Evaluation of anticoagulant therapy management in a teaching hospital in Tunisia: information and education for vitamin k antagonist newly treated patients need to be improved.

Objective: The objective of this study was to assess the level of Vitamin K antagonist (VKA) therapy knowledge among VKA newly treated patients.

Methods: Questionnaire-based interviews were administered in a university hospital to VKA newly treated patients covering both cognitive (i.e.

Family medicine: attractiveness, constraints and prospects as perceived by residents of the specialty.

Introduction: Medical studies reform in Tunisia was conducted to upgrade general medicine, depreciated by the population and experienced by practitioners as a path of failure, thus elevated to the rank of family medicine (FM).

Aim: To determine the factors of attractiveness of the FM, the prospects and career aspirations of future family physicians.

Methods: We conducted a cross-sectional survey by an anonymous questionnaire distributed via an online questionnaire platform from February 11th to April 13th, 2018 that targeted students in the 2nd year of FM at the Faculty of Medicine of Tunis.

Gelatinous Transformation of Bone Marrow in a Patient with Anorexia Nervosa: An Uncommon but Reversible Etiology.

BACKGROUND Anorexia nervosa is a relatively frequently encountered eating disorder. Beyond its psychiatric significance, it is associated with multiple hematological features such as cytopenia. It can be related to gelatinous transformation of the bone marrow.

Three scenarios of nasal obstruction revealing sarcoidosis.

The nasal location of sarcoidosis is rare. In this regard, we report three observations of sarcoidosis observed in three women with an average age of 53.6 years, revealed by annoying nasal manifestations.

Bleeding and asymptomatic overdose in patients under Vitamin K antagonist therapy: Frequency and risk factors.

Background: Vitamin K antagonists are widely used in the treatment and prevention of thromboembolic disease. However, these drugs can cause serious side effects, especially bleeding. This study aims to evaluate frequency and risk factors of both bleeding and asymptomatic overdose in North African patients undergoing Vitamin K antagonist therapy.

Efficacy and Safety of Rituximab in the Management of Pediatric Systemic Lupus Erythematosus: A Systematic Review.

Objectives: To evaluate the efficacy and safety of rituximab for treating pediatric systemic lupus erythematosus (pSLE).

Study Design: We performed a systematic review to evaluate the efficacy and safety of rituximab in children with pSLE. Data from studies performed before July 2016 were collected from MEDLINE, the Cochrane Library, Scopus, and the International Rheumatic Disease Abstracts, with no language restrictions.

[Venous thromboembolism: What other risk factors in a North African population? A study of 276 cases].

Introduction: Venous thromboembolism is a multicausal disease. Understanding interactions between risk factors is the key to advance knowledge about the etiology of venous thrombosis. These interactions are still unclear.

[Hypercalcemia related to PTH-rP revealing malignant hepatic epithelioid hemangioendothelioma].

Hypercalcemia caused by tumor production of PTH-rp occurs most often in cases of squamous cell carcinoma of the lung, aerodigestive tract cancer, gynecological cancer and lymphoma. We report an exceptional case of PTH-rp related to a hepatic hemangioendothelioma. A 70 years-old male admitted for deterioration of the general state.

Azathioprine for glucocorticoid resistant noninfectious uveitis.

Background: the systemic steroids represent the first line treatment in the majority of the noninfectious uveitis, except some specific indications as the Behcet disease. Nevertheless, this treatment may be ineffective and immunosuppressive therapy is mandatory.

Purpose: to evaluate effectiveness and side effects of azathioprine (AZA) in corticosteroid resistant noninfectious uveitis (CRNIU).

[Characteristics of deep vein thrombosis in the elderly].

Purpose Of The Study: Deep vein thrombosis is a common condition in geriatric. The identification of risk factors for venous thrombosis in the elderly is important because it allows an appropriate prescription of preventive treatments. The purpose of this study is to identify the etiologic and therapeutic characteristics of deep vein thrombosis of the lower limbs in the elderly.

[Syndrome d'activation macrophagique: une série de 11 cas tunisiens].

Background: Hemophagocytic syndromes are mostly associated with underlying pathology, they can reveal: immunodeficiency, infections, hemopathies, cancers and auto-immune diseases.

Aim: to investigate clinical, biological features, outcome characteristics and underlying pathology of Tunisian patients with hemophagocytic syndromes.

Methods: A retrospective study of patients with hemophagocytic syndromes admitted in an internal medicine department in Tunis over the period 2009-2012.

Deep vein thrombosis and tuberculosis: a causative link?

Pulmonary tuberculosis is very devastating in developing countries and its thrombogenic potential is a disturbing new entity. We report an 18-year-old woman who presented with a first episode of deep vein thrombosis. Pulmonary, hepatic and splenic tuberculosis was diagnosed while looking for secondary causes.

Liver involvement in tuberous sclerosis.

Tuberous sclerosis complex (TSC) is a rare inherited disease that affects many organs and tissues, which explains the diversity of its clinical manifestations. This disease is often diagnosed at an early age when cutaneous angiofibromas, epilepsy and mental retardation are associated. The hepatic involvement in this phakomatosis is an uncommon location.

Orbital metastasis as the inaugural presentation of occult rectal cancer.

Orbital metastasis is uncommon and occurs in 2-3% of patients with cancer. It is rarely the initial manifestation of a systemic malignancy. It usually indicates extensive haematogenous dissemination of a primary cancer and is associated with poor prognosis.

[Evaluation of urinary metanephrines for the diagnosis of pheochromocytoma].

Objective: evaluate the assay of urinary metanephrines in diagnosis of pheochromocytoma (PH) and determine diagnostic cut-off values.

Methods: this is a retrospective study about 87 patients suspected of pheochromocytoma,whose of 24-h urinary fractionated metanephrine was measured. These cases were collected from Internal Medecine Departments (A and B) at Charles Nicolle's Hospital.

Phalangeal lytic lesion: do not forget osseous sarcoidosis.

Sarcoidosis is a systemic granulomatous disease that most commonly involves the lung and thoracic lymph nodes. However, any organ can be affected. Osseous sarcoidosis has been reported in 3-13% of the cases.

Polymorphisms of Toll-like receptor-4 and CD14 in systemic lupus erythematosus and rheumatoid arthritis.

Background: Toll-like receptor 4 (TLR4) and its co-receptor CD14 play a major role in innate immunity by recognizing PAMPs and signal the activation of adaptive responses. These receptors can recognize endogenous ligands mainly auto-antigens. In addition, TLR4 (Asp299Gly) and CD14 (C/T -159) polymorphisms (SNPs) may modify qualitatively and/or quantitatively their expression.

Isolated caecal tuberculosis mimicking a neoplastic tumour in an immunocompetent woman.

Although tuberculosis is endemic in Tunisia, only a few cases of intestinal disease have been reported. This entity is usually associated with pulmonary tuberculosis. Any part of the gastrointestinal tract may be affected but usually with ileocaecal involvement.