[Phytoplankton population dynamics along the Casablanca - El Jadida Atlantic coast]. / Dynamique du peuplement phytoplanctonique le long de l'axe côtier Casablanca ­ El Jadida.

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

Title: Dynamique du peuplement phytoplanctonique le long de l'axe côtier Casablanca ­ El Jadida. Abstract: Notre étude taxonomique entre mars 2014 et novembre 2015 le long de la côte atlantique entre Casablanca et El Jadida a permis de déceler une flore phytoplanctonique représentée par les Diatomées, Dinoflagellés, Silicoflagellés et Euglenophycées avec une nette dominance des Diatomées et des Dinoflagellés. Au total, 101 taxons d'algues planctoniques ont été identifiés, témoignant d'une taxocénose relativement diversifiée. Dans cet ensemble, les Diatomées sont représentées par 62 taxons (61,4 %), les Dinoflagellés par 36 taxa (35,6 %) et les deux autres groupes (Silicoflagellés et Euglénophycées) ne sont représentés que par 3 espèces seulement (3,0 %). En ce qui concerne les espèces potentiellement toxiques, plus d'une quinzaine de taxons ont été identifiés dont la plupart sont des Dinoflagellés et des Diatomées (Pseudo-nitzschia australis et Pseudo-nitzschia cuspidata). L'analyse de l'évolution spatiotemporelle des indices de diversité (H') et d'équitabilité (E) révèle des fluctuations saisonnières prononcées sans montrer, pour autant, une grande analogie entre les différents sites prospectés. Par ailleurs, les densités phytoplanctoniques totales présentent de grandes variations à la fois spatiales et temporelles (sur les deux cycles annuels). La présence de proliférations massives de certaines espèces potentiellement toxiques (Pseudo-nitzschia australis et Pseudo-nitzschia cuspidata, Lingulodinium polyedrum, Karenia mikimotoi), d'une nouvelle espèce de Dinoflagellé ectoparasite pour le Maroc (Amyloodinium ocellatum) et d'autres espèces opportunistes (Eutreptiella, Thalassiosira, Prorocentrum scutellum) a été notée au cours de cette étude. La détection des espèces potentiellement toxiques, parfois à des concentrations alarmantes, devrait inciter les autorités compétentes à élargir le spectre et la fréquence de biosurveillance aux sites non contrôlés.

Research cartography of implantable medical devices in the three Maghreb countries: A comparative study between Morocco, Algeria, and Tunisia.

BACKGROUND: Biosafety and efficacy are essential aspects in the use of implantable medical devices (IMD) in several medical and surgical disciplines. To this effect, and depending on the therapeutic indication, the diversity of IMD imposes enormous evaluation strategies from their design through to their impact on improving the patient's quality of life. OBJECTIVE: To elaborate cartography which traces back the research tracks published on IMD regarding the three Maghreb countries, namely Morocco, Algeria, and Tunisia, and this through laying emphasis on a comparative study in view of highlighting the similarities and differences between them. METHODS: First, the research work was concerned with studies on IMD published between 2013 and 2023, which met the inclusion criteria, and which used the above-mentioned keywords on the four databases Scopus, Web of Science, ScienceDirect and PubMed. Second, the results are processed for a comparative descriptive study. In second, a descriptive and inferential analysis of association and classification to establish a research map on IMD. RESULTS: Articles selected; 86 articles out of 1081 for Morocco, 70 out of 900 for Algeria and 136 out of 1303 for Tunisia. Unlike domains (P=0.014), the research methods used highlights similarities in methodological research (P>0.05) ranging from simple descriptions to meta-analyses for the medical sciences with an inequitable distribution whose high share in favor of patient-reports. CONCLUSION: The design of maps raises a diversity of fields that concern medical and engineering sciences, while medical economic studies have yet to be developed in all three countries.

L'expérience de l'accouchement en milieu surveillé dans la province d'Essaouira au Maroc: Quelle réalité?

RésuméUne expérience positive de l'accouchement (EPA) est fondamentale pour des soins maternels de qualité. Toutefois, de nombreuses femmes subissent des comportements non respectueux lors de ce moment crucial. Au Maroc, peu d'études ont mesuré cette expérience, et les éléments l'influençant demeurent insuffisamment documentés. Nous avons conduit une recherche mixte dans la province d'Essaouira entre avril et décembre 2021. Notre enquête, basée sur un questionnaire, a sollicité l'avis de 240 femmes issues de huit centres de santé choisis au hasard. Par ailleurs, des entretiens semi-directifs ont été conduits avec 20 femmes, 47 professionnels de santé et quatre responsables administratifs. Les données quantitatives ont été soumises à des analyses descriptives, bi- et multivariées, tandis que les entretiens ont été analysés selon une approche de contenu thématique. Les données révèlent que 59.2% des participantes ont eu une expérience défavorable lors de leur dernier accouchement. Parmi elles, la majorité a déploré des soins non consentis (86.7%), un manque de respect de leur intimité (45.4%) et des abus verbaux (25%). L'EPA était principalement associée à la qualité de l'environnement de l'accouchement, au soutien pour l'allaitement, à la propreté des installations, au type d'établissement (privé) et à l'absence de complications médicales pendant le travail. Les entretiens ont révélé que le manque de motivation des professionnels de santé, l'absence de formation continue appropriée et des lacunes organisationnelles et managériales ont affecté l'EPA. Notre étude souligne le besoin crucial de formation continue axée sur le respect des patients, l'éthique et la déontologie, et met en lumière l'importance d'une politique motivante pour les professionnels de santé, notamment dans le secteur public.

[Evaluation of medicines price listed on the official bulletins in Morocco (2014-2019)]. / Évaluation du prix des médicaments figurant sur les bulletins officiels au Maroc (2014­2019).

OBJECTIVES: This study shows the evolution of medicines prices over the period April 2014 to September 2019 in order to provide an overview of the situation following the adoption of the new method for setting drug prices in Morocco. METHODS: The analysis concerned official bulletins relating to the Public Selling Price of drugs in Morocco published between April 2014 and September 2019 as part of a retrospective study. RESULTS: Out of a total of 7292 medicines, 35.9% were unchanged in price, 26.2% were new and 0.3% had a price increase. The decrease affected 37.7% equivalent to 2747 medicines. Of these, 38.6% decreased in price in 2014 and 84.13% had only one decrease. Medicines with a retail price of between 5 and 10 Euros were the most affected by the decrease. Decreases of less than 1% of the selling price represented 27.7% against 0.3% whose decrease exceeded 70% of the price. The largest decreases in number were recorded in 2014. Some medicines saw declines of up to 78.6%. The most affected price brackets in percentage terms were those with a retail price above 20 Euros. CONCLUSIONS: Following the adoption of the new decree on the pricing of medicines in 2013 in Morocco, several decreases were recorded and concerned all therapeutic classes. The percentages of the decreases in Moroccan Dirham as well as in percentage were very variable.

Physical activity level and sedentary time determinants among Moroccan hypertensive patients.

INTRODUCTION: Hypertension is closely associated with an inactive lifestyle. Physical activity and/or exercise have been shown to delay the development of hypertension. This study aimed to assess the level of physical activity and sedentary time, and its determinants among Moroccan Hypertensive patients. PATIENTS AND METHODS: A cross-sectional study was conducted between March and July 2019 including 680 hypertensive patients. We administered international physical activity questionnaire in face-to-face interview to assess the level of physical activity and sedentary time. RESULTS: The results showed that only 43.4% of participants met recommended physical activity levels (≥ 600 MET min/week). Adherence to physical activity recommendations was observed more in male participants (p = 0.035), in participants aged less than 40 years (p = 0.040) and those aged between 41 and 50 years (p = 0.047). The average sedentary time was 37.19 ± 18.92 hours per week. This time was significantly longer in people aged 51 and over, in married, divorced, and widowed people, and in those with low levels of physical activity. CONCLUSIONS: The level of physical inactivity and the sedentary time was high. In addition, participants with a high-level sedentary lifestyle had a low level of physical activity. Educational actions should be undertaken among this group of participants to prevent the risks associated with inactivity and sedentary behavior.

Avortement au Maroc et virage au drame : femmes et professionnels de santé en parlent ! Une étude transversale mixte à Agadir.

RésuméLes avortements à risque constituent une problématique majeure de santé publique, responsable de la mortalité et de la morbidité maternelles et absorbant les ressources des systèmes de santé publique à l'échelle mondiale. Malgré l'ampleur très probable du problème de l'avortement non sécurisé au Maroc, peu de données sont accessibles sur cette question. Cette recherche vise à analyser la situation de l'avortement du point de vue des femmes et des professionnels de santé dans la préfecture d'Agadir Idaoutanane au Sud du Maroc. Nous avons conduit une étude transversale mixte. De janvier à septembre 2018, 266 femmes ont été recrutées pour répondre à un questionnaire, et 45 entretiens avec les femmes et les professionnels de la santé impliqués dans la santé sexuelle et reproductive (SSR) ont été menés. Nous avons procédé à une analyse descriptive des données quantitatives et à une analyse de contenu thématique des données recueillies par les entretiens individuels. Les résultats de l'étude révèlent que les avortements sont la conjugaison de plusieurs facteurs multidimensionnels. Le manque d'informations en SSR et l'échec de la contraception sont les facteurs majeurs de grossesses non désirées. L'avortement provoqué est un sujet tabou, fortement stigmatisant, portant à l'image sociale de la personne. L'accessibilité aux services d'avortement est marquée de grandes disparités et de trajectoires différentes. Cette étude apporte une contribution à l'analyse du phénomène de l'avortement au Maroc et appelle à une action politique urgente sur plusieurs niveaux: l'accès aux programmes d'éducation sexuelle et à la contraception appropriée, l'élargissement des indications d'avortement préconisées dans le projet de loi, la mise en place des stratégies de lutte contre la stigmatisation de l'avortement par les professionnels de santé et l'accès à des soins post-avortement de haute qualité.

[Adenocarcinoma of the paranasal sinuses in sheep: First case description in Morocco]. / Adenokarzinom der Sinus paranasales bei Schafen: Erstbeschreibung in Marokko.

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

INTRODUCTION: L'adénocarcinome des sinus nasaux des petits ruminants (ANE) est une maladie contagieuse, provoquée par un betaretrovirus appelé l'Enzootic Nasal Tumor Virus ou ENTV. Les premiers cas ont sporadiquement été diagnostiqués au Maroc en 2018. Cependant, durant les deux dernières années, l'ANE a sévi de manière enzootique dans trois troupeaux, tous naisseurs, qui exploitent la race Sardi. L'incidence annuelle varie de 5 à 20 %. La majorité des cas étaient des femelles, âgées entre 15 et 42 mois. La maladie évolue en 2 à 6 mois au maximum. Les malades maigrissent progressivement et la quasi-totalité meurt si elle n'est pas abattue avant. L'affection associe principalement des lésions de la face, avec déformation du crâne souvent unilatérale, des écoulements nasaux séreux ou séro-muqueux avec difficulté respiratoire et l'exophtalmie chez certains individus. L'autopsie a permis de mettre en évidence des masses tumorales dans les sinus. A l'examen histopathologique, les masses tumorales correspondent à un néoplasme épithélial expansif et organisé. Les auteurs, après avoir passé en revue les diagnostics différentiels pouvant prêter à confusion avec l'ANE, s'interrogent sur les raisons de sa recrudescence au Maroc, particulièrement chez la race Sardi.

Intention to vaccinate under-12 children against COVID-19 by parents in the Meknes Prefecture of Morocco.

Background: Two days before the start of the 2021 school year, more than 2 million Moroccan students (12-17 years old) had received the first dose of the anti-COVID-19 vaccine and 416 810 students had received both doses. Vaccination of young children against COVID-19 would contribute to pandemic control and "herd immunity". Aims: This study aimed to assess the extent to which Moroccan parents were likely to vaccinate their under-12 children against COVID-19. Methods: We conducted a cross-sectional study in the form of an anonymous and confidential electronic survey among parents visiting pediatric clinics in Meknes Prefecture in August and September 2021. Results: Our study shows that the majority of parents were vaccinated (67.2%), but refused to vaccinate their under-12 children (83.6%). But 72% of all parents were willing to vaccinate their children if COVID-19 mortality increased among children. Conclusion: Most parents who refused to have their children vaccinated were illiterate or had only primary education. There is therefore a need to increase awareness and information campaigns on the benefits of the COVID-19 vaccine among adults and children.

Impact of COVID-19 restrictions on building energy consumption using Phase Change Materials (PCM) and insulation: A case study in six climatic zones of Morocco.

The rapid spread of COVID-19 caused a significant impact on many sectors, including the energy demand in building due to the quarantine. This paper overviews the impact of the restriction's measures caused by the spread of COVID 19 on energy consumption in a residential building for three building constructions under six climatic conditions referring to the representative zones of the recent Moroccan climatic zoning. The three-building constructions are Reference House without any passive energy efficiency, Insulation House equipped with thermal insulation in external wall and roof and PCM House equipped with PCM (Phase Change Materials). The three houses are simulated by means of dynamic simulation using TRNSYS software. The quarantine in which the occupants have to stay all-time at home is compared to an ordinary occupancy scenario in terms of energy demand to reach the desired thermal comfort. The major finding of this work is that quarantine can significantly impact the cooling loads than the heating demand depending on building constructions and climatic conditions. The rising-rate in annual energy needs is the range of 10 %-35 %. The impact of the number of occupants is also investigated in respect to the two occupancy scenarios, the three-building constructions and under the six climatic conditions. The results show that when increasing the number of the inhabitants from 2 to 4, under the quarantine period, the energy demand of the PCM house is increased to 50 % depending on the climatic zones.

Cervical cancer in Morocco: A systematic review.

BACKGROUND: This systematic review aims to determine the epidemiological profile, etiology and risk factors, prevention, diagnosis, treatment, cost-effectiveness, survival, and quality of life related to cervical cancer in Morocco. METHODS: This study was conducted according to the recommendations of the "preferred reporting items for systematic reviews and meta-analysis." The PubMed, ScienceDirect, Springer, Web of Science data bases were used, as was Google Scholar for the grey literature. The review protocol was registered in the PROSPERO register (CRD42021235241). RESULTS: Fifty studies were selected. The mean age was 49.31 ±6.3 years. HPV infection prevalence ranged from 13.30% to 76%, with a peak in HIV-positive women. Acceptability of the HPV vaccine was higher among parents (35% and 82%) than among adolescents (16.9% to 46.6%). Knowledge of the vaccine and its price are two key factors related to vaccine acceptability among parents. This systematic review highlights that the fact that few eligible women (not more than 11%) were participating in the cervical cancer screening program. Moroccan women's level of knowledge and awareness regarding cervical cancer screening was low, negatively impacting their use of such screening tools, as illustrated by the high percentage (mean 76.32% ± 17.21) of women who had never been screened for cervical cancer. Treatment was the most significant component of the global care budget (95.87%), with an annual cost of $13,027,609. Five-year overall survival ranged from 41.3% to 73.6%, with higher survival rates for patients diagnosed at an earlier stage (77.3-85% for stage I). Lastly, low quality of life was observed in women with tumors at an advanced stage who had received brachytherapy and lacked social support. CONCLUSIONS: Subjects that require further investigation include Moroccan women's knowledge, attitudes, and awareness, especially among those at high risk of developing cervical cancer, and its impact on their quality of life and survival.

Suicide attempts in Morocco: A systematic review.

BACKGROUND: Suicide is a widespread phenomenon that affects persons of all ages, and it has become a major public health problem in Morocco. OBJECTIVES: This study aims to describe the epidemiological profile of suicide attempters in Morocco, as well as the identification of associated factors. METHODS: The present work is a systematic review that was conducted according to the recommendations of the "Preferred reporting items for systematic reviews and meta-analysis (2009)", including articles dealing with suicide attempts in Morocco that meet the usual inclusion criteria. The PubMed, ScienceDirect and Scopus databases were searched; articles had to be written in English or French. Additional studies were manually identified through via Google Scholar. Quality assessment of the included studies was carried out according to the NIH Assessment Tool. The review protocol was registered in PROSPERO (CRD42020165493). RESULTS: Twenty studies were selected. Adults and adolescents are the age groups most affected by suicide. That said, the phenomenon mainly concerns children over 10 years of age. In some studies, more than 90% of the cases involve females, and they are more numerous in urban than in rural settings, and single individuals are more affected than married people. As for children and adolescents, most of them had divorced parents, and more than 50% of suicidal persons of all ages had a low socio-economic level. Although females are more likely than males to commit suicide, males are more exposed to death due to the violent means used. CONCLUSIONS: Because of the alarming rate of suicide in our country, nationwide prevention strategies are called for.

Trends in the consumption and cost of antiepileptics in Morocco between 2008 and 2018.

INTRODUCTION: Epilepsy is one of the most common chronic neurological diseases. In Morocco, it is the second most common reason for consulting a neurologist. Its prevalence was estimated in Casablanca in 1998 at 1.1%. This study was carried out with the aim of evaluating, on the one hand, the consumption of antiepileptics and, on the other hand, the impact of their generic drugs on the pharmaceutical market between 2008 and 2018 in Morocco. MATERIALS AND METHODS: We used sales data for antiepileptic drugs collected from the Moroccan subsidiary of IQVIA, a multinational healthcare data science company, and we converted them into a defined daily dose (DDD/1000 inhabitants). RESULTS: The consumption of antiepileptic drugs increased from 442 to 641 DDD/1000 inhabitants between 2008 and 2018, all molecules combined, recording a 45% increase in the period studied. From an economic point of view, the calculation of the average cost of DDD, all molecules combined, gives an average cost of 2.42 dollars/DDD in 2018 versus 3.53 dollars/DDD in 2008 (1 dirham = 0.11 dollar), which corresponds to a decrease of -30%. This is due mainly to the introduction of generic drugs. CONCLUSION: These results show that while the average cost of a DDD has decreased, the consumption of antiepileptics has increased in Morocco over the years. Several events that have marked the drug market in Morocco have contributed to this trend, including the arrival on the market of several new molecules indicated for the treatment of epilepsy, the decrease in drug prices in 2014 and the policy of promoting generic drugs.

[Factors associated with poor blood pressure control in Moroccan hypertensive patients]. / Facteurs associés à un mauvais contrôle tensionnel chez les patients hypertendus marocains.

STUDY AIM: Hypertension is a major public health concern worldwide and non-controlling it can lead to various cardiovascular complications. Controlling blood pressure and reducing overall cardiovascular risk are two main goals of treatment. Thus, this study aimed to determine the proportion and factors associated with uncontrolled hypertension in hypertensive patients living in the Beni Mellal city. PATIENTS AND METHODS: The cross-sectional survey took place between June and March 2019. It involved 580 hypertensive patients attending the primary health care facilities in Beni Mellal city, using systematic sampling. RESULTS: A total of 580 hypertensive patients were recruited, with a mean age of 55.78 (± 10.82 years) and of which 66.89% were female. The proportion of poor blood pressure control was 74.1% and was associated in multivariate analysis with a family history of hypertension(OR = 1.60; 95% CI = [1.02-2.50]), dyslipidemia (OR = 2.05; 95% CI = [1.32 -3.20]), non-adherence to a regular BP measurement (OR = 4.13; 95% CI = [2.49 -6.86]), to treatment (OR = 3.64; 95% CI = [2.34-5.65]) and regular biological monitoring (OR = 2.45; 95% CI = [1.46-4.08]). CONCLUSION: Despite the free and available of treatment, the proportion of uncontrolled hypertension was high. This might be linked to a lack of awareness and education concerning disease self-management.

Depression and anxiety in patients with diabetes in a Moroccan region.

AIMS: To estimate prevalence of anxiety and depression in patients with diabetes mellitus and identify their determinants. METHODS: A cross-sectional study was conducted at Hassan II University-Hospital of Fes in 2019-2020. Anxiety and depression were measured by using the Hospital Anxiety and Depression Scale (HADS). Multivariate analysis by logistic regression was used to determine factors associated with depression and anxiety, adjusting for confounding factors. All statistical analyses were conducted using EPIINFO7. RESULTS: A total of 243 diabetics were included in the study. The average age of the participants was 48.07±14.25 years, 58% were females and 72% were diagnosed with diabetes type II. The prevalence of depressive symptoms and anxiety symptoms was (18, 1%, CI95%=(13-23)) and (29.6%, CI95%=(24-35)), respectively. The prevalence of depression and anxiety was higher among women than man and increases with increasing duration of the disease. In multivariate analysis, illiterates (OR=3.19, CI95%=(1.46-6.98)), those with depression (OR=3.61, CI95%=(1.78-7.32)), and type 1 diabetics (OR=3.22, CI95%=(1.44-7.21)) are a higher risk of developing anxiety. Depression was associated with older age (OR=2, 65, CI95%=(1, 14-6, 14)), use of insulin (OR=3.77 CI95%=(1.50-9.44)) and anxiety symptoms (OR=4, 27, CI95%=(2, 05-8, 91)). CONCLUSION: High prevalence of depressive and anxiety symptoms in diabetics suggests consideration of psychological aspect in implementation of diabetes managing program.

[Chronic diseases among medical students in Morocco: What are the interactions with psychosocial stress?] / Les maladies chroniques chez les étudiants en médecine au Maroc : quelles interactions avec le stress psychosocial ?

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

Ischemic stroke in Morocco: Prehospital delay and associated factors.

OBJECTIVES: This study aimed to estimate prehospital delay and to identify the factors associated with the late arrival of patients with ischemic stroke at the Souss Massa Regional Hospital Center in Morocco. PATIENTS AND METHODS: An observational, prospective, cross-sectional study was conducted from March 2019 to September 2019 in the Souss Massa regional hospital center, which is a public hospital structure. A questionnaire was administered to patients with ischemic stroke and to bystanders (family or others), while clinical and paraclinical data were collected from medical records. Univariate and multivariate logistic regression analyses were used to identify the factors associated with delayed arrival at emergency department. RESULTS: A total of 197 patients and 197 bystanders who fulfilled the criteria for the study were included. The median time from symptom onset to hospital arrival was 6hours (IQR, 4-16). Multiple regression analysis showed that illiteracy (OR 38.58; CI95%: 3.40-437.27), waiting for symptoms to disappear (patient behavior) (OR 11.24; CI95%: 1.57-80.45), deciding to go directly to the hospital (patient behavior) (OR 0.07; CI95%: 0.01-0.57), bystander's knowledge that stroke is a disease requiring urgent care within a limited therapeutic window (OR 0.005; CI95%: 0.00-0.36), and direct admission without reference (OR 0.005; CI95%: 0.00-0.07), were independently associated with late arrival (>4.5hours) of patients with acute ischemic stroke. In addition, illiteracy (OR 24.62; CI95%: 4.37-138.69), vertigo and disturbance of balance or coordination (OR 0.14; CI95%: 0.03-0.73), the relative's knowledge that stroke is a disease requiring urgent care and within a limited therapeutic window (OR 0.03; CI95%: 0.00-0.22), calling for an ambulance (relative's behavior) (OR 0.16; CI95%: 0.03-0.80), distance between 50 and 100km (OR 10.16; CI95%: 1.16-89.33), and direct admission without reference (OR 0.03; CI95%: 0.00-0.14), were independently associated with late arrival (>6hours) of patients with acute ischemic stroke. CONCLUSION: Patient behavior, bystander knowledge and direct admission to the competent hospital for stroke care are modifiable factors potentially useful for reducing onset-to-door time, and thereby increasing the implementation rates of acute stroke therapies.

[Quality of "crisis communication" media during the COVID-19 pandemic in the Great Maghreb countries]. / Qualité des supports de communication de crise lors de la pandémie de la COVID-19 au Grand Maghreb.

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

[Quality of life of silicotic former miners]. / Qualité de vie des anciens mineurs silicotiques.

BACKGROUND: The aim of this study was to assess the respiration-related quality of life (QoL) of former miners with silicosis and to determine the factors that could affect QoL (socio-demographic and professional parameters, toxic habits, co-morbidities, and degree of respiratory disability). METHODS: This cross-sectional study involved 104 people who came for routine periodic consultation and included the medical records file and a questionnaire. RESULTS: The average age was 66.3±5.4 years. Functional respiratory symptoms were exertional dyspnoea (97.2%), cough (73.1%), sputum (59.6%) and wheezing (25%). Associated respiratory illnesses were asthma (29.8%), COPD (18.3%), persistent rhinitis (13.5%) and tuberculosis (5.8%). 3/4 of the miners had at least one comorbidity. The most common were cardiovascular (43.3%), metabolic (27.9%) and musculo-skeletal (25%). The ventilatory defects were mild in 27.9%, moderate in 57.7% and severe in 14.4%. The radiological lesions exceeded four zones of the pulmonary parenchyma in 81.8%. The average scores for "symptoms", "activities ¼, « impacts" and "total" were 49.1±14%, 77.8±12%, 66.5±16% and 67±16%, respectively. Age, duration of exposure, comorbidities, moderate to severe ventilatory defects, and significant to severe impairment were correlated with altered QoL. CONCLUSION: Improvement of QoL requires comprehensive care with the management of complications, co-morbidities, better patient awareness, and better consideration of the feelings of patients.

Raphael Acquaviva: The Forgotten Pioneer of Modern Neurosurgery in Morocco.

For the young generations, it is important to state the values that define and recognize the role of leaders and pioneers in neurosurgery, especially in developing countries. This subject seems often overlooked. In Morocco, the real birth of modern neurosurgery as an independent surgical specialty was undoubtedly made thanks to Doctor Raphael Acquaviva during the 1950s and 1960s, when he founded the first neurosurgical department in Casablanca. Acquaviva was born during the First World War in Corsica (France). After finishing his undergraduate medical training in Beirut (Lebanon) in the 1940s, he joined the Maurice Gaud Hospital in Casablanca (Morocco). In 1954, Acquaviva received his medical degree from the Faculty of Medicine of Paris (France) with a thesis on brain tuberculomas. In 1960, Acquaviva became the first chief of neurosurgery at Casablanca and he accepted to train the first team of Moroccan neurosurgeons. Although the resources were limited, Acquaviva's skills and knowledge enabled him to achieve admirable results at those times. He managed to provide numerous clinical, radiologic, surgical, and pathologic descriptions in various fields of neurosurgery, especially in central nervous system infections. He was an excellent operator, very talented organizer, and fluent speaker. Moreover, he was involved in medical publications and education in his host country. In this article, the author reviews Acquaviva's career trajectory in its historical context, highlighting its impact on modern neurosurgery in Morocco and abroad. This contribution could be a good start to collect information to preserve the national neurosurgical memory in many developing countries.