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Management of Acute Myeloblastic Leukaemia (amL) Treated with Intensive Chemotherapy: Experience in a Single Centre

Open Journal of Pediatrics 2024年第2期14卷 401-411页

作者： Abdoul Karim doumbia Hawa Konaré Tati Simaga Pierre Togo Oumoulkairi Nana Kouma Hawa Gouro Diall Oumar Coulibaly Adama Dembélé Mohamed Elmouloud cissé Karamoko Sacko Belco Maiga aminata doumbia Kalirou Traoré Ibrahima cissé Boury Traoré Abdoul Aziz Diakité Fousseyni Traoré Boubacar Togo Department of Pediatrics University Hospital Gabriel Touré Bamako Mali

Introduction: Acute myeloblastic leukaemia (amL) is a haematological malignancy with a poor prognosis, despite significant therapeutic progress. This study presents the results of amL management in Mali according to GFAOP recommendations. Methodology: This was a retrospective, cross-sectional study. It included patients aged 0 - 15 years treated in the paediatric oncology unit for amL and followed up between January 2016 and December 2020. Results: During the study period, 85 cases of acute leukaemia were diagnosed in the paediatric oncology unit (including 51 cases of ALL), of which 34 cases of amL were included in this study. The majority were boys (59%). The mean age was 8 years, with extremes of 18 months and 15 years. The mean time to diagnosis was 68 days. In 79% of cases, patients were referred by 1st or 2nd level hospitals. Anaemia was observed in 91% of cases, an infectious syndrome in 68%, haemorrhage in 56% and a tumour syndrome in 85%. The haemogram showed hyperleukocytosis in 15% of cases, thrombocytosis in 22% and severe anaemia in 73%. Death occurred in 85% of cases, most often in the context of sepsis or haemorrhage. Conclusion: amL is probably underestimated in Mali and diagnosis delayed, which may be explained by patient-related factors (lack of knowledge, financial constraints) and a cumbersome referral system. These results suggest the need to implement an appropriate diagnostic and therapeutic strategy, with strong involvement of the political authorities.

关键词： Acute Myeloblastic Leukaemia Children Mali

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Early Prosthetic Valve Endocarditis with Mycobacterium Tuberculosis after Mitral Valve Replacement: A Case Report

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World Journal of Cardiovascular Surgery 2024年第3期14卷 33-40页

作者： Papa amath Diagne Mory Camara Papa Ousmane Ba Momar Sokhna Diop Moussa Samba Abdou Lahad Mbengue Jean Claude Ndiogou Dione Myriam Bizrane Marième Soda Mbaye Moussa Seck Diop Toudiani Malam Kaka Papa Salmane Ba Papa Adama Dieng am.dou gabriel ciss Assane Ndiaye Cardiovascular and Thoracic Surgery Department FANN National University Hospital Dakar Senegal

Background: Tuberculous endocarditis is a rare but serious complication of heart valve replacement surgery. We report the case of a 24-year-old patient, who presented with tuberculous endocarditis after mechanical mitral valve replacement, with a favorable clinical course following anti-tuberculosis treatment. Case Presentation: We report a 24-year-old male patient, admitted to the cardiac surgery department of the Fann Hospital (Dakar, Senegal), for the management of severe mixed (rheumatic and endocarditic) mitral insufficiency with associated tricuspid insufficiency. He had a history of recurrent angina and polyarthralgia in childhood, was hospitalized several times for refractory global cardiac decompensation, and for a suspected infective endocarditis a month before his admission. On admission, the clinical examination revealed signs suggestive of mitral and tricuspid insufficiency. Transthoracic echocardiography revealed severe post-endocarditic mitral insufficiency with A3 amputation, highly mobile 15 mm vegetations on the free edge of the large valve, moderate tricuspid insufficiency, and severe pulmonary artery hypertension. Mechanical mitral valve replacement and tricuspid valve annuloplasty using autologous pericardial strip were performed via median sternotomy. After ten days, the patient presented with global cardiac decompensation associated with a clinico-biological infectious syndrome, and tans-oesophageal echography revealed an abscess at the sinotubular junction, communicating with the aorta. A thoraco-abdomino-pelvic CT scan was done, which revealed a bilateral alveolar-interstitial syndrome with mediastinal lymphadenopathy. Anti-tuberculosis treatment with RHZE was initiated for 06 months. The clinical course was favorable. Conclusion: Tuberculous endocarditis in prostheses is a serious complication of heart valve replacement surgery, which may evolve favorably under medical treatment.

关键词： Tuberculous Endocarditis Prosthetic Valve Endocarditis Mycobacterium Tuberculosis

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Cervical Meningocele about 2 Operated Cases

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Open Journal of Modern Neurosurgery 2024年第1期14卷 1-7页

作者： Mohamed El Hassimi cissé Mam.dou Salia Diarra N’Famara Sylla Abdoulaye Diop Izoudine Blaise Koumaré Théodore Habib Maxime Coulibaly Oumar Diallo Drissa Kanikomo Neurosurgery Department of CHU Mère-Enfant “Le Luxembourg” Bamako Mali Neurosurgery Unit of Army Medico-Surgical Center of Bamako Bamako Mali Neurosurgery Department of CHNU de Fann Dakar Sénégal Neurosurgery Department of CHU Hospital du Mali Bamako Mali Neurosurgery Department of CHU gabriel Touré Bamako Mali

Cervical meningoceles are the least common forms of spina bifida, representing between 4% to 8% of all spinal dysraphisms. They are not accompanied by neurological deficit in childhood but attached cord syndrome can occur with growth. Surgical treatment, in addition to avoiding rupture and correcting the aesthetic damage, will preserve neurological functions. We report 2 cases that we took care of. They are a 5-month-old infant and a 3-year-old girl. The first presented a 7 cm rounded meningocele pedunculated through the C1 lamina defect. The second presented an 8.6 cm polylobed meningocele pedunculated through the C2 lamina defect. They both underwent surgery with good progress.

关键词： Cervical Meningocele Spinal Dysraphism Spina Bifida

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Results of the First 10 Cases of Coronary Bypass Surgery in Senegal

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World Journal of Cardiovascular Surgery 2024年第4期14卷 45-60页

作者： Papa amath Diagne Jean Claude Ndiogou Dione Papa Ousmane Ba Momar Sokhna Diop El Hadji Boubacar Ba Momar Dioum Marième Soda Mbaye Moussa Seck Diop Mory Camara Abdou Lahad Mbengue Abdou Aziz Thiaw Abdoul Khoudoss Diallo Moussa Mareme Samba Dialtabé Ibrahima Guéssé Ba Anta Mbaye Sall Papa Salmaneba am.dou gabriel ciss Department of Cardiovascular and Thoracic Surgery FANN National University Hospital Dakar Senegal

This is a review of the first 10 coronary artery bypass surgeries performed by the local team. The mean age was 62 years old [45 - 74]. The patients were predominantly male, with a M/F ratio of 4:1. Cardiovascular risk factors were mainly myocardial infarction (MI) (60%), hypertension (50%), obesity (40%) and diabetes (30%), with at least two risk factors per patient. Angina was the main symptom (80%). The average time from presentation to surgery was 8 months. The mean Euroscore 2 was 2.92 ± 1.65 [1.33 - 6.60]. Coronary angiography revealed an average of 2 lesions per patient, with 3-vessel involvement in 70% of cases: the Interventricular artery (IVA) (100%), the right coronary artery (90%) and the circumflex artery (70%). On echocardiography, the mean Left ventricular ejection fraction (LVEF) was 59% [33% - 76%]. All patients underwent median sternotomy with bypass grafting. The average duration of the cardiopulmonary bypass was 150 min [46 - 275 min];that of aortic clamping, 120 min [43 - 232 min]. The grafts used were internal thoracic artery (ITA) in 100% of cases (80% on the left and 20% on the right), and the great saphenous vein (GSV) in 60% of cases (50% on the left and 10 on the right). double bypass was performed in 60% of cases, single bypass in 30% and triple bypass in 10%. The bypasses were performed on the IVA (100%), the middle lateral of the circumflex (30%) and the bisector (20%). The average time to extubation was 11 hours and the length of stay in the intensive care unit was 7 days [03 - 17 days]. One patient had a reoperation on Day 0 post-op. The average hospital stay was 13 days [06 - 27 days]. Complications occurred in nine of the patients (90%), with a predominance of infectious and neurological complications. Overall operative mortality was 3%, all in intensive care.

关键词： Coronary Bypass Surgery Coronary Lesions Cardiac Surgery Senegal

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Evaluation of Antibiotic Prescribing in the Pediatric Department of gabriel TouréTeaching Hospital, Bamako, Mali

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Open Journal of Pediatrics 2024年第3期14卷 645-656页

作者： Pierre Togo Hawa Konaré Mariam Maïga Karamoko Sacko Djénéba Konaté Abdoul Karim doumbia Adama Dembélé Oumar Coulibaly aminata Sangaré Mohamed Elmouloud cissé Fousseyni Traoré Belco Maïga Ibrahim Aham.dou aminata doumbia Lala N’Drany Sidibé am.dou Touré Yacouba Aba Coulibaly Kalirou Traoré Tati Simaga Souleymane Sagara Leyla Bagna Maïga Bory Traoré Abdoul Aziz Diakité Fatoumata Dicko Mariam Sylla Sounkalo Dao Boubacar Togo Paediatric Department Gabriel Tour&#233 Teaching Hospital Bamako Mali Pediatric Department Distric VI Reference Health Center Bamako Mali Infectious Diseases Department Point G Teaching Hospital Bamako Mali

Objectives: The main objective was to evaluate antibiotic prescribing in the Department of Pediatrics at gabriel Touré teaching hospital. Methods: This was a prospective descriptive study conducted from September 1 to November 31, 2018, in the Department of Pediatrics at gabriel Touré teaching hospital. All children aged 0 to 15 years hospitalized for any pathology during the study period and having received at least one antibiotic had been included. Results: We collected 445 children’s records out of 1032 admissions during the study period, representing a hospital frequency of 43.1%. The sex ratio was 1.3%. The 2 - 5 age group accounted for 48.1%. Fever was the reason for consultation in 45.6% of cases. Patients’ general condition was altered in 60% of cases. The fathers were blue-collar workers in 65.4% and the mothers housewives in 85%, and had no education in 42.9% and 64.5% respectively. Hepatomegaly was present in 18.2%, splenomegaly in 9.6% and peripheral adenopathy in 3.1%. The site of infection was pulmonary in 37.6% and ENT in 9.2%. Bacterial infection was assumed on admission in 54% of cases, and meningitis in 57.7%. The discharge diagnosis was malaria in 54.6%, severe acute malnutrition in 18.6% and meningitis in 6.7%. The death rate was 3.8%. Neutrophilic leukocytosis was present in 47.3% of patients. CRP was positive in 85% of patients. Blood cultures taken in 27.6% of patients were positive in 5. CSF analysis in 30% of patients showed elevated leukocytes in 6.5%. No cultures were positive. Antibiotic prescription was justified by infectious hypotheses in 43.1% of patients. β-lactam antibiotics were prescribed in 98.6%. Antibiotic therapy was not adapted to national/international recommendations in 68.3% of cases, and was not justified in 16.3% of cases on D5 of hospitalization. Conclusion: Antibiotic use was justified in more than half of patients, but remained inadequate in almost two-thirds of cases, in line with national and international recommend

关键词： Antibiotic Prescription Hospitalization Child

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Mortality of Children with Mechanical Valve Prostheses at the CUOMO Cardio-Pediatric Center of University National Hospital of Fann (Dakar)

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World Journal of Cardiovascular Diseases 2023年第9期13卷 520-526页

作者： Momar Dioum Papa amath Diagne amina Hanfaoui Cheikh Gaye Ismael I.B. Hanifa Papa Ousmane Ba Magalie Kaya Papa Salmane Ba am.dou gabriel ciss Department of Cardiology CHU FANN Dakar Senegal Department of Thoracic and Cardiovascular Surgery CHU FANN Dakar Senegal

Introduction: Mechanical valve replacement in pediatric age is a dreaded but sometimes inevitable surgery. The purpose of this study was to determine the mortality of children with mechanical valve prostheses in the short, medium and long term. Patients and Methods: This was a retrospective and descriptive study conducted at the CUOMO cardio-pediatric center at Teaching National Hospital of Fann between January 1st, 2017 and December 31st, 2021. We included, children whose age is less than or equal to 16 years of age and who have benefited from a mechanical valve replacement and with a follow-up period of more than 6 months post-operative in the CUOMO cardio-pediatric center. Patients whose age at the time of surgery was over 16 years were excluded;patients who have benefited from bioprosthesis or valvular plastic surgery alone;as well as patients for whom a follow-up of more than 6 months was not found. Statistical analyses were carried out using the SPSS (Statistical Package for Social Science) software version 18 to calculate averages and percentages. Results: We included 85 patients. The average age was 12.84 ± 2.52 years. The male gender predominated with a sex ratio of 1.65. Dyspnea was found in 96.47% of children. Pure mitral regurgitation was the most common valve disease found in 67.06%. Rheumatic etiology was noted in 87.06% of cases. Mono valve replacement was performed in 84.71% of patients and double valve replacement in 15.3% of cases. Major mechanical complications were reported in 8 patients including 5 severe aortic mismatch cases. Hemorrhagic complications were observed in 4 patients requiring surgery. Hemodynamic complications were dominated by right ventricle dysfunction in 14 patients. Supraventricular rhythm disorders were present in 11 patients and one case of ventricular tachycardia. We found six cases of infectious endocarditis. Eight deaths were recorded with a mortality rate of 5.88%. Significant predictors of mortali

关键词： Morbidity Mortality Mechanical Valve Children Dakar

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Delayed Management of High-Grade Renal Trauma in a Child with Bilateral Lower Polar Artery: A Case Report

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Open Journal of Urology 2022年第11期12卷 556-562页

作者： doudou Gueye Florent Tshibwid A. Zeng Ibrahima Bocar Wellé Papa Alassane Mbaye Lissoune cissé Christ Tsague Momo Ndeye Aby Ndoye Aloï se Sagna gabriel Ngom Department of Pediatric Surgery Albert Royer National Children’s Hospital Centre Université Cheikh Anta Diop Dakar Senegal

High-grade renal trauma rarely occurs due to low-velocity mechanisms. With its clinical presentation, delayed diagnosis rarely happens. We report the case of a 12-year-old girl diagnosed seven days post-trauma with grade IV renal trauma complicated with infected urinoma and bilateral lower polar vessels. She was non-operatively managed with ultrasound-guided percutaneous drainage of the urinoma, which resolved, and had unremarkable six months follow-up. We discuss the role of preexistent hydronephrosis in low-velocity impact, pitfalls of diagnosis in resource-constrained settings, and management of high-grade trauma.

关键词： Renal Trauma Lower Polar Artery Urinoma Delayed Diagnosis Case Report

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Epidemiological Approach to Understand Rheumatic Heart Valve Disease: Case of Thoracic Cardiovascular Clinic of Fann Hospital (Dakar)

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World Journal of Cardiovascular Diseases 2020年第10期10卷 750-760页

作者： Marie Parsine Sall Fatimata Mbaye Mbacké Sembéne am.dou gabriel ciss Département de Biologie Animale Faculté des Sciences et Techniques Université Cheikh Anta Diop Dakar Sénégal Institut de Recherche Pour le Développement Campus Bel-Air Université Cheikh Anta Diop Dakar Sénégal Faculté de Médecine de Pharmacie et D’odontologie Université Cheikh Anta Diop Dakar Sénégal

Objective: Rheumatic heart disease is the major cause of heart valve disease in developing countries. In Senegal, cardiac pathology is dominated by rheumatic pathology whose hospital prevalence was estimated at 0.15% [1]. Epidemiological data on rheumatic heart valve disease (RHVD) are unfortunately imprecise due to the lack of good quality data collection in a large number of countries, especially in sub-Saharan areas and in Central Asia. The objective of this epidemiological study is to collect data about rheumatic heart valve disease in our clinic which is the only surgical center of Senegal. Patients and Methods: Our study conducted between 2014 and 2017 involved a population of one hundred and eighty-three patients with complete medical records, all followed at the Thoracic and Cardiovascular Surgery Clinic at Fann Hospital for rheumatic valve disease. This population was the subject of an epidemiological survey based on a questionnaire covering clinical parameters as consanguinity, clinical signs, diagnosis and surgical intervention. Results: Our work is an epidemiological study involving one hundred and eighty-three (183) patients with various types of rheumatic valve disease, followed at the Thoracic and Cardiovascular Surgery Clinic at Fann Hospital, and who responded to a questionnaire about clinical aspects of this disease. Our results showed 5.46% of family cases, of which 2.18% came from consanguineous marriages. Mean age at onset of clinical signs was 14 amily:;" "="">± 9 years with 14.20% before 6 years of age, 65.91% between

关键词： Rheumatic Valves Epidemiological Diagnosis Surgery

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Epidemiological, Clinical and Therapeutic Aspects of Spinal Pathology in Military People in a Country at War

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Open Journal of Modern Neurosurgery 2022年第1期12卷 39-46页

作者： Mam.dou Salia Diarra Mohamed El Hassimi cissé Izoudine B. Koumaré Oumar Diallo Drissa Kanikomo Military Neurosurgery Unit Infirmerie H&#244 pital de Bamako (IHB) Bamako Mali Neurosurgery Department H&#244 pital Mère-Enfant-Bamako USTT-B (Université des Sciences des Techniques et des Technologies de Bamako) Bamako Mali Neurosurgery Department H&#244 pital du Mali USTT-B Bamako Mali Neurosurgery Department H&#244 pital gabriel Touré USTT-B Bamako Mali

Introduction: Lumbar and sciatic pain are frequent motives of disability in military people in Mali. As spine surgery isn’t recognized enough, our study aims to analyze etiologies, epidemiology, clinical features and surgical standards in order to improve troop abilities. Methodology: Our descriptive and retrospective study has included 31 operated military patients who underwent medical or surgical procedures between 2010 and 2018 in the Military Neurology/Neurosurgery Unit and Mère-Enfant Hospital Neurosurgery department. Results: Among 553 seen in consultation, fifty percent were between 30 and 50 years old. Main motive was sciatic pain (65.5%). Seventy eight percent of our patients were field militaires and sub-officers, and 83.2% were males. All of them have benefited a CT scan or MRI with medical treatment in rheumatology or neurology. Thirty-one patients underwent spine surgery and were included in the study, so 6% (mean age: 43.52 years, 90.3% males). Lumbar spine surgery represented 54.8% of cases with lumbar canal stenosis in 64.5% of cases. It appeared that spondylolisthésis with isthmic fracture was frequent (12.9%), and traumatic cervical spine fractures were dominant in 2012. Instrumented arthrodesis was performed for 41.9% of patients, lumbar discectomy for 32.3% and laminectomies for 22.6%. Degenerative etiology was found in 77.4% of cases and we’ve noticed a good outcome in 93.5% of operated cases. Conclusion: amily:Verdana;">Spinal pathology in military people in Mali i

关键词： Military Spine Spondylolisthesis Mali

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Management and Outcome of Ureteropelvic Junction Obstruction in Senegalese Children

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Open Journal of Urology 2022年第11期12卷 549-555页

作者： Ibrahima Bocar Wellé Ndeye Aby Ndoye Papa Alassane Mbaye doudou Gueye Ndeye Fatou Seck Faty Balla Lo Lissoune cissé Anderson Safari Kibanja Florent Tshibwid A. Zeng Youssouph Diedhiou Aloï se Sagna Oumar Ndour gabriel Ngom Department of Pediatric Surgery Albert Royer National Children’s Hospital Centre Université Cheikh Anta Diop Dakar Senegal Department of Pediatric Surgery Aristide Le Dantec University Teaching Hospital Université Cheikh Anta Diop Dakar Senegal

Introduction: The ureteropelvic junction obstruction is a rare congenital malformation of the upper urinary tract. We report its management and outcome at Senegal’s main pediatric surgical department. Patients and Methods: We conducted a descriptive review of all patients managed in our pediatric surgical department at Albert Royer National Children’s Hospital Centre from January 1st, 2013 to December 31st, 2017. Results: Thirty patients were included in our study. The mean age was three years. Males were more affected (sex ratio of 2.75). The prenatal diagnosis was made in 23% of cases using prenatal ultrasonography. An abdominal mass was the circumstance of discovery in 36% of cases, and lumbar contact and renal sloshing were found in 66% of cases. There was no renal function impairment in 93% of cases. Urinary tract infection occurred in 50% of cases. Ultrasonography (100%) and urinary computed tomography (56%) were used to diagnose. A temporary nephrostomy was performed in 23% of cases, and as definitive treatment, an open Anderson-Hynes procedure was performed in 96% as a nephrectomy was made in a patient. Early postoperative complications were encountered in 56% of cases: urinary tract infection (36%), surgical site infection and anastomotic stenosis (6% both), and urinoma and textiloma (both in 3%). A patient died from sepsis. After a mean follow-up of 12 months, no additional complication was reported. Conclusion: Ureteropelvic junction obstruction was frequently diagnosed late, and its management carried unneglectable morbidity in our environment. A laparoscopic approach would be a solution to improve its outcome.

关键词： Ureteropelvic Junction Obstruction Management Outcome Children Senegal

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