Publications by authors named "Melki W"

Article Synopsis
  • Tardive seizures are rare, spontaneous seizures that can occur after electroconvulsive therapy (ECT), potentially leading to severe complications like status epilepticus, and the risk factors and management are not well-defined.
  • This study aimed to explore the prevalence of tardive seizures in patients undergoing ECT at Razi Hospital over seven years and to identify factors linked to this occurrence.
  • The retrospective analysis included 1,931 ECT sessions from 157 patients, revealing a 4.45% incidence of tardive seizures among patients and a prevalence rate of 0.57% for individual sessions.
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Infection with SARS-CoV-2 has been shown to predispose to thromboembolic events. The risk of such thromboses further increases in those with underlying inherited or acquired prothrombotic states. The authors present a 30-year-old lady who developed acute abdominal pain, three days after recovery from a mild COVID-19 infection.

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Aims: The present survey aims to assess the overall mood disorder prevalence and identify associated socio-demographic and clinical factors in a Tunisian community sample, with special attention to the COVID-19 pandemic.

Background: Mood disorders are one of the leading causes of all non-fatal burdens of disease, with depression being at the top of the list. The COVID-19 pandemic may have increased the prevalence of mood disorders, especially in Low and Middle-income countries (LMICs) and in vulnerable populations.

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Background: Tunisia is a lower-middle-income country located in North Africa with strengths and challenges to its mental health system.

Aims: We present an overview of available services, facilities, and human resources to offer mental health care in Tunisia.

Methods: We conducted a cross-sectional study, where data for the year 2017 was collected between May 2018 and May 2019 by consulting stakeholders involved in the health field in Tunisia.

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Background: Training based on the Mental Health Gap Action Programme (mhGAP) is being increasingly adopted by countries to enhance non-specialists' mental health capacities. However, the influence of these enhanced capacities on referral rates to specialised mental health services remains unknown.

Aims: We rely on findings from a longitudinal pilot trial to assess the influence of mental health knowledge, attitudes and self-efficacy on self-reported referrals from primary to specialised mental health services before, immediately after and 18 months after primary care physicians (PCPs) participated in an mhGAP-based training in the Greater Tunis area of Tunisia.

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Objectives: We describe the knowledge translation strategies in two projects and share lessons learned about knowledge sharing and uptake.

Methods: To generate findings for dissemination: (1) the Republic of Côte d'Ivoire (RCI) project relied on a multiple case study design to document barriers and facilitators to implementing a community-led prevention strategy targeting Ebola virus disease; and (2) the Tunisia project used several designs to assess a mental health training's effectiveness, and a case study design to explore contextual factors that may influence anticipated outcomes.

Results: To share findings with participants, the RCI project relied on workshops and a pamphlet, and the Tunisia project relied on a structured half-day dissemination workshop and research summary.

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To address the rise in mental health conditions in Tunisia, a training based on the Mental Health Gap Action Programme (mhGAP) Intervention Guide (IG) was offered to primary care physicians (PCPs) working in the Greater Tunis area. Non-specialists (such as PCPs)' training is an internationally supported way to target untreated mental health symptoms. We aimed to evaluate the programme's impact on PCPs' mental health knowledge, attitudes, self-efficacy and self-reported practice, immediately following and 18 months after training.

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Benzodiazepines may be prescribed to manage anxiety and insomnia in patients with depression. However, as noticed during our daily practice, a considerable proportion of patients treated for depression and receiving benzodiazepines developed a dependence to these medicines. Our aims were to estimate the proportion of patients with depression who develop a benzodiazepine dependence and to identify its correlates.

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Background: Primary care physicians (PCPs) working in mental health care in Tunisia often lack knowledge and skills needed to adequately address mental health-related issues. To address these lacunas, a training based on the Mental Health Gap Action Programme (mhGAP) Intervention Guide (IG) was offered to PCPs working in the Greater Tunis area between February and April 2016. While the mhGAP-IG has been used extensively in low- and middle-income countries (LMICs) to help build non-specialists' mental health capacity, little research has focused on how contextual factors interact with the implemented training program to influence its expected outcomes.

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Article Synopsis
  • The Tunisian Ministry of Health, in partnership with various organizations, prepared a training program aimed at improving access to mental health services for primary care doctors in Greater Tunis.
  • The initial phase involved adapting a pre-existing training protocol to fit the local healthcare context, which included consultations with stakeholders and on-site observations.
  • The adaptation revealed not only necessary modifications to the training materials but also highlighted systemic issues that hinder effective mental health care, suggesting that addressing these barriers alongside training implementation could enhance mental health service delivery.
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Background: In low- and middle-income countries (LMICs), addressing the high prevalence of mental disorders is a challenge given the limited number and unequal distribution of specialists, as well as scarce resources allocated to mental health. The Mental Health Gap Action Programme (mhGAP) and its accompanying Intervention Guide (IG), developed by the World Health Organization (WHO), aim to address this challenge by training non-specialists such as general practitioners (GPs) in mental health care. This trial aims to implement and evaluate an adapted version of the mhGAP-IG (version 1.

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Background: Gastrointestinal stromal tumors (GIST) are mesenchymal tumors occuring in the majority of cases in the stomach and small intestine, rarely in rectum, colon, esophagus or mesentery. They are derived from cells of cajal or their precursor, and are typically CD117/KIT + (95%), CD34 + (70%).

Aims: is to study the epidemiological, clinical, therapeutic and evolution of gastrointestinal stromal tumors.

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Unlabelled: PRÉREQUIS: Viral hepatitis is a public health problem in many parts of the globe. In Tunisia, the respective responsibility of five viruses (HAV, HDV, HBV, HCV and HEV) in the genesis of acute hepatitis in adults is only roughly indicated in the absence of suitable serological studies, given as important to plan appropriate preventive strategies.

Objectives: To approach the role of viral hepatitis in all adult with acute hepatitis, identify the current share of each virus A, B, C and E in the genesis of hepatitis and to study the epidemiological and evolution of these diseases.

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Aim: 1) To assess the applicability of EPAGE criteria in there first version (EPAGE I) in clinical practice, 2) to assess colonoscopy appropriateness using EPAGE I criteria, 3) to compare colonoscopy appropriateness and findings.

Methods: Four hundred and eighty-seven consecutive diagnostic colonoscopies were included. The appropriateness of the indication of colonoscopy was appreciated using a scoring system on the basis of the EPAGE criteria in there first version (EPAGE I).

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Purpose: admission to nursing homes is often associated with major changes in the way the elderly live, possibly leading to sleep disorders. The aim of our study was to assess sleep quality in the elderly without dementia living in nursing homes, to determine the prevalence of sleep disorders, and to examine the links between sleep quality and sociodemographic features, comorbidities, and degree of dependency.

Methods: we carried out a cross-sectional survey, involving old people living in Manouba nursing home.

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Background: Epidemiological studies suggest a positive but controversial correlation between the major mental disorders, particularly schizophrenia and delinquent or criminal acting out. aim : To study the occurrence of violence in patients with schizophrenia according to demographic, clinical and disease progression features.

Methods: This retrospective study included all out-patients, consulting during a period of one month, suffering from schizophrenia for at least five years.

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