Profil hématologique des patients atteints de COVID-19 au niveau du CHU d'Oran en Algérie / Hematological profile of patients with COVID-19 at Oran University Hospital in Algeria

Introduction: La COVID-19 est une zoonose virale causée par la souche de coronavirus SARS-CoV-2. Vue la rapidité de sa propagation, l'OMS a qualifié cette maladie infectieuse émergente de pandémie internationale. L'objectif de notre étude est de décrire les caractéristiques hématologiques des patients atteints de COVID-19 hospitalisés au niveau du CHU d'Oran en Algérie. Patients et méthodes : Il s'agit d'une étude prospective menée entre le 1er Juillet et le 15 Octobre 2020 ayant inclus des patients hospitalisés et/ou suivis au niveau des unités COVID-19 du CHU Oran en Algérie. La numération de formule sanguine a été faite sur un automate Mindray BC ­ 6800. Résultats : Notre étude a inclus 68 patients dont 67,2% de sexe masculin et 32,8% de sexe féminin (sexe ratio H/F = 2) avec une médiane d'âge de 65 ans. Les bilans ont révélé une anémie chez 38,2 % des patients. Une hyperleucocytose (62,2%), une hyperneutrophilie (72,1%), une lymphopénie (66,2%) ,Une éosinopénie (58,8%), une monocytopénie (08,8%), une monocytose (20,6%), une thrombopénie (20,6%), une thrombocytose (14,7%), un VPM (Volume Plaquettaire Moyen) élevé dans 27,9% des cas et un IDP (Indice de Distribution Plaquettaire) élevé chez tous les patients. On constate aussi que 85% des patients âgés de plus de 50 ans ont un NLR ≥ 3,13. Conclusion : Certains paramètres tels que la lymphopénie et l'éosinopénie présentent une valeur diagnostique importante, alors que d'autres paramètres tels que le NLR (Neutrophils-to-lymphocytes ratio), le MLR (Monocyte -to-lymphocytes ratio) et le PLR (Platelet-to-lymphocytes ratio) offrent une valeur pronostique très précieuse.

Evaluation de la prise en charge de l'érysipèle par les médecins généralistes de la ville de Marrakech

Introduction: l'érysipèle est la plus fréquente des dermohypodermites bactériennes non nécrosantes (DHBNN).L'objectif de notre travail est d'évaluer l'adéquation des connaissances des médecins généralistes avec les données de la littérature sur la prise en charge diagnostique et thérapeutique de l'érysipèle.Méthodes: nous avons réalisé une enquête transversale à visée descriptive et analytique auprès de 167 médecins généralistes des secteurs public et privé de Marrakech du 19 Mai au 20 Octobre 2014.Résultats: les 114 questionnaires qui nous ont été retournés ont révélé que des facteurs de risque locaux et généraux étaient souvent retrouvés en cas d'érysipèle. Le diagnostic positif des formes typiques était clinique pour 92(80,7%) médecins. La prise en charge devrait se faire en ambulatoire pour 97(85,1%), le recours à l'hospitalisation et aux examens para-cliniques ne s'avérait nécessaire que pour les formes sévères, atypiques ou compliquées. L'amoxicilline orale a été préconisée par 25 médecins (21,9%). La bi-antibiothérapie incluant une molécule antistreptococcique a été préconisée par 15(13,2%) médecins. Le recours aux anti-inflammatoires a été préconisé par 16 médecins (14%). Les préventions primaires et secondaires ont rencontré l'intérêt de nos médecins dont 108 (94,7%) ont été favorables au traitement des portes d'entrée cutanées et 53 (46,5%) à l'antibioprophylaxie à partir de la deuxième récidive.Conclusion: d'après notre étude, l'érysipèle semble relativement fréquent en pratique de ville, les éléments du diagnostic clinique devraient faire l'objet d'une vulgarisation visant à améliorer les attitudes diagnostiques et thérapeutiques de nos médecins

Anti-gliadin Antibodies and Gluten Neuropathies: A Borderline Link.

The aim of this research was to estimate the prevalence of gluten sensitivity in neurologic diseases of unknown etiology and to determine their clinical and biological characteristics in a Moroccan population. Patients and Methods: A prospective case-control study was performed on 60 patients and 57 controls. Patients and controls underwent a screening for IgG and IgA anti-gliadin antibodies (ELISA anti-Gliadin, Orgentec, threshold: 12 IU/ml), and IgA anti-tissue transglutaminase antibodies (ELISA IgA-tGTA, DRG, threshold: 10 IU/m). Results: The median age of patients was 43±13.91 years (ranges: 13-67), versus 39.4±9.12 (ranges: 19-58) for controls. Male to female sexe-ratio was 0.7 for patients vs 2.1 for controls. IgG and/or IgA anti-gliadin antibodies (AGA) were positive in 26.7% of cases (n=16) vs 15.8% (n=9) in controls (p=0.15), while IgA-tTGA was negative in all patients, but positive in 1 control. Positive AGA cases corresponded to peripheral neuropathy (n=4), ataxia (n=3), ischemic stroke (n=3), myopathy (n=2), and 1 case for each of the following conditions: multiple sclerosis, epilepsy, cerebral thrombophlebitis and myelopathy. Among the positive AGA cases, IgA isotype was more prevalent, but IgG AGA titers were higher and clinically more relevant. Conclusion: Gluten Sensitivity is a potential cause of unknown etiological neurologic diseases in young adults, particularly peripheral neuropathy, ataxia and ischemic stroke. AGA testing especially IgG isotype might be a suitable marker to screen for gluten neuropathies.

Toxicology, biosynthesis, bio-control of aflatoxin and new methods of detection

Mycotoxins and their derivatives since their discoveries and until the present time are behind unspecified economic and medical damages. Aflatoxins are classified according to their physical–chemical and toxicological characters in the most dangerous row of the mycotoxins. These aflatoxins are in part responsible, of irreversible medical disasters that are not easily manageable such as cancer of the liver and kidneys, and in the other part, of losses in the stored cereal products. Based on these crucial findings, monitoring of this toxin became imperative in post-harvest food products, during storage, during trans-formation chain and even during the long phases of conservation. Vigilance of this toxin is delivered by detection methods using very advanced technologies to respond in the shortest possible times. In addition, the knowledge of factors supporting the biosynthesis of aflatoxins such as the temperature, moisture content, concentration of nitrogen and carbon, and the molecules responsible for the genetic control of the synthesis will be reflected later in the choice of bio-control techniques. This control is currently based on new strategies using the bioactives substances of the plants, the lactic bacteria and some strains of actinomycetes that have good inhibiting activity against aflatoxins with fewer side effects on Man. On the other hand, this brief review summarizes the results of new studies demonstrating the toxicity of the toxin, new detection methods and bio-control.

Antimicrobial activity of some essential oils against oral multidrug-resistant Enterococcus faecalis in both planktonic and biofilm state

Objective: To evaluate some essential oils in treatment of intractable oral infections, principally caused by biofilm of multidrug-resistant Enterococcus faecalis (E. faecalis), such as persistent endodontic infections in which their treatment exhibits a real challenge for dentists.Methods:were evaluated for antimicrobial activity against sensitive and resistant clinical strains of E. faecalis in both planktonic and biofilm state using two methods, disk diffusion and broth micro-dilution.Results:Studied essential oils showed a good antimicrobial activity and high ability in E. Ten chemically analyzed essential oils by gas chromatography-mass spectrometry faecalis biofilm eradication, whether for sensitive or multidrug-resistant strains, especially those of Origanum glandulosum and Thymbra capitata with interesting minimum inhibitory concentration, biofilm inhibitory concentration, and biofilm eradication concentration values which doesn’t exceed 0.063%, 0.75%, and 1.5%, respectively.Conclusions:Findings of this study indicate that essential oils extracted from aromatic plants can be used in treatment of intractable oral infections, especially caused by biofilm of multidrug-resistant E. faecalis.

Screening of biological activities of Polygonum maritimum L. from Algerian coast

Objective: To investigate the antioxidant and the antibacterial activities of crude extract from aerial part of Polygonum maritimum L. (Polygonaceae) (P. maritimum) and to find new actives biomolecules. Methods:The whole plant was collected from the Rechgoune coast (West of Algeria), and methanolic crude extract of aerial parts of P. maritimum (PMCE) was prepared. The extract was tested against different bacterial strain and tested for his ability to neutralize free radical (DPPH) and to scavenge the H2O2. Results:PMCE had a very high content of total phenol, which was (352.49±18.03) mg/g dry weight,expressed as gallic acid equivalent. PMCE exhibited excellent antioxidant activity, as measured using DPPH and H2O2 scavenging assays. It also showed a high antibacterial activity against gram-positive bacterial strains: Bacillus cereus, Bacillus subtilis and Staphylococcus aureus with an highest MIC of 120 μg/mL. Conclusions: The antioxidant and antibacterial activity of the PMCE is probably due to phenolic compounds present in the extract. The contemporary presence of antioxidant and antibacterial activities in the PMCE suggests that this plant may be a source of bioactive substances with multifaceted activity.

Applying sodium profile with or without ultrafiltration profile failed to show beneficial effects on the incidence of intra-dialytic hypotension in susceptible hemodialysis patients

Intra-dialytic hypotension [IDH] is a common complication during hemodialysis [HD] treatment. Previous studies have reported that modulating dialysate sodium concentration combined or not with modulation of ultrafiltration [UF] rate may reduce the incidence of IDH. The aim of the present study was to evaluate the effect of sodium and UF profiles on the occurrence of intra-dialytic complications and dialysis quality. From a total of 64 patients, we selected 18 patients who suffered from recurrent IDH. Every patient received ten HD sessions utilizing each of the following treatments: [1] Control: constant sodium concentration and UF rates. [2] Sodium and UF profiles: a linearly decreasing sodium concentration combined with a linearly decreasing UF rate. [3] Sodium profile:decreasing sodium concentration with constant UF rate. Fourteen patients completed the study protocol. The incidence of IDH, mean inter-dialytic weight gain and the delivered dialysis dose were not different between the three treatments. However, symptomatic episodes of IDH were more common and pre-dialysis systolic blood pressure was higher during the second and third treatment modalities compared to controls. Isolated sodium profile was associated with more malaise and less achievement of target session duration compared to the other two treatments. Isolated sodium profile was associated with less achievement of target UF while combined sodium and UF profiles were associated with more achievement of target UF compared to controls. Our results indicate that sodium profile with or without UF profile does not have a beneficial effect on the incidence of IDH, achievement of target session duration or the delivered dialysis dose

Scleroderma renal crisis precipitated by steroid treatment in systemic lupus erythematosus and scleroderma overlap syndrome

Connective tissue disorders can overlap in various ways. Patients may present with features of more than one specific disease without satisfying the diagnostic criteria and thereafter evolve into a specific disease entity. Occasionally, patients may fulfil simultaneously the diagnostic criteria of two or more diseases. Several cases of systemic sclerosis [SSc] and systemic lupus erythematosus [SLE] overlap syndrome have been reported. SLE patients often develop lupus nephritis, the treatment of which is based on immunosuppression with corticosteroids [CS] and cytotoxic drugs. However, the use of high dose of CS has been associated with scleroderma renal crisis [SRC] in patient with SSc. A 43-year-old woman presented to the nephrology department of the Military hospital in Rabat, Morocco, in August 2011 with progressive dyspnea and oliguria. She was diagnosed as SLE and scleroderma overlap syndrome based on clinical and serological markers. Renal biopsy showed lupus nephritis. Immunosuppression consisting of high-dose steroid and cyclophosphamide pulses was given. There was response to treatment but 15 days later the course of the disease was complicated by scleroderma renal crisis evidenced by elevated blood pressure, deteriorating kidney function, hemolysis and thrombocytopenia. The patient was treated with perindopril and rapid reduction of steroid doses. This was followed by correction of hemolysis and thrombocytopenia. Two months later, the patient was off dialysis, but had chronic renal insufficiency with an estimated GFR of 25 ml/minute. This report describes the occurrence of SRC in a patient with lupus nephritis and SSc/SLE overlap syndrome who was treated by CS and cyclophosphamide