Recurrent myocardial infarction in a young cocaine abuser

Cocaine increases the risk of cardiovascular diseases, including myocardial infarction. We herein describe a case of a 22-year-old man with a long history of cocaine abuse. He presented at our institution because of acute coronary syndrome with ST segment elevation. Emergency coronary angiography revealed ostial occlusion of the left anterior descending artery, which required desobstruction and implantation of a bare metal stent. Angioplasty was complicated 4 months later by in-stent restenosis requiring reintervention. This case highlights myocardial infarction as a cocaineinduced effect. Appropriate treatment and cessation of cocaine abuse may prevent cardiovascular complications and recurrences

Use of interventional catheterization before surgery in an adult with univentricular heart

This article reports a 17-year-old male with univentricular heart, who had a right Blalock-Taussig shunt 6 years ago and one year later, also had a left shunt after an occlusion of the first shunt. He was admitted because of the increasing cyanosis and dyspnea (class III of New York Heart Association).peer-reviewe

Atteinte cardiaque au cours de la dystrophie myotonique de Steinert: Expérience marocaine, à propos de 18 cas

La maladie de Steinert ou dystrophie myotonique de type 1 (DM1) est une maladie génétique à transmission autosomique dominante caractériséepar une myotonie et une atteinte de plusieurs organes dont le coeur. L'atteinte cardiaque est la plus grave des atteintes systémiques puisqu'elleconditionne le pronostic vital. Ce travail a pour but de déterminer les anomalies cardiaques rencontrées au cours de la DM1 et de mettre enexergue l'intérêt d'un examen cardiaque rigoureux et régulier,  indépendamment de la sévérité de l'atteinte neuromusculaire, ainsi que l'apport des examens cardiaques complémentaires et notamment l'exploration électrophysiologique. 18 patients atteints de DM1 ont  bénéficiés d'une exploration cardiaque systématique. Il s'agit de 9 hommes et de 9 femmes, d'âge moyen de 41,8 +/- 16,2 ans. 66 p.100 des patients sont symptomatiques sur le plan cardiovasculaire. Les  anomalies électrocardiographiques sont dominées par un trouble de la conduction intraventriculaire dans 16 p.100 des cas et un BAV de 1er degré dans 16 p.100 des cas. L'Holter ECG objective une hyperexcitabilité à l'étage atrial et/ou ventriculaire dans 50p.100 des cas. L'ETT est normale chez 95 p.100 des patients. L'exploration électrophysiologique, réalisée chez 4 patients symptomatiques, a objectivé un bloc tronculaire dans un cas ayant conduit à l'implantation d'un PM double chambre. Un seul patient est décédé suite à une détresse respiratoire. Enfin, on n'a pas noté de corrélation entre l'atteinte cardiaque et neuromusculaire. Une exploration cardiaque est indispensable chez tout patient atteint de DM1, en dépit de l'absence de symptômes, et un bilan annuel minimal s'impose pour guetter un éventuel trouble rythmique et/ou conductif, fatal en l'absence de traitement adéquat

Relationship between poor quality sleep, excessive daytime sleepiness and low academic performance in medical students

Abdelkader Jalil El Hangouche,1–3 Asmaa Jniene,1 Souad Aboudrar,1 Leila Errguig,1 Hanan Rkain,1 Mohammed Cherti,2 Taoufiq Dakka1 1Exercise Physiology and Autonomic Nervous System Team “EPE-SNA”, Laboratory of Physiology, Faculty of Medicine and Pharmacy of Rabat, Mohamed V University, Rabat, Morocco; 2Department of Cardiology, Ibn Sina Hospital, Faculty of Medicine and Pharmacy of Rabat, Mohamed V University, Rabat, Morocco; 3Laboratory of Physiology, Faculty of Medicine and Pharmacy of Tangier, Abdelmalek Essaadi University, Tangier, Morocco Purpose: Poor quality of sleep and excessive daytime sleepiness affect cognitive ability and have a negative impact on the academic performance of medical students. This study aims to determine the prevalence of excessive daytime sleepiness, sleep quality and psychological distress as well as assess their association with low academic performance in this population.Participants and methods: A cross-sectional study was conducted among 457 medical students from the Faculty of Medicine and Pharmacy of Rabat, Morocco, who completed the Pittsburgh Sleep Quality Index (PSQI) questionnaire and the Epworth Sleepiness Scale to determine the quality of sleep and excessive daytime sleepiness, respectively. Sociodemographic variables and psychological distress (Kessler Psychological Distress Scale) were also measured. Multivariate linear regression was performed in order to evaluate the link between low academic performance and sleep quality after adjusting for other covariates.Results: Among the included students, the median age was 20 (19; 21) years; 70.7% of the participants were females. Almost one-third of the students (36.6%) had excessive daytime sleepiness and this was more frequently observed in female students (43% vs 20.1%, <0.001). Furthermore, 58.2% of the students were poor sleepers (PSQI ≥5), while 86.4% of them had psychological distress. The bivariate analysis showed that psychological distress was associated with decreased risk of low performance (ß=0.04; 95% CI=0.005–0.07; P=0.024). Being a poor sleeper was statistically associated with poor academic performance (ß= −0.07; 95% CI=−0.14 to −0.002; P=0.04) in the multivariate analysis. In our study, daytime sleepiness was not statistically associated with academic performance.Conclusion: A poor sleep quality determined by PSQI ≥5 was related to poor academic achievement at the end of the study year in medical students. Keywords: quality of sleep, daytime sleepiness, psychological distress, academic performance, medical student