Publications by authors named "Karim Ibn Majdoub"

20 Publications

  • Page 1 of 1

Impact of mental imagery on enhancing surgical skills learning in novice's surgeons: a pilot study.

BMC Med Educ 2021 Oct 28;21(1):545. Epub 2021 Oct 28.

Clinical Neurosciences Laboratory, Faculty of Medicine and Pharmacy of Fez, Sidi Mohammed Ben Abdellah University, BP. 1893; Km 2.200, Sidi Hrazem Road, 30000, Fez, Morocco.

Objective: Mental imagery (MI) has long been used in learning in both fields of sports and arts. However, it is restrictively applied in surgical training according to the medical literature. Few studies have evaluated its' feasibility and usefulness. The aim of this study is to assess the impact of mental imagery on surgical skills learning among novice's surgeons.

Material And Methods: In this pilot prospective randomized comparative study; we recruited 17 residents and interns of surgery education curriculum. They were all included in their first semester of the curricula. Two groups were randomly designed. Group (a) including "Mental Imagery" volunteers (n = 9) which benefited from a mental imagery rehearsal exercise prior to physical practice, while the control group (b) (n = 8) didn't underwent any MI process prior to surgery practice. Each participant of both groups was invited to perform an intestinal hand-sewn anastomosis on bovine intestine. Each procedure was evaluated and analyzed according to 14 qualitative criteria while each criterion was scored 0, 1 or 2 respectively assigned to the gesture was not acquired, gesture was performed with effort, or mastered gesture. The final score is 28 for those who master all 14 gestures. A non-parametric statistical comparison between the both studied groups was performed.

Results: Both groups of surgery students demonstrated equivalent age, sex ratio, laterality, and surgical experience. The mean overall score is significantly higher in the MI group (a) (17.78; SD = 2.42) compared to the control group (b) (10.63, SD = 2.85). However, advanced analysis of individual assessment items showed significant statistical difference between both groups only in 6 out of 14 assessed items.

Conclusion: Indeed, mental imagery will not be able to substitute the traditional learning of surgery for novice surgeons; it is an important approach for improving the technical skills acquisition and shortening the physical learning.
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http://dx.doi.org/10.1186/s12909-021-02987-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8555244PMC
October 2021

Reproduction of the Cancer Genome Atlas (TCGA) and Asian Cancer Research Group (ACRG) Gastric Cancer Molecular Classifications and Their Association with Clinicopathological Characteristics and Overall Survival in Moroccan Patients.

Dis Markers 2021 28;2021:9980410. Epub 2021 Jul 28.

Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.

Introduction: The Cancer Genome Atlas (TCGA) project and Asian Cancer Research Group (ACRG) recently categorized gastric cancer into molecular subtypes. Nevertheless, these classification systems require high cost and sophisticated molecular technologies, preventing their widespread use in the clinic. This study is aimed to generating molecular subtypes of gastric cancer using techniques available in routine diagnostic practice in a series of Moroccan gastric cancer patients. In addition, we assessed the associations between molecular subtypes, clinicopathological features, and prognosis.

Methods: Ninety-seven gastric cancer cases were classified according to TCGA, ACRG, and integrated classifications using a panel of four molecular markers (EBV, MSI, E-cadherin, and p53). HER2 status and PD-L1 expression were also evaluated. These markers were analyzed using immunohistochemistry (E-cadherin, p53, HER2, and PD-L1), in situ hybridization (EBV and HER2 equivocal cases), and multiplex PCR (MSI).

Results: Our results showed that the subtypes presented distinct clinicopathological features and prognosis. EBV-positive gastric cancers were found exclusively in male patients. The GS (TCGA classification), MSS/EMT (ACRG classification), and E-cadherin aberrant subtype (integrated classification) presented the Lauren diffuse histology enrichment and tended to be diagnosed at a younger age. The MSI subtype was associated with a better overall survival across all classifications (TCGA, ACRG, and integrated classification). The worst prognosis was observed in the EBV subtype (TCGA and integrated classification) and MSS/EMT subtype (ACRG classification). . We reported a reproducible and affordable gastric cancer subtyping algorithms that can reproduce the recently recognized TCGA, ACRG, and integrated gastric cancer classifications, using techniques available in routine diagnosis. These simplified classifications can be employed not only for molecular classification but also in predicting the prognosis of gastric cancer patients.
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http://dx.doi.org/10.1155/2021/9980410DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8342151PMC
January 2022

Mutation status and prognostic value of KRAS and NRAS mutations in Moroccan colon cancer patients: A first report.

PLoS One 2021 30;16(3):e0248522. Epub 2021 Mar 30.

Faculty of Medicine and Pharmacy, Laboratory of Biomedical and Translational Research, Sidi Mohamed Ben Abdellah University, Fez, Morocco.

This study aimed to estimate the incidence of KRAS, NRAS, and BRAF mutations in the Moroccan population, and investigate the associations of KRAS and NRAS gene mutations with clinicopathological characteristics and their prognosis value. To achieve these objectives, we reviewed medical and pathology reports for 210 patients. RAS testing was investigated by Sanger sequencing and Pyrosequencing technology. BRAF (exon 15) status was analyzed by the Sanger method. The expression of MMR proteins was evaluated by Immunohistochemistry. KRAS and NRAS mutations were found in 36.7% and 2.9% of 210 patients, respectively. KRAS exon 2 mutations were identified in 76.5% of the cases. RAS-mutated colon cancers were significantly associated with female gender, presence of vascular invasion, classical adenocarcinoma, moderately differentiated tumors, advanced TNM stage III-IV, left colon site, higher incidence of distant metastases at the time of diagnostic, microsatellite stable phenotype, lower number of total lymph nodes, and higher means of positive lymph nodes and lymph node ratio. KRAS exon 2-mutated colon cancers, compared with KRAS wild-type colon cancers were associated with the same clinicopathological features of RAS-mutated colon cancers. NRAS-mutated patients were associated with lower total lymph node rate and the presence of positive lymph node. Rare RAS-mutated tumors, compared with wild-type tumors were more frequently moderately differentiated and associated with lower lymph node rate. We found that KRAS codon 13-mutated, tumors compared to codon 12-mutated tumors were significantly correlated with a higher death cases number, a lower rate of positive lymph, lower follow-up time, and poor overall survival. Our findings show that KRAS and NRAS mutations have distinct clinicopathological features. KRAS codon 13-mutated status was the worst predictor of prognosis at all stages in our population.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0248522PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8009361PMC
October 2021

Microsatellite Instability Analysis in Gastric Carcinomas of Moroccan Patients.

Genet Test Mol Biomarkers 2021 Feb;25(2):116-123

Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.

To investigate correlations between microsatellite instability (MSI) and the phenotype, clinicopathological features, and overall survival (OS) in Moroccan gastric cancer (GC) patients. We evaluated the mutation frequency of 22 MSI-target genes in MSI-positive tumors. MSI evaluation were performed for 97 gastric tumors by multiplex polymerase chain reaction (PCR) using a panel of five quasimonomorphic mononucleotide repeat markers (NR27, NR21, NR24, BAT25, and BAT26). The mutation profiles of 22 MSI-target genes were assessed by multiplex PCR and genotyping. Kaplan-Meier curves, the log-rank test, and the Cox proportional hazard regression model were used to conduct survival analyses. Microsatellite stable (MSS) status was observed in 77/97 (79.4%) gastric cancer samples, MSI-Low in 7 (7.2%) samples, and MSI-High (MSI-H) in 13 (13.4%) cases. The MSI-H phenotype was significantly associated with older age ( = 0.004), tumor location ( < 0.001), and intestinal-type of Lauren classification ( < 0.001). Among the 22 MSI target genes analyzed, the most frequently altered genes were (84.6%), (30.8%), (23.1%), (23.1%), and (23.1%). Multivariate analysis revealed the MSS phenotype (Hazard ratio, 0.23; 95% confidence interval, 0.7-7.4;  = 0.014) as an independent indicator of poor prognosis in our population. This study is the first analysis of MSI in Moroccan GC patients. MSI-H GCs have distinct clinicopathological features and an improved OS. We have identified candidate target genes altered in MSI-positive tumors with potential clinical implications. These findings can guide immunotherapy designed for Moroccan GC patients.
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http://dx.doi.org/10.1089/gtmb.2020.0146DOI Listing
February 2021

Acute cecal volvulus: A diagnostic and therapeutic challenge in emergency: A case report.

Ann Med Surg (Lond) 2019 Dec 31;48:69-72. Epub 2019 Oct 31.

Department of General and Visceral Surgery, Hassan II University Hospital of Fez, 30050, Fez, Morocco.

Introduction: Cecal volvulus is an uncommon cause of intestinal obstruction due to an axial twist of the caecum, ascending colon and terminal ileum around the mesenteric pedicle. It is responsible for 1%-1.5 of all intestinal obstructions in adult. The clinical signs may be highly variables and can be responsible of delays in diagnostic and treatment. The delay in diagnosis leads to intestinal necrosis or perforation. The mortality ranges from 10 to 40% depending on the presence of a viable or gangrenous intestine.

Presentation Of Case: A 64 year old woman admitted the emergency department for acute bowel obstruction. Clinical examination found typically acute bowel obstruction signs. Plain radiography showed dilated gas-filled segment of the colon in the left side of abdomen and volvulus of cecum was suspected. Enhanced abdominal CT scan confirmed the diagnosis. Emergency exploratory laparotomy was performed and confirmed the cecal volvulus. A manual untwisting of volvulus and a Caecopexy were performed. The patient subsequently recovered uneventfully and was discharged on postoperative day 3.

Discussion: The management of cecal volvulus requires prompt (emergency) diagnosis and prompt surgical intervention. Any delay in diagnosis may lead to intestinal necrosis or perforation and worsening the prognosis in patients who are generally elderly. Several authors reported a high mortality rate of cecal volvulus due to delay to diagnosis and surgical intervention.

Conclusion: The low incidence of this condition needs a high index of suspicion and emergency surgical management. Despite significant progress in medical imaging, the preoperative diagnosis of cecal volvulus is very difficult. As a result, the treatment is often delayed.
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http://dx.doi.org/10.1016/j.amsu.2019.10.021DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6849140PMC
December 2019

[Total small bowel volvulus complicating common incomplete mesentery, an exceptional complication in adults: about a case].

Pan Afr Med J 2019 17;33:220. Epub 2019 Jul 17.

Service de Chirurgie Viscérale B, CHU Hassan 2, Fes, Maroc.

Total small bowel volvulus complicating common incomplete mesentery is an arrest of rotation of the primary intestinal loop at 180°. The root of the mesentery is very short and the whole small intestine is located on the superior mesenteric artery axis. Patients are at very high risk of small bowel volvulus and enteromesenteric infarction. Acute volvulus requires emergency surgery; imaging must not delay surgery. Surgery is based on the untwisting of the volvulus (counterclockwise) after the assessment of intestinal viability. The intestine placed in the complete common mesentery position: the cœcum is situated in the right iliac region. We report the case of a 60-year old patient admitted with total small bowel volvulus on an incomplete common mesentery who underwent emergency surgery with favorable postoperative outcome.
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http://dx.doi.org/10.11604/pamj.2019.33.220.18159DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6814366PMC
November 2019

Fournier gangrene: rare complication of rectal cancer.

Pan Afr Med J 2015 24;20:288. Epub 2015 Mar 24.

Urology Department, Hassan II University Hospital, Fez, Morocco.

Fournier's Gangrene is a rare complication of rectal cancer. Its discovery is often delayed. It's incidence is about 0.3/100,000 populations in Western countries. We report a patient with peritoneal perforation of rectal cancer revealed by scrotal and perineal necrotizing fasciitis.
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http://dx.doi.org/10.11604/pamj.2015.20.288.5506DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4483353PMC
April 2016

Stromal tumor of the lesser omentum : a case report.

Pan Afr Med J 2014 28;17:236. Epub 2014 Mar 28.

Département de Chirurgie, Faculté de médecine et de pharmacie de Fès, Université Sidi Mohammed Ben Abdellah, CHU Hassan II, Fès, Maroc.

Gastrointestinal stromal tumors (GISTs) represent the majority of primary non-epithelial neoplasms of the digestive tract, most frequently expressing the KIT protein detected by immunohistochemical staining for the CD117 antigen. Extragastrointestinal stromal tumors (EGISTs), neoplasms with immunohistological features overlapping those of GISTs, are found in the abdomen outside of the gastrointestinal tract with no connection to the gastric or intestinal wall. We report the clinical, macroscopic and immunohistological features of an EGIST arising in the lesser omentum of a 58-year-old woman. This is a very rare location of intra abdominal stromal tumors.
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http://dx.doi.org/10.11604/pamj.2014.17.236.3133DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4145276PMC
May 2015

[Appendiculo subcutaneous fistula: a rare complication of acute appendicitis].

Pan Afr Med J 2014 23;19:194. Epub 2014 Oct 23.

Service de Chirurgie Viscérale, CHU Hassan II, Fès, Maroc.

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http://dx.doi.org/10.11604/pamj.2014.19.194.4087DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4369298PMC
October 2015

[Giant angioma of the liver].

Pan Afr Med J 2014 20;19:174. Epub 2014 Oct 20.

Service de Chirurgie Viscérale B, CHU Hassan II, Fès, Maroc.

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http://dx.doi.org/10.11604/pamj.2014.19.174.5503DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4366117PMC
October 2015

Traumatic appendicitis: a case report and literature review.

World J Emerg Surg 2013 Aug 9;8(1):31. Epub 2013 Aug 9.

School of medicine and pharmacy of Fez, Sidi Mohammed Ben Abdellah University, BP: 1893; km2,200, route de sidi Hrazem, Fez 30000, Morocco.

Appendicitis and trauma may exist together, which causes an interesting debate whether trauma has led to appendicitis. We report a case of appendicitis after an abdominal trauma. Our patient developed acute appendicitis following a stab wound in the right iliac fossa. Surgical exploration confirmed the traumatic origin of appendicitis, appendectomy was performed and our patient made an excellent recovery. In non operative management of abdominal trauma, physical examinations and radiological explorations should be repeated in order to diagnose traumatic appendicitis.
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http://dx.doi.org/10.1186/1749-7922-8-31DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3750490PMC
August 2013

Recurrent desmoid tumor of the abdominal wall.

Pan Afr Med J 2012 20;13:60. Epub 2012 Nov 20.

Department B of general surgery, Hassan II faculty hospital, Fes, Morocco.

Desmoid tumors most often occur in abdominal wall. Their tendency to recur lead to repeated operations which can make the abdominal wall reconstruction difficult. We report a 28-year-old female history. The patient was referred to our hospital for a recurrent desmoid tumor of the abdominal wall. The tumor was totally removed. The reconstruction was successful and the patient recovery was uneventful. Radical surgery still the mainstay of the desmoid tumors treatement. In abdominal wall location, the reconstruction can be a real challenge. Many procedures are discussed in literature. We used a double layer mesh covered by a fascial bepedicled flap. Taking into account their unpredictable behaviour and treatment complications, recurrent abdominal desmoid tumors can be managed simply and efficiently.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3549445PMC
July 2013

[Resectability evaluation in pancreatic cancer].

Presse Med 2013 Sep 20;42(9 Pt 1):1171-5. Epub 2012 Nov 20.

Chirurgie viscérale B, CHU de Fès, Fès, Maroc. Electronic address:

Accurate staging of pancreatic cancer is essential in order to select patients, which are candidates for curative resection. Multidetector computed tomography is the best imaging for determination of pancreatic cancer loco regional and distal resectability. Endoscopic ultra sonography has complementary role in small tumours. It can guide regional lymph node puncture for accurate staging. Magnetic resonance with MR angiography can be helpful in determining vascular respectability of pancreatic cancer. The use of laparoscopy with laparoscopic ultrasound has been increased last years in order to avoid unnecessary laparotomy. Positron emission tomography may be useful tool for diagnosing occult metastatic disease. It is still in evaluation.
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http://dx.doi.org/10.1016/j.lpm.2012.09.007DOI Listing
September 2013

Colonic adenocarcinoma revealing Crohn's disease: a case report.

J Med Case Rep 2010 Jun 1;4:167. Epub 2010 Jun 1.

Department of General Surgery, University Hospital Hassan II of Fez, Fez, Morocco.

Introduction: There is growing evidence from epidemiological studies and clinicopathological data obtained from case reports that Crohn's disease is associated with an increased risk of carcinoma of the large bowel.

Case Presentation: A 70-year-old Arabic African man with undiagnosed Crohn's disease presented with acute abdominal obstruction due to an occlusive carcinoma of the sigmoid. At laparotomy, the colonic tumor was excised with continuity restored by end-to-end anastomosis.

Conclusion: The risk of colonic carcinoma in Crohn's disease is increasing. Several case reports actually support the possibility that a genuine association between these two conditions exists.
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http://dx.doi.org/10.1186/1752-1947-4-167DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2896949PMC
June 2010

Uncommon mimics of appendicitis: giant mucocele.

Pan Afr Med J 2010 21;7. Epub 2010 Oct 21.

Department of General Surgery, CHU Hassan II, Fes, Morocco.

Appendiceal mucocele is an infrequent but well recognized entity that can present with a variety of clinical syndromes or can be asymptomatic and discovered incidentally. A 55 years old patient was admitted in the emergency department for acute right lower quadrant pain. A diagnosis of appendicitis was made. At operation an appendiceal mucocele was found. An appendectomy was performed. The diagnosis of appendiceal mucocele is an important one in that it can be associated with malignancies and other serious gastrointestinal, ovarian, and urological complications.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3172631PMC
February 2012

[Cystic pneumatosis ileal revealed by a small bowel volvulus ].

Pan Afr Med J 2010 Aug 12;6. Epub 2010 Aug 12.

Service de chirurgie viscérale A, CHU Hassan II Fez, Morocco.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3063497PMC
August 2010

Ileosigmoid knot strangles the sigmoid.

J Emerg Trauma Shock 2009 Sep;2(3):216-7

Department of General Surgery, Universitet Hospital Hassan II, Fes, Morocco.

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http://dx.doi.org/10.4103/0974-2700.55351DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2776376PMC
September 2009

Simultaneous acute appendicitis and ectopic pregnancy.

J Emerg Trauma Shock 2009 Jan;2(1):46-7

Department of general surgery, UH Hassan II, Fez, Morocco.

The acute abdomen in pregnancy is a surgical emergency. Ectopic pregnancy and appendicitis are two causes of acute abdomen in pregnancy. Difficulties in correctly identifying the cause of the pain can be hazardous to the patient and care needs to be taken in obtaining a prompt and accurate diagnosis enabling the most appropriate management. The case presented here underlies the pathogenesis of the simultaneous existence of these two conditions in a patient.
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http://dx.doi.org/10.4103/0974-2700.44683DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2700571PMC
January 2009
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