Smoking and associated factors among school teenagers in the city of Sousse (Smoking and school teenagers).

BACKGROUND: Tobacco use among teenagers in an increasing concern for the international community, especially with the fact that early experimentation is now identified as a risk factor for durable consumption and addiction. AIM: To study Tobacco use and its determinants amongteenagers in the city of Sousse. METHODS: A descriptive cross-sectionalstudy was carried out among a sample of teenagers enrolled in the city of Sousse (Tunisia) in 2016-2017. A two-stage sampling was conducted for the selection of adolescents. Data were collected using a self-administered questionnaire in Arabic language. RESULTS: The sample consisted of 330 students. The prevalence of smoking was 9.7%(95% CI6,7% ;13%), with a male predominance (14.4% vs 6.3%). The mean age of onset of tobacco was 14.65 ± 1.38 years. 44.8% of parents ignore their children's smoking. The mean dependence score was 4.77 ± 3.6 (HONC test).  Factors significantly associated with smoking were gender, age, educational level, repeating school years, relationship with parents and teachers, presence of smokers in the environment, knowledge about the health risks of tobacco. CONCLUSION: Sensitizationactions should be strengthened within schools, starting even in primary schools, in collaboration with teachers, family and health professionals. In addition, more effective and rigorous enforcement of legislation is essential.

A case report of multiple foreign body ingestion with a ring-like configuration: The magnetic effect.

INTRODUCTION: Magnetic foreign body (FB) ingestion represents a significant health hazard among children. The increasing use of small attractive magnets as toys or parts of various household accessories makes it easily accessible to children. The aim of this report is to raise awareness of public authorities and parents around exposing children to magnetic toys. CASE PRESENTATION: We report a case of multiple FB ingestion in a 3-year-old child. Radiological imaging revealed multiple round objects arranged in a circular shape resembling a ring. Surgical exploration showed multiple intestinal perforations attributed to the magnetic attraction between the objects. CLINICAL DISCUSSION: Although more than 99 % of ingested FB pass without surgical intervention, ingestion of multiple magnetic FB provides a substantially higher risk of injury due to self-association and therefore requires a more aggressive clinical approach. A stable or clinically benign condition, though common, does not necessarily mean a safe situation in the abdomen. Literature review suggests that emergency surgical intervention should be pursued to avoid potentially life-threatening complications; perforation and peritonitis. CONCLUSION: Multiple magnet ingestion is rare, but can result in serious complications. We recommend early surgical intervention before gastrointestinal complications develop.