Pub Date : 2021-06-30DOI: 10.46327/msrjg.1.000000000000202
H. Abid, Inssaf Akoch, M. Lahlali, N. Lahmidani, M. El Yousfi, D. Benajah, M. El Abkari, A. Ibrahimi
Introduction: Primary biliary cholangitis (PBC), the new dominance of primary biliary cirrhosis, is a cholestatic disease of autoimmune etiology and represents the leading cause of intra-hepatic cholestasis. Treatment is mainly based on ursodeoxycholic acid. The biological response to treatment is the main predictor of survival without liver transplantation. The Globe-score has been recently validated as the main prognostic factor. Materials and methods: This is a retrospective study carried out in our department collating all cases of PBC followed in consultation. The aim of our work is to research the predictors of poor response to UDCA. Results: 46 patients were collected. The mean age of the patients was 58.82 years, with a predominance of women (n = 43, 93.5%). 34.78% of patients were in the stage of cirrhosis. Anti-M2 mitochondria antibodies were positive in 44 patients (95.65%). An overlap syndrome was found in 11 patients (23.9%). Treatment was based on UDCA combined with corticosteroid therapy and immunosuppressant for overlap syndrome. A biochemical response at 1 year of treatment according to the Paris II criteria was found in 47.8%. The average value of the globe score was 1.35. A score greater than 0.30 was objectified in 20 cases (43.47%). Nineteen cirrhotic patients (41.30%) had a globe score> 0.30. Factors associated with poor response to therapy were: stage of decompensated cirrhosis, elevated pre-therapy total bilirubin greater than 30 g / l and hypoalbunemia less than 35 g / l. The study of the correlation between Globe score and Paris II showed a strong and significant association with a correlation coefficient estimated at 67%. The Paris II score was significantly correlated with the response to treatment (p = 0.001). Conclusion: In accordance with the data in the literature, the globe-score and Paris II are two similar predictive means for evaluating the response at 1 year of treatment in Moroccan context. Keywords: Morocco, Predictors of response, Primary biliary cholangitis, Ursodeoxycholic acid
{"title":"Primary Biliary Cholangitis: Predictors of Poor Response to Ursodeoxycholic Acid after 1 Year of Treatment in Moroccan Patients","authors":"H. Abid, Inssaf Akoch, M. Lahlali, N. Lahmidani, M. El Yousfi, D. Benajah, M. El Abkari, A. Ibrahimi","doi":"10.46327/msrjg.1.000000000000202","DOIUrl":"https://doi.org/10.46327/msrjg.1.000000000000202","url":null,"abstract":"Introduction: Primary biliary cholangitis (PBC), the new dominance of primary biliary cirrhosis, is a cholestatic disease of autoimmune etiology and represents the leading cause of intra-hepatic cholestasis. Treatment is mainly based on ursodeoxycholic acid. The biological response to treatment is the main predictor of survival without liver transplantation. The Globe-score has been recently validated as the main prognostic factor. Materials and methods: This is a retrospective study carried out in our department collating all cases of PBC followed in consultation. The aim of our work is to research the predictors of poor response to UDCA. Results: 46 patients were collected. The mean age of the patients was 58.82 years, with a predominance of women (n = 43, 93.5%). 34.78% of patients were in the stage of cirrhosis. Anti-M2 mitochondria antibodies were positive in 44 patients (95.65%). An overlap syndrome was found in 11 patients (23.9%). Treatment was based on UDCA combined with corticosteroid therapy and immunosuppressant for overlap syndrome. A biochemical response at 1 year of treatment according to the Paris II criteria was found in 47.8%. The average value of the globe score was 1.35. A score greater than 0.30 was objectified in 20 cases (43.47%). Nineteen cirrhotic patients (41.30%) had a globe score> 0.30. Factors associated with poor response to therapy were: stage of decompensated cirrhosis, elevated pre-therapy total bilirubin greater than 30 g / l and hypoalbunemia less than 35 g / l. The study of the correlation between Globe score and Paris II showed a strong and significant association with a correlation coefficient estimated at 67%. The Paris II score was significantly correlated with the response to treatment (p = 0.001). Conclusion: In accordance with the data in the literature, the globe-score and Paris II are two similar predictive means for evaluating the response at 1 year of treatment in Moroccan context.\u0000\u0000Keywords: Morocco, Predictors of response, Primary biliary cholangitis, Ursodeoxycholic acid","PeriodicalId":41186,"journal":{"name":"Journal of Medical and Surgical Research","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49101089","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}
Pub Date : 2021-06-30DOI: 10.46327/msrjg.1.000000000000197
L. Boualila, A. Souadka, Zaineb Benslimane, L. Amrani, A. Benkabbou, Mohsine Raouf, M. Majbar
Background and objective: The last randomized controlled trials ,the ACOSOG Z6051 1,2 and the ALaCaRT trial3, 4 could not show the non-inferiority of the laparoscopy in comparison to laparotomy for rectal cancer. In fact, the ten first years of practicing laparoscopy were years when surgeons developed their learning curve. Therefore, by excluding this learning bias, it is possible to end up with a more fair and correct comparison between the two techniques. It is henceforth relevant to pursue a new meta-analysis that compares the two techniques and excludes studies done during the earlier periods of laparoscopic rectal surgery. Results: Six randomized controlled trials met the eligibility criteria, involving a total of 1556 patients in the laparoscopy group and 1188 patients in the laparotomy group. Our meta-analysis was in favor of laparoscopy in a significant way for blood loss, first bowel movement and the number of harvested lymph nodes. It was non-significantly in favour of laparoscopy for 30-days mortality after surgery and length of hospital stay. It was significantly in favor of laparotomy for operative duration. No significant difference was found in anastomotic leakage) , reoperation within 30 days, number of positive CRMs and completeness of mesorectal excision between the two groups. No difference was found in recurrence, disease-free survival and overall survival between laparoscopy group and laparotomy group. Conclusion: The comparison of the randomized controlled trials published before and after 2010, showed no significant difference in outcomes between the learning period and after. Keywords: Laparoscopy, laparotomy, long-term outcomes, meta-analysis, short-term outcomes, rectal cancer
{"title":"Comparison of Short-Term and Long-Term outcomes of Laparoscopy Versus Laparotomy in Rectal Cancer: Systematic Review and Meta-analysis of Randomized Controlled Trials","authors":"L. Boualila, A. Souadka, Zaineb Benslimane, L. Amrani, A. Benkabbou, Mohsine Raouf, M. Majbar","doi":"10.46327/msrjg.1.000000000000197","DOIUrl":"https://doi.org/10.46327/msrjg.1.000000000000197","url":null,"abstract":"Background and objective: The last randomized controlled trials ,the ACOSOG Z6051 1,2 and the ALaCaRT trial3, 4 could not show the non-inferiority of the laparoscopy in comparison to laparotomy for rectal cancer. In fact, the ten first years of practicing laparoscopy were years when surgeons developed their learning curve. Therefore, by excluding this learning bias, it is possible to end up with a more fair and correct comparison between the two techniques. It is henceforth relevant to pursue a new meta-analysis that compares the two techniques and excludes studies done during the earlier periods of laparoscopic rectal surgery. Results: Six randomized controlled trials met the eligibility criteria, involving a total of 1556 patients in the laparoscopy group and 1188 patients in the laparotomy group. Our meta-analysis was in favor of laparoscopy in a significant way for blood loss, first bowel movement and the number of harvested lymph nodes. It was non-significantly in favour of laparoscopy for 30-days mortality after surgery and length of hospital stay. It was significantly in favor of laparotomy for operative duration. No significant difference was found in anastomotic leakage) , reoperation within 30 days, number of positive CRMs and completeness of mesorectal excision between the two groups. No difference was found in recurrence, disease-free survival and overall survival between laparoscopy group and laparotomy group. Conclusion: The comparison of the randomized controlled trials published before and after 2010, showed no significant difference in outcomes between the learning period and after.\u0000\u0000Keywords: Laparoscopy, laparotomy, long-term outcomes, meta-analysis, short-term outcomes, rectal cancer","PeriodicalId":41186,"journal":{"name":"Journal of Medical and Surgical Research","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48996545","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}
Pub Date : 2021-02-28DOI: 10.46327/msrjg.1.000000000000
A. Gojayev, Cemil Yuksel, O. Ersen, H. Celasin, Ali Ekrem Unal, S. Demirci
Introduction: Coronavirus disease 2019 (COVID-19) was declared to be a global pandemic by the World Health Organization on March 11, 2020. The impact on gastric cancer (GC) surgery is unknown. Various reports have shown data indicating that cancer patients with COVID-19 have high morbidity and mortality rates. The choice of surgical procedures and perioperative management of the patients with malignancy has become even more impor¬tant in the COVID-19 pandemic. In this study, we aimed to evaluate the effects of the COVID-19 pandemic on the preopartive, intraoperative, and postoperative findings of patients operated for gastric cancer in our clinic. Materials and Methods: We defined the ‘COVID-19’ period as occurring between 12-03-2020 and 31-08-2020. All the enrolled patients were divided into two groups, pre-COVID-19 group (Pre-CG; 64 cases) and COVID-19 group (CG; 39 cases). A total of 103 patients with gastric cancer were included in this study. Patient characteristics, preoperative, intraoperative, and postoperative clinicopathological findings were compared between groups. Results: The waiting times before admission increased in CG (Pre-CG [6.73±2.85] vs CG [20.61±5.16] ; p<0.001). After admission, the waiting time before surgery was longer in CG (Pre-CG [5.06±3.06] vs CG [6.89±3.32] ; p=0.006). No significant difference was detected between the groups in terms of operation time, surgical procedure, combine organ resection, intraoperative blood transfusion requirment (p values, respectively; p=0.108; p=0.951; p=0.204; p=0.597). Postoperative complications were oesophagojejunostomy leak (3/1) , atelectasis (2/2), duodenal leak (2/2), ileus (3/0), pleural effusion (2/2), and others (1/1), and there was no statistically significant difference between the two groups (p = 0.333). There was no significant difference between the two groups in terms of hospital stay (p = 0.086) and ICU stay (p = 0.989). Conclusion: In this study, it was seen that the COVID-19 pandemic did not affect morbidity and mortality in gastric cancer surgery, but it prolonged admission waiting and operation waiting times. Since there is very little data in the literature regarding the effect of COVID-19 on gastric cancer surgery, our study will guide future studies on this subject. Keywords: COVID-19, Impact, Gastric Cancer, Pandemics, Surgery
{"title":"The Impact of the COVID-19 Pandemic on Gastric Cancer Surgery: A Single-Center Study.","authors":"A. Gojayev, Cemil Yuksel, O. Ersen, H. Celasin, Ali Ekrem Unal, S. Demirci","doi":"10.46327/msrjg.1.000000000000","DOIUrl":"https://doi.org/10.46327/msrjg.1.000000000000","url":null,"abstract":"Introduction: Coronavirus disease 2019 (COVID-19) was declared to be a global pandemic by the World Health Organization on March 11, 2020. The impact on gastric cancer (GC) surgery is unknown. Various reports have shown data indicating that cancer patients with COVID-19 have high morbidity and mortality rates. The choice of surgical procedures and perioperative management of the patients with malignancy has become even more impor¬tant in the COVID-19 pandemic. In this study, we aimed to evaluate the effects of the COVID-19 pandemic on the preopartive, intraoperative, and postoperative findings of patients operated for gastric cancer in our clinic. Materials and Methods: We defined the ‘COVID-19’ period as occurring between 12-03-2020 and 31-08-2020. All the enrolled patients were divided into two groups, pre-COVID-19 group (Pre-CG; 64 cases) and COVID-19 group (CG; 39 cases). A total of 103 patients with gastric cancer were included in this study. Patient characteristics, preoperative, intraoperative, and postoperative clinicopathological findings were compared between groups. Results: The waiting times before admission increased in CG (Pre-CG [6.73±2.85] vs CG [20.61±5.16] ; p<0.001). After admission, the waiting time before surgery was longer in CG (Pre-CG [5.06±3.06] vs CG [6.89±3.32] ; p=0.006). No significant difference was detected between the groups in terms of operation time, surgical procedure, combine organ resection, intraoperative blood transfusion requirment (p values, respectively; p=0.108; p=0.951; p=0.204; p=0.597). Postoperative complications were oesophagojejunostomy leak (3/1) , atelectasis (2/2), duodenal leak (2/2), ileus (3/0), pleural effusion (2/2), and others (1/1), and there was no statistically significant difference between the two groups (p = 0.333). There was no significant difference between the two groups in terms of hospital stay (p = 0.086) and ICU stay (p = 0.989). Conclusion: In this study, it was seen that the COVID-19 pandemic did not affect morbidity and mortality in gastric cancer surgery, but it prolonged admission waiting and operation waiting times. Since there is very little data in the literature regarding the effect of COVID-19 on gastric cancer surgery, our study will guide future studies on this subject.\u0000\u0000Keywords: COVID-19, Impact, Gastric Cancer, Pandemics, Surgery","PeriodicalId":41186,"journal":{"name":"Journal of Medical and Surgical Research","volume":"1 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44715132","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}
Pub Date : 2021-02-28DOI: 10.46327/msrjg.1.000000000000196
M. H. Ismail, Loo Guo Hou, H. Haron, Mohd Ramzisham Abdul Rahman
Surgery has been the mainstay of treatment in managing patients with lung or pleural tumors. Surgery can be either a video-assisted or an open technique. Pre-operative investigation such as computed tomography (CT) scan of the thorax has been an important tool of assessment in deciding the approach of surgery. Traditionally, a tumor of more than 6 cm would necessitate an open approach. Herein, we would like to report a patient with a large solitary fibrous tumor of the pleura which was thoracoscopically excised and evacuated in an unconventional approach. Keywords: Solitary fibrous tumor, VATS, Pleura
{"title":"Solitary Fibrous Tumor of the Pleura: A Simple Solution with a Simple Technique","authors":"M. H. Ismail, Loo Guo Hou, H. Haron, Mohd Ramzisham Abdul Rahman","doi":"10.46327/msrjg.1.000000000000196","DOIUrl":"https://doi.org/10.46327/msrjg.1.000000000000196","url":null,"abstract":"Surgery has been the mainstay of treatment in managing patients with lung or pleural tumors. Surgery can be either a video-assisted or an open technique. Pre-operative investigation such as computed tomography (CT) scan of the thorax has been an important tool of assessment in deciding the approach of surgery. Traditionally, a tumor of more than 6 cm would necessitate an open approach. Herein, we would like to report a patient with a large solitary fibrous tumor of the pleura which was thoracoscopically excised and evacuated in an unconventional approach.\u0000\u0000Keywords: Solitary fibrous tumor, VATS, Pleura","PeriodicalId":41186,"journal":{"name":"Journal of Medical and Surgical Research","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47610746","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}
Pub Date : 2021-01-01DOI: 10.46327/msrjg.1.000000000000204
R. Sethi, A. Tripathi, D. Kotasthane
Background: In the year 2019 the National medical commission was ready to roll open its newly framed competency-based curriculum (CBME) and the colleges and medical universities were all geared up and trained to do the same. The tale began at a new pace with the academic session 2020 but was jolted soon by the spreading tentacles of COVID-19 pandemic. This disease made a drastic impact on education delivery system and the medical graduates were soon facing the challenge of not only revised curriculum but also the revised methodology of teaching. The present study compares the outcome of online education for students with CBME and with traditional variant of medical education. Material & Methods: A retrospective survey analysis questionnaire was created on google forms, on the basis of DREEM questionnaire [appendix 1]. The student's perspective was scored on Likert scale. The students were divided into study groups following traditional and CBME curriculum. The SPSS system was utilized to find the mean score of responses and student t-test and chi square tests were used. Results: The comparison of results for student's perception towards online education suggested statistically non-significant outputs between the genders but significant difference for study groups i.e. traditional vs. CBME curriculum. Conclusion: This survey highlighted that curating the new format of curriculum for delivery in an online format would produce better outputs and making availability of resources for use during online classes can increase the performance of students to be better aligned with graduate medical regulations.
{"title":"The Unprecedented times of Covid-19 Pandemic and the Online Medical Education: -a Survey Report","authors":"R. Sethi, A. Tripathi, D. Kotasthane","doi":"10.46327/msrjg.1.000000000000204","DOIUrl":"https://doi.org/10.46327/msrjg.1.000000000000204","url":null,"abstract":"Background: In the year 2019 the National medical commission was ready to roll open its newly framed competency-based curriculum (CBME) and the colleges and medical universities were all geared up and trained to do the same. The tale began at a new pace with the academic session 2020 but was jolted soon by the spreading tentacles of COVID-19 pandemic. This disease made a drastic impact on education delivery system and the medical graduates were soon facing the challenge of not only revised curriculum but also the revised methodology of teaching. The present study compares the outcome of online education for students with CBME and with traditional variant of medical education. Material & Methods: A retrospective survey analysis questionnaire was created on google forms, on the basis of DREEM questionnaire [appendix 1]. The student's perspective was scored on Likert scale. The students were divided into study groups following traditional and CBME curriculum. The SPSS system was utilized to find the mean score of responses and student t-test and chi square tests were used. Results: The comparison of results for student's perception towards online education suggested statistically non-significant outputs between the genders but significant difference for study groups i.e. traditional vs. CBME curriculum. Conclusion: This survey highlighted that curating the new format of curriculum for delivery in an online format would produce better outputs and making availability of resources for use during online classes can increase the performance of students to be better aligned with graduate medical regulations.","PeriodicalId":41186,"journal":{"name":"Journal of Medical and Surgical Research","volume":"8 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70492064","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}
Pub Date : 2021-01-01DOI: 10.46327/msrjg.1.000000000000190
B. Oneib, M. Hasnaoui
Background : This study aims to assess the psychological impact of the COVID-19 pandemic, in particular stress, depression, and Post-traumatic disorder, among health care workers in Oujda. Methods:We conducted a survey among 85 health care workers by using a google form questionnaire, during three months (from to). We assessed the work condition, fears, negative emotions, relationships, lifestyle, and coping of medical staff. We also evaluated stress, depression, and post- traumatic stress disorder through the Perceived Stress Scale (PSS), The World Health Organization- Five Well-Being Index (WHO-5), and Primary Care-Post Traumatic Disorder. Results: 65.8% work in front-line, and did between 4 to 15 shifts per month. 71.1% are in fear of COVID-19 infection. 97.6% are afraid to transmit the virus to relatives. More than two-thirds of responders describe negative feelings and exhaustion. 49.4% had a low level of well-being and probably depressed. 67% presented high perceived stress. Anxiety and depression were associated with fears, negative feelings, previous psychiatric disorder, poor sleep, and lack of family support. Conclusion: Our current study showed the high prevalence of depression and perceived stress among medical staff, hence the need to accompany and support all health workers. Keywords: COVID -19 impact; pandemic, Depression; Health care workers; Morocco. Perceived stress; style life.
{"title":"Psychological Impact of the COVID-19 Pandemic on Health Workers in Morocco: Results of a Cross Sectional Survey .","authors":"B. Oneib, M. Hasnaoui","doi":"10.46327/msrjg.1.000000000000190","DOIUrl":"https://doi.org/10.46327/msrjg.1.000000000000190","url":null,"abstract":"Background : This study aims to assess the psychological impact of the COVID-19 pandemic, in particular stress, depression, and Post-traumatic disorder, among health care workers in Oujda. Methods:We conducted a survey among 85 health care workers by using a google form questionnaire, during three months (from to). We assessed the work condition, fears, negative emotions, relationships, lifestyle, and coping of medical staff. We also evaluated stress, depression, and post- traumatic stress disorder through the Perceived Stress Scale (PSS), The World Health Organization- Five Well-Being Index (WHO-5), and Primary Care-Post Traumatic Disorder. Results: 65.8% work in front-line, and did between 4 to 15 shifts per month. 71.1% are in fear of COVID-19 infection. 97.6% are afraid to transmit the virus to relatives. More than two-thirds of responders describe negative feelings and exhaustion. 49.4% had a low level of well-being and probably depressed. 67% presented high perceived stress. Anxiety and depression were associated with fears, negative feelings, previous psychiatric disorder, poor sleep, and lack of family support. Conclusion: Our current study showed the high prevalence of depression and perceived stress among medical staff, hence the need to accompany and support all health workers. Keywords: COVID -19 impact; pandemic, Depression; Health care workers; Morocco. Perceived stress; style life.","PeriodicalId":41186,"journal":{"name":"Journal of Medical and Surgical Research","volume":"7 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70491835","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}
Pub Date : 2021-01-01DOI: 10.46327/msrjg.1.000000000000191
S. Touzani, Fatimazahra Haddari, A. Elbouazzaoui, Nawfal Houari, B. Boukatta, N. Kanjaa
Background: The vascular burden increased by COVID-19 infection and including acute limb ischemia (ALI) quickly emerged as a major medical challenge with devastating consequences such as limb loss, multiorgan dysfunction and death. We report a case series of COVID-19 infection associated with ALI to raise awareness and knowledge towards this life-threatening association. Methods: COVIDS-19 patients with acute limb ischemia (ALI) managed in a Moroccan 14 beds COVID-19 ICU between March 2020 and January 2021, were reviewed. Data collected included demographics, clinical presentation, treatments and outcomes. Results: Over the 10-month period, our ICU cared for 407 hospitalized patients with confirmed COVID-19. A total of 6 COVID-19 patients with ALI were identified. The mean age was 61 years (52 - 70) and 5 were men. The most common preexisting condition was diabetes (50%). The mean CRP level was 219 mg/L. Five patients had thrombus in multiple locations. No concomitant deep vein thrombosis was identified. Four patients presented with signs of acute arterial ischemia with or without respiratory symptoms and were subsequently diagnosed with COVID-19. The remaining two patients developed ischemia during hospitalization. Mean SOFA score was 5 (2 - 9). Respiratory support, corticosteroids and heparin therapies were used in all patients. Intubation and vasopressors were required in four patients. Revascularization was performed in five patients and reintervention was necessary in three cases. Four patients died in the ICU while two were successfully discharged. Conclusion: ALI in COVID-19 patients is a challenging life-threatening vascular emergency that requires appropriate multidisciplinary management (intensivists, anesthesiologists, vascular surgeons and interventionists, radiologists, haematologists.) and further studies focused on anticoagulation.
{"title":"Acute Limb Ischemia in Critically ill COVID-19 Patients: a Case Series and Literature Review","authors":"S. Touzani, Fatimazahra Haddari, A. Elbouazzaoui, Nawfal Houari, B. Boukatta, N. Kanjaa","doi":"10.46327/msrjg.1.000000000000191","DOIUrl":"https://doi.org/10.46327/msrjg.1.000000000000191","url":null,"abstract":"Background: The vascular burden increased by COVID-19 infection and including acute limb ischemia (ALI) quickly emerged as a major medical challenge with devastating consequences such as limb loss, multiorgan dysfunction and death. We report a case series of COVID-19 infection associated with ALI to raise awareness and knowledge towards this life-threatening association. Methods: COVIDS-19 patients with acute limb ischemia (ALI) managed in a Moroccan 14 beds COVID-19 ICU between March 2020 and January 2021, were reviewed. Data collected included demographics, clinical presentation, treatments and outcomes. Results: Over the 10-month period, our ICU cared for 407 hospitalized patients with confirmed COVID-19. A total of 6 COVID-19 patients with ALI were identified. The mean age was 61 years (52 - 70) and 5 were men. The most common preexisting condition was diabetes (50%). The mean CRP level was 219 mg/L. Five patients had thrombus in multiple locations. No concomitant deep vein thrombosis was identified. Four patients presented with signs of acute arterial ischemia with or without respiratory symptoms and were subsequently diagnosed with COVID-19. The remaining two patients developed ischemia during hospitalization. Mean SOFA score was 5 (2 - 9). Respiratory support, corticosteroids and heparin therapies were used in all patients. Intubation and vasopressors were required in four patients. Revascularization was performed in five patients and reintervention was necessary in three cases. Four patients died in the ICU while two were successfully discharged. Conclusion: ALI in COVID-19 patients is a challenging life-threatening vascular emergency that requires appropriate multidisciplinary management (intensivists, anesthesiologists, vascular surgeons and interventionists, radiologists, haematologists.) and further studies focused on anticoagulation.","PeriodicalId":41186,"journal":{"name":"Journal of Medical and Surgical Research","volume":"7 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70491974","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}
Pub Date : 2020-12-31DOI: 10.46327/MSRJG.1.000000000000176
J. Belkhadir, Mostafa Brahimi, H. Aguenaou, J. Heikel, Hicham El Berri, L. Belakhal, Fatima Gouaima Mazzi, K. Benabed
The analysis of the various reports of the epidemiological situation of obesity and diabetes in Morocco with in particular the reports of the WHO, the High Commission for Planning of Morocco (HCP) and the report of the American Mc Kinsey Study Bureau in 2014, shows a sharp increase in diabetes, obesity and their morbidity and mortality. With a Moroccan population of 35 million inhabitants in 2017, the number of people with diabetes (2.5 million), pre-diabetes (2.4 million), obesity (3.6 million), overweight (10 million including 63% of women and 16% of children) is alarming. The consequences in terms of morbidity and mortality and direct and indirect health costs through reduced productivity for the economy of Morocco and for society as a whole are very high. Total annual expenditure related to obesity amounts to $ 2.4 billion, or 3% of Morocco's GDP. The causes of this increase in obesity and diabetes are closely linked to profound changes in lifestyle: high-calorie diet rich in fast sugars, reduction in physical activity, etc. This is how it is demonstrated that too much consumption of sugary drinks is harmful to weight maintenance, metabolic balance and cardiovascular health. Conversely in many experiments around the world, the number of people with overweight and a risk of diabetes decreases significantly when the reduction of refined sugars is carried out by several preventive measures including increasing the tax on sodas, juices and other sugary drinks. The members of the Working Group who have been working together for several years in Morocco on the “Taxation of sweet products” within the framework of the Moroccan League for the Fight against Diabetes and the Moroccan Society of Nutrition, Health and Environment, have carried out multiple actions advocacy and sensitization with the government, the ministry of health, the parliament, the university, civil society and the media. The soda tax was finally adopted by the Moroccan Parliament in the 2019 finance bill. A first in the Middle East and North Africa region. In December 2019, a new acquisition was made during the discussion of the Finance Law Project (FLP) 2020 by the introduction of a progressive Internal Consumption Tax (ICT) on sugary drinks in proportion to their sugar concentration. The aim is to encourage manufacturers to reduce the sugar content of sugary drinks and energy drinks to avoid over-taxation. On the other hand, the support recently given in 2020 by the National Council of Human Rights of Morocco to this tax constitutes a very large acquisition, with a new institutional and socio-cultural dimension of human rights for the preservation health in Morocco. Members of the working group will continue their efforts to extend this tax to all products containing a significant amount of sugar. The same is true for other toxic products such as salt, fat and tobacco. Keywords: Diabetes, Obesity, Prevention, Tax soda, Morocco
{"title":"Taxation of Beverages and Sweetened Products in Morocco: A Major Achievement and a Model to Follow In the Mena Region.","authors":"J. Belkhadir, Mostafa Brahimi, H. Aguenaou, J. Heikel, Hicham El Berri, L. Belakhal, Fatima Gouaima Mazzi, K. Benabed","doi":"10.46327/MSRJG.1.000000000000176","DOIUrl":"https://doi.org/10.46327/MSRJG.1.000000000000176","url":null,"abstract":"The analysis of the various reports of the epidemiological situation of obesity and diabetes in Morocco with in particular the reports of the WHO, the High Commission for Planning of Morocco (HCP) and the report of the American Mc Kinsey Study Bureau in 2014, shows a sharp increase in diabetes, obesity and their morbidity and mortality.\u0000\u0000With a Moroccan population of 35 million inhabitants in 2017, the number of people with diabetes (2.5 million), pre-diabetes (2.4 million), obesity (3.6 million), overweight (10 million including 63% of women and 16% of children) is alarming. The consequences in terms of morbidity and mortality and direct and indirect health costs through reduced productivity for the economy of Morocco and for society as a whole are very high. Total annual expenditure related to obesity amounts to $ 2.4 billion, or 3% of Morocco's GDP.\u0000\u0000The causes of this increase in obesity and diabetes are closely linked to profound changes in lifestyle: high-calorie diet rich in fast sugars, reduction in physical activity, etc. This is how it is demonstrated that too much consumption of sugary drinks is harmful to weight maintenance, metabolic balance and cardiovascular health. Conversely in many experiments around the world, the number of people with overweight and a risk of diabetes decreases significantly when the reduction of refined sugars is carried out by several preventive measures including increasing the tax on sodas, juices and other sugary drinks.\u0000\u0000The members of the Working Group who have been working together for several years in Morocco on the “Taxation of sweet products” within the framework of the Moroccan League for the Fight against Diabetes and the Moroccan Society of Nutrition, Health and Environment, have carried out multiple actions advocacy and sensitization with the government, the ministry of health, the parliament, the university, civil society and the media.\u0000\u0000The soda tax was finally adopted by the Moroccan Parliament in the 2019 finance bill. A first in the Middle East and North Africa region. In December 2019, a new acquisition was made during the discussion of the Finance Law Project (FLP) 2020 by the introduction of a progressive Internal Consumption Tax (ICT) on sugary drinks in proportion to their sugar concentration. The aim is to encourage manufacturers to reduce the sugar content of sugary drinks and energy drinks to avoid over-taxation.\u0000\u0000On the other hand, the support recently given in 2020 by the National Council of Human Rights of Morocco to this tax constitutes a very large acquisition, with a new institutional and socio-cultural dimension of human rights for the preservation health in Morocco. Members of the working group will continue their efforts to extend this tax to all products containing a significant amount of sugar. The same is true for other toxic products such as salt, fat and tobacco.\u0000\u0000Keywords: Diabetes, Obesity, Prevention, Tax soda, Morocco","PeriodicalId":41186,"journal":{"name":"Journal of Medical and Surgical Research","volume":"1 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44969828","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}
Pub Date : 2020-06-30DOI: 10.46327/MSRJG.1.000000000000170
Y. Boujenane, S. Rostom, B. Amine, F. Allali, R. Bahiri
Introduction: The purpose of our study is to compare between physical activity (PA) in postmenopausal women with osteoporotic vertebral fractures and healthy women and to evaluate the relationship between PA and clinical and para clinical parameters related to osteoporotic fracture. Methods: A case-control crosssectional study, which included 128 postmenopausal women with densitometric osteoporosis as defined by Worlds Health Organization, with at least one radiological vertebral fracture. Physical activity was assessed by the International Physical Activity Questionnaire (IPAQ) short version with three items: vigorous, moderate activity and walking. Bone mineral density (BMD) and X-rays were performed in all patients. The controls were healthy women included in a randomized order in the general population, they were matched for age. Results: 128 patients with a mean age of 61.01± 8.40 years were included. 100 controls were included with a mean age of 60.61 ± 8.25 years. The patients had a median age of menopausal of 48.90 years [48-50], were osteoporotic in 49.2% and had osteopenia in 34.9%. 84 patients had a current back pain, and an average of three vertebral fracture with a median Genant score of 3.02[1-23]. There was no significant difference between the subjects of our study for total PA. However, vigorous-intensity activity and walking were significantly different between the two groups (p<0.05). Three independent factors were associated with a reduction of total physical activity: age, Genant score and physical function (for all p<0.05). In multivariate analysis, a significant association between total physical activity and age (p=0.003), trochanter BMD (p=0.01), Genant score (p=0.02) and physical function (2nd domain QUALEFFO) (p=0.01) persisted. Conclusion: In postmenopausal women with osteoporotic vertebral fractures, PA is decreased with the severity of vertebral fractures and with the increasing age.
{"title":"Evaluation of Physical Activity in Moroccan Postmenopausal Women with Osteoporotic Vertebral Fractures","authors":"Y. Boujenane, S. Rostom, B. Amine, F. Allali, R. Bahiri","doi":"10.46327/MSRJG.1.000000000000170","DOIUrl":"https://doi.org/10.46327/MSRJG.1.000000000000170","url":null,"abstract":"Introduction: The purpose of our study is to compare between physical activity (PA) in postmenopausal women with osteoporotic vertebral fractures and healthy women and to evaluate the relationship between PA and clinical and para clinical parameters related to osteoporotic fracture. Methods: A case-control crosssectional study, which included 128 postmenopausal women with densitometric osteoporosis as defined by Worlds Health Organization, with at least one radiological vertebral fracture. Physical activity was assessed by the International Physical Activity Questionnaire (IPAQ) short version with three items: vigorous, moderate activity and walking. Bone mineral density (BMD) and X-rays were performed in all patients. The controls were healthy women included in a randomized order in the general population, they were matched for age. Results: 128 patients with a mean age of 61.01± 8.40 years were included. 100 controls were included with a mean age of 60.61 ± 8.25 years. The patients had a median age of menopausal of 48.90 years [48-50], were osteoporotic in 49.2% and had osteopenia in 34.9%. 84 patients had a current back pain, and an average of three vertebral fracture with a median Genant score of 3.02[1-23]. There was no significant difference between the subjects of our study for total PA. However, vigorous-intensity activity and walking were significantly different between the two groups (p<0.05). Three independent factors were associated with a reduction of total physical activity: age, Genant score and physical function (for all p<0.05). In multivariate analysis, a significant association between total physical activity and age (p=0.003), trochanter BMD (p=0.01), Genant score (p=0.02) and physical function (2nd domain QUALEFFO) (p=0.01) persisted. Conclusion: In postmenopausal women with osteoporotic vertebral fractures, PA is decreased with the severity of vertebral fractures and with the increasing age.","PeriodicalId":41186,"journal":{"name":"Journal of Medical and Surgical Research","volume":"1 1","pages":"770-777"},"PeriodicalIF":0.2,"publicationDate":"2020-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44849087","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}
Pub Date : 2020-06-30DOI: 10.46327/MSRJG.1.000000000000173
A. Idowu, Damilola Akinola Olawuyi, Chioma Olive Nwadioke
The novel Covid-19 pandemic has caused disruption of several activities globally It has resulted in lockdown of economic activities in most countries including Nigeria The effects of the pandemic and the associated lockdown on the mental health status of Nigerian students have not taken into perspective in the control efforts This study was conducted to assess the burden of the psychological problems associated with COVID-19 pandemic and coping strategies among students at Bowen University, Iwo (BUI), Nigeria A cross-sectional survey was conducted, and multi-stage sampling technique employed to recruit 433 eligible respondents Validated online self-administered, semi-structured questionnaire was used to collect relevant information from respondents Appropriate summary statistics were carried out, and Binary logistic regression model was developed to examine protective/riskfactors of decreased mental wellbeing among the respondents Mean age of the respondents was 20 11 +/- 2 9 years, almost three-quarter (72 7%) of them were females In all, 55 0% of the respondents had decreased psychological wellbeing because of the lockdown Protective factors against decreased mental wellbeing included online catting with friends/watching films (OR=0 22, 95%CI=1 37-3 59), and participating in online vocational training (OR=0 25, 95%CI=0 25-0 61) The odds of decreased mental wellbeing was significantly higher in students who indicated a need for substance use as coping strategy(OR=1 50, 95%CI=0 55-4 05), and those who were not satisfied with online teaching method (OR=5 34, 95%CI=4 13-9 18) The mental health impacts of COVID-19 on the Nigerian students is huge Thus, psychological wellbeing of the Nigerian students should be taken into cognizance and prioritized in the post-COVID-19 national rebuilding strategies
{"title":"Impacts of CoVID-19 Pandemic on the Psychological Well Being of Students in a Nigerian University","authors":"A. Idowu, Damilola Akinola Olawuyi, Chioma Olive Nwadioke","doi":"10.46327/MSRJG.1.000000000000173","DOIUrl":"https://doi.org/10.46327/MSRJG.1.000000000000173","url":null,"abstract":"The novel Covid-19 pandemic has caused disruption of several activities globally It has resulted in lockdown of economic activities in most countries including Nigeria The effects of the pandemic and the associated lockdown on the mental health status of Nigerian students have not taken into perspective in the control efforts This study was conducted to assess the burden of the psychological problems associated with COVID-19 pandemic and coping strategies among students at Bowen University, Iwo (BUI), Nigeria A cross-sectional survey was conducted, and multi-stage sampling technique employed to recruit 433 eligible respondents Validated online self-administered, semi-structured questionnaire was used to collect relevant information from respondents Appropriate summary statistics were carried out, and Binary logistic regression model was developed to examine protective/riskfactors of decreased mental wellbeing among the respondents Mean age of the respondents was 20 11 +/- 2 9 years, almost three-quarter (72 7%) of them were females In all, 55 0% of the respondents had decreased psychological wellbeing because of the lockdown Protective factors against decreased mental wellbeing included online catting with friends/watching films (OR=0 22, 95%CI=1 37-3 59), and participating in online vocational training (OR=0 25, 95%CI=0 25-0 61) The odds of decreased mental wellbeing was significantly higher in students who indicated a need for substance use as coping strategy(OR=1 50, 95%CI=0 55-4 05), and those who were not satisfied with online teaching method (OR=5 34, 95%CI=4 13-9 18) The mental health impacts of COVID-19 on the Nigerian students is huge Thus, psychological wellbeing of the Nigerian students should be taken into cognizance and prioritized in the post-COVID-19 national rebuilding strategies","PeriodicalId":41186,"journal":{"name":"Journal of Medical and Surgical Research","volume":"7 1","pages":"798-806"},"PeriodicalIF":0.2,"publicationDate":"2020-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43539275","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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