Observation Inhabituelle d'Inversion utérine puerpérale chronique: An unusual case of chronic puerperal uterine inversion

The puerperal uterine inversion is a rare and seriouscomplication occurring in the third stage of obstetricaldelivery. Chronic forms are unusual and often related toacute or subacute past unnoticed case or incompletelyreduced. It poses a problem of differential diagnosis withsome benign or malignant diseases which may lead totherapeutic errors. The clinical presentation is misleading, made of chronic pain and minimal bleeding, imaging confirms the diagnosis of inversion, and the treatment is conservative or radical surgery depending on the degree of intussusception and its chronicity. Authors reported an unusual case of chronic puerperal uterine inversion. Diagnosis and therapeutic difficulties are also described. L’inversion utérine puerpérale est une complication rare et grave se produisant dans le troisième stade du travail d’accouchement. Les formes chroniques sont plus rares et souvent en rapport avec des formes aigues ou subaigües passées inaperçues ou incomplètement réduites. Elle pose un problème de diagnostic différentiel avec certaines affections bénignes ou malignes ce qui risque d’aboutir à des erreurs thérapeutiques. La symptomatologie clinique est trompeuse, faite de douleurs chroniques et des métrorragies minimes. L’imagerie permet de confirmer le diagnostic de l’inversion et le traitement est chirurgical conservateur ou radical en fonction du degré de l’invagination et de sa chronicité. Les auteurs ont rapporté une observation clinique inhabituelle d’inversion utérine puerpérale. Les difficultés diagnostiques et thérapeutiques y sont décrites

Grossesse dans une corne rudimentaire: difficultés diagnostiques et prise en charge thérapeutique

La survenue d'une grossesse dans une corne utérine rudimentaire est une situation obstétricale extrêmement rare et potentiellement grave, menaçant le pronostic materno-foetal. Les auteurs rapportent cinq observations de grossesse dans une corne utérine rudimentaire, à travers lesquelles, ils relatent les difficultés sur le plan diagnostique ainsi que la prise en charge thérapeutique de cette entité pathologique, soulignant l'intérêt de l'échographie endovaginale, de l'IRM pelvienne et de la coelioscopie dans le diagnostic précoce de ce type de malformation uterine.Pan African Medical Journal 2016; 2

The primary fallopian tube carcinoma: a rare association with pelvic nodal tuberculosis

The primary carcinoma of fallopian tube is a rare entity. It represents 0.14 to 1.81% of genital cancers in women. It is a cancer of older women. Its association with tuberculosis is exceptional. We report a rare case of bilateral serous adenocarcinoma of the fallopian tube in a patient aged 42 years, multiparous, whose characteristic is the unexpected association with peritoneal tuberculosis.Keywords: Primary carcinoma of fallopian tube, peritoneal tuberculosis, treatment, prognosi

Molecular Antimicrobial Resistance of Neisseria gonorrhoeae in a Moroccan Area

Objectives. To identify the prevalence and the types of Neisseria gonorrhoeae (NG) resistance plasmids-mediated penicillin (PPNG) and tetracycline (TRNG), the ciprofloxacin resistance (CRNG), and related risk factors of each types of resistance. Methods. The beta-lactamase-producing plasmid types (Africa, Asia, and Toronto), tetM tetracycline resistance plasmid types (America and Dutch), and the determination of the Ser-91 mutation of GyrA were detected by specifics PCRs on 149 diagnosed NG positives samples followed by Hinf1 digestion for tetM and gyrA mutation. Results. 135 (90.1%) samples showed a profile of molecular resistance to at least one antibiotic with predominance of ciprofloxacin resistance. In fact, 36 (24.2%) and 69 (46.3%) cases harbored PPNG and TRNG, respectively, and 116 (77.9%) cases showed the mutation Ser-91 of GyrA (CRNG). From a total of 36 PPNG isolates, the Toronto, Asian, and Toronto/Asian types were detected in 13 (36.1%), 10 (27.8%), and 13 (36.1%) cases, respectively, whereas the African type was not detected. In addition, the American type of TRNG was detected in 92.8% (64/69) of cases, while the Dutch type was detected in 7.2% (5/69) of cases. The association of demographics and clinical variables with NG resistance to ciprofloxacin, penicillin, and tetracycline was studied and the risk factors have been determined. Conclusion. Resistance to penicillin, tetracycline, and ciprofloxacin among NG samples positives remained at high levels in Morocco as determined by molecular profile. So, the use of molecular tools for NG antimicrobial resistance detection can help in the management and spread limitation of this infection

Detection of Ureaplasma Biovars and Subtyping of Ureaplasma parvum among Women Referring to a University Hospital in Morocco

Objectives. The aim of this study was to determine the prevalence of Ureaplasma biovars and Ureaplasma parvum (U. parvum) serovars, their associated risk factors, and genital STI-related symptoms. Methods. DNA obtained from cervical samples of 1053 women attending the department of Obstetrics and Gynecology and the laboratory of pathological anatomy of Hassan II university hospital of Fez, Morocco, was used to detect Ureaplasma biovars (U. urealyticum and U. parvum) and to subtype U. parvum by polymerase chain reaction (PCR). Results. Of the 1053 women examined, 25.4% (268/1053) were Ureaplasma positives. The rates of U. urealyticum and U. parvum were 12.1% (128/1053) and 7% (74/1053), respectively, and the copresence of these biovars was noted in 6.3% (66/1053) cases. The U. parvum subtyping revealed a predominance of the serovar 3/14 (61.4%). The association of demographics variables with Ureaplasma biovars was studied and shows that the age (“<30” years) seems to be a risk factor of Ureaplasma spp. and U. urealyticum carriage (OR 1.729, 95% CI [1.113-2.687] and OR 1.848, 95% CI [1.026-3.330], respectively). There was no difference in the prevalence of Ureaplasma type regarding symptoms. However, a significant association was found between U. parvum serovar 1 and infertility (P=0.011). Conclusion. This first study conducted in Morocco provides an idea on Ureaplasma biovars and U. parvum serovars circulating in this region, their associated risk factors, and genital STI-related symptoms. Therefore, further studies are required to clarify and confirm the pathogenic role of these Ureaplasma species