Abderrahmane Mami Hospital

Our study showed a moderate knowledge and practice regarding breast cancer screening, alongside a generally good attitude. The factors associated with good practice underscore the importance of educational interventions and the targeted screening strategies.

Non-ST-segment elevation myocardial infarction (NSTEMI) in patients with type 2 diabetes mellitus (T2DM) is frequently associated with increased inflammation and myocardial injury. Sodium-glucose co-transporter 2 inhibitors (SGLT2-I) show cardiovascular benefits in chronic care, but their role in acute ischemia remains uncertain. To assess whether chronic use of SGLT2-I in T2DM patients admitted for NSTEMI is associated with reduced systemic inflammation, infarct size, and improved left ventricular function. This retrospective, monocentric study included 60 T2DM patients hospitalized for NSTEMI at Abderrahmen Mami Hospital between December 2024 and April 2025. Patients were divided into two groups: 21 on chronic SGLT2-I (Dapagliflozin, ≥ 3 months use) and 39 without prior SGLT2-I therapy, initiation of SGLT2-I was planned upon discharge. Inflammatory markers (C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR)), infarct size (peak troponin, affected myocardial segments), and left ventricular ejection fraction (LVEF) were assessed. HbA1c and renal function (eGFR) were also evaluated. SGLT2-I users had significantly lower CRP (17.8 ± 20.1 vs 35.7 ± 32.8 mg/L, P = 0.011), NLR (2.9 ± 1.1 vs 3.9 ± 1.6, P = 0.02), and PLR (102.5 ± 35.2 vs 132.1 ± 48.7, P = 0.03) ( Fig. 1 ). Peak troponin was markedly reduced (1273.6 ± 1473, median: 500 ng/L vs 6100.2 ± 10824 ng/L, median: 1200 ng/L, P = 0.009). LVEF, assessed by the Simpson biplane method, was significantly higher in the SGLT2-I group: 53.0 ± 9.4% (median: 52.7%), with 71.4% of patients having LVEF > 50%, compared to 48.0 ± 10.1% (median: 47.7%) and 38.5% with LVEF > 50% in the non-SGLT2-I group ( P = 0.002), with fewer affected myocardial segments (1.6 vs 2.4). HbA 1C was lower (7.7 ± 1.5% vs 8.5 ± 1.2%, P = 0.16), though not significant. Renal function was assessed using the MDRD formula. Two patients (3.3%) had an estimated glomerular filtration rate below 30 mL/min/1.73 m 2 , both from the non-SGLT2-I group. Overall, 96.7% of patients had an eGFR above 30 mL/min/1.73 m 2 . Chronic SGLT2-I use in T2DM with NSTEMI may be associated with reduced inflammation, smaller infarcts, and better cardiac function.

Objective. To analyze the risk factors of sternal wound infection (SWI) complicating BITA grafting. Material and methods. A retrospective study included patients who underwent isolated coronary artery bypass grafting (CABG) using BITA grafts between January 2018 and March 2023. Patients were assigned to the diabetic (D) or non-diabetic (ND) groups. Results. The study involves 243 patients undergoing CABG. Morbid obesity was potential risk factor associated with SWI in both groups. The overall risk of SWI was insignificantly higher in the diabetic group (p=0.094). However, deep SWI was significantly more common in diabetic patients (p=0.012). In-hospital mortality associated with SWI was 5.6% and 8.8% in groups ND and D, respectively. There was no significant difference between patients who died with or without SWI in group ND (p=0.830). Conclusion. Morbid obesity was the major risk factor associated with SWIs after CABG using BITA grafts in patients with and without diabetes. Despite small sample size, our results suggest advisability of BITA even in diabetic population.

<h3>Objective</h3> To evaluate healthcare professionals’ knowledge, attitudes, and behaviors regarding influenza vaccination, and identify key factors influencing vaccination hesitancy. <h3>Material and Methods</h3> A descriptive cross-sectional study was conducted from December 2, 2024, to April 30, 2025. An anonymous online questionnaire was distributed via Google Forms targeting healthcare workers. The survey assessed sociodemographic data, knowledge of the flu vaccine, vaccination status, and motivations or barriers to uptake. <h3>Results</h3> One hundred sixty-two healthcare professionals responded. Most were aged 30–39 (43.3%) or 40–50 (40%), with 11.7% under 30 and 5% over 50. The sample included 56.7% men and 43.3% women. Professionally, 55% were physicians, 13.3% pharmacists, 13.3% nurses, and 6.7% dental surgeons; 73.3% worked in the public sector. Knowledge was generally good: 86.7% correctly stated that one dose is given per year; 81.7% knew the vaccine changes annually due to virus mutation. Regarding administration route, 65% correctly identified the intramuscular route. On vaccine indications, 90% cited the elderly, 80% the immunocompromised, 76.7% healthcare workers, and 65% young individuals with chronic respiratory conditions. Pregnant women were cited by 30%, and only 18.3% cited children under 5. Despite this knowledge, only 28.3% had received the flu vaccine. Still, 60% expressed willingness to be vaccinated in the future, while 40% remained hesitant. The most cited reasons for refusal were: belief that vaccination is unnecessary (67.6%), fear of side effects (40.5%), lack of confidence (29.7%), and insufficient information (21.6%). Interestingly, 76.7% reported encouraging others to get vaccinated. <h3>Conclusion</h3> While healthcare workers demonstrate good knowledge of influenza vaccination, uptake remains low due to persistent misconceptions. These findings underline the urgent need for targeted awareness campaigns to address vaccine hesitancy and promote greater acceptance among medical professionals.

Rigid bronchoscopy is a specialised endoscopic modality utilising a rigid scope instrument to afford direct visualisation and intervention within the central airways. In contradistinction to flexible bronchoscopy, the augmented working channel of the rigid instrument permits the introduction of larger-calibre instrumentation, thereby facilitating complex therapeutic procedures. These procedures encompass, inter alia, foreign body retrieval, endoluminal tumour debulking, airway stent deployment, and the management of life-threatening haemoptysis. While the procedure mandates general anaesthesia and a high level of operator expertise, rigid bronchoscopy provides superior airway control and the capacity to address complex airway pathologies that may be refractory to flexible bronchoscopy.

Echinococcosis is a widespread infectious condition. When the disease affects the thoracic wall, specifically the ribs, it presents significant diagnostic, therapeutic, and prognostic challenges. <bold>Methods:</bold> It's a retrospective, multicenter study covering cases recorded between 2000 and 2024. <bold>Results:</bold> We collected 12patients (9Men/3women) with a mean age of 41 years. Five patients had a prior history of echinococcosis of the lungs or liver. Costal hydatidosis was discovered by a parietal swelling (n=5), rib pain (n=2) or fortuitously (n=5). Chest X-rays detected a parietal opacity in 8 cases, pleural effusion in 2 cases, and cortical rib irregularities in 2 cases. Thoracic ultrasound showed an anechoic parietal mass in 2 cases and a multivesicular pattern in 6 cases. CT scans revealed poorly defined hypodense lacunar lesions (n=3), multivesicular formations (n=7), and costal bone destruction (n=10). More than two ribs were affected in 6 patients. MRI depicted a lesion with hypointense T1 and hyperintense T2 signals. Hydatid serology was positive in 6 cases. All patients were operated via a posterolateral thoracotomy. Costal resection was performed in 7 cases. Postoperative course was uneventful in 10 cases. One patient presented wound infection and another presented an acute respiratory distress syndrome. Albendazole therapy was administered to all patients. During the follow-up, recurrence was observed in 2 patients. Unfortunately, 3 patients succumbed to complications related to hydatid disease. <bold>Conclusion:</bold> In the costal echinococcosis, the prognosis depends on associated vertebral involvement and recurrences that's why it should be considered similar to a malignant lesion.

Introduction : Obesity has been linked to worse asthma control, yet its precise impact on spirometric parameters and symptoms remains unclear in pediatric population. This study aimed to evaluate the association of Body Mass Index (BMI) with asthma control and spirometric parameters among children. <bold>Methods:</bold> A retrospective study was conducted on asthmatic children. Asthma control was assessed using the Asthma Control Questionnaire (ACQ). Spirometry was performed with measurement of Forced Expiratory Volume in one second (FEV₁%), Forced Vital Capacity (FVC%), and Forced Expiratory Flow at 50% of FVC (FEF50%). <bold>Results:</bold> The study included 62 children (mean age: 8.97 ± 3.01 years; BMI: 17.72 ± 3.33 kg/m²; sex ratio 1.07 M/F). Poor asthma control (ACQ ≥1.5) was observed in 38.7% of the children. Normal-weight children accounted for 69%, overweight for 27%, and obese for 4% of the study population. Regarding spirometry, FEV₁% significantly differed across BMI categories (Normal-weight:87.4±12.5%, Overweight:79.8 ± 10.7%, Obese:74.2 ± 9.3%; p < 0.001). However, ACQ scores did not significantly vary between BMI groups. BMI was correlated with FEV1% (r=-0.435, p < 0.001) and FEF50% (r =-0.580, p < 0.001) but showed no significant correlation with ACQ. Conversely, ACQ was correlated with FEV₁% (r =0.315, p = 0.013), suggesting a stronger relationship between asthma control and airway obstruction than with BMI. <bold>Conclusion:</bold> BMI was not significantly associated with asthma control but had a measurable impact on lung function. ACQ scores were more closely related to airway obstruction than BMI, reinforcing the importance of spirometric assessment in pediatric asthma management.

COVID-19 is associated with a high incidence of thromboembolic events (TEE). We aimed to determine the incidence of arterial and venous TEE, identify risk factors for their occurrence, and investigate any potential increased mortality associated with these complications in ICU patients with Covid 19. <bold>Methods:</bold> Observational, retrospective, monocentric study conducted in COVID-19 patients admitted to intensive care unit, over a period of 22 months. We studied TEE and their risk factors. <bold>Results:</bold> A total of 599 patients were included. Mean age was 61±13 years. The most common comorbidity were obesity, followed by hypertension and diabetes in 41.6%, 38.1% and 35.9% of cases respectively. The occurrence of TEE was noted in 133 patients, with a total number of 170 episodes, representing an incidence density of 24/1000 patient-days. The median time to onset of TEE from admission was six IQR [2-11] days. Venous and arterial thromboembolic complications were noted in 94 patients (15.7%) and 39 patients (6.5%) respectively. Independent predictors of TTE were invasive mechanical ventilation (IMV) (OR=3.954; CI95% [2.522-6.186]; p<0.005), use of curares (OR=4.454; CI95% [2.512-7.900]; p<0.005) and a D-dimer level >1066 µg/L (OR=4,479; [2,185-12,349]; p<0.005). TTE was an independent predictor factor for mortality (OR= 2.17; 95% CI [1.39-4.23]; p=0.002). <bold>Conclusion:</bold> Arterial and venous TEE are highly common in patients admitted to the ICU for COVID-19. Their occurrence is mainly associated with invasive mechanical ventilation, the use of curares and a D-dimer level > 1066 µg/L. A national multicenter study would be required to confirm these results.