Wided DEBBABI

Background : Diabetes mellitus is a public health problem. Diabetic foot is one of its major complications and is secondary to neuropathy, arteriopathy, infectious and mechanical foot involvement. It is a major cause of lower limb amputation and thus of motor disability. Material and methods We propose a descriptive study of the main anomalies found in the examination of thefeet in 40 patients with type 1 diabetes. Results: The median age of our population was 34.5 years. The average duration of diabetes was 25.35 years. 15% of people have neuropathic pain, and about one third describe the pain as severe. Hallux valgus and claw toes were observed in 35% of patients and a Charcot foot was found in 2 patients. 10% of subjects already had stage 4 arterial disease and 10% had intermittent claudications. The results of the care of 3 patients through telemedicine are encouraging. Management was early and further damage was prevented. Conclusion: Foot involvement in diabetes mellitus is common and often severe. Early intervention, via telemedicine, could improve outcomes.

Introduction: Treatment of Graves' disease (GD) is based on the triad of antithyroid drugs (ATD), radioactive iodine and surgery (total or subtotal thyroidectomy). ATD remains the first-line treatment. Aim: To determine predictors of GD remission after treatment with ATD. Methods: Cross-sectional study for analytical purposes including 105 patients followed for GD treated with ATD for 12 to 18 months. The collection of clinical and biological data was done through the consultation of medical records. Patients were divided to two groups according to their outcome. The "Remission" group included patients with durable euthyroidism after treatment withdrawal. The "Failure" group included patients who did not achieve euthyroidism at the end of treatment or who had relapsed after treatment withdrawal. Results were compared using Chi-Square test and t-test and logistic regression model with significance at p Results: Patients in the "Remission" group were 43 (40.95%) and patients in the "Failure" group were 62 (59.05%). Factors that were significantly associated with remission at univariate analysis were: a shorter duration of symptom progression, a shorter duration of treatment, a lower initial anti-TSH receptor antibodies level, methimazole use compared to Benzylthiouracil use and better therapeutic adherence. Multivariate analysis showed that only shorter treatment duration (p = 0.01, OR = 0.90, IC95% [0.87 0.97]), lower initial anti-TSH receptor antibodies level (p = 0.016; = 0.93, IC95% [0.87-0.98]) and methimazole use (p = 0.048, OR = 2.4, IC95% [1.00-5.74]) were significant predictors of remission. Conclusion: A lower initial level of anti-TSH receptor antibodies, the use of methimazole compared to Benzylthiouracil as well as a shorter duration of treatment are factors of better prognosis in the outcome of Graves’ disease after Antithyroid drug treatment.