[Odontogenic cervical-facial cellulitis: report of 87 cases]

Cervical-facial cellulitis are infections of the cellular fatty spaces of the face and neck with a tendency towards locoregional extension, septic and thromboembolic complications that can affect the patient's vital and/or functional prognosis. The management is multidisciplinary including a medical component, surgical drainage associated with the treatment of the causal tooth. This is a retrospective study including 87 cases of odontogenic head and neck cellulitis hospitalized in the ENT and head and neck surgery department at Fattouma Bourguiba Monastir hospital over a period of 4 years between January 2017 and December 2020. The study included 48 women and 39 men. The most affected age group was young adults (54 %). The main contributing factors were poor oral hygiene (76 %), tobacco (41 %) and alcohol (19 %). Anti-inflammatory medicines intake was found in 31 % of cases. The average consultation time was 5 days. The main reason for consultation was painful head and neck swelling associated with trismus (70 %) and fever (52 %). The cervical-facial scan was performed in 93 % of patients. It revealed suppurative cellulitis (64 %), extension to upper aerodigestive ways (20 %), compression of upper aero-digestive tract (11,5 %), Lemierre syndrome (4,6 %) and gangrenous cellulitis with mediastinal extension (1,1 %). All patients received large spectrum antibiotic, associated in 25 % of cases with surgical drainage. Treatment of the dental cause was performed in all patients. The evolution was favourable in 98,9 % of cases. There is only one death due to a septic shock (1,1 %), which is consistent with most of the results reported in the literature. Head and neck cellulitis can affect the functional and vital prognosis of the patient in the absence of rapid and adequate management. The treatment remains primarily preventive.

Post-traumatic stress disorder among tunisian healthcare professionals facing the pandemic coronavirus (COVID-19)

Introduction

The new coronavirus has spread rapidly across the planet confining entire populations, filling hospitals overwhelmed by massive arrivals of patients This new health situation was traumatic especially for health-professionals

Objectives

To study the prevalence and predictors of post-traumatic stress disorder, among health-workers.

Methods

Our study was descriptive and analytical cross-sectional, between May until June 2020. An anonymous online-survey was sent to collect those parameters Sociodemographic-information Physical symptoms The existence of contact with a suspected case The need for quarantine The stressful event The state of mental health, using: PCL-5: 20 items which measures the 20 symptoms of post-traumatic stress-disorder according to DSM-5. PSQI: 9 questions to see the existence or not of a disturbance in sleep

Results

125 participants: 28 university-hospital doctors, 55 residents, 5 interns, 4 specialist-doctors, 2 general-practitioners, 14 nurses, 14 senior-technicians, 2 midwives and a pharmacist. The average seniority at the job was 6 years. Two factors were the most stressful: The characteristics of this pandemic 37.6% The fear of caching the virus and transmit it to their families: 37.6%. 42.4% of participants presented a post-traumatic stress disorder. 3 parameters were correlated with post-traumatic stress disorder: young age, having children (p = 0.007) and fewer years of professional-experience. This pandemic altered the quality of sleep of caregivers, 62.4% of them had a bad quality of sleep. The bad sleepers developed more post-traumatic stress disorder

Conclusions

This health crisis had a major impact on the mental health of our heroes that is why we should provide them with the necessary psychological support.

The COVID-19 pandemic and its psychological impact on tunisian health professionals

Introduction

In March 2020,World Health Organization characterized the COVID-19 outbreak as pandemic. This new health situation has created an anxiety-provoking climate among health professionals

Objectives

To provide risks associated with the exposure of caregivers to COVID-19 for their mental health by studying the prevalence and predictors of post-traumatic stress disorder, anxiety and depression.

Methods

Our study was descriptive and analytical cross-sectional, carried out with healthcare in different hospitals in Tunisia, between 13 May until 20 June 2020. An online survey was sent to caregivers. mental health was assessed using 3 scales: PCL-5:measure the symptoms of post-traumatic stress disorder HADS :screen for anxiety and depression. PSQI:see the existence of a disturbance in sleep quality

Results

125 caregivers participated in the survey. The average age was 32 years. The participants were predominantly female (72.8%), married (48%), and had at least one child (39.2%). 28.7% of participants had increased their consumption of coffee, especially anxious people (p = 0.001). Anxiety was retained in 44% and depression in 47.2%. Anxiety was significantly related to sex with (p = 0.039) and affects more women. The consumers of coffee developed more anxiety (p = 0.034) and depression (p = 0.026). 42.4% of participants had presented post-traumatic stress disorder. Three parameters were correlated with post-traumatic stress disorder: young age, having children and fewer years of professional experience. 62.4% of caregivers had a bad quality of sleep

Conclusions

This health crisis had a major impact on the mental health of our heroes. So, we should provide for them with the necessary support.

Primary sinonasal meningioma

INTRODUCTION

Primary meningiomas of the sinonasal tract are rare tumors. Their positive diagnosis is difficult to establish. From one case observation, we report the clinical features, the diagnosis difficulties and the therapeutic modalities of primary meningioma of the sinonasal tract.

CASE REPORT

A seventeen-year-old girl consulted for a left unilateral nasal obstruction with progressive evolution without episodes of epistaxis, smell disorder or headaches over a year. Physical examination revealed a grayish polypoid tumor in the left nasal fossa. CT scan evidenced an isodense lesion of the left nasal fossa slightly enhanced pushing back the lateral nasal wall without invasion or intracranial connection. Biopsy was in favour of an inverted papilloma. The tumor was resected via endoscopic approach. Pathological examination established the diagnosis of meningothelial menigioma. The prognosis was favourable without recurrence after a six-month follow-up.

CONCLUSION

The positive diagnosis of primary sinonasal meningioma is difficult to establish because of their infrequent occurrence in this ectopic site and of their non-specific clinical appearance. The final diagnosis rests on the histological examination. Immunohistochemical studies are helpful to establish the accurate diagnosis. Imaging confirms the primitive nature of these tumors. Prognosis is excellent after complete surgical extirpation without the necessity of adjuvant therapy.