Challenges of Managing Type 3c Diabetes in the Context of Pancreatic Resection, Cancer and Trauma.

Type 3c diabetes mellitus (T3cDM), also known as pancreatogenic or pancreoprivic diabetes, is a specific type of DM that often develops as a result of diseases affecting the exocrine pancreas, exhibiting an array of hormonal and metabolic characteristics. Several pancreatic exocrine diseases and surgical procedures may cause T3cDM. Diagnosing T3cDM remains difficult as the disease characteristics frequently overlap with clinical presentations of type 1 DM (T1DM) or type 2 DM (T2DM). Managing T3cDM is likewise challenging due to numerous confounding metabolic dysfunctions, including pancreatic endocrine and exocrine insufficiencies and poor nutritional status. Treatment of pancreatic exocrine insufficiency is of paramount importance when managing patients with T3cDM. This review aims to consolidate the latest information on surgical etiologies of T3cDM, focusing on partial pancreatic resections, total pancreatectomy, pancreatic cancer and trauma.

Epidemiology, Isolation, and Genetic Characterization of Toscana Virus in Algerian Patients Displaying Neurological Infection, 2016-2018.

Purpose: The current study reports the results of the diagnosis of neuro-invasive Toscana virus (TOSV) infection in Algeria between 2016 and 2018 and describes the first isolation of TOSV strain from human samples in North Africa. Materiel and methods: Cerebrospinal fluid (CSF) and sera samples were obtained from 720 hospitalized patients displaying neurological infection symptoms of unknown etiology, of which 604 were screened for TOSV. The diagnosis was performed by serological and/or RT-PCR tests. In addition, TOSV was isolated in vivo and in vitro from CSF and genetically characterized. Results: 23 cases of TOSV neurological infections were detected. Cases were located in 11 Wilayas (administrative provinces), mainly in northern Algeria. In addition, we report the isolation of TOSV strain belonging to lineage A from human samples with its complete coding sequence. Conclusion: Even though the number of infections is probably underestimated, TOSV is endemic in Algeria, with several cases of neuro-invasive diseases in humans recorded each year. Therefore, the diagnosis of TOSV should be included in the differential diagnosis of neurological diseases, especially aseptic meningitis, during the period of activity of the phlebotomine vector. Further studies are required to measure precisely the nationwide prevalence of TOSV in Algeria.

Detection and Isolation of Sindbis Virus from Field Collected Mosquitoes in Timimoun, Algeria.

Sindbis virus (SINV) is a zoonotic alphavirus (family Togaviridae, genus Alphavirus) that causes human diseases in Africa, Europe, Asia, and Australia. Occasionally, SINV outbreaks were reported in South Africa and northern Europe. Birds are the main amplifying hosts of SINV, while mosquitoes play the role of the primary vector. Culex mosquitoes were collected in Algeria and subsequently tested for SINV. SINV RNA was detected in 10 pools out of 40, from a total of 922 mosquitoes tested. A strain of SINV was isolated from a pool displaying high viral load. Whole-genome sequencing and phylogenetic analysis showed that the SINV Algeria isolate was most closely related to a Kenyan strain. This was the first record of SINV in Algeria and more broadly in northwestern Africa, which can be a potential risk for human health in the circulating area. Further studies are needed to measure the impact on public health through seroprevalence studies in Algeria.

Presence of the sandfly-borne phlebovirus (Toscana virus) in different bio-geographical regions of Algeria demonstrated by a microneutralisation-based seroprevalence study in owned dogs.

Toscana virus (TOSV) is major meningitis and meningoencephalitis agent in the Mediterranean basin. Dogs are frequently exposed to TOSV; thereby they can contribute to estimating its circulation. In Algeria, little is known about its circulation, and available data are restricted to the Kabylian region. To investigate the current situation in Algeria, a total of 205 dog sera collected from 13 different wilayas over the country were analyzed by using in-house Enzyme Linked Immunosorbent Assay (ELISA) and microneutralization test (MNT). An overall seroprevalence rate of 20% (14.5-25.5%) was observed by ELISA. Whereas, a seroprevalence rate of 4.56% (1.65-7.43%) was recorded by microneutralization test elucidating the exact occurrence of TOSV exposure in dogs, in Algeria. Positive dogs were detected from the areas of Algiers, Bejaia, Blida, Bouira, Medea, Setif, and Tlemcen in the north; Laghouat in the high lands and Tamanrasset in great Sahara. Only one serum, originating from Bejaia in the north east, was positive for both testing methods, while 8/9 positive sera in MNT remained negative in ELISA. MNT negative/ELISA positive result of 40/41 might suggest evidence for dog transmission, and circulation of phleboviruses other than TOSV. Noticeably, TOSV and antigenically related viruses are largely prevalent. Thus, they are not only confined to Kabylia region, but are widespread in Algeria, despite its climate diversity.