Evaluación de las modificaciones dietéticas en el periodo de Ramadán / Evaluation of dietetic changes in the perior of Ramadan

Fundamentos: Entre las modificaciones introducidas en los hábitos de vida por el mes de Ramadán, destacan los cambios dietéticos, tanto cualitativos como cuantitativos. El objetivo fundamental del presente estudio es evaluar las modificaciones producidas por el ayuno de Ramadán en la población musulmana. Material y métodos: Se analizó la dieta diaria realizando una encuesta recordatorio a 100 voluntarios musulmanes de los que se encontraron bajo este periodo. Consistió en un inventario de 3 días sobre los alimentos consumidos, su preparación y su cantidad. Resultados: Se dedujeron cambios significativos en la dieta de ramadán. Ésta resultó ser hiperprotéica, donde predominaba la ingesta de proteínas (27%). De la repartición de energía entre las comidas, se dedujo que es igualmente desequilibrada siendo la mayor parte de energía concentrada en la primera comida. Conclusiones: Sería esencial hacer reajustes en la dieta de ramadán a fin de equilibrarla lo máximo posible. Para ello habrá que promocionar una adecuada educación e información nutricional adaptada al mes de ramadán antes de que empiece dicho mes (AU)

Background: Amongst the changes affecting daily habits during the month of Ramadan, we can distinctively observe the dietetic changes, either qualitatively of quantitatively. Our essential objective of this study is to evaluate the changes brought about by the fasting during Ramadan among Muslims. Methods: We analyzed the daily diet by carrying out a prompting survey among 100 volunteer Muslims during the period of Ramadan. We calculated inventory of 3 days consumed food and the preparation and quality of meals. Results: Observing significant changes in diets during Ramadan. The diet is a hyper-protein dominated by the intake of proteins (27%). As for the repartition of energy between meals, we concluded also disequilibrium by taking the most part of energy during the first meal. Conclusions: It would be essential to re-adjust the diet during Ramadan in order to reach the most equilibrium possible, which should be necessarily based on adequate education and adaptable nutritional information before the beginning of the month of Ramadan (AU)

[The subcutaneous mucormycosis due to Lichtheimia corymbifera: A case report in an immunocompetent child]. / Les mucormycoses sous-cutanées àLichtheimia corymbifera : à propos d'un cas chez un enfant immunocompétent.

Mucormycosis due to Lichtheimia (ex Absidia) corymbifera is a rare fungal infection, occurring most often in an environment of immune deficiency, rarely in an immunocompetent patient. It comes in different clinical forms, frequently misleading, hence the interest of a pathological and mycological examination that allows the diagnosis of certainty. The management of this condition should be introduced early because it affects the functional prognosis of the patient. In this study, the authors report a case of mucormycosis in a 10-year-old child, and with clinical immunocompetent less severe than the cases reported in the literature.

[Human rhinomyiasis due to Oestrus ovis: case report in Morocco]. / Rhino-myiase humaine a Oestrus ovis: une observation au Maroc.

The purpose of this report is to describe a case of human nasal myiasis caused by Oestrus ovis diagnosed in our laboratory in Morocco. Oestrus ovis is an obligate parasite of nasal cavities and sinuses. It is usually found in sheep and goats in the Mediterranean basin. Oestrosis is a rare finding in man.

[Epidemiology of tinea capitis in outpatients at the Children's Hospital in Rabat (Morocco)]. / Épidémiologie des teignes du cuir chevelu chez les consultants externes à l'hôpital d'enfants de Rabat (Maroc).

OBJECTIVE: The aims of this report on results of a retrospective study were to identify the incidence of this pathology among outpatients at the Children's Hospital in Rabat, Morocco, the species involved, their respective prevalence, and the influence of the age and sex of the patient. PATIENTS AND METHODS: Between 1993 and 2007, a mycological examination was performed on 2962 patients in the dermatology service of Ibn Sina University Health Center in Rabat. Mean patient age was 35 (ages ranged from three months to 70 years). RESULTS: Direct microscopic examination was made of all the patients' hair, followed by culture on Sabouraud medium leading to the identification of scalp ringworm in 1299 patients. The age group most affected was children under ten years of age (50% of the cases), mostly boys (M: F sex-ratio 1:14). The majority of cases of ringworm in our study were caused by Trichophyton mentagrophytes with 992 cases (76.4%), followed by Microsporum canis with 174 cases (13.4%). Inflammatory ringworm was identified in 32 patients (2.5%) and 30 cases of honeycomb ringworm (tinea favosa) (2.3%). Trichophyton violaceum was more frequent among girls and M. canis was more frequent among boys. Analysis of the incidence of the different species over the years revealed a clear decrease in case of tinea favosa, a decreasing trend for T. violaceum and a significant recrudescence of M. canis. CONCLUSION: T. violaceum continues to be the most common species of scalp ringworm in Morocco, despite a significant increase in M. canis. Tinea favosa has been practically eradicated.

[Primitive aspergillosis of the posterior cerebral fossa in immunocompetent patient]. / Aspergillose primitive de la fosse cérébrale postérieure chez un patient immunocompétent.

Cerebral aspergillosis arises in the great majority of cases during an invasive aspergillosis with hematogene scattering from the lung hurts. The cerebral, not rare location is one of the worse criteria forecast during the invasive aspergillosis. We report the case of patient who was hospitalized in the neurosurgery department for syndrome of increased intracranial pressure, hemiparesis and cerebellar syndrome in febrile context. The radiological exploration objectified a collection of the posterior fossa. A stereotactic biopsy was performed. It collected fragments biopsy and pus. The pathological and microbiological analysis allowed the identification of Aspergillus fumigatus. The originality of this observation comes from the rare location in the posterior fossa of aspergillosis and because the patient is immunocompetent and no primary location is found. The patient presents however a viral hepatitis B of fortuitous discovery. He is put under treatment by amphotericin B. The evolution is marked by meningitis comment-diversion. Antibiotics are prescribed, and then the patient is operated for total ablation of the tumor. He dies following an osmolar coma associated with thrombopenia and a secondary renal insufficiency due to his treatment by the amphotericin B.

[Infantile visceral Leishmaniasis: epidemiological, clinical and biological characteristics. About 93 case reports in the children hospital of Rabat]. / Leishmaniose viscérale infantile : profil épidémiologique, clinique et biologique. A propos de 93 cas.

INTRODUCTION: Infantile visceral leishmaniasis (LVI) is a problem of public health in Morocco. This parasitosis rages to the state of endemic and touches the infants. OBJECTIVES: The goal of this survey is to draw up epidemiological, clinical and biologic profile of LVI in children hospitalized in the Children's Hospital of Rabat, and to prove the contribution of serology in diagnosis of this illness. MATERIAL AND METHODS: This retrospective study concerned all LVI cases gathered in the HER during 5 years (from 1997 to 2001). For every patient included in this study, the authors collected geographical origin, age, sex, clinical data (splenomegaly, fever, hepatomegaly, paleness), and biologic data (numeration formulates red chalk, speed of sedimentation, protein in blood and electrophoresis of the proteins). The myelogram results were also exploited as well as results of serology when they were realized. RESULTS: Ninety-three LVI cases were listed with an age average of 3.5+/-3 years, and a sex ratio of 1.82 (p=0.032). Patients coming from farming surroundings or semi-urban were more numerous than those from cities: 85.5% versus 14.5% (p<0.0001). Most of the patients suffered from splenomegaly, fever and paleness; anaemia was almost constant. In case of hyperprotidemy (43.5%; n=27), the albumin-globulin report was always lower than 1.2. Indirect immunofluorescence was practised among 39 patients with a positive response in 84.6% of the cases. Forty patients whose serums were analyzed by indirect hemagglutination (HAI) had all a myelogram revealing the presence of protozoon, but only 57% of them showed a positive reaction in HAI. CONCLUSIONS: These results confirm that the LVI touches children coming from underprivileged surroundings. The triad, splenomegaly, paleness and fever, is a good element of diagnostic orientation, whereas parasite revelation in bone marrow remains the best way to establish the diagnosis of this illness.

[Cryptococcal neuromeningitis in immunosuppressed subjects at Rabat University Hospital (Morocco)]. / La cryptococcose neuroméningée chez le sujet immunodéprimé au CHU de Rabat (Maroc).

BACKGROUND: Cryptococcus neoformans is responsible for severe mycosis particularly in immunosuppressed patients. OBJECTIVE: To describe the Moroccan cases of cryptococcal neuromeningitis. MATERIAL AND METHODS: We retrospectively studied over a 12 year period (1993-2005) the cases of cryptococcal neuromeningitis diagnosed at the University Hospital of Rabat. The identification of Cryptococcus neoformans was made on cerebrospinal fluid samples after direct examination with the Indian ink and culture on Sabouraud's medium without cycloheximide. RESULTS: Nine immunosuppressed patients had a cryptococcal neuromeningitis (7 men and 2 women). The average age was 33 years. Eight patients were infected with HIV and one was treated with steroids. The cryptococcosis reevaluated the HIV infection in 5 cases and 3 patients were already at the AIDS stage. The treatment based on amphotericin B was only effective in 3 patients. CONCLUSION: These data incite us to optimise diagnosis tools and therapeutic strategies for cryptococcal neuromeningitis in Morocco.

[Human auricular myiasis caused by Wohlfahrtia magnifica (Diptera: Sarcophagidae): about three observations in Morocco]. / Otomyiases humaines dues à Wohlfahrtia magnifica (Diptera: Sarcophagidae): à propos de trois observations au Maroc.

We report three cases of human otomyiasis observed in rural Moroccan children. Myiasis of external orifices usually occurs from neglected chronic lesions of the patients with poor personal hygiene. The parasitologic identification revealed Wohlfahrtia magnifica. Wohlfahrtiosis is common myiasis of sheep and goats in Mediterranean basin. Through this paper we underline the epidemiological, pathogenic, clinical and therapeutic aspects of this parasitosis.

[Onychomycosis in Morocco: experience of the parasitology and medical mycology laboratory from Rabat children hospital (1982-2003)]. / Les onychomycoses au Maroc. Expérience du laboratoire de parasitologie et mycologie médicale de l'hôpital d'enfants de Rabat (1982-2003).

Cases of onychomycosis diagnosed by mycological examination in the parasitology and mycology laboratory (Children Hospital, Rabat, Marocco) over the 22-year period, between 1982 and 2003, have been reviewed. 17,177 dermatophytes have been isolated in 4,940 patients. Dermatophytes presented 61.46% of onychomycosis, yeasts Candida albicans were responsible in 25.5%, moulds in 1.53% and for 12% fungi identification was not determined (positive direct examination or negative direct examination and culture despite typical clinical aspect). The most frequent dermatophyte was Trichophyton rubrum (83.6%), followed by Trichophyton violaceum var. glabrum (9%) and Trichophyton mentagrophytes var. interdigitale (6.9%). Candida albicans was the prevalent yeast. Moulds were mainly Fusarium spp. (47%), followed Scopulariopsis brevicaulis (16%) and Aspergillus spp. (12%). Dermatophytes and moulds most commonly infected the toenails, yeasts the fingernails.

[American histoplasmosis: a case with cutaneous presentation in Morocco]. / Histoplasmose américaine: une observation marocaine à forme cutanée.

Histoplasmosis Histoplasma capsulatum is a common systemic mycosis in immunocompromised subjects. It has not been reported in Maghreb countries. The purpose of this report is to describe a case with cutaneous presentation involving a Moroccan woman undergoing long-term corticosteroid therapy for systemic inflammatory diseases (rheumatoid polyarthritis and scleroderma). In addition to the main pathophysiological features of the disease, the authors present the causal agent and clinical manifestations. They stress the importance of laboratory findings in the diagnosis of this fungal disease.

Molluscicidal activity of some Moroccan medicinal plants.

Among 14 plants of Moroccan folk medicine tested for molluscicidal activity, ethyl acetate extract from Origanum compactum and hexane extracts from both Chenopodium ambrosioides and Ruta chalepensis were the most active (LC(90)=2.00, 2.23 and 2.23 mg l(-1), respectively) against the schistosomiasis-transmitting snail Bulinus truncatus.

[Visceral leishmaniasis and malnutrition: a case report]. / Leishmaniose viscérale et malnutrition: à propos d'une observation.

BACKGROUND: Visceral leishmaniasis occurring in malnourished subjects can have an uncommon course, which explains difficulties in its diagnosis. CASE REPORT: A 22-month-old infant was admitted because of malnutrition and prolonged fever. The bacteriological investigation was negative. When his nutritional status improved, he developed a splenomegaly. The medullogram confirmed the diagnosis of visceral leishmaniasis. The course was then favorable with treatment by pentavalent antimonial. CONCLUSION: Malnutrition constitutes a risk factor of opportunist parasitic disease such as leishmaniasis. Its diagnosis can be very difficult.