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Biomedical subjects

H Thabet

Publications and source records attributed to H Thabet.

At least 19 recordsLinked to original sources
PubMed2006

[Impact of antibiotic use and prescribing policy in a Tunisian intensive care unit].

OBJECTIVE: The aim of this study was to assess the efficacy of local antibiotic policy in a Tunisian ICU. The predefined primary efficacy objectives were the decrease of antibiotic consumption, reduction of inappropriate antibiotic (ATB) use and antimicrobial resistance. DESIGN: This prospective intervention study lasted from January 2002 to December 2004. In the first study period or the baseline phase (from January to December 2002) we focused on physician education for ATB prescription practice. The second period concerned intervention (control of all ATB use). RESULTS: The number of infection episodes significantly decreased from 2002 to 2004; 198 infection episodes in 2002 (1.63+/-1.15 episodes/patient) versus 124 in 2003 (1.22+/-0.93) (P<0.0008) versus 121 in 2004 (1.23+/-0.8) (P1<0.0008). The number of ATB/prescription also significantly decreased from 1.85+/-1.3 in 2002 to 1.5+/-0.9 in 2003 (P=0.02) and 1.5+/-1.4 in 2004 (P1=0.05). Appropriateness of antibiotherapy improved during the intervention period: 65% in 2002 versus 86% in 2003 (P=0.0003) and 81% in 2004 (P1=0.02). The length of antibiotherapy in survivors was considerably reduced: 14.1+/-2.9 days in 2002 versus 11.9+/-1.2 days in 2003 (P<10(-5)) and 10.9+/-2.5 days in 2004 (P1<10(-5)) with a significant reduction of antibiotherapy cost and length of stay (20.4+/-9 days in 2002 versus 18.3+/-6 days in 2003 and 16.9+/-8 days in 2004; P=0.05; P1=0.02). There was a significant decrease of carbapenem resistant Enterobacteriaceae esbeta, Pseudomonas aeruginosa and Acinetobacter baumannii.

Adult↗
PubMed2006

[Predictive factors of glycemic control in patients with type 2 diabetes mellitus in primary health care].

PURPOSE: To determine the factors associated with poor glycemic control in type 2 diabetic patients followed in primary care units in Sousse, Tunisia. METHODS: A cross-sectional study was conducted on a representative sample of type 2 diabetic patients followed at least two years in primary health care units in Sousse, Tunisia. Data were gathered from three sources: a self-administrated questionnaire, analysis of patient files and HbA1c level. HbA1c level was measured with turbidimetric immunoinhibition assay. Patients were considered well-controlled if glycated hemoglobin (HbA1c) was less than 7%, according to the American Diabetics Association (ADA) recommendations. RESULTS: The study enrolled 404 type 2 diabetic patients. The mean age was 60.5+/-10.89 years, sex-ratio was 0.5, and mean disease duration 8.7+/-6.1 years. ADA recommendations were met by 16.7% of patients. Multivariate analysis using variables in relation with the patient, his/her family, the disease, the treatment and the health care unit, showed that only poor geographic access to the care center (adjusted OR: 1.89, p=0.009) and Body Mass Index (BMI) less than 30 kg/m2 (adjusted OR: 2.21, p=0.034) were significantly and independently associated with poor glycemic control. CONCLUSION: Glycemic control in type 2 diabetic patients is poor. It depends strongly on geographic access to health care. Type 2 diabetic patients should be referred, as much as possible, to the nearest health care unit.

Adult↗
PubMed2006

[Tobacco use among teachers in a district of the Tunisian Sahel].

INTRODUCTION: The aim of this study was to evaluate the scale of tobacco use among teachers in the district of Kalaa Kebira (a semi-urban region in the Tunisian Sahel). METHODS: The study design was descriptive and cross sectional, employing a self administered questionnaire given to 402 teachers. RESULTS: The response rate was 89%. The average age of respondents was 35.7 7.9 years. The global prevalence of smoking among teachers was 29.3% (men: 51.6%; women: 3.6%). 79% of smokers were addicted to nicotine according to the Fagerstrôm test. Half of the teachers were poorly informed about the hazards of smoking and 77.9% of smoking teachers didn't refrain from smoking in front of their pupils. CONCLUSIONS: The teachers' lack of knowledge limits their effectiveness both as a role model and information relay in the war against tobacco.

Adult↗
PubMed2004

Extrapyramidal syndrome as a delayed and reversible complication of acute dichlorvos organophosphate poisoning.

We describe 4 cases of delayed extrapyramidal disorder following acute dichlorvos poisonings. All patients were seriously poisoned since all exhibited profound coma and respiratory failure, and they were all tracheally intubated and mechanically ventilated. On admission, plasma cholinesterase activity was greaty decreased, < 10 micromol/ml/h at 37 C in all patients (< 10% of normal for our laboratory). Extrapyramidal symptoms occurred between 5 and 15 d and were characterized by dystonia of arms and legs, resting tremor, cogwheel rigidity, and hypereflexia. With bromocriptine therapy the features of extrapyramidal syndrome disappeared progressively with complete recovery in all patients. Our observations suggest a delayed extrapyramidal syndrome should be taken into account during the course of acute dichlorvos organophosphate poisonings.

Acute Disease↗
PubMed2002

Metformin associated acute pancreatitis.

Metformin poisoning is not common and is usually associated with lactic acidosis and acute hepatitis. A case of metformin-poisoning associated with acute pancreatitis is reported here for the first time.

Acute Disease↗
PubMed2002

Acute iron poisoning.

Intoxications with ferrous compounds are uncommon but ferrous sulphate is most frequently involved. Ferrous fumarate is less toxic than ferrous sulphate. Two cases of ferrous fumarate poisoning that resulted in digestive mucosal lesions are reported.

Acute Disease↗
PubMed2001

Endoscopic carbon dioxide laser turbinoplasty.

In the present work we describe the management of hypertrophied inferior turbinates using CO(2) laser in the UniPulse mode. The laser beam is delivered through the nasal probe delivery system, and the procedure is performed using the 0 degrees endoscope. The UniPulse mode allowed fine-tuned, char-free tissue ablation, and the nasal probes allowed delivery of laser energy to the posterior parts of the inferior turbinates. The procedure was performed on 149 patients. The one-year post-operative follow-up period revealed good functional results in 131 patients (88 per cent). The minimal nasal cross sectional area increased significantly from 0.52 cm(2) to 0.81 cm(2). The average decongestive effect, on the other hand, decreased from 0.26 cm(2) to 0.07 cm(2) indicating significant laser-induced fibrosis. The operation can be performed as an out-patient procedure with little or no morbidity.

Adolescent↗
PubMed2000

[Septic shock complicating amniocentesis].

Amniocentesis is a routine technique for prenatal diagnosis. The incidence of severe intra-amniotic infection is very low. We report a case of septic shock following an amniocentesis in a 34-year-old women. Patient admitted in intensive care unit and need mechanical ventilation and vasoactives drugs to control hemodynamic pertubation. Bacteriological data showed positive polymicrobial blood cultures to Klebsiella pneumoniae and Enterobacter. The patient gradually improved, however her renal function was still impaired and she was discharged three months after admission.

Adult↗
PubMed2000

Plant poisonings from herbal medication admitted to a Tunisian toxicologic intensive care unit, 1983-1998.

To collect data on Tunisian herbal toxicity we analysed 56 medical records of patients admitted to the toxicological intensive care unit from 1983 to 1998 following the ingestion of plants. The sex ratio of patients was 1:2, the mean age of patients was 26y (2 to 75y) and II species of plants were involved with Atractylis gummifera (32%), Datura stramonium (25%), Ricinus communis (9%), Nerium oleander (7%) and Peganum harmala (7%) most commonly infested. Poisonings involved neurological (91%), gastrointestinal (73%) and cardiovascular systems (18%). Treatment was mainly symptomatic. The only lethal cases of liver failure involved 16 Atractylis gummifera poisonings.

Adolescent↗
PubMed1999

[Acute self-induced poisoning with carbamazepine].

OBJECTIVE: We report the epidemiological, clinical, toxicological and therapeutic aspects of acute voluntary intoxication with carbamazepine. PATIENTS AND METHODS: The study included 17 cases of acute carbamazepine intoxication in patients hospitalized in our toxicology unit. RESULTS: Neurological signs predominated at admission, mainly agitation or coma associated with seizures. Mydriasis and cardiovascular signs were frequent. Blood chemistry most frequently showed hyponatremia. Mean serum carbamazepine level admission was 24 mg/l (range 4 ñ 12 mg/l). Ten patient required respiratory assistance for 28 +/- 17 hours. Symptomatic treatment and gastric lavage (+activated carbon) provided favorable outcome. CONCLUSION: Acute carbamazepine intoxication is seen with increasing frequency. Severity is related to the degree and duration of the coma, respiratory depression, seizures, cardiovascular disorders, and metabolic abnormalities. Symptomatic and specific treatment with activated carbon are required.

Acute Disease↗
PubMed1999

Endoscopic anatomy of the sphenoid sinus.

The anatomy of the sphenoid sinus, as it relates to endoscopic sinus surgery, was studied in 93 cadaver heads (186 sphenoid sinuses) using endoscopic dissections as well as sagittal sections. The relationship of the sphenoid sinuses to the carotid artery, optic nerve, floor of sella turcica, as well as other important structures, were verified and discussed. The recesses of the sinus as well as its ostium and accessory septa and crests were described and their clinical importance was discussed. Pertinent measurements were included wherever appropriate.

Dissection↗
PubMed1999

Datura stramonium poisonings in humans.

Datura stramonium is a hallucinogenic plant which causes serious poisoning. Clinical symptoms are those of atropinic intoxication with psychiatric manifestations of dryness of mouth, mydriasis, tachycardia and hallucinations. Diagnosis is essentially clinical. Treatment is symptomatic and suppurative; prognosis is usually favorable.

Adolescent↗
PubMed1996

Obstruction of the nasal valve.

Obstruction of the nasal valve is an important cause of chronic nasal obstruction in adults. In a series of 500 patients, obstruction at the level of the nasal valve was diagnosed in 65 of them (13 per cent). The obstruction was unilateral in 57 patients (88 per cent). Forty-seven patients (72 per cent) had history of previous nasal surgery of accidental trauma. Causes of obstruction of the nasal valve included high septal deviations, a weak or deformed upper lateral cartilage, adhesions, and alar collapse. All patients underwent corrective nasal surgery and the surgical procedures were tailored according to the existing pathology. Post-operatively, the mean nasal patency score increased from 2.9 to 8.6, the mean nasal airflow increased from 579.5 to 727 cm/sec (at 150 Pa), and the mean nasal resistance decreased from 0.31 to 0.23 Pa/cm3 sec-1.

Adolescent↗
PubMedDate not supplied

Histologic and histochemical study of effects of anabolic steroids on the female larynx.

The larynges of 30 unmated, mature female albino mice were examined histologically and histochemically after injecting them with 19-nandrolone phenylpropionate. Permanent irreversible changes, in the form of parakeratosis and squamous metaplasia of the epithelium, and hypertrophy of the muscle fibers, were observed together with persistence of increased alkaline phosphatase enzyme intensity in the endothelium of capillaries and increased activity of nonspecific esterase in the muscles. Similar changes may be responsible for the alteration in the human female's voice after prolonged treatment with anabolic steroids.

Anabolic Agents↗