Central corneal thickness in a healthy Tunisian population

Aim:To study the central corneal thickness of a Tunisian population and determine the influence of age, gender, axial length and refractive error on central corneal thickness (CCT) values. Methods:An observational, cross-sectional study was conducted on 608 eyes of consecutive Tunisian patients without ophthalmic disease. Corneal tomography (Oculus Pentacam, USA) and a complete eye examination were performed on all patients. The relationship between the central corneal thickness values and variables of age, refractive error, axial length and gender was assessed. Results:The mean central corneal thickness was 522±37.17μm (range 461 to 655 μm). No statistical association was found between central corneal thickness values and variables of age, refractive error, axial length and gender. Conclusions:The normal CCT value in the Tunisian population was of 522±37.17 µm. We have analyzed, for the first time, normal central corneal thickness values of a healthy Tunisian population.     

Metabolic syndrome is associated with gastroesophageal reflux disease based on a 24‐hour ambulatory pH monitoring

Several studies have focused on the relationship between metabolic syndrome and gastroesophageal reflux disease (GERD). They were based on GERD complications, whereas little is known about the association between metabolic syndrome and objectively measured esophageal acid exposure. The aim of our study was to assess the relationship between metabolic syndrome and GERD based on a 24‐hour pH testing. It was a cross‐sectional study including 100 consecutive patients who underwent a 24‐hour pH‐metry monitoring and were assessed for the five metabolic syndrome components as well as for body mass index (BMI). Among the 100 patients, 54 had a pathological acid GERD. The 46 GERD‐free patients represented control group. Sex distribution was comparable between both groups but GERD patients were older than controls (44.59 vs. 37.63 years, P= 0.006) and more often obese or with overweight (83.3 vs. 60.9%, P= 0.01). Frequency of metabolic syndrome as a whole entity was higher among patients with GERD than those without GERD (50 vs. 19.56%; P= 0.002) with a crude odds ratio of 4.11 (95% confidence interval: 1.66–10.14). Multivariate regression analysis showed that metabolic syndrome as well as an age ≥30 years were independent factors associated to GERD but not BMI and sex. Abnormal waist circumference and fasting glucose level ≥100 mg/L were the only independent factors among the five components of metabolic syndrome. Metabolic syndrome but not BMI was an independent factor associated to GERD. These results confirm the hypothesis that central obesity is associated to GERD.     

Antibodies to β2-glycoprotein I and annexin V in women with early and late idiopathic recurrent spontaneous abortions

Anti-phospholipid antibodies (APA) are heterogeneous group of autoantibodies that target phospholipid or phospholipid-binding proteins. APAs were previously shown to induce several thrombotic states, including idiopathic recurrent spontaneous abortion (RSA). Unlike the contribution of the classical lupus anticoagulant (LAC) and anticardiolipin antibodies (ACA), the contribution of anti-β2 glycoprotein 1 (β2GPI) and anti-annexin V antibodies to RSA risk remain poorly understood. We assessed anti-β2GPI and anti-annexin V IgM and IgG antibodies as RSA risk factors for RSA in 172 Tunisian women with >3 consecutive idiopathic pregnancy losses, together with 173 matched control women. The prevalence of anti-β2GPI IgG (P=0.41, OR=1.64) and IgM (P=0.50, OR=1.70) were comparable between cases and controls. Higher anti-annexin V IgG (P=0.02, OR=5.28), but not IgM (P=0.25, OR=1.78), levels were seen in cases. Regression analysis showed that anti-β2GPI IgM (OR=8.90; 95% CI=1.23–64.63) was associated with early RSA, while anti-annexin V IgG (OR=9.35, 95% CI=1.44–60.86) was associated with late RSA. For combined early + late RSA, the only variable selected was BMI (OR=0.93; 95% CI=0.87–0.99), and neither anti-annexin V nor anti-β2GPI IgM and IgG were associated with early + late RSA. Anti-annexin V and anti-β2GPI appear to be independent risk markers of RSA.     

Erythema elevatum diutinum: an "idiopathic" case

Erythema elevatum diutinum (EED) is a rare condition with an unclear pathogenesis. Initially classified within neutrophilic dermatoses, it is now considered as a leukocytoclastic vasculitis accordingly to its histopathologic pattern. Several clinical presentations as well as many associated diseases are reported in the literature. We report a new case of EED in a 58-year-old man who presented with a three-month history of plaques and nodules on the extensor surfaces of hands, elbows, knees, ankles, forearms, and buttocks. Histology showed a leucocytoclastic vasculitis, suggestive of the diagnosis of EED. Screening for an associated pathology, namely a paraproteinemia or a solid cancer, was negative. Treatment with dapsone leads to amelioration within few weeks.     

Epidermoid cyst of the buccal mucosa—An uncommon entity: Case report and literature review

Epidermoid cyst of the buccal mucosa is rare. Nevertheless, it must be included in the differential diagnosis of swelling in this area. The diagnosis is based on anatomopathological examination. The surgical enucleation is the gold standard of treatment.     

Résultats oncologiques de la reconstruction immédiate après mastectomie pour cancer du sein: à propos de 38 cas

Objective

The purpose of this study is to analyze the oncologic outcome of immediate reconstruction after mastectomy for breast cancer and the impact of adjuvant treatments on cosmetic results.

Patients and methods

This retrospective study concerns 38 consecutive advanced abdominal flap with breast prothesis, realized immediately after mastectomy for breast cancer by one surgeon between 1997 and 2008.

Results

The average retrospective period was 34.5 months. Recurrence was observed in three caseswithout late diagnosis. It was local in two cases and systemic in one case resulting in death 18 months after reconstruction. Breast tumor in these cases had several initial poor prognostic factors. Delayed scarring was noted in one case due to post-radiation cutaneous necrosis. Capsular contracture was also observed in two women who received postoperative radiotherapy. In our study, esthetic results were considered poor in three cases because of prothesis removal in these cases, acceptable in 10 cases, good in 20 cases, and excellent in 5 cases.

Conclusion

Immediate breast reconstruction using advanced abdominal flap associated to a prothesis doesn’t affect neither local and systemic recurrence rates nor overall survival. Cosmetic results are overall good.     

The Role of Nitrogen Availability for the Salt-Tolerance of Two Different Varieties of Durum Wheat

Salt stress tolerance of durum wheat was assessed in control and 200 and 300 mM NaCl-exposed seed of two cultivars (BidiAP4 and Azizi). These salt treatments were accompanied by different levels of nitrate (Ca(NO₃)₂) added to the media (0.1, 3, 10 mM). The data showed that NaCl stress increased Na⁺ and Cl^? contents and lowered K⁺ and NO₃ ^? levels in seeds of BidiAP4 cultivar. In Azizi seeds exposed to NaCl, Na⁺ and K⁺ were highly accumulated while low levels of NO₃ ^? and Cl^? were detected. Those findings highlight the difference in the salt stress tolerance of these two durum wheat cultivars also depending on nitrogen (N) availability, Azizi cultivar being less sensitive to NaCl treatment than BidiAP4. These data also suggested a relationship between salt tolerance capacity and enhancement or maintenance of nitrogen and carbon metabolisms enzyme activity.     

A cytogenetic approach to the effects of low levels of ionizing radiation (IR) on the exposed Tunisian hospital workers

Objectives

The aim of this study is to assess chromosomal damage in Tunisian hospital workers occupationally exposed to low levels of ionizing radiation (IR).

Materials and Methods

The cytokinesis-block micronucleus (CBMN) assay in the peripheral lymphocytes of 67 exposed workers compared to 43 controls matched for gender, age and smoking habits was used. The clastogenic/aneugenic effect of IR was evaluated using the CBMN assay in combination with fluorescence in situ hybridization with human pan-centromeric DNA in all the exposed subjects and controls.

Results

The study showed a significant increase of the micronucleus (MN) frequency in the lymphocytes of the exposed workers compared to the control group (13.63±4.9‰ vs. 6.52±4.21‰, p < 0.05). The centromere analysis performed in our study showed that MNs in hospital staff were predominantly centromere negative (72%) and the mean negative labeled micronucleus (C-MN) frequency was significantly higher in the exposed subjects than in the controls (9.04±4.57‰ vs. 1.17±0.77‰). The multivariate regression analysis, taking into account all confounding factors, showed that only the time of exposure to IR had a significant effect on the level of MNs and C-MN.

Conclusion

The present study shows that chromosomal damage leading to the formation of micronucleated lymphocytes is more frequent in the hospital workers exposed to IR than in the controls, despite the low levels of exposure. The results of the study confirm the well-known clastogenic properties of ionizing radiation. In regards to health monitoring, detection of early genotoxic effects may allow for the adoption of preventive biological control measures, such as hygienic improvements in the workplace or reduction of hours of occupational exposure.     

Pseudotumoral cutaneous aspergillosis in chronic granulomatous disease, report of a pediatric case

ABSTRACT:: Invasive aspergillosis is a life-threatening condition in patients with chronic granulomatous disease (CGD). Skin invasion by Aspergillus occurs most commonly by contiguity to a neighboring cavity. We describe an unusual case of invasive cutaneous aspergillosis presented as a large burgeoning tumor in a 4-year-old girl with CGD who underwent surgical treatment for bifocal osteomyelitis of the left leg. The skin invasion occurred 4 months after a "successful" treatment of invasive pulmonary aspergillosis. Atypical presentation and diagnostic difficulties are discussed. Invasive cutaneous aspergillosis may be polymorphic. The diagnosis should be considered early in the etiological investigation of any suspicious skin lesions in CGD even in uncommon aspects such as burgeoning tumors.     

Epidemiological and Etiological Study of Foot Mycosis in Tunisia

BackgroundTinea pedis and onychomycosis are among the commonest fungal diseases in the world. Recently, there has been an increase in the numbers of fungal agents implicated in these conditions.ObjectiveTo analyze the epidemiology of fungal foot diseases and to identify associated etiological factors in outpatients attending the Department of Dermatology of Charles Nicolle Hospital in Tunis, Tunisia.Patients and MethodsOne hundred and forty eight patients were assessed for the presence of fungal foot diseases during the period between January and April 2009. The mean age was 41.5 years (range: 2–87 years) and sex ratio was 0.8. A complete dermatological examination was performed on all subjects, and specimens of the feet were taken from patients presenting signs of tinea pedis or onychomycosis for microscopy and fungal culture.ResultsFungal foot infection was suspected in 71 subjects, and the diagnosis was confirmed in 67 cases (45.3%) by positive microscopy or culture. Older age and family history of mycosis were predisposing factors for foot fungal infection. The condition was caused by dermatophytes in 57.1% of cases and Candida species in 35.7%. Trichophyton rubrum and Candida parapsilosis were the predominant dermatophyte and yeast species, respectively.