Deep Brain Stimulation in Moroccan Patients With Parkinson's Disease: The Experience of Neurology Department of Rabat

Introduction: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is known as a therapy of choice of advanced Parkinson's disease. The present study aimed to assess the beneficial and side effects of STN DBS in Moroccan Parkinsonian patients.Material and Methods: Thirty five patients underwent bilateral STN DBS from 2008 to 2016 in the Rabat University Hospital. Patients were assessed preoperatively and followed up for 6 to 12 months using the Unified Parkinson's Disease Rating Scale in four conditions (stimulation OFF and ON and medication OFF and ON), the levodopa-equivalent daily dose (LEDD), dyskinesia and fluctuation scores and PDQ39 scale for quality of life (QOL). Postoperative side effects were also recorded.Results: The mean age at disease onset was 42.31 ± 7.29 years [28–58] and the mean age at surgery was 54.66 ± 8.51 years [34–70]. The median disease duration was 11.95 ± 4.28 years [5–22]. Sixty-three percentage of patients were male. 11.4% of patients were tremor dominant while 45.71 showed akinetic-rigid form and 42.90 were classified as mixed phenotype. The LEDD before surgery was 1200 mg/day [800-1500]. All patients had motor fluctuations whereas non-motor fluctuations were present in 61.80% of cases. STN DBS decreased the LEDD by 51.72%, as the mean LEDD post-surgery was 450 [188-800]. The UPDRS-III was improved by 52.27%, dyskinesia score by 66.70% and motor fluctuations by 50%, whereas QOL improved by 27.12%. Post-operative side effects were hypophonia (2 cases), infection (3 cases), and pneumocephalus (2 cases).Conclusion: Our results showed that STN DBS is an effective treatment in Moroccan Parkinsonian patients leading to a major improvement of the most disabling symptoms (dyskinesia, motor fluctuation) and a better QOL

Applied Methodological Approach for the Assessment of Soil Contamination by Trace Elements around Abandoned Coal Mines—A Case Study of the Jerada Coal Mine, Morocco

Previously conducted studies have established that soil contamination by trace elements (TEs) around coal mines affects ecological biodiversity and human health. One of the ways to protect the health of the surrounding population of coal mine sites is through the assessment of contamination impacts by accurate procedures for the establishment of relevant reclamation plan. The aim of the study is to develop an applied methodological approach to easily assess and quantify the impact of coal mining on the surrounding soils. To achieve this goal, a set of relevant geochemical indexes (enrichment factor—EF, geochemical background—GB, and geoaccumulation index—Igeo) and a geostatistical interpolation for mapping soil contamination were applied. It is experimentally established that the process of combining these techniques can be of great interest in highlighting the anomalous areas and revealing the contamination sources. A case study has been carried out on of the abandoned coal Jerada mine site in Morocco. Soils and coal mine waste rocks (CMWR) samples were collected from this site. Soil and CMWR samples were analyzed for their geochemical content. CMWRs were characterized further for their mineralogical composition and environmental behavior. Based on the EF, three TEs (As, Pb, and Zn) were targeted. The results of GB and Igeo calculations have established an evident relationship between the CMWR dump and the occurred soil contamination. TEs distribution pattern has been revealed using the obtained geochemical maps. The developed methodological approach may be in high demand when assessing soil contamination in most of abandoned coal mine sites around the word

Applied Methodological Approach for the Assessment of Soil Contamination by Trace Elements around Abandoned Coal Mines—A Case Study of the Jerada Coal Mine, Morocco

Previously conducted studies have established that soil contamination by trace elements (TEs) around coal mines affects ecological biodiversity and human health. One of the ways to protect the health of the surrounding population of coal mine sites is through the assessment of contamination impacts by accurate procedures for the establishment of relevant reclamation plan. The aim of the study is to develop an applied methodological approach to easily assess and quantify the impact of coal mining on the surrounding soils. To achieve this goal, a set of relevant geochemical indexes (enrichment factor—EF, geochemical background—GB, and geoaccumulation index—Igeo) and a geostatistical interpolation for mapping soil contamination were applied. It is experimentally established that the process of combining these techniques can be of great interest in highlighting the anomalous areas and revealing the contamination sources. A case study has been carried out on of the abandoned coal Jerada mine site in Morocco. Soils and coal mine waste rocks (CMWR) samples were collected from this site. Soil and CMWR samples were analyzed for their geochemical content. CMWRs were characterized further for their mineralogical composition and environmental behavior. Based on the EF, three TEs (As, Pb, and Zn) were targeted. The results of GB and Igeo calculations have established an evident relationship between the CMWR dump and the occurred soil contamination. TEs distribution pattern has been revealed using the obtained geochemical maps. The developed methodological approach may be in high demand when assessing soil contamination in most of abandoned coal mine sites around the word

Origin and Salinization Processes of Groundwater in the Semi-Arid Area of Zagora Graben, Southeast Morocco

Located in the southeastern region of Morocco, the Zagora area mainly relies on groundwater as a source of water supply. However, this groundwater is often of concern, due to the limited recharge and unfavorable geological conditions for the development of the aquifer. Despite this, private wells in the Zagora ditch reveal relatively rich water resources. Geochemical and isotopic studies were conducted in the area to understand the origin of the groundwater and its salinity, aiding in informed water management strategies to assist in better planning and regulation of well construction, as well as in mitigating the impacts of high salinity on local water supply and agricultural systems. The results show that the water quality varies, with some wells having conductivity values in excess of 5 mS/cm. Most groundwater samples have high salinity and low pH due to the CO2 dissolved in groundwater. Geochemical analysis indicated two chemical facies: chloride–sulfate calcic/magnesic and bicarbonate calcic/magnesic. The presence of Na+ and Cl− indicated that the origin of these two elements in these waters was the dissolution of halite, with some samples showing an enrichment of Na+ compared to Cl−. This could be attributed to cation exchange. The concentration of Ca2+ and HCO3− suggested that their origin is the dissolution of calcite and the weathering of calcium silicate minerals such as plagioclase. The isotopic analysis showed that the δ18O values ranged from −10.98‰ to −8.54‰, and δ2H values ranged from −75.9‰ to −62.3‰. This indicated that the groundwater originated from the High Atlas with a recharge altitude between 2600 m and 2800 m. The groundwater flows into the graben through fissures and regional fault networks

Impact of the COVID-19 pandemic on patients with paediatric cancer in low-income, middle-income and high-income countries: a multicentre, international, observational cohort study

OBJECTIVES: Paediatric cancer is a leading cause of death for children. Children in low-income and middle-income countries (LMICs) were four times more likely to die than children in high-income countries (HICs). This study aimed to test the hypothesis that the COVID-19 pandemic had affected the delivery of healthcare services worldwide, and exacerbated the disparity in paediatric cancer outcomes between LMICs and HICs. DESIGN: A multicentre, international, collaborative cohort study. SETTING: 91 hospitals and cancer centres in 39 countries providing cancer treatment to paediatric patients between March and December 2020. PARTICIPANTS: Patients were included if they were under the age of 18 years, and newly diagnosed with or undergoing active cancer treatment for Acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin lymphoma, Wilms' tumour, sarcoma, retinoblastoma, gliomas, medulloblastomas or neuroblastomas, in keeping with the WHO Global Initiative for Childhood Cancer. MAIN OUTCOME MEASURE: All-cause mortality at 30 days and 90 days. RESULTS: 1660 patients were recruited. 219 children had changes to their treatment due to the pandemic. Patients in LMICs were primarily affected (n=182/219, 83.1%). Relative to patients with paediatric cancer in HICs, patients with paediatric cancer in LMICs had 12.1 (95% CI 2.93 to 50.3) and 7.9 (95% CI 3.2 to 19.7) times the odds of death at 30 days and 90 days, respectively, after presentation during the COVID-19 pandemic (p<0.001). After adjusting for confounders, patients with paediatric cancer in LMICs had 15.6 (95% CI 3.7 to 65.8) times the odds of death at 30 days (p<0.001). CONCLUSIONS: The COVID-19 pandemic has affected paediatric oncology service provision. It has disproportionately affected patients in LMICs, highlighting and compounding existing disparities in healthcare systems globally that need addressing urgently. However, many patients with paediatric cancer continued to receive their normal standard of care. This speaks to the adaptability and resilience of healthcare systems and healthcare workers globally

Twelve-month observational study of children with cancer in 41 countries during the COVID-19 pandemic

Childhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality