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The AguelmamAzegza lake is located in the Middle Atlas mountain range, this region consists of carbonate rocks of Lias. It is the best-watered and richest region in Morocco in terms of wetlands, especially natural lakes, rivers and fresh springs. The lake’s water supply is ensured by the inflows of water in the form of underwater sources fed by precipitation (rain and snow) following tectonics and the genesis of karstic formations by the dissolution of carbonate rocks. The declining trend in lake levels in recent years results from the decrease in precipitation which decreases during these years.

Investigating habitat selection and ecological factors trade-offs is a major avian ecology topic which is closely implicated for conservation purposes. Studies dealing with the impacts of ecological factors on wintering Spoonbills are overall scarce. Here, we used Principal Component Analyses (PCA) and Generalized Linear Mixed Models (GLMM) to test the relevance of geographical, environmental and anthropogenic factors in predicting the occupancy and abundance of the Eurasian spoonbills (Platalea leucorodia) during 2008-2011 within 28 Moroccan wetlands. The Eurasian Spoonbill mean annual occurrence was 59.2% (± 1.5% SE; 95%CI: 56.3%-62.1%). Among the occupied wetlands, 15 (83.3%) were regularly occupied. We found that the Eurasian spoonbill occurrence was negatively related to distance to coastline, altitude and human presence, whereas its abundance increased significantly with increasing mudflat areas. These findings highlight the significant effect of human presence in selecting wintering sites, but not in the prediction of abundance. Management strategies should therefore address specific attributes of coastal wetlands and should carefully consider the effects of habitat use especially those related to mudflats. We further suggest guidelines for future studies to understand the dynamic of Eurasian spoonbills wintering in the region.

Tourism merits on natural spaces are not exhausted, namely economic dynamics, development of the local population’s life conditions, species conservation and awareness of environmental protection. However, the damage caused by Coronavirus to natural and rural spaces has impacted such merits negatively, for example, suspension of tourism and recreation activities. Further, the rebirth of ecotourism will be slower and necessitates profound changes in travel design and service delivery. Hence, sustainability, sanitary and regulatory measures will probably help manage ecotourism systems. Nevertheless, these will be affected by the increase in exploring relations between nature and wildlife regarding zoonotic and vector-borne infections and the fragility of biodiversity. Because of his mobility, a tourist appears to be a potential pathogen transmission factor of infections to natural areas, local communities, ecotourism destinations, his country and the crossed ones. New procedures would reduce travel and control traveler’s behavior, and interactions between travelers and wild animals. The slowdown in demand may thus hinder the development of ecotourism. Sensitivity to epidemiological risk and vector-borne diseases will be greater and the need for health-friendly tourism will be further strengthened.

COVID-19 pandemic has had huge impacts on multiple industries and sectors, not just ecotourism and wildlife protection in Morocco. Ecological health and wildlife are a critical resource for the country’s tourism sector recovery. Conservation is considered as one of the industries that are hit hard by the COVID-19 pandemic. Many of the threats facing biodiversity and protected areas have been exacerbated during and following, the outbreak with practices such as poaching, wildlife trafficking, and forest logging activities resumed due to the country lockdown and ecotourism collapse. Conservationists should take emergency actions in the short-term to help rural communities and grassroots organizations and review waysto achieve conservation and sustainability goals in the post-pandemic era.

The population of the African continent is significantly increasing which has given rise to societal, economic and environmental changes. This will generate an increase in demand for food, water and energy. Thus, strategies for sustainable management of natural resources need to be adopted urgently in order to match the future needs and to ensure sustainable development on the continent. The Water Energy Food (WEF) nexus is one the avenues for studying the current and future interactions and interdependencies of the WEF sectors under different scenarios and challenges in the effort towards establishing sustainable use of natural resources. Policies around the nexus approach are few or absent at the continental and countrylevels. This paper is a first review on the adoption of the Nexus in two model African countries, Morocco and South Africa. The review compares the water, energy and food sectors and the related national policies, plans and frameworks. The data related to the WEF Nexus revealed key difficulties of availability in both countries. A comparative analysis of the situation in both countries demonstrated differences in policies relating to the WEF Nexus across the sectors: water, energy, and agriculture. Additionally, the paper explores the relevance of technology-assisted frameworks for the WEF nexus and also analyzed risks to agriculture and food security in the context of the reviewed countries.

Le carcinome à cellules de Merkel (CCM) est une tumeur cutanée neuroendocrinerare d'évolution imprévisible et à grand potentiel métastatique. Ce néoplasme survient habituellement chez le sujet âgé au niveau des zones photo exposées. L'avidité constante du CCM au 18 fluorodésoxyglucose (FDG) justifie l'intérêt de la tomographie par émission de positon (TEP) au cours de cette pathologie. Toutefois, aucun consensus n'est établi à ce jour. Cette étude rapporte le cas d'une patiente de 25 ans suivie pour CCM métastatique, afin d'attirer l'attention sur cette tumeur particulière et d'illustrer l'intérêt de la TEP au 18 FDG dans la prise en charge de cette entité rare.

Bone marrow aplasia is a rare and serious hematologic disorder. Although benign, it is a hematologic disorder whose prognosis can be poor and whose spontaneous development can be fatal. Treatment is long, difficult and costly. In developing countries, the mortality rate is high due to the difficulties of therapeutic management, both supportive and specific. We conducted a retrospective study of 92 cases of AM identified in the Pediatric Hematology and Oncology Department of the 20 Août University Hospital in Casablanca over a 10-year period (January 2010-January 2020). In this work, we present an overview of the situation and highlight the difficulties encountered in the management of AM in the Pediatric Hematology and Oncology Department of the University Hospital of Casablanca. In our study, the mean age was 19 years, ranging from 3 months to 29 years, with a peak in the 15-20 age group. The sex ratio (M/F) was 2.06, with a male predominance of 67%. In our series, only 35% of patients had complete bone marrow failure. An anemic syndrome was present in 92% of patients, and hemorrhagic and infectious syndromes were present in 70% and 41% of patients, respectively. The median time from diagnosis to treatment was 82 days. According to the Camitta score, 31% of our patients had mild AM, 41% had severe AM, and 28% had very severe AM. After etiologic evaluation, we concluded that 90% of the patients had idiopathic bone marrow aplasia, 2% had constitutional bone marrow aplasia, and 8% of the patients were suspected to have secondary bone marrow aplasia: post-hepatitis (3 cases), toxic (2 cases), drug-induced (1 case), and aplastic PNH (1 case). Mortality in the first three months after diagnosis was 21%. Sixty-nine percent of our patients received specific treatment: 28 were treated with cyclosporin (CIS) alone as first-line therapy, 20 received a combination of antilymphocyte serum (ALS) and cyclosporin, 2 received hematopoietic stem cell transplantation (HSCT), while 3 were treated with androgens alone. The overall response rate was 30% with CIS, 42% with ALS+CIS and 100% with HSCT. In our study, the overall death rate was 44%, while the one-year survival rate was 40%. It is important to note that septic shock was the leading cause of death (53% of deaths), followed by hemorrhagic shock (24%). This highlights the lack of hemodynamic resuscitation and symptomatic treatment. Our multivariate study defined the following risk factors as predictive of worse survival: age greater than 16 years (RR: 3.28; CI: 1.29-8.33; P=0.012), PNN less than 200 or very severe bone marrow aplasia (RR: 3.01; 1.1-8.08; P=0.028), and failure to receive any specific treatment (RR: 4.07; 1.77-9.35; P=0.0003). The high overall mortality in our series was due to several factors: inaccessibility to effective therapies, delayed diagnosis, failure to initiate specific treatment, inadequate symptomatic treatment, and geographical and financial inaccessibility., (Copyright © 2024 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)

Primary renal marginal zone B lymphoma is extremely rare. The renal involvement by the lymphoma is most often a manifestation of a disseminated disease. We report the case of a 53-year-old patient who presented lower back pain and kidney failure. The renal biopsy showed a marginal zone B lymphoma type MALT and the PET scan showed bilateral renal involvement. A treatment based on rituximab combined with chemotherapy (cyclophosphamide, prednisone and oncovin) was started with good outcome.

Introduction: The treatment of chronic myeloid leukemia (CML) has been revolutionized by the advent of tyrosine kinase inhibitors. The results of the IRIS trial demonstrated the efficacy and long-term safety profile of Imatinib. The objective of our work is to report the results at 15 years of treatment of CML in chronic phase with Imatinib in Morocco., Patients and Methods: Retrospective study realized at the hematology unit of CHU d'Ibn-Rochd in Casablanca, from January 2003 to September 2018, including all CML patients in the chronic phase at diagnosis, were treated with Imatinib for a minimum duration of 6 months., Results: In total, 318 patients were collected, the median age was 41.5 years, the sex ratio M/F was 0.7, the Sokal score was high in 56% of cases. The complete hematological response at 3 months was 92%, the complete cytogenetic response at 12 months and the cumulative response were obtained in 43% (29/67) and 55% (153/279) of the cases respectively, the molecular response was evaluated in 125 patients witch 85% were on major molecular response. On a median follow-up of 44 months, the OS and EFS at 10 years were 86% and 59%, respectively., Discussion: Our profile is characterized by a young age of the patients, the female predominance and a high Sokal score. The rate of complete cytogenetic response remains lower compared to what is described, however the survival rates as well as the tolerance were similar to those of the literature., (Copyright © 2020 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)

Introduction: The goal of this study is to assess functional and aesthetic results of anterior lamellar resection with lid margin splitting of the upper lid in the treatment of cicatricial trachomatous entropion., Patients and Methods: Descriptive cross-sectional study of a series of 26 consecutive patients treated between January 2014 and December 2015. All patients were operated for cicatricial trachomatous entropion in our tertiary center using the technique of the anterior lamellar resection with lid margin splitting of the upper eyelid. All patients were followed for 6 to 12 months after surgery. The anatomical, functional and aesthetic results were evaluated six months after surgery. They were considered good if there was no recurrence of the entropion, no lashes in contact with the cornea and no associated eyelid complications., Results: The mean age of the patients was 68.5±10 years with a male predominance (sex ratio=1.8). The average initial corrected visual acuity was 0.65±0.35 LogMAR, ranging from counting fingers at 1m to 6/10. Involvement was bilateral in 34.6% of cases. Correction of the cicatricial entropion was achieved in 24 patients (92.3% of cases) and full correction of misdirected lashes without any contact with the ocular surface was obtained in 23 patients (88.4% of cases). The lid margin was regular in 88.4% of cases. A significant improvement of the tear film and corneal surface was observed in 84.6% of patients. During the follow-up period, no cases of recurrent entropion were reported., Discussion: Among the various surgical techniques, anterior lamellar resection with lid margin splitting is one that most respects the anatomy of the upper eyelid and allows precise intraoperative control of eyelid rotation and eversion of the misdirected lashes. Therefore, it reduces significantly the risk of recurrence and significantly enhances the aesthetic results of surgery., Conclusion: Anterior lamellar resection with lid margin splitting of the upper eyelid is a simple and effective technique that significantly improves the aesthetic result of cicatricial trachomatous entropion., (Copyright © 2017 Elsevier Masson SAS. All rights reserved.)

Purpose: To evaluate the aesthetic and functional results of the Köllner-Hughes tarsoconjonctival flap technique for large defects of over three-quarter of the lower eyelid., Patients and Methods: A retrospective descriptive study of a series of 15 patients treated between January 2013 and December 2015. We included all patients who underwent reconstructive surgery for a tumor involving more than three-quarter of the lower eyelid and sparing the canthi. Reconstruction of the lower eyelid defect was performed using Köllner-Hughes technique., Results: The mean age of our patients was 65.7±8 years. The sex ratio was 1.5 with male predominance. All patients had well-differentiated basal cell carcinoma of the lower eyelid. The average size of the eyelid defect induced by the surgery was 18±4mm. Release of the tarsoconjonctival flap was performed after a period of 8 to 10 weeks after the reconstructive surgery. After a mean follow-up of 12±6 months, the aesthetic and functional results were satisfactory in 86.7% of cases especially in terms of eyelid closure and protection of the ocular surface. Complications included erythema of the newly formed free edge in 26.7% of cases, keratinization and hypertrophy of the free edge in 20% of cases, the deformation of the upper free edge with an associated entropion in 20% of cases and lower eyelid retraction in 6.67% of cases. Ocular surface disease such assuperficial punctate keratitis or dry eye was found in 13.4% of cases., Discussion: Several authors have chosen the Köllner-Hughes technique to treat increasingly wide eyelid defects with very satisfactory results. Eyelid reconstruction with the Köllner and Hughes technique is a very attractive procedure because it offers several advantages. It is a quick and easy technique that covers wide defects over three-quarter of the lower eyelid well with very satisfactory cosmetic results and without significantly increasing morbidity at the donor site. In combination with additional procedures, this technique can totally reconstruct the lower eyelid. Despite all its benefits, the Köllner-Hughes tarsoconjonctival flap has some minor drawbacks, such as the need for two surgeries spaced a few weeks apart to open the palpebral fissure; therefore it is contraindicated for one-eyed patients and children because of the risk of amblyopia., Conclusion: The tarsoconjonctival flap as initially described by Köllner and Hughes was indicated in the reconstruction of moderate and medium-sized defects of the lower eyelid. In our practice, we can extend the indications of this technique to much larger defects than three-quarter of the lower eyelid, while ensuring satisfactory aesthetic results and minimal complications., (Copyright © 2017 Elsevier Masson SAS. All rights reserved.)

Introduction: The prevalence of pseudoexfoliation syndrome is estimated at 8 % of all cataracts operated within our institution. The goal of our study was to describe the frequency of intraoperative and postoperative complications and long-term anatomical and functional results of phacoemulsification in pseudoexfoliation syndrome., Patients and Methods: A retrospective observational study of a series including 103 patients (107 eyes) with cataract associated with pseudoexfoliation syndrome admitted between January 2010 and September 2014. All patients underwent phacoemulsification., Results: The average age of our patients was 72.5±6 years. The average initial corrected visual acuity was 0.52±0.14LogMAR. The cataract was grade C3N3 in 58 % of cases. The pseudoexfoliation syndrome was bilateral in 69 % of cases. Pupillary dilatation was≤6mm in 54 % of cases. Among intraoperative complications, zonular dialysis was found in 1.8 % of cases. Posterior capsular rupture and vitreous loss was noted at 5.4 % of patients. The incidence of secondary cataract was 31.7 % at 12 months. The mean postoperative best corrected visual acuity was 0.13±0.15 LogMAR., Discussion: The small pupil associated with high grade of the cataracts in our series explains the slightly higher frequency of intraoperative zonular dialysis. Cataract surgery by phacoemulsification allows for a statistically significant improvement in visual acuity (P<0.001). The incidence of secondary cataract, the main postoperative complication, is higher in our series compared to data in the literature., Conclusion: Pseudoexfoliation syndrome is common in our country. Functional results of phacoemulsification are very satisfactory, and secondary cataract is the main complication. A meticulous search for pseudoexfoliation is mandatory during the initial examination in order to reduce intraoperative complications. Careful removal of the cortex and systematic polishing of the lens capsule should limit the incidence of secondary cataracts., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

Objective: HAI cause considerable morbidity and mortality and are associated with prolonged hospital stay and increased health care costs. To describe the incidence of HAI in paediatric cancer patients as the first step towards improving infection control policies., Methods: A prospective surveillance study was performed in the Casablanca university hospital paediatric haematology/oncology unit over an 8-month period from January to August 2011. Data including extrinsic risk factors associated with HAI were recorded., Results: The incidence of HAI was 28 per 1000 patient-days. The median age was 9.6 years and the most frequent diagnosis was acute myeloid leukaemia (32%). Neutropenia at diagnosis was significantly correlated with the risk of HAI. 55.7% of HAls were nosocomial fever of unknown origin. Gram-negative bacteria were the main pathogens (60%), gram-positive cocci were responsible for 26% of HAI and Candida for 14% of HAI. The length of hospital stay for patients with and without infection were 16.5 and 5 days, respectively (P < 0.001). Six of the 11 deaths were related to HAI., Conclusion: These findings suggest the need to evaluate infection control measures in order to reduce morbidity and mortality in paediatric haematology/oncology units.

Willebrand's disease is the most frequent inborn coagulopathy and type 3 is its most severe form. Pregnancy and delivery are critical events in women with Willebrand's disease of type 3. Prophylactic treatment for delivery and early postpartum period is recommended. We report the management of pregnancy and successful delivery of a 32-year-old woman with type 3. Prophylactic treatment with 2000 IU of Willebrand's disease factor (WdF) was given twice a day during the delivery day and the day after, and 1000 IU per day during the next three days. The patient did not show any spontaneous metrorrhagia but anemia. No bleeding was observed in the newborn.