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Biomedical subjects

H Makni

Publications and source records attributed to H Makni.

At least 19 recordsLinked to original sources
PubMed2006

The anaerobic treatment of sewage and granule formation in upflow anaerobic sludge blanket reactor.

The granulation process was examined using synthetic wastewater containing glucose in a 1 liter laboratory upflow anaerobic sludge blanket (UASB) reactor. The anaerobic biotransformation of glucose was investigated during the granulation process. Anaerobic unacclimated sludge and glucose were used as seed and primary substrate, respectively. Massive initial granules were developed after three months of start-up. The effect of operational parameters such as influent glucose concentrations, pH, Volatile Fatty Acids (VFA) were also considered during granulation. The presence of a large concentration of sulphate in the sludge of a mesophilic (37 degrees C+/-1 degrees C) UASB reactor treating sewage resulted in severe process disturbance, with a complete inhibition of the propionate-degrading ability of the sludge. Severe inhibition of acetate removal was also observed, with concentrations of propionic acid and acetic acid in the reactor effluent of 1.72% and 18.88%, respectively. Hydrogen sulfide (H2S) is formed from the anaerobic decomposition of organic matter containing sulfate by sulfate-reducing bacteria. This gas is toxic at rate exceeding 2% tolerable by a reactor. The result shows the rate of hydrogen sulfide production was 3.8 %.

Anaerobiosis↗
PubMed2005

Data for 10 autosomal STR markers in South Tunisian population.

Allele frequencies, together with some parameters of forensic interest for 10 STRs (D3S1358, vWA, D16S539, D2S1338, D8S1179, D21S11, D18S51, D19S433, TH01 and FGA) were estimated from 201 unrelated individuals originating from southern Tunisia. Significant deviation from Hardy-Weinberg equilibrium was observed for only one marker. Comparative analyses between our population data and other populations showed that only markers D3S158, vWA and FGA were homogenous among populations. The combination of these 10 STR loci provide a powerful tool for forensic identification in Tunisian population.

DNA Fingerprinting↗
PubMed2003

[Pregnancy in patients with prosthetic heart valves].

In women with prosthetic heart valves, pregnancy carry a risk for both mother and fetus, requiring an obstetrical and cardiological management at an optimal level. We performed a systematic review of the literature to estimate the maternal and fetal complications and in order to offer pregnant women carrying a prosthetic heart valve the most practical approach enabling reduction of these risks. As there are no available controlled clinical trials, larger prospective studies are needed to provide guidelines for effective antithrombotic therapy.

Anticoagulants↗
PubMed2003

[Hydatid pulmonary embolism].

Hydatid pulmonary embolism is an uncommon condition resulting from the rupture of hydatid heart cyst or the opening of a visceral hydatid cyst often in the liver into the venous circulation. We report a case of 60 years old woman, admitted to hospital for acute heart pulmonale due to fistulization of an hepatic hydatid cyst into the inferior vena cava.

Echinococcosis, Hepatic↗
PubMed2002

[Mitral valve prolapse and sudden death: a case report].

Mitral valve prolapse (MVP) is a common disorder that, in general, has a good prognosis. Rare occasions of sudden death have been reported in patients with MVP and it is presumed that the basis of sudden death is arrhythmias. We report a case of a 47 years old men affected by MVP complicated by ventricular arrhythmias and sinoatrial block; who died suddenly from ventricular tachycardia. The pathophysiology and risk factors of sudden cardiac death in MVP are discussed.

Death, Sudden, Cardiac↗
PubMed2001

Physicians Taking Action Against Smoking: an intervention program to optimize smoking cessation counselling by Montreal general practitioners.

In 1997 the Direction de la santé publique de Montréal-Centre initiated "Physicians Taking Action Against Smoking," a 5-year intervention program to improve the smoking cessation counselling practices of general practitioners (GPs) in Montreal. Program development was guided by the precede-proceed model. This model advocates identifying factors influencing the outcome, in this case counselling practices. These factors are then used to determine the program objectives, to develop and tailor program activities and to design the evaluation. Program activities during the first 3 years included cessation counselling workshops and conferences for GPs, publication of articles in professional interest journals, publication of clinical guidelines for smoking cessation counselling and dissemination of educational material for both GPs and smokers. The program also supported activities encouraging smokers to ask their GPs to help them stop smoking. Results from 2 cross-sectional surveys, conducted in 1998 and 2000, of random samples of approximately 300 GPs suggest some improvements over time in several counselling practices, including offering counselling to more patients and discussing setting a quit date. More improvements were observed among female than male GPs in both psychosocial factors related to counselling and specific counselling practices. For example, improvements were noted among female GPs in self-perceived ability to provide effective counselling and in the belief that it is important to schedule specific appointments to help patients quit; in addition, the perceived importance of several barriers to counselling decreased among female GPs. A greater proportion of the female respondents to the 2000 survey offered written educational material than was the case in 1998, and a greater proportion of the male GPs devoted more time to counselling in 2000 than in 1998; however, among male GPs the proportion who discussed the pros and cons of smoking with patients in the pre-contemplation stage declined between 1998 and 2000, as did the proportion who referred patients in the preparation stage to community resources. Our experience suggests that an integrated, theory-based program to improve physicians' counselling practices could be a key component of a comprehensive strategy to reduce tobacco use.

Counseling↗
PubMed2001

Smoking cessation counseling practices of general practitioners in Montreal.

BACKGROUND: Despite the cost-effectiveness of physician smoking cessation counseling, many physicians do not adhere to current clinical practice guidelines. METHODS: A cross-sectional mail survey was conducted in a random sample of general practitioners in Montreal to document cessation-counseling practices and identify correlates of these activities. RESULTS: Of 440 eligible general practitioners, 337 (77%) completed the questionnaire. Despite favorable beliefs/attitudes about cessation counseling, only 10.5% of general practitioners provided "thorough" counseling. While high proportions of general practitioners ascertained smoking status and encouraged patients to quit, relatively few offered adjunct support (i.e., for patients preparing to quit, 49.8% offered follow-up visits; 42.5% offered educational material; 20% referred patients to community resources). Correlates of counseling completeness included high self-efficacy to provide counseling (odds ratio (OR) = 2.0, 95% confidence interval (1.1-3.6)) and favorable beliefs/attitudes about counseling (OR = 3.6 (2.0-6.4)). Correlates of ascertaining smoking status included female gender (OR = 2.3 (1.5-3.5)), high self-efficacy (OR = 3.5 (2.0-5.9)), and favorable beliefs/attitudes (OR = 2.7 (1.6-4.5)). Correlates of offering adjunct support included female gender (OR = 1.9 (1.1-3.2)), awareness of stages of change (OR = 2.4 (1.3-4.4)), and knowledge of community resources to help patients quit (OR = 2.3 (1.3-3.9)). CONCLUSION: Support, training, and intervention programs to overcome lack of awareness and knowledge, unfavorable beliefs/attitudes, and low self-efficacy could increase and enhance cessation counseling practices among general practitioners.

Adult↗
PubMed2001

Lack of linkage and association between autoimmune thyroid diseases and the CTLA-4 gene in a large Tunisian family.

The autoimmune thyroid diseases (AITDs) including Graves' disease and Hashimoto's thyroiditis are inherited as complex traits. We have performed linkage and association studies to investigate the role of CTLA-4 gene in the AITDs development using the D2S311, D2S143, the intragenic CTLA-4 (AT)(n) microsatellite markers and the CTLA-4 (A/G) dimorphism in exon 1. Four extended pedigrees belonging to a large Tunisian family named Akr and including 154 individuals from which 20 were affected with Hashimoto's thyroiditis and 26 with Graves' disease, were used in this investigation. No evidence for linkage with none of the markers was found under neither dominant nor recessive models [Z=-7.14 and Z=-14.32 at theta=0.0, respectively for the CTLA-4 (AT)(n) marker]. A family-based association study on 51 nuclear families derived from the Akr pedigree was performed by the FBAT approach applied to the CTLA-4 (AT)(n) marker and the CTLA-4 (A/G) dimorphism. We found no association of individual alleles to disease for both markers. These results showed no evidence for the involvement of the CTLA-4 locus in the AITDs pathogenesis.

Abatacept↗
PubMed2001

A full genome screening in a large Tunisian family affected with thyroid autoimmune disorders.

The autoimmune thyroid diseases (AITDs) including Graves' disease (GD) and Hashimoto's thyroiditis (HT) are inherited as complex traits. We initiated a whole genome linkage study of patients with AITD, in order to identify the susceptibility genes involved in their pathogenesis. We studied 39 patients affected with GD or HT and 68 related controls, who belonged to a large consanguinous family composed of more than 200 members. Linkage analysis was performed using the lod score method under two arbitrary models, one dominant and one recessive. A positive lod score was found for D2S171, assuming a recessive mode of inheritance and 50% penetrance, which suggests the presence of a major AITD susceptibility gene on chromosome 2p21. However, no linkage was found with microsatellite markers spanning the HLA system. This locus localised outside MHC will be of interest for investigation of other autoimmune disorders.

Adolescent↗
PubMed2001

Disinfection of secondary effluents by infiltration percolation.

Among the most attractive applications of reclaimed wastewater are: irrigation of public parks, sports fields, golf courses and market gardening. These uses require advanced wastewater treatment including disinfection. According to WHO guidelines (1989) and current rules and regulations in Tunisia, faecal coliform levels have to be reduced to < 10(3) or 10(2) CFU/100 mL. In Tunisia, most wastewater plants are only secondary treatment and, in order to meet health related regulations, the effluents need to be disinfected. However, it is usual for secondary effluents to need filtration prior to disinfection. Effectiveness of conventional disinfection processes, such as chlorination and UV radiation, are dependent upon the oxidation level and the levels of suspended solids of the treated water. Ozonation is relatively expensive and energy consuming. The consideration of the advantages and disadvantages of conventional techniques, their reliability, investment needs and operational costs will lead to the use of less sophisticated alternative techniques for certain facilities. Among alternative techniques, soil aquifer treatment and infiltration percolation through sand beds have been studied in Arizona, Israel, France, Spain and Morocco. Infiltration percolation plants have been intermittently fed with secondary or high quality primary effluents which percolated through 1.5-2 m unsaturated coarse sand and were recovered by under-drains. In such infiltration percolation facilities, microorganisms were eliminated through numerous physical, physicochemical and biological inter-related processes (mechanical filtration, adsorption and microbial degradation respectively). Efficiency of faecal coliform removal was dependent upon the water detention times in the filtering medium and on the oxidation of the filtered water. Effluents of Sfax town aerated ponds were infiltrated through 1.5 m deep sand columns in order to determine the performance of infiltration percolation in the polishing of secondary effluents. Elimination of bacteria (total and coliforms, faecal streptococci) and their relationship with the hydraulic load and the temperature were investigated.

Agriculture↗
PubMed2000

P53 polymorphism in codon 72 and risk of human papillomavirus-induced cervical cancer: effect of inter-laboratory variation.

An association between codon-72 p53 polymorphism and risk of human papillomavirus (HPV)-induced cervical cancer has been found recently, but it has been difficult to replicate. In this study, we assess the impact of inter-laboratory variation in p53 genotyping on the validity of the proposed association. DNA specimens were randomly selected from 54 invasive, squamous cell carcinoma cases, 52 HPV-negative, and 39 HPV-positive controls from a previous case-control study in Brazil. Codon-72 polymorphism was blindly analyzed in three different laboratories. We calculated age- and race-adjusted odds ratios (OR) and 95% confidence intervals (CI) using logistic regression for gauging the association between p53 polymorphism and cervical cancer risk. The proportions of the Arg/Arg, Arg/Pro, and Pro/Pro genotypes varied substantially among laboratories with Kappa coefficients in the 0.49-0.63 range. When disagreement between labs was allowed, the OR for the Arg/Arg genotype, compared to other forms, was as low as 1.5 (95% CI: 0.5-3. 9). In contrast, the OR increased to 8.0 (95% CI: 2.3-28.5) after exclusion of discordant genotypes. Restricting the comparison to HPV-positive controls increased the magnitude of the relation appreciably. After exclusion of all discordant diagnoses, the OR was 21.5 (95% CI: 3.4-137.8), whereas with disagreed genotypes the association was not significant (OR = 2.9, 95% CI: 0.7-11.9). Homozygous codon-72 p53-Arg apparently confers a higher susceptibility to HPV-associated cervical tumorigenesis. However, exposure misclassification consequent to inter-laboratory variation in protocols may affect the ability to detect the association.

Adult↗
PubMed2000

Polymorphisms of HLA DQB1 CAR1/CAR2 and TNFalpha IR2/IR4 microsatellite markers in patients affected with Graves disease.

Graves disease is an autoimmune thyroid disorder in which HLA class I and II confer susceptibility in different ethnic groups. An allele-specific polymerase chain reaction was used to characterize the variation of the HLA-DQB1 CAR1/CAR2 and TNFalpha markers located on chromosome 6 in 85 unrelated Tunisian patients affected with Graves disease and 148 healthy control subjects. In contrast to the results regarding TNFalpha alleles showing no difference between patients and controls (P = 0.904), the analysis of the HLA-DQB1 CAR1/CAR2 polymorphism showed a significant difference in its alleles (P < 0.0001). Nevertheless, no allele exhibited a predispositional effect on GD pathogenesis.

Alleles↗
PubMed2000

Functional outcome and satisfaction after photorefractive keratectomy. Part 2: survey of 690 patients.

PURPOSE: To document patient satisfaction and self-perceived quality of vision after bilateral photorefractive keratectomy (PRK). DESIGN: Noncomparative, interventional case series. PARTICIPANTS: Consecutive patients who underwent bilateral PRK from May 1994 through May 1997 by the 12 surgeons of four collaborating centers with a minimum of 4 months since the last surgery and up to 30 months since the first surgery. METHODS: A questionnaire with known psychometric properties was self-administered by the patients. MAIN OUTCOME MEASURES: Responses to individual questions and scale scores. RESULTS: A total of 929 questionnaires were sent, of which 690 were answered and returned (74.3% response rate). The preoperative spherical equivalent ranged from -0.38 diopters [D] to -27.75 D (mean, -5.32 D; standard deviation, 2.85 D). Although 91.8% of the patients were satisfied or very satisfied with their surgery, 96.3% considered that their main goal had been reached, and 95.7% would still choose to have surgery if they had it to do over. The degree of satisfaction was proportional to the postoperative uncorrected visual acuity in the best eye expressed in LogMAR (r = -0.18, P: = 0. 0001) and was negatively correlated with the importance of the corneal haze (r = -0.23, P = 0.0001). Daytime glare was reported to be greater than before surgery by 55.1% of patients. A decrease in night vision was reported by 31.7% of patients, and 31.1% of patients reported increased difficulty driving at night because of their vision. CONCLUSIONS: Overall satisfaction after PRK for low to severe myopia appears to be very good. Glare and night vision disturbance, particularly bothersome for night driving, seem to constitute significant secondary effects that deserve further investigation and should be kept in mind for future improvements in the technique.

Adolescent↗
PubMed2000

Functional outcome and satisfaction after photorefractive keratectomy. Part 1: development and validation of a survey questionnaire.

OBJECTIVE: The aim of this study was to develop a valid, reliable, and easy-to-administer instrument to assess patient satisfaction and perceived outcome after bilateral excimer laser photorefractive keratectomy. DESIGN: Development and validation of a psychometric questionnaire. PARTICIPANTS: Consecutive patients who underwent bilateral excimer laser photorefractive keratectomy from May 1994 through May 1997 by 12 surgeons from four collaborating centers. To be eligible, a minimum of 4 months since the last surgery and a maximum of 30 months since the first surgery was required. METHODS: The new instrument was derived in part from the Prospective Evaluation of Radial Keratotomy (PERK) study 10-year psychometric questionnaire and the Visual Functional Index (VF-14), an index of functional impairment in patients with cataract. Questions were grouped in seven scales, each covering a specific aspect of quality of vision. These included global satisfaction, quality of uncorrected vision, quality of corrected vision, quality of night vision, glare, daytime driving, and night driving. MAIN OUTCOME MEASURES: Acceptability, reliability, validity, and interpretability of the instrument, as well as its ease of administration. RESULTS: The instrument scale structure was examined and scale scores were created. Item-discriminant validity ensured that questions belonged to their hypothesized scale, based on multitrait correlation analysis. The instrument was shown to be reliable by a high level of internal consistency, and all Cronbach's alpha coefficients were superior or equal to 0.83. Construct-related validity and interpretability were assessed based on correlations between scale scores and clinically recognized success criteria such as visual acuity and refraction. Respondent burden was shown to be minimal. Acceptability of the instrument was shown to be very good, with a participation rate of 74.3% (690 of 929 patients). The instrument is available in English and in French and the translation was shown to be reliable. CONCLUSIONS: The acceptability, reliability, and interpretability of the instrument, as well as its ease of administration, were shown to be adequate. This questionnaire appears clinically useful to document patient satisfaction after excimer laser photorefractive keratectomy.

Adolescent↗