Hospital Of Casablanca Research Articles

Surgical treatment of Trapezo-metacarpal luxation

Introduction: Trapeziometacarpal dislocation, often resulting from violent trauma in young people, is generally diagnosed clinically and by imaging. It can cause instability of the first column and promote the development of rhizarthrosis . The treatment of fresh dislocations gives rise to debates between orthopedic and surgical approaches. This series reports a number of cases rarely exceeding fifteen. Material and method: This is a retrospective series of five cases of trapezio -metacarpal dislocation collected between January 2017 and October 2022 in the trauma-orthopedics department of Wing 4 of the Ibn Rochd University Hospital in Casablanca. Results: The patients were mainly men with an average age of 34 years, with lesions mainly located on the right side and caused by road accidents or falls. The diagnosis was confirmed by radiographs, mainly revealing isolated trapeziometacarpal dislocations. Treatment consisted of percutaneous metacarpo - trapezius pinning , with good short-term results for all patients. Discussion: Trapeziometacarpal dislocation is a rare pathology. Its diagnosis is based on radiological examinations and therapeutic approaches such as trapeziometacarpal pinning. Conclusion: Treatment by reduction followed by pin stabilization seems to offer satisfactory results for trapeziometacarpal dislocation.

Morbidity and Postoperative Mortality of Colorectal Tumors

Colorectal cancer, by its frequency and severity, represents a serious public health problem worldwide. In Morocco, the incidence of colorectal cancer is constantly increasing. Post-operative morbidity and mortality is an event whose evaluation and analysis are necessary to improve surgical results and optimize patient care. Thus, knowledge of the causes and risk factors of morbidity and mortality will contribute not only to a better evaluation of patients candidates for colorectal surgery, but also to reveal new avenues of research to improve the post-operative prognosis of these patients. The objective of this retrospective work is to carry out an epidemiological study of the morbidity and mortality of patients admitted during the postoperative period of colorectal surgery to the surgical intensive care unit of the Ibn Rochd University Hospital in Casablanca; as well as the search for potential predictive factors associated with it.

Infective Endocarditis in Patients with Rheumatic Heart Disease: Casablanca’s Experience

Background: Infective endocarditis poses a significant challenge with high morbidity and mortality risks, yet the African context lacks comprehensive studies on this critical health issue. Objectives: This study aims to bridge this gap by providing epidemiological insights into infectious endocarditis within a hospital in Casablanca, Morocco, a nation in perpetual development where rheumatic heart disease persists. Methods: A retrospective case series of 87 adult patients admitted to the Cardiology department of CHU Ibn Rochd between 2013 and 2022 for infective endocarditis was conducted. Data analysis was performed using Microsoft Excel and SPSS. Results: It revealed that 47 patients had rheumatic heart disease. Bacterial identification occurred in less than half of the cases, predominantly staphylococcus. Surgical interventions were limited, and the mortality rate reached 23%. Conclusions: This study sheds light on the epidemiological profile of infective endocarditis in Morocco, emphasizing a considerable disparity compared to Western counterparts. The findings underscore the urgent need for focused efforts and interventions to address the unique challenges posed by infective endocarditis in Morocco and, by extension, the broader African context.

PIMS-TS Complicating SARS-CoV-2 Infection: A Report of 10 Pediatric Cases

SARS-CoV-2, or COVID-19, is a betacoronavirus identified by the WHO as the cause of the 2020 pandemic. Unlike most respiratory virus, children exhibit lower susceptibility to COVID-19 and generally develop milder disease courses, with reduced mortality rates. Recently, there have been reports of clustered cases characterized by shock states associated with elevated cardiac biomarkers and vasoplegia, necessitating treatment with inotropes, vasopressors, and fluid resuscitation. This clinical presentation has been linked to the emergence of Pediatric Inflammatory Multisystem Syndrome Temporally associated with SARS-CoV-2 (PIMS-TS), also known as Kawasaki-like syndrome. This study is a retrospective analysis of 10 pediatric patients diagnosed with PIMS-TS secondary to COVID-19 infection, who were admitted to Mohammed VI International University Hospital in Casablanca, Morocco, from January 2021 to October 2023. The cohort's ages ranged from 2 to 13 years, with a mean age of 6 years, and demonstrated a male predominance (sex ratio 9M:1F). Clinical manifestations included prolonged fever, gastrointestinal disturbances, rash, conjunctivitis, and cheilitis. Laboratory findings revealed elevated levels of CRP, PCT, and ferritin, indicative of an atypical Kawasaki syndrome. These patients responded to intravenous immunoglobulin therapy, with adjunctive corticosteroids administered as needed. All patients experienced favorable outcomes, with resolution of systemic involvement and normalization of inflammatory markers, and no relapses or fatalities were recorded. The risk factors for PIMS-TS complicating COVID-19 infection remain unclear. However, there are noted parallels between PIMS-TS and Kawasaki syndrome diagnostic criteria, suggesting possible pathophysiological overlap. In conclusion, a novel multisystem inflammatory syndrome associated with COVID-19 infection, resembling Kawasaki syndrome, has been identified in pediatric patients. This emerging syndrome enhances our understanding of the complex pathophysiology associated with COVID-19 and underscores the need for continued research into its etiology and optimal management strategies.

Prevalence of Healthcare-Associated Infections in a Tertiary Hospital in Casablanca, Morocco, 2021.

During the COVID-19 pandemic, healthcare professionals experienced an increased workload, which may have affected infection prevention and control (IPC) programs and consequently healthcare-associated infection (HAI) rates. The objective of this study was to estimate the prevalence of HAI in Ibn Rochd University Hospital Center (IRUHC) and identify associated factors. A survey was conducted on November 30, 2021 at IRUHC, including all patients hospitalized for at least 48 hours. Data was collected using a questionnaire, and analyzed using SPSS IBM software version 16. The significance level was set at 0.05. Among 887 patients, the prevalence of HAI was 9.7% (7.7%; 11.6%). The highest prevalence was observed in intensive care units (ICUs) (44.2%). Nosocomial pneumonia was the most common site (26.8%). The main isolated microorganisms were Acinetobacter baumannii (18.0%) and Escherichia coli (16.0%). All Acinetobacter baumannii isolated strains were imipenem-resistant. The presence of HAI was significantly associated with the presence of an invasive medical device (p<0.001), a higher physical status score of American Society of Anesthesiologists (ASA) (p<0.001), and a longer hospital stay (p<0.001). Conclusion: The emergence of imipenem-resistant Acinetobacter baumannii(IRAB) represents a serious therapeutic and epidemiological problem requiring the establishment of a system for monitoring the microbial environment and the application of strict hygiene measures.

Exploring Silico-tuberculosis: A Detailed Investigation of 45 Cases in Occupational Settings

Objective: Silicosis is a lung disease caused by inhaling crystalline silica dust, leading to inflammation and scarring of lung tissue. This retrospective study investigates the association between silicosis and tuberculosis (TB) in occupational settings, analyzing 45 male silicosis patients at Ibn Rochd University Hospital in Casablanca from June 2003 to December 2023. Cases: The average duration of occupational exposure was 18 years, primarily in well-digging, stone crushing, mining, and masonry. Clinical symptoms included dyspnea (89%), persistent bronchial syndrome (83%), and hemoptysis (54%). Imaging typically revealed pseudo-tumoral opacities, often with associated mediastinal lymphadenopathy and micronodular or excavated opacities. TB diagnosis was confirmed by GeneXpert (23% in sputum, 70% in bronchial aspirate fluid) and culture (7%). Conclusion: Anti-tuberculous treatment led to clinical improvement in most cases, but there were two deaths from acute respiratory failure and one case of TB relapse. The findings underscore the importance of screening and chemoprophylaxis for TB in managing silicosis. Preventive measures and worker health protections are crucial to reduce the incidence of silicosis and its complications.

Impact of COVID-19 on child tuberculosis hospitalization.

Morocco has made remarkable progress in the fight against tuberculosis, but the Covid-19 pandemic has affected tuberculosis control worldwide, with notable fluctuations in tuberculosis epidemiology during and after the pandemic. To describe the impact of the Covid-19 pandemic on the rate of hospitalization for tuberculosis and its different localizations in children. We conducted a retrospective study based on the analysis of medical records of TB patients hospitalized within the Children's Hospital in Casablanca, during the periods before (2018-2019), during (2020) and after (2021-2022) Covid-19 quarantine. Throughout the study period (2018-2022), the total number of patients hospitalized in our department was 7390, including 283 children were hospitalized for tuberculosis, with a mean age of 6 years. Before the Covid-19 pandemic, the average number of tuberculosis cases was 49 per year, of which the percentage of pulmonary tuberculosis was 32% and extra-pulmonary tuberculosis 68%. The number of cases was 23 per year during the quarantine period, with a percentage of pulmonary tuberculosis of 26% and extra-pulmonary tuberculosis of 74%. After the quarantine period, this number rose to 81 cases per year, of which 21% were pulmonary tuberculosis and 79% extrapulmonary tuberculosis (pleural tuberculosis was predominant in 44.1% of cases). These results are consistent with data published by the World Health Organization, and with the findings of another study we carried out on the impact of COVID-19 on hospital admissions for acute lower respiratory tract infections. It is very likely that the reduction in the number of tuberculosis cases during the quarantine period is due to social distancing, which leads to a reduction in the transmission of tuberculosis between people as well as to the disruption of the national tuberculosis control program in Morocco, when positive cases are identified.

Wounds from sharp objects of the upper limb (About 504 Cases)

Introduction: Assaults by stabbing constitute a growing problem, leading to serious trauma to the upper limb. This study examines the characteristics, management and consequences of upper limb wounds caused by such attacks. Material and methods: This is a retrospective study of 504 cases of wounds of the upper limb caused by stabbing, collected over four years at the IBN ROCHD University Hospital in Casablanca. Data were collected from medical records and included information on injuries, surgical management, complications, and functional outcomes. Results: The lesions predominated on the left upper limb, mainly affecting the hand, wrist, and forearm. The injuries were varied, often involving tendons, nerves, muscles, bones, and vessels. Surgical management was carried out according to established principles, with specific repair techniques. Postoperative complications were common, including sensorimotor disorders, infections, and joint stiffness. Discussion: The results highlight the extent of upper limb trauma caused by stabbing attacks. The complexity of the lesions requires multidisciplinary care. Postoperative complications highlight the ongoing challenges faced by patients. In addition, the psychological consequences of aggression are significant and require special attention. Conclusion: This study highlights the importance of understanding and treating upper limb wounds caused by stabbing attacks. The results provide essential information to improve management strategies and prevent long-term complications, while highlighting the medical and psychological challenges associated with these traumas.

Self-locking tenotomy of the long head of the biceps: What is the benefit?

Tenotomy and tenodesis of the biceps are the surgical techniques used to treat pathology of the long biceps. Between the proponents of the two techniques, the superiority of one over the other is still debated. The Popeye sign is often cited to the disadvantage of tenotomy. The aim of our study is to report on our experience using a self-locking tenotomy and its impact on Popeye's sign, and to assess our functional results. This is a retrospective study of 53 shoulders treated for long biceps tendinopathy, isolated or associated with a rotator cuff tear. All patients underwent surgery at the AILE 4 orthopedic department of the Ibn Rochd University Hospital in Casablanca over a period of five years, and were reviewed at least six months later. A self-locking tenotomy was performed in all patients. The mean age at surgery was 58 years. Popeye's sign was observed in five patients and was well accepted in four patients. Constant-Murray scores improved significantly by an average of 25 points. Satisfaction was over 90%. Professional and sporting activities were resumed in all patients. We highlight the value of the self-locking tenotomy as a simple, rapid, reproducible, effective and low-cost arthroscopic technique, ensuring a tenodesis effect by reducing the rate of appearance of Popeye's sign.

The seroprevalence of COVID-19 among people living with HIV in Morocco

The association of COVID-19 and HIV infection would seem deadly in terms of prognosis and the possibilities of viral clearance given the immunodeficiency. However, a lower seroprevalence has been reported in some studies compared to that found in the non-HIV population. The objective of this study is to determine the seroprevalence of COVID-19 among people living with HIV (PLHIV) in Morocco. This is a prospective study carried out in the infectious diseases department of the Ibn Rochd University Hospital in Casablanca. We included PLHIV who consulted the Infectious Diseases Day-Hospital service between January 18, 2021 and March 10, 2021. After informed consent, patients completed a survey and had blood drawn for SARS-CoV-2 antibody testing. The determination of IgG antibodies against SARS-CoV-2 in blood was carried out using chemiluminescence microparticle immunoassay technology. We included 418 PLHIV in the study, most patients were male (50.24%), the average age was 40 years, 90.2% of patients were on antiretroviral treatment, 56.7% had a viral load &lt;20 copies/ml, and 47.37% had a CD4 count greater than 500 cells/μL. The IgG test was positive in 53 patients, representing a seroprevalence of 12.68%. None of the patients had clinical signs. Seroprevalence was higher in female patients (58.49%), aged between 30 and 40 years (41.51%), in patients with a negative viral load (64.15%) and a CD4 count greater than 500 cells/mm3 (49.6%). Our study showed that the seroprevalence of COVID-19 was higher among PLHIV compared to people without HIV infection. All the patients had asymptomatic forms which pushes us to evoke a theory, to demonstrate, of the action of antiretrovirals against SARS-CoV-2.

Exploring inflammatory markers of COVID-19 severity in Moroccans

IntroductionThe 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 methodsThis 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. ResultsThe 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. Conclusionour 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.

Erectile Dysfunction: Epidemiological and Clinical Case Series Profile at the Ibn Rochd University Hospital in Casablanca

Erectile Dysfunction: Epidemiological and Clinical Case Series Profile at the Ibn Rochd University Hospital in Casablanca

Interest of toxicological analysis in patients admitted to a pediatric emergency department

Objective: Evaluate the interest of toxicology screening in the management of patients in a pediatric emergency department, by assessing its diagnostic utility. Patients and Methods: This is a retrospective cross-sectional study conducted over two years in the Emergency Department of the Abderrahim Harouchi Mother and Child Hospital, of the Ibn Rochd University Hospital in Casablanca, Morocco. We included all children who underwent qualitative toxicological screening by Gas Chromatography coupled with Mass Spectrometry (GC/MS). A descriptive analysis was conducted on the clinical and toxicological characteristics of the patients. The contingency test allowed us to compare the context of the toxicological screening request and its diagnostic utility. Results: Eighty-seven children were included, with a Male-to Female sex ratio of 1.2. The age of the patients ranged from 1 month to 14 years, with a median of three years. Among the included population, 119 screenings were performed. Drugs were implicated in 27 cases, while 4 pesticide intoxications were found, including carbofuron, chloralose, methomyl and terbucarb, along with 2 cannabis intoxications. A proportion of 88% of screening requests, made in the absence of clinical guidance, turned out to be positive, accounting for 31% (24 cases out of 77) (p&lt;0.001). Conclusion: Toxicological analysis is a valuable tool to assist the clinician in managing intoxications by confirming or excluding the toxic hypothesis. However, toxicological analysis can only be useful and effective, avoiding analytical pitfalls, in the presence of dialogue between the clinician and the analyst.

Clinicopathological characteristics and tumor infiltrating immune cells associations of PD-L1 tumor expression in non-small cell lung cancer patients.

Our study aimed to perform on Moroccan patients' non-small cell lung carcinoma (NSCLC) concerning the relationship between PD-L1 tumor expression, clinicopathological features and tumor infiltrating immune cells (ICs). This is a retrospective study (2019 to 2021) conducted on samples from Moroccan patients with NSCLC at the Pathological Anatomy Laboratory of Ibn Rochd University Hospital in Casablanca. Eligible participants for our study had to meet the following predefined criteria: age ≥18 years, histologically confirmed NSCLC, no prior therapeutic interventions, availability of clinical and pathological data, and a usable tumor sample for determining PD-L1 status. Exclusion criteria applied to patients with other types of lung cancer and unusable tumor samples. The evaluation of tumor and immune expression of PD-L1 was performed using immunohistochemistry (IHC), with the 22C3 clone on the Dako Autostainer Link 48 platform. Tumor PD-L1 expression was categorized into 3 levels: TPS <1% (negative expression), TPS 1-49% (low expression), and TPS ≥50% (high expression). ICs infiltrating the tumor expressing PD-L1 were considered positive when more than 1% of positive ICs were present. Among the 316 analyzed samples, 56.6% showed a negative expression of PD-L1, 16.8% displayed a low expression of PD-L1, and 26.6% exhibited a strong expression. Regarding the histological type, among patients with TPS ≥ 50%, 25.8% had adenocarcinoma. Among patients with TPS ≥ 50%, 24.81% were smokers. PD-L1 was also strongly expressed in the lung (28.2%) and bronchi (26.5%). PD-L1 expression (TPS ≥ 50%) was observed in 35.29% of early-stage patients. Concerning tumor cells (TCs), 27.5% of tumors infiltrated by ICs had TPS ≥ 50%. Furthermore, coexpression of PD-L1 on both TCs and ICs infiltrating the tumor was found in 27.8% of tumors. Statistical analysis demonstrated a significant association between tumor PD-L1 expression and smoking status (P=0.019). However, no significant difference was observed between PD-L1 expression and the presence of ICs infiltrating the tumor (P=0.652), as well as the IHC expression of PD-L1 on ICs (P=0.259). Our results demonstrate a significant association between PD-L1 expression and smoking status. However, no significant association was observed between PD-L1 expression and the presence of infiltrating ICs, nor with the IHC expression of PD-L1 on ICs. Our data underscore the importance of participating in the study of specific factors influencing PD-L1 expression in patients with NSCLC.

LMP1 Expression of Esptein Baar Virus in Pediatric Lymphomas: A 06-Year Retrospective Series in Dakar

Persistent Epstein Baar Virus (EBV) infection may be a perfect target for the treatment of EBV-associated lymphomas and improved patient outcomes. The aim of this work was to evaluate the frequency of LMP1 (Latence membrane Protein 1) expression in pediatric lymphomas in Dakar. &amp;lt;i&amp;gt;Material and Methods&amp;lt;/i&amp;gt;: This was a retrospective, descriptive study from January 1, 2015 to December 31, 2020. It was based on blocks and anatomopathological reports of pediatric Lymphomas in 04 ACP laboratories in Dakar. The immunohistochemical study was carried out at the IBN ROCHD Hospital in Casablanca, Morocco, using a manual method. LMP1 immunostaining was considered positive if 10% of tumour cells showed cytoplasmic staining. &amp;lt;i&amp;gt;Results&amp;lt;/i&amp;gt;: Positive staining for LMP1 was noted in 13 of the 42 cases of pediatric lymphomas tested, i.e. 31% of cases. These included 09 cases of Hodgkin&amp;apos;s lymphoma, i.e. 69% (9/13), and 04 cases of non-Hodgkin&amp;apos;s lymphoma, i.e. 31%. LMP1-positive classical Hodgkin&amp;apos;s lymphomas accounted for 40.09% (9/22) of Hodgkin&amp;apos;s lymphomas, and were of the mixed cellularity (6/22) and scleronodular (3/22) subtypes. The frequency of LMP1-positive samples in non-Hodgkin&amp;apos;s lymphomas was 20% (4/20). These included 3 cases of Burkitt&amp;apos;s lymphoma and 1 case of diffuse large B-cell lymphoma. &amp;lt;i&amp;gt;Conclusion&amp;lt;/i&amp;gt;: The frequency of EBV infection in pediatric lymphomas in Senegal is lower than in endemic areas of Africa.

LED Treatment for Chronic Leg Ulcers

Introduction Chronic leg ulcers impact patients' quality of life and pose a therapeutic challenge for dermatologists. The aim of this study was to evaluate the efficacy of LED monotherapy on healing and pain in the treatment of chronic leg ulcers. Materials and Methods his prospective descriptive study was conducted at the Laser Unit of the Dermatology and Venereology Department at Ibn Rochd University Hospital in Casablanca from July 2021 to May 2023. Inclusion criteria were the presence of a leg ulcer and age &gt; 18 years. Exclusion criteria included uncontrolled diabetes and pregnancy. We used a polychromatic LED device combining five colors: violet (415nm), blue (465nm), yellow (590nm), red (630nm), and infrared (850nm), in continuous mode with total fluences of 48J/cm2 and 64J/cm2. Results 23 patients were recruited, with 78.3% being male and a male-to-female ratio of 3.6. The average age was 44.5 years (19-70 years). Vascular etiology was found in 65.2% of cases. Enzyme deficiency was observed in 17.4%: prolidase deficiency and protein C deficiency. Leg ulceration related to a systemic disease was noted in 17.4%. Hematological etiology was identified in 8.7%: sickle cell disease and thalassemia. At the end of treatment, pain regression was noted in 72% of cases. Healing was complete in 26.1% of cases and partial in 73.9%. Conclusion Chronic ulcers represent debilitating conditions with challenging healing. LED therapy using a combination of colors (violet, blue, yellow, red, infrared) accelerated the healing of chronic leg ulcers of various etiologies and reduced pain. Further largescale comparative studies are needed to assess the effectiveness of LED therapy with color combinations in the healing of chronic leg ulcers and to establish practical usage recommendations.

Prevalence of celiac disease in Moroccan children with type 1 diabetes mellitus: A 16-year cross-sectional study.

There is limited data available regarding the prevalence of celiac disease (CD) among children with type 1 diabetes mellitus (T1DM) in Arab countries and the Middle East. This cross-sectional study has been designed to explore the prevalence of CD specifically within the population of Moroccan children and adolescents diagnosed with type 1 diabetes mellitus (T1DM). This is a cross-sectional study of patients who underwent regular follow-up for T1DM at the Pediatric Endocrinology Unit, Abderrahim Harouchi Children's University Hospital in Casablanca, over a 16-year period from 2004 to 2020. Patients were screened for CD by measuring anti-tissue transglutaminase IgA, and those with positive antibodies underwent endoscopy assessment. All 550 patients regularly followed up with TIDM were screened for CD. Fifty-five (33 girls/22 boys) of the screened patients had histologically documented CD, yielding a prevalence of 10%. Nineteen (41.9%) patients had developed CD within the initial four years of diagnosis with T1DM. Therefore, among the six confirmed CD patients, the average age at the onset of T1DM was 3.7 years. For twenty-four (57.5%) of the patients, exhibited no apparent clinical indications of CD, and their condition was only identified through systematic screening. This study showed a high prevalence rate of CD associated with type 1 diabetes T1DM, particularly among young children. The results of this paper indicate one of the highest prevalence rates reported in the existing literature for the coexistence of CD and T1DM. These findings may suggest the necessity of a systematic screening of CD in T1DM patients.

Immunohistochemical-Based Molecular Subtypes of Female Breast Cancer: A Retrospective Cross-Sectional Study at Cheikh Khalifa Hospital in Casablanca, Morocco.

Breast cancer is a major public health concern worldwide and the most prevalent form of cancer in Morocco. This study aimed to describe the histological and immunohistochemical profiles of breast cancer in women admitted to Cheikh Khalifa Hospital in Casablanca, Morocco. This is a retrospective cross-sectional study. All histologically confirmed female breast cancer cases diagnosed between January 2017 and May 2021 at the Cheikh Khalifa University Hospital were included in the study. Data were collected from patient electronic medical records. Using an electronic sheet, information was collected about the socio-demographic characteristics of the patients, clinical features, histopathology, molecular characteristics, treatment received, and progression. Invasive carcinoma of no special type was the most common type of cancer accounting for 90.7% of all cases. The majority of the tumors (56.1%) were grade II tumors. About 42.1% of tumors were lymph node-positive and only 13.4% developed distant metastasis. Immunohistochemical data revealed that 57.9% of the tumors in this study were hormone receptor-positive (ER+ and PR+), 74.4% were estrogen receptor-positive (ER+), 58.5% were progesterone receptor positive (PR+), and 18.9% were HER2 positive (HER2+). The most common molecular subtype was Luminal A-like (43.9%). A statistically significant difference was found in histological grades across the four molecular subtypes (P < 0.001). Our findings should be used to guide breast cancer management policies in Morocco. Larger cohort studies are needed to determine the specificity of the breast cancer profile in Morocco as well as the epidemiological risk factors specific to every subtype.

Epidemiology and Mode of Emergency Diversion of Obstructive Renal Failure of Malignant Cause Retrospective Report

Objective: Obstructive uropathy and its surgical management. Methods: Retrospective cross-sectional study carried out in the urology department of Ibn Rochd University Hospital in Casablanca over a 12-month period (April 2019-March 2020). It included 63 cases of patients hospitalized for obstructive renal failure. We included all patients with renal failure due to a documented malignant pathology. Results: Most of the patients were men (n = 45, 71.4%). The mean age was 60.2 years, with the most affected age group between 51 and 60 years. Forty-three patients (68.3%) were being treated for cancer. The clinical symptoms were diverse, dominated by low back pain. The bladder was the first organ affected by a tumor process. Renal function was impaired in all patients. Twenty patients (31.7%) (n=20) underwent dialysis prior to any bypass. The percutaneous nephrostomy (PCN) was inserted in 56 patients (88.9%) (n=56), the double J catheter in 5 patients (7.9%) (n=5), and 2 patients (3.2%) (n=2) had a percutaneous nephrostomy and a double J catheter inserted contralaterally. Conclusions: In this cohort, bladder tumor was the main cause of obstructive renal failure. Percutaneous nephrostomy was the main mode of diversion used in our center. This choice was dictated by epidemiology and center experience not having a success rate of double J ureteral catheter placement in obstructive renal failure secondary to bladder tumor.

Epidemiological profil of post contusive hyphaema experience of the paediatric ophthalmology department of Casablanca

Aims/Purpose: Hyphaema is defined as the presence of blood in the anterior chamber. It occurs after a contusive or perforating ocular trauma or in the aftermath of ocular surgery. The aim of our work is to analyse the clinical, therapeutic and evolutionary profile of post‐contusive hyphaema.Methods: A retrospective study was conducted on 66 children (33 eyes) admitted to the ophthalmologic emergency room for post‐contusive hyphaema followed and treated in the paediatric ophthalmology department of the 20 August hospital in Casablanca between January 2015 and January 2023.Results: There was a male predominance with 67% of boys affected. The average age was 9.5 years. The main cause of consultation was visual acuity (VA) loss in 49%. On examination, the initial VA was &lt;1/10 in 38% of cases, the ocular tone was &gt;20 in 30% of cases. Hyphaema was classified as stage I in 26.4%, stage II in 52%, stage III in 15.2%, stage IV in 6.4%. Post‐traumatic cataract was present in 50% of the cases, lens dislocation in 22% of the cases, angle recession in 6%. Intravitreal haemorrhage was present in 2 patients, berlin oedema in 3 patients. The treatment prescribed in all patients was strict rest, abundant drinks, oral and local corticotherapy and dilatation with atropine. In addition, a hypotonizing treatment was prescribed for the patients who presented an ocular hypertonia. The evolution was marked by the total resorption of the hyphaema in 90% of the cases. Surgical treatment (hyphaema lavage) in 10% of cases. The final VA was &gt;6/10 in 60% of cases. The most serious complication was haematocornea in 6% of cases.Conclusions: Frequent and serious condition in children that can jeopardize the functional prognosis of the eye. When the diagnosis is made, the management must be early in order to avoid complications.