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The present study concerns the characterization of honey and olive oils obtained from Algerian varieties and the evaluation of the biological activity of polyphenolic extracts, namely, the antimicrobial activity. Samples of seven varieties: "Tlemcen, Tizi-Ouzou, Mascara, Alger, Sidi-Bel-Abbès, Tiaret and Tipaza" were used in our experiment. The evaluation of the physicochemical and organoleptic analyses allows us to classify the oils in the "extra-virgin" category. The evaluation of the antibacterial activity of the honeys reveals that the samples of Mascara and Tiaret are the most active on all the bacterial strains tested. The extracts of the oils of Tlemcen, Tipaza, and Tizi-Ouzou exhibit antibacterial activity, particularly interesting with the highest zones of inhibition and the lowest (minimum inhibitory concentration [MIC]) against three strains of bacteria Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa by tests based on the disk diffusion method and by tests for the determination of the MIC. However, a synergistic interaction was also demonstrated between the combination of honey and extracts of olive oils with respect to the bacterial strains tested (zones of inhibition from 12 to 30 mm). The results obtained by this study suggest that certain natural therapies containing honey should be used in any combination with olive oils. [ABSTRACT FROM AUTHOR]

This study was to evaluate the anti-inflammatory effect of the polyphenolic extract of olive leaves Olea europaea L. In vivo experiments were performed on the model of acute inflammation edema of the paw of male Wistar rats following inflammation induced by the injection of carrageenan. The anti-inflammatory effect is carried out by the injection of the polyphenolic extracts of olive leaves Olea europaea L. at different doses 50 mg/kg, 100 mg/kg and 150 mg/kg, the injection was carried out 30 min before induction of acute inflammation with carrageenan at 1%. The results obtained were compared with those of Diclofenac and those of the physiological control. Injection of carrageenan resulted in a significant increase in the claw leg volume of 46.24 ± 23.8%, 66.78 ± 29.69% and 90.31 ± 46.51%, respectively at 1 h, 2 h, and 3 h. The results showed that the inflammatory activity of the polyphenolic extracts of olive leaves was dose dependent. The 150 mg/kg Olea europaea L. extract of polyphenolic has an anti-inflammatory activity which results in an 88% decrease in edema. This decrease is significantly similar to that of Diclofenac® 97% confirmed that the polyphenolic extracts of Olea europaea L. leaves have anti-inflammatory activities comparable to that of Diclofenac® with a non-significant difference (p < 0.05), this anti-inflammatory effect remains lower than that of Diclofenac®. [ABSTRACT FROM AUTHOR]

The aim of the study was to evaluate the antioxidant, antibacterial and antifungal activities of phenolic extracts of extra virgin olive oil obtained from two distinct regions in Northwest Algeria. The first extra virgin oil (CHIALI) was produced industrially according to the international standards, whereas the second (TRAD) was produced by traditional methods. Antioxidant activity was evaluated using the DPPH (diphenylpicrylhydrazine) method. The antimicrobial activity of the two phenolic extracts was assessed against Escherichia coli (ATCC25922), Pseudomonas aeruginosa (ATCC27853), Staphylococcus aureus (ATCC25923), Alternaria sp., Candida albicans by using microdilution and disk diffusion methods. The extraction yield was found to be 26.7% and 20.5% for the industrial (CHIALI) and traditional methods (TRAD), respectively. The phenolic extract of the industrial extra virgin oil exhibited better antioxidant activity (IC50 = 1.56 µg/ml) when compared to those of the traditional oil (IC50 = 6.27 µg/ml). Both phenolic extracts exerted bactericidal and antifungal activities. These activities were more important with the phenolic extract of the industrial oil. Taken together, our results showed that the phenolic extract of the industrial extra virgin oil had better antioxidant, antibacterial and antifungal activities, owing to the extraction methods used. [ABSTRACT FROM AUTHOR]

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Introduction: Blood lactate is a marker of tissue hypoxia while capillary refill time (CRT) is a surrogate of tissue perfusion. Measuring these parameters is recommended for assessing circulatory status and guiding resuscitation. However, blood lactate is not widely available in African emergency departments. Additionally, CRT assessment faces challenges related to its precision and reproducibility. This study aims to evaluate the accuracy of visual CRT(V-CRT) compared to plethysmographic CRT (P-CRT) in predicting lactate levels among septic patients., Methods: This prospective observational study enrolled consecutive patients with sepsis or septic shock over a 6-month period from a tertiary hospital in Marrakech, Morroco. V-CRT and P-CRT were evaluated upon admission, and simultaneous measurements of arterial lactate levels were obtained. The precision of V-CRT and P-CRT in predicting arterial lactate was assessed using ROC curve analysis., Results: Forty-three patients aged of 64±15 years, of whom 70 % were male, were included in the study. Of these, 23 patients (53 %) had sepsis, and 20 patients (47 %) experienced septic shock. Both V-CRT and P-CRT demonstrated statistically significant correlations with arterial lactate, with correlation coefficients of 0.529 ( p < 0.0001) and 0.517 ( p = 0.001), respectively. ROC curve analysis revealed that V-CRT exhibited satisfactory accuracy in predicting arterial lactate levels >2 mmol/l, with an area under the curve (AUC) of 0.8 (95 % CI=0.65 - 0.93; p < 0.0001). The prediction ability of P-CRT was lower than V-CRT with an AUC of 0.73 (95 % CI: 0.57-0.89; p = 0.043). The optimal thresholds were determined as 3.4 s for V-CRT (sensitivity = 90 %, specificity = 58 %) and 4.1 s for P-CRT (sensitivity = 85 %, specificity = 62 %)., Conclusion: These findings suggest that the plethysmographic evaluation did not improve the accuracy of CRT for predicting lactate level. However, V-CRT may still serve as a viable surrogate for lactate in septic patients in low-income settings., Competing Interests: The authors declare no conflicts of interest., (© 2024 The Authors. Published by Elsevier B.V. on behalf of African Federation for Emergency Medicine.)

The surging global demand for fish has increased aquaculture practices, where antibiotics have become indispensable to prevent diseases. However, the passive incorporation of these compounds into the diet may have adverse effects on human health. In this work, the QuEChERS method combined with ultra-high-performance liquid chromatography tandem mass spectrometry was applied for the determination of 10 multiclass antibiotics (5 quinolones, 2 sulfonamides, 2 diaminopyrimidines, and 1 macrolide) in muscle tissue of farmed fish (European sea bass and gilt-head sea bream). The applied method demonstrated acceptable recovery values, mostly between 70 and 120%, with limits of quantification of the method meeting the established EU maximum residue limits. The analysis of twenty fish samples in duplicate revealed that most antibiotics were not present, with the only exception of oxolinic acid and tilmicosin in European sea bass, which were below the limit of quantification of the method.

Background: Providing safe and effective anaesthesia in the context of humanitarian medicine is always a challenging situation. Spinal anaesthesia, and in particular its thoracic approach, represents a promising technique for such a limited-resource environment. This prospective observational study investigated the feasibility of thoracic spinal anaesthesia (TSA) for abdominal surgery in a field-deployed military hospital., Materials and Methods: We included adults scheduled for elective open cholecystectomy in a field hospital. Patients received TSA at the T9-T10 level. The primary outcomes were the feasibility of surgery under TSA and the haemodynamic/respiratory stability of this anaesthetic technique. The secondary outcomes included patient satisfaction and surgeon comfort regarding the anaesthesia technique and postoperative events (nausea and vomiting, urinary retention, postdural puncture headache)., Results: Surgery was performed successfully in 61 patients under TSA (90% female, 53±13 years old). Intraoperative pain scores were low, with a median Numeric Rating Scale score of 0 (IQR 0-2). Surgeon and patient satisfaction scores were excellent. The haemodynamic and respiratory parameters remained stable throughout the surgery. The incidence of postoperative events was low (nausea/vomiting=8%). None of our patients presented with postdural puncture headache or urinary retention., Conclusion: TSA could be an effective anaesthetic technique for abdominal surgery in the context of a field hospital or austere environment., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: There is a growing literature showing that critically ill COVID-19 patients have an increased risk of pulmonary co-infections and superinfections. However, studies in developing countries, especially African countries, are lacking. The objective was to describe the prevalence of bacterial co-infections and superinfections in critically ill adults with severe COVID-19 pneumonia in Morocco, the micro-organisms involved, and the impact of these infections on survival., Methods: This retrospective study included severe COVID-19 patients admitted to the intensive care unit (ICU) between April 2020 and April 2021. The diagnosis of pulmonary co-infections and superinfections was based on the identification of pathogens from lower respiratory tract samples. Co-infection was defined as the identification of a respiratory pathogen, diagnosed concurrently with SARS-Cov2 pneumonia. Superinfections include hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP). A multivariate regression analysis was performed to identify factors independently associated with mortality., Results: Data from 155 patients were analyzed. The median age was 68 years [62-72] with 87% of patients being male. A large proportion of patients (68%) received antibiotics before ICU admission. Regarding ventilatory management, the majority of patients (88%) underwent non-invasive ventilation (NIV). Sixty-five patients (42%) were placed under invasive mechanical ventilation, mostly after failure of NIV. The prevalence of co-infections, HAP and VAP was respectively 4%, 12% and 40% (64 VAP/1000 ventilation days). The most isolated pathogens were Enterobacterales for HAP and Acinetobacter sp. for VAP. The proportion of extra-drug resistant (XDR) bacteria was 78% for Acinetobacter sp. and 24% for Enterobacterales. Overall ICU mortality in this cohort was 64.5%. Patients with superinfection showed a higher risk of death (OR = 6.4, 95% CI: 1.8-22; p = 0.004)., Conclusions: In this single-ICU Moroccan COVID-19 cohort, bacterial co-infections were relatively uncommon. Conversely, high rates of superinfections were observed, with an increased frequency of antimicrobial resistance. Patients with superinfections showed a higher risk of death., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2022 Aissaoui et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Post-induction hypotension (PIH) is a common side effect of general anaesthesia and is associated with poor perioperative outcomes. We assessed the ability of two point-of-care echocardiographic variables to predict the occurrence of PIH: the passive leg raising-induced changes in the velocity-time integral of the left ventricular outflow tract (ΔVTI-PLR) and the inferior vena cava collapsibility index (IVC-CI)., Methods: We studied 64 patients > 50 years scheduled for elective abdominal surgery. ΔVTI-PLR and IVC-CI were prospectively obtained before general anaesthesia induction. PIH was defined by a systolic arterial pressure < 90 mmHg or a mean arterial pressure < 65 mmHg or by a decrease in systolic or mean arterial pressure > 30% from pre-induction level. Intraclass correlation coefficients (ICCs) were calculated to assess the reproducibility of echocardiographic measurements. Receiver operating characteristic (ROC) curves with 95% confidence intervals (CIs) were generated to test the ability of ΔVTI-PLR and IVC-CI to predict the occurrence of PIH., Results: PIH occurred in 33 (51%) patients. The ICCs for VTI and IVC measurements showed excellent reproducibility. The occurrence of PIH was accurately predicted by ΔVTI-PLR with an area under the ROC curve (AUROC) of 0.89 (95% CI: 0.80-0.97), a threshold value of 18% with a sensitivity of 88% (95% CI: 71-97%) and a specificity of 84% (95% CI: 66-94%). The occurrence of PIH was poorly predicted by IVC-CI with an AUROC of 0.68 (95% CI: 0.54-0.80) and a threshold value of 42%., Conclusions: ΔVTI-PLR, unlike IVC-CI, could reliably predict the occurrence of PIH. The use of ΔVTI-PLR could help individualise anaesthesia management to prevent PIH., (Copyright © 2022 Société française d'anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.)

Staphylococcal toxic shock syndrome is an acute and systemic infectious syndrome associated with the super-antigenic activity of staphylococcal toxins. It is a pathology that is rather rare but remains burdened with a considerable mortality despite the therapeutic management. The gateway is usually cutaneous with secondary bacteremic spread could be subject to preventive measures. We report the case of a rapidly fatal staphylococcal toxic shock, developed in a chronic hemodialysis whose entry from the arteriovenous fistula was suspected.

Purpose: The ability of the parasacral sciatic nerve block (PSNB) to induce anesthesia of the obturator nerve remains controversial. Our objective was to evaluate the anesthesia of the obturator nerve after a PSNB., Methods: Forty patients scheduled to undergo knee surgery (anterior cruciate ligament reconstruction) were included in this prospective, randomized, controlled study. Patients were randomized to receive PSNB alone (control group, n = 20) or PSNB in combination with an obturator nerve block (obturator group, n = 20). After evaluation for 30 min, the two groups received a femoral nerve block, and patients were taken to surgery. The obturator nerve blockade was assessed by measurement of adductor strength at baseline (T0) and every 10 min during the 30-min evaluation (T10, T20, and T30). Pain scores after tourniquet inflation and during surgery were compared between the two groups. The requirement for additional intravenous analgesia and/or sedation was also recorded., Results: The two groups had comparable demographic and surgical characteristics. Four patients were excluded from the study because of PSNB or femoral nerve block failure. The adductor strength values were similar between groups at T0 but were significantly lower in the obturator group at T10, T20, and T30 (p < 0.0001). Patients in the obturator group reported less pain than those in the control group (p < 0.05). They also required less additional intravenous sedation and/or analgesia (p < 0.05)., Conclusion: This clinical study demonstrated that the PSNB is an unreliable means of inducing anesthesia of the obturator nerve and emphasizes the need to block this nerve separately to induce adequate analgesia during knee surgery.

To test the hypothesis that rocuronium added to a mixture of local anaesthetics could improve akinesia in Peribulbar Block (PB) we designed this prospective, randomized, double-blinded study. Sixty ASA physical status I and II patients presenting for cataract surgery (manual extracapsular lens extraction) under PB were included. Patients were randomized to 2 groups: rocuronium group (n = 30) received PB with a local anesthetic mixture (Lidocaine 2% + Bupivacaine 0.5%) to which was added 0.06 mg/Kg of rocuronium and control group (n = 30) received PB with the same mixture to which was added saline. Akinesia was assessed with a 12-point scale at 2, 5 and 10 minutes after injection (each of the four rectus muscles and each lid was scored from 0 to 2; 0 = total akinesia, 1 = partial akinesia, 2 = no akinesia). The need for supplementary injection, adverse effects and complications were also recorded. Rocuronium group demonstrated significantly better akinesia scores than control group at 2, 5 and 10 minutes post PB (p < 0.05). Supplementary injection was necessary in 4 patients (13%) in rocuronium group versus 12 patients (40%) in control group (p = 0.039). No significant complications were recorded. Rocuronium added to a mixture of local anaesthetics at a dose of 0.06 mg/Kg improved the quality of akinesia in PB and reduced the need for supplementary injections.

Background: Pain from episiotomy or perineal tears during childbirth is associated with significant pain in the postpartum period. We performed this randomized, double-blind, controlled trial to investigate the efficacy of nerve stimulator-guided unilateral pudendal nerve block for pain relief after episiotomy., Methods: Forty women who gave birth vaginally with mediolateral episiotomy were randomized to receive pudendal nerve block with 15 mL of either ropivacaine 7.5 mg/mL (pudendal group) or normal saline (control group) after repair of the episiotomy. Episiotomy pain was assessed with a visual analog scale at rest at 3, 6, 12, 24, and 48 h postepisiotomy and during activities (walking and sitting). Breakthrough pain (visual analog scale >30 mm) was treated with niflumic acid suppositories 700 mg every 12 h. The primary outcome variables were pain scores at rest and during activities over 48 h postpartum., Results: Demographic and obstetric characteristics were not different between groups. Successful pudendal nerve stimulation was achieved in all patients. Patients in the pudendal group reported significantly lower pain scores at rest than those in the control group at 3, 6, 12, 24, and 48 h after delivery (P < 0.05). They also reported better analgesia while sitting and walking (P < 0.05). Additional analgesia was required by three patients (15%) in the pudendal group versus 17 patients (85%) in the placebo group (P < 0.001)., Conclusion: This study demonstrates that nerve stimulator-guided unilateral pudendal nerve block with ropivacaine 7.5 mg/mL is associated with decreased pain and need for additional analgesics during the first 48 h postepisiotomy.