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Interest of Ultrasound in the Exploration of Rotator Cuff Lesions - Confrontation of Clinical Examination and Ultrasound Finding
No full textIntroduction: The aim of our study was to evaluate the interest of ultrasound in the exploration of painful shoulders evoking rotator cuff lesions and to determine the diagnostic value of the different tendon tests through a confrontation physical examination versus shoulder ultrasound. Materials and methods: A prospective study was conducted including patients consulting for shoulder pain that suggests a rotator cuff lesion. All patients underwent a clinical examination, an x ray and shoulder ultrasound.Results: The confrontation physical examination versus shoulder ultrasound showed that Jobe's test is very sensitive (100%) but less specific (27%), the Patte test, has a high sensitivity (100%) but an average specificity (51%), the Palm-Up test was fairly sensitive (91%) but not very specific (43%) and the Gerber test was more specific (95.7%) and less sensitive (38%). The comparison between x ray and ultrasound showed that ultrasound of shoulder is more efficient in the detection of calcifications and erosions of humeral head.Conclusion: Ultrasound of shoulder is more performant than physical examination and x ray in exploring the rotator cuff lesions
Quality of Life Post Sleeve Gastrectomy in Alqassim Region, Saudi Arabia
No full textIntroduction: Morbid obesity together with obesity-related diseases has a significant negative impact on the quality of life. Our study aims to assess the quality of life amongst patients with morbid obesity post-bariatric (sleeve gastrectomy) surgery in relation to their pre-operative state.Methods: A questionnaire was developed and administered to 298 patients, 52% of the participants were females. The highest percentage (42.3%) was in the age group 30-40 years. The mean preoperative weight was 127kg, and the preoperative BMI was 46.6Kg/m2. The quality of life is assessed regarding various criteria such as physical pain, psychological manifestation, and self-esteem.Results: There is an overall noticeable improvement in practicing different activities; Patients are able to participate in various sports (61%) with no marked alteration in terms of social activity. Productivity in terms of everyday work tasks was enhanced (57%) compared to the pre-operative Regarding post-operative pain, (57%) reported experiencing post-operative pain, the majority of these (64%) experienced postoperative pain for a total duration of less than one month. the percentage of patients who said that there is much improvement in their health status compared to their preoperative situation was higher in those who had a preoperative chronic illness.Conclusion: sleeve gastrectomy for patients with morbid obesity showed a tremendous positive impact on the quality of life of the majority of patient
Special Report from Deans Meeting - Pedagogy and Digital in Teaching Health Sciences in Morocco: Challenges and Opportunities
No full textThe deans meeting held on March 20, 2018, at the Mohammed VI University of Health Sciences, had the theme: "Pedagogy and digital in the teaching of health sciences in Morocco: challenges and opportunities ” and focused on four areas: 1 / Schools of health sciences in action: evolution or revolution?; 2 / Schools of health sciences in action: differentiated pédagogy ; 3 / From pedagogy to evaluation; and 4 / Synthesis: digital and schools of health sciences. We report here the main messages from the presentations of the various speakers at this meeting
Awareness and Knowledge of Diabetes Mellitus Among School Teaching Staff in Taif City
No full textDiabetes is one of the most common chronic diseases, usually appears during childhood or adolescence; however, it can also develop in adults. The objective of this study was to evaluate the knowledge and awareness about diabetes among teaching staff in Taif province of Saudi Arabia. A cross-sectional study, using a structured pre-tested questionnaire, was conducted in Taif. Our study involved 50.5% males and 49.5% were females. The age of participants ranged from less than 30 years old to more than 50 years old. Our results showed that the majority of teaching staff in our sample study are aware of diabetes and how to deal in case of low blood glucose levels. However, the knowledge of causes, symptoms, risk factors, complications of diabetes, and signs of low blood glucose level were not as high as expected. Therefore, training is required for the teaching staff as more than half of our sample study had taught a diabetic child
La Chirurgie Thoracique Video-Assistée : Bilan d’Activite du Service de Chirurgie Thoracique Du CHU de Marrakech
No full textIntroduction: La chirurgie thoracique vidéo-assistée [VATS] représente une véritable évolution en chirurgie thoracique. La sécurité, l’efficacité et le faible retentissement fonctionnel font de ces techniques le gold standard dans certaines indications notamment dans le pneumothorax, le talcage, la thymectomie... A travers cette communication nous partageant notre expérience en matière de VATS. Patients et méthodes: Etude rétrospective d’une durée de deux ans (Janvier 2016-Décembre2017) réalisée dans le service de chirurgie thoracique du CHU de Marrakech. Tous les patients opérés par VATS ont été inclus. Les données cliniques, paracliniques, chirurgicales et des suites postopératoires ont été recueillies à partir des dossiers médicaux et des comptes rendus opératoires. Résultats : 174 patients étaient opérés par VATS. Il s’agissait de 65% d’hommes et de 35% de femmes. L’âge moyen était de 39 ans. Le diagnostic positif était obtenu par la radiographie du thorax dans 23% des cas. La tomodensitométrie thoracique était réalisée dans 77% des cas. Les indications chirurgicales étaient : un talcage pleural (n=65), une biopsie pleurale (n=48), une chirurgie de pneumothorax (n=40), une thymectomie (n=9), une biopsie pulmonaire (n=7), et une lobectomie pulmonaire (n=5). Les suites opératoires étaient simples dans la majorité des cas. La durée moyenne d’hospitalisation était de trois jours. Conclusion: la VATS est une technique sûre, fiable avec un faible retentissement fonctionnelle et doit être utilisée de plus en plus dans notre contexte
Chirurgie de l’Aspergillose Pulmonaire Chronique
No full textIntroduction : Le poumon est le site de prédilection de l’atteinte aspergillaire, l’entité la mieux connue est l’aspergillome. Ce dernier est secondaire au développement d’une truffe aspergillaire au sein d’une cavité parenchymateuse préexistante, cette cavité est le plus souvent une séquelle de tuberculose pulmonaire dans notre contexte endémique. La chirurgie de l’aspergillose est alors une activité courante dans un service de chirurgie thoracique Matériels et méthodes : Etude rétrospective descriptive d’une période de 7 ans (Janvier 2010-Décembre 2017). Nous avons exploités tous les patients qui ont été pris en charge dans le service de chirurgie thoracique à l’hôpital Ibn Sina de Rabat. Le recueil des données a été fait à partir des dossiers médicaux, des comptes rendus opératoires et des fiches de suivi. Les patients hospitalisés mais non opérés et les dossiers non exploitables ont été exclus de l’étude. Les données de 65 patients inclus ont été décrites. Résultats : la médiane d’âge de nos patients est de 45 ans, avec un sexe ratio Homme/Femme de 2.25. L’antécédent de tuberculose était retrouvé dans 86.15% des cas. Le délai moyen entre l’atteinte tuberculeuse et la prise en charge chirurgicale était de 13.39 ans. Les symptômes apparaissaient en moyenne 2.45 ans avant la chirurgie. L’hémoptysie représentait le signe prédominant (84.61%). L’imagerie orientait le diagnostic dans 44% des cas. La sérologie aspergillaire faite chez 35 patients était positive dans 56.6 % des cas. La lobectomie constituait le geste opératoire le plus fréquent (46.15%). Les complications postopératoires étaient dominées par l’hémothorax (21%). La durée moyenne du séjour postopératoire était de 8.45 jours. Conclusion : Devant l’échec du contrôle de l’endémie tuberculeuse, et l’absence de traitement médicale efficace. La chirurgie constitue toujours une indication thérapeutique essentielle pour l’aspergillose pulmonaire, seule garante d’un pronostic favorable chez ces patients, à condition d’un bilan préopératoire détaillé et d’une préparation médicale préopératoire adéquate
Vaccination Hesitation and Vaccination Challenges in 2017
Get PDFMany countries are affected today by the rise of hesitations to vaccinate. This trend has only increased in the last two decades, as all surveys show. The last major international survey reveals that 41% of French people doubt vaccine safety. The result is a reduction in vaccination coverage in children for the measles-mumps-rubella vaccine, the meningococcal C vaccine and the HPV vaccine, and in adults a decline in influenza vaccination. The causes of this hesitation are multiple and societal: fear of the supposed serious adverse effects replacing the fear of diseases, disinformation by the media and the Internet, various beliefs and growing individualism, loss of confidence in experts and institutions. The solutions are multiple and vary from country tocountry. They are dominated by the improvement of the university and continuing education of health personnel in vaccinology, by providing more precise, readable, and transparent information. Strong commitment from health authorities is essential to improve confidence and support vaccinators. Health education should be tailored to the demands of modern society and be more relevant to education
Influence of Homocysteine and Vertebral Fractures on Prevalent Abdominal Aortic Calcification in Postmenopausal Women - A Multicentric Cross-Sectional Study
Get PDFThe main of this study was to examine the relationship between plasma homocysteine (Hcy), asymptomatic osteoporotic vertebral fractures (VFs) using vertebral fracture assessment (VFA), and prevalent abdominal aortic calcification (AAC) in Moroccan postmenopausal women. The study cohort consisted of 188 consecutive postmenopausal women with no prior known diagnosis of osteoporosis or taking medication interfering with bone metabolism. Mean age, weight, height, body mass index, and plasma homocysteine were determined. Lateral VFA images and scans of the lumbar spine and proximal femur were obtained using a Lunar Prodigy Vision densitometer (GE Healthcare Inc., Waukesha, WI). VFs were defined using a combination of Genant’s semiquantitative approach and morphometry. VFA images were also scored for prevalent AAC using a validated 24 point scale. Fifty-eight (30.9%) patients had densitometric osteoporosis. VFs were identified using VFA in 76 (40.4%) patients: 61 women had grade 1 VFs and 15 had grade 2 or 3 VFs. One hundred twenty-nine women (68.6%) did not have any detectable AAC, whereas the prevalence of significant atherosclerotic burden defined as AAC score of 5 or higher, was 13.8%. A significant positive correlation between AAC score and homocysteine was observed. Women with extended AAC were older, had a lower weight, BMI, and BMD, higher homocysteine levels, and more prevalent VFs than women without extended AAC. Multiple regression analysis showed that the presence of extended AAC was significantly associated with Age and grade 2/3 VFs and not independently associated with homocysteine levels.This study did not confirm that homocysteine is an important determinant of extended AAC in postmenopausal women. However, this significant atherosclerotic marker is independently associated with VFs regardless of age.
Cancer Control in Morocco: The Contribution of Lalla Salma Foundation
Get PDFSince the creation of Lalla Salma Foundation on 22nd November 2005, cancer prevention and control have become a public health priority in Morocco. Accordingly, the Foundation and the Ministry of Health have developed the National Cancer Prevention and Control Plan for 2010-2019. In this context, the Foundation conducts actions in the areas of awareness-raising, prevention, early detection, and access to care. In addition, the Foundation develops social solidarity activities through the construction of "Homes for Life" for patients and their relatives, the creation of a network of volunteers throughout the Kingdom, the development of palliative care at home, and assistance of orphans due to cancer.Under the leadership of Her Royal Highness Princess Lalla Salma, the Foundation mobilizes the necessary funds, coordinates the different actions, and federates the stakeholders involved in cancer control.As a Goodwill Ambassador of the World Health Organization for the promotion of prevention and cancer care, Her Royal Highness plays also an important role in the advocacy for cancer control in the world and supports several African countries in implementing programs for cancer prevention, cancer control, and access to medicines
Anti-Cytokine Biotherapies and Inflammatory Joint Diseases
Get PDFRheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis represent the most frequent inflammatory arthritis where the three cytokines TNF, IL-6, and IL-17 contribute to the clinical expression and the consequences on a joint structure. Each cytokine has a specific mode of action that explains differences in therapeutic indications. TNF inhibitors showed impressive clinical results first in rheumatoid arthritis. These results were then extended to psoriatic arthritis, and ankylosing spondylitis.IL-6 inhibitors are registered only for rheumatoid arthritis and those of IL-17 for psoriatic arthritis, and ankylosing spondylitis. The wider use of these new molecules has required the definition of recommendations to better define their field of action and to prevent their side effects, first from infections