Painful diabetic neuropathy is a frequent complication of diabetes. Its diagnosis is clinical. Our goal is to determine the prevalence of painful diabetic neuropathy in this population. We also analyzed the relationship between this neuropathy and certain parameters, concerning the patient and his diabetes. It is a cross sectional study conducted at the department of endocrinology and internal medicine of Avicenne hospital Marrakech-Morocco, among a cohort of 300 diabetic outpatients. We used the DN4 questionnaire (Douleur Neuropathique en 4 questions), for diagnosis. The results showed a prevalence of 15%. In this study: advanced age, female gender, duration of diabetes greater than 10 years, and the lack of medical follow up were found to be statistically significant risk factors for painful diabetic neuropathy, in addition to some diabetes-related comorbidities such as hypertension, dyslipidemia, sedentary life style and diabetic retinopathy. Painful diabetic neuropathy remains undertreated, in fact 74% of our patients did not receive any specific treatment, knowing that the progress in developing effective and well-tolerated therapies has been disappointing.
The Arteria lusoria or aberrant right subclavian artery (ARSA) constitutes one of the rarest malformations of the aortic arch, it can be associated with other congenital anomalies of the heart and large vessels, in particular the bi-carotid trunk or common origin of the carotid arteries (COCA) which is the presence of a single branch from the aorta giving off both right and left common carotid arteries. We report the case of a patient followed for severe mitral stenosis, and hospitalized for an ischemic cerebral vascular accident, a chest CT scan was performed in front of her clinical and biological degradation, which allowed the fortuitous discovery of an Arteria lusoria (aberrant retro-
esophageal
artery) associated with a Truncus bicaroticus.
Le ganglioneurome est une tumeur nerveuse bénigne rare, d'origine neuroectodermique et de localisation rétropéritonéale fréquente. Nous rapportons l'observation d'un patient de 55 ans dont la tumeur est révélée fortuitement sur une échographie abdominale demandée dans le cadre d'une cytolyse hépatique secondaire à une hépatite virale C. Le patient est opéré après la réalisation d'un scanner abdominal et d'un bilan hormonal. L'examen anatomopathologique de la pièce opératoire est en faveur d'un ganglioneurome. Devant une volumineuse masse rétropéritonéale avec état général conservé, on doit envisager le diagnostic de ganglioneurome car l'exérèse chirurgicale complète permet une guérison sans récidive. Préalablement, l'ensemble des autres diagnostics différentiels doit être éliminé.
Emerging cases of coinfection of coronavirus disease 2019 (COVID-19) and tuberculosis (TB), although rare, have attracted the attention of health systems around the world and have arisen many concerns about the diagnosis, treatment, and prognosis of this coinfection especially in high TB burden countries. Here, we report a rare case and, to the best of our knowledge, the first reported case in Morocco of simultaneous diagnosis of an active pulmonary TB infection and a COVID-19 pneumonia. We present a case of a sixty-seven-year-old male patient who was admitted to our COVID-19 emergency department with a diagnosis of COVID-19 pneumonia, confirmed by nasopharyngeal swab’s polymerase chain reaction (PCR) for detection of SARS-CoV-2. The atypical radiological findings suggested a TB coinfection which was later confirmed by sputum cultures and Xpert MTB/Rif assay. The patient also presented some complications including thrombosis of the left leg, pulmonary embolism and inaugural ketosis. Treatment was administered as per local protocols: broad spectrum antibiotics, corticosteroids, fixed dose-combination of antituberculosis treatment along with hydration and insulin therapy for ketosis treatment and anticoagulation. The patient was discharged after twenty-three days of hospitalization. Due to the currently limited data, further studies are necessary to establish any possible correlation between COVID-19 infection and the progression of a latent and/or the severity of an active TB infection.
Introduction: Anticoagulation therapy is widely used for curative and prophylactic purposes. The most serious complication is bleeding, which presents as an intramural hematoma of the small intestine; however, it is uncommon, seen in 1 in 2,500 patients. We report an unusual case of a warfarin overdose that resulted in spontaneous intramural hematoma of the small intestine with intestinal volvulus.
Anterior neck swellings are a common indication for cervical ultrasound in every radiology department. However, pulsatile masses in this region are relatively rare. This 62-years-old lady presented with anterior neck swelling for more than ten years which became more pulsatile recently due to hypertension. Ultrasound was first performed revealing a vascular cervical mass and a CT angiography made the diagnosis of cervical brachiocephalic artery. Right sided pulsatile cervical mass should make every clinician think of this diagnosis to avoid any interventional procedures that could be fatal for the patient.
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