Physiology and Anatomy

The epidemiological approach to glomerular diseases remains less developed in our country. The aim of our study is to identify the frequency of glomerular nephropathies in our context; and to describe their different demographic, clinical, biological characteristics, as well as their etiological and evolutive profile. We have led a retrospective study at the department of nephrology, University Hospital Med VI, between 2014 and September 2017. We collected 93 patients, including 51 men .The average age at the diagnosis was of 34,8 ± 14,8 years old. The clinical presentation was dominated by the nephrotic syndrome (60.21%), hematuria (26/88%), and hypertention (22.58%).Glomerular nephritis were primitive in 70.96 % of the cases, the minimal change disease, segmental and focal glomerulosclerosis and membranoproliferative glomerulonephritis represented the most common histological types with 18,18%, 42,4% and 24,04% of the cases , their etiologies were dominated by lupus nephropathy, 78,3% of our patients received a symptomatic treatment . The use of corticosteroids in primitive glomerular nephropathy has been proposed in only 53.7 % of the cases, and associates with immune suppressives in 17.9% of cases.

Lymphoepithelioma-like carcinoma is an undifferentiated carcinoma with histological features similar to undifferentiated, non-keratinizing carcinoma of the nasopharynx. Lymphoepithelioma-like carcinoma of the urinary bladder is uncommon with a reported incidence of 0.4%- 1.3% of all bladder cancer. We report a case of a 68 year-old-man with a muscle-invasive lymphoepithelioma-like carcinoma of the bladder who was treated with radical cystectomy with 12 months follow up.

The obesity, factor of morbidity and mortality, is considered as a real health public problem. In gynecology, its consequences on the fertility and the contraception are severe and the obesity is at the origin of important obstetric complications that must make consider these pregnancies as at risk. Our practices have to take into account these complications by assuring an adapted and premature care to improve the maternal and neonatal outcomes.

Wilm’s tumor is the most common retroperitoneal tumor extending into the Inferior vena cava (IVC) in a child. In 1% of cases right atrial (RA) extension may be encountered. Anesthesia for intracardiac resection of tumor thrombus remains a challenge. We report 2 cases of Wilm’s tumor, one extending upto IVC-RA junction and the other with RA involvement managed successfully with resection on cardiopulmonary bypass. In both patients epidural catheters were inserted for perioperative analgesia. Considerable controversy exists regarding insertion of epidural catheters in the face of systemic heparinization. However we report good outcomes in terms of analgesic efficacy, shorter perioperative course and no complications. A short discussion on the various methods of bypass employed for the removal of these tumors is included. We also discuss the utility of newer equipment like Transesophageal echocardiography (TEE) and ultrasound for perioperative anesthetic management. 

Spermatocytic seminoma (SS) is a distinct testicular germ cell tumor, representing less than 1% of testicular cancers. The clinical features that distinguish (SS) from classical seminoma (CS) are an older age at presentation and a reduced propensity to metastasize. Currently, the management (SS) has changed to the increased use of surveillance, provided that there are no risk factors which may predict recurrence. Here, we report an additional case of SS and present a comprehensive relevant literature review concerning current clinical, histopathological, and therapeutic features.

Anorectal malformations (ARM) comprises, a wide spectrum of diseases, which can affect girls and boys, and involve the rectum and distal anus as well as the genital and urinary tracts. ARM occurs in around 1 in 5000 live births. Defects range varies from the very minor or “low” which are easily treated with an excellent functional prognosis, to those that are difficult to manage, complex, are often associated with other anomalies known as “high”, and have a poor functional prognosis. The surgical approach to repairing these defects changed intensely in 1980 with the introduction of the posterior sagittal approach, Better imaging techniques, and a improved knowledge of the anatomy and physiology of the pelvic structures at the time of birth.

Transposition of the great vessels is a type of congenital heart defect involving an abnormal arrangement of any of the great vessels such as the superior vena cava, pulmonary arteries and aorta. Congenital heart diseases concerning the primary arteries are further divided into sub-group called transposition of great arteries. There are different forms of anomalies like Dextro-transposition, Levo-transposition and Dextrocardia. It was first announced about two centuries ago, but the treatment became effective from the mid 21st century. Today the survival rate for infants is greater than 90%.

Mass violence invariably results in devastating consequences that may significantly impair an individual’s cognitive, emotional, physical, and behavioral functioning, besides destroying the community’s moral, cultural and social fabric. It inevitably results in trauma, which, if not confronted with psychotropic medicine or therapy, may never heal. Psychotherapeutic interventions facilitate the victim’s understanding and acceptance of the new realities, thus giving hope and meaning to an otherwise disintegrating life. Consequently, the preparedness of humanitarian agencies in psychotherapeutic interventions can greatly assist victims especially in mass violence settings, just as happened in Kenya’s 2007 post election violence (PEV). The purpose of the study was to gather information on, and evaluate the use of psychotherapeutic support as an interventional strategy in helping trauma victims. Also, the study investigated the prevalence, provision, influence of time response and intervener skills on the effectiveness of the strategy; and, discrimination in availability and accessibility of the service across geographical localities, ethnic communities, gender, and age grouping. An estimated 31% of the internally displaced persons (IDPs) randomly selected in 12 geographical localities across two provinces in seven districts participated in the study. The sample consisted of 59% females and 41% males and maintained a balance between adults and youth. In addition, the study utilized 10 humanitarian agencies by interviewing two of their professionals who intervened in trauma cases. The study employed the causal comparative design to explore relationships between variables and utilized a questionnaire, interview schedule and an observation form as primary tools in eliciting data. In addition, time response was found to be significant in improving the effectiveness of an intervention. Lastly, the study found that to a greater extent, humanitarian agencies acted responsibly and quickly

Physical inactivity is a strong predictor of mortality in patients with end-stage renal disease and is associated with poor physical functioning. Patients with end-stage renal disease are inactive even compared to sedentary individuals without kidney disease. We sought to analyze the level of physical activity in our chronic hemodialysis patients and to identify patient barriers to physical activity. Adult patients on hemodialysis in the Department of Renal Dialysis and Renal Transplantation at the Mohammed V Military Training Hospital in Rabat were recruited and asked to complete the update Baecke physical activity questionnaire in French named AQAP (Physical Activity Self-Questionnaire) A total of 52 patients participated in the study, the mean age of the patients was 50 years ± 16.55 with extremes ranging from 24 to 76 years, sex ratio (H / F) was 1.1. The majority of participants strongly agreed that a sedentary lifestyle was a health risk and that increasing exercise was a benefit. 23% report having no physical activity. 74% of patients report difficulty in performing significant physical exertion. 17 % of patients report having a regular physical activity and sport. However, 49% of participants reported at least one barrier to physical activity. The most commonly reported barriers were fatigue on dialysis days shortness of breath and depression. Exercise provides beneficial effects in end stage renal disease, our study identified a number of barriers to physical activity that can be addressed in studies aimed at increasing levels of physical activity.

Hamartomas are one of the most common benign tumors of the lung. We report a case of huge pulmonary hamartoma of the left lower lobe in a 33-year-old female patient. The pulmonary hamartoma was solid, measuring 30 x 16.5 x 14.5 cm, closing a cystic and calcium component. It was successfully treated by surgical resection and the final histology was a pulmonary hamartoma with no signs of malignancy. we report a new case of a giant hamartochondroma very little described in the literature