IntroductionTo describe all patients admitted to Tunisian intensive care unit with a diagnosis of influenza A/H1N1 virus infection after the 2009 influenza pandemic and to analyse their characteristics, predictors of complications and outcome.MethodsAll patients with influenza > 18-years-old hospitalized to the ICU department of Tunisian University hospital of Sousse, between December 1, 2009 and March 31, 2016, with a positive influenza A/H1N1/09 reverse transcriptase polymerase chain reaction (RT-PCR) from a nasopharyngeal specimen were included, were included.Results40 cases were admitted to intensive care units. During the reporting period, 22 deaths in intensive care units (55%) were reported, the median age was 53 years (IQR 37-61), 24 (61%) were male, The median scores SAPS II and SOFA were respectively 29 (IQR 23-36) and 6 (IQR 3-10), 27% had chronic obstructive pulmonary disease (COPD), 33.3% diabetic and no patients were vaccinated against influenza A. The cause of admission was in 72.5% of the cases was hypoxemic pneumonae. By using a logistic regression, we found after adjustment to age, that acute respiratory distress syndrome (ARDS) (OR = 27; 95%CI: 3.62-203.78) was the only factor significantly associated with severe outcomes of the cases.ConclusionPatients in the first post pandemic season were significantly older and more frequently had underlying medical conditions. Multivariate analysis showed that older male patients with chronic lung disease were at increased risk for a severe clinical outcome.
Fulminant meningococcemia is a relatively rare life-threatening disease caused by Neisseria meningitidis. The clinical presentation is varied, but, when associated with myocarditis, it carries a particularly poor prognosis. We report a case of a patient with fulminant meningococcemia who subsequently developed severe myocardial dysfunction and successfully recovered within a period of 7 days of hospitalization. A 15-year-old girl presented with headache, fever, body ache for 1 day and few ecchymotic rash over her body for 3 hours. Blood cultures confirmed infection with N. meningitidis. After 2 days in the hospital, the patient developed dyspnea, elevated jugular venous pressure and shock. The patient was managed with intravenous ceftriaxone, furosemide and norepinephrine. Over the next 4 days the patient rapidly improved. Meningococcemia complicated by myocarditis has an extremely poor prognosis with high mortality. Our case suggests that recovery from a severe myocardial dysfunction can occur rapidly within a few days. Prompt recognition and management in this case might have contributed to the patient's rapid recovery from myocarditis.
The results of this study will help guide public hospital human resource managers in the choice of measures designed to increase the motivation of their employees in order to ensure staff satisfaction as well as quality health care services..
Aim: This study was designed to assess the prevalence of alcohol consumption and factors associated with alcohol consumption among students of the Sousse region of Tunisia. Methods: This was a cross-sectional study conducted among 556 students of Sousse universities during the 2012-2013 academic year, using an anonymous self-report questionnaire. Data capture and statistical analysis were performed with SPSS software 18.0. Results: Our study population was composed of 268 males (48.2%) with a mean age of 21.8 ± 2.1 years. Eighty-four students (15.1%) had consumed alcohol at least once. On multivariate analysis, male gender (OR = 6.94; 95%CI = [2.32-20.72]), smoking (OR = 13.21; 95%CI = [6.20-27.78]), drug use (OR = 32.22; 95%CI = [6.73-154.26]) and parental alcohol consumption (OR = 4.31; 95%CI = [1.70-10.91]) were the factors significantly associated with alcohol consumption among students. Conclusion: This study was designed to determine the characteristics of alcohol consumption among Tunisian students. Alcohol consumption levels were comparable to those reported in the general population and were significantly related to smoking and drug use. The next step of this study will consist of developing strategies to prevent risk behaviours in the student population.
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