New surgical technique for managing placenta accreta spectrum and pilot study of the "CMNT PAS" study.

Introduction: The gold standard for treating the placenta accreta spectrum (PAS) is a cesarean hysterectomy, which harms fertility. Another conservative surgical approach allows the uterus to be preserved: one-step conservative surgery. We will compare these two approaches through the "CMNT PAS" study.

Decavanadate Compound Displays In Vitro and In Vivo Antitumor Effect on Melanoma Models.

The efficacy of available treatments for melanoma is limited by side effects and the rapidly emerging resistance to treatment. In this context, the decavanadate compounds represent promising tools to design efficient therapeutic agents. In our study, we synthesized a dimagnesium disodium decavanadate icosahydrate compound (MgNaVO·20HO) and investigated its structure stability as well as its antimelanoma effects.

Uncommon metastatic journey: unusual breast metastases of medullary thyroid carcinoma: a case report.

Medullary thyroid carcinoma is a neuroendocrine tumor derived from thyroid C-cells. It is a rare aggressive tumor, known to metastasize to lymph nodes, liver, bones, and lungs. We report a case of a young patient with a family history of breast cancer, who developed breast metastases six months post-treatment for medullary thyroid carcinoma.

Recurrent endocarditis on restrictive perimembranous septal defect causing aortic insufficiency.

Infective endocarditis (IE) in children is a rare entity which presents a high rate of events during follow-up. Congenital heart disease, i particular ventricular septal defect (VSD), is the main predisposing condition to IE at those ages. The long-term risk of IE is of concern and whose follow-up can be complicated by a relapse of IE and reintervention.

Association of ABO Gene rs2073823 Polymorphism with Microvascular Complications, sP-Selectin Levels and Lipid Profile in Type 2 Diabetes.

Introduction: Type 2 diabetes (T2D) is a prevalent metabolic disorder linked to chronic inflammation and endothelial dysfunction, which contributes to the development of microvascular complications (MVCs) such as diabetic retinopathy (DR) and diabetic neuropathy (DN). Genetic factors, including variations in the ABO gene, may influence these complications. This study aimed to investigate the association between the ABO rs2073823 polymorphism and the risk of MVCs in patients with T2D, as well as its impact on inflammatory biomarkers, endothelial markers, and lipid profiles.

Proportion, domains, and risk factors of cognitive impairment in systemic lupus erythematosus.

Objective: Cognitive impairment (CI) in systemic lupus erythematosus (SLE) is quite common and is an important prognostic factor due to its severity. The aim of our study was to determine the proportion and type of CI in SLE and to identify associated risk factors.

Methods: We performed a cross-sectional study (January - March 2022).

Impact of sodium-glucose cotransporter inhibitors in acute coronary syndrome patients on endothelial function and atherosclerosis related-biomarkers: ATH-SGLT2i pilot study.

Little is known about the effects of sodium-glucose co-transporter 2 inhibitors (SGLT2i) on atherosclerosis. We aimed to determine if a 90-day intake of Dapagliflozin could improve atherosclerosis biomarkers (namely endothelial function assessed by flow-mediated dilatation [FMD] and carotid intima-media thickness [CIMT]) in diabetic and non-diabetic acute coronary syndrome (ACS) patients when initiated in the early in-hospital phase. ATH-SGLT2i was a prospective, single-center, observational trial that included 113 SGLT2i naive patients who were admitted for ACS and who were prescribed Dapagliflozin at a fixed dose of 10 mg during their hospital stay for either type 2 diabetes or for heart failure.

Chronic total occlusion- Percutaneous coronary intervention (CTO-PCI) experience in a single, multi-operator Tunisian center : A Five-Year Report.

Introduction: In recent years, advancements in chronic total occlusion (CTO) percutaneous coronary intervention (PCI) have been notable, improving procedural techniques, imaging, and management of complications.

Aim: We sought to assess the performance and the practice of a high-volume Tunisian PCI center in treating patients with a CTO.

Methods: We retrospectively evaluated data from consecutive CTO patients who underwent percutaneous revascularization from October 2019 to January 2024 at the cardiology department of Habib Thameur Teaching Hospital, Tunisia.

Risk factors of the appearance of anencephaly in Tunisia.

Introduction: Anencephaly is a serious developmental defect of the central nervous system in which the brain and cranial vault are grossly malformed. The cerebrum and cerebellum are reduced or absent, but the hindbrain is present. Anencephaly is a part of the neural tube defect spectrum.

Tricuspid annular plane systolic excursion/pulmonary arterial systolic pressure ratio as a predictor of outcome in acute heart failure.

Unlabelled: Introduction Acute heart failure (AHF) is a life-threatening condition that requires swift diagnosis and tailored management to enhance patient outcomes. In the pursuit of more precise prognostic indicators, Tricuspid Annular Plane Systolic Excursion (TAPSE) and Pulmonary Arterial Systolic Pressure (PASP) have emerged as potential significant advancements. The TAPSE/PASP ratio, a novel parameter, has recently gained attention as a promising predictor of outcomes in acute heart failure.

Comparison of Mesotherapy and Transcutaneous Electrical Nerve Stimulation (TENS) in the Management of Chronic Non-Specific Low Back Pain: A Randomized Clinical Trial.

Unlabelled: Introduction-Aim: Chronic low back pain affects 80% of individuals at some point in their lives and has significant socioeconomic impacts. This study aims to compare the efficacy of mesotherapy with transcutaneous electrical nerve stimulation (TENS) in treating chronic low back pain.

Methods: A randomized bicentric study was conducted at the Military Hospital of Tunis and the Multidisciplinary Military Polyclinic of Mefeteh Saadallah between August 2023 and June 2024.

Student interest and perception of ethical reasoning learning: Insights from medical education.

Introduction: Medical ethics teaching is one of the pillars of medical education. Ethical reasoning learning (ERL) is one of the means of teaching medical ethics.

Objective: The aim of our study was to evaluate the pedagogical interest and the students' perceptions of ERL in directed teaching in internal medicine among fifth-year students.

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Aim: To elaborate Tunisian recommendations for the therapeutic management in current practice of patients with spondyloarthritis who are candidates for treatment with a biological agent.

Methods: Following the standardized procedures of the INEAS (Instance Nationale de l'Evaluation et de l'Accréditation en Santé) and in collaboration with the LITAR (Tunisian League against Rheumatism), a systematic review of the literature, carried out by 6 rheumatologists, based on the questions individualized by the working group (15 expert rheumatologists), served as the basis for the working meetings, with determination of the strength of the recommendations and the degree of agreement of the experts. The recommendations were validated by an independent reading group comprising 19 experts from various related specialties.

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Aim: To develop good practice recommendations (GPR) for the therapeutic management of patients with spondyloarthritis (SpA), including psoriatic arthritis.

Methods: Following standardised procedures, a systematic review of the literature was carried out on non-pharmacological and non-biological pharmacological treatments for SpA. The review was based on questions defined by a working group of 15 rheumatologists.

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Unlabelled: Advancements in understanding SpA have greatly improved patient quality of life through early detection and effective treatment. However, non-specialist physicians often face challenges in identifying the early symptoms of SpA.

Aim: This study aims to assist healthcare practitioners in the early detection of SpA and to streamline management strategies by employing a standardized assessment protocol for adult patients with SpA.

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This framework was developed under the auspices of the Tunisian League Against Rheumatism (LITAR), coordinated by a project leader. The primary objective is to formulate recommendations for the management of spondyloarthritis, grounded in the development of questions structured according to the PICO model. This model defines four essential elements of a clinical question: P: Patient or Population or Problem, I: Intervention (the proposed action), C: Comparison (between diagnostic tests, treatments, etc.

High performance COVID-19 screening using machine learning.

Since the World Health Organization declared the Coronavirus Disease 2019 (COVID-19) pandemic as an international concern of public health emergency in the early 2020, several strategies have been initiated in many countries to prevent healthcare services breakdown and collapse of healthcare structures. The most important strategy was the increased testing, diagnosis, isolation, contact tracing to identify, quarantine and test close contacts. In this context, finding a rapid, reliable and affordable tool for COVID-19 screening was the main challenge to address the pandemic.

The mediating role of work-life balance on the relationship between emotional intelligence and job satisfaction among Lebanese critical care nurses.

Background: In healthcare settings, particularly in intensive care units, nurses face significant stress due to the high demands of their job. This stress can impact their job satisfaction, mental health, and overall quality of life. Emotional intelligence has been identified as a crucial factor that can mitigate workplace stress and enhance job satisfaction.

Extensive elastofibroma dorsi with scapulo-thoracic involvement in a male laborer: A case report.

Introduction And Importance: Elastofibroma dorsi is a rare benign soft tissue lesion primarily located in the subscapular region. This distinctive lesion, with its unique radiological and histological features, poses diagnostic challenges due to its subtle presentation and overlap with other conditions.

Case Presentation: A 48-year-old man, manual laborer with an unremarkable medical history presented with a progressively enlarging mass below the right scapula over two years.

Perforated Meckel diverticulitis: Diagnostic challenges and surgical outcomes.

Meckel's diverticulum, a congenital anomaly of the omphalomesenteric duct, is a rare cause of acute abdomen and poses significant diagnostic challenges due to its variable presentation and complications such as perforation. We present the case of a 19-year-old male with a 24-hour history of right iliac fossa pain progressing to generalized abdominal tenderness. Laboratory results showed leukocytosis and elevated C-reactive protein, while CT imaging suggested pneumoperitoneum and an inflamed Meckel diverticulum.

Tracheal adenoid cystic carcinoma presenting as a locally advanced thyroid gland carcinoma.

Tracheal adenoid cystic carcinoma is a rare malignancy. We report the case of a 65-year-old male who presented to our department due to a 3-month history of mild dysphagia without other associated symptoms. The neck, laryngeal, and hypopharyngeal examinations were normal.

SARS-CoV-2 excretion and genetic evolution in nasopharyngeal and stool samples from primary immunodeficiency and immunocompetent pediatric patients.

Background: Primary Immunodeficiency disorders (PID) can increase the risk of severe COVID-19 and prolonged infection. This study investigates the duration of SARS-CoV-2 excretion and the genetic evolution of the virus in pediatric PID patients as compared to immunocompetent (IC) patients.

Materials And Methods: A total of 40 nasopharyngeal and 24 stool samples were obtained from five PID and ten IC children.

High-Intensity Interval Training Reduces Liver Enzyme Levels and Improves MASLD-Related Biomarkers in Overweight/Obese Girls.

Background/objectives: Despite the abundant body of evidence linking high-intensity interval training (HIIT) to cardiometabolic markers, little is known about how HIIT affects liver enzymes, particularly in obese adolescents. This study aimed to investigate the effects of HIIT on metabolic dysfunction-associated steatotic liver disease (MASLD)-related biomarkers in overweight/obese adolescent girls.

Methods: Thirty-three overweight/obese adolescent girls (age, 17.

Comparative Analysis of Serum BAFF and IL-17 Levels Pre- and Post-Antipsychotic Treatment for Acute Schizophrenia.

The interplay between the cytokine network and antipsychotic treatment in schizophrenia remains poorly understood. This study aimed to investigate the impact of psychotropic medications on serum levels of IFN-γ, IL-4, TGF-β1, IL-17, and BAFF, and to explore their relationship with psychopathological features. We recruited 63 patients diagnosed with schizophrenia in the acute phase, all of whom were either drug-naïve or had been drug-free for at least three months.