S Jabnoun

Faculty of Medecine of Tunis, Tunis-Ville, Tūnis, Tunisia

Are you S Jabnoun?

Claim your profile

Publications (15)12.72 Total impact

  • Annales de Pathologie 11/2012; 32(5):S178. DOI:10.1016/j.annpat.2012.09.095 · 0.29 Impact Factor
  • La Tunisie médicale 09/2011; 89(8-9):723-5.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Aim Compare the change of prevalence, clinical and therapeutic features in Rhesus alloimmunization, in a reference maternity which involves 8% of the deliveries of the whole country. Place of study Center of maternity and neonatology of Tunis, Division on neonatology, A, B and C of gynecology and obstetrics. Patients and methods It is a retrospective study of 18 newborns which were hospitalized for rhesus alloimmunization (RAI) In the department of neonatology of the Center of maternity and neonatology of Tunis; during the period between 1st January 2004 and 31 December 2006 (third period).We have compared our results to those observed in articles which concerned 167 newborns during the period between 1st January 1981 and 31 December 1990 (first period) and 169 newborns during the period between 1st January 1991 and 31 December 2003 (second period). Results The incidence of feto-maternal incompatibility in the rhesus system is 1.9% among newborns admitted in the department of the Center of maternity and neonatology of Tunis during the first period compared with 1.2% in the second period and 0.28% in the third period. We notice a significant decrease in the prevalence of RAI during these years (χt 23.073 and p < 10–3). During the first period, jaundice was the first cause of admission (80.2% of the cases). The RAI was diagnosed antenatally in 15.5% of the cases. During the second period; the antenatal diagnosis was made in 46.1% and jaundice was the cause of admission in 35.5% of the cases. During the third period, the antenatal diagnosis was made in 44.4%. There is a significant increase in the antenatal diagnosis during the second and third period. In our study, the prevalence of low birth-weight has increased although the increase is not significant during these three periods. On the other hand, authors note the improvement postnatal management and the morbidity and mortality linked to this pathology. Conclusion The improvement postnatal management of RAI allowed to decrease the global rate of mortality linked to this pathology. However, many other efforts should be done in this field particular in the prevention of these diseases.
    Journal de Pédiatrie et de Puériculture 04/2011; 24(2):51-56. DOI:10.1016/j.jpp.2011.02.002
  • [Show abstract] [Hide abstract]
    ABSTRACT: The Glucose-6-phosphate dehydrogenase (G6PI) deficiency is the most common enzymopathy worldwide. WHO had classified Tunisia among countries that are moderately affected by this affection. However, no mass-screening reflecting the real incidence was realized. The aim of this study is to determine the prevalence of this enzymopathy and its molecular basis in Tunisia. A total of 1102 neonates, born in CMNT center of Maternity and of Neonatology of Tunis during the going periods from April, 2005 till May, 2005 and from June, 2006 till September, 2006, have been enclosed in the study. The samplings included 953peripheral venous blood and 149 blood cordon. Among 1102 samplings, only 976 were of use to the screening. In our mass-screening, we consider all newborns that were born in the CMNT during the period of study and were included in the screening. A dosage of the enzymatic activity was realized using spectrophotometric method. G6PD electrophoresis and molecular study by PCR/RFLP were realized for the overdrawn newborn children. Among 976 screening neonates, 43 individuals (4.4%) were found to be G6PD deficient by quantitative enzyme assay. Newborn affected were distributed in 23 boys and 20 girls (sex ratio of 1.15). The electrophoretic mobility and the molecular biology were realized for the affected newborn. Molecular characterization of 30 G6PD deficient neonates revealed that the G6PD A- was the most common and was detected in 20 of 43 individuals (66.7%), followed by G6PD Mediterranean that was detected in 6 (13.3%). At least, 4 other unknown mutations were not able to be determined by PCR/RFLP (n=4). In conclusion G6PD deficiency is frequent in our country, justifying a systematic neonatal screening, to avoid the arisen of grave consequences of this affection. The African variant is the most frequent in our country followed by the Mediterranean one.
    Archives de l'Institut Pasteur de Tunis 01/2010; 87(1-2):69-76.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Intra-uterine fetal death (IUFD) of one twin is a relatively frequent complication of twin pregnancy. Prognosis of the surviving twin seems to be the main problem. Management is not consensual and suffers from the lack of guidelines. To report the main involved etiologies, assess the surviving co-twin outcome and discuss strategies of management. Retrospective study of 33 twin pregnancies complicated by single intrauterine fetal death after 26 weeks of gestation, admitted in the department "A" of obstetrics and gynecology of the Tunisian center of maternity and neonatalogy from January 2000 to October 2008. Prevalence was 2.98%. Chorionicity was precised for 28 GG; 67.9% (n=19) were bichorionic (BC) and 32.1% (n=9) monochorionic (MC). The mean gestational age at the time of fetal death diagnosis was 31 weeks+2 days. Main involved pathologies in case of BC pregnancy were: intrauterine growth restriction (36.8%), pre-eclampsia (21%) and gestational diabetes (15.8%) and in case of MC pregnancy: twin-to-twin transfusion syndrome (44.4%). Prematurity rate was 85.2%. IUFD of the second twin occurred in one case and neonatal death in six cases. Tranfontanellar ultrasound on the seventh day of life found cerebral abnormalities in six liveborns. Surviving co-twin prognosis was mainly compromised by prematurity and its consequences.
    Journal de Gynécologie Obstétrique et Biologie de la Reproduction 11/2009; 38(7):580-7. · 0.62 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Introduction Intra-uterine fetal death (IUFD) of one twin is a relatively frequent complication of twin pregnancy. Prognosis of the surviving twin seems to be the main problem. Management is not consensual and suffers from the lack of guidelines. Objectives To report the main involved etiologies, assess the surviving co-twin outcome and discuss strategies of management. Patients and methods Retrospective study of 33 twin pregnancies complicated by single intrauterine fetal death after 26 weeks of gestation, admitted in the department “A” of obstetrics and gynecology of the Tunisian center of maternity and neonatalogy from January 2000 to October 2008. Results Prevalence was 2.98%. Chorionicity was precised for 28 GG; 67.9% (n = 19) were bichorionic (BC) and 32.1% (n = 9) monochorionic (MC). The mean gestational age at the time of fetal death diagnosis was 31 weeks + 2 days. Main involved pathologies in case of BC pregnancy were: intrauterine growth restriction (36.8%), pre-eclampsia (21%) and gestational diabetes (15.8%) and in case of MC pregnancy: twin-to-twin transfusion syndrome (44.4%). Prematurity rate was 85.2%. IUFD of the second twin occurred in one case and neonatal death in six cases. Tranfontanellar ultrasound on the seventh day of life found cerebral abnormalities in six liveborns. Conclusion Surviving co-twin prognosis was mainly compromised by prematurity and its consequences.
    Journal de Gynécologie Obstétrique et Biologie de la Reproduction 11/2009; 38(7):580-587. DOI:10.1016/j.jgyn.2009.09.004 · 0.62 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: We describe an outbreak of nosocomial respiratory infection caused by multi-drug resistant Acinetobacter baumannii in a neonatal intensive care unit (NICU) in Tunis and our investigation to determine the source. Between May 2006 and February 2007, 31 infants hospitalized in the NICU of the Centre of Maternity and Neonatology of La Rabta in Tunis developed A. baumannii pneumonia. A case (infected infant) was defined as any patient hospitalized in the NICU during the outbreak period, with clinical signs of pneumonia and isolation of A. baumannii from tracheal aspirate. Ten rectal swabs and 98 environmental specimens were collected for the epidemiological investigation. Thirty-nine A. baumannii isolates were collected: 31 clinical strains from tracheal aspirates (>10(3) colony-forming units [CFU]/mL), 3 environmental strains from incubators, and 5 from rectal swab. For the genotyping method, we used pulsed-field gel electrophoresis using ApaI restriction endonuclease. Thirty-one neonates developed multiple drug-resistant A. baumannii-associated pneumonia with 10 deaths due to A. baumannii infection, 48.4% had very low birth weight (<or=1500 g), and 67.7% neonates were premature. The mean age at the beginning of symptoms was 6.9 days. A. baumannii isolates were resistant to all beta-lactams. Resistance rates to other antibiotics were, respectively, 94.9% for gentamicin, 87.2% for cotrimoxazole, 41% for netilmicin, and 5.1% for tobramycin. All the isolates were susceptible to colistin. Pulsed-field gel electrophoresis analysis of outbreak-isolates indicated the presence of only one clone (A) containing nine subtypes genetically related to the outbreak strain. The clonal diffusion of A. baumannii strains in an NICU was confirmed by molecular method. Control measures were reinforced to contain the outbreak.
    Annals of epidemiology 04/2009; 19(6):372-8. DOI:10.1016/j.annepidem.2009.03.010 · 2.15 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: We conducted a prospective, randomized, single-masked pilot study with the principal aim of comparing efficacy and tolerance between oral and intravenous ibuprofen in early closure of patent ductus arteriosus in very low birth weight infants. The possibility of ductal closure with only 1 or 2 doses of treatment was a secondary objective. Sixty-four very low birth weight patients with echocardiographically confirmed patent ductus arteriosus and respiratory distress were studied. The patients were randomly assigned to receive either oral (group O, n=32) or intravenous (group I, n=32) ibuprofen starting on the third day of life. After the first dose of treatment in both groups, echocardiographic evaluation was performed to determine the need for a second or third dose. The rate of ductal closure, adverse effects, complications, and the patient's clinical course were recorded. In each group, 24 (75%) patients were born after 28 weeks' gestation. The rate of ductal closure tended to increase in group O (84.3% vs 62.5%). Closure of the ductus was obtained after 1 or 2 doses of treatment in 19 (70.3%) of 27 patients in group O and 14 (70%) of 20 patients in group I. The adverse effects were increased in group I (31.2% vs 9.3%). There were no significant differences with respect to complications during the stay. Adverse effects were significantly fewer when closure was achieved after an incomplete course of treatment (23.1% vs 76.9%). In very low birth weight infants, the rate of early ductal closure with oral ibuprofen is at least as good as with the intravenous route. Ductal closure may be obtained with an incomplete course of ibuprofen. Oral ibuprofen is associated with fewer adverse effects. However, a larger sample is needed for more definitive conclusions.
    PEDIATRICS 01/2009; 122(6):e1256-61. DOI:10.1542/peds.2008-1780 · 5.30 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this study was to investigate the molecular epidemiology of Stenotrophomonas maltophilia strains responsible for respiratory infection in a neonatal intensive care unit (NICU) in Tunis City, isolated during 22 months (December 2003-September 2005). Twelve strains of S. maltophilia isolated from tracheal aspirates of distinct infants and two environmental strains were tested for antibiotic susceptibility and genotyped by pulsed-field gel electrophoresis (PFGE) method. Unlike a large heterogeneity demonstrated by the antibiotyping method, PFGE identified two concomitant outbreaks consisting of nine, including an environmental strain (clone A), and four strains (clone B), respectively; a distinguishable strain was classified in a unique pattern (PFGE type C). The long-term dissemination of these strains is a characteristic feature of these outbreaks. Improvement of hygienic conditions attributed to a markedly decrease in their isolation frequencies. Concomitant outbreaks and long period persistence of S. maltophilia in NICU is an important finding of this study. Identification of two clonal strains of S. maltophilia responsible of respiratory infection. Epidemic strains are hardly eradicated when colonization is established.
    Pathologie Biologie 02/2008; 57(5):363-7. DOI:10.1016/j.patbio.2007.09.018 · 1.07 Impact Factor
  • Ahmed Cherif · Sami Jabnoun · Naima Khrouf
    [Show abstract] [Hide abstract]
    ABSTRACT: Intravenous indomethacin and intravenous ibuprofen are widely used for the treatment of patent ductus arteriosus (PDA) in premature infants. Intravenous indomethacin may lead to renal impairment, enterocolitis, and intraventricular hemorrhage. Intravenous ibuprofen was shown to be as effective and to cause fewer side effects. If ibuprofen is effective intravenously, it will probably be effective orally, too. This study was conducted to test oral ibuprofen in early curative closure of PDA in very premature infants hoping for a better tolerance and the same efficacy as intravenous ibuprofen. Forty very premature infants (mean gestational age: 29.4 +/- 1 to 2 weeks [range: 26 to 31.5 weeks]; mean weight: 1237.2 +/- 198 g [range: 650-1770 g]) with PDA and respiratory distress were studied prospectively. They received, while between 48 and 96 hours old, oral ibuprofen at a dose of 10 mg/kg, followed, if needed, at 24-hour intervals by one or two additional doses of 5 mg/kg each. Color Doppler echography of the heart, brain, and abdomen were performed before treatment and after each dose administration. Ductal closure, early outcome (1 week after treatment), and late outcome were recorded. Thirty-eight patients (95%) achieved pharmacological closure. Two patients did not respond to the treatment: One required surgical ligation of the ductus, and the other patient received and well tolerated ductal shunting. Twenty-four patients were treated with one dose of oral ibuprofen, 10 were treated with two doses, and 6 were treated with three doses. Early outcome showed no case of renal impairment, no significant differences in serum creatinine levels, nine cases (22.5%) of intraventricular hemorrhage, three cases (7.5%) of necrotizing enterocolitis, and two cases (5%) of gastrointestinal bleeding. Late outcome showed 15 cases (37.5%) of nosocomial sepsis, 3 cases (7.5%) of chronic lung disease, 2 cases (5%) of periventricular leukomalacia, and 17 cases of death. In this study, oral ibuprofen was effective and well tolerated for early curative closure of PDA in very premature infants. Nevertheless, larger randomized comparative studies with pharmacokinetics measures are warranted.
    American Journal of Perinatology 07/2007; 24(6):339-45. DOI:10.1055/s-2007-981853 · 1.60 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Investigation of an outbreak caused by an imipenem-resistant Pseudomonas aeruginosa strain and research of its hospital reservoir. Nine strains isolated from protected tracheal specimens during 14 weeks (October 2004 to January 2005) from 8 infants, and one strain from vacuum interrupter were studied. Epidemiological study was investigated by determination of antibiotics susceptibility, serotyping and Pulsed-field gel electrophoresis (PFGE). Strains were of O:12 serotype, they have the same antibiotype characterised by imipenem resistance. Strains were indistinguishable or closely related as determined by PFGE. The common source of P. aeruginosa O:12 strains was not determined, however eradication of the epidemic strain was obtained by amelioration of hygiene conditions and the change of disinfectors. Outbreak of respiratory infections due to an imipenem-resistant P. aeruginosa O:12. The common source of the epidemic strain was not determined.
    Pathologie Biologie 01/2007; 54(10):596-9. DOI:10.1016/j.patbio.2006.07.032 · 1.07 Impact Factor
  • Ahmed Chérif · Sami Jabnoun · Naima Khrouf
    [Show abstract] [Hide abstract]
    ABSTRACT: Beneficial effects of antenatal corticotherapy on neonates are now well established. However, after the first conference of consensus, three controversial issues were left unresolved = use of dexamethasone or betamethasone, ideal number of curses to be given, and appropriateness of corticotherapy in case of prmature of the membranes. A literature review suggests that betamethasone is preferred to dexamethasone, that prscription of a single course is more advisable than multiple courses, and that antenatal corticotherapy is finally not contraindication in case of premature rupture of membranes.
    La Tunisie médicale 05/2006; 84(4):218-20.
  • [Show abstract] [Hide abstract]
    ABSTRACT: To establish the epidemiologic profile of holoprosencephalia and determine benefits of ultrasound and foetopathologic examination to the diagnostic. METHODS AN MATERIAL: [corrected] Retrospective study about 17 cases of holoprosencephalia observed in CMNT between Janaury 1992 and September 2000. Ultrasound diagnosis was made in 13 cases (75%). Ultrasound criteria were; absence of median structure of the brain and unique ventricule. The prognosis was always bad. Foetopathologic examination revealed 7 cases of lobar holoproencephalia and 10 of semi lobar. Fascial dysmorphia were noted in 82% of cases. The foetopathology and genetic counselling looking for fascial, dysmorphia in family's members gives a good evaluation of recurrences.
    La Tunisie médicale 11/2001; 79(10):526-9.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Lethal spina bifida continue to be frequent in Tunisia; we report 88 cases of letal spina bifida: 1.05 per thousand births. This pathology was more frequent with women. The up letal spina bifida situated is predominant with female and the dow spina bifida situated is frequent with male. We have noted an association with anencephalia (46 cases) and hydrocephaly (21 cases). Prevention is based on obstetric health care and hygiene dietetic advices to avoid alimentary deficit.
    La Tunisie médicale 01/2001; 78(12):727-30.
  • La Tunisie médicale 06/1998; 76(5):139-41.