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Biomedical subjects

B Zouari

Publications and source records attributed to B Zouari.

At least 37 records · Page 2Linked to original sources
PubMed2000

[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↗
PubMed2000

[Study of the incidence and cost of nosocomial infections in general surgery].

Nosocomial infection incidence and its cost were study. We have identified 61 infected patients and 75 infectious episodes, is an incidence of 9.4% infected for 100 hospitalized by trimester. Operative site infections are the most frequent (60%), operative site infection (9.1%), inferior respiratory ways infections (2.2%). Incriminated germs are represented essentially by negative gram Bacillus (77.3%) with predominance of enterobacterias (59%). Invasive technique usage, surgery types and contamination classes have been identified as risk factors of nosocomial infection occurrence. The supplementary stay duration estimated by simple comparison between infected group and no-infected one is 9.3% days, responsible of an over cost of 336 TD by infected patient and 273 TD by infectious episode. The curative antibiotic costs have been estimated at 70 TD by infected patient being equivalent to two hospitalization days and to 57 TD by infectious episode.

Adult↗
PubMed2000

[Are there health risks for travel among Tunisians? What type of medical care should be assured?].

The present work aims to assess the importance of the international travels of Tunisians, their destinations, the risks they face as well as the means to reduce them. Therefore, data related to the period from 1989 to 1998, were collected from official organisms involved in this area. Results revealed an increase of the number of Tunisians travelling outside the country of 23% between 1989 and 1998, with a mean progress of 5.7% per year since 1993. Main destinations were Maghrebin countries (65.7%), Europe (30%) and Middle East (4%). The number of persons leaving to high risk destinations remains difficult to assess and shows the importance of implementing a surveillance system to insure an adequate medical follow-up of this category of travellers. The structures actually involved in the health management of Tunisian travellers have a weak recruitment which demonstrates the importance to strengthen the sensitization of general practitioners to this subject and the promotion of the immunization ward of "Institut Pasteur" to a national centre of travelling medicine.

Aftercare↗
PubMed1997

A five-year study of the incidence of insulin-dependent diabetes mellitus in young Tunisians (preliminary results).

Three Tunisian districts were selected to estimate the incidence of insulin-dependent diabetes mellitus (IDDM): Beja, Monastir and Gafsa. A population-based registry for new cases of IDDM was established in 1990 in these three areas according to WHO DIAMOND project methodology. A local extension of the protocol consisted in the inclusion of children up to 19 years of age. Children with a diagnosis of IDDM discharged from general hospitals and private clinics in these areas were recorded in the corresponding registry. A secondary source of case ascertainment was provided by regional school health centers. The findings of the five-year study showed that 156 cases of IDDM were recorded among children aged 0 to 19 years in the three regions. The degree of ascertainment was estimated at 96%. The global age-adjusted incidence rates were 6.76.100,000(-1) year-1 and 6.95.100,000(-1).year-1 in the 0 to 14- and 0 to 19-year age-groups respectively. Age-adjusted incidence rates were lower in Monastir than in Beja and Gafsa, respectively 4.69, 8.13 and 8.33.100,000(-1).year-1 for subjects aged 0 to 19 years. Incidence rates showed no significant difference by gender but were lower in the 0 to 4- and higher in the 10 to 14-year age groups. No time trend was detected. Sixty-two percent of all cases were diagnosed in the cold season. The incidence rate of IDDM in Tunisia is thus close to that observed in most Mediterranean countries.

Adolescent↗
PubMed1993

[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↗
PubMedDate not supplied

[Serum copper levels in obesity: a study of 32 cases].

Abnormalities of copper distribution in tissues and serum has been described in obese subjects. In this prospective study, we evaluated the seric level of copper by atomic absorption in a group of 32 obese (BMI > or = 30 kg/m2) compared to a group of 32 healthy subjects. We have noted an elevation of serum copper in obese with a middle level of 133 mg/dl significantly superior to the middle level of serum copper of healthy subjects, 108 mg/dl (p < 0.001). In another hand, we have noticed that the levels of serum cooper rise with the BMI. In fact, 58.3% of the obese that have a BMI > or = 40 kg/m2 show a high concentration of serum copper although only 5% of obese with BMI < 40 kg/m2 show this high concentration. This work must be completed by the determination of ceruloplasmin levels in a larger group of obese in order to establish correlations between the serum ceruloplasmin levels, the serum copper levels and the obesity.

Adult↗
PubMedDate not supplied

[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↗
PubMedDate not supplied

[Dispensation of opioids by pharmacists in Tunisia].

This national survey aims to evaluate opioid availability and prescription by pharmacists in Tunisia and to examine pharmacists' attitude regarding Tunisian law. We surveyed a sample of 300 pharmacists randomly selected from the National Council of Pharmacists list and using the random table. This study started in September 1999 by sending to pharmacists a confidential questionnaire asking about the importance, the rate of sale and the availability of analgesics in their pharmacy. It also tried to determine pharmacists' opinions regarding Tunisian law. A total of 157 pharmacists out of 300 responded to the survey (52 per cent), 95 per cent were working in pharmacies and 15 per cent in hospitals. Analgesics were estimated to be important to very important in their work in 84 per cent and less important in 16 per cent of cases. They were given under advice with great importance in 85 per cent of cases and with less importance in 15 per cent of cases. Analgesic self-medication was frequent in 95 per cent of cases and rare in 4 per cent of cases. Analgesics of levels 1 and 2 were often to always available in 97 per cent of cases and rarely available in 1.5 per cent of cases. Some 84.7 per cent of pharmacists had opioid supplies and 8.9 per cent had no opioids in stock and 6.4 per cent hadn't given a response. 30 per cent of pharmacists think that the 7 days law for opioid prescription should be modified and 66 per cent think it should not, fearing illicit use, fraud and dependance. Pharmacists think that the minimal list of opioids to be stocked in a pharmacy is sufficient because of low demand.

Analgesics, Opioid↗