1
|
Bellali M, Zaara MA, Belhaj A, Rammeh S, Hamdoun M, Benkhelil M. Fatal cerebral sinus thrombosis associated with diabetic ketoacidosis in a child. Forensic Sci Med Pathol 2023; 19:221-223. [PMID: 37222904 DOI: 10.1007/s12024-023-00647-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2023] [Indexed: 05/25/2023]
Abstract
Cerebral sinus thrombosis (CST) is an uncommon condition in children with a variable clinical presentation which has rarely been described in the setting of diabetic ketoacidosis. We present the case of 14-year-old child in whom lateral sinus thrombosis was caused by dehydration complicating ketoacidosis in a previously undiagnosed type 1 diabetes. The diagnosis of the CST was established during the autopsy due to the rapidity of the neurological deterioration. The cause of death was tonsillar herniation due to diffuse cerebral edema secondary to CST. This is the first published report of a CST in association with new onset type 1 diabetes in a child diagnosed at the postmortem examination.
Collapse
Affiliation(s)
- Mohamed Bellali
- Department of Forensic Medicine, Charles Nicolle Hospital, Tunis, Tunisia.
| | | | - Azza Belhaj
- Department of Forensic Medicine, Charles Nicolle Hospital, Tunis, Tunisia
| | - Soumaya Rammeh
- Department of Pathology, Charles Nicolle Hospital, Tunis, Tunisia
| | - Moncef Hamdoun
- Department of Forensic Medicine, Charles Nicolle Hospital, Tunis, Tunisia
| | - Mehdi Benkhelil
- Department of Forensic Medicine, Charles Nicolle Hospital, Tunis, Tunisia
| |
Collapse
|
2
|
Ben Ahmed H, Bellali M, Allouche E, Allouche M, Belhadj A, Ben Khelil M, Shimi M, Razghallah R, Banasr A, Benzarti A, Bezdah L, Hamdoun M. [Circadian and septadian variation in sudden cardiac death : Autopsy registry of the Tunisian North]. Ann Cardiol Angeiol (Paris) 2023; 72:101597. [PMID: 37075563 DOI: 10.1016/j.ancard.2023.101597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 02/26/2023] [Accepted: 03/21/2023] [Indexed: 04/21/2023]
Abstract
INTRODUCTION Several studies have suggested a circadian and septadian pattern of incidence of sudden cardiac death with a morning peak and a Monday peak. OBJECTIVE To analyze the circadian and septadian pattern of occurrence of sudden cardiac death in the eight northern Tunisian governorates. METHODS We prospectively collected epidemiological and autopsy data of sudden cardiac death victims occurring in the northern region of Tunisia between January 2013 and December 2019. RESULTS The population included 1834 men (79.6%) and 468 women (20.4%) with a mean age of 56.5 ± 14 years. Smoking (53.9%) was the most prevalent cardiovascular risk factor. One-fifth (20.9%) of victims had known heart disease, and 3% had a family history of sudden death. ischemic heart disease was the leading cause of sudden death (46.8% of cases). One- fourth (25.7%) of autopsies were negative. Analysis of the circadian pattern of occurrence of sudden cardiac death identified a peak (36.1%, p < 0.001) between midnight and 6 am. This nocturnal excess mortality was significant (p < 0.001) and independent of sex (34.1 % in men and 43.8 % in women) and cause of death (39.3 % of cases of sudden ischemic death and 33.3 % of cases of nonischemic death). Moreover, there was a significant septadian variability in the occurrence of sudden death (p: 0.0015), with a peak on Friday (15.8 %, p: 0.042). CONCLUSION This study showed a peak of sudden death between midnight and 6 am, and on Fridays, confirming the modification of the classic circadian and septadian pattern of sudden death occurrence. These results may help optimize the deployment of emergency mobile teams and structures during the most vulnerable periods.
Collapse
Affiliation(s)
- H Ben Ahmed
- Service de cardiologie, Hôpital Charles Nicolle, Tunis. Faculté de Médecine, Université Tunis El Manar 2092-Tunis, Tunisie
| | - M Bellali
- Service de Médecine Légale Hôpital Charles Nicolle, Tunis. Faculté de Médecine, Université Tunis El Manar 2092-Tunis, Tunisie
| | - E Allouche
- Service de cardiologie, Hôpital Charles Nicolle, Tunis. Faculté de Médecine, Université Tunis El Manar 2092-Tunis, Tunisie.
| | - M Allouche
- Service de Médecine Légale Hôpital Charles Nicolle, Tunis. Faculté de Médecine, Université Tunis El Manar 2092-Tunis, Tunisie
| | - A Belhadj
- Service de Médecine Légale Hôpital Charles Nicolle, Tunis. Faculté de Médecine, Université Tunis El Manar 2092-Tunis, Tunisie
| | - M Ben Khelil
- Service de Médecine Légale Hôpital Charles Nicolle, Tunis. Faculté de Médecine, Université Tunis El Manar 2092-Tunis, Tunisie
| | - M Shimi
- Service de Médecine Légale Hôpital Charles Nicolle, Tunis. Faculté de Médecine, Université Tunis El Manar 2092-Tunis, Tunisie
| | - R Razghallah
- Service de cardiologie, Hôpital Charles Nicolle, Tunis. Faculté de Médecine, Université Tunis El Manar 2092-Tunis, Tunisie
| | - A Banasr
- Service de Médecine Légale Hôpital Charles Nicolle, Tunis. Faculté de Médecine, Université Tunis El Manar 2092-Tunis, Tunisie
| | - A Benzarti
- Service de Médecine Légale Hôpital Charles Nicolle, Tunis. Faculté de Médecine, Université Tunis El Manar 2092-Tunis, Tunisie
| | - L Bezdah
- Service de cardiologie, Hôpital Charles Nicolle, Tunis. Faculté de Médecine, Université Tunis El Manar 2092-Tunis, Tunisie
| | - M Hamdoun
- Service de Médecine Légale Hôpital Charles Nicolle, Tunis. Faculté de Médecine, Université Tunis El Manar 2092-Tunis, Tunisie
| |
Collapse
|
3
|
Belhadj A, Shimi M, Kort I, Zaara MA, Hamdoun M, Ben Khelil M. Risk factors of sudden cardiac death in women: A 10 years study in Tunisia. J Forensic Leg Med 2023; 96:102517. [PMID: 37004373 DOI: 10.1016/j.jflm.2023.102517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 02/17/2023] [Accepted: 03/25/2023] [Indexed: 03/30/2023]
Abstract
BACKGROUND Sudden cardiac death (SCD) represents a frequent etiology of sudden death. It represents a major public health issue. Few data about SCD in women are available from the Arab world. Our work aimed to analyze the risk factors of sudden cardiac death in Tunisian women in comparison with men. METHODS A cross-sectional retrospective study including all sudden cardiac death cases, conducted in the Forensic Medicine Department of the main teaching hospital of Tunis, between January 2010 and December 2019. RESULTS We counted 417 cases of sudden cardiac death in women representing 17.5% of the total number of sudden cardiac deaths recorded during the study period. The average age was 60.03 ± 15.01 years with a predominance of urban married women. The most frequent cardiac risk factors were high blood pressure (50%), diabetes (36.2%), and cardiac disease history (34.2%). Predominately married women with a history of High blood pressure and diabetes, had a high predictive of sudden cardiac death. CONCLUSION Cardiac sudden death is no longer a male focused issue. As a matter of facts Rates of SCD in women are rising with a different pattern. We will highlight the importance of adopting specific preventive measures of SCD in female.
Collapse
|
4
|
Khalfallah M, Kort I, Hamdoun M, Nouira R, Allouche M. Ordinal disciplinary responsibility of the certifying physician. Tunis Med 2023; 101:299-305. [PMID: 37682276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Indexed: 09/09/2023]
Abstract
NTRODUCTION Writing medical certificates is part of the doctor's daily practice. AIM To analyze the complaints related to medical certificates filed to the Regional Council of the Order of Doctors (RCOD) of Tunis and to identify the predictive factors of disciplinary sanctions. METHODS We collected the complaints filed to the RCOD of Tunis between 01/01/2017 and 31/12/2017, in relation to a problem with the establishment and/or the issuance of medical certificates by registered certifying doctors at RCOD, Tunis. RESULTS We collected 32 complaints, the reason for which was a certificate of convenience in 88% of cases, a drafting error in 9% of cases and a fee problem in 3% of cases. The decision of the RCOD was a closing of the file in 56% of cases, a call to order in 28% of cases and a temporary ban on practicing medicine in 16% of cases.The multivariate analysis with logistic regression identified one independent predictor of a call to order or a sanction from the RCOD, namely the fact that the doctor did not bring the file of the patient(s) having been the subject of the complaint, at the time of his invitation to RCOD Tunis (p=0.037, OR=22.66). CONCLUSION The doctor must always keep a medical form or a patient file, which will allow him to justify himself in the event of a complaint against him, for the reason of a certificate of convenience.
Collapse
Affiliation(s)
- Mehdi Khalfallah
- Service de Chirurgie générale B23, hôpital Charles-Nicolle, Tunis, Tunisie. / Faculté de Médecine de Tunis, Université Tunis El Manar, Tunis, Tunisie
| | - Ikram Kort
- Service de médecine légale, hôpital Charles-Nicolle, Tunis, Tunisie
| | - Moncef Hamdoun
- Service de médecine légale, hôpital Charles-Nicolle, Tunis, Tunisie
| | - Ramzi Nouira
- Service de médecine légale, hôpital Charles-Nicolle, Tunis, Tunisie
| | - Mohamed Allouche
- Service de médecine légale, hôpital Charles-Nicolle, Tunis, Tunisie
| |
Collapse
|
5
|
Saadi A, Mokadem S, Chakroun M, Hermi A, Boussaffa H, Ayed H, Allouche M, Bouzouita A, Derouiche A, Ben Slama MR, Hamdoun M, Chebil M. A cadaveric anatomical study: anatomy and anatomical variations of left adrenal vein. Surg Radiol Anat 2022; 44:689-695. [PMID: 35362770 DOI: 10.1007/s00276-022-02930-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 03/15/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE Control of adrenal vein is the key of adrenal surgery. Its anatomy can present variations. Our aim was to study the anatomy of the main left adrenal vein (LAV) and its anatomical variations. METHODS Our work is based on dissection of 40 cadavers. We studied the number of LAV and the drainage of the main adrenal vein as well as its level of termination. We measured its length, its width and the distance between its termination level and the termination level of the gonadal vein (GV). RESULTS The average length of the LAV was 21 mm its mean width was 5 mm. It ended in 100% of cases at the upper edge of the left renal vein after an anastomosis with the lower phrenic vein in 36 cases (90%) and without anastomosis with the lower phrenic vein in four cases (10%). The left adrenal vein ended at the upper edge of the left renal vein either at the same level as the termination of the left GV in 14 cases (35%) or within the termination of the left GV in 26 cases (65%) by an average of 8 mm. The LAV was unique central vein in 22 cases (55%) and in 12 cases (30%), a major central adrenal vein with several small veins was found. CONCLUSIONS The LAV is usually unique but there are variations in number. There are also variations in the level of its termination in the left renal vein as well as its anastomosis. During surgery, in case of difficulty, the left GV and the adrenal-diaphragmatic venous trunk could be used as benchmarks.
Collapse
Affiliation(s)
- Ahmed Saadi
- Faculty of Medecine Of Tunis, Charles Nicolle Hospital, Urology Department, University of Tunis El Manar, Tunis, Tunisia.
| | - Seif Mokadem
- Faculty of Medecine Of Tunis, Charles Nicolle Hospital, Urology Department, University of Tunis El Manar, Tunis, Tunisia
| | - Marouene Chakroun
- Faculty of Medecine Of Tunis, Charles Nicolle Hospital, Urology Department, University of Tunis El Manar, Tunis, Tunisia
| | - Amine Hermi
- Faculty of Medecine Of Tunis, Charles Nicolle Hospital, Urology Department, University of Tunis El Manar, Tunis, Tunisia
| | - Hamza Boussaffa
- Faculty of Medecine Of Tunis, Charles Nicolle Hospital, Urology Department, University of Tunis El Manar, Tunis, Tunisia
| | - Haroun Ayed
- Faculty of Medecine Of Tunis, Charles Nicolle Hospital, Urology Department, University of Tunis El Manar, Tunis, Tunisia
| | - Mohamed Allouche
- Faculty of Medecine Of Tunis, Charles Nicolle Hospital, Department of Legal and Forensic Medicine, University of Tunis El Manar, Tunis, Tunisia
| | - Abderrazak Bouzouita
- Faculty of Medecine Of Tunis, Charles Nicolle Hospital, Urology Department, University of Tunis El Manar, Tunis, Tunisia
| | - Amine Derouiche
- Faculty of Medecine Of Tunis, Charles Nicolle Hospital, Urology Department, University of Tunis El Manar, Tunis, Tunisia
| | - Mohamed Riadh Ben Slama
- Faculty of Medecine Of Tunis, Charles Nicolle Hospital, Urology Department, University of Tunis El Manar, Tunis, Tunisia
| | - Moncef Hamdoun
- Faculty of Medecine Of Tunis, Charles Nicolle Hospital, Department of Legal and Forensic Medicine, University of Tunis El Manar, Tunis, Tunisia
| | - Mohamed Chebil
- Faculty of Medecine Of Tunis, Charles Nicolle Hospital, Urology Department, University of Tunis El Manar, Tunis, Tunisia
| |
Collapse
|
6
|
Ben Abderrahim S, Gharbaoui M, Békir O, Hamdoun M, Allouche M. Sudden death related to the gastrointestinal system in Tunisia: A 13 year autopsy study. J Forensic Sci 2021; 67:596-604. [PMID: 34897679 DOI: 10.1111/1556-4029.14953] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 10/21/2021] [Accepted: 11/29/2021] [Indexed: 12/20/2022]
Abstract
Sudden gastrointestinal (GI) death is an unexpected death due to digestive system causes mainly found after autopsy. The literature is rich in articles that studied sudden death due to cardiac causes while sudden GI deaths remain less well-documented. We retrospectively investigated all cases of gastrointestinal death at the Department of Forensic Medicine in Tunis, over 13 years (January 1, 2006 to December 31, 2018). Two hundred and eight cases were collected. The mean age of our series was 51.06 ± 20.99 years. No history of digestive disorders was reported in 78.4%, and no family history of sudden death was found in any cases. A male predominance was found in most epidemiological characteristics of the sample with a significant statistical rate in some features. Non-specific abdominal pain was the most described symptom (n = 92). Perforation of GI tract was the common mechanism involved in the death of 55 cases, of which 44 were related to ulcer perforation. These ulcer perforations were statistically more reported in smokers and people suffering from schizophrenia. Intestinal obstruction was the second commonest cause of death, mainly found in the elderly. Sudden death in children was most frequently caused by acute intussusception. This study highlights that systematic study of sudden death due to GI causes might provide opportunities to identify avenues for overall health improvement.
Collapse
Affiliation(s)
- Sarra Ben Abderrahim
- Department of Forensic Medicine, Charles Nicolle University Hospital, Tunis, Tunisia
| | - Meriem Gharbaoui
- Department of Forensic Medicine, Charles Nicolle University Hospital, Tunis, Tunisia
| | - Olfa Békir
- Department of Forensic Medicine, Charles Nicolle University Hospital, Tunis, Tunisia
| | - Moncef Hamdoun
- Department of Forensic Medicine, Charles Nicolle University Hospital, Tunis, Tunisia
| | - Mohamed Allouche
- Department of Forensic Medicine, Charles Nicolle University Hospital, Tunis, Tunisia
| |
Collapse
|
7
|
Hmandi O, Khelil MB, Zoghlami N, Skhiri H, Hamdoun M. Apport de la dixième révision de la Classification internationale des maladies dans le codage de la mortalité médico-légale. East Mediterr Health J 2021. [DOI: 10.26719/2021.27.6.605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Contexte : les rapports de mortalité en Tunisie n’incluent pas les causes de décès médico-légaux. Objectif : établir les statistiques sur les causes de décès médico-légaux au nord de la Tunisie en 2015 en se basant sur la Dixième Révision de la Classification internationale des maladies (CIM-10). Méthodes : il s’agissait d’une étude transversale et descriptive portant sur tous les décès autopsiés au nord de la Tunisie en 2015. Les caractéristiques socio-démographiques ont été identifiées, ainsi que les formes médico-légales et les causes de décès. Celles-ci ont été codées selon la CIM-10. Résultats : notre échantillon était composé de 1957 cas. Il y avait une prédominance masculine avec un sex ratio de 3,5. L’âge moyen était de 47,2 (écart type [ET] 20,6) ans. Les morts violentes ont représenté 57,4 % de la mortalité globale, suivies du groupe des maladies de l’appareil circulatoire (24,5 %) et de celui des maladies de l’appareil respiratoire (6,5 %). Les causes de décès les plus fréquentes étaient les accidents de transport terrestre (33,7 %) et les cardiopathies ischémiques (17,9 %). Les accidents de la voie publique étaient à l’origine de 56,1 % des morts accidentelles. La pendaison était le mode suicidaire le plus fréquent (51,5 %). Les homicides étaient le plus souvent secondaires à des plaies par arme blanche (35,8 %). Conclusion : la CIM-10 a permis de mettre en avant la part de la mort violente et ses caractéristiques dans la mortalité médico-légale au nord de la Tunisie, ce qui témoigne de son efficacité dans la standardisation des conclusions des rapports d’autopsie.
Collapse
|
8
|
Ben Khelil M, Zgarni A, Belghith M, Harzallah H, Zhioua M, Hamdoun M. Trends of juvenile and adolescent suicides in North Tunisia: a 12-year study. Public Health 2021; 194:223-231. [PMID: 33962100 DOI: 10.1016/j.puhe.2021.02.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 02/08/2021] [Accepted: 02/27/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The aim of our study was to analyze the epidemiological characteristics for suicide methods and factors over a 12-year period among child suicides in Northern Tunisia and to compare juvenile and adolescent suicides. STUDY DESIGN This is a cross-sectional study. METHODS We included all child and adolescent suicide cases that took place in the North of Tunisia over a 12 year period (2005-2016). Data were collected from medical records and judicial inquiries and were classified into three sections: sociodemographic data, the circumstances of suicide, and the autopsy findings. Data were then compared between the 'juvenile suicide group' and 'the adolescent suicide group', according to the WHO definition. RESULTS Casualties were equally males and females, mostly adolescents (74.5%), aged 15 years old on average. Hanging was the most frequent suicidal method. A peak of frequency was observed in 2014. CONCLUSION Our results suggested to focus, among other preventive measures, on the role of media coverage of child suicides.
Collapse
Affiliation(s)
- M Ben Khelil
- Faculty of Medicine, University Tunis El Manar, Tunis, Tunisia; Department of Legal Medicine, Charles Nicolle Hospital, Tunis, Tunisia.
| | - A Zgarni
- Faculty of Medicine, University Tunis El Manar, Tunis, Tunisia
| | - M Belghith
- Department of Legal Medicine, Charles Nicolle Hospital, Tunis, Tunisia
| | - H Harzallah
- Faculty of Medicine, University Tunis El Manar, Tunis, Tunisia; Department of Legal Medicine, Charles Nicolle Hospital, Tunis, Tunisia
| | - M Zhioua
- Faculty of Medicine, University Tunis El Manar, Tunis, Tunisia; Department of Legal Medicine, Charles Nicolle Hospital, Tunis, Tunisia
| | - M Hamdoun
- Faculty of Medicine, University Tunis El Manar, Tunis, Tunisia; Department of Legal Medicine, Charles Nicolle Hospital, Tunis, Tunisia
| |
Collapse
|
9
|
Ben Abderrahim S, Gharbaoui M, Zaara MA, Rammeh-Rommani S, Hamdoun M, Ben Khelil M. Fatal coronary ectasia: An autopsy case report and review of literature. J Forensic Leg Med 2021; 79:102132. [PMID: 33667793 DOI: 10.1016/j.jflm.2021.102132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 02/02/2021] [Accepted: 02/14/2021] [Indexed: 11/29/2022]
Abstract
Coronary ectasia is a rare vessel defect that represents a pathological and incidental finding in routine coronary angiography performed for other coronary syndromes. This defect exposes to the risk of intra-coronary thrombosis by blood stasis due to the turbulent blood flow in those dilated areas that can lead to sudden death. We report an autopsy case of a male subject suddenly deceased. A medico-legal autopsy concluded an ischemic heart failure due to a vascular thrombosis by a blood clot in a coronary ectasia. Our case report aimed to discuss the mechanisms of sudden death attributed to coronary artery ectasia.
Collapse
Affiliation(s)
- Sarra Ben Abderrahim
- Tunis Faculty of Medicine, University of Tunis El Manar, Djebel Lakhdhar Street, La Rabta, 1007, Tunis, Tunisia; Department of Forensic Medicine, Charles Nicolle University Hospital, 138, Boulevard 9 Avril 1938, 1006, Tunis, Tunisia
| | - Meriem Gharbaoui
- Tunis Faculty of Medicine, University of Tunis El Manar, Djebel Lakhdhar Street, La Rabta, 1007, Tunis, Tunisia; Department of Forensic Medicine, Charles Nicolle University Hospital, 138, Boulevard 9 Avril 1938, 1006, Tunis, Tunisia
| | - Mohamed Amine Zaara
- Tunis Faculty of Medicine, University of Tunis El Manar, Djebel Lakhdhar Street, La Rabta, 1007, Tunis, Tunisia; Department of Forensic Medicine, Charles Nicolle University Hospital, 138, Boulevard 9 Avril 1938, 1006, Tunis, Tunisia
| | - Soumaya Rammeh-Rommani
- Tunis Faculty of Medicine, University of Tunis El Manar, Djebel Lakhdhar Street, La Rabta, 1007, Tunis, Tunisia; Department of Pathological Anatomy and Cytology, Charles Nicolle University Hospital, 138, Boulevard 9 Avril 1938, 1006, Tunis, Tunisia
| | - Moncef Hamdoun
- Tunis Faculty of Medicine, University of Tunis El Manar, Djebel Lakhdhar Street, La Rabta, 1007, Tunis, Tunisia; Department of Forensic Medicine, Charles Nicolle University Hospital, 138, Boulevard 9 Avril 1938, 1006, Tunis, Tunisia
| | - Mehdi Ben Khelil
- Tunis Faculty of Medicine, University of Tunis El Manar, Djebel Lakhdhar Street, La Rabta, 1007, Tunis, Tunisia; Department of Forensic Medicine, Charles Nicolle University Hospital, 138, Boulevard 9 Avril 1938, 1006, Tunis, Tunisia.
| |
Collapse
|
10
|
Belghith M, Ben Khelil M, Harzallah H, Kebsi D, Zhioua M, Hamdoun M. Pattern of homicidal burns in Northern Tunisia: An autopsy-based study over 15 years (2005-2019). J Forensic Sci 2021; 66:940-946. [PMID: 33522609 DOI: 10.1111/1556-4029.14676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 01/04/2021] [Accepted: 01/08/2021] [Indexed: 11/29/2022]
Abstract
Data about homicidal burns remain scarce. Intentional burns are a challenging situation in the case of an individual found dead in a fire zone with no witness of the fatal act. This study aimed to analyze the victim profiles of homicidal burns in Northern Tunisia. It was a descriptive cross-sectional study with a retrospective data collection over 15 years (January 2005-December 2019). In total, 60 cases of homicidal burns were collected. The mean age was 40.22 ± 18.1 years (range 4-82 years). We noted a male predominance (sex ratio M/F = 1.3). Most of the victims were married (48.3%), unemployed (40%), and living in an urban area (63.3%). Homicidal burns occurred most frequently in private homes for female victims (80.8%) and in public places for male victims (31.4%) (p < 0.001). The reported motive varied according to the victim's sex; males were mostly assaulted by an acquaintance in an interpersonal conflict (47.1%), and females were mostly assaulted by an intimate partner while in a dispute (42.3%; p = 0.001). The median total body surface area (TBSA) that was burned was 60.4%, and burn injuries were observed mainly in the anterior part of the body. In 19 cases, the burns were associated with another type of trauma, from which the most common association was burning and stab wounds (12 cases). The identified pattern of homicidal burn casualties was similar to the reported data in Western countries and to homicides in general in Tunisia, suggesting that prevention measures should address those of intentional interpersonal violence.
Collapse
Affiliation(s)
- Meyssa Belghith
- Department of Legal Medicine, Charles Nicolle Hospital, Tunis, Tunisia.,Faculty of Medicine, University Tunis-El Manar, Tunis, Tunisia
| | - Mehdi Ben Khelil
- Department of Legal Medicine, Charles Nicolle Hospital, Tunis, Tunisia.,Faculty of Medicine, University Tunis-El Manar, Tunis, Tunisia
| | - Hana Harzallah
- Faculty of Medicine, University Tunis-El Manar, Tunis, Tunisia
| | - Dhouha Kebsi
- Department of Legal Medicine, Charles Nicolle Hospital, Tunis, Tunisia.,Faculty of Medicine, University Tunis-El Manar, Tunis, Tunisia
| | - Mongi Zhioua
- Department of Legal Medicine, Charles Nicolle Hospital, Tunis, Tunisia.,Faculty of Medicine, University Tunis-El Manar, Tunis, Tunisia
| | - Moncef Hamdoun
- Department of Legal Medicine, Charles Nicolle Hospital, Tunis, Tunisia.,Faculty of Medicine, University Tunis-El Manar, Tunis, Tunisia
| |
Collapse
|
11
|
Makni C, Manoubi SA, Bekir O, Ksentini M, Rammeh S, Hamdoun M. Unexpected fatal intramyocardial cartilaginous tumor: pathophysiology, mechanism of death and review of the literature. Forensic Sci Med Pathol 2021; 17:308-311. [PMID: 33492632 DOI: 10.1007/s12024-020-00351-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2020] [Indexed: 11/30/2022]
Abstract
Intramyocardial cartilage has never been reported in the human heart before. In the literature, the only reported localizations of cartilage in the heart were in the central fibrous body and the valves. We report a case of an unusual presence of cartilage tissue within the myocardial wall of the left ventricle in a 10-year-old boy who died unexpectedly. This case presents an interesting, unusual and apparently asymptomatic sudden cardiac death related to a cartilaginous myocardial tumor. Conducting system disturbance secondary to the myocardial tumor is the probable cause of death. This case is relevant not only for its singularity and originality, but also for the diverse and controversial hypotheses related to the onset of cartilaginous tissue in the myocardial wall. Early detection of this tumor by modern thoracic imaging may have prevented a fatal unexpected outcome.
Collapse
Affiliation(s)
- Chahnez Makni
- Department of Forensic Medicine, Charles Nicolle Hospital, Tunis, Tunisia. .,Department of Pathology, Charles Nicolle Hospital, Tunis, Tunisia.
| | | | - Olfa Bekir
- Department of Forensic Medicine, Charles Nicolle Hospital, Tunis, Tunisia
| | - Meriem Ksentini
- Department of Pathology, Charles Nicolle Hospital, Tunis, Tunisia
| | - Soumaya Rammeh
- Department of Pathology, Charles Nicolle Hospital, Tunis, Tunisia
| | - Moncef Hamdoun
- Department of Forensic Medicine, Charles Nicolle Hospital, Tunis, Tunisia
| |
Collapse
|
12
|
Makni C, Gorgi M, Gharbaoui M, Abderrahim SB, Zaara MA, Belhaj A, Hamdoun M, Allouche M. Evaluation médico-légale des certificats médicaux initiaux. Pan Afr Med J 2021; 40:255. [PMID: 35251449 PMCID: PMC8856976 DOI: 10.11604/pamj.2021.40.255.28573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 11/25/2021] [Indexed: 11/11/2022] Open
Abstract
Le certificat médical initial est un document médico-légal descriptif dont finalité est de prouver l´existence du dommage et de permettre à la victime d´obtenir ce que de droit. L´objectif de notre étude était d'étudier le contenu et d'évaluer la qualité de rédaction des certificats médicaux initiaux. Il s´agissait d´une étude rétrospective et descriptive sur une période de 18 mois allant de janvier 2015 à juin 2016. Nous avons colligé 450 certificats médicaux initiaux parvenus au service de médecine légale du centre hospitalier universitaire de Charles Nicolle à Tunis. La qualité des certificats médicaux initiaux a été évaluée grâce à un canevas qui a permis de leur attribuer une note sur 30. Les certificats médicaux initiaux évalués étaient majoritairement moyens. Les scores obtenus à partir du canevas que nous avons élaboré oscillaient entre 9,5 et 27,5/30 avec une moyenne de 18,59/30. Les médecins généralistes, les médecins ayant une spécialité d´organe comme les ophtalmologistes ou encore les neurochirurgiens et les médecins qui ont utilisé le support du ministère de la santé ont rédigé de meilleurs certificats. De même nous avons noté une qualité de rédaction meilleure lorsqu´il s´agit de coups et blessures volontaires. Notre étude a montré que la majorité des certificats médicaux initiaux ne sont pas conformes aux recommandations de rédaction. Ces insuffisances sont probablement liées au fait que les médecins n´ont jamais bénéficié d´une formation médico-légale adéquate.
Collapse
Affiliation(s)
- Chahnez Makni
- Service de Médecine Légale, Hôpital Charles-Nicolle, 138, Boulevard 9-Avril-1938, 1006 Tunis, Tunis, Tunisie
- Auteur correspondant: Chahnez Makni, Service de Médecine Légale, Hôpital Charles-Nicolle, 138, Boulevard 9-Avril-1938, 1006 Tunis, Tunis, Tunisie.
| | - Myriam Gorgi
- Service de Médecine Légale, Hôpital Charles-Nicolle, 138, Boulevard 9-Avril-1938, 1006 Tunis, Tunis, Tunisie
| | - Meriem Gharbaoui
- Service de Médecine Légale, Hôpital Charles-Nicolle, 138, Boulevard 9-Avril-1938, 1006 Tunis, Tunis, Tunisie
- Faculté de Médecine de Tunis, Université Tunis El Manar, Tunis, Tunisie
| | - Sarra Ben Abderrahim
- Service de Médecine Légale, Hôpital Charles-Nicolle, 138, Boulevard 9-Avril-1938, 1006 Tunis, Tunis, Tunisie
| | - Mohamed Amine Zaara
- Service de Médecine Légale, Hôpital Charles-Nicolle, 138, Boulevard 9-Avril-1938, 1006 Tunis, Tunis, Tunisie
| | - Azza Belhaj
- Service de Médecine Légale, Hôpital Charles-Nicolle, 138, Boulevard 9-Avril-1938, 1006 Tunis, Tunis, Tunisie
| | - Moncef Hamdoun
- Service de Médecine Légale, Hôpital Charles-Nicolle, 138, Boulevard 9-Avril-1938, 1006 Tunis, Tunis, Tunisie
- Faculté de Médecine de Tunis, Université Tunis El Manar, Tunis, Tunisie
| | - Mohamed Allouche
- Service de Médecine Légale, Hôpital Charles-Nicolle, 138, Boulevard 9-Avril-1938, 1006 Tunis, Tunis, Tunisie
- Faculté de Médecine de Tunis, Université Tunis El Manar, Tunis, Tunisie
| |
Collapse
|
13
|
Ben Ahmed H, Ben Khelil M, Bellali M, Shimi M, Belhaj A, Allouche M, Allouche E, Razghallah R, Banasr A, Benzarti A, Hamdoun M. [Sudden cardiac death in women, data from the northern Tunisian sudden cardiac-death registry]. Ann Cardiol Angeiol (Paris) 2020; 70:1-6. [PMID: 33109353 DOI: 10.1016/j.ancard.2020.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 10/04/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Sudden cardiac death is a major public health problem. Epidemiological and clinical differences according to gender have been described in sudden cardiac death. The aim of this study was to examine the gender differences between autopsy findings and circumstance of occurrence associated with sudden cardiac death. METHODS We prospectively collected epidemiological and autopsy data of victims of sudden cardiac death occurring in the northern governorates of Tunisia between January 2013 and December 2019. Symptoms preceding death, circadian, weekly and seasonal variations of sudden death were also analyzed. RESULTS The study population included 1834 men and 468 women with a mean age of 56.5±14.2 years. All cardiovascular risk factors except smoking were significantly more frequent among women but ischemic heart disease was the most common cause of death in men (51.3 %, versus 28 %, P<0.001). Women were more likely to have a negative macroscopic autopsy than men (34 % versus 23.6 %, P<0.001). Chest pain preceding sudden death was more frequent in male (24 % versus 13.2 %, P<0.001). In contrast, women were more likely to have dyspnea (8.1 % versus 15.6 %, P<0.001). Sudden death in women occurred indoors more often than in men (63.9 % versus 54.5 %, P<0.001) and also more often during night (midnight to 6 am). We also recorded an excess cardiac mortality in winter in both sexes. CONCLUSIONS Women had considerably more cardiovascular risk factors and more commonly negative macroscopic autopsy. Death occurred indoors and during night more often than in men.
Collapse
Affiliation(s)
- H Ben Ahmed
- Service de cardiologie, hôpital Charles-Nicolle, faculté de médecine, université Tunis-El-Manar, 2092 Tunis, Tunisie.
| | - M Ben Khelil
- Service de médecine légale, hôpital Charles-Nicolle, faculté de médecine, université Tunis-El-Manar, 2092 Tunis, Tunisie
| | - M Bellali
- Service de médecine légale, hôpital Charles-Nicolle, faculté de médecine, université Tunis-El-Manar, 2092 Tunis, Tunisie
| | - M Shimi
- Service de médecine légale, hôpital Charles-Nicolle, faculté de médecine, université Tunis-El-Manar, 2092 Tunis, Tunisie
| | - A Belhaj
- Service de médecine légale, hôpital Charles-Nicolle, faculté de médecine, université Tunis-El-Manar, 2092 Tunis, Tunisie
| | - M Allouche
- Service de médecine légale, hôpital Charles-Nicolle, faculté de médecine, université Tunis-El-Manar, 2092 Tunis, Tunisie
| | - E Allouche
- Service de cardiologie, hôpital Charles-Nicolle, faculté de médecine, université Tunis-El-Manar, 2092 Tunis, Tunisie
| | - R Razghallah
- Service de cardiologie, hôpital Charles-Nicolle, faculté de médecine, université Tunis-El-Manar, 2092 Tunis, Tunisie
| | - A Banasr
- Service de médecine légale, hôpital Charles-Nicolle, faculté de médecine, université Tunis-El-Manar, 2092 Tunis, Tunisie
| | - A Benzarti
- Service de médecine légale, hôpital Charles-Nicolle, faculté de médecine, université Tunis-El-Manar, 2092 Tunis, Tunisie
| | - M Hamdoun
- Service de médecine légale, hôpital Charles-Nicolle, faculté de médecine, université Tunis-El-Manar, 2092 Tunis, Tunisie
| |
Collapse
|
14
|
Saadi A, Mokadem S, Chakroun M, Nouioui MA, Allouche M, Bouzouita A, Derouiche A, Ben Slama MR, Hamdoun M, Ayed H, Chebil M. A cadaveric anatomical study of the adrenals: Relationship with the posterior abdominal wall muscles revisited. Morphologie 2020; 105:210-216. [PMID: 33071051 DOI: 10.1016/j.morpho.2020.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 09/29/2020] [Accepted: 09/30/2020] [Indexed: 10/23/2022]
Abstract
AIM OF THE STUDY The main difficulties during retroperitoneal laparoscopic adrenalectomies are due to its location. Our objective was to define the relationship of the adrenals with the diaphragm and the psoas muscle. METHODS Our work is an anatomical dissection of 80 fresh cadavers' adrenals. To study the right adrenal, we performed a right nephrectomy and adrenal remained attached to the Inferior vena cava by its main vein. On the left, the edges of the adrenal have been identified by needles and the adrenal was reclined to study its projection on the posterior muscular wall. RESULTS The right adrenal is located higher, 13mm [4-20mm] above the medial arcuate ligament (MAL) in 16 cases (40%). Its lower border was at the same level as the MAL in 18 cases (45%) and 11mm [10-17mm] below the MAL in 6 cases (15%). The posterior support of the right adrenal was the right crus of the diaphragm (Right-CD) in 34 cases (85%) and straddling the Right-CD and the psoas in 6 cases (15%). The study of the relationships of the left adrenal with the MAL showed that the lower edge of the gland was at its same level in 16 cases (40%) and below in 24 cases (60%) by 14mm [8-24mm]. The posterior support of the left adrenal was the left crus of the diaphragm (Left-CD) in 16 cases (40%) and straddling the Left-CD and the psoas in 24 cases (60%). CONCLUSIONS Our results showed that the right adrenal is higher. The MAL is an important posterior element to the adrenal gland that could serve as an anatomical landmark to identify the adrenal during laparoscopic adrenalectomy.
Collapse
Affiliation(s)
- A Saadi
- Department of Urology, Charles Nicolle Hospital of Tunis, University Tunis El Manar Faculty of Medecine of Tunis, Tunis, Tunisia.
| | - S Mokadem
- Department of Urology, Charles Nicolle Hospital of Tunis, University Tunis El Manar Faculty of Medecine of Tunis, Tunis, Tunisia.
| | - M Chakroun
- Department of Urology, Charles Nicolle Hospital of Tunis, University Tunis El Manar Faculty of Medecine of Tunis, Tunis, Tunisia.
| | - M A Nouioui
- Department of Urology, Charles Nicolle Hospital of Tunis, University Tunis El Manar Faculty of Medecine of Tunis, Tunis, Tunisia.
| | - M Allouche
- Department of legal and forensic medicine, Charles Nicolle Hospital of Tunis, University Tunis El Manar Faculty of Medecine of Tunis, Tunis, Tunisia.
| | - A Bouzouita
- Department of Urology, Charles Nicolle Hospital of Tunis, University Tunis El Manar Faculty of Medecine of Tunis, Tunis, Tunisia.
| | - A Derouiche
- Department of Urology, Charles Nicolle Hospital of Tunis, University Tunis El Manar Faculty of Medecine of Tunis, Tunis, Tunisia.
| | - M R Ben Slama
- Department of Urology, Charles Nicolle Hospital of Tunis, University Tunis El Manar Faculty of Medecine of Tunis, Tunis, Tunisia.
| | - M Hamdoun
- Department of legal and forensic medicine, Charles Nicolle Hospital of Tunis, University Tunis El Manar Faculty of Medecine of Tunis, Tunis, Tunisia.
| | - H Ayed
- Department of Urology, Charles Nicolle Hospital of Tunis, University Tunis El Manar Faculty of Medecine of Tunis, Tunis, Tunisia.
| | - M Chebil
- Department of Urology, Charles Nicolle Hospital of Tunis, University Tunis El Manar Faculty of Medecine of Tunis, Tunis, Tunisia.
| |
Collapse
|
15
|
Braham MY, Gharbeoui M, Bellali M, Attia H, Harzallah H, Bekir O, Hamdoun M, Allouche M. Unnatural death in the elderly: a retrospective study of medicolegal autopsies in Northern Tunisia. Egypt J Forensic Sci 2019. [DOI: 10.1186/s41935-019-0127-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
16
|
Ben Khelil M, Boukthir I, Hmandi O, Zhioua M, Hamdoun M. Trends of infanticides in northern Tunisia: A 40 years study (1977-2016). Child Abuse Negl 2019; 95:104047. [PMID: 31288130 DOI: 10.1016/j.chiabu.2019.104047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 05/08/2019] [Accepted: 06/12/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND The Tunisian Penal Code defines infanticide as the murder committed by the mother on her child at birth or immediately after. There is a dearth of studies and official statistics on infanticide in the Arab region and North Africa. OBJECTIVE to analyze the infanticide trends in northern Tunisia between 1977 and 2016. PARTICIPANTS AND SETTING we included all cases of infanticides autopsied at the Legal Medicine Department of Charles Nicolle Hospital in Tunis, over a period of 40 years (1977-2016). METHODS A descriptive retrospective study. RESULTS We collected a total of 513 cases of infanticide over the study period. The general prevalence of infanticide was 0.42 per 100,000 live births per year. Infanticide often occurred during the week, in winter (31.5%) and in spring (30.9%). The newborn was often found on public roads (40.9%) and in urban areas (81.4%). The newborn was often full-term (73.6%), mature, without any congenital malformation, found completely naked (75.2%) and with an empty stomach (93.7%). The umbilical cord was often cut (71.5%), not ligated (82%) with an irregular edge (64%). There was often no putrefaction (54.4%). The hydrostatic test (81.8%) and histological examination (81.1%) showed that infants had breathed. Neglect was the most common cause of death (49.9%). CONCLUSION Northern Tunisia has a low prevalence of infanticide compared to most of the previous European and American studies. A better understanding of infanticide would allow us to adapt measures of prevention.
Collapse
Affiliation(s)
- Mehdi Ben Khelil
- Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia; Department of Legal Medicine, Charles Nicolle Hospital, Tunis, Tunisia.
| | - Ilhem Boukthir
- Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia
| | - Ons Hmandi
- Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia; Department of Legal Medicine, Charles Nicolle Hospital, Tunis, Tunisia
| | - Mongi Zhioua
- Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia; Department of Legal Medicine, Charles Nicolle Hospital, Tunis, Tunisia
| | - Moncef Hamdoun
- Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia; Department of Legal Medicine, Charles Nicolle Hospital, Tunis, Tunisia
| |
Collapse
|
17
|
Ben Khelil M, Harzallah H, Elmoulehy-Majed H, Belghith M, Hamdoun M. Workplace traumatic accidental death in Northen Tunisia. Tunis Med 2019; 97:918-924. [PMID: 31872404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND Workplace accidents represented a Global public health problem with about two millions persons dying from accidents at work or occupational diseases. In Tunisia, data on fatal traumatic workplace accidents remain scarce. Work-related accidents accounted for 0.4% of the employed population in 2014, with a prevalence of fatal accidents between 4 and 25 per 100,000 workers depending on the region and the field. AIM To describe the victim's profile of workplace traumatic accidents in Northern Tunisia. METHODS It was a retrospective cross-sectional study, including all cases of accidental workplace traumatic accidents autopsied at the Department of Forensic Medicine, Charles Nicolle Hospital in Tunis over a period of 12 years (2003- 2014). RESULTS We collected 741 cases, including 724 men. The median age was 38.5 years. Construction sector represented 70% and the industrial sector represented 12.6% of cases. Victims were workers in 91.4%. Falls from height was the most frequent accident type (43.5%), followed by objects falling (26.5%) and electrocutions (18.5%). Death occurred at the place of accidents in 58% cases. CONCLUSION Our study highlighted the need to reinforce and to adapt the prevention measures toward workers in the construction sector, in order to reduce the mortality from traumatic workplace accidents.
Collapse
|
18
|
Gharbaoui M, Ben Khelil M, Harzallah H, Benzarti A, Zhioua M, Hamdoun M. Pattern of suicide by self-poisoning in Northern Tunisia: An eleven-year study (2005–2015). J Forensic Leg Med 2019; 61:1-4. [DOI: 10.1016/j.jflm.2018.10.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 09/10/2018] [Accepted: 10/19/2018] [Indexed: 11/25/2022]
|
19
|
Alami Aroussi A, Fouad A, Omrane A, Razzak A, Aissa A, Akkad A, Amraoui A, Aouam A, Arfaoui A, Belkouchi A, Ben Chaaben A, Ben Cheikh A, Ben Khélifa A, Ben Mabrouk A, Benhima A, Bezza A, Bezzine A, Bourrahouat A, Chaieb A, Chakib A, Chetoui A, Daoudi A, Ech-Chenbouli A, Gaaliche A, Hassani A, Kassimi A, Khachane A, Labidi A, Lalaoui A, Masrar A, McHachi A, Nakhli A, Ouakaa A, Siati A, Toumi A, Zaouali A, Condé AY, Haggui A, Belaguid A, El Hangouche AJ, Gharbi A, Mahfoudh A, Bouzouita A, Aissaoui A, Ben Hamouda A, Hedhli A, Ammous A, Bahlous A, Ben Halima A, Belhadj A, Bezzine A, Blel A, Brahem A, Banasr A, Meherzi A, Saadi A, Sellami A, Turki A, Ben Miled A, Ben Slama A, Daib A, Zommiti A, Chadly A, Jmaa A, Mtiraoui A, Ksentini A, Methnani A, Zehani A, Kessantini A, Farah A, Mankai A, Mellouli A, Zaouali A, Touil A, Hssine A, Ben Safta A, Derouiche A, Jmal A, Ferjani A, Djobbi A, Dridi A, Aridhi A, Bahdoudi A, Ben Amara A, Benzarti A, Ben Slama AY, Oueslati A, Soltani A, Chadli A, Aloui A, Belghuith Sriha A, Bouden A, Laabidi A, Mensi A, Ouakaa A, Sabbek A, Zribi A, Green A, Ben Nasr A, Azaiez A, Yeades A, Belhaj A, Mediouni A, Sammoud A, Slim A, Amine B, Chelly B, Jatik B, Lmimouni B, Daouahi B, Ben Khelifa B, Louzir B, Dorra A, Dhahri B, Ben Nasrallah C, Chefchaouni C, Konzi C, Loussaief C, Makni C, Dziri C, Bouguerra C, Kays C, Zedini C, Dhouha C, Mohamed C, Aichaouia C, Dhieb C, Fofana D, Gargouri D, Chebil D, Issaoui D, Gouiaa D, Brahim D, Essid D, Jarraya D, Trad D, Ben Hmida E, Sboui E, Ben Brahim E, Baati E, Talbi E, Chaari E, Hammami E, Ghazouani E, Ayari F, Ben Hariz F, Bennaoui F, Chebbi F, Chigr F, Guemira F, Harrar F, Benmoula FZ, Ouali FZ, Maoulainine FMR, Bouden F, Fdhila F, Améziani F, Bouhaouala F, Charfi F, Chermiti Ben Abdallah F, Hammemi F, Jarraya F, Khanchel F, Ourda F, Sellami F, Trabelsi F, Yangui F, Fekih Romdhane F, Mellouli F, Nacef Jomli F, Mghaieth F, Draiss G, Elamine G, Kablouti G, Touzani G, Manzeki GB, Garali G, Drissi G, Besbes G, Abaza H, Azzouz H, Said Latiri H, Rejeb H, Ben Ammar H, Ben Brahim H, Ben Jeddi H, Ben Mahjouba H, Besbes H, Dabbebi H, Douik H, El Haoury H, Elannaz H, Elloumi H, Hachim H, Iraqi H, Kalboussi H, Khadhraoui H, Khouni H, Mamad H, Metjaouel H, Naoui H, Zargouni H, Elmalki HO, Feki H, Haouala H, Jaafoura H, Drissa H, Mizouni H, Kamoun H, Ouerda H, Zaibi H, Chiha H, Kamoun H, Saibi H, Skhiri H, Boussaffa H, Majed H, Blibech H, Daami H, Harzallah H, Rkain H, Ben Massoud H, Jaziri H, Ben Said H, Ayed H, Harrabi H, Chaabouni H, Ladida Debbache H, Harbi H, Yacoub H, Abroug H, Ghali H, Kchir H, Msaad H, Ghali H, Manai H, Riahi H, Bousselmi H, Limem H, Aouina H, Jerraya H, Ben Ayed H, Chahed H, Snéne H, Lahlou Amine I, Nouiser I, Ait Sab I, Chelly I, Elboukhani I, Ghanmi I, Kallala I, Kooli I, Bouasker I, Fetni I, Bachouch I, Bouguecha I, Chaabani I, Gazzeh I, Samaali I, Youssef I, Zemni I, Bachouche I, Youssef I, Bouannene I, Kasraoui I, Laouini I, Mahjoubi I, Maoudoud I, Riahi I, Selmi I, Tka I, Hadj Khalifa I, Mejri I, Béjia I, Bellagha J, Boubaker J, Daghfous J, Dammak J, Hleli J, Ben Amar J, Jedidi J, Marrakchi J, Kaoutar K, Arjouni K, Ben Helel K, Benouhoud K, Rjeb K, Imene K, Samoud K, El Jeri K, Abid K, Chaker K, Abid K, Bouzghaîa K, Kamoun K, Zitouna K, Oughlani K, Lassoued K, Letaif K, Hakim K, Cherif Alami L, Benhmidoune L, Boumhil L, Bouzgarrou L, Dhidah L, Ifrine L, Kallel L, Merzougui L, Errguig L, Mouelhi L, Sahli L, Maoua M, Rejeb M, Ben Rejeb M, Bouchrik M, Bouhoula M, Bourrous M, Bouskraoui M, El Belhadji M, El Belhadji M, Essakhi M, Essid M, Gharbaoui M, Haboub M, Iken M, Krifa M, Lagrine M, Leboyer M, Najimi M, Rahoui M, Sabbah M, Sbihi M, Zouine M, Chefchaouni MC, Gharbi MH, El Fakiri MM, Tagajdid MR, Shimi M, Touaibia M, Jguirim M, Barsaoui M, Belghith M, Ben Jmaa M, Koubaa M, Tbini M, Boughdir M, Ben Salah M, Ben Fraj M, Ben Halima M, Ben Khalifa M, Bousleh M, Limam M, Mabrouk M, Mallouli M, Rebeii M, Ayari M, Belhadj M, Ben Hmida M, Boughattas M, Drissa M, El Ghardallou M, Fejjeri M, Hamza M, Jaidane M, Jrad M, Kacem M, Mersni M, Mjid M, Sabbah M, Serghini M, Triki M, Ben Abbes M, Boussaid M, Gharbi M, Hafi M, Slama M, Trigui M, Taoueb M, Chakroun M, Ben Cheikh M, Chebbi M, Hadj Taieb M, Kacem M, Ben Khelil M, Hammami M, Khalfallah M, Ksiaa M, Mechri M, Mrad M, Sboui M, Bani M, Hajri M, Mellouli M, Allouche M, Mesrati MA, Mseddi MA, Amri M, Bejaoui M, Bellali M, Ben Amor M, Ben Dhieb M, Ben Moussa M, Chebil M, Cherif M, Fourati M, Kahloul M, Khaled M, Machghoul M, Mansour M, Abdesslem MM, Ben Chehida MA, Chaouch MA, Essid MA, Meddeb MA, Gharbi MC, Elleuch MH, Loueslati MH, Sboui MM, Mhiri MN, Kilani MO, Ben Slama MR, Charfi MR, Nakhli MS, Mourali MS, El Asli MS, Lamouchi MT, Cherti M, Khadhraoui M, Bibi M, Hamdoun M, Kassis M, Touzi M, Ben Khaled M, Fekih M, Khemiri M, Ouederni M, Hchicha M, Kassis M, Ben Attia M, Yahyaoui M, Ben Azaiez M, Bousnina M, Ben Jemaa M, Ben Yahia M, Daghfous M, Haj Slimen M, Assidi M, Belhadj N, Ben Mustapha N, El Idrissislitine N, Hikki N, Kchir N, Mars N, Meddeb N, Ouni N, Rada N, Rezg N, Trabelsi N, Bouafia N, Haloui N, Benfenatki N, Bergaoui N, Yomn N, Ben Mustapha N, Maamouri N, Mehiri N, Siala N, Beltaief N, Aridhi N, Sidaoui N, Walid N, Mechergui N, Mnif N, Ben Chekaya N, Bellil N, Dhouib N, Achour N, Kaabar N, Mrizak N, Mnif N, Chaouech N, Hasni N, Issaoui N, Ati N, Balloumi N, Haj Salem N, Ladhari N, Akif N, Liani N, Hajji N, Trad N, Elleuch N, Marzouki NEH, Larbi N, M'barek N, Rebai N, Bibani N, Ben Salah N, Belmaachi O, Elmaalel O, Jlassi O, Mihoub O, Ben Zaid O, Bouallègue O, Bousnina O, Bouyahia O, El Maalel O, Fendri O, Azzabi O, Borgi O, Ghdes O, Ben Rejeb O, Rachid R, Abi R, Bahiri R, Boulma R, Elkhayat R, Habbal R, Rachid R, Tamouza R, Jomli R, Ben Abdallah R, Smaoui R, Debbeche R, Fakhfakh R, El Kamel R, Gargouri R, Jouini R, Nouira R, Fessi R, Bannour R, Ben Rabeh R, Kacem R, Khmakhem R, Ben Younes R, Karray R, Cheikh R, Ben Malek R, Ben Slama R, Kouki R, Baati R, Bechraoui R, Fakhfakh R, Fradi R, Lahiani R, Ridha R, Zainine R, Kallel R, Rostom S, Ben Abdallah S, Ben Hammamia S, Benchérifa S, Benkirane S, Chatti S, El Guedri S, El Oussaoui S, Elkochri S, Elmoussaoui S, Enbili S, Gara S, Haouet S, Khammeri S, Khefecha S, Khtrouche S, Macheghoul S, Mallouli S, Rharrit S, Skouri S, Helali S, Boulehmi S, Abid S, Naouar S, Zelfani S, Ben Amar S, Ajmi S, Braiek S, Yahiaoui S, Ghezaiel S, Ben Toumia S, Thabeti S, Daboussi S, Ben Abderahman S, Rhaiem S, Ben Rhouma S, Rekaya S, Haddad S, Kammoun S, Merai S, Mhamdi S, Ben Ali R, Gaaloul S, Ouali S, Taleb S, Zrour S, Hamdi S, Zaghdoudi S, Ammari S, Ben Abderrahim S, Karaa S, Maazaoui S, Saidani S, Stambouli S, Mokadem S, Boudiche S, Zaghbib S, Ayedi S, Jardek S, Bouselmi S, Chtourou S, Manoubi S, Bahri S, Halioui S, Jrad S, Mazigh S, Ouerghi S, Toujani S, Fenniche S, Aboudrar S, Meriem Amari S, Karouia S, Bourgou S, Halayem S, Rammeh S, Yaïch S, Ben Nasrallah S, Chouchane S, Ftini S, Makni S, Manoubi S, Miri S, Saadi S, Manoubi SA, Khalfallah T, Mechergui T, Dakka T, Barhoumi T, M'rad TEB, Ajmi T, Dorra T, Ouali U, Hannachi W, Ferjaoui W, Aissi W, Dahmani W, Dhouib W, Koubaa W, Zhir W, Gheriani W, Arfa W, Dougaz W, Sahnoun W, Naija W, Sami Y, Bouteraa Y, Elhamdaoui Y, Hama Y, Ouahchi Y, Guebsi Y, Nouira Y, Daly Y, Mahjoubi Y, Mejdoub Y, Mosbahi Y, Said Y, Zaimi Y, Zgueb Y, Dridi Y, Mesbahi Y, Gharbi Y, Hellal Y, Hechmi Z, Zid Z, Elmouatassim Z, Ghorbel Z, Habbadi Z, Marrakchi Z, Hidouri Z, Abbes Z, Ouhachi Z, Khessairi Z, Khlayfia Z, Mahjoubi Z, Moatemri Z. 46th Medical Maghrebian Congress. November 9-10, 2018. Tunis. Tunis Med 2019; 97:177-258. [PMID: 31535714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
|
20
|
Gharbaoui M, Naceur Y, Hmandi O, Bellali M, Ben Khelil M, Hamdoun M, Allouche M. Accidental and occupational ligature strangulation in northern Tunisia: four-case study. Egypt J Forensic Sci 2018. [DOI: 10.1186/s41935-018-0081-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
21
|
Ben Khelil M, Zgarni A, Bellali M, Thaljaoui W, Zhioua M, Hamdoun M. Deaths among homeless in northern Tunisia: a 10-year study (2005-2014). Public Health 2018; 162:41-47. [PMID: 29958113 DOI: 10.1016/j.puhe.2018.04.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 04/13/2018] [Accepted: 04/30/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To analyze the victims profile related to death among homeless people. STUDY DESIGN A descriptive, retrospective, and cross-sectional study. METHODS We included all deaths among homeless people that occurred during a 10-year period (2005-2014) that were autopsied in the Department of Legal Medicine of the Charles Nicolle Hospital of Tunis. Causes of death were classified according to the International Statistical Classification of Diseases and Related Health Problems 10th Revision. Data were classified in three sections: sociodemographic data, circumstances of death, and autopsy findings. A univariate data analysis was performed. RESULTS The sex ratio (M/F) was of 7.45. The average age was of 59 years. The majority of deaths (80.9%) occurred in the metropolis of Tunis with a significant occurrence of cases in other governorates after the 2011 revolution (P = 0.002). Deaths occurred more often during winter (34.8%). The bodies were frequently discovered in public places (36.0%) and private locations (34.0%). The deaths of 55.3% of cases were attributed to natural causes, significantly affecting the elderly, whereas the accidental causes (25.7%) were more frequent before the age of 49 years, followed by suicides (3.9%) and homicides (3.3%). CONCLUSIONS Our study highlighted a phenomenon not yet studied in Tunisia. Our results highlight an urgent need for preventive measures focused on the improvement of healthcare measures among homeless people.
Collapse
Affiliation(s)
- M Ben Khelil
- Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia; Department of Legal Medicine, Charles Nicolle Hospital, Tunis, Tunisia.
| | - A Zgarni
- Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia
| | - M Bellali
- Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia; Department of Legal Medicine, Charles Nicolle Hospital, Tunis, Tunisia
| | - W Thaljaoui
- Department of Legal Medicine, Regional Hospital of Sidi Bouzid, Tunisia
| | - M Zhioua
- Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia; Department of Legal Medicine, Charles Nicolle Hospital, Tunis, Tunisia
| | - M Hamdoun
- Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia; Department of Legal Medicine, Charles Nicolle Hospital, Tunis, Tunisia
| |
Collapse
|
22
|
Abstract
OBJECTIVES Bacteriospermia may result in male hypofertlity. Indeed, 60% of patients treated by Assisted Reproductive Techniques had a local infection or inflammation of genital tract. However, direct effects of bacteriospermia on semen parameters remain controversial. The aim of our work was to explore the effect of bacteriospermia on sperm parameters among patients consulting for hypofertility. METHODS A retrospective comparative study of two groups: a group of 70 patients with bacteriospermia (group 1) and a control group of 70 patients without bacteriospermia (group 2). For these groups, we studied the standard semen parameters (seminal volume and viscosity and spermatozoa count, initial and secondary mobility, vitality and morphology). Comparison of these parameters was made by the Chi2 test and the Fisher test. RESULTS The mean age of our population was 40.4±6.7 years. There was no significant difference between ejaculate average volume in the 2 groups (group B: 2.78mL versus group A: 2.92mL with P=0.2). Similarly, for the viscosity no difference was noted (P=0,68). The altered parameters in the presence of bacteriospermia were mean concentration and sperm motility (P=0.001 and P=0.049 respectively). The prevalence of secondary asthenospermia was higher in the presence of bacterospermia (P=0.006). No statistically significant differences were observed for morphology and vitality of spermatozoa (P=0.276 and P=0.075 respectively). The leucospermia was associated with bacteriospermia in 10% patients. Ureaplasma urealyticum was the germ most found (45.7%) followed by Streptococcus and Staphylococcacae (20.3% for each), Gram negative rods accounted for 12.9%, while Corynebacterium spp was isolated only in 4,3% patients. U. urealyticum was associated with hypospermia in 33% of cases (P=0.031). Spermatozoa motility was significatively decreased not only in the presence of this bacteria (FT=0.002) but also when cultures were positive for Streptococcus (0.04) and Corynebacterium (P<0.001). Morphological abnormalities were also noticed with Streptococcus with index of teratozoospermia of 46% versus 19% in the 2nd group (P=0.046). CONCLUSION Bacteriospermia may impair sperm parameters. The treatment of this affection seems to improve sperm fertilizing potential. In addition, it could prevent contamination of culture media.
Collapse
Affiliation(s)
- H Hannachi
- Laboratoire de microbiologie et de biochimie, hôpital Aziza Othmana de Tunis, place de la Kasbah, 1008 Tunis Bab Menara, Tunisie.
| | - H Elloumi
- Unité de procréation médicale assistée, hôpital Aziza Othmana de Tunis, place de la Kasbah, 1008 Tunis Bab Menara, Tunisie.
| | - M Hamdoun
- Laboratoire de microbiologie et de biochimie, hôpital Aziza Othmana de Tunis, place de la Kasbah, 1008 Tunis Bab Menara, Tunisie.
| | - K Kacem
- Unité de procréation médicale assistée, hôpital Aziza Othmana de Tunis, place de la Kasbah, 1008 Tunis Bab Menara, Tunisie.
| | - A Zhioua
- Unité de procréation médicale assistée, hôpital Aziza Othmana de Tunis, place de la Kasbah, 1008 Tunis Bab Menara, Tunisie.
| | - O Bahri
- Laboratoire de microbiologie et de biochimie, hôpital Aziza Othmana de Tunis, place de la Kasbah, 1008 Tunis Bab Menara, Tunisie.
| |
Collapse
|
23
|
Harzallah H, Ben Khelil M, Hamdoun M. A Case of Death Resulting from the Complications of a Rudimentary Uterine Horn Pregnancy. J Obstet Gynaecol Can 2018; 40:139. [PMID: 29447699 DOI: 10.1016/j.jogc.2017.11.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Hana Harzallah
- Forensic Pathology Service, Hôpital Charles-Nicolle de Tunis, Tunis, Tunisia; College of Medicine of Tunis, Université de Tunis El Manar, Tunis, Tunisia
| | - Mehdi Ben Khelil
- Forensic Pathology Service, Hôpital Charles-Nicolle de Tunis, Tunis, Tunisia; College of Medicine of Tunis, Université de Tunis El Manar, Tunis, Tunisia
| | - Moncef Hamdoun
- Forensic Pathology Service, Hôpital Charles-Nicolle de Tunis, Tunis, Tunisia; College of Medicine of Tunis, Université de Tunis El Manar, Tunis, Tunisia
| |
Collapse
|
24
|
Najah H, Ammar H, Gupta R, Hamdoun M, Morjane A, Mighri MM, Sassi S. Segmental branching pattern of the left portal vein: Anatomical characteristics and clinical implications. Clin Anat 2017; 31:1122-1128. [PMID: 29082657 DOI: 10.1002/ca.23009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 10/14/2017] [Accepted: 10/25/2017] [Indexed: 12/19/2022]
Affiliation(s)
- Haythem Najah
- Department of General and Digestive SurgeryHôpital Léon Binet, Route de ChalautreProvins France
| | - Houssem Ammar
- Department of General SurgeryHôpital Ibn JazzarKairouan Tunisia
| | - Rahul Gupta
- Synergy Institute of Medical SciencesDehradun India
| | - Moncef Hamdoun
- Department of Forensic MedicineHôpital Charles NicolleTunis Tunisia
- Université Tunis‐ El Manar, Faculté de Médecine de Tunis, 15 Rue Djebel Lakhdhar La RabtaTunis Tunisia
| | | | - Mohamed Mongi Mighri
- Université Tunis‐ El Manar, Faculté de Médecine de Tunis, 15 Rue Djebel Lakhdhar La RabtaTunis Tunisia
- Department of General SurgeryHôpital Mohamed Taher MaamouriNabeul Tunisia
| | - Sadok Sassi
- Université Tunis‐ El Manar, Faculté de Médecine de Tunis, 15 Rue Djebel Lakhdhar La RabtaTunis Tunisia
- Department of General SurgeryHôpital Mohamed Taher MaamouriNabeul Tunisia
| |
Collapse
|
25
|
Saadi A, Bouzouita A, Allouche M, Hamdoun M, Chebil M. Variations anatomiques du drainage veineux de la glande surrénale gauche. Prog Urol 2017. [DOI: 10.1016/j.purol.2017.07.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
26
|
Zaafrane M, Ben Khelil M, Naccache I, Ezzedine E, Savall F, Telmon N, Mnif N, Hamdoun M. Sex determination of a Tunisian population by CT scan analysis of the skull. Int J Legal Med 2017; 132:853-862. [PMID: 28936605 DOI: 10.1007/s00414-017-1688-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 09/06/2017] [Indexed: 11/29/2022]
Abstract
It is widely accepted that the estimation of biological attributes in the human skeleton is more accurate when population-specific standards are applied. With the shortage of such data for contemporary North African populations, it is duly required to establish population-specific standards. We present here the first craniometric standards for sex determination of a contemporary Tunisian population. The aim of this study was to analyze the correlation between sex and metric parameters of the skull in this population using CT scan analysis and to generate proper reliable standards for sex determination of a complete or fragmented skull. The study sample comprised cranial multislice computed tomography scans of 510 individuals equally distributed by sex. ASIRTM software in a General ElectricTM workstation was used to position 37 landmarks along the volume-rendered images and the multiplanar slices, defining 27 inter-landmark distances. Frontal and parietal bone thickness was also measured for each case. The data were analyzed using basic descriptive statistics and logistic regression with cross-validation of classification results. All of the measurements were sexually dimorphic with male values being higher than female values. A nine-variable model achieved the maximum classification accuracy of 90% with -2.9% sex bias and a six-variable model yielded 85.9% sexing accuracy with -0.97% sex bias. We conclude that the skull is highly dimorphic and represents a reliable bone for sex determination in contemporary Tunisian individuals.
Collapse
Affiliation(s)
- Malek Zaafrane
- Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia. .,Department of Legal Medicine, Charles Nicolle Hospital, Tunis, Tunisia. .,Laboratoire d'Anthropobiologie AMIS, UMR 5288 CNRS, Université Paul Sabatier, 37 Allées Jules Guesde, 31000, Toulouse, France.
| | - Mehdi Ben Khelil
- Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia.,Department of Legal Medicine, Charles Nicolle Hospital, Tunis, Tunisia
| | - Ines Naccache
- Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia.,Department of Radiology, Charles Nicolle Hospital, Tunis, Tunisia
| | - Ekbel Ezzedine
- Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia.,Department of Radiology, Charles Nicolle Hospital, Tunis, Tunisia
| | - Frédéric Savall
- Laboratoire d'Anthropobiologie AMIS, UMR 5288 CNRS, Université Paul Sabatier, 37 Allées Jules Guesde, 31000, Toulouse, France
| | - Norbert Telmon
- Laboratoire d'Anthropobiologie AMIS, UMR 5288 CNRS, Université Paul Sabatier, 37 Allées Jules Guesde, 31000, Toulouse, France
| | - Najla Mnif
- Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia.,Department of Radiology, Charles Nicolle Hospital, Tunis, Tunisia
| | - Moncef Hamdoun
- Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia.,Department of Legal Medicine, Charles Nicolle Hospital, Tunis, Tunisia
| |
Collapse
|
27
|
Ben Khelil M, Chkirbene Y, Mlika M, Haouet S, Hamdoun M. Unexpected infant death secondary to a pulmonary infiltration due to acute myelocytic leukaemia. Malays J Pathol 2017; 39:193-196. [PMID: 28866704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Acute myeloid leukaemia (AML) often presents with non-specific symptoms such as fatigue, anaemia or infection. Pulmonary involvement is uncommon in AML during the course of the disease and is usually caused by infection, haemorrhage, leukaemic pulmonary infiltrates and leukostasis. Lung localization of AML is very uncommon and potentially life threatening if not diagnosed and treated rapidly. The authors describe the sudden death of an asymptomatic five-month-infant because of a misdiagnosed lung localization of AML. Autopsy examination followed by histopathological studies showed an extensive leukostasis and extramedullary leukaemic infiltrating the lungs. Special stains and immunohistochemical studies revealed findings consistent with acute myelogenous leukaemia. This case suggests that underlying acute leukaemia should be considered as a cause of flu-like symptoms in infants. Medical personnel are urged to be alert to fever, sore throat, weakness and dyspnea that may be characteristic of serious systemic diseases.
Collapse
Affiliation(s)
- M Ben Khelil
- University Tunis-Elmanar, Faculty of Medicine, Tunis, Tunisia.
| | | | | | | | | |
Collapse
|
28
|
Ben Khelil M, Mlika M, Haj Salem N, Chadly A, Banasr A, Hamdoun M. Evaluation of the work satisfaction of the teaching physicians practicing in the hospitals of Tunis. Tunis Med 2017; 95:401-405. [PMID: 29512794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND Job satisfaction is a key element in managing human resources despite the scope of practice. It is intimately linked to motivation but acts independently. AIM To evaluate the degree of job satisfaction of the teaching physicians practicing in the hospitals of Tunis. METHODS It was a descriptive study including a sample of 75 teaching physicians practicing in Tunis hospitals, selected randomly and anonymously with a 1:20 scale with a matching based on the grade and the speciality. The evaluation was carried out by the Saphora-Job satisfaction questionnaire. RESULTS The 75 physicians who participated had a sex ratio (M / F) of 0.42. The Median seniority was of seven years. The majority of physicians who participated in the study had a professional experience of less than 10 years (72%) and were mostly Assistant Professors (57.3%). The overall job satisfaction rating of participants in the study was 3.13 ± 1.2. Indicators that were related to relatively high satisfaction were represented by the relationship between colleagues, the nature of work and the adequacy of work and personal life. Indicators that were linked to the lowest satisfaction were represented by knowledge and access to regulation, remuneration and knowledge of the organization of the institution. CONCLUSION Our study suggested the need for serious discussions between the different stakeholders about teaching physicians' salary ranges and opportunities for personal development as well as reward system for hospital-based physicians.
Collapse
|
29
|
Mlika M, Ben Khelil M, Hamdoun M, Mezni F. Legal responsibility of the pathologist in Tunisia. Tunis Med 2017; 95:388-392. [PMID: 29512792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The role of the pathologist has been highlighted by the medias since the recent years and the Tunisian law system suffers from a huge and there are no rules or jury verdicts concerning the e responsability of the doctors in general with emphasis on pathologists. One might think that the lack of laws benefits to the pathologist, on the other hand, we can consider this as dangerous either for the patients or the pathologists. This lack of laws makes the judge dependant on the expert view. Other countries like European ones and the United States, has available data furnished by the insurance bodies that enrich the jury verdicts and the different laws that are available. Our aim was to help the pathologists understand their legal responsibilities and the law system. The latter may seem as complex for the pathologist as a pathologic report for a judge.
Collapse
|
30
|
Ben Khelil M, Kamel M, Lahmar S, Mrabet A, Borsali Falfoul N, Hamdoun M. Death certificate accuracy in a Tunisian Emergency Department. Tunis Med 2017; 95:422-428. [PMID: 29512798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Assess Death Certificates accuracy (DCs) issued by a teaching emergency department in Tunis. METHODS It is a descriptive study. We included all death certificates issued in the Emergency Department of a teaching Hospital in Tunis over 17 months period (October 2013 - March 2014). Twenty-one errors have been predefined and classified as "Editing errors" or "Medical analysis error" then as major or minor errors. RESULTS 757 certificates were studied; all DCs had at least three errors with an average number of errors of 6.92±1.55. The mechanism of death was inadequate in 20% of the DCs. The cause of death was "unacceptable" in 21% of the DCs. CONCLUSION The results are similar to those reported in international literature. Therefore, it is urgent to start working on further and regular training on how to fulfil a death certificate for undergraduate and postgraduate medical students.
Collapse
|
31
|
Ben Khelil M, Farhani F, Harzallah H, Allouche M, Gharbaoui M, Banasr A, Benzarti A, Hamdoun M. Patterns of homicide in North Tunisia: a 10-year study (2005–2014). Inj Prev 2017; 24:73-77. [DOI: 10.1136/injuryprev-2016-042123] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 12/03/2016] [Accepted: 01/18/2017] [Indexed: 11/03/2022]
Abstract
BackgroundIn Tunisia and in the Arab world, few data are available about homicide patterns. The aim of our study was to analyse the victims' profiles and the general pattern.Methods636 homicide victims were autopsied at the Legal Medicine Department of Charles Nicolle Hospital in Tunis, over a period of 10 years (2005–2014).ResultsVictims were males in 79.7% with a male-to-female ratio of 3.93 and the average age was 37.7 years. The victim was generally from an urban area (66.7%), single (55.7%) and semiskilled (50.2%). The most common methods of homicide were sharp force (51.7%) and blunt trauma (24.8%).ConclusionsThis study suggests applying urgent preventive measures targeting essentially young males and the importance of a national ‘Violence Repository’.
Collapse
|
32
|
Ben Khelil M, Chkirbene Y, Azzouz H, Haouet S, Hamdoun M. Two cases of sudden death due to pulmonary tumor thrombotic microangiopathy caused by occult gastric carcinoma. Pathologica 2016; 108:160-163. [PMID: 28195256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Abstract
We present two cases of occult gastric carcinoma associated to a large pulmonary tumors thrombosis microangiopathy (PTTM). The first case is a 28 years-old man. He was dead due to a respiratory failure. Autopsy showed a whitish indurated mass invading the stomach wall. Histological findings showed a primary "signet ring" gastric adenocarcinoma with pulmonary carcinomatosis and multiple PTTM and a heart metastasis. The second case is a 24 years-old pregnant woman. The main symptoms were nausea and stomach discomfort and they were seen as pregnancy signs. She was dead because of respiratory failure, 10 hours after a vaginal delivery. Autopsy showed the absence of any cause of death related to the delivery and the presence of a whitish indurated mass in the stomach. Histological findings showed a primary "signet ring" gastric adenocarcinoma, with pulmonary carcinomatosis and multiple PTTM.
Collapse
Affiliation(s)
- M Ben Khelil
- Department of Forensic Medicine, Charles Nicolle Hospital, Tunis, Tunisia
- Faculty of Medicine, University Tunis-Elmanar, Tunis, Tunisia
| | - Y Chkirbene
- Department of Forensic Medicine, Charles Nicolle Hospital, Tunis, Tunisia
- Faculty of Medicine, University Tunis-Elmanar, Tunis, Tunisia
| | - H Azzouz
- Departement of Pathology, La Rabta Hospital, Tunis, Tunisia
| | - S Haouet
- Departement of Pathology, La Rabta Hospital, Tunis, Tunisia
- Faculty of Medicine, University Tunis-Elmanar, Tunis, Tunisia
| | - M Hamdoun
- Department of Forensic Medicine, Charles Nicolle Hospital, Tunis, Tunisia
- Faculty of Medicine, University Tunis-Elmanar, Tunis, Tunisia
| |
Collapse
|
33
|
Ben Khelil M, Zgarni A, Zaafrane M, Chkribane Y, Gharbaoui M, Harzallah H, Banasr A, Hamdoun M. Suicide by self-immolation in Tunisia: A 10 year study (2005–2014). Burns 2016; 42:1593-1599. [DOI: 10.1016/j.burns.2016.04.019] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 04/29/2016] [Indexed: 11/16/2022]
|
34
|
Ben Khelil M, Gharbaoui M, Farhani F, Zaafrane M, Harzallah H, Allouche M, Zhioua M, Hamdoun M. Impact of the Tunisian Revolution on homicide and suicide rates in Tunisia. Int J Public Health 2016; 61:995-1002. [PMID: 27193575 DOI: 10.1007/s00038-016-0834-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 01/14/2016] [Accepted: 05/08/2016] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES To analyze the impact of the Tunisian Revolution on suicide and homicide patterns in Tunisia. METHODS It is a retrospective, cross-sectional study, including all the cases of homicides and suicides that occurred during an 8-year period (2007-2014) in Northern Tunisia. We compared data before and after the revolution. RESULTS After the revolution, the number of suicides rose 1.7 times, with a prevalence rising from 1.8 to 3.12 suicides per 100,000 persons per year. Homicides rose 1.3 times after the revolution. For both manner of death, victims were mostly males, aged between 20 and 39 years, living in urban areas. Hanging and self-immolation rose, respectively, 1.8 and 3 times after 2011. We observed suicide cases most frequently occurred in public places and in front of public administration after 2011. Homicide victims' profile and circumstances showed a single variation which is an increase in number of cases happening in rural areas. CONCLUSIONS Our results proved a short-term impact of the transition period on homicides and suicides. Urgent preventive measures are needed especially to decrease the suicide rates.
Collapse
Affiliation(s)
- Mehdi Ben Khelil
- Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia. .,Department of Legal Medicine, Charles Nicolle Hospital, Tunis, Tunisia.
| | - Meriem Gharbaoui
- Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia.,Department of Legal Medicine, Charles Nicolle Hospital, Tunis, Tunisia
| | - Fethia Farhani
- Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia
| | - Malek Zaafrane
- Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia.,Department of Legal Medicine, Charles Nicolle Hospital, Tunis, Tunisia
| | - Hana Harzallah
- Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia.,Department of Legal Medicine, Charles Nicolle Hospital, Tunis, Tunisia
| | - Mohamed Allouche
- Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia.,Department of Legal Medicine, Charles Nicolle Hospital, Tunis, Tunisia
| | - Mongi Zhioua
- Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia.,Department of Legal Medicine, Charles Nicolle Hospital, Tunis, Tunisia
| | - Moncef Hamdoun
- Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia.,Department of Legal Medicine, Charles Nicolle Hospital, Tunis, Tunisia
| |
Collapse
|
35
|
Bouzouita A, Kerkeni W, Bouchiba N, Allouche M, Mighri MM, Hamdoun M, Chebil M. Anatomical variations of renal venous vascularisation. A study of 71 three-dimensional kidney endocasts. Tunis Med 2015; 93:16-20. [PMID: 25955364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND A better understanding of the anatomy of the renal vein and its relationship with the arterial and excretory systems can prevent intra operative complications. METHODS Three-dimensional endocasts of intrarenal vessels and renal collecting systems were obtained from fresh cadavers, by injecting a polyester resin coloured with different pigments. A total of 71 endocasts were studied: 37 right kidneys and 34 left kidneys. RESULTS Renal vein was unique in 88% of cases and double in 11% of cases. It was formed in 52% of cases by 3 trunks. Intrarenal veins anastomosed together to form 2 levels of arcades in 28% of cases and 3 levels in 71% of cases. The venous drainage of the upper pole was provided by two anterior and posterior plexus in 38% of cases, and by a single anterior plexus in 61% of cases. In 22% of cases, the venous drainage of the lower pole was provided by both an anterior and a posterior plexus, and in 77% of cases, there was only an anterior plexus. Renal artery was posterior to the vein in 66% of cases. It was anterior to the vein in 29% of cases, and located directly above it in 4% of cases. In 60% of cases, we noted a close relationship between the anterior surface of the ureteropelvic junction and the lower branch of the renal vein. CONCLUSION Venous vascularisation of the kidney appears to be variable and its relationship with the arterial and the excretory systems may be complex.
Collapse
|
36
|
Ahmed HB, Boussaid H, Zoghlami B, Allouche M, Baccar H, Hamdoun M. 0201: Symptoms before sudden cardiac death (the northern Tunisian sudden cardiac-death registry). Archives of Cardiovascular Diseases Supplements 2015. [DOI: 10.1016/s1878-6480(15)71741-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
37
|
Ben Ahmed H, Allouche M, Zoghlami B, Shimi M, Gloulou F, Razghallah R, Baccar H, Hamdoun M. [Relation entre la température ambiante, l'humidité et la mort subite cardiaque au nord de la Tunisie]. Tunis Med 2014; 92:681-685. [PMID: 25867151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND Several studies have suggested a relationship between weather parameters and the occurrence of sudden cardiac death. AIM The aim of this work was to study the impact of changes in temperature and humidity level on the occurrence of sudden cardiac death in the north of Tunisia. METHODS it's an autopsic study that included all victims of sudden cardiac death occurring in northern Tunisia between October 2010 and September 2012. The minimum, maximum and average of daily temperatures and humidity during the study period were recorded and compared with the monthly variation in the occurrence of sudden death. RESULTS The study population included 392 men and 108 women with a mean age of 52.2 + / - 15.8 years.The highest rate of sudden death (37%) was observed at ambient temperatures below 15 degrees and only 4.2% of deaths occurred at temperatures above 30 degrees ambient temperatures (p <0.001). Among the population aged over 60 years, the highest mortality rate (47.3%) were recorded at temperatures below 15 degrees, while 35.5% of young patients under 40 years died during periods with temperatures between 20 and 30 degrees and 56.8% of deaths occurred in the humidity levels between 60 and 78% . CONCLUSION In the north of Tunisia where the climate is temperate, a temperature drop below 15 degrees was significantly associated with a sudden cardiac death. This excess winter cardiac mortality was more pronounced in the elderly.
Collapse
|
38
|
Shimi M, Allouche M, Ben Ahmed H, Zoghlemi B, Gloulou F, Ben Khelil M, Banasr A, Zhioua M, Benzarti A, Hamdoun M, Baccar H. Sudden death due to pulmonary embolism in north Tunisia: 37 cases study. Tunis Med 2014; 92:610-614. [PMID: 25860675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
AIM To determine frequency of pulmonary embolism as the cause of sudden death and to study clinical, epidemiological characteristics and risk factors. METHODS Prospective study of cases of sudden death secondary to pulmonary embolism, whose autopsy was performed in the forensic department of Tunis, between October 2009 and of September, 2011. RESULTS During study period, 37 cases of pulmonary embolism were recorded. They represented 6.8 % of all cases of sudden cardiovascular deaths. Victims were male in most cases (65 %). Victims were aged between 21 and 87 years with an average age of about 52 years. Pathological histories were noted in 9 cases: three cases of recent surgery, four cases of pelvic trauma, a case of ovarian tumor and a case of which the PE arose in post-partum. Concerning other risk factors of pulmonary embolism, confinement to bed was noted in 24 cases (64.8 %), obesity in 12 cases (32.4 %), an arterial high blood pressure in 4 cases. Histories of psychiatric pathology were noted in 5 cases (13.5 %). Symptomatology preceding death was dominated by sudden death (35 %) followed by dyspnoea (30 %) and thoracic pains (16 %). In 8 cases , victims consulted emergencies within 48 hours preceding death, for a varied symptomatology without diagnosis of pulmonary embolism is suspected. At autopsy, in 30 cases embolism was massive. In 29 % of the cases, a deep venous thrombosis was revealing in particular at the primitive iliac veins. CONCLUSION Pulmonary embolism is an affection that still kills a lot. It can benefit from prevention and from an effective treatment. This testifies the major importance of clinical diagnosis of pulmonary embolism as well as the technical means for the diagnosis.
Collapse
|
39
|
Ben Ahmed H, Allouche M, Zoghlami B, Shimi M, Razgallah R, Baccar H, Hamdoun M. [Weekly variation of sudden cardiac death in northen Tunisia]. Tunis Med 2014; 92:527-530. [PMID: 25815536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND The sudden cardiac death remains a major public health problem. Several studies have reported weekly variation of this dramatic event. AIM The aim of this work is to determine the day-of-week variability in sudden cardiac death in northen Tunisia. METHODS We prospectively collected clinical, socio demographic and autopsic data of victims of sudden cardiac death occurring in the northern Tunisia between october 1 st ,2010 and september 30,2012. RESULTS The study population included 392 men and 108 women with a mean age of 52.27 + / - 15.8 years. Three quarters of the victims was sedentary, 57.9% were smoker and a family history of sudden death was identified in 9.8% of cases. The vast majority of deaths had occurred either in a public place (41.4%) or at home (36.6%). Ischemic heart disease was the leading cause of death with 267 cases (53.4%); however a negative autopsy was found in 13.9% of victims. The highest sudden death occurrence was on Sundays (17.8%) and the lowest on Mondays (11.4% p: 0.01).The same weekly variation was noted among both men and women , and also in victims > 60 years, a minimum of events occurred on Mondays (11.6%) and a maximum on Sundays (21.9%). In addition, we found the same peak of mortality on Sunday (18.8%) in young adults and the nadir on Monday (10.3%). CONCLUSIONS The present study demonstrates marked variation in the occurrence of sudden cardiac death in the northern Tunisia with peak on Sundays and nadir on Mondays. No age or gender- related differences were found in weekly variation of sudden death.
Collapse
|
40
|
Ben Ahmed H, Allouche M, Zoghlami B, Shimi M, Razghallah R, Gloulou F, Baccar H, Hamdoun M. Mort subite d’origine cardiaque au nord de la Tunisie : variation circadienne, hebdomadaire et saisonnière. Presse Med 2014; 43:e39-45. [DOI: 10.1016/j.lpm.2013.09.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2013] [Revised: 08/02/2013] [Accepted: 09/24/2013] [Indexed: 01/09/2023] Open
|
41
|
Sassi N, Gadgadi N, Laadhar L, Allouche M, Mourali S, Zandieh-Doulabi B, Hamdoun M, Nulend JK, Makni S, Sellami S. Notch signaling is involved in human articular chondrocytes de-differentiation during osteoarthritis. J Recept Signal Transduct Res 2013; 34:48-57. [PMID: 24251351 DOI: 10.3109/10799893.2013.856920] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
CONTEXT During osteoarthritis (OA), chondrocytes undergo de-differentiation, resulting in the acquisition of a fibroblast-like morphology, decreased expression of collagen type II (colII) and aggrecan, and increased expression of collagen type I (colI), metalloproteinase 13 (MMP13) and nitric oxide synthase (eNOS). Notch signaling plays a crucial role during embryogenesis. Several studies showed that Notch is expressed in adulthood. OBJECTIVE The aim of our study was to confirm the involvement of Notch signaling in human OA at in vitro and ex vivo levels. MATERIALS AND METHODS Normal human articular chondrocytes were cultured during four passages either treated or not with a Notch inhibitor: DAPT. Human OA cartilage was cultured with DAPT for five days. Chondrocytes secreted markers and some Notch pathway components were analyzed using Western blotting and qPCR. RESULTS Passaging chondrocytes induced a decrease in the cartilage markers: colII and aggrecan. DAPT-treated chondrocytes and OA cartilage showed a significant increase in healthy cartilage markers. De-differentiation markers, colI, MMP13 and eNOS, were significantly reduced in DAPT-treated chondrocytes and OA cartilage. Notch1 expression was proportional to colI, MMP13 and eNOS expression and inversely proportional to colII and aggrecan expression in nontreated cultured chondrocytes. Notch ligand: Jagged1 increased in chondrocytes culture. DAPT treatment resulted in reduced Jagged1 expression. Notch target gene HES1 increased during chondrocyte culture and was reduced when treated with DAPT. CONCLUSION Targeting Notch signaling during OA might lead to the restitution of the typical chondrocyte phenotype and even to chondrocyte redifferentiation during the pathology.
Collapse
Affiliation(s)
- Nadia Sassi
- Department of Rheumatology, Immuno-Rheumatology Research Laboratory, La Rabta Hospital, University of Tunis-El Manar , Tunis , Tunisia
| | | | | | | | | | | | | | | | | | | |
Collapse
|
42
|
Khelil MB, Allouche M, Banasr A, Gloulou F, Benzarti A, Zhioua M, Haouet S, Hamdoun M. Sudden death due to hydatid disease: a six-year study in the northern part of Tunisia. J Forensic Sci 2013; 58:1163-1170. [PMID: 23822140 DOI: 10.1111/1556-4029.12172] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2011] [Revised: 06/14/2012] [Accepted: 07/01/2012] [Indexed: 11/27/2022]
Abstract
Human ecchinococcosis also known as hydatid disease is a zoonotic infection caused by the tapeworm Ecchinococcus with 2-3 Million cases worldwide. We hereby report a 6 years period study of Sudden death due to hydatidosis aiming to analyze the epidemiological criteria, death circumstances, and autopsy observations attributed to hydatid disease. During the past 6 years, 26 death cases were due to hydatid disease. Our analysis shows that the sex ratio (M/F) was 1.6, the mean age was 31-year old, and 65% of the subjects lived in rural places. In 17 cases, death occurred in the victim's place, five victims died after a heavy exercise, and in two cases, death occurred immediately after trauma. At autopsy, 91% of the cysts were found in the liver. In three cases, death followed a septic state, and in two cases, it followed an acute respiratory failure. Death was attributed to anaphylaxis in 17 cases.
Collapse
Affiliation(s)
- Mehdi Ben Khelil
- Service de Médecine Légale de Tunis, Hôpital Charles Nicolle, 138 Boulevard du 9 avril 1938, Tunis, 1006, Tunisia
- Université de Tunis El Manar, Faculté de Médecine de Tunis, Tunis, 1007, Tunisia
| | - Mohamed Allouche
- Service de Médecine Légale de Tunis, Hôpital Charles Nicolle, 138 Boulevard du 9 avril 1938, Tunis, 1006, Tunisia
- Université de Tunis El Manar, Faculté de Médecine de Tunis, Tunis, 1007, Tunisia
| | - Ahmed Banasr
- Service de Médecine Légale de Tunis, Hôpital Charles Nicolle, 138 Boulevard du 9 avril 1938, Tunis, 1006, Tunisia
- Université de Tunis El Manar, Faculté de Médecine de Tunis, Tunis, 1007, Tunisia
| | - Fatma Gloulou
- Service de Médecine Légale de Tunis, Hôpital Charles Nicolle, 138 Boulevard du 9 avril 1938, Tunis, 1006, Tunisia
- Université de Tunis El Manar, Faculté de Médecine de Tunis, Tunis, 1007, Tunisia
| | - Anis Benzarti
- Service de Médecine Légale de Tunis, Hôpital Charles Nicolle, 138 Boulevard du 9 avril 1938, Tunis, 1006, Tunisia
- Université de Tunis El Manar, Faculté de Médecine de Tunis, Tunis, 1007, Tunisia
| | - Mongi Zhioua
- Service de Médecine Légale de Tunis, Hôpital Charles Nicolle, 138 Boulevard du 9 avril 1938, Tunis, 1006, Tunisia
- Université de Tunis El Manar, Faculté de Médecine de Tunis, Tunis, 1007, Tunisia
| | - Slim Haouet
- Université de Tunis El Manar, Faculté de Médecine de Tunis, Tunis, 1007, Tunisia
- Service d'Anatomie Pathologique, Hôpital La Rabta, Tunis, 1007, Tunisia
| | - Moncef Hamdoun
- Service de Médecine Légale de Tunis, Hôpital Charles Nicolle, 138 Boulevard du 9 avril 1938, Tunis, 1006, Tunisia
- Université de Tunis El Manar, Faculté de Médecine de Tunis, Tunis, 1007, Tunisia
| |
Collapse
|
43
|
Sassi N, Laadhar L, Allouche M, Zandieh-Doulabi B, Hamdoun M, Klein-Nulend J, Makni S, Sellami S. Wnt signaling is involved in human articular chondrocyte de-differentiation in vitro. Biotech Histochem 2013; 89:29-40. [PMID: 23901947 DOI: 10.3109/10520295.2013.811285] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Osteoarthritis is the most prevalent form of arthritis in the world. Certain signaling pathways, such as the wnt pathway, are involved in cartilage pathology. Osteoarthritic chondrocytes undergo morphological and biochemical changes that lead to chondrocyte de-differentiation. We investigated whether the Wnt pathway is involved in de-differentiation of human articular chondrocytes in vitro. Human articular chondrocytes were cultured for four passages in the presence or absence of IL-1 in monolayer or micromass culture. Changes in cell morphology were monitored by light microscopy. Protein and gene expression of chondrocyte markers and Wnt pathway components were determined by Western blotting and qPCR after culture. After culturing for four passages, chondrocytes exhibited a fibroblast-like morphology. Collagen type II and aggrecan protein and gene expression decreased, while collagen type I, matrix metalloproteinase 13, and nitric oxide synthase expressions increased. Wnt molecule expression profiles changed; Wnt5a protein expression, the Wnt target gene, c-jun, and in Wnt pathway regulator, sFRP4 increased. Treatment with IL-1 caused chondrocyte morphology to become more filament-like. This change in morphology was accompanied by extinction of col II expression and increased col I, MMP13 and eNOS expression. Changes in expression of the Wnt pathway components also were observed. Wnt7a decreased significantly, while Wnt5a, LRP5, β-catenin and c-jun expressions increased. Culture of human articular chondrocytes with or without IL-1 not only induced chondrocyte de-differentiation, but also changed the expression profiles of Wnt components, which suggests that the Wnt pathway is involved in chondrocyte de-differentiation in vitro.
Collapse
Affiliation(s)
- N Sassi
- Immuno-Rheumatology Research Laboratory, Department of Rheumatology, La Rabta Hospital, University of Tunis-El Manar
| | | | | | | | | | | | | | | |
Collapse
|
44
|
Sassi N, Laadhar L, Allouche M, Zandieh-Doulabi B, Hamdoun M, Klein-Nulend J, Makni S, Sellami S. The roles of canonical and non-canonical Wnt signaling in human de-differentiated articular chondrocytes. Biotech Histochem 2013; 89:53-65. [PMID: 23901950 DOI: 10.3109/10520295.2013.819123] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Osteoarthritis is the most prevalent form of arthritis in the world and it is becoming a major public health problem. Osteoarthritic chondrocytes undergo morphological and biochemical changes that lead to de-differentiation. The involvement of signaling pathways, such as the Wnt pathway, during cartilage pathology has been reported. Wnt signaling regulates critical biological processes. Wnt signals are transduced through at least three intracellular signaling pathways including the canonical Wnt/β-catenin pathway, the Wnt/Ca2 + pathway and the Wnt/planar cell polarity pathway. We investigated the involvement of the Wnt canonical and non-canonical pathways in human articular chondrocyte de-differentiation in vitro. Human articular chondrocytes were cultured through four passages with no treatment, or with sFRP3 treatment, an inhibitor of Wnt pathways, or with DKK1 treatment, an inhibitor of the canonical pathway. Chondrocyte-secreted markers and Wnt pathway components were analyzed using western blotting and qPCR. Inhibition of the Wnt pathway showed that the canonical Wnt signaling probably is responsible for inhibition of collagen II expression, activation of metalloproteinase 13 expression and regulation of Wnt7a and c-jun expression during chondrocyte de-differentiation in vitro. Our results also suggest that expressions of eNOS, Wnt5a and cyclinE1 are regulated by non-canonical Wnt signaling.
Collapse
Affiliation(s)
- N Sassi
- Immuno-Rheumatology research laboratory, Rheumatology Department, La Rabta Hospital, University of Tunis-El Manar
| | | | | | | | | | | | | | | |
Collapse
|
45
|
Allouche M, Boudriga N, Ahmed HB, Banasr A, Shimi M, Gloulou F, Zhioua M, Bouhajja B, Baccar H, Hamdoun M. [Sudden death during sport activity in Tunisia: autopsy study in 32 cases]. Ann Cardiol Angeiol (Paris) 2012; 62:82-8. [PMID: 22959438 DOI: 10.1016/j.ancard.2012.08.030] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Accepted: 08/07/2012] [Indexed: 11/26/2022]
Abstract
PURPOSE To develop profile of the victims and to study circumstances, causes of death and autopsy findings. METHODS Retrospective study of cases of sudden death in sport activity whose autopsy was performed in forensic department of Tunis, between January 2005 and December 2009. RESULTS During study period, 32 cases of SD in sport activity were recorded. These are amateur athletes predominantly male (84% of cases). Victims are aged between 15 and 79 years with an average age of about 33.16 years. Young subjects whose age is less than 35 years representing 68.7% of cases. 9.3% of victims had a family history of SD and 18.7% of cases had a known cardiac history. The sports most involved are running (40.6% of cases), football (31.3% of cases) and dance (12.5% of cases). Sixty-nine percent of victims died during sports activities. Presence of witnesses was noted in all cases; however, none of these witnesses has begun resuscitation. Cause of death was cardiac in 84.4% of cases. In young athletes, hypertrophic cardiomyopathy is the leading cause (nine cases), followed by arrhythmogenic right ventricular dysplasia (three cases). Among other causes, there is the myocardial bridge, congenital anomalies of the coronary arteries, aortic dissection and dilated cardiomyopathy. Beyond 35 years, coronary artery diseases represent the cause of death (nine cases). Only case of death secondary to non-cardiac disease occurred after a severe asthma attack. In four cases (12.5%), no cause of death was identified after a complete autopsy accompanied by further investigations. The cause of the death was imputed to a rhythmic pathology. CONCLUSION This is the first study dealing with autopsy in SD in sport have provided a specific profile of victims. Other studies on larger samples and using standardized autopsy protocols are needed.
Collapse
Affiliation(s)
- M Allouche
- Service de médecine légale, faculté de médecine de Tunis, université Tunis El Manar, hôpital Charles Nicolle de Tunis, 1006 Tunis, Tunisie.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Mahjoub M, Sassi N, Driss M, Laadhar L, Allouche M, Hamdoun M, Romdhane KB, Sellami S, Makni S. Expression patterns of Notch receptors and their ligands in human osteoarthritic and healthy articular cartilage. Tissue Cell 2012; 44:182-94. [PMID: 22455903 DOI: 10.1016/j.tice.2012.03.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2011] [Revised: 03/02/2012] [Accepted: 03/02/2012] [Indexed: 11/17/2022]
Abstract
Notch pathway plays a pivotal role in cell fate determination. There is much interest surrounding its therapeutic potential, in osteoarthritis, but the expression profile of Notch-related molecules, as well as their relation with cartilage pathological parameters, remains unclear. The purpose of our study is to analyze the expression pattern of Notch family members, type II and type I collagen, in normal (healthy) and osteoarthritic human knee cartilage. Osteoarthritic cartilages were obtained from 3 patients undergoing a total knee replacement. Macroscopically normal cartilage was dissected from 3 human knees at the time of autopsy or surgery. Immunohistochemical staining was performed using Notch1,2,3 and 4, Delta, Jagged, type II collagen and type I collagen antibodies. In healthy cartilage, type II collagen was abundantly expressed while type I was absent. This latter increased proportionally to the osteoarthritic grade. Type II collagen expression remained intense in osteoarthritic cartilage. In healthy cartilage as well as in cartilage with minor lesions, Notch family member's proteins were not or just weakly expressed at the surface and in the cells. However, Notch molecules were over-expressed in osteoarthritic cartilage compared to healthy one. This expression pattern was different according to the cartilage zone and the severity of OA. Our data suggest that Notch signaling is activated in osteoarthritic cartilage, compared to healthy cartilage, with a much more abundant expression in the most damaged areas.
Collapse
Affiliation(s)
- M Mahjoub
- Immuno-Rheumatology Research Laboratory, Rheumatology Department, La Rabta Hospital, University of Tunis-El Manar, 1007 Tunis, Tunisia
| | | | | | | | | | | | | | | | | |
Collapse
|
47
|
Slimane NB, Elleuch M, Gharbi E, Babay H, Hamdoun M. [Occupational carpal tunnel syndrome: 27 cases]. Tunis Med 2010; 88:634-637. [PMID: 20812175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
BACKGROUND Carpal tunnel syndrome is the most frequent of tunnel syndromes in the field of the professional sphere. It is related to repetitive movements of flexion-extension of the wrist and fingers or to a support on the heel of the hands. AIM To determine the posts in a risk and to specify the modalities of guaranteed reimbursement of professional carpal tunnel syndrome. METHODS A retrospective and descriptive study of 27 medical files of employees indemnified for professional carpal tunnel syndrome registered in the medical control services of the social security office in charge of medical insurance of Tunis and Sousse during a period of 10 years (1995-2004). RESULTS There were 24 women and 3 men with the average age of 40 years all occupying posts in a risk. Their average time of service is 15 years. Tow-thirds of them work in the clothing and textile industry. The attack is bilateral in 13 cases. Nightly acroparaesthesia rules the clinical rate (44.44% of cases). Motor disorders are noted in the quarter of cases. The electromyogram had confirmed diagnosis in all of cases. The previous state study put in evidence the antecedent of carpal tunnel syndrome in 5 cases and diabetes in one case. Twenty-one patients had profit of permanent partial incapacity with a rate varying from 3 to 25%. Five had got a transfer of working place and one stayed in the same post with a half-time work. CONCLUSION The professional origin of carpal tunnel syndrome must be called up in front of an activity in a risk. The reparation is done according to picture 82 of occupational diseases.
Collapse
|
48
|
Gloulou F, Allouche M, Khelil MB, Bekir O, Banasr A, Zhioua M, Hamdoun M. Unusual suicides with band saws: Two case reports and a literature review. Forensic Sci Int 2009; 183:e7-10. [DOI: 10.1016/j.forsciint.2008.09.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2007] [Accepted: 09/23/2008] [Indexed: 10/21/2022]
|
49
|
Saïdani M, Mesrati I, Benzarti A, Boussetta K, Bousnina S, Hamdoun M, Ben Redjeb S. [Community-acquired pneumonia due to Panton-Valentine producing Staphylococcus aureus: first description in Tunisia]. Tunis Med 2008; 86:924-927. [PMID: 19472814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND Community-acquired pneumonia due to Panton-Valentine producing S.aureus is a serious infection recently described. Many cases have been reported worldwide. AIM We report here the first case in Tunisia. OBSERVATION Our patient is a previously healthy fourteen-year-old girl hospitalized for bilateral hypoxemic pneumonia. The clinical course had violently deteriorated two hours later, marked by massive hemoptysis that lead to rapid degradation of her hemodynamic state and death. Toxicologic research and bloodcultures were negatives. A post-mortem pleural specimen culture yielded a meticillin-resistant Staphylococcus aureus strain that carried the Panton-Valentine leucocidin genes. CONCLUSION Community-acquired pneumonia due to Panton-Valentine producing Staphylococcus aureus is a serious affection unrecognized in our country. Thus, this pathogen must imperatively be included in the spectrum of those responsibles for pulmonary infections in children and young adults
Collapse
|
50
|
Abstract
OBJECTIVE The aim of our work was to study cardiac sequelae of penetrating cardiac injuries. MATERIAL AND METHODS It is a retrospective study including nine patients (eight men and one woman with an average age of 26.6 +/- 7.4 years) hospitalised between January 1st, 1988 and December 31, 2002 in cardiovascular surgery department of Tunis Rabta hospital for heart wounds. RESULTS It was stab wounds in all patients. Heart lesions concerned primarily the right ventricle. In admission, two patients had cardiac tamponade and seven were in shock. Beating heart surgery without cardiopulmonary bypass in all patients performed surgical repair and it consisted in simple suture. Functional symptoms were observed in five patients at late outcome. Five patients had heart sequelae. It consisted of conduction abnormalities (right bundle branch block) in five patients. One patient had a small ventricular septal defect. Finally, partial permanent disability rates were less than 10%. CONCLUSION Cardiac sequelae of penetrating cardiac wounds have good prognosis with the exception of a small partial permanent disability rate. Their prevention must be based on the fight against the urban violence and on the good initial management.
Collapse
Affiliation(s)
- H Ouldzein
- Service de cardiologie B, CHU de Rangueil, 1, avenue Jean-Poulhès, 31059 Toulouse cedex 09, France.
| | | | | | | | | |
Collapse
|