Renal Profile of Patients with Cardiorenal Syndrome: Nephrology and Cardiology Department Experience of the University Hospital IBN SINA of Rabat

Introduction: Cardio-renal syndrome (CRS) is a complex pathophysiological entity affecting the heart and kidneys in which acute or chronic dysfunction of one organ can induce acute or chronic dysfunction of the other organ. Five types of CRS have been described. Methods: The study explored the prevalence and types of Cardiorenal Syndrome (CRS) at CHU Ibn Sina in Rabat. Over a year, 120 CRS patients were assessed, excluding those with end-stage chronic renal failure. We analyzed the epidemiological, clinical, therapeutic and evolutionary profile of these patients. Results: The average age of our patients is 67.8 ± 12 years, with extremes ranging from 39 years to 92 years. The sex ratio is 1.35. The different types of CRS types (1, 2, 4 and 5) were noted respectively in 28.4%, 20.8%, 5%, 45.8%, however, we did not note patients having CRS type 3. On the renal level, we noted acute renal failure (ARF) in 51.6% of patients, of whom 61.3% had functional ARF and 38.7% presented with acute tubular necrosis. Chronic renal failure (CRF) is found in 48.4% of cases, of which 39% are at stage III and 61% are at stage IV. The etiology of CKD is dominated by hypertensive nephropathy (72.4%) followed by diabetic nephropathy (60.3%). Therapeutically diuretics are administered in 51% of our patients. We used hemodialysis in 9.1% of patients who are resistant to diuretics. Vasoactive drugs are used in 9.5% of our patients. Mortality risk factors for patients with CRS are significantly related to advanced age, long hospital stay, type 1 CRS, re-hospitalization, acute pulmonary edema (APE), use of hemodialysis, right heart failure (RHF), valvulopathy and hemodynamic instability (OR = 1.15, p = 0.01;OR = 4.5, p = 0.03;OR = 5.2, p = 0.019;p Conclusion: CRS type 5 was most common, with hypertension and diabetes being primary causes of Chronic Kidney Disease. Mortality factors were linked to acute pulmonary edema, hemodialysis, right heart failure, valvulopathy, and re-hospitalization.

Quantum correlations and entanglement in coupled optomechanical resonators with photon hopping via Gaussian interferometric power analysis

Quantum correlations that surpass entanglement are of great importance in the realms of quantum information processing and quantum computation.Essentially,for quantum systems prepared in pure states,it is difficult to differentiate between quantum entanglement and quantum correlation.Nonetheless,this indistinguishability is no longer holds for mixed states.To contribute to a better understanding of this differentiation,we have explored a simple model for both generating and measuring these quantum correlations.Our study concerns two macroscopic mechanical resonators placed in separate Fabry–Pérot cavities,coupled through the photon hopping process.this system offers a comprehensively way to investigate and quantify quantum correlations beyond entanglement between these mechanical modes.The key ingredient in analyzing quantum correlation in this system is the global covariance matrix.It forms the basis for computing two essential metrics:the logarithmic negativity(E_(N)^(m))and the Gaussian interferometric power(P_(G)^(m)).These metrics provide the tools to measure the degree of quantum entanglement and quantum correlations,respectively.Our study reveals that the Gaussian interferometric power(P_(G)^(m))proves to be a more suitable metric for characterizing quantum correlations among the mechanical modes in an optomechanical quantum system,particularly in scenarios featuring resilient photon hopping.

Optimized sequential therapy vs 10- and 14-d concomitant therapy for eradicating Helicobacter pylori: A randomized clinical trial

BACKGROUND A cure for Helicobacter pylori(H.pylori)remains a problem of global concern.The prevalence of antimicrobial resistance is widely rising and becoming a challenging issue worldwide.Optimizing sequential therapy seems to be one of the most attractive strategies in terms of efficacy,tolerability and cost.The most common sequential therapy consists of a dual therapy[proton-pump inhibitors(PPIs)and amoxicillin]for the first period(5 to 7 d),followed by a triple therapy for the second period(PPI,clarithromycin and metronidazole).PPIs play a key role in maintaining a gastric pH at a level that allows an optimal efficacy of antibiotics,hence the idea of using new generation molecules.This open-label prospective study randomized 328 patients with confirmed H.pylori infection into three groups(1:1:1):The first group received quadruple therapy consisting of twice-daily(bid)omeprazole 20 mg,amoxicillin 1 g,clarith-romycin 500 mg and metronidazole 500 mg for 10 d(QT-10),the second group received a 14 d quadruple therapy following the same regimen(QT-14),and the third group received an optimized sequential therapy consisting of bid rabe-prazole 20 mg plus amoxicillin 1 g for 7 d,followed by bid rabeprazole 20 mg,clarithromycin 500 mg and metronidazole 500 mg for the next 7 d(OST-14).AEs were recorded throughout the study,and the H.pylori eradication rate was determined 4 to 6 wk after the end of treatment,using the 13C urea breath test.RESULTS In the intention-to-treat and per-protocol analysis,the eradication rate was higher in the OST-14 group compared to the QT-10 group:(93.5%,85.5%P=0.04)and(96.2%,89.5%P=0.03)respectively.However,there was no statist-ically significant difference in eradication rates between the OST-14 and QT-14 groups:(93.5%,91.8%P=0.34)and(96.2%,94.4%P=0.35),respectively.The overall incidence of AEs was significantly lower in the OST-14 group(P=0.01).Furthermore,OST-14 was the most cost-effective among the three groups.CONCLUSION The optimized 14-d sequential therapy is a safe and effective alternative.Its eradication rate is comparable to that of the 14-d concomitant therapy while causing fewer AEs and allowing a gain in terms of cost.

Thermo-Physical Potential of Recycled Banana Fibers for Improving the Thermal and Mechanical Properties of Biosourced Gypsum-Based Materials

The development of bio-sourced materials is essential to ensuring sustainable construction;it is considered a locomotive of the green economy.Furthermore,it is an abundant material in our country,to which very little attention is being given.This work aims to valorize the waste of the trunks of banana trees to be used in construction.Firstly,the physicochemical properties of the fiber,such as the percentage of crystallization and its morphology,have been determined by X-ray diffraction tests and scanning electron microscopy to confirm the potential and the impact of the mode of drying on the quality of the banana fibers,with the purpose to promote the use of this material in construction.Secondly,the results obtained with the gypsum matrix allowed us to note a preponderant improvement in the composite’s thermal properties thanks to the variation of the banana fiber additive.Thirdly,the impact of the nature of the banana fiber distribution(either fiber mixed in matrix or fiber series model)on the flexural and compressive strengths of the composites was studied.The results obtained indicate that the insulation gain reaches up to 40%.It depends on the volume fraction and type of distribution of the banana fibers.However,the thermal inertia of the composites developed,represented by thermal diffusivity and thermal effusivity,was studied.Results indicate a gain of 40%and 25%,respectively,in terms of thermal diffusivity and thermal effusivity of the developed composites compared to plaster alone.Concerning the mechanical properties,the flexural strength depends on the percentage of the volume fraction of banana fibers used,and it can reach 20%more than the flexural strength of plaster;nevertheless,there is a significant loss in terms of the compressive strength of the studied composites.The results obtained are confirmed by the microstructure of the fiber banana.In fact,the morphology of the banana fibers was improved by the drying process.It reduces the amorphous area and improves the cellulosic crystalline surfaces,which assures good adhesion between the fiber and the matrix plaster.Finally,the dimensionless coefficient analysis was done to judge the optimal proportion of the banana fiber additive and to recommend its use even on false ceilings or walls.

Prognostic Factors in Cardiorenal Syndrome Type 1: Retrospective Observational and Analytical Study

Introduction: Type 1 cardiorenal syndrome (CRS 1) is characterized by acute impairment of cardiac function leading to acute renal dysfunction. CRS1 is present in 25% of patients admitted for heart failure. The objective of our study is to analyze the epidemiological, clinical, therapeutic profile and the risk and prognostic factors of these patients. Materials and Methods: We identified 120 patients with cardiorenal syndrome (CRS) over a one-year period to determine the prevalence and risk factors for developing CRS 1. We analyzed the clinical, biological, and evolutionary profiles of patients with CRS 1 and determined the risk factors for the occurrence of acute kidney injury (AKI) as well as the mortality factors in these patients. Résultats: The average age of our patients with CRS1 is 58 ± 9 years, with a sex ratio of 1.4. The average eGFR of our patients is 35 ± 6.5 ml/min/1.73m2. Diabetes was found in 17% of our patients and hypertension in 14%. The etiology of cardiac impairment is predominantly acute coronary syndrome (ACS), followed by rhythm disorders. Renally, all our patients have acute kidney injury (AKI), with 86% having functional acute renal failure and 14% having acute tubular necrosis. Therapeutically, 50% of our patients are on diuretics, 42% receive beta-blocker treatment, and RAAS blockers are used in 29% of cases. Renal replacement therapy (RRT) sessions were required in 13.8% of cases. In univariate analysis, male gender, tachyarrhythmia, and hypertension are associated with the early onset of acute kidney injury (AKI). The use of diuretics, anemia, and low left ventricular ejection fraction (LVEF) are linked to a higher risk of developing CRS 1 (p = 0.021, p = 0.037, p = 0.010 respectively). In multivariate analysis, advanced age is significantly associated with increased mortality risk in CRS 1 patients (p = 0.030), while beta-blocker use is considered a protective factor (p = 0.014). Conclusion: Our study identifies several key factors associated with outcomes in type 1 CRS. Male gender, tachyarrhythmia, and hypertension are linked to early-onset AKI. The use of diuretics and the presence of anemia increase the risk of developing CRS1. Advanced age is significantly associated with higher mortality rates. Conversely, the use of beta-blockers appears to be protective in this patient population. .

Secondary Hyperparathyroidism in Dialysis Patients: Short- and Long-Term Outcomes of Conservative Parathyroidectomy

Secondary hyperparathyroidism (HPT) is frequent in dialysis patients. Parathyroidectomy (PTX) is indicated for patients who failed medical therapy. We reviewed the data from 184 dialysis patients who underwent PTX between January 2015 and January 2023. We aimed to evaluate the short and long term outcomes of PTX in dialysis patients, comparing the conservative 3/4 versus 7/8 techniques in this population.166 dialysis patients with secondary HPT were included. A conservative subtotal PTX (sPTX) 7/8 was performed in 72% of patients and sPTX 3/4 in 28% of them. Severe postoperative hypocalcaemiaocurred in 45 patients (27%). Hypocalcaemia was significantly more frequent in the sPTX 7/8 group (p = 0.012). One case of persistent HPT (0.6%) and 20 cases of recurrence (12%) were diagnosed. Recurrence was more frequent in the sPTX 3/4 group (15%). No deaths were reported during the perioperative period.

Autosomal Dominant Polycystic Kidney Disease: Epidemiological, Clinical Aspects and Predictive Factors of Poor Renal Prognosis (About 300 Cases)

Introduction: Autosomal dominant polycystic kidney disease (ADPKD) is a common, multisystemic, and progressive hereditary disease. It accounts for 6 to 8% of incident cases of end-stage chronic renal disease (ESRD) in developed countries. The aim of this study is to describe the predictive factors for the development of end-stage chronic kidney disease (CKD) in the course of this disease. Material and Methods: This is a retrospective, descriptive, and analytical study including 300 cases of ADPKD collected at the Nephrology Department of Ibn-Sina Hospital in Rabat over a period of 30 years (1993 to 2023). Included in the study are all patients with ADPKD meeting the ultrasound diagnostic criteria. The analysis focused on demographic, clinical, paraclinical, evolutionary data, as well as prognostic factors associated with renal function deterioration. Results: The mean age of patients at diagnosis is 51.53 +/− 17 years [16 - 93] with a male predominance. The median serum creatinine at diagnosis is 15.5 mg/l [10 - 34]. 21% of patients had ESRD (eGFR 300 mg/24h (21%). The most common cystic complication is hemorrhage (12.3%). 21.3% of patients had hepatorenal polycystic disease. In adjusted analysis, the predictive risk factors for the occurrence of ESRD were smoking (p = 0.019), anemia (p Conclusion: ADPKD can progress insidiously to ESRD. Identification and early treatment of predictive factors for poor renal prognosis could contribute to a better outcome for this disease.

Effect of No Tillage and Conventional Tillage on Wheat Grain Yield Variability: A Review

Conservation Agriculture(CA)covers more than 205 million hectares in the world.This made it possible to face and mitigate the challenges of climate change,reducing soil erosion and providing multiple ecosystem services.The first elementary factor influenced is the yield evaluation.It has a direct effect on farmers’choices for sustainable production.The present article records a review focused on wheat yield average positive change compared between conventional tillage(CT)and no tillage(NT)systems.The international database collected showed that NT is adaptable everywhere.The results of wheat yield differentiation showed the influence of crop rotation depending on stations located in different climatic zones.In more than 40 years of research,specialists have succeeded in demonstrating the importance of crop productivity like wheat.The whole integrates also experimentations where the initiation starts more than ten years.

De Novo Glomerular Diseases after COVID-19 Vaccination: Consequence or Coincidence?

Introduction: Vaccination against COVID-19 has proven highly effective in preventing severe forms of the disease. However, the literature reports several cases associating renal damage and the anti-COVID vaccine. The aim of our work was to report a case series of patients who developed glomerulopathy after anti-COVID-19 vaccine. We evaluated the type of vaccine, the clinico-biological profile, and the anatomopathological, therapeutic and evolutionary aspects. Material and Methods: Prospective descriptive study conducted at the Nephrology Department of CHU IbnSina in Rabat between December 2021 and June 2022 including 9 patients who presented with glomerulopathy after the 1st dose of anti-COVID-19 vaccine. We excluded patients followed for nephropathy. Results: The mean age of our patients was 33 ± 16 years with a sex ratio of 0.8. Six patients received an inactivated vaccine, 2 patients received a mRNA vaccine and 1 patient received a viral vector vaccine. The mean delay between the onset of signs and the date of the first vaccine dose was 3.1 +/? 0.65 months (1 - 6 months). All patients had a nephrotic syndrome, 2 pure and 7 impure: 3 patients had acute renal failure and microscopic hematuria, 2 patients had microscopic hematuria and 2 patients had acute renal failure. Histologically, focal segmental glomerulosclerosis (FSGS) was noted in 4 patients, lupus nephropathy in 3, and membranous nephropathy (MN) in 2. Specific treatment was administered to each patient, depending on the histological type of renal involvement and the context. After 6 months, complete remission was achieved in 5 patients, with no improvement in 2, and one patient was placed on hemodialysis. One patient died of another cause. Conclusion: The causal link between anti-COVID 19 vaccination and renal disease is highly probable, but remains to be confirmed.

Bilateral Avascular Necrosis of the Femoral Head in Renal Transplant Recipient: A Case Report

Osteoarticular complications are common after renal transplantation. The complications may result from the bone condition prior to transplantation or the iatrogenic effects of the treatments administered. These complications lead to significant morbidity and mortality, in addition to chronic pain and functional impairment. We report the clinical case of bilateral avascular necrosis (AVN) of the femoral head in a kidney transplant recipient. Clinical Case: 53-year-old male with a history of chronic hypertension. He underwent chronic hemodialysis for 12 months and was treated with Entecavir for chronic hepatitis B. The patient received a kidney transplant from a non-related living donor. Induction therapy included Thymoglobulin along with tapered corticosteroids, reaching a dose of 5 mg/day after 3 months, Mycophenolate mofetil (2 g/day), and Tacrolimus adjusted based on residual levels. There was good recovery of renal graft function. After six months, the patient reported bilateral hip pain and functional impairment of both lower limbs. Pelvic X-rays showed signs suggestive of bilateral AVN of the femoral heads. The diagnosis was confirmed by MRI. The patient underwent right hip drilling and total left hip replacement (THR). A right THR was performed a year later. Conclusion: AVN constitutes a frequent cause of morbidity and mortality after RT. The pathophysiology of osteonecrosis remains complex and multifactorial. We emphasize the importance of conducting a thorough assessment of bone health in patients both before and after RT.

Renal Vein Thrombosis Suggestive of Extramembranous Glomerulonephritis Associated with Sjögren’s Syndrome (Case Report)

Introduction: Glomerular damage during Gougerot-Sjgren syndrome is much rarer than interstitial damage, and is essentially extra-membranous and membrano-proliferative glomerulonephritis. Observation: We report the case of a 44-year-old woman with primary Sjgrens syndrome, confirmed by clinical dryness syndrome, positive anti-SSA and anti-SSB antibodies, and a salivary gland biopsy revealing grade 4 lymphocytic sialadenitis according to CHISHOLMs classification. Later, the patient developed nephrotic syndrome, along with hypertension. Renal function remained normal with a creatinine level of 9.3 mg/l, and hematuria was absent. Only antinuclear antibodies tested positive, while anti-PLA2R antibodies were negative. A renal biopsy was performed, which was complicated on the same day by hemodynamic instability with hematuria. Renal CT scan with contrast injection revealed a posterior perirenal hematoma without contrast extravasation. Additionally, bilateral renal vein thrombosis was incidentally discovered, suggesting extramembranous glomerulonephritis. The patients hemodynamic status stabilized after fluid resuscitation with isotonic saline solution (0.9%), without the need for blood transfusion. Renal biopsy confirmed extramembranous glomerulonephritis with interstitial fibrosis and minimal tubular atrophy. The initial etiological assessment was negative. The patient was started on oral corticosteroids, angiotensin-converting enzyme inhibitors, and therapeutic anticoagulation for renal vein thrombosis. The patients condition improved, with the disappearance of the syndrome and spontaneous regression of the hematoma. Discussion: The association of nephrotic syndrome and renal vein thrombosis primarily suggests glomerulopathy, in particular extra-membranous glomerulonephritis. Sjgrens syndrome can be associated with extra-membranous glomerulonephritis without being its direct cause. Like, it is possible that it is a cause of glomerulonephritis, essentially extra membranous and membrano-proliferative. Conclusion: Sjgrens syndrome is generally underestimated cause of glomerulonephritis, which should be considered in cases of extra-membranous glomerulonephritis.

Infective Endocarditis in Chronic Hemodialysis Patients: Specificities and Therapeutic Management

Infective endocarditis (IE) is a frequent complication in chronic hemodialysis patients (CHD). The repeated placement and manipulation of central venous catheters, underlying valvulopathies, and immunosuppression are the main predisposing factors for these patients to develop IE. We aimed to highlight the clinical and microbiological specificities of IE in CHD patients, detail the therapeutic management in these patients and identify the risk factors for in-hospital mortality. We included 28 CHD patients in whom the diagnosis of IE was established according to modified Duke criteria. The mean age was 47 ± 17 years. Among them, 57% were hypertensive and 39% were diabetic. The average duration of hemodialysis was 3.5 ± 7 years. The vascular access was a tunnelled jugular catheter, arteriovenous fistula, and temporary catheter in 54%, 28%, and 18% of patients, respectively. Half of the patients presented with heart failure at admission. Methicillin-sensitive Staphylococcus is the most commonly implicated pathogen. Transthoracic echocardiography revealed vegetation in all patients. In 60% of cases, the lesion is located on the mitral valve, and in 35% it is on the tricuspid valve. Patients initially received empirical antibiotic therapy, which was adjusted according to bacteriological results. Valve surgery was indicated in 12 patients, with aortic valve replacement being the most performed procedure followed by tricuspid annuloplasty. The in-hospital mortality rate was 32%. Factors associated with mortality were severe mitral insufficiency (p = 0.036), heart failure (p = 0.043), and the presence of Methicillin-resistant Staphylococcus in blood cultures (p = 0.047). IE is a complication with high morbidity and mortality. Its increasing incidence, specificities in chronic CHD patients, and the complexity of its management require a rigorous preventive strategy. A multidisciplinary collaboration between nephrologists, infectious disease specialists, cardiologists, and surgeons is crucial to optimize therapeutic management.

Antioxidant,antimicrobial,and α-glucosidase inhibitory activities of saponin extracts from walnut(Juglans regia L.) leaves

Objective:To investigate the relationship between triterpenoid saponin content and antioxidant,antimicrobial,and α-glucosidase inhibitory activities of 70%ethanolic,butanolic,aqueous,supernate and precipitate extracts of Juglans regia leaves.Methods:Triterpenoid saponins of different Juglans regia leaf extracts were measured by the vanillin method.Antioxidant activity was evaluated against DPPH and ABTS free radicals.We also assessed α-glucosidase inhibitory and antimicrobial activities of the leaf extracts.Pearson’s correlation coefficient was evaluated to determine the correlation between the saponin content and biological activities.Results:The butanolic extract was most effective against DPPH with an IC50of 6.63μg/mL,while the aqueous extract showed the highest scavenging activity against ABTS free radical with an IC50of 42.27μg/mL.Pearson’s correlation analysis indicated a strong negative correlation (r=-0.956) between DPPH radical scavenging activity (IC50) and the saponin content in the samples examined.In addition,the aqueous extract showed the best α-glucosidase inhibitory activity compared with other extracts.All the extracts had fair antibacterial activity against Bacillus subtilis,Escherichia coli,and Klebsiella pneumoniae except for the aqueous extract.Conclusions:Juglans regia extracts show potent antioxidant,antimicrobial,and α-glucosidase inhibitory activities.There is a correlation between saponin levels in Juglans regia leaf extracts and the studied activities.However,additional research is required to establish these relationships by identifying the specific saponin molecules responsible for these activities and elucidating their mechanisms of action.

Impacts of anisotropy coefficient and porosity on the thermal conductivity and P-wave velocity of calcarenites used as building materials of historical monuments in Morocco

It is essential to study the porosity,thermal conductivity,and P-wave velocity of calcarenites,as well as the anisotropy coefficients of the thermal conductivity and P-wave velocity,for civil engineering,and conservation and restoration of historical monuments.This study focuses on measuring the thermal conductivity using the thermal conductivity scanning(TCS)technique and measuring the P-wave ve-locity using portable equipment.This was applied for some dry and saturated calcarenite samples in the horizontal and vertical directions(parallel and perpendicular to the bedding plane,respectively).The calcarenites were selected from some historical monuments in Morocco.These physical properties were measured in the laboratory to find a reliable relationship between all of these properties.As a result of the statistical analysis of the obtained data,excellent linear relationships were observed between the porosity and both the thermal conductivity and porosity.These relationships are characterized by relatively high coefficients of determination for the horizontal and vertical samples.Based on the thermal conductivity and P-wave velocity values in these two directions,the anisotropy coefficients of these two properties were calculated.The internal structure and the pore fabric of the calcarenite samples were delineated using scanning electron microscopy(SEM),while their chemical and mineral compositions were studied using the energy dispersive X-ray analysis(EDXA)and X-ray diffraction(XRD)techniques.

A Seismic Facies Analysis to Determine the Relative Age and History of the Al Idrissi Mud Volcano from Offshore Larache Located in the NW Moroccan Atlantic Margin

Formed on top of the Gulf of Cadiz, the Al Idrissi mud volcano is the shallowest and largest mud volcano in the El Arraiche mud volcano field of the northwestern Moroccan margin. The development and morphology of mud volcanoes from the El Arraiche mud volcanoes group have been studied at a large scale. However, the time interval related to their formation period still needs to be better understood. In this regard, we interpreted and analyzed the seismic facies from the 2D reflection data of the GEOMARGEN-1 campaign, which took place in 2011. The aim was to identify the seismic sequences and draw the Al Idrissi mud volcano system to determine the formation period of the Al Idriss mud volcano. And as a result, the Al Idrissi mud volcano system is made of both buried and superficial bicone and was identified along with the Upper Tortonian to Messinian-Upper Pliocene facies. As the initial mud volcano extrusive edifice, the buried bicone was formed in the Late-Messinian to Early-Pliocene period. However, the superficial bicone, as the final extrusive edifice, was included in the Late Pliocene. In this case, the timing interval between the buried and superficial bicone is equivalent to the Late-Messinian to Upper-Pliocene period. Therefore, the latter corresponds to the Al Idrissi mud volcano formation period.

Renal Involvement in Sarcoidosis

Introduction: Sarcoidosis is a granulomatous systemic disease. Renal damage is rare but it can evolve to chronic renal failure (CRF). The aim of our work is to describe the clinical, paraclinical, histological and evolutionary profile of renal involvement during sarcoidosis and to identify the progression factors leading to CRF. Materials and Methods: This is a retrospective descriptive study from January 2009 to December 2022. We collected the medical records of patients with sarcoidosis and renal involvement. To study the progression factors leading to CRF we identified two groups of patients: the group with normal renal function and the group that developed CRF. Results: We included in our study 17 patients with renal sarcoidosis. Their mean age was 45 ± 14.7 years and the sex ratio was 0.4. Renal involvement is revealing of sarcoidosis in 76% of cases. Renal failure was diagnosed in 88% of patients. Proteinuria was positive in 76.5% of cases, leukocyturia in 59% of patients and hematuria in 41% of patients. Renal biopsy was performed in 15 patients showing tubulointerstitial nephropathy in all biopsies. Epithelioid and gigan-to-cellular granuloma without caseous necrosis was found in 46% of cases. Associated glomerular involvement such as segmental and focal hyalinosis was found in 2 patients. Corticosteroid therapy was initiated in 88% of patients for a median duration of 15 months. Normalization of renal function was achieved in 41% of patients, while 59%, i.e. 10 patients, retained a CRF, including 2 who were on dialysis. We showed a statistically significant relationship between the evolution towards CRF and the presence of interstitial fibrosis > 25%. Conclusion: Despite its rarity, renal involvement can be revealing of sarcoidosis, which can condition the prognosis and lead to CRF. Its detection allows an early diagnosis and treatment.

Mortality Related to COVID-19 in Acute Renal Injury Patients: A Cohort Study

Introduction: The coronavirus, SARS-CoV-2, is the pathogen responsible for an acute respiratory distress syndrome that broke out in the Wuhan region and became a pandemic in early 2020. The clinical presentation of COVID-19 is polymorphic, dominated by respiratory symptoms and may be associated with cardiovascular, digestive and renal complications. The prognosis depends mainly on the patient’s condition. Acute kidney injury (AKI) during severe SARS CoV-2 infection is frequent, multifactorial and associated with excess mortality. Its pathophysiology has not been fully elucidated, and seems to involve both direct and indirect mechanisms. The aim of our work is to describe the epidemiological, clinical, paraclinical and therapeutic profile of patients presenting with AKI and confirmed COVID-19 disease, and determine the prognostic factors associated with death. Material and Methods: This was a retrospective study conducted at IBN SINA Hospital, Rabat, between March 2020 and November 2021. We included patients with confirmed SARS-CoV-2 infection who developed AKI either on admission or during hospitalization. Results: We enrolled 95 patients with a mean age of 68 ± 13 years and a M/F sex ratio of 1.9. Diabetes was present in 33.7% of cases and hypertension in 32.6%. Most patients had influenzalike illness, lymphopenia and hyperferritinemia. Median creatinine on admission was 32 mg/l [17 - 64]. Temporary catheter hemodialysis was used in 21% of cases, with hyperkalemia for purification and ultrafiltration. There were 63 deaths, it was statically significantly related (p Conclusion: AKI in COVID-19 is multifactorial, and may be secondary to sepsis, hemodynamic failure or direct viral toxicity to the kidney. In our study, mortality was secondary to viral toxicity, clinical presentation, intensive care unit management and recourse to hemodialysis.

Systemic Capillary Leak Syndrome Secondary to COVID-19 Infection: Case Report

Introduction: Systemic capillary leak syndrome (SCLS) is an increasingly recognized rare syndrome. Its diagnosis is suggested by the occurrence of edema with arterial hypotension, hemoconcentration, and paradoxical hypoalbuminemia. SCLS can be idiopathic (Clarkson syndrome) or secondary. Secondary SCLS (SSCLS) is mainly triggered by infections (especially viruses), drugs (antitumor therapy), malignancies, and inflammatory diseases. We report a case of systemic capillary leak syndrome secondary to the COVID-19 infection. Observation: A 74-year-old chronic smoker with no particular history was initially admitted to the intensive care unit (ICU) with a picture of respiratory distress secondary to a COVID-19 infection with favorable evolution, hence his transfer to the emergency services. On Day 8 of hospitalization, following the installation of arterial hypotension, not responding to filling, associated with hypoalbuminemia, and generalized edematous syndrome, and in the absence of any other explanation for this clinical picture, a SCLS secondary to COVID-19 infection was suggested. On the balance sheet, after the discovery of acute renal failure, serum creatinine went from 7.9 mg/l to 16.6 mg/l with microalbuminuria at 420 mg/24h and leukocyturia at 20 elements/mm3 without germ-evoked tubulointerstitial nephritis (TIN) secondary to a viral infection with COVID-19. The evolution was marked by the spontaneous regression of the edema and the normalization of the blood pressure figures. Discussion: The classic triad combining hypotension, hemoconcentration, and hypoalbuminemia suggests the diagnosis of SCLS once all other causes of shock have been ruled out. Hemoconcentration is less constant in SSCLS than in ISCLS. This is the case with our patient. The exact pathophysiological process of SCLS is largely unknown. Viral infections are the most common infectious cause of SCLS. The kidneys are the second-most common organs affected by the SARS-Cov-2 coronavirus infection. The presence of nephritis can be used as an indicator of SCLS, which can be a predictor of serious complications such as fluid overload, respiratory failure, and the need for ICU admission. Conclusion: In the event of COVID-19 infection, the appearance of hypotension and hypoalbuminemia with the gradual onset of generalized edema should suggest SCLS. The establishment of close monitoring is mandatory, given the risk of fatal evolution. Fortunately, for our patient, the evolution was favorable.

Processes for the Clarification of the Crude Oil of Baobab Seeds Extracted by Pressing on Activated Carbon Elaborated from the Capsules of the Fruit (Adansonia digitata L.)

The baobab, Adansonia digitata L. plays an important role in the economy of local populations. The oil from the seeds of the baobab fruit is nowadays highly prized because of its numerous cosmetic and therapeutic applications and its composition of unsaturated fatty acids, sterols and tocopherols. However, unlike refined oils, locally extracted baobab oil has not undergone purification operations to ensure its quality. Only a filtration on special cloths is carried out after decantation. Indeed, the oil obtained after pressing is cloudy because of the presence of various impurities. It therefore requires treatment operations to make it more attractive and of higher quality. Therefore, in order to provide innovative solutions to local companies to improve the quality of vegetable oils, a study of clarification (treatment) of crude oil is necessary. An experimental device has been developed in the laboratory. It includes a glass column and a filter bed of dune sand and activated carbon. This study has shown the efficiency of the experimental device. Indeed, the activated carbon, thanks to its adsorbing power, has allowed a significant decrease in turbidity at the 5% threshold, from 14.61 NTU for the raw oil to 0.08 NTU for the oil filtered on 3% carbon and 0.033 NTU for the oil filtered on 5% carbon. That is to say an abatement higher than 95%. This decrease in turbidity could be correlated with the decrease in brown index from 187.39a for the initial crude oil to 128.53d for the oil treated with 3% activated carbon versus 187.59a for the oil filtered on cloths. The lowest brown index was observed with the filtration using 5% activated carbon (35.99b). Thus, for the yellowness index, only the filtration on 5% charcoal allowed to obtain a significant decrease in yellowness. The yellowing index of the oil with 5% was 44.67b against 79.04a for the oil filtered with 3% activated carbon, 86.33a for the crude oil and 86.46a for the oil filtered on cloths. Finally, the oil sample treated with 5% activated carbon had the clearest clarity than the other samples with a clarity (L) equal to 97.98c against 95.63d for the oil treated with 3% carbon and 94.99b for the oil filtered on filter cloths. According to the results obtained, the experimental device made it possible to obtain a clearer baobab oil with a low brown index, thus improving the sensory quality of the oil.

A Huge Metastatic Liver of a Neuroendocrin Tumor Explored by SPECT/CT with 99mTc-Tektrotyd: A Case Report

Background: Colorectal neuroendocrine tumors are rare and have a heterogeneous clinical representation and variable prognosis. High grade neuroendocrine tumors (NETs) are characterized by destructive and aggressive growth, followed by rapid spread. For this purpose, SPECT/CT with 99mTc-Tektrotyd is very useful for imaging and staging of NETs. Case Report: A 50-year-old man with a huge metastatic liver from an unknown neuroendocrine tumor (NET). SPECT/CT with 99mTc-Tektrotyd was performed in this patient, it showed a huge metastatic hepatomegaly compressing neighboring organs with bone metastases, and also revealed the primary colon tumor. Discussion and Conclusion: In recent decades, the incidence and prevalence of neuroendocrine tumors (NETs), especially those of the colorectal segments, have been increasing. 99mTc-EDDA/HYNIC-TOC (Tektrotyd?) was introduced into the market and its use has been approved for scintigraphic imaging of patients with NETs and other SSTR-positive tumors. It provides in vivo metabolic data related to the over-expression of Somatostatin Receptors (SSTRs) and also predicts response to peptide receptor radionuclide therapy (PRRT).