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Acute Respiratory Infections Epidemiology and Etiology in Hospitalized Moroccan Children under 15 Years
No full textIntroduction: Acute respiratory infections (ARIs) are serious infections with multiple etiologies. Viral etiology is most common worldwide, especially in pediatric patients.Materials and methods: This study aims to describe the epidemiology and etiology of ARIs in Moroccan children under 15 years old, through patients’ clinical features analysis and genetic detection of pathogens within 84 patients admitted to Hassan II regional hospital of Agadir, Morocco, from September 2015 to September 2016. Detection of pathogens was carried out using Multiplex real-time reverse transcription-polymerase chain reaction (RRT-PCR) with Fast Track Diagnostic kit respiratory pathogens 21 plus.Results: Results gave 61.9% of positive viral and bacterial infections and 19.23% of co-infections by at least two pathogens. Males were mainly infected and the respiratory syncytial virus (RSV) was the most common in 53.8% of patients. Children aged less than 2 years were the most infected by ARIs pathogens, and especially by the RSV virus. Concerning seasonality pattern, all ARIs pathogens showed a seasonal spreading mainly in winter.Conclusion: This study summarizes a great insight into the epidemiology and etiology of ARIs among children under 15 years in Morocco. We observed that ARIs constituted a real health problem in infancy and viruses are the commonest cause
The Impact of Malocclusions and Orthodontic Treatments on a Patient's Quality of Life
No full textAim: This study aimed to compare the variations in patients’ perception of oral health-related quality of life (OHRQoL), using the Moroccan version of PIDAQ, before and after orthodontic treatment among patients with the same initial PAR Index score, age, and gender.Methods: In this study, 67 participants were divided into 2 groups. Group A (treated, control group) consisted of 30 patients who received orthodontic treatment; group B comprised of 37 patients who were either at the initiation stage of treatment or potential candidates. The matching of group A and group B was achieved by reaching a compromise between PAR index score, age and gender. The assessment of the psychosocial impact of malocclusion was carried out using the Moroccan version of PIDAQ. The Chi-square test was used to establish associations between qualitative variables. Levene and Mann Whitney's tests were employed to determine the associations between quantitative variables.Results: The age of the patients ranges from 7 to 58 years, with a mean age of 23 years +/_10. 22. While 41 subjects (61.2%) consulted for aesthetic reasons, 26 subjects (38.8%) consulted for a functional reason. The distribution of scores of the two groups before and after orthodontic intervention showed no significant difference between the mean scores of the four PIDAQ domains.Conclusion: The results of our study showed a significant improvement in the psychosocial impact of malocclusion when comparing the two case-control groups, with a reduction in the perceived needs of patients who completed orthodontic treatment
Late Post-Hysterectomy Colovaginal Fistula with Extensive Diverticular Disease
No full textThe diagnosis of colovaginal fistula came to light in this 70-year-old woman, 22 years after hysterectomy, based on clinics. But, intraoperative and histopathological diagnoses were arduous. Confirmation that a fistula extended from the sigmoid colon into the vaginal stump was sanctioned by a fragment of squamous epithelium disclosed within a colonic fistula
Clinical Manifestations of Symptomatic COVID-19 Patients in Kabul Province, the Capital of Afghanistan
No full textBackground: SARS-CoV-2 is a novel member of human coronavirus that is newly identified in Wuhan, Hubei, China. The COVID-19 pandemic has spread to over 213 countries and affected more than 33 million individuals and caused 999000 deaths worldwide.Methods: This cross-sectional study conducted on 124 symptomatic COVID-19 patients in Kabul, Afghanistan. Demographic and clinical data collected using a standard form. Nasopharyngeal/oropharyngeal swab sample collected for viral detection. Data were analyzed using IBM SPSS statistics (version 21) software.Results: Out of 124 patients, 88 (71%) were male and 36 (29%) were female. The mean age of patients was 41.2±17.07 years and the majority of patients 32 (25.8%) were in the age group of 20 – 29 and minority 3 (2.4) was over 79 years. On clinical presentation, most patients had ageusia (71.3%), fever (69.4%), headache (69.4%), sore throat (66.1%), myalgia (66.1%), cough (64.5%), weakness (63.7%), dyspnea (38.7%), and the fewer symptom was diarrhea (31.5%). 19 (15.3%) patients had Hypertension, 16 (12.9%) had cardiovascular disease, 8 (6.5%) had diabetes, 5 (4.0%) had cancer, 4 (3.2%) had chronic pulmonary disease, and 3 (2.4%) had liver disease. The mean duration for the presence of symptoms was 13.3±6.3 days. The fatality rate was 4%.Conclusion: Our study reveals that males are more affected by COVID-19 than females and the young generation is more affected than elders. The most common symptoms are ageusia, fever, headache, sore throat, and myalgia, and the less common symptom is diarrhea
Endobronchial Metastasis of Colorectal Carcinoma
No full textBackground: Endobronchial metastasis is an infrequent secondary location of extrathoracic cancer. Colorectal cancer is one of the most affected primary tumours. Case presentation: We report the clinical case of a patient who has had endobronchial metastasis of an adenocarcinoma of the colon, confirmed by mass biopsy. Surgical treatment was indicated after chemotherapy cures. The patient is currently asymptomatic 33 months after treatment. Conclusion: Endobronchial metastasis is a rare entity, occurring after years of primary disease progression. Surgery allows for prolonged survival and disease control
Glycemic Control and Diabetes Macroangiopathy
Get PDFThe issue of the efficacy of optimal glycemic control in the prevention of macroangiopathic complications of diabetes has been the subject of recent controversy. Although the facts are clear for microangiopathy, particularly in type 1 diabetes, they appear less certain for the cardiovascular complications of type 2 diabetes. This is due to the involvement of other cardiovascular risk factors that are very common in these patients. However, long-term follow-up studies are in favor of the interest of good glycemic control on macroangiopathic complications. The negative results on the mortality of the ACCORD study and the concerns regarding rosiglitazone led to the establishment of studies on the safety of new molecules. All this work led to the demonstration of the absence of risk of prescription of iDPP-4 and the very positive effect of certain molecules of the class of analogues of GLP-1 and iSGLT2.It is to be hoped that the recent publication of the Academy of Medicine stressing that complications of type 2 diabetes require multifactorial prevention that necessarily involves an optimized control of the glycemic balance put an end of this unnecessary and dangerous polemic
Orthodontical Management of Secondary Dental Migration Associated with a Reduced Periodontium: A Case Report
No full textIntroduction: Dental migrations following periodontal pathology may lead to significant aesthetic and functional complaints. In this case report, the presence of evident gingival recessions and mandibular crowding pushed us to opt for an ortho-periodontal multidisciplinary treatment plan, using extractions and incisive repositioning. Through this, we ensured tissue gain at the level of the superficial and deep periodontitis, thus avoiding the use of periodontal surgery.Clinical Case: A Moroccan 26-years-old female medical secretary who, being very concerned about her appearance and facial aesthetics, presented with pathological dental migrations following severe periodontitis, an unsatisfactory periodontal status, a clear mandibular crowding of the anterior inter-incisive diastemas, gingival recessions, attachment losses and quite large pocket depths with advanced bone resorptions in different areas. This required a specific multidisciplinary approach aiming at creating a healthy and well-structured periodontal environment through extensive periodontal treatment, combined with regular plaque control, and supplemented by an orthodontic treatment using extractions and incisive repositioning in order to avoid any vestibular movement that may worsen the recessions and will require possible overlapping. After 22 months of combined treatment, a stable occlusion was obtained with class I molar and canine relationship, perfect dental alignment, healthy periodontal architecture, and significant attachment gain and bone growth. In addition, the patient’s facial aesthetics and self-confidence have been significantly improved. Conclusion: The orthodontic treatment supplementing the meticulously planned periodontal therapy that was administered for this patient has helped to improve functionality, facial aesthetics as well as psychological self-confidence. However, it must be gradual with an application of mild forces and constant control of the periodontal status, for optimal tissue response
The Management of Massive Tibial Bone Defect Using Unifocal Bone Transport with Ilizarov Apparatus: A case study
No full textIntroduction: Ilizarov technique is one of the excellent methods used for bony lengthening. The current literature states that the maximum possible amount of tibial lengthening by bifocal transport of an Ilizarov apparatus was 22 cm, while the maximum amount of tibial lengthening by unifocal transport of an Ilizarov apparatus was 14.5 cm.Case report: 40 years old Saudi teacher was presented with an open fracture at the right tibia of type 3B. The second debridement was done and ended up with 21.49 cm bone loss of the middle Tibial segment. Local flap plastic surgery was done to cover the skin defect and the bone transport was done at a rate of 1mm/day. The overall healing was excellent, and the patient returned to his pre-injury functional activity and rejoined his job as a teacher.Conclusion: Thus, the current case report is a unique new record of 21.49 cm of tibial lengthening achieved by the Ilizarov apparatus using unifocal transport. This will be a treatment hope for patients with excessive bone loss
Decitabine: A Historical Review of the Development Process of an Epigenetic Drug
No full textDecitabine (5-aza-2p-deoxycytidine) is a hypomethylation agent with a double-action mechanism, these are the reactivation of silenced genes; exhibiting differentiation at low doses and showing cytotoxicity at high doses. Decitabine was used as a classic anticancer drug in the original studies in the 1980s, 1500 to 2500 mg/m2 per cycle was the maximum clinically tolerated dose. The dosage was reassessed after a better understanding of epigenetics in cancer and the role of decitabine in epigenetic (hypomethylation) therapy was obtained, in about 1/20th of the previous doses (i.e., 'optimal biological' doses modulating hypomethylation). It has been found that decitabine (100 to 150 mg / m2 per cycle) can be used in patients with myelodysplastic syndromes (MDS) and other myeloid tumors, with manageable side effects. Combination therapies that amplify the epigenetic effect of decitabine will most likely improve the patient responses and allow it to be used in the treatment of other malignancies