Rehabilitation takes an important place in the medico-surgical management in Pott's disease, to limite or compensate the disabilities and handicap related to this pathology.

IntroductionInternational recommendations of the exploration of non-insulin-dependent diabetes mellitus (NIDDM) are focused on deficiency and not incapacity.Aims(1) To estimate the incapacity of NIDDM patients through the 6-minute walk test (6MWT) data. (2) To determine their 6-minute walk distance (6MWD) influencing factors (3) To compare data of NIDDM patient group (PG; n = 100) with those of two control groups (CG): CG1 (n = 174, healthy nonobese and nonsmoker); CG2 (n = 55, obese nondiabetic free from comorbidities).Population and methodsThe anthropometric, socioeconomic, clinical, metabolic, and 6MWT data of 100 NIDDM patients (45 females) were collected.ResultsTotal sample means ± standard deviation of age, weight, and height were 54 ± 8 years, 81 ± 14 kg, and 1.64 ± 0.09 m. (1) Measured 6MWD (566 ± 81 m) was significantly lower than the theoretical 6MWD (90% ± 12%). The profile of the PG carrying the 6MWT, was as follows: 23% had an abnormal 6MWD; at the end of the 6MWT, 21% and 12% had, respectively, a low heart rate and a high dyspnea (>5/10), and 4% had desaturation during the walk. The estimated “cardiorespiratory and muscular chain” age (68 ± 16 years) was significantly higher than the chronological age. (2) The factors that significantly influenced the 6MWD (r2 = 0.58) are included in the following equation: 6MWD (m) = −73.94 × gender (0, male; 1, female) – 3.25 × age (years) + 7.33 × leisure activity score – 35.57 × obesity (0, no; 1, yes) + 32.86 × socioeconomic level (0, low; 1, high) – 27.67 × cigarette use (0, no; 1, yes) + 8.89 × resting oxyhemoglobin saturation – 105.48. (3) Compared to the CGs, the PG had a significantly (P < 0.05) lower 6MWD (100%+9% and 100%+8%, respectively, for the CG1 and CG2).ConclusionNIDDM seems to accelerate the decline of the submaximal aerobic capacity evaluated through the 6MWD.

Nosocomial infections (NI) have achieved an increasingly large prevalence today, in Tunisia as well as abroad. Their on-going presence and occurrence are largely responsible for increasing morbidity and sometimes mortality. The aim of this work is to determine the prevalence of NI in the Kebili regional hospital and assess its level of impact. It consists of a cross-cutting study conducted in the Kebili regional hospital which holds 124 beds dispersed throughout 6 units. All of the patients hospitalised for more than 48 hours and who were present in the hospital between midnight February 17th to midnight February 18th, 2004, were included in the study. In the small hospital, 64 patients were present on the day of the study, 45 of whom had been already been hospitalised for over 48 hours. Among these 45, 6 patients (13%) tested positive for a NI. This prevalence is higher than that which is reported in the literature (2-3-9). The proportion of NI in this study is closer to that described in other series (2-7). In fact, we recorded the following : 2 cases of infection in the body zone operated upon (33%), 2 cases of urinary infection (33%), 1 case of pneumonia (17%), and 1 case of a skin infection (17%). The microbiological documentation, as it is described and presented in the other studies (1-7), was not found in our 6 patients here. The association and linkage between NI and certain other factors related to the provision of care has been documented as follows: surgical intervention, manipulations of the veins, gall bladder probing (or insertion of a catheter), tracheotomy, and prolonged hospitalisation (with an average stay of 16.5 days). The strong relationship between the occurrence of NI and the type of service or intervention administered during a hospital stay described in a select number of studies (2-5-7-11) does not present itself in our results. The overprescription of antibiotics among the patients in the hospital (52%) can be interpreted as a poor control mechanism and insufficient surveillance of the prescriptions and the delivery of these antibiotics, which serves as an important factor which contributes to NI and the development of resistance to available treatment. The work attempts to underline the importance of such a study on NI for the development and improvement of the quality of care, most importantly because the occurrence of NI constitutes a public health problem, and this is related to both the high prevalence of NI and its human and economic costs. In spite of the deficiencies noted in the clinical diagnoses and most notably the microbiological diagnoses, nosocomial infections are present in our hospital with a prevalence of 13%.

No abstract

Flat foot in children is a common deformation, which appears during the first years of life. It requires a rigorous evaluation to rule out congenital or neurological abnormality. It is characterized by a decrease of the plantar concavity indeed collapse of the foot, often associated with other morphostatic deformations. The aim of this study is to find a correlation between the essential flat foot in children and lower limb disorders torsional. It is a cross-sectional descriptive study, recruiting 110 children (220 feet) aged between 3 and 6 years old. Each child was given an assessment of the morphology of the foot (Contact Index II…) and lower limb rotational profile (intoeing and femoral antétorsion and tibal torsion). Among 110 children, 21 (19.1%) have bilateral flat feet and 7 (6.4%) have unilateral flat feet, associated with an average value of Contact Index II equal to 0.921; the minimum value is 0.880 and the maximum value is 1.17. All children with flat feet have excessive femoral antétorsion; 45 (92%) are associated with a hip intoeing and 38 (80%) present an insufficient external tibial torsion. The analysis of multiple regression shows a significantly elevated correlation among the flat foot and excessive internal rotation of the hip (F = 70.36, r = 0.77, P < 0.001), excessive femoral antetorsion (F = 54.78, r = 0.73, P < 0.001) and insufficient external tibial torsion (F = 7.79, r = 0.37, P < 0.001).