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Epidemiological and Biological Profiling of Breast Cancer in Southern Morocco
No full textBreast cancer is one of the most frequent cancers that affect women. Risk factors include a combination of multiple factors such as heredity, age, and environment. The frequency of breast cancer in Morocco increased significantly in recent years, and it is now a major public health concern. A retrospective epidemiological study was produced for a cohort of 1559 patients attending the regional center of oncology and radiotherapy in Agadir, during a period comprised between January 2010 and December 2015.Our data shows that the average age of the patients is 48 years, the majority of them present grade II tumors 66.38%. The immunohistochemical analysis of tumors revealed that 64% of them are positive for hormone receptors. With 67.07% is positive for ER and 61.01% positive for RP, while 29.17% of tumors overexpress the HER2 protein. The distribution of molecular subtypes of breast cancer shows that luminal A has the highest percentage 50.96% followed by basal-like 20.26%.To clarify the young epidemiological profile and the etiology of breast cancer a regional cancer registry is required. Furthermore, awareness campaigns are crucial to avoid having patients with aggressive forms of the disease. Therefore, to improve survival and reduce the morbidity of breast cancer patients
Evaluation of the Rate of Surgical Site Infection in Gynecological Surgery at the Regional Hospital of Ngaoundere
No full textIn Cameroon, where the prevalence of infectious complications remains high, several factors that may or may not lead to these infectious complications are still to be known in our region. The aim of this work was to contribute to improved care delivery. This was a prospective study coupled with an exploratory study from May 10th to August 31st, 2016. All patients who had a gynecological and obstetric surgery at the HRN and without any infection before surgery were included in this study, and were followed each for 30 days. In total, we had 65 surgical procedures in gynecology and obstetrics. The average age of the patients was 29.23 years. Clean surgeries accounted for 98.5% of interventions, with contaminated clean surgeries accounting for 1.5% of interventions. A total of 6 cases of infections of the surgical site was observed (9.2%). Significant variables associated with postoperative infections were the use of antibiotics, the date of first dressing, the duration of surgery. The infection rate of the surgical site which is 9.2% is clearly greater than the data of the literature, despite the antibiotics in prophylactic in clean surgeries. However, better pre and post-operative care, as well as strict adherence to the principles of perioperative asepsis, should be the rule in our context
Squamous Cell Carcinoma of the Lower Lip Arising in Discoid Lupus Lesion - A Case Report
No full textIntroduction: Rare examples from the literature report a possible degeneration of mucosal lesions of L.E.C. We report a case of squamous cell carcinoma grafted on a lesion of the lower lip in a patient followed for L.E.C. at the ENT and Maxillo-facial department of Mohamed VI University Hospital of Oujda.Case report: A 47-year-old man, with a notion of photosensitivity, presents atrophic erythematous-violet plaques in the photo-exposed zones evolving for 20 years, evoking chronic discoid lupus cutaneous without any clinical, biological or radiological sign of systematization. The patient had a painful lower ulcer-budding process that had been evolving for 2 years, with suspected bilateral cervical lymphadenopathy. The biopsy revealed a well-differentiated infiltrating squamous cell carcinoma. Surgical excision oncology is then performed with a labial plasty and an obviously bilateral lymph node. Conclusion: The risk of degeneration of skin lesions of lupus discoid is minimal and rare, although monitoring of lupus scars remains essential, especially in the context where exposure to ultraviolet radiation is added as a predisposing factor for possible malignant transformation, surgical treatment is required at the appearance of suspicious lesions confirmed histologically
Relationship between Melanoma Stage at the Diagnosis and Survival During a Period of 30 Years (1982-2011)
No full textMelanoma is a malignant tumor of melanocytes and is a potentially aggressive cancer. The incidence of melanoma is rising at a greater rate than any other cancer in the U.S. The aim of this study was to examine the association between melanoma stage at the time of diagnosis and survival among U.S. adult melanoma patients during 1982-2011. This was a secondary analysis of a non-concurrent cohort study conducted on 185219 U.S. adult patients who were diagnosed with primary cutaneous melanoma between 1982-2011. Chi-square, Kaplan-Meier, and Cox proportional hazards regression were used to analyze the data. Significance was assessed using a p-value and 95% confidence interval. Men had more cutaneous melanoma. Black non-Hispanic patients were diagnosed less frequently. Patients who were married or in a domestic partnership were most likely to be diagnosed. The adjusted HR for distant melanoma was 141-fold that of in situ (95% CI 126.38-157.19). The adjusted HR was the highest in the first decade of diagnosis (1.7; 95% CI 1.6 1.75). In conclusion, survival is highly affected by the melanoma stage at diagnosis. Black non-Hispanic patients had the lowest hazard ratio of all races. The sample size was large, which enhances the generalizability to the U.S. population
Neuroleptic-Induced Brugada Syndrome - A Case Report
No full textBrugada syndrome is a rare genetic disease, of autosomal dominant inheritance with low penetrance, manifested by ST-segment elevation at right precordial V1, V2, and V3, and right branch block aspect. to the electrocardiogram. It exposes to a high risk of ventricular arrhythmia that can cause syncope and even sudden death, on a structurally healthy heart.We report here the case of a young patient of 25 years who has a syndrome of Brugada induced by a neuroleptic. To our knowledge, this is the first reported case of Brugada syndrome induced by a neuroleptic Morocco. Therapeutic management is based on Amiodarone and beta-blockers. Regular monitoring of the ECG should, however, be performed on patients taking psychotropic drugs and also on associations
Emergency Room Visits in Patients with Left Ventricular Dysfunction Receiving Hemodialysis : A Case Control Study
No full textIntroduction: Chronic kidney disease (CKD) prevalence in Saudi Arabia has been rising over the past few years. The risk of developing left ventricular dysfunction is high in patients with CKD on hemodialysis. Our aim is to study the frequency of emergency room visits and the length of ER stay in patients with LVD on hemodialysis.Methods: All patients who were on hemodialysis between the period of January 2011 and November 2016 were included in our study. Patients’ demographic, medical, and laboratory data were extracted for all patients. Patients were classified into three groups according to their ejection fraction (EF<40%, EF= 40-49%, and EF≥50%). Descriptive statistics were done for all variables. Logistic regression was used to assess the outcome while adjusting for confounder.Results: Analysis included 333 patients. Two hundred and fifty-seven patients had an EF ³50% and 36 patients with EF 40-49% and 40 patients with EF <40 %. Age was significantly higher in patients with EF<50% compared to patients with EF ³50% (P=0.002). Comorbidities were more prevalent in patients with EF<40% and EF 40-49%. The number of ER visits and length of stay were significantly different between the three groups (P=0.005, P=0.023) ICU admissions show a statistically significant difference between the three groups (P=0.013).Conclusion: Patients with low EF on hemodialysis have a higher rate of ER visits and length of stay in ER when compared to patients with EF≥50
A Giant Dermatofibrosarcoma of the Anterior Chest Wall
No full textDermatofibrosarcoma (DFS) is a rare skin tumor, characterized by its recurrence. Its slow development and its banal clinical appearance often cause diagnostic delays, especially when the tumor is located in covered areas. The reference treatment is wide resection. We report a case of giant chest wall DFS. The discordance between the impressive tumor volume and the limited deep invasion is the peculiarity of this case report.A conservative treatment, a wide resection, and a split-thickness skin graft could be undertaken. With a follow-up of two years, the carcinological, functional, and aesthetic results are very satisfactory
Cervicofacial Rotation Advancement Flap in Cheek Reconstruction
Get PDFIntroduction: The Cervicofacial rotation advancement flap (CRAF) is a random-pattern flap that provides an excellent match for cheek reconstruction. In this report, the authors review their experience with this flap and present their advantages in order to expand the awareness and promote the application.Methods: A retrospective analysis of reconstruction of cheek defects using CRAF was performed in 12 patients. Data on patient demographics; diagnosis, defect type, and outcome were collected. Results: These patients included 07 male and 05 female; they ranged in age from 56 to 88 years, with a mean age of 67 years.05 patients used tobacco and one patient had a history of radiation. On histopathological examinations of the specimen, 03patients had squamous cell carcinoma, and 09 patients had basal cell carcinoma. The mean defect size was 40cm² [range 10 to 67cm²]. The mean follow-up was 06 months [0 to 24 months]. One patient was lost to follow-up after suture removal. As complication 01 patient had flap necrosis No facial nerve injury was observed. All patients were pleased with the outcome of the Cosmetic results. Conclusion: Cervicofacial flap provides a technically simple, reliable, safe, efficient, and cosmetic means to reconstruct defects of the cheek
Knowledge of Moroccan Dentists Towards the Prophylaxis of Infective Endocarditis
No full textBackground: The involvement of oral bacterias in the occurrence of infective endocarditis (IE) has prompted the adoption of antibiotic prophylaxis prior to dental procedures for patients at high risk. This paper aimed to assess the knowledge of Moroccan dentists regarding the management of patients with heart disease at risk of infective endocarditis.Methods: This was a cross-sectional descriptive-analytical study that targeted 200 dentists in Rabat, Morocco. A questionnaire with 16 questions was distributed randomly. The level of dentists' level of knowledge was established based on the number of correct answers for each section and responses were assessed according to the American Heart Association (AHA) 2007 guidelines.Results: Only 133 practitioners have agreed to participate in our study with a response rate of 66,5%. 87% of dentists reported contacting the cardiologist before starting treatment, 33% of practitioners weren’t aware of any guidelines and 20% knew AHA 2007, 52% reported not following guidelines in the management of patients with heart disease. Among the cardiac conditions and dental procedures proposed in the questionnaire which required prophylaxis; 8% and 2% respectively chose the correct answer according to the AHA’s 2007 guidelines. 31% of dentists answered correctly on the prescription of antibiotic prophylaxis protocol according to the latest recommendations.Conclusion: According to our results, the knowledge of Moroccan private general dentists towards endocarditis prophylaxis was at a low level. The study highlights the need for continuous education