Ibn Rochd University Hospital

Casablanca, Morocco

Ibn Rochd University Hospital

Casablanca, Morocco
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Tazzite A.,Genetics and Molecular Pathology Laboratory | Jouhadi H.,Ibn Rochd University Hospital | Nadifi S.,Genetics and Molecular Pathology Laboratory | Aretini P.,University of Pisa | And 4 more authors.
Gynecologic Oncology | Year: 2012

Objective: Breast cancer is the most common female cancer in Morocco. About 5 to 10% are due to hereditary predisposition and mutations in BRCA1 and BRCA2 genes are responsible for an important proportion of high-risk breast/ovarian cancer families. The relevance of BRCA1/2 mutations in the Moroccan population was not studied. The main objective of this study is to investigate the spectrum of BRCA1 and BRCA2 germline mutations in early onset and familial breast/ovarian cancer among Moroccan women. Methods: We screened the entire coding sequences and intron/exon boundaries of BRCA1 and BRCA2 genes in 40 patients by direct sequencing. Results: Nine pathogenic mutations were detected in ten unrelated families, five deleterious mutations in BRCA1 gene and four mutations in BRCA2 gene. Four novel mutations were found: one in BRCA1 (c.2805delA/2924delA) and three in BRCA2 (c.3381delT/3609delT; c.7110delA/7338delA and c.7235insG/7463insG). We also identified 51 distinct polymorphisms and unclassified variants (three described for the first time). Conclusions: Our data suggest that BRCA1 and BRCA2 mutations are responsible for a significant proportion of familial breast cancer in Moroccan patients. Therefore full BRCA1/2 screening should be offered to patients with a family history of breast/ovarian cancer. © 2012 Elsevier Inc. All rights reserved.

Belhadj M.,EHU | Dahaoui A.,Novo Nordisk AS | Jamoussi H.,Institute National Of Nutrition | Farouqi A.,Ibn Rochd University Hospital
Diabetes Research and Clinical Practice | Year: 2013

Aim: To evaluate the safety and effectiveness of insulin analogues in patients with type 2 diabetes (T2D) from Morocco, Algeria and Tunisia that formed the Maghrebian cohort of the 24-week, non-interventional A1chieve study. Methods: Patients starting biphasic insulin aspart, insulin detemir and insulin aspart, alone or in combination, were included. The primary outcome was the incidence of serious adverse drug reactions (SADRs), including major hypoglycaemic events. Secondary outcomes included hypoglycaemia, glycated haemoglobin A1c (HbA1c), fasting plasma glucose (FPG), postprandial plasma glucose (PPPG), systolic blood pressure (SBP), body weight and lipids. Quality of life (QoL) was evaluated using the EQ-5D questionnaire. Results: Overall, 3720 patients with a mean age of 58.6 years, body mass index of 27.7 kg/m2 and diabetes duration of 11.5 years were enrolled. Pre-study, insulin-experienced patients had a mean±SD dose of 0.54±0.27 U/kg. In the entire cohort, the mean dose was 0.42±0.27U/kg at baseline, titrated to 0.55±0.30U/kg by Week 24. Twenty-six SADRs were reported during the study. There was a significant decrease in the proportion of patients reporting overall hypoglycaemia from baseline to Week 24 (18.3% to 13.8%, p < 0.0001). The mean HbA1c improved significantly from 9.5±1.8% to 7.9±1.4% (p < 0.001). The mean FPG, PPPG, SBP, total cholesterol and QoL also improved significantly (all p < 0.001), while the mean body weight increased by 0.9±3.9 kg (p < 0.001). Conclusion: Insulin analogue therapy was well-tolerated and was associated with improved glycaemic control. © 2013 Elsevier Ireland Ltd.

Kassogue Y.,Hassan II University | Dehbi H.,Hassan II University | Nassereddine S.,Hassan II University | Quachouh M.,Ibn Rochd University Hospital | Nadifi S.,Hassan II University
DNA and Cell Biology | Year: 2013

The multidrug resistance gene (MDR1) plays an important role in the transport of a wide range of drugs and elimination of xenobiotics from the body. Identification of polymorphisms and haplotypes in the MDR1 gene might not only help understand pharmacokinetics and pharmacodynamics of drugs, but also can help in the prediction of drug responses, toxicity, and side effects, especially, in the era of personalized medicine. We have analyzed the genotypic and haplotypic frequencies of the three most common single-nucleotide polymorphisms in the MDR1 gene in a sample of 100 unrelated healthy Moroccan subjects by polymerase chain reaction-restrictive fragment length polymorphism. The observed genotype frequencies were 43% for 1236CC, 49% for 1236CT, and 8% for 1236TT in exon 12; 49% for 2677GG, 47% for 2677GT, and 4% for 2677TT in exon 21; 39% for 3435CC, 51% 3435CT for 3435TT, and 10% for 3435TT in exon 26, respectively. We found that all polymorphisms were in Hardy-Weinberg equilibrium. Moderate linkage disequilibrium (LD) was observed between the three polymorphisms, the strongest LD in our study has been observed between C1236T and G2677T (D'=0.76; r2=0.45). We identified eight haplotypes, the most frequent were 1236C-2677G-3435C (53%), 1236T-2677T-3435T (21%), and 1236C-2677G-3435T (10%), respectively. Our findings might facilitate future studies on pharmacokinetics of P-glycoprotein substrate drugs and interindividual variability to drugs in Moroccan patients. © Mary Ann Liebert, Inc.

Bouhali Zriouil S.,Ibn Rochd University Hospital | Bouhali Zriouil S.,Hassan II University | Bekkali M.,Hassan II University | Zerouali K.,Ibn Rochd University Hospital
Brazilian Journal of Infectious Diseases | Year: 2012

Infections caused by Staphylococcus aureus are a major problem in hospitals. The multidrug resistance and the nasal carriage of S. aureus play a key role in the epidemic of these infections. In this prospective study, 160 S. aureus strains were isolated from pathological samples of patients (79 cases) and nasal swabs (81) of cases and controls from January to July 2007. The susceptibility to 16 antibiotics, including cefoxitin, was determined by the agar diffusion method, and methicillin resistance was confirmed by amplifying the mecA gene by polymerase chain reaction (PCR). The prevalence of methicilin-resistant S. aureus (MRSA) was high in the burns (57.7%) and dermatology (39.4%) wards, and the MRSA strains isolated were extremely multi-resistant, but all of them were still susceptible to vancomycin. The rate of S. aureus nasal carriage was high in both cases and controls, in state, MRSA nasal carriage was more common among people infected with S. aureus. © 2012 Elsevier Editora Ltda.

Kassogue Y.,Hassan II University | Quachouh M.,Ibn Rochd University Hospital | Dehbi H.,Hassan II University | Quessar A.,Ibn Rochd University Hospital | And 2 more authors.
Medical Oncology | Year: 2014

In the spite of the impressive results achieved with imatinib in chronic myeloid leukemia (CML) patients, differences in patient's response are observed, which may be explained by interindividual genetic variability. It is known that cytochrome P450 enzymes play a major role in the metabolism of imatinib. The present study aimed to understand the functional impact of CYP2B6 15631G>T polymorphism on the response of imatinib in CML patients and its relation to CML susceptibility. We have genotyped CYP2B6 G15631T in 48 CML patients and 64 controls by PCR-RFLP. CYP2B6 15631G>T was not found to be a risk factor for CML (OR 95 % CI, 1.12, 0.6-2, p > 0.05). Hematologic response loss was higher in patients with 15631GG/TT genotype when compared with 15631GT (36.8 vs. 13.8 %; X 2 = 3.542, p = 0.063). Complete cytogenetic response was higher in 15631GG/GT genotype groups when compared with 15631TT (X 2 = 3.298, p = 0.024). Primary cytogenetic resistance was higher in patients carrying 15631GG/TT genotype when compared with 15631GT carriers (52.6 vs. 17.2 %; X 2 = 6.692, p = 0.010). Furthermore, side effects were more common for patients carrying 15631GG genotypes when compared with GT/TT carriers (36 vs. 13.8 %; X 2 = 8.3, p = 0.004). In light of our results, identification of 15631G>T polymorphism in CML patients might be helpful to predict therapeutic response to imatinib. © 2013 Springer Science+Business Media New York.

Diakite B.,Hassan II University | Tazzite A.,Hassan II University | Hamzi K.,Hassan II University | Jouhadi H.,Ibn Rochd University Hospital | Nadifi S.,Hassan II University
African Health Sciences | Year: 2012

Background: Methylenetetrahydrofolate (MTHFR) enzyme plays an important role in folate metabolism which is involved in DNA methylation, repair, and synthesis. Objective: We investigated if the MTHFR C677T polymorphism modulates the risk of developing breast cancer in Moroccan women. Methods: Genotyping was performed by PCR-RFLP method on a sample of 96 patients with breast cancer and 117 controls. Results: A positive correlation was found between the MTHFR C677T polymorphism and progesterone receptors expression (p= 0.04). According to menopausal status, the heterozygous CT (OR = 2.29 and P = 0.03) was statistically significant in pre-menopausal women. There was a significant association between C677T polymorphism and breast cancer risk in both additive (OR = 2.2, 95% CI = 1.24-3.86, p = 0.007) and dominant (OR = 2.10, CI 95% = 1.21-3.64, p = 0.008) models. In addition, the T allele were associated with a high breast cancer risk (OR = 1.59, 95% CI = 1.04-2.44, p = 0.03).Conclusion: In the light of our preliminary study, 677T allele and 677CT MTHFR genotype may represent a genetic determinant increasing breast cancer risk in Moroccan women. A larger study including a larger sample size and more information is needed to confirm our conclusions.

Objectives: To determine the prevalence of microalbuminuria (MAU) in hypertensive outpatients visiting a cardiologist's office or clinic and to describe the relationship between MAU and cardiovascular risk factors. Methods: This was an international, observational, cross-sectional study of 22 282 patients, with 457 subjects from Morocco in 40 cardiology centres. Inclusion criteria were: male and female outpatients aged ≥ 18 years with currently treated or newly diagnosed hypertension (≥ 140/90 mmHg at rest on the day of the study visit) and no reason for false positive microalbuminuria dipstick tests. Outcome measures: Prevalence of microalbuminuria assessed using a dipstick test, co-morbid cardiovascular risk factors or disease and their relationship with the presence of MAU, and role of pharmacotherapy in modulating the prevalence of MAU. Results: The prevalence of microalbuminuria in hypertensive patients in Morocco (67.8%) was high compared to the worldwide prevalence (58.3%). Despite the fact that all physicians regarded MAU as important for risk assessment and therapeutic decisions, routine MAU measurement was performed in only 35% of the practices. In clinical cardiology, MAU is highly correlated with a wide variety of cardiovascular risk factors and cardiovascular disease. While angiotensin receptor blockers (ARBs) appeared to be associated with the lowest risk of MAU, calcium channel blockers (CCBs) were more often used in this patient group. Conclusions: Hypertensive, high-risk cardiovascular patients are common in clinical cardiology. Given the high prevalence detected, screening of MAU in addition to more aggressive multi-factorial treatment to reduce blood pressure as well as other cardiovascular risk factors is required.

El Aziz S.,Ibn Rochd University Hospital
BMJ case reports | Year: 2012

Familial hypercholesterolaemia (FH) is quite common genetic disorder resulting in high low-density lipoprotein (LDL) cholesterol levels, but homozygous FH is rare. The authors describe a Moroccan family where a 24-year-old man and his 13-year-old brother, born from a consanguineous union, showed characteristics of FH with large tendon, tuberous and planar xanthomas. They had already five deaths in the sibship before the age of 15 years. Blood analysis found high LDL cholesterol levels. Arterial assessment showed diffuse atherosis. Genetic study found that patients are homozygous for the mutation of G266C LDL receptor. Treatment with high doses of statins and ezetimibe was introduced reducing cholesterol up to 70%. Large xanthomas were removed surgically. The G266C mutation has been previously identified in Morocco. Early identification and adequate treatment of individuals with hypercholesterolaemia and their relatives are essential for prevention of early death in these populations.

Boufettal H.,Ibn Rochd University Hospital | Essodegui F.,Central University of Costa Rica | Noun M.,Ibn Rochd University Hospital | Hermas S.,Ibn Rochd University Hospital | Samouh N.,Ibn Rochd University Hospital
Diagnostic and Interventional Imaging | Year: 2012

Introduction: Idiopathic granulomatous mastitis is a benign lesion of the mammary gland characterised by the presence of non-infectious inflammatory breast lesions limited to the lobules. Objective: We report twenty cases of idiopathic granulomatous mastitis (IGM) with a discussion of epidemiology, clinical and diagnostic features, treatment and progress of this pathological entity. Materials and methods: A retrospective study of twenty cases compiled from a ten-year period, from 952 pathological anatomy examinations carried out to investigate various breast pathologies. Results: The patients had a mean age of 45.5 years. Clinical examinations revealed a tumefaction measuring between 2.5 and 18 cm in diameter. The mean size was 5.5 cm. Mammography showed nodular lesions and sonography demonstrated hypoechoic nodules. On histological examination there was a granulomatous inflammatory infiltrate of epithelioid and giant cells, without caseation necrosis, made up of lymphocytes, plasma cells and neutrophils. Microbiology investigations were negative. Lesion involvement was principally lobulocentric. Surgical excision of the lesions was combined with corticosteroid therapy in twelve cases, with non-steroidal anti-inflammatory drugs in another four and with antibiotic therapy in four cases. The patients made good progress in the short-term. Discussion and conclusion: IGM is a rare entity. It poses a problem of differential diagnosis because it clinically resembles other forms of mastitis. The diagnosis can be made with certainty on histological studies. The treatment is medical alongside surgical excision. The prognosis of this disease remains favourable. © 2012 Éditions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.

Riyad M.,Ibn Rochd University Hospital | Chiheb S.,Ibn Rochd University Hospital | Soussi-Abdallaoui M.,Ibn Rochd University Hospital
Eastern Mediterranean Health Journal | Year: 2013

In the past decade in Morocco, there has been a reactivation of zoonotic cutaneous leishmaniasis (ZCL) foci with an unusual long outbreak episode. The aims of this review article were to update our knowledge of this disease in Morocco, to compare the situation with that prevailing in the other countries of the Maghreb region and to highlight factors that could be responsible for the current situation. The data indicate a global increase of ZCL incidence in the other Maghreb countries. Several factors could be influencing this increase but most of them will depend on human activities. On the other hand, ZCL is particularly sensitive to climate changes acting on the vector and the reservoir. An analysis of prevention strategies against the disease in Morocco and the other Maghreb countries highlights the need for integrated regional control measures in all the countries of the region.

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