Military Hospital Avicenne

Marrakesh, Morocco

Military Hospital Avicenne

Marrakesh, Morocco
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Touati M.M.,Military Hospital Avicenna | Darouassi Y.,Military Hospital Avicenna | Chihani M.,Military Hospital Avicenna | Al Jalil A.,Military Hospital Avicenna | And 5 more authors.
Journal of Medical Case Reports | Year: 2015

Introduction: Malignant schwannomas or neurofibrosarcomas are rare nerve tumors of unknown etiology. These neoplasms are highly aggressive with a marked propensity for local recurrence and metastatic spread. Their management continues to be a challenge for pathologists and surgeons. Maxillofacial locations are very exceptional. We report the case of a patient with unusual malignant schwannoma of the infratemporal fossa discovered at a late evolving stage. Case presentation: A 56-year-old woman, of Moroccan nationality, presented to our hospital in 2013 with a large right-sided hemifacial swelling that had evolved over the previous 4 months, with a limitation of mouth opening, nasal obstruction and episodes of epistaxis. A CT scan and MRI showed a large and invasive tumor occupying her right infratemporal fossa and maxillary sinus, with sphenoidal, ethmoidonasal, nasopharyngeal and intraorbital extension. A nasal endoscopic biopsy was performed. Immunohistochemical examination concluded a diagnosis of malignant schwannoma, and a palliative radiotherapy was decided; however, our patient died 10 days later. Conclusions: Malignant schwannoma of paranasal sinuses and the anterior skull base is a rare tumor that involves a high rate of local invasion. The prognosis is poorer compared to that occurring in the trunk and extremities. © 2015 Touati et al.


Alayoud A.,Military Hospital Avicenne | El Kabbaj D.,Military Hospital of Instruction | Benyahia M.,Military Hospital of Instruction | Asseraji M.,Military Hospital Agadir | Zemraoui N.,Military Hospital Avicenne
Iranian Journal of Kidney Diseases | Year: 2015

Introduction. It has been suggested that a dialysate calcium concentration of 1.5 mmol/L is a compromise between bone protection and cardiovascular risk. This study aimed to investigate the effect of reducing dialysate calcium concentration to 1.5 mmol/L on mineral metabolism and hemodynamic parameters. Materials and Methods. Dialysate calcium concentration was changed from 1.75 mmol/L to 1.5 mmol/L for 9 months and observed the effects on mineral metabolism and dialysis outcome parameters in 52 hemodialysis patients. Results. The results at 9 months demonstrated that postdialytic serum calcium level decreased significantly from 109 ± 7 mg/L to 102 ± 6 mg/L, intact parathyroid hormone (PTH) increased from 372 ± 52 pg/mL to 606 ± 80 pg/mL, and the oral alfacalcidol increased from 1.4 ± 0.3 µg/w to 3.3 ± 0.4 µg/w. In patients with low PTH levels, continuous increase of PTH was observed. There were no significant variation in the oral calcium carbonate dose and serum levels of alkaline phosphatase, predialytic calcium, and pre- and postdialytic phosphorus. The ultrafiltration rate and postdialysis systolic blood pressure were significantly lower after reducing the dialysate calcium concentration to 1.5 mmol/L. Intradialytic hypotension and cramps were more frequent with this dialysate calcium concentration. Conclusions. These findings demonstrated that a decrease in dialysate calcium concentration from 1.75 mmol/L to 1.5 mmol/L improved mineral metabolism by prevention of postdialytic hypercalcemia and releasing oversuppression of PTH, but it was associated with more use of oral alfacalcidol and more hemodynamic impairment. © 2015, Iranian Society of Nephrology. All rights reserved.


El Harrech Y.,Military Hospital Avicenne | Ghoundale O.,Military Hospital Avicenne | Kasmaoui E.H.,Kasmaoui Medical Office | Touiti D.,Military Hospital Avicenne
Advances in Urology | Year: 2016

Introduction. Retrocaval ureter is a rare congenital anomaly. Open surgery was the classic treatment for this condition. Laparoscopy is currently an admitted procedure to treat many urological diseases. The objective of our study is to present our experience and discuss the safety and the feasibility of transperitoneal laparoscopic pyelopyelostomy for treatment of retrocaval ureter (RCU). Materials and Methods. Three symptomatic patients underwent laparoscopic repair for RCU in our department. The diagnosis was suspected on the computed tomography scan (CT) and confirmed on ascending pyelography. After placement of a JJ stent, and, using the transperitoneal approach, the retro peritoneum was exposed; the ureter was identified in both sides of the vena cava. The retrocaval segment was entirely mobilized and pulled from behind of the vena cava after section of renal pelvis. A pyelopyelostomy was done in a normal anatomic position. Results. All operations were achieved laparoscopically without conversion to open surgery. The mean operative time was 140 minutes (110-190). No intraoperative complication occurred. Blood loss was less than 50 mL in all patients. The mean hospital stay was 5 days (4-6 days). All patients were symptom-free after surgery and had reduction of hydronephrosis in control imagery. Conclusion. Laparoscopy seems safe, feasible, and reproducible in managing retrocaval ureter. © 2016 Y. El Harrech et al.


PubMed | Military Hospital Avicenne and Kasmaoui Medical Office
Type: | Journal: Advances in urology | Year: 2016

Introduction. Retrocaval ureter is a rare congenital anomaly. Open surgery was the classic treatment for this condition. Laparoscopy is currently an admitted procedure to treat many urological diseases. The objective of our study is to present our experience and discuss the safety and the feasibility of transperitoneal laparoscopic pyelopyelostomy for treatment of retrocaval ureter (RCU). Materials and Methods. Three symptomatic patients underwent laparoscopic repair for RCU in our department. The diagnosis was suspected on the computed tomography scan (CT) and confirmed on ascending pyelography. After placement of a JJ stent, and, using the transperitoneal approach, the retro peritoneum was exposed; the ureter was identified in both sides of the vena cava. The retrocaval segment was entirely mobilized and pulled from behind of the vena cava after section of renal pelvis. A pyelopyelostomy was done in a normal anatomic position. Results. All operations were achieved laparoscopically without conversion to open surgery. The mean operative time was 140 minutes (110-190). No intraoperative complication occurred. Blood loss was less than 50mL in all patients. The mean hospital stay was 5 days (4-6 days). All patients were symptom-free after surgery and had reduction of hydronephrosis in control imagery. Conclusion. Laparoscopy seems safe, feasible, and reproducible in managing retrocaval ureter.


El Harrech Y.,Military Hospital Avicenne | Abaka N.,Military Hospital Avicenne | Ghoundale O.,Military Hospital Avicenne | Touiti D.,Military Hospital Avicenne
Urology Annals | Year: 2013

Self-mutilations of the external genitals in psychiatric patients also known as Klingsor syndrome is a rare urologic trauma. Men with religious conflicts, low self-esteem, unresolved transsexual issues and feelings of guilt are the most vulnerable. This condition requires immediate surgical intervention. Currently replantation involves meticulous microsurgery and has become the primary method for managing these patients. In this paper, we report a case of self amputation of penis in a patient with a psychiatric history significant for schizopfrenia. Because of the unavailability of a microscope in our department, a non-microsurgical replantation without microscopic magnification was attempted. After surgery, normal appearance and function including a good normal voiding, sensation, and erections were observed.


Kamal M.,Military Hospital Avicenne | Touiti D.,Military Hospital Avicenne | Jouhadi H.,Military Hospital Avicenne | Benider A.,Military Hospital Avicenne
Journal of Cancer Science and Therapy | Year: 2012

Objectives: Contribution of a case of unusual spread of cervical carcinoma mimicking iliopsoas abscess fifteen years after initial radiotherapy. Method: A 65-year-old white woman with history of squamous cell carcinoma of uterine cervix treated 15 years ago, was referred to our department with clinical and imaging's findings simulating a psoas abcess. Result: Colposcopy and punch biopsy confirmed the diagnosis of carcinoma of the cervix. Needle aspirate of cystic mass yielded a watery chocolate-colored. Cytopathology revealed cells suggestive of squamous cell carcinoma consistent with the diagnosis of metastasis from carcinoma cervix. Consultations with radiation therapy and medical oncology suggested no additional therapy.The patient became increasingly cachectic and died with generalized metastasis 3 months after admission. Conclusion: Through this case, the authors highlights the fact that metastasis from squamous cell carcinoma of the cervix can present as a psoas abscess and demonstrates certain difficulties in diagnosis even with the newer imaging modalities. © 2012 Kamal M, et al.


Lrhezzioui J.,Military Hospital Avicenne | Jalal O.,Military Hospital Avicenne | Niamane R.,Military Hospital Avicenne | Mansouri A.,Military Hospital Avicenne
Pan Arab Journal of Neurosurgery | Year: 2011

Neuromyelitis optica (NMO) or Devic's syndrome is defined by Gault and Devic as a retrobulbar neuritis or papillitis accompanied by acute myelitis and occasionally other neurological symptoms or signs not restricted to the spinal cord or optic nerves. Infectious aetiology was suggested but never recognised. We report a 36-year-old woman with NMO which revealed a multisystemic tuberculosis with fatal issue. We discuss this case with review of literature and try to demonstrate that tuberculosis can be considered as NMO's aetiology directly by Mycobacterium Tuberculosis (BK) infestation, or indirectly by immune mediated response to BK. We conclude to search tuberculosis in patients with NMO, especially in countries where tuberculosis is endemic and a great problem of public health, and not to consider it only as a variant of multiple sclerosis because of different therapeutical options.


PubMed | Military Hospital Avicenne
Type: | Journal: Urology | Year: 2016

Retrovesical cysts are very rare, with more reported cases being hydatid or seminal cyst. To our knowledge, no case of pelvic kidney revealed as cystic mass of the retrovesical space has been reported. We provide images of a direct retrovesical kidney in a 24-year-old patient who presented with lower urinary tract symptoms.


PubMed | Military Hospital Avicenne
Type: Journal Article | Journal: Urology annals | Year: 2013

Self-mutilations of the external genitals in psychiatric patients also known as Klingsor syndrome is a rare urologic trauma. Men with religious conflicts, low self-esteem, unresolved transsexual issues and feelings of guilt are the most vulnerable. This condition requires immediate surgical intervention. Currently replantation involves meticulous microsurgery and has become the primary method for managing these patients. In this paper, we report a case of self amputation of penis in a patient with a psychiatric history significant for schizopfrenia. Because of the unavailability of a microscope in our department, a non-microsurgical replantation without microscopic magnification was attempted. After surgery, normal appearance and function including a good normal voiding, sensation, and erections were observed.


PubMed | Military Hospital Avicenne
Type: Journal Article | Journal: Iranian journal of kidney diseases | Year: 2015

It has been suggested that a dialysate calcium concentration of 1.5 mmol/L is a compromise between bone protection and cardiovascular risk. This study aimed to investigate the effect of reducing dialysate calcium concentration to 1.5 mmol/L on mineral metabolism and hemodynamic parameters.Dialysate calcium concentration was changed from 1.75 mmol/L to 1.5 mmol/L for 9 months and observed the effects on mineral metabolism and dialysis outcome parameters in 52 hemodialysis patients.The results at 9 months demonstrated that postdialytic serum calcium level decreased significantly from 109 7 mg/L to 102 6 mg/L, intact parathyroid hormone (PTH) increased from 372 52 pg/mL to 606 80 pg/mL, and the oral alfacalcidol increased from 1.4 0.3 g/w to 3.3 0.4 g/w. In patients with low PTH levels, continuous increase of PTH was observed. There were no significant variation in the oral calcium carbonate dose and serum levels of alkaline phosphatase, predialytic calcium, and pre- and postdialytic phosphorus. The ultrafiltration rate and postdialysis systolic blood pressure were significantly lower after reducing the dialysate calcium concentration to 1.5 mmol/L. Intradialytic hypotension and cramps were more frequent with this dialysate calcium concentration.These findings demonstrated that a decrease in dialysate calcium concentration from 1.75 mmol/L to 1.5 mmol/L improved mineral metabolism by prevention of postdialytic hypercalcemia and releasing oversuppression of PTH, but it was associated with more use of oral alfacalcidol and more hemodynamic impairment.

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