Gynécologie Obstétrique, Hôpital Militaire d’Instruction Mohammed V (HMIMV), Faculté de Médecine et de Pharmacie de Tanger, Université Abdelmalek Essaadi, Morocco
Endometrial cancer (EC) is the most common gynecologic malignancy in developed countries and affects predominantly postmenopausal women. It is estimated, however, that 15%
Background: The clinical reasoning is expressed daily in the ability to solve clinical problems of patients. Its supervision is essential to establish an individualized educational plan that encourages its development. Objective: To analyze the impact of clinical reasoning learning sessions as remediation strategy of clinical reasoning difficulties. Method: exploratory retrospective study of medical students analyzing the difficulties of clinical reasoning and pedagogic practice of supervision promoting its development through the introduction of clinical reasoning learning sessions guided by a course book and grids evaluation as remediation strategy. Results: After the application of our supervision model of the clinical reasoning, 94.6 % of students were satisfied. They thus suggested the introduction of clinical reasoning evaluation before clinical examinations 7th year. Conclusion: the introduction of clinical reasoning learning sessions both in diagnosis and remediation of difficulties reasoning proves a real need. It would be appropriate to propose models applicable in other disciplines and to integer its evaluation in university program of internship
Juvenile granulosa tumor is a sex cord stromal tumor extremely rare, with usually estrogenic effects, while virilizing form is exceptional, often discovered at a stage confined to the ovary, justifying therefore a conservative treatment. Its prognosis appears favorable, depending on early management. However, its evolvement may be hampered by early and aggressive recurrence. We report a new case compiled in Obstetrics Gynecology Service (HMIMV) of virilizing form of juvenile granulosa cell tumors, discovered during a recent exacerbation of a preexisting androgen syndrome in a girl of 24 years. It's extreme rarity prompted us to report it highlighting, through a literature review, its diagnostic features, therapeutic and evolutionary.
Aplasia cutis congenital is a rare congenital absence of skin, exceptionally involves extremities. Most cases are sporadic but familial autosomal dominant pattern can be found. The etiology remains unclear, both genetic and environmental causes have been implicated. This lesion has primarily a clinical diagnosis. Imaging studies may be used to evaluate underlying tissues and investigate other comorbid abnormalities. Treatment modalities depend upon the extent defect and involvement of underlying tissues. Genetic counseling is useful in cases of hereditary form. We report a new case of extensive bilateral aplasia cutis congenital of extremities in a new born, occurred as an isolated sporadic case without family history, no teratogenic medication and no evidence for an amniotic band or infection in pregnancy.
Kasabach Merritt syndrome is defined by clinical and biological association of a purplish-red vascular tumor rapidly extensive, thrombocytopenia, a variable degree of disseminated intravascular coagulation and sometimes anemia. It usually occurs in neonates and infants less than 6 months, sometimes in utero. The imaging can confirm the diagnosis and search for deep locations. This syndrome can be life-threatening by the risk of bleeding, coagulopathy, thrombosis, compression and heart failure. The therapeutic management should be early, multidisciplinary adapting therapeutic benefits to risks in order to improve the prognosis. We report a case of Kasabach Merritt syndrome, we insist through a literature review of diagnostic, therapeutic and evolutionary difficulties.
Pseudo tumoral peritoneal tuberculosis is a rare clinical form witch clinical and para clinical aspects can mimic advanced ovarian cancer leading to unjustified radical surgery, with high risk of morbidities, often in a young woman. We report a new case of pseudo tumoral peritoneal tuberculosis in a girl of 21 years old in which diagnosis of ovarian cancer with ascitis and peritoneal carcinomatosis was suspected clinically, radiologically and biologically by rising CA125. Exploratory laparotomy with extemporaneous histological examination has confirmed tuberculosis diagnosis.