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Anti-Jo1 antibodies are usually known markers of myositis. However, they can be associated with different pathologies. We aimed to determine the immuno-clinical characteristics of patients with positive anti-Jo1. We enrolled 31 anti-Jo1 positive patients, selected from 10429 cases tested for antinuclear antibodies (ANA) by indirect immunofluorescence. The anti-Jo1 identification was motivated by the ANA pattern or the clinical data of patients. The average age of patients was 36.9 ± 10 years (F/M sex ratio: 3.4). The overall prevalence of anti-Jo1 was 0.3% among all ANA-tested cases. The ANA pattern associated with the presence of anti-Jo1 was heterogeneous with ANA negative in 38.7 % of cases. They were associated with different autoantibody specificities in 64.5 % of cases and were alone in 35.5% of cases. When confronted with clinical data, anti-Jo1 positivity was associated with autoimmune (77,4%) and non-autoimmune (22,6%) clinical conditions. Our study shows a low overall prevalence of anti-Jo1. These antibodies must be systematically tested for in the context of myositis even if ANA is negative. Nevertheless, their positivity in other systemic or even non-autoimmune diseases requires further studies to better understand their clinical significance.

Introduction: Globally and in Morocco, viral hepatitis is a major public health priority, and knowledge and awareness are essential in the combat against this disease., Aim: To assess the knowledge, attitudes and practices of university students regarding viral hepatitis., Methods: A descriptive and analytical cross-sectional study was conducted among students enrolled at Mohammed Premier University in Oujda, for the 2023-2024 academic year, using a self-administered and anonymous online questionnaire., Results: 503 students completed the online questionnaire. The results showed that hepatitis B (73.6%) and C (67.4%) are better known than hepatitis A (52.0%) and E (24.3%). The majority of students (78.0%) knew that HBV can be transmitted by blood, and 62.0% by sexual transmission. For the main mode of transmission of hepatitis C, around two-thirds of respondents (69.0%) indicated transmission by contact with infected blood. Transmission of HVA and HVE viruses was known by 43.5%. The level of knowledge about hepatitis was significantly associated with education levels, medical school affiliation and socio-economic status. Students' preventive practices were positive, but their attitudes towards people with viral hepatitis were negative., Conclusion: Our results suggest that knowledge of hepatitis needs to be improved through awareness and education campaigns, in order to combat these diseases, especially as Morocco has committed to a global movement to eliminate viral hepatitis by 2030.

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.)

Introduction: Gliptins are a relatively recent class of oral antidiabetic agents used in the treatment of type 2 diabetes. The aim of this study is to identify the adverse effects of gliptins in patients with type 2 diabetes, compare the tolerability of these drugs with data from the literature, and determine patients' behavior in the face of these adverse effects with a view to optimizing their management., Methods: Our study is cross-sectional, descriptive, and analytical, involving 100 patients aged over 20 years, followed at the Endocrinology Department of the Military Hospital Mohammed V., Results: The average age of the patients was 63 years, with a sex ratio F/H of 1.13. The median age of diabetes in the patients was 13 years, with an average blood glucose level of 1.64 and an average hemoglobin A1c of 8.26. The comorbidities were 30% cardiovascular disease, 25% hypertension, and 14% dyslipidemia, and 30% of patients had no comorbidities. Forth-six percent of patients reported adverse events and 54% did not report any adverse event. Twenty-eight percent of the adverse events were gastrointestinal, 18% skin disorders, 14% urinary tract infections, 12% hypoglycemia, 12% nervous system disorders, 8% airway infections, and 8% general disorders., Conclusion: This study shows that gliptins remain a safe option as the side effects seem fairly well tolerated by patients. Adverse events may impact patient compliance and pose a problem of adherence to treatment. Thus, it would be advantageous to develop therapeutic education for diabetic patients to detect and manage adverse effects., (Copyright © 2024 Copyright: © 2024 Annals of African Medicine.)

Background: dermatophytoses are a current fungal infection, caused by keratinophilic fungi (dermatophytes) able to invade the nails, hair and skin of humans and animals., Aim: the aim of this study was to establish the epidemiological and mycological profile of dermatophytes isolated in the parasitology-mycology laboratory of the Mohammed VI University Hospital in Oujda., Methods: this is a 48-month retrospective study from January 2019 to December 2022.The study includes samples taken or sent to our parasitology-mycology laboratory for mycological study. A direct examination and culture were performed on each biological specimen. Species identification was based on macroscopic and microscopic colony criteria., Results: in the present report we reviewed 950 mycological samples. Dermatophytes were isolated in 505 (53.15%) cases. The most common infections were tinea unguium (n=353; 69.90%), followed by tinea corporis (n=123; 5.74%) and tinea capitis (n=29; 5.98%). Trichophyton rubrum was the most frequently incriminated species., Conclusion: dermatophytes are the most frequent mycoses in humans. They are generally benign and often develop in a chronic and frequently recurrent pattern. Mycological examination is essential. It confirms the fungal origin and isolates the species responsible, in order to identify the source of contamination and implement an appropriate treatment.

Introduction: Our purpose was to study the body composition in a healthy female Moroccan adult group, and to help physicians to evaluate nutritional status., Materials and Methods: Five hundred and nineteen healthy women aged from 20 to 80 years were included in the study. Bone mineral density at the hip and lumbar spine and the body composition parameters were measured by dual-energy X-ray absorptiometry: fat mass (FM), fat-free mass (FFM), and percentage (%) of body fat. The FFM index (FFMI) and the FM index (FMI) were calculated. We analyzed the population by age and body mass index (BMI) defined groups., Results: The mean age of the population was 53.14 ± 13.69 years with an average BMI of 29.30 ± 5.04 kg/m2. Means of FM and FFM were 33.93 ± 9.18 kg and 36.91 ± 5 kg, respectively, with FM and FFMI of 13.65 ± 3.66 kg/m2 and 14.85 ± 1.91 kg/m2, respectively. The % FM, FFM, and their corresponding indices increased with age; a statistically significant difference was observed between the 20 and 39 age categories and the two other categories. The BMI category analysis showed that FFMI and FMI increased in obese women with a statistically significant difference between the four groups. Age and BMI were correlated significantly with the different parameters., Conclusion: This is the first Moroccan study to present body composition indexes in healthy Moroccan female adults. These reference values may be useful for the clinical evaluation of body composition and nutritional status., (Copyright © 2024 Copyright: © 2024 Annals of African Medicine.)

Geriatric in-patient dermatoses are diverse. Few data in Morocco describe the epidemiological profile and factors associated with average length of stay (LOS). Our aim was to identify these dermatoses and determine the factors associated with LOS., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Introduction: The increase in hip arthroplasties predicts a rise in periprosthetic fractures in Morocco, posing challenges for orthopedic surgeons. Therapeutic strategies vary considerably, highlighting the absence of a universally accepted treatment protocol., Aim: To analyze the management of per-prosthetic hip fractures, while addressing the challenges associated with them., Methods: This was a retrospective study, conducted in the trauma-orthopedics department between December 2015 and November 2022. Nineteen patients who presented to the hospital with fractures around a hip prosthesis were included., Result: Nineteen periprosthetic fractures were observed. The majority of patients (68%) were women, with an average age of 68. The Vancouver classification showed that 52.6% of the fractures were type B1, and 21.1% type C, while the other fracture types were distributed differently. These fractures were mainly associated with diagnoses such as femoral neck fracture (63.2%) and coxarthrosis (31.6%). We observed variations in treatment recommendations and results between the different series analyzed. We noted discrepancies with certain series concerning fracture types and therapeutic choices. However, in our series, we achieved satisfactory results, with successful consolidation and the absence of complications in all patients., Conclusion: These results underline the importance of an individualized approach to fracture management, taking into account the specificities of each case.

Introduction Substance use among resident physicians is an underestimated, poorly understood, and serious problem because of its negative consequences for the health of physicians and also for the health and safety of the patients in their care. Objective To estimate the prevalence and identify factors associated with addictive behaviors among resident physicians at different university hospitals in Morocco. Method We conducted a multicenter cross-sectional descriptive and analytical study involving resident doctors from the 7 university hospital centers in Morocco. Resident doctors were invited to participate voluntarily in the study by completing an anonymous self-questionnaire created on Google Forms and sent via email. Results The questionnaire was completed by 310 resident physicians, representing 11.07% of the total population of resident physicians in Morocco. Among the participants, 16.1% (n=50) reported consuming one or more psychoactive substances, including 11.1% (n=37) for tobacco, 10% (n=31) for alcohol, and 6.1% (n=19) for cannabis. The consumption of ecstasy and cocaine was observed in 0.7% (n=2) for each substance. Additionally, 11.9% (n=37) of resident physicians had psychiatric disorders, and 3.2% (n=10) had attempted suicide at least once. The consumption of psychoactive substances among resident physicians was statistically significantly associated with the male gender (4.59 [2.20-9.57]; p=0.000), as well as with surgical specialty (0.48 [0.26-0.88]; p=0.017). Conclusion At the end of this work, we found that the use of psychoactive substances is frequent among resident doctors, which explains the need for preventive measures and appropriate management.

Our taxonomic study from March 2014 to November 2015 along the atlantic coast between Casablanca and El Jadida revealed that phytoplanktonic structure is mainly represented by Diatoms (Bacillariophyceae), Dinoflagellates (Dinophyceae), Silicoflagellates (Dictyophyceae) and Euglenophyceae with a clear dominance of Diatoms and Dinoflagellates. A total of 101 taxa of planktonic algae have been identified revealing a relatively diversified taxocenosis. In terms of respective diversity, the Diatoms are represented by 62 taxa (61.4%), the Dinoflagellates by 36 taxa (35.6%) whereas the other two groups of Silicoflagellates and Euglenophyceae are only represented by 3 species (3.0%). Regarding potentially toxic species, more than fifteen taxa have been identified, most of which were Dinoflagellates and Diatoms (Pseudo-nitzschia australis and Pseudo-nitzschia cuspidata). The total phytoplankton densities exhibited great spatial and temporal variations as shown by analyses of diversity (H') and equitability (E) indices at the different coast sites investigated throughout the 2014-2015 years. Massive proliferation of some toxic species (e.g. Pseudo-nitzschia australis and Pseudo-nitzschia cuspidata, Lingulodinium polyedrum, Karenia mikimotoi) was also noticed. In addition, our study revealed the presence of opportunistic species (e.g. Eutreptiella, Thalassiosira, Prorocentrum scutellum) and of the new ectoparasite Dinoflagellate Amyloodinium ocellatum for the first time in Morocco. The detection of such diversity of toxic species, sometimes with alarming concentrations, should prompt the competent authorities to broaden the spectrum and frequency of biomonitoring to uncontrolled seafood harvesting sites., (© Société de Biologie, 2024.)

Introduction: Older adults were among those who suffered most from the COVID-19 pandemic. In Morocco, where 64.4 percent of older adults suffer from a form of chronic illness, the main challenge facing local authorities was how to maintain essential care for this population group in the context of the pandemic., Purpose of the Research: The aim of the study was to determine the effects of the COVID-19 pandemic on older adults’ access to primary healthcare in the Essaouira Province (Morocco), with a view to ensuring the ongoing provision of healthcare for older adults during health emergencies. A longitudinal retrospective survey was conducted from October to December 2021 based on a structured questionnaire with a sample of 196 people aged sixty and above. The data obtained were compiled and analyzed using SPSS software (version 20.0)., Results: The COVID-19 pandemic has adversely affected older adults’ access to primary healthcare. Older adults’ use of primary healthcare services fell by 51.6 percent during the pandemic compared with the same periods in previous years. In addition, the measures taken to control the pandemic have had a negative impact on the quality of services offered to the survey participants., Conclusion: The COVID-19 pandemic resulted in significant changes in the operation of primary healthcare for older populations. The findings of this study provide a basis for anticipatory actions to improve the ongoing provision of healthcare for older adults in the context of health emergencies.

Introduction: Pediatric radiotherapy (PR) faces several issues in middle- and low-income countries., Aim: Our study is a cross-sectional observation which aimed to describe the current situation of PR in Morocco in order to identify the needs and to propose an organizational shema for this discipline., Methods: The collection of data used two surveys, one of which was intended to the heads of the radiotherapy department of all university hospital centers (UHC) in Morocco concerning the hospital's infrastructure, human resources, technical and the course of radiotherapy. A second survey was intended for all radiation oncologists trained and working in Morocco with data related to the practice of PR., Results: In 2021, 295 children were treated in the radiotherapy departments of the seven university hospitals in Morocco. One hundred and two radiation oncologists responded to our survey. The multidisciplinary consultation board is held in five university hospitals, four of which have a complete multidisciplinary team. The children are sent to another structure by default of anesthesia according to 21% of the radiotherapists questioned. The three-dimensional technique is available in all university hospitals. Intensity modulated radiotherapy is available in 5 UHC. Additional training in radiotherapy after residency was necessary according to 60% of the radiotherapists questioned., Conclusion: Despite the progress that Morocco has made in terms of infrastructure and radiotherapy equipment, this first national survey has identified some weaknesses and developed some recommendations for the organization of PR.

Competing Interests: Les auteurs ne déclarent aucun conflit d’intérêt.

Introduction: Small ruminant sinus adenocarcinoma (ENA) is a contagious disease caused by a beta retrovirus called Enzootic Nasal Tumor Virus or ENTV. The first cases were sporadically diagnosed in Morocco in 2018. However, in the last two years, ENTV has appeared enzootic in three herds of the Sardi breed. The annual incidence varied between 5 and 20 %. Most cases involved female animals aged 15 to 42 months. The disease developed within 2 to a maximum of 6 months. Diseased animals presented with progressive weight loss and increased mortality or needed to be slaughtered. The condition associated mainly with unilateral skull deformation, serous or seromucous nasal discharge with dyspnea, and in some individuals an exophthalmos. During pathology tumor-like masses were found in the paranasal sinuses, which showed the growth of an expansive and organized epithelial neoplasm on histopathology. After an overview of the differential diagnoses that can lead to confusion with ANE, the authors investigate why the disease occurs more frequently in Morocco and particularly in the Sardi breed.

Objectives: To evaluate the prevalence and factors associated with Chronic psychiatric and somatic illness among medical students in Morocco., Methods: A multicentric cross-sectional study during a period of four weeks in February 2019 involving 605 students of 1st, 2nd and 3rd cycle of medical studies of the faculties of medicine in Morocco., Results: 41.5% (251) of students confirmed having a chronic disease, among which 80% were under treatment. Psychiatric conditions represented the most frequent chronic illnesses among medical students (28%), followed by dermatological (16%), allergic and respiratory (12.2%), and gastroenterological (11%) conditions. Chronic illnesses among medical students were significantly associated with female gender (P: 0.0000000037), level of education (P: 0.0000), personal history of suicide attempts (P: 0.0000259), and a consumption of psychoactive substances (P: 0.0000029046)., Conclusion: Chronic illnesses are frequent, underestimated and undertreated among medical students in Morocco. The link with stress has been suggested as the value of establishing a program to train medical students in stress management., (Copyright © 2021 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.)

Introduction: Stigma underlies the violation of certain social, economic, and cultural rights of patients with schizophrenia, including their access to treatment and care. Measurement of stigma remains as complex and multifaceted as the phenomenon itself. Several measurement tools are available to assess the prevalence, intensity and qualities of stigma. The aim of the study was to carry out a cross-cultural adaptation of the Explanatory Model Interview Catalogue (EMIC), in the Moroccan Arabic dialect commonly known as "Darija"., Patients and Method: The study was conducted in three psychiatric departments of public hospitals in the Souss-Massa region, located in southern Morocco. For the diagnosis of schizophrenia, the study was based on the decisions of the psychiatrists practicing at the study sites. The cross-cultural adaptation in Moroccan Darija of the stigma scale developed by Michel Weiss in the EMIC was carried out according to the six-step scientific method developed by Dorcas et al., Results: Cronbach's alpha (internal consistency) was 0.845. Convergent validity determined by Pearson's coefficient showed a significant inter-item correlation and the intra-class correlation coefficient (test-retest) was 0.975 (0.993; 0.991). The item added in relation to the COVID-19 situation presented psychometric values similar to the others., Conclusion: The Darija version is culturally acceptable and can be used to approach the phenomenon of stigmatization in Morocco., Competing Interests: Conflict of interest none declared., (Copyright © 2022 Elsevier Masson SAS. All rights reserved.)

Introduction: tuberculosis is a public health problem in Morocco. This study aims to examine the epidemiological profile as well as the evolutionary and diagnostic features of tuberculosis in Settat, Morocco., Methods: we conducted a retrospective descriptive and analytical study of data from the medical records of TB patients managed at the Diagnostic Centre for Tuberculosis and Respiratory Diseases in Settat, Morocco from 1 st January 2015 to 31 December 2019., Results: we identified 1270 cases of tuberculosis. Lung involvement was more common than extrapulmonary involvement. Ganglionic tuberculosis mainly occurred in patients with extrapulmonary tuberculosis. Severe forms included tuberculous meningitis (10 cases) and miliary tuberculosis (10 cases). Diagnosis was bacteriologically confirmed in the majority of patients (84.09%). Extreme ages and female sex were mainly affected by extrapulmonary tuberculosis. Recovery was reported in 35.12% of patients and its rate was higher in pulmonary TB patients than in extrapulmonary TB patients (62.18% vs 0.37%; P<0.001). Patients with pulmonary tuberculosis (19.33% vs 10.81%; P<0.001) were mainly lost to follow-up. Death occurred to almost the same extent in patients with pulmonary and extrapulmonary tuberculosis (2.52% vs. 2.56%)., Conclusion: efforts on all fronts are still needed if the country is to achieve the goal of eliminating TB by 2030., Competing Interests: Les auteurs ne déclarent aucun conflit d´intérêts., (Copyright: Mohamed Chahboune et al.)

Introduction: given the lack of information about monoclonal gammopathies, our primary study outcome was to describe the epidemiological, clinical and biochemical profiles of monoclonal gammopathies in the Souss-Massa region, in southern Morocco., Methods: we conducted a retrospective study, by selecting only complete medical records. We used records of patients diagnosed with monoclonal gammopathy at the local oncology center during a period of over 10 years., Results: one hundred and seventeen patients were included in the study, with a high male predominance (65%) and a male/female sex-ratio of 1.85. The average age of our study population was 61.44 (ET 14.54) years. Diagnoses (based on frequency) included: multiple myeloma 82.0% (n=96), solitary plasmacytoma 8.5% (n=10), monoclonal gammopathies of undetermined significance 2.6% (n=3), lymphoma 2.5% (n=3), secondary plasma cell leukaemia 1.7% (n=2), Waldenström´s disease 1.7%(n=2) and chronic lymphoid leukemia (n=1). The isotype distribution was as follows: IgG Kappa 33.7% (n=28), IgG lambda 21.7% (n=18), IgA Kappa 12.0% (n=10), IgA lambda 7.2% (n=6), IgM kappa 3.6% (n=3), and IgD lambda 2.4% (n=2). Biconal peak was reached in two cases, with a percentage of 2.4%., Conclusion: diagnostic delay was observed compared to international studies due to the unavailability of electrophoresis in the care structures., Competing Interests: Les auteurs ne déclarent aucun conflit d´intérêts., (Copyright: Aissam El Maataoui et al.)

Objective: To determine the costs of non-antiretroviral drugs and to identify the factors associated with their prescription in HIV-1 patients on antiretroviral therapy in Morocco., Methods: Retrospective study of a cohort of 264 patients living with HIV-1 who were given antiretroviral therapy in the Venerology Dermatology Department at the Mohamed V Military Training Hospital of Rabat during the period from January 1st, 2014, December 31st, 2018. The costs retained were those of the hospital pharmacy for essential drugs, otherwise they were the costs in the private pharmacies. The logistic regression model was used to analyze the factors associated with prescription., Results: Of the 264 patients included, the male predominance was 75%. The median age of patients was 49 [41-57]. At the onset, 21.2% of patients were already in the AIDS stage. After a mean duration of 11.1 ± 6.8 months of antiretroviral therapy, 71.6% of patients received at least one prescription for a non-antiretroviral drug. Over the entire follow-up period, the mean cost per patient was 24.2 €, and the mean cost supported per patient was 22.1 €. After cotrimoxazole (30.7% of patients), the most frequently prescribed drugs were iron (29.2% of patients), antibiotics (20.8% of patients), hypolipemics (20.1% of patients) and general antimycosics (16.3% of patients). Age (RR: 1.01; 95% CI: 1.00-1.07), AIDS stage (RR: 2.15; 95% CI: 1.61-4.19), anemia (RR: 2.02; 95% CI: 2.10-5.41) and number of comorbidities (RR: 2.45; 95% CI: 2.10-5.41) were significantly associated with the prescription of non-antiretroviral drugs., Conclusion: Our work highlights the high frequency of prescription of non-antiretroviral drugs in patients living with HIV in Morocco; especially those who are older, anemic at the onset and those who are already at the AIDS stage., (Copyright © 2022 SFMTSI.)

Introduction&#160;: Maternal morbidity is a public health problem in developing countries.Purpose of research&#160;: The aim of this study was to determine the prevalence of maternal morbidity among women of reproductive age in the province of Essaouira (Morocco) and to describe the factors associated with it. The authors conducted a cross-sectional structured interview survey of 1300 married women aged 18 to 49. Data entry and statistical processing were performed by the SPSS-PC 18 program.Results&#160;: The prevalence of maternal morbidity was 66.8%. The main morbidities were sexually transmitted infections (48.8%) and anemia (46.6%). Multivariate analysis showed that frequency of postnatal visits, literacy of the couple and socioeconomic level were statistically associated with maternal morbidity.Conclusion&#160;: The use of postnatal care, the fight against illiteracy and the improvement of the socio-economic level of households, are factors that would reduce maternal morbidity.

Introduction: A major public health issue worldwide, induced abortion is probably the least documented demographic and social phenomenon in Morocco. The scarcity of data, the sensitivity of the subject due to its penalization by law (with some exceptions) and the social stigma, make abortion difficult to study. This article aims to contribute to the knowledge of the scale of this phenomenon in Morocco by combining direct and indirect methods., Method: Based on data from the 2009-10 National Demographic Survey, the 2003-04, 2011, and 2018 National Family Planning and Health Surveys, in addition to the 2004 and 2014 General Population and Housing Censuses, the authors measured abortion rates using indirect approaches, such as the Bongaarts model (1978) and the reduced and improved Westoff method (2008), and a direct method based on women's self-reports., Results: The annual abortion rate reached, respectively, according to the Bongaarts and improved Westoff method, 11.6‰ versus 37.6‰ in 2004, 5.1‰ versus 38.7‰ in 2009 and 4.4‰ versus 39.9‰ in 2014. In 2009-10, this rate reached 7.21‰ among unmarried women, 8.35‰ in rural areas and 6.34‰ in urban areas, according to the direct method., Conclusions: Estimates of annual abortion rates should be reproduced or completed by other approaches to better capture the reality of the level of this phenomenon in Morocco.

Self-denial and sense of duty are fundamental ethical principles in health care. Since the outbreak of health crisis, healthcare workers have been the first bulwark against the spread of coronavirus, and therefore, the occupational category at higher risk of contamination. In this regard, in a statement dated 23 March 2020, the World Health Organization published a guidance regarding the management of the disease caused by Covid-19 in health workers, but also in workers employed in all sectors exposed to the risk of contamination. In Morocco, the Ministry of Health published on April 6, on its official website, a condolence message to the families of the first two doctors died following contraction of coronavirus, while specifying that coronavirus infection was not due to the exercise of their professional functions. The Minister of Labor and Professional Integration recently appointed an internal committee to undertake a reflection on this issue. At present, given Morocco's law, what are the chances to categorize coronavirus as an occupational disease?, Competing Interests: Les auteurs ne déclarent aucun conflit d'intérêts., (Copyright: Meryem Bouchalta et al.)

Objective: To objectively assess the quality of "crisis communication" media, during the COVID-19 pandemic, in the three Greater Maghreb countries (Tunisia, Algeria, Morocco)., Methods: A compliance audit for press releases and epidemiological bulletins was analyzed against a quality benchmark, which had been specifically designed by the authors. This framework, made up of five dimensions and 50 items, graded (0/1), was applied by two researchers in preventive medicine. Multiplying the scores by a coefficient of two resulted in a partial score of 20 points for each dimension and a total score of 100 points for the checklist taken as a whole. The quality of the communication media was considered to be good when exceeding the thresholds of 15/20 for the different dimensions and 75/100 for the entire grid., Results: A total of 141 information media were included in this audit (Tunisia: 60; Algeria: 60; Morocco: 21). The overall median quality score for these media was only 56/100 (IIQ: [46-58]), without major variability between countries. The most appreciated dimension was "maintaining the confidence of the population", with an overall median score of 14/20 (12/20 for epidemiological bulletins and 16/20 for press releases). The most poorly rated dimension was "strengthening community participation", with a median score of only 4/20 (6/20 for epidemiological bulletins and 4/20 for press releases)., Conclusion: The quality of the Maghreb crisis communication media during COVID-19 was insufficient in most of its dimensions and items, particularly from a psychosocial standpoint. Reinforcement of the capacities of communication officers to develop information material and supports during health crises is indispensable and should be considered as an urgent matter., (Copyright © 2021. Published by Elsevier Masson SAS.)

Objectives: To evaluate the prevalence and factors associated with dermatological conditions and to study the peculiarities of comorbidity between psychiatric disorders and dermatological conditions among medical students in Morocco., Methods: This is a multicenter, descriptive, and analytical cross-sectional study over a period of 4 weeks during the month of February 2019., Results: Six hundred and five students from the seven faculties of medicine of Morocco were included. Dermatological conditions were present in 15.5% (94) of students, acne being the most common condition (10.7%), followed by psoriasis in 1.65% of students as well as urticaria in 1.65%. Psychiatric disorders were present in 28% (168) of the students depression being the most common disorder (10.4%), followed by anxiety disorders (7.8%), comorbidity between depression and anxiety disorder (6.94%), and psychotic disorders (2.46%). Dermatological diseases were significantly and independently associated with the presence of a psychiatric disorder (0.0000) and marital status (P=0.0103). Suicide attempts and substance use are more common among medical students who have an association between psychiatric disorder and dermatological pathology compared to students with isolated dermatological conditions or students with isolated psychiatric disorders., Conclusion: Dermatological and psychiatric conditions are frequent and underestimated among medical students in Morocco. Dermatologic and psychiatric comorbidity is associated with a higher prevalence of psychoactive substance use and suicide attempts., (Copyright © 2020 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.)

Phenylketonuria is an inherited metabolic disease, of autosomal recessive transmission, due to the enzymatic deficit of phenylalanine hydroxylase, which transforms phenylalanine into tyrosine. The deficit leads to an increase in phenylalanine and its metabolite, phenylpyruvic acid which is responsible for the toxicity and symptomatology characterized by serious neurological disorders. Through this work, we wanted to show: 1) the profile of phenylalanine concentrations in a cohort of 52 Moroccan phenylketonuric patients diagnosed in our laboratory by Tandem Mass Spectrometry coupled with HPLC; 2) The value of biological monitoring in the nutritional management of phenylketonuric patients. The results showed that phenylketonuria diagnosed in Morocco is characterized by a predominance of classic and moderate phenylketonuria in both sexes with a median concentration = 1,107 μmol/L, 26 times higher than that observed in the control group (median value = 42 μmol/L - p < 0.0001). The phenylalanine and tyrosine concentrations of 33 phenylketonuric patients regularly monitored by our laboratory highlights the effectiveness of the hypoproteic diet with a marked improvement in psychomotor development, a significant regression in behavioral disorders and an encouraging overall development of children. Conclusion: phenylketonuria is a disease that would be frequent in Morocco but it is still diagnosed at the stage of severe mental retardation. A better management of these patients could be considered when setting up a nation-wide neonatal screening program.

Introduction: intentional poisoning is a major public health problem in both developed and developing countries. The purpose of this study is to describe the epidemiological features of criminal intoxication in Morocco., Method: we conducted a retrospective study of all cases of criminal intoxication identified by the Morocco Poison Control and Pharmacovigilance Centre (MPCPC) between 1980 and 2014., Results: during the study period, 611 cases of criminal poisoning were recorded, reflecting a rate of 2.1% of all intentional poisoning reported during the same period. The average age of intoxicated patients was 26.4±14.3 years. More than a quarter of the subjects were children under the age of 15 (28.6%). According to the study results, 55.9% were male, with a sex-ratio (M/F) of 1.3. The majority of cases (89.4%) occurred in urban areas. Collective intoxications were reported in 24.4% of cases. The most frequently used products were pesticides (19.1%) and plants (19%). Patients developed different symptoms based on the toxic substances used, the amount ingested and the time elapsed before treatment. A range of digestive, neurological, respiratory and cardiovascular disorders were reported. Out of 440 patients with outcome data available, 27 died. The remainder of patients survived with or without sequelae., Conclusion: criminal poisoning is a major issue. The number of cases is probably underestimated due to a large number of undiagnosed or unreported cases., Competing Interests: Les auteurs ne déclarent aucun conflit d´intérêts., (Copyright: Sara Boukhorb et al.)

Stomach cancer is essentially represented by gastric adenocarcinomas. It remains one of the world's top ten causes of death with a poor prognosis. The aim of our work is to describe the epidemiological characteristics of gastric adenocarcinoma through a retrospective, observational study over a period of one year. One hundred and twenty one cases were sent to the Pathology Laboratory of the IPM-Casablanca, 98 were selected for this study. There was a male predominance. Patients aged over 50 years represented the predominant age group (62%) (P-value=0.03). The average tumor size was 5,17±2,16cm, and most patients were diagnosed in the advanced TNM stage with a rate of 72.44%. In the absence of specific symptoms, gastric adenocarcinoma is a cancer of elderly, frequently diagnosed at a late stage, minimizing the chances of any curable treatment. The adoption of a screening policy in our area would probably be beneficial. Indeed, the benefit of annual screening at least among people aged over 50 years should be assessed., (Copyright © 2020. Published by Elsevier Masson SAS.)

Objective: To investigate the clinical features of venous thrombosis in patients with Behçet's disease and to determine the patients at high risk for this complication., Methods: We retrospectively studied patients with venous thrombosis (n = 157) who were followed up in the Internal Medicine department. These patients were divided into two groups according to the existence (n = 60, 38.2%) or not (n = 97, 61.8%) of Behçet disease. To find correlations between venous involvement and other manifestations of the disease, patients with Behçet's disease and venous thrombosis were compared to those without venous., Results: Behçet's disease patients were younger (p = 0.020) and most often men (p < 0.01) compared with patients with venous thrombosis unrelated to Behçet disease. Unusual location was also more frequent in the Behçet's disease group, especially thrombosis of the superior and inferior vena cava (p = 0.030 and p = 0.013) and the suprahepatic veins (p = 0.006). Among Behçet's patients, those with venous thrombosis were more male (p = 0.003) and had less ocular and articular involvement (p < 0.001 and p = 0.004, respectively)., Conclusion: Compared to patients without venous thrombosis, patients with Behcet's disease with venous thrombosis are younger, are predominantly male, have a lower frequency of ocular and articular involvement and present an unusual topography of the thrombosis., (Copyright © 2020 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier Masson SAS. All rights reserved.)

Introduction: Behçet's disease is a systemic disease of unknown etiology. Its ocular manifestations are multiple and polymorphic, with uveitis at the top of the list. Classically, uveitis in Behçet's disease does not cause elevation of intraocular pressure. However, this may be found in 10 to 20% of cases, secondary to trabeculitis, trabecular obstruction by inflammatory cells, anterior or posterior synechiae, or induced by prolonged use of corticosteroids. Its occurrence is a major complication, the management of which is especially delicate when glaucoma occurs. The purpose of this study was to study the factors predictive of glaucoma in Behçet's disease., Materials and Methods: This is a retrospective study of all the charts of patients consecutively hospitalized for Behçet's disease over a period of 8years in the ophthalmology A department of the specialty hospital of Rabat university medical center., Results: Fifty patients were treated for Behçet's disease during the study period. There were 41 men (82%), and 9 women (18%). Glaucoma was diagnosed in 11 patients (22%). The mean age of this subgroup was 31years, with a gender ratio of 6 women/5 men. The glaucoma was associated with anterior synechiae in 4 cases, primary open-angle glaucoma in 5 cases, neovascular glaucoma in 1 case and seclusio pupillae in 1 case. Therapeutically, all patients were on glaucoma eye drops, and five underwent filtering surgery. Statistically, on univariate analysis, ocular hypertension was observed particularly in patients with low initial visual acuity (less than 1/10) (P=0.001), with severe posterior segment involvement, especially retinal vasculitis (29% vs. 6%, P=0.04), macular edema (40% vs. 4%, P=0.001), and optic disc edema (50% vs. 15%, P=0.02). A high number of recurrences was also associated with glaucoma (1.0 vs. 3.0, P<0.0001). On multivariate analysis, low baseline visual acuity, presence of retinal vasculitis, and high number of recurrences were independent risk factors for ocular hypertension in our patients followed for Behçet's disease., Conclusion: Glaucoma can complicate the management of Behçet's disease. This glaucoma will be more difficult to manage in this delicate pathological context. It requires special vigilance in patients with severe posterior segment inflammation, to institute effective management to avoid its potentially blinding complications., (Copyright © 2020 Elsevier Masson SAS. All rights reserved.)

Background: Recent studies first reported the relevant role of the immune system in the pathophysiology of schizophrenia and then the association between inflammation and agitation., Objectives: In this study, we aim to explore the relationship between CRP (C-reactive protein) levels and agitation in patients with schizophrenia., Methods: We conducted a cohort study with a comparison group of 60 patients with a DSM5 diagnosis of schizophrenia who were followed by the Department of Psychiatry of the University Hospital of Marrakech in Morocco. Patients were divided into two groups according to the state of agitation evaluated by the PANSS Excitement scale. These two groups have been matched according to age and gender. A comparison of CRP level, clinical and laboratory characteristics between the two groups and a monitoring of CRP level in the agitated group after 3 weeks of treatment were performed., Results: Inpatients with agitation displayed a significantly high CRP (P<0.0001), a high score of PANSS total (P<0.0001), PANSS positive (P<0.0001) and general PANSS (P<0.0001). After treatment, there was a significant reduction in CRP (P<0.0001) and PANSS excitement (P<0.0001)., Conclusion: These results confirm the role played by inflammation and immunity in agitation behavior in patients with schizophrenia and highlight the interest of the CRP assay at the time of admission of patients as a potential marker of agitation in hospitalized patients with schizophrenia., (Copyright © 2020 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.)

Aim: Psychiatric disorders represent a huge burden of disease worldwide. Significant gaps in their diagnosis and treatment remain. In Morocco, an observed shortage of psychiatrists would logically call for their collaboration with family physicians. Our objectives were to analyse perceptions of general practitioners' capacity to manage psychiatric disorders, to study the difficulties encountered in their management of these pathologies, and to assess their degree of collaboration with existing mental health structures., Methods: A cross-sectional nationwide survey of family physicians practicing in urban and rural areas in the private and public sectors in the Kingdom of Morocco was organised. Carried out over a period of 10 months (April 2016 to January 2017), the study was based on an anonymised self-administered questionnaire comprising 23 items. Were excluded from the sample: physicians who had tested the questionnaire prior to its distribution, medical students, family physicians employed in administrative services, resident doctors in university hospitals, and questionnaires with incomplete answers., Results: All in all, five hundred and four questionnaires were distributed, with a participation rate of 79.8%, while 57.9% of the respondents were men. Their seniority as doctors ranged from 1 year to 60 years with average duration of 19.5±11 years. An overwhelming majority of the doctors had obtained their doctorates in Morocco, while 8.4% had been trained abroad. The majority of the doctors surveyed worked in private practice in urban areas (53.1%), and most of them (81.9%) agreed that the management of psychiatric disorders is a public health priority. The participating physicians stated that they received an average of five patients per day suffering from mental disorders, representing 17.3% of their medical consultations. According to their perceptions, the most frequent psychiatric pathologies were depression, somatoform disorders and sleep disturbances, which were cited by 92.9%, 78.8% and 78.5% of them respectively. Regarding the diagnosis of psychiatric pathologies, 60.2% of the doctors considered bipolar disorder as a difficult pathology to diagnose, followed by schizophrenia, autism and dementia, while the pathologies reported as the most difficult to treat were addictive behaviours, schizophrenia, bipolar disorder, autism and dementia. Physicians felt a need for training, primarily pertaining to anxiety disorders, schizophrenia and bipolar disorders (49.5%, 35% and 33.7%, respectively). Nearly a quarter of the respondents (22.4%) mentioned a need for training in management of all psychiatric illnesses. Regarding the reasons for their referral of patients to mental health care structures, 65.4% of the physicians justified their doing so by a need for hospitalisation, while in 43.7% of cases, the transfer was carried out at the request of the patient or his family. The difficulties mentioned by the respondents were firstly a lack of adapted means of care (77.5%), followed by their insufficient training in mental healthcare (52.4%) and absence of collaboration with mental health professionals (52.4%)., Conclusion: For the majority of the physicians surveyed, psychiatry represented a public health priority, and their prioritising provides a probable explanation for their positive perception of their role in the management of mental disorders. However, we went on to observe that a number of difficulties constituted obstacles to their role in management of mental disorders and induced them to refer their patients to psychiatrists. Our analysis highlighted the impact of continuing education on physicians' attitudes and the interest of collaboration between practitioners. Efforts in university teaching and continuous education should be encouraged in view of enabling family physicians to more effectively cope with the demands of daily practice and meet the expectations of the overall population., (Copyright © 2020 Elsevier Masson SAS. All rights reserved.)

The pre-analytical step of the cytobacteriological examination of urine (CBEU) is one of the most critical in microbiology. The objectives of our study were to determine the rate of urinary contamination and to analyze the factors that would facilitate this in order to propose solutions to this problem., Method: This is a 26-month descriptive study including all CBEU requests to our laboratory. Urine was treated in accordance with the recommendations of the medical microbiology recommendations. Urine was considered contaminated in the case of polymorphic culture with at least three different types of germs with a count from 10 3 CFU/mL., Results: We collected 16,412 CBEU requests. Urine was contaminated in 4,830 cases (29.43%). Of the contaminated urine, 39.23% (n=1,895) was from emergency departments, 79.44% (n=3,837) was collected in the middle of the stream, 69.83% (n=3,373) was from a female patient and 16.34% (n=789) was from children under the age of 5., Discussion and Conclusion: To reduce urine contamination, quality instructions describing sampling procedures should be available and samples in the middle of the stream and through the collection adhesive bags should be replaced by sus-pubic puncture samples in children, whenever the profit/risk ratio of this method is favourable.

Introduction: given its frequency and severity, colorectal cancer is a major public health problem. Diet plays a key role in preventing this type of cancer. The purpose of our study was to determine dietary risk factors for colorectal cancer in our Moroccan context., Methods: we conducted a case-control study including patients with colorectal cancer compared with controls. The statistical analysis of results was carried out using R software., Results: our study included 225 patients treated for cancer at the Mohammed VI Hospital Center and 225 controls. The average age of our study population at the time of diagnosis was 55.49±14.06 years, including 119 men (52.9%) and 106 women (47.1%) with a sex ratio of 1.12. Associations were found between the highest intakes of red meats, cold meats, sausages and the risk of colorectal cancer (p = 0.0001) with F4 (4-7 times / week) vs F1 (never): OR = 4.4 (1.6-11.9); (p = 0.001), OR = 1.7 (0.5-5.7); (p = 0.003), OR = 5.7 (1.2-27.4)). On the other hand, consumption of fish was associated with a reduced risk of colorectal cancer (p = 0.0001; OR = 0.3 (0.11-0.7)), while consumption of poultry and grilled eggs was not associated with colorectal cancer. We also found that consumption of fresh vegetables and cooked vegetables was low in patients compared to controls (p = 0.0001). Furthermore, a high intake of black coffee was associated with a reduced risk of colorectal cancer (p = 0.0001; F4 vs F1: OR = 0.2 (0.1-0.4))., Conclusion: our study highlights that dietary changes can prevent or impede the growth of colorectal cancer. It is essential to promote balanced diet, rich in fish, vegetables, fruits and fibers without exceeding recommended levels of red meat and avoiding cold meats and sausages., Competing Interests: Les auteurs ne déclarent aucun conflit d’intérêts., (© Fatima Ezzahra Imad et al.)

Introduction: Obesity is a serious public health problem having a direct impact on physical and psychological health of individuals. The purpose of this study was to determine the prevalence of obesity and overweight in a child population attending urban and rural schools in the oasis of Tafilalet., Methods: We conducted a cross-sectional descriptive study within the urban and rural public schools in of the oasis of Tafilalet. We recruited a representative sample of 3,684 children attending 39 public primary schools., Results: The average age of patients was 9.81 ± 2.13 years. The total sample was divided into 1,794 boys (48.70%) and 1,890 girls (51.30%). Two thousand three hundred and nine lived in an urban area (62.70%) and 1,375 in a rural area (37.30%). According to the World Health Organization References, our study showed a rate of obesity of 1.9% and of 10.8% for overweight. Overweight and obesity were not significantly associated with children sex., Conclusion: The prevalence of obesity in the oasis of Tafilalet is less than the national and international values; lifestyle and dietary habits of this population appear to be a protective factor against overweight and obesity., Competing Interests: Les auteurs ne déclarent aucun conflit d’intérêts., (© Karima Azekour et al.)

Introduction: Cutaneous leishmaniasis (CL) is a parasitic disease caused by a flagellate protozoa of the genus Leishmania and is a public health problem throughout the world. In Morocco, CL may be sporadic or endemic depending on the species of Leishmania and the region involved. Casablanca is a non-endemic city but many children with CL come from elsewhere in the country. The aim of our study is to describe the clinical and epidemiological particularities of CL diagnosed in children at the Casablanca University Hospital., Materials and Methods: A cross-sectional study was conducted between 2010 and 2016. All patients with one or more skin lesions suggestive of CL underwent parasitological and molecular investigation. Epidemiological and clinical data from patients with positive genotyping were collected and analyzed. A comparative study was made of epidemiological and clinical variables between children and adults and between different species found in children., Results: One hundred and six cases of CL were diagnosed, of which 40 in children (37.7%): 29 due to L. tropica (72.5%), 7 due to L. major (17.5%), and 4 due to L. infantum (10%). CL caused by L. tropica was significantly associated with children (P=0.009) and was distinguished by the predominance of the nodular form (P=0.04) and a facial location (P=0.007). Compared to adults, childhood CL lesions were characterized by their small size (P=0.001) and facial location (P=0.003). Children were treated mainly with pentavalent antimonials, with good safety and clinical response., Conclusion: In our series, CL due to L. tropica was predominant in children, reflecting the epidemic nature and wide geographical distribution of this species in Morocco. CL due to L. tropica was significantly associated with facial location and nodular form in children., (Copyright © 2019 Elsevier Masson SAS. All rights reserved.)

Introduction: Our purpose is to evaluate our results of surgery for tracheobronchial carcinoid tumour as well as the long-term survival., Methods: This is a retrospective and descriptive study performed in the department of thoracic surgery of CHU Hassan II (Marocco) over a period of 9 years. It concerns all patients with a tracheal or bronchial carcinoid tumour who underwent surgery., Results: Twenty-three patients with a mean age of 39 years were operated on for 24 carcinoid tumours. The sex ratio was 0.29. The diagnostic delay ranged from 3 months to 8 years and the main symptom was haemoptysis in 74% of cases (n=17). The tumour was localized in the right bronchial tree in 70% of cases (n=16). The procedures performed were tracheal resection and end-to-end anastomosis in 1 case, lobectomy in 12 cases including 3 sleeve lobectomies, bilobectomy of middle and lower lobes in 7 cases and pneumonectomy in 4 cases. The prognosis was favourable in 91% after an average follow-up of 29 months., Conclusions: Surgery remains the only curative therapeutic option for tracheobronchial carcinoid tumours with acceptable morbidity and mortality., (Copyright © 2019 SPLF. Published by Elsevier Masson SAS. All rights reserved.)

Introduction: Twenty million cases of typhoid and paratyphoid fever (TF) are observed annually worldwide with more than 200,000deaths. These fevers occur in areas where hygiene is precarious, mainly in developing countries. The objective of this study was to describe epidemiological patterns of TF in Meknes, Morocco in order to improve preventive measures., Methods: We conducted a case series study based on data from 2013 to 2016 in the Meknes TF surveillance system. Data collected included socio-demographic variables, place of residence, season, mode of water supply, and food consumed. Diagnosis of TF was confirmed with the Widal test. Data were analyzed with Epi-info version 7 and mapping was done with Qgis version 2.18.1., Results: Three hundred and twenty-two cases were reported with a male/female sex ratio of 0.9. Average age was 26±20years. Incidence increased from 13 per 100.000inhabitants in 2013 to 8 per 100.000 inhabitants in 2016. Two hundred and seventy-nine (87%) cases occurred in urban areas and 174 (54%) cases developed in summer. One death was recorded., Conclusion: Public awareness campaigns on health education for hygiene are needed. Focus should be placed on transmission by food handlers., (Copyright © 2019 Elsevier Masson SAS. All rights reserved.)

Introduction: Colorectal cancer is a true scourge and a major public health problem. The main purpose of this study was to identify the impact of socio-economic factors and education level on the onset of colorectal cancer and of diagnosis stage in the Moroccan population., Methods: We conducted a case-control study of patients treated for cancer at the Mohammed VI center from January 2015 to January 2017. We interviewed, on a prospective basis and using a structured and pre-tested questionnaire, 225 patients and 225 eligible and consenting subjects., Results: The average age of patients was 55.49± 14.06 years. In 53% of cases diagnosis was made at early-stage colorectal cancer while in 47% at advanced stage. In addition, a detailed analysis of the studied population according to the socio-economic status (SES), showed a proportion of 25.33% (patients) versus 17.33% (control) in the low SES group, while, equivalent rates (45.33% patients versus 45.33% control) in the middle SES group. In the high SES group, the rate of patients was only 16.89% patients versus 37.34% control (p = 0.0001). Education and SES were strongly correlated with diagnosis stage, with a significant difference. Then 36.44% of illiterate patients were diagnosed in advanced stage versus 5.33% of patients who had completed their secondary education level or university course (p = 0.02). Similarly 20.45% of patients with low SES were diagnosed in late stage versus 5.33% of patients with higher SES (p = 0.03)., Conclusion: Our results highlight that the risk of developing colorectal cancer is strongly dependent on the education and the socio-economic status of patients. A more thorough investigation is needed to clarify the causes of this inequality., Competing Interests: Les auteurs ne déclarent aucun conflit d'intérêts., (© Fatima Ezzahra Imad et al.)

Introduction: Lung cancer is the most common cancer in men living Eastern Morocco. We here present the first report on the clinical, pathological and therapeutic features of lung cancer in Eastern Morocco., Methods: We conducted a retrospective study of 738 patients diagnosed with lung cancer at the Hassan II, Oncology Center between October 2005 and December 2014., Results: Among the cases studied, 671 patients were men and 67 women; 95.01% of men and 1.54% of women were smokers. The average age of patients was 59.1 ± 11.9 years. Most patients (97%) were diagnosed at advanced stage disease. Only 4 out of 227 patients with advanced adenocarcinoma underwent molecular test. In addition, no patient in our series received targeted therapy. In this series, 20.46% of patients had less than 50 years. Compared to patients aged 50 years and older, cannabis consumption was higher (p<0.001) in patients less than 50 years and as well as a higher rate of adenocarcinoma (p<0.01). By contrast, in these patients, tobacco consumption was lower (p<0.001) as well as the rate of squamous cell carcinoma (p<0.01) and small cell cancer (p<0.05)., Conclusion: Unlike Western countries, in Eastern Morocco lung cancer is diagnosed late, affects younger people and access to molecular tests is still very limited. These results justify the need to implement effective programs against lung cancer as well as to facilitate access to molecular tests and new therapeutic tools in Eastern Morocco., Competing Interests: Les auteurs ne déclarent aucun conflit d'intérêts., (© Mohammed Bellaoui et al.)

Depression as such causes emotional and physical disturbances that affect biological functions such as sleep, appetite, decreased libido and lack of interest in sexual function. Indeed, there is a significant incidence of sexual dysfunction in depressed patients. In addition, depression and sexual dysfunction have a significant impact on the quality of life of couples which can be improved by managing these two conditions between which there seems to be a two-way causal link. Sexual dysfunction has long been neglected in the clinic of depression. In Morocco, depression affects more than a quarter of the population. However, to date, no study has focused on the assessment of sexual function in relation to depression among Moroccans., Objectives: This work aimed to evaluate the prevalence and characteristics of sexual dysfunction in Moroccan patients consulting for a first depressive episode., Methods: This is a descriptive cross-sectional study. All subjects included in this study were consulting for a first major depressive episode according to DSM-5 criteria from June 1st to November 30th, 2017 at the psychiatric university department at Ibn Nafis hospital in Marrakech. The severity of depression was assessed using the Hamilton scale. The ASEX (Arizona Sexuel Experience) scale was used to define sexual dysfunction. Statistical analysis was performed using SPSS 22 software., Results: Fifty eight patients were recruited 34 of whom were female. They had an average age of 37 years. The majority were between 27 and 42 years old (59 %), married (81 %), with an average level of education (34.5 %). The average duration of the episode was 57 days. The major depressive episode was severe in 62 % of patients. According to the ASEX, 77.6 % of the depressed patients had a clinically significant sexual dysfunction. The majority of our patients (60.3 %) consulting for depression attach their sexual dysfunction to their depressed mood, either by reporting the onset of sexual dysfunction at the same time as depression (53.4 %), or worsening after the depression onset (6.9 %). The frequency of sexual intercourse with the pre-depressive state was decreased in the majority of our sample. Sexual desire was the most impaired phase of the sexual response (58.6 %) followed by excitation (53.4 %) and then orgasm (51.7 %). Of the 47 married patients, more than two thirds (32 patients) were dissatisfied with their life as a couple as well as with different aspects of their relationship life. The majority of patients reporting marital dissatisfaction attributed the cause to the quality of their sexual intercourses rather than to their frequency or other relational aspects. Sexual dysfunction was significantly correlated with the severity of depression (P=0.031), whereas it was not correlated with duration of depressive episode (P=0.412) or age or patient sex (P=0.114, P=0.202 respectively)., Conclusions: The prevalence of sexual dysfunction is high in depressed patients. It significantly impacts the couple's quality of life. Although our main limitation was the small sample size which prevented us from doing a multi-varied analysis, the robust nature of this study lies in documenting the initial prevalence and types of sexual dysfunctions in both sexes in the first major depressive episode unrelated to the dysfunctions induced by antidepressant drugs. The early identification of sexual disorders and the consideration of couple dynamics would be two important elements in the management of the depressed patient., (Copyright © 2019 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.)

With more than 3300 new cases and almost 2500 deaths each year, cervical cancer (CC) ranks second among female cancers in Moroccan women. The majority of cases occurs in women aged 50 and over. In absence of a national cancer registry, data published in Morocco are limited to the number of cases recorded in some oncology centers, so the incidence of this cancer is likely much higher than estimated. A Moroccan national program against CC based on the practice of visual inspection after application of acetic acid was set up in 2010, allowing both screening and possibly immediate treatment of (pre)cancerous lesions. However, this program has not been implemented in all regions of the country. The CC develops slowly and most often without any symptoms, and so it is diagnosed at an advanced stage of the disease. Virtually, all CC are associated with persistent infection of high risk human papillomavirus (HPV), particularly HPV16 and 18. For more than ten years, two prophylactic vaccines targeting these two HPV genotypes have been marketed. They have proved their excellent immunogenicity and efficacy and they are well tolerated. However, HPV vaccine is not yet recommended by health authorities in Morocco. In this literature review, we focused on the current situation of CC, the prevalence of HPV infection and the prevention strategies against CC in Morocco., (Copyright © 2019 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)

Introduction: Infertility is a global public health problem that affects 15% of couples of childbearing age. Male infertility is involved in 20 to 50% of cases. These figures are sharply increasing around the world. Several factors may be responsible for this infertility with especially hormonal, genetic, toxic or infectious factors. The latter are dominated mainly by Chlamydia infection. Among the most serious complications of this infection are infertility related to urethritis, epididymitis and irreversible total azoospermia in men and tubal obstructions and ectopic pregnancies in women., Study Objective: To determine the prevalence of IgG anti-Chlamydia trachomatis in men consulting for infertility and the association between previous contact with this bacterium and the impairment of sperm quality and sperm function., Material and Methods: Prospective study over 26months of 143 patients referred to the service for infertility assessment of the couple. Demographic data, primary or secondary character of infertility, risk factors (tobacco, inguinal hernia, varicocele and history of urogenital infections), semen parameters (volume, mobility, pH, vitality and morphological abnormalities) were studied as well as the determination of the anti-C. trachomatis IgG titer. The prevalence of Chlamydia infection and the association of the infection and alteration of the various parameters of the semen were analyzed., Results: The average age of patients was 38.5±8.55. Infertility was primary in 72% of patients. Among the patients, 54.5% had an abnormal spermogram. Chlamydia IgG antibodies were positive in 37.1% of patients whose 58.5% had abnormal spermogram. Analysis of sperm parameters of patients with and without IgG C. trachomatis showed an altered vitality in Chlamydia positive patients with an OR at 2.41, P=0.02, (95% CI: 1.15-5.06)., Conclusion: The prevalence of Chlamydia infection is high in infertile male. C. trachomatis IgG antibodies may be associated with an alteration of spermatozoa vitality without significant impairment of other semen parameters., Level of Evidence: 3., (Copyright © 2019 Elsevier Masson SAS. All rights reserved.)

Introduction: Research addressing the perception of liaison psychiatry by caregivers is still limited in Morocco. Collaboration between practitioners in liaison psychiatry is necessary, and the perception of physicians influences their implications in liaison psychiatry., Objectives: To evaluate the perception of this activity among the various medical and surgical units, determine the involvement, level of collaboration and expectations of practitioners, as well as the difficulties and constraints encountered., Methodology: A survey was carried out among medical personnel at the Hassan II University Hospital Centre in Fez in 2016, through a self-questionnaire determining the perception and position of carers with regard to liaison psychiatry. The data are collected using an anonymous self-administered questionnaire, consisting of 27 items. We included in this study a targeted population: interns, residents and professors., Results: The total population of caregivers participating in this survey was 615 physicians, including 111 professors, 436 residents, and 68 interns. The participation rate was 80.32%. The average age was 30.25 years, with 47.6% (236) women and 52.4% (258) men. The percentage of doctors who obtained their doctorates in medicine in Morocco was 89.3% (85.9% at the Faculty of Medicine in Fez) and 92.3% had received a unique internship in the psychiatry department during their university studies, while 98.7% never received any continuing training in the field of psychiatry. Half of responding physicians reported difficulties in managing psychiatric disorders diagnostically, and 59.5% (292) reported difficulties in treating patients with psychiatric disorders, while 90% (444) reported that they are unable to provide therapeutic follow-up. Only 35.6% of the doctors surveyed were informed about the establishment of liaison psychiatry, but only 10% of these doctors were informed about the procedure for requesting a psychiatric opinion. Faced with a psychiatric disorder, 98% of doctors managed the situation by seeking psychiatric advice, 87.1% considered this request urgent. The reasons for not soliciting q psychiatrist were divided between difficulties in identifying a psychiatric disorder (51%) and difficulties in requesting an opinion (49%)., Conclusion: Our study showed several difficulties perceived by practitioners, whether in the diagnosis, treatment or follow-up of patients with psychiatric manifestations. Collaboration between different practitioners is an indispensable element of patient management. Improving knowledge through awareness-raising and the organization of scientific days bringing together the different specialties will help to improve doctors' perceptions., (Copyright © 2019 Elsevier Masson SAS. All rights reserved.)