Knowledge towards Physical Medicine and Rehabilitation among Training Doctors and Medical Students at the Mohammed VI University Hospital of Marrakech

The aim of our study is to evaluate the knowledge regarding physical medicine and rehabilitation among physicians in training and medical students at the Mohammed VI University Hospital in Marrakech, to approach the knowledge, attitudes, and practices of doctors regarding physical medicine and rehabilitation and evaluate the knowledge in theoretical training related to PRM among the students. We conducted a monocentric cross-sectional analytical study, using a web-based anonymous survey, carried out among 558 undergraduate student and training doctors, randomly selected in the form of a survey on the knowledge towards Physical Medicine and rehabilitation. We received 558 survey duly completed by students of the Faculty of Medicine and Pharmacy of Marrakech (62.4%) and training doctors (37.6%). The mean age of the participants was 24.53 ± 3.9 years, with extremes ranging from 17 to 39 years. 52.7% of the participants were from the former educational reform, The predominance of participation was remarkable among pediatricians 23%, The population who knew PRM was the majority (79.3%), 40.7% of the participants were unaware of the availability of a PRM department at Mohamed VI University Hospital, 0.5% of all training doctors and medical students questioned strongly agreed with the sufficiency of their training in disability management were belonging to the new reform, 84.1% of participants had never attended or referred a patient to the PRM department. 23.2% of training doctors affirmed the referral of patients to PRM for further management. Despite the essential role of PRM in the management of diseases, it remains little known by training doctors and medical students. This lack of knowledge of PRM reflects the lack of the undergraduate and postgraduate of the medical education in the field of rehabilitation.

Sacrococcygeal Teratoma a Rare Tumor in Children: Case Report

Sacrococcygeal teratomas (SCTs) are uncommon congenital tumors that typically develop in newborns, they are rarely associated with chromosomal abnormalities or other congenital anomalies. The majority of pediatric teratomas are benign in the neonatal age group, but the risk of malignancy increases with age. Diagnosis is based on a combination of clinical, radiological, and hormonal findings, but confirmed by anatomopathological study. Treatment is primarily surgical, with the aim of achieving complete resection to prevent recurrence. We present the case of a 22-month-old child who was admitted for management of a sacrococcygeal mass and was diagnosed with an immature teratoma.

Wave propagation of a functionally graded plate via integral variables with a hyperbolic arcsine function

Several studies on functionally graded materials(FGMs)have been done by researchers,but few studies have dealt with the impact of the modification of the properties of materials with regard to the functional propagation of the waves in plates.This work aims to explore the effects of changing compositional characteristics and the volume fraction of the constituent of plate materials regarding the wave propagation response of thick plates of FGM.This model is based on a higher-order theory and a new displacement field with four unknowns that introduce indeterminate integral variables with a hyperbolic arcsine function.The FGM plate is assumed to consist of a mixture of metal and ceramic,and its properties change depending on the power functions of the thickness of the plate,such as linear,quadratic,cubic,and inverse quadratic.By utilizing Hamilton’s principle,general formulae of the wave propagation were obtained to establish wave modes and phase velocity curves of the wave propagation in a functionally graded plate,including the effects of changing compositional characteristics of materials.

A Typical Case of Classic Potter’s Syndrome: A Case Report

Potter syndrome is a rare congenital malformation that primarily affects male fetuses;it is characterized by pulmonary hypoplasia, skeletal malformation, and kidney abnormalities. The pressure of the uterine wall due to oligohydramnios leads to an unusual facial appearance, abnormal limbs in abnormal positions, or contractures. The fetus generally dies soon after birth due to respiratory insufficiency. The baby was a live preterm male, born to a 30-year-old multigravida, out of a non-consanguineous marriage via cesarean section. There was no liquor at the time of delivery. The baby did not cry immediately after birth and required resuscitation, followed by mechanical ventilation. Multiple congenital anomalies suggestive of Potter’s syndrome were noted including facial features, flattened nose, low protruding ear, retrognathism, and epicanthal folds with unilateral atresia of the choana. Chest X-ray showed small volume lung fields suggestive of pulmonary hypoplasia, and we had on ultrasonography bilateral polycystic kidney disease on ultrasonography. At 42 hours of life, the baby developed tachypnea and severe chest retractions and died due to respiratory insufficiency. Our case highlights the importance of regular prenatal checks and examinations in each pregnancy, which helps to collect suspected cases and improve knowledge of this syndrome for better management.

Macrophage Activation Syndrome as the Primary Presentation of Pediatric Systemic Lupus Erythematosus: A Case Report and Review of the Literature

Macrophage activation syndrome (MAS), in its secondary form, often complicates rheumatic diseases but rarely constitutes a mode of revelation. Systemic lupus erythematosus (SLE) is a systemic autoimmune disease of unknown etiology that primarily affects women in adulthood. MAS is a serious condition that may be the first presentation of SLE. Here, we report the case of a 4-year-old female with MAS as the primary manifestation of Systemic Lupus Erythematosus (SLE). In this case, we outline the characteristics of a complex case of SLE that was initially accompanied with MAS, and also review the literature to discuss the clinical, biological, and therapeutic aspects of this condition.

Fasting and Cancer: Practice and Patients’ Quality of Life during Ramadan

Introduction: Ramadan is the ninth lunar month of the Muslim calendar, and fasting during Ramadan is one of the five pillars of Islam. Muslim cancer patients and health professionals are faced with a dilemma between the necessity of fasting and its possible adverse effects during Ramadan on the health status of cancer patients. We believe that addressing the issue of fasting in cancer patients is of global interest. Objectives: Prevalence of fasting in cancer patients during Ramadan;Predictive factors of Ramadan fasting in cancer patients;The effect of fasting during Ramadan on the quality of life of cancer patients. Materials and Methods: A structured questionnaire was used to interview adult cancer patients who received chemotherapy IV—or oral treatment at the medical oncology department at the Hassan II University Hospital in Fez during the month of Ramadan 1443 Hijri (April to May 2022). The quality of cancer patients’ lives during their fasting practice in Ramadan was evaluated via the QLQ-C30 questionnaires. Results: 48% of patients did not fast during Ramadan, 22% and 30% were partial and complete fasters respectively. Patients, with OMS 0 to 1, who receive outpatient treatment, non-metastatic patients and patients on oral treatment were more frequent in the completely fasted group. All these factors showed statistically significant values (p < 0.05). 44% of patients sought advice from the treating oncologist if they could fast, while only 15% of patients during Ramadan asked an imam if they could be excused from fasting. A comparison of the QLQ-C30 data showed a significant improvement in emotional functioning with fasting, however, patients had clinically more but not significantly fatigue after fasting. Conclusion: Female gender, good WHO, non-metastatic disease, and oral or outpatient treatment were more likely to be fasting. This study argues that fasting did not influence the quality of life, and appears to significantly improve emotional functioning in cancer patients during Ramadan.

Impact of the COVID-19 Pandemic on Cancer Patients: Experience of the medical oncology department of CHU HASSAN II Fez.

Introduction: In December 2019, COVID 19 spread worldwide, but did not officially start in MOROCCO until March 02, 2020. Since then, this pandemic has significantly impacted the health status of patients in general and cancer patients in particular. The main objective of our study is to evaluate the prognosis of patients treated for cancer and infected with COVID-19. Material and method: A descriptive study with prospective collection was carried out at the medical oncology department of CHU Hassan II in FEZ over a period of two years, from March 2020 to March 2022. Data was carried out on the software SPSS. Results: One hundred cancer patients tested positive for COVID-19 infection and were collected within our department. The average age was 56 years [22-91]. The sex ratio was 1.2. Patients with breast cancer were the most affected by this infection (34%). The clinical symptomatology was dominated by the respiratory syndrome (45%).The diagnosis was made through thoracic CT scan in 62% of cases. 76% of patients were in a metastatic stage. 96% of patients were undergoing oncological treatment. For symptomatique patients, the standard treatment approach involved using antibiotics in 76% of cases. Evolution was marked by recovery in 79% of patients, with a death rate of 12% in this cancer patient population. Conclusion: COVID-19 infection is particularly severe in cancer patients. Mortality among these patients remains high and is associated with overall patient characteristics. However, anticancer treatments have not shown deleterious effects on the course of COVID-19.

Urinary Tract Infection in Pediatric Emergency Department of Mohamed VI Hospital in Marrakech: Epidemiological Profile and Antibiotic Resistance

Background: Urinary tract infection (UTI) is one of the most frequent bacterial infections in pediatrics. The aim of our work was to establish the epidemiological and bacteriological profile of UTIs in children and then to study the sensitivity of the bacterial strains isolated to antibiotics. Materials and methods: This is a retrospective descriptive study over 3 years (2019-2022), including all cytobacteriological examination of urine (CBEU), performed in children aged 3 months to 14 years, admitted and treated for UTI, in the pediatric emergency department of Mohamed VI University Hospital. Results: A total of 239 children were included in our study. The mean age was 26 months. The sex ratio was 1.08. Escherichia coli was the most isolated bacterial strain in 79% of samples. The tested strains showed a high level of sensitivity to susceptibility rate toward amikacin (91%) and ciprofloxacin (100%) and whereas the level of resistance was high to the most current recommended antibiotics, mainly beta-lactams. Management was based, in severe forms of pyelonephritis, dual antibiotic therapy based on Third-generation cephalosporins combined with gentamycin. Favorable outcome was noted in 94% of children. Conclusion: Awareness-raising on the proper use of antibiotics, issuing national recommendations for the treatment of urinary tract infections in order to standardize therapeutic regimens is strongly recommended. Effective control of these infections requires a global prevention strategy that implies close collaboration between epidemiologists, clinicians, bacteriologists, hygienists and the health care team.

Viral Hepatitis B during Chronic Inflammatory Bowel Diseases at Fez University Hospital: Prevalence and Risk Factors

Patients with chronic inflammatory bowel diseases (IBD) have long been considered at risk for viral hepatitis B. However, recent epidemiological studies have found similar prevalence, or even lower than in the general population. The objective of this work is to determine the prevalence of viral hepatitis B (HVB) during IBD, to determine the risk factors in the service of Hepato-gastroenterology of university hospital Hassan II-Fez, and of evaluate the impact on therapeutic management. PATIENTS AND METHODS: This is a retrospective study, spread over a period of 17 years and a half (January 2001-June 2017). All patients treated for IBD who are tested for Hbs Ag and anti Hbcwere included. The HVB DNA levels were tested in case of positivity of HbsAgor anti Hbc. Results: Over the study period, 755 patients were included. The average age of our patients was 35 years [14 - 87] with a sex-ratio H/F of 0.67. We had 391 cases (51.8%) of Crohn’s disease (CD) and 364 cases (48.2%) of ulcerative colitis (UC). Anti HBctest was positive in 1.98% of cases (N = 15). In these patients, HBsAg was positive in 1.19% of cases (N = 9). The prevalence of HVB was 2.55% in CD (N = 10) versus 1.37% in UC (N = 5). In our work, no history of surgery, digestive endoscopy or transfusion has been shown to be a risk factor for viral transmission. CONCLUSION: The prevalence of HVB in IBD is similar to that of the general population. The safety of blood transfusions and the improvement of asepsis probably explain these results. However, the risk of viral reactivation during HVB, sometimes fatal under immunosuppressive treatment, requires systematic screening.

Evaluation of Impacts of Sea Level Rise on the Coast of Mohammedia(Morocco):Land at Risk of Flooding and Socioeconomic Impacts

One of the significant consequences of the climate change predicted for the next decades is the sea and ocean level rise.The coastal zone of Mohammedia (Morocco),a site of significant socio-economic activeties largely open to the Atlantic Ocean,is thus confronted with hydrodynamic agents and a possible sea level rise,whose impacts will result in an immersion of the low topography areas。

Hbs antigen, what prevalence among pregnant women in Morocco? Preliminary results of a prospective study conducted in Hospital University Hassan II, Fez

The chronic viral hepatitis B is a public health problem and remains a global challenge with 350 million carriers of HBs antigen (HBsAg). The prevalence of HBsAg varies from one country or continent to another. In France, it is estimated to be 0.5%. In Morocco, the data are rare but some studies have estimated the prevalence to be 2.5%. Our aim is to estimate the prevalence of HBsAg among women who have recently given birth at the maternity CHU Hassan II of Morocco Fez, and to describe the epidemiological profile and risk factors for infection. In pregnancy, infection with hepatitis B virus (HBV) is dominated by the risk of mother to child transmission (vertical transmission), which can be avoided by serovaccination of the newborn. The search for HBsAg should be performed in all pregnant women.

Portal Vein Thrombosis in Non Cirrhotic Patients: Experience of Gastroenterology and Hepatology Department University Hospital Hassan II

Portal thrombosis (PT) is a rare condition of heterogeneous etiologies. The aim of our work is to study the epidemiological and etiological profile of portal thrombosis in non cirrhotic patients through the experience of our department. Patients and Methods: This is a retrospective study over a 9-year period (January 2009-July 2018), 54 cases of PT in non cirrhotic patients were collected in the department of Hepato-Gastro-Enterology of the HASSAN II Fez Hospital, 73 cases of PT were excluded among cirrhotic patients. Results: We collected 54 cases of PT cases;the average age was 45 years, with an F/M ratio of 1.42. PT was revealed by abdominal pain in 20 cases, complications of portal hypertension in 24 cases, and ultrasound discovery in 10 asymptomatic cases. Main underlying causes of PT were: A proteine S deficiency in 7 cases, Acute pancreatitis in 5 cases, colonic cancer in 4 cases, pancreatic cancer in 4 cases, Hydatic liver Echinococcoses (3 cases), anti phospholipid syndrom (3 cases), myeloproliferative syndrom (2 cases) and jak mutation 2 in 1 case, non identified etiology was reported in 20 cases (37%). Treatment was based on anticoagulation, treatment of portal hypertension complications, and etiological treatment in cases where etiological diagnosis was certainly posed. Conclusion: PT is a rare but serious condition, according to our study neoplastic causes are predominant followed by protein S deficiency. Etiological investigations have to be wide and early treatment is the best option to avoid extension and complication.

The Alternative Therapeutic in Pediatric Cancer: What We Know?

Scientific research has brought about enormous national advancements in cancer management. Currently, Morocco provides several therapeutic tools for cancer, among them chemotherapy, surgery and radiotherapy. In Morocco, there is not enough published data on the use of alternative medicine in pediatric oncology. Owing to the increased interest and lack of data on this practice, we conducted this study. It aims to evaluate the uptake, the types of therapies used, the factors influencing, the reasons for this choice and the cost of AM used by patients. An investigation through a questionnaire was carried out on thirty-four children following for cancer within the pediatric hematology and oncology department (PHO) of Marrakech. The survey was conducted over a period of one month and a half between July 25 and September 5, 2022. Data were collected through a questionnaire. From the medical files, we collected data regarding type of cancer, date of admission to PHO department and the treatment received. We asked about the type of AM used: herbs, honey, spiritual AM, zamzam water (water from a “sacred” source in Mecca). Using alternative therapies is a common practice in pediatric oncology with various reasons, among them, the declining socioeconomic level, the diversity, the cultural background, the psychological and the functional status of patients and sometimes the dissatisfaction with conventional medicine.

Thermoelectric generators and their applications:Progress,challenges,and future prospects

Our community currently deals with issues such as rising electricity costs,pollution,and global warming.Scientists work to improve energy harvesting-based power generators in order to reduce their impacts.The Seebeck effect has been used to illustrate the capacity of thermoelectric generators(TEGs)to directly convert thermal energy to electrical energy.They are also ecologically beneficial since they do not include chemical products,function quietly because they lack mechanical structures and/or moving components,and may be built using different fabrication technologies such as three-dimentional(3D)printing,silicon technology,and screen printing,etc.TEGs are also position-independent and have a long operational lifetime.TEGs can be integrated into bulk and flexible devices.This review gives further investigation of TEGs,beginning with a full discussion of their operating principle,kinds,materials utilized,figure of merit,and improvement approaches,which include various thermoelectric material arrangements and utilised technologies.This paper also discusses the use of TEGs in a variety of disciplines such as automobile and biomedical.

Insights into the oxidation resistance mechanism and tribological behaviors of multilayered TiSiN/CrVxN hard coatings

In the last decades,vanadium alloyed coatings have been introduced as potential candidates for self-lubrication due to their perfect tribological properties.In this work,the influence of V incorporation on the wear performance and oxidation resistance of TiSiN/CrN film coatings deposited by direct current(DC)reactive magnetron sputtering is investigated.The results show that vanadium incorporation significantly decreases the oxidation resistance of the coatings.In general,two layers are formed during the oxidation process:i)Ti(V)O_(2) on top,followed by a protective layer,which is subdivided into two layers,Cr_(2)O_(3) and Si-O.ii)The diffusion of V controls the oxidation of V-containing coatings.The addition of vanadium improves the wear resistance of coatings,and the wear rate decreases with increasing V content in the coatings;however,the friction coefficient is independent of the chemical composition of the coatings.The wear of the V-containing coatings is driven by polishing wear.

Osteoid Osteoma of the Second Metatarsal: An Exceptional Localization and Unusual Clinical Features

Osteoid osteoma of the foot can be difficult to diagnose, the clinical presentation may be mimicking other local pathologies leading to a considerable delay in diagnosis. We report an exceptional localization of osteoid osteoma in the second metatarsal in a 30-year-old patient, expressed for 3 years by metatarsalgia, with no clinical and radiological architecture defect of the foot. After discovering the nidus, the patient underwent surgical excision with an excellent outcome.

Exploration and Mapping of Metalliferous Black Shales in the Saghro Temporary Subsidence Zones (Anti-Atlas, Morocco)

The Saghro massif constitutes a vast metallogenic province with numerous deposits and shows of base metals (lead, zinc, copper) and precious metals (gold and silver), besides various useful substances (talc, pyrophyllite, barite, fluorite). Silver/lead occurrences are concentrated along the Cryogenian Imiter series and moderately at Boumalne and Sidi Flah. Copper occupies the plutonic intrusions and intrusive rocks of the East-Central Saghro while barite deposits are widespread throughout the Cambrian cover of the East Saghro in contact with the Ediacaran basement. To justify this distribution, the new contributions of the cartography and the organic geochemistry of the black shales of Jbel Saghro have clearly shown the particularity of the Imiter black shales in terms of the richness in organic matter (TOC = 0.18%), the blackish color and the friability. The Boumalne and Sidi Flah groups present some similarities with the Imiter group, such as the sub-equatorial structuring, the friable pelites and the richness in organic matter (Boumalne TOC = 0.11% and SidiFlah TOC = 0.16%), which is a quite good show that requires to reinforce the exploration works. For Western Saghro in the Iknioun and Qalaa’t M’Gouna groups, the variations in the thickness of the volcanic cover show an irregular paleotopography with hard, greenish, organic-poor pelitic sediments (TOC = 0.01 to 0.04%). We can conclude that the formation of Imiter-type silver concentrations requires the combination of the sedimentological, the volcanic and structural factors. For Imiter-type silver these factors are: a fine pelitic and argillic casing deposited in a confined environment, a basic volcanism source of metals and other intermediate to acid generated by the hydrothermalism and heat, a convenable paleotopography and a network of fracturations to trap the mineralizations.

Alobar Holoprosencephaly in a Neonate: A Rare Case Report and Review of the Literature

Holoprosencephaly (HPE) is a rare brain malformation with multiple etiologies and is often associated with suggestive facial anomalies. This pathology is the result of a defect in the early development of the forebrain. There are three clinical forms: lobar, semi-lobar, alobar and another milder subtype of HPE called middle interhemispheric. In this clinical case, we present a newborn with alobar holoprosencephaly and we highlight the clinical, radiological and progressive clinical aspects of this illness during the neonatal period.

Factor VII Deficiency: A Rare Cause of Severe Bleeding Disorder in a Newborn

Factor VII deficiency is rare. It is an autosomal recessive inherited disease with an estimated prevalence of 1/1,000,000. We report the case of a newborn male from first-degree consanguineous parents admitted at 15 days of life due to a hemorrhagic syndrome. Hemostasis tests showed low prothrombin time (PT) and normal activated partial thromboplastin time (aPTT). A coagulation panel revealed isolated factor VII deficiency. In this case, we highlight the clinical, biological, and therapeutic aspects of this condition during the neonatal period.

Kimura Disease: A Rare Case of Parotid Localization and Review of the Literature (Case Report)

Kimura’s disease is a rare chronic affection of unknown etiology, endemic in the far east with a net male predominance. We present the case of a 37-year-old female patient who developed a tumor process in the left parotid region over a period of 3 years. A total left parotidectomy was performed with simple postoperative course. The anatomopathological study of the surgical specimen was in favor of Kimura’s disease. Through this case and a review of the literature, we present the main clinical, anatomopathological, therapeutic and evolutionary characteristics of this rare disease.