Over past few years, there has been an increase in various new concepts in diabetic foot few of which are derived from other fields like oncology as some of those concepts serves to be suitable in diabetic foot too. One known model over past 3 to 4 decade was reconstructive ladder model in field of reconstructive surgery. Reconstructive ladder was extremely popular over years and with introduction of newer techniques, various people proposed modifications of it like reconstructive elevator, reconstructive triangle, reconstructive pie, etc all being variants of reconstructive ladder. Antonym of reconstruction is destruction and amputations are destructive surgeries. Similar to the line of reconstructive ladder model and its variants, the author redesigned, encompassed and implemented all the variants that are suitable in the new amputation models and other subsets in diabetic foot. Interestingly, over so many years, no attempt were done to apply these interesting models to diabetic foot field, some of which the author believes, would suit it appropriately. The author attempts to create various models of amputation and different subsets in diabetic foot field some of which are akin to reconstructive ladder and its variants and some being relatively new like diabetic foot wheel. All these are open models which means any newer concept developed later over years can be directly added to any of these models.

The emergence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causes coronavirus disease (Covid-19) pandemic has made it a universal health difficulty in both developed and developing countries, spreading fears, uncertainties and death. Worldwide, the disease is skyrocketing, spinning from a total of 124, 719 cases in 118 countries on March 12, 2020 to a high of 1,004,336 cases in 204 countries on April 2, 2020. Out of the 1,004,336 confirmed cases, 704,570 (95%) are categorized as mild cases 37,710 (5%) serious cases 51,556 deaths while 210,500 have recovered. SARS-CoV-2 belongs to beta coronavirus; usually these viruses form a polypeptide after genome transcription that needs to be cleaved enzymatically in order to produce non-structural proteins, this process is only possible with synergistic functions of Main protease or 3-chymotrypsin-like protease (3CLpro) and Papain-like protease (PLpro). Inhibiting these proteases will in no doubt interfere with replication and subsequent release of viral progenies. The current in silico study was performed to predict the possibility of 7 phytochemicals from Carica papaya as potential inhibitors of Covid-19 proteases and RNA dependent RNA polymerase. The protein structures and ligands were downloaded from RCSB Protein data bank (pdb) and PubChem respectively. The qualitative assessment of physicochemical properties, liphopilicity, water solubility, medicinal chemistry, drug likeness and ADMET were predicted virtually using swissadme. Molecular docking analysis showed that kaempferol, quercetin have good binding affinity and hydrophobic interactions with both Covid-19 proteases and RdRp. However, this hypothesis would be used as a background which needs to be proven otherwise in vitro.

Although the stimulating effect of thyroid hormones on energy metabolism has been known for about a century, the relationship between thyroid function, weight control, and obesity is unclear. Objective: Our work aims to bring a focus on the association between obesity and thyroid pathology. Methods: A descriptive and retrospective study of all obese patients who had consulted or been hospitalized in the Department of Endocrinology, Diabetology and Nutrition at University Hospital Center Hassan II in Fez, over a period of 2 years from January 2016 to December 2018. All patients with a BMI ≥ 30 kg / m2 were included. The data were plotted on a table in the Excel 2010 program and analyzed using the SPSS 18 program. Results: 150 patients met our criteria, their mean age was 45.26+/-12.77 years with a female predominance (sex-ratio = 1/25). 10.66 % of our patients had dysthyroidism; among them hypothyroidism was individualized in 56.25% of cases. In this category, the serum TSH concentrations were positively correlated with BMI (p=0.011) and a significant weight loss was objectified after the start of hormonal treatment. While hyperthyroidism was present in 43.75% of our patients, 57.14% had morbid obesity and the response to weight gain after radical treatment (iratherapy or surgery) was minimal. Conclusion: Obese patients may develop thyroid dysfunction and even thyroid dysfunction may contribute to the gradual increase in body weight, resulting in overt obesity.

Background: Escherichia coli is one of the commonest pathogens causing community acquired Urinary Tract Infection (UTI). Increase in resistance to antibiotics and limited option of oral antibiotics for UTI calls for search for better alternative options. Extended Spectrum Beta Lactamase producing E. coli (ESBL- EC) further reduces the therapeutic options complicating the management. Nitrofurantoin (NIT) is one of the commonly prescribed oral drugs and Fosfomycin (FO) though an old drug is regaining its medical importance. The aim of the study was to study and compare the sensitivity of NIT and FO in ESBL-EC causing UTI. Material and Method: A total of 215 mid-stream urine samples showing growth of E. coli were collected and ESBL-EC identified. Antibiotic sensitivity testing was done by Kirby Bauer disc diffusion method as per CLSI 2019 guidelines using NIT (300μg) and FO (200μg) discs. The results were compared. Result: Out of 215 urine sample, 57(26.5%) isolates showed resistance to NIT while FO resistance was observed only in 11 (5.1%) of the isolates. Amongst isolated E. coli, 122 (56.7%) were extended spectrum beta lactamase (ESBL). Among the resistant isolates, ESBL producers were 45.5% (5 out of 11) and 57.8% (33 out of 57) for FO and NIT respectively. Conclusion: Increase in resistance trend in NIT calls for search of other oral options for treatment and FO promises to be one of them.

Introduction: the demand for abdominoplasty is increasing. It is a set of surgical procedures aimed at improving the abdominal wall for aesthetic and/or functional purposes. The aim of this work is to highlight the epidemiological and clinical profile of patients who are candidates for abdominoplasty and to evaluate the therapeutic results as well as the complications of the technique of lower transverse abdominal dermolipectomy with transposition of the umbilicus. Materials and Methods: Fifty lower transverse abdominoplasties with transposition of the umbilicus, associated or not with liposuction, were performed between June 2016 and September 2018 in the plastic surgery department of the Military Hospital of Meknes. Results: Forty-seven women and three men were counted. The mean age was 42 years. The majority of our patients were overweight (88%). All of our patients underwent a transverse low abdominoplasty with umbilicus transposition. Associated liposuction was performed in 36 patients (72%), and muscle plasty in 30 cases. A two-sided plaque was placed in the 4 cases of eventration. The frequency of immediate postoperative complications was 22% in our series. Hematomas requiring revision surgery (8%) and infection (4%) were the most frequent major complications. Discussion: Recent advances in abdominal plastic surgery currently allow satisfactory management of patients who come to consult for weight loss, pregnancy or aesthetic concerns. The technique of low transverse abdominoplasty with transposition of the umbilicus has become perfectly standardised, but it should not be forgotten that it is not devoid of risks. The knowledge and management of possible complications are as important as the surgery itself.

Aim of the Study: The purpose of the study was to assess the knowledge of parents in influencing as well as maintaining the oral hygiene practices of their children. Methodology: The parents were requested to complete a 25‑item questionnaire which was semi‑structured and self‑administered for obtaining the required data. The parents’ questionnaire, which included questions on habits and beliefs, and some of the questions concerning attitudes. Also, questions related to the knowledge about the primary dentition, functions, tooth shedding, effects on permanent teeth, and importance of fluoride were also included in the survey. To find out the association between categorical variables, the Chi‑square test was applied. P < 0.05 was considered statistically significant. Results: Of the parents, 42% of the respondents had the practice of changing the child’s tooth brush every 6 months, 27.3% once in a month, 19.9% when the bristles fray out, and 13.8% were not particular. It was noted that 64% of the parents visited a dentist while having oral problems, whereas 6.2% of them had the good practice of visiting the dentist at least once in a year. 85.6% of the parents agreed that they would opt for the treatment and 14.4% of the parents would deny the treatment due to the factors such as time constraint (2.9%), expenditure (58.8%), and both time and money (35.3%). Conclusion: Good practices for maintaining child’s oral health was less than satisfactory in some aspects. Education had a major role to play in their care of child’s teeth. Hence, improving awareness among parents/caregivers is crucial in the care of child’s oral health.

The Covid-19 pandemic reveals the combined and potentiating effects of pollution, notably on rare earths and electromagnetic fields, all of which contribute to a deficiency in the immune system. We note that countries with technologies using pollutants such as rare earths, electromagnetic fields are the most affected by this pandemic. This could explain the low number of deaths in the so-called poor countries compared to industrialized countries like England, the USA, France.