Catégorie : Uncategorized

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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.

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DOI: 10.48087/BJMS.2026.130109

Authors: Sihem KOURTAA, Assia HADDOUCHE, Sabrina AMRIT, Fella HANNI

Keywords: hand osteoarthritis, pain, musculoskeletal ultrasound.

Abstract

Objective: To study the relationship between structural abnormalities on musculoskeletal ultrasound (MSU) and the clinical signs of hand osteoarthritis (HO). Patients and Methods: We included 116 patients with HO (109 women and 7 men; mean age 66 years) according to the American College of Rheumatology criteria and the modified Kellgren-Lawrence (KL) radiographic score. We recorded clinical characteristics (number of painful and swollen joints, visual analogue scale [VAS] pain on palpation, VAS global pain, stiffness and fatigue, and the Dreiser functional score) as well as structural ultrasound abnormalities (osteophytes, joint space narrowing, and erosions) in 28 distinct joints. The associations between the different clinical and ultrasound scores were analyzed using Pearson’s r coefficient. Results: We evaluated 3,248 joints. The frequencies of osteophytes, joint space narrowing, and erosions were 73.3%, 64.8%, and 11%, respectively. There was a weak but significant association between osteophytes and clinical scores (number of tender joints on palpation, number of swollen joints, and VAS pain on palpation); between erosions and clinical scores (VAS global pain, VAS pain on palpation, and Dreiser score); and between joint space narrowing and the number of swollen joints. We also observed a moderate correlation between erosions and two clinical scores: number of tender joints and number of swollen joints. Conclusion: Structural lesions detected on ultrasound are associated with the clinical signs of hand osteoarthritis, particularly at the individual joint level.

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DOI: 10.48087/BJMS.2026.130108

Authors: Fouzia kawter BAROUDI, Naouel ALLAL, Amina KEDDAR, Djazia EL YEBDRI, Fouad OUDGHIRI.

Keywords: Amelogenesis imperfecta, Calcium hydroxide, Composite restoration, Endodontics, Warm vertical obturation.

Abstract

Introduction: Amelogenesis imperfecta (AI) is a rare genetic disorder affecting enamel development, resulting in fragile, worn, and sensitive teeth. Its diagnosis relies on clinical examination, radiographic analysis, and family history. Case Presentation: A 15-year-old girl in good general health presented with pain and aesthetic concerns. She reported having had fragile teeth since primary dentition, with progressive wear and spontaneous dental pain. Family history revealed similar dental involvement in several members, suggesting hereditary transmission. Clinically, the teeth showed generalized wear, significant enamel loss, and dentin exposure. Panoramic radiography revealed enlarged pulp chambers, roots of normal morphology, eruption anomalies, and absence of certain permanent teeth. These findings were consistent with type I AI and helped exclude severe fluorosis, molar-incisor hypomineralization (MIH), syndromic AI, and dentinogenesis imperfecta. Complete endodontic treatment was performed, including the use of calcium hydroxide, warm vertical obturation, and direct composite restorations. A 6-month follow-up showed absence of pain, functional teeth, and no radiographic complications, confirming treatment success. Conclusion: This case highlights the importance of an appropriate multidisciplinary approach, combining endodontic therapy and restorative treatment to preserve masticatory function and aesthetics in patients with AI.

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DOI: 10.48087/BJMS.2026.130107

Authors: Fouzia Kawter BAROUDI, Naouel ALLAL, Fouad OUDGHIRI.

Keywords: Bioceramic, Splint, Horizontal root fracture, Trauma, Endodontic treatment.

Abstract

Introduction: Horizontal root fractures (HRFs) are a rare form of dental trauma, accounting for approximately 0.5% to 7% of cases, and primarily affect maxillary central incisors. They result from severe impact causing rupture of the dentinal structures and sometimes pulpal involvement. Management relies on a conservative approach aimed at preserving tooth vitality and function. Case Report: A 14-year-old patient presented with a horizontal fracture of the middle third of the root of the right maxillary central incisor. Treatment consisted of repositioning the coronal fragment, placing a semi-rigid splint, followed by endodontic therapy with calcium hydroxide medication and obturation with bioceramic cement. Subsequently, endodontic treatment was also performed on the left maxillary central incisor (21), which had become necrotic. Follow-up examinations showed favorable clinical and radiographic outcomes, with no signs of resorption or periapical lesions. Conclusion: HRFs have a good prognosis when diagnosed early and managed conservatively. The use of bioceramics, due to their biocompatibility and sealing ability, promotes healing and long-term stability. Regular follow-up remains essential to ensure treatment durability.

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DOI: 10.48087/BJMS.2026.130106

Authors: Aicha CHERIF HOSNI, Yasmina RAHAL, Fatima Zohra ABDELOUAHAB, Imene TASSA, Imene ZIOUANI, Reda MESSAOUDI

Keywords: gastric neuroendocrine tumor, pernicious anemia, autoimmune gastritis, hypergastrinemia, case report.

Abstract

Type I gastric neuroendocrine tumors (GNETs) are closely associated with autoimmune atrophic gastritis, particularly pernicious anemia. They arise as a consequence of chronic hypergastrinemia, which induces enterochromaffin-like cell hyperplasia and subsequent neoplastic transformation. We report the case of a 34-year-old woman followed since 2014 for pernicious anemia, in whom a well-differentiated grade 1 gastric neuroendocrine tumor was diagnosed in 2025—11 years after the initial diagnosis. Endoscopy revealed multiple polypoid lesions in the gastric fundus. Histology and immunohistochemistry confirmed a well-differentiated NET (Ki-67 index: 1%; chromogranin A and synaptophysin positive) arising in the setting of autoimmune fundic gastritis with severe glandular atrophy and both pseudopyloric and intestinal metaplasia. Staging evaluations showed no metastatic spread. The patient underwent total gastrectomy, and final pathology revealed a NET staged pT1bN1M0. Following surgery, biological markers normalized (gastrin: 32 pg/mL; chromogranin A: 25 ng/mL). This case highlights the well-established pathophysiological link between pernicious anemia and type I gastric NETs and underscores the importance of long-term endoscopic surveillance in patients with autoimmune atrophic gastritis.

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DOI: 10.48087/BJMS.2026.130105

Authors: Mohamed Chahine CHEKKOUR.

Keywords: Palatal Myoclonus; Palatal Tremor; SARS-CoV-2; Post-COVID-19 Syndrome; Cochleovestibular Syndrome.

Abstract

Palatal myoclonus (PM) is a rare hyperkinetic movement disorder characterized by rhythmic involuntary contractions of the soft palate, sometimes producing audible clicks. We report the case of a 59-year-old woman presenting with persistent isolated PM several months after PCR-confirmed SARS-CoV-2 infection. Extensive neurological, laboratory, neurophysiological, and neuroimaging evaluations revealed no structural, autoimmune, metabolic, or infectious abnormalities. The disorder remained stable without progression over long-term follow-up, and symptomatic management with low-dose clonazepam provided partial relief. The temporal sequence raises the possibility of a post-infectious contribution, although the underlying mechanism remains uncertain. This observation expands the spectrum of focal movement disorders reported following systemic viral illnesses and underscores the importance of recognizing atypical presentations when routine investigations are unrevealing. It also illustrates the generally benign course of isolated PM in the absence of identifiable structural pathology.

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DOI: 10.48087/BJMS.2026.130104

Authors: Horiya TAHRI, Soumia HAMZAOUI, Abdelaali Ali BELHACHEM, Nihed AMARA, Nadra KARZOUN, Halima ROUABAH, Amina SERRADJ, Houari TOUMI.

Keywords: BCC, HRQoL, DLQI, Vismodegib, Adverse events.

Abstract

Objective: The objective of our study was to evaluate the health-related quality of life (HRQoL) in patients with locally advanced or metastatic basal cell carcinoma (BCC) using the Dermatology Life Quality Index (DLQI) after six months of treatment with vismodegib and to describe the adverse events (AEs). Materials and Methods: A prospective, monocentric study was conducted over a one-year period in the Department of Dermatology and Venereology, in collaboration with the Pharmacovigilance Department at EHU-Oran, Algeria. The study included all adult patients treated with vismodegib for locally advanced or metastatic BCC at the day hospital to assess HRQoL using the DLQI after six months of treatment and to describe the associated AEs. Results: Three male patients with histologically confirmed BCC—two with locally advanced BCC and one with metastatic BCC—were included in the study. The median age of the participants was 64 years. The BCC lesions were located on the auricle, face, and back, with the metastatic patient experiencing pulmonary and osseous metastases. The DLQI was assessed both before the initiation of treatment and after six months of vismodegib therapy. The mean DLQI score decreased from an initial average of 9 to 0.33. Reported AEs included muscle spasms, fatigue, alopecia, loss of appetite, and creatine phosphokinase elevation. Conclusion: This study highlights a significant improvement in HRQoL among patients treated with vismodegib, as evidenced by the reduction in DLQI scores over six months.

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DOI: 10.48087/BJMS.2026.130103

Authors: Habib ZIDANE, Nesrine ZAHI, Mohamed Hadjar KHERFANE.

Keywords: nasopharyngeal cancer, treatment, induction chemotherapy, survival

Abstract

Introduction: Nasopharyngeal carcinoma is common in Algeria. Its worldwide incidence is geographically dependent, diagnosis is often delayed, and prognosis remains guarded despite high radiosensitivity. Methods: This retrospective study was conducted from January 2021 to August 2024 in the medical oncology department of Mostaganem University Hospital and included 49 cases of nasopharyngeal carcinoma. Results: The mean age was 50.2 years, with 83.7% males (n=41) and 73.5% (n=36) non-smokers. The median time to diagnosis was 4 months (range: 1-20 months). Cervical lymphadenopathy was palpated in all patients, while the oto-rhino-neurological triad was present in 10.2% of cases (n=5). Undifferentiated nasopharyngeal carcinoma was diagnosed in 93.9% of cases (n=46). T4 tumors were found in 24.5% (n=12) and M1 disease in 8.2% (n=4). Chemotherapy was administered to 47 patients, with neoadjuvant chemotherapy in 89.4% (n=42). The PTX protocol (cisplatin, docetaxel, capecitabine) was used in the majority of cases (n=40), with a mean of 3.4 cycles (range: 1-9 cycles). The complete response rate to neoadjuvant chemotherapy was 16.7% (n=7). Radiotherapy was performed in 42 patients, with a mean delivered dose of 62.46 Gy (range: 30-70 Gy). Five patients died during the study period, yielding a three-year overall survival rate of 89.6%. Conclusion: Nasopharyngeal carcinoma is a relatively common tumor in Algeria, often diagnosed at an advanced stage. It is chemosensitive and radiosensitive, with radiotherapy as the primary treatment. Survival analysis showed a trend toward better outcomes in male patients under 60 years of age with minimal lymph node involvement (N1); however, these associations did not reach statistical significance. Further studies are needed to establish a comprehensive profile of nasopharyngeal carcinoma in Algeria.

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DOI: 10.48087/BJMS.2026.13102

Authors: Farah OSAMA ABDALLA KHALEEL

Keywords: Neonatal care, technological innovation, preterm infants, neonatal intensive care, clinical practice.

Abstract

Introduction: Background: Technological innovation is increasingly recognized as a key driver in enhancing neonatal care, particularly for preterm infants. Understanding the impact of modern technologies on healthcare outcomes is crucial for optimizing clinical practice and improving the quality of patient care. Objective: This study aimed to examine the relationship between modern technological innovations and the quality of care provided to premature infants in neonatal units. Methods: A descriptive cross-sectional study was conducted among 60 pediatricians in the eastern region of Amman, selected using purposive sampling due to institutional access constraints. Data were collected via an electronic questionnaire between July 8 and September 18. The sample comprised 12 consultants, 18 specialists, and 30 residents. The questionnaire’s reliability and validity were confirmed, and data cleaning procedures were implemented prior to statistical analysis. Results: The hypothesis that there is no relationship between modern technologies and premature infant care quality was tested using Pearson correlation analysis. Results revealed a strong positive correlation (r = 0.979, p < 0.05) between the use of modern technologies and the quality of care provided to preterm infants. This finding indicates that technological innovation has a significant positive impact on healthcare outcomes, supporting the role of innovation as a structural driver of improved neonatal care. Conclusion: This study demonstrates that the integration of modern technologies in neonatal care is strongly associated with improved outcomes for premature infants. These results underscore the importance of incorporating innovative tools and systems into clinical practice to enhance care quality. However, the implementation of such technologies requires adequate financial and human resources, highlighting challenges faced in resource-limited healthcare settings.