Physiology and Anatomy

Onchocerciasis is the second leading cause of infectious blindness in the world after trachoma. A parasitic disease caused by a nematode specific to humans, Onchocerca volvulus, it is transmitted by the female black fly in places close to fast-flowing streams. This affection is serious by its ocular complications which earned him the name of river blindness. The World Health Organization estimates that 120 million people are exposed to onchocerciasis and about 18 million people are infected, of whom more than 99% live in intertropical Africa. Among them, 350 thousand are blind. The aim of our study is to determine the types of ophthalmological lesions in patients with onchocerciasis in the city of Inga in the Democratic Republic of Congo. Our series includes 100 patients, having benefited from a complete clinical examination and an ex-blood biopsy to confirm the onchocerciasis diagnosis. The prevalence in our study is 58%. The average age of our patients was 39.12 ± 15.71 years. We noted a male predominance with a sex ratio of 2.62. People working in fishing are the most affected by onchocerciasis, ie 44.85%. 27 out of 58 patients, ie 46.55%, benefited from mass treatment with Ivermectin. The lifespan of patients in the city of Inga was 24.71 ± 9.5 years. Ocular manifestations were 67.2%. The city of Inga is a known endemic focus for onchocerciasis (Prevalence 58%), ophthalmological manifestations are frequent in the city of Inga (67.2.%, 13.7% of blind people). The treatment of masses with ivermectin remains the only means of preventing the ophthalmological complications of onchocerciasis, hence the importance of good awareness-raising so that the population living in endemic regions participates in the treatment of masses.

Mature teratomas are benign ovarian tumors, which are generally asymptomatic. They rarely cause ovarian torsion. A typical clinical picture associates an abdominal pain with adnexal sensitivity and palpable mass. The imaging aspect of mature teratoma or dermoid cyst is typical. The ultrasound, CT scan, and the MRI play a crucial role in the diagnosis of adnexal torsion with the ovarian teratoma.

Acute respiratory distress syndrome (ARDS) is characterized by bilateral pulmonary lesions and poor lung compliance. Its basic treatment is mechanical ventilation. However, this last can lead to serious complications, including pulmonary barotrauma. Barotrauma is favored both by the underlying pulmonary pathology and by the use of excessive pressures delivered by the ventilator. The incidence of barotrauma during ARDS no longer exceeds 10% since the advent of tidal volume reduction and plateau pressure limitation.

The main objective of this study was to describe the epidemiological and evolutionary characteristics of children infected by Ferragat (PF) at the pediatric ward level of the Ibn Zohr Hospital in Marrakech over a three-year period from January 2013 to December 2015. 58 cases of (PF) were identified (7.97%) out of 727 cases of poisoning received. Children under one year of age were affected in 94% with a male predominance (70%) from the urban environment and observed in the winter and spring periods. Obstacles related to training, management and practice are among the factors hindering Poisonings by Ferragat care. 

Primary biliary cholangitis (PBC), formerly known as primary biliary cirrhosis, and autoimmune hemolytic anemia (AIHA) are autoimmune diseases. Although the association of several autoimmune diseases is common, however the association between primary biliary cholangitis (PBC) and autoimmune hemolytic anemia (AIHA) is rare. We report a case of (AIHA) confirmed by direct Coombs test in a patient followed in our unit for a year for PBC under ursodesoxycholic acid (UDCA) well conducted.

Crohn's disease is a chronic disabling inflammatory disease affecting the entire digestive tract. The development of biotherapy, in the forefront of which are the anti-TNF alpha drugs, has led to changes in the management of this disease, particularly in terms of improving fistulising forms of the disease outside the anoperineal lesions. We report on the evolution of fistulising Crohn's disease excluding APL under biotherapy.

The electronic cigarette is a product of common consumption which has known a remarkable commercial success. Its use is controversed by the doctors because of its toxicity, especially in the long term. A lesser toxicity of vaping compared to cigarettes is also an established fact. We report the case of a young electronic cigarette smoker, who arrived at the emergency department with a myocardial infarction. In the literature, a significant impact of electronic cigarette use on intermediate endpoints or markers of cardiovascular but it is not clear whether these changes have medium- and long-term clinical consequences. Few clinical studies have been conducted to specifically evaluate the cardiovascular effects of vaping. Thus, the electronic cigarette should never be used on a non-smoker or ex-smoker. Ideally, its use should be limited in time necessary for smoking cessation.

The myelogram is an essential tool for the diagnosis of haematological disorders. The sternal puncture is the gesture that allows the extraction of the spinal cord. This invasive technique is achievable by practitioners outpatient but is not devoid of life-threatening complications. We report the case of a patient hospitalized for etiological assessment of a myelodysplastic syndrome, sent in cardio-respiratory arrest state after sternal puncture. The echocardiography performed concomitantly with cardiopulmonary resuscitation was able to demonstrate cardiac tamponade by hemopericardium. Following an unsuccessful xiphoidal puncture attempt, a rescue thoracotomy was performed. The thoracotomy revealed a wound in the anterior wall of the right ventricle. Complications of sternal punctures can be fatal. The choice of the material used, the learning curve of the gesture itself, the early detection of complications are necessary elements to consider.

Hyperlipidemia is commonly ascribed to obesity. In the current study, the association of anthropometric profile with hyperlipidemia after adjustment for important confounding variables such as smoking, alcohol intake, and diabetes in volunteers with elevated lipoproteins was analyzed. Anthropometric assessment included measurement of weight, height, waist and hip circumferences. Serum levels of total cholesterol (TC), High- density lipoprotein-cholesterol (HDL-C) and triglyceride (TG) were measured. Low-density lipoprotein-cholesterol (LDL-C) was calculated by the Friedewald formula. Statistical analysis was done to examine the associations between anthropometric variables and lipids. The mean age of the study population was 63.31±9.56 years (30-80 yrs). Majority of individuals (51.5%) were in the age group of 61-70 years. Nearly 75.7% and 64.7% of the male and female population of the study respectively had BMI >30 kg/m2. Overall analysis of data revealed that HDL-C and BMI were correlated negatively (r= -0.25, p<0.05), whereas other lipid sub fractions did not have any significant association with the markers of obesity.

Describe the different therapeutic modalities of Carcinosarcoma of the Larynx.We report the case of a 55-year-old patient who presented with a Carcinosarcoma of the Larynx. Mr. M., 55 years old, chronic smoker, consults for dysphonia and dysphagia associated with dyspnea, which has been evolving for 12 months, progressively worsening, and necessitated an emergency tracheotomy. CT scan showed a well-circumscribed three-stage process of tissue density. Containing hyperdense images, without cartilage lysis. Carcinosarcoma of the larynx is an extraordinarily rare histological type and prone to metastases to the cervical ganglion. A complete surgical procedure of primary laryngeal lesions with wide margins, associated with a well-established bilateral cervical lymph node dissection is the best therapeutic option. Close and frequent monitoring is necessary to detect a local recurrence or a metastatic. It is essential to collect more data on the biological behavior of these tumors to determine the prognostic factors and the appropriate treatment modalities.