Mois : mars 2026

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DOI: 10.48087/BJMS.2026.130311

Authors: Fazia KERKOUB^1,2, Naila KERKOUB³, Rachid DJAFER^1,2

Affiliations: 1- Laboratoire de toxicologie, Département de pharmacie, Faculté de médecine, Université Badji Mokhtar, Annaba, Algerie. 2- Laboratoire de Toxicologie Médicale, CHU Ibn Sina, Annaba, Algérie. 3- Laboratoire de biologie cellulaire, Département de biologie, Faculté des sciences, Université Badji Mokhtar, Annaba, Algeria.

Abstract

Introduction: Vitamin B6, or pyridoxine, encompasses six interconvertible vitamers involved in essential biological functions, particularly in neuronal metabolism. While its neuroprotective role is well established at physiological doses, neurotoxic effects have been observed with excessive supplementation, presenting clinical symptoms that may resemble those of deficiency and thereby complicate diagnosis. In the Algerian context, high-dose pyridoxine prescriptions appear to be frequent, often without clear regulatory oversight. This study aims to explore the frequency of adverse effects associated with high-dose vitamin B6 administration. Materials and Methods: This descriptive study includes 22 participants consuming pyridoxine at doses of 250 mg or higher, with varying dosages, as well as an analysis of 59 prescriptions containing this compound, collected from six pharmacies across the Annaba region. Data were gathered from medical records, patient interviews, and prescription reviews, with clinical signs categorized into sensory and motor manifestations. Results: The most common dosage was 500 mg/day, primarily prescribed by general practitioners and orthopedic surgeons for diabetic or secondary neuropathies. Inappropriate prescriptions were also noted, particularly in cases of Wernicke-Korsakoff syndrome, where vitamin B1 is the recommended treatment. The most frequently reported sensory symptoms were paresthesia (57%), numbness (50%), and burning sensations (42.9%), while motor signs included difficulty walking (42.9%), muscle weakness (35.7%), and cramps (28.6%). Conclusion: These findings highlight a concerning pattern of high-dose pyridoxine prescriptions and underscore the need to raise awareness among healthcare professionals about the associated risks. Establishing national guidelines to regulate its use is essential to align medical practices with international recommendations and to ensure the safe administration of a vitamin whose daily requirements are largely met through a balanced diet.

Keywords: pyridoxine, vitamin B6, neurotoxicity, overdose, prescription, public health.

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DOI: 10.48087/BJMS.2026.130310

Authors: Sihem KOURTAA, Assia HADDOUCHE, Sabrina HAID, Naouel KHALDOUN, Fella HANNI

Affiliations: Service de rhumatologie, EHS Ben Aknoun, Alger ; Université des Sciences et Santé, faculté de médecine – Algérie.

Abstract

Objective: To investigate the association between ultrasonographic inflammatory findings in hand osteoarthritis (HOA) and clinical symptoms. Patients and Methods: This study was conducted on 116 patients fulfilling the American College of Rheumatology (ACR) criteria for hand osteoarthritis, graded using the modified Kellgren-Lawrence (KL) radiographic scoring system. Twenty-eight joints per patient were examined, and both inflammatory ultrasonographic findings and clinical data were collected, including tender and swollen joint counts, global finger pain intensity, pain on palpation, stiffness, fatigue, and functional impairment assessed by the Dreiser index. Correlations between clinical and ultrasonographic scores were analyzed using Pearson’s correlation coefficient. Results: A total of 3,248 joints were examined. Synovitis was strongly correlated with joint swelling and moderately correlated with joint pain and the Dreiser score. Effusion was weakly associated with all clinical scores except fatigue. Power Doppler signal showed a significant but weak association, restricted to clinical synovitis. Conclusion: Ultrasono-graphically detected inflammatory lesions (synovitis and effusion) are associated with the clinical manifestations of hand osteoarthritis, particularly at the joint level.

Keywords: digital osteoarthritis, pain, synovitis, musculoskeletal ultrasound.

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DOI: 10.48087/BJMS.2026.130309

Authors: Nassila Farah LALLAOUI¹, Maissem MADOUI², Hayet MADANE², Wahiba AMHIS¹, SAMIRGOURARI¹

Affiliations:1- Service de microbiologie, CHU Mustapha, Alger, Algérie. 2- Université des sciences de la santé Youcef El Khatib, Alger, Algérie.

Abstract

Introduction & Objectives: Peritonitis is a critical intra-abdominal infection whose management relies on epidemiological, clinical, and microbiological data. This study aimed to identify the causative bacteria, assess their antibiotic resistance profiles, describe the epidemiological characteristics, and track the clinical progression of peritonitis cases. Materials & Methods: This prospective study (January 1 to July 31, 2021) included patients with community-acquired peritonitis (CAP) and nosocomial peritonitis (NP) treated at Mustapha Hospital. Microbiological analyses were performed on intra-abdominal samples in a microbiology laboratory, and a standardized data collection form was completed for each case. Results: A total of 95 cases of peritonitis were collected (63% CAP and 37% NP). A male predominance was observed (sex ratio = 2.3), and patients in the NP group were significantly older (44.9 ± 24 years) than those in the CAP group (25.3 ± 24.3 years) (p < 0.001). Microbiological analysis identified 138 bacterial isolates, predominantly Escherichia coli (35%) and Enterococcus sp. (13%). Resistance of Enterobacteriaceae to cefotaxime was significantly higher among NP isolates than CAP isolates (51.7% vs. 2%, p < 0.001), and carbapenem resistance was recorded at 5.1%. Five methicillin-resistant Staphylococcus aureus strains and one vancomycin-resistant Enterococcus sp. strain were identified exclusively among NP isolates. The mortality rate was 5% in the CAP group versus 17.1% in the NP group (p = 0.07). Conclusion: This study highlights the key epidemiological and clinical features of peritonitis in our setting. Microbiological analysis is essential for identifying causative pathogens and guiding appropriate antibiotic therapy.

Keywords: peritonitis, bacteria, antibiotic resistance, epidemiology.

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DOI: 10.48087/BJMS.2026.130308

Authors: Ouafa GUELLATI¹, Ouissem GUELLATI²,Mehdi MIADI³, Imed DIABI¹, Amina BELLILI¹

Affiliations: 1- Service de Gynécologie-Obstétrique, CHU Ibn Rochd, Annaba / Université Badji Mokhtar, Annaba – Algérie. 2- Service de cardiologie CHU Ibn Sina Annaba / Université Badji Mokhtar, Annaba – Algérie. 3- Service de néphrologie CHU Ibn Sina Annaba / Université Badji Mokhtar, Annaba – Algérie.

Abstract

Background/Objective: Severe preeclampsia (PE) frequently leads to acute kidney injury (AKI), with serious maternal-fetal consequences. This prospective study aimed to identify independent clinical and biological predictors of AKI in PE and to evaluate its maternal-fetal prognostic impact. Materials and Methods: This prospective analytical study (2020–2023), conducted at Ibn Rochd University Hospital, Annaba, included 1,254 preeclamptic patients from 54,830 deliveries, divided into 310 AKI cases — defined by serum creatinine >90 µmol/L, and/or urea >7 mmol/L, and/or urine output <400 mL/24h, classified using the AKIN staging system — and 944 controls. Sociodemographic, clinical (blood pressure, proteinuria, oliguria), and biological variables (hemoglobin, uricemia) were analyzed using univariate tests (χ², t-test; p<0.05) and stepwise descending multivariate logistic regression (SPSS v25.0). Results: The incidence of PE was 2.28% (1,254/54,830), and the incidence of AKI was 24.7% (310/1,254), predominantly AKIN stage 1 (82.9%). Univariate analysis identified the following risk factors: emergency transfer (RR=2.80, 95% CI [2.23–3.50]), blood pressure >160/110 mmHg (RR=1.78 [1.47–2.17]), massive proteinuria >3.5 g/24h (RR=2.60 [2.17–3.12]), oliguria (RR=3.21 [1.96–3.54]), and iron-deficiency anemia (Hb <10 g/dL; RR=3.05 [2.52–3.68]), all p<0.0001. Multivariate logistic regression confirmed five independent predictors: emergency transfer (aOR=2.45, 95% CI [1.85–3.25]), severe hypertension (aOR=1.62 [1.28–2.05]), massive proteinuria (aOR=2.12 [1.68–2.68]), oliguria (aOR=2.78 [2.05–3.77]), and anemia (aOR=2.41 [1.92–3.03]), all p<0.0001. Maternal morbidity included HELLP syndrome (49.4%, RR=4.5), retroplacental hematoma (23.9%), eclampsia (18.7%), and all 12 maternal deaths occurred in the AKI group (mortality rate: 3.9%). Perinatal outcomes included prematurity <34 weeks (57.4%, RR=3.18), neonatal mortality (35.5%, RR=4.59 [3.58–5.89]), and prolonged hospitalization (8.27±5.99 vs. 5.42±4.38 days). Renal recovery occurred in 78.7% of cases by day 7; 17.4% required hemodialysis (mean 3±2.22 sessions), and 2.2% progressed to chronic kidney disease. Conclusion: AKI frequently complicates severe PE. Multivariate analysis identifies five major independent predictors that enable early high-risk stratification. Proactive multidisciplinary management targeting delayed transfer, severe hypertension, massive proteinuria, oliguria, and anemia is essential to prevent dialysis dependence, chronic kidney disease, and maternal-fetal mortality.

Keywords: severe preeclampsia, acute kidney injury, independent predictive factors, maternal-fetal prognosis.

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DOI: 10.48087/BJMS.2026.130307

Authors: Fatema Zohra BENABED^1,2,3, Ibtissem BOUTRIF¹, NH BENZAZOU¹, Meriem BENABED⁵, Nesrine FEKAR⁴, Souad GUENDOUZ^1,2,3, Mohammed Adil SELKA^1,2, Fatma BOUDIA^3,6, Hassene BOUCIF^1,4, Houari TOUMI^3,6

Affiliations: 1- Faculté de médecine de Tlemcen, Université de Tlemcen – Algérie. 2- Service de Pharmacie, CHU Tlemcen– Algérie. 3- Laboratoire de recherche en développement pharmaceutique – Algérie. 4- Service de psychiatrie, CHU Tlemcen – Algérie. 5- Université des Sciences et de la Technologie d’Oran – Algérie. 6- Faculté de Médecine d’Oran, Université d’Oran – Algérie

Abstract

Introduction Sleep disturbances are a frequent and disabling symptom of pregabalin withdrawal and represent a major risk factor for relapse. In the absence of specific therapeutic recommendations, various pharmacological strategies are used in clinical practice to improve withdrawal-related comfort. Objective This study aims to compare the effects of amitriptyline and prazepam on sleep quality in patients with pregabalin use disorder. Materials and Methods This was an open-label comparative study including 40 patients managed in an addiction medicine unit. Patients were divided into two groups receiving either amitriptyline or prazepam as part of a medically supervised withdrawal program. Sleep quality was assessed at baseline and at day 30 using the Pittsburgh Sleep Quality Index (PSQI). A comparative statistical analysis was performed, with the type I error rate (α) set at 5% (p < 0.05). Results A significant improvement in the global PSQI score was observed in both groups after 30 days of treatment. No statistically significant difference was found between the two groups regarding the global PSQI score. However, sleep onset latency was significantly shorter in patients treated with amitriptyline. Conclusion Both amitriptyline and prazepam appear to be effective options for improving sleep quality during pregabalin withdrawal. Amitriptyline may represent a valuable non-benzodiazepine alternative, particularly in patients with predominant sleep-onset insomnia. Larger-scale studies are needed to confirm these findings.

Keywords: Pregabalin, Substance-Related Disorders, Drug Withdrawal Syndrome, Sleep Quality, Pittsburgh Sleep Quality Index.

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DOI: 10.48087/BJMS.2026.130306

Authors: Lilia NAOUN^1,2, Sanah NACERDDINE², Karima MELAIS², Soumeya MANSOURI², Amina AMIRECHE², Abdesselem BRIHMAT²

Affiliations: 1- Université Badji-Mokhtar Annaba. 2- Service de radiothérapie – CHU Annaba – Algérie

Abstract

Introduction: Delineation of target volumes and organs at risk (OARs) is a crucial but time-consuming step in head and neck (H&N) radiotherapy planning and is associated with significant interobserver variability. Atlas-based automatic segmentation systems, such as ABAS (Atlas-Based Automatic Segmentation), have been proposed as a promising approach to improve efficiency and standardization in clinical practice. Objective: To evaluate the geometric and dosimetric agreement between manual contouring and atlas-based automatic segmentation using ABAS in patients treated for nasopharyngeal carcinoma, and to assess the impact of the number of atlases on system performance. Methods: A prospective comparative study was conducted in 10 patients with nasopharyngeal carcinoma. Six OARs (spinal cord, brainstem, right and left parotid glands, optic chiasm, and mandible) were manually contoured by an experienced radiation oncologist and automatically segmented using ABAS. Volumes, maximum dose (Dmax), and mean dose (Dmean) were compared. The influence of the number of atlases (1, 10, and 20) and contouring time was analyzed. Correlations were assessed using Pearson’s correlation test, with statistical significance set at p < 0.05. Results: Using 10 atlases, strong correlations were observed between manual and automatic contours for most OARs (R > 0.9, p < 0.05), both volumetrically and dosimetrically. Larger discrepancies were noted for small-volume structures with complex anatomical boundaries, particularly the optic chiasm. The average contouring time was markedly reduced from approximately 4–5 hours for manual contouring to about 21 minutes using ABAS. Conclusion: Atlas-based automatic segmentation using ABAS demonstrates satisfactory agreement with manual contouring in head and neck radiotherapy while providing a substantial reduction in contouring time. This technology represents a reliable clinical decision-support tool, provided that systematic expert validation and manual correction are performed.

Keywords: Radiotherapy, Head and neck cancer, Atlas-based segmentation, Automatic contouring, Organs at risk.

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DOI: 10.48087/BJMS.2026.130305

Authors: Lilia NAOUN^1,2, Hadjar GOSSA¹, Karima MELAIS¹, Amina AMIRECHE¹, Billel BACHA¹, Nacereddine SANAH¹, Abdesselem BRIHMAT¹

Affiliations: 1- Service de radiothérapie – CHU Annaba. 2- Université Badji-Mokhtar Annaba – Algérie.

Abstract

Adjuvant radiotherapy is a fundamental component of the multidisciplinary management of breast cancer, significantly contributing to improved local control and overall survival. However, irradiation of the left breast remains a major challenge due to the risk of late toxicities, particularly cardiovascular and pulmonary complications, related to the close anatomical proximity of critical organs.Technological advances in radiotherapy have led to the development of techniques aimed at optimizing the benefit–risk ratio. Deep inspiration breath-hold (DIBH), by increasing the distance between the heart and the irradiation field, allows a significant reduction in cardiac dose. The integration of surface-guided radiotherapy (SGRT) enhances the accuracy and reproducibility of respiratory control without additional radiation exposure. In this context, we conducted a retrospective study in the radiotherapy department of Annaba University Hospital, including 32 patients treated for left-sided breast cancer. To our knowledge, this is the first study reporting the clinical use of surface-guided deep inspiration breath-hold (SGRT-guided DIBH) in Algeria. The primary objective of this study was to evaluate the dosimetric benefits of SGRT-guided DIBH by comparing cardiac and pulmonary dosimetric parameters obtained with this technique to those achieved during free-breathing irradiation.

Keywords: Left-sided breast cancer, Cardiac dose, Surface-guided radiotherapy, Respiratory control, Deep inspiration breath hold.

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DOI: 10.48087/BJMS.2026.130304

Authors: Melissa CHABANE¹, Habiba FETATI¹, Halima ROUABAH², Souhila BOUATTAM¹, Saîda Hanane ZITOUNI-NOURINE¹, Fatma BOUDIA¹ Houari TOUMI¹

Affiliations: 1- Faculty of Medicine, Ahmed Benbella Oran 1 University – Algeria. 2- Faculty of Medicine, Ferhat Abbas, Setif University 1 – Algeria.

Abstract

Introduction: Idiopathic pulmonary fibrosis (IPF) is a rare disease. Its management requires significant human and material resources, increasing the economic burden on the healthcare system. The aim of this study was to evaluate the direct medical costs of managing IPF and its complications, mainly acute exacerbations, at the Hospital and University Establishment of November 1st, 1954 of Oran (EHUO) in Algeria. Patients/Materials and Methods: This was a descriptive, retrospective study conducted over a five-year period involving patients with IPF hospitalized at the EHUO. The analyzed costs included direct medical costs. The time horizon encompassed the entire duration of patient hospitalization. Results: The study included 17 IPF patients, predominantly male (15 out of 17, or 88.23%), with a sex ratio (M/F) of 8.5 and a mean age of 68.41 ± 8.63 years. The average cost per patient increased from 394,034.11 DZD for the stable form to 1,185,332.74 DZD for the exacerbated form. The acute exacerbation stage was more costly, averaging 5,710,581.14 DZD per patient. More than three-quarters of expenditure was attributable to hospitalization costs. Conclusion: The results of this study suggest that optimal management of IPF could reduce costs associated with hospitalizations during acute exacerbations, thereby limiting the economic burden of the disease.

Keywords: health economics, exacerbation, pharmaco-economics study, cost.

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DOI: 10.48087/BJMS.2026.130303

Authors: Sofiane GHEMRI, Adlane REZZOUG, Sihem ATOUB, Nachida BENMIRADI

Affiliations: Université des Sciences de la Santé El Moudjahid Dr Youcef El Khatib, Faculté de Médecine, Alger ; EHS Dr Maouche Mohand Amokrane, Alger, Algérie.

Abstract

Background: While Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) is a recognized cardiovascular risk factor, its impact on the anatomical extent of coronary lesions during acute coronary syndrome (ACS) remains debated. Chronic intermittent hypoxia may promote more diffuse atherosclerosis. Objective: This study aimed to determine whether the presence and severity of OSAHS are associated with increased clinical severity and multivessel coronary artery disease in patients admitted for a first episode of non-ST-segment elevation acute coronary syndrome (NSTE-ACS). Methods: This prospective, single-center study included 241 consecutive patients admitted for an inaugural NSTE-ACS between September 2019 and September 2020. All patients underwent coronary angiography and OSAHS screening via type III respiratory polygraphy during hospitalization. Severe OSAHS was defined as an Apnea-Hypopnea Index (AHI) >30 events/h. Disease severity was assessed using the GRACE risk score, echocardiography, and the number of stenosed coronary vessels. Results: The overall prevalence of OSAHS (AHI >15) was 52.7%, with a large proportion of severe forms. Multivariate analysis demonstrated that severe OSAHS was associated with more diffuse anatomical disease. Specifically, compared to single-vessel disease, the presence of severe OSAHS significantly increased the risk of two-vessel disease (OR = 2.30; 95% CI: 1.07–4.98; p = 0.019) and showed a strong trend toward three-vessel disease (OR = 2.07; 95% CI: 0.93–4.63; p = 0.048). Clinically, this anatomical diffusion was accompanied by an increased severity profile, with severe OSAHS being strongly associated with a GRACE risk score >140 (OR = 2.27; 95% CI: 1.30–3.98; p = 0.002) and the presence of left ventricular wall motion abnormalities (OR = 2.72; p = 0.013). Conclusion: Among patients admitted for an inaugural NSTE-ACS, severe OSAHS goes beyond being a mere comorbidity to establish itself as an independent predictor of coronary artery disease extent. It is associated with more diffuse angiographic lesions (multivessel disease) and a higher clinical risk profile upon admission, which may directly impact the revascularization strategy.

Keywords: Severe OSAHS, NSTE-ACS, Coronary Angiography, Multivessel Disease, GRACE Score.

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DOI: 10.48087/BJMS.2026.130302

Authors: Zohra KHELIFI, Hacène MEHDIOUI, Leila BELKADI, Mohamed BOUGRIDA

Affiliations: Faculté de médecine, université Constantine 3 – Algérie.

Abstract

Chronic obstructive pulmonary disease (COPD), defined by irreversible airflow obstruction, and coronary artery disease (CAD) are both highly prevalent worldwide and frequently co-occur. However, the prevalence of COPD according to its severity in patients with coronary artery disease remains poorly characterized. The objective of this study was to assess the respiratory function of stable coronary artery disease patients. Methods. This descriptive, prospective, cross-sectional study included patients of both sexes, regardless of age, with coronary artery disease documented by positive coronary angiography and no previously known obstructive ventilatory disorder. Patients were recruited from private outpatient consultations in the city of Constantine between June 2016 and August 2017. They completed a questionnaire adapted from the American Thoracic Society (ATS) survey and underwent spirometric evaluation with a bronchodilator reversibility test. The diagnosis of COPD and the grading of bronchial obstruction were based on the GOLD (Global Initiative for Chronic Obstructive Lung Disease) criteria. All spirometric assessments were performed in accordance with ATS/ERS guidelines. Results. A total of 146 patients with coronary artery disease were enrolled; however, only 117 subjects were able to perform acceptable spirometry. The remaining patients were excluded due to poor cooperation. Among the 117 participants, 81.2% were male, with a mean age of 62 ± 9 years. Additionally, 78.7% were current or former smokers. Post-bronchodilator FEV1/FVC ratio below 70% — consistent with a diagnosis of COPD — was found in 17.1% of subjects. Among those with COPD, 25% were at GOLD stage 1, 70% at stage 2, and 5% at stage 3; no patients were classified at severity stage 4. Subjects with COPD were older, presented with greater comorbidity burden, and had more frequent multi-vessel coronary involvement. Conclusion. Patients with coronary artery disease carry a substantial risk of concurrent COPD. COPD in this population is frequently asymptomatic and therefore often goes undiagnosed. Systematic spirometric assessment of respiratory function in coronary artery disease patients appears warranted, as it enables the detection and staging of COPD and may contribute to improved monitoring and management of these patients.

Keywords: Coronary heart disease, chronic obstructive pulmonary disease (COPD), Obstructive Ventilatory Disorder, irreversible airflow obstruction.