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Barriers to Utilization of Postnatal Care: A Qualitative Study in Guinea

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Open Journal of Obstetrics and Gynecology 2021年第4期11卷 391-402页

作者： Mamadou Dioulde Balde Aissatou Diallo Anne Marie Soumah Alpha Oumar Sall Boubacar Alpha Diallo Fanta Barry amadou oury touré Alpha amadou Barry Sadan Camara Center for Research in Reproductive Health/Cellule de recherche en santé de la reproduction en Guinée (CERREGUI) Conakry Guinée University Hospital Donka Clinic of Gynecology and Obstetrics Conakry Guinea

Maternal mortality remains very high in developing countries. In Guinea, it is 550 maternal deaths in 100.000 living birth. More than half of these deaths occur in the postpartum period. Hence the interests to have a better understanding of the factors that hinder the realization of post-natal care (PNC) arise. It is for this reason that the objective of this study is to identify barriers to the use of post-natal care in Guinea. Methods: A qualitative study was conducted in the prefectures of Kindia and Dubréka, in the Administrative Region of Kindia (Guinea) in April and May 2014. Fourteen focus group discussions of women and girls of the community, as well as fifteen individual in-depth interviews (9 with women and 6 with healthcare providers). Results: Most women do their PNC during their child vaccination or in case of postpartum complications. Financial constraints are the main barrier to using postnatal care identified by participants. In general, distance from the health center associated with lack of transport mean and insufficient staffs are factors related to the health system. In addition, poor reception of clients, women’s experience during childbirth, poor programming for PNC as well as the lack of trust and confidentiality between clients and health care providers are the barriers related to health providers. The participants also mentioned the la

关键词： Barriers Postnatal Consultation Maternal Mortality Guinea

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

Child Victims of Road Traffic Accidents: Epidemiological and Clinical Aspects in the Medical and Surgical Emergency Department of the Donka National Hospital

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Case Reports in Clinical Medicine 2024年第3期13卷 63-72页

作者： Ibrahima Sory Diallo Mamadou Moustapha Diop amadou oury toure Mamadou Aliou Doukouré Aîssata Barry M’mah Aminata Bangoura Mariama Sadjo Diallo Abdoulaye Oumare Diallo Salimatou Hassimiou Camara Thierno Mamadou Aliou touré Ouo Ouo Kolié Mohamed Lamine Diallo Fatoumata Binta Diallo Ibrahima Sory Souaré Institute of Child Nutrition and Health Conakry Guinea Department of Pediatrics Donka National Hospital Conakry Guinea UNICEF-Guinea Community Health Section Conakry Guinea Gamal Abdel Nasser University of Conakry Conakry Guinea

Introduction: Children involved in road accidents most often suffer head or limb injuries. The severity of these injuries varies according to the age of the child, the type of road user and whether or not protective devices are used. The aim of this study was to carry out a census of admissions and to identify the epidemiological and clinical profile of children involved in road traffic accidents at Donka National Hospital. Methods: This is a descriptive cross-sectional study of children involved in traffic accidents over a 3-month period from September 1 to November 30, 2021. All children admitted to the emergency department for a traffic accident were included in the study. Results: During the study period, 435/530 children (82.1%) were victims of road accidents. Boys accounted for 54.94% of cases, compared with 45.06% for girls. The age group most affected was 12-17 years old (48.97%). October had the highest accident rate (36.4%). Pedestrians are most affected (52.87%). Bicycles and mopeds were involved in 59.77% of accidents. Head injury was the most frequent pathology (33.33%). The study showed that 12.64% of victims were referred to intensive care, pediatric surgery, etc. We recorded 8 cases of death (1.84%). Conclusion: This study highlighted the characteristics, incidence and risk factors for accidents in children admitted to emergency departments. Accident prevention, particularly serious accidents in children, requires more precise knowledge of the factors and circumstances leading to their occurrence.

关键词： Child Accident Public Highway Donka

Nutritional Profile of Children with Major Sickle Cell Syndrome at the Centre of Medical and Health Advice of Kipé, Conakry, 2018

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Case Reports in Clinical Medicine 2024年第3期13卷 73-84页

作者： Mamadou Aliou Doukoure Ibrahima Sory Diallo M’mah Aminata Bangoura amadou oury toure Mamadou Moustapha Diop Fatoumata Binta Diallo Mohamed Sama Cherif Thierno Saidou Diallo Saidouba Cherif Camara Abdoulaye toure Faculty of Health Science and Technology Gamal Abdel Nasser University Conakry Guinea National AIDS Control Programme Ministry of Health Gamal Abdel Nasser University Conakry Guinea

Introduction: Growth is a reflection of a child’s health and nutritional status. Children with sickle cell disease often have slower statural and weight development. The aim of this study was to evaluate the nutritional profile of children with sickle cell disease (SCD) registered in the CEMECO centre database. Methodology: This was a cross-sectional study with simple random sampling of children aged 1 to 16 years registered in the clinic database. Results: We collected information on 208 children, 121 of whom had sickle cell disease and 87 of whom were normal, with a sex ratio of 1.02. The mean age of the sickle cell patients was 8.7 ± 4.4 years, while that of the non-sickle cell patients was 9.5 ± 4 years. Haemoglobin electrophoresis revealed 103 homozygous (SS), 18 double heterozygous (SC, SBetaThal, SE) and 87 normal (AA) and/or sickle cell trait (AS) sickle cell cases. We observed a significant difference in the height/age ratio (P ¥). Conclusion: The results of our study revealed stunted growth in children with sickle cell disease.

关键词： Sickle Cell Disease Nutrition Growth Puberty Guinea

Overview of Adrenals Tumors in Dakar Hospitals

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Open Journal of Internal Medicine 2024年第2期14卷 141-150页

作者： Nafy Ndiaye Yakham Mohamed Leye Mouhamadou Moustapha Ndong Ngoné Diaba Diack amadou Fall Cisse Abdoulaye Leye Baidy Sy Kane Alpha Omar touré Cherif Mohamed Dial Pape Saloum Diop Internalmedeccine and Endocrinology Department Teaching Hospital of Pikine Dakar Senegal General Surgery Department Aristide Le Dantec Teaching Hospital of Dakar Dakar Senegal Anatomo-Pathology Department General Hospital of Grand Yoff Dakar Dakar Senegal General Surgery Department General Hospital of Grand Yoff Dakar Dakar Senegal

Introduction: Adrenal tumours (AT) are commonly encountered in clinical practice. For any patient presenting an adrenal mass, there are two crucial points to consider: is the adrenal mass malignant and is it hormonally active? The objective of our study was to evaluate the epidemiological, diagnostic, therapeutic, and evolutionary aspects of AT in a developing country. Methodology: We conducted a retrospective study spanning 17 years (from January 2005 to October 2022) in four Dakar hospital services. We included all patient medical records with explored AT. Results: AT was diagnosed in 35 patients who had a mean age of 36.62 years (range: 12-79), and a female predominance (26 women to 9 men). Among these patients, 17.2 % had incidental AT. Hypertension was the commonest presenting symptom in 27 patients (77%), which was associated with Mnards triad in 14 patients (40%). Abdominal pain was reported by 20 patients (57%), and 14 presented with an abdominal mass. Among the patients, 29 had functional AT: 22 with pheochromocytoma, 5 with primary hyperaldosteronism, and 2 with hypercortisolism. Imaging evaluations revealed that 33 patients had unilateral AT and one had bilateral AT. Tumour sizes varied, 5 patients had tumours 10 cm. Two patients presented with metastases. The therapeutic approach involved adrenalectomy in 32 patients. Perioperative complications were observed in five patients, including haemorrhage (two patients), hypotension (two cases), and hypertensive crisis (one case). One patient with bilateral pheochromocytoma developed acute adrenal insufficiency postoperatively, followed by abdominal herniation. Histopathological examination confirmed pheochromocytoma in 21 patients, Conns adenoma in 5, adrenocortical carcinoma in 3, cortisol adenoma in 2, and adrenal cyst in 1 patient. Non-functional AT included adrenocortical carcinoma (three patients), adrenal cyst (one patient), and pheochromocytoma (two patients). After a one-year follow-up, 29 patients with benign tumours had favourable outcomes, while

关键词： Tumour Adrenal Pheochromocytoma Conn Adrenocortical Carcinoma Dakar

Causes and Prognosis of Cases of Acute Obstructive Renal Failure Managed at the Donka National Hemodialysis Center

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Open Journal of Nephrology 2024年第2期14卷 136-146页

作者： amadou Yaya Diallo Mamadou Mouctar Diallo Mamadou Dian Barry Kadiatou Mamadou Bobo Barry Saikou Oumar Diallo Djenabou Diallo Soriba Bangoura Mamadou Malal Diallo Thierno Mamadou oury Diallo Mohamed Lamine Kaba Alpha Oumar Bah Department of Nephrology-Hemodialysis CHU Donka Conakry Guinea Faculty of Health Sciences and Techniques Gamal Abdel Nasser University of the Republic of Guinea Conakry Guinea Department of Urology-Andrology CHU Ignace Deen Conakry Guinea

Introduction: Acute obstructive renal failure (AORF) is a frequent clinical situation, secondary to obstruction of the urinary excretory tract. Whatever the cause, urinary tract obstruction suddenly opposes glomerular filtration and is responsible for tubulointerstitial lesions. It accounts for 10% of acute renal failure (ARF). The aim of this study was to identify the causes and prognosis of cases of acute obstructive renal failure managed at the Centre National d’hémodialyse Donka. Material and Methods: This was a prospective descriptive study lasting 6 months, from September 1, 2022 to February 29, 2023. All patients undergoing haemodialysis for acute obstructive renal failure who agreed to participate in the study and whose medical records were complete were included. Results: During the course of the study, we registered 97 haemodialysis patients, including 20 cases (20.62%) of acute obstructive renal failure. The mean age of the patients was 57.8 ± 10.54 years, with a male predominance of 11 cases (55%) and a sex ratio of 1.22. The reasons for consultation were dominated by physical asthenia 11 cases (55%), lumbar pain 9 cases (50%), vomiting 6 cases (30%) and acute urine retention 6 cases (30%). Arterial hypertension 16 cases (80%) and urinary tract infection 10 cases (50%) were the most common antecedents. The etiologies of RAOI were dominated by lithiasis 10 cases (50%), neoplasia 6 cases (30%) and benign prostatic hypertrophy 3 cases (15%). mean creatinine was 1267.60 ± 710.76 μmol/l with extremes of 243 μmol/l and 2822 μmol/l, mean urea was 39.56 ± 18.36, hyperkalemia in 14 cases (70%) and hyponatremia in 8 cases (40%). After hemodialysis, 9 cases (45%) recovered renal function, 4 cases (20%) became chronic and 7 cases (35%) died. Conclusion: The frequency of AKI remains non-negligible in our department, and early detection and prompt management would considerably reduce the morbidity and mortality associated with this pathology.

关键词： Acute Obstructive Renal Failure Hemodialysis Prognosis Donka

Duplication of the Urethra in Boys: A Case Report

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Open Journal of Urology 2024年第6期14卷 353-358页

作者： Mamadou Tidiani Coulibaly Falaye Sissoko Moumine Diarra Adama Toutou Diallo Issa amadou amadou Berthé Sory Koné CHU Gabriel tour Urology Department Bamako University of Science Technology and Engineering Bamako Mali Lafiabougou Reference Health Center Bamako University of Science Technology and Engineering Bamako Mali CHU Gabriel tour Pediatric Surgery Bamako University of Science Technology and Engineering Bamako Mali Korofina Reference Health Center Bamako University of Science Technology and Engineering Bamako Mali Segou Regional Hospital Bamako University of Science Technology and Engineering Bamako Mali

Supernumerary urethra in boys is a very rare anatomical entity. Sagittal urethral duplications are classified into four groups: epispadias, hypospadias, fusiform and Y-shaped urethra. The most widely used classification is that of Effmann and Lebowitz, which describes 6 types, one of the rarest being the ‘Y’ subtype IIA2, which corresponds to a duplicated urethral path from the vesical neck to an ectopic perineal or anal outlet. We report here the case of a 4-year-old child presenting with subtype IIA2 with a perineal orifice and no other urinary disorders.

关键词： Duplicity Ureter Malformation

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

Pleomorphic Adenoma of the Salivary Glands: Two Atypical Locations

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International Journal of Otolaryngology and Head & Neck Surgery 2024年第3期13卷 251-257页

作者： Sidibé Youssouf Diarra Abraham Samaké Djibril Sanogo Boubacar Traoré Abdoul Moumine Diarra Kassim Coulibaly Bourama Diakité Youssouf Keita Mohamed amadou Department of ENT and Head and Neck Surgery Mother-Child University Hospital “ Le Luxembourg&#8221 Bamako Mali Faculty of Medicine and Odontostomatology Bamako Mali Department of ENT and Head and Neck Surgery The Mali-Gavardo Hospital Bamako Mali Ministry of Higher Education and Scientific Research Bamako Mali ENT and Head and Neck Surgery Department of the Commune V Reference Health Center (CSRef CV) Bamako Mali Department of ENT and Head and Neck Surgery at CHU Gabriel touré Bamako Mali Department of Anatomy and Pathological Cytology Gabriel Tour&#233 University Hospital Center Bamko Mali Department of Oral Surgery Sikasso Regional Hospital Sikasso Mali

Pleomorphic adenoma is the most common tumor of the salivary glands, accounting for approximately 50% of salivary gland lesions. It develops mainly in the salivary glands: parotid (80%), submaxillary (10%), sublingual (1%) and in the accessory oral-pharyngeal glands (9%). The aim of this work was to report 2 cases of pleomorphic adenoma of atypical location and then to discuss the difficulties linked to its diagnostic and therapeutic management in the Malian context. They were a 40-year-old man and a 72-year-old woman. They were admitted to the ENT department of the “Luxembourg Mere-infant” hospital for oropharyngeal swelling for the first and swelling of the palate for the second. The clinical expression was a swelling in both cases, of a hard, mobile consistency with healthy mucosa on their surface. The remainder of the physical examination was unremarkable. The diagnosis of a tumor of the oropharynx and palate was made following clinical radiological examinations. The histopathological examination of the surgical specimen made it possible to make the diagnosis of pleomorphic adenoma of the palate and the left palatine tonsil. The follow-up surgery was straightforward, with a favorable outcome. Pleomorphic adenomas are relatively rare benign tumors of the accessory salivary glands;their clinical expression remains swelling. Therapeutic management is surgery and the diagnosis is confirmed by histopathological examination.

关键词： Pleomorphic Adenoma Palate Tonsil Mali