Molecular evaluation of human papillomavirus as an oncogenic biomarker in prostate cancer.

BACKGROUND: Prostate cancer (PCa) is one of the most common tumors in men, regardless of ethnicity and demographics. In many risk factors causing PCa, genes and viral infections are strong candidates for the development of prostate tumors. Indeed, tissue infections of PCa have been reported by the presence of several types of viruses including Human Papillomaviruses (HPV). OBJECTIVE: the present study was planned to determine whether HPV DNA could be detected in the blood of known men with prostate cancer and to assess the potential association between HPV infection and clinico-pathological characteristics of the patients. MATERIALS AND METHODS: In order to achieve our objectives, 150 liquid blood samples were taken from Moroccan patients, 100 patients with PCa, and 50 control cases. The viral DNA was extracted, calibrated and the target genes were amplified by PCR using specific primers and the use of 2% agarose gel with visualization under UV. RESULTS: Of the 100 samples tested, (10%) were infected with HPV), However, none of the control cases were infected with HPV. The analysis of the data made it possible to establish a correlation between the frequency of the viral infection of the human papilloma and the tumoral criteria. CONCLUSION: Therefore, this study strengthens the potential role of HPV as a cofactor in prostate cancer development, and we propose that infection with this virus may be involved in the development of PCa metastases.

Incidence of neural tube defects and their risk factors within a cohort of Moroccan newborn infants.

BACKGROUND: Neural tube defects (NTDs) are a group of birth defects that result from a partial or complete failure of the neural tube to close during embryogenesis. Their prevalence varies between 0.5 to 2 per 1000 births in countries without folic acid supplementation. The aim of our study is to assess the NTDs incidence and describe the risk factors within Moroccan newborn infants. METHOD: This is a descriptive study over a period of 5 and a half years including all births at "Les Orangers" Maternity and Reproductive Health Hospital of Rabat with notification of NTD cases, whether isolated or combined with other anomalies. Data were reported on pre-established sheets and on the teratovigilance registry. Statistical analysis was performed with SPSS version 18 statistical software. RESULTS: During the study period, 43,923 births were recorded including 44 cases of neural tube defects, an incidence rate of 1 per 1000 births, with a female predominance; sex ratio = 0.8. These defects included anencephaly (50%), spina bifida (38.6%) and encephalocele (11.4%). The risk factors detected during this study include consanguinity (34%), consumption of fenugreek or other plants (36%), diabetes (4.5%) and medication (2.2%). A family history of malformation was reported in 6.8% of cases and among siblings in 4.5% of cases. The average maternal age was 30.38 ± 6.88 and the average gestational age was 36.80 ± 5.11. A quarter of mothers did not benefit from any medical monitoring during pregnancy while 59% did not take folic acid supplementation during the first trimester of pregnancy and none of them took B9 vitamin during the periconceptional period. The antenatal diagnosis was performed in 63% of cases. The mortality rate was 3.8 per 10,000 and 16% of cases evolved positively. CONCLUSION: NTDs require high intensity and multidisciplinary care which stresses the importance, in our context, of strengthening and optimizing acid folic supplementation strategies during the periconceptional period.

Increases in statin eligibility to reduce cardiovascular risk according to the 2013 ACC/AHA cholesterol guidelines in the Africa Middle East region: a sub-analysis of the Africa Middle East Cardiovascular Epidemiological (ACE) study.

BACKGROUND: With development of cholesterol management guidelines by the American College of Cardiology/American Heart Association (ACC/AHA), more individuals at risk of cardiovascular disease may be eligible for statin therapy. It is not known how this affects statin eligibility in the Africa and Middle East Region. METHODS: Data were used from the Africa Middle East Cardiovascular Epidemiological (ACE) study. The percentage of subjects eligible for statins per the ACC/AHA 2013 cholesterol guidelines and the 2002 National Cholesterol Education Program-Adult Treatment Panel (NCEP-ATP III) recommendations were compared. Analyses were carried out according to age, gender, community (urban/rural), and country income categories based on World Bank definitions. RESULTS: According to the ACC/AHA recommendations, 1695 out of 4378 subjects (39%; 95% confidence interval [CI], 37-40%) satisfied statin eligibility criteria vs. 1043/4378 (24%; 95% CI, 23-25%) per NCEP-ATP recommendations, representing a 63% increase in statin eligibility. Consistent increases in eligibility for statin therapy were seen according to the ACC/AHA vs. NCEP-ATP guidelines across sub-groups of age, gender, community, and country income. Notable increases for statin eligibility according to ACC/AHA vs. NCEP-ATP were seen, respectively, in subjects aged ≥65 years (86% vs. 39%), in males (46% vs. 25%), in low-income countries (28% vs. 14%), and rural communities (37% vs. 19%). CONCLUSION: An increase in statin eligibility was seen applying ACC/AHA cholesterol guidelines compared with previous NCEP-ATP recommendations in the Africa Middle East region. The economic consequences of these guideline recommendations will need further research. TRIAL REGISTRATION: The ACE trial is registered under NCT01243138 .

Immune activation and regulatory T cells in Mycobacterium tuberculosis infected lymph nodes.

BACKGROUND: Lymph node tuberculosis (LNTB) is the most frequent extrapulmonary form of tuberculosis (TB). Studies of human tuberculosis at sites of disease are limited. LNTB provides a unique opportunity to compare local in situ and peripheral blood immune response in active Mycobacterium tuberculosis (Mtb) disease. The present study analysed T regulatory cells (Treg) frequency and activation along with CD4+ T cell function in lymph nodes from LNTB patients. RESULTS: Lymph node mononuclear cells (LNMC) were compared to autologous peripheral blood mononuclear cells (PBMC). LNMC were enriched for CD4+ T cells with a late differentiated effector memory phenotype. No differences were noted in the frequency and mutifunctional profile of memory CD4+ T cells specific for Mtb. The proportion of activated CD4+ and Tregs in LNMC was increased compared to PBMC. The correlation between Tregs and activated CD4+ T cells was stronger in LNMC than PBMC. Tregs in LNMC showed a strong positive correlation with Th1 cytokine production (IL2, IFNγ and TNFα) as well as MIP-1α after Mtb antigen stimulation. A subset of Tregs in LNMC co-expressed HLA-DR and CD38, markers of activation. CONCLUSION: Further research will determine the functional relationship between Treg and activated CD4+ T cells at lymph node sites of Mtb infection.

[Management of a compressive goiter in a pregnant woman]. / La prise en charge d'un goiter compressif chez une femme enceinte.

UNLABELLED: Emergency physicians frequently encounter patients with thyroid disease. However, it is unusual for these thyroid disorders to create acute, life-threatening situations. Critical airway compression attributable to benign thyroid enlargement may occur suddenly and require urgent treatment. CASE REPORT: We report a case of pregnant women who was admitted for compressive goiter with laryngeal dyspnea, which required emergency total thyroidectomy. CONCLUSION: Urgent thyroidectomy in pregnant women can be performed if we respect the precautions.

Aneurysm of the internal carotid artery after minor trauma.

We report a rare case of posttraumatic aneurysm of the internal carotid artery. The aneurysm was surgically removed, followed by a simple postoperative course. Such lesions should be highly suspected in cases of penetration into the retroangulomandibular neck region.

The Performance of GeneXpert in the Diagnosis of Lymph Node Tuberculosis: A Prospective Study Comparing GeneXpert and Culture Findings.

Background and objective Lymph node tuberculosis (LNTB) is a common manifestation of extrapulmonary tuberculosis (EPTB). GeneXpert is a rapid diagnostic molecular test that simultaneously detects tuberculosis and rifampicin (RIF) resistance. In this study, we aimed to assess the epidemiology of LNTB and diagnostic performance parameters of the GeneXpert in routine ENT practice. Methods We conducted a cross-sectional prospective study from January to July 2019, in the Department of Otorhinolaryngology and Head Neck Surgery at the Hassan II University Hospital Center of Fez, Morocco. The samples were collected using lymph node biopsy and subjected to GeneXpert assay, culture, and histopathology. Diagnostic performance parameters of the GeneXpert were calculated and compared with culture. Results All patients with cervical adenopathy were included. Lymph node biopsies were performed for all patients. The performance of the GeneXpert was assessed according to culture findings. Among the 75 cases, the mean age was 21.6 ± 12.7 years with a female predominance (60%). GeneXpert was positive in 66.7% of specimens. The sensitivity and specificity of the GeneXpert assay were 78.6% and 40.4% respectively. GeneXpert accuracy was 54.6%. The positive predictive value (PPV) and negative predictive value (NPV) were found to be 44% (95% CI: 30.2-57.8) and 76% (95% CI: 59.3-92.7) respectively. Mycobacterium bovis was isolated in all samples, with no case of resistance to RIF found. Conclusions The performance of GeneXpert was found to be superior in terms of establishing the diagnosis of LNTB. It offers speedy and prompt results and clinicians should adopt it in routine clinical practice.

[Primary laryngeal lymphoma: a case report]. / Lymphome primitif laryngé: à propos d'un cas.

Primary laryngeal lymphoma is rare, accounting for less than 1% of all laryngeal cancers. Treatment depends on the stage and severity of the disease. We here report the exceptional case of a 64-year-old woman, non-smoker, suffering from dysphagia for solids and a foreign body sensation. Laryngoscopy and biopsies revealed polyploid tumor of the left epiglottic fold. The diagnosis of diffuse large B-cell lymphoma was made. The patient underwent chemotherapy followed by radiotherapy, with significant improvement at 2-year follow-up, with no local recurrence. Due to the rarity of this disease and the variety of symptoms, the optimal management strategy for this type of cancer is controversial, requiring a specific diagnostic and therapeutic approach.

Evaluating the Expression Levels of Human Endogenous Retrovirus-K 10 (HERV-K10) Gag as a Biomarker in Prostate Cancer Tissue.

Prostate cancer is one of the most common major health problems. Several risk factors are potentially involved in its development. Therefore, a biomarker capable of early diagnosis is necessary to facilitate the early detection and treatment of prostate cancer. Human endogenous retroviruses (HERVs) are abnormally expressed in various diseases. Our study aims to evaluate the specific role of HERV K-10 gag expressions in the progression of prostate cancer. For this, we collected a set of 50 prostate tumor tissue samples as well as 50 healthy tissue samples. After extracting RNA from the prostate samples, we analyzed the expression of HERV-K gag using quantitative real-time PCR (qRT-PCR). The resulting data revealed a significant correlation of HERV-K gag expression in malignant regions of the prostate in men with prostate cancer than in men without prostate cancer (p < 0.05). The presence of the HERV-K gag protein was detected in 10 of 50 tumor samples (20%), while no healthy samples presented this protein. These results suggest that increased HERV-K gag RNA and protein expression could serve as a sensitive and specific biomarker of prostate malignancy in this cohort of prostate carcinoma patients, further supporting its potential as a promising clinical marker.

[Cancer patient satisfaction survey in a Moroccan university hospital]. / Enquête de satisfaction des patients atteints de cancer dans un hôpital universitaire au Maroc.

OBJECTIVES: Assessment of patient satisfaction helps to guide hospital strategies concerning optimal patient management. The objective of this study was to evaluate the satisfaction of cancer patients hospitalised at Fez university hospital, to study the various components of satisfaction and to integrate the patient in quality of care improvement policies. METHODS: A prospective study was conducted in two voluntary wards of the hospital. An anonymous standardized questionnaire was administered to patients hospitalised for cancer surgery or treatment. RESULTS: 87.1% of patients reported that they were very satisfied with their hospitalisation, while 12.9% rated their stay as acceptable. 98.4% would recommend the hospital to their relatives. In contrast, 67.2% of patients surveyed considered that the cost of their stay was too expensive. CONCLUSION: The majority of items were declared as "Very satisfactory" by the patients. They represent a challenge to be maintained in the future: ward reception, comfortable accommodation, the behaviour and availability of staff, the doctor-patient relationship, respect for patient, the explanations provided concerning the health problem and treatment, psychological support and pain management. For items reported to be less satisfactory, recommendations should be implemented concerning the admissions office, administrative formalities on admission, the information provided at the time of discharge, quality of meals, development of nursing skills and dietary advice.

Current Management of Congenital Choanal Atresia: Litteratur Review.

Background: Congenital Choanal Artesia (CCA) is a rare cause of upper airway obstruction, yet it is the most common congenital anomaly of the nose. While the unilateral condition could be undiagnosed, bilateral CCA may be life-threatening, especially for newborns. Some CCA may be associated with other congenital abnormalities, which leads to a systematic screening during the diagnostic assessment. The diagnosis is easy. However, surgical management is still controversial. Methods: We conducted a retrospective study gathering data on management of CCA over 42 months. We reported epidemiological aspects and results of our series, and discussed management issues. Results: We operated 22 choanae using the endoscopic technique. The age of bilateral CCA patients on the day of surgery ranged from 8 to 21 days (mean 11.7+/_ 2.6 days). Their birth weight ranged from 2.9 to 4.5 kg (mean 3.4 +/_ 0.5 kg), and their gestational age ranged from 30 to 41 weeks. Surgery duration for neonatal bilateral CCA repair ranged from 75 to 110 min (mean 90 min +/_ 11.5 min). We performed an exclusive endonasal endoscopic approach for all patients with no stenting or mitomycin C application. We deplore one post operative complication related to minor palatal perforation resolved spontaneously. Conclusion: Since newborns solely depend on nasal breathing during the first month of life, bilateral CCA is an emergency. Endonasal endoscopic management is the primary procedure. Currently, surgery steps are standardized. However, how to prevent post-operative synechiae and restenosis is still controversial. The mainstream is meticulous post-operative nursing with frequent endonasal saline irrigation, regular removal of crust, and prevention of inflammation due to reflux or infection.

"OCTOPUS": An Intelligent Tool for Assisted Multidisciplinary ORL Oncology Meetings-Preliminary Study.

Current sessions of multidisciplinary team meetings (MDMs) have several limitations, including increased costs and duration, as well as limited discussion time for each case. To address these issues, we have developed a computer application called OCTOPUS, which helps manage the patients' list for MDMs. The application allows for the generation of automatic MDM decisions based on predetermined criteria filled in by the patient's doctor and algorithms that comply with the latest oncology guidelines from the National Comprehensive Cancer Network. These decisions must be validated by the MDM faculty members. In cases of nonagreement or complex cases, the application proposes a "face-to-face MDM." The internal mailing system connects all members and allows for the request of a second opinion regarding pathology or imaging results. Initial results suggest that this ergonomic tool provides more flexibility in time management and improved uniformity in selecting cases that would most benefit from face-to-face MDMs.

Knotted double j ureteral stent: a case report and literature review.

Many complications due to double j (DJ) stent placement have been reported. DJ stent knotting is a rare complication, with only a few cases reported in the literature. We presented a case of DJ stent knotting and reviewed the literature regarding this complication. We reported a 20-year-old man with a history of cystinuria and ureteral stone managed with retrograde ureteroscopy and holmium laser three months ago. The patient comes for DJ stent removal. Firstly, we tried to remove the DJ stent via the cystoscopic procedure, which failed. A fluoroscopic image revealed a knotted DJ stent lodged at the ureteropelvic junction and was removed via holmium laser ureteroscopic procedure without complications. In conclusion, when cystoscopic procedure with simple traction fails to remove DJ stents, multimodality urological procedures such as holmium laser should be tried, especially in patients with urolithiasis predisposing factors.

Bladder lipoma: Moroccan case report.

Lipomas are encapsulated benign tumors typically found in the integument, central nervous system or gastrointestinal tract and represent the most common benign mesenchymal neoplasm in adults. Bladder lipoma is a rare tumor that has been reported in a handful of cases in medical literature. A literature review from PubMed, MEDLINE, EMBASE and Cochrane databases of bladder lipoma yielded less than 20 cases. We report a case of a 69 year-old Moroccan male patient with hematuria as a chief symptom. The diagnosis of bladder lipoma was suspected by flexible fibroscopy and assessed by transurethral resection. Macroscopic and histological examination revealed a lipomatous tumour with no sign of malignancy. There was no recurrence after one year of follow-up. Although bladder lipomas are rare entities, they must be considered in the differential diagnosis of bladder tumor. However, we should always keep in mind that any bladder tumor is malignant until proven otherwise.

Three simultaneous primary urologic malignancies iA single patient: A case report and review of the literature.

INTRODUCTION: The simultaneous appearance of several primary cancers is rare. PRESENTATION: We report the case of a 77-year-old man admitted to the Mohammed V military hospital in Rabat (university hospital) and presenting severe dysuria on the PSA test which was 10.83 ng / ml. The prostate MRI performed revealed a suspected lesion. He had left renal colic associated with hematuria two weeks later. A CT scan of the abdomen and pelvis performed revealed a 14 × 12 mm middle and lower calyx excretory tract tumor on the left and a 27.6 × 26.4 lower right polar kidney tumor enhanced after injection of product from contrast. The prostate biopsy confirmed an adenocarcinoma of the prostate. He first underwent a left nephroureterectomy for the tumor of the excretory tract, followed by radiotherapy combined with hormone therapy for his adenocarcinoma. It was decided to monitor the tumor of the right kidney. DISCUSSION: The literature contains only a few case reports and reviews of patients with three or more synchronous malignancies. We report the case of a man in whom three different cancers were found over a period of three months. The patient had no significant medical history, such as a family history of cancer or chemotherapy other than old age and chronic smoking. Therefore, we suggest that these factors may favor the occurrence of several synchronous primary cancers. CONCLUSION: There is no consensus on the treatment of multiple malignant tumors. Patient care is individual, by a multidisciplinary team, accounting for the type and the stage of each tumor with a more conservative approach.

Schwannoma of the descending loop of the hypoglossal nerve: case report.

Schwannomas of the descending loop of the hypoglossal nerve are very rare. Existing literature of the schwannoma of the descending loop of the hypoglossal nerve is limited to two previously reported case. They are slow-growing tumors that may masquerade a carotid body tumor. We herein described a rare case of schwannoma of the descending loop of the hypoglossal nerve in the s right latero-cervical region with diagnostic imaging and histopathological findings. A 37-years-old woman has had a palpable firm, mobile mass in the right latero-cervical region, of imaging, MR images showed homogeneous hypointensity on T1-weighted imaging (T1-WI), heterogeneous hyperintensity on T2-WI, and heterogeneous enhancement on contrast-enhanced T1-WI. Diagnostic imaging using computed tomography (CT) and magnetic resonance imaging (MRI) was suspected of Chemodectoma or neurogenic tumor. At operation, a 4 cm mass arising from the descending loop of the hypoglossal nerve of was resected en bloc with the loop itself; Final diagnosis was confirmed on the basis of histopathological finding and intraoperative findings. Postoperative course was uneventful and the patient is free from disease recurrence at tree-year follow-up. En bloc resection remains the real curative treatment of Schwannomas, ensuring unlimited freedom from disease, although causing functional impairment which may be significant. Nonetheless recurrence should be prevented as, besides requiring reintervention, it may harbor a malignant evolution towards sarcoma. Schwannomas of the descending loop of the hypoglossal nerve may masquerade a chemodectoma of the carotid bifurcation and can be curatively resected without any functional impairment. This case confirmed the differential diagnosis on the basis of the intraoperative finding that the tumor was continuous with the hypoglossal nerve.

Prevalence, control and risk factors related to hypertension among Moroccan adults: a multicentre study.

BACKGROUND: Hypertension is a leading risk factor for mortality and morbidity. AIMS: The objective of this study was to determine the prevalence and clinical profile of hypertension in a large sample of individuals in Morocco. METHODS: This was a multicentre and cross-sectional study conducted on patients consulting primary care physicians in Morocco between 2008 and 2009. Data were collected via a medical examination and a questionnaire covering patient demographics, medical history and cardiovascular risk factors. RESULTS: In total, 10 714 individuals attending primary care physicians participated in this study. Mean age was 49.6 ± 16.3 years. The total prevalence of hypertension was 39.8%. When adjusted for age and sex, the overall prevalence of hypertension was 26.6% (26.3% in men and 28.0% in women). Among patients with history of hypertension, 85.9% of patients were prescribed antihypertensive medication and/or lifestyle and dietary advice. Nevertheless, only 17.1% had controlled hypertension. CONCLUSIONS: This study suggests that the prevalence of hypertension in Morocco is high. Hypertension may also be underdiagnosed and ineffectively treated. Efforts to heighten public awareness and control of hypertension should be enhanced in the public primary care services.

Cardiovascular risk factor burden in Africa and the Middle East across country income categories: a post hoc analysis of the cross-sectional Africa Middle East Cardiovascular Epidemiological (ACE) study.

BACKGROUND: A significant number of cardiovascular disease (CVD)-related deaths occur in developing countries. An increasing prevalence of CVD is associated with a change in the macro-economy of these countries. In this post hoc analysis, CVD risk factor (CVDRF) prevalence is evaluated across countries based on national income in the Africa and Middle East Region (AfME). METHODS: Data from the Africa Middle East Cardiovascular Epidemiological (ACE) study were used; a cross-sectional study in 14 AfME countries (94 clinics) from July 2011-April 2012, which evaluated CVDRF prevalence in stable adult outpatients. World Bank definitions were used to classify countries as low-income (LI), lower-middle-income (LMI), upper-middle-income (UMI) or high-income (HI) countries. Four thousand three hundred seventy-eight subjects were recruited where 260 (6%), 1324 (30%), 1509 (35%) and 1285 (29%) were from LI, LMI, UMI, and HI countries, respectively. RESULTS: Of all the CVDRFs evaluated, almost two-thirds of the study population across the national income groups had abdominal obesity and dyslipidemia. Countries in the HI category were associated with a higher prevalence of diabetes (32%), obesity (44%) and smoking (16%). UMI and HI countries were associated with higher clustering of CVDRFs where at least one-third of subjects having four or more CVDRFs. Lower income countries had lower blood pressure control rates and lower percentages of outpatients achieving LDL-cholesterol targets. CONCLUSION: The burden of CVDRFs in stable outpatients is high across the national income categories in the AfME region, with HI countries showing a higher prevalence of CVDRFs. The high burden in lower income countries is associated with sub-optimal control of dyslipidemia and hypertension. Lowering the CVDRF burden would need specific public health actions in line with positive changes in the macro-economy of these countries. TRIAL REGISTRATION: The ACE trial is registered under NCT01243138.

Physician assessment of stroke risk in hypertensive patients in the Middle East and Africa: results of the action survey.

OBJECTIVES: In the absence of reliable, contemporary national data, the ACTION survey was designed to: a) provide preliminary data on stroke risk in the MEA (Middle East and Africa); b) describe the contribution of specific cardiovascular risk factors; 3) assess blood pressure (BP) control. DESIGN AND PATIENTS: This was a multi-center observational study in nine countries in the MEA region. From 2003 to 2005, 562 physicians from a variety of specialties recorded observations of cardiovascular risk factors in 4,747 hypertensive patients, aged 54-80 years. The 10-year absolute stroke risk was calculated using a scoring system based on the Framingham Heart Study observations, and comparisons made with an age-matched cohort. RESULTS: The mean 10-year stroke risk was estimated at 22.7% and was significantly higher for men (25.4%) than for women (19.5%) (P < .001) and for diabetics (28.2%) than for non-diabetics (19.4%) (P < .001). Compared with an age-matched Framingham cohort, the estimated stroke risk in our population was almost double, and was significantly higher for females (212%) than for males (192%) (P < .001). Hypertension, diabetes, left ventricular hypertrophy, and smoking were major contributing risk factors, as were physical inactivity and elevated cholesterol. Blood pressure was controlled in only 18% of the population and in 12% of diabetics. CONCLUSION: Physicians of all specialties were willing to participate in stroke risk assessment. The risk of stroke in hypertensive patients in the MEA region is high, and is higher than would be predicted using Framingham data, particularly for females. Hypertension appears to be poorly controlled in more than 80% of hypertensive patients in the MEA region.

GJB2 (connexin 26) gene mutations in Moroccan patients with autosomal recessive non-syndromic hearing loss and carrier frequency of the common GJB2-35delG mutation.

OBJECTIVE: Mutations in the connexin 26 gene (GJB2), which encodes a gap-junction protein expressed in the inner ear, have been shown to be responsible for a major part of autosomal recessive non-syndromic hearing loss in Caucasians. The aim of our study was to determine the prevalence and spectrum of GJB2 mutations, including the (GJB6-D13S1830) deletion, in Moroccan patients and estimate the carrier frequency of the 35delG mutation in the general population. METHODS: Genomic DNA was isolated from 81 unrelated Moroccan familial cases with moderate to profound autosomal recessive non-syndromic hearing loss and 113 Moroccan control individuals. Molecular studies were performed using PCR-Mediated Site Directed Mutagenesis assay, PCR and direct sequencing to screen for GJB2, 35delG and del(GJB6-D13S1830) mutations. RESULTS: GJB2 mutations were found in 43.20% of the deaf patients. Among these patients 35.80% were 35delG/35delG homozygous, 2.47% were 35delG/wt heterozygous, 3.70% were V37I/wt heterozygous, and 1 patient was E47X/35delG compound heterozygous. None of the patients with one or no GJB2 mutation displayed the common (GJB6-D13S1830) deletion. We found also that the carrier frequency of GJB2-35delG in the normal Moroccan population is 2.65%. CONCLUSIONS: These findings indicate that the GJB2-35delG mutation is the major cause of autosomal recessive non-syndromic hearing loss in Moroccan population. Two other mutations were also detected (V37I and E47X), in agreement with similar studies in other populations showing heterogeneity in the frequencies and types of mutation in connexin 26 gene.