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OBJECTIVES@#Envenomation from snake bites is a significant cause of morbidity and mortality worldwide. The aim of this study was to describe the epidemiological features of snake bites in Morocco and to evaluate time-space trends in snake bite incidence, the mortality rate, and the case-fatality rate.@*METHODS@#This is a retrospective study of snake bite cases reported to the Moroccan Poison Control Center between 1999 and 2013.@*RESULTS@#During the study period, 2,053 people were bitten by snakes in Morocco. Most victims were adults (55.4%). The average age of the patients was 26.48±17.25 years. More than half of the cases (58.1%) were males. Approximately 75% of snake bites happened in rural areas, and 85 deaths were recorded during this period. The incidence of snake bites remained generally steady over the 15-year period of this study, with a marked increase noted since 2012. The mortality rate has increased slightly, from 0.02 deaths per 100,000 inhabitants in 1999 to 0.05 in 2013. The geographical distribution of snake bite cases in the regions of Morocco showed that Tanger-Tétouan had the highest annual incidence of snake bites (1.41 bites per 100,000 inhabitants). However, the highest annual mortality rates were recorded in the Guelmim-Es Semara and Souss-Massa-Drâa regions (0.09 deaths per 100,000 inhabitants for both regions).@*CONCLUSION@#The geographical distribution of the incidence, mortality, and case-fatality rates of snake bites in Morocco showed large disparities across regions during the three 5-year periods included in this study, meaning that certain areas can be considered high-risk for snake bites.
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Objective To establish animal models of avascular necrosis of the femoral head. Methods Rat models of avascular necrosis of the femoral heads with liquid nitrogen freezing left femoral head were made. After operations, we accessed behaviors and regular observed X - ray graphy. we observed the femoral head after the rats were killed one monthe later. Results The rats in model group presented "new month syndrom" two weeks after operation,and became more and more worse. Conclusion The rat models of avascular necrosis of the femoral heads made by liquid nitrogen is economic and of low mortality. We can use it in making large - scale mordels, particularly in drug treatment' study.
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Objective To study the feasibility of applying nanometer ceramics artificial bone in clinical repair of bone defects. Methods The animal models of bone defect was made on the unilateral radius of 45 New Zealand white rabbits, which were divided into experimental group(repair with nanometer ceramics artificial bone), control group (repair with ceramics artificial bone) and blank group (unrepaired) randomly. The reconstructive effect in each group was evaluated by gross observation, alkaline phosphatase(ALP) detection of blood serum, histopathological observation, X-ray examination and SEM detection at 4th, 8th and 12th weeks postoperatively. Results In the experimental group there was more bone formation than in the control and the blank groups. The differences in reconstructive effect were statistically significant ( P
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Purpose: To evaluate the accuracy and feasibility of sentinel lymph node biopsyly by using radiopharmaceuticals for sentinel lymph node mapping. Methods: From April 1999 to October 2001, lymphatic mapping by using radiopharmaceuticals( either99mTc-antimony sulfide or 99mTc-sulfur colloid ) injection into subdermal directly overlying the tumor was performed on 79 patients with early breast cancer followed by SLND, then all patients received breast opreations including standard axillary lymph nodes dissection ( ALND). To analyze the results of SLND performed by radiopharmaceuticals. Results: The sentinel nodes were successfully identified by lymphoscintigraphy in 67 of 75 cases (89. 33%). Of the 68 patients in this study whose sentinel nodes were identified both by lymphoscintigraphy and handhold ?-probe ,65 patients' SLNs could predict the axillary status accurately(95. 59%) . The false negative rate is 8. 33%(3 of 36). We failed to identify SLN in 9 cases and found 3 cases SLNs to be false negative in the first 28 cases while there were only 2 cases whose SLN could not be identified and no false negative in the other 51 cases. The differences between the two groups were statistically significant(P
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Purpose: To study the short-term efficacy and toxicity of the neoajuvant chemotherapy with epirubicin (EPI) plus paclitaxel( TAX) in treatment of patients with breast cancer. Methods: 20 patients with stage Ⅱ,Ⅲ breast cancer were treated with paclitaxel plus epirubicin (TE) for 2 - 4 cycles every 3 weeks, their clinical response and the toxicity were assessed after 2-4 cycles of neoajuvant chemotherapy, and they are compared with those of the patients treated with vinorelbine plus epirubicin( VE) as neoadjuvant chemotherapy. Patients in TE arm received epirubicin 60 mg/m2 by intravenous injection on d 1, paclitaxel 150 mg/m2 by 3-hour continuous infusion on d 2, 3 weeks was 1 cycle. Patients assigned to the VE arm received epirubicin 60 mg/m2 by intravenous injection on d 1, vinorelbine 30 mg/m by intravenous injection on d 1 and d 8, 4 weeks was 1 cycle. All patients were treated by modified radical operation after neoajuvant chemotherapy. Results: The overall response rate( RR) was 80% (16/20) both in TE arm and VE arm. There were 3(15%) clinical complete response( cCR) and 2(10%) pathologic complete response ( pCR) in every arm. No patient showed progressive disease. A higher proportion of RR and pCR was observed in patients with 4 cycles of neoajuvant chemotherapy than those with 2 cycles in the two groups. The major toxicity, including leukopenia, gastroenteric reaction, flushing of face and phlebitis, were similar in both groups, but fatigue, alopecia and neurotoxicity were more severe in VE arm than in TE arm(P
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Objective To investigate the surgical techniques of laparoscopic procedures in the management of stones straddling between the cystic duct and the common bile duct. Methods Clinical data of 19 cases of stones straddling between the cystic duct and the common bile duct treated by laparoscopic cholecystectomy (LC) from January 2001 to June 2003 were retrospectively reviewed. Results The operations were completed by opening the gallbladder ampulla and/or the cystic duct in all the patients. The stones were 0 4~0 6 cm in diameter (mean,0 5 cm).The drainage was removed 48 hours ofter the surgery.The patients were discharged from hospital 3~5 days postoperatively.Follow-up checkups in the 19 cases for 2~24 months (mean,10 months) found no residual stones. Conclusions Thorough exposure of the union of the cystic duct with the common bile duct and the opening of the cystic duct to expel the stones is the best way to manage stones straddling between the cystic duct and the common bile duct under laparoscope, and also the most effective method to prevent postoperative residual stones.
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To evaluate the safety of laparoscopic vagotomy this study included 20 patients with chronic duodenal ulcer, admitted in Al-Zahraa university hospital in the period between 1994-1997. Preoperatively, full history, clinical examination upper gastrointestinal endoscopy, abdominal ultrasonography and barium meal were done to all patients. Laparoscopic posterior truncal vagotomy associated with anterior highly selective vagotomy was done to all patients and any operative or postoperative complications were recorded. Postoperatively clinical evaluation and endoscopy were repeated to compare with the preoperative data and to assess ulcer healing. 90 to 180 minutes [mean 135 mm.]. Intraoperatively there was minimal bleeding in 2 cases and was controlled by diathermy and clips, two cases of arrthymia and one case of hypercapnoea improved spontaneously after temporal desufflation of co2. Postoperatively scapular pain, diffuse abdominal pain and mild fever were noticed in 6,2 and 2 patients respectively. Postoperative stay in the hospital was ranged from one to 5 days [mean 3 days]. Two patients were still complaining of dyspepsia and were improved by medical treatment. Six months follow up by endoscopy revealed that 19 cases were completely free and one case still had an ulcer which also was improved by medical treatment. One patient developed a very small hernia at the site of laparoscopic port above the umbilicus. However laparoscopic vagotomy is a new promising, minimally invasive technique. Its simplicity, safety, efficacy, minimal scarring and early mobilization support its wider use, but it will be necessary to validate this initial experience with a large number of patients and adequate long term follow up. So we concluded that laparoscopic vagotomy should not be developed so as to avoid or be contrary to the established principles of open surgery, but rather it should be designed as a continuation of classical surgery with new and different techniques
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Humans , Male , Female , Laparoscopy , Vagotomy , Ultrasonography , Abdomen , Postoperative Complications , Length of Stay , Follow-Up StudiesABSTRACT
Objective To investigate the effect of taurine on proliferation and apoptosis of rat mesangial cells cultured in vitro and explore its possible mechanism. Methods Rat mesangial cells were incubated with different concentration of taurine. Cell proliferation was assessed by MTT colorimetric assay. Cell cycle and apoptosis was analyzed by flow cytometry. Form of apoptosis was examined by vital staining of alcidine orange. The expression of c-jun and c-fos was determined by immunocytochemistry and computed video text analysis system. Results Administration of 5 ~ 50 mmol/L taurine into culture medium had no loxicity to mesangial cells, but could significantly inhibit mesangial cells proliferation in dose-dependent manner, subsequently increased the cells in Go/Gi phase and decreased the cells in S phase. In addition, turine could markedly inhibit the expression of c-jun and c-fos( P
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Objective Since rocuronium (R) is excreted unchanged in the urine and bile, thus the duration of action may be increased in patients with liver dysfunction. The purpose of this study was to evaluate the neuromuscular blocking effect of R in patients with portal hypertension. Methods Seventy ASAⅠ-Ⅱ patients (36 males, 34 females) aged 30-60 yrs were divided into 2 groups : portal hypertension group (n=36) (PH) and control group (C) (n = 34). The liver function of the patients in PH group was classified as Child-Turcottee grade Ⅱ while those in C group had no liver dysfunction. The patients were premedicated with intramuscular phenobarbital 0.1 g and atropine 0.5 mg. Anesthesia was induced with midazolam 0.02 mg?kg-1 , propofol 1.0 mg?kg-1 , fentanyl 5 ?g?kg-1 and R 0.6 mg?kg-1 and maintained with isoflurane and intermittent i.v. boluses of fentanyl. R was continuously infused. The patients were mechanically ventilated after tracheal intubation. PETCO2 was maintained at 35-45 mm Hg . The N-M function was monitored by accelerography using TOF stimulation. (1) The onset time (from the end of R injection to maximal paralysis (T1=0). (2) Maximum depression time (the duration of completely no response to TOF stimulation. (3) Maintenance time (T1 returned to 10% ) . (4) recovery time (T1 returned to 25% after R infusion was stopped) and (5) recovery index (T1 returned from 25%-75%) were recorded. The amount of R infused every 30 min was also recorded. Results The two groups were comparable with respect to sex and age. The onset time and maximum depression time were significantly longer in PH group than in group C ( P
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Objective To investigate the correlations between histological grading of the mucosal biopsies, clinical appearances and endoscopies of patients with active ulcerative colitis ( AUC) , and their roles in the therapeutic outcomes. Methods To analyze the grading in pathological, endoscopic and clinical manifestations of 133 patients, and use the scores to estimate each clinical appearance. A prospective study and Spearman correlation coefficients analysis were taken in this study. Results Among 133 patients, the grading of histological, clinical and endoscopic results in grades Ⅰ ,Ⅱ , Ⅲ , andⅣwere 29,45 ,37 and 22; 85 , 39,9 and 0; 8,30,16 and 79 cases respectively. There were significant positive correlations between histological grading and the following parameters; melena ( r =0. 49, P= 0. 000) , bowel movement ( r =0. 30, P = 0.001) , ESR (r=0. 42, P =0.000) , AI(r=0.56, P=0.000) , clinical grade (r=0.52, P=0.000) endoscopic grade (r = 0. 35 , P =0. 000). And no significant negative correlation with Hb (r = -0. 13, P = 0. 125). In 68 mild and moderate cases after administered SASP for 6 weeks with clinical remission there were 16 and 19 cases with 0 grade in endoscopies and histology respectively, and in the former group 7 cases fall in histological grade I . Conclusion There was no agreement in the clinical, endoscopic and histological grades of the AUC patients. For the evaluation of therapy, the sequence of priority is histological grade, endoscopic grade, and then clinical grade.
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Objective To enrich the knowledge in large gastric folds. Methods We investigated 45 cases of large gastric folds in ten years (1990 - 2001) retrospectively. All cases were examined endo-scopically and histologically. Some of them were examined by endoscopic ultrasonography and upper gastrointestinal barium. Results Of 45 cases with large gastric folds there were 30 cases with gastritis (66. 7% ) , seven with malignant tumors( 15. 6% ) (five with gastric carcinoma and two with malignant lymphoma) , four with Menetrier disease(8. 9% ) , two with systemic lupus erythematosus, one each with Billroth II anastomosis and gastric ulcer. The diseases including tumors, Menetrier disease and connective tissue diseases were located in gastric fundus and/or body . Conclusion The diseases located in upper stomach have more clinical significance. All of endoscopic ultrasonography, upper gastrointestinal barium and endoscopic mucosal resection are helpful in differential diagnosis of the large gastric folds.
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Objective To investigate the effects of tunicamycin(TM)-inhibitor of N-glycosylation of proteins on proliferation and apoptosis of glomerular mesangial cells(GMC) and synthesis of FN. Methods Morphology of GMC apoptosis was observed under eletron microscopy, and flowcytometry was used for assessing apoptosis rate. GMC proliferation was examined by MTT assay. The amount of FN was measured by ELISA. Results TM inhibited the proliferation of GMC as compared with untreated controll ( P
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One hundred recruits from the Central Security Forces in Alexandria were investigated for the presence of Phthirus pubis infestation. 20% of them were infested by the lice. Factors responsible for the transmission of the condition were evaluated. It was found that non-sexual factors play a major role in spreading the infestation more than sexual contact especially in that community. Recommendations to control Phthirus pubis in this important closed community were discussed in details