Houda Kanoun

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Maternal and neonatal outcomes after caesarean delivery in the African Surgical Outcomes Study: a 7-day prospective observational cohort study

The Lancet Global Health (2019)

David G. Bishop Robert A. Dyer Salome Maswime Reitze Rodseth Dominique van Dyk

Maternal and neonatal mortality is high in Africa, but few large, prospective studies have been done to investigate the risk factors associated with these poor maternal and neonatal outcomes.A 7-day, international, prospective, observational cohort study was done in patients having caesarean delivery in 183 hospitals across 22 countries in Africa. The inclusion criteria were all consecutive patients (aged ≥18 years) admitted to participating centres having elective and non-elective caesarean delivery during the 7-day study cohort period. To ensure a representative sample, each hospital had to provide data for 90% of the eligible patients during the recruitment week. The primary outcome was in-hospital maternal mortality and complications, which were assessed by local investigators. The study was registered on the South African National Health Research Database, number KZ_2015RP7_22, and on ClinicalTrials.gov, number NCT03044899.Between February, 2016, and May, 2016, 3792 patients were recruited from hospitals across Africa. 3685 were included in the postoperative complications analysis (107 missing data) and 3684 were included in the maternal mortality analysis (108 missing data). These hospitals had a combined number of specialist surgeons, obstetricians, and anaesthetists totalling 0·7 per 100 000 population (IQR 0·2-2·0). Maternal mortality was 20 (0·5%) of 3684 patients (95% CI 0·3-0·8). Complications occurred in 633 (17·4%) of 3636 mothers (16·2-18·6), which were predominantly severe intraoperative and postoperative bleeding (136 [3·8%] of 3612 mothers). Maternal mortality was independently associated with a preoperative presentation of placenta praevia, placental abruption, ruptured uterus, antepartum haemorrhage (odds ratio 4·47 [95% CI 1·46-13·65]), and perioperative severe obstetric haemorrhage (5·87 [1·99-17·34]) or anaesthesia complications (11·47 (1·20-109·20]). Neonatal mortality was 153 (4·4%) of 3506 infants (95% CI 3·7-5·0).Maternal mortality after caesarean delivery in Africa is 50 times higher than that of high-income countries and is driven by peripartum haemorrhage and anaesthesia complications. Neonatal mortality is double the global average. Early identification and appropriate management of mothers at risk of peripartum haemorrhage might improve maternal and neonatal outcomes in Africa.Medical Research Council of South Africa.

Placental abruption

10.1016/s2214-109x(19)30036-1

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Citations (162)

A double mutation in AGXT gene in families with primary hyperoxaluria type 1

Gene (2013)

Houda Kanoun F. Jarraya Ikhlass Hadj Salem H. Mahfoudh Y. Chaabouni

Primary hyperoxaluria

10.1016/j.gene.2013.08.083

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Citations (6)

Primary hyperoxaluria type 1: report of the worldwide largest family

International Urology and Nephrology (2021)

I. Agrebi Houda Kanoun K. Kammoun Soumaya Yaich Mouna Turki

Primary hyperoxaluria

Nephrology

10.1007/s11255-021-03067-3

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Citations (1)

Identification of compound heterozygous patients with primary hyperoxaluria type 1: clinical evaluations and in silico investigations

BMC Nephrology (2017)

Houda Kanoun F. Jarraya B. Maalej A. Lahiani H. Mahfoudh

Primary hyperoxaluria type 1 (PH1) is an autosomal recessive inherited disorder of glyoxylate metabolism in which excessive oxalates are formed by the liver and excreted by the kidneys. Calcium oxalate crystallizes in the urine, leading to urolithiasis, nephrocalcinosis, and consequent renal failure if treatment is not initiated promptly. Mutations in the AGXT gene which encodes the hepatic peroxisomal enzyme alanine:glyoxylate aminotransferase are responsible of PH1. In the present work, we aimed to analyze AGXT gene and in silico investigations performed in four patients with PH1 among two non consanguineous families. Exhaustive gene sequencing was performed after PCR amplification of coding exons and introns boundaries. Bioinformatic tools were used to predict the impact of AGXT variants on gene expression as well as on the protein structure and function. Direct sequencing of all exons of AGXT gene revealed the emergence of multiple mutations in compound heterozygous state in the two studied families. Two patients were compound heterozygous for the c.731 T > C, c.32C > T, c.1020A > G and c.33_34insC and presented clinically with recurrent urinary tract infection, multiple urolithiasis and nephrocalcinosis under the age of 1 year and a persistent hyperoxaluria at the age of diagnosis. The two other patients presenting a less severe phenotypes were heterozygous for c.731 T > C and homozygous for the c.32C > T and c.1020A > G or compound heterozygous for c.26C > A and c.65A > G variants. In Summary, we provided relevance regarding the compound heterozygous mutations in non consanguineous PH1 families with variable severity.

Primary hyperoxaluria

Nephrocalcinosis

Compound heterozygosity

10.1186/s12882-017-0719-y

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Citations (8)

Annexin A1 and its receptor gene polymorphisms in systemic lupus erythematosus in the Tunisian population

Clinical Rheumatology (2022)

Fatma Dhaffouli H. Hachicha Olfa Abida N. Gharbi Nésrine Elloumi

10.1007/s10067-022-06057-7

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Citations (5)

Perioperative patient outcomes in the African Surgical Outcomes Study: a 7-day prospective observational cohort study

The Lancet (2018)

Bruce Biccard T E Madiba Hyla‐Louise Kluyts Dolly M. Munlemvo Farai Madzimbamuto

10.1016/s0140-6736(18)30001-1

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Citations (474)

Congenital factor XIII deficiency caused by two mutations in eight Tunisian families: molecular confirmation of a founder effect

Annals of Hematology (2009)

Nacim Louhichi Moez Medhaffar Ikhlass Hadjsalem Emna Mkaouar‐Rebai Nourhène Fendri-Kriaa

Proband

Factor XIII deficiency

Founder effect

Coding region

10.1007/s00277-009-0863-y

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Citations (21)

Next-generation sequencing in patients with familial FSGS: first report of collagen gene mutations in Tunisian patients

Journal of Human Genetics (2021)

Sawssan Ammar Houda Kanoun K. Kammoun Andrea Domingo-Gallego Patricia Ruíz

10.1038/s10038-021-00912-2

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Citations (10)

Dorfman–Chanarin Syndrome with Renal Involvement: A Rare Case Report and Literature Review

Indian Journal of Nephrology (2023)

I. Agrebi Achraf Jaziri Houda Kanoun N. Dammak M. Boudabous

Abstract Dorfman–Chanarin syndrome (DCS) is a rare autosomal recessive disease. It is a multisystemic disease in which renal involvement is uncommon. We report the case of a woman with nephrotic syndrome associated with DCS. A 36-year-old woman was referred to the nephrology department for edema with known history for DCS. On physical examination, she had ichthyosiform erythroderma with generalized scaly skinand ascites. The ophthalmologic examination revealed a cataract in the right eye. Abdominal ultrasound examination showed hepatomegaly and splenomegaly. Laboratory tests showed normal renal and liver function. The blood cell count showed pancytopenia. Immunologic exams showed the presence of anti-mitochondrial antibodies. Kidney biopsy showed mesangial proliferative glomerulonephritis with extensive lipid vacuoles in the tubular epithelial cells. Immunofluorescence study showed mesangial deposits of IgG, C3, kappa, and lambda. To the best of our knowledge, this is the first case of DCS with renal involvement reported in an adult.

10.4103/ijn.ijn_203_22

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Citations (1)

The ASOS Surgical Risk Calculator: development and validation of a tool for identifying African surgical patients at risk of severe postoperative complications

British Journal of Anaesthesia (2018)

Hyla‐Louise Kluyts Yannick Le Manach D.M. Munlemvo Farai Madzimbamuto Apollo Basenero

Calculator

Surgical procedures

10.1016/j.bja.2018.08.005

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Citations (38)