these results are in line with data from the literature, particularly on larger series in China. Identify the lessons learned in the Greater Maghreb, during the first semester of the fight against the COVID-19 pandemic, in the field of response. During the first week of May 2020, a consultation of experts was conducted, using the "Delphi" technique, through an email asking each of them, the drafting of a good practice recommendation for "Public health". The Group coordinator finalized the text of the lessons, later validated by the signatories of the manuscript. Five lessons of good «response» against epidemics have been deduced and approved by Maghreb experts, linked to the following aspects 1. Total reservation of hospital beds for patients; 2. Clinical management of the response; 3. Discreet conflict of interest; 4. Community participation in the response; 5. Contextualization of the global fight strategy. Based on the finding of low relevance of the Maghreb response against COVID-19, this list of lessons would help support the performance of Maghreb health systems in the management of epidemics. Based on the finding of low relevance of the Maghreb response against COVID-19, this list of lessons would help support the performance of Maghreb health systems in the management of epidemics.Tuberculosis is a topical issue in endemic countries. Foot involvement is rare and accounts for 5-10% of all osteoarticular tuberculosis. Pediatric cases of osteoarticular tuberculosis are uncommon especially in well vaccinated children. The clinical presentation is not specific and can be confused with common germ like staphylococcus. Biopsy is mandatory in endemic zone, and if the evolution is not good with antibiotherapy. Debridement can be indicated but must be gentle, because of the risk of navicular necrosis.Neurological presentation of paraneoplastic syndromes is rare. They are often difficult to diagnose, especially when they precede the diagnosis of cancer. https://www.selleckchem.com/products/hg106.html Hodgkin's lymphoma is associated with several paraneoplastic neurological syndromes such as cerebellar degeneration and dermato/polymyositis. Peripheral vestibular syndrome is uncommon presentation of these paraneoplastic syndromes. We report the case of a 52-year-old man with no prior medical history who presented to the otolaryngology clinic with vertigo precipitated by nystagmus, nausea and weight loss. Diagnostic workup revealed a nodular sclerosing variant of Hodgkin's lymphoma without paraneoplastic antibodies. The patient's symptoms resolved after institution of chemotherapy, radiotherapy and vestibular rehabilitation. Hodgkin's lymphoma has been reported to be associated with many paraneoplastic syndromes with neurological presentation in which peripheral vestibular syndrome is an uncommon one. Sometimes it can be the only presenting symptom of an unknown Hodgkin's lymphoma. This create a real diagnostic challenge for clinicians specially when paraneoplastic antibodies are negative. Chemotherapy and radiotherapy as treatment of the underlying disease is of a big benefit if started as early as possible. Few studies have examined the quality of life (QOL) of type 1 diabetic patients (T1D) in adulthood and its association with glycemic control. To assess the QOL of a Tunisian population of T1D adults and to identify the factors that may influence it. It's a cross-sectional study including 100 T1D patients over 18 years of age whose QOL was assessed by the ADDQOL scale. A multivariate logistic regression analysis was performed to identify the factors independently associated with impaired QOL. The QOL score without diabetes was -1.5±0.7 indicating that patients' QOL would be better without diabetes. Factors associated with impaired QOL were age≥33 years (p=0.011), poor socioeconomic status (p=0.01), longer-lasting diabetes (p=0.007), lower daily insulin dose (p=0.001), human insulin-based treatment (p=0.049), higher prevalence of hospitalization for ketoacidosis (p=0.003) and infectious complication (p=0.008), higher incidence of hypoglycemia (p=0.003), higher prevalence of nephropathy (p=0.029) and diabetic retinopathy (p=0.038), higher HbA1c level (p=0.031) and irregular follow-up (p=0.021). According to multivariate analysis poor glycemic control (HbA1 ≥ 9.3%) and lower insulin dose (<0.84IU/Kg/d) were independently associated with impaired QOL. There is an association between glycemic control and QOL in T1D patients in adulthood, prompting us to consider this parameter in the management of T1D patients. There is an association between glycemic control and QOL in T1D patients in adulthood, prompting us to consider this parameter in the management of T1D patients. Carbapenemase-producing Enterobacterales (CPE) present a threat to public health worldwide. To study their prevalence at the Trauma and Burn Center's Burn Unit and investigate their molecular characteristics and their associated antibiotics resistance patterns. This is a retrospective study conducted at the Trauma and Burn Center's laboratory between july 2017 and december 2018. It included all patients hospitalized in the Trauma and Burn Center's Burn Unit infected with Enterobacterales resistant to carbapenems. The search of the carbapenemases genes was performed by PCR amplification GeneXpert® IV (Cepheid, Sunnyvale, CA, USA) by Xpert® Carba-R kit. During the study period, among 574 Enterobacterales, 64 strains (11.1%) were resistant to carbapenems, 58 strains (90.6%) of which were CPE. K. pneumoniae was the most predominant bacteria (n=50) fllowed by E. cloacae (n=7), P. mirabilis (n=3), E. aerogenes (n=2), E. coli (n=1) and P. rettgeri (n=1). The most common carbapenemase gene was blaNDM gene (58.6%) followed by blaOXA48 (24.1%). The co-existence of these two genes was identified in ten strains (17.3%). For the 58 CPE, resistance to ertapenem, imipenem and meropenem was 100%, 18.4% and 36.2%, respectively. The highest resistance rates were found to third-generation-cephalosporins (100%), ciprofloxacin (95%) and gentamicin (89.7%). Fosfomycin and colistin had the best susceptibility in vitro with only 5.2% and 4.8% of resistance, respectively. The high prevalence of CPE in our center requires continued screening and reinforcement of hygiene measures. The high prevalence of CPE in our center requires continued screening and reinforcement of hygiene measures.