ABSTRACT
Acquired haemophilia is a rare disease; it occurs most frequently in elderly patients. We report the case of a 26 -year-old women, Thyroidectomized 5 years ago, Followed since 2013 for bullous dermatosis [bullous pemphigoid] currently under Corticotherapy, Under neuroleptic for a psychosis. Which presents a superficial hematoma of the left leg with spontaneous bruising. The diagnosis was established by the demonstration of an isolated prolongation of the activated partial thromboplastin time [APTT] with a reduced factor VIII level and evidence of factor VIII inhibitor activity to 92.1 Bethesda Unit [92,1 UB/ml]. Diagnosis of acquired haemophilia A confirmed, patient received corticosteroid treatment. Bleeding symptoms had completely disappeared and coagulation tests become normal. In conclusion, if bleeding symptoms are associated with unexplained prolongation of APTT, an inhibitor against factor must be searched for not missing an acquired coagulation disease
ABSTRACT
Glanzmann thrombasthenia is a rare autosomal recessive disease, secondary to a deficiency in platelet membrane glycoproteins GP IIb IIIa, with a defect of platelet aggregation. The result is a disturbance of the primary haemostasis leading to more or less significant haemorrhages, appearing from childhood. We report a case of a female child, 11 months of age, Born of a first-degree consanguineous marriage, without any haemorrhagic familial history. Who presented a abundance dental bleeding following a dental thrust. The biological assessment carried out in her showed a normal blood count; There is no thrombocytopenia and the platelets have a mean average volume of 9.4 fl. prothrombin time, activated partial thromboplastin time and fibrinogen level are normal, The time of platelet occlusion measured on the PFA-200® automaton is elongated: it is greater than 300 seconds in the presence of collagen/epinephrine and collagen/ADP. The analysis of the Willebrand factor does not reveal any abnormality. On the other hand, the exploration of the platelet functions shows a lack of aggregation whatever the platelet activator used: there is no aggregation in the presence of collagen, ADP, arachidonic acid, Aggregation induced by ristocetin is highly disrupted. Immunophenotyping of platelet glycoproteins and the study of expression of glycoproteins after activation by thrombin by flow cytometry show a lack of expression of Gp IIb IIIa [CD41]. This method made it possible to measure the level of Gp IIb IIIa at 1%. Furthermore, factor VIII [coagulant] is greater than 110% and factor IX [coagulant] is at 115%. The diagnosis of Glanzmann type I disease was made
ABSTRACT
Improving the diagnostic strategy of the lupus anticoagulant is prerequisite in hemostasis. The objective of our work is to develop and evaluate the three integrated tests expressed as normalized ratio or Lupus Ratio and can combine the various stages in the diagnosis of these antibodies. Three Lupus Ratio are used, they were determined with activator thromboplastin time, the diluted thromboplastin time and diluted Russell Viper venom time. Reference values and thresholds for positivity were determined for all tests. Our preliminary results showed concordant and discordant profiles with those previously obtained by conventional methods of detection of circulating lupus antibody type. The interest of the integrated testing is to discusse and compari our results with those of the literature. The determination of the Ratio Lupus offers compelling and promising results and allows considering, for in a short term, the replacement of conventional techniques with improved diagnosis
Subject(s)
International Normalized Ratio , Daboia , Partial Thromboplastin TimeABSTRACT
The antimicrobial therapy for the treatment of bacteremia is often empirical in the first 48 hours and based on the epidemiological knowledge of susceptibility profiles of the most common bacteria causing such infections. The aim of our study was to determine the epidemiological profile and the antibiotics susceptibility of bacteria identified in blood culture in a teaching hospital center, to improve the empirical antibiotherapy for the treatment of bacteremia. A retrospective study was carried out at the Microbiology laboratory of Mohammed VI hospital of Marrakech from January 2008 to June 2009. It included all the bacteria identified in blood culture. We collected 146 strains responsible for bacteremia. Gram-negative bacilli [BGN] represented 52.7%. The most frequently isolated species were Staphylococcus aureus [21.3%], Entrobacter cloacae [14%], Acinetobacter baumannii [12.3%] and Pseudomonas aeruginosa [8.9%]. The incidence of resistance to methicillin were 48.3% for Staphylococcus aureus. No resistance of glycopeptides was found among the enterococci and staphylococci isolates. 64.3% of enterobacteriaceae were resistant to third generation cephalosporins and had a broad-spectrum betalactamase phenotype. The proportion of non fermenting Gram negative bacilli resistant to imipenem was 49.9%. The resistance rate of Acinetobacter baumannii and Pseudomonas, aeruginosa was 49.9% for imipenem. To carry out an epidemiological control of bacteremic episodes occurring at every hospital, it is necessary to improve the empirical antibiotherapy
ABSTRACT
Objective: our study aims at studying the sensibility of isolated staphylococci at hospital Ibn Sina of Rabat [during six months] to various antibiotics, to allow a better therapeutic approach
Method: We included all non doubled stump of isolated staphylococcus from various pathological samples taken from hospitalized patients in University Hospital Center
Results: The stumps of isolated staphylococcus represent 12,85% of all the positive isolates. Global sensibility of stumps to penicillin G was low, All s. aureus are sensitive to the pristinomycine and vancomycine, while the SCN is less in sensibility to the assiociation thrimethoprime - sulfamethoxazol in the order of 87.1 % for S. aureus and 35. 75 % for the SCN. Stumps of S. aurens are more sensitive to erythromycine lincomycine and the acid pusidique, while that of SCN sensibility to aminosides is very variable. The SARM represent 25.2% of staphylococcus aureus and present the phenotypes of multiresistance
Conclusion: Amony all pathogenics, staphylococci remains the most grave and important in human infections. The meticillino - resistance still represent the essential marker of the the antibio-resistance of staphylococcus
ABSTRACT
This is prospective study to evaluate the influence of the long-term fasting on the biochemical constants and deducing from it the credibility of the analyses carried out during this month. At thirty one healthy volonteers, three blood analysis was done per day at three different times: 9h of the morning, midday and 16h. Several biological parameters - glucose, cholesterol total, triglycerides, rates of protids, urea, creatinin, uric acid were made by system Synchron cx delta. We found that the concentration of some parameters does not accept any significant change during the day [triglycerides, urea], others accept a significant change only at the end of the day [glycemia, cholesterol], whereas the concentration in protids, uric acid and creatinin changes at a significant degree along the day. Observing Ramadan led to a change of several blood parameters, represents primarily increase in cholesterol HDL and a reduction in the glycemia. These changes do not affect the biological analysis done during the month of Ramadan if we respects the hour of fasting necessary before each measurement