B. Dhahri

Traitement de la tuberculose

The aim of this article is to give practicing physicians a practical approach to the treatment of latent and active tuberculosis. Most patients follow TB standard treatment recommended by WHO that depend on category of patient. It is a combination of four essential tuberculosis drugs of the first group: isoniazid, rifampicin, pyrazinamid and ethambutol; in some cases streptomycin can replace ethambutol. This initial phase of intensive treatment is followed by a consolidation phase. Drugs should be administered in the morning on an empty stomach one hour before meals. Treatment of latent tuberculosis (TB) infection is an important component of TB control programs. Preventive treatment can reduce the risk of developing active TB.

Recurrent iliac hydatidosis: A case report

INTRODUCTION Hydatid cysts may occur in any area of the body, but they usually localize to the liver and the lungs. Primary localization in bone is not common. PRESENTATION OF CASE The authors report the case of multifocal hydatid disease appeared 3 years after the surgical treatment of a cyst of the hip. The patient presented with cough and chest pain of 2 months duration. Only the lung localization was symptomatic. The thoracic echography, the abdominal and chest scan allowed the diagnosis. DISCUSSION Hydatid recurrence remain frequent, whatever is the nature of the treatment, surgical or chemical. CONCLUSION The premature detection of recurrence is of great importance.

Pulmonary embolism in young adults, what particularities?

Background: Pulmonary embolism (PE) is a frequently seen complication in pulmonology department. Little information is available on the presentation of this event in patients under the age of 50 years, yet early detection and treatment continue to be the main predictors of clinical course. Aim: We aimed to describe the clinical presentation of PE in patients less than 45 years old, with emphasis on identifying risk factors. Methods: Cases of PE diagnosed in our hospital9s pulmonology department over a period of 10 years were reviewed retrospectively. Patients were divided into 2 groups: group 1, composed of patients aged less than 50 years and group 2 of patients aged more than 50 years Results: Among 156 patients diagnosed during the period study, 147 were included (group 1: n = 53, group 2: n = 94). The epidemiological data, the risk factors (RF) identified, symptoms, and exploratory test findings in tow groups are summarized on Conclusion: We would highlight that the risk of PE, especially in older patients, increased with the number of low-weight risk factors, and some are exclusively found in this age group.

Prevalence of overlap syndrome and its correlation with severity of obstructive sleep apnea syndrome

Background: 9Overlap Syndrome9 is togetherness of Obstructive Sleep Apnea Syndrome (OSAS) with Chronic Obstructive Pulmonary Disease (COPD) and asthma. Aim: We aimed to determine frequency of COPD and Asthma in OSAS patients and effect of these diseases on severity of OSAS. A Tunisian group consisting of 150 patients, investigated for suspected OSAS, was recruited during 6 years. We divided the patients into four groups: Group 1= OSAS with COPD, group 2 = OSAS with asthma, group 3 = OSAS without COPD nor Asthma, group 4 = Non OSAS All cases were examined for COPD, Asthma and severe daytime sleepiness according to Epworth Sleepiness Scale (ESS). Results: Out of 150 cases, 106 (71.6 %) were diagnosed as OSAS, 30.6 % COPD, 8.66 % asthma. The mean age in group 1 (60,5 years ±7,8) was significantly higher than in group 3 (47,9 years ± 14,2) p = 0.041, as well as the Epworth scale was significantly higher in group 1 than in group 3, no significant difference in term of BMI was found. In group 2 comparing to group 3 there was no significant differences in frequency of female sex, the ESS was determined to be significantly higher in group 2 (13.8 versus 4.86 ; p = 0.003) also as the BMI (32.63 versus 29.57 ; p = 0.044). A relation between severity of OSAS and presence of COPD or asthma was found: Patients with COPD or asthma have a severe OSAS, the mean of apnea hypopnea index was 23.4 in patients with overlap syndrome versus 9.09 in patients without overlap (p=0.001) Conclusion: We must insist on the screening of overlap syndrome in patients with OSAS considering this association a predictive factor of severity of OSAS.