MAINTENANCE. “Mind tumors are increasingly more frequent in Algeria”

MAINTENANCE. “Mind tumors are increasingly more frequent in Algeria”

Prof. Souhil Tliba is head of the neurosurgery division on the CHU Frantz-Fanon in Blida. On this interview, this eminent surgeon warns concerning the frequency of mind tumors in Algeria. The specialist outlines a number of attainable explanations for this phenomenon.

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TSA. Inform us about your exercise in your neurosurgery division on the CHU de Blida?

Prof. Tliba : It is a neurosurgery division which is managed by a group of 33 medical doctors (professors, lecturers, assistant professors, assistants, residents and basic practitioners) and 138 non-physician nursing workers (paramedics, service brokers).

The division has 4 particular working rooms and a typical room for medical and surgical emergencies.

Our division tries to satisfy the wants of sufferers with a robust neurosurgical exercise. As it’s a hospital-university construction, our division, which mainly supplies care, has, amongst different issues, coaching and analysis actions.

Both educational analysis as a part of college development to assist doctoral theses, or sectoral analysis below the supervision of the Ministry of Increased Training or intersectoral analysis tasks involving the Ministry of Well being.

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Academic exercise is supplied for the graduate coaching of medical college students doing their internship, and neurosurgery residents as a part of post-graduate coaching to develop into specialists.

Concerning care, our service supplies neurosurgical care in addition to emergency care. We have now a really intense daycare exercise. The latter is structured since daily a group, made up of a specialist with two residents, covers 24 hours within the medical and surgical emergencies of the CHU. Throughout his shifts, the groups function on common 3 to five sufferers per day.

TSA. The place do the sufferers you deal with come from in your division on the Blida College Hospital?

Prof. Tliba : As Blida is a passage on the east-west motorway axis between Algiers and Oran, there are a lot of accidents on public roads.

There are additionally different emergencies through the summer season, similar to motorbike accidents, diving accidents on the coast, brawls, suicide makes an attempt….

There are additionally home accidents similar to when youngsters fall from the roofs of homes, a uncommon factor below different skies…

TSA. Concerning highway accidents, in what situation do you obtain the sick?

Prof. Tliba : It is rather variable. There are sufferers who arrive in a state of obvious loss of life, there may be not a lot to do. It’s a minority. We primarily function on cerebral hemorrhages (hematomas), sure fractures of the cranium and backbone.

The benefit is that the on-call exercise is structured: at any time, the block is open for the care of the affected person. Afterwards, there are different parameters that escape us: the space, the circumstances of assortment and evacuation and the seriousness of the accident.

Alternatively, we saved numerous sufferers. We stock out greater than fifty emergency consultations.

There are different neurosurgical emergency actions similar to mind tumors which might worsen at any time and tumoral or infectious spinal twine compressions.

We have now gathered through the two years of Covid a really massive ready listing that we try to soak up by doubling our efforts. We have now many sufferers who haven’t been operated on, we attempt to function on as many as attainable.

Moreover, we function on one or two mind tumors a day. Typically we schedule two a day. It is enormous for a service, for an working theater and an intensive care unit to have two tumors to function on a day.

Interventions that final between 6 and eight hours. It is exhausting for the groups and it requires numerous sources, as a result of we’re overusing our gear.

The latter such because the working microscope, the neuro-endoscopy column, the neuronavigation, the motors of craniectomy, the ultrasonic aspiration, the respirators…. Require very expensive particular, specialised upkeep.

We’re additionally one of many few facilities that carry out cerebrovascular surgical procedure (cerebral aneurysms, vascular malformations). Alternatively, the demand is bigger than the care providers, therefore the orientation of many sufferers overseas.

I remind you that the administration of this situation (neurovascular) is shared between neurosurgeons and interventional neuro-radiologists.

Certainly, there may be nonetheless an pressing have to arrange neurovascular centres. This mannequin is initiated on the College Hospital of Blida with the participation of 4 specialties: neurosurgery, interventional radiology, neurology and medical resuscitation.

Our goal is first to take care of after which to strengthen this exercise with gear for care and others for coaching.

TSA. You say that mind tumors are widespread in Algeria, what are they because of?

The topic could be very difficult. There are a number of hypotheses, a few of that are confirmed, similar to genetic predisposition, the involvement of sure viruses, a historical past of head trauma…

Two different components that affect the incidence of mind tumors also needs to be famous: entry to diagnostic means (radiology) and the extension of most cancers survival, therefore the rise within the variety of mind metastases.

At this time, scientific articles evoke sure hypotheses however no power of certainty. Some speak about electromagnetic waves such because the overuse of cell telephones, particularly amongst youngsters, as a result of the cranium continues to be skinny and fragile and the warmth is transmitted extra simply to the mind.

On a cohort of 600 sufferers with mind tumours, an epidemiological examine was carried out in comparison with different research carried out in North Africa and people printed by the WHO in Europe and the world on the whole.

There are a number of options which are genuinely disturbing. The common age in Algeria of sufferers with mind tumors is 47 years.

Whereas on the earth this common age is 58 years. In our nation, mind tumors have an effect on the younger inhabitants greater than the world common. That is the primary worrying parameter. This isn’t associated to the age pyramid.

The second ingredient is mortality because of mind tumours.

On the planet, mind tumors are ranked twelfth by way of tumor mortality, whereas in our nation this illness is available in sixth place.

When it comes to frequency, such a most cancers ranks 18th on the earth, in accordance with WHO figures. In Algeria, the mind tumor occupies the ninth place. Now now we have to search for hypotheses. I may give you a number of…

TSA. Go for it…

Prof. Tliba: I might slightly tackle the speculation of phytosanitary merchandise similar to pesticides. We did work that was printed with collaborators and analysis colleagues from the College of Bejaia.

We have now spoken of a predisposition however the speculation which maybe comes near actuality is the usage of pesticides and pesticides in agriculture and this in a considerably anarchic method.

It is regulated however is there any discipline monitoring for his or her use? Do the customers (farmers and customers) respect the prevention guidelines? We converse for instance of the DAR (the pre-harvest interval). Are we certain that this deadline is revered?

We did laboratory work on mice and we discovered that there was a causality between pesticides and the event of a mind tumour. It’s an Algerian examine.

TSA. Are youngsters affected by this illness?

Prof. Tliba : The work was printed, we made communications, conferences and we talked about all this. Once more, it is a speculation to be confirmed in a bit of extra depth.

We can not ban these merchandise (pesticides), as a result of it’s a necessity; alternatively, we all know that it’s regulated however it could be obligatory that the use is effectively adopted and particularly managed within the laboratories.

Mind tumors are more and more widespread in Algeria. What now we have discovered is that there are a lot of youngsters who’re affected. They’re born with mind tumors. It is worrying. As soon as once more, we’re within the state of affairs.

There are mind tumors, malformations. Furthermore, we’re doing work on the Covid and malformations. Currently, now we have seen that there are newborns with malformations of the nervous system.

These are moms who had been contaminated with Covid throughout being pregnant. Is there a causality? The virus is thought to disrupt the event mechanism of the fetus. Did the virus assault the fetus and trigger mutations?

As well as, there are increasingly more spinal issues in younger folks and youngsters. There are increasingly more scoliosis, herniated discs… in relation to sedentary way of life and way of life, lack of bodily exercise, and many others.

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