Hepatocellular carcinoma is the most common primary tumor of the liver and is estimated to cause more than a quarter of a million deaths each year throughout the world. Extrahepatic metastasis of HCC occurs in about 30-50% of patients, and it depends on HCC stages. Materials and methods: We carried out a retrospective study including 16 patients, 10 men and 6 women with a mean age of 58.5 years ranging from 37 years to 75 years. 13 patients had cirrhosis due to hepatitis C virus, 1 patient had cirrhosis due to viral B infection and 2 patients had HCC within a non-cirrhotic liver. All patients had one or more HCC, ranging in size from 2 to 10 cm. The AFP was normal in 11 cases and elevated in 4 cases (> 200 ng / ml). We collected 4 cases of adrenal metastases, 3 costovertebral metastases, 2 gastric metastases, 2 brain metastases, 1 cranial metastasis, 1 clavicular metastasis, 1 ovarian metastasis, 1 nasopharyngeal metastasis, and a case of metastasis in the path of percutaneous biopsy of HCC. In 4 cases the diagnosis of HCC and metastasis was synchronous while in 12 cases median time from diagnosis of hepatocellular carcinoma and extrahepatic HCC was 15.5 months. Therapeutic abstention was decided in 14 patients for the advanced stage of the disease. Cutaneous metastasis was resected surgically and HCC occurring in healthy liver was treated by lumpectomy and upper pole gastrectomy in gastric metastasis. The average survival was estimated at 14 months with a decline of 17.3 months, 6 cases were lost to follow and 6 deaths occurred in our series. Conclusion: The incidence of unusual and extrahepatic metastasis of HCC diagnosed during clinical course was not frequent. The diagnostic procedures for extrahepatic metastasis have not been standardized, however considering the substantial advances in treatment of HCC, the detection of extrahepatic HCC is crucial for patients to receive appropriate therapy, which ultimately determines patient survival.

Introduction: The prevalence of diabetes is growing progressively worldwide, despite the efforts of various national and international health organizations. Aim: the aim of this study was to determine the prevalence, the consequences and the treatment of diabetes in the provincial reference center for diabetes (CRD) in Kenitra, Morocco, in 2014 and 2015. Material and methods: During 2014-2015, the total of 31563 patients (2227diabetic and 29336 non-diabetics), who consult the urban health center Moulay El Hassan kenitra were considered as a target population of this study. The data has been collected by nurses under the direction of doctors of the health center, using a data sheet containing information on: socio-demographic (age, gender); types of complications related to the disease. All the collected data were analyzed using SPSS software version 16. Thus the categorical variables as means and standard deviations (δ) for quantitative variables were used to determine the frequencies and percentages of each studied group. Results: The age of patients is between 8 months and 80 years with a predominance of women (64.4% and 35.5% of women and men, respectively). Besides, the diabetes is higher among people having 40 years of age and older with a prevalence of 90.99 % than other ages, which prevalence is only 9.01%. It is also higher among women with 61.47% than men aged 40 years and older (29.53%). Accordingly, the globalprevalence of diabetes for 2014 and 2015 are 6.6% and 7.05%, respectively, with a non-significant increase (p> 0.05). Nevertheless, the prevalence of diabetes-related complications decreased insignificantly (p>0.05) from 9.75% in 2014 to 8.24% in 2015. Conclusion: The results of this work demonstrate that even if the increased prevalence of diabetes is low, his pattern still increasing. Factors such as lifestyle and socioeconomic status population are required to better understand the factors promoting the increase of diabetes occurrence.

Objective: The aim of this study was to assess the relationship between birth weight and nutritional status among preschool children of Kenitra city, Morocco. Materials and methods: A cross-sectional survey of a sample of 338 preschool children aged 5-6 years. Children’s height and weight were measured using a standardized protocol and body mass index (BMI) was calculated. The question on birth weight was included in the questionnaire completed by the parents, three conditions were selected: low birth weight, normal birth weight and, high birth weight. Statistical analyzes were performed using SPSS Software/version 20. Results: The Chi-square test shows that there was no significant association between the gender of the children and the birth weight classifications. While there is a strong link between Body Mass Index classes and birth weight classifications categories. Conclusion: Birth weight is a discriminating factor in the nutritional status of the population studied. Further studies are needed to better assess the other factors that influence nutritional status for children of preschool age. And we recommend more attention be given to child nutrition to improve the health and growth of children in our society.

Aims: This study was carried out to explore the prevalence of HBV and HCV infections among type 2 diabetes mellitus (T2DM) patients and risk factors. This cross-sectional study was conducted at BIRDEM General Hospital, Dhaka, Bangladesh between January 2012 and March 2013. Subjects and Methods: A total of 1024 type 2 diabetics were included. Well-structured questionnaire was used to collect demographic profile and history of the study populations. Venous blood samples were collected to screen HBV, HCV infections and to estimate other biochemical tests. Data analysis was carried out using SPSS version 16.0. Descriptive analysis was performed and results expressed as means±SD and n (%). P <0.05 was considered significant. Results: Prevalence of HBV in type 2 diabetics was 3.0% (31/1024) and HCV was 0.48% (5/1024). Among all subjects, mean±SD of body mass index (BMI) was 24.9±3.8, fasting blood sugar mmol/L was 10.7±4.6, post prandial blood sugar mmol/L was 17.6±7.2, fasting cholesterol mg/dl was 198.5±81.3, haemoglobin gm/dl was 13.1±1.5, serum ALT IU/L was 40.5±36.0. Mean serum ALT was significantly higher among HBV-positive T2DM participants (57.7 IU/L) than HBV-negative participants (36.2 IU/L) (P=0.001). Conclusions: The seroprevalence of HBV was higher than that of HCV in T2DM patients. T2DM patients should take necessary preventive measures like prophylactic vaccination to reduce the risk of HBV infection and its consequences.

In the pathophysiology of non-insulin dependent diabetes, characterized by hyperglycemia, at least three factors seem to be involved: a defect in insulin secretion, increased hepatic glucose production and insulin target. Over the past decade, significant advances in knowledge about the cellular mechanisms of action of insulin were performed. This has led to a better understanding of the mechanisms that could explain the insulin resistance in the type 2 diabetes, regardless of their primary or secondary origin. The deficit of magnesium is frequently associated with diabetes mellitus. This depletion ubiquitous cation in the body, alters glucose metabolism and insulin sensitivity and, is also implicated in the occurrence of complications and the risk of diabetes occurred among subjects predisposed who should receive a follow-up search of a magnesium deficiency, expression of a lack of intake and / or increased urinary loss. In our study, we found a correlation between magnesium deficiency and metabolic disorders affecting carbohydrate and lipid metabolism, labeled with revealing glycemic levels, insulin resistance, and lipid profile. The cause of magnesium deficiency in diabetic patients is not fully known. As the beneficial effects of magnesium supplementation, the long-term studies are needed before recommending routine supplementation in type 2 diabetes and subjects at risk with subclinical magnesium deficiency.

Aim: To assess the impact of acute gastroenteritis on the quality of life of both parents and children ages 3mos-5years old. Methods: A prospective study with Ninety-five respondents recruited based on inclusion/exclusion criteria for a duration of six months (April 2016-September 2106) at a local government hospital in the Philippines. A Self-administered standardized questionnaire was given to parents. Results: Acute gastroenteritis moderately affected the children’s sleep. They were noted to become more clingy, irritable and sad. Parents themselves became severely worried. Their sleep, daily activities inside the home, level of energy, and social interactions were moderately affected. In addition, Acute Gastroenteritis also brought moderate stress to the parents. They became mildly upset, frustrated, guilty, embarrassed and helpless. Moreover, there was no significant association demonstrated between the demographic status of the parents and the negative impact on their physical, emotional and social interaction because of the children’s gastroenteritis. Furthermore, there was a statistically significant association between the symptom severity of gastroenteritis with the child’s functional and emotional symptoms. Conversely, Acute gastroenteritis did not show statistical significant association with the physical and emotional status of the parents. It significantly affected their social interaction with other family members, friends and extended family. Conclusion: Acute gastroenteritis affects the quality of life of both parents and children and poses a significant negative impact on their daily lives. Relevant measures such as proper counseling on sanitation and hygiene, nutrition and vaccination by healthcare practitioners are therefore imperative to prevent the disease occurrence.

Background: Esophageal Stricture due to accidental hot water ingestion. Case characteristics: 5-year-old boy presented with nausea, vomiting and dysphagia following hot water ingestion 20 days back. Intervention: Stricture dilatation by Savary Gilliard dilator. Outcome: Relief in symptoms. Message: Hot water ingestion should be kept in mind while evaluating oesophageal stricture.

Benzalkonium chloride (BAC) is a common topical antiseptic. Ingestion of the compound may lead to injury of the esophagus. A six-year-old male was admitted after four days of vomiting with coffee ground emesis and abdominal pain after repeated ingestion of “Band-Aid Hurt-Free cleansing and infection protection foam”™, containing 0.13% BAC. An upper endoscopy revealed marked circumferential esophagitis, requiring supportive care with total parenteral nutrition and eventual gastrostomy placement. The patient was treated with sucralfate, proton pump inhibitor therapy, and enteral nutritional support. One month after discharge the child was tolerating oral feedings and the gastrostomy tube was remove. BAC has been reported to cause injury through its caustic irritant and possible allergenic components. This is the first report of repeated ingestion of hand sanitizer containing 0.13% BAC causing significant esophageal injury and morbidity in a pediatric patient. Parents and health care providers should be aware of the potential risk of accidental ingestion of BAC-containing hand sanitizers.

Pancreas divisum (PD) is the most common congenital anomaly of the pancreas. Its diagnosis is currently based on the magnetic resonance imaging (MRI). However endoscopic retrograde cholangiopancreatography (ERCP) remains the reference examination, especially in difficult cases;it has a diagnostic and therapeutic role. The treatment of PD is recommended only for symptomatic patients; it is endoscopic and /or surgical .The Response to treatment depends on the clinical present. We report a new case of PD in 13 years old child revealed by recurrent acute pancreatitis diagnosed by ERCP: the pancreaatography via minor papilla revealed a very dilated duct of Santoriny wich is following main pancreatic duct. Sphincterotomy of the minor papilla was performed with good clinical and biological response. Through this case of PD and review of the literature, the authors insist on diagnostic challenges and the role of ERCP in the diagnosis and treatment of PD.

Malnutrition is a globally prevalent disease, more so in the developing countries. It includes both macronutrient and micronutrient or trace element deficiency. Of late, zinc has been recognized as an essential trace element, required for maintaining normal body homeostasis. Zinc deficiency is associated with growth retardation (height and weight), delayed sexual and bone maturation, impaired immune function, recurrent infections, dermatitis, diarrhea, alopecia, anorexia and mental disturbances.¹ Serum zinc levels have been found to be low in protein energy malnutrition globally. Zinc supplementation during the rehabilitation phase of malnutrition has been associated with rapid weight gain.