Based on the evaluation of the performance of the Maghreb fight against COVID-19, characterized by the vulnerability of the preparation of health systems, this list of lessons could constitute a roadmap for the reform of health systems. Maghrebian health, towards more performance in managing possible waves of COVID-19 or new emerging diseases with epidemic tendency.

Based on the evaluation of the performance of the Maghreb fight against COVID-19, characterized by the vulnerability of the preparation of health systems, this list of lessons could constitute a roadmap for the reform of health systems. Maghrebian health, towards more performance in managing possible waves of COVID-19 or new emerging diseases with epidemic tendency.Biermer’s anemia is an auto immune disease that can lead to neurological manifestations. Medullary combined sclerosis accounts for only 10% of neurological complications. There are few reports of documented bone marrow involvement by magnetic resonance imaging (MRI). Observation We report a case of combined sclerosis of the cervical spinal cord assessed by cerebro-medullary MRI in a context of vitamin B12 deficiency in a 36-year-old patient who was hospitalized in the intensive care unit for septic shock with respiratory starting point, requiring the use of mechanical ventilation for 13 days and the discovery in post-extubation of pancytopenia with macrocytic anemia and flasquo-spasmodic tetraparesis prompting an emergency MRI showing combined sclerosis of the spinal cord , with vitamin B12 deficiency and megaloblastic anemia at the myelogram. The patient had benefited of vitamin therapy combined with a physical rehabilitation and the evolution was marked by a recovery of walking and normalization of biology after 2 months. Conclusion The advantage of medullary MRI in a severe clinical form with neurological impairment of vitamin B12 deficiency to guide the diagnosis. The treatment is based on vitamin therapy with a good evolution.

Osteochondromas (or exostoses) are the most common benign tumors of the bone. Vascular complications of these tumors are rare but have been increasingly reported in recent literature.

Throughout an unusual case report of popliteal artery entrapment syndrome secondary to a femoral osteochondroma, we highlight the necessity of thorough clinical and radiological examinations as well as meticulous and prompt surgical resection.

A 27-year-old male patient, who had been diagnosed with multiple osteochondromas and had never been operated on, presented with a one-year history of exercise-induced left calf pain, paresthesias of the left leg and pallor in cold weather. After radiographic and Computed Tomography angiographic evaluation, we diagnosed distal femur osteochondroma associated with an arterial compression of the left popliteal artery. A surgical treatment of all lesions was performed. No operative complications occurred. The pain was relieved. Good postoperative results have been noticed.

Popliteal aretery entrapment syndrome may be caused by solitary or multiple osteochondromas around the knee. Therefore, prophylactic resection of exostoses in the surrounding area of a vessel should be performed. Selleck DRB18 Moreover, the orthopedic surgeon should consider and prevent vascular complications during surgical resection of knee osteochondromas.

Popliteal aretery entrapment syndrome may be caused by solitary or multiple osteochondromas around the knee. Therefore, prophylactic resection of exostoses in the surrounding area of a vessel should be performed. Moreover, the orthopedic surgeon should consider and prevent vascular complications during surgical resection of knee osteochondromas.

Obstructive Sleep Apnea Syndrome (OSAS) is a common but often under diagnosed condition that constitutes a real public health problem. The prevalence of OSAS in atrial fibrillation (AF) patients ranges from 32 to 85% according to recent studies.

To determine the prevalence and severity of OSAS in a population followed for non-valvular AF (NVAF), and to identify OSAS’s predictive factors in this population.

A cross-sectional study was conducted, including successive patients followed for NVAF. Patients with a known history of OSAS were not included. All patients had a clinical screening for symptoms suggestive of OSAS and underwent an ambulatory sleep study.

We included 100 patients in this study. OSAS was detected in 90% of NVAF patients. The average apnea-hypopnea index (AHI) was 21.6 ± 13.6 e/h. OSAS was mild in 32%, moderate in 27% and severe in 31% of cases. Clinical characteristics were comparable between patients with and without OSAS. The multivariate analytical study concluded that independent predictive factors of OSAS in AF patients were an age greater than 61 years (p=0.029), AF duration more than 2 years (p=0.04) and snoring (p=0.01).

OSAS was diagnosed in 90% of NVAF patients. Thus, a systematic screening for OSAS in AF patients may be a relevant approach given its high prevalence in this population and its therapeutic implications. Snoring, age greater than 61 years, and AF duration more than 2 years were independently associated with OSAS in our study.

OSAS was diagnosed in 90% of NVAF patients. Thus, a systematic screening for OSAS in AF patients may be a relevant approach given its high prevalence in this population and its therapeutic implications. Snoring, age greater than 61 years, and AF duration more than 2 years were independently associated with OSAS in our study.

The standard control parameters of cardiopulmonary bypass (CPB) currently used in Tunisia are replaced in Western countries by the concept of “goal-directed-perfusion” requiring oxygen delivery (DO2) minimum at 270ml / min / m2.

In this study, we explored the association between the DO2 and the postoperative morbidity and mortality.

This is a cross-sectional and retrospective observational study including a series of 50 patients operated on for myocardial revascularization under CPB.

We noticed a significant correlation between starting DO2i and Creatinine clearance at day 0, Δcreate (day 1-day 0) and ventilation time. There was also a significant correlation between discharge DO2i and daytime urine output, ventilation time, hospital stay and in-hospital mortality. Through a univariable study, we compared the classic parameters of perfusion monitoring during CPB in addition to the starting DO2i with the different postoperative results. It was noted that the starting DO2i figures below the threshold of 270ml / min / m² were significantly correlated with the duration of administration of catecholamines postoperatively, with prolonged ventilation, with the variation in serum creatinine postoperatively and with in-hospital mortality.