Morbimortalité périnatale dans les grossesses gémellaires dans une maternité marocaine de niveau 3

Introduction: Les grossesses gémellaires sont associées à un risque de morbimortalité périnatale plus élevé que les grossesses simples. Le but de cette étude était d’évaluer la morbimortalité périnatale dans les grossesses gémellaires dans une maternité marocaine de niveau 3. Méthodes: Il s’agit d’une étude transversale comparative de la morbimortalité périnatale des nouveau-nés issus de grossesses gémellaires versus grossesses simples ayant accouché à la maternité Souissi de Rabat du 1 janvier au 28 février 2014. Résultats: Il y a eu 3297 naissances issues de 65 grossesses gémellaires et 3167 grossesses simples. Les grossesses gémellaires étaient associées à des taux plus élevés de prééclampsie et d’éclampsie (P = 0,046), de HELLP syndrome (P= 0,030), de rupture prématurée des membranes (P < 0,001), de présentation dystocique (P < 0,001), de prématurité (P < 0,001), d’hypotrophie chez les nouveau-nés à terme (P < 0,001), de détresse respiratoire néonatale (P < 0,001), de malformations congénitales (P = 0,015), d’hospitalisation en période néonatale (P = 0,001) et de mortalité périnatale (P = 0,001) par rapport aux grossesses simples. Les jumeaux monochoriaux présentaient des taux plus élevés d’hypotrophie en cas de grossesse menée à terme (P = 0,016) et de mortalité périnatale (P = 0,017) par rapport aux jumeaux bichoriaux. Conclusion: Les grossesses gémellaires étaient à risque plus élevé de morbimortalité périnatale par rapport aux grossesses simples en exposant notamment à la prématurité. Les grossesses gémellaires monochoriales étaient plus à risque en exposant notamment à l’hypotrophie chez les nouveau-nés à terme.Pan African Medical Journal 2016; 2

Fetal outcome in emergency versus elective cesarean sections at Souissi Maternity Hospital, Rabat, Morocco

Introduction: Perinatal mortality rates have come down in cesarean sections, but fetal morbidity is still high in comparison to vaginal delivery and the complications are more commonly seen in emergency than in elective cesarean sections. The objective of the study was to compare the fetal outcome and the indications in elective versus emergency cesarean section performed in a tertiary maternity hospital. Methods: This comparative cross-sectional prospective study of all the cases undergoing elective and emergency cesarean section for any indication at Souissi maternity hospital of Rabat, Morocco, was carried from January 1, to February 28, 2014. Data were analyzed with emphasis on fetal outcome and cesarean sections indications. Mothers who had definite antenatal complications that would adversely affect fetal outcome were excluded from the study. Results: There was 588 (17.83%) cesarean sections among 3297 births of which emergency cesarean section accounted for 446 (75.85%) and elective cesarean section for 142 cases (24.15%). Of the various factors analyzed in relation to the two types of cesarean sections, statistically significant associations were found between emergency cesarean section and younger mothers (P < 0.001), maternal illiteracy (P = 0.049), primiparity (P = 0.005), insufficient prenatal care (P < 0.001), referral from other institution for pregnancy complications or delivery (P < 0.001), cesarean section performed under general anesthesia (P < 0.001), lower birth weight (P < 0.016), neonatal morbidity and early mortality (P < 0.001), and admission in neonatal intensive care unit (P = 0.024). The commonest indication of emergency cesarean section was fetal distress (30.49%), while the most frequent indication in elective cesarean section was previous cesarean delivery (47.18%). Conclusion: The overall fetal complications rate was higher in emergency cesarean section than in elective cesarean section. Early recognition and referral of mothers who are likely to undergo cesarean section may reduce the incidence of emergency cesarean sections and thus decrease fetal complications.Pan African Medical Journal 2016; 2

Critères de gravité des brûlures: à propos de 337 cas de brûlés au Maroc

L'objectif était d'étudier les critères de gravité des brûlures chez des patients brûlés hospitalisés à  l'hôpital militaire d'instruction Mohamed V de Rabat. Il s'agit d'une étude rétrospective qui concernait 337 patients hospitalisés de 2004 à 2010. Les variables étudiés sont: l'âge, la surface corporelle brûlée, la profondeur, la localisation de la brûlure, l'indice de Baux et le score unité de brûlure standard. Ces  variables ont étaient analysés par une analyse en composante principale suivie d'une analyse de survie pour déterminer les facteurs  influençant la gravité de la brûlure. Parmi les 337 brûlés hospitalisés dans le service, nous avons enregistrés 19 décès. Le taux global de mortalité était 5,9%. L'analyse univariée a montrée que la TBSA ≥20%, la localisation de la brûlure au niveau de la tête et des  membres supérieurs et les scores pronostiques étaient statistiquement associés significativement à la mortalité. Toutes ces variables ont était inclus dans le  modèle de Cox pour une analyse multivariée et seulement la TBSA ≥20%, la localisation de la brûlure au niveau de la tête et des membres supérieurs et les indices  pronostiques sont des facteurs aggravant de la brûlure. La TBSA ≥20%, la localisation de la brûlure au niveau de la tête et des membres supérieurs et les scores pronostiques sont des facteurs prédictifs de la mortalité.Key words: Surface corporelle brölée, localisation de la brölure, mortalit

Risk factors associated with a breast cancer in a population of Moroccan women whose age is less than 40 years: a case control study

Introduction: Breast cancer is the most common cancer in morocco women were it occupies the first place in term of incidence and mortality. The aim of the present paper is to evaluate the risk factors associated with a breast cancer in a population of Moroccan women. Methods: A casecontrol study was conducted with population women whose age is less than 40 years during 2008-2010 at the National Institute of Oncology of Rabat. These women were interviewed for Epidemiological information and risk factor for breast cancer. Results: Included in this study were 124 cases and 148 age matched controls. No statistically significant case-control difference was found for the early age of menarche (OR = 2.474; CI 95%: 1.354- 4.521), and family antecedents of first degree of breast cancer (OR = 11.556; 95% CI: 2.548-52.411). However physical activity (OR = 0.507; 95% CI: 0.339 -0.757) early maternity age (OR = 0.212; 95% CI: 0.087 - 0.514), multiparity (OR = 0.742; 95% CI: 0.359 -1.539) and breastfeeding than 6 months (OR = 0.739; 95% CI: 0.357 -1.523) appear as significant protective factors. Conclusion: This study show the criminalization of only part of the known risk factors of breast cancer in this age group and confirms the probable protective role of physical activity and factors related to life reproductive women in our study (early childbearing, multiparity and lactation).Pan African Medical Journal 2016; 2

First draft genome assembly of the Argane tree (Argania spinosa)

Background: The Argane tree (Argania spinosa L. Skeels) is an endemic tree of southwestern Morocco that plays an important socioeconomic and ecologic role for a dense human population in an arid zone. Several studies confirmed the importance of this species as a food and feed source and as a resource for both pharmaceutical and cosmetic compounds. Unfortunately, the argane tree ecosystem is facing significant threats from environmental changes (global warming, over-population) and over-exploitation. Limited research has been conducted, however, on argane tree genetics and genomics, which hinders its conservation and genetic improvement. Methods: Here, we present a draft genome assembly of A. spinosa. A reliable reference genome of A. spinosa was created using a hybrid de novo assembly approach combining short and long sequencing reads. Results: In total, 144 Gb Illumina HiSeq reads and 7.2 Gb PacBio reads were produced and assembled. The final draft genome comprises 75 327 scaffolds totaling 671 Mb with an N50 of 49 916 kb. The draft assembly is close to the genome size estimated by k-mers distribution and covers 89% of complete and 4.3 % of partial Arabidopsis orthologous groups in BUSCO. Conclusion: The A. spinosa genome will be useful for assessing biodiversity leading to efficient conservation of this endangered endemic tree. Furthermore, the genome may enable genome-assisted cultivar breeding, and provide a better understanding of important metabolic pathways and their underlying genes for both cosmetic and pharmacological purposes

First draft genome assembly of the Argane tree (Argania spinosa) [version 2; peer review: 2 approved]

BACKGROUND : The Argane tree (Argania spinosa L. Skeels) is an endemic tree of mid-western Morocco that plays an important socioeconomic and ecologic role for a dense human population in an arid zone. Several studies confirmed the importance of this species as a food and feed source and as a resource for both pharmaceutical and cosmetic compounds. Unfortunately, the argane tree ecosystem is facing significant threats from environmental changes (global warming, over-population) and over-exploitation. Limited research has been conducted, however, on argane tree genetics and genomics, which hinders its conservation and genetic improvement. METHODS : Here, we present a draft genome assembly of A. spinosa. A reliable reference genome of A. spinosa was created using a hybrid de novo assembly approach combining short and long sequencing reads. RESULTS : In total, 144 Gb Illumina HiSeq reads and 7.6 Gb PacBio reads were produced and assembled. The final draft genome comprises 75 327 scaffolds totaling 671 Mb with an N50 of 49 916 kb. The draft assembly is close to the genome size estimated by k-mers distribution and covers 89% of complete and 4.3 % of partial Arabidopsis orthologous groups in BUSCO. CONCLUSION : The A. spinosa genome will be useful for assessing biodiversity leading to efficient conservation of this endangered endemic tree. Furthermore, the genome may enable genome-assisted cultivar breeding, and provide a better understanding of important metabolic pathways and their underlying genes for both cosmetic and pharmacological.DATA AVAILABILITY: All of the A. spinosa datasets can be retrieved under BioProject accession number PRJNA294096: http://identifiers.org/ bioproject:PRJNA294096. The raw reads are available at NCBI Sequence Reads Archive under accession number SRP077839: http://identifiers.org/insdc.sra:SRP077839. The complete genome sequence assembly project has been deposited at GenBank under accession number QLOD00000000: http://identifiers. org/ncbigi/GI:1408199612. Data can also be retrieved via the International Argane Genome Consortium (IAGC) website: http://www.arganome.org.https://f1000research.compm2021BiochemistryGeneticsMicrobiology and Plant Patholog

Energy management system for residential customers integrating Multi Agent Approach

The paper deals with an Energy Management System of a micro-grid feeding a community of several residential buildings. The proposed micro-grid includes a photovoltaic energy production and a storage system based on batteries. The energy management system object is to optimize the main grid energy efficiency. To ensure the concept of management decentralization, we propose in this study the integration of an Artificial Intelligence Algorithm: The Multi Agent Systems. A specific agent is dedicated to each Micro-Grid component. Physical agents using Raspberry Pi are also presented and the communication between the different agents is insured by Wi-Fi technology.The simulation results of Micro-Grid based Multi Agent Systems management are mentioned and a porotype of experimental exchange between two physical agents is also propose

The impact of maternal socio-demographic characteristics on breastfeeding knowledge and practices: An experience from Casablanca, Morocco

Background: Breastfeeding is universally recognized by the World Health Organization as the best way of feeding infants. Therefore, several countries have initiated health promotion interventions to support successful breastfeeding based on the factors influencing breastfeeding outcomes. Objective: To examine the association between the knowledge of breastfeeding and maternal socioeconomic and demographic characteristics, and to determine any impact on child nutritional status. Methods: A cross-sectional study using both qualitative and quantitative methods was conducted with mothers of infants aged six- to twenty-four months. Data was collected by a semi-structured questionnaire and face-to-face, in-depth interviews with mothers to get an insight into their breastfeeding perceptions and experiences. Educational achievement and occupational class were used as indicators of socio-demographic status. Nutritional status was assessed by anthropometric measurements. Results: A significant relationship between exclusive breastfeeding and the mother's education (P < .001) and socio-economic status (P < .001) has been highlighted. A significant link was pointed out between breastfeeding and length-for-age Z score (LAZ) (P < .001), and weight-for-age Z score (WAZ) (P = .005). Moreover, a strong association was found between maternal employment and exclusive breastfeeding (P < .001). Conclusions: Our findings shed some light on challenges faced by mothers, as well as an association between socio-demographic characteristics and practices for facilitating exclusive breastfeeding to guide the mothers in breastfeeding management. Keywords: Breastfeeding, Lactation, Human milk, Child nutrition, Nursing, Nutritional statu

A Rare Case of Idiopathic Plastic Bronchitis

Plastic bronchitis is a rare disorder characterized by formation of large, branching bronchial casts, which are often expectorated. We present an interesting case of a 35-year-old woman who presented for evaluation of a chronic cough productive of voluminous secretions. Clinical and radiological examination confirmed a total left lung atelectasis without any pathological mediastinal node. Flexible bronchoscopy demonstrated tenacious, thick, and sticky whitish secretions blocking the left stem bronchus. This material was extracted, and inspection demonstrated a bronchial cast, whose pathological analysis revealed necrotic epithelial cells, some eosinophils, and Charcot-Leyden crystals. Two days after bronchoscopy, the patient rejected more bronchial casts, and dyspnea improved. Control of chest x-ray revealed complete left lung aeration and the diagnosis of idiopathic plastic bronchitis was obtained. This article shows the interest in clinical practice to evoke the diagnosis of plastic bronchitis in front of a productive chronic cough. Our case illustrates a rare clinical presentation represented by an atelectasis of an entire lung

Field evaluation of a dog owner, participation-based, bait delivery system for the oral immunization of dogs against rabies in Tunisia.

International audienceWe evaluated a dog owner, participation-based, bait delivery system for the oral immunization of dogs against rabies. In a field study in a semirural area of northern Tunisia, dog owners were asked to come to temporary bait delivery sites. A total of 314 baits were given to 178 dog owners in four sites. The experimental baits used consisted of a freeze-dried core unit containing sulfadimethoxine (SDM) as a biological marker and an aromatized paraffin envelope. No vaccine was used. Preliminary tests had shown that by using a rapid commercial card test, positive SDM serum levels were detected in more than 95% of dogs up to two days after bait ingestion. During the two days following bait delivery, we visited more than 95% of all households in the study area and took blood samples from as many owned dogs as possible. Unconsumed baits were recovered and human contacts with the bait matrix were recorded. The campaign required 7.6 person-min per bait and 13.5 person-min per dog owner for providing baits, gloves, and instructions. The estimated average cost effectiveness ratio per dog accepting a bait was 1.7 US dollars. From the indications given by the dog owners and the results of the SDM test, it was concluded that 85-90% of the owned dogs in the study area had consumed a bait at least partially. Of 314 baits delivered, 78.7% were fully consumed by dogs and 4.1% were recovered during the household survey. The remaining baits (17.2%) that were not recovered were either not consumed or only partially consumed by the target dogs (3.7 baits per 100 inhabitants). These baits probably remained within the highly populated areas and were potentially accessible to other domestic animals and other nontarget species, including humans. Twenty-five unprotected human contacts with baits were recorded (1.7% of all inhabitants). Our study has demonstrated the potential of dog owner based bait delivery. This technique is simple and efficient, particularly if the human population is accustomed to mass immunization in defined centers. Before applying this method on a large scale with live vaccine loaded baits, further studies should focus on minimizing the number of human contacts with the vaccine bait, systematizing contact identification and establishing structures in ensuring proper treatment if exposure to vaccine should occur