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Amine S, Aziz S, Babty M, Jaafar F, Abdellatif K, Ahmed IA. Successful management of chylous ascite after removal of residual mass in non-seminomatous germ cell tumours following chemotherapy: A single-center experience and review of the literature. Int J Surg Case Rep 2024; 118:109502. [PMID: 38657515 PMCID: PMC11063513 DOI: 10.1016/j.ijscr.2024.109502] [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: 01/19/2024] [Revised: 03/02/2024] [Accepted: 03/07/2024] [Indexed: 04/26/2024] Open
Abstract
INTRODUCTION Chylous ascites is a rare but morbid condition following removal of residual mass in non-seminomatous germ cell tumours following chemotherapy. CASE PRESENTATION We hereby present the case of a 20-year-old man who had undergone RPLND with complete surgical excision. A lesion of the Cisterna chyli complicated the operation. The post-operative course was marked by the appearance of chylous ascites. The conservative management strategy for this complication was successful, but only after a month. CLINICAL DISCUSSION Chylous ascites is a rare but morbid condition following removal of residual mass in non-seminomatous germ cell tumours following chemotherapy. Conservative management based on a high-protein diet with fat restriction and medium-chain triglyceride supplementation, and somatostatine are usually successful. Surgery should be reserved for situations that are refractory to treatment. CONCLUSIONS We report our successful management and, we also analysed the different management protocols using our experience and review of the literature.
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Affiliation(s)
- Slaoui Amine
- Urology Department, Avicenne Hospital, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco.
| | - Slaoui Aziz
- Gynaecology-Obstetrics and Endoscopy Department, Maternity Souissi, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco
| | - Mouftah Babty
- Urology Department, Avicenne Hospital, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco
| | - Fouimtizi Jaafar
- Urology Department, Avicenne Hospital, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco
| | - Koutani Abdellatif
- Urology Department, Avicenne Hospital, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco
| | - Iben Atyya Ahmed
- Urology Department, Avicenne Hospital, University Hospital Center IBN SINA, University Mohammed V, Rabat, Morocco
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Ihssan E, Salma E, Ayoub M, Amine S, Zakia B, Kaoutar Z. Primary intra-testicular rhabdomyosarcoma: Case report. Int J Surg Case Rep 2022; 96:107340. [PMID: 35793590 PMCID: PMC9284074 DOI: 10.1016/j.ijscr.2022.107340] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 06/18/2022] [Accepted: 06/18/2022] [Indexed: 02/07/2023] Open
Abstract
Intra-testicular localization of rhabdomyosarcoma remains exceptional and few cases have been reported in the literature. Anatomopathological examination is the gold standard for diagnosis and for confirming the intratesticular origin Radical inguinal orchiectomy followed by chemotherapy is the treatment of choice.
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Affiliation(s)
- Elouarith Ihssan
- Pathology Department, Ibn Sina Hospital, Mohammed V University, Rabat, Morocco,Corresponding author at: Pathology Department, Oncology National Institute, Faculty of Medicine and Pharmacy, Mohammed V University, 10100 Rabat, Morocco.
| | - Elmajoudi Salma
- Pathology Department, Ibn Sina Hospital, Mohammed V University, Rabat, Morocco
| | - Mamad Ayoub
- Urology B Department, Ibn Sina Hospital, Mohammed V University, Rabat, Morocco
| | - Slaoui Amine
- Urology B Department, Ibn Sina Hospital, Mohammed V University, Rabat, Morocco
| | - Bernoussi Zakia
- Pathology Department, Ibn Sina Hospital, Mohammed V University, Rabat, Morocco
| | - Znati Kaoutar
- Pathology Department, Ibn Sina Hospital, Mohammed V University, Rabat, Morocco
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Ferjani S, Sassi I, Saidani M, Mhiri E, Ghariani A, Boutiba Ben Boubaker I, Slim L, Amine S. Polymorphism of ftsI gene in Haemophilus influenzae and emergence of cefotaxime resistance in two Tunisian hospitals. New Microbes New Infect 2020; 36:100690. [PMID: 32489667 PMCID: PMC7262452 DOI: 10.1016/j.nmni.2020.100690] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 03/19/2020] [Accepted: 04/27/2020] [Indexed: 11/23/2022] Open
Abstract
The decreased affinity to β-lactams in Haemophilus influenzae is usually caused by specific alterations in penicillin-binding protein 3 due to varieties of substitutions in ftsI gene. This study aimed to characterize the polymorphism of ftsI gene in 19 H. influenzae strains, isolated between 2014 and 2016 (different resistance phenotypes to β-lactams (n = 9) and susceptible strains (n = 10) used for comparative purposes). All strains were characterized for capsular type by PCR and agglutination tests and for β-lactam resistance by amplification and sequencing of ftsI. Biotyping and clonality were performed by API-NH and pulsed-field gel electrophoresis, respectively. Four strains were β-lactamase-negative ampicillin-resistant and five were β-lactamase-positive clavulanic-acid-resistant. One strain from each group was resistant to cefotaxime. Our isolates belonged mainly to biotype IV and I and were non-typeable and genetically unrelated. According to mutation profiles of their ftsI, strains were classified as group I (n = 3), group II (n = 4), group–III–like (n = 1) and group III (n = 1). All group II strains were further classified as subgroup IIb, except for one strain, which harboured a new mutation (N422I). Ampicillin MICs of β-lactamase-negative ampicillin-resistant strains were 6 to 12 times the MICs of susceptible strains. Only blaTEM-1 was detected in β-lactamase-positive clavulanic-acid-resistant strains, and was responsible for high MICs for ampicillin (>256 mg/L), whatever the ftsI mutational resistance group. The emergence of cefotaxime-resistant isolates in our country is a matter of concern and requires strict surveillance and rationalization of antibiotic use to preserve these molecules.
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Affiliation(s)
- S Ferjani
- University of Tunis El Manar, Faculty of Medicine of Tunis, LR99ES09 Laboratory of Research 'Resistance to Antimicrobial Agents, Tunis, Tunisia
| | - I Sassi
- Charles Nicolle Hospital, Laboratory of Microbiology, Tunis, Tunisia
| | - M Saidani
- University of Tunis El Manar, Faculty of Medicine of Tunis, LR99ES09 Laboratory of Research 'Resistance to Antimicrobial Agents, Tunis, Tunisia.,Charles Nicolle Hospital, Laboratory of Microbiology, Tunis, Tunisia
| | - E Mhiri
- Abderrahmen Mami Hospital, Laboratory of Microbiology, Ariana, Tunisia
| | - A Ghariani
- Abderrahmen Mami Hospital, Laboratory of Microbiology, Ariana, Tunisia
| | - I Boutiba Ben Boubaker
- University of Tunis El Manar, Faculty of Medicine of Tunis, LR99ES09 Laboratory of Research 'Resistance to Antimicrobial Agents, Tunis, Tunisia.,Charles Nicolle Hospital, Laboratory of Microbiology, Tunis, Tunisia
| | - L Slim
- Abderrahmen Mami Hospital, Laboratory of Microbiology, Ariana, Tunisia
| | - S Amine
- University of Tunis El Manar, Faculty of Medicine of Tunis, LR99ES09 Laboratory of Research 'Resistance to Antimicrobial Agents, Tunis, Tunisia.,Charles Nicolle Hospital, Laboratory of Microbiology, Tunis, Tunisia
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Souhail R, Amine S, Nadia A, Tarik K, Khalid EK, Abdellatif K, Ahmed IA. Complete androgen insensitivity syndrome or testicular feminization: review of literature based on a case report. Pan Afr Med J 2016; 25:199. [PMID: 28270903 PMCID: PMC5326263 DOI: 10.11604/pamj.2016.25.199.10758] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Accepted: 11/02/2016] [Indexed: 12/29/2022] Open
Abstract
Testicular feminization, or the androgen insensitivity syndrome, is a rare disease. Because of various abnormalities of the X chromosome, a male, genetically XY, has some physical characteristics of a woman or a full female phenotype. Indeed the androgen insensitivity syndrome occurs because of a resistance to the actions of the androgen hormones, which in turn switches the development towards the aspect of a woman. We report a case of complete androgen insensitivity syndrome in a 30 years old woman who presented primary amenorrhea. We aim to improve our knowledge of this illness from the data that provides us this study, and a review of the literature.
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Affiliation(s)
- Regragui Souhail
- Department of Urology B, Ibn Sina University Hospital, Rabat, Morocco
| | - Slaoui Amine
- Department of Urology B, Ibn Sina University Hospital, Rabat, Morocco
| | - Abounouh Nadia
- Department of Gynecology Obstetrics, Maternity ibn Sina, Rabat, Morocco
| | - Karmouni Tarik
- Department of Urology B, Ibn Sina University Hospital, Rabat, Morocco
| | - El Khader Khalid
- Department of Urology B, Ibn Sina University Hospital, Rabat, Morocco
| | | | - Ibn Attya Ahmed
- Department of Urology B, Ibn Sina University Hospital, Rabat, Morocco
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Hammami S, Boutiba-Ben Boubaker I, Ghozzi R, Saidani M, Amine S, Ben Redjeb S. Nosocomial outbreak of imipenem-resistant Pseudomonas aeruginosa producing VIM-2 metallo-β-lactamase in a kidney transplantation unit. Diagn Pathol 2011; 6:106. [PMID: 22035284 PMCID: PMC3223140 DOI: 10.1186/1746-1596-6-106] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2011] [Accepted: 10/28/2011] [Indexed: 01/05/2023] Open
Abstract
Background Twenty four non replicate imipenem resistant P. aeruginosa were isolated between January and November 2008, in the kidney transplantation unit of Charles Nicolle Hospital of Tunis (Tunisia). This study was conducted in order to establish epidemiological relationship among them and to identify the enzymatic mechanism involved in imipenem resistance. Methods Analysis included antimicrobial susceptibility profile, phenotypic (imipenem-EDTA synergy test) and genotypic detection of metallo-β-lactamase (MBL) (PCR), O-serotyping and pulsed-field gel electrophoresis. Results All strains showed a high level of resistance to all antimicrobials tested except to colistin. The presence of MBL showed concordance between phenotypic and genotypic methods. Sixteen isolates were identified as VIM-2 MBL-producers and 13 of them were serotype O4 and belonged to a single pulsotype (A). Conclusions This study describes an outbreak of VIM-2-producing P. aeruginosa in a kidney transplantation unit. Clinical spread of blaVIM-2 gene is a matter of great concern for carbapenem resistance in Tunisia.
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Affiliation(s)
- S Hammami
- Laboratoire Résistance aux Antimicrobiens, Faculté de Médecine de Tunis Université Elmanar, 15 Rue Djebel Akhdhar-La Rabta-1007 Bab Saâdoun-Tunis, Tunisie.
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Lyons S, Zidouh A, Ali Bejaoui M, Ben Abdallah M, Amine S, Garbouj M, Fitzner J. Implications of the International Health Regulations (2005) for communicable disease surveillance systems: Tunisia's experience. Public Health 2007; 121:690-5. [PMID: 17544043 DOI: 10.1016/j.puhe.2007.02.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [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: 06/03/2006] [Revised: 01/17/2007] [Accepted: 02/20/2007] [Indexed: 10/23/2022]
Abstract
BACKGROUND In May 2005, the revised International Health Regulations, known as IHR (2005), were adopted in response to the evolving nature of communicable diseases (CD) and the rapid increase in global trade and travel. CD surveillance is an integral part of a country's core requirements under the regulations. METHODS The implications of these requirements were assessed as part of a review of the national CD surveillance system of Tunisia using a qualitative methodology of strengths, weaknesses, opportunities and threats (SWOT). RESULTS Tunisia is some way towards meeting the requirements of IHR (2005) while some specific areas that need to be addressed are highlighted for improvement: standardization of surveillance documents, strengthening the role of the laboratory in surveillance, increased human resources and training. CONCLUSIONS Tunisia's experience can offer some lessons to other countries in this process. While meeting the capacity obligations of IHR (2005) requires investment and commitment, this investment will enable countries to better protect themselves against public health emergencies arising within their borders and threatening from elsewhere in the world.
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Affiliation(s)
- S Lyons
- European Programme for Intervention Epidemiology Training, Department of Epidemic and Pandemic Alert & Response, World Health Organization, 1211 Geneva 27, Switzerland.
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