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Aim: The burden of non alcoolic fatty liver disease (NAFLD) is globally increasing. While crucial for management, NAFLD patient adherence to the Mediterranean diet (MD) is underexplored, especially in Mediterranean countries such as Tunisia. Materials & methods: A prospective study (Nov 2022-Feb 2023) supervised MD introduction by a nutritionist, evaluated adherence with MEDAS scores (≥10 for good compliance), and explored barriers to good adherence. Results: Among 41 patients (11 male/30 female, mean age 56 [29-70]), 63% had low education and 51% had metabolic syndrome. Good MD adherence stood at 14.6%. Poor adherence tied to diet-induced higher costs (p = 0.021) and difficulty to new-diet adoption (p = 0.026). Conclusion: Tunisian NAFLD patients had low MD adherence due to financial constraints and dietary adaptation challenges.
The study focused on nonalcoholic fatty liver disease (NAFLD), a widespread liver disease with increasing prevalence. It aimed to assess Tunisian NAFLD patients' adherence to the Mediterranean diet (MD), an essential aspect of NAFLD management that lacked sufficient investigation in this context. Over a 3-month period, a nutritionist introduced and supervised the MD. Adherence was measured using MEDAS scores, with scores of 10 or higher indicating good compliance. Additionally, patients answered six questions about barriers. Only 14.6% of the 41 patients adhered well to the MD. The study underscores that Tunisian NAFLD patients face challenges in adhering to the MD, primarily due to financial constraints and dietary adaptation issues, highlighting the need for tailored support in managing their condition.
Limited short-term adherence to the Mediterranean Diet in Tunisian NAFLD patients. Major hurdles: extra food costs & adapting to a new diet. Personalized, extended support is the key to better adherence. #Nutrition #Health #NAFLD #MediterraneanDiet.
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BACKGROUND: Azathioprine, which is an immunosuppressive agent commonly used for chronic inflammatory bowel disease, may be associated with an increased risk of certain cancers such as hematologic malignancies. CASE REPORT: A 50-year-old man with a 27-year history of Crohn's disease had been under azathioprine treatment at a dose of 2.5 mg/kg/day (150 mg/day) since 2007, after ileocecal resection to avoid postoperative recurrences. Ten years later, the patient presented with a 3-week history of worsening general condition and fever. The physical examination revealed skin paleness and fever. The biological assessment showed pancytopenia. Hematological toxicity of azathioprine was suspected. The drug was immediately stopped. A bone marrow biopsy with immunophenotyping studies confirmed the diagnosis of acute myeloid leukemia. Chemotherapy was indicated but the patient passed away 2 weeks later. CONCLUSION: Azathioprine may be implicated in therapy-related acute myeloid leukemia. Close monitoring of its hematological toxicity, as well as patient education to adhere to this monitoring program, are crucial to detect this life-threatening complication.
