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Key Clinical Message We report the case of multiple myeloma of unexpected discovery in an old patient admitted to the emergency department of cardiomyopathy. This observation emphasizes the need for exploring any anemia before linking it to heart failure or kidney disease. Serum protein electrophoresis remains crucial especially in the elderly patients.

Light‐chain multiple myeloma is a malignant hemopathy characterized by medullary invasion by tumor plasma cells, with the secretion of free light chains of immunoglobulins in the blood giving signs of bone disorders. However, it can be asymptomatic or can start by less clear clinical manifestations such as recurrent infections, anemic syndromes, renal failure, neurological symptoms, pathological fractures, or even amylosis 1. Revelation through pulmonary embolism is exceptional. Through this observation, we are emphasizing on the particularities of light‐chain myeloma.

Multiple Myeloma is a blood cancer type B characterized by clonal proliferation of malignant plasma cells, the median age at diagnosis is 70 years, cases among younger patients are rare, and less than 0, 3 % patients are younger than 30 years in most series. We report a case of a 25-year- old women; she was suffering of a sacred pain radiating towards the left lower limb and fatigue for three months, a magnetic resonance imaging for dorso-lumbar spine showed an expansive process and multiple osteolytic lesions in 2nd, 3rd and 4th sacred vertebras. She underwent a laparotomy that revealed a heavy mass invading the sacrum and the rectum. The histological examination with immunocytochemistry analysis revealed a plasmocytoma and the diagnosis of symptomatic multiple myeloma stage III was established then she received 2 courses of chemotherapy. Despite the rarity of multiple myeloma among young patients, this diagnosis should be evoked when clinical, biological and radiological signs are in favor. It appears that there is no difference between younger and elderly patients on the presentation of the disease, although a longer survival has been reported among young patients.

Background Post cardiac surgery mediastinitis is the major infectious complication, despite the development of surgical techniques and the application of strict preventive measures. The Haemophilus influenzae mediastinitis is very rare. The mediastinitis caused by the association between Haemophilus influenzae and Aggregatibacter aphrophilus has never been described to our knowledge. Case presentation We report the case of an exceptional combination of Haemophilus influenzae and Aggregatibacter aphrophilus in a patient operated for single bypass which is complicated by mediastinitis the 10th day after the surgical act. Conclusion The conclusion to be drawn from this work is to think in unusual seeds in case of mediastinitis post cardiac surgery for the elaboration of recommendations for antibiotic prophylaxis.

Scolymus hispanicus or the Golden Thistle, locally known as ‘Guernina’ or ‘Taghediwt’, is one of the most appreciated wild vegetables in Morocco. This study aims to characterise the functional chemical and pharmacological variability of Scolymus hispanicus parts (roots, stems, leaves and flowers). The chemical analysis revealed higher content of α-tocopherol in the flowers (2.79 ± 0.07 mg/100 g) and lead to the identification of 3 flavonoids and 13 phenolic acids, with high content of gallic acid in leaves (187.01 ± 10.19 mg/kg); chlorogenic (936.18 ± 92.66 mg/kg) and caffeic (4400.14 ± 191.43 mg/kg) acids in flowers, roots were much more higher in sinapic acid (0.25 ± 0.03 mg/kg) compared to the other parts. Moreover, Scolymus hispanicus ethanolic extracts exhibited interesting antioxidant and antimicrobial properties, promising anti-amylase and anti-glucosidase activities and relevant diuretic effect that confirms its traditional uses.

Extra pulmonary small cell carcinomas are extremely rare, accounting for 0.1-0.4% of all malignancies and 2.5-4% of small cell carcinomas. In the head and neck region, the most common primary sites are the larynx, salivary gland, nasal cavity, paranasal sinus, tonsil, and oral cavity. Small cell carcinomas occurring in nasopharynx are extremely rare, to our best knowledge, only four cases of primary nasopharyngeal small cell carcinoma has been described in English literature. We report another case of nasopharyngeal small cell carcinoma arising in a 46-year-old woman. She accused, for five months, nasal blockage, right hypoacousia, exophthalmos and reduced visual acuity. Cerebral and facial magnetic resonance imaging showed an extensive mass of the nasopharynx with the invasion of sphenoidal body, the diagnosis of disseminated small cell carcinoma of nasopahrynx was established. The patient received three courses of systemic chemotherapy; unfortunately, she died after the third course. The prognosis of such entity is poor and is similar to that for patients with extensive small cell lung cancer.

Introduction: This study aims to determine the Acinetobacter sp clinical isolates frequency and its antibiotic susceptibility pattern by comparing results obtained from the Intensive Care Units (ICUs) to that of other units at the Mohammed V Military Teaching Hospital in Rabat. Methods: This is a retrospective study over a 2-years period where we collected all clinical isolates of Acinetobacter sp obtained from samples for infection diagnosis performed on hospitalized patients between 2012 to 2014. Results: During the study period, 441 clinical and non-repetitive isolates of Acinetobacter sp were collected representing 6.94% of all bacterial clinical isolates (n=6352) and 9.6% of Gram negative rods (n=4569). More than a half of the isolates were from the ICUs and were obtained from 293 infected patients of which 65, 2% (191 cases) were males (sex ratio = 1.9) and the median age was 56 years (interquartile range: 42-68 years). Acinetobacter clinical isolates were obtained from respiratory samples (44.67%) followed by blood cultures (14.51%). The resistance to ciprofloxacin, ceftazidime, piperacillin / tazobactam, imipenem, amikacin, tobramycin, netilmicin, rifampicin and colistin was respectively 87%, 86%, 79%, 76%; 52%, 43%, 33% 32% and 1.7%. The difference in resistance between the ICUs and the other units was statistically significant (p