Evaluation of therapeutic education on intermittent fasting in patients with secondary adrenal insufficiency: A clinical trial.

Objectives: Intermittent fasting was associated with complications in patients with adrenal insufficiency (AI). The study aimed to evaluate the impact of therapeutic education and drug adjustment on Ramadan fasting outcomes in patients with secondary AI (SAI).

Methods: A case-control prospective interventional study including patients with SAI willing to fast Ramadan 2023, and age-, gender-, and body mass index-matched healthy fasting controls.

[Not Available].

Introduction: Vaginal delivery after caesarean section (VBAC) is recommended, but the rising rate of uterine rupture calls into question the safety of this practice.

Aim: To identify risk factors for uterine dehiscence and rupture.

Methods: This was a prospective, analytical and descriptive observational study, carried out in a tertiary care maternity.

Effects of high-intensity statin therapy on steroid hormones and vitamin D in type 2 diabetic men: A prospective self-controlled study.

The study aimed to assess the effect of high-intensity statin therapy on testicular and adrenal steroids and vitamin D levels in type 2 diabetic men. A prospective study, conducted between March 2021 and July 2022, including 60 men with type 2 diabetes, aged 40-65 years, statin-free, and in whom treatment with high-intensity statin was indicated. The patients had two visits, before and 6 months after a daily intake of 40 mg of atorvastatin.

Long-term complications of permanent hypoparathyroidism in adults: prevalence and associated factors.

Introduction: Patients with Chronic hypoparathyroidism (CHPT) receiving conventional treatment are exposed to several long-term complications including basal ganglia calcifications, posterior subcapsular cataract, kidney stones, and renal insufficiency. The aim of this study was to assess the prevalence and the associated factors of these complications in patients with CHPT.

Methods: We conducted a cross-sectional study including 58 patients with CHPT.

Salivary Cortisol Measurement Contamination After Oral Hydrocortisone: A Randomized Crossover Trial.

The study aimed to evaluate salivary cortisol (SC) contamination and determine the associated factors in secondary adrenal insufficiency (SAI) patients treated with hydrocortisone (Hc). A randomized crossover trial involved SAI patients. SC was measured before the morning Hc dose, then at one, two, and four hours after.

Assessment of quality of life in patients with permanent hypoparathyroidism receiving conventional treatment.

Introduction: Patients with permanent hypoparathyroidism suffer from multiple complaints and are exposed to long-term complications that might compromise their well-being. The aim of this study was to assess the quality of life (QoL) in patients with permanent hypoparathyroidism receiving conventional therapy and to determine the associated factors.

Methods: This was a cross-sectional matched case-control study including 53 patients with permanent hypoparathyroidism and 53 matched controls.

Metabolic disorders during endogenous Cushing's syndrome: prevalence, associated factors, and outcome after remission.

The prognosis of Cushing's syndrome (CS) is related to a higher cardiovascular morbidity and mortality. This study aimed to determine the prevalence of metabolic disorders in patients with CS, the associated factors, and the rate of remission of these disorders after the remission from CS. It is a retrospective study including 75 cases of CS followed up at the university hospital La Rabta of Tunis from 1987 to 2018.

Spontaneous bladder rupture after non-traumatic vaginal delivery: a rare case report.

Spontaneous bladder rupture (SBR) is a rare condition and often missed diagnosis, especially after a non traumatic vaginal delivery. A 32-year-old para 3 woman, consulted for abdominal pain and anuria two days after instrumental vaginal delivery with forceps for foetal distress in second sate of labour. Blood tests were suggestive of an acute renal failure.

Thyroid hormone resistance syndrome caused by a novel mutation in the thyroid hormone receptor-beta gene (, GLU457LYS) treated with methimazole.

A 15-year-old girl presented with hyperactivity and behavior disorders. She had tachycardia and no goiter. Thyroid hormones were high and TSH normal.

A case of Hashimoto's thyroiditis following Graves' disease.

Graves' disease is characterized by the presence of circulating autoantibodies that stimulate the TSH receptor, inducing hyperthyroidism and goiter. Hashimoto's thyroiditis is an autoimmune disease leading to thyroid tissue destruction by cell and antibody-mediated immune processes. The occurrence of Hashimoto's thyroiditis following Graves' disease has been rarely reported.

Management of patients with cardiovascular diseases during Ramadan.

During the month of Ramadan, over one billion Muslims observe a water and food fast from sunrise to sunset. The practice of this religious duty causes marked changes in eating and sleeping habits. With the increasing incidence of cardiovascular (CV) risk factors, the number of patients with CV pathologies who wish to fast is increasing worldwide, and in Tunisia, which is ranked as a high CV risk country.

Management of severe hypercalcaemia secondary to primary hyperparathyroidism: The efficacy of saline hydration, furosemide, and zoledronic acid.

Introduction: Severe hypercalcaemia is a life-threatening condition that should be managed urgently. The aim of this study was to assess the efficacy of saline hydration, furosemide, and zoledronic acid in the management of severe hypercalcaemia secondary to primary hyperparathyroidism (PHPT).

Methods: We conducted a retrospective analysis of the management of 65 patients with severe hypercalcaemia (≥3 mmol/L) secondary to PHPT.

Professional practices in the management of adrenal insufficiency in two tertiary referral hospitals (Tunis, Tunisia).

Background: Adrenal insufficiency (AI) is a rare and life-threatening disease. Glucocorticoid replacement therapy and patient education are crucial. Few is known about physician practice in this topic.

Diabetic patient satisfaction on the quality of outpatient health care services.

Aim: To assess the degree of satisfaction of diabetic patients with health care services and to determine the factors that influence it.

Methods: It was a cross sectional study conducted in 2018 among diabetic outpatients of the department of endocrinology of the university hospital La Rabta. Patients general characteristics were noted.

Interest of the waist-to-height ratio to predict metabolic syndrome in type 2 diabetic patients.

Introduction: Metabolic syndrome (MetS) is defined as a cluster of risk factors for cardiovascular disease.

Aim: To determine the optimal cut-off point of the waist-to-height ratio (WHtR) at which MetS can be identified with maximum sensitivity and specificity in a sample of Tunisian type 2 diabetic patients.

Methods: We enrolled 457 type 2 diabetic patients in a cross-sectional study.

The remission phase in adolescents and young adults with newly diagnosed type 1 diabetes mellitus: prevalence, predicting factors and glycemic control during follow-up.

Objective: There is little data about the remission phase in adolescents and young adults with newly diagnosed type 1 diabetes mellitus (T1D). The aims of this study were to determine the prevalence of remission and its predicting factors among adolescents and young adults with newly diagnosed T1D and to assess the association between remission and long-term glycemic control in this population.

Methods: This is a longitudinal and retrospective study including 128 type 1 diabetic patients aged between 12 and 30 years at diabetes onset.

Predictive factors for recurrence of Cushing's disease after pituitary surgery.

Introduction: The first-line treatment for Cushing's disease (CD) is transsphenoidal excision of the corticotropic adenoma.

Aim: To identify the predictive factors of recurrence of corticotropic adenomas after pituitary surgery.

Methods: This is a retrospective and longitudinal study conducted in 28 patients operated for corticotropic adenoma between 1987 and 2014 and followed up in the department of endocrinology of La Rabta Hospital in Tunis (Tunisia).

[Risk factors for major lower limb amputations in diabetic patients hospitalized for diabetic foot ulcer].

Background: Amputations in diabetes patient lead to high postoperative morbidity and mortality .

Aim: To indentify the risk factors for major lower limb amputations in diabetic patients hospitalized in endocrinology department.

Methods: It was a descriptive retrospective study including diabetic patients hospitalized in the endocrinology department of the Rabta Hospital for management of an infected foot lesion.

A diffuse large B-cell thyroid lymphoma presented as a compressive goiter in a young woman with no evidence of Hashimoto's thyroiditis.

Thyroid lymphoma should be suspected in case of rapid enlargement of the thyroid gland even in a young patient with no history of Hashimoto thyroiditis. The confirmation is based on histopathology and immunohistochemistry.

Intermittent fasting in adrenal insufficiency patients: a review and guidelines for practice.

Ramadan fasting is a religious duty for adult Muslims. Even though sick people are exempted from fasting, numerous are those who insist on fasting, and seek advice from their physicians. The role of the physician is to support his patient and preserve his health.

Late-Onset Isolated Corticotrope Deficiency in a Woman with Down Syndrome.

Isolated corticotrope deficiency is a rare cause of secondary adrenocortical insufficiency. Its occurrence in patients with Down syndrome is exceptional. Herein, we report a case of an isolated corticotrope deficiency diagnosed at the age of 33 years in a woman with Down syndrome and discuss its possible mechanisms.

Assessment of quality of life in adult type 1 diabetic patients.

Introduction: Few studies have examined the quality of life (QOL) of type 1 diabetic patients (T1D) in adulthood and its association with glycemic control.

Aims: To assess the QOL of a Tunisian population of T1D adults and to identify the factors that may influence it.

Methods: It's a cross-sectional study including 100 T1D patients over 18 years of age whose QOL was assessed by the ADDQOL scale.

A Case of Von Hippel-Lindau Disease with Bilateral Pheochromocytoma and Ectopic Hypersecretion of Intact Parathyroid Hormone in an Adolescent Girl.

Von Hippel-Lindau disease is an autosomal dominant inherited syndrome predisposing to a variety of highly vascularised tumors in different organs. Although bilateral pheochromocytoma was reported in patients with von Hippel-Lindau disease, the coexistence of primary hyperparathyroidism is not a common condition. We report an observation of a primary hyperparathyroidism secondary to an ectopic secretion of intact parathyroid hormone in a 17-year-old girl with von Hippel-Lindau disease and bilateral pheochromocytoma.