Ibn Sina Hospital Research Articles

Suicidal attempt among patients with schizophrenia: A cross-sectional study from Morocco

Suicide constitutes the greatest risk factor for mortality in individuals with schizophrenia. Although numerous risk factors have been suggested as important predictors of suicidality in schizophrenia, most studies have focused on Caucasian and Chinese patients. This study aimed to examine the prevalence of suicide attempts in schizophrenia patients in Rabat-Sale-Kenitra, Morocco, and to identify associated clinical and sociodemographic characteristics. A cross-sectional study was conducted at the Ar-RAZI Psychiatric Center of Ibn Sina Hospital in Rabat. We examined 175 Moroccan schizophrenic patients. The sociodemographic and clinical variables were analyzed based on the presence or absence of suicide attempts. The prevalence of suicide attempts among patients was 32%. 43% of them had reported multiple suicide attempts. The majority of those who attempted suicide were single, younger, and with a lower economic status. Visual hallucinations were significantly prevalent among attempter patients compared to non-attempters (p =0.032). Consequently, visual hallucinations could be a risk factor for suicide attempts in the Moroccan population. Understanding sociodemographic and clinical characteristics associated with suicide attempts can help identify patients at higher risk and provide appropriate support and interventions to prevent suicide among the Moroccan population.

The pattern of self in women with borderline personality disorder in the context of their life narratives: A qualitative study

Introduction: Although self-disturbance is considered as an essential aspect of borderline personality disorder, there is little knowledge about its nature in affected individuals. Aim: The present study aimed to determine the patterns of self in women with borderline personality disorder. Method: This study was a basic research with a qualitative approach. The statistical population consisted of women with borderline personality disorder in Mashhad and psychologists and psychiatrists in Mashhad and Tehran, Iran, in 2021. Fifteen women with borderline personality disorder were selected by convenience sampling using Leichsenring's Borderline Questionnaire (1999) from Ibn Sina Hospital in Mashhad, and eight specialists were selected through purposive sampling. Data was collected through semi-structured interviews and coded through thematic analysis. Results: In the data analysis, five main themes, including self-knowledge, self-agency, loneliness, self and injury, and self and emotions, were identified. The self-knowledge theme has two sub-themes, namely, lack of self-awareness and instability. Self-agency included two external and internal themes. Loneliness was also divided into three themes of rejection, being misunderstood, and avoidance. Self and injury contained the themes of self pathology and self-harm, and finally, the main theme of self and emotions was divided into positive and negative emotions. Conclusion: In women with borderline personality disorder, under the influence of adverse and harmful experiences from early relationships and due to the accumulation of unprocessed emotions that cause impulsive behaviors, the self is incoherent, unstable with low self-awareness, and weak agency in facing life difficulties. Therefore; the extracted themes can provide a more comprehensive understanding of these individuals.

The Effect of Intravenous Ketamine on Suicidal Ideation in Depressed Patients: A Randomized Clinical Trial

Background: Major depressive disorder (MDD) generally occurs together with depression in patients with no history of manic, mixed, or hypomanic episodes. The suicidal ideation in MDD patients is very common and can potentially be considered an emergency circumstance in many cases. Among the developed drugs and medicines, ketamine (KET) is a potential option to treat patients with MDD. This study aims at investigating the effect of KET on the treatment of suicidal ideation and the reduction of the intensity of symptoms in patients suffering from MDD. Materials and Methods: This randomized double-blind clinical trial was performed on 30 patients who suffered from MDD and had suicidal ideation at Ibn Sina Hospital, Bandar Abbas, Iran, during 2016-2017. The patients were divided into two groups: the KET group which received 0.5 mg/kg of intravenous (IV) KET diluted in 500 mL of normal saline over 30 minutes and the control group which received 500 mL of normal saline without KET over 30 minutes. Results: According to the statistical analysis, 24 hours after the intervention, suicidal ideation score reached 2.53 and 20.6 in the KET and control groups, respectively. In fact, KET caused a significant reduction in the score of the suicidal ideation (SSI) (SSI<4) in comparison with the control group (P<0.001). Conclusion: It was observed that KET can play a key role in the treatment of depression disorders, especially severe and life-threatening forms that require immediate intervention, such as the use of electroconvulsive therapy.

Chest CT in covid-19 pneumonia's follow-up: A 30 patients case series.

Lung abnormalities do not fully resolve in all Covid-19 survivors and may progress to fibrosis. Understanding post-COVID lung changes helps identify patients susceptible of post-COVID-19 sequelae. We analyzed scannographic residual lung abnormalities and the full resolution percentage on intermediate- and long-term follow-up (3 months or more). Data from 30 RT-PCR positive COVID-19 patients undergoing at least one follow-up chest CT at Ibn Sina Hospital, with a minimal time interval of 3 months between the RT-PCR and the CT performance were gathered retrospectively. The following elements were analyzed: (1) lung opacities, (2) distribution, (3) dominant lung opacity, (4) Sub-pleural bands, (5) Interlobular septal thickening, (6) Vascular dilatation, (7) Bronchiectasis, (8) Honey combing, (9) Architectural distortion, (10) mosaic attenuation, and (11) Additional findings: Enlarged lymph nodes, Pleural and Pericardial fluid. To evaluate the degree of lung opacification, a score founded on visual evaluation of the lung involvement's percentage was employed. Patients were then subdivided into two categories: (1) no residual opacities and (2) remaining pulmonary opacities. 30 patients were enrolled. The age ranged between 40 and 87 years. CT was indicated for symptoms or functional impairment. The time range between the positive RT-PCR and Follow-up CT varied between 3 and 12 months. CT severity score ranged between o and 23. Residual lung opacities were present in 24 cases (80%). The dominant lung opacities were Ground glass (46.7%), and linear/curvilinear opacities (23.3%). Signs of fibrosis were present in 9 patients (30%). CT abnormalities following Covid-19 pneumonia's prevalence varies based on the extent of the original lung affection and the time gap since the acute phase. Residual anomalies' effects on respiratory physiology, symptoms, and quality of living are unknown. Maintained monitoring of COVID-19 survivors with clinical examination, iterative pulmonary function tests, and HRCT is advised.

Application of Poisson's Hierarchical Regression Model to the Deaths of Covid-19 in Mosul City Hospitals

This research deals with the study of the partial hierarchical Poisson regression model (with a random intercept), where this model is one of the most important models widely applied in analyzing data that is characterized by the fact that the observations take a hierarchical form. Where it the full maximum likelihood (FML) method is used to estimate the model parameters. The model was applied to the covid-9 deaths in Mosul city, were recorded during the period (1/1/202 - 1/9/2021), where four major hospitals in the city were selected to represent the group of second level of data (Ibn Sina Hospital, Al Salam Hospital, Shifa Hospital, General Mosul Hospital). *طالب دبلوم عالی/ قسم الاحصاء والمعلوماتیة/ کلیة علوم الحاسوب والریاضیات/ جامعة الموصل. **استاذ مساعد/ قسم الاحصاء والمعلوماتیة/ کلیة علوم الحاسوب والریاضیات/ جامعة الموصل. تاریخ استلام البحث: 4/3/2022 تاریخ القبول: 9/4/2022 تاریخ النشر: 1/12/2022 The research found the adequate of the model for this type of data, as it was found that there are some factors that contribute to the increase in the number of deaths in the epidemic, such as the advanced age of the patient, the length of stay in the hospital, the percentage of oxygen in the patient's blood, in addition to the incidence of some chronic diseases such as asthma. The study recommended a more in-depth study of other types of these models, and the use of other estimation methods, in addition to paying attention to the methods of data recording by the city health department.

Polypharmacy-related polypathology in the elderly: A case study at Ibn Sina Hospital, Morocco

Purpose: To determine the polypathological and therapeutic profiles of a population of elderly subjects at the Ibn Sina Hospital, Rabat, Morocco. 
 Methods: This was a prospective cross-sectional observational study on a population made up of 356 patients aged ≥ 65 years. Data were collected from different departments during the study period, regarding age, sex, educational level, socio-cultural and economic status, self-care ability, polypathologies, polymedication, effectiveness of treatments, adverse effects, and knowledge of the concept of generic medication. The results, which are presented in percentages and simple averages, were processed with Excel 2016 software. 
 Results: Patients aged 66 - 75 years comprised 60.4 % of the studied population. The most common pathologies were diabetes, asthma, and cardiovascular disease. A total of 237 patients (66.6 %) took < 6 drugs, while 119 patients (33.4 %) were on polypharmacy, i.e., > 6 drugs. The elderly were more vulnerable to polypathology and polypharmacy due to age-related reduction in physiological functions and their impact on pharmacological parameters. Polypathology led to polypharmacy which increased the risk of side effects and problems with adherence to medications. 
 Conclusion: This study provides information on the pathological profiles of a population of elderly subjects in a Moroccan hospital, and details of the therapeutic strategies used in managing these patients.

In-hospital mortality in a dermatology department

Background: Far from popular belief making dermatological conditions benign and harmless, we know that some dermatoses may be life-threatening. The aim of our study was to evaluate the overall mortality resulting from dermatological disorders in our department because of the rarity of similar studies. Materials and Methods: We conducted a retrospective, observational study on all patients who died in the Ibn Sina Hospital of Rabat between January 2017 and December 2021 (a period of five years), after they were initially admitted to the dermatology department. Results: Among 1731 patients hospitalized during this period, 45 died, corresponding to an average of 2.6%. The male-to-female ratio was 1.9 and the mean age at death was 63.2 years. The mean number of comorbidities per patient was 1.2, dominated by diabetes. The reasons for hospitalization were as follows: twenty-three cases of extensive bullous dermatoses (60.5% of the cases), four cases of severe toxidermia (10.5%), three cases of erythroderma (7.8%), one case of acro-lentiginous melanoma, one case of squamous cell carcinoma, and one case of pyoderma gangrenosum. In twenty patients (52.6%), the cause of death was directly related to the dermatosis. In sixteen, the cause of death was septic shock of cutaneous origin. Sixteen patients (42.1%) died of causes unrelated to dermatosis. Conclusion: This study showed that life-threatening dermatoses are not uncommon. Among these conditions, autoimmune bullous dermatoses and severe toxidermia, such as TEN and DRESS syndrome, were found to be the most lethal. An advanced age, a surface area of skin involvement, mucosal involvement, associated comorbidities, and the development of sepsis may be considered poor prognostic factors.

Adrenocortical Tumor: With Special Reference to A Case Report

Adrenocortical tumor (ACT) is a rare tumor, the annual incidence of which is estimated to be 0.5 to 2 cases per million [1], leading to 0.04 and 0.2% of causes of cancer death.We report here the case of a patient admitted in the surgery department B at Ibn Sina hospital in Rabat.This is a 50-year-old man, a chronic smoker with 33 smoking years, who underwent an operation a month ago for suspicion of a Hydatid Cyst of the right lobe of the liver, with intraoperative finding of a right adrenal mass and a normal liver. Biopsy later on reported a malignant adrenocortical tumor, so the patient was referred for subsequent care and management. The patient subsequently underwent surgery by laparotomy, and complete resection of the adrenal tumor mass was successful, followed by simple postoperative consequences.

Occupational exposures and lung cancer in Morocco: An epidemiologic study

Lung cancer is the leading cause of cancer incidence and mortality worldwide. It is one of the cancers most associated with environmental and occupational exposure. This study aimed to describe the epidemiological profile of lung cancer in patients exposed to environmental carcinogens, and assess differences between the exposed and unexposed people in Morocco.This is a retrospective study of all patients diagnosed with primary lung cancer over 4 years at Ibn Sina hospital in Rabat (capital of Morocco). Occupational exposure to carcinogens was examined concerning the patients' occupations. Patients under 30 years of age were excluded from the analysis because the latency period for cancer between the initial exposure to a carcinogen and the diagnosis of cancer is generally greater than 10 years.Of the 478 patients included in this study, 227 patients (47.5 %) were exposed to occupational carcinogens and aged greater than 30 years. Of these, 93.8 % were men. The average age at diagnosis was 58.8 ± 10.2 years. The most common occupation for men was related to masonry construction and painting (47.1 %), agriculture (30.8 %), and transportation (12.8 %). Women were more exposed to cleaning products (50 %) and coal smoke (42.8 %). Adenocarcinoma was the most frequent histological type with 57.71 %. Only 9.25 % of cases were considered operable. Compared to the unexposed patients, the exposed patients were more likely to be men (p < 0.001), smokers (p < 0.001), suffer more from chronic obstructive pulmonary disease (p = 0.011), and had more neuroendocrine tumors (p = 0.035).

Post‐dural puncture headache: a prospective study on incidence, risk factors, and clinical characterization of 285 consecutive procedures

BackgroundLumbar puncture (LP) is a common and relatively safe neurological procedure. It can be complicated by post-dural puncture headache (PDPH) after both diagnostic and therapeutic procedures. The aim of this study is to identify the incidence, risk factors and clinical characterization of PDPH in the inpatient setting of the main tertiary neurology hospital in Kuwait.MethodsWe conducted a prospective observational cohort study that included patients who were admitted to neurology department at Ibn Sina hospital, Kuwait, from January 1, 2019 to December 31, 2020, on whom, LP was performed for diagnostic and/or therapeutic reasons. Multivariate logistic regression analysis was performed to evaluate the association between PDPH and different clinical parameters.ResultsA total of 285 patients were included; 225 females (78.9%), mean age of 32.9 ± 11.7 years. PDPH was reported by 84 patients (29.5%), with mean headache onset of 1.7 ± 0.8 days, and mean duration of 2.4 ± 2.1 days. The commonest headache type was dull aching in 49 patients (58.3%). Headache severity was mild to moderate in 64 patients (76.2%), with mean NRS of 4.1 ± 0.9. Most PDPH (99.3%) resolved with conservative medical management, with only 2 patients (0.7%) requiring epidural blood patch. In multivariate logistic regression model, there was a statistically significant correlation between development of PDPH and young age (p = 0.001), female gender (p = 0 .001), low BMI (p < 0 .001), pre-LP headache (p = 0.001), history of previous PDPH (p = 0.001), and number of LP attempts (p < 0.001). PDPH was statistically significantly higher in patients with optic neuritis (p = 0.009), and cerebral venous thrombosis (p = 0.007), and lower in patients with peripheral neuropathy (p = 0.011) and spinal muscular atrophy (p = 0.042).ConclusionsFindings from clinical practice in the main tertiary neurology hospital in Kuwait were in line with literature findings. Younger age, female gender, lower BMI, pre-procedural headache, previous history of PDPH, and number of LP attempts were found to be independent risk factors for developing PDPH. To our knowledge, this study represents the first comprehensive description of PDPH in a population from the Arabian Gulf Region.

Thyroid angiosarcoma: A case report and review of literature.

Thyroid angiosarcoma is a very aggressive and rare malignancy that is mostly seen in elderly of Alpine regions, related to high prevalence of iodine deficient goiter. The major diagnostic challenge is to distinguish between this entity and anaplastic carcinoma and to specify whether it is a primary or metastatic angiosarcoma. The objective of this work is to clarify this distinction through our case report and a revue of literature. We report the case of a 55 years-old female patient, with no medical history, admitted to the General Surgery Department of Ibn Sina Hospital in Rabat for the management of a cervical mass classified sonographically TI-RADS 6. It was also noted a lesion of the skin next to the thyroid lodge. The patient underwent total thyroidectomy with simple post-operative course. A third tumor location was discovered in the stomach during Oesophago-Gastro-Duodenoscopy (OGD). Microscopically, the thyroid, cutaneous and gastric tumors showed rows of oval to spindle-shaped cells, with marked cytonuclear atypia and high mitotic activity. The stroma was richly vascularized and fibro-inflammatory. Immunohistochemical studies demonstrated that the tumor cells showed positive staining for cytokeratin (AE1/AE3), CK7, ERG and CD31, while they exhibited no immunoreactivity for CK20, thyroglobulin or CD34. The first diagnostic challenge is to rule out anaplastic carcinoma. Using and the classification proposed by Cutlan et al. and a large immunohistochemical panel the diagnosis of epithelioid angiosarcoma was retained. Based on epidemiological and clinical criteria, the primary site in our case was more likely to be cutaneous. In summary, thyroid angiosarcoma is an uncommon thyroid neoplasm which poses a problem of differential diagnosis with anaplastic carcinoma and metastatic angiosarcoma. The use of a large panel of antibodies as well as the epidemiological and clinical data can solves the problem in the most difficult cases. • Thyroid angiosarcoma is a very rare malignancy that is mostly seen in elderly of Alpine regions, related to high prevalence of iodine deficient goiter. • It is a very aggressive tumor that can rapidly spread to the cervical lymph nodes, lungs, and brain or can metastasize to the duodenum, small bowel and large bowel. • Metastatic disease is associated with poor prognosis and limits the mean survival time to a few months after diagnosis and surgical treatment. • The first diagnostic challenge is to rule out an angiomatoid anaplastic carcinoma, using a large panel of antibodies. • The second challenge is to specify whether it is a primary or metastatic angiosarcoma especially when other sites are involved, based on clinical and epidemiological criteria.

Potentially Inappropriate Medication Use in Older Adults with Chronic Kidney Disease.

This study aimed to identify the prevalence of potentially inappropriate medication use (PIMU) in adults above the age of 65 with chronic kidney disease (CKD) according to the American Geriatric Society Beers Criteria (Beers), Screening Tool of Older People's Potentially Inappropriate Prescriptions Criteria (STOPP) and medication appropriateness index (MAI) 30 criteria and to compare them to justify their use in this specific patient group. This was a retrospective and descriptive study conducted between October 1st, 2019 and March 18th, 2020 at Ibni Sina Hospital, Nephrology Department, Faculty of Medicine, Ankara University. Among 269 patients discharged from the hospital during the study period, 100 of them were eligible for the study. The mean age was 73.3 ± 6.9 years and 51.9% of them were male. The prevalence of 35 PIMU was 91%, 42%, and 70% according to the Beers, STOPP, and MAI criteria, respectively. There was a statistically significant difference in terms of prevalence among 3 criteria (p<0.001). Beer detected more PIMU (11.3% vs. 6.4%) and had higher sensitivity among older adults with CKD (0.97 vs. 0.56) compared to the STOPP criteria. Most patients had at least one drug-drug interaction (DDIs) in their discharge prescription (93%) and DDI was one of the main contributors of PIMU. Proton pump inhibitors were the most common medication associated with PIMU in all 3 criteria. The prevalence of PIMU was high among older adults with CKD at discharge according to these criteria. To improve the prescriptions after hospital discharge, it is considered appropriate to use Beers criteria under guidance of a clinical pharmacist.

Prevalence and Predictors of Toxoplasma gondii Infection in Psychiatric Inpatients in Fars Province, Southern Iran.

BackgroundPsychiatric patients are at increased risk of exposure to Toxoplasma gondii infection, which may be linked to their living facilities and behaviors. Limited knowledge on the prevalence of T. gondii infection and its associated risk factors in psychiatric patients are available to the international medical communities. Thus, the aim of the current study was to assess seroprevalence of T. gondii and its associated risk factors in psychiatric inpatients in Fars Province, southern Iran.MethodsThis cross-sectional study was carried out on psychiatric patients hospitalized in Ibn Sina Hospital affiliated to Shiraz University of Medical Sciences, Fars Province, southern Iran, March to July 2021. Blood samples were collected from 318 psychiatric patients and assessed for the detection of IgG against T. gondii using enzyme-linked immunosorbent assay (ELISA). Moreover, structured questionnaires were completed for the participants at the time of sampling. Logistic regression analysis was used to assess possible associations between the latent toxoplasmosis and the variables.ResultsThe overall seroprevalence of anti-T. gondii IgG in psychiatric inpatients was 22.3% (71/318; 95% CI = 17.9–27.3). Multivariate analyses revealed that age > 30 years [adjusted odds ratio (AOR) = 2.24, 95% CI = 1.10–4.60, p = 0.03], contact with cats (AOR = 2.52, 95% CI = 1.14–5.58, p = 0.03), raw vegetable consumption (AOR = 3.65, 95% CI = 1.74–7.65, p = 0.001), raw/undercooked meat consumption (AOR = 4.30, 95% CI = 1.47–12.63, p = 0.008), suicide attempt (AOR = 3.77, 95% CI = 1.58–8.97, p = 0.003) and cigarette smoking history (AOR = 0.38, 95% CI = 0.17–0.83, p = 0.02) were independent risk factors for T. gondii infection.ConclusionThe current results demonstrated that contact with cats, raw vegetable consumption and raw/undercooked meat consumption were independent risk factors for T. gondii seropositivity. Moreover, the current study showed significant associations between seropositivity of T. gondii and suicide attempts as well as negative associations between seropositivity of T. gondii and cigarette smoking in psychiatric inpatients using multivariate logistic regression.

A STUDY OF SOME BIOCHEMICAL INDICATORS OF KIDNEY FUNCTION AND ESTIMATION OF SOME ELEMENTS CONCENTRATION IN THE BLOOD SERUM OF PATIENTS WITH CELIAC DISEASE

Celiac disease is a long-term autoimmune and digestive disorder that damages small intestine. The current study aimed to estimate some important enzymatic and biochemical variables for kidney functions in patients who eat gluten and abstain from it, compare them with healthy ones, see the usefulness of the GFD “Gluten free diet” to improve the health status of patients, and find biomarkers that contribute to the early diagnosis of celiac disease. The current study was conducted in Nineveh Governorate on patients who came to Al-Salam, Ibn Sina and Al-Khansa Hospital, as well as some private laboratories, as well as some patients from the students of Mosul University, the Technical Institute, and Al-Jada’a and Salamiyah camps after accurate diagnosis by specialist Doctors . 183 blood serum samples were collected for people of both sexes, aged between (2-25) years,. The samples were distributed into three groups, the group of patients who take gluten, including (62) samples (31 males and 31 females), and the group of patients who abstain from eating gluten, which includes (61) samples (31 males and 30 females), as well as the healthy group (control). It includes (60) samples (30 males and 30 females) The results of the current study showed a significant increase in tissue transglutaminase tTG-IgA enzyme for patients taking gluten compared to healthy subjects and no significant difference in enzyme activity in GFD patients compared to healthy subjects at a probability level (p ≤ 0.05). The results also showed that there was no significant difference in the measurement of creatinine, uric acid and glucose in patients who eat gluten as well as for gluten free diet GFD patients, and a significant increase in the measurement of urea in patients who take gluten compared with the healthy group , and no significant difference in the measurement of urea for GFD patients compared with control. The results also showed a significant decrease in Fe+2, Cu+2, Ca+2, and Zn+2 in patients who take gluten, as well as for GFD patients, compared with healthy subjects at a probability level (p ≤ 0.05). In conclusion monitoring of these biochemical markers is important in diagnosis and follow-up of celiac patients.

Outcomes of Mini-Percutaneous Nephrolithotomy in Children and Adolescents: A 10-Year Single-Centre Experience From Kuwait.

The current study retrospectively reviewed data for all children and adolescents who underwent mini-percutaneous nephrolithotomy (PCNL) at Ibn Sina Hospital and Sabah Al Ahmad Urology Centre in Kuwait over 10 years. Accordingly, the 40 patients underwent mini-PCNL. Among them, 21 patients (52.5%) had varying degrees of hydronephrosis, with mild to moderate severity accounting for nearly half of them, whereas six (15%) had multiple stones. The median operative time was 54.5 (43.3-64) minutes. Moreover, 11 patients needed flexible ureteroscopy (URS) and double-J (DJ) ureteric stent, and one patient required DJ ureteric stent only. None of the cases developed intraoperative bleeding. The median hospital stay of the included patients was three (2.3-4) days. Residual stone was observed in 11 patients (27.5%), with a median size of 3 (2 to 7) mm. The incidence of postoperative complications was 27.5% (n = 11 patients), with three patients experiencing postoperative bleeding (7.5%) and eight patients developing a fever (20%). All patients had mild postoperative pain. However, no leakage, sepsis, or pelvic injury occurred. None of the patients required revision. In conclusion, mini-PCNL was a safe and effective procedure in children and adolescents with renal stones.

Detection of Human Papillomavirus Subtype 16 in Esophageal Squamous Cells Carcinoma in Sudanese Patients

Oesophageal cancer is the sixth most common cancer among males and the ninth among the females worldwide. The purpose of this study is to detect association of Human papilloma virus subtype 16 and esophageal squamous cell carcinoma in Khartoum state Hospitals by polymerase chain reaction method. A retrospective descriptive study of archival formalin fixed paraffin embedded tissue from Esophageal Squamous cells carcinoma specimens acquired at Omdurman Teaching hospital, Alribat, IbnSina Hospital and Military hospital. 50 were used to detect HPV-16 by DNA Extraction and polymerase chain reaction method (PCR). PCR was performed on formalin-fixed, paraffin-embedded tissue samples from 50 patients with ESCCS. PCR detection method was used to detect the role of HPV-16. SPSS was used to analyze the data, the role of HPV-16 and the histological grade of tumors was determined. In 18 % of cases, the presence of HPV-16 was positive in the ages above 40 years old (54.2%). Females predominantly affected by squamous cellscarcinoma (22.6%). The most common histological differentiation observed with high rate of human papilloma virus type 16 was found in poorly differentiated squamous cells carcinoma (20%). The frequency of human papilloma virus type -16 was statistically insignificant associated by gender, age and histological differentiation. (P value &lt; 0.05).

Serologic survey of leishmaniasis in Ibn Sina patients, Sirte, Libya.

The clinical and parasitological features of leishmaniasis were investigated, retrospectively, in 162 patients who attended the out-patient clinic of Ibn Sina hospital during January 2017 and June 2018. The aim was to evaluate the epidemiological characteristics of leishmaniasis. Sera from all the suspected patients were examined for slit and smear examination. Seventy one represent (43.82%) of 162 were positive. Of them, 52 (73%) were males and 19 (26.76%) females. The most affected age group was found to be between 21 and 30; the least affected was age group below 10 years.

Modified Traction Technique for Intraabdominal Testes With Short Vessels

ObjectiveTo assess the safety and efficacy of modified testicular traction technique in treatment of intraabdominal and peeping testes with short vessels. Patients and methodsIn the pediatric surgery unit, Sheikh Khalifa Medical City, Abu Dhabi, UAE, and in the pediatric urology unit, Ibn Sina Hospital, Kuwait, Forty testes in 32 patients were operated using the modification of staged traction laparoscopic-orchiopexy. The modified technique involved intracorporeal placement of suture, gabernacular sparing, no intraabdominal dissection and shorter traction duration as short as 7 days without the need of inguinal incision. ResultsAll patients tolerated both stages of surgery well without any intra-operative nor post-operative complications. The 1 year follow up period proved successful outcome in all the cases. ConclusionThe modified staged traction laparoscopic orchiopexy is safe, successful and feasible in intra-abdominal and peeping testes.

Potential drug-drug interactions of immunosuppressants in kidney transplant recipients: comparison of drug interaction resources.

Background Drug-drug interactions are frequently observed in kidney transplant recipients due to polypharmacy and use of immunosuppressants. However, there is only one study evaluating clinically relevant potential drug-drug interactions of immunosuppressants specially in kidney transplant recipients by means of online databases and Stockleys Drug Interactions, as a gold standard. Aim This study aimed to compare four online databases used frequently to determined clinically relevant potential drug-drug interactions of immunosuppressants in kidney transplant recipients according to the Renal Drug Handbook. Method This was a descriptive cross-sectional study conducted between October 1, 2019, and March 18, 2020, in the nephrology ward of Ankara University School of the Medicine, Ibn-i Sina Hospital. In total, 52 adult patients' discharge prescriptions were retrieved from their medical records and analyzed retrospectively. Micromedex®, Lexicomp®, Medscape, and Drugs.com databases were used to evaluate drug interactions. The Renal Drug Handbook was used as a gold standard to do specificity and sensitivity analysis. Results A total of 127 potential drug-drug interactions between the immunosuppressants and co-medications were detected by at least one online database. 32 (25.2%) of these were approved as clinically relevant potential drug-drug interactions by the Renal Drug Handbook. Lexicomp® and Drugs.com have exhibited the highest sensitivity (0.72 and 0.75) while Micromedex® has shown the highest specifity (0.83). Furthermore, the highest positive predictive value has been observed in Micromedex® (0.53). Micromedex® and Medscape had the highest negative predictive value (0.83 and 0.82). However, the kappa value of all was low. The values of inter-rater agreement (Kappa index) between online databases and the Renal Drug Handbook were weak (range 0.05-0.36). In addition, only 11 (8.7%) of potential drug-drug interactions were identified by all online databases. Conclusion This study showed that there was a weak compatibility between each database examined and the Renal Drug Handbook to detect clinically relevant potential drug-drug interactions for immunosuppressants in kidney transplant recipients. Therefore, we suggest that although databases might be practical to take a quick glance in detection of potential drug-drug interactions between immunosuppressants and co-medications, the data should be evaluated in detail and interpreted with caution in combination with a reference book like Renal Drug Handbook.

Epidemiology of Pemphigus: A Single Center Experience in Morocco

Abstract Objective: Pemphigus is a life threatening autoimmune bullous disease which involves the skin and mucous membranes of the stratified squamous epithelium. The global distribution of Pemphigus varies according to genetic, ethnic, socioeconomic, and cultural backgrounds. The purpose of our study is to evaluate the epidemiological features of pemphigus a single center in Morocco and compare our results with those reported elsewhere. Methods: A retrospective analysis was conducted of 302 pemphigus patients seen between 1990 and 2020 in the Dermatology Department of Ibn Sina Hospital (Rabat, Morocco). We further collected all the Moroccan scientific researches published by now to compare. Results: The average annual incidence was 0.32/100,000 inhabitants. The incidence doubled to 0.72 in 2020. The most common variant was pemphigus vulgaris (125 cases) followed by pemphigus erythematosus (99 cases), pemphigus foliaceous (40 cases), and vegetans (27 cases). The female to male ratio was 0.75, the average age at onset was 53years old and the mean duration of the disease before diagnosis was 13.36months. Conclusion: This study joins the main characteristics of pemphigus in the Maghreb and around the world (pemphigus vulgaris most frequent subtype). In 2020, an epidemiological peak occurred during the coronavirus disease 2019 pandemic; probably related to stress and delayed time consultation for fear of contracting the severe acute respiratory syndrome coronavirus 2.