Background and propose Cisplatin is a cytotoxic drug that triggers several toxicities. However, nephrotoxicity and ototoxicity remain major clinical limitations. The aim of our study was to evaluate the incidence of chemotherapy toxicity induced by cisplatin and to analyze the influence of risk factors in the Tunisian population. Methods We performed a prospective descriptive study in a period of four months. Patients were eligible if they had pathologically confirmed malignancies and treated with cisplatin-regimen chemotherapy. Nephrotoxicity and digestive toxicity were graded according to the World Health Organization toxicity scale and ototoxicity was scored clinically according to the Common Terminology Criteria for Adverse Events (CTCAE). Multivariate logistic regression analysis was performed to evaluate the influence of clinical variables on cisplatin-induced toxicity. Results A total of 150 patients were included. Forty-four percent of patients developed cisplatin-regimen toxicity: 15% developed cisplatin-induced nephrotoxicity, 9% cisplatin-induced ototoxicity and 27% digestive toxicity. In the multivariate analysis, age >65 years (OR= 6.129, p = 0.010), metastatic cancer (OR = 0.171, p = 0.007) and cumulative dose (OR= 1.004 mg/m2; p = 0.042) were strong predisposing factors for CDDP-induced nephrotoxicity. The cumulative dose was an independent prognostic indicator for digestive toxicity (OR = 0.997, p = 0.002). Conclusion In our study, age >65 years and metastatic cancer were risk factors for cisplatin-induced nephrotoxicities. We also found the correlation between cumulative dose and nephrotoxicity or digestive toxicity.

Introduction The use of complementary and alternative medicine (CAM) among cancer patients is prevalent worldwide as cancer patient are perpetually seeking for a way to improve their quality of life and to cure their disease. Unfortunately, the majority ignore the danger that can resort when they use CAM currently with conventional therapies. The purpose of this study is to assess prevalence and predictors of CAM use in cancer patients. Methods Cross-sectional study using a questionnaire administered to cancer patients, who were attending Salah Azaiz institute, Tunis, Tunisia. The study took place from September to December 2018. Results In 222 cancer patients, the overall prevalence of CAM use was 40.54%. On univariate analysis, patients who had university education level were less likely to use CAM (p = 0.05). Based on multivariate analysis, CAM users had more likely metastatic tumor (p = 0.047; OR = 1.913).It is reported that the majority of the population used herbal medicine. The most common herbal products consuming by patients, included Ephedra foeminea (51.8%), Annona muricata (12%) and Curcuma longa L. (10.84%).The main source of information was entourage (family, friends, hospital entourage) (74.44%).The majority of CAM users (61.11%) reported to consume CAM currently with conventional therapies. Conclusion This survey revealed a high prevalence of CAM use. The most common type of CAM use is herbal products. Some of the used herbal products are known to interact with conventional anticancer medication. This emphasizes the importance of patients disclosure of CAM use to health professionals in order to avoid herb-medications interactions.

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BackgroundTherapeutic non-adherence is a major problem in patients with chronic kidney disease. This is the major cause of rejection in renal transplant patients.PurposeThe aim of this work was to evaluate the therapeutic adherence in renal transplant patients and to identify the causes of poor adherence.Material and methodsThis was a prospective study carried out on patients hospitalised in the renal transplant unit over a period of 4 months: from 1 April to 31 July 2016. All patients hospitalised during this period are included in the study. The test used to assess therapeutic adherence was Morisky’s test. Questioning was conducted for each patient to who were asked to fill inclinical information sheet. Data analysis was done by SPSS.ResultsWe studied 33 renal transplant patients. The average age of these patients was 43-years-old with extremes ranging from 20 to 59 years old. The number of male patients was 22 (66.6%) and the number of female patients was 11 (33.3%). Twenty-one patients had secondary level of education (63,3%), seven patients had primary level of education (21.2%) and four patients had university level of education (12%). Only one patient was illiterate (3.03%). Twenty patients had a minimal therapeutic adherence problem, which represents 60.6%. Twelve patients had good compliance (36.4%) and one had poor compliance (3.03%). Several reasons for non-compliance were raised. Forgetting medication represents 15.2%. The important number of drugs leads to therapeutic non-compliance and accounts for 18.2%. The ineffectiveness of the treatment represents a reason for non-compliance and represents 3.03%. The occurrence of adverse events represents 9.09%. The feeling of embarrassment and shyness when taking medication in front of others accounts for 25.7%.ConclusionSeveral causes are responsible for non-compliance such as forgetfulness, the multitude of drugs, ineffectiveness, the occurrence of adverse effects and the feeling of shyness when taking medication in front of others. A lot of these barriers are preventable just by better communication between the patient, his doctor and the care system. Therapeutic education is important in improving therapeutic adherance.References and/or AcknowledgementsM. Belrhiti, L. Benamar S. Hacib, A. Abouzoubair. Observance thérapeutique après transplantation rénale:expérience du service de néphrologie du CHU Ibn-Sina de Rabat. 2017.No conflict of interest

Introduction Cardiotoxicity is the most important side effect of Trastuzumab treatment. The purpose of this study is to evaluate the prevalence of Trastuzumab induced cardiotoxicity and to analyze risk factors associated with this side effect. Materials and Methods A retrospective institutional study was carried out from June 2018 to December 2018 at the department of Medical Oncology of Salah Azaiz institute, Tunis, Tunisia. Demographic, clinical characteristics (menopausal status, breast cancer stage, anthracyclines exposure, comorbidities presence…) and left ventricular ejection function (LVEF) measurements, were collected from patient records. Results Twenty-three women (20%) had Trastuzumab induced cardiotoxicity.65.2% (N = 15) experienced a decrease in LVEF more than 10% with a decrease below normal value and 34.8% (N = 8) experienced a decrease in LVEF more than 20%. Obesity is a risk factor for the occurrence of Trastuzumab induced cardiotoxicity (adjusted odds ratio (OR) = 2.919 (95% confidence interval (CI) [1.0411–8.186]; p = 0.042). Conclusion Our study highlighted that obesity is associated with a high risk of cardiotoxicity in women treated with Trastuzumab. Therefore, close monitoring of cardiac function is recommended especially for obese women during Trastuzumab administering.