Prevalence and associated factors of psychiatric comorbidities in epilepsy in the Casablanca-Settat region of Morocco: A cross-sectional study.

OBJECTIVE: To determine the estimated prevalence of anxiety, depression, and anxiety-depression syndrome (ADS) and to identify the associated factors in Moroccan people with epilepsy (PWE). METHOD: A cross-sectional study was conducted among adult PWE (June 2021-December 2022) in the Casablanca-Settat region. PWE were interviewed by completing a questionnaire collecting sociodemographic and clinical data. Anxiety and depression were assessed by the Hospital Anxiety and Depression Scale (HADS). Out of 21 points, a score ≥8 is in favor of considerable anxiety/depression symptoms and a sum of the two scores ≥15 indicates the presence of ADS. Data were analyzed using Statistical Package for Social Sciences (SPSS) 21.0. p-values ≤0.05 were considered statistically significant and logistic regression was performed to determine the associated factors. RESULTS: Among 294 PWE, the median age was 39 years (interquartile range [IQR]: 25.75-54.00). The median anxiety, depression, and ADS scores were 8 (IQR: 5.00-10.00), 7 (IQR: 4.00-10.00), and 15 (IQR: 10.00-20.00), respectively. Anxiety, depression, and ADS were revealed in 51.4%, 44.9%, and 51.0% of PWE, respectively. Depression was the only predictor for anxiety (aOR = 24.20; 95%CI: 12.45-47.01). Antiseizure polytherapy (aOR = 3.35; 95%CI: 1.72-6.54) and anxiety (aOR = 24.04; 95%CI: 12.12-47.67) were the factors associated with depression. The risk of ADS was increased by female gender (aOR = 2.83; 95%CI: 1.68-4.78), antiseizure polytherapy (aOR = 2.75; 95%CI: 1.62-4.65), structural epilepsy (aOR = 1.73; 95%CI: 1.01-2.94), and the presence of concomitant conditions with epilepsy (aOR = 1.96; 95%CI: 1.16-3.31). SIGNIFICANCE: Our study reports high psychiatric comorbidity prevalence in epilepsy, which supports the bidirectional link hypothesis. Associated factors found are important in the prognosis and prevention. PLAIN LANGUAGE SUMMARY: The neural mechanisms underlying epilepsy tend to expose PWE to psychiatric disorders. Our study aims to quantify the rate of psychiatric comorbidities and their predictive factors in Moroccan PWE. The estimated prevalences of significant symptoms of anxiety, depression, and ADS were 51.4%, 44.9%, and 51.0%, respectively. Depression was the predictor of anxiety. Antiseizure polymedication and anxiety were the associated factors with depression. The risk of SAD was increased by female gender, antiseizure polymedication, structural epilepsy, and concomitant diseases with epilepsy. Our results are important for considering the psychiatric aspect of PWE and improving their care and quality of life.

Knowledge, attitudes and practices towards epilepsy in morocco: A cross-sectional study.

BACKGROUND: This study aims to assess knowledge, practices and attitudes of the general Moroccan population towards epilepsy and to highlight predictive factors. METHOD: A cross-sectional study was conducted in the Casablanca-Settat Moroccan region. A questionnaire was used to collect sociodemographic data and item answers from 400 people with epilepsy (PWE) and without epilepsy caregivers on dependent variables: knowledge, attitudes, and practices towards epilepsy. Bivariate and logistic regression analyses were performed using IBM SPSS Statistics 21.0. Statistical significance was set when P value < 0.05. RESULTS: The rates of poor knowledge, practices, and attitudes toward epilepsy were 11.5 %, 41 %, and 66.6 %, respectively. In the multivariate analysis, the risk of having poor knowledge about epilepsy was favored by lack of education (ORa = 4.31;CI95%:1.83-10.13;p = 0.001) and the absence of familiarity with epilepsy (ORa = 4.05;CI95%:1.92-8.54;p < 0.001). The risk of preferring allopathic practices to treat epilepsy was associated with lack of education (ORa = 2.21;CI95%:1.01-4.82;p = 0.046), residence in a city outside Casablanca (ORa = 2.33;CI95%:1.06-5.15;p = 0.035), age over 59 years (ORa = 2.50;CI95%:1.26-4.95; p = 0.008), residence in a rural areas (ORa = 4.41;CI95%:2.61-7.47;p < 0.001) and absence of familiarity with epilepsy (ORa = 4.08;CI95%:2.33-7.15;p < 0.001). Predictors of stigma towards epilepsy were female sex (ORa = 3.05;CI95%:2.04-4.56;p < 0.001) and the tendency to abandon anti-seizure medication for allopathic alternatives (ORa = 3.98;CI95%:2.21-7.17;p < 0.001), whereas advanced age was a protective factor (ORa = 0.57;CI95%:0.36-0.89;p = 0.014[39-59 years vs 18-29 years];ORa = 0.44;CI95%:0.23-0.82;p = 0.011[>59 years vs 18-29 years]). CONCLUSIONS: The rate of poor attitudes and treatment-seeking behavior was high. This socio-cultural context certainly impacts the quality of life and care of Moroccan PWE. These results should be considered to raise awareness in the Moroccan population.

In Vitro Activity of Ceftazidime-Avibactam Against Enterobacteriaceae and P. aeruginosa Isolated at the Ibn Rochd University Hospital of Casablanca.

BACKGROUND: The aim of this study is to determine the in vitro activity of ceftazidime-avibactam (CZA) on Entero-bacteriaceae and P. aeruginosa strains isolated in the bacteriology-virology laboratory of the Ibn Rochd University of Casablanca. METHODS: This is a prospective descriptive longitudinal study conducted from May 28 through June 25, 2022, on Enterobacteriaceae and P. aeruginosa isolated from diagnostic samples received at the Bacteriology-Virology and Hospital Hygiene Laboratory of the Ibn Rochd University Hospital of Casablanca. The isolation and identification of the strains were carried out using standard bacteriological techniques. The study of sensitivity to ceftazidime-avibactam was done by diffusion susceptibility testing on agar medium according to EUCAST 2022 recommendations. RESULTS: During the study period, 271 strains of Enterobacteriaceae were isolated. The sensitivity rate to ceftazidime-avibactam was 91% vs. 74% for ceftazidime alone. R. terrigena was the most resistant strain to CZA with a rate of 69%, followed by E. cloacae (14%), then K. pneumoniae (6%), and finally E. coli (5%). Among the strains isolated, 24% (n = 66) produced ESBL, of which 29% (n = 19) were resistant to CZA, and 10.7% (n = 29) were re-sistant to imipenem, including 44, 8% (n = 13) that were resistant to imipenem and CZA. Regarding P. aeruginosa, 92 strains were isolated. The CZA resistance rate was 33.6% (n = 31). Among the strains isolated, 30.4% (n = 29) were resistant to imipenem, of which 82.7% (n = 24) were resistant to CZA. CONCLUSIONS: The in vitro evaluation of the ceftazidime-avibactam activity on the strains isolated, mainly: E. Coli, K. Pneumoniae, and E. Cloacae, showed a good inhibitory activity of this molecule which can constitute a therapeutic alternative for the treatment of infections due to these microorganisms.

Student's attitudes towards medical education in Arabic (Morocco 2020).

INTRODUCTION: Several studies suggest that teaching medicine in the national language is essential for quality training and for communication with patients. AIM AND METHODS: To measure the students' level of understanding of their French language training and skills acquisition, as well as the difficulties they encounter in communicating with patients and their families, and the extent to which they accept medical studies in Arabic, we conducted a descriptive crosssectional study on a random sample of 450 students from the Faculty of Medicine and Pharmacy of Casablanca. RESULTS: 16% of the students had trouble assimilating their lessons in French, 48.9% of them had trouble communicating with the patient, and 22% were ready to study medicine in Arabic. Regarding the effect of teaching medicine in Arabic on different fields, 42.2% of the students mentioned a positive effect on the training, 85.2% on the communication with the patient during their training on field and 64.8% on the quality of care. CONCLUSION: Our study revealed the existence of multiple difficulties among students, particularly in the field of communication with the patient, which is a fundamental pillar for the quality of health care, hence the need to provide effective and rapid solutions to the problem of language in medical education.

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.

[Imatinib in the treatment of chronic myeloid leukemia in Morocco]. / Imatinib dans le traitement de la leucémie myéloide chronique au Maroc.

INTRODUCTION: The treatment of chronic myeloid leukemia (CML) has been revolutionized by the advent of tyrosine kinase inhibitors. The results of the IRIS trial demonstrated the efficacy and long-term safety profile of Imatinib. The objective of our work is to report the results at 15 years of treatment of CML in chronic phase with Imatinib in Morocco. PATIENTS AND METHODS: Retrospective study realized at the hematology unit of CHU d'Ibn-Rochd in Casablanca, from January 2003 to September 2018, including all CML patients in the chronic phase at diagnosis, were treated with Imatinib for a minimum duration of 6 months. RESULTS: In total, 318 patients were collected, the median age was 41.5 years, the sex ratio M/F was 0.7, the Sokal score was high in 56% of cases. The complete hematological response at 3 months was 92%, the complete cytogenetic response at 12 months and the cumulative response were obtained in 43% (29/67) and 55% (153/279) of the cases respectively, the molecular response was evaluated in 125 patients witch 85% were on major molecular response. On a median follow-up of 44 months, the OS and EFS at 10 years were 86% and 59%, respectively. DISCUSSION: Our profile is characterized by a young age of the patients, the female predominance and a high Sokal score. The rate of complete cytogenetic response remains lower compared to what is described, however the survival rates as well as the tolerance were similar to those of the literature.

The effects of Ramadan fasting during pregnancy on fetal development: a general review.

BACKGROUND: From a religious point of view, Ramadan fasting (RF) is not mandatory during pregnancy. However, some pregnant women insist to fast. Does this choice affect fetal development? AIM: The objective of this general review was to determine the impact of RF on fetal development. METHODS: The search was conducted via the following databases PubMed, Scopus, Web of Sciences and Google Scholar from January 1st 2009 to December 31th 2018, using the following query: (« Ramadan « OR « Ramadan month « OR « fasting «) AND (« fetal development « OR « fetal growth « OR « fetal programming «) AND (pregnanc* OR gestat* OR pregnant wom*n). Articles published in English or French were included, and comparative studies on the impact of RF on fetal development in the group of pregnant women who fasted and the group who did not fast, regardless of the stage of gestation. RESULTS: Ten studies met the research criteria and all were case-control ones. Six studies were conducted in Turkey, two in Egypt, one in Iran and one in Pakistan. The RF coincided with the summer period in 8 studies. An obstetrical ultrasound with Doppler was performed on 1390 pregnant women at the beginning and end of Ramadan. Significant decreases in cephalic perimeter, biparietal diameter and femoral length were noted in a single study. A change in the amniotic fluid index was observed in two studies. CONCLUSION: The RF practiced by healthy pregnant women has no negative impact on fetal development.

Bibliometric profil of medical publication at Faculty of Medicine of Casablanca (2008-2017).

AIM: To measure productivity in scientific publications of teachers of the Faculty of Medicine and Pharmacy of Casablanca (FMPC). METHODS: This is a descriptive bibliometric study of the publications of the FMPC, indexed in the Medline and Scopus databases, between 2008 and 2017. Articles of physicians affiliated to the FMPC or its university hospital center were included in this study. RESULTS: With 1041 articles, the average scientific productivity of the FMPC was 38 articles / 100 teachers-year. These articles were published in 244 journals of which 18% in Pan African Medical Journal and 67% in French. In 58% of the articles, the type was "case reports". Dermatology and Genetics were the most prolific medical disciplines with 122 and 76 articles respectively. In surgery, Oto-Rhino-Laryngology and Gynecology-Obstetrics ranked first, with respectively 75 and 60 articles. The impact factor of the journals that published the articles of the FMPC ranged from 0.05 to 26.56 and was less than two in 84% of the cases. National and international scientific collaboration was 2.6% and 6.4% respectively. CONCLUSION: The publication at the FMPC was largely unproductive in English-language journals with a high impact factor. Training in scientific medical writing would be a priority for faculty development and institutional visibility of the FMPC.

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.

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.

[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.

Les barrieres a une bonne prise en charge des diabetiques dans les structures de premiere ligne de la province de Khouribga (MAROC)

Le diabete constitue un important enjeu de sante publique au Maroc et represente un defi auquel les medecins generalistes sont confrontes dans leur pratique quotidienne. Le but de ce travail etait de decrire les barrieres entravant une bonne prise en charge des patients diabetiques dans les structures de 1ere ligne de la province de khouribga. Methodes Il s'agit d'une etude transversale menee de decembre 2010 a mars 2011; chez les 54 medecins generalistes (MG) exercants dans les centres de sante de la province. La collecte des donnees a ete realisee a l'aide d'un questionnaire preteste et auto administre et la saisie et l'analyse effectuees sur le logiciel SPSS 16. Resultats :Huit pourcent des MG disposaient de registre informatise pour le suivi des diabetiques. Les principales barrieres a une prise en charge correcte des patients etaient le statut socio-economique faible des patients (94); leur niveau scolaire bas (86); le manque de moyens de traitement et de suivi (80); le nombre insuffisant de diabetologues (80); le manque de coordination avec les structures de 2eme ligne (74) et l'insuffisance des seminaires de formation continue (58). Conclusion Les medecins generalistes sont confrontes a de nombreux obstacles concernant la prise en charge des patients diabetiques. L'equipement des centres de sante en moyens diagnostiques et therapeutiques suffisants; l'amelioration de l'accessibilite des diabetiques aux soins et la formation continue des medecins pourraient etre des solutions pour ameliorer cette prise en charge surtout devant la penurie de specialistes dans notre pays