Chronic kidney disease-associated pruritus (CKDaP) is a prevalent and challenging symptom in individuals suffering from advanced chronic kidney disease (CKD). Its underlying mechanism remains ...inadequately understood, leading to a limited array of unsatisfactory therapeutic interventions. Despite various attempts, identifying the most effective treatment remains inconclusive. Nevertheless, there is a growing interest in employing ultraviolet phototherapy, particularly for non-responsive patients, although its efficacy is not definitively established. To investigate the potential benefits of narrowband ultraviolet B (NB-UVB) phototherapy on individuals experiencing CKDaP, we report our experience with NB-UVB light in management of CKDaP in dialysis patients.
The study group consisted of patients with end-stage chronic kidney disease who underwent hemodialysis. These patients received dermatological consultations and follow-ups for itching. They were all unresponsive to the conventional treatment (emollients and antihistamines). Screening laboratory examinations, including complete blood count, liver function test, thyroid function, electrolytes, and others, were also arranged to exclude systemic etiologies. The main potential pruritogens were dosed: calcium, phosphate, and parathyroid hormone. Itch intensity was evaluated with a numerical rating scale (0-10), based on the worst level of itching in the past two weeks. They had sessions of NB-UVB light (311 nm, TL01) twice per week. After UVB exposure, patients were advised to use topical emollients. A questionnaire was employed to document the extent, intensity, frequency, and sleep disruption experienced to evaluate the efficiency of the treatment, using a scale from 0 to 10. Results: In a group of 38 patients, the average age of the patients was 56 years (16-80); 63.2% were female and 36.8% were male. Median duration of pruritus was 4.7 years, and that of dialysis was 8.4 years. Pruritus was intermittent and diffuse in most cases, localized to the arteriovenous fistula site in two cases, and exacerbated by heat in all cases. Itch intensity was evaluated with a numerical rating scale (0-10) based on the worst level of itching in the past two weeks and showed a moderate average score (5/10). Xerosis was found in 63%, and scratch lesions such as excoriation in 34%. NB-UVB phototherapy was used twice per week on nonconsecutive days, with protection of the genital area and also the eyes using UVB-blocking goggles. The initial dose was 0.4 J/cm
and further doses were introduced according to the erythema response until a maximum of 2 J/cm
. No sunburn, hyperpigmentation, or blistering was noted. Emollients were maintained in patients with xerosis. Average number of sessions was 13 (6-24) and reduction of itch intensity was observed starting from the sixth session. Total improvement was obtained at the end of treatment duration except for three patients who required additional sessions. One patient had recurrence one year later. Conclusion: In conclusion, phototherapy represents a significant advancement in the treatment options for CKD-associated pruritus. Its positive impact on reducing itching and improving the quality of life for many patients is undeniable. However, to fully unlock its potential, ongoing research is needed to optimize dosing, understand relapse mechanisms, and identify the patients who will benefit most from this therapy.
Higher education institutions (HEIs) are increasingly being held accountable for maintaining quality in their activities by governments, industry, students, and the community as a whole. ...Accreditation agencies formulate assessment criteria covering the entire range of HEI activities so that the quality of HEI activities can be measured. However, as the perceptions of stakeholders varies of what makes a good HEI, it is crucial to investigate their opinions about the standards set by these agencies. This study uses focus group discussions involving Omani HEI stakeholders, including students, HEI staff, and employers, to gain insights into their perceptions on the most significant standards set by Oman Academic Accreditation Authority (OAAA) in measuring the quality of HEIs. It was found that stakeholders’ views of the key standards that measure HEI quality varies. Students were in favor of the standards related to the quality of teaching and learning. Students also show a good level of awareness about employers’ priorities. Employers were more concerned about the research skills of graduates and their industry and community involvement. There was also some agreement between staff and employers on the importance of governance and management. This study provides HEIs, OAAA, and partner universities insights into stakeholder priorities and concerns.
Background
Few epidemiological studies on primary cutaneous lymphomas are available and related to limited populations.
Objectives
To characterize the epidemiologic, clinical and therapeutic features ...of primary cutaneous lymphomas from a global perspective at the national level.
Methods
A cross‐sectional descriptive multicenter study including patients treated for cutaneous lymphomas at dermatology and venereology departments of different university hospitals in the kingdom of Morocco from January 2012 to December 2021.
Results
Our multicenter cohort consisted of 402 patients. The median age was 56 years (15–114) with a male predominance (61%, 245 cases). Based on the WHO‐EORTC classification, the most frequent histological type was cutaneous T‐cell lymphoma (CTCL) (88% of cases). Of these, mycosis fungoides (MF) was the most common (78%). B‐cell lymphomas represented 12% of cases, mainly centro‐follicular B‐cell lymphoma (40%). The clinical presentation was most frequently erythematous and scaly infiltrated lesions in 187 CTCL patients (52.6%), and nodular lesions in 37 patients (78%) with B‐cell lymphomas. Treatment modalities depended on the tumour's histological type and stage and included: topical corticosteroids and phototherapy in 52% of cases, monochemotherapy, radiotherapy, photopheresis and polychemotherapy. The evolution was marked by remission in 41% of patients, relapse in 17% and death in 12%.
Conclusions
Our national study provides data on primary cutaneous lymphomas in Morocco, never before mentioned in indexed literature. We identified 402 cases over a 10‐year period. A better knowledge of these entities is key to optimize diagnosis and therapy.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Aim
We aimed to examine the validity and reliability of a newly developed tool that measures nursing and allied health students’ knowledge of caring for patients with COVID‐19.
Method
We developed in ...five phases (literature review, item development, expert evaluation using content validity index, revisions based on a pilot test, and exploratory factor and reliability analyses on the data from the main study). We administered online surveys (the pilot test & the main study using a cross‐sectional design) to students in a governmental health sciences college in Oman.
Results
The pilot test had 43 participants, and the main study had 507. The item content validity index scores ranged from 0.81–1.00, and the scale content validity index for 20 items was 0.95. The factor analysis revealed a three‐factor solution. The overall Cronbach’s alpha for the final (19‐item) version of the tool after item deletion was 0.76. The reliabilities for Subscales 1, 2, and 3 were 0.83, 0.67, and 0.51, respectively.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK, VSZLJ
We propose to study the epidemiological aspects of North African psoriasis and determine the cardiovascular comorbidities and addictive behaviors associated with psoriasis. This is a North African ...case-control study which was conducted over a five year period (October 2008 through August 2013), involving 671 psoriatic patients and 1,242 controls identified in various Algerian, Tunisian and Moroccan university hospitals. For each patient, epidemiological characteristic, addictive behaviors, and cardiovascular pathologies associated with psoriasis were noted. Six hundred and seventy one psoriasis patients and 1,242 controls were included in this study. The average age was 47.24 years and the M/F sex-ratio was 1.11 (354 men and 317 women). Statistical analysis showed that psoriasis patients were more likely to develop addictive behaviors than controls (smoking p<10-5 and alcohol consumption: p < 10-5), together with dyslipidemia (30.1% of patients p < 10-5), obesity (23.8% of patients p < 10-4), hypertension (22.3% of patients p < 10-5), diabetes (21.7% of occurrences p < 10-5) and metabolic syndrome (37.4% of patients p<10-5). The relative risk for developing psoriasis was 1.9 in hypertensive patients, 1.7 in diabetic patients, 3.9 in dyslipidemic patients, 1.8 in obese patients, 2.6 in those with metabolic syndrome, 2.1 in smokers and 2.8 in alcoholics. Our work confirms the high incidence of addictive behaviors and of cardiovascular and metabolic comorbidities during the North-African psoriasis, hence the need for a multidisciplinary comprehensive care based on a guideline suited to the characteristics of North-African psoriatic patients.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Ovarian tumours are commonly seen in reproductive age group in women. However, when they occur at extremes of age, the suspicion of malignancy increases. The detection of dermoid cyst at 56 years of ...age is uncommon, hence proper imaging with CA-125 level monitoring is essential. Awareness of benign tumours or rare possibility of malignant transformation in such age is mandatory for surveillance management or planning the surgical procedure.
Gallstone is an expensive and very common gastrointestinal disorder affecting 10–20 % of the adult population. The traditional use of medicinal plants in Morocco is an ancestral and common practice ...to solve health problems, including gallstone disease. Our study aimed to identify the medicinal plants used by patients suffering from gallstones.
A cross-sectional survey was conducted on the use of medicinal plants for the treatment of gallstones in the visceral surgery department, University Hospital Center Ibn Rochd of Casablanca, Morocco. Face to face interviews were carried out with 128 hospitalized patients using a closed-ended questionnaire.
Patients with gallstones underlined the use of 35 species belonging to 21 botanical families. The most frequently used plant was Citrus limon, followed by Petroselinum sativum, Herniaria hirsuta and Olea Europea, belonging respectively to Rutaceae, Apiaceae, Caryophyllaceae and Oleaceae. The respondents used different parts of plants; seeds, aerial parts, fruits and leaves. The most commonly preparations were decoction, infusion and powder form. More than two-thirds of the patients were overweight or obese, regularly consume soft drinks and drink little water a day.
The pharmacological effect of the inventoried plants and their active ingredients are consistent with their use in the traditional Moroccan pharmacopoeia to treat and to prevent gallstones. These plant species could be a potential avenue for the discovery of an alternative treatment; however, further chemical and pharmacological investigations are needed.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
The fish industry has grown considerably worldwide, and fungal infections represent a significant aspect that increases economic losses and challenges through high mortality rates. The Egyptian ...aquaculture industry is particularly vulnerable to Saprolegnia parasitica, a deadly fish pathogen. Using phytobiotics as immunomodulators, antioxidants, and health promoters in aquaculture have been proven recently as an alternative strategy for banned malachite green. This research aimed to examine the thyme effect (Thymus vulgaris) on the immune status of cultured Nile tilapia against Saprolegniasis. A total of 50 fish (Oreochromis niloticus) with skin lesions were gathered from a private fish farm in Alexandria, Egypt. Skin swabs, gill swabs, and muscle tissue were obtained from each fish. After the mycological examination, results revealed that 35 isolates out of 150 examined samples (23.33%) were positive for fungal growth, of which 15 (10%) isolates were identified as Saprolegnia species. In addition, other fungi were detected; 5 (3.33%), 8 (5.33%), 4 (2.67%), and 3 (2%) isolates were identified as Penicillium species, Aspergillus flavus, Alternaria species, and Fusarium species, respectively. To evaluate the immunomodulatory effect of thyme, 300 healthy Nile tilapia fish with a mean weight of 30 ± 5 gm were brought to be experimentally designed; they were distributed into four groups (with three replicates) and were fed on an experimental diet including 0.0, 0.5, 1.0, and 1.5 thyme oil (gm/100gm diet) continuously for two months. Then fish were infected with S. parasitica zoospores, which were thoroughly mixed with their diet. According to results, after two months of feeding, catalase (CAT), serum lysozyme activity, and total protein dramatically increased according to the levels of thyme added; the acquisition was for the group fed on a 1.5 gm/100gm diet. Additionally, the expression of interleukin-10 (IL-10) and interleukin-1β (IL-1β) in liver tissues increased similarly. Hence, it is concluded that employing thyme would improve the well-being and yield of the farmed Nile tilapia.
Le carcinome verruqueux du lit unguéal est rare et le retard diagnostique est fréquent d'où l'intérêt de biopsier les lésions unguéales chroniques.Sa localisation fréquente est au niveau des ...muqueuses, des doigts surtout le pouce, rarement les orteils et plus rarement le siège sous unguéale. Il survient surtout chez le sujet âgé de plus de 60 ans avec prédominance masculine. Plusieurs facteurs sont incriminés dans sa pathogénie: l'exposition aux radiations ionisantes, les radiodermites chroniques, les microtraumatismes répétés, et l'infection chronique à HPV.Il est de bon pronostic, à malignité locale. Les métastases viscérales sont exceptionnelles. L'approche thérapeutique n'est pas standardisée à l'heure actuelle. Le traitement conservateur est préférentiel afin de préserver les fonctions de l'orteil. L'amputation de la phalange distale est réalisée généralement en cas d'atteinte osseuse. Les récidives sont fréquentes d'où l'intérêt d'une exérèse large et un suivi prolongé des patients. Nous rapportons l'observation d'une patiente âgée de 60 ans, sans antécédents pathologiques particuliers, qui présentait depuis 4 ans, une tumeur verruqueuse sous unguéale du gros orteil gauche, sans adénopathies palpables, faisant évoquer une verrue vulgaire, une tuberculose verruqueuse, une maladie de Bowen ou une mycose profonde. La radiologie standard de l'orteil était normale. La biopsie cutanée était en faveur d'un carcinome verruqueux. La patiente a bénéficié d'une exérèse du lit de l'ongle et de la matrice avec limites d'exérèses saines à l'étude histologique. Une greffe de peau totale est réalisée après bourgeonnement. Le recul est de 2 ans.
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