A rare case of cade oil poisoning complicated by acute pancreatitis and acute tubular necrosis.

Introduction: Cade oil is often used in traditional medicinal practices despite of its toxic effects, hence the occurrence of intoxication incidents often requiring intensive care. Case presentation: We present the case of a young patient with no prior medical history who was exposed to significant doses of Cade oil both on skin and ingested, and who subsequently developed an apyretic consciousness disorder warranting an admission to our ICU department for specialized management. Discussion: in this chapter we discuss the place of cade oil within Morocco's unsupervised medicinal practices. We also detail the spectrum of cade oil poisoning which is rarely reported in the literature, before discussing the therapeutic options. Conclusion: The phenol derivatives of Cade oil, which is still used frequently and widely, are responsible of an acute intoxication, mainly impairing the cardiovascular, respiratory and renal functions. A pancreatic involvement is rarely reported.

Guillain Barre syndrome as a complication of SARS-CoV-2 infection: A case report.

INTRODUCTION: Covid-19 infection usually manifests with respiratory symptoms, but neurological signs might be the mean symptom revealing this infection such as Guillain Barre syndrome (GBS).COVID-19 associated GBS seems to be more severe than non-COVID-19 GBS. CASE MANAGEMENT: We reported a 49 old-man admitted in the intensive care unit for bilateral ascending symmetrical paresthesia associated with lower limb numbness and sphincter disorders two weeks after an upper respiratory infection. The diagnosis of post-Covid-19 GBS was maintained, and the evolution was favorable after Intravenous Immunoglobulin (IVIg) and plasma exchange (PLEX) as a second therapy. CONCLUSION: This case report suggest the probable causal link between COVID 19 and GBS. This severe association prompts us to do further research that may help professionals in an early diagnosis and early treatment thus improving morbidity and mortality.

COVID 19 pneumonia in Down syndrome patients: About 2 cases.

INTRODUCTION: Covid-19 is a severe emerging infection with high rate of mortality. Patients with Covid-19 and Down syndrome represent a high rate of morbidity and mortality. CASE PRESENTATION: Case 1: A 27-year-old white male with Down's syndrome admitted to the ICU for Covid-19 infection with lung damage of 30-50%. The patient improved and referred to the pulmonology department.Case 2: A 49-year-old man admitted to the ICU for Covid-19 infection with a lung damage of 50%. The evolution was lethal and he passed away after 12 days of his admission. CONCLUSION: People suffering from Down syndrome should be given priority in the management of acute respiratory distress following infection with SARS COV2, or even candidates for early immunosuppressive treatment and possible vaccination once started.

Dexamethasone or methylprednisolone therapy in covid-19 pneumonia: A retrospective and comparative study of 513 cases.

BACKGROUNDS: Corona virus disease 19 (Covid-19) affects especially the respiratory tract, and induces lung injury which may progress to the acute respiratory distress syndrome (ARDS). Various treatment options were tried all over the world, corticosteroids had showed beneficial effects.The Objective of this study, is to compare the safety and efficiency of two corticosteroids: dexamethasone and prednisolone in the treatment of Covid-19 infection. METHODS: This retrospective and comparative study included 513 patients diagnosed with Covid-19 infection and were admitted to intensive care unit of our university hospital center of MOHAMMED VI Oujda from March 1, 2020, to December 31st, 2020. RESULTS: In this study, 513 cases were included, 230 patients were received methylprednisolone, and 283 were treated with dexamethasone. The median age in methylprednisolone group was 64 years, and 63 years in the second group treated with dexamethasone. Patients treated with dexamethasone had more critically lesions compared to patients treated with methylprednisolone (67.6%), these patients had a good evolution with a significant reduction of oxygen supplementation, lower use of invasive ventilation and a significant improvement in biological parameters. The difference in outcome between the two groups in terms of mortality was significantly reduced in the second group. CONCLUSION: Both steroids are efficient in the management of mild, moderate and severe Covid-19 pneumonia with a clear superiority of dexamethasone especially in severe forms.

[Rupture of the descending thoracic aorta following sudden traumatic deceleration injury]. / Rupture de l'aorte thoracique descendante suite à une décélération brutale post traumatique.

Acute post-traumatic rupture of the thoracic aorta is the second cause of road traffic deaths; 80% of patients die at the scene of the accident. The involvement of its descending portion outside the isthmus is rare and it is estimated to be less than 3%. We report the case of a 60-year old man, victim of road traffic accidents (RTA) whose mechanism was: the motorcyclist was struck by a car; the points of impact included the right upper limb and the chest. This RTA caused a fracture in both bones of the forearm and a rupture of the descending thoracic aorta (ATD). Treatment was based in the first time on the suture of the aortic rupture complemented by synthetic circumferential prosthesis implantation with aorto-aortic anastomosis and in a second time on the application of a screwed plate in the forearm. The outcome was good and the patient was referred to the Department of vascular surgery.