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Lamyaa S, Tamaoui L, Birouk N, Amrani L, Fadel H, Belaidi H, Ouazzani R. Neuronopathie sensitive (NNS) révélée au cours de la grossesse et associée à une hépatite auto-immune (HAI) : à propos d’une observation. Rev Neurol (Paris) 2017. [DOI: 10.1016/j.neurol.2017.01.089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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El Khateeb SM, Abu-Hammad O, Fadel H, Dar-Odeh N. A Retrospective Analysis of Radiographic Jaw Findings in Young Women; Prevalence and Predictors. J Int Soc Prev Community Dent 2017; 7:22-27. [PMID: 28316945 PMCID: PMC5343679 DOI: 10.4103/2231-0762.200707] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 12/23/2016] [Indexed: 12/20/2022] Open
Abstract
AIMS AND OBJECTIVES To determine the prevalence and types of jaw pathologic findings as detected in panoramic radiographs of a sample of young women attending a teaching hospital in Al Madinah Al Munawarah, Saudi Arabia, and to determine the most important factors that predict the occurrence of jaw pathologic findings. MATERIALS AND METHODS The electronic clinical files of a representative sample of female patients who attended the outpatient dental clinics were retrieved. Patients were aged 18 to 25 years. Types of pathologic radiographic jaw findings and their prevalence were determined through screening of panoramic radiographs. Data were analyzed using the statistical analysis software [SPSS version 21 (IBM Corp.)]. Multiple linear regression was used to explore the significance of some types of dental lesions as predictor variables for the occurrence of jaw pathologic findings. RESULTS A total of 190 patients (mean age, 22.4 ± 2.46 years) were included in the study. Periapical lesions, retained roots, and alveolar bone loss were detected in 53.6%, 24.8%, and 17.4% of the participants, respectively. Other odontogenic abnormalities such as supernumerary and impacted teeth (6.4% and 33.7%, respectively) were also detected. Patients' age was found to be a good predictor for alveolar bone loss and number of periapical lesions (P ≤ 0.05). CONCLUSIONS A high prevalence of periapical lesions, retained roots, and alveolar bone loss was found among a sample of young female dental attendees, as shown by their panoramic radiographs. Further studies are needed to explore potential risk factors for such a noticeable trend of poor oral health, and the needed strategies to counteract this trend.
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Affiliation(s)
- Sara M. El Khateeb
- Department of Oral Medicine, Periodontology, Diagnosis and Oral Radiology, Ain Shams University, Cairo, Egypt
- Department of Basic and Clinical Oral Sciences, Taibah University Dental College and Hospital, Al Madinah Al Munawarah, Saudi Arabia
| | - Osama Abu-Hammad
- Department of Removable Prosthodontics, Faculty of Dentistry, University of Jordan, Amman, Jordan
- Department of Substitutive Dental Sciences, Taibah University Dental College and Hospital, Al Madinah Al Munawarah, Saudi Arabia
| | - Hani Fadel
- Department of Preventive Dental Sciences, Taibah University Dental College and Hospital, Al Madinah Al Munawarah, Saudi Arabia
| | - Najla Dar-Odeh
- Department of Basic and Clinical Oral Sciences, Taibah University Dental College and Hospital, Al Madinah Al Munawarah, Saudi Arabia
- Department of Oral Surgery, Oral Medicine and Periodontics, Faculty of Dentistry, Amman, Jordan
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El Otmani H, Lahlou I, Raji L, Omari S, Belmansour Y, Moutaouakil F, Boulaajaj FZ, Mouden M, Gam I, Hakim K, El Moutawakil B, Rafai MA, Fadel H, Slassi I. [Striatopallidodentate calcinosis, hypoparathyroidism and neurological features: a case series study]. Rev Neurol (Paris) 2013; 169:495-501. [PMID: 23523016 DOI: 10.1016/j.neurol.2012.11.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2012] [Revised: 11/12/2012] [Accepted: 11/14/2012] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The respective roles of hypocalcemia and intracerebral calcifications in the occurrence of various neurological manifestations in hypoparathyroidism is not entirely clear. Nevertheless, therapeutic and prognostic implications are important. OBJECTIVES We analyze the neurological clinical aspects observed in hypoparathyroidism and correlate them to the biological calcium abnormality and radiological CT scan findings. We also compare these results with data reported in the idiopathic form of striatopallidodentate calcinosis. PATIENTS The neurological clinical, CT scan findings and outcome have been retrospectively studied in patients recruited during 13 years (2000-2012) for neurological features associated with hypoparathyroidism or pseudohypoparathyroidism. RESULTS Twelve patients with primary hypoparathyroidism (n=5), secondary to thyroidectomy (n=4) and pseudohypoparathyroidism (n=3) were studied. The sex-ratio was 1 and mean age was 39 years. All patients had a tetany, 60% had epilepsy, associated in one patient with "benign" intracranial hypertension; 50% had behavioral changes. Response to calcium therapy was excellent for all these events. Moderate cognitive deficit was noted in three patients (25%), parkinsonism in two patients and hyperkinetic movement disorders in one other. These events were not responsive to calcium therapy and were more common in cases of extensive brain calcifications and in patients who had pseudohypoparathroidism. COMMENTS This study suggests that, in patients with hypoparathyroidism, epilepsy and psychiatric disorders are induced by hypocalcemia and reversible after its correction. Cognitive and extrapyramidal impairment seem to be related to the progressive extension of intracerebral calcification, particularly in patients with a late diagnosis. In patients with pseudohypoparathyroidism, this finding is different because of the contribution of other factors, specific to this disease.
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Affiliation(s)
- H El Otmani
- Service de neurologie, CHU d'Ibn Rochd, 1, rue des Hôpitaux, Casablanca, Maroc.
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Moutaouakil F, El Otmani H, Fadel H, Slassi I. [Benign nocturnal alternating hemiplegia: a new case]. Rev Neurol (Paris) 2012; 169:174-5. [PMID: 23079856 DOI: 10.1016/j.neurol.2012.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2012] [Revised: 06/13/2012] [Accepted: 06/15/2012] [Indexed: 11/29/2022]
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El Otmani H, Moutaouakil F, Fadel H, Slassi I. [Subarachnoid hemorrhage induced by cerebral venous thrombosis]. ACTA ACUST UNITED AC 2012; 37:323-5. [PMID: 23021190 DOI: 10.1016/j.jmv.2012.08.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2012] [Accepted: 08/20/2012] [Indexed: 11/29/2022]
Abstract
Nontraumatic subarachnoid hemorrhage is a relatively rare disease, typically secondary to a ruptured aneurysm. We report the case of a 23-year-old patient who developed a subarachnoid hemorrhage caused by extensive cerebral venous thrombosis due to a factor V Leiden mutation. Cerebral venous thrombosis is an uncommon etiology of subarachnoid hemorrhage. This raises diagnostic difficulties and a therapeutic dilemma regarding the use of anticoagulants.
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Affiliation(s)
- H El Otmani
- Service de Neurologie, CHU Ibn Rochd, Casablanca, Maroc.
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El Otmani H, Moutaouakil F, Fadel H, Slassi I. [Hyperprolactinemia and gynaecomastia induced by benserazide]. Rev Neurol (Paris) 2012; 168:877-8. [PMID: 22677327 DOI: 10.1016/j.neurol.2012.02.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2012] [Revised: 02/17/2012] [Accepted: 02/24/2012] [Indexed: 11/28/2022]
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Fadel H, Al Hamdan K, Rhbeini Y, Heijl L, Birkhed D. Root caries and risk profiles using the Cariogram in different periodontal disease severity groups. Acta Odontol Scand 2011; 69:118-24. [PMID: 21142897 DOI: 10.3109/00016357.2010.538718] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To study root caries and risk profiles using the Cariogram in relation to periodontal disease severity and to analyse indicators associated with high caries risk. MATERIAL AND METHODS A cross-sectional examination was carried out on 112 patients with periodontal disease from two government clinics in Saudi Arabia. The investigation comprised a questionnaire, bitewing radiographs, measurement of salivary secretion rate, buffering capacity and cariogenic microorganisms, and registration of periodontal status, plaque amount and coronal and root caries/fillings (DFT and RDFT). The data were then entered into the Cariogram pedagogic model to illustrate the caries risk profiles. RESULTS Patients were grouped according to periodontal disease severity into one of three groups: (1) gingivitis (n = 44); (2) mild-to-moderate periodontitis (n = 33); and (3) severe periodontitis (n = 35). The prevalence of RDFT in the total sample was 17%. There were no statistically significant differences between the three groups in number of root lesions or mean 'Actual Chance to Avoid New Cavities' (Chance-AC) according to the Cariogram. Of the total sample, 22% displayed high caries risk (Chance-AC ≤ 40%). The most significant risk indicators in high caries risk patients were infrequent use of fluoride and unfavourable salivary and microbial parameters. CONCLUSIONS Root surface lesions and high caries risk were present in about one-fifth of the patients referred for periodontal treatment. A combination of risk indicators rather than a single one contributed to the increased risk. Caries and risk profiles were not significantly correlated with periodontal disease severity.
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Affiliation(s)
- Hani Fadel
- Department of Periodontology, Institute of Odontology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
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Guynerane M, Benmansour Y, Fadel H, Sekkat Z, Sibai M, Rafai M, El Moutawakil B, Slassi I. PO17-TU-02 Neurological signs of Gougerot Sjogren syndrome: study series about 12 cases. J Neurol Sci 2009. [DOI: 10.1016/s0022-510x(09)70914-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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El Otmani H, Moutaouakil F, Fadel H, Rafai M, El Moutawakil B, Slassi I. PO17-TU-10 A case of laughter-induced syncope. J Neurol Sci 2009. [DOI: 10.1016/s0022-510x(09)70922-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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El Otmani H, Moutaouakil F, Fadel H, Rafai M, El Moutawakil B, Slassi I. PO25-TH-10 Chorea-Ballismus in non-ketotic hyperglycaemic crisis. J Neurol Sci 2009. [DOI: 10.1016/s0022-510x(09)71133-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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El Otmani H, Moutaouakil F, Fadel H, El Ouafi N, Abdoh Rafai M, El Moutaouakil B, Slassi I. Chorea-ballismus in acute non-ketotic hyperglycaemia. Funct Neurol 2009; 24:129-132. [PMID: 20018139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Diabetic patients during hyperglycaemic crises may present a rare syndrome characterised by a typical triad: unilateral involuntary movements (hemichoreahemiballism), radiological contralateral striatal abnormality, and rapid resolution of symptoms after glycae - mic correction. This study reports a series of patients showing less usual aspects and also discusses the pathophysiology of this clinical-radiological syndrome. We included in this study four patients presenting choreic or ballic involuntary movements and in whom aetiological assessment revealed frank non-ketotic hyperglycaemia, without other abnormalities that could explain the movement disorder. All the patients underwent CT or MR brain imaging. The typical triad was present in only one case. Less classical aspects were more frequently found: movement disorders revealed diabetes in two patients and one patient had generalised chorea and strictly normal neuroimaging. Correction of blood glucose was not sufficient to improve symptoms in two cases. In one, abnormal movements persisted despite treatment with tetrabenazine. The clinical, radiological and outcome spectrum of the syndrome of chorea-ballismus induced by non-ketotic hyperglycaemia is heterogeneous and not restricted to a typical triad.
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Affiliation(s)
- H El Otmani
- Department of Neurology, Al Kortobi Hospital, Tangie, Morocco.
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El Otmani H, Moutaouakil F, Fadel H, Slassi I. [Painful legs and moving toes syndrome associated with lumbar radiculopathy]. Rev Neurol (Paris) 2009; 165:980-3. [PMID: 19446858 DOI: 10.1016/j.neurol.2009.01.041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2008] [Revised: 12/30/2008] [Accepted: 01/21/2009] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Painful legs and moving toes (PLMT) is a rare syndrome characterized by spontaneous neuropathic pain in the lower limbs associated with peculiar involuntary movements of the toes. It has been associated with a variety of peripheral and central nervous system diseases. Pathophysiology is unclear and treatment approaches remain largely empirical. CLINICAL CASE We report a case of a 42-year-old women with typical presentation of PLMT syndrome, associated with lumbar (L5) disc prolapse. Oxcarbazepine gave a partial improvement. CONCLUSION Clinical presentations and etiological aspects of the PLMT syndrome are described and pathophysiological mechanisms and therapeutic possibilities discussed.
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Affiliation(s)
- H El Otmani
- Service de neurologie, hôpital Al Kortobi, 90000 Tanger, Maroc.
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Moutaouakil F, El Otmani H, Fadel H, Sefrioui F, Slassi I. La l-arginine, une thérapeutique symptomatique efficace au cours d’un syndrome MELAS. Rev Neurol (Paris) 2009; 165:482-5. [DOI: 10.1016/j.neurol.2008.08.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2008] [Accepted: 08/21/2008] [Indexed: 10/21/2022]
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Moutaouakil F, El Otmani H, Fadel H, Slassi I. [Severe apathy following head injury: improvement with Selegiline treatment]. Neurochirurgie 2008; 55:551-4. [PMID: 19084243 DOI: 10.1016/j.neuchi.2008.10.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2008] [Accepted: 10/16/2008] [Indexed: 11/24/2022]
Abstract
Apathy is defined as reduced goal-directed behavior due to lack of motivation. Traumatic brain injury is a frequent cause. Drugs activating the dopaminergic system provide variable benefit. A 30-year-old patient was the victim of a severe head injury with frontal bruise at the age of 15. At the request of his family, he consulted for a 7-year history that included a lack of initiative and the inability to generate behavior spontaneously, contrasting with the ability to execute behaviors on command. He also presented indifference, major emotional disruption without sadness, pessimism, and other depressive signs. The examination found a severe apathetic syndrome confirmed by specific scales with a mild impairment of executive functions and without depressive syndrome. Encephalic MRI showed atrophy of the whole prefrontal cerebral cortex. The patient was treated with bromocriptine, which he did not tolerate, then with Selegiline at 15 mg per day, which dramatically improved his symptoms. Apathy occurs frequently after traumatic brain injury, in 23-71% of patients according to the authors. The pathophysiology of apathy has been described in anatomical terms as related to disruption of frontal-subcortical pathways. The biochemical hypothesis postulates a disruption in dopaminergic activity. The use of dopaminergic agents usually improves cases similar to our patient. Apathy is frequent following head injury, warranting a search for systematic causes. Since it increases dopaminergic activity, Selegiline is well worth trying in these patients.
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Affiliation(s)
- F Moutaouakil
- Service de neurologie, hôpital Al-Kortobi, 90000 Tanger, Maroc.
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Rafai M, Boulaajaj F, Seito A, Suga Y, Slassi I, Fadel H. Syndrome de Sjögren-Larsson en rapport avec une nouvelle mutation chez un enfant marocain. Arch Pediatr 2008; 15:1648-51. [DOI: 10.1016/j.arcped.2008.07.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2007] [Revised: 05/25/2008] [Accepted: 07/31/2008] [Indexed: 11/16/2022]
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Rafai MA, Fadel H, Boulaajaj FZ, Sibai M, Rafai M, El Moutawakkil B, Bourezgui M, Trafeh M, Slassi I. [POEMS syndrome with plasmocytoma lytic bone lesion]. Rev Neurol (Paris) 2008; 164:722-7. [PMID: 18805304 DOI: 10.1016/j.neurol.2007.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2007] [Revised: 10/10/2007] [Accepted: 11/23/2007] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Crow-Fukase or Polyneuropathy, Organomegaly, Endocrinopathy, M-protein, and Skin changes syndrome (POEMS) is a rare multisystemic affection with incompletely elucidated etiopathogenesis. CASE REPORT We report a case of POEMS syndrome in a 48-year-old adult revealed four months before admission by areflexic flask tetraparesis prevalent on the lower limbs in connection with demyelinating and axonal CIDP "like" sensoriomotor neuropathy of the four limbs electroneuromyographically. The patient presented elevated protein level in the CSF with monoclonal standard IgG gammapathy associated with a narrow band lambda, suggesting POEMS syndrome. Further explorations revealed skin lesions with glomeruloid angiomas, edematous vasomotor disorders as well as erythrocyanose, hypogonadism, papillar edema and a lytic bone lesion of the left scapula. Radiotherapy was associated with corticosteroids and plasma exchanges. Outcome was good with resolution of the symptoms and stabilization of the neuropathy. DISCUSSION POEMS syndrome is rare; the diagnosis is based on necessary criteria, the presence of a demyelinating and axonal polyneuropathy associated with an IgA or IgG monoclonal gammapathy, the light chain being almost entirely lambda, associated to other characteristic elements, in particular glomeruloid angiomas, endocrinopathy, sclerosing plasmocytoma which must be carefully required. Treatment is based on surgical cure or radiotherapy for bone lesion and non specific treatments such as corticosteroid therapy, plasma exchanges and IVIG.
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Affiliation(s)
- M A Rafai
- Service de neurologie - explorations fonctionnelles, CHU Ibn Rochd, Casablanca, Maroc.
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El Otmani H, Moutaouakil F, Fadel H, Slassi I. [Familial trigeminal neuralgia]. Rev Neurol (Paris) 2008; 164:384-7. [PMID: 18439932 DOI: 10.1016/j.neurol.2007.10.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2007] [Revised: 09/03/2007] [Accepted: 10/04/2007] [Indexed: 10/22/2022]
Abstract
Trigeminal neuralgia in its classic form is usually an isolated disease that occurs in sporadic fashion, but familial cases have been described. We report the case of a 45-year-old man who presented with left V2 trigeminal neuralgia. The neurological examination was normal and imaging and laboratory investigations were non-contributive to the etiological work-up. Carbamazepine gave excellent symptomatic relief. During patient evaluation, we became aware of a clustering of trigeminal neuralgia in four other family members over three generations. Familial trigeminal neuralgia has been expounded on in fewer than 30 reports in the literature. Our cases and the literature review suggest an autosomal dominant transmission. The clinical features of familial trigeminal neuralgia are described and pathophysiological implications of this genetic clustering discussed.
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Affiliation(s)
- H El Otmani
- Service de neurologie, hôpital Al Kortobi, B.P. 90000, Tanger, Morocco.
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Boulaajaj FZ, Rafai MA, El Otmani H, El Moutawakkil B, Hakim K, Fadel H, Slassi I. [Subacute myelopathy revealing systemic sarcoidosis]. Rev Neurol (Paris) 2007; 163:1049-53. [PMID: 18033043 DOI: 10.1016/s0035-3787(07)74177-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The spinal localization is rare for neurosarcoidosis (0.43 percent of cases) but can be the inaugural manifestation of the disease. We report two cases of spinal neurosarcoidosis in a 57-year-old man and a 43-year*old woman with uneventful past medical histories. Both presented progressive myelopathic features. METHODS Magnetic resonance imaging (MRI) of the spine demonstrated intramedullary lesions, dorsal in the first case, and cervical in the second case. Serum angiotensin converting enzyme was elevated. Radiographs of the chest revealed bilateral symmetric hilar mediastinal lymphadenopathy in the first patient, and bronchial biopsy demonstrated non caseating granulomas. In the second patient the diagnosis was made on pathological examination of a minor salivary gland biopsy. RESULTS The patients received corticosteroid therapy with good response in the second patient. CONCLUSION The diagnosis of intramedullary sarcoidosis is difficult without a previous diagnosis of systemic sarcoidosis or other apparent symptom(s). Extraneurologic biopsies may be suggestive. We reviewed the literature on the diagnosis and treatment of intramedullary sarcoidosis.
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Affiliation(s)
- F Z Boulaajaj
- Service de Neurologie--Explorations Fonctionnelles, CHU Ibn Rochd, Quartier des Hôpitaux, Casablanca, Maroc.
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Rafai MA, Fadel H, Boulaajaj FZ, Gam I, El Moutawakkil B, Karkouri M, Hakim K, Slassi I. Neuropathie périphérique au cours du lupus érythémateux disséminé avec vascularite épineurale et anticorps antiphospholipides. Rev Neurol (Paris) 2007; 163:103-6. [PMID: 17304181 DOI: 10.1016/s0035-3787(07)90363-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Neurological manifestations of systemic lupus erythematosus are frequent and polymorphic. Their frequency varies according to authors (24-75p.cent). Central nervous system complications predominate; peripheral features are rare, classically symmetrical polyneuropathy, multiple mononeuropathies or cranial nerve involvement. We report a case of a 48-year-old woman presenting a histologically documented sensitivo-motor polyneuropathy with severe motor involvement complicating lupus associated with antiphospholipides antibodies. Outcome was good after cyclophosphamid pulse. We discuss the frequency of peripheral involvement in systemic lupus erythematosus, pathogenic mechanisms, therapeutic possibilities and outcome of this complication.
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Affiliation(s)
- M A Rafai
- Service de Neurologie - Explorations Fonctionnelles, CHU Ibn Rochd, Casablanca, Maroc.
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Rafai MA, Fadel H, Gam I, Hakim K, El Moutawakkil B, Kissani N, Slassi I. Accidents vasculaires cérébraux révélant un syndrome catastrophique des anti-phospholipides associé à une hépatite virale C. Rev Neurol (Paris) 2006; 162:1131-4. [PMID: 17086152 DOI: 10.1016/s0035-3787(06)75128-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Very little cases of antiphospholipid syndrome (APLS) have been described among patients having chronic hepatitis C virus infection (HCV). CASE REPORT We report the observation of a 43-year-old woman who presented APLS diagnosed following recurrent strokes. Etiological investigations concluded on an association of APLS with HCV infection. DISCUSSION Besides being exceptional, this association raises certain etiopathogenic problems. Indeed while antiphospholipid antibodies (aPL) are frequently noted during chronic hepatitis C, they rarely generate thromboembolic complications.
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Affiliation(s)
- M A Rafai
- Service de Neurologie, Explorations Fonctionnelles, CHU Ibn Rochd, Quartier des Hôpitaux, Casablanca, Maroc.
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Fadel H, Ishida T, Wegner G, Guillon D, Skoulios A. Influence of Polar Endgroups on Mesomorphic Behavior of Symmetric Smectogens. ACTA ACUST UNITED AC 2006. [DOI: 10.1080/10587259408029756] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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El Ouafi N, Rafai MA, Fadel H, Gam I, Slassi I. [Bilateral idiopathic orbital myositis]. Rev Neurol (Paris) 2006; 162:750-2. [PMID: 16840985 DOI: 10.1016/s0035-3787(06)75074-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Orbital myositis is an idiopathic inflammation of the extraoccular muscles. It is often included under the broad description of orbital pseudotumor. It is commonly a unilateral affection. CASE REPORT We report one case of bilateral orbital myositis in a 45-year-old woman. The first symptoms were diplopia and acute bilateral orbital pain exacerbated by eye movements. Physical examination especially neurological was normal. Serum creatine kinase and biological thyroid function were normal. CT scan found a bilateral enlargement of rectus oculi medialis and lateralis. Clinical improvement was obtained a few days after oral corticosteroid treatment with remission of all signs. CONCLUSION Orbital myositis is a rare entity. 90-95p.cent of cases are unilateral. Bilateral forms are exceptional and in this case require search for specific etiologies particularly thyroid ophthalmopathy. There is controversy concerning treatment options but corticosteroids are still the most common first choice therapy with good outcome.
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Affiliation(s)
- N El Ouafi
- Unité de Radiologie, Hôpital Mohammed V, Tanger, Maroc
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Rafai MA, Moutaouakil F, El Otmani H, Fadel H, Boulaajaj FZ, El Moutawakil B, Gam I, Slassi I. Polyradiculonévrite chronique idiopathique de l’enfant: évolution sous bolus de méthylprednisolone. Rev Neurol (Paris) 2006; 162:753-6. [PMID: 16840986 DOI: 10.1016/s0035-3787(06)75075-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Chronic inflammatory demyelinating polyneuropathy (CIDP) in children is relatively rare and treatment is based primarily on intravenous immunoglobulins or oral corticosteroids. Boluses of methylprednisolone (MP) are a seldom used alternative. CASE REPORT We report the case of an 8-year-old child, first presented at the age of 3 years, with recurring episodes of functional impotence of both lower limbs and walking impairment, partially reversible without treatment. Clinical, progressive, and electrophysiological data and the analysis of the cerebrospinal fluid were compatible with CIDP. MP boluses were administered: after a total eight monthly boluses, very satisfactory progression on the clinical and electrophysiological fronts was noted after 24 months. CONCLUSION Childhood CIDP presents clinical, electrophysiological, progressive, and prognostic particularities, they recur readily and the outcome is good. Boluses of methylprednisolone are an alternative to the treatment of these neuropathies in childhood.
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Affiliation(s)
- M A Rafai
- Service de Neurologie - Explorations Fonctionnelles, Pavillon 30, CHU Ibn Rochd, Casablanca, Maroc.
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Rafai MA, Gam I, Fadel H, Hakim K, El Moutawakkil B, Bendahmane A, Kissani N, Alaoui R, Cherkaoui A, Slassi I. Neuropathies périphériques sans cryoglobulinémie révélatrices de l’hépatite virale C. Rev Neurol (Paris) 2006; 162:623-7. [PMID: 16710128 DOI: 10.1016/s0035-3787(06)75056-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Peripheral neuropathies are the most common neurological complication of viral hepatitis C infection with mixed cryoglobulinemia. CASES REPORT We report five cases (three men, two women) of peripheral neuropathies revealing viral hepatitis C infection without cryoglobulinemia; the patients' mean age was 56 years. Paresthesias were the most frequent symptom. Electroneuromyographic examination found one case of polyneuropathy and four cases of multiplex mononeuropathies; the complement level was normal in all patients and the rheumatoid factor positive in two cases. Etiological investigations for peripheral neuropathy remained negative. Treatment and outcome were variable. DISCUSSION Negative cryoglobulinemia in cases of VHC infection with neurological features has been described in the last few years, suggesting the possibility of other mechanisms such as direct action of the virus on the nervous system. There is no consensus on the treatment and outcome is variable. CONCLUSION Peripheral neuropathy may reveal VHC infection, underscoring the need for VHC serology testing in etiological investigations for peripheral neuropathies.
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Affiliation(s)
- M A Rafai
- Service de Neurologie - Explorations fonctionnelles, CHU ibn Rochd, quartier des hôpitaux, Casablanca, Maroc.
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Rafai MA, El Moutawakil B, Gam I, Hakim K, Fadel H, Kissani N, Slassi I. Syndrome choréo-athétosique révélant une maladie lupique associée à des anticorps antiphospholipides. Rev Neurol (Paris) 2005; 161:967-70. [PMID: 16365627 DOI: 10.1016/s0035-3787(05)85161-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Chorea is a rare manifestation of systemic lupus erythematosus (1-4 percent), commonly affecting young woman. Chorea is revealing lupic disease in 50 percent, in the other cases it occurs early in the course of the disease. OBSERVATION A 33-year-old woman was hospitalized for choreo-athetosic movements prevailing on the left leg and arm accompanied by behavioral and general state deterioration. The biological assessment consolidated the diagnosis of lupic disease associated antiphospholipides antibody (aPL). Cerebral magnetic resonance imaging (MRI) was normal except for cortical and subcortical atrophy. The patient was treated by corticosteroids (1mg/kg/day) and then was lost to follow-up. CONCLUSION We review data in the literature on the pathophysiological mechanisms of lupic chorea focusing particularly on role of aPL.
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Affiliation(s)
- M A Rafai
- Service de Neurologie et Explorations Fonctionnelles, CHU Ibn Rochd, Casablanca, Maroc.
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El Moutawakil B, Rafai M, Gam I, Fadel H, El Otmani H, Tahiri M, Smail R, Alaoui R, Cherkaoui A, Slassi I. Polyradiculonevrite aiguë à rechute révélant une maladie de Crohn : à propos d’un cas. Rev Neurol (Paris) 2004. [DOI: 10.1016/s0035-3787(04)71124-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Rafai M, El Moutawakil B, Gam I, Hakim K, Fadel H, Kissani N, Slassi I. La forme spinale de la neurofibromatose de Von Recklinghausen : à propos d’un cas. Rev Neurol (Paris) 2004. [DOI: 10.1016/s0035-3787(04)71115-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Rafai M, Fadel H, El Moutawakil B, Hakim K, Kissani N, Chebraoui M, Abdelouafi A, Hamdani M, Divry P, Saudubray J, Slassi I. Syndrome de Refsum : à propos de 8 cas. Rev Neurol (Paris) 2004. [DOI: 10.1016/s0035-3787(04)71117-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Fadel H, Percec V, Zheng Q, Duran RS, Advincula RC. Liquid crystalline poly(vinyl ether)s with bulk smectic C* phases at the air/water interface. Macromolecules 2002. [DOI: 10.1021/ma00059a024] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Fatihi E, Ramdani B, Fadel H, Hachim K, Zahiri K, Benghanem GM, Sqalli S, Zaid D. [Prevalence of subcutaneous, labial and rectal amyloid lesions in patients wi histologically confirmed renal amyloidosis]. Nephrologie 2000; 21:19-21. [PMID: 10730276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
Our work is to evaluate the biopsies rectal (RB), cutaneous and one about the accessory salivary glands (ASGB) in the diagnosis of amyloidosis renal through 20 cases of renal amyloidosis confirmed by renal biopsy in unit of nephrology and hemodialysis in UHC lbn Rochd from February 1996 to January 1998. The mean age of our patients was 39 years old (15-80) with a male predominance of (4/1). The infectious pathology has been the most frequent cause (70%) which consisted essentially in the tuberculosis and the surinfection on dilatation of the bronchi. All the patients had nephrologic symptomatology dominated by the nephrotic syndrome. The 4 biopsies were practised in the 20 patients. Wright's reaction practised in all renal biopsy confirmed the AA nature of the amyloidosis. The amyloïd deposits were noticed in 100% of renal needle biopsy, 80% of accessory gland biopsy, 75% of rectal biopsy and in 35% of cutaneous biopsy. The association of RB and ASGB was positive in 90% of the cases. If the renal biopsy gave more positivity than the other biopsies, it caused complications that were severe sometimes. Also, the biopsy of the ASG, the simple technique is very reliable in the recognition of the amylosis and seems to be the best diagnostic test for this affection.
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Affiliation(s)
- E Fatihi
- Service de néphrologie-hémodialyse du CHU IBN ROCHD, Casablanca
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Abstract
PURPOSE To assess the value of accessory salivary gland biopsy for the diagnosis of amyloidosis, a study was conducted in the nephrology and hemodialysis department at Ibn Rochd University Hospital from February 1996 to January 1998. METHODS Renal amyloidosis was confirmed by renal biopsy accompanying accessory salivary gland biopsy. RESULT The patient's mean age was 39 years old (range 15-80), with a 4:1-male/female ratio. An infectious cause (either tuberculosis or superinfection and dilatation of the bronchi) was the most frequent (70% of the cases) etiology. All the patients presented renal symptomatology. Nephrotic syndrome predominated. Amyloid deposits were observed in 100% of renal needle biopsies and in 80% of accessory salivary gland biopsies. CONCLUSION Renal biopsy led to more positive cases than the other biopsies. It may be accompanied by severe complications. Furthermore, biopsy of the accessory salivary glands is a simple and very reliable technique for the diagnosis of amyloidosis. It is currently the best diagnostic test.
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Affiliation(s)
- E Fatihi
- Service de néphrologie-hémodialyse, CHU Ibn Rochd, Casablanca, Maroc
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Benslama A, Moutaouakkil S, Mjahed K, el Moknia M, Lahbil D, Fadel H. [Intermediary syndrome in acute malathion poisoning]. Presse Med 1998; 27:713-5. [PMID: 9767909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND Acute poisoning by an organophosphorus insecticide is frequently observed in Morocco. We report a case of malathion poisoning complicated by an intermediate syndrome. CASE REPORT A 42-year-old woman was hospitalized 3 hours after ingestion of 50 g of malathion. Intubation and ventilatory assistance was required due to failing consciousness and bronchial plugging. On day 4, a neurological syndrome suggestive of the intermediary syndrome with diaphragmatic palsy made it necessary to continue ventilatory assistance to day 20. DISCUSSION The intermediary syndrome occurs 24 to 96 hours after the acute cholinergic phase of organophosphorus poisoning. It consists of an exclusive neuromuscular involvement. The intermediate syndrome is confined to an abnormality of neuromuscular function in specific muscle groups: proximal limb muscles, neck flexors, motor cranial nerves and respiratory muscles, with difficult weaning from respiratory assistance. The intermediary syndrome is quite uncommon. The risk of respiratory failure emphasizes the need for close monitoring in an intensive care setting for at least 96 hours, depending on the intensity of the cholinergic syndrome.
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Affiliation(s)
- A Benslama
- Service de Réanimation médicale, CHU Ibn Rochd, Casablanca, Maroc
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Abstract
BACKGROUND Little is known about the organization and performance of outpatient substance abuse treatment (OSAT) centers. We examine several performance measures of OSAT units, including clients treated, services provided, revenue sources, financial performance, and access to care, in relation to ownership of the center. METHODS Data were drawn from a national random sample of 575 OSAT centers (85.8% response rate) participating in a telephone survey conducted in 1988. Analysis of variance by ownership was conducted on each performance measure, with differences subjected to tests of statistical significance. RESULTS Descriptive results show that major funding sources differ by ownership. Private for-profit centers generate higher profits, charge higher prices, and achieve higher levels of financial performance than public and not-for-profit centers. Public centers provide better access to care for persons who are unable to pay. CONCLUSIONS There appear to be substantial and interrelated differences by ownership type in the financing and operation of OSAT units.
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Affiliation(s)
- J R Wheeler
- School of Public Health, University of Michigan, Ann Arbor 48109-2029
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Larison J, Fadel H, Squires J, Barnwell C. Antenatal Rh iso-immunization prophylaxis: implications for blood bank assessment. J Med Assoc Ga 1985; 74:560-1. [PMID: 2995529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Fadel H, Abd-Elbary A, Noureldin E, Kassem AA. Investigation of the discolouration developed in aged chloramphenicol suppositories. Pharmazie 1981; 36:362-5. [PMID: 7267686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The colouring matter developed in aged chloramphenicol (1) suppositories formulated with polyethylene glycol base was separated by extraction with water/n-butanol mixture, n-butanol or abs. alcohol. These extracts were tested for colour stability, the presence of the main degradation products of 1 p-nitrophenylaminopropandiol (2) and p-nitrobenzaldehyde (3), and investigated by TLC and absorption spectrum. Results showed that the extracted matter gave the tests for the main degradation products of 1. TLC of n-butanol layer of the first mixture or n-butanol extract gave 2 spots with different RF values identified as 2 and 3. In the case of abs. alcohol extract 2 spots adhering to each other were obtained. The same spots in the latter case were obtained for an equimolecular condensation product of 2 and 3 (obtained by condensation in acid medium). The absorption spectrum of the extracted matter showed high absorbance in the visible region and maxima appeared only in the UV region. The condensation product of 2 and 3 gave the same absorbance pattern and did not produce Schiff's base. The colour of the aqueous layer of the first mixture faded gradually which assured its not being due to azocompounds. These findings indicated that the discolouration may be due to complex formation. Using model systems of known chemical reactions showed that discolouration is due to complex formation between 2 and 3 between 1 and 2.
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Fadel H, Abd Elbary A, Nour El-Din E, Kassem AA. Availability of norethisterone acetate from combined oral contraceptive tablets. Pharmazie 1979; 34:49-50. [PMID: 432256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The availability of norethisterone acetate in HCl (0.1 mol/l) from combined oral contraceptive tablets in the presence of certain proprietary preparations and adsorbent drugs which are used as antacids, intestinal adsorbents and for peptic ulcer was investigated. The percent dissolution of the hormone in the presence of these drugs was greatly reduced depending mainly on the nature of the adsorbent drugs.
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