[Factors associated with poor blood pressure control in Moroccan hypertensive patients]. / Facteurs associés à un mauvais contrôle tensionnel chez les patients hypertendus marocains.

STUDY AIM: Hypertension is a major public health concern worldwide and non-controlling it can lead to various cardiovascular complications. Controlling blood pressure and reducing overall cardiovascular risk are two main goals of treatment. Thus, this study aimed to determine the proportion and factors associated with uncontrolled hypertension in hypertensive patients living in the Beni Mellal city. PATIENTS AND METHODS: The cross-sectional survey took place between June and March 2019. It involved 580 hypertensive patients attending the primary health care facilities in Beni Mellal city, using systematic sampling. RESULTS: A total of 580 hypertensive patients were recruited, with a mean age of 55.78 (± 10.82 years) and of which 66.89% were female. The proportion of poor blood pressure control was 74.1% and was associated in multivariate analysis with a family history of hypertension(OR = 1.60; 95% CI = [1.02-2.50]), dyslipidemia (OR = 2.05; 95% CI = [1.32 -3.20]), non-adherence to a regular BP measurement (OR = 4.13; 95% CI = [2.49 -6.86]), to treatment (OR = 3.64; 95% CI = [2.34-5.65]) and regular biological monitoring (OR = 2.45; 95% CI = [1.46-4.08]). CONCLUSION: Despite the free and available of treatment, the proportion of uncontrolled hypertension was high. This might be linked to a lack of awareness and education concerning disease self-management.

[Relationship between arterial stiffness and the severity of coronary artery disease in acute coronary syndrome]. / Relation entre la rigidité artérielle et la sévérité du statut coronaire après un syndrome coronaire aigu.

BACKGROUND: The association between arterial stiffness (AS) and stable coronary artery disease (CAD) has been previously demonstrated. Whether increased arterial stiffness is associated with severe CAD in patients with acute coronary syndrome (ACS) is less explored. AIM: We aim to investigate the relationship between AS parameters and the extent and severity of CAD in patients with ACS. METHODS: The study population consisted of 275 patients with ACS. We measured various AS parameters including pulse wave velocity (PWV), augmentation index (AIx), and central pulse pressure (cPP). CAD extent and severity was evaluated by the number of vessels with greater than 70% stenosis. RESULTS: The study population was predominantly men (77, 5%) with an average age of 56, 4±10, 6 years. One hundred and fifteen patients were diabetic and 97 were hypertensive. One hundred fifty patients were admitted for ST elevation myocardial infarction (54, 5%) and 37, 5% for non ST elevation myocardial infarction. Thirty six percent of patients had single vessel disease and 47, 6% of the study population had multivessel disease. At the multivariate analysis, a positive correlation was observed between the number of coronary vessels disease and PWV. PWV (OR=1,272; IC95% [1,090; 1,483]; p=0,002) and cPP (OR=1,071; IC95% [1,024; 1,121]; p=0,003) were also independent predictors of multivessel disease. CONCLUSION: In patient with ACS, PWV is correlated with the extent of coronary artery disease, as measured by the number of vessels disease. PWV and cPP were also independent predictors of multivessel disease.

Anthropometric status and body image perception among Moroccan university students.

BACKGROUND: University students aged between 18 and 25 undergo several physical changes as a result of transition from adolescence to adulthood. Students do not always accept those changes and sometimes develop dissatisfaction towards their figures. In such cases, it is still not clear how actual body weight status can be affected by socio-cultural factors such as body image perception. The objective of this study was to determine the link between anthropometric status and body image perception among university students. METHODS: Two hundred and forty six (246) university students from the Faculty of Sciences and Technologies within the Beni Mellal-Khenifra region in Morocco, aged 20-24 years were interviewed using face-to-face questionnaires. Anthropometric measurements and Body Mass Index were collected. Body image perception was assessed by Figure Rating Scale, and body size dissatisfaction was calculated as Feel minus Ideal Discrepancy (FID). Data were described using means and proportions. The Student t-test and the chi-square test have been used to assess the statistical significance of group differences. RESULTS: Underweight students represented 16.7% of the investigated sample, while 11.4% suffered from overweight and obesity, higher in females students (14.4%) than in males (7.9%). Regarding body image perception, 43.9% of participants considered themselves underweight; whereas only 4.2% considered themselves overweight with no significant differences related to gender. Of note, the total prevalence of body image dissatisfaction was around 69.8%. Finally, among overweight/obese students, 88.9% of females and 71.4% of males expressed the wish to become thinner while 28.6% of the overweight/obese males wanted to get heavier. CONCLUSION: The results of this study indicate a high rate of body image dissatisfaction and a tendency of participants to underestimate their body weight. This behavior may be a reflection of a real influence of social and psychological factors occurring during this critical period and may make university students vulnerable to many risk-taking behaviors. Thus, there is a need for suitable interventional programs and innovative strategies to ensure the understanding of the health consequences of overweight and obesity and to prevent associated comorbidities.

[Investigation of the prevalence of nosocomial infection in a Tunisian regional hospital]. / Prévalence de l'infection nosocomiale dans un hôpital régional tunisien.

Nosocomial infections (NI) have achieved an increasingly large prevalence today, in Tunisia as well as abroad. Their on-going presence and occurrence are largely responsible for increasing morbidity and sometimes mortality. The aim of this work is to determine the prevalence of NI in the Kebili regional hospital and assess its level of impact. It consists of a cross-cutting study conducted in the Kebili regional hospital which holds 124 beds dispersed throughout 6 units. All of the patients hospitalised for more than 48 hours and who were present in the hospital between midnight February 17th to midnight February 18th, 2004, were included in the study. In the small hospital, 64 patients were present on the day of the study, 45 of whom had been already been hospitalised for over 48 hours. Among these 45, 6 patients (13%) tested positive for a NI. This prevalence is higher than that which is reported in the literature (2-3-9). The proportion of NI in this study is closer to that described in other series (2-7). In fact, we recorded the following : 2 cases of infection in the body zone operated upon (33%), 2 cases of urinary infection (33%), 1 case of pneumonia (17%), and 1 case of a skin infection (17%). The microbiological documentation, as it is described and presented in the other studies (1-7), was not found in our 6 patients here. The association and linkage between NI and certain other factors related to the provision of care has been documented as follows: surgical intervention, manipulations of the veins, gall bladder probing (or insertion of a catheter), tracheotomy, and prolonged hospitalisation (with an average stay of 16.5 days). The strong relationship between the occurrence of NI and the type of service or intervention administered during a hospital stay described in a select number of studies (2-5-7-11) does not present itself in our results. The overprescription of antibiotics among the patients in the hospital (52%) can be interpreted as a poor control mechanism and insufficient surveillance of the prescriptions and the delivery of these antibiotics, which serves as an important factor which contributes to NI and the development of resistance to available treatment. The work attempts to underline the importance of such a study on NI for the development and improvement of the quality of care, most importantly because the occurrence of NI constitutes a public health problem, and this is related to both the high prevalence of NI and its human and economic costs. In spite of the deficiencies noted in the clinical diagnoses and most notably the microbiological diagnoses, nosocomial infections are present in our hospital with a prevalence of 13%.