Health Sciences https://mediterraneanjournals.com/index.php/hs <p><strong>Health Sciences (2658-865X)</strong> is an Open Access peer-reviewed journal based on a continuous publication model. It aims to publish original works of high quality written in English and covering health sciences fields (Medicine, Dentistry, Public Health, Nursing, Biomedical Engineering, and Pharmacy).</p> en-US hs@mediterraneanjournals.com (Health Sciences) contact@mediterraneanjournals.com (The Editorial Team) Fri, 01 Jan 2021 00:00:00 +0000 OJS 3.3.0.7 http://blogs.law.harvard.edu/tech/rss 60 Clinical Benefits of Ketamine and Lidocaïne in the Morphine Saving Strategy in Major Digestive Surgery in a Middle-income Country https://mediterraneanjournals.com/index.php/hs/article/view/512 <p><strong>Introduction:</strong> The use of adjuvants in general anesthesia (GA) is experiencing renewed interest in digestive surgery [1,2].</p> <p><strong>Objective: </strong>To provide proof of the efficacy of Ketamine and Lidocaine in the morphine saving strategy in digestive surgery.</p> <p><strong>Materials and Methods:</strong> This was a randomized, single-blind, controlled trial. The study took place over a period of 6 months, from July to December 2020 at the Essos hospital center. Patients over 18 years of age scheduled for digestive surgery were divided into 3 groups: Ketamine (GK), Lidocaine (GL), control (GT). At induction of anesthetic, the GK group received IV ketamine as a bolus dose of 0.5 mg / kg; then 0.125 mg / kg / h continuously intravenously with an electric syringe pump (IVSE). The GL group received Lidocaine as an IV bolus of 1.5 mg / kg at induction anesthetic, followed by 1 mg / kg / h IVSE. The GT group did not receive any adjuvant administration. Intra and postoperative opioid consumption, intensity of postoperative pain, area of peri-scarring hyperalgesia and incidence of postoperative nausea and vomiting (PONV) were listed. A probability P &lt;0.05 was used as the significance level.</p> <p><strong>Results:</strong> During the survey period 60 participants met the inclusion criteria: 27 for the GK group, 15 for the GL group and 18 for the GT group. The average age of the participants was 55 with extremes ranging from 18 to 65. The sex ratio was 2.5 in favor of men. The majority of the workforce was in the ASA 2 class (57.1%). The main indications for surgery were hemicolectomy (33.3%), bilio-digestive bypass (19%) and cholecystectomy (14.8%). Ketamine and Lidocaine reduced intraoperative fentanyl consumption by 67.7% and 42.85%, respectively (P &lt;0.001). The postoperative morphine savings were remarkable with Ketamine and Lidocaine in the order of 14.8mg and 20mg respectively (P = 0.001). The numerical scale was significantly improved with Ketamine and Lidocaine in the first 24 hours postoperatively (P = 0.001). The area of pericicatricial hyperalgesia was limited to the operative site for all participants in the GK and GL groups (P &lt;0.001). The incidence of PONV was reduced in the test groups in a comparable manner (p = 0.045).</p> <p><strong>Conclusion:</strong> The use of ketamine and IV lidocaine in the morphine sparing strategy in digestive surgery has been shown to be effective. The benefit / risk balance argues in favor of the use of these molecules in countries with low per capita income.</p> Serge Vivier Nga Nomo, Pierre René Binyom, Bonaventure Jemea, Cristella Iroume, Aristide Kuitchet, Lowe Gueguin, Chewa Gisele , Samson Nkoumou Copyright (c) 2021 Serge Vivier Nga Nomo et al. https://creativecommons.org/licenses/by/4.0 https://mediterraneanjournals.com/index.php/hs/article/view/512 Fri, 10 Sep 2021 00:00:00 +0000 Prevalence of Cutaneous leishmaniasis in Khartoum State-Sudan https://mediterraneanjournals.com/index.php/hs/article/view/443 <p>&nbsp;Cutaneous leishmaniasis is the known form of leishmaniasis affecting humans. It is a skin infection caused by the protozoan parasite Leishmania from animals to humans by the bite of a vector phlebotomine sandfly. About 21 species causing leishmaniasis depending on geographical distribution and host immunity. Populations of northern areas of Sudan are commonly affected by the disease.</p> Wahaj Muawyia, Abdelsalam Bashir Satti, Basma Ahmed Awed Allseed, Tasneem Hamoda Kalifa Al-Toom , Nadia Musa Seleman Mohammed Copyright (c) 2021 Muawyia W et al. https://creativecommons.org/licenses/by/4.0 https://mediterraneanjournals.com/index.php/hs/article/view/443 Mon, 01 Mar 2021 00:00:00 +0000 Treatment of a Case of Subtotal Maxillary Edentulism by Composite Prosthesis https://mediterraneanjournals.com/index.php/hs/article/view/230 <p>In the subtotally edentulous, facing the last remaining teeth, the practitioner may be faced with a dilemma: "Keep or extract". Of course the answer is not always obvious, it must take into consideration several parameters. When the practitioner decides to keep the residual teeth, he can consider, depending on the case, the implant solution, the supra-radicular prosthesis or the composite prosthesis.</p> <p>In this article we present a case of maxillary subtotal edentulism treated by the composite prosthesis.&nbsp;The choice of this therapy was based on a diagnostic approach leading to the manufacture of temporary prostheses that were re-evaluated over six months, then a definitive prosthesis made according to the rules of art, giving the patient a suitable smile and optimal comfort during mastication.</p> Asmaa Hatim, Anas Bennani, Samira Bellemkhannate, Amal Elouazzani Copyright (c) 2021 Hatim A et al. https://creativecommons.org/licenses/by/4.0 https://mediterraneanjournals.com/index.php/hs/article/view/230 Thu, 04 Mar 2021 00:00:00 +0000 Pulmonary Alveolar Microlithiasis - Report of Two New Cases and Review of the Literature https://mediterraneanjournals.com/index.php/hs/article/view/524 <p><strong>INTRODUCTION:</strong> Pulmonary alveolar microlithiasis (PAM) is a rare autosomal recessive disease characterized by the intra-alveolar accumulation of spherical calcified microliths, of a phospho-calcium nature, in the absence of any problem of phosphocalcium metabolism. The majority of patients are asymptomatic. The disease is often diagnosed on routine radiological examination.<br><strong>CASE REPORTS:</strong> We report two cases of PAM; A 17-year-old girl with three generations of consanguinity, who consulted for bronchial syndrome. Auscultation revealed very fine diffuse ronchi. The X-ray showed a bilateral alveolar syndrome, especially on the right, a bilateral bronchointerstitial syndrome, and diffuse bilateral calcifications. The thoracic CT scan showed calcified micro and macronodules with thickening of the septa, middle section involvement with fibrosing remodeling, fibrosis, and tractional bronchiectasis of the bases, pleural and pericardial calcifications. Respiratory function tests showed a restrictive syndrome with a vital capacity of 70% and normal GDS. This radiological and scanographic picture made us think of PAM. We then decided to carry out a family investigation with chest radiographs. All family members had normal radiographs, except for a sister who was three years old, with no particular history, no functional respiratory signs, and no particular complaints. Her chest radiograph showed the famous sandstorm appearance of microcalcifications, with pulmonary distension at the apexes and retractions at the bases. Spirometry and blood gases were normal. Chest CT found microcalcifications, with bilaterally distributed and diffuse ground-glass aspects, with a slight right-hand predominance.<br><strong>CONCLUSION:</strong> MLA is known to be radio-clinically dissociative. The diagnosis can be made by radiology alone in typical cases; sometimes, Transbronchial or surgical lung biopsies are needed. The prognosis is compromised in the long term. The only effective treatment nowadays is lung transplantation.</p> Abdelilah Tebay, Khalid Bouti Copyright (c) 2021 Tebay A & Bouti K https://creativecommons.org/licenses/by/4.0 https://mediterraneanjournals.com/index.php/hs/article/view/524 Sat, 26 Jun 2021 00:00:00 +0000 COVID-19 and Management of Gastrointestinal Disorders: Experience of a Moroccan Hospital https://mediterraneanjournals.com/index.php/hs/article/view/506 <p>Pandemic Covid-19 is a real challenge for the medical profession. SARS-CoV-2 virus attacks several human organs, including the digestive tract. Digestive disorders have been described as revealing symptoms or accompanying signs of infection. The treatment of these symptoms must be early and codified. At Cheikh Khalifa International University Hospital in Casablanca, a codified treatment protocol has been proposed to facilitate the management of these disorders.</p> Hanane Delsa, Mohamed Reda Cherkaoui Jaouad , Amine Benfaida , Anass Nadi, Fedoua Rouibaa Copyright (c) 2021 Hanane Delsa et al. https://creativecommons.org/licenses/by/4.0 https://mediterraneanjournals.com/index.php/hs/article/view/506 Mon, 20 Sep 2021 00:00:00 +0000 The Reform of Primary Health Care / PHC in Algeria : A First Step Towards a More Equitable and Efficient Health System https://mediterraneanjournals.com/index.php/hs/article/view/366 <p>Primary care in the national health care service in Algeria plays an important role: the execution of the National Immunization Schedule for infants, the care of mother and child, the monitoring of chronically ill patients, etc. However, offering modern primary health care to cover the real health needs of the population requires responsible and courageous self-criticism, either by health officials or by health economists.<br>This is a descriptive and analytical study that highlights the reality of primary health care in the Algerian health system, which aims to make a constructive critique in relation to the pillars and principles of modern and effective primary health care. We have arrived that the sine qua none conditions must be realized in order to boost the role of primary health care in Algeria, among them: organizational non-accessibility, medium or poor quality care, non-availability of resources early detection of some pathologies… are recurring problems which push the care-seeker to desert primary health care structures, as well as non-compliance with the organization of care.</p> Nasreddine AISSAOUI Copyright (c) 2021 Aissaoui N https://creativecommons.org/licenses/by/4.0 https://mediterraneanjournals.com/index.php/hs/article/view/366 Wed, 27 Jan 2021 00:00:00 +0000