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Biomedical subjects

A Ben Hamida

Publications and source records attributed to A Ben Hamida.

At least 19 recordsLinked to original sources

[Arthritis of the hip in spondylarthorpathy: retrospective study about 126 cases].

PURPOSE: To determine epidemiological and clinical features of arthritis of the hip in a Tunisian population of spondylarthrpathy (SA). PATIENTS AND METHODS: This is a retrospective study about patients suffering from SA treated in a rheumatology unit. A radiological investigation of the pelvis was systematically performed on each patient. RESULTS: The study in involved 126 cases of SA (83 men and 43 women), with a middle age of 32.6 years. Arthritis of the hip showed within 3.8 years. Total hip arthroplasty was indicated in 18% of cases. Arthritis of the hip in spondylarthropathy is an important cause of functional disability. We insist in our study on the frequency of arthritis of the hip in North Africa and particularly in patients aged under 16 years.

Adolescent↗

Calcipotriol and PUVA as treatment for vitiligo.

We performed a prospective study to evaluate efficacy of the combination of calcipotriol and psoralen plus ultraviolet A (PUVA) in the treatment of vitiligo. Twenty-three patients with essentially bilateral symmetrical lesions of vitiligo were included. Calcipotriol (0.005 %) ointment was applied twice daily over the right side of the body, and the other side was not treated. PUVA was performed three times per week. All patients received at least forty five sessions of PUVA. Patients were evaluated clinically and photographed all fifteen weeks. At the fifteenth session, 69 percent of the patients had minimal to moderate improvement on the calcipotriol side compared to 52 percent on the PUVA-only side (p = 0.015). At the forty-fifth session, 52 percent showed marked improvement on the calcipotriol side compared to 30 percent on the PUVA-only side (p = 0.13), with more intense repigmentation on calcipotriol-treated areas. Treatment was well tolerated, and no adverse effect was noted. This combination was an effective treatment for vitiligo, especially in initiating repigmentation.

Administration, Cutaneous↗

[Receptivity of the Tunisian to malaria after its eradication: analysis of the situation for adequacy of the surveillance].

In Tunisia, there has been no local transmission of malaria since 1979. Although the disease has been eradicated, its re-emergence is not considered impossible. An epidemiological evaluation has been conducted in order to evaluate the current level of receptivity. A. labranchiae and A. sergenti, the former vectors of malaria in the country, are still present and the anopheline population in the country is increasing following the building of dams and manmade lakes. It is hoped that Tunisian vectors are refractory to sub-Saharan strains of malaria parasites. According to the data collected regarding malaria history, climate, geography and socio-economic development, we assume that the receptivity level of the country is low and the risk of re-emergence of local foci is small.

Aedes↗

[Vaccination against viral hepatitis B for public health personnel: the case of the National Fund of Social Security].

Viral hepatitis B is endemic in Tunisia at an intermediate level. Health professional are a group particularly exposed to the infection. Immunization is the most efficient way to prevent this disease. In this study, we had try to estimate the cost of three strategies of immunization: immunization after a complete serology, immunization after a sequencial serology and immunization without previous serology. The study was conducted at the clinic of the National Fund of Social Security in El Khadra. All the personal of the clinic was invited to participate to a program of immunization after complete serology. Participation rate was at 93.8%. 33.3% of the personal was immunized (24% by a previous contact with the virus and 9.9% by a previous immunization). The costs of the three strategies were as below: immunization after complete serology: 53.4 tunisian dinars by person. immunization after sequantial serology: 33.06 tunisian dinars by person. immunization without serology: 16.2 tunisian dinars by person. Immunization without previous serology has the lower cost, and doesn't expose at any sid effect. However, a post immunization serology vaccinal should be desirable.

Adult↗

[Certification of cause of death in Tunisia].

We have led a study about 2251 death witch are declared during 1996 in the Great-Tunis. Results are following: The hospital deaths are as many betters certified that the physician is a specialist. The cause mention rate is about 88.6% for death observed by specialists against 28.5% for those observed by internists. Paradoxically, a precise cause mention is best for deaths that are observed outside hospitals and when the physician is an internist. Badly define morbid states represent 17.1% of outside hospitals mentioned causes against 30.8% in the Hospital. They represent 12% of causes mentioned by internist against 30.1% of those mentioned by specialists. Despite death medical certificate obligation, the strong proportion of badly defined morbid states characterizes death causes. We hope that this situation will be improved by the new model usage of the witch will be introduced since 2000. This certificate mentions death causes distinguished in initial, immediate and associated. This certificate has be the object of the decree n degree 99-1043 of 17 may 1999.

Adolescent↗

[Incidence and management of male urethritis in the district of Tunis].

BACKGROUND: The aim of the study was to evaluate the incidence of male urethritis and the relative frequency of the different etiological agents in order to adapt standard case management. METHODS: The incidence of urethritis has been estimated with a postal study made on a sample of druggists (1/10) of the area. The total observation period was four weeks. The relative frequency of the etiological agents and the positive predictive value (PPV) of the therapeutic approach based on antibiotic treatment of gonorrhoea and Chlamydia trachomatis was achieved on 92 cases of male urethritis attending general physicians in two polyclinics. RESULTS: The annual incidence of male urethritis was estimated at 680 per 100,000. The relative frequency of etiological agents was as 34.7% for Neisseria gonorrhoea, 7.6% for Chlamydia trachomatis and was found at 3.3% for Trichomonas vaginalis; the PPV was only 43% because of the high proportion of negative results reported by the laboratory. CONCLUSION: Gonococcal urethritis incidence tends to decrease regarding non gonococcal urethritis and the therapeutic approach appears to be warranted.

Adult↗

[Prevalence of sexually transmitted diseases among pregnant Tunisian women and validation of a clinical algorithm proposed by WHO for the management of sexually transmitted diseases].

The objectives of our study are to assess the prevalence of STD agents in Tunisia and to validate the WHO algorithm of STD management. The most frequent STD agents are Trichomonas vaginalis and Chlamydiae trachomatis, respectively with a prevalence of 5.6% and 1.7%. The assessment of the syndromic approach shows that the sensitivity and specificity of the WHO algorithm can be improved by the introduction of risk factors. The training of health care service providers and the use of an algorithm including risk factors can improve this approach, which is useful when laboratories services are not available.

Adult↗

[Tunisian pemphigus. Apropos of 70 cases. (Experience of the dermatology department of La Rabta Hospital 1974-1992)].

INTRODUCTION: Pemphigus frequently seen in Tunisia has specific characteristics distinguishing it from the European or American forms. Between 1974 and 1992, we observed 70 cases in the dermatology unit of the La Rabta University Hospital in Tunis. Most patients were young (mean age 39 yr), predominantly women (80%). Deep pemphigus (pemphigus vulgaris and vegetans) occurred in 56% and superficial pemphigus (seborrheic and foliaceus) in 44%. High-dose corticosteroids were given as initial treatment (1.4 mg/kg/day). Infectious complications were frequent. Mortality was 14%. Pemphigus in Europe and North America usually occurs in adults in the 50-60 year age range. Superficial forms are rare (2-10%). In Tunisia, pemphigus is similar to Brazilian pemphigus with high frequency and predominant superficial forms (pemphigus foliaceus).

Adult↗

Epidemiological analysis of Acinetobacter baumannii strains isolated from a surgical intensive care unit.

A serious epidemic of Acinetobacter baumannii resistant to imipenem occurred in the surgical intensive care unit of the hospital Charles-Nicolle in Tunis during February 1994, causing two deaths among three patients. The Acinetobacter strains were isolated from various samples of the intensive care unit. The techniques used for typing were biotyping, antibiogram, plasmid profiles and chromosomal DNA by random amplified polymorphic DNA (RAPD). The A baumannii strains isolated from patients exhibited an identical pattern with all the epidemiological markers utilized; the strains from the surrounding areas showed four and six different patterns respectively for phenotypic and genotypic characters. The strain isolated from a care table had the same phenotypic and genotypic pattern as that of the patients' strains.

Acinetobacter↗

[Assessment of the quality of management of arterial hypertension in a public health center (Ariana - Tunisia)].

The management of hypertensive outpatients in a primary health care center raises problems of follow-up and effectiveness. This study attempts to assess the management of high blood pressure, using the Medical Audit method, essentially. For that purpose, 194 medical records of hypertensive outpatients registered between 1980 and 1986 were studied. More than 80% of these patients were women between the ages of 40 and 70 years. The medical records of these patients were compared to a standard management scale including 68 items devised by cardiologists and general practitioners. Globally, 32% of the items were cardiologists and general practitioners. Globally, 32% of the items were respected during management of the outpatients. The initial check-up was the least followed item (6.9%), but afterwards care of patients improved, giving ratings of: 29% for respect of treatment protocol, and 35% for surveillance of treatment. As concerns treatment effectiveness, only 28% of the patients (n = 36) actually completed the five-year follow-up period. In these patients average blood pressure fell from 193 to 143 mmHg (systolic), and from 113 to 93 mmHg (diastolic), between the beginning of monitoring and the end of the fifth year. The insufficiency of high blood pressure management results not only from a shortage of resources, but also from underuse of existing ones, and the practitioners' lack of information.

Adult↗

[Incidence of male urethritis in Tunisia: estimate done with a survey by general practitioners (1985)].

In order to evaluate the yearly incidence of male urethritis in Tunis, a survey was carried out among general practitioners, dermatologists and dispensing chemists. During a 6-week period, the mean incidence was 3.16 +/- 1.2 for general practitioners, 4.65 +/- 2.0 for dermatologists and 3.76 +/- 1.0 for dispensing chemists. Taking into account the number of general practitioners in the Tunis district, the mean yearly incidence would be about 1,200 cases per 100,000 inhabitants, or 300 cases per 10,000 men aged 15 years and more. This rate is intermediate between estimations obtained by two mathematical hypotheses, taking non-responses into account: an optimistic hypothesis with an estimated incidence of about 1,700 cases, and a pessimistic hypothesis of about 800 cases per 100,000 inhabitants, a figure which agrees with an estimate based on the sale of specific drugs used for gonorrhoea. This study emphasizes the fact that more than two-thirds of the patients are treated by private dispensing chemists, and only 7% of the cases are notified to the primary health care centres.

Adolescent↗