[Surgical treatment of secondary hyperparathyroidism in chronic renal failure. Report of 57 cases]

The aim of this study was to report the experience of the department of general surgery [Aile III] Ibn Rochd Hospital in surgical management of hyperparathyroidism in patients with end-stage renal disease [ESRD]. Fifty seven patients [24 M, 33F] with hyperparathyroidism underwent surgical parathyroidectomy from 1998 to 2004. Surgical indication was established according to clinical or biological assessment. Fifty nine operations were performed [57 first-hand cervicotomies and resumptions in two cases]. Histological examination of parathyroid gland specimens disclosed adenoma in 33 patients and hyperplasia in 14 patients. The follow-up was normal in 52 patients, marqued by cervical hematoma in 2 cases and death was deplored in 4 patients. The post-operative calcium level was in the normal range in 43 cases, low comparatively to the baseline in 12 cases and high in 2 cases. The PTH level was normal in 55 patients and high in two patients. Long-term outcome was evaluated in 36 patients mean follow-up [18 months]. A good evolution was noted in all patients referring to clinical, biological and radiological investigations. That, in our context, surgical parathyroidectomy still an appropriate approach for the treatment of hyperparathyroidism in patients with end-stage renal disease

[Descriptive study of the oral and dental health state in patients with chronic renal insufficiency under hemodialysis]

In order to evaluate the state of health and needs in oral and dental treatments among the patients affected by chronic renal insufficiency under Hemodialisis, a descriptive transverse investigation bas beeb led in the service of nephrology of CHU lbn Rochd of Casablanca, that concerned a population of 161 patients patient adults IRC [middle age: 44,9 years]. The main results of this survey showed that: "A weak oro-dental hygiene level with an indication of plate means of 2,5% and 52,59% of the patients present the plate and tartar respectively. "The CAO indication is lower to the one of the general population and he is on average of 10, with a rate of dental attack of 3 5,80%. "97,03" to present a periodontal attacks with a middle ICPBT of 2,9 the rate of bleeding is of 97,04%. "31,68" of the patients endure xerostomia. This situation of the bucco-dental health state lets foresee the particularity of the needs in bucco-dental treatments among the renal chronicle insufficient patients and the needs of the physician dentist to professional formation

Acute renal failure in children: a 111 cases report

Acute renal failure [ARE] is not exceptional in child. The aim of this study was to analyze the epidemiology, etiologies and the prognosis of ARE in children in Casablanca. We report 111 children with ARE, treated from 1991 to 2001 in the department of nephrology and pediatric unit of Ibn Rochd Universitary Hospital of Casablanca. The children were separated into 3 groups: newborn [6 cases], infants [28 cases] and child [77 cases]. Oligoanuria was observed in 71 cases [63%]. Causes of ARE were: functional ARF in 16 cases [14.4%], organic ARF in 86 cases [77.4%] due to glomerulonephritis in 39 cases [45.3%], hemolytic-uremic syndrome in 21 cases and acute tubular necrosis in 19 cases [18.2%]. Obstructive ARF was observed in 9 cases. The treatment depended on the cause of ARF. Renal replacement therapy was necessary in 37 cases [33%]. Eighty three children [90.2%] recovered a normal renal function, 9 children [9.7%] involved to chronic renal failure. Death occurred in 14 cases [12.6%]. We conclude that ARE prognosis depends on the cause and the early treatment

[Renal papillary necrosis retrospective study of 7 cases]

In this retrospective study, the authors precise the different aspects of 7 cases of renal papillary necrosis, hospitalized in the department of Nephrology-Hemodialysis of UHC Ibn Rochd of Casablanca between 1st January 1984 to December 1990. During these 7 years, the renal papillary necrosis constituted 5% of the annual hospitalizations. The study of age and sex-ratio showed a male predominance [7]%], with an average age equal to 31,7 +/- 12,9 years. Clinically, the most frequent signs were hematuria [100%]. The etiology has been dominated by diabetes associated with acute pyelonephritis in 71% of cases. One patient had sickle-cell hemoglobinopathy and the other had renal papillary necrosis due to the abuse of analgesics. Antibiotics has been given in cases of urinary infection. Blood transfusion has been necessary in the patient having sickle-cell hemolgobinopathy. There was an improvement in the outcome of all patients

[ surgery in hemodialysis patients]

The experience of the hemodialysis unit in the university hospital lbn Rochd Casablanca since its beginning in 1983 rest on 20 patients who underwent at least one surgical operation, that is 16 percent, of the population undergoin hemodialysis in our unit. The study of age and sex-ratio showed; 13 men [65%] and 7 women [35%] with an average age equal to 42 years. The frequency of untercurrent surgical pathology unrelated to renal failure is 4 percent. The analysis of the nature of operation in terms of kind of kidney disease shows a high frequency of urological surgery in chronic pyelonephritis. Regarding glomerulonephretis it is rather question of general surgery. Consequences of operation were simple in 90 percent of cases. We didn't deplore any decease after surgery

Nephrotic syndrome with minimal charge

On 230 cases of nephrotic syndrome treated between 1982 and 1988, 40 nephrotic syndromes were with minimal charge. The average of age was 22 years with a light male predominance [56%]. Oedema was the first motive of consultation, no case of arterial hypertension was seen. While hematuria was noted in 16% of the cases, proteinuria was between 3 g/24h and 22g/24h, protidemia average was 42.5 g/l, albuminemia was 17g/l. Corticosensibility was observed in 95.5% of cases. Relapse were frequent, the infection was the principal reason

Hepatitis B vaccination. Evaluation of efficacy in a high risk hospital personnel population

B. Viral hepatitis endemo-epidemiological potencial in hospital practice remains a preoccupyng problem. The study of serological status in an order of an active protection has been realised in a group of 100 of the medical staff in university hospital of Casablanca. 49 of the subjects had at least one of the markers of B. hepatitis among them one is chronical carrier of H.B.S. antigen. 51 seronegative and volonteers subjects [51%] have received 3 injections of the vaccine Hevac B [R] of Pasteur Institute, at one month interval. The evolution controls of Anti H.B.S. antibodies have been realised a month later after each injection. At the end of this vaccination 86.2% of the subjects have acquired a protection with rates of anti H.B.S. superior to the minimal protective rate. 5 bad responders have received a forth injection of the vaccine. The control of the antibodies H.B.S. was realised one year after, in 30 subjects [58.8%], 29 have kept Anti H.B.S. antibodies, among them 25 at protective rates