Gastric metastasis and peritoneal carcinosis revealing primary breast cancer: an unusual presentation.

Breast cancer is the most frequent cancer among women. Gastrointestinal tract metastases are uncommon and might be misidentified as primary carcinoma.A noteworthy case-study involved 53-year-old-woman complaining from epigastric pain, ascites and overall health decline.

Guillain-Barré syndrome in ulcerative colitis and SARS-CoV-2 infection: a case report and literature review.

Guillain-Barré syndrome (GBS) occurrence is rare during inflammatory bowel disease (IBD) and SARS-CoV-2 infection. Its association with thrombotic vascular events, which are common during these two entities, is extremely rare. We report an exceptional association of GBS and cerebral venous thrombosis in a 28-year-old woman with active ulcerative colitis and no previous history of SARS-CoV-2 vaccination.

Adherence and barriers to Mediterranean diet in Tunisian patients with nonalcoholic fatty liver disease.

The burden of non alcoolic fatty liver disease (NAFLD) is globally increasing. While crucial for management, NAFLD patient adherence to the Mediterranean diet (MD) is underexplored, especially in Mediterranean countries such as Tunisia. A prospective study (Nov 2022-Feb 2023) supervised MD introduction by a nutritionist, evaluated adherence with MEDAS scores (≥10 for good compliance), and explored barriers to good adherence.

Unexpected isolated hepatic tuberculosis discovered during laparoscopic cholecystectomy: A case report.

Isolated hepatic tuberculosis is a rare form of extrapulmonary tuberculosis. We report an exceptional case of a 51-year-old female patient complaining from right upper abdominal quadrant pain, who underwent laparoscopic surgery for millimetric gallbladder polyps. Preoperative ultrasound hepatic morphology and biochemical hepatic tests revealed no abnormalities.

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Introduction: Vitamin D plays a role in regulating the immune response through an immunomodulatory effect, and is probably involved in the pathophysiology of Crohn's disease (CD).

Aim: to assess vitamin D status in patients with CD as well as in healthy controls and to determine associated factors of vitamin D deficiency in patients with CD.

Methods: We conducted a prospective study over 18 months, including CD patients with age and sex matched with healthy controls.

[Not Available].

Helicobacter pylori infection is the most common infectious disease worldwide. It is associated with duodenal and gastric ulcer disease and the risk of gastric neoplasia. The management of helicobacter pylori infection currently represents a real challenge for clinicians, given the ever-increasing rate of resistance of Helicobacter pyolori to various antibiotics.

Prevalence and prognosis of Computed-Tomography defined sarcopenia in Tunisian cirrhotic patients.

Introduction: Sarcopenia is an underdiagnosed and understudied complication of cirrhosis, especially in patients not undergoing liver transplantation.

Aim: To evaluate the prevalence and prognostic impact of radiological sarcopenia in non-transplanted cirrhotic patients.

Methods: Longitudinal retrospective study including cirrhotic patients explored by an abdominal CT scan, over a period of 6 years, in a single gastroenterology department in Tunisia.

Mesenteric Arterial Thrombosis Revealing Relapse of Nephrotic Syndrome in Young Women.

Background: Nephrotic syndrome (NS) is associated with a hypercoagulable state and may be complicated by thrombotic events. Venous thrombosis is well-acknowledged, while arterial thrombosis is rather unusual.

Case Presentation: We present the case of a 20-year-old woman with a 12-year history of idiopathic NS revealed by extensive cerebral venous thrombosis with pulmonary embolism treated with anticoagulation therapy and oral corticosteroid therapy followed by mycophenolate mofetil (MMF).

EncephalApp Stroop Test for covert hepatic encephalopathy screening in Tunisian cirrhotic patients.

Covert hepatic encephalopathy (CHE) is underdiagnosed and is difficult to detect. The EncephalApp Stroop test is validated for its screening. The aim of the study was to define Tunisian norms for the test based on healthy controls norms and to estimate the prevalence of CHE in cirrhotic Tunisian patients.

A primary hepatic lymphoma in a patient with Crohn's disease receiving thiopurine and anti-TNF therapy: a case report.

Primary hepatic lymphoma is a rare variant of non-Hodgkin's lymphoma with an incidence of 0.016% of all non-Hodgkin lymphomas. The most common histologic subtype is large diffuse B-cell lymphoma.

Non-ANCA Leucocytoclasic Vasculitis Induced by Sofosbuvir/Ledipasvir Treatment: A Case Report.

Background: The development of direct-acting antivirals directed against the Hepatitis C Virus has dramatically modified the therapeutic approach to chronic hepatic viral disease. Larger use of such drugs has also led to increasing reports about their adverse effects. This report aimed to describe a case of leucocytoclasic vasculitis following treatment based on the sofosbuvir/ledipasvir regimen with complete disappearance shortly after withdrawal in a 61-year-old patient treated for genotype 1 hepatitis C.

Imputability of Azathioprine in the Occurrence of Chronic Myeloid Leukemia in Crohn's Disease: An Exceptional Case Report.

Background: Patients with Cohn's disease (CD) treated with thiopurines are at an increased risk of developing cancer. Leukemias are less frequent than other hematopoietic tumors and the development of Chronic myeloid leukemia (CML) after immunosuppression has not been proven.

Case Report: We describe the case of a 61-year-old female who developed a CML after 8 years of treatment with azathioprine (AZA) for ileal Crohn's disease associated with a duodenal localization.

Primary hepatic large B-cell lymphoma following direct-acting antiviral treatment for hepatitis C.

Hepatitis C virus (HCV) infection is a major public health concern worldwide, raising important medical and economic issues. HCV-related end-stage liver disease is one of the most common indications for hepatic transplantation. Chronic hepatitis C is also assimilated to a systemic disease because of multiple extrahepatic manifestations, including lymphoproliferative disorders.

Anemia-induced liver injury: A rare case revealing glucose-6-phosphate dehydrogenase deficiency.

Hypoxic hepatitis may occur due to hemodynamic mechanisms of hypoxia secondary to anemia without any context of reduced blood flow, respiratory failure, or shock state. Etiology of anemia should be investigated in order to avoid recurrence.

Estimation of the prevalence of obstructive sleep apnea in non alcoholic fatty liver disease.

Introduction: The prevalence of non alcoholic fatty liver disease is increasing in parallel with the epidemic of obesity and metabolic syndrome. Recent data have shown frequent association between non alcoholic fatty liver disease (NAFLD) and obstructive sleep apnea.

Aim: To estimate the prevalence of sleep disorders, to search an obstructive sleep apnea syndrome by conducting a ventilator polygraphy and to search the particularities of obstructive sleep apnea when its exists, in patients with NAFLD.

Effect of long-term proton pump inhibitors on bone mineral density.

Background: Proton pump inhibitors (PPIs) are widespread nowadays. Recent concerns haveemerged about possible bone complications of their long-term use, as lowbone mineral density (BMD) and an increased risk of fractures.

Aim: To evaluate the effect of long-term use of PPIs on boneby estimating the frequency of osteopenia andosteoporosis, and determining the risk factors associated to these complications.

Hepatic sarcoidosis: a case series.

Sarcoidosis is a systemic non caseous granulomas disease. Liver is a common location but usually asymptomatic. Evidence based guidelines for this location treatment is lacking and the effect of corticosteroids may be inadequate.

Association between sHLA-G and HLA-G 14-bp deletion/insertion polymorphism in Crohn's disease.

The aim of this study was to evaluate the association between the HLA-G 14-bp deletion/insertion (Del/Ins) polymorphism and soluble (s) HLA-G production in patients with Crohn's disease (CD). We analyzed also the sHLA-G molecules by ELISA and western blot in plasma samples. Among unselected patients, the 14-bp Del/Ins polymorphism was not significantly associated with increased CD risk neither for alleles (P = 0.