In the service of Health

 
2015 is the 20th anniversary of MédiS laboratories.

2015 is the 20th anniversary of MédiS laboratories.

"It‘s been 20 years ago when MédiS was just an ambition with vague outline, A lined intuition of a profound conviction of success of the dream of my life..." Lassaad BOUJBEL | Founder and Pharmacist MédiS CEO

Lire la suite

Quality Control Laboratory

Quality Control Laboratory

The quality control department, within MédiS Laboratories, is one of the complex systems of quality evaluation in its widest sense, ensuring diverse activities of control and expertise…

Lire la suite

You are here :  » FAQ

FAQ

Kidney transplantation: what is it?

Kidney transplantation: what is it?

Kidney transplantation or renal transplantation is a surgical procedure to replace a failed kidney with a healthy kidney taken from a donor. Current transplantation is the only therapeutic alternative to dialysis, under the management of advanced chronic renal failure.

In Tunisia, the general organization of the removal and transplantation of organs is the responsibility of a public institution, the National Centre for Promotion of Organ Transplantation. Its duties include the management of the waiting list, the distribution of grafts, health vigilance, assessing the results of transplantation.

Following surgery, the immunosuppressive therapy required throughout the life of the transplant, involves the combination of several drugs. The immunosuppression protocols vary depending on the immunological status of the recipient, the period after the transplant, and acute rejection episodes eventuality. Each recipient must be clearly informed of the peculiarities of the chosen treatment and side effects associated with drugs used.

The first kidney transplant is performed by the team of Professor Saadeddine ZMERLI at Charles Nicolle Hospital in Tunis in 1986. Since then Five Renal transplant centers performed more than 1,000 kidney transplants, 90% of grafts come from a living donor.

Essential hypertension?

Essential hypertension?

The more often, no cause of hypertension is found, we call it essential hypertension. It is not rare to find hypertension in some other family members. It is necessary to take in charge all these patients and to treat them in aim to normalize their blood pressure, i.e. under 14/9.

Hypertension is often associated to other cardio-vascular pathologies. Atherosclerosis and its atheroma plaques deposits in the arteries linings making them rigid, they can not dilate normally and the pressure in the vessels become high. The old aged persons have their arteries age, their vessels become old and are less flexible. Blood pressure may be, therefore, higher than normally.

A bad quality of life: sedentary life, rich and greasy alimentation, overweight or obesity, type 2 diabetes, smoking… all these factors associated to hypertension can lead to cardio-vascular diseases and their multiple complications.

The stress which can sometimes be avoided is also a risk factor of hypertension.

Hypertension?

Hypertension?

Many people are hypertensive, some know that and are usually badly monitored, not correctly treated; the others do not know and are, therefore, not treated at all. It is important to know our blood pressure: that is why blood pressure is measured at almost each medical examination. Blood pressure needs better to be measured in healthy patients and in case of limited consultations.

Hypertension symptoms:

Hypertension dose not usually have symptoms which are likely to alert the patients. The more often hypertension is revealed by a routine medical examination. Sometimes, however, some signs can evoke hypertension:

  • frontal or occipital headaches occurring in the morning
  • dizziness
  • Visual disorders: spotted vision, blurred vision…
  • fatigue
  • nose bleedings
  • nose hemorrhages
  • muscles cramps
  • pollakiuria (frequent need to urinate)
  • dyspnea (breathing difficulties related to a left ventricular insufficiency)

When discovering a hypertension, the doctor will control blood pressure under different conditions: resting, effort, standing, lying, left and right arm… ensuring like this its permanent characteristic.

What we know and what we do not yet know about Multiple Sclerosis (MS)!

What we know and what we do not yet know about Multiple Sclerosis (MS)!

What we know  about Multiple Sclerosis (MS):

Multiple sclerosis is a Chronic, inflammatory disease and common cause of disability, which affects exclusively the myelin sheath and axons of the Central Nervous System (CNS).

MS is the result of Different mechanisms; and the most probable mechanism is immunological with cells of the immune system that attack myelin and can cause permanent damage.

Primary symptoms of this disease which affects twice more women than men appear at the age between 15 and 45 years and are:  spasticity, weakness, bladder/bowel dysfunction, pain, and associated depression.

Diagnosis is made essentially by neurological examination and Magnetic Resonance Imaging.

Clinical course of multiple sclerosis leads to permanent disability but this course is different from one person to another.

More then  2.3 millions of people are affected all around the world with widely varying prevalence.

MS is most common in North America and Europe with respectively prevalence of 140 and 108 cas per 100 000 .

In Tunisia the number of patient is around 5000 and incidence is around 1.3 per 100 000.

The Essential current treatment aims are reduction of relapses, delaying disease progression and disability and psychological support, but we do not yet have the cure.

What we do not yet know about multiple sclerosis (MS):

  1. Why the disease occurs in a given individual?
  2. How to repair damage?
  3. And Especially How to cure disease?

When LMWH is prescribed before air travel?

When LMWH is prescribed before air travel?

The economic class syndrome

Deep Vein Thrombosis is a known severe disease; a leading cause to death from pulmonary embolism. The annual incidence of Thrombo – Embolic disease in the Caucasian population is 1 to 2 per 1000.

Cases were described a long air flights without taking care neither about the medical professionals nor about the airlines until the death of a 27 year old woman at “Heathrow Airport” after a flight from Australia. 

Risk factors related to air travel are the following: immobilization, low local pressure and dehydration [1].

According to GENEVA meeting conclusions, travelling trip is undeniably a risk factor

Prevention

No systematic prevention should be proposed for air flights of less than 4 hours outside the eventual wear of elastic medical socks which is always recommended to avoid edema.

For travelers who are taking flights > 8h, we recommend the following general measures according to the recommendation of the American College of Chest Physicians [2]: 

For patients with no personal history of DVT or known family thrombophilia; it is recommended to (1C grade):

  • Avoid wearing  tight clothing 
  • Do not drink alcoholic beverage
  • Avoid hypnotics and hypnotics in association with alcohol
  • Wear elastic medical compression socks
  • Perform regular rotational movements and dorsiflexion of both feet by avoiding to cross your legs
  • Make inspirations and forced expirations breathing
  • Drink a glass of water each hour
  • Stand up and walk each 2 or 3 hours in the corridor

For patients with  a history of recent or recurrent DVT, a known and documented thrombophilia, an active post thrombotic disease, a reduced mobility (gonarthrosis, osteoarthritis, disabling neurological disease) or active cancer; it is advised the same rules of lifestyle described/listed above in association / in combination with:

  • An elastic medical compression by socks of 20 to 30 mmHg
  • Low Molecular Weight of heparin prescription as a preventive dose. A subcutaneous injection will be carried out 1 to 2 hrs before departure and repeated 1 to 2 hrs before return (2C grade).
  • According to experts coagulation; aspirin has no preventive  action on the venous system (1B grade)

For long-distance travelers with additional risk factors for VTE, we recommend the general measures listed above. If active thromboprophylaxis is considered because of perceived high risk of VTE, we suggest the use of properly fitted, below-knee GCS, providing 20 to 30 mm Hg of pressure at the ankle (grade 2C), or a single prophylactic dose of LMWH, injected prior the departure (Grade 2C).

For long-distance travelers, we recommend against the use of aspirin for VTE prevention (Grade 1B).

In LONFILT study, out of 467 subjects/patients at risk of DVT ; i twas found no thrombosis duting prophylaxis by LMWH (1000UI per 10Kg) but a thrombotic episode was found in 3.6% of cases under aspirin and in 4.8% within the absence of prophylaxis

In patients with a recent DVT, air travel will is allowed after 10 days anticoagulation with LMWH or VKA at effective doses with 2 consecutive INR between 2 and 3.

In patients with a half-recent thromboembolic episode, and always under VKA, it is recommended to make a monitoring of INR the week before the air flight and prescribe medical elastic compression socks 20 to 30 mmHg.

VTE: venous thromboembolism/ LMWH: low-molecular-weight heparin/ GCS: graduated compression stockings/ DVT: deep vein thrombosis

VKA: vitamin K antagonist/ INR: international normalized ratio

Bibliography

  1. F.Clheir, maladie thrombo-embolique des voyages aériens. ELSEVIER MASSON 20122
  2. KEARON C, KAHN S, AGNELLI G et al. Antithrombotic therapy forvenous thromboembolic disease. American College of ChestPhysician (8th edition). Chest, 2008 ; 133 : 454S-545S.
  3. CEASARONE M. R, BELCARO G, NICOLAIDES A et al. Venous thrombis from Air Travel : The Lonflit study. Angiology, 2002 ; 53 : 1-6.

What is cholesterol and what do we mean by "Dyslipidemia"?

What is cholesterol and what do we mean by "Dyslipidemia"?

Dyslipidemia is an abnormally elevated or decreased concentration of lipids (cholesterol, triglycerides, phospholipids or free fatty acids) in the blood. There are several types, but cholesterol-linked disorders are among the most common.

Cholesterol is a waxy substance (fat) naturally present in the body. It serves to cell structure and in the manufacture of certain hormones, and vitamin D and to produce bile acids, which help to digest fat. Cholesterol comes from two sources: first we produce (especially liver) the quantity we need but it is also present in some foods we eat. All foods with animal fats contain a certain amount of cholesterol. The main dietary sources of cholesterol are cheese, egg, beef, poultry and shrimp.

Cholesterol is therefore an essential substance for our body but it is widely recognized that high cholesterol is a major risk factor of cardiovascular disease.

Cholesterol flowing in the blood in two forms: LDL (bad cholesterol) and HDL (good cholesterol).

The "bad" cholesterol can form deposits on the walls of arteries (plaques). These deposits can narrow the arteries, reducing blood flow and cause a heart attack or a stroke. Conversely, high HDL levels reduces the risk of heart disease where the "good" cholesterol. HDL ("good" cholesterol) recovers cholesterol and carries it to the liver where it is eliminated.

Excess LDL cholesterol and / or low HDL can be dangerous on the long-term.  The excess cholesterol is deposited on artery (such as coronary, arteries of the heart) forming plaques that can grow over the years (atherosclerosis). The plates can slow or stop blood flow, while causing angina. If the flow is very small, this will cause a possibility of myocardial infarction (heart tissue destruction).

Can we prevent headaches?

Can we prevent headaches?

Factors triggering headaches are many and variable from one person to another. We mention the most common:

  • Environmental factors: heat, strong light, noise, strong odors...
  • Dietary factors: alcoholic drinks, coffee, fat dishes or sauces, chocolate ...
  • Hormonal factors: menstruation, pill, puberty ...
  • Psychological factors: stress, anxiety, lack or excess of sleep.

The eviction of these factors can reduce the frequency of attacks. Remember every time you have a headache to note the elements that triggered your pain in order to avoid them in the future.