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Ankylosing Spondylitis in a West African Hospital

Open Journal of Rheumatology and Autoimmune Diseases 2023年第1期13卷 8-16页

作者： Abdoulaye Barry Oumar Diouhé bah adama bah Mamadou Lamine Diallo Kaba Condé Samba Frein Condé Aly Badra Kamissoko Rheumatology Department of the National Ignace Deen Hospital in Conakry Conakry Guinea Biomar 24 Medical Laboratory Conakry Guinea

Introduction: Ankylosing spondylitis (AS) is an inflammatory rheumatic disease characterized by predominant axial and peripheral (enthesitis, sacroiliitis) involvement affecting young subjects aged 30 to 40 years, 80% to 98% of cases are associated with HLA-B27. Objective: To determine the epidemiological profile of ankylosing spondylitis in the rheumatology department of the Ignace Deen National Hospital in Conakry (Guinea). Materials and Methods: This was a descriptive cross-sectional study carried out within the said department over a period of 18 months from July 1, 2018 to December 31, 2020, including all patients seen in consultation and/or hospitalized in the department in which the diagnosis of ankylosing spondylitis had been retained according to the modified New York criterion. The parameters studied were sociodemographic, clinical, paraclinical and therapeutic. Result: We collected 73 cases or 4.1% of ankylosing spondylitis out of a total of 1781 patients seen during the study period. The male gender was represented with 54.8% for a sex ratio of 1.2 M/F. The average age of our patients was 32.18 ± 12.44 years with extremes ranging from 17 to 54 years. Axial involvement was present in 89.9% of cases with a lumbar predominance (95.2%), followed by the sacroiliac seat (35.5%), cervical (14.5%) and dorsal at 4.8%. The pain was chronic in 93.2% of cases. The most common drug treatment was taking analgesics and NSAIDs (100%) followed by cortisone infiltration (41.1%), corticosteroids (30%), and physiotherapy (21.9%). Ankylosing spondylitis represents 83% of spondyloarthritis followed by undifferentiated spondyloarthritis (9.1%) and juvenile spondylitis (3.4%) were the most common conditions.

关键词： Ankylosing Spondylitis Rheumatology Ignace Deen Guinea

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Osgood Schlatter Disease: Study of 2 Observations in Conakry, Guinea

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Open Journal of Rheumatology and Autoimmune Diseases 2024年第2期14卷 77-83页

作者： adama bah Laetitia Cynthia Abandazegoue Andjembe Abdoulaye Barry Mamadou Lamine Diallo Moustapha Niasse Aly Badra Kamissoko Rheumatology Department Ignace Deen Hospital Conakry Conakry Guin&#233e Rheumatology Department CHU Aristide Le Dantec of Dakar Dakar S&#233n&#233gal Department of Rhumatology Sylvanus Olypio University Hospital Lom&#233 Lom&#233 Togo

Introduction: OSD is a growth osteochondrosis affecting the apophyseal cartilage of the anterior tibial tuberosity of the knee, 20 to 30% of young growing athletes suffer from this pathology, described by Osgood and Schlatter in 1903. Objective: To report 2 observations and review the literature. Observation 1: This was a 14-year-old Guinean teenager, Halpoular, living in Conakry, a right-handed footballer who presented with a painful swelling of the right knee that looked mechanical, whose father had HLA B27 positive ankylosing spondylitis. X-ray of the right knee showed fragmentation of the anterior tibial tuberosities, and ossicle with edema of the patellar tendons at stage 4 according to Ehrenbord and Lagergren (1961). Thus, the disease of OSD is retained, He received 120 mg of diclofenac, 20 mg omeprazole for 1 month and the cessation of sports activity, the evolution was favorably marked by the regression of pain. Observation 2: A 16-year-old girl, initials M.L.T, Guinean, residing in Coyah (Republic of Guinea), a handball player, consulted for intense pain (VAS: 8/10) in her knees after a violent shock received when she hit the post. The physical examination found a painful, soft swelling at the anterior tibial tuberosity of the right knee, the rest of the examination was normal. The X-ray of the right knee shows fragmentation of the anterior tibial tuberosity, and ossicle with edema of the patellar tendon at stage 4 according to Ehrenbord and Lagergren 1961, thus the OSD disease is retained, the treatment instituted was 120 mg of diclofenac, the cessation of sports activity which gives a good evolution (EVA at 2/10). Conclusion: OSD is a growth osteochondrosis affecting the apophyseal cartilage of the anterior tibial tuberosity of the knee in young growing athletes, resolving at rest.

关键词： Osgood Shlatter Disease Young Athlete

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Osteoarticular Manifestations of Pediatric Acute Lymphoblastic Leukemia: Study of an Observation and Review of the Literature

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Case Reports in Clinical Medicine 2024年第11期13卷 490-501页

作者： Fatou Sow Diouck adama bah Harouna Ousmane Sow Moustapha Niasse Amy Thiam Birahim Lo Matar Ndiaye Saidou Diallo Department of Rheumatology Aristide Le Dantec University Hospital Dakar Senegal Department of Rheumatology Ignace Deen National Hospital Conakry Guinea Departement of Hematology Biology and Oncology Hematology National Blood Transfusion Center Dakar Senegal Department of Clinical Hematology Dalal Diam Hospital Dakar Senegal Department of Medical Aristide Le Dantec University Hospital Dakar Senegal

Introduction: Acute lymphoblastic leukemia (ALL) is a monoclonal hematological malignancy characterized by infiltration of the bone marrow by more than 20% of hematopoietic cells with blocked differentiation, called blasts, belonging to the lymphoblastic lineage of lymphoid nature (B or T lymphoblasts). Around 40% of childhood cancers are leukemias, and 85% of these are ALL. The first descriptions of osteoarticular involvement as an inaugural manifestation date back to 1913 with August Strauch. Our aim was to describe an isolated case of ALL with osteoarticular manifestations as an inaugural event supported by a review of the literature. Observation: A 14-year-old adolescent with no known pathological history was referred from pediatrics to investigate the etiology of a chronic peripheral polyarthritis that had been progressively evolving for about seven weeks. Clinically, he presented with chronic peripheral polyarthritis, polysynovitis, non-ankylosing deforming involving knees, shoulders, wrists, and proximal interphalangeals (PIP), and a leukemic facies (facial puffiness and periorbital erythema). Biological investigations revealed a non-specific inflammatory syndrome with a VS of 60 mm in the first hour and CRP increased to 45 mg/l (N ≤ 6 mg/l). The blood count showed hyperleukocytosis at 25,600/mm3 with lymphocyte predominance at 18,660/mm3, normocytic normochromic anemia with hemoglobin at 11 g/dl, and hyperplakettosis at 510,000/mm3. The blood smear showed 37% blasts confirmed on the medullogram, with more than 20% blastic invasion and a predominance of common B-type lymphocytes on immunophenotyping with negative Philadelphia. Immunological, renal, infectious, hepatic, lipid, and uricemia tests were normal. These clinical and paraclinical findings led to the diagnosis of B-type lymphocytic leukemia. The patient received multidrug therapy for induction, consolidation, and intensification. As part of the management of his osteoarticular disorders, infiltrations

关键词： Acute Lymphoblastic Leukemia Osteoarticular Manifestations

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Bilateral Cervical Ribs Fusing or Naffziger Syndrome: About an Observation in Guinea and Literature Review

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Open Journal of Rheumatology and Autoimmune Diseases 2024年第4期14卷 157-164页

作者： adama bah Fatou Sow Diouck Laetitia Cynthia Abandazegoue Andjembe Moustapha Niasse Birahim Lo Seydina Omar Cissé Mohamed Lamine Keïta Aly Badra Kamissoko Rheumatology Department Ignace Deen National Hospital Conakry Guinea Rheumatology Department Aristide Le Dantec University Hospital Dakar Senegal Medical Department Aristide Le Dantec University Hospital Dakar Senegal Orthopaedic Traumatology Department Aristide Le Dantec University Hospital Dakar Senegal

Thoraco-brachial outlet syndrome (TDSD) or cervical rib brings together all the clinical symptoms (arterial, neurological and/or venous) due to extrinsic, intermittent or permanent compression of the vascular-nervous elements of the root of the upper limb during cervico-thoraco-brachial crossing syndrome. This pathology is relatively common but often overlooked;it affects women more often (between 4/1 and 2/1) and is rare in children. We report the case of a 59-year-old female patient seen in the department for paresthesia and muscular weakness of the upper limbs rated 3/5 on the right and 4/5 on the left progressively evolving over 39 years, electromyography (EMG) showed indicated compression of the brachial plexus and the CT scan confirmed the presence of bilateral cervical ribs fused with the first on the left. She benefited from physiotherapy while awaiting her surgery, and unfortunately, she died of a stroke in the traumatology department. This pathology is the first in our department to be supported by a review of the literature.

关键词： Cervical Ribs Naffziger Syndrome Guinea

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Management of Trauma to the External Genitalia at the Nianankoro-Fomba Hospital in Segou Mali

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Open Journal of Urology 2022年第6期12卷 376-382页

作者： Sory Ibrahim Koné Abdoulaye Kassogué Brehima Samaké Mahamoudou Keita Tidiani Traore Abdoulaye Nouhoum Coulibaly Mamadou adama Togo Thierno Boubacar Bagayoko adama bah Aminata Fofana Alpha Sanogo Damissa Coulibaly Sidi Modibo Doucouré Honoré Jean Gabriell Berthé Urology Department The Nianankoro Fomba Hospital Ségou Mali Paediatric Ward The Nianankoro Fomba Hospital Ségou Mali General Surgery Department The Nianankoro Fomba Hospital Ségou Mali Obstetrics and Gynaecology Department The Nianankoro Fomba Hospital Ségou Mali Ophthalmology Department The Nianankoro Fomba Hospital Ségou Mali Forensic Medicine Department The Nianankoro Fomba Hospital Ségou Mali ENT Department The Nianankoro Fomba Hospital Ségou Mali Cardiology Department The Nianankoro Fomba Hospital Ségou Mali Department of General Medicine The Nianankoro Fomba Hospital Ségou Mali Social Security Fund Ségou Mali Department of Urology CHU du Point G Bamako Mali

Trauma to the male genitalia is not very common and mainly affects a young population. There is probably a particular instinct in men to defend their external genitalia;indeed, in the flaccid state, the penis is little exposed, and fairly well protected and its mobility allows it to move with the impact of trauma and thus reduce the vulnating force. Open trauma is rare, as is testicular dislocation, the most common being closed trauma. Testicular trauma is an uncommon accident that affects young people. Trauma is most often caused by road and traffic accidents. Animal bites are rare, as is genital self-mutilation related to a psychiatric disorder. Surgical exploration is the rule except in cases of moderate testicular trauma. Our objective was to report our experience in an emergency context where treatment is poorly codified and to review the literature. We recorded four patients with external genitalia trauma managed in the urology department from April 2013 to March 2022. Our patients were children with open genitalia trauma following a traffic accident, scrotal injuries were encountered in three patients, and additional penile injuries in one patient. All patients were treated surgically. The follow-up was straightforward.

关键词： Trauma Genitalia Open Segou

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Familial Forms of Spondyloarthritis Study of 100 Senegalese Multiplex Families

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Open Journal of Rheumatology and Autoimmune Diseases 2024年第3期14卷 132-143页

作者： adama bah Chiekh Ahamadou Bamba Diaw Dieynaba Sala Tamara Kane adama Doucouré Siddiki Charifah Ramadhane Bouchrane Harine Abdel Aziz Garba Aissatou N’diaye Mondukpe Joane Immanuelle Houansou Laurine Marlyse Adogle Yaye Aminata Gueye Moustapha Niasse Saidou Diallo Service de Rhumatologie CHU Aristide Le Dantec Dakar Sngal Service de Rhumatologie Hpital National Ignace Deen Conakry Conakry Guine Service de Mdecine Interne Hpital Dalal Jamm de Dakar Dakar Sngal

Introduction: Spondyloarthritis (SpA) comprises a group of chronic inflammatory rheumatic diseases characterized by predominant axial involvement. These include ankylosing spondylitis (AS), reactive arthritis (ReA), psoriatic arthritis (PsA), arthritis associated with inflammatory bowel diseases (IBD), SAPHO syndrome (Synovitis, Acne, Pustulosis, Hyperostosis, and Osteitis), juvenile spondyloarthritis (JSPA), and undifferentiated SpA. Their exact cause is unknown but is believed to stem from a combination of factors. The first familial forms were described by de Blécourt et al. in 1961. The objective was to evaluate the epidemiological, clinical, therapeutic and evolutionary aspects of familial forms of SpA and in particular, to prove the severity of the disease in family members compared to index cases in the rheumatology department of the Aristide Le Dantec University Hospital in Dakar. Methodology: This was a prospective, cross-sectional and descriptive study with an analytical aim on patients with the familial form of spondyloarthritis defined by the existence of at least one other family member with SpA outside the propositus, collected within the Aristide Le Dantec rheumatology department in Dakar over a period of 10 years between January 2012 and December 2021. There were two phases of study, the first of which consisted of collecting index cases with miserly SpA and the second of which consisted of family screening after consent. The data analysed were epidemiological, clinical, paraclinical, therapeutic and evolving. Results: Out of 100 families of 1905 members, 667 SpA patients included, i.e. a prevalence of 35%, including 225 (33.73%) men and 412 women (61.17%), i.e. a ratio of 1.8. The mean age at diagnosis among relatives was 26.3 years (range 13 and 80 years), 47.14 years among the propositus, in whom the mean age at onset was 36.26 years and that of relatives 49.9 years in the first degree, 15 years in the second degree and 1 year in the third degree.

关键词： Familial Forms of Spondyloarthritis Propositus Senegal

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Para Testicular Pseudotumeurs of Calcified Gait: A Case Report from the Nianankoro Fomba Segou Hospital (Mali)

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Open Journal of Urology 2022年第12期12卷 602-606页

作者： Ibrahim Kone Sory Brehima Samaké Abdoulaye Kassogué Mahamoudou Keita Tidiani Traoré Thierno Boubacar Bagayogo adama bah Alpha Sanogo Damissa Coulibaly Abdoulaye Nouhoum Coulibaly Mamadou Togo Aminata Fofana Urology Department of the Nianankoro Fomba Segou Mali Hospital Ségou Mali General Surgery Department of the Nianankoro Fomba Segou Mali Hospital Ségou Mali Pediatrics Department of Nianankoro Fomba Segou Mali Hospital Ségou Mali Obstetrics and Gynaecology Department of the Nianankoro Fomba Segou Mali Hospital Ségou Mali Forensic Medicine Department of the Nianankoro Fomba Segou Mali Hospital Ségou Mali Cardiology Department of the Nianankoro Fomba Segou Mali Hospital Ségou Mali General Medicine Department of the Nianankoro Fomba Segou Mali Hospital Ségou Mali Ophthalmology Department of Nianankoro Fomba Segou Mali Hospital Ségou Mali ENT Department of the Nianankoro Fomba Segou Mali Hospital Ségou Mali

Fibrous tumors of para testicular location are extremely rare benign tumors. The diagnosis of benignity, which allows a conservative treatment, will be made intraoperatively in front of the macroscopic aspect with well enucleable nodules and confirmed by the extemporaneous anatomopathological examination. We report a case of multiple calcified paratestinal pseudotumors in a 25-year old patient with no particular history, whose benignity was proven by the histology of the operative parts. Our objective was to discuss, from this observation and a review of the literature, the diagnostic and therapeutic aspects of these tumors.

关键词： Pseudotumor Para Testicular Benign

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Emergency C-Section on Multi-Scar Uterus: Maternal and Fetal Prognosis at the Nianankoro Fomba Hospital in Segou, Mali

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Open Journal of Obstetrics and Gynecology 2023年第5期13卷 997-1005页

作者： Tidiani Traoré Seydou Traoré Seydou Z. Dao Abdoul K. Ballo Kassoum Sidibé Brahima Donigolo Babou Traoré Famakan Kané adama Coulibaly Abdrahamane Diarisso Alima Sidibé adama Camara Yacouba Dembélé Thierno Boubacar Bagayoko Alpha Sanogo adama bah Abdoulaye Kassogue Hamidou Toungara Seydina Alioun Beye Agoustin Thera Youssou Traoré Ibrahima Teguété Niani Mounkoro Amadou Dolo Gynecology Department of Hospital Nianankoro Fomba Segou Mali Gynecology Department of Reference Health Center of Koutiala Koutiala Mali Gynecology Department of Reference Health Center of Commune II of Bamako Bamako Mali Gynecology Department of Reference Health Center of Bla Bla Mali Gynecology Department of Reference Health Center of Kayes Kayes Mali Gynecology Department of Reference Health Center of Commune V of Bamako Bamako Mali Gynecology Department of Reference Health Center of Sikasso Sikasso Mali Gynecology Department of Mohamed VI Polyclinic of Bamako Bamako Mali Gynecology Department of Point G Teaching Hospital Bamako Mali Gynecology Department of Gabriel Touré Teaching Hospital Bamako Mali Gynecology Department of Pasteur Clinic of Bamako Bamako Mali

Background: Multi-scar uterus is a uterus with two or more scars due to surgery or trauma. Objective: The aim was to compare the maternal and fetal prognosis of emergency C-sections of bi-scar uteruses to those of uteruses with at least 3 scars at the Nianankoro Fomba Hospital in Segou. Materials and Methods: It was a descriptive and analytical cross-sectional study with prospective data collection over a 24-month period from March 20, 2018, to March 20, 2020. Results: In 2 years, we collected 103 emergency C-sections for multi-scar uterus out of 1198 C-sections with a frequency of 8.6%. The age group of 20 to 35 years was the most represented with 86.4%. The bi-scar uteruses were the most frequent with 77.7%. In 71.8% of cases, the C-section was performed during the latent phase of labor. The C-section was performed under loco-regional anesthesia in 89.3% of cases. Difficulties in hemostasis and bladder injury were the most frequent intraoperative accidents. Surgical site infection was the main postoperative complication. No maternal deaths were recorded. The perinatal prognosis was marked by 4.3% fresh stillbirths in bi-scar uterus against 3.7% in three or more scar uteruses and including 2 fresh stillbirths and 1 macerated. We did not record any early neonatal deaths after C-section. Conclusion: The frequency of emergency C-sections in patients with a multi-scar uterus remains very high in our hospital. A better awareness of the patients, their spouses and all the actors involved in the management of pregnancies and childbirth, can contribute to curb this trend.

关键词： C-Section Prognosis Segou Multi-Scar Uterus Emergency

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Maternal and Perinatal Prognosis of Artificial Induction of Labor with Misoprostol at the Reference Health Center of Commune 2 in Mali

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Open Journal of Obstetrics and Gynecology 2022年第4期12卷 267-275页

作者： Tidiani Traoré Seydou Z. Dao Seydou Traoré Adoul Azize Togo Bakary Abou Traoré Ahmadou Coulibaly Ibrahim Ousmane Kanté Kassoum Sidibé Thierno Boubacar Bagayoko Alpha Sanogo Famakan Kané adama bah Ibrahima Donigolo Babou Traoré adama Coulibaly Abdrahamane Diarisso Youssouf Traoré Ibrahima Teguété Augustin Tiongani Théra Nianankoro Fomba Hospital Ségou Mali Common Reference Health Center II Bamako Mali Koutiala Reference Health Center Koutiala Mali Point G University Hospital Center Bamako Mali Bla Reference Health Center Bla Mali Center Hospitalier Universitaire Gabriel Touré Bamako Mali

Introduction: The artificial induction of labor is increasingly common. Objective: Evaluate the maternal-fetal prognosis of artificial induction with misoprostol at the referral health center of the commune II. Methods: This is a cross-sectional, prospective, descriptive and analytical study which took place from September 1, 2019 to December 31, 2020. Included in the study were pregnant women carrying an evolving or terminated single-fetal pregnancy of at least 28 WA in cephalic presentation on a healthy uterus. The trigger has been made with 50 μg misoprostol administered sublingually into the posterior vaginal fornix. The dose was renewed as needed every 6 hours, until sufficient uterine contractions were obtained without exceeding 200 μg. Results: The frequency of artificial induction of labor was 1.25%. Indications were dominated by premature rupture of membranes (29.8%), overdue (19.1%), high blood pressure (19.1%), suitability of pregnant women (14.9%) and terminated pregnancies (10.6%). The vaginal delivery rate was 85.1% The Apgar score was greater than or equal to 7 in 83.3% of cases at the 1stminute. Maternal morbidity was marked by postpartum hemorrhage due to uterine atony in 4.3% cases. No maternal and neonatal deaths were noted. Conclusion: Induction of labor with misoprostol is a safe and effective method if careful selection of patients is made.

关键词： Childbirth Induction Artificial Misoprostol Prognosis

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Seizures in Children under Five in a Pediatric Ward: Prevalence, Associated Factors and Outcomes

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Open Journal of Pediatrics 2021年第4期11卷 627-635页

作者： Abdoul Karim Doumbia Oumou Koné Guédiouma Dembélé adama Dembelé Oumar Coulibaly Hawa Gouro Diall Karamoko Sacko Amadou Touré Pierre Togo Abdoul Aziz Diakité Mohamed Elmouloud Cissé Belco Maiga Djeneba Konaté Fatoumata Léonie Diakité Lala N’drainy Sidibe Fousseyni Traoré adama bah Djibril Kassogue Boubacar Togo Madou Traoré Department of Pediatrics at CHU Gabriel Touré Bamako Mali National Institute of Public Health Bamako Mali Mohammed VI Perinatal Clinic Bamako Mali

Introduction: convulsion is a frequent cause of neurological and cognitive sequelae and then of epilepsy. The objective of this work was to describe the socio-demographic, clinical, therapeutic, and evolutionary aspects. Methodology: This was a descriptive retrospective study carried out in the general pediatrics department of CHU-Gabriel Touré. It took place over a period of 02 years from January 2017 to December 2018. We included all children aged 1 to 59 months hospitalized in the ward for convulsion. Results: During the study period, 2653 children aged 2 months to 59 months were hospitalized in the general pediatric ward. We included 288 medical records of children who presented with a seizure on admission. Convulsions represented 11% of pediatric hospitalizations from 1 month to 59 months. The average age was 29 months. Fever was present in 86% of patients. The cerebrospinal fluid (CSF) test was positive in 38 patients. Hypoglycemia was present in 14 patients. Serum calcium was low in 3 patients. The most implicated etiologies were malaria 70%, meningitis 20%, and dehydration 13%. Management consisted of airway clearance, oxygen therapy as needed, and administration of diazepam (54%). Antibiotics were prescribed in 77% of cases and antimalarials in 70%. The average length of hospital stay was 8 days with extremes of 1 and 30 days. The outcome was favorable in 95% of cases. Sequelae were observed in 5% of cases and one case of death was observed. Conclusion: Acute convulsions are one of the most common causes of hospitalization in children under 5 years old. The causes were dominated by infectious diseases (mal

关键词： Convulsions Child Infant Prognosis Sub-Saharan Africa

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