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Psychogenic Dystonia in Tunisian Children

Journal of Behavioral and Brain Science 2012年第2期2卷 191-194页

作者： Hanene ben rhouma Ichraf Kraoua Jihene Yacoubi Narjes Fradj Neziha Gouider-Khouja Department of Child and Adolescent Neurology National Institute of Neurology Tunis Tunisia

Psychogenic dystonia in children is rare and often difficult to distinguish from organic dystonia. It is usually related to a psychological or psychiatric underlying cause. From January 2004 to November 2009, 5 children with psychogenic dystonia among 200 with dystonia were followed up in our department. Elements of history, physical examination, videotaping and management were analyzed. Mean age was 14.9 years, mean age of onset was 13 years and mean follow up period was 6 months. The dystonia onset was abrupt in 3 patients and progression resulted rapidly into fixed dystonia in 4 patients. Pain was observed in all patients. Paroxysmal dystonia was observed in one patient. An underlying psychiatric disorder was found in all patients. All patients improved with psychotherapy and anxiolytic or antidepressant drugs. Only one patient showed relapse after each familial conflicts. The small size of our series reflects this disorder is rare (1 case/year). Pain was a prominent feature in all patients. Children have acute onset, short duration of disease and improved under psychological therapy and drugs. Psychogenic dystonia in children is usually misdiagnosed. It is necessary to analyze clinical features and outcome of this disorder to reach a clear diagnosis and adequate management, which requires multifaceted approach, including psychological, physical and pharmacological therapies.

关键词： Dystonia Psychiatric Disorders Childhood

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Medical Expulsive Therapy (MET) for Large Distal Ureteral Stones: A Prospective Study Comparing Three Drugs

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Open Journal of Urology 2020年第5期10卷 152-157页

作者： Mourad Dali Khereddine Traore Mamadou Tiéoulé Kacem Aziz Chaker Kays ben rhouma Sellami Ahmed Nouira Yassine Service d’urologie de Hospital la Rabta Tunis Tunisia Service d’urologie de l’Hôpital de Ouahigouya Ouahigouya Burkina Faso

Introduction: One of the most common disorders of the urinary tract is Urolithiasis. Twenty percent of lithiasis are located in the ureter of which 68% are seen in the distal ureter. The concept of medical expulsive therapy (MET) has been developed with enough knowledge of the ureter physiology in order to make easier the spontaneous expulsion of the stone. The aim of this study was to evaluate the efficacy and safety of three different drugs for the treatment of pelvic ureteral stones. Materiel and Methods: Between October 2017 and November 2018, 90 adult patients presenting with low or non-obstructive pelvic ureteral stones sized 8 to 10 mm were included. They were prospectively randomized, using computer-based randomization charts, into three equal groups: treatment with ketoprofen 100 mg once daily (Group I), silodosin 8 mg once daily (Group II) and tadalafil 5 mg once daily (Group III). The aim was to compare spontaneous expulsion of stone between those drugs Results: The mean expulsion time from the start of MET was 11.5 ± 3.27 days for ketoprofen group, 10.71 ± 3.98 days for silodosin group and 10.57 ± 3.40 days for tadalafil group. But these differences were also not significant (P = 0.79). The use of analgesics (grade II) was higher in groups II and III compared to group I, but without significant difference (23.33% in group I, 33.33% in group II and 40% in group III, p = 0.38). Discussion: The overall chance of spontaneous passage is low when the stone diameter is sized more than 7 mm. A wide range of spontaneous passage rates have been reported in the literature, varying from 71% to 98% for distal ureteral stones less than 5 mm and 25% - 53% for stone sized 5 to 10 mm with a mean expulsion time of more than 10 days. Conclusion: The three drugs have a low expulsion rate for 8, 9 and 10 mm pelvic ureteral stones with a higher adverse event rate for the NSAID group.

关键词： Expulsive Therapy Ureteral Stones Drugs

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Primary Prostatic Tuberculosis: A Rare Entity

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Open Journal of Urology 2022年第2期12卷 129-135页

作者： Tiéoulé Mamadou Traore Abdoul Kader Tapsoba Kays Chaker Amine Hermi Kheireddine Mrad Dali Mokhtar Bibi Yassine Ouanes Ahmed Sellami Sami ben rhouma Yassine Nouira University of Ouahigouya Ouahigouya Burkina Faso Department of Urology La Rabta Hospital Tunis Tunisia University of Joseph Ki-Zerbo Ouagadougou Burkina Faso Faculty of Medicine of Tunis University Tunis Manar Tunis Tunisia

Objectives: To clarify the clinical, histological and therapeutic features of prostatic tuberculosis. Methods: We conducted a single-centre retrospective descriptive study of all patients presenting with prostatic tuberculosis between January 2002 and December 2020. Patients who were lost to follow-up, could not be reached by telephone or whose records were not usable were excluded from this study. Results: 240 patients were treated for urogenital tuberculosis, including 13 for isolated prostatic tuberculosis. The average age of the patients was 75 years. None of our patients had a history of tuberculosis. The average of international prostate symptom score (IPSS) was 27. Lower urinary tract symptoms in the filling phase were predominant. The digital rectal examination was suspicious in only one patient. The mean preoperative PSA was 9.24 ng/ml. 46.15% of patients underwent transurethral resection of the prostate and 53.85% underwent ultrasound-guided prostate biopsy. Histological examination showed epithelioid gigantocellular granuloma with isolated caseous necrosis in 61.53% of patients and associated adenomyomatous hyperplasia in 38.47% of patients. Antituberculosis treatment was given for 6 months. The average of follow up was 15 months. All patients reported an improvement in clinical signs with a mean post operative IPSS score of 17 and a normalisation of PSA levels. Conclusion: Isolated prostatic tuberculosis is a rare entity, it can simulate a cancer. In front of the symptoms of the lower urinary tract, the clinicians must think of it especially in the developing countries where tuberculosis still prevails in an endemic state.

关键词： Prostatic Tuberculosis Epithelioid Gigantocellular Granuloma Antituberculosis Treatment

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