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.

[Tinnitus : from the general practitioner to the specialist]. / Acouphènes : du généraliste au spécialiste.

Tinnitus is a common reason for ENT consultation. Patients who suffer from tinnitus are becoming more demanding and frequently ask questions about the cause, the mechanisms of onset, and the cure of their pathology. Quite often, they feel poorly managed or misunderstood, all the more so that, despite the proposed treatments, tinnitus persists and leads to adverse effects on the patients’ daily life. The general practitioner, because of his proximity, must be involved in the prevention, diagnosis and information of individuals with tinnitus and, thus, fully fulfill his acting public health role. To approach this condition, we will outline the clinical diagnosis and discuss the possible psychological repercussions; then, we will envisage the various treatment options that are currently available and evoke the future prospects in this area.

Les acouphènes représentent un motif fréquent de consultation en ORL. Les patients qui en souffrent sont de plus en plus exigeants et posent des questions sur la cause et les mécanismes d'apparition ainsi que sur le traitement curatif de leur affection. Souvent, ils se sentent mal pris en charge, voire incompris et, ce, d'autant plus que, malgré les traitements proposés, les acouphènes persistent et entraînent des retentissements sur leur vie quotidienne. Le médecin généraliste, par sa proximité, doit s'impliquer dans la prévention, le diagnostic et l'information des individus atteints d'acouphènes et remplir ainsi, pleinement, son rôle d'acteur de la santé publique. Pour approcher cette affection, nous tracerons les grandes lignes du diagnostic clinique en précisant les éventuelles répercussions psychologiques; ensuite, nous exposerons les différentes possibilités thérapeutiques actuellement disponibles tout en évoquant les perspectives d'avenir dans ce domaine.

Oral Burkitt's lymphoma in children: the Moroccan experience.

Thirty-seven children with Burkitt's lymphoma of the oral region diagnosed between 1998 and 2005 were reviewed. There were 31 boys and 6 girls. The mean age at diagnosis was 6.64 years (range 2-15 years) with a mean delay to diagnosis of 41 days (range 10 days-2 months). There was a predominance of maxillary over mandibular involvement: 1.44:1. Complaints included exophytic mass with dental displacement (100%), abdominal pain (68%), nerve palsy (28%) and orbital swelling (21%). Toothache as initial complaint led to dental extraction in 12 cases. According to the Murphy classification, there were 4 stage II, 11 stage III and 22 stage IV tumours; 43% and 41% had bone marrow and central nervous system involvement, respectively. After chemotherapy, complete remission was seen in 59% of cases. Remission in two children was relatively brief, lasting no more than 3 months. After a median follow-up of 45 months (range 9-99 months), the disease-free survival rate was 54%. In conclusion, in this series, oral presentation of Burkitt's lymphoma was a component of more widely disseminated disease. The pattern seemed to fall between that of the endemic and the sporadic types. Even with intensive chemotherapy, patients with advanced disease maintained a poor prognosis.

Treatment of submandibular fibromatosis with chemotherapy and surgery. A case report.

Fibromatoses are a broad group of fibrous tissue proliferation that arise from the musculoaponeurotic structures. Because of the locally aggressive behaviour and the high recurrence rate of these tumors, various treatment options are suggested but there is still no optimal therapy for these diseases. This paper describes a case of infantile fibromatosis of the submandibular region, which was successfully treated with an interdisciplinary approach using chemotherapy and surgery. A three-year-old girl with a growing submandibular mass over a period of six months is described. The tumor was clinically aggressive, causing bone erosion and invading adjacent soft tissue structures. The diagnosis of infantile fibromatosis was established on histological and immunohistochemical findings. With a combined treatment based on ''low-dose'' chemotherapy including vinblastine and methotrexate and surgery; complete remission was achieved in 30 months. Management of head and neck fibromatoses in child-hood needs a specific approach. Combined treatment by chemotherapy and nonmutilating surgery seems to offer the best potential for cure.

Sex, age and ABO blood groups in chemotherapy-induced oropharyngeal mucositis.

AIM: The contribution of host genetic factors in oropharyngeal mucositis is not fully understood. Therefore, we conducted this study to determine possible associations of age, sex, underlying disease, type of chemotherapy and ABO blood group antigens with the risk of chemotherapy-induced oropharyngeal mucositis. METHODS: A total of 641 patients (395 boys and 246 girls; mean age 6.82+/-4.08 years) treated by standard chemotherapy for different type of malignancies were enrolled in the study. Mucositis was scored using the WHO scale. RESULTS: Oropharyngeal mucositis was found in 65.4% of our population. Patients with hematological malignancies (RR=1.87; 95% CI 1.33-2.67; P<0.0001) and under antimetabolities drugs (RR=1.88; 95% CI 1.33-2.63; P<0.0001) were associated with increased risk of oropharyngeal mucositis. Also, patients with blood group O were at higher risk (RR=2.86; 95% CI 2.03-4.02; P<0.0001) compared to patients with blood type A (RR= 0.47; 95% CI 0.33-0.66; P<0.0001) and blood type B (RR=0.59; 95% CI 0.38-0.91; P= 0.01). No relationship was found between oropharyngeal mucositis and age or sex. CONCLUSIONS: To our knowledge this is the first report demonstrating an association between ABO blood group and oropharyngeal mucositis. Further investigations are needed for a better understanding of this relationship.

ABO blood groups in relation to breast carcinoma incidence and associated prognostic factors in Moroccan women.

The association between blood groups ABO and different types of diseases was established in several previous studies. Our aim was to seek the possible association between the ABO blood group and breast cancer-associated prognostic factors. The Chi-squared analytic test was used to compare phenotypic ABO distribution among Moroccan blood donors and 442 cases of women suffering from breast carcinoma with archived files in Maternity Ward of University Hospital C.H.U Ibn Rochd between 2008 and 2011. High incidence of breast carcinoma was observed in blood type B patients (p < 0.05). Blood type B was associated with breast carcinomas overexpressing human epidermal growth factor receptor HER2 (p < 0.05) and high risk of cancer at age over 70 years (p < 0.001). Blood type A was associated with high risk of cancer among women younger than 35 years old. Blood type A and AB were associated with high incidence of lymph node metastasis (p < 0.05). Multivariate analysis has shown correlation between O blood type and estrogen receptor-positive tumor. Patients with blood group A, B, and AB were more likely to develop aggressive breast carcinoma. Further follow-up studies are necessary to clarify the role of ABH antigens in the progression of breast carcinoma.