Impact of Covid 19 on Primary healthcare in Tunisia.

INTRODUCTION: Public primary healthcare facilities, the cornerstone of the Tunisian health system, were impacted by the Covid 19 crisis as all health systems in the world. AIM: This study aims to assess this impact of the pandemic. METHODS: We analyzed the budgetary evolution of the basic healthcare group (BHG) of Medenine and Djerba between 2019 and 2020. Similarly, we examined the evolution of all the activities of BHG of Medenine. This analysis was also completed by a semi-structured questioning with a regional expert. RESULTS: Our results showed an increase in expenditure, a decrease in revenue (12.4% for GSB of Medenine and 10.8% for BHG of Djerba), and an accumulation of outstanding payment. BHG's activities have been affected by the pandemic. We showed that stomatology and vaccine activities were well maintained during the pandemic. However, we noted a regression in the number of patients and some illnesses. Activity related to child health and health education has significantly decreased. This impact has had and will have repercussions on the epidemiological state of the population. Despite the intervention of the regional management in terms of organization, training and strengthening of equipment and human resources, the pandemic has generally impacted the operation process of these establishments, which are already facing several challenges. CONCLUSION: We recommend above all to activate the already existing opportunities to replenish the financial resources of primary healthcare facilities, to improve work environment and continuous professional development and to computerize the data and its analysis according to a scientific approach.

Comparison of Mineral Contents in Three Different Tobacco Formulations.

We identified and quantified a variety of mineral elements in 18 tobacco samples purchased from a Tunisian market. In total, 25 mineral elements have been measured in cigarettes, water pipe tobacco, and smokeless tobacco using inductively coupled plasma-optical emission spectroscopy following microwave-assisted digestion. Statistical analyses were performed using SPSSTM, version 18.0. The lowest concentrations of all studied elements were observed in water pipe tobacco. Significantly higher concentrations of Al, Fe, Mg, Na, Ca, Cr, and Co were found in smokeless tobacco, while cigarettes brands contained the highest concentrations of K, Mn, Ni, Ba, and Sr. There was no significant difference between the mineral contents of local and foreign cigarettes and conventional and light cigarettes. Our findings demonstrated that local smokeless tobacco appears to be the most hazardous tobacco type. The concentration of minerals in light cigarettes was not significantly different from the concentration in conventional cigarettes.

LC-ESI-MS quali-quantitative determination of phenolic constituents in different parts of wild and cultivated Astragalus gombiformis.

High-performance liquid chromatography electrospray ionization mass spectrometry (LC-ESI-MS) profiling of the MeOH extract of Astragalus gombiformis Pomel (Fabaceae) aerial parts guided the isolation of seven phenolic compounds among which 7-methylquercetin 3-O-α-l-rhamnopyranosyl-(1→2)-ß-D-galactopyranoside (2) and 7-methylquercetin 3-O-α-L-rhamnopyranosyl-(1→2)-[6-O-(3-hydroxy-3-methylglutaryl)-ß-D-galactopyranoside] (7) whose structures were elucidated by NMR and ESI-MS experiments. The radical scavenging activities of isolated compounds were investigated, by using the TEAC assay. Furthermore quantitative analyses were performed by LC-ESI-MS and applied to the comparative profiling of different parts (aerial parts, leaves and stems) of cultivated and wild A. gombiformis samples, confirming the interest of these compounds as markers of the species. Finally, a Principal Component Analysis was carried out in order to highlight the differences between different parts of cultivated and wild plants.

Biological and chemical study of Astragalus gombiformis.

Extracts of aerial parts and roots of wild Astragalus gombiformis Pomel were tested for their antibacterial, antioxidant, and insecticidal activities and contents of phenolic compounds. Antibacterial activity was tested by the paper disk agar diffusion method and determination of the minimal inhibitor concentration. Among the tested extracts, three extracts (methanol, chloroform, and ethyl acetate) from aerial parts and two extracts (water, methanol) from roots exhibited diameters of inhibition zone equal or above 12 mm (at 150 microg/ disk) and minimal inhibitor concentrations ranging between 233 and 1250 microg/ml. Spectrophotometric and HPLC analyses showed that contents of both total polyphenols and flavonoids, as well as antioxidant activity were higher in the methanolic extract of aerial parts as compared to roots. No insecticidal activity of the extracts of the aerial parts was found against Culex pipiens.

Development of a method of clozapine dosage by selective electrode to the iodides.

Clozapine (Leponex(®)), the main neuroleptic indicated in the treatment of resistant schizophrenia, requires therapeutic monitoring because of its side effects and the individual variability in metabolism. In addition, several cases of intoxication by this drug were described in the literature. In this work, we studied the indirect dosage of clozapine by selective electrode to the iodides for the optimization of an analytical protocol allowing therapeutic monitoring and the diagnosis of intoxication and/or overdose. Our results showed that the developed method is linear between 0.05 and 12.5 µg/mL (r = 0.980), with a limit of detection of 0.645.10(-3) µg/mL. It presents good precision (coefficient of variation less than 4%) and accuracy (coefficient less than 10%) for all the studied concentrations. With a domain of linearity covering a wide margin of concentrations, this method can be applicable to the dosage of clozapine in tablets and in different biological matrices, such as plasma, urines, and postmortem samples.

Variation in volatiles of Astragalus gombiformis Pomel.

The essential oils obtained by hydrodistillation (Clevenger apparatus) from aerial parts of Astragalus gombiformis were analysed by gas chromatography coupled with mass spectrometry (GC/MS). This study showed that the A. gombiformis essential oils are complex mixtures of important natural compounds, which varied qualitatively and quantitatively between cultivated and wild plants and between phenological stages of development. All analysed oils are characterized by the constant presence of phytol, 6,10,14-trimethyl-2-pentadecanone, 4-terpineol, and gamma-terpinene. This study is the first report on the chemical composition of essential oils from A. gombiformis and indicates that these oils should be more studied.