[Ditrovie scale: Translation and validation in standard Arabic]. / Échelle Ditrovie : traduction et validation en langue arabe standard.

OBJECTIVES: Our work aimed to translate Ditrovie scale into standard Arabic and to verify its validity and reliability in the Tunisian population. MATERIALS: The translation-retro-translation method was the chosen translation method. The committee of experts analyzed these versions and elaborated a pre-final version The Arabic version obtained was conducted on a sample of 100 patients with idiopathic overactive bladder. The reliability of the scale was verified by Cronbach's alpha coefficient and intraclass correlation coefficient. RESULTS: The feasibility and acceptability of the scale was good. The Cronbach's alpha was 0.86. The reproducibility of our scale as well as of each domain were very good (intraclass correlation coefficient>0.9) with a mean of the differences centered and homogeneous in the Bland and Altman graph. CONCLUSION: The standard Arabic version of the Ditrovie scale is a reliable instrument with satisfactory psychometric properties allowing evaluation of quality of life of patients with idiopathic overactive bladder. LEVEL OF EVIDENCE: B.

[Anti-D prophylaxis in fetal-maternal erythrocyte incompatibility in Tunisia]. / Prophylaxie anti-D dans l'incompatibilité fœto-maternelle érythrocytaire en Tunisie.

Generalization of postnatal prophylaxis using anti-D immunoglobulins decreased the incidence of erythrocyte fetal-maternal incompatibility (EFMI) in the Rhesus system. Few recent studies have investigated the situation of anti-D prophylaxis in Tunisia and its effects on maternal and neonatal health. The aim of this study was therefore to analyze the situation of anti-D prophylaxis in Tunisia to detect defects and propose solutions. We conducted a retrospective descriptive study of IFME cases in the rhesus system in the Department of Medicine and Neonatal Resuscitation of the Tunis Maternity and Neonatology Center (CMNT) during an 8-year period from 1 January 2006 to 31 December 2015. We collected 51 cases of IFME. The prevalence of IFME was 3.4 per 10 000 live births; 41 % of the patients were transferred in utero and they were from the northwest of the country (17 %). The rate of women with a history of at least one spontaneous miscarriage (SCF) was 45 %. In 42 % of the cases, pregnancies were monitored at local clinics. The search for irregular agglutinins (RAI) was performed in 86 % of the women studied. RAI was positive in 97 % of the cases. Anti-D prophylaxis was correctly performed in only 27 % of the cases. The systematic prophylaxis of the third trimester and a systematic Kleihauer test must be combined with postpartum prophylaxis to better identify dysfunctions and improve the application of the recommendations.

Total knee arthroplasty in a spinal cord-injured patient: a case report.

Patients with spinal cord injuries are prone to knee hydrarthrosis (also known as "water on the knee"), which can cause pain, functional impairment and the restriction of social activities. Total knee arthroplasty is a potentially appropriate treatment. Here, we report on a patient presenting partial T12 AIS grade C paraplegia who was able to walk with two forearm crutches, an ankle-foot orthosis on the right leg and a knee-ankle-foot orthosis on the left leg. Thirteen years after the spinal cord injury, the patient presented with septic arthritis of the right knee, complicated by recurrent hydrarthrosis during standing and walking. Arthroscopy revealed advanced osteoarthritis. Total knee arthroplasty was performed, with very good functional and social outcomes two and half years after surgery.

Botulinum toxin and refractory non-neurogenic overactive detrusor.

PURPOSE: To study the value and efficacy of botulinum toxin for treatment of cases of non-neurogenic detrusor overactivity (NNDO) that are refractory to anticholinergic drugs. MATERIALS AND METHODS: A systematic review of the literature, based on a keyword search of the Medline database. Selection of articles in French and English (meta-analyses, reviews, case studies and randomized, controlled clinical trials) on intradetrusor botulinum toxin injection in the management of refractory NNDO. RESULTS: Nineteen publications (including three randomized, controlled trials) were selected. Intradetrusor injection of botulinum toxin in patients with refractory NNDO has produced promising results, with a significant improvement in physical symptoms, urodynamic parameters and quality of life. The rare side effects consist primarily of dose-dependent urine retention. CONCLUSION: On the basis of preliminary data, botulinum toxin appears to be a valuable therapeutic option and fills the gap between anticholinergics and surgery in the treatment of NNDO that is refractory to anticholinergic agents. Botulinum toxin has a promising future in urology but requires further scientific evaluation.