Mois : mars 2026

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DOI: 10.48087/BJMS.2026.130321

Authors: Dalila REMACHE¹, Sana CHABOU², Salim MAKHLOUFI¹

Affiliations: 1-Department of surgery A, University Hospital of Constantine, University of Constantine3, Algeria. 2- Department of Anesthesiology and Intensive Care, EHS Sidi Mabrouk, University of  Constantine3, Algeria.

Abstract

Introduction: Intestinal perforations caused by fish bones are an uncommon but recognized cause of digestive tract perforation, often presenting with variable clinical features. Abdominopelvic computed tomography (CT) remains the cornerstone for diagnosis. Case report: We describe the case of a 60-year-old woman admitted with diffuse abdominal pain initially localized to the right iliac fossa, accompanied by vomiting. Plain abdominal radiography revealed pneumoperitoneum, confirmed by CT scan, which demonstrated diffuse, multi-compartmental pneumoperitoneum without intraperitoneal fluid or clinical signs of peritonitis. CT also identified two foreign bodies within the ileum. The surgical procedure consisted of extraction of the fish bones and closure of the perforations. Conclusion:  This case highlights an atypical presentation characterized by the coexistence of two fish bones and two ileal perforations, along with diffuse pneumoperitoneum in the absence of clinical peritonitis. It underscores the pivotal role of CT imaging in rapidly identifying unusual scenarios.

Keywords: fish bone, foreign body, perforation, ileum.

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DOI: 10.48087/BJMS.2026.130320

Authors: Asma MOUS¹,Lotfi TALEB¹, Abdelbaki BOUKERCHE²

Affiliations: 1- Faculté de Médecine Dr Benaouda Benzerdjeb, Université Abou Bekr Belkaid de Tlemcen ; Service de Radiothérapie, EHS.CAC Ahmed Ben Bella, Tlemcen – Algérie. 2- Faculté de Médecine, Université d’Oran 1 ; Service de Radiothérapie, EHS en oncologie Emir Abdelkader d’Oran – Algérie.

Abstract

The association of glioblastoma and cerebral sarcoma constitutes an exceptionally rare and complex clinicopathological entity, first described by Stroebe in 1895. We present the case of a 30-year-old woman with a personal history of neurofibromatosis type 1 who was diagnosed with a mixed brain tumor. The diagnosis of glioblastoma associated with sarcoma was confirmed by histopathological and immunohistochemical examination. Therapeutic management consisted of two neurosurgical resections one month apart, followed by concomitant chemoradiotherapy and subsequently adjuvant chemotherapy.

Keywords: glioblastoma, sarcoma, central nervous system, radiotherapy, chemotherapy.

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DOI: 10.48087/BJMS.2026.130319

Authors: Abdourahaman ABOUBACAR NAHANTCHI¹, Djibrilla BEN ADJI^1,2, Mamane MAIKASSOUA^2,4, Babana ADAMOU⁴, Ousmane ISSOUFOU HAMA⁴

Affiliations: 1- Service de Neurologie de  l’Hôpital de Référence de Maradi – Niger. 2- Université Dan Dicko Dankoulodo de Maradi – Niger. 3- Services d’Anesthésie et Réanimation de  l’Hôpital de Référence de Maradi – Niger. 4- Service de  Neurochirurgie de l’Hôpital de Référence de Maradi – Niger.

Abstract

Cerebral venous thrombosis (CVT) is a neurological emergency. In young women, CVT occurs more frequently postpartum than during pregnancy. The clinical manifestations are polymorphic, characterized by neurological or psychiatric signs. The presence of cerebral hemorrhage on imaging in CVT poses a diagnostic challenge. We report the case of a 20-year-old Nigerien woman who was admitted to the neurology department of Maradi Referral Hospital for bilateral hemorrhagic suffusion in the parafalcine region of the brain, revealing cerebral venous thrombosis. The patient received treatment with low-molecular-weight heparin (enoxaparin) at an anticoagulant dose for 10 days, followed by acenocoumarol and triple antibiotic therapy with metronidazole, gentamicin, and ceftriaxone, as well as motor rehabilitation. At three-month follow-up, the clinical outcome was characterized by recovery of muscle strength in the upper limbs and partial recovery in the lower limbs, with the ability to walk without assistance, and complete resolution of aphasia.

Keywords: Hemorrhagic cerebral, venous thrombosis, Postpartum.

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DOI: 10.48087/BJMS.2026.130318

Authors: Ali AIT-MOHAND

Affiliations: Faculté de médecine – Université Mouloud Mammeri de Tizi-Ouzou – Algérie

Abstract

Medical certification of causes of death is a core component of health information systems and a key tool for health planning, epidemiological surveillance, and the evaluation of public health policies. In Algeria, although administrative death registration has achieved high coverage, the production and use of medical cause-of-death data remain incomplete and heterogeneous across wilayas. The regulatory reform introduced by Executive Decree No. 22-78 of April 28, 2022, which established a medical death certificate aligned with World Health Organization standards, represents a major regulatory advancement. However, its impact remains contingent on the consolidation of existing institutional arrangements and is constrained by the absence of a structured and sustainable national mortality registry. This review analyzes the organization of medical certification of causes of death in Algeria, describes recent developments, and discusses persistent system limitations in light of international experiences, particularly in low- and middle-income countries. It critically examines prospects for digitalization of the medical death certificate and highlights key conditions required for the effective institutionalization of a national mortality registry, which is essential for improving health governance and ensuring international comparability of mortality data.

Keywords: mortality, causes of death, medical death certificate, mortality registry, Algeria.

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DOI: 10.48087/BJMS.2026.130317

Authors: Amine RAHOU, Saliha BOUKHEMACHA, Najib TALEB, Malika BACHAOUI

Affiliations: Faculté de Médecine de l’Université Oran 1 Ahmed Ben Bella. Service de Médecine Interne, EHU 1er Novembre 1954, Oran, Algérie.

Abstract

Melkersson–Rosenthal syndrome (MRS) is a rare orofacial granulomatosis that primarily affects young adults, with an estimated incidence of less than 0.1% and a slight female predominance. The diagnosis relies on a characteristic clinical triad: recurrent orofacial swelling, fissured tongue, and recurrent peripheral facial palsy; however, this complete triad is observed in only 8 to 25% of cases. Labial biopsy may reveal non-caseating epithelioid granulomas, which are essential for excluding other granulomatous conditions. We report two cases of young women presenting with the complete MRS triad. Both cases were characterized by recurrent lip swelling and successive episodes of facial palsy, resulting in significant functional and aesthetic impairment. Biopsy, imaging, and immunological workup excluded alternative diagnoses. Initial systemic corticosteroid therapy proved ineffective in both patients, necessitating the introduction of methotrexate, which led to notable clinical improvement. The etiopathogenesis of MRS remains poorly understood, with genetic, environmental, and immunological factors potentially implicated. Diagnosis is frequently delayed, particularly in monosymptomatic presentations. Treatment is primarily based on corticosteroid therapy, whereas immunosuppressants and reconstructive surgery are reserved for severe or disfiguring forms. Given the considerable aesthetic and psychosocial burden of the disease, a multidisciplinary approach — including psychological support — is warranted.

Keywords: Melkersson–Rosenthal syndrome, peripheral facial paralysis, fissured tongue, orofacial swelling, non-caseating granuloma.

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DOI: 10.48087/BJMS.2026.130316

Authors: Hichem El Azhari BENMAMAR¹, Mustapha BOUMENDJEL², Youcef KHENCHOUL³, Dalal ZERROUK⁴

Affiliations: 1- Radiologie et imagerie médicale. Centre Hospitalier et Universitaire de Constantine ; Algérie 2- Service de gastro-entérologie, Centre Hospitalier et Universitaire  de Constantine – Algérie.  3- Service de chirurgie générale A, Centre Hospitalier et Universitaire  de Constantine -Algérie.  4- Service d’oncologie médicale, Centre Hospitalier et Universitaire  de Constantine – Algérie.

Abstract

Hepatocellular carcinoma (HCC) is the most common primary liver cancer and is often associated with a poor prognosis due to its biological and clinical heterogeneity. Imaging plays a central role in diagnosis and can also provide valuable prognostic information. This article aims to summarize the main prognostic and predictive imaging biomarkers of HCC and to discuss their clinical relevance. Tumor features associated with poor prognosis include large tumor size, necrosis, irregular margins, satellite nodules, and bile duct invasion, whereas small tumor size, the presence of intratumoral fat, and T1 hyperintensity on MRI are correlated with favorable outcomes. Identification of these factors helps anticipate the risk of recurrence and guide patient follow-up and treatment strategies. Thus, imaging provides valuable prognostic and predictive biomarkers in HCC, contributing to improved patient stratification and more personalized management. Artificial intelligence and radiomics additionally offer promising perspectives for further refining prognostic and predictive assessments in the future.

Keywords: Hepatocellular carcinoma, Prognostic imaging,  LI-RADS,  Imaging biomarkers,  MRI and CT,  Tumor aggressiveness, Microvascular invasion, Diffusion-weighted imaging (ADC), Radiomics, Artificial intelligence.

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DOI: 10.48087/BJMS.2026.130315

Authors: Nora RIGHI¹, Loubna RAHMOUNE¹, Mélissa DOUMANDJI¹, Rihab FELLAH¹, Yahia Abdelmoumen MEKKI², Daniel FLORET³, Bruno LINA²

Affiliations: 1- Faculty of Medicine, Batna, Algeria. 2- Virology Laboratory, Croix-Rousse Hospital, Claude Bernard University Lyon 1, France. 3- Claude Bernard University Lyon 1, France.

Abstract

Acute encephalitis in children most often occurs in the context of a systemic infection; however, in some cases, neurological involvement may be the sole manifestation. Infectious encephalitis is more frequent in young children and may be associated with meningeal involvement (meningoencephalitis) or spinal cord involvement (encephalomyelitis). Herpes simplex virus (HSV) is the most common cause of encephalitis in children older than six months, and polymerase chain reaction (PCR) constitutes the cornerstone of diagnosis. Objectives: To describe the specific features and frequency of encephalitis and meningoencephalitis in children. Methods: From April 1, 2012 to August 31, 2015, a prospective, longitudinal, and exhaustive study was conducted, including patients older than 28 days presenting with clinical features suggestive of encephalitis and meeting the inclusion and exclusion criteria defined by the French Infectious Diseases Society (SPILF). Patients were recruited from three hospital departments (intensive care, infectious diseases, and pediatrics). HIV-positive patients were excluded. Results: Among 141 cases, 38 were children (27%). The median age was 5 years (range: 1–9), with a male predominance (22/38; M/F ratio: 1.37). Comorbidities were present in 4 cases (10.5%). Onset was abrupt in 81.6% of cases. Severe presentations were observed, with a Glasgow Coma Scale score below 8 in 18.4% of patients. Seizures and status epilepticus occurred in 73.7% and 36.8% of cases, respectively. Focal neurological deficits were observed in 57.8% and behavioral disturbances in 34.2%. Respiratory involvement was noted in 36.8%. Cerebrospinal fluid pleocytosis was found in 83.8%, elevated protein levels in 51.4%, and hypoglycorrhachia in 32.4%. Neuroimaging was abnormal in 60.5% of cases, and electroencephalography was abnormal in 23.7%. An etiological diagnosis was established in 28 of 38 children (73.7%), including 14 monomicrobial infections (36.8%) and 14 coinfections (36.8%). Viral etiologies predominated: 34 children (89.5%) had at least one confirmed or probable viral cause (coronavirus, EBV, adenovirus, CMV, influenza virus, VZV, enterovirus, HSV, rubella virus, rhinovirus, HHV-6, and parvovirus B19). Nine children (23.7%) had at least one confirmed or probable bacterial etiology. Mortality was 23.7%. Conclusion: This study highlights the etiological spectrum of encephalitis and meningoencephalitis in children, along with their clinical and paraclinical characteristics, in eastern Algeria (Batna).

Keywords: post-infectious encephalitis, primary encephalitis, PCR.

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DOI: 10.48087/BJMS.2026.130314

Authors: Nora RIGHI¹, Meriem DEBBABI¹, Rihab FELLAH¹, Mélissa DOUMANDJI¹, Yahia Abdelmoumen MEKKI², Bruno LINA²

Affiliations: 1- Faculty of Medicine, Batna, Algeria. 2-Virology Laboratory, Croix-Rousse Hospital, Claude Bernard University Lyon 1, France.

Abstract

Over the past three decades, a clear neuroinvasive and neurotropic potential has been demonstrated for human coronaviruses (HCoVs), involving both primary and secondary central nervous system (CNS) involvement. The classical coronaviruses (229E, OC43, and NL63) are primarily responsible for upper and lower respiratory tract infections but have also been implicated in gastrointestinal and neurological diseases. Objective: To demonstrate the involvement of coronaviruses in encephalitis and meningoencephalitis prior to the SARS-CoV-2 pandemic, and to compare these findings with the neurological manifestations observed during COVID-19. Materials and Methods: To determine the etiological spectrum of encephalitis in Batna, Algeria, we conducted a prospective study using a broad diagnostic approach from April 2012 to August 2015. We adopted a case definition consistent with those used in previous studies, encompassing acute cerebral dysfunction with signs of inflammation, as well as cases presenting with meningeal inflammation and an associated encephalitic component (meningo-encephalitis). Patients were recruited from three departments — intensive care, infectious diseases, and pediatrics — and data were collected using a standardized case report form. The study aimed to identify etiological agents through a standardized diagnostic procedure and to describe the epidemiological, clinical, and biological characteristics, as well as outcomes associated with the different causes. Results: Using a comprehensive diagnostic approach, over 30 pathogens were tested in blood and cerebrospinal fluid (CSF). Among the 141 patients with acute infectious encephalitis, a viral etiology was established in 73 (51.8%), including 18 cases involving coronaviruses, of whom 4 had no coinfection. The median age was 20 years (range: 0–45), with immunosuppression present in 16.7% of cases. Sudden onset was observed in 38.9% of patients, neck stiffness in 38.9%, and a Glasgow Coma Scale score below 8 in 22.2%. Respiratory and hepatic involvement were each observed in 27.8% of patients. Pleocytosis was noted in 77.8% of cases, with hyperalbuminorachia in 55.6%. Respiratory viral coinfection was detected in 11.1%. The median duration of hospitalization was 19.5 days (range: 1–874), with a mortality rate of 5.6%. Conclusion: The neurological involvement of coronaviruses remains to be fully elucidated. Nonetheless, coronaviriform particles have been observed in brain tissue sections, and coronaviruses have been isolated from patients with multiple sclerosis (MS). Moreover, anti-coronavirus antibodies have frequently been detected at high titers in the CSF of MS patients.

Keywords: Encephalitis, Meningoencephalitis, Respiratory Involvement, Coinfections.

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DOI: 10.48087/BJMS.2026.130313

Authors: Sabrina HAID, Sihem KOURTAA, Naouel KHALDOUN, Imen MEGATELI, Aicha LADJOUZE-REZIG, Fella HANNI

Affiliations: Department of Rheumatology. EHS Ben Aknoun, Algiers, Algeria.

Abstract

Background: Spondyloarthritis (SpA) comprises a group of chronic inflammatory rheumatic diseases affecting the axial skeleton and/or peripheral joints, and frequently associated with extra-articular manifestations that contribute substantially to disease burden and reduced quality of life. Acute anterior uveitis (AAU) represents the most common extra-articular manifestation and may adversely affect long-term visual prognosis. This study aimed to determine the prevalence of uveitis and to identify factors associated with its occurrence in patients with SpA. Methods: In this prospective observational cohort study, 1,285 patients with SpA fulfilling the ASAS classification criteria and followed in routine rheumatology practice were included. Data regarding history of uveitis, demographic and clinical characteristics, disease activity, structural damage, and treatments were collected. Factors associated with uveitis were assessed using univariate and multivariate logistic regression analyses. Results: Uveitis was reported in 206 patients (16%). The mean age at uveitis onset was 28 ± 10 years. Uveitis was symptomatic in 98% of cases, unilateral in 65.5%, and represented the inaugural manifestation in 32.6% of patients. A recurrent course was observed in 93.7% of cases, while complications occurred in 5.8%, including synechiae, papillary edema, glaucoma, and severe visual impairment. Patients with uveitis were older at diagnosis (42 vs. 37 years) and had longer disease duration (15 vs. 12 years). Axial involvement, inflammatory back pain, and heel enthesitis were more frequent in this group. In multivariate analysis, independent factors associated with uveitis included axial SpA (OR 1.50; 95% CI 1.10–2.00; p = 0.01), inflammatory back pain (OR 2.00; 95% CI 1.30–3.10; p = 0.002), heel enthesitis (OR 1.30; 95% CI 1.17–2.10; p = 0.003), older age at diagnosis (OR 1.03 per year; 95% CI 1.01–1.04; p = 0.001), and longer disease duration (OR 1.04 per year; 95% CI 1.02–1.05; p = 0.001). Juvenile onset, peripheral or polyarticular involvement, anterior chest wall pain, HLA-B27 positivity, structural damage, and comorbidities were not significantly associated with uveitis. Conclusion: Uveitis affects approximately 16% of patients with SpA and is characterized by a highly recurrent course with potential sight-threatening complications. Older age at diagnosis, longer disease duration, axial involvement, inflammatory back pain, and heel enthesitis were identified as independent predictors. Early recognition and close collaboration between rheumatologists and ophthalmologists are essential to preserve long-term visual outcomes in patients with SpA.

Keywords: HLA-B27; anterior uveitis; acute anterior uveitis; ankylosing spondylitis – associated uveitis; HLA-B27 – associated uveitis, peripheral spondyloarthritis, spondyloarthritis, uveitis.

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DOI: 10.48087/BJMS.2026.130312

Authors: Hasna SEHAB¹, Zahira BOUDIAF², Djamila BELAMRI¹

Affiliations: 1- Service de pédiatrie, clinique Sainte-Thérèse CHU de Annaba, Algérie. 2- Service des maladies infectieuses, CHU Annaba – Algérie.

Abstract

Introduction: Type 1 diabetes (T1D) is a chronic disease prevalent in children, including in Algeria. Its diagnosis is often straightforward, in contrast to the complex and urgent management required in certain clinical situations. The aim of this work is to analyze, through our experience, the diagnostic and therapeutic contexts of this condition and to describe the sociodemographic characteristics of diabetic children and adolescents. Material and Methods: This was a retrospective, cross-sectional, descriptive study carried out at the pediatric diabetology clinic of the « Sainte-Thérèse » Pediatric Hospital, University Hospital of Annaba. It included 227 children and adolescents aged 5 to 18 years diagnosed with T1D. Data were obtained from hospitalization and consultation records and supplemented by a structured survey sheet collecting recent information. Results: The mean age at the time of the study was 10.64 ± 3.47 years, with a slight female predominance (sex ratio: 0.81). The mean age of onset of T1D was 7.82 ± 3.61 years, and the mean disease duration was 2.87 ± 2.88 years. The initial clinical presentation was dominated by ketosis (64.3%), while diabetic ketoacidosis (DKA) at onset accounted for 29.5% of cases. The latter was significantly more frequent in children under 5 years of age and in those from disadvantaged socioeconomic backgrounds (p < 0.001). Nearly all patients (94.3%) had a height within the normal range (between −2 and +2 SD), and 51.1% were prepubertal. Glycemic control, as measured by mean HbA1c, was 8.58 ± 1.48%. The conventional insulin regimen was the most commonly used initial treatment (74.44%), whereas at the time of the study, the basal-bolus regimen was predominant (66.5% of cases). Acute complications included hospitalizations for ketosis or ketoacidosis in 25.3% of patients and for severe hypoglycemia in 9.6%. Conclusion: Type 1 diabetes is common in Algeria, particularly in Annaba. While its diagnosis is often straightforward, early recognition of initial ketoacidosis remains essential. The optimal treatment regimen is one that achieves good HbA1c levels while minimizing acute complications and preserving quality of life.

Keywords: type1 diabetes, child, adolescent, insulin.