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Introduction and Importance: The spontaneous and non-traumatic rupture of renal cysts is a rare clinical condition, which can lead to hemorrhagic shock. In this paper, the authors report a case of spontaneous rupture of a renal cyst and discuss the main features of this condition., Case Report: A 21-year-old patient presented urgently with hemorrhagic shock with no history or evidence of trauma. Physical examination revealed a swollen left lumbar fossa on palpation. Abdominal CT revealed an abundant retroperitoneal hematoma. Resuscitation measures were urgently initiated to ensure hemodynamic stabilization, followed by a hemostasis nephrectomy. The patient was stabilized, and subsequent postoperative recovery proceeded without complications. He was sent home on the seventh day following his admission., Discussion: Spontaneous retroperitoneal hemorrhages may stem from various pathologies, including simple renal cysts, and frequently manifest with Lenk's triad. Wunderlich syndrome, an infrequent manifestation of such hemorrhages, necessitates prompt recognition and hemodynamic stabilization, with potential treatment including embolization or surgical intervention., Conclusion: Although simple renal cysts are generally asymptomatic, they can lead to serious complications such as hemorrhage that could be life-threatening without appropriate medical intervention. The treatment involves performing an emergency nephrectomy for hemostasis, along with implementing resuscitation measures., Competing Interests: The authors declare no conflicts of interest.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

Introduction and Importance: The clinical and radiological similarities between COVID-19 and lung cancer pose diagnostic challenges, particularly in young, non-smoking individuals. Ground glass opacities (GGO) on imaging, often associated with COVID-19, can also indicate lung cancer. Distinguishing between these conditions is crucial but complex, requiring a systematic approach., Case Presentation: The authors present a case of a 31-year-old non-smoking woman initially suspected of COVID-19 due to cough, dyspnea, and GGO on chest CT. Despite negative RT-PCR and inconclusive bronchial aspiration, symptoms persisted, prompting further investigation. A PET scan revealed hypermetabolic consolidation, leading to a biopsy confirming adenocarcinoma., Clinical Discussion: Lung cancer can mimic COVID-19 symptoms, complicating diagnosis, especially in young, non-smoking patients. While smoking remains the primary risk factor, lung cancer in non-smokers, particularly young individuals, is increasingly recognized. GGO, commonly associated with COVID-19, should prompt consideration of malignancy, emphasizing the importance of a comprehensive differential diagnosis., Conclusion: Early detection of lung cancer in young, non-smoking individuals is vital yet challenging. Clinicians should maintain a high index of suspicion, promptly investigating persistent or worsening symptoms, even in the absence of traditional risk factors. Timely biopsy and intervention are critical for improving outcomes in this population., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

Hypertension is the leading cause of cardiovascular diseases and nephropathies. Its treatment and management require long-term follow-up which can be facilitated by the emergence of device-based therapies. Novel recommendations have been well described in the latest ESH guidelines as well as new risk factors have been identified. The authors summarized the published evidence on hypertension management. The authors also cited in this review novel treatment approaches in different settings and the intervention of medication adherence in treatment success. Such non-communicable disease requires long-term follow-up and monitoring, which is quite facilitated in the era of digitalization by cuff-less devices based on prediction tools., Competing Interests: We claim we don’t have any conflict of interest that could inappropriately influence our work.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

Therapeutic compliance (TC) refers to the patient's compliance with the prescriptions and recommendations of a doctor. Patients with cancer often exhibit unsatisfactory TC. The objective of our study was to assess TC levels in cancer patients and identify predictors of poor compliance. The authors conducted a cross-sectional study in March 2023 at the oncology centre, where the vast majority of medical activity is performed in the day hospital. TC was measured using a questionnaire or survey. Various parameters were analyzed to identify predictive factors of poor therapeutic compliance. The authors' study included 175 cancer patients with a mean age of 55 years. The study revealed that 85% exhibited good compliance (GC) as indicated by the CI [8.500 ± 0.075], signifying patients who consistently adhered to their medication schedule. Conversely, 15% demonstrated poor compliance (PC), as indicated by the confidence interval [0.825 ± 0.750]. Compliance status was assessed by considering patients who adhered to the prescribed medication timing as good compliance (GC) and those who did not adhere as poor compliance (PC). The analysis of our study results indicated that poor therapeutic compliance was associated with low socio-economic and educational levels. Therefore, it is important to utilize all available resources to improve therapeutic compliance. The majority of factors contributing to poor compliance can be mitigated through effective coordination between the patient and their support network., Competing Interests: The authors declare that they have no conflicts of interest.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

Background: Acute myocardial infarction (MI) is a major cause of cardiovascular mortality, which is the leading cause of death in the world. Our objective in this study was to evaluate the epidemiological, clinical, and angiographic features of right ventricular infarction (RVI), as well as its complications and its therapeutic approaches., Patients and Methods: It is a single-centered retrospective descriptive study conducted over a period of 2 years from November 2018 to October 2020. The authors included 82 patients with RVI hospitalized in the cardiovascular ICU during the initial phase of acute coronary syndrome with persistent ST segment elevation. Patients who were diagnosed with RVI at electrocardiogram and echocardiography were recruited., Results: The authors included 500 patients hospitalized for STEMI, 82 had MI extended to the RV, reflecting a rate of 16.4%. The mean age in our study was 64±12.3 years. Dyslipidemia, diabetes mellitus, and hypertension were the most common cardiovascular risk factors among these patients. RVI co-existed with inferior MI in 62.2 of cases and in 37.8% of anterior MI, while isolated RVI was seen in only one patient. Transthoracic echocardiography showed right ventricular (RV) systolic dysfunction in 24.39% of cases, while RV dilatation was seen in only 10.9% of patients. Therapeutic approach was based essentially on revascularization with thrombolysis and coronary angiography +/- PCI. The percentage of mortality was 2.4%., Conclusion: RVI is relatively rare and is mostly related to an extension of an inferior MI. Early diagnosis, prompt treatment, and appropriate are the keys to improve prognosis, and reduce complications., Competing Interests: The authors declare no relevant competing interests related to the content of this article.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)

Background: The aim of our study was to explore the utility of the Sysmex UF-1000i analyzer as a rapid screening tool for urinary tract infections (UTI) and its ability to predict bacterial shape in order to help physicians choose the appropriate empiric treatment., Materials and Methods: This is a retrospective study, including 1023 urine cytobacteriological examinations. Urines were processed according to the recommendations of the medical microbiology reference system (REMIC). Using the Sysmex Uf-1000i analyzer, the authors evaluated bacteria forward scatter (B_FSC) and fluorescent light scatter (B_FLH) in a preliminary discrimination step for UTI caused by bacilli or cocci bacteria., Results: The authors got 1023 positive samples. Comparing baccili and cocci bacteria, the authors observed a statistically significant difference for B_FSC but not for B_FLH. The values of B_FLH are very close for the four categories of microorganisms compared (bacilli, cocci, bacilli-cocci association, and yeasts). For these same categories, tests show different values for the B_FSC. A separate analysis of the B_FSC values for bacilli shows that their distribution is relatively homogeneous and exhibits a peak between 20 and 30 ch., Conclusion: Dimensional parameters of bacteria generated by UF-1000i could be a rapid and useful tool for predicting the bacterial shape causing UTI., Competing Interests: The authors declare that they have no conflicts of interest.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)

Introduction: The dacryocystorhinostomy (DCR) procedure is linked to a high success rate; however, cases of tearing recurrence are not rare and should be managed efficiently. Thus, evaluating cases of DCR failure allows highlighting the factors significantly impacting the results in order to realize better controlled primary surgeries., Material and Method: Twenty-eight patients were operated in our Otolaryngology Department for endoscopic revision of DCR failure between January 2019 and June 2022. Their clinical presentation, postoperative evolution, and findings of the primary and revision surgeries were assessed until the actual follow-up., Results: The first surgery was based on an external approach in 17 patients and the bicanalicular silicone tube intubation was kept for a mean of 4.25 months. The recurrence delay varied from 0.5 to 9 months. Revision surgery revealed synechia in 10 patients, a completely closed DCR ostium in 22 patients (78.57%) by mucosal scarring and granulation, and lacrimal sac fibrosis in 16 patients (57.14%). A significant correlation was found between maintenance of the silicone intubation tube greater than or equal to 3 months and lacrimal sac fibrosis ( P =0.016<0.05)., Conclusion: Thus, better controlled primary surgeries with optimal exposure, wild marsupialisation of the lacrimal sac and no longer systematic bicanalicular intubation which should be dedicated to difficult anatomies and canalicular affections should guarantee better functional results., Competing Interests: The authors declare that they have no financial conflict of interest with regard to the content of this report.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)

Social media use has become widely popularized in modern society and because of that, human interactions have drastically changed. In parallel, depression and anxiety have reached unprecedented levels among the youth, and concerns have emerged on social media use compromising mental health. The objectives of our review are to explore if there is a relation between social media and the development of those two disorders among youth, to highlight the patterns that could lead to them, and to give recommendations for future research., Methods: Based on the Scale for the Assessment of Narrative Review Articles (SANRA) Criteria, the authors performed a search of all-time articles published in the Medline database using terms such as social media, social media use, problematic social media use, depression, anxiety, suicidality, self-harm, fear of missing out, cyberchondria, cyberbullying, sexting, and online shopping. The initial search yielded 184 924 articles. After review, 77 articles were included for discussion., Results: Social media use is often associated with depression and anxiety. Different patterns are thought to predict poorer mental health outcomes like multitasking, emotional investment, appearance-based activities, passive media use, problematic social media use, cyberbullying, sexting, and disaster awareness., Conclusion: Specific patterns of engagement with social media appear to be associated with poor mental health outcomes in youth. It is important for physicians to address social networks exposure in well-visits and for parents to communicate about it openly. However, more in-depth research needs to be done to determine a relation of causality., Competing Interests: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)

Acute myocarditis represents one of the most mysterious acute cardiovascular diseases due to the great diversity of its clinical presentation, ranging from simple symptoms such as flu-like syndrome to lethal conditions such as cardiogenic shock or sudden cardiac death. The diagnosis will be suspicious in the presence of chest pain in a subject with risk factors, and guided mainly by the ECG, biological markers, trans-thoracic echocardiography, and the cardiac MRI. In this sense, and returning to the pathophysiological bases of this condition, the positive diagnosis will rely mainly on the detection of tissue abnormalities secondary to the myocardial inflammatory storm. Cardiac MRI represents a diagnostic pillar, given the information it can provide, both in analyzing the morphology, and the myocardial function but also tissue abnormalities that represent the main element of the diagnostic criteria of Lake Louisse., Competing Interests: The authors state that they have no conflicts of interest for this report., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)

Primary lung cancer is the leading cause of mortality worldwide. The major sites of lung cancer metastasis are the bones, liver, brain, lung, and adrenal glands. However, secondary localizations in the genital tract are extremely rare., Case Presentation: The authors report the case of a 36-year-old woman who consulted for a right scapular swelling evolving for 4 months associated with a chronic cough. Clinical examination showed a hard fixed right scapular mass with any inflammatory signs. The extension assessment followed by histological analysis concluded in a secondary ovarian location of a lung adenocarcinoma. A very high serum procalcitonin level unrelated to sepsis was detected in the patient along with a substantial hematological paraneoplastic disease. The patient died after 6 months of palliative chemotherapy., Clinical Discussion: Ovarian localization is found in only 0.4% of metastatic ovarian tumors, which is extremely low, the differentiation between primary and secondary ovarian adenocarcinoma is fundamental since the treatment and prognosis are very different. The serum procalcitonin can be elevated in lung adenocarcinoma., Conclusion: This case report highlights the interest to encourage doctors to look for ovarian metastasis during the clinical course of lung cancer, and explain the elevation of serum procalcitonin during lung adenocarcinoma., Competing Interests: The authors declare that they have no financial conflict of interest with regard to the content of this report., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)

Cardiovascular diseases, particularly acute coronary syndrome, are the leading cause of death in chronic hemodialysis patients. Our study aims to analyze the pathophysiological, clinical, angiographic, and therapeutic characteristics of coronary heart disease in hemodialysis patients., Patients and Methods: This single-centered retrospective descriptive study included 34 hemodialysis patients hospitalized in the cardiovascular ICU., Results: The mean age of patients in our study was 64.4±11.3 years. The main cardiovascular risk factor found in our study was age, with a prevalence of 76.50%, followed by hypertension, with a prevalence of 67.60%. Diabetes was present in 55.90% of patients. The authors also found that 17.90% of patients were obese, and 29.40% had abdominal obesity. The main cause of renal disease in our study was diabetic nephropathy (52.90% of cases), followed by hypertensive nephropathy (23.50% of cases). ST segment elevation myocardial infarction was found in 14.70% of cases, and non-ST-segment elevation myocardial infarction in 85.30% of cases. Coronary angiography was performed in 76.40% of patients. Single-vessel coronary artery disease (CAD) was found in 20%, two-vessel CAD in 50%, and three-vessel CAD in 30% of the cases. Coronary artery calcifications were observed in 21.42% of cases. 38.23% had an angioplasty, and 20.58% were referred for a coronary artery bypass graft., Conclusion: Despite the high mortality rate after acute coronary syndrome, hemodialysis patients are less likely to undergo diagnostic angiography or coronary revascularization. Patients on hemodialysis tend to have multiple, diffuse, calcified CAD., Competing Interests: The authors have no competing interests to declare that are relevant to the content of this article., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)

Bladder metastases are rare, representing only 2% of all bladder tumors, secondary bladder localization from a primary lung is exceptional., Case Presentation: The authors describe the case followed for lung adenocarcinoma with an exceptional metastatic site, which is the bladder. A computed tomography scan showed a left suprahilar bronchial tumor with pleurisy (Fig. 1A), which biopsies concluded to a moderately differentiated adenocarcinoma. The patient is treated with palliative cisplatin-based chemotherapy. And died 11 months after diagnosis., Clinical Discussion: Bladder metastases are rare, representing only 2% of all malignant bladder tumors. Metastatic lesions of the bladder are generally revealed by hematuria. Confirmation of bladder invasion is immunohistochemical, facilitated by knowledge of the primitive., Conclusion: In the presence of any adenocarcinoma of the bladder, a thoracic-abdominal-pelvic computed tomography scan must be requested in search of a primary extra-vesical cancer who can facilitate the diagnosis., Competing Interests: The authors declare no conflict of interest., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)

Emphysematous pyelonephritis (EPN) is a rare and serious complication of urinary tract infections that mainly occurs in diabetic patients. It results in the development of aerobic gas-forming bacteria1. Diagnosis is based mainly on a computed tomography scanner. Therapeutic management is based on the patient's clinical condition and radiological classification., Case Presentation: We present a case of a 64-year-old female patient with type 2 diabetes under insulin and hypertension under amlodipine, who was admitted to the intensive care unit for a state of septic shock on EPN. The patient received resuscitation measures and antibiotic therapy, and the evolution was favorable. The patient was transferred to the urology unit after 10 days of hospitalization in the intensive care unit., Discussion: EPN is frequently caused by gram-negative cocci and generally develops in diabetics. The clinical signs of EPN are not very specific and are essentially based on the signs of acute pyelonephritis, which responds badly to treatment., Conclusions: It is essential to take preventive measures in diabetic patients to avoid this complication. Early diagnosis allows for avoiding surgery by preserving the kidney., Competing Interests: There are no conflicts of interest., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)

Spontaneous hepatic rupture is an uncommon and fatal complication that most often occurs in the setting of severe pre-eclampsia., Case Presentation: In this article, the authors describe a case of spontaneous liver rupture occurring on the sixth day of an uncomplicated pregnancy in postpartum., Discussion: According to the literature, liver rupture in the obstetrical setting is mostly linked to pre-eclampsia and HELLP syndrome., Conclusion: A collaborative multidisciplinary approach is required to define adequate medical and surgical management when there is suspicion of liver rupture in pregnant women., Competing Interests: None., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)

Ollier disease is a rare genetic disorder characterized by the development of multiple enchondromas. The clinical manifestations of the disease vary widely, but patients often present with bone deformities and an increased risk of developing chondrosarcoma. Here, the authors present a case report of a 25-year-old male patient with a devastating and historic evolution of Ollier disease., Case Presentation: At the age of 10, the patient developed a sub-centimeter mass in the first phalanx of the left middle finger, which subsequently grew in size. A biopsy was performed at the age of 14, which confirmed the diagnosis of chondroma. At the age of 14, the patient developed multiple large masses on the left hand, resulting in the amputation of his left hand. At 25 years old, the patient developed new masses in his contralateral hand and left foot., Discussion: Ollier disease is caused by somatic mutations in the PTH/PTHrP receptor gene, leading to the formation of multiple enchondromas. Patients with Ollier disease are at an increased risk of developing chondrosarcoma, which can be life-threatening. The diagnosis of Ollier disease is usually made based on clinical and radiographic findings, and genetic testing can confirm the diagnosis. Treatment is typically focused on managing the symptoms and preventing the development of chondrosarcoma., Conclusion: The authors presented a case report of a patient with a devastating and historic evolution of Ollier disease. This case highlights the importance of early diagnosis and management of this disease to prevent the development of chondrosarcoma and minimize the risk of complications. Further research is needed to better understand the underlying mechanisms of the disease and develop effective treatments., Competing Interests: None., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)

As a global pandemic, coronavirus disease 2019 (COVID-19) has led to a growing number of related research studies being published worldwide. However, there is no study on the bibliometric analysis of these Moroccan studies. This study aims to provide a general overview of COVID-19 studies in Morocco and may provide a direction for hot topics and future research trends., Method: The global literature about COVID-19 published between 2019 and 2022 was scanned in PubMed, the Web of Science collection database, Scopus, and two preprint platforms. 'COVID-19', 'Novel Coronavirus', '2019-nCoV', and 'SARS-CoV-2' were used as the keywords to reach the relevant publications. The VOS viewer was applied to perform the bibliometric analysis of these articles., Results: A total of 987 Moroccan publications on the topic of COVID-19 were retrieved. Of all these publications, 166 (61.9%) were original journal articles, 10 (3.7%) were review articles, 514 (8.38%) were letters and 56 (20.9%) were others, such as case reports, notes, or book chapters. Ten original articles (3.7%) had not yet been peer-reviewed and were retrieved from the preprint servers medRxiv and bioRxiv. The highest number of COVID-19 publications was published by Mohammed V University in Rabat ( n =45, 16.8%), followed by Hassan II University ( n =32, 11.9%) and Mohammed VI University of Health Sciences ( n =29, 10.8%). The open-access format was the predominant publishing model (43.2%) and 92.9% were written in English. The main research lines identified in COVID-19 for Morocco are related to the pandemic's indirect effects: education (11.2%), mental health (6.3%), and the environment (6.3%)., Conclusion: Moroccan institutions have made a profound contribution to COVID-19 research than that in other African countries, but lags behind compared to that in Arabic countries., Competing Interests: None., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)

Suicide is an important cause of death among patients affected by schizophrenia. The lifetime prevalence is 10-15%. The identification of factors associated with suicide attempts will help to identify preventive and therapeutic strategies to reduce the toll of suicide., Aims: The purpose of this study is to investigate the prevalence of suicide attempts and their sociodemographic and clinical characteristics in Moroccan patients with schizophrenia., Materials and Methods: This is a cross-sectional study of patients admitted to our Hospital of Psychiatry in Morocco, between year and year, with adiagnosis f schizophrenia., Results: In our sample ( n =304), 65 (21.4%) had attempted suicide. Suicide attempts were significantly and positively associated with a family history of bipolar disorder, comorbidity with a substance use disorder, a relatively short duration of treatment, poor adherence to medication, and severe general, positive, and depressive symptoms., Conclusion: The prevention of suicide risk requires the effective management of depressive and addictive comorbidities, the reduction of schizophrenia symptoms through appropriate treatment and an effort to improve adherence., Competing Interests: The authors report there are no competing interests to declare., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)

Infective endocarditis (IE) is a rare but serious disease, and despite improvements in diagnostic and therapeutic tools, it remains associated with high mortality. It can develop in a healthy heart, but most commonly in underlying heart disease. The authors discuss a 34-year-old patient, who has presented for 4 months with generalized asthenia, fever, and chills, without any notion of chest pain, arthralgias. On admission, the patient was conscious, hemodynamically, and respiratory stable, the temperature was 38.5°C. The cardiac exam heart revealed a systolic murmur rated 4/6th at the mitral focus. Transthoracic echocardiography showing vegetation on the mitral and aortic valve. Three blood cultures were taken at 1 h intervals, all positive for enterococci, thoracoabdominal and brain computed tomography scan with contrast injection was performed showing, ischemic stroke, aortic coarctation, splenic and renal infarction, mycotic aneurysms in the descending aort. IE can be the cause of several extracardiac manifestations, through vascular and/or immunological phenomena. Embolic complications are the most frequent extracardiac complications and are secondary to septic emboli from the vegetations. The prognosis of IE is worsened by the addition of cardiac and extracardiac complications such as mycotic aneurysms and septic embolic events., Competing Interests: The authors have no competing interests to declare that are relevant to the content of this article., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)

Testicular cancer is the most frequent type of cancer in the young adult men, it is relatively rare. Infertility is an important risk factor for testicular cancer, with a doubled risk of developing cancer compared to the general population. The standard treatment for testicular cancer is the radical orchiectomy, but partial orchiectomy or testicular sparing surgery (TSS) is indicated for small masses, as many experiences, have shown that many small masses found incidentally turn out to be benign., Case Presentation: The authors report the case of a patient presented for primary infertility, a clinical examination for left-sided gynecomastia without inflammatory signs. A testicular MRI revealed a 7 mm suspicious nodule in the posterior-inferior aspect of the right testicle, with contrast enhancement in the juxta-tumoral area corresponding to a heterogeneous area on ultrasound. Due to the lesion described on MRI, monorchidism, and azoospermia, a TSS combined with testicular biopsy and testicular sperm extraction was indicated., Clinical Discussion: The reference treatment for testicular cancer is the radical orchiectomy, but in some selected situations, partial orchiectomy or TSS is indicated, as many experiences have shown that many small masses found incidentally turn out to be benign., Conclusion: This case suggests that TSS or partial orchiectomy for small nonpalpable testicular masses in monorchidic patients can provide an excellent outcome for the patient., Competing Interests: None., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)

B-Raf proto-oncogene has been found in a variety of neoplasms. BRAF stimulation can promote tumour proliferation through the activation of the MAP/ERK kinase pathway. This study aimed to determine the germline spectra of BRAF and the association with pathological criteria of prostate tumours., Methods: Fifty blood samples from men treated with prostate cancer were analyzed for BRAF germline mutations and confirmed by Sanger sequencing, in addition, to establishing the frequencies and clinical correlations of frequent mutations in the BRAF gene for both exon 11 and exon 15. The frequency and distribution of high-frequency mutations were analyzed according to the pathological criteria of the patients., Results: Frameshift mutations: c.1628&#95;1629insA and c.1624&#95;1625insT with a frequency of (46%) and (18%), respectively, Nonsense mutations: c.1181C>A (p.Ser394Ter) was detected in one patient, missense mutations: c.1226A>G (p.Gln409Arg), c.1270T>C (p.Trp424Arg), c.1270&#95;1271delins2 (p.Trp424Leu), with a frequency of (4%) were detected. There was no significant difference between mutation carriers and non-carriers regarding medical and surgical history, but prostate-specific antigen concentration was significantly different between the two groups., Conclusion: The results of this study elucidate the presence and involvement of germline mutations in prostate cancer, which could serve as a potential indicator for the diagnosis and therapeutic management of prostate cancer in the population studied., Competing Interests: The authors declare no conflict of interest., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)

Autonomic dysfunction is a prevalent symptom of Guillain-Barré syndrome (GBS); cardiovascular involvement in this scenario has been mentioned infrequently in the literature., Case Presentation: A 65-year-old man with GBS presented with reversible left ventricular systolic failure. On first presentation, our patient had no history or indications of heart malfunction. During the clinical manifestation of his autonomic dysfunction, he had electrocardiographic alterations, modestly increased cardiac enzymes, significant left ventricular systolic dysfunction, and segmental wall motion irregularity. Once the initial episode was over, these anomalies and his symptoms resolved quickly., Discussion: We believe the reversible left ventricular dysfunction was caused by the toxic impact of elevated catecholamines as well as transiently injured sympathetic nerve endings in the myocardium, which was apparently caused by GBS. We recommend that echocardiography be performed in patients who exhibit clinical signs of autonomic dysfunction, particularly if they are associated with abnormal electrocardiographic findings, cardiac enzyme elevation, or hemodynamic instability, so that appropriate medical therapy can be instituted as soon as possible., Conclusion: GBS is a not a very rare situation in our context. Thus, doctors are supposed to know the life-threatening complications such as neurogenic stunned myocardium and be prepared to dodge it., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)

Liposarcoma is a rare, primary, malignant mesenchymal tumor. It represents ∼7% of all mesenchymal sarcomas and 1% of all cancers. Their incidence does not exceed to 2.5 cases/million inhabitants/year. This tumor is locally invasive, diagnosed at a late stage, and can reach a significant size and weight, resulting in a locally advanced tumor., Case Presentation: A 59-year-old female patient consulting for a large abdominal mass. The abdominal computed tomography showed three retroperitoneal masses, and the surgical exploration revealed a huge process in the retroperitoneal cavity, which takes the left renal compartment, and the left colon. The intervention consisted of a mono-bloc excision of the mass taking the spleen, the left renal compartment, and the left colon with colonic anastomosis. The histological examination concluded the existence of a well-differentiated myxoid liposarcoma of grade I, the postoperative follow-up was simple. One year later, she underwent an excision of a recurrence of the same retroperitoneal location, but of a pleomorphic cell histological type of grade II according to the FNCLCC classification. We review the literature, the pathological, therapeutic, and prognostic aspects of this tumor., Discussion: Retroperitoneal liposarcoma is a rare tumor. Its gravity is due to an often-late diagnosis, a complete imaging workup including ultrasound, computed tomography and often MRI is necessary preoperatively to determine the relationship with the different organs. The definitive diagnosis is histological, surgery is the most effective treatment and can be extended to neighboring organs. the frequency of recurrence requires particular surveillance., Conclusions: We highlight the importance of radical surgical excision to avoid retroperitoneal liposarcoma tumor complications and to minimize the recurrence risk., Competing Interests: The authors declare that they have no financial conflict of interest with regard to the content of this report., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)

Wernicke's encephalopathy is an acute neuropsychiatric syndrome resulting from thiamine deficiency, which is associated with significant morbidity and mortality. The diagnosis of Wernicke's encephalopathy is based on the clinical manifestations and rapid reversal of symptoms with thiamine., Case Presentation: The authors present the case of a 25-year-old female patient at the 19th week of gestation (Gravid 1 para 0) with an unremarkable medical history who was admitted to the hospital for an areflexic flaccid tetraparesis with ataxia after persistent vomiting. The brain and spinal MRIs did not reveal any abnormalities, and the evolution was marked by an important improvement after supplementation with thiamine., Conclusion: Gayet Wernicke encephalopathy is a medical emergency. Clinical symptoms are inconstant and varied. MRI is the reference examination to confirm the diagnosis, but in 40% of cases it is strictly normal. Early thiamine administration can prevent morbidity and mortality in pregnant women., Competing Interests: The authors state that they have no conflicts of interest for this report., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)

The purpose of the study is to evaluate the correlation between caloric test results and video head impulse test (VHIT) vestibulo-ocular reflex (VOR) gains in unilateral horizontal canal deficits in order to define a possible threshold value above which caloric deficits should be associated with predictable low VHIT VOR gains. Caloric test and VHIT were realised in 105 patients presenting with symptoms of rotational vertigo occurring within the last 2 weeks. The authors defined the cutoff value for a caloric abnormality as more than 15% of canal deficit, which allowed us to divide our patients on groups based on the severity of their caloric asymmetry. Then, the authors performed the VHIT considering abnormal horizontal gain as less than 0.8 with catch-up saccades. The authors evaluated the prevalence of results dissociation between the two tests and the correlation between the caloric asymmetry and the horizontal VHIT VOR gains in each group according to the severity of canal deficit. The correlation was considered statistically significant if P less than 0.05 (Fisher's exact test). The caloric test revealed a significant unilateral deficit in 50 patients (47.6%). The interval of deficit between 21 and 40% included 25 patients, 18 (72%) presenting with normal VHIT VOR gains versus 7. On the other hand, for the 12 patients in the intervals of 81-100% of deficit, the VHIT VOR gain was highly abnormal in all cases. In comparison with the normal caloric test group, a correlation between each interval of caloric deficits and VHIT VOR gains has been assessed. This correlation was significant in the interval of 41-60% ( P =0.04 <0,05) and in the interval of 81-99% next to patients with a total deficit of 100% ( P =0.006 <0.05 for each). It appears that simultaneous affection of high vestibular frequencies evaluated on VHIT may be more likely and predictable above a minimal threshold of 40% caloric asymmetry, with better discrimination between normal and abnormal VHIT above 80%. Thus, they are two complementary tests to use as a couple rather than a replacement one for the other., Competing Interests: The authors declare that they have no financial conflict of interest with regard to the content of this report., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)

Lung cancer can be revealed by thromboembolic complications. Its association with pregnancy is becoming more frequent due to the increasing number of smoking women. The care of a pregnant woman with cancer is quite delicate because it requires finding a balance between the treatment of the mother and the potential foetal risk., Case Presentation: The authors report the case of a 38-year-old patient, with a twin pregnancy of 16 weeks, complicated by proximal and distal peripheral venous thrombosis of the left lower limb under low molecular weight heparin therapy at a curative dose. A week later, the patient presented to the emergency room with respiratory distress associated with chest pain and low-abundance metrorrhagia. The obstetrical ultrasound performed confirmed the vitality of only one of the two foetuses. The transthoracic ultrasound objectified a very abundant pericardial effusion producing a tamponade, which was drained percutaneously and whose cytological study revealed a liquid rich in tumour cells. After the unfortunate death of the second twin and an endouterine evacuation, a chest computed tomography angiogram demonstrated a bilateral proximal pulmonary embolism associated with bilateral moderate pulmonary effusion as well as multiple thrombosis and secondary aspect liver lesions with a suspicious parenchymal lymph node of the upper lung lobe. A liver biopsy concluded to a secondary hepatic localization of a moderately differentiated adenocarcinoma whose immunohistochemical complement revealed a pulmonary origin. A multidisciplinary consultation meeting leaned towards treatment with neoadjuvant chemotherapy. The patient died 7 months later., Discussion: Venous thromboembolic disease is more common in pregnant women. Delayed diagnosis is common in these cases, resulting in a high rate of locally advanced or metastatic disease. Since the treatment of pregnancy-associated cancer does not rely on a standardized approach, the decision on how to proceed must be made by a multidisciplinary team., Conclusion: The cornerstone of management remains to find the balance between treating the mother as well as possible while preventing the foetus from the possible harm of cytotoxic drugs frequently used to treat lung cancer. Because of the delayed diagnosis, the maternal prognosis often remains poor., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)

Due to its incidence, clinical polymorphism and severity, urinary tract infection is an important problem in elderly. The objectives of the authors' work were to establish the bacteriological profile of urinary tract infection and/or colonization in the elderly and then to study drug resistance of bacterial strains isolated., Materials and Methods: This is a 36 months retrospective study from 22 March 2016 to 11 May 2019. The study included urinary specimens of persons aged 65 years or over, hospitalized or consulting at the authors' hospital. Urines were processed according to the recommendations of the medical microbiology reference system and European Committee on Antimicrobial Susceptibility Testing., Results: The authors collected 6552 requests for cytobacteriological examination of urine. Most of the specimens was collected in the middle stream ( n =5503; 84%). Cultures were sterile in 49.77% of cases. Positive in 50.22% of cases. Among positive samples we had 53.41% polymorphic cultures, 32.75% urinary tract infection, and 13.82% urinary tract colonization. Gender distribution showed a sex ratio at 0.62. Gram-negative bacilli, with Escherichia coli as the main species, dominated the isolated bacteria. Resistance rates of E. coli strains that we isolated were 70% for amoxicillin, 36.31% for amoxicillin-clavulanate and 25% for ciprofloxacin. A high resistance rate was seen for third generation cephalosporins. Least resistance recorded to nitrofurantoin., Conclusion: ITU in the elderly is diverse and significantly different from that of younger patients, through its high contamination rate, difficulty in acquiring clinical information, high rate of asymptomatic bacteriuria, and high proportion of multidrug resistant bacteria., Competing Interests: The authors declare that they have no competing interests., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)

This paper aims to investigate the three areas [diet, physical activity (PA), and social relationship] and their relationship with depressive disorders in the North African population., Study Design: This is an observational cross-sectional study of 654 participants residing in the urban commune of Fez ( n =326) and the rural commune of Loulja ( n =328) in the province of Taounate. Participants were categorized into two groups: G1 without a current depressive episode and G2 with a current depressive episode. Risk factors, including locality, gender, marital status, age, parental status, employment status, tobacco use, alcohol consumption, social habits, and dietary patterns, were assessed. A multinomial probit model in Stata software was used to identify factors associated with depression occurrence in the population., Results: A total of 94.52% of the participants who engaged in PA did not experience a depressive episode ( P =0.001). Additionally, 45.39% of the participants in our series were on a processed diet and presented with a depressive disorder ( P =0.0001), the social contact (time spent with friends >1.5 h) remained strongly associated with reduced depressive symptoms when comparing the two groups ( P =0.001). The results showed that being rural, a smoker, an alcohol user, and having no spouse significantly increased depression in participants. The coefficient of age was negatively related to the probability of the occurrence of age-related depression; however, this factor was not significant in the model. Thus, having a spouse and/or children and spending time with friends on a healthy diet significantly decreased depression in our population., Discussion: The converging evidence suggests that physical exercise, a stable social relationship, a healthy diet, and the use of PA can alleviate depression symptoms, but limited understanding and few studies have attempted to characterize or identify the neural mechanisms of these effects., Conclusion: Nonpharmaceutical interventions such as PA and dietary changes have proven to be effective treatments for depression, while maintaining positive social relationships can act as a protective factor, serving a prophylactic role in the prevention of depression., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)

The myocardial bridge is a congenital coronary anomaly defined as the presence of a region of myocardium overlying an epicardial coronary artery. This is a 51-year-old patient, diabetic for 4 years on oral hypoglycemic, has had stress angina for 4 years, neglected by the patient. The current history goes back to 2 months by the installation of an episode of syncope occurring with the effort, then of a second episode the day of its admission. Electrocardiogram on admission showed complete atrioventricular block with an heart rate of 32 beats per minute, the patient spontaneously recovered sinus rhythm with a heart rate of 88 beats per minute and a PR interval of 200 ms, coronary angiography was performed showing coronary arteries without stenosis with an intramyocardial bridge of the left anterior descending artery. During exercise and in the presence of a myocardial bridge on the left anterior descending artery, systolic compression leads to a decrease in flow to the septal branches, which is responsible for an alteration of the vascularization of the sub-nodal tissue with paroxysmal conduction disorders leading to syncope. Conduction disorders of ischemic origin are not always associated with atherosclerotic or thromboembolic lesions, but may also be secondary to myocardial bridges., Competing Interests: The authors have no competing interests to declare that are relevant to the content of this article., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)

Laubry-Pezzi syndrome is a rare congenital heart disease characterized by the association of ventricular defect septal to aortic cusp prolapse responsible for aortic regurgitation (AR)., Case Presentation: We reported three cases of Laubry-Pezzi syndrome diagnosed in our department of cardiology on a cohort of more than 3000 cases of congenital heart disease. A 13-year-old patient presented a Laubry-Pezzi syndrome with severe AR and significant volumetric left ventricle overload and was operated on in time to allow a good evolution of his condition. A 43-year-old patient, followed for congenital cardiac pathology, presented with severe dyspnea. The echocardiogram found global dysfunction of the left ventricle with an ejection fraction of 35%, a perimembranous ventricular septal defect (VSD) almost completely closed by the prolapse of the noncoronary cusp, and severe eccentric aortic insufficiency due to the prolapse of the noncoronary cusp. Aortic valve replacement and VSD closure were indicated. The third patient is a 21-year-old patient with Down syndrome, in whom a grade 2/6 systolic murmur was detected. Transthoracic echocardiography revealed a perimembranous VSD measuring 4 mm without any hemodynamic repercussions and a moderate aortic insufficiency due to the prolapse of the noncoronary cusp. Clinical and echocardiographic monitoring with Osler prevention was indicated as a modality of management., Clinical Discussion: The pathophysiology is explained by the Venturi effect, the restrictive shunt of the VSD creates an area of low pressure that sucks the adjacent cusp resulting in aortic prolapse and regurgitation. The diagnosis is essentially based on transthoracic echocardiography; it must be conducted before the emergence of AR. The management of this rare syndrome still remains nonconsensual, whether it is through timing or operative techniques., Conclusion: Management must be early by closing the VSD with or without aortic valve intervention to prevent the onset or worsening of AR., Competing Interests: The authors have no conflicts of interest., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)

It is a great challenge to distinguish the parietal inflammation, centered on the foreign body that pierced the digestive tract and remained in the wall before surgery, because of its atypical clinical nature. Ingestion of foreign bodies is not uncommon. Fish bones are particularly notorious culprits; however, most will pass through the gastrointestinal tract uneventfully., Patients and Methods: The authors report a case of a patient who presented with periumbilical abdominal pain and a computed tomography (CT) scan that revealed the presence of periumbilical fat infiltration on a foreign body admitted on the Department of Digestive Cancer Surgery and Liver Transplantation, Casablanca, Morocco. An exploratory laparotomy revealed a parietal mass centered by a fish bone., Results: Accidental ingestion of foreign bodies is common in clinical practice. However, perforation of the intestine by a foreign body is less common because the majority of foreign bodies pass without incident into the feces and only 1% of them (the sharpest and most elongated objects) will perforate the gastrointestinal tract, usually at the level of the ileum.CT, especially multidetector CT, is considered the method of choice for preoperative diagnoses of ingested foreign bodies and their complications due to its high-quality multiplanar capabilities and high resolution.Foreign body ingestion usually goes unnoticed, but the complications of this incident can be severe., Conclusion: This case report highlights the fact that intestinal perforation caused by an ingested foreign body is a difficult diagnosis that should always be suspected in an attack of abdominal pain. Frequently, the clinical diagnosis is difficult, and recourse to imaging is sometimes necessary. Most of the time, the treatment is only surgical., Competing Interests: The authors declare having no conflicts of interest for this article., (© 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)

Competing Interests: We have read and understood the policy on declaration of interests and have no relevant interests to declare. The responsibility for the content lies with the author and the views stated herein should not be taken to represent those of any organizations or groups with and for which he works.

Purpose: This article aimed to evaluate the different epidemiological aspects of the population (Fez-Meknes region), expose the secular trends of the food habits related to it, present the basic concepts and mechanisms of food in urban and rural areas in the Fez-Meknes region, and finally to analyze the results in the light of a literature review., Materials and Method: A survey was conducted among a representative sample of the urban and rural population in the Fez-Meknes region (654 people aged 15 years and over, of which 326 people reside in the urban commune of Fez and 328 in the rural commune of Loulja in the province of Taounate)., Results: The results are, a difference between the two urban and rural groups concerning the rhythm of taking meals outside the home (P < 0,001); the average frequency of consumption of certain foods according to social class (p < 0,001); the frequency of food consumption per week of legumes, olive oil, fermented milk, and tea is more increased than that recorded in the urban environment (p < 0,001). On the other hand, the quantification of the consumption of sweet products, dairy products, and whole grains did not conclude a significant difference between the two study environments (p > 0,05)., Discussion: Changing dietary patterns over the past few decades, including more shift work, more meals eaten outside the home or family setting, and more irregular eating patterns, including skipping breakfast and eating late at night., Conclusion: A disparity in eating habits between urban and rural areas was noted. It would be necessary to act judiciously on the environmental factors by encouraging the Moroccan populations to maintain, as much as possible, their good traditional habits, and to reinforce the new good food habits., Competing Interests: Authors of this article have no conflict or competing interests. All of the authors approved the final version of the manuscript., (© 2022 The Authors.)

•Developmental Care contributes to improving the quality of neonatal life.•Professionals must develop multidisciplinary approaches to clinical practice.•This research identified a low level of knowledge and practice in Developmental Care.•Significant correlations were detected between clinical practice and knowledge.•The implementation of Developmental Care seems to be a priority., (© 2022 The Authors.)

Introduction: The systematic realization of biochemical and radiological examinations of the parathyroid has increased the incidence of primary hyperparathyroidism; which explains the increasing incidence of parathyroid surgery. Our study aims to predict the factors determining the diagnosis and management of parathyroid adenomas., Methods: We included 87 patients who presented with hyperparathyroidism and underwent parathyroid surgery. Ultrasound, computed tomography (CT), and more rarely sestamibi, were performed to localize the lesion preoperatively. Body mass index (BMI), blood and urine calcium and PTH concentrations before and after surgery, and preoperative vitamin D concentrations were evaluated., Results: In 90.8% of the cases, the location of the adenomas was retained thanks to cervical ultrasound, and in 86% of the cases, the ultrasound results were concordant with the intraoperative results, whereas the MIBI scanner was used in only 6 patients with a specificity and sensitivity of 100%, but these results cannot be taken into account because the sample is too small. No significant association was found between weight and preoperative vitamin D concentration, whereas we find a positive correlation between preoperative vitamin D concentration and adenoma weight (p = 0.001). Postoperative follow-up showed a positive relationship between the onset of hypocalcemia and vitamin D deficiency, and an inverse correlation between PTH concentration and postoperative hypocalcemia. All patients with an unknown vitamin profile (n:4) who developed postoperative hypocalcemia had a BMI greater than 25 kg/m2. The higher the PTH concentration in the preoperative period, the more profound the hypocalcemia., Conclusion: Further studies are needed to explore the role of vitamin D in the localization of parathyroid adenomas on the one hand, and to properly document the association between BMI and preoperative PTH concentration on the other., Competing Interests: The authors declare no conflicts of interest., (© 2022 The Authors.)