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The sub-mitral annular aneurysm is a rare cardiac pathology. The etiologies are diverse, ranging from the congenital form to the idiopathic form, including the acquired form. The clinical case we report is that of a 27-year-old young man, with no particular history, admitted with a picture of global heart failure. A cardiac ultrasound diagnosed a ruptured mitral sub-annular aneurysm in the pericardium. The difficulty lies in the surgical management of this condition, due to the lack of an adequate cardiac surgery service in most of the countries in Africa south of the Sahara.

Introduction: Deep vein thrombosis is a frequent disease, its origin is most often multifactorial. Venous thromboembolic disease (MVTE) and cancer are two frequently entangled pathologies. Here we report the diagnosis of deep vein thrombosis that discovered prostate cancer in an 88-year-old Guinean man. On clinical examination, there was a painful and hot swelling of the right leg, an absence of sloshing of the calf, a positive sign of Homans. The digital rectal examination revealed an enlarged prostate with an irregular surface. Cardiopulmonary auscultation was normal. The electrocardiogram showed a regular sinus rhythm at 65 cycles/min, with no sign of enlarged cavities or conduction disturbance. Venous Doppler ultrasound of the lower limbs showed the presence of an extensive acute deep venous thrombosis of the right sural vein extended to the popliteal and to the homolateral deep femoral. The reino-vesico-prostatic ultrasound concluded in a heterogeneous prostatic hypertrophy with projection of a median lobe associated with a bladder of fight with an important post voiding residue evaluated at 170 ml; the rate of specific antigen of the prostate PSA was at 84.87 ng/ml. The pathology analysis made after a prostate biopsy puncture concluded with an adenocarcinoma with a Gleason score of 3. Conclusion: The association of venous thromboembolic disease (MVTE) and neoplasia is frequent. The existence of active cancer in a patient is a known risk factor for MVTE and, conversely, the discovery of a first episode of deep vein thrombosis (DVT) or pulmonary embolism (PE) may be the mode of revelation of cancer.

Elderly people occupy a prominent position in African societies; however, their potential linkage to high case fatality rate (CFR) in Ebola virus disease (EVD) was often overlooked. We describe the predictive factors for EVD lethality in the elderly. A total of 2,004 adults and 309 elderly patients with confirmed EVD were included in the analysis. The median age (interquartile range) was 35 years (23–44) in adults and 65 years (60–70) in the elderly. The proportion of funeral participation was significantly higher in the elderly group than in the adult group. Duration (in days) between the onset of symptoms and admission was significantly longer in elderly. CFR in the elderly people was also significantly higher (80.6%) than in the adult group (66.2%). Funeral participation constituted a risk factor for the transmission of EVD in elderly people.

Introduction The Atrioventricular Canal is a serious pathology due to the complexity of the lesions and the risk of fixed Pulmonary Arterial Hypertension. It represents 3 to 7.3% of congenital heart disease. Its prognosis depends on the precocity of its diagnosis and its management. The interest of this work therefore was to evaluate the management of CAV at IBN-ROCHD CHU. Purpose It is to make an inventory of the CAV profile, their diagnostic and therapeutic management on the one hand, the delay of management, the postoperative evolution, the reasons for intervention and the factors predicting mortality of patients follow-up for CAV at the cardiology department of CHU Ibn-Rochd-Casablanca. Methods We conducted a 10-year retrospective study from 2008 to 2017 including all cases of CAV found in the study period. Results Three hundred and thirteen patients were found in the study period. Surgical management of patients with CAV was performed in the liberal sector in 59.3% of cases, followed by 37% in the public sector, and surgeries performed in foreign missions accounted for only 3.7%. CAV surgery in our study. The median age of operated patients was 10.4 months with a minimum of 4.9 months and a maximum of 35.9 years. Of the operated patients, 69.2% received curative treatment at a median age of 7 months with a minimum of 2 months and a maximum of 35.9 years,while 13.3% received palliative treatment. Conclusion The surgical management of CAV must be early to improve the survival of these patients in the long term. The Atrioventricular Canal is a serious pathology due to the complexity of the lesions and the risk of fixed Pulmonary Arterial Hypertension. It represents 3 to 7.3% of congenital heart disease. Its prognosis depends on the precocity of its diagnosis and its management. Hence the interest of this work which was to evaluate the management of CAV at IBN ROCHD CHU.

Introduction: Heart Failure (HF) is a growing public health concern in Morocco and there is a striking paucity on determinants of severe HF (SHF) in this population. The aim of this study was to identify patients admitted with HF at Ibn Rochd Hospital, Casablanca from 2011 onwards, when electronic record keeping began.Methods: a total of 105 patients underwent a series of cardiological examinations between July 2011 and January 2014. The New York Heart Association (NYHA) criteria was used to evaluate the severity of HF. Patients with NYHA classification gradings of I and II were defined as having moderate HF (MHF) and those graded as III and IV were defined as having a SHF. Univariable and multivariable risk factors associated with SHF were explored using logistic regression. The results were reported following the RECORD (Reporting of studies Conducted using Observational Routinely-collected Data) statement.Results: a total of 24 (33%) patients were identified as having a SHF. Four predictors of SHF were identified in univariate analysis: haemoglobin 3, mean corpuscular haemoglobin concentration (MCHC) 3 and HDL 3 were at 6-fold increased odds of SHF [adjusted odds ratio (AOR): 6.78, 95% confidence interval (CI): 1.40-32.80, p=0.017], and those with HDLConclusion: the independent biomarkers of SHF identified in this study provide valuable information to ward clinicians in resourceconstrained facilities to identify patients vulnerable to developing severe heart complications.

Background The Sustainable Development Goal (SDG) for neonatal mortality has identified its reduction as one of the main targets to be achieved by 2030. We provide a descriptive report on neonatal outcomes from the only neonatal intensive care unit (NICU) in Guinea. Methods Data collection took place between November 2004 and May 2005 at the NICU of the Institute of Child Health in the capital, Conakry. A descriptive summary of the neonatal, maternal and intrapartum characteristics is reported. Results A total of 294 neonates were admitted to the NICU incubators during the study period, transferred either from hospitals (48%) or directly from their homes (52%). The most common reasons for admission were foetal distress (37.1%) and maternal–foetal infections (35.4%). Among 270 neonates with known outcome, the overall mortality among the admitted children remained high at 20.7% (56/270),with a large proportion of the deaths (71.4%, 40/56) occurring within 7 d of their admission. The mortality rate was 23.7% (31/131) among the neonates who were admitted to our NICU after home birth and 17.9% (25/139) among those who were transferred from hospitals (OR: 1.41, 95% CI: 0.75–2.67). Conclusion Almost one in every five neonates who were admitted to the NICU incubator died during the study period. More hospitals equipped with NICU facilities are urgently required if Guinea is to achieve the SDG target for neonatal mortality.

The purpose of this study was to examine the association of any demographic and clinical factors with mortality outcome among adult patients with Ebola virus disease (EVD) in Guinea. This retrospective observational study analyzed medical records of laboratory confirmed EVD adult patients during the 2014–2015 EVD outbreak in Guinea. The associations between any demographic or clinical variables and mortality outcome of EVD were assessed using univariate and multivariate logistic regression analyses. Of 2,310 EVD adult patients included for analysis, the overall case fatality rate was 68.1%. Univariate analyses identified factors possibly associated with mortality outcome, including patient age (p

The most recent epidemic of Ebola virus disease (EVD) has resulted in more than 11,000 deaths in West Africa. It has threatened child health in the affected countries, including Guinea. This nationwide retrospective cohort study included all children under 20 years of age with laboratory-confirmed EVD in Guinea during the 2014-2015 Ebola outbreak for analysis. Of 8,448 children with probable or suspected EVD, 695 cases were laboratory-confirmed EVD. The overall case fatality rate (CFR) was 62.9%. Pediatric patients with younger age had a significantly higher rate of death (adjusted OR = 0.995; 95%CI = 0.990-1.000; p = 0.046), with the highest CFR of 82.9% in children aged less than 5 years. Fever (91%), fatigue (87%), and gastrointestinal signs and symptoms (70%) were common clinical features on admission of the pediatric patients, while bleeding signs were not occurring often (24%). None of clinical features and epidemiologic risk factors for Ebola were associated with mortality outcome in our cohort study.EVD is a major threat to child health, especially among children under 5 years of age. To date, none of demographic and clinical features, except younger age, have been consistently shown to affect mortality outcome in children infected with Ebola virus. What is Known: • The 2014-2015 West Africa Ebola epidemic is the largest and most widespread outbreak of Ebola virus disease (EVD) in history, with more than 11,000 deaths in Guinea, Liberia, and Sierra Leone. • During ongoing outbreak investigations, it is suggested that young children aged less than 5 years are particularly vulnerable and highly susceptible to death. What is New: • Demographic and clinical characteristics of the nationwide cohort of pediatric patients with laboratory-confirmed EVD in Guinea are reported. • The results confirm the high rate of death among EVD children under 5 years of age, while none of demographic and clinical features, except younger age, could serve as a predictor of mortality outcome in pediatric patients with EVD.

Background The purpose of this study was to test the hypothesis that the Neutrophils to Lymphocytes count ratio (NLR) provides better correlate of the Heart failure (HF) the severity in addition to the physical examination in patients with suspected HF. Thus, its use in the resource limited health facilities lacking with ultrasound and or CT scan, may reduce treatment delay and also improve the follow-up and referral system for HF patients. Materials and methods Patients admitted for HF underwent physical examination, ECG and echocardiogram. Venous blood collected from each patient was assessed for the haematological and biochemistry parameters. Results Of 105 patients were included in this study, of them, 81 cases were classified into moderate including NYHA class I and II and 24 cases as severe including NYHA class III and IV. The median-age was 64.8 years (IQR: 55.5-72.6) and 58.4 (IQR: 52.3-67.84) for moderate and severe HF respectively. The NLR (p = 0.029) and HDL levels (p = 0.018) were found to be an independent risk factor for a severe HF. After adjusting other factors, area under the ROC curve of NLR and HDL in predicting severe HF were 0.68 (95% CI = 0.541–0.816) and 0.168 (95% CI = 0.076–0.259) respectively. NLR showed the better predicting ability of the severe HF. Conclusions Our findings revealed that NLR derived as a simple marker using a routine complete blood count data, was significantly and independently related to the severity of HF. Therefore, NLR is a potential indicator for HF severity in the resource limited health facilities.

Background Abnormal liver function tests are common in ambulatory chronic heart failure but characterization and importance of liver dysfunction are poorly defined. The aim of this study was to evaluate the incidence of liver dysfuction in ambulatory patients diagnosed with chronic heart failure in order to establish a correlation with the risk factors, evolution and prognosis. Methods 1613 consecutive ambulatory patients with chronic heart failure were enrolled from 2006 to 2013 and registered in the therapeutic unit of chronic heart failure. Clinical, echocardiographic and biological data were investigated. In only 358 HF patients, liver function was determined by aspartate and alanine aminotransferase (AST, ALT). We divided our population into three groups: group 1 with elevated ALT>45 UI/l, group 2 with elevated AST >45 UI/l and group 3 with normal liver enzymes. Results Liver dysfunction was present in 13.68%. Mean serum levels of ALT and AST were 98.44 UI/l and 88.43 UI/l respectively. Liver dysfunction was associated with male sex (p=0.019), dyslipidemia, smoker and coronary heart disease (p=0.004). Compared with a normal liver function, those with dysfunction had a higher heart rate and more cardiac right and left decompensation. Also Transaminases elevated were associated with more tricuspid regurgitation (p Conclusions Liver dysfunction is frequent in chronic heart failure. Patients with heart failure and abnormal liver function had less optimized traitment with more hospitalizations for cardiac decompensation

Background The embolism from cardiac origin represent the second cause by order of frequency of stroke. Among the accidents of ischemic type, 20 per cent are related to an embolism of cardiac origin and are accessible to an effective prevention thanks to a quick diagnosis of the heart defect. The purpose of our work is to determine the epidemiological profile, clinical, para-clinical heart disease emboligenes and assess their complex support on ground of ischemic stroke in a hospital environment. Methods We conducted a retrospective study of descriptive type in the cardiology department of the hospital Ibn Rochd of Casablanca during a period of three years (January 2012 -December 2014). Have been included in our study all patients with this clinical manifestations suggestive of a stroke that the ischemic nature has been confirmed to the brain scanner by a hypodensity with or without flaw. Patients had to be carriers of a proven heart disease high-risk of embolism as defined by the classification TOAST (Total Occlusion Angioplasty Study) and hospitalized during these past three years in the service. Results 102 exhibited an ischemic heart disease with high risk of embolism giving a prevalence of 9.5 per cent or 48 men and 54 women. There was, overall a predominantly male before 65 years and then a predominantly female from 65 years ago. The peak occurred in the male is located between 55 and 64 years. The heart disease encountered are: AF (46%) on valve disease, ischemic heart disease (27%), dilated cardiomyopathy (9%). In the Transoesophageal Echocardiography (TEE), a spontaneous contrast with a thrombus in the left atrial appendage in 4 cases, a dysfunction of pros-theses in 6 cases, an infective endocarditis. The support has been carried out on a case-by-case basis with consultation with the medical team neurological. However, approximately 9% of the cases are complicated by haemorrhage including 5% of deaths. Conclusion Stroke is a major complication of heart disease. This work has highlighted the high frequency and the role of cardiac sources of embolism (AF; AF on mitral valve disease, mechanical valve prosthesis; the myocardial infarction,) in the occurrence of a stroke especially Ischemic. The association of heart disease with stroke is a public health problem in Morocco. The support for this association requires an interdisciplinary collaboration (cardiologists, neurologists, radiologists) and prevention remains the only effective measure.