Introduction: Healthcare activities are generally associated with the production of healthcare waste, a large part of which is assimilated to household waste (packaging, kitchen waste, green waste, etc.) and another category of waste which may have a risk to health and the environment given its nature and typology. This category of waste at risk includes waste at risk of infection such as stinging, sharp waste (needles, blade, scalpel, etc.), and waste at chemical risk. Poor management of hospital waste is a problem in most countries and especially in developing countries. We aimed to determine the health and environmental impacts of the poor management of healthcare waste. Methods: We carried out a systematic review of the French and English literature on the scientific research sites Medline/PubMed and Embase. This research was carried out over 3 months (April–June 2020). The search strategy was used by combining keywords and Boolean operators: Health, Health impact assessment, Hospitals, Medical waste, Waste disposal facilities, Environment, Environment/Epidemiology, Hospital waste, impact, workplace, Environment hazards, Healthcare works, Waste management. Results: It has been clear that the current management of healthcare waste is not capable of adequately preserving human health and environmental contamination from infection. The surveys analyzed showed that if incineration is properly treated, it would be an appropriate treatment method to deal with healthcare waste. However, exposure to pollutants produced by the incineration is still a public health problem. If incineration is seen as a practical solution for dealing with healthcare waste, low-temperature incinerators should be banned and replaced by modern incinerators equipped with air pollution control units. These problems are typical for any developing country which does not have the means to purchase incinerators which are more protective for the environment and equipped with the latest technologies. Conclusions: Thus, autoclaving and microwaves are considered better alternatives for treating healthcare waste. However, these methods are generally not adequate for the disposal of pathological, radioactive, laboratory, and chemotherapy wastes. Therefore, the specific management of healthcare waste is a major concern due to the potentially high risks for human health and the environment.

Although efforts to manage coronavirus disease 2019 (COVID-19) pandemic have understandably taken immediate priority, the impacts on traditional healthcare-associated infection (HAI) surveillance and prevention efforts remain concerning. To describe trends in HAIs in a Tunisian university hospital through repeated point prevalence surveys over 9 years, assess the impact of measures implemented for COVID-19 pandemic, and to identify associated factors of HAI. The current study focused on data collected from annual point prevalence surveys conducted from 2012 to 2020. All types of HAIs as defined by the Centers for Disease Control and Prevention (CDC) were included. Data collection was carried out using NosoTun plug. Univariate and multivariate logistic analysis were used to identify HAI risk factors. Overall, 2729 patients were observed in the 9 surveys; the mean age was 48.3 ± 23.3 years and 57.5% were male. We identified 267 infected patients (9.8%) and 296 HAIs (10.8%). Pneumonia/lower respiratory tract infections were the most frequent HAI (24%), followed by urinary tract infection (20.9%).The prevalence of infected patients increased from 10.6% in 2012 to 14.9% in 2020. However, this increase was not statistically significant. The prevalence of HAIs increased significantly from 12.3% to 15.5% (P =.003). The only decrease involved is bloodstream infections (from 2% to 1%). Independent risk factors significantly associated with HAI were undergoing surgical intervention (aOR = 1.7), the use of antibiotic treatment in previous 6 months (aOR = 1.8), peripheral line (aOR=2), parenteral nutrition (aOR=2.4), urinary tract within 7 days (aOR=2.4), central line (aOR = 6.3), and prosthesis (aOR = 12.8), length of stay (aOR = 3), and the year of the survey. Young age was found as protective factor (aOR = .98). Contrary to what was expected, we noticed an increase in the HAIs rates despite the preventive measures put in place to control the COVID-19 pandemic. This was partly explained by the vulnerability of hospitalized patients during this period.

Introduction: Mental health is recognized as a critical component of public health Given the close relationship between mental health and life style and the importance of students as valuable human resources, the present study aimed at determining the relationship between life style and mental health among medical students in Sousse during COVID-19 pandemic. Methods: We conducted a cross-sectional observational study in university students from the first to the fifth grade of the Faculty of Medicine of Sousse during the academic year 2020/2021. Data were collected anonymously via an online questionnaire published on the Facebook groups of each grade, on december 2020. The online survey consisted of three sections. The first one aimed to collect sociodemographic information. The second section of the survey addressed recent lifestyle choices and the third one assessed psychological distress using the French version of 12 items of The General Health Questionnaire (GHQ-12). The significance level was considered 0.05. Results: Overall 147 were studied. Using the bimodal scoring, the total score was between 0 and 12, to evoke psychiatric disorders, we set the threshold of 4. For our sample, the median scale was 7 [4-9], and more than half of the students (68%; n = 100) had a score higher than 4. Psychiatric disorder was significantly more frequent in female students (73.3% vs 42.3%; p = 0.002). Higher GHQ-scale was found in younger students, foreigners, students who need more than 30 minutes to get to the faculty, unemployed students, and students of fifth grade. However, differences were not statistically significant. Regarding lifestyle choices, we found that physical inactivity, no smoking habits, no alcohol use, no illicit substance use, other substance use, changing in eating habits, and absence of coping methods of stress were higher in students with psychiatric disorders. However, this association was statistically significant only for physical activity (p = 0.016). The results of the regression analysis suggest female gender as an independent predictor of high GHQ-12 scores. Practicing physical activity was found as protective factor for psychiatric disorders. Conclusion: Considering the vital role of medical students in providing and promoting community health, the need for more detailed planning and interventions to improve their life style and mental health is essential.

Background and Objectives: Knee arthroplasty often leads to marked postoperative muscle weakness, with strength losses of up to 62% in the first month, contributing to functional impairment and patient dissatisfaction. Blood flow restriction (BFR) training, which combines low-load exercise with partial vascular occlusion, has shown promise in enhancing muscle strength across musculoskeletal conditions and may represent a valuable rehabilitation strategy for this vulnerable population. This review aimed to systematically evaluate the effectiveness and safety of BFR training in improving muscle strength and functional outcomes following knee arthroplasty. Materials and Methods: This systematic review was prospectively registered within PROSPERO (CRD420250652404) and conducted according to PRISMA guidelines. PubMed, Embase, and Cochrane Library were searched through February 2025 for randomized controlled trials (RCTs) investigating BFR training in knee arthroplasty patients. Study selection, data extraction, and risk of bias assessment (RoB 2 tool) were performed independently by two reviewers. Eligible trials reported muscle strength and/or functional outcomes as primary or secondary endpoints. Results: Four RCTs, including 148 patients undergoing total knee arthroplasty (mean age: 67 ± 6.5 years), met the inclusion criteria. All applied preoperative BFR training for 4–8 weeks with heterogeneous protocols. Two trials demonstrated significant improvements in muscle strength (1 RM leg press, 1 RM knee extension; large effect sizes) and functional outcomes (6 min walk test, 30 s sit-to-stand; earlier recovery), favoring BFR. The remaining studies showed no significant between-group differences, though moderate-to-large effect sizes generally favored BFR training. No adverse events were reported. Conclusions: Prehabilitation with BFR training shows considerable potential to enhance early postoperative muscle strength and functional recovery in patients undergoing knee arthroplasty, particularly when compared with usual care lacking structured preoperative intervention. The evidence to date suggests that BFR is a safe and well-tolerated strategy, offering an alternative for patients who cannot perform high-load resistance training. Its favorable safety profile, combined with the potential to accelerate functional recovery, highlights the promise of BFR for reducing rehabilitation costs and healthcare utilization. Nonetheless, larger, high-quality RCTs with standardized protocols and extended follow-up are required to confirm these preliminary findings and establish clear clinical guidelines for their implementation.

Background and Objectives: Tennis involves repetitive high-velocity movements, rapid directional changes, and challenging environmental conditions, exposing players to injury risk. However, injury surveillance data for North African youth players are lacking. This study aimed to determine the frequency, characteristics, and management of tennis-related injuries among competitive Tunisian youth players. Materials and Methods: A cross-sectional study was conducted among players aged 5–18 years from tennis clubs (October 2023–November 2024). Data were collected using researcher-administered questionnaires, incorporating the Oslo Sports Trauma Research Center Overuse Injury Questionnaire and a sport-specialization assessment, following International Olympic Committee guidelines. Results: Among 256 players, 53.5% (n = 137) reported 366 injuries. Lower limbs were most affected (58.5%), followed by upper limbs (32.8%); knees (23.2%), ankles (17.5%), and wrists (10.1%). Muscle/tendon (36.9%), superficial tissue (28.1%), and ligament/joint capsule injuries (27.6%) predominated. Most injuries occurred during practice (74.9%) and hot weather (93.4%). Severe injuries represented 24%, while 29.5% were minor without time loss. Subsequent injuries occurred in 54.6% of injured players, with significantly higher rates in those with incomplete rehabilitation (p < 0.001). Conclusions: The high frequency of recurrent injuries and limited rehabilitation highlight critical gaps in injury management, emphasizing the need for targeted neuromuscular training, accessible rehabilitation, and standardized return-to-play protocols.