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Karia Ba Mohamed, Morocco

Hajjaj-Hassouni N.,University Mohammed Vth Souissi | Al-Badi M.,Security Force Hospital | Al-Heresh A.,King Hussein Medical Center | Al-Emadi S.,Cornell University | And 19 more authors.
Clinical Rheumatology | Year: 2012

Biologics, including tumor necrosis factor (TNF) inhibitors, are increasingly used for the treatment of inflammatory conditions such as rheumatoid arthritis (RA), psoriatic arthritis, and ankylosing spondylitis. The efficacy of these drugs has been demonstrated in randomized controlled trials (RCTs). However, these studies are conducted in controlled environments, and the results may not necessarily reflect clinical outcomes in daily clinical practice. In Europe and other western countries, numerous biologics registries that enroll and monitor patients receiving biologics have been established. These registries follow patients irrespective of whether they continue with the initial biologic drug. Thus, real-life efficacy data from these registries can be used to assess the long-term safety of biologics through longitudinal studies. In Africa and Middle East (AFME), such registries currently exist only in Morocco and South Africa. In light of the increasing availability of biologics and scarcity of long-term safety data of these agents in the AFME population, there is a need to establish biologics registries in other countries across the region. This review discusses the value of biologics registries versus RCTs as well as safety and efficacy data from observational studies presented as lessons from well-established biologics registries. In addition, the rationale for establishing such registries in the AFME region is also presented. © 2012 Clinical Rheumatology.

El Malki H.O.,University Mohammed Vth Souissi | El Malki H.O.,Foundation University | Souadka A.,University Mohammed Vth Souissi | Benkabbou A.,University Mohammed Vth Souissi | And 5 more authors.
British Journal of Surgery | Year: 2014

Background The management of liver hydatid cysts is controversial. Surgery remains the basic treatment, and can be divided into radical and conservative approaches. The purpose of this study was to compare the results of radical and conservative surgery in the treatment of liver hydatid cysts. Methods Data from all patients with liver hydatid cyst treated in a hepatobiliary surgical unit, between January 1990 and December 2010, were retrieved from a retrospective database. To minimize selection bias, propensity score matching was performed, based on 17 variables representing patient characteristics and operative risk factors. The primary outcome measure was hydatid cyst recurrence. Results One hundred and seventy patients were matched successfully, representing 85 pairs who had either a radical or a conservative approach to surgery. At a median (i.q.r.) follow-up of 106 (59-135) and 87 (45-126) months in the radical and conservative groups respectively, the recurrence rate was 4 per cent in both groups (odds ratio (OR) 1·00, 95 per cent confidence interval 0·19 to 5·10). There were no statistically significant differences between conservative and radical surgery in terms of operative mortality (1 versus 0 per cent; P=0·497), deep abdominal complications (12 versus 16 per cent; OR 1·46, 0·46 to 3·49), overall postoperative complications (15 versus 19 per cent; OR 1·28, 0·57 to 2·86), reinterventions (0 versus 4 per cent; P=0·246) and median hospital stay (7 (i.q.r. 5-12) days in both groups; P=0·220). Conclusion This study could not demonstrate that radical surgery reduces recurrence and no trend towards such a reduction was observed. Radical surgery is not better © 2014 BJS Society Ltd. Published by John Wiley & Sons Ltd.

Rkain M.,University Hospital Rabat Sale | Rkain I.,University Mohammed Vth Souissi | Safi M.,University Hospital Rabat Sale | Kabiri M.,University Hospital Rabat Sale | And 2 more authors.
Eastern Mediterranean Health Journal | Year: 2014

Parents often have misperceptions about childhood fever, and little information is available about the home management of feverish children in Morocco. In this study of the perceptions, knowledge and practices of families regarding children's fever, the parents of 264 febrile children aged 0-16 years were interviewed in a paediatric emergency department in Rabat in 2011. Only 3.5% of parents knew the correct temperature definition for fever, 54.4% determined their children's fever using a thermometer, and the preferred site was rectal. Most of them (96.8%) considered that fever was a very serious condition, which could lead to side-effects such as brain damage (28.9%), seizures (18.8%) paralysis (19.5%), dyspnoea (14.8%) and coma (14.8%). Paracetamol was used by 85.9% and traditional treatments by 45.1%. Knowledge about the correct definition of fever was significantly associated with parents' profession, educational level and receipt of previous information and advice from health professionals.

Souadka A.,University Mohammed Vth Souissi | Majbar M.A.,University Mohammed Vth Souissi | El Harroudi T.,University Mohammed Vth Souissi | Benkabbou A.,University Mohammed Vth Souissi | Souadka A.,The Surgical Center
BMC Surgery | Year: 2015

Background: The aim of this study was to evaluate oncologic results and satisfaction rate results of pseudocontinent perineal colostomy (PCPC) using Schmidt's technique in patients undergoing abdominoperineal resection (APR) for managing low rectal adenocarcinoma. Methods: From January 1993 and December 2007, One hundred and forty six patients underwent successfully PCPC after abdominoperineal resection for lower rectal adenocarcinoma. There were 75 women, with an average age of 47 years old. All patients received neoadjuvant radiotherapy with or without chemotherapy. Long-term oncological results and satisfaction rate were evaluated. Results: After a median follow up of 36 months (range 12-156) months, the five-year overall survival and disease free survival rate were 74.6% and 60.3% respectively. Local and distant recurrences occurred respectively in 10 (6,8%) and 29 (20%) patients. Seventy-seven percent (77%) of the patients were highly satisfied with this technique and only one patient was unsatisfied. However, none of them accepted the conversion to an abdominal colostomy neither would have changed PCPC for an iliac colostomy at first intent. Conclusion: This study showed that pseudocontinent perineal colostomy is a safe and reliable pelvic reconstruction technique after abdominoperineal resection for low rectal adenocarcinoma. It provides high degree of patient satisfaction without compromising oncological results. It is a good option in selected patients, especially in Muslim countries. © 2015 Souadka et al.; licensee BioMed Central.

El Malki H.O.,Sina | El Malki H.O.,University Mohammed Vth Souissi | El Malki H.O.,University Mohammed Vth Souissi | El Mejdoubi Y.E.,Sina | And 7 more authors.
Journal of Gastrointestinal Surgery | Year: 2010

Background and aims: Hydatid disease is still a major health problem in sheep-raising areas. Surgery remains the basic treatment for liver hydatid cyst (LHC). However, recurrences can occur after all therapies. Surgery for recurrence of LHC becomes technically more difficult with higher rate of morbidity and mortality. The aim of this study was to determine perfective factors associated to hepatic recurrence after LHC surgery and to propose and discuss postoperative follow-up schedules. Methods: It is a retrospective cohort study of 672 patients with LHC treated at the surgery department "A" at Ibn Sina University Hospital, Rabat, Morocco, from January 1990 to December 2004. Recurrence rates have been analyzed by the Kaplan-Meier method for patients undergoing surgery. Results: Fifty-six patients (8.5%) had LHC recurrence after surgery. There were 34 females (60.7%) and 22 males (39.3%). Median duration of recurrence's diagnosis was 24 months (interquartile range: 10-48 months). Recurrence's risk was 2.3% ± 0.6% at 1 year and 9.1% ± 1.3% at the 10th year. The history of LHC (hazard ratio, 2; 95% confidential interval, 1.13-3.59) and three cysts or more (hazard ratio, 3.8; 95% confidential interval, 2.07-6.98) was an independent risk factor for recurrence. Conclusion: We think that the surgeon's practice and experience are the most important to success the surgical treatment. It prevents complications and recurrences. © 2010 The Society for Surgery of the Alimentary Tract.

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