Cancer développé sur dilatation kystique de la voie biliaire: à propos d’un cas

Les auteurs rapportent un cas de dilatation kystique du cholédoque intra- pancréatique découvert chez une femme de 46 ans et compliqué d'un carcinome tubulo-papillaire n'envahissant pas le pancréas. Le traitement a consisté en une duodénopancréatectomie céphalique avec un curage ganglionnaire et anastomose hépatico-jéjunale; la survie était de 30 mois; les auteurs abordent les aspects radiologiques, anatomopathologiques, thérapeutiques et pronostiques de ces cancers développé sur dilatation kystique de la voie biliaire et discutent la place d'une radiothérapie complémentaire de la chirurgie susceptible d'améliorer la survie

The CYP7A1 gene rs3808607 variant is associated with susceptibility of tuberculosis in Moroccan population

Introduction: Despite the medical progress in treatment. Tuberculosis (TB) continues to be a serious global health problem. A genome-wide linkage study identified a major susceptibility locus on  chromosomal region 8q12-q13 in Moroccan TB patients. The CYP7A1 gene is located in this region and codes for cholesterol 7a-hydroxylase, an enzyme involved in cholesterol catabolism. Methods: We selected three SNPs (rs3808607, rs8192875 and rs8192879) and studied their genotype and allele frequencies distribution in patients with pulmonary (PTB) or pleural TB (pTB), and compared them to Healthy Controls (HC). Genotyping of rs8192875 and rs8192879 SNPs was carried out using the Taq Man SNP genotyping Assay while rs3808607 was investigated by PCR-RFLP.Results: We reported here for the first time a statistically significant increase in the AA homozygote genotype frequency of rs3808607 in PTB patients compared to HC (p = 0.02, OR = 1.93, 95% CI: 1.93 (1.07;3.49). The increased risk of developing TB was maintained when we combined the groups of patients (PTB-pTB) (p = 0.01, OR= 1.91, 95% CI = (1.07 - 3.42). In contrast, no genetic association was observed between the rs8192875 or rs8192879 polymorphisms and TB. Conclusion: Our investigations suggest that rs3808607 may play a role in susceptibility to TB in a Moroccan population.Key words: Tuberculosis, cholesterol 7-alpha-hydroxylase, polymorphisms, SNPs, cholestero

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

An Attempt at Applying Vladimir Propp’s Morphology of the Folktale on Charles Dickens’s Great Expectations

The present paper is an attempt at approaching Charles Dickens’ Great Expectations from a morphological perspective based upon Vladimir Propp’s Morphology of the Folktale. The paper is divided into two parts. The first part is concerned with a brief view of the nature of formalism: its background and its process of analysis. The second part is devoted to putting into practice what has been dealt with in the first part. It will be mostly concerned with the question as to whether all the functions of dramatis personae as stated by Propp figure in the object of analysis, Great Expectations. Finally, the paper will draw the conclusion as to whether the aforementioned elements constitute an organic unity

Epidémiologie et facteurs de risque des anomalies de fermeture du tube neural: données marocaines

Introduction: les anomalies de fermeture du tube neural sont des défauts congénitaux de la formation du système nerveux central. L'incidence varie entre 3 et 40 cas pour 10000 dans le monde. Il existe des facteurs de risque de survenue de cette affection. La prévention reste un élément important dans la prise en charge. L'objectif de ceete étude est d'étudier les paramètres sociodémographiques, maternels, obstétricaux et néonatals des anomalies de fermeture du tube neural et analyser les facteurs de risque responsables dans notre contexte. Méthodes: étude prospective cas-témoin sur 4 ans. Ont été recrutés tous les cas portant une malformation du tube neural isolée ou associée à d'autres malformations. Les données maternelles, obstétricales et néonatales ont été enregistrées. L'analyse statistique était réalisée par le biais d'un logiciel de statistiques SPSS version 17.0 pour Windows. Résultats: soixante huit cas ont été inclus. Quatre-vingts cinq pour cent des malformations étaient isolées. L'anencéphalie était l'anomalie la plus retrouvée (67 %). L'âge maternel moyen était 31,03±7,50 ans. La consanguinité parentale était notée dans 9 cas. Un niveau socio-économique bas et un non suivi des grossesses ont été rapportés dans 29 % des cas. L'étude a retrouvé des antécédents de mort-nés et de morts néonatales dans 4 % des cas. La consommation de Fenugrec était significativement associée aux malformations du tube neural et a été retrouvée dans 8 cas contre 1 cas dans le groupe sain. La voie haute d'accouchement était utilisée dans 29 % des cas. L'âge gestationnel moyen était de 35,55±4,16 semaines d'aménorrhée. Il n'y avait pas de prédominance de sexe. On avait noté une relation significative entre les malformations du tube neural et l'avènement d'une asphyxie périnatale, 15 cas présentaient un apgar à 0 à la première minute et 12 cas un apgar inférieur à 7 à la cinquième minute. Conclusion: le bas niveau socio-économique, le non suivi des grossesses et la consommation maternelle de fenugrec en période gestationnelle étaient des facteurs prédictifs de développement d'anomalies du tube neural dans notre contexte.The Pan African Medical Journal 2015;2

Primary solitary fibrous tumor of the retroperitoneum

Solitary fibrous tumor is an uncommon neoplasm affecting adults and typically located in the pleura and can also occur in a large number of other extra thoracic sites. We present the case of a solitary fibrous tumor (SFT) of the retroperitoneum and describe their histopathological and immunohistochemical features. The identification of SFT in the retroperitoneum is of importance because its clinico-pathological behaviour is still unclear. The pathologist plays a fundamental role in establishing both the positive and differential diagnosis

COMPARISON OF A DNA BASED PCR APPROACH WITH CONVENTIONAL METHODS FOR THE DETECTION OF MYCOBACTERIUM TUBERCULOSIS IN MOROCCO

<p><strong>Background:</strong> Worldwide, tuberculosis (TB) is a major public health problem and the rapid diagnosis and appropriate chemotherapy become the first priority and a serious challenge to improve TB treatment.</p><p>In the objective of early TB diagnosis and rapid detection of <em>Mycobacterium tuberculosis </em>(MTB) in the clinical specimens, the utility of the Polymerase Chain Reaction (PCR) using the Insertion Sequence 6110 (IS6110) as target was compared to conventional methods.</p><p><strong>Methods:</strong> Out of 305 patients with different clinical manifestations: suspected, new, drug relapse, drug failure and chronic cases were enrolled in this study and tested by mycobacteriological and PCR techniques for the investigation about the tubercle bacilli.</p><p><strong>Results:</strong> The results of the in house IS6110 PCR showed a good sensitivity (92, 42%) and high specificity (98%), the positive and negative predictive values were 96.4 % and 95.3 % respectively.</p><p><strong>Conclusion:</strong> This study showed clearly that the PCR testing using the IS6110 in the routine analysis is a potential tool for the rapid TB diagnosis, especially for critical cases and would be of great interest to help the clinician in the misdiagnosed critical cases by the traditional radiology.</p&gt

Molecular Typing of Mycobacterium Tuberculosis Complex by 24-Locus Based MIRU-VNTR Typing in Conjunction with Spoligotyping to Assess Genetic Diversity of Strains Circulating in Morocco.

Standard 24-locus Mycobacterial Interspersed Repetitive Unit Variable Number Tandem Repeat (MIRU-VNTR) typing allows to get an improved resolution power for tracing TB transmission and predicting different strain (sub) lineages in a community.During 2010-2012, a total of 168 Mycobacterium tuberculosis Complex (MTBC) isolates were collected by cluster sampling from 10 different Moroccan cities, and centralized by the National Reference Laboratory of Tuberculosis over the study period. All isolates were genotyped using spoligotyping, and a subset of 75 was genotyped using 24-locus based MIRU-VNTR typing, followed by first line drug susceptibility testing. Corresponding strain lineages were predicted using MIRU-VNTRplus database.Spoligotyping resulted in 137 isolates in 18 clusters (2-50 isolates per cluster: clustering rate of 81.54%) corresponding to a SIT number in the SITVIT database, while 31(18.45%) patterns were unique of which 10 were labelled as "unknown" according to the same database. The most prevalent spoligotype family was LAM; (n = 81 or 48.24% of isolates, dominated by SIT42, n = 49), followed by Haarlem (23.80%), T superfamily (15.47%), >Beijing (2.97%), > U clade (2.38%) and S clade (1.19%). Subsequent 24-Locus MIRU-VNTR typing identified 64 unique types and 11 isolates in 5 clusters (2 to 3isolates per cluster), substantially reducing clusters defined by spoligotyping only. The single cluster of three isolates corresponded to two previously treated MDR-TB cases and one new MDR-TB case known to be contact a same index case and belonging to a same family, albeit residing in 3 different administrative regions. MIRU-VNTR loci 4052, 802, 2996, 2163b, 3690, 1955, 424, 2531, 2401 and 960 were highly discriminative in our setting (HGDI >0.6).24-locus MIRU-VNTR typing can substantially improve the resolution of large clusters initially defined by spoligotyping alone and predominating in Morocco, and could therefore be used to better study tuberculosis transmission in a population-based, multi-year sample context

Detailed Results obtained including demographic, drug-resistance and genotyping information on 5 Clusters and 69 unique patterns defined by identical spoligotyping and 24-loci MIRU from 75 <i>M</i>.<i>tuberculosis</i> strain isolated in Morocco.

<p>ID: Identifying number</p><p>DST: Drug SusceptibilityTesting</p><p>MLVA-MtbC15-9: Multi Locus Variant Allele-Mycobacterium tuberculosis complex15-9</p><p>Detailed Results obtained including demographic, drug-resistance and genotyping information on 5 Clusters and 69 unique patterns defined by identical spoligotyping and 24-loci MIRU from 75 <i>M</i>.<i>tuberculosis</i> strain isolated in Morocco.</p