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Introduction. Malaria had been eliminated in Tunisia since 1979, but there are currently 40 to 50 imported cases annually. Soldiers are no exception as the incidence of imported malaria is increasing in Tunisian military personnel after returning from malaria-endemic area, often in Sub-Saharan Africa. Methods. We retrospectively analyzed the clinical and biological presentations, treatment, and outcomes of 37 Tunisian military personnel hospitalized at the Department of Internal Medicine, the Military Hospital of Tunis, between January 1993 and January 2011, for imported malaria. The clinical and laboratory features were obtained from the medical records and a questionnaire was filled by the patients about the compliance of malaria prophylaxis. Results. Thirty-seven male patients, with a mean age of 41 years, were treated for malaria infection. Twenty-two were due to Plasmodium falciparum. The outcome was favourable for all patients, despite two severe access. The long-term use of chemoprophylaxis has been adopted by only 21 (51%) of expatriate military for daily stresses. Moreover, poor adherence was found in 32 patients. Conclusion. The risk of acquiring malaria infection in Tunisian military personnel can largely be prevented by the regular use of chemoprophylactic drugs combined with protective measures against mosquito bites.

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Rare cases of Cryptococcus have been documented in patients living with multiple myeloma. To date there has been no documented evidence of cryptococcosis revealing multiple myeloma. We reported a 63-year-old man who had a 2-months history continuous holocranial headaches, morning vomiting, complaining of blurred vision and fever. The biologic and the imaging showed a Cryptococcus meningoencephalitis. The search for a cause of immunodeficiency revealed a multiple myeloma. The diagnosis for Cryptococcus was confirmed according to an India ink stain, blood and cerebrospinal fluid culture. The patient's treatment for multiple myeloma was initiated with a chemotherapy regimen. The evolution was good without complication. Cryptococcosis, especially in the neuro-meningeal form, is a serious, deadly opportunistic infection. The search of an underlining immunodeficiency must be systematic. In this case, it was associated with early stage multiple myeloma.

Objectives In this study we compared the clinical findings and some provocative tests (Tinnel, Phalen, reverse phalen) with electrophysological examination (ENMG) results. Methods This study was carried out on 48 patients who had pain, numbness, tingling and weakness complaints in at least one hand. Provocative tests and ENMG investigation were applied for each patient whom suspected for carpal tunnel syndrome. 67 hands of 48 patients which represent positive sign for carpal tunnel syndrome were evaluated and compared with ENMG positivity. In order to evaluate validity of provacative tests, chisquare test was used. Positive-negative predictive values of provocative tests also investigated. Results 20 patients had bilateral complaints, 28 patients had complaints only in one hand. When compared with ENMG results, reverse Phalen test was founded most spesific test (% 78.8). This was followed by Tinnel test%72.3 and Phalen test% 70.2. Conclusion We concluded that provacative tests for ENMG have increased sensitivity, for that reason can be applied in epidemiological studies for carpal tunnel syndrome. But to make an definite diagnosis of carpal tunnel syndrome electrophysiological examination should be applied.