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1.
Tunis Med ; 101(7): 617-625, 2023 Jul 05.
Artículo en Francés | MEDLINE | ID: mdl-38445423

RESUMEN

AIM: To identify the predictive factors for the publication of theses defended at the Faculty of Medicine of Sousse (FMSO) in Tunisia. METHODS: The development of the dissertation was studied following the interrogation of three databases "Medline", "Scopus" and "article @INIST" as well as "Scholar Google". The drafting quality of the thesis summary was assessed using a grid of 20 iso-weighted items. The predictors of publication were studied by binary logistic regression, with a significance level of 10%. RESULTS: Out of the 670 theses defended at the FMSO, the mention "proposal for the thesis prize" was awarded for 22% of the thesis students. These theses were of the "clinical" type in 68% of cases, 80% of which were in "case study" format. The writing quality was deemed satisfactory in 47% of the theses. The publication rate was only 10.3%. The univariate analysis found three factors determining the publication of theses: the field of non-clinical research: epidemiological or fundamental, good editorial quality and the mention "proposal for the thesis prize". After adjustment, the latter was the only independent predictor of the publication of the thesis (ORa=1.60[1.007-2.559]). CONCLUSION: This low rate of publication of theses at the FMSO illustrates the difficulties of thesis students and their directors in research methodology and scientific writing. Theses accepted with distinction must be better accompanied to facilitate their publication.


Asunto(s)
Medicina , Humanos , Túnez/epidemiología , Bases de Datos Factuales , Docentes , MEDLINE
2.
Tunis Med ; 100(5): 396-402, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36206089

RESUMEN

OBJECTIVE: To assess the writing quality of the theses defended at the Faculty of Medicine of Sousse (FMSo). METHODS: This is a bibliometric, transversal and exhaustive study done on all theses defended at the FMSo between 2001 and 2005. The writing quality of the thesis was assessed, via double reading, by a grid applied to its abstract. This grid was composed of 20 items detailing the principles of scientific writing. A thesis was considered "satisfactory" when the writing score was ≥15 / 20. RESULTS: During this five-year period, 670 theses was defended at the FMSo (an average of 134 theses per year), which in 93% of cases were research ones. All these theses were written in French except for one. On a 20-point scale, the average thesis editorial score was 14.1 ± 2.2. The writing quality was judged satisfactory in 47% of the theses. The objective of the thesis, research design and study population were mentioned, respectively, in 81%, 77% and 91% of theses abstracts. However, the descriptors chosen were MeSH words in only 42% of the time; Data sources and standard deviation were mentioned in only 25% and 9.6% of the abstracts, respectively. CONCLUSION: The writing quality of the thesis at the FMSo suffered mainly from documentary, methodological and statistical insufficiencies. The introduction of a scientific medical writing module in the curriculum of the FMSo would be essential for the optimization of the medical thesis.


Asunto(s)
Bibliometría , Médicos , Docentes , Humanos , Túnez , Escritura
3.
Libyan J Med ; 17(1): 2009100, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-34895105

RESUMEN

The objective of this work was to establish the bibliometric profile of Tunisian theses in 'general surgery' and to describe their themes, their study designs, and their writing quality. This is a retrospective descriptive bibliometric study, covering all the theses in medicine in the specialty of 'general surgery', defended in the four medical faculties of Tunisia, during the forty last years from 1980 to 2019. During the study period, 739 theses in 'general surgery' were discussed in Tunisia, with an average of 19 theses per year. The most studied research topic was emergencies (41%), followed by common surgical pathologies (26%) and digestive oncology (21.5%). Descriptive studies and case studies represented the majority of study designs with respective proportions of 56.9% and 40.6%. Only 20.7% of these theses had a scientific writing quality deemed satisfactory. The least respected elements in writing their summaries were statistical (confidence intervals and standard deviations) and documentary (keywords). Despite the plethora of themes of Tunisian theses in 'general surgery', their basic methodology and their editorial non conformity require the educational reform of the dissertations, both doctoral students and supervisors, by strengthening their skills in research methodology and scientific communication written.


Asunto(s)
Bibliometría , Humanos , Estudios Retrospectivos , Túnez
4.
Tunis Med ; 99(1): 29-37, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33899172

RESUMEN

Family Medicine, a true scientific and academic discipline, has been defined by the World Organization of National Colleges, Academies and academic associations of general practitioners / family physicians (WONCA) since 2002, as being a "clinical specialty oriented towards primary care". This paper details the specificities of Family Medicine: a horizontal specialty, primary care, providing comprehensive and continuous care, patient-centered and community-oriented. The promotion of Family Medicine in the Maghreb countries requires a multi-axial strategy based on the social marketing of Family Medicine, the recognition of Family Medicine as a medical specialty and of Family Medicine as a gateway to national health system, the establishment of a quality approach in basic health centers and free practice offices (centers of health centers) and regular validation of the Family Medicine diploma.


Asunto(s)
Medicina General , Médicos Generales , África del Norte , Medicina Familiar y Comunitaria , Humanos , Atención Primaria de Salud
5.
Tunis Med ; 99(7): 693-705, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-35261000

RESUMEN

OBJECTIVES: Describe the 2020 report of the ARWU "Academic Ranking World Universities" classification and identify, accordingly, the roadmap of academic excellence, particularly in the countries of the Greater Maghreb. METHODS: This is an in-depth reading of the 2020 results of the ARWU bibliometric platform (launched in 2003) from top 1000 world-class universities. Six criteria were used in this ranking: 1. Alumni (10%): students who received Nobel / Fields prizes; 2. Award (15%): professors who have won the Nobel / Fields prizes; 3. HiCi (20%): Most cited scientists; 4. PUB (20%): number of publications 5. TOP (20%): proportion of publications in the most influential periodicals; 6. PCP (10%): Per Capita Performance. RESULTS: The 2020 ARWU ranking was characterized by the domination of the "Top 10" ranking by the United States, particularly the "Harvard University", the Asian boom of 55% of the "Top 1000" ranking (Chinese universities evolved from 16 in 2004 to 81 in 2020 in the "Top 500" list) and finally an African incubation of academic excellence, manifested by the selection of nine South African institutions (including the "University of Cape Town ", world rank between 201-300), and the re-entry for the first time of a Maghreb university in the" Top 1000 "list, Tunis El Manar (rank between 901-1000), with the following scores: N&S: 1 , 4; Pub: 26.1 and PCP: 10.3, for a total score of 37.8 points. CONCLUSION: This report proves once again, the promising academic perspectives of Asia and Africa in the inclusion of the "Top 1000" list of the ARWU ranking. The roadmap for academic excellence would thus be based on the triad of centering scientific publications, in prestigious journals and by national author networks.


Asunto(s)
Bibliometría , Universidades , África , Asia , Humanos , Publicaciones , Estados Unidos
6.
Tunis Med ; 99(8): 847-858, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-35261011

RESUMEN

OBJECTIVE: Describe the trend and the characteristics of the positioning of Maghreb medical production and its visibility, at the global, African and Arab level, following an in-depth reading of the Scimago platform, over a period of 25 years (1996-2020 ). METHODS: This is an in-depth reading, centered on the Maghreb, of the Maghreb medical production referenced on the Scimago platform, from 1996 to 2020. The bibliometric extracts were based on the number of published "documents" and the index H: number of articles (h) from a country having received at least h citations. The benchmarking of the productivity and medical visibility of the five Maghreb countries (Tunisia, Morocco, Algeria, Libya, Mauritania) was carried out at the global (237 countries), African (59 countries) and Arab (21 countries) level. RESULTS: Following the first African countries producing the most medical documents (South Africa, Egypt and Nigeria), the position of the Maghreb countries varied from 4 in Tunisia to 36 in Mauritania. In Arab countries, the position of medical production, dominated by Egypt and Saudi Arabia, was 12 and 18, successively in Algeria and Libya. The evolution of medical documents recorded a cross between Tunisia and Morocco in 2014, followed by a deceleration in Moroccan production. In the Maghreb, the h index varied from 154 in Tunisia to 29 in Mauritania. CONCLUSION: In addition to its weak position in the world, African and Arab rankings over the past 25 years, Maghreb medical research has been characterized by a major fluctuation. The "Alliance for Excellence" charter of the PRP2S Network, based on the promotion of university essays and electronic journals, constitutes an operational roadmap for the development of the production and visibility of research in the Maghreb.


Asunto(s)
Bibliometría , Investigación Biomédica , Argelia/epidemiología , Humanos , Marruecos/epidemiología , Túnez/epidemiología
7.
Tunis Med ; 99(12): 1156-1166, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-35288922

RESUMEN

OBJECTIVE: Describe the bibliometric profile of medical dissertations in Sousse Faculty of Medicine (SOFM) in Tunisia. METHODS: This is a cross-sectional bibliometric study of all dissertations defended from 2001 to 2005. The data were collected through a reading grid applied to the cover page, conclusion, and summary of the thesis. The specialty of the dissertation has been attributed to its first director. Themes were defined by the "essential descriptor", chosen from the descriptors used for the indexing. RESULTS: The 670 theses collected, all written in French except one in Arabic, were original, pedagogic or bibliographical works in respectively 93.3%, 6.4%, and 0.3% respectively. "Community and Preventive Medicine" was the discipline that generated the most theses with a proportion of 8.9%. About half (48%) of the dissertations were supervised by two directors. The first director was a University Hospital Professor or an Associate Professor of Conferences, respectively in 34% and 42% of cases. The chairman of the thesis jury belonged to the same specialty as the first director and was from the same department in respectively 54% and 41% of cases. Four "essential descriptors" were frequently cited as indexation of the dissertation: "tumor", "CD-Rom", "trauma", and "diabetes". These dissertations were "clinical" type in 68% of cases, of which around 80% were "case studies". CONCLUSION: The doctoral dissertation in SOFM was characterized by the orientation towards clinical and epidemiological research and the preference for general medicine and community health themes. It's often recourse to a basic research estimate and its writing in French would be two factors limiting its scientific promotion and its social influence.


Asunto(s)
Bibliometría , Medicina , Estudios Transversales , Docentes , Humanos , Túnez/epidemiología
8.
Tunis Med ; 98(10): 657-663, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-33479936

RESUMEN

OBJECTIVE: To compile the lessons learned in the Greater Maghreb, during the first six months of the fight against the COVID-19 pandemic, in the field of "capacity building" of community resilience. METHODS: An expert consultation was conducted during the first week of May 2020, using the "Delphi" technique. An email was sent requesting the formulation of a lesson, in the form of a "Public Health" good practice recommendation. The final text of the lessons was finalized by the group coordinator and validated by the signatories of the manuscript. RESULTS: A list of five lessons of resilience has been deduced and approved : 1. Elaboration of "white plans" for epidemic management; 2. Training in epidemic management; 3. Uniqueness of the health system command; 4. Mobilization of retirees and volunteers; 5. Revision of the map sanitary. CONCLUSION: Based on the evaluation of the performance of the Maghreb fight against COVID-19, characterized by low resilience, this list of lessons could constitute a roadmap for the reform of Maghreb health systems, towards more performance to manage possible waves of COVID-19 or new emerging diseases with epidemic tendency.


Asunto(s)
COVID-19/epidemiología , COVID-19/terapia , Atención a la Salud/organización & administración , Atención a la Salud/normas , Reforma de la Atención de Salud , África del Norte/epidemiología , Argelia/epidemiología , Actitud del Personal de Salud , Defensa Civil/métodos , Defensa Civil/organización & administración , Defensa Civil/normas , Participación de la Comunidad/métodos , Conflicto de Intereses , Atención a la Salud/estadística & datos numéricos , Técnica Delphi , Testimonio de Experto , Salud Global/normas , Reforma de la Atención de Salud/organización & administración , Reforma de la Atención de Salud/normas , Capacidad de Camas en Hospitales/normas , Capacidad de Camas en Hospitales/estadística & datos numéricos , Humanos , Mauritania/epidemiología , Programas Nacionales de Salud/organización & administración , Programas Nacionales de Salud/normas , Pandemias , Salud Pública/métodos , Salud Pública/normas , SARS-CoV-2/fisiología , Túnez/epidemiología
9.
Tunis Med ; 98(10): 664-673, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-33479937

RESUMEN

OBJECTIVE: Measure the overall and specific satisfaction rates of patients hospitalized in surgical services in Sahloul University Hospital in Sousse during the year 2018. METHODS: The study population was recruited by a quota sample of hospitalized patients in the surgical departments of Sahloul University Hospital in Sousse. Data collection was done via a patient satisfaction questionnaire, administered to outgoing patients. The questionnaire was composed of 33 items exploring technical, administrative, logistical and relational dimensions. Overall patient satisfaction, called "reactivity", was defined by a concomitant positive response to the three questions exploring satisfaction, recommendation and loyalty. RESULTS: A total of 735 patients hospitalized in six surgical departments were included (general surgery, orthopedics, maxillofacial surgery, urology, neurosurgery and cardiovascular surgery). The rates of "satisfaction", "recommendation" and "loyalty" of the patients were 71%, 70% and 69% respectively, equivalent to an "overall positive reactivity" of 62%, 95% CI [58,5%-65.5%], particularly low in the orthopedic department (43%). The logistics dimension was the least appreciated by patients, including room's condition, with almost 23% overall and 17% in the orthopedic department. CONCLUSION: The responsiveness of patients hospitalized in the surgical services of Sahloul University Hospital was low, particularly for items related to the hotel services in the hospital. Furthermore, plans to improve the quality of care and support the performance of public hospitals should pay close attention to the logistical dimension of patients' hospital stays.


Asunto(s)
Hospitalización/estadística & datos numéricos , Satisfacción del Paciente/estadística & datos numéricos , Procedimientos Quirúrgicos Operativos/estadística & datos numéricos , Adulto , Femenino , Hospitales Generales , Hospitales Universitarios , Humanos , Tiempo de Internación , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios , Túnez
10.
Tunis Med ; 98(12): 879-885, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33479988

RESUMEN

OBJECTIVE: Identify the lessons learned in the Greater Maghreb, during the first semester of the fight against the COVID-19 pandemic, in the field of response. METHODS: During the first week of May 2020, a consultation of experts was conducted, using the "Delphi" technique, through an email asking each of them, the drafting of a good practice recommendation for "Public health". The Group coordinator finalized the text of the lessons, later validated by the signatories of the manuscript. RESULTS: Five lessons of good «response¼ against epidemics have been deduced and approved by Maghreb experts, linked to the following aspects: 1. Total reservation of hospital beds for patients; 2. Clinical management of the response; 3. Discreet conflict of interest; 4. Community participation in the response; 5. Contextualization of the global fight strategy. CONCLUSION: Based on the finding of low relevance of the Maghreb response against COVID-19, this list of lessons would help support the performance of Maghreb health systems in the management of epidemics.


Asunto(s)
COVID-19/epidemiología , COVID-19/prevención & control , Defensa Civil/organización & administración , Defensa Civil/normas , Reforma de la Atención de Salud , África del Norte/epidemiología , Argelia/epidemiología , Actitud del Personal de Salud , Atención a la Salud/métodos , Atención a la Salud/organización & administración , Atención a la Salud/normas , Técnica Delphi , Reforma de la Atención de Salud/métodos , Reforma de la Atención de Salud/organización & administración , Reforma de la Atención de Salud/normas , Humanos , Control de Infecciones/métodos , Control de Infecciones/organización & administración , Control de Infecciones/normas , Mauritania/epidemiología , Programas Nacionales de Salud/organización & administración , Programas Nacionales de Salud/normas , Pandemias , Salud Pública/métodos , Salud Pública/normas , Administración en Salud Pública/métodos , Administración en Salud Pública/normas , SARS-CoV-2/fisiología , Túnez/epidemiología
11.
Tunis Med ; 98(8-9): 589-595, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33480011

RESUMEN

OBJECTIVE: To compile the lessons learned in the Greater Maghreb, during the first six months of the fight against the COVID-19 pandemic, in the field of preparation of health systems. METHODS: An expert consultation was conducted during the first week of May 2020, using the "Delphi" technique. An email was sent to them requesting the formulation of a lesson, in the form of a "Public Health" good practice recommendation. The final text of the lessons was finalized by the group coordinator and validated by the signatories of the manuscript. RESULTS: A list of five lessons for the preparation of the national health systems of the Greater Maghreb for the fight against epidemics, was deduced and approved: 1. Liberal health systems are incapable of managing epidemics; 2. The specialties of "Public Health" are often marginalized; 3. Health personnel in the Maghreb are doubly devalued; 4. Flagrant regional disparities in the field of health care are still observed; 5. A general shortage of preventive equipment and medical devices has been noted. CONCLUSION: Based on the evaluation of the performance of the Maghreb fight against COVID-19, characterized by the vulnerability of the preparation of health systems, this list of lessons could constitute a roadmap for the reform of health systems. Maghrebian health, towards more performance in managing possible waves of COVID-19 or new emerging diseases with epidemic tendency.


Asunto(s)
COVID-19/prevención & control , África del Norte/epidemiología , COVID-19/epidemiología , Humanos
12.
Clin J Gastroenterol ; 13(3): 408-412, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31758483

RESUMEN

Primary hepatic tuberculosis is a rare manifestation of extra-pulmonary tuberculosis even in highly endemic countries. The incidence of hepatic tuberculosis has increased in the recent years due to high prevalence of HIV/AIDS. Radiological imaging is an important tool for making the diagnosis, but often the imaging findings are non-specific and may mimic other benign or malignant hepatic diseases. We report a case of 54-year-old woman who was detected to have hepatic mass on radiological imaging which was misdiagnosed as hydatid cyst. Intraoperatively, the characteristic features of hydatid cyst were absent. A partial resection of this cystic mass was performed. Histopathological examination of the resected specimen revealed granulomatous inflammation consisting of histiocytes and Langhans-type giant cells surrounded by lymphocytes suggestive of hepatic tuberculosis. The patient was administered antitubercular therapy for 1 year. Repeat imaging on follow up showed disappearance of the hepatic lesion.


Asunto(s)
Equinococosis Hepática/diagnóstico , Tuberculosis Hepática/diagnóstico , Antituberculosos/uso terapéutico , Terapia Combinada , Errores Diagnósticos , Equinococosis Hepática/diagnóstico por imagen , Femenino , Hepatectomía , Humanos , Imagen por Resonancia Magnética , Persona de Mediana Edad , Radiografía , Tomografía Computarizada por Rayos X , Tuberculosis Hepática/diagnóstico por imagen , Tuberculosis Hepática/terapia
13.
Tunis Med ; 97(7): 833-841, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31872392

RESUMEN

OBJECTIVE: To describe the bibliometric characteristics of Tunisian publications in "General Surgery", indexed in "Medline" database from 2009 to 2018. METHODS: This is a bibliometric study conducted through a comprehensive documentary query applied to the "Pubmed" portal and using the "Medline" database. The essential themes of a publication have been defined by referring to its major keywords. RESULTS: A total of 173 publications were included in this study, representing a productivity rate of 14 articles / 100 surgeons' teachers-year. These publications were co-authored by 65 authors in first position and published by 55 journals in 15 countries, including mainly the national journal "Tunis Med" during the first five-year period 2009-2013 (27%) and the Ugandan magazine "Pan Afr Med J" during the second five-year period 2014-2018 (33%). Case reports were the most widespread type of publication in Tunisian "General Surgery", during the two periods of the study, respectively in 63% and 51% of cases. English was the major language with 57% of publications. Among the 259 major descriptors used to index the "General Surgery" articles, the occurrence of "Pancreatic Neoplasms" and "Echinococcosis, Hepatic" was respectively 3% and 2%. CONCLUSION: During the decade 2009-2018, the Tunisian research in "General Surgery" was not very prolific and was mainly "case reports" but it was directed toward population health problems; Hence the interest of a thorough training of surgeons in research methodology and scientific medical writing.


Asunto(s)
Cirugía General , Publicaciones Periódicas como Asunto/estadística & datos numéricos , Publicaciones/estadística & datos numéricos , Bibliometría , Humanos , MEDLINE , Túnez
14.
Tunis Med ; 97(6): 739-770, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31872406

RESUMEN

OBJECTIVE: To describe the epidemiology of cancers in terms of global burden of disease, incidence, prevalence and typology in the three Central Maghreb countries from 1990 to 2017, as well as their trends from 2017 to 2040. METHODS: This is a descriptive and predictive study of the epidemiology of cancers in the Central Maghreb (Tunisia, Algeria and Morocco) from 1990 to 2040. The epidemiological data: incidence, prevalence, specific mortality rate and Disability Adjusted Life Years were collected via the Global Burden of Disease Database created by the Institute of Heath Metrics and Evaluation. These parameters were expressed in terms per 100,000 inhabitants. RESULTS: In 2017 and for the three Central Maghreb countries, cancers represented the second leading cause of death, with an overall specific mortality rate of 69/100,000 and an overall incidence rate of 116/100,000 inhabitants. The Disability Adjusted Life Years rate varied from 1516/100,000 in Algeria to 1992/100,000 in Morocco. In the three Central Maghreb countries and during the year 2017, lung cancer was the first cancer in terms of mortality, regardless of age and sex, followed by colorectal cancer in Tunisia and breast cancer in Algeria and Morocco. These three cancers will remain in 2040 the most important in terms of mortality rate with lung cancer topping the list in Tunisia and Morocco with respective mortality rates of 30 and 16/100,000. CONCLUSION: Cancers are currently, and in the next two decades, an important component of the GlobalBurden of Disease in Central Maghreb countries. The typology is dominated by lung, breast and colorectal cancers. The establishment of a Maghreb cancer registry would be a fundamental component of the Maghreb cancer plan.


Asunto(s)
Neoplasias/epidemiología , Años de Vida Ajustados por Calidad de Vida , Argelia/epidemiología , Femenino , Humanos , Incidencia , Masculino , Marruecos/epidemiología , Neoplasias/mortalidad , Neoplasias/patología , Prevalencia , Túnez/epidemiología
15.
World J Surg Oncol ; 17(1): 173, 2019 Oct 28.
Artículo en Inglés | MEDLINE | ID: mdl-31660992

RESUMEN

BACKGROUND: The recurrence after curative surgery of the rectal adenocarcinoma is a serious complication, considered as a failure of the therapeutic strategy. The aim of this study was to identify the different prognostic factors affecting the recurrence of adenocarcinoma of the rectum. METHODS: A retrospective analysis of patients operated for adenocarcinoma of the rectum between January 2000 and December 2015 was conducted. The study of the recurrence rate and prognostic factors was performed through the Kaplan Meier survival curve and the Cox regression analysis. RESULTS: During the study period, 188 patients underwent curative surgery for rectal adenocarcinoma, among which 53 had a recurrence. The recurrence rate was 44.6% at 5 years. The multivariate analysis identified four parameters independently associated with the risk of recurrence after curative surgery: a distal margin ≤ 2 cm (HR = 6.8, 95% CI 2.7-16.6, 6), extracapsular invasion of lymph node metastasis (HR = 4.4, 95% CI 1.3-14), tumor stenosis (HR = 4.3, 95% CI 1.2-15.2), and parietal invasion (pT3/T4 disease) (HR = 3, 95% CI 1.1-9.4). CONCLUSION: The determination of the prognostic factors affecting the recurrence of rectal adenocarcinoma after curative surgery allows us to define the high-risk patients for recurrence. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03899870 . Registered on 2 February 2019, retrospectively registered.


Asunto(s)
Adenocarcinoma/cirugía , Recurrencia Local de Neoplasia/epidemiología , Neoplasias del Recto/cirugía , Adenocarcinoma/mortalidad , Adenocarcinoma/patología , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Modelos de Riesgos Proporcionales , Neoplasias del Recto/mortalidad , Neoplasias del Recto/patología , Estudios Retrospectivos
16.
Int J Surg Case Rep ; 64: 94-96, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31622934

RESUMEN

INTRODUCTION: Patients with appendicular endometriosis (AE) constitute <1% cases of all pelvic endometriosis cases. AE presents with pain in right iliac fossa and symptomatically mimics appendicitis and definitive diagnosis is possible only after histopathological examination of excised appendix. PRESENTATION OF CASE: In this case report, we present a rare case of appendicular endometriosis in a young woman suffering from pain in right iliac fossa and periumbilical region (on/off) for the past one year. She had a past history of infertility. Blood investigations were normal and CT scan of abdomen demonstrated findings suggestive of appendicitis. Laparoscopic appendicectomy was performed, which revealed 2 cm tumor-like mass (1.5 cm diameter) present at the tip of appendix involving the mesoappendix. There was no ascites, peritoneal or omental deposits or any signs of inflammation. Post-operative recovery was good. Dissected appendix specimen was sent for histopathological examination which confirmed endometriosis of appendix. DISCUSSION: Gastrointestinal endometriosis (GE) accounts for 3-37% of all endometriosis cases, whereas AE is present in only ∼3% of all GE cases and constitutes <1% of all the endometriosis cases. AE frequently involves tip and body of the appendix. The layers of appendix most commonly affected are muscular and seromuscular (∼2/3rd cases), followed by the serosa (∼1/3rd cases). CONCLUSION: Thus, appendicular endometriosis is a rare entity and should be included in differential diagnosis in young women presenting with pain in right iliac fossa and having history of infertility.

17.
Int J Surg Case Rep ; 60: 66-68, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31203002

RESUMEN

INTRODUCTION: Omentum is a well vascularized organ. Omentum infarction is uncommon. Most of the cases are secondary due to torsion, intra-abdominal infections and vascular thrombosis. Primary idiopathic segmental omental infarction is rare. PRESENTATION OF CASE: A 26-year-old male presented with acute onset right iliac fossa pain mimicking acute appendicitis. On radiological imaging, early acute appendicitis was suspected. On diagnostic laparoscopy, appendix appeared normal and there was idiopathic infarction of a part of the greater omentum lying close to the cecum. Patient underwent laparoscopic appendectomy with excision of the diseased segment of the omentum and had uneventful recovery. CONCLUSION: Idiopathic omental infarction should be included in the differential diagnoses while treating patient with acute abdomen.

18.
Tunis Med ; 97(12): 1316-1325, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-32173799

RESUMEN

OBJECTIVE: To describe the bibliometric profile of Tunisian "case report" publications in general surgery over the last thirty years (1989-2018). METHODS: This is a descriptive bibliometric study on "case reports", general surgery, Tunisian affiliation, indexed in the Medline database, between January 1, 1989 and December 31, 2018. The themes of Search articles were defined by referring to their major keywords used for their indexing. RESULTS: During 30 years of study, Medline indexed 188 papers in "General Surgery" type "case reports", signed by 80 authors in first position and 71 authors in last position, belonging to ten academic specialties and 19 professional affiliations. These papers were published by 60 journals, including the Ugandan magazine "Pan African Medical Journal", which published 23% of these "case reports" alone. The number of major indexing keywords was 299 words, mainly "Echinococcosis", "Pancreatic Cancers" and "Echinococcosis of the liver", together accounting for 18.1% of articles. CONCLUSION: The plethora of "case reports" in Tunisian general surgery publications over the last three decades was accompanied by a preferential edition in the journal "Pan Afr Med J" and a thematic focus on hydatid cysts and cancers pancreatic. Hence the importance of strengthening the capacity of Tunisian surgeons in research methodology and scientific medical writing.


Asunto(s)
Bibliometría , Cirugía General/estadística & datos numéricos , Escritura Médica , Publicaciones , Bibliometría/historia , Investigación Biomédica/historia , Investigación Biomédica/estadística & datos numéricos , Manejo de Caso/historia , Manejo de Caso/estadística & datos numéricos , Cirugía General/historia , Cirugía General/organización & administración , Cirugía General/normas , Historia del Siglo XX , Historia del Siglo XXI , Humanos , Factor de Impacto de la Revista , MEDLINE/historia , MEDLINE/estadística & datos numéricos , Escritura Médica/historia , Publicaciones/historia , Publicaciones/estadística & datos numéricos , Publicaciones/provisión & distribución , Edición/historia , Edición/estadística & datos numéricos , Túnez/epidemiología
19.
Int J Surg Case Rep ; 34: 126-129, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28391172

RESUMEN

INTRODUCTION: Bronchogenic cysts are congenital cysts arising as an abnormal budding from primitive tracheobronchial tree. They are lined by pseudostratified columnar or cuboidal ciliated epithelium and contain smooth muscle fibers, submucosal bronchial glands and/or cartilage. They are most frequently located in the mediastinum or the lung parenchyma. Intramural occurrence of bronchogenic cyst in the gastric wall is very rare. PRESENTATION OF CASE: We present a case of 65-year-old lady with a 7×8cm lesion in the gastric cardia suspicious of gastrointestinal stromal tumor. Because of the large size, total gastrectomy with Roux-en-Y esophagojejunal anastomosis was performed. The postoperative course was uneventful. Histopathological examination revealed a sub-mucosal cyst lined by PCCE with presence of smooth muscle fibers and focal mucous glands. Final diagnosis of bronchogenic cyst was made. On the last follow up at one year, she was symptom free. DISCUSSION: On extensive Medline/Pubmed search, only 38 cases of gastric bronchogenic cysts were found to be reported till date. They are typically located in the posterior gastric wall close to the gastric cardia. On radiological imaging, they appear as well defined intramural cystic lesion without any characteristic features. Surgical resection is considered in symptomatic cases or in case of diagnostic dilemma. CONCLUSION: Gastric bronchogenic cysts often mimic gastrointestinal stromal tumor on preoperative imaging. They should be included in the differential diagnosis while dealing with an intramural gastric lesion close to the cardia or gastroesophageal junction.

20.
Libyan J Med ; 12(1): 1260886, 2017 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-28452603

RESUMEN

BACKGROUND: Music therapy, an innovative approach that has proven effectiveness in many medical conditions, seems beneficial also in managing surgical patients. The aim of this study is to evaluate its effects, under general anesthesia, on perioperative patient satisfaction, stress, pain, and awareness. METHODS: This is a prospective, randomized, double-blind study conducted in the operating theatre of visceral surgery at Sahloul Teaching Hospital over a period of 4 months. Patients aged more than 18 undergoing a scheduled surgery under general anesthesia were included. Patients undergoing urgent surgery or presenting hearing or cognitive disorders were excluded. Before induction, patients wore headphones linked to an MP3 player. They were randomly allocated into 2 groups: Group M (with music during surgery) and group C (without music). Hemodynamic parameters, quality of arousal, pain experienced, patient's satisfaction, and awareness incidence during anesthesia were recorded. RESULTS: One hundred and forty patients were included and allocated into 2 groups that were comparable in demographic characteristics, surgical intervention type and anesthesia duration. Comparison of these two groups regarding the hemodynamic profile found more stability in group M for systolic arterial blood pressure. A calm recovery was more often noted in group M (77.1% versus 44%, p < 10-3). The average Visual Analog Scale (VAS) score was lower in the intervention group (33.8 ± 13.63 versus 45.1 ± 16.2; p < 10-3). The satisfaction rate was significantly higher among the experimental group (81.4% versus 51.4%; p < 10-3). The incidence of intraoperative awareness was higher in group C (8 cases versus 3 cases) but the difference was not statistically significant. CONCLUSION: Music therapy is a non-pharmacological, inexpensive, and non-invasive technique that can significantly enhance patient satisfaction and decrease patients' embarrassing experiences related to perioperative stress, pain, and awareness.


Asunto(s)
Abdomen/cirugía , Musicoterapia/métodos , Método Doble Ciego , Femenino , Hemodinámica , Humanos , Masculino , Satisfacción del Paciente , Estudios Prospectivos , Resultado del Tratamiento
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