Hopital University Tahar Sfar

Mahdia, Tunisia

Hopital University Tahar Sfar

Mahdia, Tunisia
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Ben Hamouda H.,hopital University Tahar Sfar | Mahjoub B.,hopital University Tahar Sfar | Soua H.,hopital University Tahar Sfar | Laradi S.,Laboratoire Of Biochimie Clinique | And 2 more authors.
Archives de Pediatrie | Year: 2017

The beta-thalassemia trait is a heterozygous beta-thalassemia characterized by a partial deficiency of the synthesis of beta-globin chains of hemoglobin. It is usually asymptomatic and the diagnosis is often made on the occasion of the completion of a systematic blood count or a family survey. Clinical expression during the neonatal period is impossible and its association with hereditary spherocytosis is common. We report two monozygotic twins who, on the 3rd day of life, presented intense jaundice, unconjugated bilirubin associated with anemia, without hepatosplenomegaly. Laboratory tests found nonimmune hemolytic anemia with microcytosis and hypochromia justifying iterative blood transfusions. The etiological investigation found heterozygous beta-thalassemia associated with hereditary spherocytosis. The family investigation and molecular analysis objectified the beta-thalassemic mutation IVS1nt110 (G→A) in the heterozygous state in the twins, the father, the mother, and in one of the two brothers. With any nonimmune hemolytic anemia in newborns, the etiological investigation should be systematic for early diagnosis and to plan appropriate treatment. © 2016 Elsevier Masson SAS


PubMed | CHU Gabriel Montpied, Hopital University Tahar Sfar, Hopital des Forces de Securite Interieure, Hopital Bicetre and 4 more.
Type: | Journal: European journal of ophthalmology | Year: 2016

This study compared the efficacy and safety of hyaluronic acid (HA)-trehalose, a new eyedrop containing trehalose (a natural bioprotectant) and HA, to an established formulation containing only HA.This was a phase III, randomized, active-controlled, investigator-masked, multicenter study in France and Tunisia. In all, 105 adult patients (18 years) with moderate to severe dry eye disease (DED) received either HA-trehalose (n = 52) or HA (n = 53) 3-6 times per day for 84 days. The primary efficacy variable was the Oxford grading score at day 35. A questionnaire on dry eye and symptoms, Schirmer test, tear break-up time, conjunctival hyperemia, and global performance were assessed as secondary efficacy criteria at baseline, day 35, and day 84. Safety assessments were standard.Noninferiority of HA-trehalose to HA for keratoconjunctivitis sicca assessed by Oxford grading score was demonstrated at day 35. For the secondary efficacy parameters, reductions in dry eye questionnaire classes of none or mild at day 84, dry eye symptoms of stinging, itching, and blurred vision at day 35, and investigator (days 35 and 84) and patient assessments (day 35) of global performance were significantly better for HA-trehalose. There were no clinically meaningful differences between groups for the other secondary criteria. Both treatments were well-tolerated, and there were fewer ocular symptoms upon instillation and fewer adverse events for HA-trehalose than for HA.Hyaluronic acid-trehalose is effective and safe, with better patient satisfaction, than existing HA-only eyedrops particularly from the first month of treatment, and offers a therapeutic advancement in the treatment of moderate to severe DED.


Bouzidi H.,Hopital University Tahar Sfar | Bouzidi H.,Laboratoire Of Biochimie A | De Brauwere D.,Laboratoire Of Biochimie A | Daudon M.,Laboratoire Of Biochimie A
Nephrology Dialysis Transplantation | Year: 2011

Background. Primary hyperparathyroidism (HPT) is a common cause of urolithiasis. Only a few data are available on stone composition and morphology in HPT patients.Methods. We compared the composition and morphology of stones from 264 HPT patients (143 males and 121 females) and 24 567 non-HPT stone formers (16 918 males and 7649 females) including a subgroup of 1356 patients with idiopathic hypercalciuria (IH) (1049 males and 307 females). We excluded uric acid and infection stones containing struvite.Results. Calcium oxalate (CaOx) was the most prevalent crystalline species among the main components of stones in all groups. However, CaOx stones were significantly less frequent in patients with vs without HPT (51.9% vs 82.2%; P < 0.0001). An inversion of CaOx crystalline phases was observed in HPT and IH patients: whewellite was predominant in 16.3% and 30.2% of cases, respectively, vs 57.4% in the non-HPT group (P < 0.001), whereas weddellite was predominant in 35.6% of HPT and 49.5% of IH vs 24.8% of non-HPT stones (P < 0.0001). Among calcium phosphates, brushite was 7-fold more frequent in HPT than in non-HPT patients (14.0% vs 2.2%; P < 0.0001) and almost three times as frequent as in IH patients (4.9%, P < 0.0001). Carbapatite was significantly more frequent in male patients with HPT vs non-HPT or IH patients (23.1% vs 8.3% and 9.9%, P < 0.0001). Morphological data showed that pure type I calculi were markedly less frequent in HPT patients (1.1% vs 25.3% in non-HPT group, P < 0.0001, and 9.1% in IH subgroup, P < 0.001). A high occurrence of IVd calculi and of the association of types IVa and II was observed in HPT vs non-HPT and IH patients (14.4%, 2.3% and 6.3%, P < 0.0001 and 58.3%, 17.2% and 29.9%, P < 0.0001, respectively).Conclusions. Our data highlight a striking increase in the proportion of calcium-dependent crystalline species, especially brushite in HPT patients, with particular morphological associations in both genders which were more marked than in IH patients. © The Author 2010. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.


Ben Ghozlen H.,Hopital University Tahar Sfar | Kaziz H.,Hopital University Tahar Sfar | Abid F.,Hopital University Tahar Sfar | Zitoun Y.,Hopital University Tahar Sfar | Sassi N.,Hopital University Tahar Sfar
Archives de Pediatrie | Year: 2015

Clinical manifestations of subacute osteomyelitis may lead to delayed diagnosis. Acetabular subacute osteomyelitis is an uncommon disease. Bone tumors are usually suggested first. Diagnosis is often made based on radiological findings. We report on the case of a 9-year-old girl who consulted at the emergency department because of limping and pain in her left limb lasting 2 weeks. No fever was reported. Physical examination found a clear, painful reduction in hip mobility. X-ray findings revealed a posterior loss of bone in the acetabular wall. MRI found a mild invasion of the periarticular hip joint and muscles. The surgical exploration of the hip found a collection in the posterior acetabular wall suggesting septic disease. Bacteriological and pathological exams confirmed acetabular subacute osteomyelitis. Nine months after surgery, antibiotic therapy, and physiotherapy, the patient was painless and the hip mobility showed near normal values with a reduction in external rotation and flexion. The aim of this case report is to review the characteristics of subacute acetabular osteomyelitis, including therapeutic modalities, underlining surgical debridement as a rule for both diagnosis and treatment. © 2015 Elsevier Masson SAS.


Ben Hamouda H.,Hopital University Tahar Sfar | Tfifha M.,Hopital University Tahar Sfar | Elghezal H.,University of Sousse | Tlili Y.,Hopital University Tahar Sfar | And 3 more authors.
Archives de Pediatrie | Year: 2010

Triploidy is one of the most common chromosomal aberrations in spontaneous abortions characterized by a 69-chromosome karyotype. This chromosome abnormality is rare in live-born children. Prevalence is lower than 1/50,000. We report on two premature newborns, male and female, born at 35 and 37 weeks of gestation, who presented with severe intrauterine growth retardation, facial dysmorphy, myelomeningocele, and syndactyly. They died during the first hours of life due to respiratory distress syndrome. Analysis of the karyotype showed a homogeneous triploidy on all mitoses: 69 XXY and 69 XXX. The parental origin of the triploidy can have specific effects in the fetal phenotype and the development of the placenta. © 2010 Elsevier Masson SAS.


Ben Hamouda H.,Hopital University Tahar Sfar | Chioukh F.,Hopital University Tahar Sfar | Boussetta B.,Hopital University Tahar Sfar | Mahjoub B.,Hopital University Tahar Sfar | And 5 more authors.
Annales d'Endocrinologie | Year: 2010

Neonatal diabetes mellitus is a rare entity defined as hyperglycaemia occurring within the first 3 months of life that lasts for at least 2 weeks and requiring insulin therapy for unforeseeable duration. We report the case of a full-term female infant with permanent neonatal diabetes mellitus, stemming from consanguineous parents, born with severe intra-uterine growth retardation and birth weight of 1400. g. The patient presented on the 15th day of life a severe dehydration with a fever and ponderal loss of 14 %. The biology showed hyperglycaemia to 15 mmol/L, moderate metabolic acidosis, glucosuria and ketonuria. The diagnosis of neonatal diabetes mellitus was reserved, justifying its stake under insulin. Etiologic investigation showed a type HLA-DR4/DR8; anti-insulin antibodies were weakly positive, Langerhans islet cell and anti-GAD antibodies were negative. Abdominal magnetic resonance imaging scans, karyotype, molecular biology and chromatography of amino and organic acids did not show any abnormalities. During the first 2 years of age, the patient presented a big instability of glycaemia having required several hospitalizations. After 12 years of age, the patient is still under insulin with a satisfactory glycaemia balance and her growth is normal. Besides, she presents a microcephaly with a spastic walking. The search of neonatal diabetes mellitus must be systematic in front of any fetal hypotrophy allowing a premature coverage and a good prognosis. © 2010 Elsevier Masson SAS.


PubMed | Hopital University Tahar Sfar
Type: Journal Article | Journal: Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association | Year: 2011

Primary hyperparathyroidism (HPT) is a common cause of urolithiasis. Only a few data are available on stone composition and morphology in HPT patients.We compared the composition and morphology of stones from 264 HPT patients (143 males and 121 females) and 24 567 non-HPT stone formers (16 918 males and 7649 females) including a subgroup of 1356 patients with idiopathic hypercalciuria (IH) (1049 males and 307 females). We excluded uric acid and infection stones containing struvite.Calcium oxalate (CaOx) was the most prevalent crystalline species among the main components of stones in all groups. However, CaOx stones were significantly less frequent in patients with vs without HPT (51.9% vs 82.2%; P<0.0001). An inversion of CaOx crystalline phases was observed in HPT and IH patients: whewellite was predominant in 16.3% and 30.2% of cases, respectively, vs 57.4% in the non-HPT group (P<0.001), whereas weddellite was predominant in 35.6% of HPT and 49.5% of IH vs 24.8% of non-HPT stones (P<0.0001). Among calcium phosphates, brushite was 7-fold more frequent in HPT than in non-HPT patients (14.0% vs 2.2%; P<0.0001) and almost three times as frequent as in IH patients (4.9%, P<0.0001). Carbapatite was significantly more frequent in male patients with HPT vs non-HPT or IH patients (23.1% vs 8.3% and 9.9%, P<0.0001). Morphological data showed that pure type I calculi were markedly less frequent in HPT patients (1.1% vs 25.3% in non-HPT group, P<0.0001, and 9.1% in IH subgroup, P<0.001). A high occurrence of IVd calculi and of the association of types IVa and II was observed in HPT vs non-HPT and IH patients (14.4%, 2.3% and 6.3%, P<0.0001 and 58.3%, 17.2% and 29.9%, P<0.0001, respectively).Our data highlight a striking increase in the proportion of calcium-dependent crystalline species, especially brushite in HPT patients, with particular morphological associations in both genders which were more marked than in IH patients.


PubMed | hopital University Tahar Sfar and Laboratoire Of Biochimie Clinique
Type: | Journal: Archives de pediatrie : organe officiel de la Societe francaise de pediatrie | Year: 2016

The beta-thalassemia trait is a heterozygous beta-thalassemia characterized by a partial deficiency of the synthesis of beta-globin chains of hemoglobin. It is usually asymptomatic and the diagnosis is often made on the occasion of the completion of a systematic blood count or a family survey. Clinical expression during the neonatal period is impossible and its association with hereditary spherocytosis is common. We report two monozygotic twins who, on the 3rd day of life, presented intense jaundice, unconjugated bilirubin associated with anemia, without hepatosplenomegaly. Laboratory tests found nonimmune hemolytic anemia with microcytosis and hypochromia justifying iterative blood transfusions. The etiological investigation found heterozygous beta-thalassemia associated with hereditary spherocytosis. The family investigation and molecular analysis objectified the beta-thalassemic mutation IVS1nt110 (GA) in the heterozygous state in the twins, the father, the mother, and in one of the two brothers. With any nonimmune hemolytic anemia in newborns, the etiological investigation should be systematic for early diagnosis and to plan appropriate treatment.

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