[Screening of cervical HPV infection at the reproductive health centre of ariana]. / Détection de i'infection à papillomavirus humain chez des consultants d'un centre tunisien de recherché de la santé de la reproduction.

BACKGROUND: Cervical cancer is the leading cause of cancer mortality among women in developing countries. Over 99 per cent of cases are linked to genital infection with Human Papillomaviruses (HPVs), which are the most common sexually-transmitted viruses worldwide and infect an estimated 660 million people. In light of the advances of the development of HPV vaccines in the world, the challenges to introducing and sustaining such vaccines in the public sector are faced by our countries, generating the need of understanding the local epidemiology of the disease. aim : This study aims to obtain some relevant data on local disease burden in a big health care centre of Tunis. method : In this study, 133 healthy Tunisian women are screened for HPV infection with detection of 37 genotypes. Samples are collected on dry cotton swabs and genotyping use PCR and linear array assay. results : 7,8 % of women were infected and HPV 16 was the only High-risk genotype encountered. 62,5% of infected women doesn't show any cytological abnormality on pap smears. Low and High grade epithelial lesions were associated with HPV 16. Conclusion : There is currently few and sparse data in Tunisia. This work represents to our knowledge the first HPV cervical infection screening study in Tunisia in a basic health centre. The most relevant data is the High frequency of High risk HPV infections related to HPV 16. More than a half of cervical smears in infected women does not show any cytological abnormality and thus, pap smear screening is not appropriated to detect this infection.

[Interest in prolactin levels in galactorrhea]. / Interet du dosage de la prolactine en presence d'une galactorrhee.

The action of prolactin (PRL) in supra-physiological levels on the ovaries or on the hypothalamic-pituitary axis for the release of gonadotropins leads to a reversible inhibition of the cyclic functioning of the pituitary gland and of the ovaries. The consequences are either the production of immature follicles marked by anovulatory or dysovulatory cycles, or the absence of follicle production marked by amenorrhea. Thus, prolactin plays a major role in the productive system by its lactotropic and antigonadotropic effects. Through this study we intend to try to determine the diagnostic value of the association of the cyclic dysfunctions with galactorrhea by measuring the prolactin levels in 2236 patients complaining of galactorrhea. Measurements of FSH and LH levels were also performed in 236 women among those consulting for infertility associated with galactorrhea. The results obtained showed that galactorrhea was associated with prolactenemia in only 17% of cases and of the ovaries was proportional to the prolactin in blood.

[Cervical cancer screening by Pap smear: experience of the National Research Center in Reproductive Health. ONFP]. / Depistage du cancer du col de l'uterus par frottis cervical: experience du centre national de recherche en sante de la reproduction. ONFP.

We have analysed the result of 17,173 pap smears screened in the national research center in reproductive health of Ariana from 1 may 1993 to 30 april 1997. Among these pap smears, 613 colposcopy and 380 biopsy have been performed. The results show that: 1.9% of pap smears present cytological anomalies with 0.79% of low Squamous Intraepithelial lesions and 0.66% high Squamous Intraepithelial lesions. The incidence of CIN III is 1.8% and 0.9% for invasive cancer. The age interval 35-44 years is at high risk of CIN III and invasive cancer of the cervix. evaluation of our diagnostic approach shows that: positive predictive value of pap smears with low SLI is 43.2% positive predictive value of pap smears with high SLI is 37.3%.