Background: Patients with thalassemia major are at risk of developing abnormal lipid profiles.

Aim: In this study, the relationship between iron accumulation and blood lipid profile in TM children was evaluated.

Methods: In this study, blood hemoglobin, ferritin, and lipid levels of pediatric patients with TM aged 1-18 years were investigated. Those with other chronic diseases were excluded from the study.

Results: The median age of 184 patients included in the study was 8 (range 1-18), and 96 (52.2%) of the patients were girls. There is an inverse and statistically significant relationship between age and total cholesterol (TC) level (p<0.05) and age and low-density lipoprotein cholesterol (LDL-C) level (p<0.05). There was an inverse, and statistically significant correlation between ferritin- high-density lipoprotein cholesterol (HDL-C) levels (p:0.015).

Conclusion: As ferritin levels increase in children with thalassemia, HDL-C levels decrease. For cardiac iron accumulation, HDL-C level may be a guide instead of ferritin.

In diseases of the body where the pathogenesis is presumed to be a disorder of structure and/or function of one or more of its components, the psychological aspect of the patient is side-lined and the spiritual aspect is out of consideration. In the presence of negative thoughts, the way a patient responds to a given treatment can be below expectations. Such negative thoughts can be recognized by probing into the patient’s mental attitude. Similar is the adverse effect when the patient feels a lack of genuine love and understanding in one’s social circle. Not recognising the presence of negativity in a patient’s psycho-spiritual history can lead to inappropriate or ineffective treatment. Inclusion of psycho-spiritual history in clinical medicine leads to opening up of a hidden aspect of the patient’s problem, which when tackled has significant therapeutic potential.

Background: Sino atrial block in acute coronary syndrome with ST segment elevation is not rare and may be dangerous by causing severe bradycardia.

Its incidence was reported in the literature, but no data about its predictive factors or related mortality, also its epidemiological data is lacking in Algeria.

Aims: The main objective of our study is the determination of the frequency of Sino Atrial Block in acute coronary syndrome with ST segment elevation, the secondary objective was the analysis of predictive factors of this Brady arrhythmia, and related mortality.

Methods and materials:  In this prospective study, conducted in the cardiology department of Hussein Dey hospital (Algiers-Algeria), 467 patients with acute coronary syndrome with elevated ST segment (87 women and 380 men) were enrolled between 28 February 2014 and 16 July 2015. The average age is 60 ± 13 years; at admission, a Holter recorder was attached for continuous ECG monitoring during 48 hours

Kruskal’s ANNOVA or H tests were used for comparison of quantitative variables, χ2 test or Fisher’s exact test, were used for qualitative variables, all tests were performed with 1^st species risk of 5%.

Results:  The frequency of complete Sino atrial block is 2.6 % (12 patients), CI 95%: [1.2%-4%], multivariate analysis identified the following independent predictors: right ventricular acute coronary syndrome, infero basal acute coronary syndrome, and large right atrium surface.

The risk of mortality expressed by Hazard Ration (HR) is 5.4. (CI95%: [1.2-24], p = 0.024); right acute coronary syndrome is the only predictive factor of mortality identified in our study.

Conclusion: Sino atrial block is not rare in acute coronary syndrome with elevated ST segment, its predictive factors according to our study are: right ventricular acute coronary syndrome, infero basal acute coronary syndrome, and large surface of right atrium, its occurrence increases the risk of hospital mortality.

Aim: This study sought to examine the intraoperative and postoperative outcomes of Controlled cord traction and manual removal of the placenta in the third stage of labour during the caesarean section.

Methods: We prospectively enrolled pregnancies who were admitted to the clinic of the Department of obstetrics and Gynaecology for caesarean section (Pfannenstiel method) in addition to providing sociodemographic data (age, body mass index) and clinical data (haemoglobin, total operative time, removed placenta total time, postpartum haemorrhage, need to blood transfusion, hospital stay, intensive care unit (ICU) admission, postoperative eating and drinking time, and intrabdominal blood).

Results: Of 196 participating women, 98 performed controlled cord traction removal of the placenta, and 98 performed manual removal. The controlled cord traction removal of the placenta group and the manual removal of the placenta group had similar blood loss (haemoglobin drop) and postpartum haemorrhage (p>0.05). In the controlled cord traction removal of placenta group, significant intra-operative findings were shorter removal of placenta time (18.7±10.6 vs 28.6±13.1 second, p=0.0001), shorter total operative time (36.3±10.7 vs 41.8±11.4, p=0.003) and lower prevalence of presenting intrabdominal blood (12.2% vs 26.7%, p=0.021). Significant postoperative findings were earlier eating time ( 15.0±7.3 vs 19.6±14.4 hours, p=0.011) and lower incidence of endometritis ( 1% vs 4.1%, p=0.042) compared with the manual removal of placenta.

Conclusion: The umbilical cord traction maneuverer for the placenta delivery had more advantages than the manual removal maneuverer. This technique should be recommended during the third stage of labour during the caesarean section.

Introduction: Cardiovascular diseases are the main cause of death in the world, and some of these diseases can be controlled or avoided with a healthier lifestyle. These diseases are often associated with the emergence of other diseases such as diabetes mellitus, obesity, high cholesterol levels and high blood pressure. Research has shown that vitamin D deficiency can be a factor that also helps in the appearance of these diseases, since if the serum levels of vitamin D are adequate, it can help in the control and prevention of these diseases.

Objectives: To evaluate the relationship between vitamin D and cardiovascular diseases, specifically systemic arterial hypertension and its effects.

Methods: A systematic review was carried out by searching for original articles in scientific databases: Pubmed, Science Direct, Lilacs and Scielo in English and Portuguese.

Results: No conclusive data were found for the indication of vitamin D supplementation in the treatment of systemic arterial hypertension, due to its lack of efficiency so far, requiring further research to better clarify the subject.

Conclusion: The results obtained do not present conclusive data for the indication of vitamin D supplementation in the treatment of systemic arterial hypertension, due to its lack of efficiency up to the present moment, more research is necessary for a better clarification on the subject.

Background: Non-Sustained Ventricular Tachycardia is the most frequent ventricular arrhythmias in acute coronary syndrome with ST segment elevation, the assessment of its incidence and prognosis have been the subject of several international studies, but its epidemiological data is lacking in Algeria.

Aims: The main objective of our study is the determination of the frequency of Non-Sustained ventricular tachycardia in acute coronary syndrome with ST segment elevation, the secondary objective was the analysis of predictive factors of this arrhythmia, and related mortality.

Methods and materials:  In this prospective study, conducted in the cardiology department of Hussein Dey hospital (Algiers-Algeria), 467 patients with acute coronary syndrome with elevated ST segment (87 women and 380 men) were enrolled between 28 February 2014 and 16 July 2015. The average age is 60 ± 13 years; at admission, a Holter recorder was attached for continuous ECG monitoring during 48 hours

Kruskal’s ANNOVA or H tests were used for comparison of quantitative variables, χ2 test or Fisher’s exact test, were used for qualitative variables, all tests were performed with 1^st species risk of 5%.

Results:  The frequency of Non-Sustained Ventricular Tachycardia is 28.3 % (132 patients), CI 95%: [24.2%-32.4%], multivariate analysis identified the following independent predictors: Age ≤ 58 years, current active smoking, presence of akinetic segment in echocardiography, and short time from symptom onset to emergency room.

The risk of in-hospital mortality is low, but not significant (Hazard Ration of 0.156. CI 95%: [0.21-1.177], p = 0.072)

Conclusion: NonSustained Ventricular tachycardia is the most frequent arrhythmias during acute coronary syndrome with elevated ST segment, its predictive factors according to our study are: Age ≤ 58 years, current active smoking, presence of akinetic segment in echocardiography, and short time from symptom onset to emergency room. The risk of in-hospital mortality is low, but not significant

Nomophobia characterized as the fear of being without a mobile phone or being unable to use it has become widespread in today's technologically advanced society. Given the growing reliance on mobile, it is essential to comprehend the potential psychological effects of nomophobia. Body image satisfaction is a person's subjective assessment and perception of their own physical appearance. It includes sentiments, attitudes, and general body pleasure, including weight, shape, size, and overall attractiveness. Excessive smartphone use may result in an obsession with virtual relationships, limiting face-to-face social interactions and empathy, which can contribute to violence. This research aimed to examine the influence of nomophobia on body image satisfaction and aggression.

The study utilized a quantitative research design and collected data from a sample of college students (N = 52) using convenience sampling. Correlational analysis and regression analysis were also employed on the data.

Findings suggest that the sample under study suffers from a moderate risk of nomophobia higher level of body image satisfaction and moderate levels of aggression. Also, there is a weak negative correlation between nomophobia and body image satisfaction and weak positive correlation between nomophobia levels and four aspects of aggression. In addition, nomophobia is not a significant predictor of college students' body image satisfaction and aggression. These findings highlight the detrimental effects of nomophobia on college students' psychological well-being.  In conclusion, results suggest that guided intervention could help decrease the levels of nomophobia in college students, resulting in increased satisfaction with their body image and lower levels of aggression.

Introduction: Heart failure with preserved LVEF (left ventricular ejection fraction) is an important cause of mortality and morbidity in hypertensive patients. A close correlation between the achievement of diastolic function and longitudinal systolic dysfunction could have several explanations, first the diastole is a dependent energy process, especially during its first phase, it also includes active systolic components during the iso volumetric relaxation phase.

The objective of this work is to determine the effect of diastolic function on the drop in GLS (global longitudinal strain) in hypertensive patients with preserved LVEF.

Materials and methods: This work is to perform in a series of 400 hypertensive patients (aged 25-75 years) an echo study full cardiographic, including the study of the systole-diastolic function, and the evaluation of the function by the longitudinal 2D strain.

Results: Of the 400 hypertensive patients, 356 patients (89%) had impaired diastolic function, of which 46 patients (13%) had high filling pressures.144 patients had a high LA(left atrial) volume, of which 46 patients had high filling pressures.

Of the 144 patients with high LA volume 118 patients (81.9%) had low GLS.

The mean of blood pressure was significantly higher in patients with low GLS.

There is a statistically very significant relationship between lower GLS, increased left atrium volume, and increased left ventricular filling pressures in hypertensive patients.

Conclusion: The decline in longitudinal index of function, despite preserved LVEF, correlates well with increased left atrial volume, filling pressures in hypertensive patients with LVH (left ventricular hypertrophy). The association between hypertension with LVH and the deterioration of asymptomatic diastolic function is well recognized.

Introduction: The study was carried out to get a greater awareness of the impact of early ambulation and positioning on coronary angiography complications. And to build an evidence study on what other research said.

Objectives: The objective of this study is to review the effect of changing position and early ambulation on coronary angiography complications.

Methods: I used search engines were Identified 700 articles, I excluded 500, then screened total of 200 articles, 150 articles are not my concern, I included 36 articles in this research

Result: According to the various research early ambulation and early position is safe after coronary angiography because it is effective way to minimize the risk of back pain and has no linkage in increasing risk of vascular complications like bleeding or hematoma.

Study Design: A literature review was conducted in order to provide an overview of physiotherapy intervention on prevention and management of open fractures.

Objectives: In addition to determining the issue and choosing the best approach to decrease or get rid of the source of the loss of movement, this research will review the key functions of physiotherapy in relation to fractures. It is still debatable whether open fractures should be treated with irrigation and debridement (I&D) within six hours after the injury.

Materials and Methods: A narrative of the literature was performed by 21 articles with actual content based on relevant articles that were identified by a hard copy textbook, engines such as SCIENCE DIRECT, PUBMED, GOOGLESCHOLAR, ORTHOINFO and COCHRANE DATA BASE OF SYSTEMATIC REVIEW (www.cochrane.org),and CINALE. Website like physiopedia (www.physiopedia.com) was searched and published texts were `also reviewed in these studies.

Results: For rapid primary wound closure in gustilo-anderson grade 1, 2, and 3 An open fracture, infection rates of 2 to 3 percent have been documented. When primary wound closure was attained for Gustilo-Anderson grade 3 B, complete wound healing, bone consolidation, and no need for secondary surgery were reported in 86.7% of cases.

Conclusion: The most frequent open fractures are tibial, phalangeal, forearm, ankle, and metacarpal. Open fractures have a high rate of morbidity and mortality. All patients with open fractures require coverage for antibiotics and current tetanus injections. Optimal outcomes will result from early surgical care with involvement from plastic and vascular surgery as needed.

Since the time homoeopathy was introduced to the world in 1790 by Dr. Samuel Hahnemann, homoeopathy is popular for treating chronic diseases. When that was the case in late 18^th, 19^th & 20^th century, homoeopathy was dealing with chronic diseases that were morbid but not mortal. In 21^st century, after the epidemiologic transition, the chronic diseases have taken the form of Non-Communicable Diseases (NCD). [2, 15]

'These NCDs have not only morbidity but also high mortality'. The most hostile chronic diseases like diabetes, heart disease & cancer affects our health & reduces life expectancy. Conditions like heart disease, stroke, cancer, chronic respiratory diseases & diabetes are leading causes of death worldwide. These chronic diseases can affect viral organs like heart, lungs, kidneys & liver causing damage & impacting overall health & longevity & can lead to complications. [1, 2, 15]

The article looks at the role of homoeopathy in dealing with the chronic diseases. It brings out the fact that homoeopathy can deal with not only treating these diseases but also prevent this diseases & promote health. The properties of homoeopathic medicines that are aligned to the essential medicines are also discussed. Finally, it mentions that these diseases can only be dealt only if Universal Health Coverage (UHC) is achievable. Achievability of UHC is only possible if the AYUSH systems are integrated into the mainstream & homoeopathy is an active component of this package. [12, 16, 17]

Background: Viruses and mainly COVID and the pneumonia it causes are among the pathologies that cause the greatest damage to the alveolus-capillary membrane of the lungs in patients with this disease.

Objectives: To relate the alveolar arterial oxygen gradient (GAaO2) and the start of early mechanical ventilation in patients with SARS COV - 2 virus infection in the continuous admission area.

Methodology: Descriptive, retrospective, observational, cross-sectional, with 165 clinical records of patients admitted to the emergency area in a period from April 2020 to 2021. Kolmogorov – Smirnov test, Mann-Whitney U and Pearson correlation coefficient were performed. with p>0.05, ROC curve for sensitivity and specificity with Youden index and multivariable regression analysis for correlation.

Results: A cut-off point of GAaO2 = 210.25 was obtained with sensitivity of 95% and specificity of 94%, with 2 times more risk of starting mechanical ventilation and correlation of 89%.

Conclusion: It was observed that the cut-off point was related to greater risk and correlation of initiation of mechanical ventilation. This is a reliable value to decide the start of invasive ventilation.

Infertility is one of the global burning issues which affects the couple socially and individually in a negative way. There are numerous etiological factors that play a significant role to it e.g. like hormonal variations, structural abnormality, functional disorders, psychological factors etc. In Ayurveda a separate department (Tantra) known as sexual invigoration (Vajeekarana) is mentioned by Charak Samhita and Sushrut Samhita to address this problem. The study patient reported with oligozoospermia (low sperm count) and Asthenozoospermia (low sperm motility). Where medicinal treatment (shaman chikitsa) and purification therapy (shodhana chikitsa) i.e. panchakarma especially Intra Urethral Uttar Basti (IUUB) is the management. After 4 months of treatment, his condition is improved from severe oligoasthenozoospermia to normozoospermia. Ayurvedic Panchakarma treatment is safe and effective approach for oligoasthenozoospermia.

The cardiac rehabilitation is a part of coronary’s therapy. This is a discordence between his advantage and his development, principaly on the countries in development’s way. There effects have a good report benefit/cost.

We collaborated with the departement of sports medecine who taked up this activity. We report our first expérience with 158 patients doing the ambulotary’s phase.

The results showed an improvment in the functional’s capacity, a better quality of life for all the patients.

This case report describes an 8-year-old boy with a prior history of   open  heart surgery for sub-aortic stenosis who presented with shortness of breath and chest pain four months post-operation. Echocardiography and AngioTDM revealed a large false aneurysm of the ascending aorta. Closure of the communication orifice was successfully achieved using ADO II 6/6, with subsequent coagulation of the blood within the false aneurysm and thrombus formation.

Introduction: levosimendan is an inodilator successfully used in the treatment of acute and chronic heart failure. Its use in the treatment of low cardiac output syndrome pre- and postoperatively after cardiac surgery under extracardiac circulation is poorly documented, but it appears to be a very interesting alternative in terms of morbimortality.

Aim of the study: to evaluate the value of levosimendan versus dobutamine in the rapid weaning of inotropic drugs in low output patients awaiting cardiac surgery and after surgery under extracorporeal circulation.

Materials and methods: sixty patients with low cardiac output syndrome before surgery on levosimendan and after cardiac surgery on extracorporeal circulation, requiring positive inotropic and vasopressor drugs (dobutamine ± noradrenaline). Post-operatively, in the context of drug weaning, we identified two groups : levosimendan group (n=30) and dobutamine group (n=30). In the levosimendan group, dobutamine was replaced immediately postoperatively by levosimendan. Hemodynamic parameters (MAP, HR, CI, ESV, SVR), ICU length of stay and 30-day mortality were assessed and compared between the two groups of patients.

Results: Cardiac index was significantly higher in the levosimendan group than in the dobutamine group (2.8 [0.3] l/min/m² versus 2.3 [0.4] ml/min/m²) respectively, P

Conclusion: the use of levosimendan in the treatment of low cardiac output syndrome before and after cardiac surgery with extracorporeal circulation resulted in rapid improvement in hemodynamic status with a short intensive care unit stay and low mortality.

Ruptured aortic sinus of Valsalva aneurysm is a rare cardiac anomaly that can lead to life-threatening complications. We present a case of a 12-year-old girl with complete heart block, who presented with these symptoms and was diagnosed with a ruptured aortic sinus of Valsalva aneurysm dissecting into the interventricular septum, with probable compression of the conduction system. Echocardiography and AngioTDM confirmed the diagnosis, and the anomaly was successfully managed percutaneously by closing the orifice of communication using a ventricular septal defect (VSD) muscular occluder. Follow-up examinations showed no flow inside the aneurysm, indicating a successful closure procedure. This case highlights the importance of early diagnosis and prompt intervention in managing ruptured aortic sinus of Valsalva aneurysm in pediatric patients.

This is a 9-year-old child hospitalized for an intraoperative partial venous return anomaly and after an exploration we found a complex congenital cardiac pathology such as an anomaly of total venous return associated with an anomaly of systemic venous return which is mainly seen at early ages Mots-clés Anomalie de retour veineux systémique, Anomalie de retour veineux pulmonaire total, Collecteur Confluence pulmonaire, Urgence néonatale

Background: Complete right bundle branch in acute coronary syndrome with ST segment elevation is common and may predict a poor clinical prognosis.

Its incidence has been the subject of several international studies, as well as, its related mortality, but its epidemiological data is lacking in Algeria.

Aims: The main objective of our study is the determination of the frequency of complete right bundle branch block in acute coronary syndrome with ST segment elevation, the secondary objective was the analysis of its predictive factors and related mortality.

Methods and materials:  In this prospective study, conducted in the cardiology department of Hussein Dey hospital (Algiers-Algeria), 467 patients with acute coronary syndrome with elevated ST segment (87 women and 380 men) were enrolled between 28 February 2014 and 16 July 2015. The average age is 60 ± 13 years; at admission, a Holter recorder was attached for continuous ECG monitoring during 48 hours.

Kruskal’s ANNOVA or H tests were used for comparison of quantitative variables, χ2 test or Fisher’s exact test, were used for qualitative variables, all tests were performed with 1^st species risk of 5%.

Results:  The frequency of complete right bundle brunch block is 10.9 % (51 patients), CI 95%: [8.1%-13.7%], multivariate analysis identified the following independent predictors: anterior acute coronary syndrome, persistence of chest pain after thrombolysis, and diabetes type 2.

The risk of mortality expressed by Hazard Ration (HR) is 3.4, CI95%: [1.07-11.35], p = 0.037; persistence of ST segment elevation after thrombolysis is the only predictive factor of mortality, identified in our study.

Conclusion: Complete right bundle brunch block is frequent in acute coronary syndrome with elevated ST segment, its predictive factors according to our study are: anterior acute coronary syndrome, persistence of chest pain after thrombolysis, and type 2 diabetes.

Its occurrence increases the risk of in-hospital mortality, and the predictor of this latter is the failure of thrombolysis.

Introduction: Zoonoses are diseases transmitted from animals to humans and pose a major threat to human health and life. Animals are often asymptomatic carriers of pathogens and spread them in the environment with their excreta. Their course varies from the common cold to more severe and often fatal diseases in humans. Before the COVID-19 infection caused the global pandemic in 2020, coronavirus diseases were primarily of veterinary interest.

The COVID-19 pandemic has changed the way we live and strained healthcare systems around the world. This pandemic has necessitated the development of protective and therapeutic measures against the spread of SARS-CoV-2. The lack of optimal vaccine against SARS-CoV-2 offering long-lasting protection against the different viral variants, as well as a drug, allowing the treatment of all variants of COVID-19 directed us to the use of dietary components and agents that are applicable in the context of competitive inhibition by blocking part of the receptors to protect against coronavirus-related diseases.

Discussion: Lactobacillus and carrageenans may have a protective effect against SARS-CoV-2 infection alone or in combination in healthy subjects. Reducing the viral load in the nasopharynx may drastically reduce the risk of transmission of COVID-19.

Infectious diseases are among the strongest types of selective pressure driving human evolution. Genetics in the coming decades will likely allow us to understand the dynamics of human immune system formation. By learning from our mistakes and successes, we will be able to more successfully deal with the challenges posed by zoonoses in the future.

Background: Understanding the hematological manifestations of the COVID-19, is of paramount importance in terms of patient management and prognosis.

Aim: To review the fundamental hemogram parameters and their clinical significance.

Methods: This is a retrospective, cross-sectional, and observational investigation. Hemogram findings of the participants within 30 days following the onset of symptoms were analyzed. Participants were categorized into moderate and severe groups based on the assessment of disease severity.

Results: Both erythrocyte sedimentation rate and C-reactive protein are considerably elevated in both groups, with higher levels observed in the severe group compared to the moderate group. The percentage of neutrophils, is elevated above normal in both groups, with the severe group demonstrating higher values. The statistical difference between the groups is significant.

Conclusion: Hemogram-derived ratios would be beneficial to include them in common laboratory practices.