Primary plasma cell leukemia (pPCL) is a rare lymphoproliferative disease characterized by a malignant proliferation of plasma cells in the bone marrow and peripheral blood. It is either primary (in 60% of cases) or a secondary complication of multiple myeloma [1]. In this context, we report the case of a 37-year-old patient with respiratory distress, whose bone marrow smear showed the presence of 64% of dystrophic plasma cells. A serum protein electrophoresis with immunofixation was performed, revealing results in favor of pPCL. A cytogenetic study was not performed due to lack of resources. The patient was put on multidrug therapy with a favorable evolution.

Introduction: There are millions of people in the world but no two humans are exactly alike not even identical twins. Genetic variations in man are caused by several environmental factors acting alongside with selection, gene flow, genetic drift and migration. Studies have been done on morphogenetic traits such as the pattern of hand clasping in some parts of Africa and among some tribes in southern region of Nigeria but there is no available data on the pattern of hand clasping among the Idoma tribe of Benue State. Hence, this study aimed to determine the pattern of hand clasping among the Idoma people of Benue State, Nigeria. Materials and Methods: The study was community-based, descriptive, and cross-sectional with a sample size of 401. Data was collected using a closed-ended questionnaire that was administered by an interviewer following an examination of hand clasping pattern. Results and Discussion: The proportion of participants that expressed hand clasping with the left thumb on top was 16.7%, while right thumb on top was 83.3%. There were no significant socio-demographic characteristics among participants (p > 0.05). Conclusions: The study implies that hand clasping with the right thumb on top is a marked characteristic of the people of Idoma and, as such, can be used to identify them amongst other tribes where the identity of the tribes is not known ab initio.

Despite decades of research, the causes and biology of schizophrenia remain unknown. The condition is associated with metabolic symptoms such as hyperinsulinemia, dyslipidaemia, type 2 diabetes (T2DM), and obesity. These sensations are a prevalent side effect of the new antipsychotic medications. Nevertheless, metabolic dysfunction in schizophrenia has been studied before the antipsychotic phase, and it has also been documented in patients with first- onset schizophrenia prior to antipsychotic treatment. We investigate the evidence for metabolic abnormalities in schizophrenia patients, both in the central and peripheral nervous systems. Post-mortem brain tissue molecular analysis indicated alterations in glucose metabolism and insulin signalling pathways, whereas blood-based molecular profiling revealed hyperinsulinemia and abnormalities in insulin and co-released factor synthesis after the development of symptoms. Yet, such features are not seen in all patients with the disorder, and not all people with such defects have schizophrenia symptoms. One explanation of these facts is the presence of an underlying metabolic sensitivity in a subset of persons that interacts with environmental or hereditary factors to create the disorder's overt symptoms.

Therapeutic phlebotomy is the removal of red blood cells or serum iron from the blood. It is one of the preferred treatments for blood disorders. In ancient times this process was known as bloodletting. Generalized method included were venesection and arteriotomy and systemic methods included were cupping and by leeches. It stimulates bone marrow stem cells to generate new red blood cells (RBCs). Iron for hemoglobin synthesis is taken from the body thus reducing serum iron. Different indications of therapeutic phlebotomy include Polycythemia Vera, Hemochromatosis, Porphyria cutanea tarda, Sickle cell disease, Non-Alcoholic Fatty liver disease (NAFLD) with hyperferritinemia. Other methods available for reducing RBC and iron level include apheresis and administration of desferroxamine. Phlebotomy can cause rare adverse effects, such as thrombosis, mostly seen in patients with polycythemia Vera. Other adverse effects include Hematoma at phlebotomy site. Usually hematoma is mild but in severe cases can cause damage in nerves and surrounding tissue. Haemoconcentration, extravasation, Syncope and Fainting, petechiae, Excessive Bleeding, edema, arterial puncture, pain and anemia are some of the adverse effects caused by therapeutic phlebotomy. Unsafe phlebotomy can expose patients and health workers to various infections like Hepatitis B virus (HBV), Hepatitis C virus (HCV) and Human Immunodeficiency virus (HIV); syphilis and malaria. Different countries have approved allogenic use of blood units obtained from therapeutic phlebotomy. Mostly blood collected from patients with hemochromatosis is permitted. The article also discusses criteria for initiating therapeutic phlebotomy and various regimen followed in different diseases.

Background: Over the years, aligner therapy has undergone a great evolution. The use of aligners is now an alternative to braces for aesthetic reasons. Their effectiveness and impact have yet to be evaluated. Objective: The objective of this study was to compare the effectiveness of dental movements with aligners versus the use of conventional appliances, as well as the effectiveness and impact on periodontal health and root resorption. Materials and Methods: A systematic search of PubMed, Ebsco Host and Scopus was performed using a well-designed formula. Articles published in the last 10 years in English and French were included after filtering the titles, abstracts then full texts. Results: Twenty-six records were deemed suitable for the objectives of our systematic review. All records focused on the comparison of treatment with aligners and fixed appliances. The difference in treatment and time efficiency was assessed in 17 papers, 6 papers evaluated the impact of orthodontic appliances on periodontal health, and the remaining 3 records focused on the occurrence of root resorption. Conclusion: Clear aligners produce clinically acceptable outcomes that could be comparable to fixed appliance therapy. Aligners facilitate oral hygiene practices which results in better periodontal health. However, it appears that Invisalign may not be as effective as fixed appliances in achieving certain tooth movements like vertical, radicular and rotational movements.

Visual impairment has been reported as one of the leading causes of physical impairment among older adults. Age related visual loss has been found to be associated with increased risk of depression. Affective support which usually come from family has been found to have positive impact on mental health. This descriptive study was carried out to determine the association between visual impairment, family support and depression among older adults aged 60 years and above at the ophthalmology clinic of a tertiary hospital. All consenting participants were consecutively selected over the three months study period. Trained ophthalmologist and Ophthalmic Nurse took the respondents’ sociodemograhic data and administered the Family support scale among the elderly and the Hospital anxiety and depression scale. Their visual acuity was also documented. Prevalence of depression was 8.7% among respondents. Both visual impairment and family support were significantly associated with depression. However, further regression analysis found family support as the only predictor of depression.

[3, 17]: On April 10th 2023, the 180th world homoeopathy day is to be celebrated to honor the 180th birth anniversary of Dr. Samuel Hahnemann (10.4.1755- 2.7.1843), the father of homoeopathy. The current article is a tribute to his immense contribution to the medical science and celebrates his birth anniversary in 2023. When a patient visits a doctor for any chronic physical or mental problem, invariably the doctor gets the current status of the thyroid gland of the patient. As is evident, the COVID 19 impacted the thyroid gland as well and which continues to manifest problems in COVID 19 affected patients. Cases of naturally non-resolving or long term hypothyroidism are rising in post COVID 19 patients. As cases are rising, it implies that the modern system of medicine is finding its challenging to deal with and it is here that Homoeopathy can play an active role. The current article explores what Homoeopathy can offer to masses while being cost effective and clinically effective as well. The article suggests one treatment protocol that can be applied at the state and national level in the public sector and as well as private sector. It looks at the treatment protocol while aligning with the Essential Drug List of Homoeopathy that is in the public domain of AYUSH ministry of government of India.

Diabetes is a progressive and severe chronic metabolic disease. It is a major public health problem, responsible for a high morbidity and mortality rate in the world and in Morocco. Our study involves 50 patients with type 2 diabetes recruited at the Hay Ennahda II Extention III Non-Communicable Disease Medical Center in Rabat. This is a descriptive and analytical observational study, the purpose of which is to assess the quality of life of Moroccan type 2 diabetic patients by means of a generic questionnaire "SF-12" and a specific questionnaire for diabetes "Diabetes-39". The results showed that diabetes negatively affects the quality of life of diabetic patients and established that the factors associated with their quality of life are multiple: factors related to socio-demographic characteristics (gender, ethnicity and marital status), comorbidities (hypertension and dyslipidemia), related to the pathology itself (obesity) and its chronic degenerative complications (diabetic neuropathy and obliterative arteriopathy of the lower limbs). Unlike the literature, some socio-economic characteristics (age, level of education, professional activity), others related to diabetes (age of diabetes and glycemic control) and therapeutic management do not affect quality of life in our study, this can be explained by the size of our sample. This preliminary study is a pilot study that introduces the issue of the quality of life of people with diabetes in Rabat. It will be continued to obtain a larger sample, in order to better study the peculiarities of the Moroccan patients in this field.

Since the onset of the COVID-19 pandemic, it has become evident that individuals living with diabetes are at a heightened risk of experiencing severe forms of the disease. As such, a retrospective descriptive study was conducted in 236 diabetic patients who were admitted to the Ibn Sina hospital in Rabat due to COVID-19 infection. The study aimed to provide a comprehensive overview of the clinical, biological, radiological, and evolutionary parameters of diabetic patients infected with COVID-19. This article summarizes the results of the study and compares them with existing literature.

Calcific aortic stenosis can be associated with gastrointestinal bleeding mainly from angiodysplasias which refer to Heyde syndrome. This association is considered as a form of acquiredVon Willebrand syndrome.Aortic valve replacement allows cessation of gastrointestinal bleeding and the need for blood transfusions in these patients. We describe three cases with medical history of aortic stenosisand they presented gastrointestinal bleeding related to angiodysplasias of the stomach and colon. In one case, aortic valve replacement leads to a stable hemoglobin with no further episodes of gastrointestinal bleeding.

The aim was to study the epidemiological, clinical and therapeutic aspects of paraphimosis at the CSRéf of Markala. Patients and Methods: We conducted a prospective and descriptive study of five patients who had consulted for paraphimosis in the operating theatre of the Markala referral health centre from 1er January 2019 to 31 December 2021, i.e. a two-year period. Our study included all patients who consulted for paraphimosis at the CSRéf of Markala with a usable medical file. The criteria for non-inclusion were: Phimosis without other pathologies of the penis. The records were not usable, as this was a prospective study. Results: The frequency of paraphimosis was 2.1% out of 235 patients hospitalized and operated on at the CSRéf of Markala during the study period. Four of our patients had no particular medical or surgical history, but the oldest of our patients had already undergone a hernia repair and an appendectomy at the time ; the average age of our patients was 15.3 years, with extremes ranging from 3 years to 53 years . However, we note that there is no specific age of onset of paraphimosis The treatment received by all our patients was posthectomy. No major complication was noted in our patients, however we deplore a loss of sight in two of our patients for a long term follow-up in order to identify other unknown aspects in the management of paraphimosis. Conclusion: Paraphimosis is a true urological emergency that occurs in uncircumcised men when the foreskin is trapped behind the glans crown, which can lead to long-term strangulation of the glans and compromise its vascularity hence their immediate management paraphimosis.