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Management of rectal varices in portal hypertension

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World Journal of Hepatology 2015年第30期7卷 2992-2998页

作者： kawtar Al Khalloufi Adeyinka O Laiyemo Division of Gastroenterology Department of Medicine Howard University College of Medicine

Rectal varices are portosystemic collaterals that form as a complication of portal hypertension, their prevalence has been reported as high as 94% in patients withextrahepatic portal vein obstruction. The diagnosis is typically based on lower endoscopy(colonoscopy or sigmoidoscopy). However, endoscopic ultrasonography has been shown to be superior to endoscopy in diagnosing rectal varices. Color Doppler ultrasonography is a better method because it allows the calculation of the velocity of blood flow in the varices and can be used to predict the bleeding risk in the varices. Although rare, bleeding from rectal varices can be life threatening. The management of patients with rectal variceal bleeding is not well established. It is important to ensure hemodynamic stability with blood transfusion and to correct any coagulopathy prior to treating the bleeding varices. Endoscopic injection sclerotherapy has been reported to be more effective in the management of active bleeding from rectal varices with less rebleeding rate as compared to endoscopic band ligation. Transjugular intrahepatic portsystemic shunt alone or in combination with embolization is another method used successfully in control of bleeding. Balloon-occluded retrograde transvenous obliteration is an emerging procedure for management of gastric varices that has also been successfully used to treat bleeding rectal varices. Surgical procedures including suture ligation and porto-caval shunts are considered when other methods have failed.

关键词： Rectal varices Portal hypertension Liver cirrhosis Colonoscopy Gastrointestinal bleeding

Antimycobacterial natural products from Moroccan medicinal plants: Chemical composition, bacteriostatic and bactericidal profile of Thymus satureioides and Mentha pulegium essential oils

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Asian Pacific Journal of Tropical Biomedicine 2016年第10期6卷 836-840页

作者： Marwa Chraibi Abdellah Farah Sara Lebrazi Oumaima El Amine Mohammed Iraqui Houssaini kawtar Fikri-Benbrahim Laboratory of Microbial Biotechnology Faculty of Science and Technology Sass Sidi Mohamed Ben Abdellah University Laboratory of Aromatic Plants Medicinal and Natural Substances National Institute of Medicinal and Aromatic PlantsPhytochemistry Department

Objective: To evaluate the susceptibility of Mycobacterium aurum and Mycobacterium smegmatis in vitro to the essential oils obtained from two medicinal plants: Thymus satureioides(T. satureioides) and Mentha pulegium(M. pulegium), and to study their chemical ***: The aerial parts of T. satureioides and M. pulegium(leaves and stems) were hydro-distillated using a Clevenger-type apparatus and essential oils were analyzed and identified by gas chromatography-mass spectrometry. Antimycobacterial screening of essential oils was performed on the basis of the inhibition zone diameter by disc diffusion method against two mycobacterial strains whereas the minimal inhibitory concentration and minimal bactericidal concentration were determined by using the micro-dilution ***: Chemical analysis of their aerial part's essential oils gave as major compounds,borneol(34.26%), carvacrol(31.21%) and thymol(3.71%) for T. satureioides and R(+)-pulegone(75.48%), carvone(6.66%) and dihydrocarvone(4.64%) for M. *** their antimycobacterial effect evaluation, using the micro-dilution method,indicated that minimal inhibitory concentration values of T. satureioides essential oil ranged from 0.062% to 0.015%(v/v) and from 0.125% to 0.031%(v/v) for M. pulegium respectively against Mycobacterium aurum and Mycobacterium ***: It is clearly evident from the results obtained that the Moroccan medicinal plants have great potential to be used as anti-tuberculosis agents. These findings may help scientists to undertake several research projects to discover useful natural product as new anti-tuberculosis drug.

关键词： Thymus satureioides Mentha pulegium Essential oil Chemical composition Antimycobacterial activity

Fahr’s Syndrome Discovered at Adulthood Revealing the Pseudohypoparathyroidism

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Open Journal of Rheumatology and Autoimmune Diseases 2019年第4期9卷 129-133页

作者： kawtar Nassar Saadia Janani Department of Rheumatology Ibn Rochd University Hospital Center Medicine and Pharmacy University of Casablanca Casablanca Morocco

Fahr’s syndrome is a rare clinicopathological entity, defined by the presence of intracerebral calcifications not arteriosclerotic, bilateral and symmetric at the level of the basal ganglia, whose main etiology is dysparathyroidism, rarely pseudohypoparathyroidism. Hypocalcemia and hyperphosphatemia despite normal or high levels of parathyroid hormone are the result of resistance to the action of parathyroid hormone. The clinical profile is not specific but dominated by neuropsychiatric symptoms. We report the case of a 30-year-old patient with type pseudohypoparathyroidism revealed one year ago by Fahr’s syndrom. The diagnosis made by convulsion history since the age of 5 years resistant to treatment, the disturbance of metabolism disorders, and the presence of intracerebral calcifications. The vitamin D and calcium supplementation have contributed to the stabilization of the disease.

关键词： Fahr’s Syndrome Pseudohypoparathyroidism Convulsion Intracerebral Calcification Hypocalcemia

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Lupus and Pregnancy

Open Journal of Rheumatology and Autoimmune Diseases 2024年第3期14卷 125-131页

作者： Soukaina Zaher Hussein Boufettal kawtar Nassar Naima Samouh Saadia Janani Rheumatology Department Ibn Rochd University Hospital of Casablanca Faculty of Medicine and Pharmacy Hassan II University Casablanca Morocco Obstetrics and Gynecology Department Ibn Rochd University Hospital of Casablanca Faculty of Medicine and Pharmacy Hassan II University Casablanca Morocco

Introduction: Systemic lupus erythematosus is a multifactorial autoimmune disease characterised by its clinical polymorphism and its course in flares. The aim of our study was to determine the effects of pregnancy on lupus and vice versa. Material and Methods: This is a retrospective study conducted over a period of 14 years from 2002 to 2015. We included cases of systemic lupus erythematosus associated with pregnancy followed at the obstetrics and gynecology department “C” of the Ibn Rochd University Hospital in Casablanca. Results: The mean age of our parturients was 31.4 years. All our patients were known to have lupus and were followed up. Pregnancy was terminated in six (20%) cases. We noted one (3%) case of intrauterine fetal death, four (13%) cases of intrauterine growth retardation, and five (16%) cases of prematurity. Lupus flare during pregnancy occurred in 16 (52%) cases, including one (3%) patient who developed superimposed pre-eclampsia, had a renal relapse in the third trimester requiring an abortion at 32 weeks of gestation with three sessions of hemodialysis, and another patient who developed eclampsia. Conclusion: A better understanding of the aggravating factors and compatible treatments has led to a more widespread authorization of pregnancy.

关键词： Systemic Lupus Erythematosus Pregnancy Morbidity Prognosis Retrospective Study

Review Venous Thromboembolism Risk with Anti-Osteoporosis Drugs

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Open Journal of Rheumatology and Autoimmune Diseases 2018年第4期8卷 111-119页

作者： kawtar Nassar Wafae Rachidi Saadia Janani Ouafa Mkinsi Department of Rheumatology Ibn Rochd University Hospital Center Medicine and Pharmacy University of Casablanca Casablanca Morocco

Osteoporosis is the most common skeletal diseases, predisposing the patient to an increased risk of fractures. It is an important health issue linked to increased morbidity and mortality. Prevention and treatment strategies are now well defined and are always updating. Indeed, the therapeutic decision is based on the individual risk of fracture, efficiency and degree of therapeutic tolerance. However, some side effects, although rare can be attributed to drugs used. The benefit and risks of prescription drugs can be optimized by choosing the right time and the right treatment. The purpose of this article is the study of thromboembolic risk of various drugs recommended in osteoporosis. Furthermore we discuss preventive measures, and the different approaches after the first event.

关键词： Osteoporosis Venous Thrombosis Drugs Estrogens Progestins

Can optical diagnosis of small colon polyps be accurate? Comparing standard scope without narrow banding to high definition scope with narrow banding

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World Journal of Gastroenterology 2016年第28期22卷 6539-6546页

作者： Hassan Ashktorab Firoozeh Etaati Farahnaz Rezaeean Mehdi Nouraie Mansour Paydar Hassan Hassanzadeh Namin Andrew Sanderson Rehana Begum kawtar Alkhalloufi Hassan Brim Adeyinka O Laiyemo Department of Medicine and Cancer Center Howard University College of Medicine

AIM: To study the accuracy of using high definition(HD) scope with narrow band imaging(NBI) vs standard white light colonoscope without NBI(ST), to predict the histology of the colon polyps, particularly those < 1 ***: A total of 147 African Americans patients who were referred to Howard University Hospital for screening or, diagnostic or follow up colonoscopy, during a 12-mo period in 2012 were prospectively recruited. Some patients had multiple polyps and total number of polyps was 179. Their colonoscopies were performed by 3 experienced endoscopists who determined the size and stated whether the polyps being removed were hyperplastic or adenomatous polyps using standard colonoscopes or high definition colonoscopes with NBI. The histopathologic diagnosis was reported by pathologists as part of routine care. RESULTS: Of participants in the study, 55(37%) were male and median(interquartile range) of age was 56(19-80). Demographic, clinical characteristics, past medical history of patients, and the data obtained by two instruments were not significantly different and two methods detected similar number of polyps. In ST scope 89% of polyps were < 1 cm vs 87% in HD scope(P = 0.7). The ST scope had a positive predictive value(PPV) and positive likelihood ratio(PLR) of 86% and 4.0 for adenoma compared to 74% and 2.6 for HD scope. There was a trend of higher sensitivity for HD scope(68%) compare to ST scope(53%) with almost the same specificity. The ST scope had a PPV and PLR of 38% and 1.8 for hyperplastic polyp(HPP) compared to 42% and 2.2 for HD scope. The sensitivity and specificity of two instruments for HPP diagnosis were ***: Our results indicated that HD scope was more sensitive in diagnosis of adenoma than ST scope. Clinical diagnosis of HPP with either scope is less accurate compared to adenoma. Colonoscopy diagnosis is not yet fully matched with pathologic diagnosis of colon polyp. However with the advancement of both imaging and training,

关键词： High definition colonoscopy Narrow band imaging Polyp detection Colon cancer screening

Type IV Aggressive and Symptomatic Vertebral Hemangioma

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Open Journal of Rheumatology and Autoimmune Diseases 2015年第3期5卷 87-91页

作者： kawtar Nassar Wafae Rachidi Saadia Janani Ouafa Mkinsi Rheumatology Department Ibn Rochd University Hospital Casablanca Morocco

Vertebral hemangiomas (VHs) are benign tumours with rich vasculature. They are the most common tumours of the spine with an estimated incidence of 10% - 12% of the population. Despite its high incidence, they are often asymptomatic and only 0.9% - 1.2% are symptomatic. They may also be aggressive and are characterised by bone expansion, extra osseous extension of the tumour, disturbance of local blood flow and, in rare cases, compression fractures. We report a 59-year-old woman, presented with back pain after falling from standing height. Magnetic resonance imaging revealed lumbar spine vertebral fractures and T12 osteolytic lesion with spinal canal extension, concurring to VH type IV, according to Tomita’s surgical classification of spinal. Embolization, posterior decompression and fixation were performed followed by postoperative radiotherapy. Her symptoms were resolved immediately without recurrence after 6 mouths.

关键词： Vertebral Haemangioma Extension Radiotherapy Ethanol Embolization Surgery

AA Amyloidosis Secondary to Primary Sjögren Syndrome: Can It Be Developed without Chronic Inflammation?

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Open Journal of Rheumatology and Autoimmune Diseases 2021年第2期11卷 29-35页

作者： Soukaina Zaher kawtar Nassar Ibtissam Razzouki Meriem Regragui Mehdi Karkouri Saadia Janani Department of Rheumatology University Hospital Center of Ibn Rochd Hassan II-Casablanca University Casablanca Morocco Department of Pathology University Hospital Center of Ibn Rochd Hassan II-Casablanca University Casablanca Morocco

Background: The association of primary Sjögren syndrome (PSS) and AA amyloidosis is a rare occurrence. Objective: To describe the phenotype of patients with this association through our two cases and a literature review. Materials and methods: A report of two cases of AA amyloidosis complicating primary Sjögren syndrome with a literature review. Results: Eight patients of Primary Sjögren’s Syndrome complicated by AA amyloidosis were studies. Six cases were reported in the literature by consulting several databases. 50% of patients had a positive immunological assessment, three cases with kidney damage, and three cases lung damage. Conclusion: The immunological activity in the Primary Sjogren’s Syndrome requires the search not only a lymphoma but also AA amyloidosis apart from any clinical or biological chronic inflammation.

关键词： AA Amyloidosis Amyloid Primary Sjögren Syndrome

In Vitro Development and Germination of Immature Embryos of Sweet Oranges Parson Brown and Pineapple(Citrus sinensis)

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Journal of Agricultural Science and Technology(B) 2018年第7期8卷 405-419页

作者： Karim Mahmoudi Najat Handaji Mohammed Ibriz Najat Arsalane Tarik Aderdour kawtar Label Hanae Ennaciri Hamid Benyahya Laboratory for the Improvement and Conservation of Plant Genetic Resources National Institute of Agronomic Research(INRA)KenitraBP 257Morocco Laboratory of Genetics and Biometry Faculty of SciencesUniversity Ibn TofailKenitraMorocco

Oranges are classified as the most traded fruit variety *** diversification of the varietal profile of this group is among the objectives of the Citrus breeding ***,the creation of new triploid hybrids via immature embryos rescue,can lead to an increase in gene pool and produce seedless *** addition,flow cytometry was successfully used for analyzing ploidy levels and genetic origin of triploid *** present study was aimed at optimizing immature embryos in vitro germination and plantlet development based on medium chemical composition of the two orange varieties,Pineapple and Parson *** the fruit gets matured,they are harvested and the seeds extracted are classified according to their *** those which are small are cultured in a sterile Murashige and Tucker(MT)basal *** different concentrations of growth regulators are put to the test in order to gain the best medium for seeds development.M1(MT+1 mg/L gibberellic acid(GA3)),M2(MT+1 mg/L kenitin+0.5 mg/L 6-benzylaminopurine(BAP)+0.1 naphthalene acetic acid(NAA)),M3(MT+25 mg/L adenine sulfate(ADS)),M4(MT+0.5 mg/L kenitin+0.5 mg/L BAP+1 mg/L GA3).Percentage of germinated embryos(PGE)is the highest in M3 with 100%and 90%for both Pineapple and Parson Brown varieties,*** addition,the germination interval average(GIA)is shorter in M1 for both varieties,which takes 6 d and 7 d,*** regard to speed seedling growth(mm/week),both varieties undergo significant change in all four ***,the highest rate of acclimatization for the Pineapple and Parson Brown varieties is 80%and 90%in *** general,the smaller the embryos are,the more sensitive they are to culture medium *** is therefore essential to optimize the medium components in order to stimulate their in vitro ***,M1(MT+1 mg/L GA3)remains the best to promote short term good germination and produce a better rate of acclimatization.

关键词： Citrus orange triploids in vitro germination immature embryos flow cytometry genetic