Prevalence of smoking in the Maghreb: a systematic review and meta-analysis.

INTRODUCTION: Tobacco is the leading preventable cause of death in the world and kills up to seven million people each year. Monitoring its prevalence is important for prevention programs. The aim of this work was to summarize the literature on the prevalence of smoking in the Maghreb countries during the past two decades. METHODS: The research was conducted on Medline via Pubmed based on the Mesh terms: «Tobacco Use¼, «Smoking¼ and «Africa, Northern¼. Were included articles reporting the prevalence of current smoking in the general population or a subgroup of the population in one or more Maghreb countries. The extracted data was related to current smoking, its definition, total prevalence and prevalence by sex. RESULTS: About 50 articles were included, the data was mainly from Morocco, Algeria and Tunisia. Two studies reported prevalence among college students in Libya. The highest prevalences in the general population were noted in Tunisia with an overall prevalence, during the period studied, of 25% (95% CI [21% -29%]). This prevalence was 16% (95% CI [14% -18%]) in Morocco and 14% (95% CI [8% -22%]) in Algeria. CONCLUSION: The prevalence reported was generally high, especially in Tunisia, although lower than in developed countries, hence the importance of setting up and strengthening prevention and control measures, mainly among young people.

[Tinnitus : from the general practitioner to the specialist]. / Acouphènes : du généraliste au spécialiste.

Tinnitus is a common reason for ENT consultation. Patients who suffer from tinnitus are becoming more demanding and frequently ask questions about the cause, the mechanisms of onset, and the cure of their pathology. Quite often, they feel poorly managed or misunderstood, all the more so that, despite the proposed treatments, tinnitus persists and leads to adverse effects on the patients’ daily life. The general practitioner, because of his proximity, must be involved in the prevention, diagnosis and information of individuals with tinnitus and, thus, fully fulfill his acting public health role. To approach this condition, we will outline the clinical diagnosis and discuss the possible psychological repercussions; then, we will envisage the various treatment options that are currently available and evoke the future prospects in this area.

Les acouphènes représentent un motif fréquent de consultation en ORL. Les patients qui en souffrent sont de plus en plus exigeants et posent des questions sur la cause et les mécanismes d'apparition ainsi que sur le traitement curatif de leur affection. Souvent, ils se sentent mal pris en charge, voire incompris et, ce, d'autant plus que, malgré les traitements proposés, les acouphènes persistent et entraînent des retentissements sur leur vie quotidienne. Le médecin généraliste, par sa proximité, doit s'impliquer dans la prévention, le diagnostic et l'information des individus atteints d'acouphènes et remplir ainsi, pleinement, son rôle d'acteur de la santé publique. Pour approcher cette affection, nous tracerons les grandes lignes du diagnostic clinique en précisant les éventuelles répercussions psychologiques; ensuite, nous exposerons les différentes possibilités thérapeutiques actuellement disponibles tout en évoquant les perspectives d'avenir dans ce domaine.

ABO blood groups in relation to breast carcinoma incidence and associated prognostic factors in Moroccan women.

The association between blood groups ABO and different types of diseases was established in several previous studies. Our aim was to seek the possible association between the ABO blood group and breast cancer-associated prognostic factors. The Chi-squared analytic test was used to compare phenotypic ABO distribution among Moroccan blood donors and 442 cases of women suffering from breast carcinoma with archived files in Maternity Ward of University Hospital C.H.U Ibn Rochd between 2008 and 2011. High incidence of breast carcinoma was observed in blood type B patients (p < 0.05). Blood type B was associated with breast carcinomas overexpressing human epidermal growth factor receptor HER2 (p < 0.05) and high risk of cancer at age over 70 years (p < 0.001). Blood type A was associated with high risk of cancer among women younger than 35 years old. Blood type A and AB were associated with high incidence of lymph node metastasis (p < 0.05). Multivariate analysis has shown correlation between O blood type and estrogen receptor-positive tumor. Patients with blood group A, B, and AB were more likely to develop aggressive breast carcinoma. Further follow-up studies are necessary to clarify the role of ABH antigens in the progression of breast carcinoma.

Adaptation and validation of the Moroccan Arabic version of the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ).

OBJECTIVE: The aims of this study were to translate and culturally adapt the PIDAQ native English version into Moroccan Arabic, and to assess the psychometric characteristics of the version thereby obtained. MATERIALS AND METHODS: The PIDAQ original English version was sequentially subjected to translation into Moroccan Arabic, back-translation into English, committee review, and pre-testing in 30 subjects seeking orthodontic treatment. RESULTS: The final Moroccan Arabic version further underwent an analysis of psychometric properties on a random sample of 99 adult subjects (84 females and 15 males, aged 20.97 ± 1.10 years). The intraclass coefficient correlation of the scores of the responses obtained after administration of the questionnaire twice at a 1-month interval to a random sample of 30 subjects ranged from 0.63 for "Self-confidence" to 0.85 for "Social Impact". Cronbach α coefficients ranging from 0.78 for "Aesthetic Concerns" to 0.87 for "Self-confidence" were obtained; the different subscales of the Moroccan Arabic version of the PIDAQ showed good correlation with the perception of aesthetics and orthodontic treatment need. CONCLUSION: The results of the present study indicate that the Moroccan Arabic version of the PIDAQ obtained following thorough adaptation of the native form is both reliable and valid. It is able to capture self-perception of orthodontic aesthetic and treatment need and is consistent with normative need for orthodontic treatment.

[Intra-articular use of sodium hyaluronate (2,2,-2,7 MDa) in the treatment of Moroccan patients with knee osteoarthritis: randomized controlled trial]. / Intérêt de la viscosupplémentation a l'hyaluronate de sodium (2,2-2,7 MDa) dans le traitement de la gonarthrose chez des patients marocains: etude randomisée contrôlée.

OBJECTIVE: To assess the efficacy of intra-articular sodium hyaluronate, administred once weekly for 3 weeks (3 injections) in Moroccan patients with knee osteoarthritis over 6-month period. MATERIAL AND METHODS: We prospectively studied the outcome of 75 patients with painful knee osteoarthritis in grade 1, 2 and 3 on ACR radiological criteria in our rheumatology clinic in Morocco. Group 1: 45 patients were treated with 3-weekly injections of intra-articular sodium hyaluronate (1%; 2,2-2,7 MDa). Group 2 : 30 patients treated with symptomatic slow-acting drugs for osteoarthritis (SYSADOA). The efficacy parameters were Visual Analogue Scale (VAS) and Lequesne index. RESULTS: In group 1: 35/45 were female, a mean age of patients was 57.2 (± 8.2) years, and a mean Body Mass Index (BMI) was 28 (± 1.4) kg/m2. In group 2: 23/30 were female, a mean age of patients was 58.6 (± 2.8) years, and a mean of BMI was 27.8 (± 1.4) kg/m2. Before treatment in group 1, the mean of VAS was 6.5 cm (± 1), and of Lequesne index 10.5 (± 2.1). At 3 and 6 months after the third injection of sodium hyaluronate, there was a significant improvement from baseline of Lequesne index and VAS (P = 0.001). In group 2 before treatment, the mean of VAS was 7 cm (± 0,7), and of Lequesne index 8 (+ 1.1), but the improvement from baseline at 3 and 6 months of treatment was lower than group 1. CONCLUSION: The results of this prospective study, showed the efficacy of 3-weekly injections of sodium hyaluronate in the treatment of knee osteoarthritis in Moroccan patients over a 6-month period.

Medical informatics in morocco.

OBJECTIVES: Informatics is an essential tool for helping to transform healthcare from a paper-based to a digital sector. This article explores the state-of-the-art of health informatics in Morocco. Specifically, it aims to give a general overview of the Moroccan healthcare system, the challenges it is facing, and the efforts undertaken by the informatics community and Moroccan government in terms of education, research and practice to reform the country's health sector. METHODS: Through the experience of establishing Medical Informatics as a medical specialty in 2008, creating a Moroccan Medical Informatics Association in 2010 and holding a first national congress took place in April 2012, the authors present their assessment of some important priorities for health informatics in Morocco. RESULTS: These Moroccan initiatives are facilitating collaboration in education, research, and implementation of clinical information systems. In particular, the stakeholders have recognized the need for a national coordinator office and the development of a national framework for standards and interoperability. CONCLUSION: For developing countries like Morocco, new health IT approaches like mobile health and trans-media health advertising could help optimize scarce resources, improve access to rural areas and focus on the most prevalent health problems, optimizing health care access, quality, and cost for Morocco population.

[Attitudes and behavior in relation to smoking among medical students in Casablanca in 2010]. / Comportement des étudiants en médecine de Casablanca vis-à-vis du tabac en 2010.

OBJECTIVE: Smoking is a major public health problem. The doctor should be at the forefront in the fight against tobacco. Our study aims to determine the prevalence of smoking among medical students and to evaluate their attitudes towards this problem. PATIENTS AND METHODS: A cross-sectional survey was conducted among 736 medical students enrolled in the faculty of medicine and pharmacy of Casablanca in the academic year 2009/2010. RESULTS: The prevalence of smoking was 7.9%. It was significantly higher in men (16% against 3% in women) and varied little from one age group to another (7-8%). The average number of cigarettes smoked per day was eight. More than half of the students (58%) had attempted to quit smoking. The main motivation was the occurrence of certain symptoms (66%). Ex-smokers accounted for 10% of the total. Moroccan anti-smoking law was poorly understood by more than half of our students (72%). The majority was in favor of prohibition of tobacco sales to children (92%) and the training of health professionals to help patients who want to quit smoking (86%). CONCLUSION: Compared with previous years this study shows a marked decrease in the prevalence of smoking among medical students in Casablanca as well as a better understanding of its ill effects. This is due not only to greater awareness of this problem among medical students but also to the introduction of the teaching of the pathologies related to tobacco.

The application of a telemedicine management system: the case of a Moroccan hospital unit.

This study is a contribution to the ongoing debate on the application of informatics in medicine. It attempts to outline a theoretical framework supported by a software application of a telemedicine management system. The proposed model is based on a detailed benchmarking of Telecom environments, hardware environments, and content management systems. This approach, which uses open source technologies, helps to create an interface with two entities: web and medical care USB. In sum, for the proposed telemedicine model to be successful, health professionals, telecom operators and research medical informatics laboratories must play an active role in the conception and implementation of telemedicine applications.

Cross-cultural adaptation and validation of the knee and hip health-related quality of life (OAKHQoL) in a Moroccan Arabic-speaking population.

The aim of this study was to adapt the knee and hip osteoarthritis quality of life questionnaire (OAKHQoL) into Moroccan Arabic and to determine its psychometric properties. After translation, back-translation and pretesting, the translated version was submitted to an expert committee. The psychometric properties were tested on patients with hip or knee osteoarthritis. Internal consistency was tested using Cronbach's alpha coefficient (α), and the test-retest reliability using intraclass correlation coefficients (ICC). Construct validity was assessed by examining item-convergent and divergent validity and by comparing the average scores between age groups and walk perimeter groups. The study was conducted on 131 patients (115 with osteoarthritis of the knee and 16 with osteoarthritis of the hip). The "physical activities" (α = 0.93), "mental health" (α = 0.84) and "pain" (α = 0.88) dimensions of the Arabic version were internally reliable. The ICC were adequate to good; 0.83 for "physical activities", 0.65 for "mental health" and 0.70 for "pain" dimensions. The instrument demonstrated good construct validity; all items exceeded the 0.4 criterion for convergent validity, except items 13 and 41 and most of the correlations between items and their own scale were significantly higher than their correlations with other scales. A semantically equivalent translation has been developed with cultural adaptation of OAKHQoL. It is quite reliable and a valid measure of the effect of osteoarthritis on the quality of life on Moroccan patients.

Medical informatics in Morocco: Casablanca Medical Informatics Laboratory.

BACKGROUND: In 2005, Medical Informatics Laboratory (CMIL) became an independent research unit within the Faculty of Medicine and Pharmacy of Casablanca. CMIL is currently run by three persons (a university professor, a data processing specialist and a pedagogical assistant). The objectives of CMIL are to promote research and develop quality in the field of biomedical data processing and health, and integrate new technologies into medical education and biostatistics. It has four units: Telehealth Unit, Network Unit, Biostatistics Unit, Medical data processing Unit. OBJECTIVES: The present article seeks to give a comprehensive account of Casablanca Medical informatics laboratory (CMIL) activities. For ease of exposition, the article consists of four sections: Section I discusses the background of CMIL; section II is devoted to educational activities; section III addresses professional activities; and section IV lists projects that CMIL is involved in. RESULTS: Since its creation, CMIL has been involved in a number of national and international projects, which have a bearing on Telemedicine applications, E-learning skills and data management in medical studies in Morocco. CONCLUSIONS: It is our belief that the skills and knowledge gained in the past few years would certainly enrich our research activities, and improve the situation of research in Medical informatics in Morocco.

La prevalence des dysfonctions craniomandibulaires chez les patients ages

Ce travail rapporte les resultats d'une enquete epidemiologique transversale et analytique sur la prevalence des dysfonctions craniomandibulaires. Notre etude a ete realisee au Centre de Consultations et Traitements Dentaires de Casablanca chez 100 patients ages de 50 ans et plus. Pour evaluer les symptomes des dysfonctions de l'appareil manducateur (DAM); nous avons utilise l'indice d'anamnese d'Helkimo ; 72de notre echantillon rapportent des symptomes de DAM; le bruit articulaire est le symptome le plus rapporte (64). 67de notre population cible decrivent des habitudes nocives : 28ont de mauvaises postures; 18serrent leurs machoires et 16grincent des dents. L'analyse statistique a revele une association entre les habitudes nocives et l'apparition des DAM. 32de ces individus ont une perte de calage posterieur; 23sont porteurs de PAT; et 10sont des edentes complets non appareilles; nous n'avons pas trouve d'association entre l'etat dentaire et l'apparition des DCM

Smoking in Mediterranean countries: Europe, North Africa and the Middle-East. Results from a co-operative study.

SETTING: Although smoking is considered a major public health problem, it remains an important component of social behaviour and economic activity. OBJECTIVE: To provide an initial evaluation, from available data, of the main characteristics of smoking in the Mediterranean region. DESIGN: A questionnaire was sent to a group of correspondents-clinicians or epidemiologists involved in tobacco prevention-in the different countries. RESULTS: The proportion of smokers was quite different in men and women. In the majority of the countries over 45% of men and under 15% of women were smokers. The mean age of initiation of smoking was about 15. In every country mainly manufactured cigarettes were smoked, and the younger population preferred American cigarettes. Doctors and medical students had smoking habits similar to those of the general population. All of the countries included in the study had antismoking legislation, but only some put restrictions on advertising or sponsoring from the tobacco industry. CONCLUSION: To deal with the situation, recommendations have been proposed by a group of IUATLD experts in the different regions. The first of these is the implementation of a co-operative study in order to collect reliable data on smoking. Other recommendations are to set up educational programmes for health professionals to aid them in their smoking prevention activities.