologic, cytogenetic, and molecular responses) and outcome-overall survival (OS), event-free survival (EFS), and progression-free survival (PFS)-were evaluated. The following prognostic factors were analyzed for their impact on the European leukemia net (ELN) response, OS, EFS, and PFS at 5 years: age, sex, leukocyte count, Sokal score, European Treatment and Outcome Study (EUTOS) score, CML phase, time to starting IM, and impact of adverse events. The median age was 45 years (3-85 years). Two hundred ten (51.2%) patients were male. Splenomegaly was present in 322 of the 410 (79%). Additional cytogenetic abnormalities were encountered in 25 (6.3%) patients. At diagnosis, 379 (92.4%) patients were in CP, 31 (7.6%) were in AP. The Sokal risk was low in 87 (22.5%), intermediate in 138 (35.7%), and high in 164 patients (41.9%). The EUTOS risk was low in 217 (74%), and high in 77 (26%) patients. The rates of cumulative complete cytogenetic response (CCyR), major molecular response (MMR), and molecular response 4/5 log (MR4.5) in CP/AP-CML patients were 72, 68.4, and 46.4%, respectively. The median time to reach CCyR, MMR, and MR4.5 was 6 months (3-51), 18 months (3-72), and 24 months (3-100), respectively. According to the ELN criteria, optimal, suboptimal response, and failure were noted in 206 (51.8%), 61 (15.3%), and 125 (31.4%) patients, respectively. Five-year event-free survival (EFS), progression-free survival (PFS), and overall survival (OS) were 81, 90, and 90%, respectively. By multivariate analysis, AP, high EUTOS risk, and baseline WBC ≥ 150G/l remained independent predictive factors of non-optimal response to IM. The adverse events (AE) of IM were moderate and tolerable. With the caveats that the monitoring of the disease was not optimal, response rates were similar to those reported in previous studies. It is clear to us that improvements should be made in treatment of AP-CML and high Sokal risk group of CP-CML. The frontline use of second-generation tyrosine kinase inhibitor (TKI) is expected to improve the results of the first-line treatment of these high-risk Tunisian patients, but cost and accessibility of this therapy remain the problems in developing countries