Mois : janvier 2026

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DOI: 10.48087/BJMS.2026.130206

Authors: Kamel REMITA, Atef DARWISH

Affiliations: Al Emadi hospital, Doha, Qatar

Keywords: Endometriosis, Musculoskeletal Pain, Diagnostic Delay, Extrapelvic Endometriosis, Catamenial Pain, Multidisciplinary Care.

Abstract

Classically defined as a chronic, recurrent gynaecological disease characterized by progressive pelvic pain, infertility, and/or abnormal uterine bleeding, endometriosis is increasingly recognized for its systemic manifestations. Emerging evidence links the disease to broad inflammatory and neurobiological processes that may account for symptoms extending beyond the pelvis. Not uncommonly, endometriosis may present solely with musculoskeletal (MSK) manifestations, such as diverse pain patterns, muscle weakness, numbness, gait disturbance, or knee weakness, closely mimicking primary orthopaedic or rheumatological disorders. Pain in endometriosis arises through multiple interconnected mechanisms, including direct lesion infiltration, persistent inflammation, peripheral neuromuscular involvement, and central sensitization. Consequently, its clinical spectrum is broad, encompassing nociceptive MSK pain, neuropathic or radicular symptoms, joint-related pain, mass-forming lesions, and widespread nociplastic pain, often with a characteristic cyclical (catamenial) pattern. This represents a significant clinical gap, as affected patients frequently first seek care in non-gynaecological settings such as orthopaedic or rheumatology clinics. Diagnostic delays are common, averaging 5–10 years, during which patients are often managed symptomatically while the underlying aetiology remains unrecognized. The objective of this narrative review is to raise awareness among clinicians and synthesize evidence-based guidance for diagnosing and managing endometriosis-related MSK manifestations. We propose a stepwise diagnostic approach emphasizing careful history-taking for cyclical symptoms, focused physical examination, judicious use of imaging, and early gynaecological consultation. Management should be multimodal and integrated, combining hormonal therapies, surgical excision for refractory lesions, targeted rehabilitation, and pain neuroscience-informed strategies. Ultimately, optimizing outcomes requires MSK clinicians to serve as sentinels, recognizing red-flag presentations and initiating timely multidisciplinary co-management.

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DOI: 10.48087/BJMS.2026.130205

Authors: Nouara BENKACIMI¹, Saliha LAHFAYA¹, Farida AIT MESSAOUD², Fatima TAOURIRI³, Sabiha BELHAOUA³, Amina MAADADI⁴, Abdelkader HASROUF⁴,  Mourad KASTALI¹

Affiliations: 1-Université Blida 1, Faculté de médecine de Blida et Service de Néphrologie , Etablissement Hospitalier Spécialisé en Transplantation d’Organes et de Tissus de Blida, Algérie. 2- Centre  de dialyse LILIA (Blida), Algérie. 3- Centre de dialyse DIAM (Mouzaia), Algérie. 4- Centre de dialyse MITIDIAL(Boufarik), Algérie.

Keywords: Calcium, Phosphate, PTH, Vitamin D, Hemodialysis.

Abstract

Introduction: Mineral and bone disorders related to chronic kidney disease (CKD-MBD) are a major complication in patients on chronic hemodialysis. Their clinical consequences and prognostic impact require regular assessment and close monitoring. The aim of this study was to evaluate adherence to the 2017 KDIGO therapeutic targets in our patients and to describe the main associated factors. Materials and Methods: This was a cross-sectional, descriptive, multicenter study including 218 patients aged 18 years and older who had been on chronic hemodialysis for at least 3 months. We determined the proportion of patients achieving the 2017 KDIGO targets for three biochemical parameters (calcium, phosphate, and PTH), both individually and in combination, and examined factors associated with phosphocalcic control. Results: The mean age of patients was 54.5 ± 14.8 years, with a median hemodialysis duration of 6 years. Individual adherence to KDIGO recommendations was 69.3% for calcium, 54.1% for phosphate, 40.8% for PTH, and 23.4% for vitamin D. Combined parameter analysis showed adherence of 38.5% for the calcium–phosphate pair, while only 13.8% of patients simultaneously met the targets for calcium, phosphate, and PTH. A higher Kt/V was significantly associated with better control of phosphate, PTH, and combined targets. Additionally, higher serum magnesium levels favored achieving calcium targets. Native vitamin D supplementation increased the likelihood of reaching adequate 25(OH)D₃ levels, whereas the use of active vitamin D was associated with lower adherence to calcium and phosphate targets. Conclusion: This cross-sectional study highlights low adherence to KDIGO recommendations (13.8%) and identifies associations between key phosphocalcic parameters (calcium, phosphate, and PTH) and dialysis- and treatment-related factors. Longitudinal studies are needed to further explore these findings.

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DOI: 10.48087/BJMS.2026.130204

Authors: Louiza IAICHE ACHOUR¹,Lydia BOUKARMA², Sihem MAMMERI³, Zakaria SEOUDI¹, Razika IBAGHRACHE¹, Abdelkrim ANOU¹

Affiliations: 1- Department of General, Oncologic & Emergency Surgery .Douera University Hospital, Faculty of medecine Blida 1University, Algeria. 2- Department of General Surgery.Ksar El Boukhari, Medea. Algeria. 3- Department of cytology & embryology , M’hamed  Yazid hospital .Faculty of medecine Blida 1University, Algeria.

Keywords: cystic mass, lymphatic malformation, retroperitoneal lymphangioma, surgical resection.

Abstract

Retroperitoneal lymphangiomas are rare benign cystic tumors of the lymphatic system, accounting for 1% of all lymphangiomas. To date, fewer than 200 cases have been reported in the literature. Approximately 95% of lymphangiomas occur in the head, neck, and axilla, where they are most frequently encountered. Cystic lymphangiomas present with polymorphic clinical manifestations. While imaging plays a key role in diagnosis, it cannot reliably differentiate retroperitoneal lymphangiomas from other retroperitoneal cystic masses, and histological confirmation is therefore required. Complete surgical excision remains the treatment of choice. We present the case of a 45-year-old male with a symptomatic retroperitoneal cystic mass who presented with abdominal pain and a palpable abdominal mass. The patient was successfully treated with complete surgical excision. The final diagnosis was confirmed on pathological examination, and no recurrence or complications were noted during follow-up.

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DOI: 10.48087/BJMS.2026.130203

Authors: Redha LAKEHAL, Radouane BOUKARROUCHA

Affiliations: Faculté de médecine Constantine 03, lakehal.redha@gmail.com, ALGÉRIE.

Keywords: Papillary fibroelastoma, Cardiac tumor, Systemic embolism, Echocardiography, Cardiac surgery.

Abstract

Cardiac papillary fibroelastomas are rare benign tumors that usually involve the heart valves. They are often asymptomatic; however, they can cause serious complications when associated with clinical events such as systemic embolism. Diagnosis is suggested by echocardiography and confirmed by histopathological examination. The only curative treatment is surgical excision of the tumor under cardiopulmonary bypass. This approach is safe and prevents the risk of recurrent embolism. We report the case of a patient presenting with anginal chest pain. Transthoracic and transesophageal echocardiography revealed a mitral valve tumor. Pathological examination of the surgical specimen confirmed the diagnosis of fibroelastoma. Simple excision of the tumor prevented further embolic events.

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DOI: 10.48087/BJMS.2025.130202

Authors: Nadir BENABDERRAHMANE¹, Mohamed Lyes DJAMA¹, Hayet BACHA¹, Yasmine BAGHDALI², Hind ARZOUR², Hayat KHALFAT³, Charaf Amir ZINE³, Malika BOUCELMA¹

Affiliations: 1- Internal medicine department, Bachir Mentouri Hospital, Algiers, Algeria. 2- Nephrology department, Mustapha Bacha Hospital, Algiers, Algeria. 3- Anatomopathology departement, Mustapha Bacha Hospital, Algiers, Algeria.

Keywords: Polyarteritis nodosa, Hepatitis B, Vasculitis, Plasmapheresis, Antiviral therapy.

Abstract

Polyarteritis nodosa (PAN) is a necrotizing vasculitis affecting medium and small arteries. Its secondary form linked to hepatitis B virus (HBV-PAN) has become rare. This report describes a 49-year-old Algerian woman with HBV-PAN presenting with prolonged fever. She exhibited fever, fatigue, leg edema, rash, elevated inflammatory markers, mild proteinuria, and elevated liver enzymes. Workup revealed acute hepatitis B infection. During admission, she developed sensorimotor polyneuropathy, diffuse abdominal pain, myocarditis with heart failure, and severe hypertension. Renal biopsy confirmed PAN with fibrinoid necrosis of small vessels, fulfilling the ACR 1990 criteria. Treatment included tenofovir, nine plasma exchange sessions, corticosteroid pulses followed by oral prednisone, and rehabilitation. The clinical course improved significantly, with resolution of pain, recovery of neurological function, and stabilization of cardiac and renal function. However, at six-month follow-up, hepatitis B remained chronic, posing an ongoing relapse risk. HBV-associated PAN is now rare but remains a severe condition. It should be suspected in patients presenting with systemic vasculitic symptoms and positive HBV serology. Combined therapy with antivirals, corticosteroids, and plasmapheresis can lead to favorable outcomes.

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DOI: 10.48087/BJMS.2026.130201

Authors: Sarah BOUAMEUR¹, Meriem DADOUCH², Yamina SEFFIH², Amani MEDJAHED²

Affiliations: 1- Département de pharmacie, Faculté de Médecine, Université Oran1. Oran. 2- Département de pharmacie, Faculté de Médecine, Université Djillali Liabes, Sidi Bel-Abbès – Algérie

Keywords: antidiarrheal, citric acid, extemporaneous preparation, loperamide, syrup, tincture.

Abstract

Loperamide hydrochloride is the most commonly indicated molecule for the symptomatic treatment of acute and chronic diarrhea. However, its presentation in solid forms (tablets and capsules) limits its use in children and patients with dysphagia, while the oral solution remains unavailable due to supply shortages and discontinuation of marketing. In response to this situation, a 0.02% loperamide hydrochloride extemporaneous syrup was developed as an alternative to existing formulations. Materials and Methods. Four syrups containing 0.02% loperamide hydrochloride were formulated. Different solubilization media for the active ingredient were investigated: 2% citric acid solution, lemon tincture, distilled water, and glycerol. The simple syrup used as a vehicle was prepared by cold method with sucrose at a concentration of 65% ± 1%. The formulations underwent quality control testing for macroscopic appearance, pH, density, viscosity, and assay content over a 20-day storage period at room temperature and protected from light. Results and Discussion.  Under experimental conditions, the density of the syrups and their loperamide hydrochloride content remained within acceptable limits for 14 days. The pH and macroscopic appearance showed notable changes, with the exception of the syrup containing 2% citric acid solution, which demonstrated relatively satisfactory stability. Conclusion. The formulation of 0.02% loperamide hydrochloride in syrup form is an innovative approach aimed at meeting the specific needs of patients with dysphagia and the pediatric population. The stability of this extemporaneous preparation is adequate for the duration of treatment of an acute episode of non-infectious diarrhea.