Design of a typical residence for the elderly in Morocco

The population of Moroccan elders is in full increase; their requirements for quality and quantity of services are becoming increasingly important. On the basis of this, reality and extension of many major innovative projects in Morocco (industrial expansion plan, renewable energy stations, the road infrastructure network, rural electrification, drinking water, accelerated urbanization, globalization...) gain importance. Reflection on the design of a typical residence for the elderly has become an ambitious idea possessing all the chances of its success; it is also worth noting that it is a citizen opportunity to be seized by all political decision-makers for the promotion of health and the improvement of the quality of life of a growing category of the population. The typical residence of the elderly remains not only a place of life but also an environment of therapeutic care and at different levels of autonomy and dependence of our elders

Vitamin D Status in Moroccan Patients With Pemphigus.

Objective: The aim of this study was to assess the vitamin D status and the factors that may influence this vitamin in Moroccan patients with pemphigus. Study Design: Case-control study. Place and Duration of Study: Department of Dermatology at the University Hospital of Rabat- Salé between 2012 and 2013. Methods: In this case-control study, 30 patients with pemphigus were included. Sixty healthy persons were recruited to serve as controls. The patients underwent anthropometric assessment and clinical evaluation. Serum 25 hydroxyvitamin [25(OH) D] D2 and D3 were measured using radioimmunoassay. Hypovitaminosis D was defined as serum 25(OH) D <30 ng/ml. Results: The average age of participants was 56 years ± 11.4. Hypovitaminosis D was observed in 100% of patients. The prevalence of hypovitaminosis D was higher (p <0.001) in patients than in controls. Serum 25(OH) D levels were associated with disease duration (r=0.34, p=0.05), ESR (r=- 0.31, p=0.05) and PTH (r=-0.66, p<0.001). No relationship was found between serum 25(OH) D levels and the other characteristics related to patients or pemphigus. Conclusions: Our study suggested that serum levels of vitamin D were significantly lower in Moroccan patients with pemphigus. Future studies with a larger population are needed to confirm our results.

Prognostic factors of acute aluminum phosphide poisoning.

Background : In Morocco, acute aluminum phosphide poisoning (AAlPP) is a serious health care problem. It results in high mortality rate despite the progress of critical care. Aims : The present paper aims at determining the characteristics of AAlPP and evaluating its severity factors. Setting and design: We studied consecutive patients of AAlPP admitted to the medical intensive care unit (ICU) (Ibn Sina Hospital, Rabat, Morocco) between January 1992 and December 2007. Materials and Methods : Around 50 parameters were collected, and a comparison was made between survivor and nonsurvivor groups. Statistical Analysis : Data were analyzed using Fisher exact test, Mann-Whitney U test and Cox regression model. Results : Forty-nine patients were enrolled: 31 females and 18 males; their average age was 26± 11 years. The ingested dose of aluminum phosphide was 1.2± 0.7 g. Self-poisoning was observed in 47 cases, and the median of delay before admission to the hospital was 5.3 hours (range, 2.9-10 hours). Glasgow coma scale was 14± 2. Shock was reported in 42.6% of the patients. pH was 7.1± 0.4, and bicarbonate concentration was 16.3± 8.8 mmol/L. Electrocardiogram abnormalities were noted in 28 (57%) cases. The mortality rate was 49% (24 cases). The prognostic factors were APACHE II (P= 0.01), low Glasgow coma scale (P= 0.022), shock (P= 0.0003), electrocardiogram abnormalities (P= 0.015), acute renal failure (P= 0.026), low prothrombin rate (P= 0.020), hyperleukocytosis (P= 0.004), use of vasoactive drugs (P< 0.001), use of mechanical ventilation (P= 0.003). Multivariate analysis by logistic regression revealed that mortality in AAlPP correlated with shock (RR = 3.82; 95% CI= 1.12-13.38; P= 0.036) and altered consciousness (RR= 3.26; 95% CI= 1.18-8.99; P= 0.022). Conclusion : AAlPP is responsible for a high mortality, which is primarily due to hemodynamic failure.