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A New Perspective for Prevention and to Cure COVID-19 Patients: Encouraging Medical Teams to Contact Healed People Treated with Chlorine Dioxide in Solution (CDS)
No full textThis article is written to encourage medical teams from all over the world to contact the patients already treated with this soluble gas. To contact also their medical teams accompanying the study cases as to verify the actual health conditions of patients. Finally, the invitation is to question whether CDS should be tried in their respective local healthcare environments
A Novel Concept to Prevent and Treat Respiratory Infections
No full textActual systems of prevention and treatment of new emerging airborne germs seem to be ineffective as shown with the ongoing Covid-19 pandemic. Here I present a novel concept allowing to develop specific immunity when being exposed without even getting infected. I concretize this concept in a facial device whose composition, way of use, and potential interests are detailed in this paper
Evaluation of The Effectiveness and Side Effects of Radiotherapy in Patients With Primary Nervous System Lymphoma. A Single Center Experience
No full textAim: In this study, we aimed to evaluate the overall and progression-free survival, the radiotherapy process and the early and late adverse effects in patients who underwent radiotherapy (RT) for primary nervous system lymphoma in our clinic.Method: Between January 2010 and September 2019, 16 patients who received radiotherapy due to primary central nervous system lymphoma in our clinic were examined according to their statistically significant differences in terms of survival and side effects.Results: The median disease-free survival of the patients was 6 months, and the median overall survival was 12.5 months. 18.75% of the patients could not receive chemotherapy but only radiotherapy. Radiotherapy doses were range from 2600 to 5000 cGy. When patients were evaluated in terms of radiotherapy dose, field size and chemotherapy, no statistically significant difference in overall survival was detected. Cognitive disorders were observed as the most common late side effects while the most common acute side effects in patients were headaches.Conclusion: In the treatment of primary central nervous system lymphoma, changes in radiotherapy portals and radiotherapy doses can be predicted in patients who received high-dose methotrexate chemotherapy or not. Furthermore, it has been considered that more comprehensive studies are needed to increase the success of treatment and provide standardization in treatment, especially in patients with elderly and comorbid diseases
Active Sacroiliitis on MRI, Inflammation Biomarkers, and Clinical Disease Activity: What Relationship Does Link Between the Three, in Non-Radiographic Axial Spondyloarthritis?
No full textIntroduction: Magnetic resonance imaging of sacroiliac joints (MRI SI) is the gold standard imaging tool for axial spondyloarthritis (ax SpA) diagnosis, when the pelvic radiograph is normal or non-conclusive. In fact, subchondral bone marrow edema (BME) is the primary MRI feature of early ax SpA. The associated factors with active sacroiliitis on MRI are still not properly elucidate. The main objective of this study is to identify the relationship between active sacroiliitis on MRI, biomarkers of inflammation and Disease Activity Scores.Materials and methods: Our work could be categorized as a cross sectional study that enrolls all patients with non-radiographic axial spondyloarthritis (nr axSpA), meeting each; the assessment of SpondyloArthritis international Society axSpA criteria (ASAS 2009), and who were admitted in our Rheumatology Department, in the university hospital Hassan II of Fez (Morocco), all along the period laying between January 2012 and March 2018. The relationship between MRI-SI, Ankylosing Spondylitis Disease Activity Score (ASDAS), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), C reactive protein and erythrocyte sedimentation rate was investigated. Results: 105 patients were involved in the study. The average age was [44years ± 13.5]. The Sex ratio was about [1.4]. 29 % of patients were smokers. 76% of cases had active sacroiliitis on MRI, while only 28% had inactive sacroiliitis. The average CRP serum level was roughly [23.5 ± 36mg / l]. On the other side, the ESR blood level was almost [25.9±24mm/h]. 94.2% of patients used non-steroidal antiinflammatory drugs (NSAIDs). The average ASDAS value was about [2.3 ± 1]. Whereas the BASDAI one was [4.2± 1], and the BASFI one was about [4± 1.5]. Actually, No significant relationship was found between active sacroiliitis and inflammation’s biomarkers. Indeed, men had 5.6 times more active sacroiliitis, of which smokers had even 3 times more the risk to develop active sacroiliitis, while treatment with NSAIDs was proved to be a protective factor. Conclusion: Biomarkers of inflammation cannot be used as a marker of objective inflammation of sacroiliac joints on MRI; hence, the necessity of MRI screening, and more additional studies with a larger number of patients, should be conducted, to identify this association even better
Evaluation of the interpretation criteria of Western Blot profiles for the HIV-1 infection diagnosis in a South Moroccan group: Sensitivity, specificity and predictive values of HIV-1 Western Blot method in a South Moroccan group
No full textIntroduction : Western Blot (WB) is the most commonly used method to confirm the presence of antibodies against Human Immunodeficiency Virus type 1 (HIV-1). The interpretation of WB, however, poses difficulties since of the multiplicity of criteria proposed by various international organizations. Some criteria generate an unacceptable number of indeterminate results, thus preventing the early management of patients. The present work aims to evaluate the different criteria for interpretation of WB according to various organizations compared to viral load test.Material and methods : This is a study carried out on a total of 2 618 Western Blot profiles registered during a period of 56 month (from January 2013 to September 2017) at the Laboratory of Medical Analysis of Regional Hospital Center in Agadir.Results : The results obtained indicate that some organizations have very interesting values concerning the positivity of the WB profiles; WHO (94.84%), CDC/ ASTPHLD (94.61%) and SFTS (93.09%). For the negative profiles, all the organizations have identical values with 3.59%. Regarding indeterminate profiles, the WHO gave the minimum of these cases (1.57%) followed by CDC / ASTPHLD (1.8%) and SFTS (3.32%). The WHO provided very interesting values for sensitivity (98.93%), specificity (91.26%), positive predictive value (99.64%) and negative predictive value (74.60%). Similarly, the CDC / ASTPHLD criteria remain favorable and are highly consistent with those of WHO (p = 0.8113).Conclusion : Sensitivity, specificity, and predictive values are characteristics of WB test that interpret the results and allow applying them to patients. In our context, it is recommended to adopt the WHO criteria to facilitate the interpretation of western blot profiles. The CDC / ASTPHLD criteria remain favorable to adoption
Barriers to Early Detection of Breast Cancer Among Women Living in Poverty
No full textObjective: Early detection and screening are the most effective means to reduce breast cancer mortality in all populations. In this study, the inhibiting factors in the applications of qualitative research methods used for the early diagnosis of breast cancer among poor women were identified.Material and methods: Through focus group interviews, 40 women ranging between 20-60 years of age, meeting the absolute poverty criteria, without regular breast self-examination, clinical breast examination, and mammography were recruited for the study. A conventional content analysis method was used in the data analysis. Interviews were recorded using a voice recorder, and the average duration of the interviews was 53 minutes.Results: Factors inhibiting women's behaviors regarding early detection of breast cancer were identified as, respectively; individual attitudes and beliefs, provision of healthcare services and, cultural factors.Conclusion: According to the data achieved, we concluded that initiatives should be planned in order to reduce the inhibiting factors in the breast cancer screening behaviors of women living in poverty. In addition, health policies concerning the provision of health care services should be revised
The Correlation Between the Vitamin D Level and Glycemic Control Status Among Diabetic Patients - A Clinical Observational Study
No full textBackground: Vitamin D deficiency is widespread and coexisted with diabetes. However, the relation between Vitamin D level and glycemic control is not yet fully understood. This study examines the correlation between vitamin D level and glycemia indicators and diabetic microvascular complications.Methods: The study is a cross-sectional study, had been done at the outpatient department in Najran university hospital, Saudi Arabia from May 2019 to February 2020. 220 patients recruited by simple random sampling.Results: 60% of diabetes (n-130) had been using oral anti-glycemic medications, though most of them had uncontrolled glycemic status and had got microvascular complications. It is notable that among diabetes having a low vitamin D level; 55.5% had high FBS, 45.6% had high RBS and 65% had high HBA1C. Besides,17% have retinopathy, 16.6% have nephropathy, 26.2% have peripheral neuropathy and 1.9% have a diabetic foot.Conclusion: The clinical and laboratory assessments are essential to control the glycemic state in diabetes. The study noted that an inverse relationship between the level of vitamin D with blood sugar levels and diabetic microvascular complications. To assure the feasibility of the prediction of vitamin D level in assessing the progress of diabetes further studies are needed
Role of Multidetector CT in Evaluation of Benign Focal Liver Lesions in a Tertiary Care Centre in North India
No full textIntroduction: Introduction of Multi Detector computed Tomography has been a huge leap in the CT technology. MDCT has a high diagnostic accuracy, sensitivity and specificity in the evaluation of focal and diffuse lesions of liver. The present study aimed to study the role of MDCT as a diagnostic modality for the benign lesions of liver. Material and methods: A prospective study of the role of MDCT in detecting and characterizing neoplastic hepatic lesions was conducted in the period in radiology department of RMCH, Bareilly. Thirty patients, with hepatic benign lesions, were selected. Diagnosis was confirmed by surgery and histopathology, follow up imaging and other non-radiological investigations. Results: Thirty patients were finally included as they were found to have benign lesions. Mean age of the patients was 49.8 years. 37% patients aged between 41 and 50 years while 17% patients were elderly. 63% were females. 63% patients had alcohol abuse while 60% were smokers. The most common presenting complaint was pain abdomen (n=15) followed by abdominal discomfort (n=13). Total of 29 lesions were identified on MDCT. The most common lesions were hemangioma (n=15) followed by simple cyst (n=5). Conclusion: MDCT is “The Imaging Modality of choice” in characterizing benign hepatic lesions
Les Adénomes Parathyroïdiens Ectopiques Médiastinaux : Quelle Voie d’Abord ?
No full textIntroduction : L’hyperparathyroïdie primaire est le mode révélateur le plus fréquent des adénomes parathyroïdiens. Ces adénomes peuvent être localisés en situation ectopique dans 11 à 25% des cas, dont l ́emplacement le plus fréquent est le médiastin (70% des cas sont intra-thymique, 30% sont dans la gaine carotidienne, en para-oesophagien, dans le sillon trachéo-oesophagien ou en intrathyroïdien). Le diagnostic topographique représente une étape essentielle dans la prise en charge diagnostique des adénomes parathyroïdiens ectopiques médiastinaux (APEM), ce dernier est responsable parfois de 50% d ́échec de la chirurgie cervicale réalisée initialement. Objectifs: Décrire les caractéristiques épidémiologiques, cliniques, thérapeutiques et évolutives de cette affection, et souligner la place prépondérante de l’imagerie préopératoire permettant un acte chirurgical réussi. Matériels et méthodes : Etude rétrospective de 7 cas suivis pour hyperparathyroïdie primaire dans le service d’endocrinologie et opérés dans notre service pour un APEM. Résultats : Tous les cas étaient de sexe féminin, l’âge moyen était de 56,8 ans (44-70 ans). Les circonstances de découverte étaient des manifestations urinaires à type de douleurs lombaires et une lithiase rénale récidivante présentes chez 4 patientes. Des manifestations ostéo-articulaires à type de douleurs osseuses et une fracture spontanée ainsi qu’une ostéoporose chez deux patientes, et une patiente était suivie pour un syndrome sec. Sur le plan biologique, toutes les patientes présentaient une hypercalcémie corrigée variant de 110 à 138 mg/l avec une moyenne à 124 mg/l, ainsi qu’un taux de parathormone variant entre 3 et 20 fois la normale avec un taux moyen à 9,5 fois la normale. L’échographie cervicale n’a objectivé de nodule parathyroïdien ectopique que chez une patiente. L’imagerie par résonnance magnétique (IRM) cervicale réalisée dans un cas était la cause d’une cervicotomie blanche faite par les chirurgiens viscéralistes. La tomodensitométrie cervicothoracique était réalisée dans tous les cas, elle objectivait la localisation précise de l’A.P.E.M qui était situé dans le médiastin antéro-supérieur (4 cas), dans le médiastin moyen (1cas), et dans le médiastin postérieur (1 cas). La scintigraphie au 99mTc-sestamibi était réalisée pour 5 patientes, elle montrait une hyperfixation de l’adénome parathyroïdien au niveau médiastinal dans 3 cas et cervical au niveau latérotrachéal dans 2 cas. La prise en charge médicale initiale avait permis une normalisation de la calcémie. Les voies d’abords chirurgicales étaient une cervicotomie de Kocher seule pour deux patientes, elle était associée à une manubriotomie pour une patiente, une cervicotomie présternocleïdomastoïdienne associée à une manubriotomie, une sternotomie, une manubriotomie et une thoracotomie respectivement dans un cas. La résection de l’A.P.E.M était associée à une thymectomie chez 03 patientes, et à une lobo-isthmectomie thyroïdienne chez une patiente. L’examen extemporané était nécessaire pour une patiente. Les suites opératoires étaient simples, les taux du calcium et de la parathormone post-opératoire étaient normaux. Une hypocalcémie transitoire jugulée par un traitement substitutif était survenue chez deux patientes. Le recul variant de 1 mois à 16 mois avec une moyenne de 8 mois était sans particularités. Conclusion : Le bilan radiologique représente un temps essentiel dans le prise en charge des APEM, offrant une cartographie cervico-médiastinale exacte permettant au chirurgien de réaliser un acte opératoire ciblé « Frappe chirurgicale », grâce à des voies d’abord adaptées ; un temps opératoire écourté ; et évitant les explorations chirurgicales blanches
Survival and Prognostic Factors of Patients Operated for Bronchopulmonary Cancer Invading the Chest Wall at Ibn Sina Hospital in Rabat (Morocco)
No full textIntroduction: Non-small cell bronchopulmonary cancer (NSCLC) invading the chest wall is operable cancer at the cost of a parietal sacrifice. Their survival is estimated at 15% at 5 years in the literature. The factors of poor prognosis, particularly recurrence, have been studied in the literature in various ways.The objective of this study is to describe the overall survival and the recurrence-free survival of patients operated on in our department for NSCLC invading the chest wall (parietal pleura and bone wall) and to assess prognostic factors.Material and methods: We carried out a retrospective study on a series of cases of bronchopulmonary cancer invading the chest wall operated on in our department between 2010 and 2014. We analyzed overall and recurrence-free survival according to the Kaplan-Meier method depending of several parameters.Results: Twenty-nine patients were operated on, all of them male, with an average age of 57 years. The main clinical sign was chest pain. Bone involvement was found in 7 patients, 22 patients presented with an invasion of the parietal pleura alone. The resection was in one piece, removing the pulmonary parenchyma and the wall in 23 patients. Parenchymal resections were dominated by lobectomy performed in 23 patients (79.31%). Seven patients were lost to follow-up. The overall survival of the patients is on average 34 +/- 4.9 months and the survival without recurrence is 24 months +/- 5.53 months. We analyzed overall survival as a function of bone involvement, monobloc resection, and association with perioperative treatment. The chi-square test was respectively p = 0.659; p = 0.194; p = 402. Survival without recurrence was analyzed according to the same parameters with p = 0.197; p = 0.050; p = 0.036.Conclusion: NSCLCs invading the chest wall is not limited to surgical resection. The association with perioperative adjuvant treatment seems to have an impact on the improvement of survival and on the occurrence of recurrence