[Tamponade reveals an intra-pericardial hydatid cyst - a case report]. / Tamponnade révélant un kyste hydatique intra-péricardique - un cas.

INTRODUCTION: Hydatid disease is a parasitic infection caused by the development of the larval form of the Teania of Echinococcus granulosus. It is endemic in many regions of the world such as the Mediterranean basin. Location without pericardial cardiac involvement is extremely rare. In this case study, we will elaborate the case of an intra-pericardial hydatidosis disease without cardiac location revealed by a tamponade. OBSERVATION: AA is a 60-year-old man with no pathological history and who was admitted for a tamponade assessment. Indeed, the cardiovascular examination showed a muffling of the heart sound and signs of a right heart failure. Besides, the ECG shows a microvoltage, and the chest radiography shows cardiomegaly. Moreover, the transthoracic echocardiogram confirmed the presence of an abundant pericardial effusion along with signs of a tamponade. It also reifies the presence of, at the intra-pericardial level, a multiple vesicular formation giving a cluster of grapes highly suggestive of an intra-pericardial hydatid disease. An emergency surgical drainage allowed removing about two liters of suspicious fluid along with cysts and white membranous. The pathological examination of the membranous confirmed the diagnosis of a pericardial hydatid cyst. The performance of a chest CT and an abdominal ultrasound's scan to identify other locations shows no further anomalies. The patient was put under medical treatment (Albendazole(®)) and is showing a good clinical improvement. CONCLUSION: The intra-pericardial hydatid disease is another cause of tamponade not to fail despite its rareness, as it is endemic to North African countries.

Diabetes and hospital morbidity in the Monastir governorship (Tunisia).

Diabetes is a public health problem worldwide. In Tunisia, the rate of prevalence is 3.8% in urban areas and 1.3% in rural areas, whereas the socioeconomic impact of the disease has rarely been investigated. This study conducted in the Monastir health district evaluated the burden of hospital care for diabetes. All admissions for diabetes (973) recorded in the regional morbidity register during 1993 for all public hospitals in the region were taken into consideration. Admission for diabetes represented 5.9% of total admissions and was the first cause of hospitalisation. The university hospital centre received 40% of these patients. The annual hospital rate of diabetes is estimated to be 2.7%, but varies according to the district considered and the age of patients (1.1% for those under 50 years of age and 12.8% for those over 65). The number of days of hospitalization related to diabetes was 10,069, i.e. 7.6% of the total for the district. The mean cost of a single hospitalization is about 251 Tunisian dinars (US$251). Diabetes treatment could be improved and the cost lowered by providing appropriate ambulatory care and health education to reduce hospital admissions.

[Evaluation of mothers' knowledge in pre- and postnatal preventive care in the Tunisian Sahel]. / Evaluation des connaissances des mères concernant les soins préventifs pré et postnatals dans le Sahel tunisien.

Maternal and child health is one of the major concerns of public health throughout the world. Health education and increased knowledge of mothers in relation to their health is a strategy of choice adopted in many countries for improving maternal and child health. It is within this framework that this action is being carried out, which aims to evaluate the knowledge of mothers in the area of preventive care for women. A cross-sectional survey was carried out among 915 parturient women from the Monastir region (coastal region of Tunisia) at the time of delivery, between May 1 and July 26, 1996. The survey was based on a questionnaire that explores, in addition to the socio-demographic characteristics of parents, the level of surveillance during pregnancy and mothers' knowledge in relation to preventive care of women. The majority of women (95%) are aware of the importance of prenatal surveillance, yet 12% don't have any knowledge of the recommended number of prenatal visits. Concerning contraception, the tetanus vaccination and the post-natal consultation, knowledge concerning their importance is high, but practice in these areas is not. Roughly only 1/3 of mothers used contraception before their current pregnancies, and only 70% had both doses of the tetanus vaccination. Health education on preventive care received by the mothers helps increase knowledge and probably practices as well. The increase in mothers' knowledge happens with appropriate initial and continued training in health education, provided by health professionals and with the reinforcement of educational activities during each contact with the mother both during her pregnancy and in periods where she isn't pregnant.

[Value of vaccination data analysis at the district level]. / Intérêt de l'analyse des données de vaccination à l'échelle du district.

This study aimed to demonstrate the importance of analysing local immunization data to improve performance of national prevention programmes. From the immunization registers kept in basic health centres, we identified 1271 children receiving their first vaccine at 3 months. Examination of the age at the subsequent vaccinations and time intervals between vaccinations showed that 81.9% had received all the vaccines required by the Ministry of Health but only 48.5% had received immunization meeting the requirements for age and time interval. The analysis also helped identify health centres with best performance (fewer children lost to follow-up and better implementation of immunization schedule) and those vaccinations needing the greatest attention from health professionals.