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Introduction: The global impact of the SARS-CoV-2-induced COVID-19 pandemic has reached Morocco. Early identification of factors contributing to severity is imperative for effective management. There is, however, a notable research gap, as only a limited number of studies have systematically investigated the importance of inflammatory biomarkers in assessing COVID-19 severity in the Moroccan context. No study has included the dosage of IL-6 which represents one of the main inflammatory agents responsible for the inflammatory storm. This study attempts to fill this gap by exploring the role of inflammatory biomarkers in the severity of COVID-19 in Moroccan patients. Material and methods: This prospective cross-sectional study was conducted at the Medical Immunology Laboratory of Ibn Rochd University Hospital in Casablanca, between November 2, 2020, and December 1, 2021. Data on demographic characteristics, underlying comorbidities, and laboratory tests were collected from medical records. The patients were divided into non-severe and severe groups. we performed an assay of il-6 using an automated chemiluminescence. technique. Results: The study analyzed 371 confirmed COVID-19 patients and found that lymphopenia, hyperneutrophilia, increased NLR, CRP, and IL-6 were associated with the severity of COVID-19. Significant positive correlations were found between IL-6 and other immune-inflammatory parameters, including neutrophil count, CRP, and NLR. Conclusion: our study provides evidence that NLR, CRP are potential biomarkers for predicting COVID-19 severity in Moroccans. This finding could help with the early identification of severe cases, which can lead to better management and outcomes.

Previous studies on Culex pipiens pipiens mosquitoes collected from Tunisia between 1990 and 1996 revealed an alarming resistance to organophosphate insecticides. However, since then very few studies have assessed the evolution of insecticides resistance in this species of mosquitoes. Three populations of Cx. pipiens pipiens mosquitoes were collected in three districts across the country between 2003 and 2005 and subjected to evaluation of their fenitrothion resistance/susceptibility status and associated mechanisms. Studied populations showed moderate resistance to the used insecticide which ranged from 7.59 to 11.8. The use of synergists revealed the lack of detoxification enzymes as metabolic resistance. However, starch gel electrophoresis indicated that resistance at the Ester locus was attributed to different Ester alleles. On the other hand, the positive cross-resistance to organophosphate fenitrothion and carbamate propoxur insecticides indicating a high prevalence of insensitiveAChE1 mechanism in field populations.AChEactivity showed that all populations exhibited a significant excess of heterozygotes ([RS]) compared to other detected genotypes ([SS] and [RR]) in the studied samples. Our analysis suggests that the heterozygotes often have a fitness advantage over the homozygotes. [ABSTRACT FROM AUTHOR]

Acute kidney injury (AKI) is very common in intensive care units (ICUs). Its complications are often fatal, life-threatening, and may lead to kidney impairment. This is a multicentric, prospective, and descriptive study, spread over a period of six months, from January 1, 2017 to June 30, 2017, including incident cases of AKI defined according to the AKI Network criteria seen in the ICUs of Ibn Rochd University Hospital of Casablanca. Their evolution was studied during the hospital stay at three, six, 12, and 24 months. A total of 102 patients were included, 52% of whom were female. The median age was 45.2 ±0 22.93 years (10 days-87 years). Clinically, 28.4% were oligo-anuric and 54.8% had a multivisceral failure, mainly neurological and respiratory. The median creatinine level was 37.6 mg/L ± 19.82 (8-230). AKI was mainly organic and functional in 43.1% and 40.2% of cases, respectively, and the main etiologies were dehydration, sepsis, and tumor obstruction. Dialysis was required in 25.5% of cases. When discharged from the hospital, mortality occurs in 35% of cases, total recovery of renal function was observed in 22%, progression to chronicity in 38%, and end-stage renal disease (ESRD) in 5% of cases. The progression to chronicity and ESRD increased in the 1st and 2nd year of followup after the first episode of AKI. The risk factors for progression to chronicity were as follows: age, hypertension, the presence of comorbidities, the presence of multivisceral failure and the severity of AKI. AKI is now considered a risk factor for chronic kidney disease and longterm mortality, hence the interest and importance of nephrological monitoring.

Neurovascular involvement is a frequent occurring reported in COVID-19 patients. However, spontaneous hematomas of the corpus callosum are exceptionally seen. The authors of this article aim to report an unusual case of corpus callosum hematoma in a COVID-19 patient and discuss potential etiologies and mechanisms responsible for intracranial hemorrhage.

The SARS-CoV-2 primarily attacks the respiratory system and the most common symptoms include cough, shortness of breath, and fever. However, its tropism for the digestive system has been demonstrated and its clinical digestive manifestations are increasingly recognized. Nevertheless, little attention has been paid to pancreatic lesions included in SARS-CoV-2 infection. This case describes the presentation of acute pancreatitis as a complication associated with SARS-COV-2 infection and the importance of looking for this complication in any patient with COVID-19. Data was collected from a patient admitted with COVID-19 to intensive care in July 2020. The patient was diagnosed with acute pancreatitis associated with SARS-CoV-2. Other causes of acute pancreatitis were excluded for both patients (including alcohol, obstruction/gallstones, drugs, trauma, hypertriglyceridemia, hypercalcemia). This case highlights acute pancreatitis as a complication associated with COVID-19 and highlights the importance of measuring lipasemia and performing an abdominal computed tomography (CT) scan in patients with COVID-19.

With the major spread of SARS-COV-2 around the world, its association with various pathologies has been reported. However, hemopathy has rarely been revealed during a coronavirus infection. The authors of this article aim to emphasize the diagnostic and therapeutic challenges faced while treating COVID/hemopathy patients.

Le syndrome de sécrétion inappropriée de l'hormone antidiurétique (SIADH) représenterait environ 50% de tous les cas diagnostiqués d'hyponatrémie. Seule une faible proportion de SIADH serait d'origine médicamenteuse. Nous rapportons le cas d'une patiente suivie pour un trouble schizo-affectif qui a développé le SIADH après avoir commencé un traitement à base de la rispéridone et la carbamazépine. Les résultats des tests biochimiques suggéraient un SIADH secondaire à l'utilisation de la rispéridone et la carbamazépine. La patiente a été traitée avec succès par l'arrêt des deux médicaments et une restriction hydrique. Après correction de la natrémie la décision thérapeutique était de mettre la patiente sous clozapine. Elle est actuellement sous 400mg avec des taux de natrémie stables. Les psychiatres doivent être conscients du risque d'hyponatrémie sévère associé aux médicaments psychotropes. Il est donc primordial de surveiller les électrolytes, en particulier le sodium, chez les patients prenant des antipsychotiques et des anticonvulsivants.

INTRODUCTION: The aim of the study is to compare efficacy of IvIg versus PE in treatment of mechanically ventilation adults with GBS in intensive care unit. METHODS: It is a prospective, non randomized study, realized in a medical ICU from 2006 to 2010. We included all patients with GBS who required mechanical ventilation (MV). We defined two groups: group 1 (group treated by IvIg: 0.4 g/kg/day for 5 days) and group 2 (group treated by PE: 4 PE during 10-14 days). We collected demographic characteristics, clinical and therapeutic aspects and outcome. Statistical analysis used: The quantitative variables are expressed on mean , standard derivation and compared by Student test. The statistic analysis has been based on SPSS for windows. P = 0.05 is considered as significant. RESULTS: Forty-one patients (21 in group 1 and 20 in group 2) were enrolled. The mean age was 37.4 , 9.2 years, with a masculine predominance (75.4%). Electromyogram in all patients found acute inflammatory demyelinating polyradiculoneuropathy in 80.5 % of patients. The mean length of hospitalization was 45.3 9.2 days. The length of hospitalization of the IvIg group is less long than PE group (p = 0.03). The weaning of the MV was more precocious in IvIg group than PE group (p = 0.01). Also, the beginning of motility recuperation was precocious at IvIg group than PE group (p = 0.04). CONCLUSION: Our work reveals a meaningful difference for the MV weaning and precocious recovery in IvIg group compared to PE group.

Objective: To examine the effects of urbanization on the resistance status of field populations of Culex pipiens pipiens to organophosphate insecticide., Methods: Bioassays and biochemical assays were conducted on Tunisian field populations of Culex pipiens pipiens collected in four various areas differing in the degree of urbanization. Late third and early fourth larvae were used for bioassays with chlorpyrifos and adults mosquitoes for biochemical assays including esterase and acetyl cholinesterase (AChE) activities., Results: The distribution of resistance ratios in this study appears to be influenced by the degree of urbanization. The highest resistance was recorded in the population from most urbanized areas in Tunisia whereas the lowest resistance was found in relatively natural areas. Both metabolic and target site mechanisms were involved in the recorded resistance., Conclusion: This is the first study in Tunisia showing evidence of the impact of urbanization on the resistance level in Culex pipiens pipiens . Proper management of the polluted breeding sites in the country and effective regulation of water bodies from commercial and domestic activities appear to be critical for managing insecticide resistance.

Background: Mosquitoes are considered as the main groups of arthropods that cause nuisance and public health problems., Objectives: Evaluation of resistance to temephos insecticide in Culex pipiens pipiens larvae collected from three districts of Tunisia., Methods: Late third and early fourth instars larvae of Culex pipiens pipiens were collected in three localities of Northern and Southern Tunisia. Field collected populations were tested against temephos insecticide and compared to bioassays of a susceptible reference strain. The cross-resistance between temephos and propoxur, and the polymorphism of over-produced esterases and AChE 1 were investigated., Results: Studied populations exhibited tolerance to temephos with low and high levels of resistance. The resistance ratio (RR 50 ) values of temephos ranged from 1.34 to 114. Synergists and starch electrophoresis showed that the metabolic resistances were involved in the recorded resistance. Likewise, the resistant target site (acetyl cholinesterase: AChE 1) was responsible for the recorded resistance to temephos compound in Culex pipiens pipiens ., Conclusion: The low and high resistance recorded to temephos insecticides is particularly interesting, because it leaves a range of tools useable by vector control services. However, further studies are needed to determine its spread and anticipate vector control failure where these insecticides are used.

Objectives: The aim of the present study was to determine the susceptibility status of Culex pipiens pipiens populations against deltamehtrin insecticide., Methods: Larvae of Culex pipiens pipiens were collected from three breeding places in Northern and Southern Tunisia between 2003 and 2005. Early third and late fourth instars were tested against deltamethrin pyrethroid insecticide. Cross-resistance with DDT resistance was evaluated in studied samples to estimate the role of target site insensitivity and two synergists including piperonyl butoxide (Pb) and S,S,S-tributyl phosphorotrithioate (DEF) were used to estimate the role of detoxification enzymes., Results: Our results revealed that the level of deltamehtrin resistance ranged from 0.67 to 31.4. We also showed the non-involvement of kdr resistance in pyrethroid resistance and no cross-resistance with DDT resistance was detected in all studied populations including the most resistant one. Synergists study on the resistant population (sample # 1) showed the involvement of CYP450 in the recorded resistance to the deltamethrin insecticide., Conclusion: The results obtained from this study should be considered in the current control programs to combat mosquitoes in Tunisia.

Charcot-Marie-Tooth (CMT) disease constitutes a clinically and genetically heterogeneous group of hereditary neuropathies characterized by progressive muscular and sensory loss in the distal extremities with chronic distal weakness, deformation of the feet, and loss of deep tendon reflexes. CMT4H is an autosomal recessive demyelinating subtype of CMT, due to mutations in FGD4/FRABIN, for which nine mutations are described to date. In this study, we describe three patients from a consanguineous Tunisian family, presenting with severe, early onset, slowly progressive, autosomal recessive demyelinating CMT, complicated by mild to severe kyphoscoliosis, consistent with CMT4H. In these patients, we report the identification of a novel homozygous frameshift mutation in FGD4: c.514_515insG; p.Ala172Glyfs*27. Our study reports the first mutation identified in FGD4 in Tunisian patients affected with CMT. It further confirms the important clinical heterogeneity observed in patients with mutations in FGD4 and the lack of phenotype/genotype correlations in CMT4H. Our results suggest that FGD4 should be screened in other early-onset CMT subtypes, regardless of the severity of the phenotype, and particularly in patients of consanguineous descent. In Tunisians, as in other populations with high consanguinity rates, screening of genes responsible for rare autosomal recessive CMT subtypes should be prioritized., (© 2013 John Wiley & Sons Ltd/University College London.)

Resistance toward 2 pyrethroïd insecticides (permethrin and deltamethrin), and an organochloric one (DDT) was analyzed in 18 samples of Culex pipiens pipiens common mosquitoes collected from different Tunisian areas between March 2002 and November 2005. Bioassays were performed over different larvae samples. The recorded mortalities, after 24h exposure to increased doses of insecticides, were compared to those obtained on a susceptible reference strain (S-LAB). All samples were resistant to permethrin. However, a large variation in the tolerance to this insecticide was observed between samples. Resistance ratio levels at LC50 (RR50) for the analyzed samples were ranged from 1.5 to 9092 folds. For deltamethrin, 14 among 17 studied samples were resistant. RR50, in the resistant samples, were ranged from 3 to 453 folds. Resistance to the two tested pyrethroids and DDT were correlated. The use of synergists showed that the cytochrome P450-dependent monooxygenases had a major contribution to the permethrin and deltamethrin resistance and that the esterases (and/or glutathione-S-transferases) had only a minor contribution. Results were discussed in relation to resistance mechanisms and mosquito's control.