Burnout syndrome chez les internes en médecine marocains.

INTRODUCTION: Medical interns are subject to chronic stress due to long working hours, sleep deprivation and leisure time that can lead to burnout. The aim of this study was to estimate the prevalence of burnout among medical interns of Casablanca University Hospital and to investigate potential its risk factors. METHODS: We conducted a cross-sectional study during March 2017 among medical interns of Casablanca University Hospital. The exploration of burnout was performed using the Maslash Burnout Inventory. Data were collected using a self-questionnaire. Data entry and analysis were performed using SPSS version 16.0 software. RESULTS: The prevalence of burnout was 90%. Variables statistically associated with it were female gender (p=0.024) and excessive daytime sleepiness (p=0.025) for the “Emotional exhaustion” component, and worked hours for the “Personal fulfilment” component (p=0.05). CONCLUSIONS: This survey revealed a worrying rate of burnout among medical interns. Prevention actions should be undertaken to preserve the mental health of this population at high risk of burnout.

Missed opportunities for HIV testing in patients newly diagnosed with HIV in Morocco.

BACKGROUND: In Morocco, of the estimated 29,000 people living with HIV in 2011, only 20% were aware of their HIV status. More than half of diagnoses were at the AIDS stage. We assumed that people who were unaware of their infection had contacts with the healthcare system for HIV indicators that might prompt the healthcare provider to offer a test. The aim was to assess missed opportunities for HIV testing in patients newly diagnosed with HIV who accessed care in Morocco. METHODS: A cross-sectional study was conducted in 2012-2013 in six Moroccan HIV centers. Participants were aged ≥18, and had sought care within 6 months after their HIV diagnosis. A standardized questionnaire administered during a face-to-face interview collected the patient's characteristics at HIV diagnosis, HIV testing and medical history. Contacts with care and the occurrence of clinical conditions were assessed during the 3 years prior to HIV diagnosis. Over this period, we assessed whether healthcare providers had offered HIV testing to patients with HIV-related clinical or behavioral conditions. RESULTS: We enrolled 650 newly HIV-diagnosed patients (median age: 35, women: 55%, heterosexuals: 81%, diagnosed with AIDS or CD4 < 200 cells/mm3: 63%). During the 3 years prior to the HIV diagnosis, 71% (n = 463) of participants had ≥1 contact with the healthcare system. Of 323 people with HIV-related clinical conditions, 22% did not seek care for them and 9% sought care and were offered an HIV test by a healthcare provider. The remaining 69% were not offered a test and were considered as missed opportunities for HIV testing. Of men who have sex with men, 83% did not address their sexual behavior with their healthcare provider, 11% were not offered HIV testing, while 6% were offered HIV testing after reporting their sexual behavior to their provider. CONCLUSIONS: Among people who actually sought care during the period of probable infection, many opportunities for HIV testing, based on at-risk behaviors or clinical signs, were missed. This highlights the need to improve the recognition of HIV clinical indicators by physicians, further expand community-based HIV testing by lay providers, and implement self-testing to increase accessibility and privacy.

Knowledge by physicians concerning cervical cancer and testing: Benimellal province, Morocco.

BACKGROUND: Cervical cancer is the second most common cancer among women after skin cancer. AIMS: This study aimed to evaluate the knowledge of general practitioners with regard to cervical cancer in the province of Benimellal, Morocco. METHODS: A cross-sectional study using a self-reported questionnaire given to 71 general practitioners operating in public and private healthcare centres in the province of Benimellal. RESULTS: Almost half of general practitioners (49.3%) were not aware of a national plan for the prevention and control of cancer in Morocco, and only 18.2% gave a correct response on the incidence rate for cervical cancer. The human papilloma virus as the principle risk factor was identified by 21% of general practitioners. CONCLUSIONS: The knowledge of general practitioners was deficient and therefore initial and continuing training on cervical cancer is required.

[Prevalence and associated factors of low birth weight in the provincial hospital of Mohammedia--Morocco]. / Prevalence et facteurs associés au faible poids de naissance à la maternité de l'hôpital provincial de Mohammedia--Maroc.

BACKGROUND: Low birth weight (LBW) constitutes a major public health problem, both in developed than in developing countries, due to its extent and its strong association with childhood morbidity and mortality. OBJECTIVE: to estimate prevalence of low birth weight and determine its related factors in the Prefectoral Hospital in Mohammedia. METHODS: We carried out a cross sectional study from May to July 2012 which concerned 713 newborns and theirs mothers. We collected information about socioeconomic and anthropometric factors and characteristics of pregnancy. A multivariate analysis was performed. RESULTS: Among the 713 studied newborns, 38 had LBW; the prevalence of LBW was 5,3% (95% CI: 3,7%-6,9%). Factors significantly associated with LBW in multivariate analysis were: mother age ( OR 9,27; IC95%:2,15-39,85), prematurity (OR 9,34; IC95%:1,29-67,32), twin pregnancy (OR 195,07; IC 95%:30,38-125,39) and gender of new born (OR 5,26; IC 95%:1,61-17,18). Well-balanced diet (OR 0,12; IC 95%:0,04-0,34) and hours of sleep equal or more than 8 per day (OR 0,20; IC 95%:0,07-0,58) were protector factors. CONCLUSION: Actions of education, screening and treatment of the diseases occurred in the pregnancy are necessary. Facilitating the access of pregnant women to high quality antenatal care, promoting a healthy lifestyle as a balanced diet, fighting against the active and passive smoking and offering a psychological support to the pregnant woman is necessary to reduce the prevalence of LBW and to improve the maternal and child health.

Bibliometric analysis of COVID-19 research in Morocco: short communication.

As a global pandemic, coronavirus disease 2019 (COVID-19) has led to a growing number of related research studies being published worldwide. However, there is no study on the bibliometric analysis of these Moroccan studies. This study aims to provide a general overview of COVID-19 studies in Morocco and may provide a direction for hot topics and future research trends. Method: The global literature about COVID-19 published between 2019 and 2022 was scanned in PubMed, the Web of Science collection database, Scopus, and two preprint platforms. 'COVID-19', 'Novel Coronavirus', '2019-nCoV', and 'SARS-CoV-2' were used as the keywords to reach the relevant publications. The VOS viewer was applied to perform the bibliometric analysis of these articles. Results: A total of 987 Moroccan publications on the topic of COVID-19 were retrieved. Of all these publications, 166 (61.9%) were original journal articles, 10 (3.7%) were review articles, 514 (8.38%) were letters and 56 (20.9%) were others, such as case reports, notes, or book chapters. Ten original articles (3.7%) had not yet been peer-reviewed and were retrieved from the preprint servers medRxiv and bioRxiv. The highest number of COVID-19 publications was published by Mohammed V University in Rabat (n=45, 16.8%), followed by Hassan II University (n=32, 11.9%) and Mohammed VI University of Health Sciences (n=29, 10.8%). The open-access format was the predominant publishing model (43.2%) and 92.9% were written in English. The main research lines identified in COVID-19 for Morocco are related to the pandemic's indirect effects: education (11.2%), mental health (6.3%), and the environment (6.3%). Conclusion: Moroccan institutions have made a profound contribution to COVID-19 research than that in other African countries, but lags behind compared to that in Arabic countries.

Evaluation of the quality of life in patients followed for differentiated cancer of the thyroid.

Thyroid cancer often has good prognosis but can impact quality of life. The objective of this study is to evaluate quality of life in patients treated for differentiated thyroid carcinoma and look for associated factors. An observational cross-sectional study with comparison group was conducted in the Endocrinology Department of the Ibn Rochd University Hospital between October 2013 and February 2015. The patient group included 124 adult patients followed for differentiated thyroid carcinoma; the control group comprised 124 healthy subjects of the same age. Quality of life was evaluated by 3 questionnaires validated in Arabic: SF36, Hamilton anxiety and Hamilton depression. Patients' quality of life was significantly impaired compared to controls on the two Hamilton and all SF36 scores. Factors influencing quality of life were TNM stage, radioiodine therapy and dose, and the presence of metastases. The psychological management of patients with thyroid cancer is an essential point always to be considered, especially in the presence of risk factors for impaired quality of life.

[Awareness of breast cancer screening among general practitioners in Mohammedia (Morocco)]. / Connaissances des médecins généralistes de Mohammedia (Maroc) concernant le dépistage du cancer du sein.

INTRODUCTION: Breast cancer is a major public health problem in Morocco. It is the most common cancer in women. Our study aims to evaluate the extent of breast cancer awareness among general practitioners (GP) in the prefecture of Mohammedia, Morocco. METHODS: We conducted a cross-sectional, descriptive, exhaustive study including 97 GP working in primary health care facilities (public and private sector) of the province of Mohammedia. RESULTS: Participation rate was 87%. The average age of GP was 49.6 ± 8.1. Eighty percent (n = 55) of the GP misstated the incidence of breast cancer, 77.6% (n = 85) recognized the existence of a national plan to prevent and control cancer (NPPCC) in Morocco and 67.1% of GP reported the existence of a cancer registry in Morocco. General practice sector was significantly related to the awareness of NPPCC among GP and to the existence of guidelines for the early detection of breast cancer (p = 0.003 and p = 0.001 respectively). A significant relationship was found between seniority and the existence of guidelines for the early detection of breast cancer and a breast cancer registry (p = 0.005 and p = 0.002 respectively). CONCLUSION: In light of these results GP awareness and practices should be enhanced by promoting initial and continuing training on breast cancer screening.

Connaissances des médecins généralistes marocains de la province de Béni Mellal sur le cancer du col de l’utérus et son

Contexte : Le cancer du col de l'utérus constitue le deuxième cancer chez les femmes après le cancer du sein. Objectif : Évaluer les connaissances des médecins généralistes concernant le cancer du col dans la province de Benimellal au Maroc. Méthodes : Il s'agit d'une étude transversale utilisant un questionnaire auto-administré qui inclut 71 généralistes exerçant dans les établissements de soins de santé de base du secteur public et privé de la province de Béni Mellal. Résultats : Près de la moitié des médecins généralistes (49,3 %) ne connaissait pas l'existence d'un plan national de prévention et de contrôle du cancer au Maroc et seulement 18,2 % ont donné une réponse correcte sur l'incidence du cancer du col . Le papillomavirus humain a été identifié comme principal facteur de risque par 21 % des généralistes. Conclusion : Les connaissances des généralistes étaient défaillantes, d'où la nécessité de promouvoir la formation initiale et continue sur le cancer du col pour ce type de médecins.

Background: Cervical cancer is the second most common cancer among women after skin cancer.Aims: This study aimed to evaluate the knowledge of general practitioners with regard to cervical cancer in the province of Benimellal, Morocco.Methods: A cross-sectional study using a self-reported questionnaire given to 71 general practitioners operating in public and private healthcare centres in the province of Benimellal.Results: Almost half of general practitioners (49.3%) were not aware of a national plan for the prevention and control of cancer in Morocco, and only 18.2% gave a correct response on the incidence rate for cervical cancer. The human papilloma virus as the principle risk factor was identified by 21% of general practitioners.Conclusions: The knowledge of general practitioners was deficient and therefore initial and continuing training on cer- vical cancer is required.

Pemphigus: use of the Japanese severity index in 56 Moroccan patients.

INTRODUCTION: In pemphigus, there still is no consensus on parameters mesuring clinically the disease severity. The aim of this study is to use the Japanese severity index in Moroccan patients with pemphigus. METHODS: Multicenter prospective study from September 2007 to September 2009 including consecutive patients with confirmed pemphigus. We used the Japenese severity index for pemphigus. For each patient, the score was calculated at diagnosis and at 6 months of follow-up and correlated to type of pemphigus; mean dosage of corticosteroids and clinical statuts at 6 months: dead or not. RESULTS: Fifty six patients were included, 20 men and 36 women, mean age 46.62 ± 15.9 years. At diagnosis, the mean initial score was 7.7 + 2.36; at six months, it was 1.61 + 1.83. The score variation at 6 months and inclusion was 6.19 ± 2.18 for deep pemphigus and 5.43 ± 2.85 for superficial pemphigus (p = 0,3 non significant). At six months, 4 patients were dead: their initial score was 11 + 1.41 while the initial score in the 52 patients was 7.4±2.03 (p = 0,001, significant). Data showed no correlation between initial severity scores and cumulative dosage of corticosteroids at 6 months (Pearson coefficient of correlation 0.144; p = 0.580). CONCLUSION: In this study, initial severity scores for pemphigus were high and decreased at 6 months of treatment. Both deep pemphigus and superficial pemphigus were severe as their score variation was similar. Japenese severity score is useful for Moroccan patients with pemphigus.