M. Ghorbel

Centre Hôpital Universitaire Farhat Hached, Susa, Sūsah, Tunisia

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Publications (70)38.38 Total impact

  • Menif H · Kharrat RK · Dhieb A · Louati · Rekik TR · Rekik H · Ghorbel M · Elloumi M · Gargouri J
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    ABSTRACT: OCCASIONAL AND LONG TERM AUTOMATED RED BLOOD CELLS EXCHANGE IN SICKLE CELL DISEASE PATIENTS: IMPACT ON HOSPITALIZATION FREQUENCIES Menif H1, Kharrat RK1, Dhieb A1, Louati N1, Rekik TR1, Rekik H1, Ghorbel M2, Elloumi M2, Elloumi M2 and Gargouri J1 1CRTS Sfax, 99/UR/08-33, facult�e de m�edecine de Sfax, universit�e de Sfax, Sfax, Tunisia 2Hematology service, facult�e de M�edecine de Sfax, Sfax University, Sfax, Tunisia Aim: Effectiveness of automated red blood cells exchanges (ARE) in managing sickle cell patients (SCP) have been proven either during acute crisis or as prophylactic treatment of recurrent stroke or in pre-operative management (ASFA 2013: categories I–III). In this study, we report our 10 years of ARE in SCP and evaluate the impact of chronic ARE on hospitalizations frequency. Material and method: Twenty six SCP were enrolled. Seven patients were converted from chronic transfusion (5 had already occasional ARE) to chronic ARE: 4 with history of resistant vaso-occlusive crisis (RR VOC), 2 patients for acute chest syndrome and 1 for acute stoke and multiorgan failure and 19 patients received occasional ARE: [preoperative: 12, resistant priapism: 4 and repeated resistant vaso-occlusive crisis (RR VOC) in pregnancy: 3]. Seven patients had Hydrea [priapism: 1, perioperative: 1, RR VOC: 2, acute chest syndrome: 1 and acute stoke and multiorgan failure: 1). Erythrocytapheresis was performed on COBE Spectra (Terumo BCT) (fluid balance: 95–100%). Compatible cross-matched, phenotyped and WBC-depleted packed Red Blood Units (PRBU) were used to replace patients RBC. Peripheral venous access was the preferred route for treatment. Results: We performed a total 200 ARE on 26 SCP [mean age at inclusion 26 (11– 50) years and sex ratio 1.6). The 7 patients who experienced chronic ARE achieved a mean of 24 procedures (6–49), with a mean visit interval of 3.4 (2.2–7) months, [mean follow-up period 5.4 (2.4–9.7) years]. Thirty ARE were performed occasionally on 19 patients (see table). In 2 cases (priapism and painful VOC), symptoms resolved before the end of the procedure. In the chronic ARE group, mean hospitalization (frequency/duration) dropped from 2.4/year/patient before ARE inclusion (mean follow up: 7.3 year) to 1.6 after (mean follow up: 4.8 year) and from 19.7 to 8.6 day/year/patient. A non observant patient continued to have a mean of 3.8 hospitalization/year (mean 33 day/year). Adverse events were observed in 1 patient (3%) in the ‘occasional’ group and 9 patients (5%) in the chronic group (P0.001). A patient in the occasional group needed a CVC (two procedures prematurely stopped). Two patients in the chronic group had fistula from whom one showed repeated thrombosis. Discussion: In our experience, ARE was safe, well tolerated, no serious adverse event were observed within the procedure. Despite less frequent procedures than reported by other centers and higher levels of abnormal hemoglobin, ARE were successful in bettering patient life quality, reducing hospitalization (frequency and duration) and thus reducing global disease cost in chronic transfused SCP. Vascular problem access could be a limitation factor and, as known, fistula at risk of repeated thrombosis.
    No preview · Conference Paper · Jun 2015

  • No preview · Article · Feb 2015
  • N. Sellami · W. Mnejja · W. Siala · N. Toumi · M. Ghorbel · M. Frikha · J. Daoud

    No preview · Article · Feb 2015
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    Full-text · Article · Mar 2013 · Diabetes & Metabolism
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    ABSTRACT: Background: Aplastic Anemia (AA) is a quantitative marrow failure resulting in pancytopenia. The prognosis depends on the risk of infection and bleeding.Thebone marrow allograftis the best curative treatment. In Tunisia, this technique has been available since 1998 at the National Centre for bone marrow transplantation in Tunis. Aims: The purpose of our study is to investigate the diagnostic, therapeutic and evolutive characteristics of patients presenting with AA followed in hematology department of Sfax. Methods: This is a retrospective study concerned with all cases of acquired AA, diagnosed in hematology department of Sfax, during a period of 13 years (between January 1999 and December 2011). The diagnostic confirmation of AA is based on the bone marrow biopsy for all patients. The etiological assessment involved: karyotype on blood and on marrow, liver function tests, viral serology and Ham Dacia test and withflow cytometry. For the severity of the disease we adopted the criteria of Camitta. The proposed treatment was bone marrow allograft (indicated for all patients younger than 45 years with an identical HLA donor), immunosuppressive therapy (cyclosporine+/- antithymocyte globulin: ATG) and / or androgenic and symptomatic treatment. Results: We collected 92 patients; the mean age was 26 years, ranging from 2 to 87 years. The sex ratio was 1.42%. Sixty-five percent of patients had severe form and 35% moderate form. AA was idiopathic in 78%, post-hepatitic in 16%, toxic in 4% and associated with paroxysmal nocturnal hemoglobinuria in 2%. The allograft was indicated for 55 patients. Thirty-three patients (60%) had a compatible HLA donor. Among them, 82% had a bone marrow allograft. The graft was rejected, due to unfavorable economic conditions in 4 patients and a genetic disease of the donor in one case. In total: 27 among 92 patients were grafted (29%). Thirty seven patients (34%) were treated by immunosuppressive therapy with an objective response up to 37%. Androgen and symptomatic treatment were used respectively in 20and 8 patients (8% and 18% respectively). The 5-year survival was 87% for allograft patients and 36% for patients treated with immunosuppressive therapy. Summary / Conclusion: The diagnostic and the epidemiological aspects of AA in our series are similar to those seen in the literature (rare disease, young population, predominance of severe and idiopathic forms). Compatible HLA donor was found in 2/3 of cases which is higher than the western series rate, due to the important number of families in our country. Thebone marrow allograftis the potentially curative treatment in our series as well as in the literature. But, objective response was found in 1/3 of our cases after immunosuppressive therapy because of the difficulty of using the ATG in some patients.
    No preview · Article · Jan 2013 · Haematologica

  • No preview · Article · Feb 2012 · Journal de Pédiatrie et de Puériculture
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    ABSTRACT: Four patients (two women aged 50 and 67 years, a 36-year-old man, and a 5-year-old child) presented with necrosis of the eyelid after local anesthesia using 2% lidocaine with epinephrine. In three cases, the anesthesia was administered prior to suturing an eyelid laceration, and the necrosis involved the upper lid; in one case, the anesthesia was administered prior to temporal artery biopsy. Surgical debridement of the necrotic tissue was performed in all cases. Three patients developed a bacterial superinfection treated with systemic antibiotics with good results. Necrosis of the eyelid is a rare complication occurring after local anesthesia using lidocaine with epinephrine. Most dermatologists refrain from use of epinephrine with local anesthetics for digital blocks. Necrosis is due to prolonged vasoconstriction of arteries. It is observed especially commonly in patients at increased risk (arteritis, Raynaud's phenomenon and severe microvascular diseases). In the eyelid, few cases have been reported.
    No preview · Article · Feb 2012 · Journal francais d'ophtalmologie
  • A. Ghenim · D. Daoud · M. Ghorbel · A. Ben Hamida · J. Tomas
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    ABSTRACT: A performed dual band telemetry system with a DPSK data modulation scheme is reported for inductively powered biomedical implants. The innovation of this system consists on improving data rates with a novel full digital DPSK demodulator that achieves a data-rate-to-carrier-frequency ratio of 100% and a power consumption of 136.3μW @ 3.3 V at a data transmission rate of 10 Mbps. The whole receiver was designed with the 0.35-μm CMOS technology of Austria Micro Systems.
    No preview · Conference Paper · Jan 2011

  • No preview · Article · Jan 2011 · La Tunisie médicale
  • S Hdiji · M Ghorbel · O Kassar · E Daoud · H Bellaaj · M Medhaffar · N Ajmi · Z Mnif · M Elloumi

    No preview · Article · Jan 2011 · La Tunisie médicale
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    ABSTRACT: Nasopharyngeal carcinoma (NPC) represents one of the most frequent epithelial tumours of the child in intermediate risk regions. In the Maghreb, it represents the first cancer of teenagers of 15-20 years old. The Epstein Barr virus (EBV) is the most important etiologic factor. Its role in the pathogeneses of NPC has been confirmed by several studies. Young NPCs are characterized by a low rate of EBV antibodies and a high level of LMP1 cell expression than in adult's NPC. The undifferentiated carcinoma nasopharyngeal type (UCNT) represents the most frequent histological type. Immunohistochemical analyses of North Africa early onset NPC is characterized by a weak expression of bcl-2 and p53 and a strong expression of LMP1 and c-kit what makes them different from the adult's NPC. Clinically, cervical node involvement is constantly present. Juvenile NPC is characterized by a very important locoregional extension as well as a high rate of distant metastases. More than 15% of patients had metastases at diagnosis. Radiotherapy is still the standard therapy of NPC. Only some retrospectives studies have been published to determine the benefit, the type and the timing of the chemotherapy in the treatment of juvenile NPC. Metastatic relapses constitute the main cause of death at these young patients. An improvement of the prognosis can be waited with concomitant chemotherapy and intensity modulated radiotherapy. However, randomized multi institutional studies are necessary to standardize the treatment of the NPC in childhood.
    No preview · Article · Apr 2010 · Bulletin du cancer
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    ABSTRACT: Amoeba of the genus Acanthamoeba are ubiquitous free-living protozoa encountered in water and soil. They frequently cause sight-threatening keratitis. Report of the three first cases diagnosed at the laboratory of Parasitology of Sousse Hospital, (Tunisia). Our study concerned three lens-wearing female patients, aged 17, 20 and 29 years respectively. The patients originate from central Tunisia and presented with unilateral (2 cases) or bilateral (one case) keratitis. Diagnosis was made by demonstrating Acanthamoeba trophozoites and/or cysts on direct examination and/or culture (in agar - Escherichia coli medium) of contact lenses and/or lenses' solution. Direct examination of corneal swabs was negative in three cases but culture was positive in one. The three patients were treated with hexamidine and neomycine eye-drops for three months. Treatment led to scarring of lesions with however sequellar opacities that was minor to moderate in two cases and consisted of a central leucoma with a poor visual outcome in the last case. The need for systematic research of amoeba in lenses wearing patients with keratitis is emphasized.
    No preview · Article · Feb 2010 · La Tunisie médicale
  • M. Ghorbel · A. Ben Hamida · J. Tomas
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    ABSTRACT: In this paper we present a wireless RF powering system dedicated to a cochlear implant. Most current systems use discrete components to achieve the back telemetry power supply. In order to achieve an efficient power consumption and a minimum size of the implant, our RF powering system is conceived with MOS transistors in order to have an integrated system. Using the signal recovered by the inductive link, the system generates a regulated 3.3 V voltage which is used to generate power supply for the entire implanted device. The system is designed in AMS 0.35 ¿m standard CMOS technology.
    No preview · Conference Paper · Dec 2009
  • Amira Derbel · Mohamed Ghorbel · Mounir Samet · Ahmed Ben Hamida
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    ABSTRACT: The use of auditory models in cochlear implant sound processing strategies aims to improve cochlear implant user perception of speech. This paper presents the implementation of a cochlear implant signal processing strategy on DSP. As for concretization, TMS320C6416 DSP board was chosen. The aim of the new strategy is to obtain more natural sound in CIs by better mimicking the human auditory system. Knowing that, wavelet transform, is characterized by its time-frequency resolution that is similar to the hearing perception procedure, we concern our work to develop a strategy based on auditory model based continuous wavelet transform processing DSP implementation. To gain software flexibility and interactivity, the Assembly programming environment is used. The paper chooses the processing algorithm which is taken to achieve a real-time throughput. This experimentation provides directives guidelines on our work to treat the speech signal sample per sample. Code energies of input samples can be obtained and send one per one in weft to the cochlear implant internal part in duration less than the arrival of the second sample for real time operations.
    No preview · Conference Paper · Nov 2009

  • No preview · Article · Apr 2009 · Journal Français d Ophtalmologie

  • No preview · Article · Apr 2009 · Journal Français d Ophtalmologie

  • No preview · Article · Apr 2009 · Journal Français d Ophtalmologie
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    ABSTRACT: Introduction La cataracte secondaire est la complication post-opératoire la plus fréquente de la chirurgie de la cataracte. Nous nous proposons d’étudier dans ce travail l’impact de la technique chirurgicale sur le taux de survenue de cette complication après chirurgie de la cataracte congénitale. Matériels et Méthodes Il s’agit d’une étude rétrospective des dossiers de 78 enfants (108 yeux), opérés entre janvier 2002 et janvier 2007 pour une cataracte congénitale. Les patients ont été subdivisés en deux groupes : Groupe I : 41 enfants (57 yeux) âgés de moins de 6 ans, opérés par phaco aspiration et implantation dans le sac. Un capsulorhexis postérieur a été réalisé dans 10 yeux, et associé à une vitrectomie antérieure dans 17 yeux. Groupe II : 37 enfants (51 yeux) âgés entre 6 et 15 ans, opérés tous par phaco aspiration et implantation dans le sac. Résultats Dans le groupe I, 18 yeux ont développé une cataracte secondaire dont 14 parmi 30 après phaco aspiration et implantation dans le sac (47 %), 3 parmi 10 après phaco aspiration, capsulorhexis postérieur et implantation dans le sac (30 %) et un œil parmi 17 après phaco aspiration, capsulorhexis postérieur, vitrectomie antérieure et implantation dans le sac (6 %). Dans le groupe II, 14 yeux (28 %) ont développé une cataracte secondaire. Discussion La chirurgie de la cataracte préservant la capsule postérieure chez l’enfant s’accompagne d’un taux élevé d’opacification capsulaire. La réalisation d’un capsulorhexis postérieur associé à une vitrectomie antérieure est recommandée par la majorité des auteurs. Conclusion La réalisation d’un capsulorhexis postérieur associé à une vitrectomie antérieure au cours de la chirurgie de la cataracte diminue considérablement la fréquence de cataracte secondaire chez l’enfant.
    No preview · Article · Apr 2009 · Journal Français d Ophtalmologie

  • No preview · Article · Apr 2009 · Journal Français d Ophtalmologie
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    ABSTRACT: Introduction Divers troubles oculomoteurs, congénitaux ou acquis, peuvent être associés au ptôsis. Cette association rend plus difficile la prise en charge des malades tant sur le plan diagnostique que thérapeutique. Notre travail vise à relever les caractéristiques cliniques des différentes formes étiologiques et à évaluer les résultats thérapeutiques. Matériels et Méthodes Notre travail est rétrospectif, portant sur 78 patients (102 paupières) présentant un ptôsis associé à des troubles oculomoteurs. Tous les patients ont bénéficié d’un examen clinique complet. Les examens complémentaires ont été demandés en fonction de l’orientation étiologique. Lorsque la chirurgie a été décidée, elle a été réalisée en deux temps : chirurgie oculomotrice puis chirurgie du ptôsis. Résultats L’atteinte oculo-palpébrale était congénitale dans 43 cas (55,1 %) et acquise dans 35 cas (44,9 %). Les ptôsis acquis étaient d’origine myogène (51,4 %), myopathique (37,1 %) ou myasthénique (14,3 %), d’origine neurogène (40 %) et d’origine traumatique (8,6 %). Les résultats de la chirurgie du ptôsis ont été jugés bons dans 63 % des cas et satisfaisants dans 24,6 % des cas. Une hypercorrection a été notée dans 3,7 % des cas et une hypo-correction dans 8,7 % des cas. La principale complication était l’ulcère cornéen d’exposition (3,5 % des ptôsis opérés). Discussion La stratégie du diagnostic étiologique des ptôsis acquis est orientée par l’aspect du ptôsis et son mode d’installation et nécessite un examen neurologique clinique et radiologique. La confirmation diagnostique des ptôsis myogènes nécessite souvent un test à la prostigmine et parfois le recours à une biopsie du muscle deltoïde. La stratégie thérapeutique quant à elle doit tenir compte du risque cornéen et de l’étiologie de la ptose palpébrale amenant à l’abstention en cas de myasthénie ou de risque cornéen majeur. La chirurgie du ptôsis, quand elle est décidée, constitue toujours le dernier temps opératoire après la chirurgie oculomotrice. Conclusion L’association d’une paralysie oculomotrice au ptôsis n’est pas rare. Elle modifie la stratégie de la prise en charge de ce dernier tant sur le plan diagnostique que thérapeutique. Les résultats thérapeutiques restent, toutefois, moins bons comparés aux résultats de la chirurgie du ptôsis isolé.
    No preview · Article · Apr 2009 · Journal Français d Ophtalmologie

Publication Stats

98 Citations
38.38 Total Impact Points


  • 2006-2012
    • Centre Hôpital Universitaire Farhat Hached
      Susa, Sūsah, Tunisia
  • 2004-2011
    • Ecole Nationale d'Ingénieurs de Sfax
      • Laboratoire d’Electronique et des Technologies de l’Information (LETI)
      Şafāqis, Şafāqis, Tunisia
  • 2000-2009
    • University of Sfax
      • Department of Electrical Engineering
      Şafāqis, Şafāqis, Tunisia