COVID-19 and Pulmonary Tuberculosis Coinfection in a Moroccan Patient with Pulmonary Embolism: A Case Report and Literature Review.

Emerging cases of coinfection of coronavirus disease 2019 (COVID-19) and tuberculosis (TB), although rare, have attracted the attention of health systems around the world and have arisen many concerns about the diagnosis, treatment, and prognosis of this coinfection especially in high TB burden countries. Here, we report a rare case and, to the best of our knowledge, the first reported case in Morocco of simultaneous diagnosis of an active pulmonary TB infection and a COVID-19 pneumonia. We present a case of a sixty-seven-year-old male patient who was admitted to our COVID-19 emergency department with a diagnosis of COVID-19 pneumonia, confirmed by nasopharyngeal swab's polymerase chain reaction (PCR) for detection of SARS-CoV-2. The atypical radiological findings suggested a TB coinfection which was later confirmed by sputum cultures and Xpert MTB/Rif assay. The patient also presented some complications including thrombosis of the left leg, pulmonary embolism and inaugural ketosis. Treatment was administered as per local protocols: broad spectrum antibiotics, corticosteroids, fixed dose-combination of antituberculosis treatment along with hydration and insulin therapy for ketosis treatment and anticoagulation. The patient was discharged after twenty-three days of hospitalization. Due to the currently limited data, further studies are necessary to establish any possible correlation between COVID-19 infection and the progression of a latent and/or the severity of an active TB infection.

Factors influencing Quality of life in Moroccan patients with cancer: A monocentric Prospective study.

BACKGROUND: Cancer as a chronic and serious disease affects the quality of life (QoL) of patients, which has increasingly become a major challenge at the heart of cancer management. The purpose of our study was to define the most involved factors in the degradation of QoL in cancer patients. MATERIALS AND METHODS: We conducted a prospective, mono-centric, qualitative and descriptive study carried out within the medical oncology department of the Ibn Sina Military Hospital spread over six months between January and June 2019. RESULTS: Of the 100 patients included, 58% were male with a median age of 54.42 years. 90% were married, 39% were illiterate and 43% were retired while 99% of patients had social coverage. Breast cancer was the most common in 29%. More than 54% of the patients included had localized cancer while 38% were metastatic. The Pain was estimated to be greater than or equal to six on the Visual Analog Scale (VAS) in 23%. In 78% of the cases, chemotherapy was indicated in these patients and treatment with psychotropic drugs was initiated only in 2% of the patients. The analytical study showed that most of the patients had a slightly degraded QoL 63% with a large participation of the psychic dimension, followed by the physical and spiritual dimension while the socioeconomic dimension came last. It was established a clear correlation between the QoL and certain socio-demographic factors (sex, marital status, level of education), and significant correlation with some factors related to the disease (a type of cancer, stage, and treatment received). CONCLUSION: We tried to assess the impact of cancer and to identify factors affecting the QoL of patients to guide the establishment of the support structure and accompanying devices.

Multiple Hereditary Exostoses with Tetraparesis Due To Cervical Spine Osteochondroma.

This is a case report of a 34-year-old man with hereditary multiple exostoses who presented with gradual tetraparesis. Neuroimaging evaluation revealed an important posterior spinal cord compression by a C3 bony formation. Following posterior microsurgical decompression, the patient recovered nearly completely. Histopathologic examination of the intraspinal lesion confirmed the diagnosis of benign osteochondroma. The patient returned to a normal life without evidence of recurrence at 2-year follow-up.

The prevalence of painful diabetic neuropathy in 300 Moroccan diabetics.

Painful diabetic neuropathy is a frequent complication of diabetes. Its diagnosis is clinical. Our goal is to determine the prevalence of painful diabetic neuropathy in this population. We also analyzed the relationship between this neuropathy and certain parameters, concerning the patient and his diabetes. It is a cross sectional study conducted at the department of endocrinology and internal medicine of Avicenne hospital Marrakech-Morocco, among a cohort of 300 diabetic outpatients. We used the DN4 questionnaire (Douleur Neuropathique en 4 questions), for diagnosis. The results showed a prevalence of 15%. In this study: advanced age, female gender, duration of diabetes greater than 10 years, and the lack of medical follow up were found to be statistically significant risk factors for painful diabetic neuropathy, in addition to some diabetes-related comorbidities such as hypertension, dyslipidemia, sedentary life style and diabetic retinopathy. Painful diabetic neuropathy remains undertreated, in fact 74% of our patients did not receive any specific treatment, knowing that the progress in developing effective and well-tolerated therapies has been disappointing.

Splenic abscess in cancer chemotherapy.

BACKGROUND: Splenic abcess is an uncommon complication for cancer treatment. It occurs more frequently in immunocompromised patients. They are characterized by high mortality. The classic triad (fever, pain of the left hypochondrium, and sensitive mass left) is only present in one-third of cases the clinical spectrum ranging from no symptoms to events such as fever, nausea, vomiting, weight loss, abdominal pain left, splenomegaly. Treatment options are limited, but must be discussed and adapted to the patient profile. CASE PRESENTATION: We report the case of a 62-year-old Arabic male, diagnosed with metastatic lung adenocarcinoma, who, after several cycles of chemotherapy, presented symptoms and signs of splenic abcess. CONCLUSION: Splenic abcess is rare situation, which must be actively researched, to have access to an optimal therapeutic approach.