Publications by authors named "Ach Koussay"

Objective: The aim of this study was to identify factors associated with severe diabetic ketoacidosis (DKA) at the onset of type 1 diabetes mellitus (T1DM) in adult patients.

Methods: We conducted a retrospective analysis over a 10-year period including adults newly diagnosed with T1DM. Eligible participants were diagnosed with DKA at the time of T1DM diagnosis.

View Article and Find Full Text PDF

Background Some studies suggest that the SARS-CoV-2 pandemic has contributed to diverting attention from other community-acquired infections (CAIs), leading to an increase in their incidence and severity. Our study aimed to describe and compare clinical features of CAI before and during the pandemic as a factor precipitating diabetes ketoacidosis (DKA). Methodology We included 250 patients who presented with DKA due to CAIs, other than SARS-CoV-2, divided into two distinct groups: 100 patients (G1) who consulted two years before the pandemic, and 150 patients (G2) who consulted during the SARS-CoV-2 pandemic.

View Article and Find Full Text PDF

Background: The severity of diabetic ketoacidosis (DKA) at diagnosis increased during the global COVID-19 pandemic. This study aimed to analyze the impact of the pandemic on the clinical and biological severity of DKA in patients with new-onset diabetes mellitus (DM) in Tunisia.

Research Design And Methods: The study included patients hospitalized for new-onset DKA 2 years prior and 2 years during the COVID-19 pandemic.

View Article and Find Full Text PDF

Context: In some patients, symptoms may persist after COVID-19, defined as long COVID. Its pathogenesis is still debated and many hypotheses have been raised.

Objective: Our primary objective was to evaluate the corticotroph and somatotroph functions of patients previously infected with SARS-CoV-2 and experiencing post-COVID-19 syndrome to detect any deficiencies that may explain long COVID.

View Article and Find Full Text PDF

Introduction: Reports around the world indicate that COVID-19 pandemic may be contributing to an increase in the incidence of new onset diabetic ketoacidosis (DKA). This has yet to be studied in Africa. We aimed to compare the incidence trend of new onset DKA before and during the COVID-19 pandemic, with a focus on the type of diabetes mellitus (DM).

View Article and Find Full Text PDF
Article Synopsis
  • APECED is a rare genetic disorder caused by mutations in the AIRE gene, characterized by symptoms like candidiasis, hypoparathyroidism, and adrenal insufficiency.
  • A 17-year-old female patient with APECED experienced severe abdominal pain and needed increased doses of calcium and hydrocortisone, indicating complications associated with the syndrome.
  • Gastrointestinal issues, including autoimmune atrophic gastritis, can arise from APECED and require prompt treatment to avoid serious health risks like adrenal crises and hypocalcemia.
View Article and Find Full Text PDF

Viral infection is known to be a trigger of autoimmune diseases. Numerous cases of coronavirus disease 2019 (COVID-19) with autoimmune manifestations have been reported and several authors have highlighted the relationship between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and autoimmune diseases. Autoimmune myopathies being one of these manifestations.

View Article and Find Full Text PDF

Xeroderma pigmentosum (XP) is a rare genodermatosis predisposing to skin cancers. Autoimmune diseases related to XP are rarely discussed in the literature. Type 1 diabetes (T1D) has been associated with other genodermatoses like Cockayne syndrome, but it has never been described in XP.

View Article and Find Full Text PDF

We report a case of a patient who presented for ACTH-dependent Cushing after a confirmed hypercortisolism and an inadequate normal ACTH. A transsphenoidal surgery of a pituitary picoadenoma has been done. After surgery, the patient showed the persistence of hypercortisolism.

View Article and Find Full Text PDF

Coronavirus disease 2019 (COVID-19) was first reported in December 2019. The disease is caused by severe acute respiratory syndrome virus corona virus 2 (SARS-CoV-2). Mild respiratory symptoms are the most common manifestations of SARS-CoV-2, but new signs are constantly being discovered as it spreads.

View Article and Find Full Text PDF

Acromegaly is, in most cases, caused by growth hormone secreting pituitary adenomas. Those patients often develop different pathologies of the thyroid gland, however, the occurrence of Grave´s disease is quite a rare situation. We report a case of a 64-year-old female patient who presented with signs of hyperthyroidism and imbalance of her diabetes mellitus.

View Article and Find Full Text PDF

Background: Although it takes more time, the Glucagon Stimulation Test (GST) is a reliable measure for assessing growth hormone (GH) and Adrenocorticotropic Hormone (ACTH) secretion. The GST is considered to be a safe test; however, it still has mild side effects and potential risks.

Objectives: The objective of this study was to analyze the side effects of the GST while testing adrenal-insufficient patients.

View Article and Find Full Text PDF

Aims And Methods: Prolactinomas are a common cause of sexual dysfunction and infertility. We aimed, through this case report, to illustrate the difficulties of management of women with giant prolactinoma, especially in cases of desire of pregnancy.

Results: A 30-year-old woman was referred to our department for secondary amenorrhea.

View Article and Find Full Text PDF

Background: Neuropathy is a frequent complication in diabetic patients with variable clinical presentations and evolutions.

Aim: The purpose of the study was to specify the clinical features of diabetic third nerve palsy, to assess the risk factors and to observe its evolution.

Methods: We report a series of 11 diabetic patients with oculomotor paralysis collected in the department of endocrinology and diabetology of FarhatHached Hospital of Sousse between 1996 and 2005.

View Article and Find Full Text PDF

Objective: To determine the correlation between superficial, and intra-operative specimens in diabetic foot infections (DFIs).

Methods: We conducted a cross-sectional study in patients with DFIs hospitalized in a Tunisian teaching hospital. Superficial specimens were collected for all patients, and intra-operative specimens were collected in operated patients.

View Article and Find Full Text PDF
Article Synopsis
  • Ketosis-prone diabetes is a serious complication arising from ketone build-up in the blood, particularly noted in Tunisia, where there's limited data about its prevalence and characteristics.
  • This study analyzed 391 patients with inaugural ketosis over a 6-year period, categorizing them into two groups based on the presence of autoimmune factors (DAI and DNAI).
  • Findings revealed that young adult males are predominantly affected, with viral infections being the most significant contributing factor to ketosis onset, especially in those with autoimmune features.
View Article and Find Full Text PDF

The influence of stress as a precipitating factor associated with the onset of type 1 diabetes have been widely studied in the literature. The relationship between physical and psychological traumas and diabetes has been rarely studied in the military environment. Posttraumatic diabetes is a controversial topic.

View Article and Find Full Text PDF

Diagnosis of adrenal insufficiency requires evaluation by dynamic stimulation tests. The insulin tolerance test (ITT) is accepted as the gold-standard test for the evaluation of hypothalamo-pituitary-adrenal (HPA) axis but the test is unpleasant and dangerous. Although it takes more time, glucagon stimulation test (GST) is a good alternative to ITT.

View Article and Find Full Text PDF
Article Synopsis
  • About 30% of children with idiopathic growth hormone deficiency (IGHD) have other hormone deficiencies, particularly impacting cortisol levels during stress.
  • The study tested 39 children with IGHD using the glucagon stimulation test (GST) to check for adrenal insufficiency, finding that 25.64% had low cortisol response.
  • Children with both growth hormone and ACTH deficiencies had significantly lower peak growth hormone levels than those with IGHD alone, indicating a need for monitoring as many may lack obvious symptoms of adrenal insufficiency.
View Article and Find Full Text PDF
Article Synopsis
  • Macroprolactinemia is a condition related to elevated prolactin levels but often leads to mild symptoms; it can occur on its own or alongside other causes, like empty sella syndrome, which is rare.
  • A case study of a 47-year-old woman with bilateral galactorrhea and irregular menstruation revealed high prolactin levels, normal thyroid function, and an empty sella on brain imaging.
  • In her treatment with dopaminergic medication, she experienced a pregnancy, but further testing showed that most of her prolactin was in a macroprolactin form, suggesting that such cases may not require conventional dopaminergic therapy.
View Article and Find Full Text PDF
Article Synopsis
  • Prolactin-secreting adenomas are uncommon in older women and can be mistaken for menopause symptoms, complicating diagnosis.
  • A case study of a 57-year-old woman showed symptoms of secondary amenorrhea and galactorrhea, leading to the discovery of hyperprolactinemia and an 8 mm left pituitary adenoma via MRI.
  • Dopaminergic treatment resulted in a temporary return of menstrual cycles, reduction of hot flushes, normalization of prolactin levels, and a decrease in adenoma size.
View Article and Find Full Text PDF

During Ramadan fast, Muslims must refrain from smoking, eating, drinking, having sexual activity, and consuming oral medications from sunrise to sunset. It has been previously shown that Ramadan fasting induces favourable changes on metabolic parameters, reduces oxidative stress and inflammation and promotes cardiovascular benefits. Although ill people are exempted from fasting, most patients with chronic diseases are keen on performing this Islamic-ritual.

View Article and Find Full Text PDF