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Open Journal of Gastroenterology 2012年第4期2卷 193-199页

作者： Constant Assi Marie Jeanne Lohouès-Kouacou Emile Allah-Kouadio Christian Jomo Njossu Anassi Jean-Baptiste Okon Stanislas Doffou Siaka koné Ganda Soumaré amadou koné amadou Ouattara Dramane Soro Mamadou Diakité Benoit-Mathieu Camara Department of Gastroenterology Faculty of Medical Sciences Cocody Teaching Hospital Center AbidjanCote d’Ivoire

Aims: 1) To assess the feasibility of EPAGE criteria in clinical practice;2) To assess appropriateness colonoscopy using EPAGE criteria;3) To compare colonoscopy appropriateness and endoscopic lesions. Method: Hundred thirtynine consecutive patients explored by colonoscopy were included. The appropriateness of colonoscopy was evaluated by EPAGE criteria. Results: EPAGE criteria were applicable among 127 patients (91% of the cases). Colonoscopies were appropriate, uncertain and inappropriate in respectively 40%;27% and 24% of the cases. Rate of abnormal colonoscopies was significantly different between the 3 groups (p = 0.03). Cancers were diagnosed exclusively in the groups with appropriate and uncertain colonoscopies (11% and 5%). Colonic adenomas were observed in the three groups (appropriate (7%), uncertain (5%) and inappropriate (6%)). Subjects with uncertain indication were older (58.25 years;p = 0.035). Conclusion: EPAGE criteria are feasible in clinical practice in Cocody’s teaching hospital center. Colonoscopies are generally appropriate in our hospital. However, within sight of the significant number of normal colonoscopies and discovered lesions in uncertain indication, colonoscopy cannot concern exclusively calculation of a score of appropriateness.

关键词： Colonoscopy Appropriateness EPAGE Score Colorectal Cancer Cote d’Ivoire

Helicobacter pylori Infection and Gastroduodenal Lesions: Prevalence and Associated Factors in Cote d’Ivoire

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Open Journal of Gastroenterology 2022年第2期12卷 27-35页

作者： Mamadou Diakité amadou koné Akoun Fabrice Aké Kouassi Olivier Claver Koffi Anassi Jean Baptiste Okon Kadidiatou Diallo Department of Medicine and Hepato-Gastroenterology Teaching Hospital of Bouaké Bouaké Cote d’Ivoire Faculty of Medical Sciences Alassane Ouattara University Bouaké Cote d’Ivoire

Objective: The objective is to determine the prevalence of Helicobacter pylori (Hp) infection and highlight the determinants of the infection as well as the gastric histopathological lesions associated with this infection. Methods: This is a retrospective study carried out from August 01, 2015 to December 31, 2020 in Bouaké. It included all patients with gastric and/or duodenal lesion on upper gastrointestinal endoscopy in whom gastric biopsies and histopathology results are available. Results: The study involved 510 patients (301 men and 209 women). The prevalence of Hp was 66.47% (339/510 patients). The presence of Hp was not significantly related to age and gender. Epigastralgia was the most common indication with no significant difference between the positive and negative Hp groups (65.37% vs 34.63%, p = 0.35). A significant difference was only observed for duodenal ulcers (84.31% Hp+ vs 15.69% Hp-, p = 0.004). Regarding histological lesions: Chronic and active gastritis was strongly related to the presence of Hp (p < 0.05). Intestinal metaplasia and gastric atrophy were not significantly associated with the presence of Hp. These precursor lesions of gastric cancer (metaplasia and atrophy) were, however, significantly related to chronic gastric disease with p = 0.02 and p Conclusion: The prevalence of Hp is high in Bouaké. Our study confirms the link between Hp infection and chronic and active gastritis.

关键词： Helicobacter Pylori Gastritis Atrophy Intestinal Metaplasia

Predictive Factors for Viral B and C Infection in Health Workers in a University Hospital in Ivory Cost

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Open Journal of Gastroenterology 2018年第10期8卷 377-385页

作者： Okon Anassi Jean-Baptiste koné amadou Diakité Mamadou Aké Fabrice Thot’o Amani Sroboua N’dri N’guessan Hepato-Gastroenterology Department University Hospital Center Bouaké Ivory Coast

Purpose: To evaluate the serological status of hepatitis B and C and to identify the risk factors for viral B and C infection in health workers at the university hospital. Material and Method: Mono-centric cross-sectional study carried out at Bouaké University Hospital from March 2nd to May 16th, 2016, concerning the health staff of the Bouaké University Hospital. Cross-sectional study mono-centric concerning the serological status of viral hepatitis B and C from the period from March 2nd to May 16th, 2016 of the health staff of the University Hospital of Bouaké. It has benefited from data from PNLHVi (national program against viral hepatitis) as part of its awareness campaign. The data were analyzed by SPSS software version 20.0. Results: Of the 1107 health workers, 632 had been included, representing a participation rate of 57.1%. The average age of the staff was 37.8 years with extremes ranging from 18 to 66 years. The sex ratio (H/F) was 0.8. Accidents with blood exposure were noted in 52.4% of cases. The maximum vaccine coverage was 16.1%. The prevalence of HBsAg was 8.4%. Contact with HBV was present in 3/4 of the staff. Anti HCV Ab was positive in 1.4% of the staff. Males, age over 50 and over 20 years of seniority were associated with HBV. Also, HBV infection was significantly higher in boys and girls (81.7%), nurses (78.3%) and nursing aides (73.8%), (p = 0.022). HCV infection was significantly correlated with emergency services. Conclusion: Age, gender, seniority, paramedic qualification, and high risk of exposure to body fluids were correlated with viral B infection while emergency department membership was a factor risk of HCV infection.

关键词： Prevalence Risk Factors Viral Hepatitis B Viral Hepatitis C Health Personnel

Interest of SAAG in Etiological Diagnosis of Ascites in African Black

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Open Journal of Gastroenterology 2018年第10期8卷 337-347页

作者： Okon Anassi Jean Baptiste Soro Dramane Doffou Stanislass Diakite Mamadou koné amadou Aké Fabrice Thot’o Amani Sroboua N’dri N’guessan Hepato-Gastroenterology Department University Hospital Center Bouaké Ivory Coast Hepato-Gastroenterology Department University Hospital Center Abidjan Ivory Coast

Purpose: To show the interest of the serum-ascites concentration gradient in albumin (SAAG) in the etiological diagnosis of ascites in African black. Materiel and Methods: This was a monocentric observational and analytical study performed on patients over 15 years old and hospitalized in the Hepato-Gastroenterology department of Cocody from January 1st, 2010 to March 31st, 2017 for ascites. The cytology and chemistry of the ascites fluid and the protidogram were performed. The main outcome measure was the prediction of portal hypertension (PHT) or non-portal hypertension related causes of ascites from SAAG. Results: The hospital prevalence of ascites was 11%. There were 82 women (46.9%) and 93 men (53.1%) with a sex ratio (M/F) of 1.1. SAAG was low in 68.6% of cases and high in 31.4% of cases. The most common etiologies were post-viral cirrhosis (74%), HCC (16.60%) and peritoneal tuberculosis (13.7%) respectively. In the case of high SAAG, 91% of ascites related to PHT were observed, but also 77.5% of a low SAAG corresponded to ascites related to PHT (p = 0.024) with Se = 35% Sp = 84% and accuracy = 44%. All patients with peritoneal tuberculosis had a SAAG low of less than 1.1 g/dl significantly (p = 0.002). SAAG had a diagnostic performance of 89% in peritoneal tuberculosis at the cutoff value of ?1.24 g/dl (AUROC = 0.91, Se = 96%, Sp = 86%) while in post viral hepatitis cirrhosis at a threshold of 0.58 g/dl the diagnostic performance was 60% (AUROC = 0.69, Se = 53%, Sp = 79%). Conclusion: The simple technical SAAG, allowing to distinguish the ascites linked to the PHT and the ascites not bound to the PHT, can be used like a method of diagnosis of the etiologies of the ascites especially in the peritoneal tuberculosis in the African countries low income.

关键词： SAAG Ascites Peritoneal Tuberculosis Cirrhosis PHT

Interest of Non-Invasive Markers (APRI, FIB-4) for Assessing Hepatic Fibrosis in Patients with Chronic Viral Hepatitis B without Cytolysis and with Low Viral Replication

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Open Journal of Gastroenterology 2024年第5期14卷 192-201页

作者： Mamadou Diakité Kouassi Olivier Claver Koffi amadou koné Akoun Fabrice Aké Oury Diallo Ahmadou Stellart Jean M. Brou Anassi Jean-Baptiste Okon Department of Medicine and Hepato-Gastroenterology Teaching Hospital of Bouak&#233 Bouak&#233 C&#244te d&#8217Ivoire Faculty of Medical Sciences Alassane Ouattara University Bouak&#233 C&#244te d&#8217Ivoire

Background and Objectives: The indication for treatment in HBsAg-positive patients with low viral load and normal transaminases requires an assessment of fibrosis. In resource-limited settings, free hepatic fibrosis evaluation tests can aid in therapeutic decision-making. Our study aims to demonstrate the utility of assessing hepatic fibrosis using non-invasive markers (APRI and FIB-4) in patients with chronic B viral hepatitis without cytolytic activity and low viral replication in our context. Patients and Methods: This is a retrospective cross-sectional study conducted between January 2018 and December 2021 at the University Hospital Center of Bouaké. Included were all patients aged ≥18 with normal transaminases (Results: Our study included 241 patients, with a mean age of 36.19 years (±10.52 years) and a male predominance of 52%. The mean FibroScan® value was 6.44 ± 2.3 kPa, and 68 patients (28.22%) had fibrosis >7 kPa. To exclude significant fibrosis (FS Conclusion: A significant proportion of HBV-infected patients with normal ALT and low viral load have active liver disease. Both FIB-4 and APRI biological scores are useful in identifying individuals without significant fibrosis with a good negative predictive value (>50%).

关键词： HBV Infection APRI FIB-4 Impulse Elastography BouakéUniversity Hospital

Prevalence of HBs Ag among blood donors in Transfusion Center, Abidjan (Ivory Coast)

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Open Journal of Gastroenterology 2013年第3期3卷 165-169页

作者： N’guessan N’dri Amani Sroboua Thot’o Anassi Jean-Baptiste Okon Constant Assi Emile Allah-Kouadio Dramane Soro Mamadou Diakité amadou koné Siaka koné Marie Jeanne Lohouès-Kouacou Benoit-Mathieu Camara Department of Gastroenterology Faculty of Medical Sciences Cocody Teaching Hospital Center Abidjan Cote d’Ivoire

Aim: To study the prevalence of HBsAg among persons without risk factors for hepatitis B. Patients and Methods: Cross-sectional study (28 January to 31 December 2010) about 4310 new volunteers blood donors consecutively recruited. Among all, a risk factor for hepatitis B was investigated (standardized questionnaire and clinical examination). Blood of all blood donors without risk factors of hepatitis B (n = 3823) were systematically collected for HBsAg, hepatitis C antibody, syphilis serology and human immunodeficiency virus serology. The blood was analyzed with a third generation ELISA (Abbott Murex). Results: HBsAg was positive in 179 persons (4.68% [95% CI 4% - 5%]). It was associated with hepatitis C antibodies (0.28% (n = 11)), syphilis antibodies (0.68% (n = 26)) or anti-human immunodeficiency virus antibodies (0.2% (n = 8)). In multivariate analysis, age 30 to 39 years (1.545 [95% CI 1.074 to 2.222]), male sex (2.426 [95% CI 1.550 to 3.799]) and positive syphilis serology (14.344 [95% CI 5.161 to 39.865]) were associated with presence of HBsAg. Conclusion: The prevalence of HBsAg among adult without risk factors for hepatitis B was not negligible. Also, it is essential to maintain routine screening before any vaccination against hepatitis B in adult. Our study is not for an immunization against hepatitis B only targeting risk populations in adult.

关键词： HBsAg Prevalence Risk Factor Adult Abidjan

Lipid Profile among the Diabetic and Non-Diabetic Obese Patients

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Open Journal of Internal Medicine 2018年第1期8卷 89-97页

作者： Djénèbou Traoré Aminata Hamar Traoré Djeneba Sylla Sow Massama konaté amadou koné Hadiaratou Doumbia N’Diaye Modibo Mariko Ibrahim amadou Dembélé Moctar Bah Bah Traoré Djibril Sy Ichaka Menta Hamidou Oumar Ba Nongoba Sawadogo Abdramane Traoré Assa Traoré Sidibé Assétou Soukho Kaya Abdel Kader Traoré Mamadou Dembélé Hamar Alassane Traoré Service of Internal Medicine and Endocrinology of Hospital of Mali Bamako Mali Service of Internal Medicine of Point G University Hospital Center Bamako Mali Service of Cardiology of Gabriel Touré University Hospital Center Bamako Mali Service of Internal Medicine of CHR de Kaya Kaya Burkina Fasso Service of Internal Medicine of Kati University Hospital Center Bamako Mali

Objective: To study the lipid profile among the diabetic and non-diabetic obese patients. Methods: It was a descriptive and prospective study carried out over a period of 9 months from March to December 2010. It concerned all the patients who came for consultation in endocrinology at the internal medicine of Point G University Hospital Center and at the National Center for Diabetes Research. All the patients were included without any gender or age difference, voluntary and with a BMI ≥ 30 kg/m2. Results: Out of the 1543 patients received in consultation, we had identified 178 obese people that is to say 11, 53% of the cases. Among these cases 60 abided by our criteria with 30 diabetic patients and 30 non-diabetic ones. The average age was 45.83 ± 14.68 years old;73.3% were more than 40 years old. The sex ratio was 0.07. Two third (66.7%) of our patients limited their eating diet to the three main meals/day and 61.7% were sedentary. The notion of family obesity was found in 93.4% of the cases, of family diabetes in 58.3% of the cases, of past personal medical history of hypertension in 43.3% of the cases. It was about an android obesity in 91% and Gynoid in 9% of the cases. The BMI was 55% of the cases comprised between 30 - 34.9 kg/m2. The lipid profile noticed was: A hypertriglyceridemia: 33% of diabetic patients and 10% of non-diabetic patients, a high LDL cholesterol: 37% of diabetic patients and 30% of our diabetic patients, a HDL hypocholesterolemia: 40% of the diabetic patients and 20% of the non-diabetic patients, a total hypercholesterolemia: 37% of the diabetic patients and 23% of non-diabetic patients. A hyperglycemia was noticed in 13.3% of non-diabetic patients. Conclusion: The frequency of metabolic troubles was higher in obese diabetic patients compared to non-diabetic obese patients mainly the hypertriglyceridemia.

关键词： Diabetes Obesity Dyslipidemia

Screening of Foot at Risk in Diabetic Patients

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Open Journal of Internal Medicine 2019年第3期9卷 62-71页

作者： Djenebou Traore Djeneba Sylla Sow Massama konaté Ousmane Sidibé Modibo Mariko Djibril Sy Bah Traoré Karim Dao amadou koné Nanko Doumbia Nouhoum Ouologuem Yacouba Lazard Diallo Boua Daoud Camara Nongoba Sawadogo Ibrahima amadou Dembélé Barry Boubacar Sangaré Mamadou Cissoko Mahamadou Saliou Youssouf Fofana Mamadou Mallé Mamadou Togo Adramé Keita Abdramane Traoré Nagou Tolo Madani Ouologuem Abdel Kader Traoré Assa Traoré Sidibé Department of Internal Medicine The University Teaching Hospital of Point G Bamako Mali Department of Internal Medicine and Endocrinology The Mali Hospital Bamako Mali CHR Internal Medicine Department of Kaya Kaya Burkina Faso Department of Internal Medicine The Mother and Children Hospital “Luxembourg” Bamako Mali Department Internal Medicine The Hospital of Kati Bamako Mali

Introduction: The term “diabetic foot” refers to all conditions that affect the foot and are directly related to the impact of diabetes. Objective: Screen the foot at risk in diabetic patients at the hospital of Mali. Methods: It was a cross-sectional study from January 1st, 2016 to June 30, 2016, at the Department of Internal Medicine and endocrinology of the Hospital of Mali. It was focused on all hospitalized diabetic patients. Results: Thirty-two (32) patients had a foot at risk among 76 diabetic patients during the study period representing 42.10%. The sex ratio was 0.52. Type 2 diabetes accounted for 82%. A glycemic imbalance (HBA1C > 7%) was observed in 88.15%. Eighteen percent (18%) of patients had a history of ulceration or amputation;33% were walking barefoot;78.9% had tingles in the foot;31.6% had intermittent claudication;64.5% had foot cleanliness;8% claw toes;42% had abolition or reduction of superficial tenderness to monofilament and 21% had mixed foot (neuropathy + arteriopathy). In our study, 58.9% of patients had no risk of podiatry. Conclusion: Screening of foot at risk is essential in the management of diabetes because it determines the podiatric risk enabling to minimize future functional disabilities.

关键词： Foot at Risk Diabetes Hospital of Mali

Echocardiographic Aspects of Type 2 Diabetics Patients Hospitalized in the Medicine and Endocrinology Department of the Mali Hospital

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World Journal of Cardiovascular Diseases 2024年第3期14卷 129-139页

作者： konaté Massama Mamadou Touré Mariam Sako Samba Sidibé Souleymane Mariko Djeneba Sylla Sow Elhaj Mahamane Maiga Coumba Adiaratou Thiam Youssouf Camara Hamidou Oumar Ba Asmao Keita Maiga Djenebou Traoré Zoumana Traoré Souleymane Coulibaly Bah Traoré Modibo Mariko Nouhoum Ouologuem amadou koné Ichaka Menta Faculty of Medicine and Dentistry Bamako USTTB Department of Medicine Hospital of Mali Bamako Mali Department of Cardiology CHU Gabriel TOURE Bamako Mali Department of Cardiology CHU Point G Bamako Mali Department of Medicine Hospital of Timbuktu Bamako Mali Department of Cardiology Hospital of Kati Bamako Mali Department of Cardiology CHU Mother and Child Bamako Bamako Mali Department of Internal Medicine CHU Point G Bamako Mali

Introduction: Cardiovascular disease is the leading cause of death in diabetics. The objective of our study was to investigate the echocardiographic aspects of type 2 diabetics. Patients and Method: Descriptive and cross-sectional study of 12 months from June 2020 to June 2021. We included hospitalized type 2 diabetics who underwent transthoracic cardiac ultrasound in the Department of Medicine and Endocrinology at the Mali Hospital. Results: We collected 128 type 2 diabetics. The predominance was male with a sex ratio of 1.2. The mean age of patients was 60.06 ± 11.54 years with extremes of 28 and 84 years. Echocardiographic abnormalities were dominated by abnormal relaxation of left ventricle in 62.5%, increased of left ventricle mass in 54.7% and left atrium dilation in 28.1%. Patients with type 2 diabetes mellitus and hypertension had more left atrium dilation with a p of 0.02. Disorders of global kinetics and systolic dysfunction were more prevalent in smoking patients with statistically significant associations, respectively, p = 0.02;p = 0.03. Dyslipidemia had a statistically significant association with segmental kinetic disorders with a p of 0.008. Duration of diabetes greater than 5 years was associated with left atrium dilation and p-value was 0.04. Conclusion: Diabetes is responsible for cardiovascular manifestations that can be identified with transthoracic echocardiography. Its performance in diabetic patients makes it possible to refine the patient’s management.

关键词： Diabetes Echocardiography Mali Hospital

Pulmonary Embolism: Epidemiological, Clinical, Therapeutic and Evolution Aspects in the Medicine Department of Hospital of Mali Bamako

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World Journal of Cardiovascular Diseases 2021年第4期11卷 242-248页

作者： Massama konaté Mariam Sako Boubacar Sonfo Samba Sidibé Souleymane Mariko Djeneba Sylla Sow Coumba Adjaratou Thiam Djenebou Traoré Hamidou Oumar Ba Asmaou Keita Maiga Ibrahima Sangare Mamadou Toure Souleymane Coulibaly Nouhoum Diallo Bah Traoré Modibo Mariko Nouhoum Ouologuem amadou koné Youssouf Camara Yacouba Lazare Diallo Nanko Doumbia Mahamadoun Coulibaly Ichaka Menta Faculty of Medicine and Dentistry (FMOS) of the University of Sciences Technique and Technology of Bamako (USTTB) Bamako Mali Medicine Department Hospital of Mali Bamako Mali Cardiology department CHU Point G Bamako Mali Cardiology Department Hospital of Kati Kati Mali Medicine Department Hospital of Tombouctou Tombouctou Mali Internal Medicine Department CHU Point G Bamako Mali Cardiology Department CHU Gabriel Toure Bamako Mali Cardiology Department CHU Mère Enfant Bamako Mali

Background: Pulmonary embolism (PE) is a severe form of venous thromboembolic disease. In Africa, prevalence of PE in hospitalized medical patients varies among studies. Objective: Aim of this work was to study the epidemiological, clinical, therapeutic and evolution aspects of PE in the medicine department of Mali’s Hospital Bamako-Mali. Methodology: This was a retrospective cross-sectional study carried out from January 01, 2017 to December 31, 2020 in the medicine department of Mali’s hospital Bamako, including all inpatients admitted for PE during the study period. Results: Of 1814 hospitalized patients, 54 patients had pulmonary embolism. Hospital frequency of pulmonary embolism was 2.97%. Predominance was female and sex-ratio M/F was 0.38. Mean age in our series was 54.24 ±1.19 years. Predisposing factors to pulmonary embolism were dominated by obesity 37%, high blood pressure 35.2% and history of cardiovascular disease 20.4%. Dominant signs were dyspnoea and chest pain in 83.3% and 70.4% of cases respectively. Probability of pulmonary embolism was high in 40.7% according to Wells score. Patients with right heart failure were 22.2%. EKG showed sinus tachycardia70.4% and S1Q3 aspect 7.4%. Heart right chambers were dilated at transthoracic echography 42.6%. Obstruction was bilateral at chest angio CT for 51.9% and proximal for 42.6%. Deep venous thrombosis was associated at EP in 16.6%. Treatment was low weight molecular heparin followed by vitamin K antagonist or direct oral anticoagulant. One patient was successfully treated by thrombolysis. Hospital mortality was 16.7%. Conclusion: PE is a serious disease probably underdiagnosed. It is responsible of important mortality.

关键词： Pulmonary Embolism Epidemiology Mali’s Hospital