Military Teaching Hospital Research Articles

Accuracy and Safety of Freehand Placement of Upper Thoracic Pedicle Screws Supported Solely by Anteroposterior, i.e., Frontal, X-Ray Fluoroscopy (C-Arm): Technical Note Including 23 Patients

IntroductionThe biomechanical resistance and the surgical morbidity of spinal posterior pedicle screw fixation relies on the intraosseous position of the implants. Upper thoracic pedicle screws are particularly demanding given their convergence and thin character. We present our experience as military surgeons of free hand placement of upper thoracic pedicle screws supported by antero-posterior, i.e. frontal X-ray fluoroscopy solely. Materials and methodsMonocentric retrospective analysis at Sainte-Anne Military Teaching Hospital between 2017 and 2024 of patients operated on using upper thoracic pedicle screws (levels T1 to T5) using antero-posterior fluoroscopy solely. Results23 patients were included (mean age 59, male/female 3.6), 16 traumas and 7 neoplastic lesions), with 15 cervicothoracic junction fixation and 8 upper thoracic spine surgeries. 124 screws were inserted (T1 to T5). 85% (106/124) were graded 0 (Gertzbein-Robbins scale) whereas 14.5% (18/124) displayed some degree of misplacement (grade 1 to 3): all the T1 screws (22/22) were accurately placed compared to 83% (20/24) of T2 screws, 88% (30/34) of T3 screws, 85% (17/20) of T4 screws, and finally 71% (17/24) of T5 screws, without any clinical consequences. There were 3 surgical revisions (1 asymptomatic misplaced screw, 2 mechanical failures in trauma). Last, 92.7% (n=51/55) of the screws inserted during working hours were accurately placed compared to 79.7% (n=55/69) during after-hours surgeries (p=0.039) ConclusionClinically speaking, placement of upper thoracic pedicle screws using antero-posterior fluoroscopy solely appears safe. The surgical technique is simple enough to be used in strained resources settings such as a mobile field surgical team.

Screening for BK Virus Infection in Kidney Transplant Recipients at Mohamed V Military Teaching Hospital

After kidney transplantation, BK polyomavirus reactivation can manifest as nephropathy in 1% to 10% of patients. PCR testing of urine and blood is commonly used to screen for BK polyomavirus nephropathy. The study aims to detect BK virus infection in kidney transplant patients to prevent tubulointerstitial nephropathy and graft loss. This retrospective study includes 26 patients who underwent kidney transplants between January 2019 and December 2023. We diagnosed BK virus infection by performing real-time PCR on blood and urine samples. BKV DNA was detected in 3 patients. Reducing immunosuppressive therapy led to negative PCR results and favorable clinical and biological outcomes in these 3 patients.

Human papillomavirus and cervical cancer: laboratory diagnosis and genotype distribution at mohammed v military teaching hospital (RABAT, MOROCCO)

Human papillomavirus and cervical cancer: laboratory diagnosis and genotype distribution at mohammed v military teaching hospital (RABAT, MOROCCO)

Investigations of carbapenem resistant and hypervirulent Klebsiella pneumoniae.

Hypervirulent Klebsiella pneumoniae is an emerging pathogen that has gained attention due to its increased ability to cause infections even in healthy individuals. The aim of this study is to investigate virulence factors in K. pneumoniae strains isolated from clinical specimens and their association with carbapenem resistance. The study was conducted on 260 isolates identified between 2018 and 2023 at the Mohammed V Military Teaching Hospital in Rabat, Morocco. The isolates were categorized based on their susceptibility to antibiotics. The hypermucoviscosity was determined by a string test, while thepresence of capsular serotypes and virulence genes were identified by PCR. Among our strains, 6.2% (n= 16) exhibited hypervirulent characteristics, 56% were resistant to carbapenem. Notably, 5.7%(n=6) of carbapenem-resistant isolates expressed the hypermucoviscous phenotype, while 1.5% (n=2) of carbapenem-susceptible K. pneumoniae isolates exhibited the same trait. In our study, we found that a total of 10 isolates (3.8%) had virulent capsular serotypes, with K2 being the most prevalent 40% (n = 4) and K20 in 30% (n = 3). Furthermore, we detected the presence of the Aerobactin gene in 1.5% (n = 4) of the isolates examined. Based on our findings, it appears that there was no correlation between the presence of virulence factors and carbapenem resistance. In conclusion, identifying hypervirulent K. pneumoniae in clinical specimens and assessing their antibiotic resistance profiles are crucial to ensure effective therapy and to prevent outbreaks.

Unlocking the Impact of Renal Function on Acute Coronary Syndrome: Insights from A Cohort Of 318 Cases

Introduction: Chronic kidney disease (CKD) represents a distinct risk factor by itself for the development of coronary artery disease (CAD). Notably, CAD stands as the primary driver of both sickness and death among individuals diagnosed with CKD. Furthermore, individuals with CKD tend to experience worse outcomes when it comes to CAD. In addition to conventional risk factors, numerous factors associated with uremia, including inflammation, oxidative stress, endothelial dysfunction, coronary artery calcification, elevated homocysteine levels, and the use of immunosuppressants, have been linked to an increased risk of accelerated atherosclerosis. Objective and method: In this study, we aim to assess the differential effect of renal impairment across the spectrum of patients with acute coronary syndrom. We conducted this study in the intensive care unit of cardiology in the Military Teaching Hospital of Rabat. Results: A total of 318 patients were included in the study. The average age was 63.8 +/- 9.41 years and 77% (244/318) were male. Normal kidney function was reported in 72.8% (220/318) of patients. Of the 318 included patients, 121(38.3%) were presented with STEMI, 154 (48.7%) with NSTEMI, and 41 (13%) with unstable angina. The difference of age was significant with a p-value of <.001 with a mean of age of 61.8 in patients with normal renal function vs 68.1 in impaired renal function patients. Patients with impaired GFR had more history of previous PCI (21) compared to those with normal GFR (23) with a p value of 0.001. Hb was lower (12.5vs 13.9 p<0.01) and Grace score was higher (45 vs44 p<.001) in patients with impaired GFR vs patients with normal GFR. Percentage of cardiogenic shock and death was respectively higher in renal impairment (12(60%) vs 8 (40%) with p of 0.004); (10(62.5%) vs 6(37.5%) with p 0.005. Conclusion: The magnitude of renal impairment is significant in our study in the most deadly complication: cardiogenic shock and death; which confirms that outcomes of coronary artery disease especially in acute coronary syndrome are significantly poorer in patient with kidney disease.

Foreign Body (FB) in High Respiratory Tract: Case Report

Objectives: The objective of our case report is to describe the clinical, radiological and therapeutic aspects of foreign body aspiration at the ENT department in the Military Teaching Hospital Mohammed V, RABAT, Morocco. Case report: a 48-YEAR-OLD patient with no particular history, who presented to the hospital emergency room 4 days after an aspiration syndrome during a dinner. a pharyngo-laryngeal scan was requested urgently and which showed the presence of an embedded chicken bone in the patient's glottic plane, the treatment was rapid and the patient benefited from sedation in the operating room with extraction of the foreign body. Discussion: Foreign bodies (FB) represent a pathology frequently encountered in emergency ENT practice. They can constitute a life-threatening emergency due to their appearance or location. FBs in the ENT sphere remain frequent in daily practice, especially in children. Their treatment requires rapid intervention with suitable equipment and trained doctors. Prevention remains the best solution. Conclusion: Inhalation of a foreign body is a public health problem. The increase in the incidence of this accident and the epidemiological transition require better prevention.

Independent factors of preventable death in a mature trauma center: a propensity-score analysis.

The rate of potentially preventable deaths (PPD) and preventable deaths (PD) can reach more than 20% of overall trauma mortality. Bleeding is the leading cause of preventable mortality. The aim of our study is to define the independent factors of preventable or potentially preventable mortality in our mature trauma system. We conducted a single-center retrospective study in the Sainte Anne Military Teaching Hospital, Toulon, France, including all severe trauma patients admitted to our trauma center and discharged alive as well as all severe trauma patients who died with a death considered preventable or potentially preventable from January 2013 to December 2020. We matched the two groups using a propensity score and searched for independent factors using a generalized linear model. 846 patients were included and analyzed. After matching, our cohort consisted of 245 patients in the survivor group and 49 patients in the preventable deaths group. Pre-hospital delays (73min vs 54min P = 0.003) as well as delays before incision in the operating room (80min vs 52min P < 0.001) were significantly longer in the PD group. These delays were independent factors of preventable mortality OR 10.35 (95% CI [3.44-31.11] P < 0.001) and OR 37.53 (95% CI [8.51-165.46] P < 0.001) as well as pelvic trauma OR 6.20 (95% CI [1.53-25.20] P = 0.011). Delays in pre-hospital care, delays in access to the operating room from arrival at the trauma center, and pelvic injuries are independent factors associated with an increased risk of preventable mortality in trauma.

A Single-Center Study of the Impact of the COVID-19 Pandemic on the Organization of Healthcare Service Delivery to Patients with Head and Neck Cancer.

The aim of this study was to identify and assess the impact of the COVID-19 pandemic on the diagnosis and treatment of head and neck cancer (HNC) patients of the Department of Otolaryngology, Head and Neck Surgery of the 4th Military Teaching Hospital in Wroclaw for whom oncological treatment was planned by a cancer case board between March 2018 and February 2022. We analysed the medical records of 625 patients. In order to verify whether the relationships between the analysed features were statistically significant, the chi-square test of independence and the Student's t-test for independent samples were used (p < 0.05). Our analysis showed that the impact of the pandemic on the organization of health service delivery to HNC patients was not uniform. The largest difference in the number of formulated treatment plans was observed at the beginning of the pandemic (22.1% reduction compared with the year before the pandemic). During the pandemic, the proportion of patients admitted on the basis of a DILO (diagnosis and oncological treatment) card issued by a primary care physician, instead of a regular referral to hospital, issued also by a primary care physician, was significantly higher compared with the that during the pre-pandemic period. The majority of cancer patients with a oncological treatment planned during the pandemic lived in urban areas. During the pandemic, the number of patients with more-advanced-stage cancer, assessed on the basis of the type of planned treatment (radical vs. palliative), did not increase compared with that during the pre-pandemic period. However, our follow-up period was quite short. It is necessary to intensify activities aimed at promoting health and increasing health awareness in people living in rural areas and setting long-term priorities and objectives for health policies at the national, regional and local levels, with particular focus on this group of people.

Spontaneous Upper Cervical Cord Infarction: A Cohort of 13 Cases and Review of the Literature

The purpose of this study was to evaluate the risk factors, etiologies, clinical features, and functional outcomes of 13 consecutive patients who were admitted to our institution with a spontaneous upper cervical cord infarction (SUCI), a rare and devastating condition. A literature review of variables relevant to our case series was conducted. Methods: We revised all spinal cord stroke cases admitted between 2005 and 2020 to the Department of Neurology of the University Hospital Center “Mohammed V Military Teaching Hospital” of Rabat (Morocco). Data on the patient’s demography, clinical features, and functional outcomes of the upper cervical cord infarction patients were analyzed in Jamovi software for descriptive analysis. Results: Abdominal aortic aneurysm repair n=5(38.5%) and aortic dissection secondary to giant cell arteritis n=5(38.5%) were the possible etiology found. Nadir’s deficits were ASIA grade A in 4(30.8%) patients, grade B in 2(15.4%), C in 4(30.8%) and D in 3(23.1%). The Modified Rankin Scale at admission was mRS3 in 2 patients 15.4%, mRS4 in 7(53.8%), and mRS5 in 4(30.8%). At different stages of follow-up, three patients, 23.1% had died. In the other 10 patients, the residual deficits were ASIA grade B in (1/10) patients, D in (3/10), and E in (6/10). The recovery and degree of continued disability over time were mRS1 in (6/10) patients, and mRS2 in (4/10). Conclusion: The overall better outcome observed in this study can be related to the fact that more than half of the patients in our cohort had nadir ASIA C/D with mRS 3-4.

French Military Neurosurgery: At Home and Abroad.

The origins of military neurosurgery are closely linked to those of neurosurgery in France and more particularly in Paris. The history of the field starts with its origins by 2 men, Thierry de Martel and Clovis Vincent. The first note about the creation of military neurosurgery was in 1942, when Marcel David was reassigned from the Sainte Anne Hospital to practice at the Val-de-Grâce Military Hospital. David trained the first military neurosurgeon. The field of military neurosurgery was subsequently developed at the Val-de-Grâce Military Hospital, at Sainte Anne Military Teaching Hospital in Toulon in 1990 and then at Percy Military Teaching Hospital in 1996. Over 29 military neurosurgeons were trained in these institutions. Since 2000, French military neurosurgeons have been deployed from France in the Mobile Neurosurgical Unit. This Mobile Neurosurgical Unit represents 12% of all medical evacuation of casualties categorized as the high dependency level. Neurosurgeons were able to adapt to asymmetrical wars, such as in the Afghanistan campaign where they were deployed in the Role 3 medical treatment facility, and more recently in sub-Saharan conflicts where they were deployed in forward surgical roles. To manage the increasing craniocerebral war casualties in the forward surgical team, the French Military Health Service Academy established a training course referred to as the "Advanced Course for Deployment Surgery" providing neurosurgical damage control skills to general surgeons. Finally, military neurosurgery is reinventing itself to adapt to future conflicts through the enhancement of surgical practices via the addition of head, face, and neck surgeons.

Evaluation of Preoperative Cardiology Consultations: Incidence, Characteristics and Implications for Perioperative Management

Background: This retrospective study examines the importance of preoperative cardiology consultations in optimizing patient care and anesthesia surgical perioperative management. Methods: The study includes 7,756 patients from the Department of Anesthesiology at Mohammed V Military Teaching Hospital. Out of these, 122 patients were referred to cardiology consultations. Demographics, surgical specialties, reasons for referral, diagnostic tests, and interventions were analyzed. Results: Referred patients (average age 61.45 years) were mainly over 65 years old, with 59.01% being male. Common surgical specialties seeking consultations were abdominal surgery (30.327%), orthopedic surgery (26.230%), and urological surgery (19.672%). Hypertension, dyslipidemia, and diabetes were prevalent risk factors. Most patients were classified as ASA II (50%) or ASA III (27.04%), with NYHA I (61.5%) or NYHA II (31.2%) classifications. Referrals were due to ECG abnormalities (41.0%), routine evaluation (19.7%), and history of myocardial infarction or previous coronary angiography (39.3%). Discussion: Preoperative cardiology consultations accounted for 1.57% of all pre-anesthesia clinic patients. They were vital in assessing and managing cardiovascular risks, consistent with previous studies. The impact of these consultations was evident in optimizing patient management through treatment plan adjustments and interventions. Conclusion: Preoperative cardiology consultations play a crucial role in identifying and managing cardiovascular risks, contributing significantly to patient care and improving perioperative management. Further research should evaluate long-term outcomes and cost-effectiveness across different patient populations.

Epidemiological and clinical aspects of chronic infections of hepatitis b virus at the Mohammed V military teaching hospital in Rabat – Morocco

Background: Infection with hepatitis B virus is a major public health problem worldwide. Globally hepatitis B virus’s prevalence is 5.4%, more than one million between them die each year from complications that are essentially cirrhosis and hepatocellular carcinoma. The objective of this study is to describe epidemiological and clinical aspects of patients with chronic viral hepatitis B monitored in the Military Teaching Hospital Mohammed V in Rabat. Patients and methods: This are a retro-prospective study carried out in the virology laboratory of the Mohammed V Military Teaching Hospital in Rabat, spread over a period of 15 years from January 2001 to January 2016. Were included in our study all Moroccan patients aged 18 years and over with chronic viral hepatitis B defined by the presence of HBsAg beyond 6 months and the absence of IgM anti-HBc antibodies. Results and discussion: Out of 104 infected persons, 71% are men and 50% of infected was discovered by screening, 19% of patients had fatigue as a primary symptom, 69% had dental care as a risk factor and 46% of patients were carriers of the active form of chronic hepatitis B. Currently, few studies relate the epidemiology of HBV in Morocco. The prevalence of HBsAg during the study period was 1.03, despite this, Morocco is so far considered, according to WHO's data, as having an intermediate prevalence of viral hepatitis B. Conclusion: Immunization, compliance with universal recommendations for the use of medical and paramedical equipment as well as education and awareness are the only guarantee to limit the spread of Hepatitis B virus.

Intérêt du lambeau plantaire médial dans la réparation des pertes de substance du quart distal de la jambe

Soft tissue repair of the distal leg is a challenge for the surgeon. The objective of our work is to evaluate the interest of medial plantar flaps in the repair of soft tissue loss in the distal quarter of the leg, by highlighting the advantages and disadvantages of this technique. We conducted a retrospective study over 4years in the Department of Plastic, Reconstructive and Burn Surgery of the Mohammed V Military Teaching Hospital of Rabat, including 8patients admitted for coverage of a distal quarter of the leg with a medial plantar flap. Eight patients were included, 5men and 3women with an average age of 45.5years. All patients received coverage with a medial plantar flap. The functional and aesthetic results were very good with a low complication rate. The medial plantar flap should no longer be reserved for covering loss of substance of the foot only, but should be integrated into the therapeutic arsenal of reconstruction of the distal quarter of the leg.

ACTIfit™: 38% full resorption at 8 years in a cohort of 18 cases

BackgroundPreserving meniscal tissue is a major priority in young, physically active patients. Extensive meniscal defects may result in exercise pain and premature osteoarthritis. ACTIfit™ is a synthetic meniscal substitute that may improve short-term functional scores via biological integration with meniscal tissue regeneration. However, long-term data on the lifespan and chondroprotective effect of this newly formed tissue are lacking. The primary objective of this study was to assess the biological integration of ACTIfit™ based on magnetic resonance imaging (MRI) findings. The secondary objective was to evaluate long-term clinical outcomes. HypothesisThe ACTIfit™ meniscal substitute undergoes biological integration over time, suggesting chondroprotective potential. Materials and methodsA 2014 report by Baynat et al. described the 2-year clinical and radiological outcomes of 18 patients after ACTIfit™ implantation at the Clermont-Tonnerre military teaching hospital (Brest, France). The patients had chronic knee pain of at least 6 months’ duration after failure of primary meniscal surgery with segmental meniscal defects. Mean age was 34.0±7.9 years. A concomitant procedure was performed in 13 (60%) patients, including osteotomy in 8 and ligament reconstruction in 5. For the current study, the clinical and radiological follow-up was at least 8 years. Assessments were with the Genovese grading scale for substitute morphology on MRI scans, International Cartilage Research Society (ICRS) score for osteoarthritis progression, and Lysholm score for clinical outcome. Failure was defined as total substitute resorption (Genovese morphology grade 1) or revision surgery with implant removal, conversion to meniscus allografting, or arthroplasty. ResultsMRI scans were available for 12 (66%) patients. The reason for not having long-term MRI scans was surgery for substitute removal or arthroplasty in 3 of the remaining 6 patients. Complete implant resorption (Genovese grade 1) was noted in 7/12 (58%) patients and osteoarthritis progression to ICRS grade 3 in 4/12 (33%) patients. At last follow-up, the mean Lysholm score was significantly improved vs. baseline (79±15 vs. 55±13, P=0.005). ConclusionThe frequency of complete ACTIfit™ resorption 8 years after implantation was high. This finding argues against ability of this substitute to induce the regeneration of durable meniscal tissue with a chondroprotective effect. The clinical outcome score was significantly improved at last follow-up. However, no conclusions can be drawn regarding the effectiveness of ACTIfit™ given the high frequency of concomitant surgical procedures. Level of evidenceIV, retrospective observational cohort

Prevalence of Comorbidities in the Urological Patients at the Former Military Teaching Hospital of Cotonou

Prevalence of Comorbidities in the Urological Patients at the Former Military Teaching Hospital of Cotonou

A Panorama of the Urological Diseases at the Former Military Teaching Hospital of Cotonou

Background: Urological care has been advancing quickly over the last ten years in Benin. In order to conveniently support that trend towards better urological care standards, decision-makers need sound data on urological diseases in the country. Objective: To determine the prevalence of urological diseases in the former Military Teaching Hospital of Cotonou. Patients and Method: We retrospectively collected the urological diseases that the institution had managed from January 2012 to December 2020. We used Excel© 2010 and SPSS© to analyze the collected data. Results: 4244 patients, i.e. 3717 males (87.58%) and 527 females (12.42%) were managed during the study period. The main diseases diagnosed were benign prostatic hyperplasia (32.61%, n = 1384), erectile dysfunction (10.44%, n = 443), chronic prostatitis (5.94%, n = 252), prostate cancer (4.03%, n = 171), and ejaculatory disorders (3.44%, n = 146). In patients ≤ 15 years, predominant diseases were peritoneal vaginal canal (15.9%, n = 43), circumcision (15.6%, n = 42), testicular dystopia (10.7%, n = 29), hydrocele (7.8%, n = 21), and hypospadias (5.6%, n = 15). Wilms tumor (1.9%, n = 5) was the first cancer, testicular (0.4%, n = 1) and para-testicular (0.4%, n = 1) tumors were the next. In patients > 15 and ≤40 years, the main diseases were infertility (14.1%, n = 189), chronic prostatitis (12.9%, n = 173), erectile dysfunction (10.1%, n = 135), ejaculatory disorders (6.2%, n = 83), genital infections (6.2%, n = 83) and urinary stone (4.9%, n = 66). The first cancer was kidney cancer (0.97%, n = 13) followed by bladder cancer (0.3%, n = 4) and testicular tumor (0.3%, n = 4). In patients >40 years, the most prevalent diseases were BPH (52.0%, n = 1370), erectile dysfunction (11.7%, n = 308), prostate cancer (6.5%, n = 171), inguinal hernia (5.1%, n = 134), and urinary stone (3.9%, n = 102). Prostate cancer is the first cancer; the next were bladder (0.95%, n = 25) and kidney (0.68%, n = 18) cancers. Conclusion: Benign prostatic hyperplasia and urological cancers (prostate, bladder and kidney cancers) were the main urological diseases at the former Military Teaching Hospital of Cotonou. Urological malformations and Wilms tumor were the main diseases in the children.

Loneliness among surgical patients - measuring levels of loneliness using De Jong Gierveld Loneliness Scale and Revised UCLA Loneliness Scale

Objective: Loneliness is a state that most people will experience during their lifetime. In order to raise awareness of loneliness and its complexity, we attempted to measure the span of loneliness among the surgical patients hospitalized in the Department of Surgery in the 4th Military Teaching Hospital in Wroclaw. &#x0D; The aim of this study was to establish correlations between loneliness, measured using and four other variables: age, gender, nutritional state and quality of life of surveyed patients.&#x0D; Material and methods: A total of 100 patients in the Surgery Department in the 4 th Military Teaching Hospital in Wroclaw, Poland, were enrolled. The Mini-Nutritional Assessment (MNA) questionnaire was used to assess their nutritional status; the World Health Organization Quality of Life Scale (WHO-QoL-BREF) was used to assess their quality of life; the De Jong Gierveld Loneliness Scale (DJGLS) and Revised UCLA Loneliness Scale (R-UCLA) were used to assess their loneliness level.&#x0D; Results:The WHO-QoL-BREF showed that patients’ quality of life (QoL) self-perception was between average and good, health self-perception was average as well. Lowest score of QoL was found in the physical domain whereas the highest was found in the social domain. The MNA showed that 8% of the study group was malnourished, 49% at risk of malnutrition&#x0D; and 43% displayed a normal nutritional status. 49% of the study group experience loneliness during study by DJGLS. A significant positive correlation between loneliness status and QoL was observed in physical health self-perception (r=0,226, p=0,024). Negative correlation was found between loneliness and QoL in psychological, social and environmental domains (p&lt;0,001).&#x0D; &#x0D; Conclusions: Loneliness has a significant negative impact on the quality of life.Sex, age and nutritional status can not be predictors of patient’s loneliness.&#x0D; More than half of patients were in a disturbing nutrition state.&#x0D;

Ambulatory ENT Surgery: Eight Years of Experience in A Tropical Environment

Introduction Ambulatory surgery allows minimizing the time spent in the hospital, which could reduce the transmission of nosocomial pathologies and the occupation of hospital resources and infrastructures. The objective of the study was to assess the ambulatory activity of the ENT department of Military Teaching Hospital of Cotonou since its creation. Materials and methods The study was monocentric retrospective covering an eight-year period from January 1, 2013, to January 1, 2021. It concerned all ENT surgeries where the patient was discharged on the same day, regardless of the type of anaesthesia used. A pre-established survey form was used to collect data from the medical records. The variables studied were socio-demographic factors, eligibility criteria, indications and conversion to inpatient mode. Results Over the study period half of the procedures performed (334 patients) corresponded to indications for outpatient surgery and then were included. Of these, 130 patients (38.9%) were rejected for various contraindications like geographical and financial accessibility and communication difficulties. A total of 204 patients (61.1%) underwent ENT ambulatory surgery. The sex ratio was 3 males to 5 females (0.6). Children under 15 years of age accounted for 43.7% (n=146). Tonsillectomy with or without adenoidectomy was the most frequent surgery accounting for half of the outpatient surgery cases. Pharyngeal surgery was the most performed: (126 patients) followed by cervico-facial surgery (44 patients). Reconversion to inpatient mode occurred in 39 patients (19.12%). No respiratory complications were noted. No deaths were recorded. Conclusions Ambulatory care is a mode of management mainly used for pharyngeal surgery, in particular tonsillectomy and adenoidectomy in children. The main contraindications to patient eligibility were geographical and financial accessibility and communication difficulties. This activity would benefit from being better structured with specific staff and premises.

MEDICATION ERRORS: A PROSPECTIVE STUDY IN MOHAMED V MILITARY TEACHING HOSPITAL, RABAT, MOROCCO

Medication errors (MEs) are preventable events that may cause or lead to inappropriate medication use or patient harm. Annually 98,000 patients die because of avoidable MEs, and it is considered a financial burden on public health organizations. The purpose of our study was to examine the incidence rate, types, and causes of medication errors. We conducted a prospective, descriptive study from 1st November 2018 to 1st March 2019 at Mohammed V Military Teaching Hospital in Morocco. We performed prescriptions analysis for all patients, and the proper corrective measures were taken. We analyzed 19,200 prescriptions during the study period and made 2,152 (11.20%) pharmaceutical interventions (PI). We identified 752 medication errors (34.94%) of the total PIs) in 562 patients, with an incidence rate of 3.91%. The number of medication errors was higher in men than in women. The most frequent medication errors were: drug interaction errors, dosage or concentration errors, and dose errors. Bearing in mind the outcomes of our study, it is crucial to raise awareness among healthcare professionals of the significance of medication errors. Further investigations are required to fully understand and establish measures to reduce the prevalence rate of medication errors.

MEDICATION ERRORS: A PROSPECTIVE STUDY IN MOHAMED V MILITARY TEACHING HOSPITAL, RABAT, MOROCCO

Medication errors (MEs) are preventable events that may cause or lead to inappropriate medication use or patient harm. Annually 98,000 patients die because of avoidable MEs, and it is considered a financial burden on public health organizations. The purpose of our study was to examine the incidence rate, types, and causes of medication errors. We conducted a prospective, descriptive study from 1st November 2018 to 1st March 2019 at Mohammed V Military Teaching Hospital in Morocco. We performed prescriptions analysis for all patients, and the proper corrective measures were taken. We analyzed 19,200 prescriptions during the study period and made 2,152 (11.20%) pharmaceutical interventions (PI). We identified 752 medication errors (34.94%) of the total PIs) in 562 patients, with an incidence rate of 3.91%. The number of medication errors was higher in men than in women. The most frequent medication errors were: drug interaction errors, dosage or concentration errors, and dose errors. Bearing in mind the outcomes of our study, it is crucial to raise awareness among healthcare professionals of the significance of medication errors. Further investigations are required to fully understand and establish measures to reduce the prevalence rate of medication errors.