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Secondary Hypertension in Sub-Saharan African Populations: A Retrospective Study between 2011 and 2016 at Regional Hospital of Saint-Louis, Senegal

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Open Journal of Nephrology 2016年第3期6卷 93-97页

作者： Yaya Kane Joel Simon Manga Diatou Gueye Dia Maiga Moussa Zeinabou Tondi Ahmed Tall Lemrabott Maria Faye Sidy Mouhamed Seck Mouhamadou Moustapha Cisse alex ismael keita Kalilou Diallo El Hadj Fary Ka Abdou Niang Boucar Diouf Nephrology-Cardiology and Internal Medicine Department Assane Seck University Ziguinchor Sénégal Nephrology and Internal Medicine Department Gaston Berger University Saint-Louis Sénégal Nephrology Department Abdou Moumouni University Niamey Niger Nephrology Department Teaching Hospital Aristide Le Dantec Dakar Senegal

Introduction: High blood pressure (HBP) is a worldwide health issue responsible of high cardiovascular morbidity and mortality. Even though essential HBP is far the most frequently reported in patients, secondary causes must be known because of their severity and the possibility of aetiological treatment. No recent epidemiological data are available about secondary causes of HBP in black African populations. The aim of this study was to describe aetiological patterns of secondary HBP in patients followed at Saint-Louis Hospital. Patients and Method: We conducted a retrospective and descriptive study in regional hospital of Saint-Louis. All patients aged ≥15 years old admitted from January 1st 2011 to January 31st 2015 in internal medicine, nephrology, emergency and cardiology departments were included. Clinical, paraclinical data and patients outcomes were collected from medical records. Hypertension was defined according to JNC8 criteria. Secondary HBP was considered if explorations identified a clear aetiology to hypertension. Statistical analysis was done with Excel 2010 and STATA 12.0. Results: We included 9253 patients with mean age of 35 ± 12 years (15 - 83 years) and sex-ratio of 1.6. Overall 67.5% of patients had hypertension and secondary causes were found in 10.5% of them. The majority of patients presented clinical symptoms suggesting a secondary cause of HBP and first-line laboratory explorations were normal in half of cases. Renal diseases were responsible for 79.1% of secondary HBP cases mainly dominated by glomerulonephritis (22.6%), vascular nephropathies (18.7%) and autosomal dominant polycystic kidney disease (5.8%). They were followed by preeclampsia (13.6%) and endocrinal aetiologies such as hyperthyroidism (5.8%), hypercorticism (0.5%), pheochromcytoma (0.5%), primary hyperparathyroidism (0.4%) and Conn’s adenoma (0.1%). Combination of ≥3 antihypertensive drugs was necessary in 71.5% of cases and surgical treatment was performed in three patient

关键词： Secondary High Blood Pressure Internal Medicine Black Africans

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Retro Placental Hematoma: Maternal and Fetal Prognosis at the Maternity of the University Hospital of Bouake

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Open Journal of Obstetrics and Gynecology 2024年第1期14卷 44-56页

作者： Samake Yaya Djanhan Lydie Estelle Menin-Messou Benie Michele Kouadio Kouadio Narcisse Akanji Iburaima Alamun M’bro Clausen Georgie Boko Dagoun Dagbesse Elysee Camara Sokhona N’guessan Kouadio ismael Foua Bi Paul Hyacinthe keita ismael Vaho Magnificat Marina Kone Minzata Yasmine Doumbia Yacouba Gynaecology-Obstetrics Department Centre Hospitalier Universitaire de Bouaké Bouake Ivory Coast Mother and Child Department Alassane Ouattara University Bouake Ivory Coast

Introduction: Retroplacental haematoma (RPH) is a very serious complication of pregnancy, with life-threatening consequences for both the mother and foetus. The aim of this study is to determine the incidence and epidemiological characteristics of patients with retroplacental haematoma (RPH) and describe the maternal-foetal complications at Bouaké University Hospital. Methods: This was a cross-sectional prospective, descriptive and analytical study carried out at Bouaké University Hospital over a period of 3 years, from January 1, 2019 to December 31, 2021. All parturients with RPH whose delivery took place at the hospital were included in the study. Data were entered and analysed using EPI INFO software version 7.***.2.6. Results: We recorded 2,0959 deliveries, including 202 cases of RPH, representing an incidence of 0.96%. The 21 to 35 age group accounted for 64.4%, multigestas and large multigestas accounted for 58.5% and multiparas accounted for 41.6%. The main signs on clinical examination were metrorrhagia (100%), arterial hypertension (84.6%) and cervical cerclage (79.7%). Preeclampsia accounted for 50% of per-gestational pathologies. Maternal mortality was 12.9%. Morbidity was dominated by anaemia in 64.1%, followed by disseminated intravascular coagulation (DIC) in 21.8%, and the factors associated with this maternal prognosis were multiple gestations, multiparity, Sher grade IIIb and the occurrence of complications such as DIC, shock, renal complications and HELLP syndrome. Neonatal mortality was 79.2%, and the factors associated with these fetal prognoses were cup size ≥ 5 cm and hematoma weight ≥ 500 g. Conclusion: Better screening of at-risk populations, early diagnosis and treatment in an organised and equipped medical and surgical facility would improve prognosis.

关键词： Retroplacental Haematoma Lethality Bouaké and Prognosis

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Kati Chu BSS External Genital Organ Delivery Syndrome: Inguinal Pedicle Flap Plasty

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Surgical Science 2021年第11期12卷 357-364页

作者： Koniba keita Sidiki keita Oulematou Coulibaly Abdoulaye Diarra Fodé Mory keita Boubacar Kone Lassina Traoré Salia Coulibaly Amadou Traoré Assitan Kone Amadou Kassogué Issa Traoré Oumou Traoré ismael Konaré Daouda Diallo Drissa Traoré Bacary T. Dembélé General Surgery Department Hospital BSS Kati Mali General Surgery “A” Department Hospital Point-G Bamako Mali Reference Health Centre of the Commune VI Bamako Mali Medical Imaging Department Hospital BSS Kati Mali General Surgery Department Hospital Gabriel Toure Bamako Mali Urology Department Hospital BSS Kati Mali Anesthesia Resuscitation Department Hospital BSS Kati Mali General Surgery “B” Department Hospital Point-G Bamako Mali

Fournier’s syndrome is a poly microbial necrotizing fasciitis, of severe evolution of the perineum and external genitals. Objectives: We report the experience of the service in the management of Fournier gangrene of the external genital organs by inguinal flap pediculated in front of the loss of significant substances of the scrotum. Patients and method: This was a mono-centric retrospective study from January 2008 to August 2021 in the General Surgery Department of the Bocar Sidi Sall University Hospital (CHU BSS) in Kati. It focused on patients treated for Fournier gangrene of external genitals. The variables studied were age, sex, blood count, germs encountered, the antibiogram, duration of evolution, reconstruction of the scrotum by pedicle flap, and morbidity. Results: During the study period we collected 5 cases of Fournier gangrene of external genitals in the service. The average age was 57.6 years and all the patients were male. The average duration of evolution was 5 days for an average age of 57.6 years. All patients were male. Echerichia coli (E. coli)

关键词： Fournier’s Gangrene Scrotum Inguinal Pedicular Flap

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Ileal Occlusion on Bezoars at Kati BSS Hospital

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Surgical Science 2019年第1期10卷 39-43页

作者： keita Koniba Abdoulaye Diarra Sidiki keita Issa Traore Salia Coulibaly Fadima Tall Daouda Diallo Oulematou Coulibaly Assitan Kone Boubacar Kone Mahamadou Bacary Coulibaly Daouda Konate ismael Konare Drissa Traore General Surgery Department Kati Mali Medical Imaging Department Kati Mali Anesthesia Resuscitation Department Kati Mali Ophthalmology Department Kati Mali

Bowel occlusions by bezoars are rare pathologies. They are due to an ob-struction of the intestinal lumen by a solid mass of fruits or undigested vegetable fibers. They are seasonal (wild fruit season from March to June) in the Sahel Zone. We report a case of small bowel obstruction in a 35-year-old rural man after swallowing a significant amount of wild grapes (Lannea microcarpa). We proceeded to the resection of the occluded ileal segment and performed an ileal terminal ileal anastomosis. There weren’t any complications during the postoperative site.

关键词： Bezoars Occlusion Jejunum Season

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Intradialytic Hypertension: Prevalence and Associated Factors in Chronic Hemodialysis Patients in Senegal

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Open Journal of Nephrology 2018年第2期8卷 29-37页

作者： Faye Moustapha Lemrabott Ahmed Tall Kane Yaya Cisse Mouhamadou Moustapha Seck Sidy Mohamed Faye Maria Daher Abdoul Karim Omar Fall Khodia Sakho Binta keita Rick alex ismael Mbengue Mansour Niang Abdou Diouf Boucar Ka Elhadji Fary Nephrology Department Aristide Le Dantec Hospital Cheikh Anta Diop University Dakar Senegal Department of Nephrology Regional Hospital Center Assane Seck University Ziguinchor Senegal Department of Nephrology Regional Hospital Center Gaston Berger University Saint Louis Senegal

Introduction: Intradialytic hypertension is defined as elevation of blood pressure to more than 10 mmHg in the post-dialysis period as compared to the pre-dialysis one. It is an important factor of morbidity and mortality in hemodialysis patients. The aim of our study is to assess the prevalence and associated factors of intradialytic hypertension. Patients and methods: This is a descriptive and analytical cross-sectional study that was conducted over a period of 3 weeks in the hemodialysis units of Aristide Le Dantec Hospital in Dakar and Regional Hospital Center in Ziguinchor. Chronic he-modialysis patients who are at least 18 years old and agreed to participate in study have been included. Patients who did not have 4 measures or those who decided to withdraw from the study were excluded. Intradialytic hypertension was restrained by an increase in systolic blood pressure immediately after the hemodialysis session > 10 mmHg compared to that recorded before session, with a repetition of this phenomenon for at least 4 hemodialysis sessions. Results: Our study included 539 hemodialysis sessions for 93 hemodialysis patients with a mean age of 48.72 ± 14.06 years and a sex ratio (M/F) of 1.21. The mean duration of dialysis was 64.22 ± 45.63 months. Hypertensive nephropathy was significantly common, noted in 38.7% (36 patients). Mean inter dialytic weight gain was 2.04 ± 1.06 kg, and the average dry weight was 62.71 ± 13.69 kg. The average hemoglobin level was 9.27 ± 1.91 g/dl. The mean albumin level was 35.4 ± 7.48 g/l. Nineteen (19) patients were administered erythropoietin stimulating agents (20.4%), and 59 patients were given antihypertensive drugs (63.4%). An elevation of more than 10 mmHg of post-dialysis BP compared to pre-dialysis was noted in 179 sessions, which is 33.2 per 100 hemodialysis sessions. IDH was noted in 21 patients, which represents 22.6%. The factors associated with IDH were as follows: high post-dialysis pulse pressure (PP) (p = 0.0008), pre-dial

关键词： Intradialytic Hypertension-Hemodialysis-Senegal

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Sigmoid Colon Volvulus: Surgical Management at Kati BSS Hospital (Mali)

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Surgical Science 2019年第3期10卷 76-82页

作者： Koniba keita Abdoulaye Diarra Salia Coulibaly Sidiki keita Issa Traore Moussa Doumbia Fadima Tall Daouda Diallo Oulematou Coulibaly Assitan Kone Boubacar Kone Daouda Konate Amadou Kassongue Moussa Salifou Diallo ismael Konare Drissa Traore Nouhoum Ongoiba General Surgery Department Kati Mali Medical Imaging Department Kati Mali Anesthesia Resuscitation Department Kati Mali Ophthalmology Department of Kati Kati Mali Department of Urology of Kati Kati Mali

The objective of this study was to describe the therapeutic aspects and to evaluate the surgery results of sigmoid Volvulus in the Kati (MALIA) General Surgery Department. Patients and Methods: This was a descriptive study conducted in our General Surgery Department. It took place in two phases for six years: A retrospective phase from January 1st, 2010 to December 31st, 2015 and a prospective phase from January 1st, 2016 to December 31st, 2017. This study has been approved by the Ethics Committee. It’s concerned all the patients operated in the department for colon Volvulus. Results: We collected 70 patients’ files. The Sigmoid Volvulus represented 7.8% of emergency surgery activities and 37.2% of intestinal obstruction. The male sex predominated with 98.57% against 1.43% of the female sex. The average age was 42.11 years old with limits of 18 to 70. The average deadline evolution was 2.53 days with limits of 1 to 3. The sigmoidectomy with immediate anastomosis was performed in 66% of patients, colectomy with 2-times anastomosis: according to Hartman 20% and Bouilly Volkman 11%, detorsion with colopexy 3%. The early morbidity rate was 5.71%. The average duration of hospitalization was 10.8 days with limits of 5 to 40 days. Two deaths were recorded. Conclusion: Sigmoid Volvulus is frequent in young adult sex male in Africa. We did not find any significant difference between the surgical technique and the advent of complications. The Colectomy with immediate anastomosis seems to be ideal to us that anytime the conditions are appropriate.

关键词： Volvulus Sigmoid Colectomy Surgery

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Deafness: Epidemiological, Clinical and Therapeutic Aspects in 15 Year Olds and over at the University Hospital Center Gabriel Toure of Bamako

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International Journal of Otolaryngology and Head & Neck Surgery 2022年第4期11卷 202-210页

作者： Kassim Diarra N’faly Konaté Yaya Dembele ismael Berthé Drissa Kaloga Bagayoko Boubacary Guindo Fatogoma Issa Koné Siaka Soumaoro Doumbia Kadidiatou Singare Mohamed Amadou keita ENT and Head and Neck Surgery Department university hospital Gabriel Toure Bamako Mali Armies Polyclinic of the Kati Bamako Mali Department of Anesthesia Resuscitation CHU Mother-Child “Luxembourg” Bamako Mali

Objective: To study the epidemiological, clinical and therapeutic aspects of hearing loss in 15-year-olds and over at the CHU GT of Bamako. Materials and Method: This is a longitudinal prospective study carried out in the ENT department of the University hospital Gabriel Toure in Bamako over 13 months (from September 2018 to September 2019). We carried out an exhaustive sampling of all the patients who consulted in the department for hearing loss and whose deafness was confirmed at pure tone audiometry with age greater than or equal to 15 years. The exclusion criteria were all patients under the age of 15 as well as a hearing loss related to earwax or foreign bodies and refusals to participate in the study. Results: Two hundred and thirty (230) patients were collected during the study. Dominated by the male sex with a sex ratio of 1.5 or 3 men for 2 women, with an average age of 38.16 ± 19 years with extremes ranging from 15 to 86 years. Among our patients, 37.40% had unilateral deafness, progressive installation evolving more than 12 weeks with a rate of cases had headaches 41% and had a history of chronic otitis media (CMO) 27%. There were a few cases of mixed type deafness, 30% had mild deafness, 22% moderate deafness and 40% severe deafness, according to the BIAP classification. Among our patients, 22.16% had conductive hearing loss, and those with sensorineural hearing loss accounted for 15.24%. Conclusion: Pure tone audiometry remains essential in the diagnosis of deafness. It not only makes it possible to confirm or invalidate the deafness, but also to define the type of deafness and especially to classify the deafness according to the degree of the average hearing loss established by the BIAP.

关键词： Pure Tone Audiometry Deafness BIAP

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Demons-Meigs Syndrome: A Case Report at the Fatick Regional Hospital

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Open Journal of Obstetrics and Gynecology 2021年第12期11卷 1735-1743页

作者： Abdoulaye Mihimit Alhassane ismael Toure Oumar Abakar Oumar Bafode Camara Abdoulaye keita Malick Bah Ermerlindo Rodrigues Pereira Ibrahima Dara Diamé Bangaly Traore Sidy Ka Ahmadou Dem Centre Hospitalier Régional de Fatick Fatick Sénégal Université de N’Djamena N’Djamena Tchad Université Cheikh Anta Diop de Dakar Dakar Sénégal Centre Hospitalier Universitaire de Fann Dakar Sénégal Hô pital Jean Paul II Conakry Guinée Centre Hospitalier Universitaire Le Dantec Dakar Sénégal

Demons-Meigs syndrome combines a benign tumor of the ovary with thoracic and abdominal effusion, it is a rare disease whose pathophysiological mechanism is not yet well understood. This rare syndrome often gives rise to fear of ovarian neoplasia due to the existence of ascites and the significant elevation of CA 125. In this observation, we report the case of Demons-Meigs syndrome diagnosed in a 36-year-old young woman who presented with pleural and peritoneal effusion syndrome with an ovarian mass and a CA 125 level = 406.6 IU/ml. Laparotomy performed revealed very abundant ascites, the uterus and tubes were healthy, no suspicious peritoneal lesions, the left ovary is healthy, a right ovarian mass of 300 × 150 mm. A right annexectomy was performed. The operative suites were simple with drying of the effusions. The control CA 125 returned to normal after 6 months of follow-up. A pathological anatomy result is a fibrothecoma. Demons-Meigs syndrome has a good progno

关键词： Demons-Meigs Syndrome Ovarian Tumor CA 125 Ascites Hydrothorax Senegal

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Postoperative Occlusion of the Small Bowel with Flanges and/or Adhesions in General Surgery of Kati BSS CHU

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Surgical Science 2018年第9期9卷 293-299页

作者： Abdoulaye Diarra Koniba keita Amadou Traore Assitan Koné Issa Traore Idrissa Tounkara Abdoulaye Kante Fadima K.Tall Daouda Diallo Moustaph Issa Magané Madiassa Konate Aboubacar Koné Deborah Sanra Sanogo ismael Konare Alhassane Traoré General Surgery Department KatiMali Anesthesia Service and Resuscitation Department KatiMali Gastroenterology Department KatiMali

Objectives were to determine the frequency, describe the epidemiological and clinical aspects, therapeutic and analyze the postoperative course. Methodology: This was a retrospective study that covered 08 years (January 2009-December 2017). Inclusion criteria: all patients operated for obstruction of the small bowel by hail and/or flanging. Exclusion criteria: other types of occlusion and non-operated patients. Result: We recorded a total of 162 cases of hail obstruction by adhesions and/or flanges at 2.87%. The average age was 32.04, the sex ratio was 1.2. The average consultation time was 4 days. Abdominal pain associated with stopping of material and gas was present in all our patients. X-ray of the abdomen without preparation carried out in all the patients made it possible to objectify in 150 patients (92.6%) of the hydro-hail levels. Inoperative occlusion of hail on flange was present in 80 patients (49.4%). Occlusion of the small bowel on flange and adhesion was present in 69 patients. Adhesion obstruction of hail accounted for 6.8% (11 cases). The most commonly used surgical technique was flange resection in 91 patients (56.2%). The follow-up was simple in 151 patients (93.2%). Mortality was 1.2% of cases, i.e. 2 deaths. The average duration of hospitalization was 6 days. Conclusion: Occlusion of the small bowel by flanging and/or adherence is a surgical emergency whose prognosis depends on early management.

关键词： Postoperative Occlusion Hail Bridle/Adherence Mali

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