Assessment of therapeutic compliance and its associated factors in tunisian adult asthmatic patients.

INTRODUCTION: Despite therapeutic advances, morbidity attributed to asthma continues to increase. This seems partly to be due to poor adherence. AIM: To assess therapeutic adherence and the association between poor compliance and asthma control. METHODS: We carried out a descriptive cross-sectional study on a sample of 150 asthmatics, followed in the pneumology department of Charles Nicolle hospital for more than 6 months. The survey took place over 1 month. The 4-item Morisky questionnaire (MMAS-4) was used to assess adherence to therapy. RESULTS: Our patients had a median age of 44.2 years and a sex ratio of 0.47. Asthma was severe in 48% of cases and poorly controlled in 34% of cases. Adherence was poor in 66% of patients. Factors significantly associated with adherence were educationlevel (p=0.02), socio- economic status (p = 0.01), treatment cost (p= 0.02), its availability (p=0.04) and its free cost (p = 0.001), consultation waiting time (p=0.03) and knowledge on asthma (p=0,04). We retained in multivariate analyze two factors determining therapeutic adherence, which are socio-economic status (OR = 2.02 ; [1.2-6.26]) and participation in the therapeutic choice (OR = 1.2 ; 95% CI [2.02-4.25]). CONCLUSIONS: It appears that medication adherence is widely influenced by socio-economic status. So, improving these conditions would guarantee better treatment compliance.

Association of simple bone cyst and cemento-osseous dysplasia: A long-term follow-up.

Cemento-osseous dysplasia (COD) is a non-neoplastic, usually asymptomatic condition characterized by the presence of amorphous cement-like calcifications located exclusively in the tooth-bearing regions of the jawbone. Simple bone cysts (SBCs) of the jaws are benign intraosseous cavities, empty or filled with serous, serohematic, or blood fluid. They are characterized by the absence of an epithelial lining. COD and SBCs are two distinct lesions of the jaws that have long been described separately in the literature; however, their co-occurrence remains rare and only a few cases have been reported illustrating this relationship. This association can be considered as a distinct entity since it presents specific epidemiological, clinical, and radiological data. The aim of this article was to report a new case of association between COD and SBC by illustrating a florid COD formation in mandibular SBC detected in a 31-year-old patient followed over a period of 11 years.

Misdiagnosis asthma in adult, three rare causes.

INTRODUCTION: All that wheezes is not asthma. Although, asthma is the most common cause of wheeze and cough in children and adults, it is often attributed inappropriately to these symptoms from other causes. AIM: We illustrate through this manuscript three rare causes of wheeze in adults, misdiagnosis as asthma. OBSERVATIONS: The three reported cases were misdiagnosed as difficult-to-treat asthma. They were found as mimicking asthma. Final diagnoses were localized tracheobronchial amyloidosis, aortic arch anomalies, and idiopathic chronic eosinophilic pneumonia. CONCLUSION: Although asthma is a common cause of various respiratory symptoms, all that coughs and wheezes is not asthma. So before retaining the severe asthma diagnosis, we have to exclude various differential diagnoses, even the rarest ones. Several diagnostic tests have to be done to have the appropriate diagnosis.

Mammary analogue secretory carcinoma: A case report.

BACKGROUND: Mammary analogue secretory carcinoma is a rare new entity of low-grade malignant tumor of salivary glands. It shared the same histologic features and the chromosomal translocation t(12;15)(p13;q25) as secretory carcinoma of the breast. AIM: To highlight the diagnosis approaches and the attitude of management in a case of MASC which is the first case reported in Tunisia. Reported case: A case of MASC of the lower left jugal mucosa was reviewed for its microscopic and immunohistochemical features. Fluorescence in situ hybridization (FISH) for the ETV6-NTRK3 translocation was performed. Surgery was the only treatment required in this case. No signs of local or regional recurrence during the one-year follow-up were noticed. COMMENTARIES: Secretory carcinoma was confused with other salivary gland tumors especially acinic cell carcinoma due to their morphological similarities, making diagnosis dilemma. Fluorescence in-situ hybridization (FISH) is the one definitive finding to confirm the diagnosis of MASC and to differentiate it from the other types of salivary gland tumor. At the present time, no specific therapy is available for patients with MASC.