A paraduodenal hernia revealed by bowel obstruction: case report and literature review

Internal hernias are defined as the protrusion of abdominal viscera through an aperture in the intraperitoneal recesses, they are considered as a rare cause of intestinal obstruction. The paraduodenal hernias are the most common type of congenital hernia especially the left-sided ones. We report a case of a 46 year-old man presenting a left paraduodenal hernia with acute small bowel obstruction, which was firstly (preoperatively) assigned to a tumoral cause

Coinfection virus de l’immunodéficience humaine (Virus de l’hépatite B chez une femme enceinte)

La prévalence de l’infection par le virus de l’hépatite B (VHB) est élevée chez les patients infectés par le virus de l’immunodéficience humaine (VIH). En France, 37.6% des personnes atteintes par le VIH présentent des marqueurs sérologiques témoignant d'une infection par le VHB. Du fait de leurs modes de transmission communs (voie sexuelle, voie sanguine, voie périnatale), un organisme hôte peut contracter ces deux virus, on parle alors de coinfection VIH/VHB.  La prévalence de l’hépatite B chronique chez les femmes enceintes infectées par le VIH peut être dix fois supérieure ou plus à celle de la population générale. La grossesse est une situation clinique particulière en cas de coinfection par le VIH et le VHB, essentiellement, en termes de prise en charge thérapeutique et de prévention de la transmission mère enfant. La prise en charge thérapeutique de la coinfection chez les femmes enceintes devient complexe et exige de bonnes associations médicamenteuses puisqu’il faut traiter simultanément deux virus

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Habitat clandestin au Maroc

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A literature review of igneous Moroccan rocks for thermal energy storage in CSP plants

It has been proved that thermal energy storage (TES) is a convincing technology ensuring the continuous generation of concentrating solar power (CSP) as well as to play a major role in the industrial field. Since then, a dual-media thermocline (DMT) becomes the appropriate storage system, according to technical and economic criteria used to evaluate CSP plant performances. Certainly, to better understand the thermal behavior of this system, it is important to measure and control the effect of thermo-physical properties of the storage material (rocks). However, the choice of the suitable material used as potential storage remains a great challenge. In this scope, there are few experimental studies on dual-media thermocline which are reported in the literature. This paper aims to present a specific literature review on the igneous rocks (Granite, Basalt, Peridotite, Gabbro...) as filler storage materials in TES application. These rocks are identified in different regions of Morocco. Comparison of their thermo-physical properties (density, thermal capacity, thermal conductivity, porosity...) and their thermal stabilities were presented and discussed. This comparative study shows that the Peridotite rock is the most suitable to be used as a storage material at high temperature in TES systems.</p

Numerical study of a latent heat storage system adapted to concentrated solar power (CSP) plants at medium temperatures

Latent Heat Storage (LHS) is a promising solution to overcome the intermittent nature of solar energy for concentrated solar power (CSP) plants. In fact, it matches at a relatively low cost between the electricity produced by these plants and the periods of demand. Moreover, LHS systems have higher energy density compared to Sensible Heat Storage (SHS) ones. However, their inorganic materials have low thermal conductivity, which reduces the dynamics of the storage system with respect to the limitation of operating conditions of a CSP plant. One of the effective ways to resolve this problem is the use of extending surfaces such as fins. The present work evaluates the viability of this LHS applied to the case study of a heat exchanger with and without fins. A Computational fluid dynamics (CFO) model of the studied system was built in the COMSOL-Multyphysics environment. Furthermore, it was succefully validated against the available experimental results. Overall, the obtained simulation results show a considerable enhancement of the global dynamic performances of the LHS: the charging period and the phase change duration were decreased by 30.5% and 44.64% respectively.</p

Retroperitoneal Ectopic Pregnancy: Diagnosis and Therapeutic Challenges

Background. Retroperitoneal ectopic pregnancy is extremely rare. This unusual location represents a great challenge for clinicians due to the difficulties of diagnosis and high risk of life-threatening complications. Case Report. We report the case of a spontaneous early pregnancy of undetermined location in a patient with a history of previous laparoscopic surgery. Diagnosis steps using clinical examination, ultrasound, and magnetic resonance imaging led to the localization of the pregnancy, in the left side of the para-aortic region, in the retroperitoneal space. Conclusion. Retroperitoneal ectopic pregnancy is an uncommon entity with rather complex pathogenesis. Clinicians should carefully interpret clinical signs, biological findings, and imaging features and be aware of unusual locations such as the retroperitoneum for ectopic pregnancies. Early diagnosis and appropriate management strategy are conditio sine qua non for successful treatment outcomes