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Biomedical subjects

J Gargouri

Publications and source records attributed to J Gargouri.

15 recordsLinked to original sources
PubMed1999

[Prevalence of hemoglobin abnormalities in Kebili (Tunisian South)].

BACKGROUND: Hemoglobin abnormalities constitute a public health problem in many countries in the world. In Tunisia, these disorders were thought to affect only the North-western population. However, the existence of hemoglobinosis concentration in Kebily in south Tunisia has been suggested by previous work. In order to estimate their frequencies, we performed a screening of hemoglobin abnormalities in the North-Kebili region, to establish a prevention program of the homozygous forms. METHODS: This screening concerned all 1st and 2nd grade primary school pupils in North Kebily. After a questionnaire, a blood sample was drawn from every child. Hemogram, sickling test, and hemoglobin electrophoresis at alkaline pH were performed for all children. Hemoglobin electrophoresis at acid pH and a specific hemoglobin A2 titration were performed for some children. RESULTS: The study concerned 1,400 children, aged between 5 and 12 years, the mean age was 7 years and 7 months +/- 10 months. Consanguinity rate and coefficient were respectively 44% and 2249 x 10(5). Endogamy was very high. The global rate of hemoglobin abnormalities was 9.4%. Drepanocytosis with a rate of 4.9% was the most frequent, followed by beta thalassemia (3.1%) and C hemoglobinosis (1.6%). These abnormalities were unequally distributed; very frequent in some localities, they were quite absent in others. CONCLUSIONS: This study revealed a hemoglobinosis concentration in Tunisia, which can be classified second after that of Beja in North-western Tunisia. The heterogeneous distribution of the hemoglobin abnormalities in North-Kebili region and the high consanguinity and endogamy rates constitute factors that promote homozygous and double heterozygous forms to arise and justify the elaboration of a preventive strategy.

Age Factors↗
PubMed1999

[Markers of viral hepatitis in blood donors. Study apropos of 300 donors].

In order to locate the rate of positivity of the different markers of hepatitis that can be transmitted through blood (Ag HBs, anti-HBc Ab, anti-HCV Ab and transaminases (ALAT)), we have conducted a study over 300 blood donors and who are sale, equally shared between the parts of age and of sex. The ALAT were superior to the normalcy in 10.66% of the cases, the male sex being 3 times more affected than that of the female. The Ag HBs was positive in 4.66% of the cases. The male sex is twice as affected as the female sex. One of three persons who donated blood (37.33%) had anti-HBc Ab. Finally none of the 300 blood donors has the anti-HCV Ab. There's a very weak recovering between the presence of Ag HBs and of ALAT superior to the normalcy, a weak recovering between Ag HBs and anti-HBc Ab and a certain recovering between ALAT superior to the normalcy and the présence of anti-HBc Ab. There is no recovering between the anti-HCV Ab and the indirect markers. Eventually, the systematization of all these tests over each donation engenders the elimination of more than 2/5 of the collected products.

Adult↗
PubMed1998

[Hemoglobin beta S haplotype in the Kebili region (southern Tunisia)].

Sickle cell anemia is a monogenic hereditary disease characterized by a mutation in the beta globin gene. Five major haplotypes associated with the beta S mutation have been defined: Benin, Bantu, Senegalian, Camerounian, and Arabo-Indian. Previous studies in northern Tunisia showed that sickle cell anemia was of Benin origin in this region. Patients from the south of Tunisia, mainly from the Kebili region, were not previously concerned. In this study, we have determined the beta S haplotype and evaluated phenotypical expression of the disease in 14 patients from this latter region. The use of four restriction endonucleases having polymorphic sites in the beta globin gene showed that all patients had the Benin haplotype, confirming the Benin origin of sickle cell anemia in Tunisia. This haplotype is associated with an heterogeneous expression of fetal hemoglobin (HbF) with extremes varying from 2.4 to 16.3% and a mean expression rate of 8.16%, which is in accordance with literature data. In spite of the haplotype homogeneity in our patients, clinical heterogeneity was noted. A unique case of alpha-thalassemia could not explain this heterogeneity. In contrast, we found a certain correlation between fetal hemoglobin expression and clinical severity.

Adolescent↗
PubMed1996

[Low dose cytarabine in the treatment of acute myeloid leukemia. Apropos of 41 cases].

This is a retrospective study on the use of cytarabine at low doses in acute myeloid leukemias in 41 patients. Four groups of AML are included: group A: 19 cases of de novo AML in elderly patients; group B: ten cases of AML in relapse; group C: five cases of AML refractory to previous treatment and group D: seven cases of secondary AML. Cytarabine was given subcutaneously at the dose of 10 mg/m2 of body surface, for 21 days per month for the first course; then 15 days per month for the following courses. The response rates were 42, 20, 0, and 43% respectively for the A, B, C, and D groups. A complete remission was attained in only 15% (six patients). Extra haematological tolerance was excellent. Infection complications were noted in 66%, whereas a severe neutropenia was observed in 34% of patients. Hemorrhagic complications were more rare (20% of patients). The mean duration of complete remission was 10 months. The median survival was 10.5 months (2 to 31 months) for the responder patients, and 2.4 months (1 to 7 months) for the non-responders. Cytarabine at low doses seems to be a good indication for first intention treatment of AML in elderly patients. It does not give a bone marrow aplasia, the infection and hemorrhagic episodes are less numerous than with conventional dose chemotherapy, the life quality is improved, and treatment at home is often possible.

Adolescent↗
PubMedDate not supplied

[Non-groupable streptococci: identification, sensitivity to antibiotics (Charles Nicolle Hospital in Tunis)].

50 strains of viridans streptococci isolated from human material are identified by biochemical tests (bile esculin, Cl Na 6,5%, acid production from lactose, mannitol, sorbitol, inulin, arginine, esculin and starch hydrolysis; production of levan and dextran in sucrose media) Streptococcus salivarius and Streptococcus mitis are predominant species. Susceptibility to antibiotics was studied: 70% of viridans streptococci were susceptible to all antibiotics tested, high level resistance to aminoglycoside was not present. The only resistance observed were to tetracycline, macrolides and related drugs.

Aminoglycosides↗
PubMedDate not supplied

[Group D streptococci and enterococci: identification, sensitivity to antibiotics and a study of the high level resistance to aminosides (Charles Nicolle Hospital in Tunis)].

197 strains of enterococcus and group D Streptococcus were isolated from human material at Charles Nicolle Hospital (Tunis) and identified by biochemical tests: 174, Enterococcus faecalis, 6 Enterococcus faecium, 2 Enterococcus durans and 15 Streptococcus bovis. The sensitivity to antibiotics was studied: all Enterococcus faecium were resistant at least to one antibiotic, 15% of Enterococcus faecalis were sensitive for all antibiotics tested the other species were frequently sensitive. High level resistance to aminoglycosides were frequent in Enterococcus faecalis 40%: among these strains high level resistance to gentamicin accounts for 12% and 18 frequently associated with resistance to kanamycin and streptomycin, this situation present therapeutic problems in case of severe infection.

Aminoglycosides↗
PubMedDate not supplied

[Treatment of aplastic anemia with cyclosporine, prednisolone and androgens (primary results apropos of 10 cases].

Aplastic anaemia is a potentially fatal haematopoietic disorder whose aetiology is not yet clarified. In our preliminary study we have introduced cyclosporin in the aplastic anaemia treatment to evaluate its effect on the disease evolution. Ten aplastic anaemia patients, mean age 33.33 +/- 20.01 years, were treated with cyclosporine (9 +/- 2.35 mg/kg/d), prednisolone (0.5 mg/kg/d) and androgens (1 mg/kg/d). The prednisolone was always combined with cyclosporine. The androgens were administered concomitantly with the cyclosporine or alternately. Seven patients responded to the treatment after a median remission delay of 6 weeks (2-12 weeks). They became independent of blood requirements at a median of 36 weeks (8-108 weeks); the three other patients died during the first trimester without showing any improvement. Among the seven responders, two relapsed early and transiently. The rate of actuarial survival was 70 per cent. The median duration of survival was 10.5 months. The side effects observed included one case of malignant lymphoma, six cases of liver toxicity and five cases of kidney toxicity. This toxicity was reversible after dose adjustment of the cyclosporine. In our study, the introduction of cyclosporin in the aplastic anaemia treatment resulted in improved therapeutic response. Androgens should be used to maintain the haematologic response. This therapeutic protocol associated with drug monitoring seems promising and the side effects should not limit its use because of the severity of the underlying disease.

Adolescent↗