Reference Values for Spirometry in Moroccan Adults.

INTRODUCTION: This novel study aimed to establish spirometric reference values and prediction equations based on a sample of the adult Moroccan population, an endeavor that has not been attempted previously. METHODS: In this cross-sectional study involving healthy Moroccan adults, data was collected through a mobile spirometry setup. RESULTS: Our sample comprised 841 healthy adults (384 men and 457 women) aged 18-86 years who underwent spirometry. For both sexes, the Global Lung Function Initiative 2012 equations for Caucasians corresponded the best to the studied sample but were not perfectly compatible. CONCLUSION: The spirometric prediction equations established in this study for Moroccan adults aged 18-86 years best represent the Moroccan population. More extensive future studies are needed to enrich the database of reference values and prediction equations derived from our research.

Predictive Regression Equations of Flowmetric and Spirometric Peak Expiratory Flow in Healthy Moroccan Children.

INTRODUCTION: Peak Expiratory Flow (PEF) has never been characterised among healthy Moroccan school children. AIM: To study the relationship between PEF and anthropometric parameters (sex, age, height and weight) in healthy Moroccan school children, to establish predictive equations of PEF; and to compare flowmetric and spirometric PEF with Forced Expiratory Volume in 1 second (FEV1). MATERIALS AND METHODS: This cross-sectional study was conducted between April, 2016 and May, 2016. It involved 222 (122 boys and 100 girls) healthy school children living in Ksar el-Kebir, Morocco. We used mobile equipments for realisation of spirometry and peak expiratory flow measurements. SPSS (Version 22.0) was used to calculate Student's t-test, Pearson's correlation coefficient and linear regression. RESULTS: Significant linear correlation was seen between PEF, age and height in boys and girls. The equation for prediction of flowmetric PEF in boys was calculated as 'F-PEF = -187+ 24.4 Age + 1.61 Height' (p-value<0.001, r=0.86), and for girls as 'F-PEF = -151 + 17Age + 1.59Height' (p-value<0.001, r=0.86). The equation for prediction of spirometric PEF in boys was calculated as 'S-PEF = -199+ 9.8Age + 2.67Height' (p-value<0.05, r=0.77), and for girls as 'S-PEF = -181 + 8.5Age + 2.5Height' (p-value<0.001, r=0.83). The boys had higher values than the girls. The performance of the Mini Wright Peak Flow Meter was lower than that of a spirometer. CONCLUSION: Our study established PEF predictive equations in Moroccan children. Our results appeared to be reliable, as evident by the high correlation coefficient in this sample. PEF can be an alternative of FEV1 in centers without spirometry.

Predictive Regression Equations of Flowmetric and Spirometric Peak Expiratory Flow in Healthy Moroccan Adults.

Introduction. PEF has never been characterized among healthy Moroccan adults. The objective of this study is to describe the values of PEF among healthy Moroccan adults, to study its relationship with anthropometric parameters (gender, age, height, and weight), to compare spirometric and flowmetric PEF, to establish the prediction equations for PEF, and to study the correlation between PEF and FEV1. Methods. Cross-sectional study conducted between May and June 2016. It involved healthy nonsmoking volunteers living in Tetouan, Morocco, gathered through a mobile stand realization of spirometry and peak flow measurements. Results. Our final sample concerned 313 adults (143 men and 170 women). For both men and women, age and height were the main determinants of PEF, and a positive correlation was found between PEF and FEV1. Conclusion. Our study has established the PEF predictive equations in the Moroccan adult population. Our results allow us to conclude that the PEF can be a reliable alternative of FEV1 in centers not equipped with spirometry.

Importance of Therapeutic Drug Monitoring in the Treatment of Active Tuberculosis - A Retrospective Study of 4 Cases

Background: In the treatment of active tuberculosis, therapeutic drug monitoring (TDM) is used to optimize dosing that maximizes therapeutic benefit while minimizing toxicity. In Morocco, TDM is not routinely used, yet low levels of anti-TB drugs can be associated with poorer treatment outcomes.Methods: We retrospectively checked our archives for patients with active TB for whom TDM was performed during 2014. Medical records were reviewed to abstract demographic, clinical, radiographic and microbiological data including time until smear and culture conversion. Then, we looked for cases with delay of TB conversion.Results: In total, 24 patients were identified, for whom TDM was performed, they all had low serum drug levels. Among them, 4 patients showed delayed bacteriological conversion. Conclusions: Our study cases are showing the benefit of serum dosage in the follow-up of the patients showing a delay of sputum examination conversion,both direct and culture, during their evolutions. TDM is potentially useful for the treatment of active TB, but is currently underused in Morocco

Scarf pin inhalation: clinical characteristics and surgical treatment.

OBJECTIVE: Scarf pin inhalation is becoming a frequent accident among young Moroccan woman who wears islamic veil. The aim of the study is to highlight indications, principles and challenges of surgical removal of that particular foreign body. METHODS: Twenty-eight patients were hospitalized in Thoracic Surgery department of Ibn Sina Hospital at Rabat between January 2008 and June 2013 for surgical removal of a pin scarf after unsuccessful endoscopy. RESULTS: Mean age was 20 years. Inhalation was accidental in all cases. Average interval between inhalation and surgery was 10 days. Penetration syndrome was found in 82% of patients. Pin was located at the left tracheo-bronchial tree in 53.5% of cases and at the right one in 46.4%. All were operated by thoracotomy. Surgery was conservative in all cases, and postoperative course was uneventful. CONCLUSION: In case of failure endoscopic treatment, surgery remains the only alternative. It must be as conservative as possible. Short interval between inhalation accident and surgery prevents parenchymal resection.

Postmenopausal breast tuberculosis - report of 4 cases.

BACKGROUND: Breast tuberculosis is an uncommon disease even in countries where the incidence of tuberculosis is high. CASE REPORT: This is a case series concerning 4 postmenopausal breast tuberculosis cases encountered in Moulay Youssef Hospital between January 2007 and December 2010. Breast tuberculosis represents 0.25% of all hospitalized tuberculosis patients in our department. The mean age of our patients was 62.5 ± 5.8 years. Clinical findings were heterogeneous; 1 case was multifocal tuberculosis, and another case was coexistent tuberculosis and malignancy of the breast. Mammography and ultrasonography findings were suspicious for malignancy in all 4 cases. Fine needle aspiration was negative in 3 cases. The diagnosis was made in all patients by histological examination of biopsy specimens, which revealed typical tuberculous lesions. Anti-tuberculosis therapy formed the mainstay of treatment. CONCLUSION: The clinical and radiological features of mammary tuberculosis can be very confusing and easily mistaken for breast cancer. Symptoms suggestive of tuberculosis warrant a biopsy to exclude possible cancer.