La tuberculose est une maladie infectieuse due au bacille de Koch (BK). La forme multifocale s’associe habituellement a une immunodepression notamment du VIH. A ce propos, nous rapportons un cas inhabituel de tuberculose multifocale associant des foyers visceraux a une atteinte vertebro-medullaire etagee, cervicale dorsale et lombaire non contigue, chez un sujet immunocompetent. Le patient a eu un traitement medico-chirurgical. Il s’agit d’une maladie a diagnostic difficile. Nous discuterons, a travers ce cas, les particularites cliniques, diagnostiques et therapeutiques de cette entite clinique.
Introduction: The aim of this study was to evaluate in “real life” the efficacy and the tolerance of Tocilizumab (TCZ) in the treatment of rheumatoid arthritis (RA).Materials and methods: A cross-sectional study including patients with RA patients treated with TCZ at the commended dose of 8 mg/kg/ 4 weeks. The therapeutic response was evaluated by the EULAR DAS 28 ‐CRP/ VS at month 3 and month 6 of treatment.Results: RA was in most cases severe (76,5 %), seropositive (88,2 %) and erosive (81,3 %). TCZ was prescribed as an alternative to a previous biotherapy in 23 % of the patients and in monotherapy in 76, 5 % of the patients. After treatment follow-up at 3 and 6 months, the different parameters observed were significantly improved including: VAS (visual analogue scale) pain (p=0,000), CRP (mg/L) p=0,000), ESR (mmH1) (p=0,000), DAS 28 CRP (p=0,000), and DAS 28 ESR (p=0,000). Apart from a worsening of renal function in a patient contraindicated continuation of tocilizumab, no serious side effects were noted.Conclusion: Our study confirmed the efficacy and tolerance of TCZ therapy in Moroccan patients suffering from RA.Keywords: rheumatoid arthritis, tocilizumab, efficacy, tolerance
The manifestation of breast cancer recurrence in the form of skin lesions has always been a frustration for both the oncologist and the breast surgeon. Surgeons are asked to treat a recurrent disease that is yet unclear whether it represents disseminated or local disease. Cancer cells are found both in the lymphatics as well as the blood vessels, but, on the other hand, skin recurrence usually does not respond well to the current forms of systemic treatment, and it often needs some form of local treatment for symptom control.
Introduction: Giant cell tumors account for 5% of all bone tumors. However, the anterior chest wall is rarely involved.Clinical case: This is a 68-year-old housewife who has been thyroidectomized, for 11 years and is under hormone replacement therapy, and hysterectomies for 6 years after a uterine tumor. She is present for the onset of a 5-month-old hard submammary mass on the left associated with left anterior chest pain under mammals. The clinical examination had found an irregular hard mass under the left mammary which is fixed to the anterior arch of the 4th left rib. A thoracic x-ray showed a limited left Hilo-axillary with a homogeneously dense opacity. The thoracic CT scan showed the presence of a thoracic parietal mass of osteolytic tissue density centered on the anterior arch of the 4th left rib; without a contrast agent, the surgical exploration through thoracotomy revealed a thoracic parietal tumoral process at the expense of the anterior arch of the 4th limb pushing the corresponding lung inwards. Surgical excision allowed ablation of the whole tumor in monobloc towards a healthy zone. The anatomopathological study of the operative specimen showed a morphological and histopathological aspect compatible with a costal tumor with giant cells. The postoperative recovery was marked by a good clinical and radiological improvement. The last check-up after the surgery revealed that the patient was still asymptomatic. Good clinical, biological and radiological improvement was noted with a decline of 8 months.Conclusion: Giant cell tumors are aggressive bone tumors, yet histologically benign. The chosen examination is a thoracic CT scan with surgical treatment. Clinical and radiological monitoring is necessary. The recurrence is rare, but it usually necessitates a second surgery. The objective of this clinical observation is to highlight the possibility, although rare, of a giant cell tumor in case of the swelling of the soft parts, and a lytic lesion of the anterior part of a rib. Therefore, this tumor must be added to the list of diagnoses to be mentioned in this situation.
Introduction: Penile fracture is a misnomer, penile fracture is defined as rupture of the tunica albuginea of one or both corpus cavernosum. The usual cause is abrupt bending of the erect penis by blunt trauma, which may occur during sexual intercourse, masturbation, rolling over on the bed, or falling onto the erect penis. Diagnosis of penile fracture is made on the basis of history and physical examination. the standard model of management is surgical.Methods: This retrospective study was conducted in the department of surgery SMHS hospital Srinagar,(Jammu and Kashmir), extending over a period of about three and a half years from June 2013 to January 2017. All patients with diagnosed penile fracture were included in this study. All except one patient were operated on the same day of admission.Results: out of a total of 50 patients studied, the mean age of presentation was 26.7 years. The majority (56%)were below 30 years of age.21 (42%) of the patients were married.majority42% of the patients reported masturbation as a cause of trauma, followed by vaginal intercourse in38% and rolling on the erect penis in 20%. About 80% of patients gave a history of audible click/crackling sound. All patients had swelling and discoloration on examination,90% of patients had a penile deformity, only 36 % had a palpable defect. Doppler USG was correct in 93% of patients. The majority (44%) of patients had defects less than 1cm. the defect was mostly seen on the right side (68%).most patients had proximal penile defect (56%). Mean hospital stay was 2.9 days. One patient (2%) had urethral trauma.Surgery had a recurrence of 2%.and a total postoperative complication rate of 10%.Conclusions: Penile fracture though reported rarely, is a common entity. Penile fracture is a urological emergency.Diagnosis is mainly on clinical grounds.Immediate surgical repair is the standard treatment of a penile fracture.
Background : Advanced novel therapies and antiretroviral medications for the treatment of human immunodeficiency virus (HIV) infection have led to the improved management and survival of the infected patients. However, I [i]t manifestations in late-stage diseases such as cardiac deformities, which are the major cause of fatality in HIV-infected patients. Hence the current study was undertaken to derive the association of cardiac dysfunctions in HIV-infected patients using electrocardiograph (ECG)and echocardiography (ECHO).Methodology : The study included a total of 100 consecutive patients with HIV infection and was performed during January–December 2016 in the Department of General Medicine. Prior to the commencement of the study, ethical clearance was obtained from the Institutional Ethical Committee. Patients underwent complete blood count, ECG, and ECHO. Data were analyzed using Microsoft Excel spreadsheet and R-3.4.1 software.Results : Majority of the patients were males (79) and 40–49 years was the most common age group. The duration of HIV infection in most of the patients (73) was 1–10 years. Among the study population, 79 patients received antiretroviral drugs. Chi-square test was used to find the association of clinical symptoms and cardiac abnormalities with CD4 count. Cardiac manifestations were observed in 62% patients; sinus tachycardia (29%) was found to be the most common cardiac manifestation on ECG. Diastolic and systolic dysfunctions were observed in 35 patients and 49 patients, respectively.Conclusion : Patients with HIV infection are at a higher risk of developing cardiac dysfunctions. Early identification through ECG and ECHO-revealed abnormalities might assist in cardiac-targeted interventions, which can significantly reduce the fatal outcomes in HIV-infected patients.
Introduction : L’atteinte vasculaire dans la maladie de Behcet touche 5 a 40% des patients. Tous les vaisseaux quel que soit leur type, taille ou localisation peuvent etre concernes. Cette atteinte est grave pouvant engager le pronostic vital. Observations : On a collige 12 cas de Janvier 2010 a Janvier 2017. Il s’agit de 11 hommes et 1 femme avec un âge moyen de 32,5ans. L’atteinte veineuse concernait 11 malades avec une thrombose de la veine cave superieure (VCS) chez 6 malades, thrombophlebite des membres inferieurs chez 5 malades et une thrombose de la veine cave inferieure et des veines sus hepatiques chez 1 malade. L’atteinte arterielle touchait 9 malades (75%) avec anevrysme des arteres pulmonaires chez 5 malades et une embolie pulmonaire chez 5 autres. L’atteinte cardiaque concernait la moitie des patients a type de pericardite chez 3 malades et de thrombus intra cardiaque chez 4 malades. Conclusion : L’atteinte thoracique de l’angiobehcet est frequente et grave necessitant un diagnostic rapide et une therapeutique specifique intense pour ameliorer son pronostic.
Introduction: Histiocytic sarcoma is an aggressive malignancy of mature histocytes which often carries a poor prognosis. Histiocytic sarcoma is defined in the World Health Organisation (WHO) classification of histiocytic and dendritic cell neoplasms. Case Presentation: Case 1 depicts a 42 year old Malay gentleman with no premorbids presented to the haematology unit with a three month history of fever, night sweats, unintentional weight loss, left axillary and bilateral inguinal swellings which were progressively enlarging. Physical examination revealed a medium built gentleman with left axilla, bilateral inguinal lymphadenopathies and hepatosplenomegaly. Excision biopsies of the left axillary and inguinal lymph nodes were compatible with histiocytic sarcoma. He did not have any bone marrow infiltration. He was treated with 6 cycles of CHOP (Cyclophosphamide, doxorubicin, vincristine, prednisolone) polychemotherapy but he subsequently succumbed to severe hemophagocytic syndrome shortly after his 6th CHOP chemotherapy. Case 2 describes a 55-year-old previously healthy Malay gentleman who presented with perianal swelling and weight loss for two months. Physical examination revealed a large perianal swelling measuring 10 cm with bilateral inguinal lymphadenopathies. Anorectal tissue histology was compatible with the diagnosis of histiocytic sarcoma. He underwent a transverse colostomy which was subsequently reversed post-chemotherapy. He completed 6 cycles of CHOP chemotherapy followed by upfront consolidation autologous stem cell transplant. He is currently 9 months in complete remission. Conclusion: Histiocytic sarcoma remains a disease with poor treatment outcomes and high mortality. Understanding the pathogenesis and pathobiology of the disease will provide a future to the development of novel therapies.
Introduction: Unintentional post-operative open abdominal wall (UPOAW) is a postoperative complication that consists of the early separation of the fascial layer after a primary closure of a laparotomy incision. This complication is associated with great morbidity and mortality. In this article, we studied the frequency of some of these known factors in our series and we briefly discussed the management of this complication. Methods: It was a monocentric retrospective and descriptive study. We enrolled patients with UPOAW, admitted in the department of surgery in Habib Thameur hospital in Tunis (Tunisia), between January 2010 and December 2015.We did not include traumatic patients. We excluded patients with missing data from medical records. Results: The study was conducted on fifteen patients. Eight out of fifteen were men. Patients were aged between 41 and 76 years, with a mean age of 66.6 ± 11.4 years. In the past medical history, chronic obstructive pulmonary disease was noted in three patients, cirrhosis in three patients, diabetes in one patient and a history for laparotomy in one patient. Eight out of fifteen underwent emergent surgeries. Two out of these eight patients had haemodynamic instability throughout surgery. In the postoperative course, coughing was noted in three patients, abdominal distension from ileus in three patients, vigorous postoperative ventilation in two patients and vomiting in one patient. UPOAW was diagnosed between postoperative day zero and postoperative day twenty-one, with a mean time of diagnosis of 10.1 ± 6.6. All patients had immediate closure of the fascial layer. The surgeon used retro-fascial polyglactin mesh in three patients. Relaxing incisions were used in 5 patients. Morbidity after reoperation was 46.7 % (7/15) and mortality was 33.3 % (5/15). Conclusion: UPOAW is a serious complication with high morbidity and mortality. Many factors can contribute to this complication. Every visceral surgeon is confronted with this problem at some point of his carrier and should apply the adequate treatment to his patients depending on his decision and experience. Strong level of evidence is needed to establish clear guidelines for the management of this heterogenous complication.
Objective: Correlation of Ultrasound and RIPASA scoring system in the diagnosis of acute appendicitis. Study Design: 50 patients presenting to emergency underwent ultrasound and evaluation as per RIPASA scoring system followed by emergency appendicectomy. The sensitivity, specificity, positive and negative predictive value calculated for each goups. Results: The sensitivity, specificity, Positive Predictive Value and Negative Predictive Value for ultrasound were 75.51%, 100%, 100% and 7.69% respectively and that for RIPASA scoring system were 93.9%, 100% 100% and 25% respectively. The negative appendicectomy rate was 2%. Conclusion: RIPASA scoring system may be used for correctly diagnosing acute appendicitis but low sensitivity of ultrasound precludes its routine use and may be used as a complementary tool in diagnosing acute appendicitis. Keywards: Acute Appendictis, RIPASA, Ultrasound.
Background: Peritonsillar abscess (PTA) is the most common deep infection of neck space that occurs in adults and is potentially life threatening if not treated appropriately. The surgical treatment of peritonsillar abscess that is not complicated with upper airway obstruction still remains controversial. Objectives: This review attempts to explore the controverseries between different types of management and compare the efficacy of needle aspiration, tonsillectomy and/or incision and drainage. Methodology: This study was done in King Abdulaziz University. All researches, between 1988 to 2015 were recruited and reviewed in this study. Results and conclusion: Studying the three accepted methods of draining: incision and drainage, abscess tonsillectomy, or needle aspiration, Incision and drainage is an efficient and safe procedure to treat peritonsillar abscess. As well as it is superior to Needle aspiration in terms of the post-procedure pain score. It can be performed as the first-line treatment of peritonsillar abscess. Quinsy tonsillectomy can offer several advantages, by allowing full evacuation of the abscess cavity, effectively relieving symptoms, but holds risk in general anesthesia intubation. and also higher post-operative complication like Peritonsillar abscess make it not a favorable step.
BACKGROUND : Peritonitis is classified as primary, secondary and tertiary. In primary peritonitis (spontaneous bacterial peritonitis) and continuous ambulatory peritoneal dialysis-associated peritonitis, the source of the infection is not due a breach in the gastrointestinal tract and usually caused by a single organism. Secondary peritonitis ensues, which may be localized and contained or diffuse carrying a high mortality in the absence of surgical intervention and appropriate antimicrobial therapy. Another sequelae of perforated viscus is intra-abdominal abscesses, located in the intra or retroperitoneal space, which occur in partially treated diffuse peritonitis, postoperatively or in localized disease where the omentum has sealed off the perforation and formed an inflammatory barrier. In contrast, secondary peritonitis following perforation of the gastrointestinal tract or an infection originating in an intra-abdominal structure, e.g. gall bladder, pancreas etc. Tertiary peritonitis is an ill-defined entity, which occurs despite adequate treatment of primary or secondary peritonitis. Combination antibiotic therapy has been used to provide the patient with broad-spectrum coverage against the many potential pathogens encountered in abdominal sepsis. Several potential benefits of the clinical use of antibiotic combinations have been advanced. So this study will be conducted to focus on the efficacy of combination of two versus three antimicrobial drug in the management of patients with perforated peritonitis. OBJECTIVES OF THE STUDY: 1.To assess the efficacy of two antimicrobials(Ceftriaxone And Metronidazole) in perforative peritonitis. 2.To assess the efficacy of three antimicrobials(Ceftriaxone, Metronidazole And Amikacin)in perforative peritonitis. 3.To compare the clinical outcome of perforative peritonitis with two and three antimicrobials in the terms of reduction in postoperative infections and hospital stay. MATERIALS AND METHODS SOURCE OF DATA: This is a prospective clinical study conducted on 140 consecutive patients who presented to the surgical department of R. L. Jalappa Hospital and Research Centre, Tamaka, Kolar with peritonitis secondary to hollow viscus perforation. Study period was from December 2015 to June 2017. This is a randomized study and all the patients were divided in two groups. GROUP A: Patients with all odd serial numbers were included in this group and treated with two antimicrobials (Inj Ceftriaxone 1gm IV BD and Inj Metronidazole 500mg IV TID). GROUP B: Patients with all even serial numbers were included in this group and treated with three antimicrobials(Inj Ceftriaxone 1gm IV BD , Inj Metronidazole 500mg IV TID and Inj Amikacin 500mg IV BD). INCLUSION CRITERIA : 1.Patients with peritonitis secondary to hollow viscus perforation. 2.Patients with age >18years and <70years. EXCLUSION CRITERIA: 1.Peritonitis secondary to trauma to the abdomen. 2.Peritonitis secondary to gynaecological interventions like D&C. 3.Peritonitis secondary to malignancies and immuno-compromised state 4.Patients allergic to Ceftriaxone, Metronidazole and Amikacin. 5.Tertiary peritonitis. RESULTS: The clinical outcome in the form reduction in postoperative complications and hospital stay were assessed in 140 patients, in Group A( with the usage of two antimicrobials , Ceftriaxone and Metronidazole) and Group B( with usage of three antimicrobials, Ceftriaxone, Metronidazole and Amikacin). There was decrease in postoperative complications and hospital stay in Group B. The p-value was significant in Group B patients <0.05(0.007). There were 6 deaths, all of them had severe form of peritonitis with massive contamination and delayed presentation to the hospital. This study also revealed that men are commonly affected and duodenal ulcer perforation is the commonest site of perforation. Escherichia coli is the most common organism isolated. CONCLUSION: In our study peritonitis is more common in men compared to women. The most common age group is in between 21 – 40 years in cases of peritonitis with the mean age of 37 years. Duodenal ulcer perforation is the commonest site of perforation. Escherichia coli is the most common organism isolated in the peritoneal fluid. Use of with usage of three antimicrobials, Ceftriaxone, Metronidazole and Amikacin(p<0.05) is beneficial in reduction in postoperative complications and hospital stay when compared to usage of two antimicrobials, Ceftriaxone and Metronidazole which is statistically significant.
Background: The involvement of oral bacterias in the occurrence of infective endocarditis (IE) has prompted the adoption of antibiotic prophylaxis prior to dental procedures for patients at high-risk. The aim of this paper was to assess the knowledge of Moroccan dentists regarding the management of patients with heart disease at risk of infective endocarditis. Methods: This was a cross-sectional descriptive analytical study which targeted 200 dentists in the city of Rabat- Morocco. A questionnaire with 16 questions was distributed randomly. The level of knowledge of dentists was established based on the number of correct answers for each section and responses were assessed according to the American Heart Association (AHA) 2007 guidelines. Results: Only 133 practitioners have agreed to participate in our study with a response rate of 66,5%. 87% of dentists reported contacting the cardiologist before starting treatment, 33% of practitioners weren’t aware of any guidelines and 20% knew AHA 2007, 52% reported not following guidelines in the management of patients with heart disease. Among the cardiac conditions and dental procedures proposed in the questionnaire which required prophylaxis; 8% and 2% respectively chose the correct answer according to the AHA’s 2007 guidelines. 31% of dentists answered correctly on the prescription of antibiotic prophylaxis protocol according to the latest recommendations. Conclusion: According to our results, the knowledge of Moroccan private general dentists towards endocarditis prophylaxis was in a low level. The study highlights the need for continuous education.
Following the controversial use of the mitochondrial replacement technique in IVF procedures to prevent the transmission of potentially incurable and fatal inherited mitochondrial disorders, various ethical and safety concerns and regulatory issues were raised in the medical community. The diseases in question affect mitochondria, and are only inherited from the mother [9], patients with more than 60% mutated mitochondrial DNA (mtDNA) may develop severe systemic diseases, such as cancer, diabetes, blindness, deafness, liver failure, infertility, neuropathy, myopathy, cardiomyopathy, sensory deficit and many others [1, 2, 3]. The incidence of clinically present mtDNA disorders is at least 1 in 10 000 individuals, but the frequency of the pathogenic mtDNA mutation is approximately 1 in 200 of the general population [4] . Currently there is no effective therapy or genetic screens for these maternally inherited diseases, and at present, the mitochondrial replacement technique (MRT) holds promises for human reproductive health and the production of healthy babies. This article will discuss some objections that oppose the procedure in principle and present a perspective surrounding the legalization of these techniques in Morocco.
Introduction: Rare examples from the literature report a possible degeneration of mucosal lesions of L.E.C. We report a case of squamous cell carcinoma grafted on a lesion of the lower lip in a patient followed for L.E.C. at the ENT and Maxillo-facial department of Mohamed VI University Hospital of Oujda.Case report: A 47-year-old man, with a notion of photosensitivity, presents atrophic erythematous-violet plaques in the photo-exposed zones evolving for 20 years, evoking chronic discoid lupus cutaneous without any clinical, biological or radiological sign of systematization. The patient had a painful lower ulcer-budding process that had been evolving for 2 years, with suspected bilateral cervical lymphadenopathy. The biopsy revealed a well-differentiated infiltrating squamous cell carcinoma. Surgical excision oncology is then performed with a labial plasty and an obviously bilateral lymph node. Conclusion: The risk of degeneration of skin lesions of lupus discoid is minimal and rare, although monitoring of lupus scars remains essential, especially in the context where exposure to ultraviolet radiation is added as a predisposing factor for possible malignant transformation, surgical treatment is required at the appearance of suspicious lesions confirmed histologically.
Melanoma is a malignant tumor of melanocytes, and is a potentially aggressive cancer. The incidence of melanoma is rising at a greater rate than any other cancer in the U.S. The aim of this study was to examine the association between melanoma stage at the time of diagnosis and survival among U.S. adult melanoma patients during 1982-2011. This was a secondary analysis of a non-concurrent cohort study conducted on 185219 U.S. adult patients who were diagnosed with primary cutaneous melanoma between 1982-2011. Chi-square, Kaplan-Meier, and Cox proportional hazards regression were used to analyze the data. Significance was assessed using p-value and 95% confidence interval. Men had more cutaneous melanoma. Black non-Hispanic patients were diagnosed less frequently. Patients who were married or in a domestic partnership were most likely to be diagnosed. The adjusted HR for distant melanoma was 141-fold that of in situ (95% CI 126.38-157.19). The adjusted HR was the highest in the first decade of diagnosis (1.7; 95% CI 1.6 1.75). In conclusion, survival is highly affected by melanoma stage at diagnosis. Black non-Hispanic patients had the lowest hazard ratio of all races. The sample size was large, which enhances the generalizability to the U.S. population.
Introduction: Morbid obesity together with obesity-related diseases has a significant negative impact on the quality of life. Our study aims to assess the quality of life amongst patients with morbid obesity post-bariatric (sleeve gastrectomy) surgery in relation to their pre-operative state. Methods: A questionnaire was developed and administered to 298 patients, 52% of the participants were females. The highest percentage (42.3%) was in the age group 30-40 years. The mean preoperative weight was 127kg, and the preoperative BMI was 46.6Kg/m2. The quality of life is assessed regarding various criteria such as physical pain, psychological manifestation, and self-esteem. Results: There is an overall noticeable improvement in practicing different activities; Patients are able to participate in various sports (61%) with no marked alteration in terms of social activity. Productivity in terms of everyday work tasks was enhanced (57%) compared to the pre-operative Regarding post-operative pain, (57%) reported experiencing post-operative pain, the majority of these (64%) experienced postoperative pain for a total duration of less than one month. the percentage of patients who said that there is much improvement in their health status compared to their preoperative situation was higher in those who had a preoperative chronic illness. Conclusion: sleeve gastrectomy for patients with morbid obesity showed a tremendous positive impact on the quality of life of the majority of patients
Acute myocardial infarction (AMI) is a leading cause of death in the United States with over three million cases per year. Since the mid-1970s, the total number of deaths related to AMI in the United States has not declined. Studies suggest that women with AMI have worse outcomes compared to men. However, there is limited information regarding this topic among Hispanics. This study was a secondary analysis of the Puerto Rican Heart Attack Study, which reviewed the records of Hispanic patients of Puerto Rico hospitalized for AMI at 21 academic and/or non-teaching hospitals in 2007, 2009 and 2011. This study set examined the differences in in-hospital mortality rates between genders. A p-value of 0.2 was used to select possible confounders and the chi-square test was used to examine associations between categorical variables. Factors associated with in-hospital mortality rates were identified using logistic regression. Collinearity was assessed using Pearson correlation coefficients. The 95% confidence interval and a p-value of 0.05 were used to determine statistical significance of odds ratios. Analysis was restricted to patients with ICD-9-CM code 410-414 who are above 18 (n = 2265). In our sample, there were more men than women (1291 versus 974, respectively). Men were younger and smoked more compared to women. Compared to men, women were older and suffered more comorbidities, such as stroke and congestive heart failure (CHF). Women had higher rates of in-hospital mortality compared to men (OR = 1.4, p = 0.040). Factors associated with higher rates of in-hospital mortality included age and CHF (p<0.001). Patients with CHF showed higher rates of in-hospital deaths compared to patients who did not have CHF (OR = 1.6, p = 0.026). Patients over the age of 86 showed higher odds of in-hospital death compared to younger patients (OR = 10.5, p <0.001) Significant disparities existed by gender in this sample of Hispanic AMI patients, with women showing higher in-hospital mortality compared to men. Women over 50 should perform regular checkups and discuss hormone replacement therapy or follow other preventive measures as suggested by their healthcare provider.
EXTRACT Placées sous le Haut Patronage de Sa Majesté Le Roi Mohammed VI, les journées du 24 et 25 avril 2017 resteront inscrites dans l’histoire de l’Université Mohammed VI des Sciences de la Santé ainsi que dans celle de l’Académie de médecine de France. En effet, l’Académie nationale de médecine française effectuait sa première séance délocalisée à l’étranger. Elle avait également choisi notre institution pour y tenir cette première séance organisée à l’étranger, ce auquel notre Université a été très sensible. Ce projet prestigieux a été porté par notre Président Directeur Général, le Pr Abdelaziz MAAOUNI qui l’a soutenu et suivi avec un intérêt permanent durant toutes les étapes de son organisation et jusqu’à sa réalisation ....
None of the food classes is to be neglected, as each presents nutritional specificities, in terms of vitamins, oligo-elements, minerals, essential amino acids, omega-3, and 6 polyunsaturated fatty acids. Milk and milk products occupy a specific place. In terms of a diversified diet, their presence ensures better health, because of the reduction of the number of pathologies. For nay years, milk suffers many attacks, most of them not justified, intuitive, or pseudo-scientific. Thus, milk products and milk detractors, are using, globally, two-line of arguments. One is using false or abusive scientific and medical data. The other presents arguments not at all based on scientific arguments, possibly qualified as a fantasist. Unfortunately, the consumer is interested in them.
