Spontaneous transomental hernia: a case report of a rare internal hernia with a challenging diagnosis.

Introduction And Importance: Transomental hernia (TOH) is an extremely rare clinical condition that represents 1-4% of all internal hernias. Spontaneous TOH occurs in patients with no history of surgery or previous abdominal trauma. It happens after protrusion of the abdominal viscera, commonly the small bowel loops through a defect on the great omentum.

Coexistence of Tuberculosis and Malignancy in a Single Cervical Lymph Node: A Case Series.

The coexistence of tuberculosis (TB) and malignancy within the same lymph node is a rare, if not exceptional, pathology, with only a few cases reported. We collected patients who presented concomitant TB and malignancy within the same cervical lymph node diagnosed during the period (2010-2023). Ten patients were included.

Primary non-cutaneous melanomas of the head and neck: Case series and review of the literature.

Primary non-cutaneous melanoma is a rare type of melanoma that occurs mostly on mucosal surfaces. The head and neck region is the most common site for these melanomas. The following cases described herein include patients diagnosed with primary non-cutaneous melanomas.

Increased Rheumatoid Factor production in patients with severe COVID-19.

Background: Searching for Rheumatoid Factors (RF) in patients with coronavirus disease (COVID-19) has rarely been described.

Objectives: To investigate the association between RF isotypes (IgM, IgA, and IgG) and different clinical presentations of COVID-19 in a series of Tunisian patients.

Study Design: Eighty-two COVID-19 patients were enrolled in this study.

Siewert II esophagogastric junction adenocarcinoma: Still searching for the right treatment transabdominal or transthoracic surgical approaches?

Introduction: To date, the discussion is still ongoing whether the Siewert II adenocarcinoma of the esophagogastric junction (AEG) should be resected either by thoracoabdominal esophagectomy or gastrectomy with resection of the distal esophagus by transhiatal extension. The aim of our study was to compare the oncological and perioperative outcomes of the transthoracic approach (TTA) and the transabdominal approach (TAA).

Methods: Searches of electronic databases identifying studies from Cochrane, PubMed and Google Scholar were performed.

Blunted cerebral hemodynamic responses to incremental exercise in patients with end-stage renal disease.

Purpose: The aims of this study were to compare cerebral hemodynamics and maximal oxygen uptake (VO) in patients with end-stage renal disease (ESRD) vs. age-matched healthy controls during maximal exercise.

Methods: Twelve patients with ESRD and twelve healthy adults (CTR group) performed exhaustive incremental exercise test.

Hemodynamic and neuromuscular basis of reduced exercise capacity in patients with end-stage renal disease.

Purpose: The present study aimed to characterize the exercise-induced neuromuscular fatigue and its possible links with cerebral and muscular oxygen supply and utilization to provide mechanistic insights into the reduced exercise capacity characterizing patients with end-stage renal disease (ESRD).

Methods: Thirteen patients with ESRD and thirteen healthy males (CTR group) performed a constant-force sustained isometric contraction at 50% of their maximal voluntary isometric contraction (MVC) until exhaustion. Quadriceps muscle activation during exercise was estimated from vastus lateralis, vastus medialis, and rectus femoris EMG.

Hypogonadism in hemodialysis patients: a first snapshot of prevalence and predictive factors in Tunisian patients.

Introduction: patients with chronic kidney disease commonly exhibit testosterone deficiency. We aimed through the current study to assess the prevalence and the risk factors of hypogonadism in male patients on hemodialysis and to establish their relationship with erectile dysfunction.

Methods: we conducted a cross-sectional study based on data collected from hemodialysis male patients.

Muscle oxygen supply impairment during maximal exercise in patients undergoing dialysis therapy.

This study aimed to investigate whether Chronic Kidney Disease (CKD) influences O supply including O delivery and release to the active muscles during maximal physical exercise. Twelve CKD patients undergoing dialysis therapy (HD group) and twelve healthy adults (CTR group) performed an incremental exercise test to determine maximal oxygen uptake (VO). Throughout the exercise, near-infrared spectroscopy allowed the investigation of changes in oxyhemoglobin (∆OHb), deoxyhemoglobin (∆HHb), and total hemoglobin (∆THb) in the vastus lateralis muscle.

Resource utilization and preparedness within the COVID-19 pandemic in Tunisian medical intensive care units: A nationwide retrospective multicentre observational study.

Background: The worldwide SARS-CoV-2 pandemic represents the most recent global healthcare crisis. While all healthcare systems suffered facing the immense burden of critically-ill COVID-19 patients, the levels of preparedness and adaptability differed highly between countries.

Aim: to describe resource mobilization throughout the COVID-19 waves in Tunisian University Medical Intensive Care Units (MICUs) and to identify discrepancies in preparedness between the provided and required resource.

Acute acalculous cholecystitis in hospitalized patients in intensive care unit: study of 5 cases.

Background: Acute acalculous cholecystitis (AAC) is an inflammation of the gallbladder with no evidence of gallstones. It occurs mostly in patients in intensive care units and is associated with several risk factors (fasting, parenteral nutrition, mechanical ventilation) leading to ischemia of the gallbladder wall.

Methods: This is a retrospective multiple cases study of five cases of AAC in patients hospitalized in the Medical Intensive Care Unit at Tahar Sfar Hospital in Mahdia over a 4-year period between January 2016 and December 2020.

Case Report: Central retinal artery occlusion following sildenafil intake.

To report a case of central retinal artery occlusion associated with sildenafil intake and briefly discuss its causative pathogenesis. A 50-year-old man with no premorbidities presented with symptoms of sudden severe visual field constriction in the left eye (LE). Best-corrected visual acuity in the LE was 20/25.

Design and Rationale of the National Observational Multicentric Tunisian Registry of Hypertension: Protocol for Evaluating Hypertensive Patient Care in Clinical Practice.

Background: This study was designed to evaluate the care of hypertensive patients in daily clinical practice in public and private centers in all Tunisian regions.

Objective: This study will provide us an overview of hypertension (HTN) management in Tunisia and the degree of adherence of practitioners to international recommendations.

Methods: This is a national observational cross-sectional multicenter study that will include patients older than 18 years with HTN for a duration of 4 weeks, managed in the public sector from primary and secondary care centers as well as patients managed in the private sector.

An uncommon case of synchronous gastric and colonic metastases from breast cancer.

Invasive lobular carcinoma is the second-most-common subtype of breast cancer. It is characterized by a different metastatic pattern with a propensity to metastasize to pleura, peritoneum, gastrointestinal tract, and ovary. We report a woman with known metastatic disease outside the gastrointestinal tract who had endoscopy and colonoscopy for gastrointestinal symptoms.

Sulodexide Significantly Improves Endothelial Dysfunction and Alleviates Chest Pain and Palpitations in Patients With Long-COVID-19: Insights From TUN-EndCOV Study.

Objective: Non-respiratory long-coronavirus disease 2019 (COVID-19) symptoms are mainly related to a long-lasting endothelial dysfunction and microcirculation impairment. We hypothesized that Sulodexide, a purified glycosaminoglycan mixture with a beneficial endothelial effect in arterial and venous peripheral diseases, may be effective in a subset of patients with long COVID-19.

Approach And Results: We conducted a multicenter prospective quasi-experimental study.

Retrorectal epidermoid mistaken for perirectal swelling: A case report.

Introduction And Importance: Epidermoid cysts are developmental cysts of the retrorectal space. They are benign lesions resulting from ectodermal inclusion during neural tube closure. Generally, they are misdiagnosed given that symptoms are often vague and nonspecific.

Obturator hernia: A case report of intestinal obstruction with challenging diagnosis and non-standardized treatment.

Introduction And Importance: Obturator Hernia (OH) is a rare clinical entity that constitue less than 1% of all abdominal hernias. It happens in elderly thin women malnourished. The diagnosis is usually delayed because symptoms are non-specific, and patients commonly have features of intestinal obstruction.

Epidemiologic features and management of hypertension in Tunisia, the results from the Hypertension National Registry (NaTuRe HTN).

Background: Hypertension is the leading cause of morbi-mortality in our country. Thus, we conducted this national survey on hypertension to analyze the profile of the Tunisian hypertensive patient and to assess the level of blood pressure control.

Methods: Nature HTN is an observational multicentric survey, including hypertensive individuals and consulting their doctors during the period of the study.

Angioplasty of Anomalous Coronaries Arising from the Opposite Sinus with an Interarterial Course, is it Safe?

Background: The coronary artery with an interarterial course CAIAC is the most threatening coronary anomaly, especially if it concerns the left coronary. Percutaneous coronary intervention PCI is scarcely described given its low prevalence and lack of long-term outcome data. Therefore, we assessed through this case series the feasibility and safety of PCI in this population.

Trichobezoar: A case report of a double gastric and ilial localization revealed by an occlusion.

Introduction And Importance: A bezoar is an agglutination of ingested materials forming an indigestible and insoluble mass inside the gastrointestinal tract. Trichobezoars formed by ingested hair are rare. The stomach tends to be the typical location.