Hela Elloumi

Hopital Habib Thameur, Tunis-Ville, Tūnis, Tunisia

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Publications (83)67.14 Total impact

  • La Tunisie médicale 05/2015; 93(1):48.

  • La Tunisie médicale 06/2014; 92(6):423.
  • M Béjaoui · D Trad · N Bibani · A Ouakaa · H Elloumi · A Kochlef ·

    La Tunisie médicale 02/2014; 92(2):185.

  • Arab Journal of Gastroenterology 12/2013; 14(4). DOI:10.1016/j.ajg.2013.10.003
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    ABSTRACT: Background: The epidemiological studies showed that the incidence of the inflammatory bowel diseases describes a gradient North-South. Besides, concerning the evolution according to the time,recent studies noted an increase of the incidence of the Crohn's disease at the expense of the one of the ulcerative colitis. Aim: To determine the evolution of the epidemiology of the inflammatory bowel diseases across the time. Methods: The study included inpatients followed for Crohn's disease, ulcerative colitis and indeterminate colitis, in the department of gastroenterology of Habib Thameur hospital. For every patient were collected the sex, the age and the year of the diagnosis, the type of inflammatory bowel disease and the initial location. We compared the evolution of the frequency of the inflammatory bowel diseases,them type and their initial location according to 5 periods of 3 years. Results: During this period, 202 cases of inflammatory bowel disease were diagnosed (55,5% of Crohn's disease, 41,5% of ulcerative colitis, 6% of indeterminate colitis). For the first period,we noted 21 cases of inflammatory bowel disease, for the 5th period, we noted 43 cases. The frequency of the Crohn's disease passed from 8 cases in the 1st period to 23 cases in the 5th one. The frequency of the ulcerative colitis passed from 12 cases in the 1st period to 17 cases in the 5th one. The number of indeterminate colitis was 1 in the 1st period and 3 in the 5th one. These differences did not been significant. The distribution of initial locations of the Crohn's disease and the ulcerative colitis increased in a proportional manner for each period. The average age to the diagnosis was 32 years in the 1st period and 35 years in the 5th period and comparable whatever the inflammatory bowel disease type. Conclusion: Although we cannot amount the exact incidence, we noted an increase of the frequency of the inflammatory bowel diseases, with a more marked elevation for the Crohn's disease.
    La Tunisie médicale 02/2013; 91(1):70-3.

  • Endoscopy 03/2012; 44(03). DOI:10.1055/s-0032-1305693 · 5.05 Impact Factor
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    ABSTRACT: Introduction La stéatose est fréquente chez les patients infectés par le virus de l’hépatite C. Ainsi, le retentissement de la stéatose sur la maladie hépatique a fait l’objet de nombreuses études, dont les résultats sont controversés. Le but de ce travail était d’étudier l’impact de la stéatose sur la sévérité de la maladie hépatique au cours de l’hépatite chronique C. Patients et méthodes Nous avons réalisé une étude prospective, incluant 50 patients suivis pour une hépatite chronique C. Les malades ont été subdivisés en 2 groupes selon la présence ou non de stéatose et comparés en fonction des lésions histologiques. Résultats La prévalence de la stéatose était de 56 % (groupe I, n = 28). L’activité nécrotico-inflammatoire était plus prononcée dans le groupe I par rapport au groupe II (n = 22), avec des moyennes respectives de 1,8 ± 0,64 et de 1,7 ± 0,57, mais la différence n’était pas significative (p = 0,54). La fibrose était beaucoup plus marquée chez les patients du groupe I, avec des moyennes respectives de 2,67 ± 0,85 et de 2,14 ± 0,80. La différence entre les 2 groupes était significative (p = 0,03). La fibrose était d’autant plus sévère que le degré de stéatose était important (p = 0,029). En analyse univariée, la fibrose était également associée à l’âge (p = 0,02), au taux des transaminases (p = 0,004) et à l’activité nécroticoinflammatoire (p = 0,03). Conclusion Dans cette étude, la stéatose était significativement associée à la fibrose, suggérant que la présence d’une stéatose devrait être considérée pour poser l’indication d’un traitement antiviral.
    Journal Africain d?Hépato-Gastroentérologie 01/2012; DOI:10.1007/s12157-012-0374-7
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    ABSTRACT: Patients with hepatitis C virus seem to often have hepatic steatosis. To assess the prevalence and the predictive factors of steatosis during chronic hepatitis C. We studied 50 HCV RNA positive subjects, who had liver biopsy performed. Steatosis was searched and patients were divided into to groups according to the presence or not of steatosis. On liver biopsy, 28 patients (56%) had steatosis. Multivariante analysis showed that steatosis was associated with age 58 years > 1,1 μmol/l, odds ratio 2 (95% CI 1.48 - 2.6; p= 0.02) and triglycerides level, odds ration 4,22 (95% CI 1.05 - 16.98; p = 0,03. In this study, steatosis was significantly associated with metabolic factors.
    La Tunisie médicale 11/2011; 89(11):830-6.
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    ABSTRACT: Mucosa-associated lymphoid tissue lymphoma is a histological type of marginal zone non-Hodgkin's lymphoma. Its clinical features and prognosis have seldom been reported because of its indolent clinical course. To establish prognostic factors that should be considered for the staging and management of this disease. Methods: Clinical data of 40 pathologically confirmed gastric lymphoma patients, treated during a period of 13 years, were analyzed. Of the 40 patients, 65% had stage IE - II1E disease and 35% had stage II2E - IV disease. A total of 18 patients received surgeries.Eighteen patients had chemotherapy and 10 patients had Helicobacter Pylori eradication therapy. The complete remission rate after treatment was 50%. The patients were followed up for a median of 26.75 months. The 5-year overall survival rate was 70%. Early stage at presentation, surgery, normal lactic dehydrogenase (LDH) levels and Helicobacter Pylori infection were associated with longer survival in univariate analysis. This study suggested that surgery might be an important factor predicting the long-term survival of patients with primary gastric lymphoma. Patients with poor prognostic factors should be treated more aggressively.
    La Tunisie médicale 10/2011; 89(10):752-7.
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    ABSTRACT: To report the clinicopathological data and the treatment outcomes in patients with primary gastric low grade non-Hodgkin's lymphoma. We carried out a retrospective analysis of 16 consecutive patients (median age 46 and range 28-75 years) who presented to our department with histopathological diagnosis of primary gastric low grade non-Hodgkin's lymphoma. We analyzed clinical manifestations, endoscopic features, pathological features,Helicobacter pylori infection and treatment. Common symptoms included abdominal pain (87.5%),vomiting (62.5%), and gastrointestinal bleeding (25%). Endoscopic appearances were mainly ulcers and ulcerations (93.75%).Endoscopic biopsy confirmation rate reached 87.5% when biopsies were repeated. Helicobacter pylori detection rate was 75%. A total of 9 patients received surgeries. Three patients had chemotherapy and 8 patients had Helicobacter pylori eradication therapy. The range of follow-up was 2-74 months with a median of 27 months. A complete remission was obtained in 12 cases, whereas 1 patient died and 3 were lost of view. Eradication therapy may be offered as an initial treatment option in patients with low-grade gastric lymphoma.
    La Tunisie médicale 09/2011; 89(8-9):676-81.

  • Journal Africain d?Hépato-Gastroentérologie 06/2011; 5(2):72-73. DOI:10.1007/s12157-011-0245-7
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    ABSTRACT: Endoscopic extraction of biliary tract stones is safe and effective. When the procedure is not successful, the use of a biliary stent can be a solution. To prospectively analyse the usefulness of a stenting in management of biliary obstruction due to choledocolithiasis. All patients referred to our endoscopic unit from January 2005 to January 2008, for management of bile duct stone are studied. We included patients subjected to an endoscopic insertion of a biliary stent. Of 414 patients with choledocolithiasis, 51 failed to have their ducts cleared with the first endoscopic retrograde cholangiopancreatography (ERCP): 25 patients (6%) were referred to surgical stone removal. Twenty six consecutive patients had endoscopic insertion of a 10 Fr biliary stent: There were 12 men and 14 women ranging in age from 35 to 102 years (median age 68 years). The indications for stent placement in common bile duct stone were mainly the endoscopic portal hypertension, elderly patients or with a short life expectancy. Twenty four patients (88%) are symptom free after stenting. Six patients (23%) had duct clearance after a median of 3 sessions at a mean of 13 months (range 3-48 months). In 3 patients endoprosthesis was inserted as a permanent therapy of biliary obstruction. Cholangitis occurred in 5 patients, early in two cases and later at a mean of 18 months (range 6-24 months) in 3 patients and was managed endoscopically by stent replacement and fluid antibiotics. These data favor temporary use of biliary endoprostheses in patients with endoscopically irretrievable bile duct stones until the definitive treatment is carried out. However, as a permanent therapy, late complications occur in many patients and the risk increases proportionally in time. Therefore, permanent biliary stenting should preferably be restricted to patients unfit for elective treatment at a later stage and with a short life expectancy.
    La Tunisie médicale 04/2011; 89(4):342-6.
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    ABSTRACT: Colorectal cancer occurs more frequently in older patients. Since the older population is increasing, a better understanding of the characteristics of colorectal neoplasm according to the age would be useful. To determine the differences of clinical characteristics of colorectal neoplasm including polyps between the elderly and young patients. Colonoscopy database from 2004 to 2008 was retrospectively analyzed. There were 1510 eligible patients who underwent colonoscopy with a mean age of 54 years. Patients were classified into two groups: the older age group (Group 1, aged ³ 60 years, n = 626) and the younger age group (Group 2, aged < 60 years, n = 884). Data were recorded on age, gender, colonoscopic indications, colonoscopic findings, and their related histological findings and tumor location. The risk of finding polyps and cancer at colonoscopy increases with age (29.4% in the older age group and 11% in the younger age group (p < 0.05). Left-sided lesions were noted to be more frequent in both age groups (66% and 67% respectively). The chance of detecting colorectal neoplasm by colonoscopy was higher in the elderly. However, both groups had the lesions predominately located in the left side.
    La Tunisie médicale 03/2011; 89(3):262-5.
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    ABSTRACT: Dysphagia is a common complaint of patients with Sjogren's syndrome, but its mechanism remains a subject of controversy. The association of Sjogren's syndrome with Plummer-Vinson syndrome remains uncommon. We report a 56-year-old women who presented both disorders. The diagnosis of the Plummer-Vinson syndrome was based on the classic triad of dysphagia, iron-deficiency anaemia and oesophageal webs. The diagnosis of Sjogren's syndrome was based on the presence of three Fox criteria. This association should incite us to search for common immuno-genetic pathogenic factors between these two syndromes.
    La Revue de Médecine Interne 02/2011; 32(2):e21-2. DOI:10.1016/j.revmed.2010.03.459 · 1.07 Impact Factor

  • Journal of Crohn s and Colitis 12/2010; 4(6):705-6. DOI:10.1016/j.crohns.2010.09.005 · 6.23 Impact Factor

  • Annals of Hematology 11/2010; 90(7):861-2. DOI:10.1007/s00277-010-1116-9 · 2.63 Impact Factor
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    ABSTRACT: Plummer - Vinson syndrome is one of the names given to the constellation of dysphagia, iron- deficiency anemia, and esophageal webbing. It is a rare affection which affects mainly white women. The purpose of this study is to precise epidemiological, clinical, paraclinical and therapeutic features of the affection. We report a retrospective study enrolled over 6 years (2002 - 2008). Were studied the age, the sex, the main symptoms and the biological parameters (full blood cell, albumin, hepatic, renal and lipidic balance sheet). Patients were explored by an upper endoscopy. Ten patients with the diagnosis of Plummer-Vinson syndrome were collected. There were 9 women, the average age was 57 years old. Dysphagia was the main symptom, observed in 100% of the cases. Fifty per cent of our patients had iron-deficiency anemia. Iron supplementation was indicated each time there is an iron- deficiency anemia. All the patients were treated with endoscopic dilatation and three of them needed multiple session of endoscopic dilatation. Eighty per cent had a favorable evolution. The malignancy was observed in 2 cases. Dysphagia is the main symptom of the Plummer-Vinson syndrome, which must indicate an upper endoscopy. This syndrome is known to be associated with an increased risk of squamous cell carcinoma of the upper airway tract, so the patients should be followed closely. Endoscopic dilatation is the procedure of choice in the treatment of cervical web of the esophagus.
    La Tunisie médicale 10/2010; 88(10):721-4.

  • La Tunisie médicale 09/2010; 88(9):682.
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    ABSTRACT: Endoscopic stent insertion is as a method of choice for palliative treatment of malignant biliary strictures. Two types of biliary stent were actually used plastic and metallic self-expandable. Occlusion of the stent can be observed in both. To assess the management of biliary stent occlusion. From january 2006 to december 2007, 120 biliary stents were inserted in 97 patients. Indications of biliary stents were malignant stricture in 67% of cases. Biliary stent occlusion was defined by necessity of stent replacement. 118 plastic and 2 metallic self-expandable biliary stents were inserted. Obstruction of the biliary stent was observed in 12 patients, after a mean time of 5,5 months [1-15]. A recurrent biliary desobstruction was necessary in 6 patients. Stent exchange was realised in 33,3% of cases for malignant biliary stenosis and in 66,6% for benign stricture (p=0,01). Obstruction of the stent was symptomatic (cholangitis, jaundice) in more of 50% of cases. Management consisted on the stent exchange by a new plastic stent for clogging plastic stent and on insertion of plastic stent inside the metallic one for the occluded metallic stent. Obstruction can occur for the two types of biliary stent. Survival of the patient, cost of the stent guide the choice of the stent will be used.
    La Tunisie médicale 07/2010; 88(7):462-6.
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    ABSTRACT: Intravenous ciclosporin is a promising alternative, rapidly effective, for patients with severe steroid-refractory colitis previously facing only surgical options, however its use is controversial because of the frequency of adverse effects and the doubt about the long-term response. Aim: This review will provide information on clinical pharmacology, clinical indications for use, methods of dose adjustment, monitoring of metabolites for efficacy and for potential side effects and the adverse event profile of ciclosporin in severe refractory colitis. Literature review. Toxicity is dominated by opportunistic infections. Renal and neurotoxicity are also recognized. Risks of toxicity can be reduced by using lower doses, by oral microemulsion or by monotherapy without corticosteroids. The drug should not be continued for more than 3 to 6 months. As a bridge to other maintenance therapy such as azathioprine or 6-mercaptopurine ciclosporin can be an effective treatment. CSA is a viable alternative to emergency colectomy in severe UC in the short term. Although these benefits are not maintained in all patients, more than a half will also avoid colectomy in the longer term. Careful selection and monitoring of patients, use of lower doses, and oral therapy will help to reduce side effects.
    La Tunisie médicale 06/2010; 88(6):390-3.