Recurrent dysosmia induced by pyrazinamide

Pyrazinamide can have adverse effects such as hepatic toxicity, hyperuricemia or digestive disorders. In rare cases, alterations in taste and smell function have been reported for pyrazinamide when combined with other drugs. We report a case of reversible olfactory disorder related to pyrazinamide in a woman, with a positive rechallenge. The patient presented every day a sensation of smelling something burning 15 min after drug intake. Dysosmia disappeared completely after pyrazinamide withdrawal and recurred after its rechallenge. The case was reported to the Tunisian Centre of Pharmacovigilance.     

Association hyperlipidemia and retinal hard exudates in diabetic retinopathy

Diabetes mellitus is usually accompagned with dyslipidemia, which can be correlated with diabetic retinopathy (DR). The aim of the study is to determine the relation between DR and hyperlipidemia. We studied prospectively 64 diabetic patients classified into 2 groups: the first associated diabetics having dyslipidemia (n=34) and the second without dyslipidemia (n=30). The mean follow up was 11 months. We observed a high frequency of retinal hard exudates in diabetics with dyslipidemia in comparison with the second group (32% versus 10%). The control of dyslipidemia is recommended in diabetic patients.     

Drug-gene interactions between genetic polymorphisms and antihypertensive therapy

Genetic factors may influence the response to antihypertensive medication. A number of studies have investigated genetic polymorphisms as determinants of cardiovascular response to antihypertensive drug therapy. In most candidate gene studies, no such drug-gene interactions were found. However, there is observational evidence that hypertensive patients with the 460 W allele of the alpha-adducin gene have a lower risk of myocardial infarction and stroke when treated with diuretics compared with other antihypertensive therapies. With regard to blood pressure response, interactions were found between genetic polymorphisms for endothelial nitric oxide synthase and diuretics, the alpha-adducin gene and diuretics, the alpha-subunit of G protein and beta-adrenoceptor antagonists, and the ACE gene and angiotensin II type 1 (AT(1)) receptor antagonists. Other studies found an interaction between ACE inhibitors and the ACE insertion/deletion (I/D) polymorphism, which resulted in differences in AT(1) receptor mRNA expression, left ventricular hypertrophy and arterial stiffness between different genetic variants. Also, drug-gene interactions between calcium channel antagonists and ACE I/D polymorphism regarding arterial stiffness have been reported. Unfortunately, the quality of these studies is quite variable. Given the methodological problems, the results from the candidate gene studies are still inconclusive and further research is necessary.     

Computation of conversion coefficients relating air Kerma to Hp(0.07,alpha), Hp(10,alpha), and H*(10) for x-ray narrow spectrum from 40 to 140 kV

A computation method was implemented to predict the conversion coefficients and the angular dependence factors relating air Kerma to Hp(0.07,alpha), Hp(10,alpha), and H*(10) in an ICRU slab phantom for tungsten anode x-ray spectra for tube potentials from 40 to 140 kV. The simulation of the unfiltered x-ray spectra is based on the Boone and Seibert model. The calculation of conversion coefficients were performed for an x-ray narrow spectrum at any filtration material and tube potentials in the diagnostic radiology range. This computation method has been checked for five narrow x-ray spectra using a comparison of the results with published data given by the International Organization for Standardization (ISO), and American National Standards Institute (ANSI). In all cases, the mean deviation of the calculated mean conversion coefficients values do not exceed 1% for Hp (0.07,alpha) and 1.5% for Hp (10,alpha), except at 60 degrees where a mean deviation from the ISO values of 1.72% and of 2.27% was, respectively, found. But it is still lower than the mean deviation of 2.31% for Hp(0.07,alpha), and of 3.08% for Hp(10,alpha) observed at this angle between ISO and ANSI values. Otherwise, the computed values of conversion coefficients of H*(10) differ by only 0.41% from the ISO values. The results of this computation method can be considered satisfactory considering the accuracy required in radioprotection fields, and can allow an appreciable estimation of conversion coefficients for the narrow x-ray spectra indispensable to calibrate the personnel dosimeters in terms of the personal dose equivalent.     

A conversion method of air kerma from the primary, scatter, and leakage radiations to effective dose for calculating x-ray shielding barriers in mammography

In this study, a new approach has been introduced for derivation of the effective dose from air kerma to calculate shielding requirements in mammography facilities. This new approach has been used to compute the conversion coefficients relating air kerma to the effective dose for the mammography reference beam series of the Netherlands Metrology Institute Van Swinden Laboratorium, National Institute of Standards and Technology, and International Atomic Energy Agency laboratories. The results show that, in all cases, the effective dose in mammography energy range is less than 25% of the incident air kerma for the primary and the scatter radiations and does not exceed 75% for the leakage radiation.     

Prevalence of chromosomal abnormalities in couples with recurrent miscarriage

Chromosome abnormalities affect 6.93% of Tunisian couples with recurrent miscarriage.     

Which place for VDD mode single electrode pacemaker?

VDD mode single electrode pacemaker is a technique of cardiac stimulation which preserves auriculo-ventricular synchronism using a single electrode. Its importance has decreased because of the numerous satisfactions previous by the DDD mode. We describe our experience with this mode and we discuss the advantages, limits and indications of this mode of cardiac stimulation.     

Total body irradiation: techniques and main indications

The radiotherapy department at Salah Aza?z institute had started, in March 2000, a new sophisticated technique of irradiation consisting in total body irradiation (TBI). TBI is used in many preparative regimens before bone marrow transplantation in the treatment of haematological malignancies. TBI aims to destroy immunocompetent tissues in order to avoid graft rejection and to eradicate residual tumor cells. In this article, we review different TBI techniques and its main indications. We also describe the acute and late effects of TBI.