Despite the existence of well codified indications, the performance of mutilating surgery in ophthalmology is not an easy decision to take due to the aesthetic and moral damages that patients may suffer. This surgery should be considered as a last resort in the case of a non-functional, painful and unsightly eye or in the presence of an oncological involvement and after all conservative alternatives have been exhausted. This study aims to define the factors making it possible to favor ocular evisceration, which is the least mutilating of the above-mentioned surgeries, by determining the epidemiological and clinical aspects of the patients. In addition, the results of the study will serve as a starting point for epidemiological surveillance and will guide preventive activities and the fight against blindness.
We conducted an exhaustive retrospective study of medical records from the archives of the ophthalmology departments of the Dr. Tidjani Damardji University Hospital Center in Tlemcen, the Specialized Hospital Establishment in ophthalmology of Oran Hamou Boutlelis, the Specialized Hospital Establishment in ophthalmology of Oran Front de mer and the University Hospital Center of Bejaia (unit Franz Fanon), in order to specify the epidemiological-clinical profile of patients who have undergone an ocular evisceration in the north of Algeria from January 1, 2008 to December 31, 2014.
We have identified 136 patients, representing an admission rate of 0,13% in all these services. We noted a slight male predominance with an estimated sex-ratio of 1.4. Evisceration was carried out mainly following an ocular trauma in 39% of cases. The surgical technique performed in all patients is a classic non-conservative evisceration of \"four quadrants\" or \"four squares\" under general anesthesia in 55.9% of cases. Post-operative complications were found in 19.8% of patients in our series, the main one being exteriorization of the intra-scleral implant in 9.5% of cases. This rate corresponds to the data in the literature, with figures between 0 and 67%. This complication may be in relation with the experience or even the competence of the surgeon. Accessibility to ocularists and the quality of prosthetic equipment were also studied. All the data collected were compared with data from the international medical literature. Our study carried out in the north of Algeria on ocular eviscerations, allowed us to deduce that this surgery is rarely carried out in ophthalmology. Its main indications are post-traumatic and post-infectious.
The prevention of mutilating surgeries requires early diagnosis and appropriate treatment of ophthalmological pathologies and trauma. Losing an eye is always experienced as a tragedy and can be devastating at any age, affecting self-image and self-esteem. Psychological support is therefore essential.

Breastfeeding is considered the best nutrition for infants and plays a significant role in a child\'s growth and development. In this regard, the World Health Organization (WHO) strongly recommends exclusive breastfeeding for the first 6 months of life, as well as continued breastfeeding when safe and appropriate complementary foods are introduced, up to 2 years of age or beyond. Nonetheless, breastfeeding practices remain sub-optimal in many parts of the world. In this respect, many children have shown not to be breastfed up to 6 months of age or are not breastfed during their first hours of life or are weaned too early. This allows for the use of infant formula, which can be life threatening due to poor hygiene, storage conditions or inappropriate foods. Likewise, breastfeeding rates in the Middle East and North Africa (MENA) region are lower than the global average. In Algeria, the breastfeeding rate up to 6 months of age is among the lowest in the world according to previous Multiple Indicators Cluster Surveys (MICS) reports. In addition, by the end of the sixth month, the percentage of children exclusively breastfed is less than 3% and only 23% of children receive breast milk at 22-23 months. The median duration of breast-feeding is 12 weeks. However, the socio-demographic factors associated with this sub-optimal breastfeeding practice are not explored in these reports, as studies and research conducted in this context using other data are few and mostly conducted in limited geographical areas.
This stands for a descriptive cross-sectional study of all children who were breastfed in the MICS database, carried out in 2019, 8 709 children, including 4 471 boys and 4 238 girls, registered in the database. To explore factors associated with the duration of breastfeeding, we only included weaned children to minimize bias related to children who were still breastfeeding. This allowed to analyze data from 3 761 children, including 1 930 boys (5.4%) and 1,831 girls (48.6%). Through using a logistic regression model, we could attain the assessment of the role of different socio-demographic, economic and geographical factors in the maintenance of breastfeeding beyond 6 months.
The prevalence of breastfeeding is 81.1%; the rate of exclusive breastfeeding of children aged 0-6 months is 28.7%. The factors associated with breastfeeding beyond six months are area of residence, mother\'s occupational status and wealth quintile. In fact, rural area appears to be a factor favoring the continuation of breastfeeding beyond six months, compared with urban area (OR = 1.29; CI [1.032-1.369]). Mothers living in the Eastern Highlands geographic region appear to be 1.56 times more likely to maintain breastfeeding for more than six months compared to those living in the Southern region (OR = 1.56; CI [1.123 - 1.677]). Children of non-working mothers are almost 1.5 times more likely to be breastfed after 6 months than those of working mothers (OR = 1.489; CI [1.107 - 1.947]). Parents belonging to the \"richest\" wealth quintiles appear to increase the chance of continued breastfeeding after 6 months with a 1.24-fold increase compared to those belonging to the \"poorest\" quintile (OR = 1.24; CI [1.086 - 1.812]). Factors such as the child\'s gender, maternal education level, and functional difficulties do not appear to be determining factors for the continuation of breastfeeding after six months.
The prevalence and factors associated with the initiation and continuation of breastfeeding vary from one country to another. Notwithstanding the numerous studies to better comprehend mothers\' breastfeeding behaviour and various initiatives for promotion thereof, many countries have low rates. In consequence, the downward trend in breastfeeding is directly linked to advances in the production and marketing of industrial milks, the lack of information and awareness among mothers and the lack of training of health professionals. In this respect, it is highly recommended to encourage behavioural changes, to improve communication about the duration of breastfeeding, to increase the use of postnatal counselling and training of paramedical staff according to the recommendations with support for mothers.This study is of great interest in developing countries like Algeria, in order to adopt preventive interventions, and to organise communication and pre- and post-natal counselling in the breastfeeding project. Clearly, this study should be enhanced with supplementary qualitative studies concerning the factors contributing to early discontinuation of breastfeeding.

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UNASSIGNED: Cystic echinococcosis is highly endemic in Algeria and constitutes a major socio-economic problem. Typing the species of the Echinococcus granulosus sensu lato complex circulating in cattle requires the use of a hydatid cyst sampling method adapted to difficult field conditions (high heat and humidity, long transport time). The FTA Card method currently constitutes an effective means of preserving biological samples before their molecular analysis. In the present study, the FTA Card method was used in the collection of hydatid cysts to identify the species of E. granulosus sensu lato circulating in ruminants (intermediate hosts) in eastern Algeria.
UNASSIGNED: A PCR was carried out for 41 samples of hydatid cysts taken from six slaughterhouses in eastern Algeria, targeting the cox1 mitochondrial gene. PCR products were visualized by electrophoresis in a 1% agarose gel.
UNASSIGNED: The results of the molecular analysis of all hydatid cyst samples confirmed the presence of E. granulosus sensu stricto in sheep, cattle and camels. The ubiquitous nature of the G1 genotype has been demonstrated. The use of FTA Card sampling is an efficient and simple method to obtain a biological sample in order to characterize the species of E. granulosus sensu lato in Algeria. The good preservation of the DNA in this matrix will make it easier to obtain new molecular data from difficult regions. The identification of the species of the E. granulosus sensu lato complex involved in the biological cycle is an essential prerequisite for the implementation of control measures, since different host species participate in their evolutionary cycle. The characterization of E. granulosus genotypes is essential to define an appropriate control strategy against cystic echinococcosis.

UNASSIGNED: Myiasis is an infestation of humans or animals by larval forms of brachycetes. Commonly observed locations are otolaryngological and cutaneous. Gastrointestinal localization remains exceptional. In this work, we report the observation of a Moroccan case of gastrointestinal myiasis caused by Drosophila melanogaster. Observation. The patient was a 56-year-old man living in a rural region of northwest Morocco. He was being followed at the National Oncology Institute in Rabat for pulmonary and renal adenocarcinoma and was put on neo-adjuvant chemotherapy with concomitant radiochemotherapy. The patient presented vomiting twice containing about forty small white, circular and hairless worms measuring 4 mm in length. This sample was sent to the parasitology and mycology laboratory for identification. Microscopic study of the larvae and adult flies obtained after rearing in the laboratory of parasitology allowed the diagnosis of myiasis caused by Drosophila melanogaster.
UNASSIGNED: This observation is noteworthy for both its exceptional anatomical localization and the implicated parasite species.

To attempt resolving this issue accurately, it was necessary to anchor our experimental approaches in the observations and pioneering work of our predecessors, notably Alphonse Laveran, Louis Parrot, Edmond and Étienne Sergent. The latter, among other things, had identified as natural hosts of leishmaniasis, rodent populations with which hematophagous telmophagous sand fly populations cohabited closely.When human populations emerged in these natural ecosystems, after the sedentarization of Homo sapiens, more or less important disturbances would have led to a transition of sand fly hematophagy, from zoophilia, to zoo-anthropophilia and anthropophilia.The creation of infrastructures that allow the breeding and integration into experimental groups of both holobiont sand flies and holobiont laboratory rodents (rats, mice, hamsters, etc.) remains crucial. With such infrastructures, it becomes possible to grasp and characterize the multilateral dynamic processes - mostly clinically silent - that account for the biogenesis of tissue and/or cellular niches protecting populations of Leishmania developmental morphotypes, including those ensuring host-to-host transmission, albeit in small numbers.

Since December 2019, a novel coronavirus (SARS-CoV-2) has triggered a global pandemic with a heavy medical and societal-economic toll. The health consequences were not similar during the successive waves that affected several countries. The aim of our study was to compare the sociodemographic, clinical and evolutionary features of COVID-19 patients hospitalized at the Military Hospital of Tunis (HMPIT) during the 2nd and 3rd waves that affected the country.
Observational prospective study involving 1,527 COVID-19 patients hospitalized at HMPIT over 11 months, divided into two periods: from July 2020 to December 2020 called the second wave (V2) and from January 2021 to May 2021 called the third wave (V3). We compared the epidemiological data, the clinical form and the evolution of the patients for each period.
The number of hospitalized patients was 636 during V2 compared to 891 during V3. Average age was 63.5 ± 15.3 years during V2 versus 65.8 ± 17.8 years during V3 (P = not significant [NS]). The percentage of young adults [18-40 years] was 6.5% during V2 compared to 6.7% during V3 (P = NS). The gender ratio (M/F) was 1.59 for V2 and 1.42 for V3 (P = NS). Comorbidities were present in 65% of V2 patients and 66.3% of V3 patients (P = NS), with hypertension being the most prevalent one in both groups (47.2% for V2 versus 44.9% for V3; P = NS), followed by overweight, dyslipidemia and diabetes (33% for V2 versus 39.3% for V3; P = 0.012). The median duration between symptoms onset and hospitalization was 7 days [5-10] during V2 versus 8.5 days during V3 [5-12] (P = 0.0004). The severe clinical form was present in 49% of patients admitted during V2 compared to 34.8% during V3 (P < 10-3). The critical form represented 18.6% of cases during V2 against 16.8% during V3 (P = NS). The average hospital length of stay in COVID units (outside of intensive care unit) was 8.4 ± 5.4 days during V2 and 9.8 ± 5.7 days during V3. The average length of stay was significantly longer for the intensive care unit (11.3 ± 3.4 days for V2 versus 13.8 ± 3.9 days for V3; P = 0.01). The case fatality rate was 24.5% during V2 and 20.7% during V3 (P = NS). Median age of death was 70.2 years [42-88] during V2 and 70.4 years [22-96] during V3 with 2 patients less than 40 years of age (1%) for the latter period. The gender ratio (M/F) of deceased patients was 3.21 for V2 and 1.5 for V3 (P = 0.001). The case fatality rate was higher in the intensive care unit (65.4% for V2 versus 69.7% for V3; P = NS). Causes of death were dominated by ARDS (acute respiratory distress syndrome) for both periods (55.1% for V2 versus 70.8% for V3; P = 0.002), followed by septic shock (12.8% for V2 versus 10.8% for V3; P = NS) and multi-organ failure (9.6% for V2 versus 7.0% for V3; P = NS).
This study revealed a decrease in severe and critical clinical forms during the 3rd wave, as well as a decrease in the case fatality rate compared to the previous wave, due to improved management and vaccination. On the other hand, the percentage of ARDS was significantly higher during this wave probably related to the beginning of circulation in our country of the Delta variant causing more severe clinical cases.

Myiasis is the infestation of living bodies of animals and humans with fly larvae or maggots. These accidental or obligatory parasites grow in three stages in the host while feeding on his tissues. Myiasis in a hospital area is a rare situation when flies accidentally lay their eggs on patients, mostly in open wounds or cavities. Case presentation. We report a case of a 72-year-old patient admitted to a general surgery department for peritonitis, then to an intensive care unit (ICU) for septic shock where he was intubated. Some maggots were seen moving in his nasal cavity a few days after his admission and were sent to our laboratory for examination. The larvae were identified as the third larval stage of Lucilia sp. They were removed entirely after intense nasal washing. A checking examination of his nasal cavities revealed no evidence of further infestation. After nasal washing, no other larvae were seen but unfortunately, the patient died of septic shock a few days later.
Few cases of nasal myiasis in hospitalized patients were reported. ICU myiasis, extremely rare, is caused by the patient\'s inability to fend off the flies because of their conscious state, presence of blood or odors caused by infections, and the warm humid environment.
Myiasis in intensive care unit is a delicate situation that might be underreported. Preventing this infection is directly related to the control of the flies.

Hydatidosis is a zoonosis caused by Echinococcus granulosus. It\'s a real public health problem in Morocco. Muscle localization is unusual, even in endemic countries. We report a rarely described case of a hydatid cyst of the psoas muscle diagnosed in our laboratory.
The patient was a 32-year-old male, living in a rural area. He reported a contact with dogs. He was admitted in vascular surgery department for left hypochondrium pain, with heaviness of the left lower limb and appearance of varicose veins. Clinical examination has found a huge painful and hard mass of the left flank arriving to the hypogastrium with varicose veins of the left leg. An injected CT scan of the pelvic region showed a 189 x 137 mm cystic mass of the left psoas muscle reflowing left iliac vessels. This suggested hydatid cyst. No other localization was found. Hydatid serology was positive with an ELISA test and an indirect hemagglutination test. The patient underwent surgery to remove the mass. Several white vesicles of a few centimeters were found in the cyst and were sent to the parasitology laboratory. Microscopic examination has confirmed the presence of viable Echinococcus granulosus. The patient received albendazole 400 mg twice daily for only a month and was not seen for follow-up. One year after surgery, he showed the same symptoms of abdominal pain and heaviness. Recurrence of hydatid cysts in the same localization was diagnosed with ultrasound showing two hydatid cysts type 3 according to Gharbi classification.
Diagnosis of all hydatidosis localizations is based on epidemiological, clinical, and radiological data and confirmed by serology and parasitological examination of the surgical specimen. Surgery is then a diagnostic and therapeutic tool that cannot be bypassed since it allows the definitive elimination of the parasite and eviction of recurrence if it\'s well done. Conservative methods are related to recurrent cysts.
Muscle hydatidosis is extremely rare but should not be forgotten when radiological and epidemiological data suggest it. It\'s a benign infection but can be severe and deadly if not appropriately treated.

BACKGROUND: Availability of stage information by population-based cancer registries (PBCR) remains scarce for diverse reasons. Nevertheless, stage is critical cancer control information particularly for cancers amenable to early detection. In the framework of the Global Initiative for Cancer Registry Development (GICR), we present the status of stage data collection and dissemination among registries in the Middle East and Northern Africa (MENA) region as well as the stage distribution of breast cancer patients.
METHODS: A web-based survey exploring staging practices and breast cancer stage was developed and sent to 30 PBCR in 18 countries of the MENA region.
RESULTS: Among 23 respondent PBCR, 21 collected stage data, the majority (80%) for all cancers. Fourteen registries used a single classification (9 TNM and 5 SEER), 7 used both staging systems in parallel. Out of 12,888 breast cancer patients (seven registries) 27.7% had unknown TNM stage (11.1% in Oman, 46% in Annaba). When considering only cases with known stage, 65.3% were early cancers (TNM I+II), ranging from 57.9% in Oman to 83.3% in Batna (Algeria), and 9.9% were stage IV cancers. Among the nine registries providing SEER Summary stage for breast cancer cases, stage was unknown in 19% of the cases, (0 in Bahrain, 39% in Kuwait). Stage data were largely absent from the published registry reports.
CONCLUSIONS: Despite wide stage data collection by cancer registries, missing information and low dissemination clearly limit informing efforts on early detection. The use of two classification systems in parallel implies additional workload and might undermine completeness. The favourable results of early cancer (TNM I+II) in two thirds of breast cancer patients needs to be interpreted with caution and followed up in time. Although efforts to improve quality of stage data are needed, our findings are particularly relevant to the WHO Global Breast Cancer Initiative.