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Epidemiological, Clinical and Echocardiographic Aspects of Non-Obstructive Hypertrophic Cardiomyopathy in the Nephrology and Haemodialysis Department of the POINT G University Hospital

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Open Journal of Nephrology 2023年第2期13卷 81-90页

作者： Hamadoun Yattara Nouhoum Coulibaly Yohana Koné Atabieme Kodio Seydou Sy Aboubacar Sidiki Fofana abdou messoum dolo Djenebou Maiga Magara Samaké Alkaya Touré abdoul Karim Traoré Mahamadoun Kougouliba Moustapha Tangara Sahare Fongoro Point G University Hospital Bamako Mali Sikasso Regional Hospital Sikasso Mali Kayes Regional Hospital Kayes Mali Segou Regional Hospital Segou Mali Faculty of Medicine and Odontostomatology University of Science Technique and Technologies of Bamako Bamako Mali

Introduction: LVH is the earliest cardiovascular abnormality in CKD. It is a significant risk factor for mortality and cardiovascular morbidity in patients with chronic kidney disease. The objective of this study was to investigate non-obstructive hypertrophic cardiomyopathy in CKD patients hospitalised in the nephrology and haemodialysis department of the POINT G University Hospital. Methods: This is a prospective study carried out from January 1, 2021 to December 31, 2021 and concerned chronic renal failure patients with non-obstructive hypertrophic cardiomyopathy. Results: During our study, we recorded 89 cases of non-obstructive hypertrophic cardiomyopathy, a prevalence of 42.8%. The sex ratio was 1.2 in favour of men. The average age of the patients was 45 ± 14.4 years with extremes of 16 and 78 years. The risk factors frequently found were anaemia (100%) and hypertension (92.1%). The clinical picture was dominated by the left heart failure syndrome (66.3% of cases). The different types of echocardiographic hypertrophy found were concentric (72%), eccentric (18%) and septal hypertrophy (10%). Conclusion: Non-obstructive hypertrophic cardiomyopathy is the early cardiovascular abnormality encountered in CKD. It is associated with cardiovascular risk factors such as hypertension, anaemia and phosphocalcic disorders.

关键词： LVH Risk Factor Chronic Renal Failure Echocardiography

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Single-Centre Descriptive Epidemiological Study of Emergency Haemodialysis Patients in the Haemodialysis Unit of the CHU Point G (Mali)

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Open Journal of Nephrology 2023年第3期13卷 246-255页

作者： Hamadoun Yattara Nouhoum Coulibaly abdoul Karim Traoré Seydou Sy Atabieme Kodio Karamoko Djiguiba Mahamadoun Kougoulba Moctar Coulibaly Sah Dit Baba Coulibaly Modi Sidibé abdou messoum dolo Yohana Koné Moustapha Tangara Alkaya Touré Aboubacar Sididki Fofana Magara Samaké Sahare Fongoro Point G University Hospital Bamako Mali Regional Hospital of Segou Segou Mali Hopital Mère-Enfant le Luxembourg Bamako Mali Mali Gavardo Hospital Bamako Mali Infirmary Garnison de Kati Kati Mali Sikasso Regional Hospital Sikasso Mali Kayes Regional Hospital Sikasso Mali Faculty of Medicine and Ondotostomatology of Bamako Bamako Mali

Introduction: Haemodialysis is an exchange of solutes and water between the patient’s blood and a dialysis solution with a composition close to that of normal extracellular fluid, through a semi-permeable membrane. It is used in the treatment of acute or chronic renal failure. The aim was to study the clinical and paraclinical aspects and the outcome of patients starting dialysis treatment for renal failure in an emergency setting. Method: This was a prospective study from 1 January to 31 July 2020, with a sample of 62 patients receiving haemodialysis in an emergency setting in the nephrology department of the Point G University Hospital. Results: The study showed that the sex ratio was 1.38 in favour of men and that the mean age of patients was 36.82 years. The group of patients with a low socio-economic standard of living dominated, accounting for 71% of cases. Hypertension and anaemia were the predominant risk factors in 77.4% and 87.3% respectively. Hyperphosphaemia, hypocalcaemia and secondary hyperparathyroidism accounted for 94.7%, 98.2% and 97.7% respectively. Left ventricular hypertrophy was 29.27% on electrocardiogram and 22% on cardiac ultrasound. Isolated cardiomegaly was found in 30.76% of patients. The main indications for dialysis were uraemic syndrome (69.2%), pericardial friction (27.4), anuria for 48 hours (20.1%), hyperkalaemia (17.7%) and acute lung oedema (16.1%). The mean duration of haemodialysis was less than one month in one out of two cases. There was no significant association between age and time on dialysis (p = 0.178). The death rate was 20.97%. Case fatality was higher in patients whose duration of dialysis was less than one month than in the others (p = 0.0006). Conclusion: CKD is a public health problem in Mali. It affects young people, especially males. Low economic income is an obstacle to the management of this disease.

关键词： Haemodialysis Emergency CHU Point G

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Epidemiological and Clinical Aspects of Chronic Renal Failure in the Medical Department at the Hospital of Sikasso

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Open Journal of Nephrology 2023年第1期13卷 57-66页

作者： Djénéba Maïga Drissa Goïta Magara Samaké Aboudou messoum dolo Yohanna Koné Aboubacar Sidiki Fofana Seydou Sy Moctar Coulibaly Atabième Kodio Sahdit Baba Coulibaly Saharé Fongoro Nephrology Unit of Sikasso Hospital Sikasso Mali National Center for Scientific and Technological Research (CNRST) Bamako Mali Service de Médecine CHU Mère-Enfant le Luxembourg Bamako Mali Nephrology Unit of the Fousseyni DAOU Hospital Kayes Mali Nephrology and Hemodialysis Service CHU du Point-G Bamako Mali Faculty of Medicine of Bamako Bamako Mali Nephrology Unit of Mali GAVARDO Hospital of Sebenicoro Bamako Mali

Introduction: Chronic renal failure is a real public health problem because of its prevalence, the cost of its management and the high morbidity and mortality rate associated with it. The objective of this study was to determine the frequency, causes and main aggravating factors of chronic renal failure in the medical department of the hospital of Sikasso. Materials and Methods: This was a cross-sectional, retrospective, descriptive study conducted in the medical department of the Sikasso hospital from January 1, 2021 to November 30, 2022. It covered all the records of patients with chronic renal failure hospitalized in the department during this period. The MDRD formula was used to estimate the glomerular filtration rate. The KDIGO 2012 classification was used to stage CKD. Results: Of 820 patient records reviewed, we retained 197 records. The mean age of our patients was 42.25 ± 10 years. The male sex represented 114 (57.9%). The socio-economic level was considered low and precarious in 79.8% of cases. The frequency of chronic renal failure was 24%. The reason for hospitalization was mostly hyper creatinine > 185 μmol/l (92.4%). Herbal medicine was reported in 103 cases (52.3%). Medical history was hypertension 101 cases (51.3%), undocumented gastro duodenal ulcer (UGD) 14 cases (7.6%), hypertension and diabetes 11 cases (5.1%), diabetes 8 cases (4%), lower limb edema 9 cases (4.6%). Hypocalcemia was 147 cases (75.6%) with hyper phosphoremia was 153 cases (77.7%). Hemoglobin level was: <6 g/dl, 44 cases (22.3%);between 6 - 8 g/dl, 77 cases (39.1%), from 8 - 10 g/dl, 54 cases (27.4%). The etiologies of CKD were vascular nephropathy 106 cases (53.8%), interstitial nephropathy, 44 cases (22.3%), glomerular nephropathy, 33 cases (16.8%), diabetic nephropathy, 12 cases (6.1%) and polycystic kidney disease 2 (1%). CKD was classified as stage 5, 171 cases (86.8%), stage 4, 11 cases (5.6%), stage 3, 13 cases (6.6%) and stage 2, 2 cases (1%.) Dialysis was performed in 1095

关键词： Epidemiology Clinical Chronic Renal Failure Sikasso Mali

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Epidemiological and Clinical Profile of Patients Undergoing Primary Nephrological Consultation at the Fousseyni DAOU Hospital in Kayes, Mali

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Open Journal of Nephrology 2022年第1期12卷 142-153页

作者： Magara Samaké Seydou Sy Aboubacar Sidiki Fofana Hamadoun Yattara Sah Dit Baba Coulibaly Djénéba Diallo Nanko Doumbia Moctar Coulibaly Kodio Atabieme Djénéba Maiga Aboudou messoum dolo Nouhoum Coulibaly Saharé Fongoro Nephrology Unit Fousseyni DAOU Hospital Kayes Mali National Center for Scientific and Technological Research (CNRST) Bamako Mali Nephrology and Hemodialysis Department Point G Teaching Hospital Bamako Mali Faculty of Medicine of Bamako University of Bamako Bamako Mali Nephrology Unit Somine DOLO Hospital Mopti Mali Department of Medicine Mali Hospital Bamako Mali Nephrology Unit Mali GAVARDO Hospital Sebenicoro Bamako Mali Nephrology Unit Sikasso Hospital Sikasso Mali

Introduction: The first nephrological consultation is often late, even in developed countries. This delay is related to the insidious nature of renal disease, the lack of qualified personnel and structures for the management of these conditions and the context of chronic insecurity in our country. In Kayes, there is no data related to the first consultations of patients with the nephrologist, hence the interest of this study, which aimed to describe the epidemiological and clinical characteristics of patients undergoing a first nephrological consultation in Kayes hospital. Materials and methods: This was a retrospective, descriptive study conducted from January 1 to December 31, 2020 at the nephrology unit of the Fousseyni DAOU hospital in Kayes. All patients received for nephrological consultation for whom a medical record was made were included. The following data were collected and analyzed: the specialty of the medical referent, the reason for consultation, sociodemographic characteristics and the renal assessment of patients. Patients who consulted for non-nephrological pathologies and those who had no medical record were not included. Results: We collected the records of 346 patients, composed of 180 (52%) women and 166 (48%) men, i.e. a sex ratio of 0.92. The age group [20 - 40 years] was the most represented, 107 cases or 30.9%, with a mean age of 48.84 ± 21.33 years and extremes of 1 and 90 years. Housewives were the most consulted population, 149 cases (41.33%). Patients consulted more between the months of January and February, 116 cases (33.5%), this period was followed by the months of October-December, July-September and April-June with respectively 94 cases (27.2%), 76 cases (22.0%) and 60 cases (17.3%). The patients were referred by the general practitioner in 59.5% (209 cases), specialist doctor, 26.0% (90 cases). The patients came mainly from hospital practitioners, 172 cases (49.7%), private clinic and practice 81 cases (23.4%), community health c

关键词： Primary Consultation Nephrology Kayes Mali

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Severe Thromboembolic Complication Revealing a Nephrotic Syndrome Due to Segmental and Focal Hyalinosis: A Case Report

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Open Journal of Nephrology 2021年第3期11卷 450-457页

作者： Sah Dit Baba Coulibaly Magara Samaké Aboubacar Sidiki Fofana Seydou Sy Hamadoun Yattara Nanko Doumbia Katilé Drissa Moctar Coulibaly Kodio Atabieme Djénéba Maiga Aboudou messoum dolo Nouhoum Coulibaly Hamat Ibrahim Saharé Fongoro Konaté Anselme Nephrology Unit of Somino dolo Hospital Mopti Mali Nephrology Unit of the Fousseyni DAOU Hospital Kayes Mali National Center for Scientific and Technological Research (CNRST) Bamako Mali Faculty of Medicine of Bamako Bamako Mali Department of Nephrology and Haemodialysis University Teaching Hospital of Point-G Bamako Mali Medicine Department of Mali Hospital Bamako Mali Gastrohepato-Enterology Unit of the Fousseyni DAOU Hospital Kayes Mali Nephrology Unit of the Mali GAVARDO Hospital of Sebenicoro Bamako Mali Nephrology Unit of Sikasso Hospital Sikasso Mali Department of Nephrology-Hemodialysis National General Reference Hospital N'Djamena Chad Department of Gastro-Hepato-Enterology Gabriel Touré University Hospital Bamako Mali

Adult Nephrotic Syndrome (NS) is defined by proteinuria > 3 g/24h or 50 mg/kg/day, hypoprotidemia < 60 g/24h, hypoalbuminemia < 30 g/L. It is a disease with high thromboembolic risk. Peripheral vein thrombosis is common, while its association with pulmonary localizations has been more rarely reported. We report a case of nephrotic syndrome revealed by an association of pulmonary embolism, renal vein and inferior vena cava thrombosis. The diagnosis was confirmed by thoracic angioscan. Renal biopsy revealed Focal Segmental Hyalinosis (FSH). An anti-coagulant treatment and an anti-proteinuric treatment were instituted based on a calcium channel blocker (amlodipine) associated with the conversion enzyme inhibitor (perindopril).

关键词： Thromboembolic Complication Nephrotic Syndrome Segmental and Focal Hyalinosis Bamako/Mali

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Digestive Pathologies during Chronic Renal Failure in the Nephrology and Haemodialysis Department at the University Hospital Center of Point G in Mali

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Open Journal of Clinical Diagnostics 2020年第1期10卷 41-48页

作者： Magara Samaké Seydou Sy Hamadoun Yattara Moctar Coulibaly Mamadou Badou Sanogo Aboubacar Sidiki Fofana Aboudou messoum dolo Djénéba Maiga Djénéba Diallo Atabieme Kodio Bakary Diarra Karamoko Djiguiba Djibril Sy Saharé Fongoro Nephrology Unit of the Fousseyni DAOU Hospital Kayes Mali Nephrology and Haemodialysis Department of the CHU of Point G Bamako Mali Faculty of Medicine of Bamako University of Bamako Bamako Mali Nephrology Unit of Mali GAVARDO Hospital Bamako Mali Nephrology Unit of the Sikasso Regional Hospital Sikasso Mali Nephrology Unit of the Mother and Child Hospital The Luxembourg Bamako Mali Internal Medicine Service of the University Hospital Center of Point G Bamako Mali

Introduction: Chronic kidney disease (CKD) is the progressive and irreversible loss of kidney function. It exposes to many complications, among which, digestive complications. In Mali, we do not have data on the prevalence of digestive pathologies in people with chronic renal failure, hence the interest of this study. Objective: To determine the prevalence of digestive pathologies and to describe their manifestations during chronic renal failure. Patients and Methods: This was a prospective cross-sectional study conducted from September 2016 to August 2017, a period of 12 months. Included were patients hospitalized in our department with CKD who received digestive endoscopy and/or liver serology. Results: Seventy-one patients underwent digestive endoscopy with oesogastroduodenal fibroscopy (60 patients), rectoscopy (6 patients) and anoscopy (5 patients), i.e. 15.9% of those hospitalized. The mean age of the patients was 48 ± 14 years with extremes of 15 and 84 years. The sample consisted of 59.2% men versus 40.8% women, for a sex ratio of 1.5. The functional signs are in order of frequency: vomiting (72.4%), anorexia (51.3%) and epigastralgia (48.7%). Terminal CKD by creatinine clearance accounted for 88.2% of cases, of which 47.4% were monitored by hemodialysis. Hepatitis C virus infection was present in 21.3% of cases, hepatitis B (18%) and HIV (7.5%). Endoscopic examinations were represented by fibroscopy (84.5%), rectoscopy (8.5%) and anuscopy (7%). The fibroscopic lesions were respectively gastric (96.8%), duodenal (14.1%) and esophageal (12.5%). They were dominated by gastritis (40.5%), duodeno-gastric reflux (16.4%), pyloric gap (12.6%). Rectoscopy found 4 cases of hemorrhoids, 2 cases of rectitis and no lesions were observed at anuscopy. Conclusion: The prevalence of these digestive manifestations and the endoscopic lesions encountered indicate the importance of digestive endoscopy and the performance of hepatic serologies in chronic renal failure patients w

关键词： Chronic Renal Failure Digestive Signs Mali

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Quality of Antenatal Care at the Referral Health Center of the Fourth Commune of Bamako District

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Open Journal of Obstetrics and Gynecology 2023年第3期13卷 609-624页

作者： Amaguiré Saye Dessé Diarra Sirima Diarra Brahima Dembele abdou Guire Souleymane Dembele Yéli Dianessi Moussa Samake Seydou Mariko Seydou Fomba Diakaridia Kone abdoul Razakou Dicko Pierre Coulibaly Daouda Camara Hamidou Toure Mama Sy Konake Obstetrics and Gynecology Service Commune IV Reference Health Center Bamako Mali Obstetrics and Gynecology Department of Bamako Mali Hospital Bamako Mali Department of Study and Research in Public Health Faculty of Medicine and Odontostomatology USTTB Bamako Mali Reference Health Center of Commune I Bamako Mali Obstetrics and Gynecology Department of the Somine dolo Hospital Mopti Mali Reference Health Center of Kati Kati Mali

Purpose: To contribute to the improvement of the quality of prenatal consultation at the reference health center of the commune IV of the district of Bamako. Patients Methods: This was a qualitative cross-sectional study to assess the quality of prenatal consultation that took place from December 1, 2017 to January 31, 2018. It included 139 pregnant women whose consultations were monitored by the investigator and then the women were interviewed upon discharge from the facility to collect their opinions on the services they received. Results: The age group of 20 to 29 years was the most represented with 60.44%. In our study, 50% of our patients were managed by midwives. Among the antecedents constituting the risk factors sought in pregnant women, scar uterus was more frequent with 33.93% followed by arterial hypertension with 14.28% and multiparity with 7.14%. Conclusion: This study shows that the evaluation of the quality of services is an absolute necessity for the improvement of services in integrated reproductive health care centers.

关键词： Quality Prenatal Consultation Bamako Mali

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