The study's aim is to evaluate the vaccination status against viral hepatitis B and the prevalence of HBs antigen in the medical staff of the University Hospital of Marrakech. This cross-sectional survey was conducted at the level of the various hospital services with the medical staff of Med VI University Hospital of Marrakech. A systematic search for the antigen /antibody pair level (Ag HBs/Ac antiHBs) and anti-nucleocapsid antibodies (Ac antiHBc) was performed in every person who participated in this study. A total of 172 doctors participated in the screening; the participation rate was 74%. 93% of the screened physicians were unaware of their serologic status with respect to the hepatitis B virus and 36% were not vaccinated against hepatitis B. The prevalence of HBsAg was 1.7% in our context with only one identified case of cure. As for the risk factors studied. In properly vaccinated doctors, 77% were immunized (≥100 IU / l) and this immunization rate was 8% in people who received 2 doses of vaccine. Health personnel constitute a population at risk for both infection and transmission of the Hepatitis B virus. Hence, raising staff awareness and introducing compulsory HBV vaccination for all health professionals is important.
The ABO and RHD systems represent the most immunogenic systems and the most sought after in blood transfusion. The objective of this work was to present new statistics of phenotypic prevalence of ABO and RHD systems in Morocco using a new sample. Our study was a retrospective, descriptive and epidemiological one carried out at the Blood Transfusion Center at the Avicenne Military Hospital in Marrakech on a sample of 10,000 donors collected between the year 2009 and the year 2017. The study of the expression Erythrocyte blood group antigens by the serological phenotyping technique was based on haemagglutination. Double determination was necessary to avoid the risk of grouping errors. This technique was simple and inexpensive, and today remains a gold standard for immunohematology. At the end of this study, the frequency of the antigens of the red blood cell systems ABO and RHD was as follows: ABO system: A (32.7%), B (16.33%), AB (5.26%), O (45.71%). RHD system: RHD positive (92.29%), RHD negative (7.71%). Our results were compared to other previous Moroccan and other foreign countries studies; this allowed us to locate hemotypologically the transfusion center of the Avicenne military hospital of Marrakech in the world. At the end of this study, we have concluded that our results were consistent with previous studies in Morocco. These results were identical to those found in the Mediterranean countries and showed that Morocco was in an intermediate position between the countries of Europe and those of Black Africa.
Thrombophilia is a situation characterized by an increased tendency to thrombosis. The main objective of this work is to report on the experience of the Haematology Laboratory of the Avicenne Military Hospital of Marrakech, through a retrospective descriptive study carried out over a period of 9 years, on 200 requests for a thrombophilia check-up; and secondly, to discuss its indications and interest in the etiological diagnosis of unexplained thrombosis in the light of the latest recommendations. The thrombogenic risk factor most commonly found in our study was PS deficiency, in contrast to the predominance of Factor V mutation in Western countries, hence the importance of emphasizing that in clinical practice, the first-line thrombophilia assessment should always combine, in accordance with the latest recommendations: inhibitor deficiencies, F V and F II mutations, antiphospholipid antibodies and possibly F VIII determination.
Article reçu le 26 juin 2019, accepté le 12 septembre 2019 Résumé. Le syndrome d'activation macrophagique (SAM) est un état d'hyper-inflammation qui résulte d'une sécrétion accrue des cytokines proinflammatoires, responsables de l'activation inappropriée et de la prolifération de cellules issues de la lignée lymphohistiocytaire. Il associe des signes cliniques, des anomalies biologiques et des images d'hémophagocytose. C'est une atteinte rare mais grave, qui peut être « primaire » ou « secondaire » à une infection, une néoplasie, ou une maladie auto-immune. L'étiologie cancéreuse par tumeur solide est exceptionnelle. Nous rapportons ici un cas de SAM ayant révélé un carcinome colique avec métastase médullaire chez un patient de 62 ans. Le SAM peut compliquer ou révéler une tumeur solide dans seulement 1,6 % des cas, notamment lorsqu'il existe des métastases médullaires. Cette association a rarement été rapportée dans la littérature, et ce seulement à travers des cas isolés. Chez notre patient le SAM est associé à un néo colique avec métastases osseuses. Celles-ci sont moins fréquentes que les métastases hépatiques et pulmonaires. Le SAM est une pathologie grave avec une mortalité élevée, liée à une activation inappropriée du système immunitaire. Le traitement à visée étiologique est nécessaire et peut être suffisant.
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