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J Dammak

Publications and source records attributed to J Dammak.

11 recordsLinked to original sources
PubMed2006

[Bacteriological profile of infectious endocarditis in the area of Sfax (Tunisia)].

We performed a study to analyze epidemiological characteristics and bacteriological profile of infectious endocarditis (I.E) in the area of Sfax (Tunisia). We analyzed, retrospectively, all cases of I.E, according to Duke Criteria, hospitalized in the CHU Hédi Chaker of Sfax between January 1997 and December 2000. Bacteriological investigation included blood culture, cardiac valve culture and serology. Seventy-two cases of I.E were diagnosed. The average of age was 32.3 years. 47.3% of the patients did not have cardiac disease, 25% had a valvular prosthesis, 20.8% a native valvulopathy and 6.9% a congenital cardiopathy. Antecedent of acute rheumatic fever was noted in 66% of I.E on native valvulopathy and in 55.5% of I.E on prosthesis. The mitral valve was involved in 39%, the aortic in 27.5% and the two in 26% of the cases. The origin of bacteremia was found or supposed in 55.5% of the cases and was commonly dental (33 % of EI). The bacteriological diagnosis was positive in 51 cases (70.8%). Staphylococci were isolated in 17 cases (23.6%), Streptococci in 17 cases (23.6%) and dominated by oral streptococci (12 cases). Chlamydial serology was positive in 8 cases (11.1%). Diagnosis of infectious endocarditis due to Chlamydia pneumoniae was confirmed in a case by genomic amplification (PCR) and in situ hybridization on the valve. Endocarditis in Tunisia remains frequent. It reaches with predilection the young person in particular with rheumatic heart diseases. The bacteriological profile remains dominated by Streptococci and the Staphylococci.

Adolescent↗
PubMed2005

[The Oswestry index for low back pain translated into Arabic and validated in a Arab population].

OBJECTIVE: To translate into Arabic and validate the Oswestry index for low back pain in an Arab population. BACKGROUND: No functional disability index to assess low back pain written in the Arabic language and validated in an Arab population is available. DESIGN: Arabic translation of the Oswestry index was obtained by the "forward translation/backward translation" method. Adaptations were made after a pilot study involving ten patients aged 18 to 65 years old. Impairment outcome measures (pain as measured on a visual analog scale [VAS], Schober-McRae, index, duration of morning stiffness and number of night awakenings), disability (Quebec index, Waddell index), handicap (as measured on a VAS) and Beck depression scale scores were recorded. Inter-rater reliability was assessed by use of the intra-class correlation coefficient (ICC) and the Bland and Altman method. Construct validity was investigated with use of the Spearman rank correlation coefficient (convergent and divergent validity), and factor analysis was performed. Internal consistency was assessed by use of the Cronbach alpha coefficient. RESULTS: Eighty Tunisian patients with low back pain were included in the validation study. Two items were excluded. Inter-rater reliability was excellent (ICC = 0.98). Expected divergent and convergent validity results suggested good construct validity. Two main factors were extracted by factor analysis and explained 58.19% of the cumulative variance: the first factor represented discomfort in dynamic activities, the second discomfort in static activities. The Cronbach alpha coefficient was 0.76 for factor 1 and 0.70 for factor 2. CONCLUSION: We translated into and adapted the Oswestry index for the Arabic language in a population of Tunisian women? with low back pain. The 8-item version is reliable and valid. Although the scale was validated in a Tunisian population, we expect that it is suitable for other Arab populations, especially North Africans. Further study is needed to confirm such a hypothesis.

Adolescent↗
PubMed2004

[The functional and professional future of lower limb amputees with prosthesis].

OBJECTIVE: The objective of our study is to evaluate the functional and professional becoming of lower limb amputated population with prosthesis. MATERIAL AND METHODS: Our study is retro-prospective. It interested lower limbs amputated patients who have beneficed during the period between 1982-1998 with prosthesis and have consulted in 1999. Data of our study were gathered by an hetero questionnaire. In order to evaluate the functional results of our patients, we have adopted the score established by the National association of doctors specialized in apparatus in France (ANMA). However, this score was little modified (in fact, we have eliminated the item "use of personalized vehicle for handicapped [VHP]", because no one of our patients possess it). The results were judged favourable: score 6-7; unfavourable: mean score between 3-5 and bad between 0-2. RESULTS: During the year of our survey, we have questioned 85 lower limb amputated patients with prosthesis: 67 were male and 18 were female. The mean age of our patients is 48 years (6 to 86 years). Our population was divided into: 31 traumatic amputated, 28 arteritics and 26 amputated of other etiologies (tumoral, infectious, congenital...). In 76 cases, the amputation is unilateral. It's located upper the knee in 51 cases. The evaluation of functional autonomy of our patients according to score adopted showed those results: 54.11% were favourable and 45.88% were unfavourable. In professional side, only 35 among our 60 active patients before amputation, have been able to resume, 12 have needed a professional rehabilitation. Among the 25 who hadn't taken up again their work, 15 have early retirement and ten are in unemployment. CONCLUSION: The amputation of lower limb constitute a major handicap which involves a functional and professional incapacity. We can reduce the risk of this incapacity by a good and appropriate rehabilitation.

Activities of Daily Living↗
PubMed2003

[Life years lost and epidemiological transition in the Sfax region (Tunisia)].

OBJECTIVE: To assess the burden of disease in the Sfax region and identify the main diseases that are the cause of lost life years due to premature death. METHODOLOGY: The calculation of lost life years due to premature death was conducted using the demographic mortality data for the region obtained from the National Institute of Statistics combined with data on the classification of the causes of death collected through a survey on these causes conducted through a random sample taken from half of the deaths in the region. As described by Murray and Lopez, years of life lost as a result of premature death represent the difference between the age of death and an age corresponding to life expectancy falling between 65 and 85 years. RESULTS: Out of a total of 52,316 life years lost that were recorded 27,902 were in the male population and 24,414 in the female. The main diseases found in males which cause lost life years are accidents (24.9%), cardiovascular diseases (17.3%), communicable diseases (17%), respiratory diseases (10.8%), prenatal problems (59.5%), and cancer (7.5%). For women the main causes were cardiovascular diseases (26.5%), respiratory illness (15.5%), accidents (11.5%), communicable diseases (10.3%) and cancer (9.5%). RECOMMENDATIONS: These results marking the epidemiological transition in the region should serve to steer decision-makers to better rationalize and plan for health care costs and expenditure.

Adolescent↗
PubMed1999

[Prevalence of hemoglobin abnormalities in Kebili (Tunisian South)].

BACKGROUND: Hemoglobin abnormalities constitute a public health problem in many countries in the world. In Tunisia, these disorders were thought to affect only the North-western population. However, the existence of hemoglobinosis concentration in Kebily in south Tunisia has been suggested by previous work. In order to estimate their frequencies, we performed a screening of hemoglobin abnormalities in the North-Kebili region, to establish a prevention program of the homozygous forms. METHODS: This screening concerned all 1st and 2nd grade primary school pupils in North Kebily. After a questionnaire, a blood sample was drawn from every child. Hemogram, sickling test, and hemoglobin electrophoresis at alkaline pH were performed for all children. Hemoglobin electrophoresis at acid pH and a specific hemoglobin A2 titration were performed for some children. RESULTS: The study concerned 1,400 children, aged between 5 and 12 years, the mean age was 7 years and 7 months +/- 10 months. Consanguinity rate and coefficient were respectively 44% and 2249 x 10(5). Endogamy was very high. The global rate of hemoglobin abnormalities was 9.4%. Drepanocytosis with a rate of 4.9% was the most frequent, followed by beta thalassemia (3.1%) and C hemoglobinosis (1.6%). These abnormalities were unequally distributed; very frequent in some localities, they were quite absent in others. CONCLUSIONS: This study revealed a hemoglobinosis concentration in Tunisia, which can be classified second after that of Beja in North-western Tunisia. The heterogeneous distribution of the hemoglobin abnormalities in North-Kebili region and the high consanguinity and endogamy rates constitute factors that promote homozygous and double heterozygous forms to arise and justify the elaboration of a preventive strategy.

Age Factors↗
PubMedDate not supplied

[Treatment of aplastic anemia with cyclosporine, prednisolone and androgens (primary results apropos of 10 cases].

Aplastic anaemia is a potentially fatal haematopoietic disorder whose aetiology is not yet clarified. In our preliminary study we have introduced cyclosporin in the aplastic anaemia treatment to evaluate its effect on the disease evolution. Ten aplastic anaemia patients, mean age 33.33 +/- 20.01 years, were treated with cyclosporine (9 +/- 2.35 mg/kg/d), prednisolone (0.5 mg/kg/d) and androgens (1 mg/kg/d). The prednisolone was always combined with cyclosporine. The androgens were administered concomitantly with the cyclosporine or alternately. Seven patients responded to the treatment after a median remission delay of 6 weeks (2-12 weeks). They became independent of blood requirements at a median of 36 weeks (8-108 weeks); the three other patients died during the first trimester without showing any improvement. Among the seven responders, two relapsed early and transiently. The rate of actuarial survival was 70 per cent. The median duration of survival was 10.5 months. The side effects observed included one case of malignant lymphoma, six cases of liver toxicity and five cases of kidney toxicity. This toxicity was reversible after dose adjustment of the cyclosporine. In our study, the introduction of cyclosporin in the aplastic anaemia treatment resulted in improved therapeutic response. Androgens should be used to maintain the haematologic response. This therapeutic protocol associated with drug monitoring seems promising and the side effects should not limit its use because of the severity of the underlying disease.

Adolescent↗