Child sexual abuse: Report of 311 cases with review of literature

Child sexual abuse (CSA) is a global problem that has significant  consequences for public health; it has been a prominent topic of public  concern for more than a decade, but many basic facts about the problem remain unclear or in dispute. We conducted a study of 311 cases of CSA in order to highlight the epidemiological features and negative impact on victims' well-being and to emphasize the need for a multidisciplinary approach to the primary prevention and management of CSA. We noted an increase in cases number with male predominance. Most of our patients came from lower  socioeconomic classes. The perpetrators were male in 100% of cases;  acquaintances in 70% of cases and family members in 22 cases. Physical  examination were normal in 61% of cases, however, a range of psychological and physical effects were identified with dramatic health consequences: three cases of attempted suicide, five pregnancies and one case of HIV virus  infection

Gaucher’s disease: Report of 11 cases with review of literature

Gaucher's disease (GD) is a lysosomal storage disorder due to  glucocerebrosidase deficiency; it's one of the rare genetic diseases for which therapy is now available. The purpose of this work is to study the epidemiological features of the disease and to highlight the diagnostic difficulties. We performed an 11-year retrospective study of 11 patients with GD followed-up in the department of paediatric hepatology  gastroenterology and nutrition of Rabat children's Hospital. We observed 11 patients with GD: 6 males and 5 females. Age at onset ranged from 3 months to 10 years with an average of 3.41 years. Mean age at diagnosis was 4 years (range 3months-14years).Parental consanguinity was noted in 85% cases. According to the clinical presentation, we classified our patients into: 9 cases of type 1 (81%) and two cases of type 2 (19%), none of the patients presented GD type 3. GD type 1: The age at diagnosis ranged from 2 years to 14 year with an average of 6 years. Main symptoms were:splenomegaly, hepatomegaly , pallor, haemorrhagic appearance (40%), bone pain (40%). The diagnosis was based on histology showing the Gaucher's cells in various tissues (100%). Enzymatic activity dosage  confirmed the diagnosis of GD for 4 patients (44.5%). The treatment wasalways symptomatic (analgesics, transfusion). A splenectomy was  performed in one case presenting with multiple splenic abscesses and hightransfusion requirements. None of the patients received a specific  treatment (substitutive enzymotherapy). The follow-up period ranged from 3 months to 6 years with an average follow-up of 4 years. We noticed  stability in 4 cases, 2 worsening cases with bone and spleen complications.Three patients were lost to follow-up. GD type 2: we observed two cases of GD type 2 diagnosed at 3 and 18 months. The visceral symptoms wereserious and the neurological features included seizures, hypertony, squint, physical developmental milestones delay. Both of them died. Gaucher'sdisease is not exceptional in Morocco. Type 1 is the most common type. We noted through this study some diagnostic difficulties as the diagnosiswas delayed and the enzymatic dosage was performed in only 42% of the cases as well as therapeutic difficulty with no prescription of the specifictreatment given the high cost of the enzyme