[Cross-sectional study of iron level during pregnancy at the Mohamed V Military Training Hospital, Rabat]. / Etude transversale du statut martial au cours de la grossesse à l'Hôpital Militaire d'Instruction Mohamed V, Rabat.

Iron deficiency is the most widespread nutritional disorder. Anaemia during pregnancy is common in developing countries. The purpose of this study was to check iron levels during pregnancy by evaluating laboratory indicators of iron deficiency. Our study was conducted in the Department of Obstetrics and Gynaecology of the Mohamed V Military Training Hospital (MVMTH) and included 66 patients monitored during three trimesters of pregnancy. Biochemical tests including ferritin, serum iron, CRP and blood counts were performed. The average age of patients was 28.3 years, with a standard deviation of 5.2. The prevalence of iron deficiency was 15.2% (n = 10), 25.8% (n = 17) and 42.2% (n = 28) in the first, second and third trimester, respectively. Anemia progressed from 10% (n = 7), 24% (n = 16) to 42% (n = 28). ANOVA test was used to compare the means for the parameters serum ferritin and iron, hemoglobin and hematocrit within the three trimesters. This showed a significant difference with p = 0.001. This study highlights a high prevalence of iron deficiency during pregnancy, especially in the third trimester, that would justify a systematic iron supplementation.

[Biochemical analysis of an uncommon monoclonal peak on urine protein electrophoresis: a case report]. / Analyse biochimique d'un pic insolite d'allure monoclonale en électrophorèse des protéines urinaires: à propos d'un cas.

Urine protein electrophoresis is often required for diagnosis and monitoring of urological or renal diseases and lymphoid hemopathies. We here report an uncommon urine protein electrophoresis result. The test was performed using agarose gel electrophoresis and capillary electrophoresis. It was a monoclonal peak of unknown significance migrating with gammaglobulins. Scientific literature and the tests performed demonstrated that it was myoglobin. In fact, myoglobin (17 kDa) is freely filtered by the glomerulus and normally reabsorbed by the tubules. If tubule capacity for reabsorption is exceeded, its presence results in overcharging proteinuria. Myoglobinuria helped diagnose rhabdomyolysis in our patient. Thus, the analysis of unknown peaks, can provide information on symptoms but also underlying pathologies, which may be of clinical interest.

[Unusual serum protein electrophoresis in a patient with cholangiocarcinoma]. / Une électrophorèse des protéines sériques insolite dans un contexte de cholangiocarcinome.

Serum protein electrophoresis is of certain diagnostic interest. We report a case of unusual electrophoresis associated with cholestatic jaundice complicating a cholangiocarcinoma. The study involved a 55-year old patient hospitalized for the exploration of cholestatic jaundice. Capillary electrophoresis showed bisalbuminemia diagnosed based on the thickening of the bottom of the albumin peak and a supernumerary peak X. Second electrophoresis with Hydragel showed the disappearance of the two above abnormalities which was the proof that bisalbuminemia was acquired and of the lipidic nature of the Pic X. In our case, the most likely cause was the presence of interfering substances such as free bilirubin (hyperbilirubinemia), lipids (hyperlipidaemia) and bile acids. Bisalbuminemia in a patient with similar electrophoretic picture should suggest the search for underlying diseases.

[Difficult immunofixation electrophoresis interpretation of serum proteins]. / Interprétation délicate de l'immunofixation des protéines sériques.

Immunofixation is currently very used in medical laboratories. The interpretation of the results is usually easy, but some cases raise interpretative problems. We here report two cases difficult to interpret. In the first case, we report a case of nonspecific precipitation of the protein on each track, in the second case we report a case of double monoclonal band on immunofixation electrophoresis. Reducing agent such as ß2-mercaptoethanol used in these two cases allowed to solve the problem and to make a diagnosis. A comparison between clinical radiological and laboratory test data is necessary before making a diagnosis of monoclonal immunoglobulin.

[Evolution of biochemical and hematological parameters in patients living with HIV/AIDS treated with antiretroviral therapy at the Aboubacar Sangoulé Lamizana General Camp Medical Center]. / Evolution des paramètres biochimiques et hématologiques chez les personnes vivant avec le VIH/SIDA sous traitement antirétroviral au Centre Médical du Camp General Aboubacar Sangoule Lamizana.

INTRODUCTION: This study aimed to evaluate the impact of treatment on biochemical and hematological parameters in HIV-positive patients followed up at the Aboubacar Sangoulé Lamizana General Camp Medical Center in Burkina Faso. METHODS: We conducted a retrospective study over the period January 2010-September 2015. The study only included HIV-positive patients treated with ART having undergone laboratory tests at treatment initiation (M0), at sixth month (M6), and at twelfth month (M12). RESULTS: Sex-ratio was 0.88 and the most affected age group was 45-55 years. The most prescribed treatments were triple combination therapies based on 2INTI + 1INNTI (74,5%), 2INTI+1 IP (14,9%). Viral load test was little requested. The rate of patients with normal laboratory tests showed a statistically significant regression between M0 (70%), and M6 (13%) (p<0.05). Severely immunocompromised patients showed a significant increase in average TCD4 lymphocytes value, ranging from 79,22 at M0 to 227.95 cells/mm3 at M12 (p<0.05). Anaemic patients showed a significant increase in the rate of mean haemoglobin levels from 10.5 g/dl at M0 to 12.53 g/dl at M12 (p<0.05). The analysis of biochemical parameters could not be performed because of a lack of data. CONCLUSION: The increase in the rate of TCD4 lymphocytes and in the rate of hemoglobin levels gives an indication of ART effectiveness and of patient's tolerance to treatment. Viral load test accessibility and an improvement in laboratory testing monitoring are essential.

Polymorphisme génétique des cytochromes p450: synthèse méthodiques des études primaires effectuées dans la population Africane

Il existe une grande variabilité interindividuelle de réponse aux médicaments, tant en terme d'efficacité que de toxicité. Pour comprendre cette variabilité, de multiples travaux de recherche sur le polymorphisme génétique des cytochromes P450 ont été menés de par le monde. Notre étude a pour but de faire le point des études réalisées en Afrique ayant porté sur le polymorphisme génétique des cytochromes P450 afin de recenser leurs variants alléliques susceptibles d'entrainer une variabilité interindividuelle de réponse aux médicaments.Il s'agissait d'une revue systématique des travaux de recherche qui ont porté sur le polymorphisme génétique des cytochromes P450. Elle a été réalisée au Burkina Faso à partir des articles publiés dans la base de données Pubmed et a concerné les populations africaines.Parmi les 1625 études primaires collectées dans la base de données Pubmed, 23 se sont intéressées aux populations africaines. Ces études ont été réalisées essentiellement dans la plupart des régions africaines sauf la partie centrale. Ces études primaires ont traité de la distribution des cytochromes P450 1A1, 1B1, 1A2, 2A6, 2B6, 2C8, 2C9, 2C19, 2D6 et 3A4. Les variants alléliques CYP 1A2*2, 1B1 (*2,*6), B6 (*6,*18,*20,*27), 2C8 (*2,*3), 2C9 (*2,*3,*5,*11), 2C19 (*2,*3), 2D6 (*4,*17,*29), 3A4*1B et 3A5*3 sont ceux susceptibles d'entrainer une anomalie de réponse aux médicaments. Cela montre la nécessité d'entreprendre des études spécifiques sur les populations africaines où on retrouve la plus grande variabilité génétique par rapport aux autres continents

[Difficulties in interpreting the monoclonal gammopathy of chance discovery: transitional gammopathy case in a significant inflammatory syndrome]. / Difficultés d'interprétation des gammapathies monoclonales de découverte fortuite : cas d'une gammapathie transitoire au cours d'un syndrome inflammatoire important.

The discovery of a monoclonal immunoglobulin is usually witnessed a malignant lymphoproliferative disease, but sometimes it is a transient event during viral, bacterial or fungal infections and during an inflammatory syndrome. Achieving electrophoresis performed in an elderly patient aged 55 with anemia to 63 g/L hemoglobin showed a consistent profile with intense inflammatory syndrome and chronic atypical with elevated C-reactive protein (CRP) greater than 300 mg/L (normal values: 0-8 mg/L) associated with the presence of two thin appearance monoclonal migrating bands in gamma position. Achieving immunofixation showed IgM kappa monoclonal confirmed by using betamercaptoethanol (BME). Radiological findings, hematological, revealed nothing. The recovery of blood away from the inflammation on another sample report presented a CRP at 5 mg/L and a subnormal profile electrophoresis and immunofixation revealed nothing. The comparison of the results of biochemical investigations, haematological and clinical and radiological control of the electrophoretic profile of a remote inflammatory syndrome to exclude cases of transient gammopathies.