Oral manifestations of Behçet's disease.

INTRODUCTION: Behçet's disease is a chronic vasulitis. The aphtous stomatitis is present in nearly the totality of patients having this disease. AIM: The purpose of this study was to evaluate the oral health of Behcet's disease (BD) patients and then compare it with healthy controls. METHODS: Twenty patients with BD and 20 healthy subjects were included in this cross-sectional study conducted at the military hospital of Bizerta from 01/10/2017 to 31/05/2019. The level of plaque were recorded using the plaque index (PI). The gingival index (GI) was used to evaluate the gingival inflammation. The depths of the sulci/pockets were probed with a periodontal probe. The clinical attachment loss (CAL) was measured from the cementoenamel junction to the sulcus base. The caries status was scored by using DMFT introduced by Klein and Palmer.The diagnosis of oral lesions was performed using the visual tactile examination. RESULTS: The two groups were age, sexe, and socioeconomic level matched. The percentage of oral ulcers was observed to be higher in BD patients compared with healthy controls (40% Vs 5%, p0.01). Statistical significant differences in the two groups' PI (1,19±0,38 Vs 0,86±0,37 ; p=0,011) and GI (1,10±0,30 Vs 0,75±0,36 ; p=0,03) were observed. The probing depth, the CAL and the DMF/T showed no associations with the BD. CONCLUSION: Our results showed that gingival health is worse in BD patients. Therfore, the dentist must play an important part in the management of BD and the motivation for the oral hygiene.

Trends in Adult and Elderly Vaccination: Focus on Vaccination Practices in Tunisia and Morocco.

Vaccine preventable diseases (VPDs) are a prevailing concern among the adult population, despite availability of vaccines. Unlike pediatric vaccination programs, adult vaccination programs lack the required reach, initiative, and awareness. Clinical studies and real-world data have proven that vaccines effectively reduce the disease burden of VPDs and increase life expectancy. In Tunisia and Morocco, the national immunization program (NIP) focuses more on pediatric vaccination and have limited vaccination programs for adults. However, some vaccination campaigns targeting adults are organized. For example, influenza vaccination campaigns prioritizing at risk adults which includes healthcare professionals, elderly, and patients with comorbidities. Women of childbearing age who have never been vaccinated or whose information is uncertain are recommended to receive tetanus vaccination. Tunisia NIP recommends rubella vaccine mainly for women of childbearing age, while in Morocco, national vaccination campaigns were organized for girls and women (up to 24 years of age) to eliminate rubella. Further, travelers from both countries are recommended to follow all requirements and recommendations in the travel destination. The objective of this manuscript is to provide an overview of the global disease burden of common VPDs including (but not limited to) meningococcal diseases, pneumococcal diseases, hepatitis, and influenza. The review also provides an overview of clinical data and guidelines/recommendations on adult vaccination practices, with special focus on Tunisia and Morocco. Some European and North American countries have concrete recommendations and strategies for adult vaccination to keep the VPDs in check. In Morocco and Tunisia, although, there are sporadic adult vaccination initiatives, the efforts still need upscaling and endorsements to boost vaccination awareness and uptake. There is a need to strengthen strategies in both countries to understand the disease burden and spread awareness. Additional studies are needed to generate economic evidence to support cost-effectiveness of vaccines. Integration of private and public healthcare systems may further improve vaccination uptake in adults.

Determinants of metabolic syndrome: a population survey at Bizerte military garrison in 2015-2017.

INTRODUCTION: Metabolic syndrome (MetS) is a worldwide major public health problem. In Tunisia, few studies have focused on MetS in general population and in military setting in particular. AIM: To determine the prevalence of the MetS in a military population at Bizerte garrison (Tunisia) and to identify its associated factors. METHODS: An analytical cross sectional study was conducted in Bizerte military garrison during the period 2015-2017. The study population was the active military persons who were presents during the time of the survey and assigned at the three main navy, air force and army units of Bizerte garrison. The adopted definition for the diagnosis of MetS was the International Diabetes Federation 2005 (IDF 2005). Multivariate analysis using a binary logistic regression model to identify independent factors to MetS (variable of interest) was performed. Data entry and analysis were performed using SPSS 20.0 Software. RESULTS: During the study period, 2500 active military were enrolled among them 2418 men. The mean age was 36.6 ± 9.1 years [20.0 - 59.0]. The prevalence of MetS was 17.7%. MetS was significantly higher among participants aged 40 and above, (23.8% vs 13.1%), single (21.6% vs 13.7%), diabetic (38.5% vs 15.5%), and assigned in the air force (23.1% vs 14.6%) compared to the rest of the study population. The independent factors identified in multivariate analysis were age, armed forces' affiliation and marital status. CONCLUSION: The prevalence of MetS in our military population was relatively high despite of the medical criteria imposed before incorporation. Population and targeted approach are needed to prevent this scourge and to protect from the complications.

Association Between Thrombophilic Gene Mutations and the Risk of Vascular Access Thrombosis in Hemodialysis Patients.

The cause of thrombosis in hemodialysis vascular access is considered to be of a multifactorial nature, including stenosis of the venous or arterial connection. Therefore, identification of relevant thrombotic risk factors could lead to an improved antithrombotic therapy. This case control study was performed to evaluate the relationship between Factor V (G1691A and A4070G) and Factor II polymorphisms and vascular access thrombosis in hemodialysis patients. One hundred and twenty-one patients undergoing dialysis were selected as subjects. This sample was divided into two groups; a case group of 60 patients who had sustained one or more thrombotic events that resulted in vascular access failure and a control group of 61 patients, who never had a thrombotic occlusion of a functioning permanent dialysis access. Our data demonstrated a significantly increased risk of vascular access thrombosis in carriers of the mutant FV (G1691A and A4070G) polymorphisms (P < 0.05).Further studies on a large-scale population and other genetic variants will be needed to find candidate genes for vascular access thrombosis in hemodialysis patients.