Rachida Soulaymani-Bencheikh

Epidemiological profile of snakebites in Morocco

The present work aims to find the epidemiological profile of snakebites in Morocco through a retrospective study of 1,423 snakebite cases that occurred between 1992 and 2007. Data were obtained from medical charts of envenomation at the Poison Control and Pharmacovigilance Center of Morocco. Results revealed that 86% of the snakebites had occurred in rural areas and that males were significantly more affected than females at a sex ratio of 23:20. Furthermore, 35% of the bites happened during the summer, with a peak of 215 cases in June (15.1%). We also discovered that 67.3% of the patients were bitten during the day. The age group that comprised the most agriculturally active persons, from 20 to 44 years old, was the most affected by snakebites (551 cases). In terms of evolution, patients who were at least 60 years of age (8.89%) as well as those who were less than 10 years old (7.50%) presented higher mortality. According to clinical severity grades, the data revealed a 70% predominance of grade 2 cases (430). Deaths had occurred only in patients with grades 3 and 4. Furthermore, grade 4 patients presented 100% mortality whereas grade 3 registered 10.7%. The distribution of snakebites according to administrative regions in Morocco showed a predominance of the Souss-Massa-Daraa region both in terms of frequency (32%) and mortality (72.1%). Our study clearly displayed the severity and extent of the snakebite problem in the country, thus revealing that public health authorities should give more attention to this serious situation.

First line anti-tuberculosis induced hepatotoxicity: incidence and risk factors

In our days, tuberculosis, whet ever its localization, became a curable disease. The cornerstone is a 6 month course of isoniazid, rifampicine and pyrazinamide. All of the three first line antituberculosis drugs may induce hepatic damage which may have negative consequences for treatment outcome. Several risk factors were associated with the development of antituberculosis- drug-induced hepatotoxicity (ATDH). A retrospective study was conducted from July 2014 to March 2015 regarding all therapeutic drug-monitoring requests sent to the Laboratory of Poison Control and Pharmacovigilance Centre of Morocco. 142 patients diagnosed with active tuberculosis were included in study. Plasma peak levels of isoniazid, rifampicin and pyrazinamide were analyzed in plasma samples after 2 to 3 hours of administration of anti-tuberculosis treatment. Logistic regression was used to identify the ATDH risk factors. The incidence of ATDH was found 24.6% (35 patients out of 142). Intergroup differences in the plasma levels were statistically significant for isoniazid (p=0.036). ATDH was found to be associated with combined form of anti-TB drugs (p=0.002, COR=13.1, AOR= 13.5) and plasma concentration of INH superior to 2mg/l (p=0.045, COR=1.3, AOR= 1.4).age, gender, alcohol intake and smoking status were not significantly associated with ATDH. The finding of 24.6% incidence of hepatotoxicity is extremely high. Many factors can be associated with the development of ATDH such as genetic factors, combined forms of treatment and plasma peak levels.

Epidemiology and risk factors of voluntary pesticide poisoning in Morocco (2008-2014)

OBJECTIVES To determine the epidemiological profile and risk factors of voluntary poisoning by pesticides. METHODS A retrospective analysis was conducted of all cases of voluntary poisoning by pesticides registered at the AntiPoison and Pharmacovigilance Center of Morocco between January 2008 and December 2014. RESULTS During the study period, 2,690 cases of acute pesticide poisoning were registered. The region of Rabat-Salé-Zemmour-Zaer accounted for the largest proportion, with 598 cases. The average age of the patients was 24.63±10.29 years. The sex ratio (female-to-male) was 0.45. Adults and teenagers were most affected by this type of poisoning, with 1,667 cases (62.0%) and 806 cases (30.0%), respectively. Suicide attempts accounted for 98.4% of the cases (2,469 cases). Pesticide poisoning occurred more often in urban zones (64.8%). Insecticides were incriminated in 14.0% of cases, with a mortality rate of 4.2%. Among the 1,635 patients for whom the outcomes were known, 154 died, corresponding to a mortality rate of 5.7%. CONCLUSIONS Voluntary intoxication by pesticides presents a real scourge that affects public health, and in this study, we developed an epidemiological profile of this phenomenon. Nevertheless, this study has limitations in that it did not evaluate the impact of the socioeconomic and psychological factors that are important contributors to this type of poisoning.

0034 Acute occupational pesticide poisoning in morocco: a 6 year retrospective study

Introduction Pesticide poisoning has become a major public health problem worldwide, following the intensification of agriculture. The easy availability of highly toxic pesticides in the homes of farming communities has made pesticides the preferred means of suicide with an extremely high fatality rate. Similarly, the extensive use of pesticides exposes the community to both long-term and acute occupational health problems. The aim of this study is to describe the epidemiological characteristics of acute occupational pesticide poisoning in Morocco. Methods This is a descriptive retrospective study of occupational poisoning cases, notified between 2007 and 2012 in the Moroccan Poison Control Centre. Results There were 151 cases of acute occupational pesticide poisoning (35.7% of women and 64.3% of men), which was 43.7% of all occupational poisoning cases notified during the period of study. These products were responsible for poisoning of varying severity, depending on the types of pesticides, the route of exposure, and the duration and frequency of exposure. The average age of victims was 27.9±0.9 years. More than half of reported cases resulted from inhalation (53%), 36.2% from oral exposure and only 9.4% from dermal exposure. The risk was mainly related to the use of insecticides (50%). Among the 136 cases for whom the evolution is known, a 26-year-old man died. For other cases, the outcome was favourable with or without sequelae. Conclusions Preventive measures should be taken to rationalise pesticide use, which pose a real public health problem, not only for users, but also for the general population.

Suivi Thérapeutique Pharmacologique Des Antituberculeux : Quinze Ans d’Expérience

Introduction: The vertical and sagital position of the maxilla and mandible is influenced by the size and the angulation of the cranial base. Sellae turcica is part of the cranial base. It is located in the middle cranial fossa. Thus, the growth and the development of this bony structure are influenced by neural and general skeletal pattern as well. Cephalometric analysis is an important part of orthodontic diagnosis and treatment planning. From numerous cephalometric landmarks, the Ssellae point is commonly used to describe the cranial base. Also, it is used to evaluate other bony structures’ position towards it. Objective: The purpose of this study is to evaluate the shape and the dimension of the sellae turcica in different types of malocclusions. Materials and Methods: 136 randomly selected lateral cephalometric radiographs were analyzed. Also, skeletal and facial pattern was identified and the shape and sagital dimension of the sellae was measured. Results: Statistical analysis presented no significancy regarding sellae’s shape in different types of malocclusion. However, the skeletal class II cases presented the most anarchic sellae shapes. Comparing linear measurements of skeletal length and sellae diameter, we found that the smallest diameter of the sellae appears in class III malocclusions. Thus, other skeletal length presents the lowest mean values also. Statistically significant differences among maxillary, mandibular, and cranial base length and sellae diameter were found in class I malocclusion (p=0.013). Conclusions: Sella morphology appears to have certain correlation with cranial and jaw base length and jaw base relationship in skeletal Class I Romanian population European Scientific Journal July 2016 edition vol.12, No.21 ISSN: 1857 – 7881 (Print) e ISSN 18577431 2

64 Acute pesticide poisoning in Sikasso, Mali

Objectives Pesticide poisoning has become a major public health problem worldwide, following the intensification of agriculture. The easy availability of highly toxic pesticides in the homes of farming communities has made pesticides the preferred means of suicide with an extremely high fatality rate. Similarly, the extensive use of pesticides exposes the community to both long-term and acute occupational health problems. The aim of this study is to describe the main characteristics of acute pesticide poisoning in Sikasso. Methods A descriptive retrospective analysis of pesticide poisoning cases, recorded between 2002 and 2010 in Sikasso hospital, was performed. Results A total of 47 acute pesticide poisoning cases were identified, constituting 10,6% of poisoning cases notified during the period of study. These products were responsible for poisoning of varying severity, depending on the nature of the compounds, duration and frequency of exposure. The average age of victims is 24 years. Almost 90% of reported cases result from oral exposure and 10% from inhalation. The risk is mainly related to the use of organophosphates. Among the cases for whom the evolution is known, 6 of them died. For other cases, the outcome was favourable with or without sequelae. Conclusions Preventive measures should be taken to rationalise pesticide use, which pose a real public health problem, not only for users, but also for the general population.

P184 - Les intoxications chez les enfants dans la région de Tadla-Azilal, Maroc

Objectif decrire les aspects epidemiologiques, cliniques et evolutifs des enfants intoxiques au niveau de la region de Tadla-Azilal au Maroc. Materiels et Methodes une etude retrospective sur une duree de 19 ans, basee sur la banque de donnees de toxicovigilance au niveau du CAPM. Resultats Sur les 19 ans d’etude, le CAPM a enregistre 1267 cas d’hospitalisation d’enfants âges de 5-14 ans. La frequence des intoxications accidentelles etait de 1123 cas sur 1237 qui ont declare leurs circonstances, soit 90,8 % contre 9,1 % tentatives de suicides et suicides. Sur 586 enfants qui ont declare leurs origines, 51,5 % des enfants etaient d’origine rurale. L’intoxication etait d’origine alimentaire dans 50,12 % des cas, secondaire a l’inhalation de produits gazeux dans 16,9 %, a l’ingestion accidentelle de pesticides dans 11,9 %, ou d’origine medicamenteuse dans 7,9 % des cas. L’evolution etait favorable dans 98,2 %.La region de Tadla-Azilal a enregistre 10 deces durant la periode d’etude, soit une letalite de 0,01 %. Conclusion Pour remedier ce probleme pediatrique, une meilleure conservation des aliments, le respect des criteres d’etablissement d’une ordonnance destinee aux enfants, sont les moyens de prevention de l’intoxication accidentelle chez l’enfant.