Although electro-surgery is one of the most important tools in modern surgery, its use is not without risks. Burns caused by electro cautery plates are one of these dreaded accidents that remain rare but serious. The occurrence of such an accident in a surgical context is difficult for the patient as well as for the medical team. In this case report, we describe a burn of the hand of a patient admitted to the neurosurgery operating room due to a defective plate and we discuss the means of prevention of these incidents to improve the safety of patients in the operating room.

Intraoperative hypotension should be differentiated with respect to the different underlying causal mechanisms. Post-induction hypotension is defined as arterial hypotension occurring during the first 20 minutes after induction of anaesthesia and early intraoperative hypotension is arterial hypotension during the first 30 minutes of surgery. The aim of our study is to evaluate the incidence of intraoperative hypotension during surgery under general anaesthesia in a patient population and the factors influencing its occurrence. Materials and Methods: This is a prospective study, carried out over a period of 4 months on 154 patients scheduled for surgery under general anaesthesia at the Military Hospital of Instruction Mohammed V in Rabat. We collected the following information : age, sex, ASA score, body mass index, comorbidities, drug intake and type of surgery. The occurrence or not of post induction hypotension and early intraoperative hypotension. Results: The mean age of the patients in our case series was 58.5 ± 12 years. The sex ratio was 1.4 with a predominance of males. ASA I and II status were predominant. In univariate analysis: advanced age, the existence of chronic arterial hypertension and the decrease in systolic blood pressure before induction were factors favouring the occurrence of intraoperative hypotension. In multivariate analysis: We found that these 3 factors were independently related to the occurrence of intraoperative hypotension. Conclusion: We found that lower pre-induction systolic blood pressure, older age and comorbidity such as hypertension are factors independently associated with post-induction and early intraoperative hypotension. We believe that this will allow preventive optimisation of the risk through early implementation of continuous haemodynamic monitoring and adequate therapeutic intervention.

Mediterranean spotted fever (MSF) is a rickettsial disease of the spotted group caused by rickettsia conorii. This zoonosis is known to have a benign course but can be complicated in severe forms by neurological damage, which sometimes makes it so serious. We report an observation of a 45-year-old female patient, who presented with headaches, vomiting evolving in a febrile context, in whom the clinical examination showed an inoculation chancre associated with diffuse skin lesions, a sub-stiff neck, the lumbar puncture showed a lymphocytic meningitis, after the administration of doxycycline the evolution was favorable.

Dysnatremias have several particular aspects concerning their etiology and evolution. They are associated with morbidity and mortality in various clinical contexts. The Primary aim of our study is to evaluate the prognosis impact of postoperative dysnatremia in cardiac surgery under extracorporeal circulation. Methods: This is a descriptive and analytical retrospective study, concerning patients operated for a period of 18 months between September 2018 and February 2020 in the cardiovascular surgery department at the Mohammed V Military teaching hospital in Rabat, and including 253 adult patients. The bioassay of plasma sodium was done immediately, at 4, 24 and 48 hours after admission to the intensive care unit. Results: The average age of the patients was 56 years with male predominance. Fifty-seven patients (22.5%) presented at least hypernatremia and 30 patients (11.9%) at least hyponatremia. The overall mortality rate was 7.9%. 17.5% when hypernatremia. Conclusion: The level of plasma sodium after admission to intensive care is an independent predictor of morbidity and mortality during cardiac surgery under extracorporeal circulation. Hypernatremia is an alarm signal that requires rapid and effective management to avoid progression to serious complications.

Mechanical ventilation is a fundamental tool in daily anesthetic practice. Several ventilation modes are used for the ventilation of patients during the induction of general anesthesia; the controlled volume mode is most commonly used by anesthesiologists. Ventilation often causes gastric insufflation, which may be responsible for gastric fluid inhalation, with serious consequences. The aim of our study was to compare the incidence of gastric insufflation according to the ventilatory mode used during anesthesia induction. Methods: This was a randomized prospective study carried out in the central operating complex of the Mohamed V Military Teaching Hospital in Rabat for a period of 06 months between January and June 2021. The patients included in our study were candidates for laparoscopic cholecystectomy. Gastric insufflation was assessed using epigastric auscultation. Finally, it is evaluated using the camera. Results: During the study period, 120 patients were enrolled and divided into three groups of 40 patients according to the ventilation mode used: Group VM (Manual Mode), Group VV (Controlled Volume Mode) and Group VP (controlled pressure Mode). There were no statistically significant differences between the three groups in terms of hemodynamic and respiratory parameters. Gastric insufflation rate was lower in the VP group (14%). The pressure-controlled ventilation mode causes less gastric insufflation without additional hemodynamic or respiratory cost and gives the surgeon greater comfort without the need for a stomach probe.