Management of mucoid cysts of the oral cavity: Cases series and review

INTRODUCTION

A mucoid cyst is a benign lesion in the oral mucosa resulting from the rupture of a salivary gland duct and the subsequent discharge of mucin into the soft tissues. Mucoceles are more common in children and young adults, and the most common site is the lower inner lips.

CASES SERIES PRESENTATION

We describe 3 clinical cases managed in service between 2022 and 2023. Clinical cases are presented in order to detail their clinical history, paraclinical and treatment.

DISCUSSION AND CONCLUSION

In general, mucoceles tend to resolve spontaneously, but can sometimes interfere with swallowing or speech. Therefore, in such cases, these lesions must be promptly diagnosed and treated. There are various methods of managing these lesions, each with its own advantages and disadvantages. Surgical technique is preferable when the lesion is persistent, recurrent or symptomatic, and remains the most effective strategy, despite the existence of other, more modern techniques that are better tolerated by patients. But in all cases, follow-up is very important, especially when the mucocele is located in a particular area, such as the ventral side of the tongue, or in a younger population.

AB1504 WILL YOU CHOOSE RHEUMATOLOGY? SURVEY ON THE ATTRACTIVENESS OF RHEUMATOLOGY AMONG MOROCCAN STUDENTS, INTERNS AND FRESHLY GRADUATED DOCTORS

Background

In several countries, studies have shown that fewer medical students choose rheumatology as specialty. In Morocco no study has yet focused on this subject.

Objectives

The aim of our study is to assess the attractiveness of rheumatology as a specialty among Moroccan medical students, recently graduates and interns, and to analyze the factors that may be associated with it.

Methods

An online survey was sent to 297 medical students who had started their hospital practice, to 100 medical interns (students in 6th and 7th year who successfully passed the internship competition) and to 280 freshly graduated doctors (residency program candidates before choosing a medical or surgical specialty). The survey covered three areas: anonymous social and demographic informations, data on clinical trainee in a rheumatology department, and the attitude toward rheumatology as a specialty. Descriptive data were collected and Chi 2 Tests were used to assess differences between groups, Logistic regression was performed to investigate associations between demographic and exposure variables and the choice of rheumatology as a career.

Results

We collected responses from 161 students (response rate: 54%), 68 interns (68%) and 89 freshly graduated doctors (32%). The demographic characteristics are presented in Table 1.

Table 1.Medical students (N=161)Interns (N=68)Freshly graduated doctors (N=89)Age*21.5 ±124.2 ±1.128.62.3Gender (females) (%)+93 (57.8)30 (44.1)64 (71.9)level (%)+Third year: 44 (27.3)First year: 44 (64.7)-Fourth year: 53 (32.9)Second year: 24Fifth year:64 (39.8)(35.3)Training in a rheumatology departement (%)+118 (73.3)28 (41.2)37 (41.6)Dduration of training (weeks)*3.4 ± 0.75.3 ±1.46.3 ±2.6

(*) expressed as a number and percentage /(+) expressed as a mean and standard deviation

73% of students, 41.2% of interns and 41.6% of graduates said they had already completed a clinical trainee in a rheumatology department. While 41.6% of students and 43.8% of graduates consider the possibility of choosing rheumatology as their specialty, only 11.2% of students, 5.9% of interns and 7.9% of graduates said that rheumatology is their dream career specialty. In uni and multivariate analysis, clinical exposure to rheumatology is retained as the main statistically significant factor predicting the choice of rheumatology in all categories (Odds ratio (95% CI) = 0.191 (0.07- 0.497; p= 0.02)), to this is added the female sex among freshly graduated doctors (Odds ratio (95% CI) = 4.02 (1.251- 12.918; p= 0.001).

Conclusion

Our study showed that rheumatology is considered a fascinating specialty by Moroccan medical students and freshly graduated doctors. Clinical exposure to rheumatology is the strongest predictor factor for choosing rheumatology as a future career.

Disclosure of Interests

None declared

AB1376 RELATIONSHIP BETWEEN INTRANEURAL HYPERVASCULARIZATION OF THE MEDIAN NERVE IN POWER DOPPLER AND ELECTROMYOGRAPHIC SEVERITY STAGES IN THE DIAGNOSIS OF SEVERITY OF CARPAL TUNNEL SYNDROME (PRELIMINARY RESULTS)

Background

Carpal tunnel syndrome (CTS) is the most common tunnel syndrome in the upper limbs. Ultrasound has been increasingly used in recent years in the diagnosis of positive and severe CTS. Although the diagnosis of severity is essentially based on the ENMG, several studies have shown that ultrasound data can also constitute criteria for the severity of CTS.

Objectives

The objective of our study is to evaluate the relationship between intraneural hypervascularization of the median nerve in power Doppler and the severity of CTS measured by ENMG.

Methods

This is a descriptive cross-sectional study of patients with clinically retained CTS. We excluded from the study operated patients and patients who received cortisone infiltration in the previous six months. All patients underwent ultrasound examination (B mode and Doppler mode) and electromyography one week apart. The severity stages of CTS have been defined according to the classification of Stevens (1997). The study is still ongoing.

Results

To date we have included 14 patients with typical signs of CTS. 25 wrists were examined sonographically and by ENMG. The mean age of the patients was 54± 10 years. Bilateral SCC was present in 11 patients. Of the 25 affected wrists: 10, 7 and 8 were classified by the ENMG as mild, moderate and severe SCC respectively. On ultrasound, positive Doppler was found in 5 wrists (20% of wrists studied): Doppler was present in 10% of wrists with mild-stage SCC, 14.3% of wrists with moderate-stage SCC and in 37.5% of wrists with severe SCC. But this difference was not statistically significant (p=0.31) probably related to the small size of our current sample (study still ongoing).

Conclusion

The preliminary results of our study suggest that intraneural hypervascularization of the median nerve in power Doppler could provide additional information on the severity of carpal tunnel syndrome. Results to be confirmed by the final results.

References

[1]Ghasemi-Esfe et All. Color and power Doppler US for diagnosing carpal tunnel syndrome and determining its severity. Radiology 2011

[2]Mohammadi A et All. Correlation between the severity of carpal tunnel syndrome and color Doppler sonography findings. AJR Am J Roentgenol 2012

[3]Ghasemi-Esfe AR, Morteza A, Khalilzadeh O, Mazloumi M, GhasemiEsfe M, Rahmani M. Color Doppler ultrasound for evaluation of vasomotor activity in patients with carpal tunnel syndrome. Skeletal Radiol 2012; 41: 281-6

Disclosure of Interests

None declared

AB1577-PARE DO MOROCCAN PATIENTS DISCUSS WITH THEIR RHEUMATOLOGISTS ABOUT DIET AS PART OF THE MANAGEMENT OF THEIR OSTEOARTHRITIS?

Background

The question of diet is frequently asked by patients with osteoarthritis. Beyond the effect of weight on the worsening of their symptoms, patients often ask whether certain foods, labelled as inflammatory or anti-inflammatory, can improve or worsen their disease.

Objectives

The aim of our study is to find out whether patients with osteoarthritis discuss diet during their medical visits and to investigate the association between patients’s reported dietary beliefs and practices and their willingness to discuss them.

Methods

This is a survey based on a questionnaire that included all patients followed for osteoarthritis who presented to the rheumatology department. The questionnaire consists of 3 parts:

1) Socio-demographic data, co-morbidities, and information on osteoarthritis (location, duration of evolution, functional impact and treatments),

2) Patients’s beliefs and attitudes about diet in relation to osteoarthritis

3) Discussions about diet during medical visits and whether there is any patient interest in such discussions.

Results

At that time we included 120 patients. The average age was 57.1 ± 11.8, 88.3% of the patients were women, 41.2% had comorbidities, 62.5% were illiterate. The median duration of evolution of osteoarthritis was 4 years [2; 7]. 64.2% of the patients were followed for Gonarthrosis, 25% for Discarthrosis and 10.8% for Digital osteoarthritis. The average BMI was 27.8 ± 5.2. 8.3% of the patients thought that diet influenced their osteoarthritis. 9.5% of the subjects stated that food had an effect on their symptoms, with 9.2% reporting an improvement and 8.3% an aggravation. 6.7% of patients reported food avoidance behaviours, while 10.8% adopted certain diets in order to relieve joint symptoms.

Only 2.5% of the patients reported having ever had discussions about diet with their rheumatologists while 99.2% showed interest in such discussions. For those who had never done so, the main reason was that the rheumatologist had never broached the subject.

In uni and multi-variate analysis, the experience of a food that improves symptoms (OR: 13; 95% CI [1,258-134,333]; p=0.019) and the adoption of dietary practices (OR: 13; 95% CI [1,258-134,333]; p=0.019) were associated with discussing diet.

Conclusion

Discussions about diet are reported by a minority of osteoarthritis patients and seem to be mainly related to patients’s experiences with certain foods that improve their symptomatology and also to patients’ adoption of certain diets. This situation needs to be improved as nutritional advice should be an integral part of the management of our patients.

Disclosure of Interests

None declared