Chalbi Belkahia

Smoking during pregnancy and postpartum among Tunisian women

Objective. The validity of self-reported smoking in population surveys remains an important question yet to be answered. This has been of particular concern in a situation where there is a strong social pressure against pregnant and postpartum women. An associated question is what would be the value of measuring urinary cotinine concentrations in such surveys to obtain validated smoking data. Methods. Cross-sectional analysis of data on self-reported smoking and urinary cotinine among a sample of 398 pregnant women and recently pregnant, mothers of infants under the age of 2 months, who came to the Family Planning Clinic in Tunis urban area for either prenatal or newborn care. We used quantitative colorimetric urine test based on the könig reaction, in which pink-red chromophores formed from nicotine and its metabolites condensation with barbituric acid were extracted into acetate buffer. Results. The smoking prevalence among Tunisian pregnant women or mothers of newborn infants was 4%. The validity of self-reported daily smoking was relatively low. Among women reporting no smoking at the interview 16% misreported active smoking. According to urinary cotinine values, the smoking prevalence was 18.8%. Conclusions. These results substantiate the unreliability of self-report on smoking status among women in prenatal and postnatal period and have implications in clinical and education practice.

An animal model of testicular toxicity by cyclosporine: evaluation and protection

CyclosporineA (CsA) improves the survival of patients who benefited from transplantation. However, its use is generally limited by its side effects. The aim of our study was to measure, in an experimental model, the changes of the testosterone plasma levels after 21 days of CsA treatment and to explain the mechanism of this modification. After treatment, the levels of CsA, testosterone, corticosterone, transaminases were measured. The cytotoxic effect of CsA was evaluated by microscopic observation. The experimental study showed that CsA had no effect on the plasmatic levels of hepatic enzymes ‐ alanine aminotransferase, aspartate aminotransferase and gamma‐glutamyl‐transferase – because their plasma concentrations in treated rats did not differ from those of the sham group. The plasma concentration of corticosterone was not modified, the plasma level of testosterone decreased when the dose of cyclosporine was increased to 4 mg/kg/day. The photonic microscope observation showed that the number of Leydig cells was increased and the electronic microscope observation showed mitochondria alteration. The treatment by CsA and trimetazidine did not correct the alteration caused by CsA. N‐benzyl‐N’‐(2‐hydrox‐3, 4‐dimethyloxybenzyl)‐pipeazine did not protect the mitochondrial function but partially protected mitochondria structure from the deleterious effect induced by CsA. The decrease of the plasma level of testosterone induced by CsA was due to the inhibition of the mitochondrial 20–22 desmolase which blocked the formation of the testosterone precursor and the destruction of the mitochondria structure.

Recurrent dysosmia induced by pyrazinamide.

Pyrazinamide can have adverse effects such as hepatic toxicity, hyperuricemia or digestive disorders. In rare cases, alterations in taste and smell function have been reported for pyrazinamide when combined with other drugs. We report a case of reversible olfactory disorder related to pyrazinamide in a woman, with a positive rechallenge. The patient presented every day a sensation of smelling something burning 15 min after drug intake. Dysosmia disappeared completely after pyrazinamide withdrawal and recurred after its rechallenge. The case was reported to the Tunisian Centre of Pharmacovigilance.

Validity of self-reported smoking among women hospital staff in Tunisia

In Tunisia, smoking prevalence is high1 (55.6% males vs 5.2% females).2 However, under-reporting of smoking may occur, particularly among women from cultures where social proscriptions still exist.3 No studies on womens smoking have been published in Tunisia which have validated self-reported smoking with biomarkers such as urinary cotinine.4 We aimed to assess the validity of self-reported smoking among female staff in a Tunisian hospital. Our data were extracted from a cross-sectional study5 conducted between January and May 2005 to assess smoking behaviours of the health professional staff at Charles Nicolle Hospital in Tunis, the largest University Hospital in Tunisia. About 1120 …

Effect of Liver Hypothermic Preservation: Exploration and Protection

Background/Aims: The principal aim of conservation is to maintain the viability of grafts. This requires the addition of a cellular protector allowing better conservation of the graft. The aim of this work is to evaluate the effect of trimetazidine (TMZ) addition to Wistar rat livers conserved in Krebs-Henseleit solution, compared to the livers preserved only in Krebs-Henseleit solution (24 h at 4°C). Methods: 40 Wistar female rats divided into 5 groups were used: the first group consists of nonpreserved livers, the second consists of livers preserved only in the Krebs-Henseleit solution, and the other 3 groups consist of livers preserved in Krebs solution with different concentrations of TMZ added (16.5, 49.5 and 165 μg/ml). Results: The obtained results show an improvement in the state of the liver in the presence of a high concentration of TMZ, which approaches normal physiological conditions. We note a clear diminution of transaminase activities, as well as an amelioration in metabolic capacities of the liver if the mitochondrial esterase pathway is supported in Wistar rats by a reduction of histological injuries. Conclusion: A TMZ concentration of 165 μg/ml clearly restored the metabolic capacities of the liver. Indeed, TMZ limited the appearance of necrotic areas and almost suppressed apoptotic cells.

Orofacial dyskinesia associated with tiemonium

Tiemonium, an anti‐spasmodic drug, can have adverse effects related to its anti‐muscarinic effect. Dyskinesia is described with other anti‐cholinergic drugs, but there are no reports of dyskinesia associated with tiemonium. We report a reversible orofacial dyskinesia following tiemonium intake (contained in Viscéralgine forte®) in a woman with positive rechallenge. She presented these symptoms two times after two separate injections with an interval of 2 months. The case was reported to the Tunisian Centre of Pharmacovigilance.