A. Hasnaoui, D. Haddad, H. Zaafouri, A. Bouhafa, Anis Ben Maamer
Introduction: Unintentional post-operative open abdominal wall (UPOAW) is a postoperative complication that consists of the early separation of the fascial layer after a primary closure of a laparotomy incision. This complication is associated with great morbidity and mortality. In this article, we studied the frequency of some of these known factors in our series and we briefly discussed the management of this complication. Methods: It was a monocentric retrospective and descriptive study. We enrolled patients with UPOAW, admitted in the department of surgery in Habib Thameur hospital in Tunis (Tunisia), between January 2010 and December 2015.We did not include traumatic patients. We excluded patients with missing data from medical records. Results: The study was conducted on fifteen patients. Eight out of fifteen were men. Patients were aged between 41 and 76 years, with a mean age of 66.6 ± 11.4 years. In the past medical history, chronic obstructive pulmonary disease was noted in three patients, cirrhosis in three patients, diabetes in one patient and a history for laparotomy in one patient. Eight out of fifteen underwent emergent surgeries. Two out of these eight patients had haemodynamic instability throughout surgery. In the postoperative course, coughing was noted in three patients, abdominal distension from ileus in three patients, vigorous postoperative ventilation in two patients and vomiting in one patient. UPOAW was diagnosed between postoperative day zero and postoperative day twenty-one, with a mean time of diagnosis of 10.1 ± 6.6. All patients had immediate closure of the fascial layer. The surgeon used retro-fascial polyglactin mesh in three patients. Relaxing incisions were used in 5 patients. Morbidity after reoperation was 46.7 % (7/15) and mortality was 33.3 % (5/15). Conclusion: UPOAW is a serious complication with high morbidity and mortality. Many factors can contribute to this complication. Every visceral surgeon is confronted with this problem at some point of his carrier and should apply the adequate treatment to his patients depending on his decision and experience. Strong level of evidence is needed to establish clear guidelines for the management of this heterogenous complication.
{"title":"UNINTENTIONAL POST-OPERATIVE OPEN ABDOMINAL WALL IN NON-TRAUMATIC PATIENTS: A MONOCENTRIC RETROSPECTIVE STUDY IN TUNISIA","authors":"A. Hasnaoui, D. Haddad, H. Zaafouri, A. Bouhafa, Anis Ben Maamer","doi":"10.15342/ijms.v5iR.195","DOIUrl":"https://doi.org/10.15342/ijms.v5iR.195","url":null,"abstract":"Introduction: Unintentional post-operative open abdominal wall (UPOAW) is a postoperative complication that consists of the early separation of the fascial layer after a primary closure of a laparotomy incision. This complication is associated with great morbidity and mortality. In this article, we studied the frequency of some of these known factors in our series and we briefly discussed the management of this complication. Methods: It was a monocentric retrospective and descriptive study. We enrolled patients with UPOAW, admitted in the department of surgery in Habib Thameur hospital in Tunis (Tunisia), between January 2010 and December 2015.We did not include traumatic patients. We excluded patients with missing data from medical records. Results: The study was conducted on fifteen patients. Eight out of fifteen were men. Patients were aged between 41 and 76 years, with a mean age of 66.6 ± 11.4 years. In the past medical history, chronic obstructive pulmonary disease was noted in three patients, cirrhosis in three patients, diabetes in one patient and a history for laparotomy in one patient. Eight out of fifteen underwent emergent surgeries. Two out of these eight patients had haemodynamic instability throughout surgery. In the postoperative course, coughing was noted in three patients, abdominal distension from ileus in three patients, vigorous postoperative ventilation in two patients and vomiting in one patient. UPOAW was diagnosed between postoperative day zero and postoperative day twenty-one, with a mean time of diagnosis of 10.1 ± 6.6. All patients had immediate closure of the fascial layer. The surgeon used retro-fascial polyglactin mesh in three patients. Relaxing incisions were used in 5 patients. Morbidity after reoperation was 46.7 % (7/15) and mortality was 33.3 % (5/15). Conclusion: UPOAW is a serious complication with high morbidity and mortality. Many factors can contribute to this complication. Every visceral surgeon is confronted with this problem at some point of his carrier and should apply the adequate treatment to his patients depending on his decision and experience. Strong level of evidence is needed to establish clear guidelines for the management of this heterogenous complication.","PeriodicalId":259657,"journal":{"name":"International Journal of Medicine and Surgery","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127967331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F. Laboudi, Ghizlane Slimani, Mohamed Essaid Gourani, A. Ouanass
Brugada 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 betablockers. Regular monitoring of the ECG should, however, be performed on patients taking psychotropic drugs and also on associations.
{"title":"A BURGADA SYNDROME INDUCED BY A NEUROLEPTIC – A CASE REPORT","authors":"F. Laboudi, Ghizlane Slimani, Mohamed Essaid Gourani, A. Ouanass","doi":"10.15342/ijms.v5iR.189","DOIUrl":"https://doi.org/10.15342/ijms.v5iR.189","url":null,"abstract":"Brugada 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 betablockers. Regular monitoring of the ECG should, however, be performed on patients taking psychotropic drugs and also on associations.","PeriodicalId":259657,"journal":{"name":"International Journal of Medicine and Surgery","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117030952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In preterm labor, tocolytics are used to stop uterine contractions and to allow the administration of corticosteroids for fetal lung maturation, nicardipine is a calcium channel blocker increasingly used for this indication. Several adverse effects have been reported during tocolysis using nicardipine, one of the most serious complications is Acute Pulmonary Edema. We report a case of a parturient who was admitted at 28 weeks pregnancy for preterm labor and developed a respiratory failure two days following tocolysis with nicardipine. Echocardiography and Computed Tomography Pulmonary Angiography (CTPA) ruled out a pulmonary embolism and a decompensated heart disease. The patient received oxygen therapy and diuresis for Acute Pulmonary Edema with favorable outcome. The purpose of this paper is to discuss the risk factors for occurrence of pulmonary edema after tocolysis, importance of etiologic investigation to exclude differential diagnoses and therapeutic options for management of this complication.
{"title":"Nicardipin Associated Pulmonary Edema : A Severe Complication of Tocolysis - A Case Report","authors":"Youssef Motiaa, W. Otmani, N. Oudghiri, A. Tazi","doi":"10.15342/IJMS.V5IR.200","DOIUrl":"https://doi.org/10.15342/IJMS.V5IR.200","url":null,"abstract":"In preterm labor, tocolytics are used to stop uterine contractions and to allow the administration of corticosteroids for fetal lung maturation, nicardipine is a calcium channel blocker increasingly used for this indication. Several adverse effects have been reported during tocolysis using nicardipine, one of the most serious complications is Acute Pulmonary Edema. We report a case of a parturient who was admitted at 28 weeks pregnancy for preterm labor and developed a respiratory failure two days following tocolysis with nicardipine. Echocardiography and Computed Tomography Pulmonary Angiography (CTPA) ruled out a pulmonary embolism and a decompensated heart disease. The patient received oxygen therapy and diuresis for Acute Pulmonary Edema with favorable outcome. The purpose of this paper is to discuss the risk factors for occurrence of pulmonary edema after tocolysis, importance of etiologic investigation to exclude differential diagnoses and therapeutic options for management of this complication.","PeriodicalId":259657,"journal":{"name":"International Journal of Medicine and Surgery","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125043192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND : Peritonitis is classified as primary, secondary and tertiary. In primary peritonitis (spontaneous bacterial peritonitis) and continuous ambulatory peritoneal dialysis-associated peritonitis, the source of the infection is not due a breach in the gastrointestinal tract and usually caused by a single organism. Secondary peritonitis ensues, which may be localized and contained or diffuse carrying a high mortality in the absence of surgical intervention and appropriate antimicrobial therapy. Another sequelae of perforated viscus is intra-abdominal abscesses, located in the intra or retroperitoneal space, which occur in partially treated diffuse peritonitis, postoperatively or in localized disease where the omentum has sealed off the perforation and formed an inflammatory barrier. In contrast, secondary peritonitis following perforation of the gastrointestinal tract or an infection originating in an intra-abdominal structure, e.g. gall bladder, pancreas etc. Tertiary peritonitis is an ill-defined entity, which occurs despite adequate treatment of primary or secondary peritonitis. Combination antibiotic therapy has been used to provide the patient with broad-spectrum coverage against the many potential pathogens encountered in abdominal sepsis. Several potential benefits of the clinical use of antibiotic combinations have been advanced. So this study will be conducted to focus on the efficacy of combination of two versus three antimicrobial drug in the management of patients with perforated peritonitis. OBJECTIVES OF THE STUDY: 1.To assess the efficacy of two antimicrobials(Ceftriaxone And Metronidazole) in perforative peritonitis. 2.To assess the efficacy of three antimicrobials(Ceftriaxone, Metronidazole And Amikacin)in perforative peritonitis. 3.To compare the clinical outcome of perforative peritonitis with two and three antimicrobials in the terms of reduction in postoperative infections and hospital stay. MATERIALS AND METHODS SOURCE OF DATA: This is a prospective clinical study conducted on 140 consecutive patients who presented to the surgical department of R. L. Jalappa Hospital and Research Centre, Tamaka, Kolar with peritonitis secondary to hollow viscus perforation. Study period was from December 2015 to June 2017. This is a randomized study and all the patients were divided in two groups. GROUP A: Patients with all odd serial numbers were included in this group and treated with two antimicrobials (Inj Ceftriaxone 1gm IV BD and Inj Metronidazole 500mg IV TID). GROUP B: Patients with all even serial numbers were included in this group and treated with three antimicrobials(Inj Ceftriaxone 1gm IV BD , Inj Metronidazole 500mg IV TID and Inj Amikacin 500mg IV BD). INCLUSION CRITERIA : 1.Patients with peritonitis secondary to hollow viscus perforation. 2.Patients with age >18years an
背景:腹膜炎分为原发性、继发性和三级。在原发性腹膜炎(自发性细菌性腹膜炎)和持续动态腹膜透析相关腹膜炎中，感染源不是由于胃肠道的破裂，通常由单一生物体引起。继发性腹膜炎随之发生，在没有手术干预和适当的抗菌药物治疗的情况下，可能是局部的、受控制的或弥漫性的，死亡率很高。内脏穿孔的另一个后遗症是腹内脓肿，位于腹膜内或腹膜后间隙，发生在部分治疗的弥漫性腹膜炎、术后或局部疾病中，其中网膜已封闭穿孔并形成炎症屏障。相反，继发性腹膜炎是胃肠道穿孔或腹腔内结构(如胆囊、胰腺等)感染引起的。三期腹膜炎是一种定义不清的疾病，尽管对原发性或继发性腹膜炎进行了适当的治疗，但仍会发生。联合抗生素治疗已被用于为患者提供广谱覆盖，以对抗腹部败血症中遇到的许多潜在病原体。已经提出了临床使用抗生素组合的几个潜在益处。因此，本研究将重点研究两种与三种抗菌药物联合治疗穿孔性腹膜炎的疗效。本研究的目的:1。评估两个抗菌素(头孢曲松和甲硝唑治疗的疗效 ) 在贯穿腹膜炎。2.评价头孢曲松、甲硝唑和阿米卡星三种抗菌剂治疗穿孔性腹膜炎的疗效。3.比较两种和三种抗菌素治疗穿孔性腹膜炎在减少术后感染和住院时间方面的临床结果。资料来源:这是一项前瞻性临床研究，对140例连续出现在R. L. Jalappa医院和Kolar Tamaka研究中心的腹膜炎继发于空心内脏穿孔的患者进行了研究。研究时间为2015年12月至2017年6月。这是一项随机研究，所有患者被分为两组。A组:序列号均为奇数的患者，给予两种抗菌剂(注射头孢曲松1gm IV BD和注射甲硝唑500mg IV TID)治疗。B组:序号均为偶数的患者，给予头孢曲松注射液1gm IV BD、甲硝唑注射液500mg IV TID、阿米卡星注射液500mg IV BD三种抗菌素治疗。纳入标准:1;继发于空心内脏穿孔的腹膜炎患者。2.患者年龄>18岁，<70岁。排除标准:1;腹膜炎继发于腹部外伤。2.如D&C等妇科干预后继发的腹膜炎。3.继发于恶性肿瘤和免疫低下状态的腹膜炎4。对头孢曲松、甲硝唑、阿米卡星过敏者。叔腹膜炎。结果:对140例患者术后并发症和住院时间减少的临床结果进行了评估，A组(使用头孢曲松和甲硝唑两种抗菌剂)和B组(使用头孢曲松、甲硝唑和阿米卡星三种抗菌剂)。B组患者术后并发症及住院时间明显减少，p值<0.05(0.007)，差异有统计学意义。有6人死亡，他们都有严重的腹膜炎，严重的污染和延迟到医院就诊。该研究还显示，男性是常见的影响和十二指肠溃疡穿孔是最常见的穿孔部位。大肠杆菌是分离出来的最常见的生物。结论:在我们的研究中，腹膜炎在男性中比女性更常见。腹膜炎最常见的年龄组为21 - 40岁，平均年龄为37岁。十二指肠溃疡穿孔是最常见的穿孔部位。大肠杆菌是腹膜液中最常见的分离菌。联合使用头孢曲松、甲硝唑和阿米卡星三种抗菌剂(p<0.05)比联合使用头孢曲松和甲硝唑两种抗菌剂在减少术后并发症和住院时间方面有统计学意义。
{"title":"“CLINICAL EFFICACY OF TWO ANTIMICROBIALS (CEFTRIAXONE AND METRONIDAZOLE) VERSUS THREE ANTIMICROBIALS ( CEFTRIAXONE , METRONIDAZOLE AND AMIKACIN )IN PERFORATIVE PERITONITIS","authors":"K. Reddy","doi":"10.15342/IJMS.V5IR.199","DOIUrl":"https://doi.org/10.15342/IJMS.V5IR.199","url":null,"abstract":"BACKGROUND : Peritonitis is classified as primary, secondary and tertiary. In primary peritonitis (spontaneous bacterial peritonitis) and continuous ambulatory peritoneal dialysis-associated peritonitis, the source of the infection is not due a breach in the gastrointestinal tract and usually caused by a single organism. Secondary peritonitis ensues, which may be localized and contained or diffuse carrying a high mortality in the absence of surgical intervention and appropriate antimicrobial therapy. Another sequelae of perforated viscus is intra-abdominal abscesses, located in the intra or retroperitoneal space, which occur in partially treated diffuse peritonitis, postoperatively or in localized disease where the omentum has sealed off the perforation and formed an inflammatory barrier. In contrast, secondary peritonitis following perforation of the gastrointestinal tract or an infection originating in an intra-abdominal structure, e.g. gall bladder, pancreas etc. Tertiary peritonitis is an ill-defined entity, which occurs despite adequate treatment of primary or secondary peritonitis. Combination antibiotic therapy has been used to provide the patient with broad-spectrum coverage against the many potential pathogens encountered in abdominal sepsis. Several potential benefits of the clinical use of antibiotic combinations have been advanced. So this study will be conducted to focus on the efficacy of combination of two versus three antimicrobial drug in the management of patients with perforated peritonitis. OBJECTIVES OF THE STUDY: 1.To assess the efficacy of two antimicrobials(Ceftriaxone And Metronidazole) in perforative peritonitis. 2.To assess the efficacy of three antimicrobials(Ceftriaxone, Metronidazole And Amikacin)in perforative peritonitis. 3.To compare the clinical outcome of perforative peritonitis with two and three antimicrobials in the terms of reduction in postoperative infections and hospital stay. MATERIALS AND METHODS SOURCE OF DATA: This is a prospective clinical study conducted on 140 consecutive patients who presented to the surgical department of R. L. Jalappa Hospital and Research Centre, Tamaka, Kolar with peritonitis secondary to hollow viscus perforation. Study period was from December 2015 to June 2017. This is a randomized study and all the patients were divided in two groups. GROUP A: Patients with all odd serial numbers were included in this group and treated with two antimicrobials (Inj Ceftriaxone 1gm IV BD and Inj Metronidazole 500mg IV TID). GROUP B: Patients with all even serial numbers were included in this group and treated with three antimicrobials(Inj Ceftriaxone 1gm IV BD , Inj Metronidazole 500mg IV TID and Inj Amikacin 500mg IV BD). INCLUSION CRITERIA : 1.Patients with peritonitis secondary to hollow viscus perforation. 2.Patients with age >18years an","PeriodicalId":259657,"journal":{"name":"International Journal of Medicine and Surgery","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133832417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Khalid Alharbi, Azzam Owayed Almutairi, A. Alshebromi, Abdullah Saeed Almufareh, Rabah Abdullah Alharbi, M. Alhajjaj, I. Alanazi, Abdullah Suleiman Alwehibi, Yazeed Ibrahim Alomar, A. AlMutairi, A. Alhumaid
Introduction: 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 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 post-operative 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 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 patients
{"title":"QUALITY OF LIFE POST SLEEVE GASTRECTOMY IN ALQASSIM REGION, SAUDI ARABIA","authors":"Khalid Alharbi, Azzam Owayed Almutairi, A. Alshebromi, Abdullah Saeed Almufareh, Rabah Abdullah Alharbi, M. Alhajjaj, I. Alanazi, Abdullah Suleiman Alwehibi, Yazeed Ibrahim Alomar, A. AlMutairi, A. Alhumaid","doi":"10.15342/IJMS.V5IR.191","DOIUrl":"https://doi.org/10.15342/IJMS.V5IR.191","url":null,"abstract":"Introduction: 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 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 post-operative 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 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 patients","PeriodicalId":259657,"journal":{"name":"International Journal of Medicine and Surgery","volume":"74 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124770383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Sbai, A. Eabdenbitsen, F. Elayoubi, M. R. Ghailan
Introduction 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 an 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. A 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.
{"title":"SQUAMOUS CELL CARCINOMA OF THE LOWER LIP ARISING IN DISCOID LUPUS LESION - A CASE REPORT","authors":"A. Sbai, A. Eabdenbitsen, F. Elayoubi, M. R. Ghailan","doi":"10.15342/IJMS.V5IR.196","DOIUrl":"https://doi.org/10.15342/IJMS.V5IR.196","url":null,"abstract":"Introduction 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 an 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. A 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.","PeriodicalId":259657,"journal":{"name":"International Journal of Medicine and Surgery","volume":"136 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116550323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The 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 pedagogy ; 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.
{"title":"Special Report from Deans Meeting - Pedagogy and Digital in Teaching Health Sciences in Morocco: Challenges and Opportunities","authors":"K. Bouti","doi":"10.15342/v5ir.218","DOIUrl":"https://doi.org/10.15342/v5ir.218","url":null,"abstract":"The 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 pedagogy ; 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.","PeriodicalId":259657,"journal":{"name":"International Journal of Medicine and Surgery","volume":"46 Suppl 1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114272882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Melanoma 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 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 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.
黑色素瘤是黑色素细胞的恶性肿瘤，是一种潜在的侵袭性癌症。在美国，黑色素瘤发病率的上升速度比任何其他癌症都要快。本研究的目的是研究1982-2011年间美国成年黑色素瘤患者诊断时的黑色素瘤阶段与生存率之间的关系。这是一项对1982-2011年间诊断为原发性皮肤黑色素瘤的185219名美国成年患者进行的非同期队列研究的二次分析。采用卡方、Kaplan-Meier和Cox比例风险回归对数据进行分析。采用p值和95%置信区间评估显著性。男性有更多的皮肤黑色素瘤。非西班牙裔黑人患者的诊断率较低。已婚或有同居关系的患者最有可能被确诊。远处黑色素瘤的校正HR是原位黑色素瘤的141倍(95% CI 126.38-157.19)。调整后的HR在诊断的前10年最高(1.7;95% ci 1.6 1.75)。总之，诊断时黑色素瘤的分期对生存率有很大影响。非西班牙裔黑人患者的风险比在所有种族中最低。样本量很大，这增强了对美国人口的普遍性。
{"title":"Relationship between Melanoma Stage at the Diagnosis and Survival During a period of 30 Years (1982-2011)","authors":"Talal M Alkhaldi, Sakhr Dawari, S. Aldaham","doi":"10.15342/IJMS.V5IR.190","DOIUrl":"https://doi.org/10.15342/IJMS.V5IR.190","url":null,"abstract":"Melanoma 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 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 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.","PeriodicalId":259657,"journal":{"name":"International Journal of Medicine and Surgery","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132654674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
N. Akasbi, A. E. Aissaoui, I. Yazghich, S. Fakir, T. Harzy
Introduction: 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.
{"title":"Interest of Ultrasound in the Exploration of Rotator Cuff Lesions - Confrontation of Clinical Examination and Ultrasound Finding","authors":"N. Akasbi, A. E. Aissaoui, I. Yazghich, S. Fakir, T. Harzy","doi":"10.15342/ijms.v5ir.219","DOIUrl":"https://doi.org/10.15342/ijms.v5ir.219","url":null,"abstract":"Introduction: 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.","PeriodicalId":259657,"journal":{"name":"International Journal of Medicine and Surgery","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122194065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Primary Sarcomas of the breast account for less than 1% of breast tumors. Leiomyosarcomas are less common. Only 51 cases have been reported in the literature, which only 4 cases in men. We present a new case of male breast leiomyosarcoma and discuss management and therapy of these unusual neoplasms. The confirmation of diagnosis was obtained by immunohistochemical study of surgical biopsy. The patient underwent a radical mastectomy and axillary lymphadenectomy. Adjuvant radiotherapy was indicated. Two years after surgery the patient is still in life without recurrence.
{"title":"Primary breast leiomyosarcoma in male - A case report","authors":"A. Arsalane, A. Zidane, S. Saadi, Y. Msougar","doi":"10.15342/IJMS.V4IR.166","DOIUrl":"https://doi.org/10.15342/IJMS.V4IR.166","url":null,"abstract":"Primary Sarcomas of the breast account for less than 1% of breast tumors. Leiomyosarcomas are less common. Only 51 cases have been reported in the literature, which only 4 cases in men. We present a new case of male breast leiomyosarcoma and discuss management and therapy of these unusual neoplasms. The confirmation of diagnosis was obtained by immunohistochemical study of surgical biopsy. The patient underwent a radical mastectomy and axillary lymphadenectomy. Adjuvant radiotherapy was indicated. Two years after surgery the patient is still in life without recurrence.","PeriodicalId":259657,"journal":{"name":"International Journal of Medicine and Surgery","volume":"15 5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124359344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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