Parental Response to Children's Chronic Pain.

AIMS: The aim of this study was to describe the behavior of Moroccan parents toward their children's chronic pain. METHODS: A cross-sectional study was conducted in different hospital wards. Parents of hospitalized children with chronic pain aged six or over participated in the study. The parents' behavior toward their children's pain was assessed using an Arabic version of the Adult Responses to Children's Symptoms (ARCS) scale. The scores for each dimension were calculated by summing the responses of the items related to that dimension, and then they were normalized to obtain scores ranging from 0 to 100. The comparison of scores was performed using Student's t-test or ANOVA. The association between quantitative variables was assessed using a correlation coefficient. RESULTS: A total of 100 parents of children with chronic pain participated in the study. The children's average age was 10.0 ± 2.7 years. The majority of children (62%) experienced pain for more than six months. The joints were the most common location of pain (43%), followed by the abdomen (35%). The "Protect" and "Monitor" dimensions had good reliability with Cronbach's alpha coefficients of 0.80 and 0.69, respectively. The highest mean normalized scores were noted for the "Monitor" and "Protect" dimensions, with means of 82.1 and 70.8, respectively. The "Minimize" dimension had the lowest mean score of 41.4. Parental behavior was not linked to child- or pain-related characteristics. There was no difference in how mothers and fathers behaved towards their children's pain. CONCLUSION: Parents of children with chronic pain in Morocco scored higher on all dimensions of the ARCS, with the highest scores in the "protect" and "monitor" dimensions. These behaviors can negatively affect children's somatic symptoms, functional disability, and anxiety. Our study revealed the importance of providing support to both children and parents of children with chronic pain to manage the pain and related behaviors.

Women's Knowledge and Attitudes Towards Cervical Cancer Screening in Morocco.

High incidence rates of cervical cancer are still common in low- and middle-income countries (LMICs) with ineffective prevention policies. This study assessed Moroccan women's knowledge and practices regarding the cervical cancer screening program. A cross-sectional study was conducted in 2019 in four primary healthcare centers in Casablanca. Women over the age of 18 who came to these centers during the study period were invited to participate in the study. The variables collected were related to women's knowledge of cervical cancer, the screening program, and their reasons for not participating in the screening program. The main risk factors identified by the participants were multiple sexual partners (4.3%) and sexually transmitted diseases (4%). About 77% of the cases (95% confidence interval (CI): 72.1%; 80.4%) knew that a cervical cancer screening program exists in Morocco. However, a small proportion had an idea about the population targeted by the program (46%) and the recommended interval between two screening tests (20%). Only 28% (95% CI: 19.2%; 38.2%) of eligible women had ever been screened for cervical cancer. These results underline the importance of implementing a communication strategy to increase women's awareness of the cervical screening program and their involvement in it.

Current State and Prospects of Telemedicine in Morocco: Analysis of Challenges, Initiatives, and Regulatory Framework.

The Moroccan healthcare system is grappling with a pronounced lack of resources, particularly in terms of human personnel. Presently, Morocco has 28,892 doctors, which equates to a ratio of around 7.8 doctors per 10,000 inhabitants, whereas the WHO recommends a minimum of 23 doctors per 10,000 inhabitants. More than half of these doctors work along the Casablanca-Rabat axis, underscoring a significant disparity between urban and rural areas. In addition, about 270 rural municipalities find themselves in a state of critical medical isolation, denoting their location more than an hour away from a hospital facility. Among these municipalities, 160 are classified as priority, encompassing roughly two million inhabitants. Hence, the Moroccan healthcare system is confronted with several challenges in ensuring equitable access to quality services and curbing the escalating costs. Telemedicine holds the potential to address these twin needs by optimizing the utilization of existing human and material resources through telecommunications. In fact, telemedicine enables a reimagining of the healthcare landscape, promoting a territorial rebalancing in favor of regions with lower medical density. In this context, Morocco has established a regulatory framework outlining the rules for telemedicine practice. Numerous initiatives have emerged, particularly within the public sector, such as the National Telemedicine Initiative launched in October 2018, with the aim of covering 80% of medical deserts in Morocco by 2025. Nevertheless, despite the concerted efforts, there remain challenges to overcome in order to make strides and achieve the objectives set forth by the Moroccan healthcare system. This literature review aims to examine and analyze the current state of telemedicine in Morocco. It seeks to highlight the challenges, initiatives, regulatory progress, and existing gaps in the landscape of telemedicine in Morocco.

Cross-Cultural Adaptation and Validation of "Malocclusion Impact Questionnaire" into Moroccan Arabic.

INTRODUCTION: The malocclusion index questionnaire (MIQ) is widely used in research and clinical practice. To our knowledge, there are no studies of its use in Moroccan patients. AIM: The objective of this study was to translate and culturally adapt the malocclusion impact questionnaire (MIQ) into Moroccan Arabic and to assess its reliability and validity among a sample of young Moroccan teenagers. The PIDAQ was cross-culturally adapted into Malay version by forward- and backward-translation processes, followed by psychometric validation. MATERIALS AND METHODS: The MIQ was cross-culturally adapted into Moroccan Arabic by forward- and backward-translation processes, followed by psychometric validations. The MIQ was completed by a representative sample of 94 Moroccan adolescents aged 12-17 years selected randomly from five public schools of Casablanca. Internal consistency reliability was determined from Cronbach's alpha, and the intraclass coefficient of the item scores was obtained in 1 month in a subset of 30 subjects. Data were analyzed using the Statistical SPSS software, version 16.0, SPSS Inc, Chicago, IL, USA. RESULTS: The MIQ was completed twice by each participant at one-month interval to assess test reliability; the intraclass coefficient was r = 0.958, showing an excellent reproducibility. The internal consistency demonstrated the reliability of the questionnaire with Cronbach's alpha coefficient of 0.917. The validity of the questionnaire was assessed by evaluation of the relationship between the total scores of the MIQ and normative need for orthodontic treatment according to ICON. The questionnaire showed an insignificant correlation (0.129, p < 0.05). CONCLUSION: The Moroccan Arabic version of the MIQ was found to be reliable, whereas it has unacceptable validity according to ICON, and hence, it is unlikely to be a useful measure in orthodontic clinical trials for Moroccan adolescents.

Expression of Histo-blood Group Antigens in Tumor and Adjacent Normal Breast Tissues as Prognostic Markers of Breast Carcinoma.

PURPOSE: Aberrant glycosylation of the histo-blood group antigens (including the angina bullosa haemorrhagica [ABH]) is often observed during malignant transformation in most types of carcinomas. Data concerning their ethnic distributions are diverse which explains why their biological characteristics have to be studied in different populations. Our aim was to analyze the expression of the histo-blood group (specifically the ABH) antigens in breast carcinoma. METHODS: The expression of the histo-blood group (specifically the ABH) antigens was studied in 109 patients with breast carcinoma using immunohistochemistry. Statistical analysis was performed using χ2 and Fisher analyses. RESULTS: The loss of expression of histo-blood group (ABH) antigens in breast carcinoma was observed in 81.13% of patients with blood group O, 37.93% with blood group A, and 96.30% with blood group B. One key finding of this study was that the loss of expression of the ABH antigen was also observed in normal tissues adjacent to the tumor. The loss of expression was associated with higher tumor grade (p < 0.05). Expression of H antigen was observed in 50% of cases with loss of expression of B antigen and was associated with human epidermal growth factor receptor 2 (HER2) overexpression (p < 0.05). The loss of H antigen in patients with blood group O was associated with estrogen receptor expression (p < 0.001). Incompatible A antigen in tumor was expressed in 20.75% of patients with blood group O. CONCLUSION: Loss of the ABH antigens correlated with the Scarff-Bloom-Richardson histologic grading. H antigen was associated with HER2 overexpression in breast cancer. However, further studies are needed to determine the role of incompatible A antigen in mammary carcinogenesis.

[Occupational exposure to blood among medical students in Casablanca (Morocco): Analysis of knowledge and practices]. / Les accidents d?exposition au sang chez les étudiants en médecine de Casablanca (Maroc) : Analyse des connaissances et pratiques.

Occupational exposure to blood (OEB) is associated with a significant risk of transmission of bloodborne viruses to medical students. The objective of this study was to evaluate the knowledge and practices of Casablanca medical students concerning OEB preventive measures and their behaviour after accidental exposure. A cross-sectional study was carried out at the Ibn Rochd University Hospital in Casablanca using stratified cluster sampling ; data from this study were collected by means of an anonymous self-administered questionnaire. The mean age was 22.38 years (SD = 1.69) with a female predominance (56.0%). About 17.5% of students had experienced at least one OEB, and only 38.3% were familiar with the standard precautions to prevent these accidents. Accidental exposure was significantly associated with needle recapping (p = 0.002) and ignorance of standard precautions (p = 0.028).These results illustrate the insufficient knowledge and poor compliance with preventive measures of occupational exposure to blood, indicating the need for awareness-raising and training activities for medical students.

Effect of orthodontic treatment on lip position.

UNLABELLED: Does an advanced or retracted position of the upper and lower incisors lead to modifications in lip position? The aim of our study was to evaluate modifications in lip position following orthodontic treatments. MATERIAL AND METHODS: This study concerned 100 patients who underwent treatment in the dento-facial orthopedic unit in Casablanca. Profile headfilms at the start and at the end of orthodontic treatment were compared using Frapier's analysis. The Student test was applied to evaluate the variations in the cephalometric measurements. RESULTS: We noted a non-significant increase in the nasolabial angle (P = 0.274), a significant decrease in the sagittal position of the lower vermillion border (PsVei) (P < 0.001) and the sagittal position of the soft-tissue supramentale (PsSmc) (P < 0.001), and a significant increase in the vertical position of the soft-tissue menton (PvMec) (P = 0.035). CONCLUSION: The results of this study demonstrate marked improvements in the situation of soft tissues. We suggest further investigation to throw light on the relationship between tooth movement and soft tissue, increasing the size of the sample and taking growth into account.

Immunohistochemical expression of CD44s in human neuroblastic tumors: Moroccan experience and highlights on current data.

BACKGROUND: Peripheral neuroblastic tumors (pNTs), including neuroblastoma (NB), ganglioneuroblastoma (GNB) and ganglioneuroma (GN), are extremely heterogeneous pediatric tumors responsible for 15 % of childhood cancer death. The aim of the study was to evaluate the expression of CD44s ('s': standard form) cell adhesion molecule by comparison with other specific prognostic markers. METHODS: An immunohistochemical profile of 32 formalin-fixed paraffin-embedded pNTs tissues, diagnosed between January 2007 and December 2010, was carried out. RESULTS: Our results have demonstrated the association of CD44s negative pNTs cells to lack of differentiation and tumour progression. A significant association between absence of CD44s expression and metastasis in human pNTs has been reported. We also found that expression of CD44s defines subgroups of patients without MYCN amplification as evidenced by its association with low INSS stages, absence of metastasis and favorable Shimada histology. DISCUSSION: These findings support the thesis of the role of CD44s glycoprotein in the invasive growth potential of neoplastic cells and suggest that its expression could be taken into consideration in the therapeutic approaches targeting metastases. VIRTUAL SLIDES: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1034403150888863