Burden of cancer attributable to insufficient physical activity in Tunisia.

Background: Insufficient physical activity is a risk factor for several types of cancer. Therefore, estimating the burden of cancer attributable to insufficient physical activity is essential to evaluate the effect of health promotion and prevention interventions. Aims: We estimated the number of incident cancer cases, deaths and disability-adjusted life years (DALYs) attributable to insufficient physical activity in the Tunisian population aged 35 years and older in 2019. Methods: We estimated the age-specific population attributable fractions by sex and cancer site to estimate the proportion of cases, deaths and DALYs that could be avoided with optimal levels of physical activity. We used data on cancer incidence, mortality and DALYs from the Global Burden of Disease study estimates for Tunisia in 2019, and data on physical activity prevalence from a Tunisian population-based survey in 2016. We used site-specific relative risk estimates from meta-analyses and comprehensive reports. Results: The prevalence of insufficient physical activity was 95.6%. In 2019, 16 890 incident cancer cases, 9368 cancer-related deaths and 230 900 cancer-related DALYs were estimated to have occurred in Tunisia. We estimated that 7.9% of incident cancer cases, 9.8% of cancer-related deaths and 9.9% of cancer-related DALYs were attributable to insufficient physical activity. At cancer sites known to be associated with inadequate physical activity, 14.6% of cancer cases, 15.7% of deaths and 15.6% of DALYs were attributable to insufficient physical activity. Conclusion: Insufficient physical activity contributed to almost 10% of the cancer burden in Tunisia in 2019. Reaching optimal physical activity levels would considerably reduce the burden of associated cancers in the long-term.

Case Report: Tropical sprue, diagnostic challenges of an old but unrecognized disease.

Tropical sprue (TS) is a post-infective disease of the small bowel characterized by a malabsorption syndrome affecting tropics inhabitants and visitors. Diagnosis of TS remains challenging since it can be confused with common diarrheal diseases, especially in non-endemic areas. We report a Tunisian case of latent TS. A 58-year-old male with a history of chronic watery diarrhea, was admitted to the intensive care unit for confusion which was related to a severe metabolic acidosis. Despite the neurological improvement after hydro-electrolytic resuscitation and acid-base disorders correction, the patient continued to have three to five loose stools daily. A nutritional assessment showed a malabsorption syndrome: iron, Vitamin B12and folate deficiencies; normochromic normocytic anemia and hypoalbuminemia. Gastrointestinal endoscopy showed duodenal villous atrophy and biopsy confirmed subtotal villous atrophy with increased intraepithelial lymphocytosis and a thickened hyalonalized sub-epithelial basal lamina. Celiac disease was evoked, however the patient did not improve on a gluten-free diet and the celiac serology was negative. On re-interviewing, we discovered that the patient had spent two months in India three years prior. Given the travel history, clinico-biological and histological data TS was highly considered and a good response to a five-month antibiotic course combined to nutritional supplementation supported this diagnosis. Clinico-biological, endoscopic and histological findings were overlapping between TS and other malabsorption diseases, explaining diagnosis difficulties. TS should be systematically discussed in tropics visitors presenting with chronic diarrhea. Improvement after micronutrient and vitamin deficiencies replacement combined to a prolonged antibiotic course supports the diagnosis of TS.

[Pleural textiloma discovered after treatment of a persistant arterial channel]. / Textilome Pleural découvert après la Cure d'un Canal Artériel Persistant.

BACKGROUND: Post-operative foreign bodies are rare and localized in the abdomen for the majority of cases. 80% of these foreign bodies were textiloma. AIM: Report a new case of post operative body localized in the pleukral cavity. CASE: A 6 years old boy, previously treated on age 11 months for persistant arterial channel, was admitted with the diagnosis of persistant left pneumopathy since 6 months. Thorax x ray showed a non systematized operety in middle fueld of cefts lung. Ultrasonography demonstrated a plural hyperchonic. Tumor with a posserior shadow one evaluated to scan aloy its longitudinal axis secondary by condensation of lung tissue, this among evolved in textiloma. CT scan showed a condensation of lung tissue hyperdense tumor in its center. Pleuval membrane because thick the foreign body was removed significantly and a pleural decortication was performed post operative course was uneventful CONCLUSION: pleural textiloma, is rare but it still severe complications with its life listening wish an medico legal consequences.

[Epidemiologic and clinical features of congenital heart diseases in children at the Bizerta Hospital]. / Profil épidémiologique et clinique des cardiopathies congénitales chez l'enfant à l'Hôpital de Bizerte.

UNLABELLED: The aim of this study is to establish the epidemiologic profile of congenital heart disease in newborns in a Tunisian department of the north west of Tunisia. METHODS: We report 79 cases of congenital heart defects treated which are followed up in the department of general paediatrics in the University Hospital of Bizerta during 9 years. The informations concerning the patients is taking to a data file. The newborns included had a congenital heart disease suspected clinicly or confirmed by a cardiac echography. RESULTS: The sex-ratio was 0,79 with a mean of weight birth of 3075 g. The prematurity reaches 20.1%. The consanguinity was 30.5%. Congenital heart defects were detected the first week of life in 47% with a murmur on 77.6%, cyanosis on 70%, dyspnea on 89%. The annual incidence was evaluated 2.5% per hundred. One hundred and Twelve heart defects were diagnosed. The medical treatment was indicated on 46.3% and the surgery on 22.5%. Mortality was on 23.8%. CONCLUSION: Congenital heart disease particularly in neonatal period are crippled by a high morbidity and mortality, it's a case of emergency in pediatric cardiology.

[Epidemiologic profile of the newborn of unmarried mother in Bizerta. About 187 cases]. / Profil epidemiologique des nouveaux--nés de meres Celibataires dans le gouvernorat de Bizerte. A propos de 187 cas.

UNLABELLED: The aim of this study is to establish the epidemiologic profile of 187 illegitimatepregnancies compared topregnancies from married mothers. PATIENTS AND METHODS: A transversal retrospective study was carried out in Bizerta from 1990 to 2003. The witness group was constitued by women whose gonna delivery at the same period with p < 0.05. RESULTS: Throughout this study, we have found that single mothers with a mean age of 24 years, are younger than married mothers and has a rural origin and primiparous status. Pregnancy was not followed-up in 70.6% vs. 1.6% and maternal serology was done in 17% vs. 96.8%. 38.4% of new-borns of single mothers were hospitalised (vs. 13.2% in the group witness) for materno-foetal infection (14.4%), respiratory distress syndrome (11.7%), prematurity (9.6%) and intra-uterine growth delay (2.1%). The mortality rate in newborns of single mothers was 5.3%. CONCLUSION: Illegitimate pregnancy is not well followed-up, worst to live and comport a risk for the health and mental in mothers and newborns.