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Biomedical subjects

T Najjar

Publications and source records attributed to T Najjar.

At least 19 recordsLinked to original sources
PubMed2001

[Vaccination against viral hepatitis B for public health personnel: the case of the National Fund of Social Security].

Viral hepatitis B is endemic in Tunisia at an intermediate level. Health professional are a group particularly exposed to the infection. Immunization is the most efficient way to prevent this disease. In this study, we had try to estimate the cost of three strategies of immunization: immunization after a complete serology, immunization after a sequencial serology and immunization without previous serology. The study was conducted at the clinic of the National Fund of Social Security in El Khadra. All the personal of the clinic was invited to participate to a program of immunization after complete serology. Participation rate was at 93.8%. 33.3% of the personal was immunized (24% by a previous contact with the virus and 9.9% by a previous immunization). The costs of the three strategies were as below: immunization after complete serology: 53.4 tunisian dinars by person. immunization after sequantial serology: 33.06 tunisian dinars by person. immunization without serology: 16.2 tunisian dinars by person. Immunization without previous serology has the lower cost, and doesn't expose at any sid effect. However, a post immunization serology vaccinal should be desirable.

Adult↗
PubMed1999

[Colonic tuberculosis: an exceptional cause of a massive surgical hemorrhage apropos of a case and review of the literature].

Colonic tuberculosis rarely causes massive bleeding, as a matter of fact less than twenty cases have been reported in medical literature. Resorting to surgery in this context is even more exceptional. We have not found any case operated on in the literature we have consulted. Endoscopy together with histological study of biopsies is the best exam for the diagnosis of this disease. We report the case of a 37 year old male, coronarian, carrying a caecal lesion evocative of tuberculosis at the endoscopic exam, who had an emergency right hemicolectomy for massive bleeding caused by caecal tuberculosis. The surgical indication was dictated by the abundance and the persistence of the bleeding. The post-operative course was uneventful.

Adult↗
PubMed1996

[Eikenella corrodens pleuro-pulmonary infection. Apropos of a case].

A case of single bacteria pleuropulmonary infection was observed in a 21-year-old patient with heterozygous sicle-cell amenia. The role of this bacteria in pleuropulmonary suppuration, the pathophysiology and secondary lesions are discussed together with therapeutic modalities.

Adult↗
PubMed1989

Treatment of alpha chain disease. Results of a prospective study in 21 Tunisian patients by the Tunisian-French intestinal Lymphoma Study Group.

Between 1981 and 1985, the authors studied 21 Tunisian patients with alpha chain disease. Twenty of 21 underwent laparotomy. According to Galian et al. six patients were classified Stage A, two Stage B, and 13 Stage C. The therapeutic regimen included the following: (1) Antibiotics: In the case of intestinal bacterial overgrowth (IBO), antibiotics selected by their antibiograms were delivered; in absence of IBO, metronidazole plus ampicillin were first given. The antibiotic treatment was changed in case of therapeutic failure. (2) Chemotherapy: From 1981 to 1983 a cyclophosphamide, Adriamycin (doxorubicin), teniposide (VM-26), prednisone (CHVP) protocol (Adriamycin 35 mg/m2, teniposide 50 mg/m2 day 2, cyclophosphamide 300 mg/m2 days 2 through 4, prednisone 40 mg/m2 days 1 through 10) was used. After 1983 bleomycin 15 mg, Adriamycin 30 mg, vinblastine 10 mg were given on day 15. Serum immunoelectrophoresis and immunohistochemical study of duodenojejunal specimens were made on a 3-month and 6-month basis, respectively. Survival curve analysis was made according to Kaplan and Meier. Results were as follows: (1) Stage A: Six patients were first treated by antibiotics alone; two complete responses (CR) persisting 42 and 55 months later were observed, respectively. The four antibiotic failures were submitted to further chemotherapy with four subsequent failures and two deaths. (2) Stage B-C: Chemotherapy led to nine CR with one precocious relapse, a salvage chemotherapy allowing to one more CR. (3) All stages mixed, percentage of survival reached 90 +/- 12% at 2 years and 67 +/- 25% at 3 years, all patients alive beyond 3.5 years being disease-free.

Actuarial Analysis↗
PubMed1989

Immune deficiency with polymorphic reticulosis.

A case of fatal polymorphic reticulosis, currently considered to be a peripheral T cell lymphoma, that was initially seen as a nasolabial swelling with a left lower lobe pulmonary nodule in a 40-year-old woman is reported. At autopsy, it was found to be associated with disseminated cryptococcosis and Pneumocystis carinii pneumonia associated with secondary severe immunodeficiency of unknown origin.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Results of laparotomy in immunoproliferative small intestinal disease.

Immunoproliferative small intestinal diseases (IPSID), previously known as Mediterranean Lymphomas, constitute more than 60% of the non-Burkitt's small intestinal lymphomas in Tunisia. A multidisciplinary study of IPSID was undertaken by the Tunisian/French Lymphoma Study Group in 1980 to reach a better understanding of the two subgroups of the disease: secreting IPSID (essentially alpha-chain disease [ACD]); and nonsecreting IPSID (NS-IPSID) (extensive small intestinal lymphomas without gammopathy). The results of initial exploratory laparotomy performed in 38 cases of IPSID (17 ACD and 21 NS-IPSID) are described here, and show notable similarities between the two groups: the extensive pattern of the abnormal cell infiltrate along the major part of the small intestine; frequent and extensive involvement of the mesenteric lymph nodes; the existence of several degrees of severity in small intestinal mesenteric lymph nodes; and other intraabdominal organ involvement. Certain differences also were observed: the relatively high degree of tropism of the NS-IPSID towards the gastric mucosa which was absent in the ACD of this series; and the more frequent involvement of the entire length of the small bowel in ACD. In spite of these discrete differences, the IPSID form a homogeneous group which is definitely distinguishable from the segmentary small intestinal lymphomas known as Western-type, and which account for approximately one third of our non-Burkitt's small bowel lymphomas.

Adolescent↗
PubMed1986

Diagnostic value of upper intestinal fiber endoscopy in primary small intestinal lymphoma. A prospective study by the Tunisian-French Intestinal Lymphoma Group.

To assess the diagnostic value of upper intestinal fiber endoscopy in primary small intestinal lymphomas observed in an underdeveloped Mediterranean country, the endoscopic records of 40 patients (Group A) offering histologic evidence of lymphoma were compared with those of 80 patients (Group B) displaying clinical findings of small intestinal disease, but who eventually proved to be free of lymphoma after a complete work-up. The endoscopic procedure reached the jejunum in 91% cases and was well tolerated with only one reversible complication. Five primary endoscopic patterns could be defined, occurring either alone or in various combinations. The infiltrated pattern was the most sensitive (0.80) and specific (0.96) finding with predictive positive and negative values reaching 0.88 and 0.93, followed by the nodular pattern (sensitivity 0.60, specificity 0.84). Other primary lesions (ulcerations, mosaic pattern, mucosal fold thickening alone) were either nonsensitive or nonspecific or both. The infiltrated pattern proved to be more valuable than any association of primary lesion. Per endoscopic biopsies were diagnostic of lymphoma in 85% cases. These findings strongly suggest that upper intestinal fiber endoscopy, using long ending view instruments should be the first investigation in patients suspected of small intestinal lymphoma in developing Mediterranean countries.

Adolescent↗