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Background: Antibiotics are overused in poultry industry, and this has resulted in the emergence of multidrug resistant (MDR) bacteria. The current study is aimed at determining antimicrobial resistance (AMR) patterns of Enterobacteriaceae isolates from poultry in the west of Algeria. Methodology: Different chicken samples (kidney, bone and intestine) were collected and processed for culture using standard microbiological methods to isolate Enterobacteriaceae. Isolates were identified biochemically using API 20E, while isolated Escherichia coli was typed for O1, O2 and O78 antigens using slide agglutination with specific antisera. All identified isolates were tested against 26 antibiotic disks using the Kirby Bauer disk diffusion method according to the CLSI standards. The minimum inhibitory concentrations (MICs) of chloramphenicol, tetracycline, nalidixic acid, ofloxacin and ciprofloxacin were determined for selected isolates. Conjugative plasmid transfer, plasmid incompatibility and colicin tests were used to detect transferable resistance traits in 48 selected E. coli isolates. Results: One hundred and thirty-eight bacteria species were isolated, which included Escherichia coli (n=107), Salmonella spp (n=11), Klebsiella spp (n=8), Enterobacter spp (n=7), Pseudomonas spp (n=3) and Citrobacter spp (n=2). Serotyping identified 24 agglutinable E. coli isolates with O78:K80 (n=11), O1:K1 (n=9) and O2:K1 (n=4). Antibiotic susceptibility showed high frequency of E. coli resistance to nalidixic acid (89.7%), tetracycline (82.2%), streptomycin (82.2%), nitrofurantoin (68.2%), ampicillin (45.8%), ticarcillin (44.9%), piperacillin (42.1%), and chloramphenicol (15.9%). The percentage of multi-drug resistance isolates (resistance to more than 3 antibiotic classes) was 87.9%. The results of conjugative transfer in 48 E. coli isolates shows that the most important resistance traits transferred by plasmids are ASTeSuTmp (18.5%) and SuTmp (12.3%). Conclusion: This study confirmed the presence of multiple antibiotic resistant E. coli and other members of family Enterobacteriaceae in poultry in Algeria, and showed that these antibiotic resistance traits are easily disseminated by plasmids, with dire consequences on human health. [ABSTRACT FROM AUTHOR]

Background: Klebsiella pneumoniae is a bacterial pathogen commonly associated with severe nosocomial and community acquired infections especially through the acquisition of extended spectrum ß-lactamases (ESßL) and biofilm formation capacity. The objectives of this study are to determine the prevalence of K. pneumoniae ESßL (KP-ESßL)-producing isolates in the Regional Military University Hospital of Oran (HMRUO) Algeria, characterize their antibiotic resistance profile, genetically detect blaTEM and blaCTX-M genes, and evaluate their biofilm formation capacity. Methodology: Different clinical specimens including blood, cerebrospinal fluids, urine and catheter, pus, perirectal abscess, and surgical wounds were collected from patients with suspected clinical infections in different units and departments of the hospital. The specimens were cultured on Blood, MacConkey and CLED agar (for urine only) plates and incubated aerobically for 24 hours at 37°C for preliminary identification of bacteria using conventional colony morphology, Gram stain reaction, and disk diffusion test for antibiotic susceptibility testing (AST). Confirmation of isolates, antibiogram, minimum inhibitory concentration (MIC) and detection of resistance phenotypes, were carried out by the automated Vitek 2 (BioMérieux) identification and susceptibility method. ESßL production was confirmed by the synergy and combination disk tests. ESßL genes were detected by conventional simplex PCR and biofilm formation was detected by the tissue culture plate (TCP) method. Results: A total of 630 patients' clinical samples (one sample per patient) were processed. Klebsiella pneumoniae was isolated in 40 (6.3%) samples, and 15 of these (37.5%) produced ESßL. In the disk diffusion AST assay, all 40 K. pneumoniae isolates were resistant to ampicillin and ticarcillin while all 40 isolates were sensitive to cefoxitin, imipenem and ertapenem. KP-ESßL producing isolates were more frequently recovered from intensive care unit (33.3%) and from urine (46.7%) samples. Group 1 blaCTX-M genes were detected in 13 of the 15 (86.7%) KP-ESßL isolates, and 46.7% of these isolates were moderate biofilm producers. Conclusion: There is need for health departments to put in place preventative measures through regular surveillance of these resistant pathogens and initiating appropriate infection prevention and control strategies to limit their spread in Algerian hospitals and worldwide. [ABSTRACT FROM AUTHOR]

This study was carried out to evaluate survival of Bifidobacterium infantis 20088 in fermented beverage formulated from selected traditional Sudanese fruits Gudaim and dom. The viable counts of the strain and physiochemical changes during refrigeration were determined. 10% beverages (w/v) were prepared from dom and gudaim powder. 2.5% (w/w) skim milk was supplemented to each formulation to provide the required nutrient for bacteria growth during the fermentation. After sterilization and cooling, the mixture was inoculated with a 10% culture of B. infants 20088 followed by incubation for 36 h at 37°C. Reconstituted skim milk was used as control. Fermented beverages were held at refrigeration (4°C) for a period of 2 weeks. During the refrigeration storage of the fermented beverages there was significant reduction in Bifidobacterium infantis of all fermented beverages. Nevertheless, the strain was maintained high; fulfill the number required to presence in probiotic foods, which was at least 6 log CFU/ml fermented product. There was no significantly difference in TSS and pH as compared to their initial at the beginning of fermentation except in pH of fermented gudaim. Therefore gudaim and dom are suitable carrier to deliver Bifidobacterium infantis 20088 to consumer.

Competing Interests: None disclosed.

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are acute, life-threatening and rare severe cutaneous adverse reactions induced by drugs in most cases. The drugs most often reported to be implicated in inducing TEN/SJS are allopurinol, antibacterial sulfonamides, antiepileptic drugs and oxicam. Pristinamycin is an oral streptogramin antibiotic with bactericidal activity against Gram-positive bacteria that is rarely linked to TEN. Typically, this condition develops 4-28 days after drug exposure, Herein, we report a case of a 71-year-old female who developed TEN within 3 days of administration of pristinamycin and was managed successfully with supportive care, including intravenous fluids, pain control, prophylactic antibiotics and intravenous methylprednisolone. This case of rapidly developing SJS/TEN after administration of pristinamycin highlights the possibility that these complications can develop within only a few days following ingestion of drugs thought to be probably safe., (© 2022 British Pharmacological Society.)

Background: Maxillary sinuses may present a wide spectrum of anatomical variations and pathological lesions whose recognition is mandatory for the clinician, especially prior to any surgical intervention in the area, such as in cases of sinus floor elevation. The goal of this study was the evaluation, mapping and prevalence of sinus anatomical variants and pathoses in Cone Beam Computed Tomography (CBCT) scans of dental patients., Material and Methods: 660 CBCT examinations of adult patients involving both sinuses were obtained (between 2017 and 2023) and analyzed. The following anatomic variants and pathologic findings were evaluated: antral septa (AS), posterior superior alveolar artery (PSAA), sinus hypoplasia, sinusitis, odontogenic cysts, retention cysts, antroliths, and various less common lesions (e.g.: benign fibro-osseous dysplastic lesions, neoplasms etc.). Investigation of the association of the findings with patients' age and gender was performed using the Chi-square test (X2), Fisher's exact test, t-test, and ANOVA (P<0.05). Differences in prevalence between findings, based on their location (right and/or left sinus), were investigated using z-test and t-test., Results: AS were found in 38.6%, and PSAA was identifiable in 90.2% (mean distance from the sinus floor=6.44 mm) of the patients respectively. 3% of patients had hypoplasia, 15.6% sinusitis, 2.7% odontogenic cysts, 16.1% retention cysts, 8.6% antroliths, and 1.7% uncommon lesions (e.g. malignant neoplasms and fibrous dysplasia). A statistically significant association was found between gender and PSAA diameter, PSAA distance from the sinus floor, hypoplasia, sinusitis, and retention cysts, as well as a statistically significant association between age and PSSA diameter and sinusitis., Conclusions: The prevalence of various anatomical variants and pathologic findings of the maxillary sinus did not differ based on their location. However, some of these findings appear to be related to either gender or age. CBCT is a valuable diagnostic tool to identify various anatomical variants and pathological findings of the maxillary sinus. Key words: Sinus, anatomy, pathology, CBCT., Competing Interests: The authors have no conflict of interest to declare., (Copyright: © 2024 Medicina Oral S.L.)

Aim: The aim is to evaluate laparoscopic cholecystectomy safety based on American Society of Anesthesiologists score for acute cholecystitis in patients with comorbidities. Patients & methods: This is retrospective study of patients who underwent laparoscopic cholecystectomy for acute cholecystitis between 2003 and 2021. According to their respective ASA-score, patients were divided into group 1: ASA1-2 and group 2: ASA3-4. Results: We collected 578 patients. Even though the gangrenous forms were more frequent and the operative time was longer in group 2, laparoscopic cholecystectomy seems safe and effective. We didn't observe any differences in terms of intraoperative incidents, open conversion rate, or postoperative complications compared with other patients. Conclusion: ASA3-4 patients with acute cholecystitis don't face elevated risks of complications or mortality during laparoscopic cholecystectomy., Competing Interests: The authors have no competing interests or relevant affiliations with any organization or entity with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties., (© 2024 The Authors.)

Hiccups, also called hiccoughs, are sudden, involuntary and rapid expulsion of air from the lungs with synchronous closure of the glottis causing blockade of the air flow. Hiccups may be induced by a multitude of etiologies such as central nervous disorders, gastrointestinal disorders, cardiovascular disorders, psychogenic factors, and metabolic disorders. Hiccups induced by medications are rare. The diagnosis of drug-induced hiccup is difficult. The exact mechanism responsible for this adverse drug reaction is still unknown. Herein, we report the first case of cefotaxime-induced hiccups and briefly review the literature on antibiotic-induced hiccups., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2023.)

Background: Synovial sarcoma is an uncommon soft tissue malignancy that mainly occurs near tendon sheath and bone joints. Primary intra-abdominal location is exceedingly rare and characterized by non-specific clinical signs., Case Presentation: We report the case of a young female without medical history who presented with acute abdominopelvic pain. Ultrasound echography revealed a right mass measuring 7 cm in greater diameter cystic with solid areas, likely of ovarian origin. A coelioscopy with peritoneal biopsies was performed. Histological examination with immunohistochemistry concluded the diagnosis of GIST. The patient was referred to the surgery department and after laboratory routine analysis and computed tomography, the patient was proposed to surgical management. Per-operative findings revealed a mesenteric mass locally invading the greater omentum and the appendicular wall. Pathological examination with immunochemistry confirmed the diagnosis of mesenteric monophasic synovial sarcoma invading the appendicular wall with positive surgical margins. Chemotherapy was proposed with a good response. Our patient is free from disease 9 months later., Conclusions: We aimed through this case report to discuss mesenteric presentation monophasic SS, mimicking ovarian malignancy, emphasizing clinicopathological features and differential diagnoses., (© 2023. Japan Surgical Society.)

Aim: Advances in laparoscopic surgery and perioperative care have improved the prognosis of operated patients, especially the oldest among them. This study aimed to assess the outcomes of early laparoscopic cholecystectomy for acute calculous cholecystitis in older adult patients., Methods: A retrospective analysis was carried out of 567 patients who underwent early laparoscopic cholecystectomy for acute calculous cholecystitis between January 2003 and July 2021. The outcomes of older adult patients (≥ 75 years) were compared with those of younger patients., Results: The older adult group had significantly more patients with an American Society of Anesthesiologists score ≥3 (37.5% vs 8.3%; P < 0.001) and more severe acute calculous cholecystitis (grade II; 82.8% vs 67%; P = 0.01). There were no significant differences regarding operative time (90 vs 80 min; P = 0.064), conversion rate (20.3% vs 13.5%; P = 0.144), and both intra- and postoperative morbidity, principally bile duct injuries (1.6% vs 0%; P = 0.113) and bile leakage (0% vs 1.2%; P = 1)., Conclusion: Early laparoscopic cholecystectomy could be proposed safely for older adult patients with mild and moderate acute cholecystitis. Geriatr Gerontol Int 2023; 23: 671-675., (© 2023 Japan Geriatrics Society.)

Acute necrotic pancreatitis is an emergency of evolution and is often unpredictable because of the potentially life-threatening complications it can cause. We report a unique case of a 56-year-old woman hospitalized for acute necrotic pancreatitis. The evolution of the latter was characterized by the occurrence of two very rare complications, of which the clinical presentations were atypical. The first complication was a gastroduodenal pseudoaneurysm compressing the main biliary tract and causing obstructive jaundice, which evolved well following percutaneous embolization. The second complication was a giant 20 cm pancreatic pseudocyst revealed by obstructive jaundice secondary to biliary compression, which progressed well following surgical treatment., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2023.)

Background: The deadline for early laparoscopic cholecystectomy (ELC) in patients with acute calculous cholecystitis (ACC) is the subject of much debate. The aim of this study was to assess outcomes of ELC in patients with more than 7 days of symptoms., Methods: It is a retrospective analysis of 564 patients having undergone ELC for ACC between January 2003 and June 2021. Patients were divided into two groups according to the timing between the onset of symptoms and surgery: group 1 (G1), within the first 7 days of symptoms, and group 2 (G2) after day 7 of symptoms., Results: Apart from a longer operative time (G1 80 min vs. G2 90 min; p = 0.016), there were no significant differences regarding conversion rate (G1 14.5% vs. G2 13.2%; p = 0.748), both intra- and postoperative complications, mainly bile duct injuries (G1 0.2% vs. G2 0%; p = 1) and bile leakage (G1 1.2% vs. G2 0%; p = 1) and postoperative length of stay (G1 2 days [1-3] vs. G2 2 days [1-4]; p = 0.125)., Conclusion: Early laparoscopic cholecystectomy could be proposed for patients with acute calculous cholecystitis even beyond 7 days of symptoms., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Introduction: Colorectal cancer is a major public health problem. In younger patients, its incidence continues to rise and its prognosis appears to be worse. Its treatment is based on curative surgery associated with neo-adjuvant and adjuvant therapies., Aim: To describe the clinical and pathological characteristics of colorectal cancers in young patients., Methods: In this monocentric cohort study, we retrospectively analyzed the clinicopathological features in colorectal cancer patients who underwent treatment from 2002 to 2014. Data of younger (group A, ≤50years) vs older (group B, >50years) patients were compared., Results: Two hundred and sixty-six patients met inclusion and non-inclusion criteria. The younger and older groups consisted respectively of 25.2% and 74.8% of patients. Both groups were comparable regarding the symptom presentation and duration. Synchronous tumors were more frequent amongst the group A (10.7% vs 1.0%, p = 0.024). Preoperative staging showed a higher frequency of tumors classified as advanced stage (stages III and IV) in the group A (p = 0.001). The patients of group A were diagnosed with a higher proportion of poorly differentiated or undifferentiated adenocarcinomas (13.4% vs 3.5%, p = 0.005), the mucinous character was also more frequent in the group A (28.4%). According to the pTNM (tumor, nodes and metastases) classification, tumors were more advanced in the group A than in group B (80.6% vs 48.7%, p <0.001)., Conclusion: This study revealed that colorectal adenocarcinomas in the younger patients, compared to the older ones, were more aggressive with a higher proportion of poorly differentiated or undifferentiated adenocarcinomas, more often mucin production and more advanced tumors.

Introduction: The study of the anatomy of the extra hepatic bile ducts has demonstrated the existence of a significant number of variants which can be explained by hepato-biliary embryology. A good knowledge of this anatomy is essential for the interpretation of radiological examinations, and for a good practice of hepato-biliary and pancreatic surgery. Several imaging methods are used to study the anatomy of the bile ducts, including classical cholangiography, which is still practiced and very useful., Aim: To study the modal anatomy (the most frequent) and the anatomical variants of the extrahepatic bile ducts through the interpretation of postoperative cholangiograms and to examine their implication on the surgical practice., Methods: This is a monocentric, retrospective observational study. It concerned any patient who underwent hepato-biliary or pancreatic surgery at the Department of General and Digestive Surgery of Farhat Hached University Hospital of Sousse between 2007 and 2016, and who received postoperative cholangiography. A data form was fulfilled for each patient., Results: Out of a total population of 293 patients, we identified 158 patients (53.9%) with anatomic variants of the extrahepatic bile ducts. The common bile duct was modally implanted in the second duodenum in 96.2% of cholangiographies and in the genu inferius in 3.8% of cases. The main pancreatic duct had a V-shaped implantation in 87.1% of cholangiograms, a U-shaped implantation in 4.2% of cases and a Y-shaped implantation in 7.1% of cases. The common bile duct had a modal aspect in 71.3% of cholangiograms, with 28.7% of anatomic variants, organized in 4 models. The cystic duct had a modal presentation in 80.9% of cases, and we recorded 6 other branching models (19.1% of cases). No significant difference was observed between the presence of anatomic variants on the one hand, and age, sex, conversion rate, intraoperative incidents, postoperative complications, postoperative hospital stay and overall hospital stay on the other hand., Conclusion: Conventional cholangiography constitutes a more or less precise tool for detecting these anatomic variants and is therefore very useful in the practice of hepato-biliary surgery even after the advent of new techniques in this field. However, it also requires a more extensive and in-depth knowledge of these anatomic variants, which nevertheless remain quite frequent, and represent a source of surgical difficulties.

Introduction: The evolution of hepatic hydatid cyst can be enameled with complications, mainly biliary fistula, which can be both symptomatic or occult. The aim of this study is to identify the predictive factors of occult cysto-biliary communication., Material and Methods: This is a retrospective study of patients operated-on for uncomplicated hepatic hydatid cyst in Farhat Hached Hospital of Sousse over a period of 10 years., Results: Two hundred twenty patients were operated-on for uncomplicated hydatid cyst. In univariate analysis, alkaline-phosphatase, gamma-glutamyl-transferase, alanine-transferase elevated levels and multiple type were factors associated with occult fistula, but gamma-glutamyl-transferase level was the only predictor in multivariate analysis., Conclusion: These predictive factors could contribute to determine preoperative probability of occult fistula, thus indicating additional intraoperative procedures to ensure its identification.

The nutritive value of spontaneously fermented brown rice flour medida, a Sudanese cereal thin porridge, is low. This study was carried out to improve the nutritional quality of medida. The flour was soaked and malted at 30◦C to optimise the protein content. Flour malted for two days had the highest protein content. Skim milk was added to the malted brown rice flour medida and fermented using Bifidobacterium longum BB 536. Maximum count of B. longum BB 536 up to 9 log CFU/ ml was attained at 4.6 final fermentation pH. The resultant viscosity was similar to that of the spontaneously fermented brown rice flour medida. There was significant (P< 0.01) increase in both the energy density and the protein content, having increased 12 folds and 24 folds, respectively. The essential amino acids including lysine and methionine were highly augmented. The resultant medida have stable flowing characteristics and meet the whole protein and energy requirements for infants and children aged 1 - 10 years old.