A 13-year-old boy with Sandifer's syndrome whose only symptoms were abnormal posture and movements of the head and neck, underwent a repair of a hiatus hernia. The disappearance of all symptoms following the operation could be explained by the common innervation of the diaphragm and the neck.

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Telemedicine is defined by the practice of medicine at a distance using means of information and communications technology. Given the importance of clinical examination, cardiology is not very well suitedto telemedicine. However, just like inall medical specialties, telemedicine facilitates and supplements clinical medicine. The Diagnosis Center of Cardiology in Rabat welcomes patients from different regions of Morocco. The longdistance travel, difficulty of access to care in rural Morocco, transportation problems, and delayed appointments all make follow-up of patients a very difficult task, therefore, many patients miss their consultation appointments. To avoid this problem, we followed our patients by social messaging platforms, thenjudged the effectiveness of this methoda year later. Materials and Methods:-This is a prospective, comparative analytic study of 200 patients underoral anticoagulant therapy based on vitamin K antagonists (VKA), followed in cardiology consultation, all of whom come from rural areas where access to care is difficult.