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A Ben Hamida

Publications and source records attributed to A Ben Hamida.

35 records · Page 2Linked to original sources

[Infectious endocarditis surgically-treated in the active phase. Apropos of 46 cases].

The clinical and microbiological characteristics, the surgical indications and procedures, the evolution and the principal prognostic factors were reviewed in 46 cases of infectious endocarditis operated in the active phase. Using this date, the authors try to determine the optimal time for surgery during the acute active phase of infectious endocarditis. The study population comprised 28 men and 18 women aged 7 to 64 years (average age: 30). The patients were selected on strict criteria: positive blood cultures during the 48 hours prior to surgery (29 cases), positive valve or valve prosthesis culture (15 cases), the presence of an active cardiac abscess at surgery (7 cases), the presence of a large number of bacteria on histological examination of the valve (17 cases). The patients were divided into two groups: those with endocarditis of native valves (27 cases) and those with endocarditis on prosthetic valves (19 cases). The preoperative clinical features included all the classical signs of IE but congestive cardiac failure was particularly prevalent (62% of cases). Microbiologically, most cases of native valve endocarditis (67%) were due to sensitive organisms (streptococci) whilst the more virulent organisms (staphylococci, gram-negative bacteria and fungi) were observed in prosthetic valve endocarditis (64% of cases). The commonest surgical indication was haemodynamic deterioration (30 cases). The indications were mixed in 15 cases but only one case was operated for uncontrolled infection alone in this series. The surgical procedure was technically complex in 6 cases. Operative mortality was high (18 cases, 39%). The main cause of death was low cardiac output (13 cases).(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗

[General physicians and general medicine: social image and public opinion].

During the last two decades, importance of general practice of medicine was more recognised. The kind of interest was different between Health decision makers and population. For Health decision makers, revalorisation of general medicine is the better solution we could develop in order to improve efficiency of the health care financing systems. However, From the side of population social image of the general physician is going down. In order to investigate the population view point about general practitioner, we conduct a trial next to 289 persons living Tunis area. Peoples recognized to the general practitioner some qualities: Useful for first aid, he integrates all aspects of the morbidity, initiates best relations with his patients and appropriately manages medical files. In the other side, He's less qualified than the specialist to take appropriate decision, for monitoring and for the quality of communication with patients. He' also lack of technicality and investigation procedures. Ours results indicate how it is urgent to lead a reform of teatching of general medicine in the country.

Adolescent↗

[Screening for carential anemia in pregnant women: prospective study. Report of 200 cases].

To report the frequency and intensity of anemia in a population of pregnant tunisian women. Our retrospective study concern 200 patients collected from january to july 1999 in a population of pregnancies. Mean age was 30.1 years and 68.5% of patients consult in the third trimester with a 33.5% rate of multiparity. The frequency of anemia is 37.5%. Anemia was ferriprive in 97.3% and hypochromic in 24% of cases. Mean ferritinemia is 4.19 ng/ml after 24 weeks of amenorrhea with a marqued decrease in case of multiparity and pregnancy evolution. Mean transferrinemia is significantly low in anemic (3.98 g/dl) versus non anemic (3.60 g/dl) patients (< 0.05). The comparison of anemia with parity, the delay between two pregnancies and term of pregnancy showed a higher risk with multiparity, short delay between two pregnancies and advanced term. The frequency of anemia in tunisian pregnant women is relatively high, prevention is based on iron supplementation and hygienodietetic advices.

Adult↗

[Analysis of different aspects of the health systems in Tunisia].

The health care system in Tunisia is composed of two sectors, public and private. Given the social and economic development level of the country, it can be said that the hospitals, health centers and workforce devoted to health are not severely limited. However, these structures are under-equipped and finance management is not relevant. The establishment of a National Health Service would render all the system more efficient.

Delivery of Health Care↗

[Health transition in Tunisia over the past 50 years].

We describe the dramatic demographic, socioeconomic and health changes witnessed in Tunisia over the past 50 years. Demographically, the gross mortality rate and the infant mortality rate have gone from 19 per 1000 and 150 per 1000 respectively in 1956 to 5.7 per 1000 and 26.2 per 1000 now, and life expectancy at birth going from 50 to 72 years for the same period. Socioeconomically, the urban population has risen from 25% to 62%, the literacy rate from 15% to 73%, and the per capita income has increased 5-fold in real terms. Epidemiologically, the infectious and perinatal diseases prevailing in the 1960s have decreased whereas chronic and degenerative diseases have risen. The proportion of the GNP related to health expenditure has risen from 3.8% to 6.2%. The implication of these changes on the Tunisian health system and the need to adapt in terms of curative care and prevention of risks are discussed.

Cardiovascular Diseases↗