Avicenna Medical Research

LES AUTOPSIE JUDICIAIRES DES DECES PAR INTOXICATION AIGUE AU MONOXYDE DE CARBONE : UNE ETUDE RETROSPECTIVE SUR UNE PERIODE DE 10 ANS

2025-03-30T22:05:00+00:00

Introduction
L'intoxication au monoxyde de carbone (CO) constitue une cause majeure de décès
accidentels en Algérie, principalement liée aux appareils de chauffage domestique
défectueux. Ce gaz inodore et incolore entraîne une hypoxie tissulaire grave. Cette étude
vise à analyser les caractéristiques démographiques, circonstancielles et toxicologiques des
décès par CO recensés lors des autopsie judiciaires au CHU Mustapha d'Alger entre 2015 et
2024 afin de proposer des mesures préventives adaptées.
Méthodes
Il s'agit d'une étude rétrospective descriptive portant sur 75 autopsies judiciaires pour
intoxication au CO. Les données ont été extraites des rapports d’autopsies judiciaires et
incluent les variables démographiques, les circonstances du décès et les résultats
toxicologiques. L'analyse statistique a été réalisée avec SPSS 27.
Résultats
La majorité des victimes (57%) étaient des hommes, avec un âge moyen de 36,5 ans. Les
intoxications collectives représentaient 60% des cas. Le chauffe-bain était impliqué dans
75% des décès, souvent en raison de problèmes d’évacuation des gaz (80%). Les taux
moyens de carboxyhémoglobine par analyse des prélèvements lors de ces autopsies étaient
élevés (71%), confirmant la gravité des intoxications. Une saisonnalité hivernale marquée a
été observée.
Discussion & Conclusion
Les résultats soulignent l'urgence de renforcer la prévention par des normes de sécurité
améliorées, la sensibilisation du public et l’installation de détecteurs de CO. Une approche
multisectorielle impliquant les autorités sanitaires et les professionnels du bâtiment est
essentielle pour réduire ces décès évitables.

Abstract
Introduction
Carbon monoxide (CO) poisoning is a major cause of accidental deaths in Algeria, primarily
linked to faulty domestic heating appliances. This odorless and colorless gas leads to severe
tissue hypoxia. This study aims to analyze the demographic, circumstantial, and toxicological
characteristics of CO-related deaths recorded in judicial autopsies at CHU Mustapha in
Algiers between 2015 and 2024 to propose appropriate preventive measures.
Methods
This is a retrospective descriptive study of 75 judicial autopsies related to CO poisoning.
Data were extracted from judicial autopsy reports and included demographic variables,
circumstances of death, and toxicological findings. Statistical analysis was performed using
SPSS 27.
Results
The majority of victims (57%) were male, with an average age of 36.5 years. Collective
poisonings accounted for 60% of cases. Water heaters were involved in 75% of deaths, often
due to gas evacuation issues (80%). The average carboxyhemoglobin levels from autopsy
samples were high (71%), confirming the severity of poisoning. A marked winter seasonality
was observed.
Discussion & Conclusion
The findings highlight the urgent need to strengthen prevention through improved safety
standards, public awareness campaigns, and the installation of CO detectors. A multisectoral
approach involving health authorities and construction professionals is essential to reduce
these preventable deaths.
Keywords: Carbon monoxide poisoning, Judicial autopsy, Water heater,
Carboxyhemoglobin, Prevention

Prevalence and risk factors associated with the severity of depression in patients with end-stage renal disease undergoing haemodialysis in southern Algeria.

2025-03-30T22:05:01+00:00

SUMMARY

Introduction: The management of patients suffering from end-stage chronic renal failure on haemodialysis is a major public health issue. Haemodialysis patients face a number of challenges: social, relational, family, financial, and psychological distress, of which depression is the main psychiatric condition described in this population.

High prevalence of depression in haemodialysis patients, which is underestimated, unrecognised and undiagnosed, represents a risk removed by non-compliance with treatment, indirectly responsible for an increase in morbidity and mortality in these patients.the severe nature of depression leads the patient to commit suicide, increases the potential for mortality and reduces quality of life.It is an additional burden for haemodialysis patients. Diagnosis and early detection of depression and its management is considered an indicator of quality of life .In Algeria, there is little data on depression in chronic haemodialysis patients, although it is the main psychiatric manifestation described in this population.We conducted this study in order to help improve the management of haemodialysis patients and improve their quality of life.. The aim of our study was: to assess the prevalence of depression and the clinical and epidemiological characteristics of this depression in haemodialysis patients in the EPHs of Laghouat, and to assess its severity using a Hamilton psychometric scale. And to look for factors associated with the severity of depression in patients with chronic renal failure undergoing haemodialysis.

Patients and Methods: This is a prospective cross-sectional descriptive study of patients with end-stage chronic kidney disease undergoing haemodialysis. From 13 July 2021 to 14 July 2022, a period of 12 months with a diagnosis of EDC, based on the DSM-5 diagnostic criteria.

Results and Discussion: A total of 379 patients were treated in the four haemodialysis centres in the wilaya of Laghouat during the study period. Of these, 289 met the inclusion criteria; 57.1% were men and 42.9% women, corresponding to a sex ratio of 1.33 with an average age of 52.38± 17.13 years, ranging from 18 to 91 years; the average duration of haemodialysis was 8 years and 2 months and 4 days; 56% had an average standard of living, 58.1% had completed their primary education, 56.1% were married, however kidney disease limited their activities, most of the patients (90%) had no activities, most of them (74.7% had undergone haemodialysis treatment for more than 5 years, the majority (69.6%) were less than 50 km from the haemodialysis centre to their home, almost all (90%) had received social support and 58.1% lived in an urban environment, 46% had comorbidities such as diabetes and hypertension, evenly distributed. In addition, the majority (58%) had a fistula as their vascular approach, 92% had regular sessions 3 times a week and 56.7% had frequent dialysis incidents. The prevalence of EDC was 76.5% in the population of haemodialysis patients in the wilaya of Laghouat, of whom 48.8% had mild depression, 27.7% had mild to moderate depression and 23.5% had moderate to severe depression. Five factors were found to be strongly correlated with the severity of depression, which was confirmed in multivariate analysis by ordinal logistic regression with: profession, average socioeconomic level, distance of haemodialysis centre from home, frequent dialysis incidents and accidents, duration of haemodialysis treatment. The risk of having severe depressive symptoms was 50.15 times for patients who had dialysis incidents during haemodialysis sessions,
25.99 times for non-active patients, 9.45 times for patients who had been on haemodialysis for between 1 and 2 years, 4.78 times for patients whose distance from home centre was greater than 100km, 3.75 times for patients whose socio-economic status was average.

Conclusion: This study shows that depression is common in chronic haemodialysis patients and is often unrecognised and underestimated. Early diagnosis and management of the haemodialysis patient must be multidisciplinary. Collaboration between psychiatrists and nephrologists must begin as early as possible in order to inform the patient of the difficulties that are likely to arise during the course of treatment. The aim is to reduce the severity of depression and improve quality of life by keeping patients active and improving their socio-economic conditions, by creating new centres close to haemodialysis patients' homes and by preventing frequent dialysis incidents and accidents.

Caractérisation des Profils d’Intoxication en Algérie 2020 -2022

2025-03-30T22:05:01+00:00

Abstract

Les intoxications médicamenteuses et aux substances psychoactives représentent un enjeu majeur de santé publique. L’identification précise des substances impliquées est essentielle pour améliorer la prise en charge des patients, adapter les stratégies de prévention et optimiser les politiques de santé.

Méthodes : Cette étude rétrospective et descriptive a porté sur 162 échantillons urinaires collectés entre janvier 2020 et octobre 2022. Les analyses toxicologiques ont été réalisées par chromatographie en phase gazeuse couplée à la spectrométrie de masse (GC-MS) et immunoanalyses. Les données cliniques et sociodémographiques des patients ont été extraites du logiciel EL-TYRIAK et analysées à l’aide de Microsoft Excel et IBM SPSS version 26.

Résultats : Les résultats montrent une prédominance masculine (85,8 %) et une concentration importante de cas chez les jeunes adultes âgés de 21 à 30 ans. Parmi les 47 molécules identifiées, la Prégabaline, le cannabis et la morphine se démarquent par leur fréquence d’apparition et la forte implication des opioïdes dans les cas d’intoxication, plaçant ces substances en tête des drogues détectées. Par ailleurs, 79,9 % des demandes de dépistage étaient motivées par des contextes médicaux, suivis des accidents de la voie publique et des tentatives de suicide. Le délai de prélèvement, variant principalement entre 6 et 48 heures après l’intoxication.

Discussion : L’analyse révèle une forte implication de la toxicomanie dans les cas étudiés et souligne l’importance d’un délai de prélèvement optimal pour une détection fiable. Ces résultats suggèrent la nécessité de renforcer les stratégies de prévention et d’optimiser la prise en charge toxicologique, tout en élargissant le panel des substances détectables afin d’améliorer l’efficacité diagnostique et thérapeutique.

Predictive prognostic value of reverse shock index multiplied by Glasgow scale in trauma patients

2025-03-30T22:05:01+00:00

Abstract:

Background: Trauma is one of the leading causes of death and disability around the world, and it is one of the important issues in public health. In the field of emergency medicine, a careful evaluation of trauma severity is essential to steer clinical interventions and enhance patient outcomes. The Reverse Shock Index multiplied by Glasgow Scale (RSIG) holds promise as a potential prognostic tool for trauma patients. However, there is limited research examining its predictive efficacy in real-world clinical settings, particularly within the context of Colonel Lotfi Hospital. This study aims to externally validate the accuracy of the rSIG in the prediction of mortality, need for transfusion and need for surgical procedure

Materials and methods: This is a retrospective, comparative, analytical cohort study, Data were collected from the medical records of hospitalized patients and operative protocols of Colonel Lotfi Mixed Hospital and Hmida Benadjila Hospital in Laghouat for severe trauma between January 2018 and December 2022, where the series focused on patients aged between 18 and 80 years who were hospitalized for severe trauma or polytrauma. The outcomes were circumstances of the trauma, vital signs (SBP, DBP, HR, RR) at ED presentation, GCS and hemoglobin levels at ED presentation, the need of transfusion and the need of surgical intervention, and the in-hospital mortality.

Results:78 patients were admitted to the emergency department for severe trauma, the average age of our study population was close to 40 years old, with a male predominance (80.8%). The inferential analysis comparing two groups (survivals and dead) found that rSIG, HB, need for transfusion, Damage control, some sites of injury like traumatic brain injury and many has significant impact on the mortality rate. the average of rSIG score among survivals was around 17.4, and its average among dead was 7.9 with a (P < 0.00*), another inferential analysis comparing group A (rSIG<15) and group B (rSIG>15) with different parameters that tend to have significant results whom are Dead in hospital, need for transfusion, damage control, operated patients and re-operated patients. The frequency of in-hospital mortality was significantly higher in group A when compared to group B [51.2% versus 02.7%; P<0.00

Conclusion: The rSIG is more accurately identifies patients with severe trauma at highest risk of death. These findings may help further refine early risk assessments for patient management.

Forme pseudo psoriasis a Trichophyton mentagrophytes « Chez un diabétique ; A propos d’un cas »

2025-03-30T22:05:02+00:00

Résumé

La recherche mycologique d'une lésion évoquant une dermatophytie de la peau ou des phanères est de courante pratique au laboratoire d'analyse médicale, mais le diagnostic clinique peut rencontrer plusieurs difficultés ou pièges, notamment chez les diabétiques.Nous rapportons un cas clinique d’une patiente diabétique originaire et demeurante à Laghouat au Sud Algérien qui présente des lésions papulo squameuses en plaque d’évolution chronique diagnostiqué en premier temps comme étant un psoriasis ,devant l’évolution défavorable des lésions sous corticothérapie la patiente à consulter une deuxième fois ,un examen mycologique été effectuer mis en évidence l’origine fungique à T.mentagrophytes des lésions ,avec une amélioration brillante des lésions sous antifongique Certaines dermatoses peuvent simuler une dermatophytie : lupus érythémateux systémique, eczémas nummulaires, psoriasis, érythrasma… , le clinicien doit bien les connaître afin de minimiser les dommages physiques et psychologiques en traitant des patients fragilisés, en identifiant et en prévenant la multi morbidité associée à la maladie.

Mots clés ; Psoriasis, diabète, Trichophyton mentagrophytes

Abstract

Mycological research for a lesion suggestive of dermatophytia of the skin or appendages is common practice in the medical analysis laboratory, but clinical diagnosis can encounter several difficulties or pitfalls, particularly in diabetics. We report a clinical case of a diabetic patient originating and residing in Laghouat in southern Algeria who presents papulo-squamous lesions in plaque of chronic evolution diagnosed initially as psoriasis, given the unfavorable evolution of the lesions under corticotherapy, the patient to be consulted a second time, a mycological examination was carried out highlighting the fungal origin of T.mentagrophytes of the lesions, with a brilliant improvement of the lesions under antifungal. Certain dermatoses can simulate dermatophytia: systemic lupus erythematosus, nummular eczemas, psoriasis, erythrasma…, the clinician must know them well in order to minimize physical and psychological damage by treating weakened patients, by identifying and preventing the multi-morbidity associated with the disease.

Keywords; Psoriasis, diabetes, Trichophyton mentagrophytes.

Récidive cutanée du cancer du sein au niveau du cuir chevelu : Un cas rare de carcinome canalaire Infiltrant Luminal A

2025-03-30T22:05:02+00:00

Résumé :

La récidive cutanée du cancer du sein est une entité rare, encore plus lorsqu'elle siège au niveau du cuir chevelu. Nous rapportons le cas d'une patiente de 55 ans, sans antécédents médico-chirurgicaux, ayant présenté une récidive cutanée au niveau du cuir chevelu après traitement d'un carcinome canalaire infiltrant du sein gauche de type luminal A. Nous discuterons les particularités cliniques et thérapeutiques de cette localisation rare et procéderons à une revue de la littérature.