Epidemiology, clinical features, and mortality rate of Wilson disease in Moroccan children: A pediatric case series.

BACKGROUND AND STUDY AIMS: Wilson's disease is an autosomal recessive disorder, that affects copper metabolism, leading to copper accumulation in the liver, nervous system, and cornea. Data are lacking on the epidemiology, the clinical and laboratory characteristics, treatment, and survival of Wilson's disease in Morocco. The aim of this study was to examine these features and the cause of death in a Moroccan pediatric population. PATIENTS AND METHODS: The study was carried out at the University Hospital Center of Marrakesh, Morocco; 46 children were diagnosed with Wilson's disease from 2008 to 2019. The diagnosis was based on low serum ceruloplasmin, increased urinary copper concentrations, the presence of Kayser-Fleischer rings, a family history of Wilson's disease, and a Leipzig score of ≥ 4. RESULTS: A total of 42 patients were referred to the center for hepatic or neurological manifestations; four patients were asymptomatic. Consanguineous marriage was found in 67.4% of the cases. The mean duration of illness (42 patients) was 4.9 ± 3.9 years. Kayser-Fleischer rings were found in 60.9% of 46 patients. Of the 42 symptomatic patients: 28 of 30 (93.3%) patients had low serum ceruloplasmin (<0.2 g/L), and 24 h urinary copper >100 µg/day was found in 34 of 35 (97.1%) cases. The treatment was established with D-penicillamine for 43 of the 46 patients, with zinc acetate for one patient and with zinc sulfate in for one patient, while one patient was not treated. D-penicillamine was discontinued in nine patients because of adverse effects such as thrombocytopenia, neurological deterioration, pancytopenia, severe vomiting and severe hypersensitivity. In total 28 patients were clinically and biologically stabilized, two patients experienced vision loss, and 16 patients died (38%). The main cause of death was diagnosis made at an advanced stage of disease and stopping treatment. CONCLUSION: Wilson's disease is a rare condition associated with treatement efficacy, but late diagnosis and stopping treatment can lead to a high mortality rate.

Augmentation of biodegradability of olive mill wastewater by electrochemical pre-treatment: effect on phytotoxicity and operating cost.

In order to exploit the fertilizer value of olive oil mill wastewaters (OMW), a novel method has been developed for its treatment. OMW effluents were pre-treated first by electrocoagulation using aluminum electrode and then by a biological process using a selected strain of Aspergillus niger van Tieghem. The effect of treatments was assessed through COD removal, reduction of total phenols, and decrease of phytotoxicity using durum wheat (Triticum durum) seeds. This sequential treatment scheme was capable of reducing concentration of organics, phenolics and phytotoxicity. The goal of this investigation was achieved, the phytotoxicity was completely removed and the germination index was 106% of OMW after sequential treatment. It can be concluded that the sequential process of OMW treatment might serve for the production of a fertilizer which is able to improve the growth of plants. These results are encouraging in the context of developing a low-budget technology for the effective management of OMW.

Detoxification and discoloration of Moroccan olive mill wastewater by electrocoagulation.

The objective of the present study was to assess the electrocoagulation treatment of olive mill wastewater using an aluminum electrode. We have examined the effect of the following parameters on the removal of chemical oxygen demand (COD), polyphenols and dark color removal efficiency: Electrolysis time, Current density, Chloride concentration and Initial pH. The olive mill wastewater (OMW)--diluted 5 times--used in this study had 20.000 mg/L chemical oxygen demand, 3.6 mS/cm conductivity and acidic pH (4.2). It also contains considerable quantities of polyphenols (260 mg/L). The evolution of the physico-chemical parameters during the treatment by electrocoagulation showed that under the following conditions: electrolysis time 15 min, NaCl concentration 2g/L, initial pH 4.2 and current density 250 A/m(2), the discoloration of the olive mill wastewater, the reduction of the chemical oxygen demand and the reduction of polyphenols exceeded 70%, the electrodes consumption was 0.085 kg Al/kg COD(removed) and the specific energy consumed was 2.63 kWh/ kg COD(removed). Under these optimal experimental conditions, olive mill wastewater became non-toxic for Bacillus cereus.