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Evaluation of Antibiotic Prescribing in the Pediatric Department of Gabriel touréTeaching Hospital, Bamako, Mali

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 Ahamadou Aminata Doumbia Lala N’Drany Sidibé amadou 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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Epidemiological and Clinical Aspects of Abnormal Movements in Children from 2 Months to 15 Years in the Pediatric Department of Gabriel toure University Hospital Centre of Bamako

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Open Journal of Pediatrics 2022年第1期12卷 170-178页

作者： Karamoko Sacko Djeneba Konaté amadou touré Belco Maiga Fousseyni Traoré Adama Dembelé Pierre Togo Abdoul Karim Doumbia Andoule Guindo Rokia Togola Oumar Coulibaly Diakite Fatoumata Léonie Francois Ibrahima Ahamadou Kalirou Traoré Abdoul Aziz Diakité Boubacar Togo Gabriel toure University Hospital Centre Bamako Mali University Hospital Centre Point G Bamako Mali

Introduction: Abnormal or involuntary movements correspond to a disorder in the programming and/or execution of movement. They have two characteristics;they are hardly or not at all controlled by the will and occur in the absence of any paralysis. Objective: To determine the epidemiological, clinical and etiological characteristics of abnormal (involuntary) movements in children aged 2 months to 15 years. Patients and Methods: This was a prospective, descriptive study from January 2016 to December 2018 of children aged 2 months to 15 years seen in neuropediatric consultations for abnormal movements. Results: During the study period 1920 children were seen in neuropediatric consultations and 57 presented with abnormal movements, i.e. a frequency of 2.96%. Children aged between 6 and 60 months were the most affected (54.4%). The sex ratio was 1.53. Movement abnormality was the most common reason for consultation (45.7%), followed by apyretic convulsions (28%), and laxity (5.3%). The onset was progressive in 68.4% of children. The main types of abnormal movements were chorea (31.6%), dystonia (26.3%), myoclonus (17.5%), tremor in 10.5%. The causes were infectious (73.68%). Conclusion: Abnormal movements are rare in paediatric practice. They have multiple causes and their management is urgent in certain situations that can jeopardise the future of children.

关键词： Abnormal Movements Convulsions Children Bamako

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Non-Chemotherapy Medullary Aplasia in the Pediatric Oncology Unit of the Gabriel touré Teaching Hospital, Bamako

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Open Journal of Pediatrics 2023年第6期13卷 798-806页

作者： Pierre Togo Ibrahim Ahamadou Tati Simaga Abdoul Karim Doumbia Fousseyni Traoré Oumar Coulibaly Djénéba Konaté Salif Zigmé Adama Dembélé Mohamed Elmouloud Cissé Belco Maïga Karamoko Sacko Hawa Gouro Diall Boubacar Ali touré amadou touré Yacouba Aba Coulibaly Aminata Doumbia Hawa Konaré Kalirou Traoré Souleymane Sagara Abdoul Aziz Diakité Fatoumata Dicko Cheick Bougadari Traoré Boubacar Togo Department of Pediatrics Gabriel Touré Teaching Hospital Bamako Mali National Institute for Training in Health Sciences Bamako Mali Center for Research and Fight against Sickle Cell Disease Bamako Mali Pathological Anatomy Department Point G Teaching Hospital Bamako Mali

Objectives: The main objective was to study the epidemiological, diagnostic and therapeutic aspects of medullary aplasia (MA). Methods: This was a prospective and descriptive retro study conducted from January 1, 2008 to December 31, 2018 in the pediatric oncology unit of the pediatrics department of the Gabriel touré teaching Hospital in Bamako. Results: We collected 29 children’s cases out of 1632 admissions during the study period, representing a frequency of 1.8% and an incidence of 2.6 cases per year. The sex ratio was 2.6. The 11 - 15 age group accounted for 45%, with an average age of 8.93 years. The majority of fathers (55.2%) and mothers (62.1%) had received no education;they were mainly farmers (62.1%) and housewives (86.2%). The average consultation time was 92.21 days. Anemia was the reason for consultation in 69% of cases. Pallor was present on admission in 96.5%;infectious syndrome accounted for 79.3%, anemic syndrome for 51.7% and hemorrhagic syndrome for 27.6%;the three syndromes were associated in 27.6%. Malaria was associated with bone marrow aplasia in 58.6%. Anemia was present in 93.1%, neutropenia in 65.5% and thrombocytopenia in 86.2%. All had received a labile blood product (LBP) transfusion, and 24 (83%) had received antibiotics. Patients were treated with corticosteroids (58.6%), androgens (20.7%) and immunosuppressants (20.7%). The death rate was 34.6%. At last count, 15 (83%) had discontinued treatment, 2 (11%) were undergoing treatment and 1 (6%) was in remission. Conclusion: Effective treatment of MA requires improved technical facilities and better economic conditions for parents.

关键词： Medullar Aplasia Children Bamako

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Women’s Knowledge and Attitudes about Complications during Pregnancy and Childbirth in Guinea

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Open Journal of Obstetrics and Gynecology 2021年第10期11卷 1291-1305页

作者： Mamadou Dioulde Balde Aissatou Diallo amadou Oury touré Anne Marie Soumah Alpha Oumar Sall Sadan Camara Ousmane Balde Ramata Diallo Alpha amadou Barry Center for Research in Reproductive Health in Guinea/Cellule de Recherche en Santé de la Reproduction en Guinée (CERREGUI) Conakry Guinea CHU Donka Clinique de Gynécologie et Obstétrique Conakry Guinea

Introduction: Maternal mortality remains a major public health problem in the world. Complications during pregnancy and childbirth are the main causes of maternal mortality in low-income countries. It is estimated that 15% of deaths are related to these complications. Studies have shown that women have little or no acquaintance on sign danger and complications during pregnancy and childbirth. Limited literature exists on women’s knowledge and attitudes about pregnancy and childbirth’s complications as well as the barriers for their management, therefore necessity to carry out this study. Objective: To explore women’s knowledge and attitudes in the community about complications during pregnancy and childbirth. Method: A qualitative study was conducted in three prefectures of Guinea. Eighteen focus groups were conducted with women of reproductive age living in urban and rural areas. Results: Complications during pregnancy and childbirth are common among pregnant women in Guinea. Many women have knowledge about various sorts of complications related to pregnancy and childbirth. These complications were mostly vaginal bleeding, abortions and maternal mortality. The use of a health facility in ca

关键词： Complications Pregnancy Childbirth Knowledge Attitude Guinea

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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 p

关键词： Barriers Postnatal Consultation Maternal Mortality Guinea

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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 wit

关键词： Tumour Adrenal Pheochromocytoma Conn Adrenocortical Carcinoma Dakar

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哈尔滨城市森林土壤对污水的净化能力

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生态学杂志 2018年第7期37卷 2130-2138页

作者：段文标段文靖陈立新沈海龙韩冬荟曲美学 amadou touré 张玉双东北林业大学林学院哈尔滨150040

为探明城市森林不同林型土壤对污水净化能力,为水岸防护林的配置提供依据,选择哈尔滨市城市林业示范基地内代表性的3种人工林(蒙古栎、黄檗、水曲柳)为研究对象,将无植被生长的裸地作为对照,通过室内土柱模拟法,定期采集马家沟污水进行... 详细信息

为探明城市森林不同林型土壤对污水净化能力,为水岸防护林的配置提供依据,选择哈尔滨市城市林业示范基地内代表性的3种人工林(蒙古栎、黄檗、水曲柳)为研究对象,将无植被生长的裸地作为对照,通过室内土柱模拟法,定期采集马家沟污水进行室内模拟浇灌,对土柱中淋滤液进行成分测定。结果表明:所选的3个林型对铵态氮的去除效果显著(P0.05);3个林型及对照土柱淋滤液中硝态氮量与未经土柱过滤的污水相比均极显著增加(P0.05),各林型间的差异也不显著;3个林型及对照土柱淋滤液的p H值均显著低于未经土柱过滤的污水;各林型土柱淋滤液中溶解氧均高于未经土柱过滤的污水,但差异并不显著,且与对照无显著差异;除蒙古栎人工林外,其他两个林型及对照土柱淋滤液的氧化还原电位、电导率和总溶解固体与未经土柱过滤的污水相比均显著增加。

关键词：森林土壤污水处理原状土柱淋滤

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Study of the Management of Children with Major Sickle Cell Disease in Pediatric Emergencies at the Gabriel toure University Hospital

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Open Journal of Pediatrics 2023年第2期13卷 244-252页

作者： Mohamed Elmouloud Cissé Abdoul Aziz Diakité Adama Dembélé Belco Maiga Fatoumata Nampomo Diarra Oumar Coulibaly Hawa Diall Pierre Togo Abdoul Karim Doumbia Abdoulaye Barry Karamoko Sacko Fousseyny Traore Djeneba Konaté Kalirou Traoré Lala N’Drainy Sidibé Ibrahim Ahamadou amadou touré Fatoumata Dicko Boubacar Togo Mariam Sylla Department of Pediatrics Gabriel Toure University Hospital Bamako Mali

Objective: To study the epidemiological, clinical and therapeutic aspects of sickle cell disease in children admitted to the pediatric emergency department of the Gabriel toure University Hospital. Materials and methods: This was a prospective study over 12 months in sickle cell children aged 6 months to 15 years. Results: The frequency of sickle cell disease was 4.67% with 71.1% of SS form. The age range of 60 - 120 months predominated with 43.4% and the sex ratio 1.4. Vaso-occlusive crises (VOC) were the most frequent reason for consultation (50.6%) and osteoarticular pain was the main symptom followed by fever and pallor with respectively 67.5%, 60.2%, 39.8%. The pain subsided in less than 72 hours in 39.8% and hyper hydration was performed in 85.1% of patients. Analgesic treatment was given in 90.4%, antibiotic therapy in 51.8% and phenotyped red blood cells transfusion was performed in 36.1%. The average duration of treatment was 10 days. Conclusion: Vaso-occlusive crisis remains the main reason for consultation in sickle cell disease children at Gabriel toure University Hospital. The management consisted, in addition to the correction of the triggering factors, of hyper hydration and the administration of analgesics and blood products.

关键词： Sickle Cell Disease Pediatrics Emergencies

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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

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Study of Cerebral Vascular Accidents in Children with Sickle Cell from 6 Months to 15 Years of Age at the Gabriel toure University Hospital Center

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Open Journal of Pediatrics 2023年第6期13卷 852-861页

作者： Mohamed Elmouloud Cissé Abdoul Aziz Diakité Adama Dembélé Belco Maiga Moussa Diallo Abdoul Karim Doumbia Oumar Coulibaly Pierre Togo Hawa Gouro Diall Abdoulaye Barry Karamoko Sacko amadou touré Issa Sanou Fousseyny Traore Djeneba Konaté Kalirou Traoré Lala N’Drainy Sidibé Bory Traoré Ibrahim Ahamadou Yacouba Aba Coulibaly Hawa Konaré Aminata Doumbia Department of Pediatrics Gabriel Toure University Hospital Bamako Mali

Sickle cell disease is a hereditary disease that remains a public health problem in Mali. Our objective was to study strokes in children with sickle cell disease aged from 6 months to 15 years in the pediatrics department of the Gabriel toure university hospital center. This was a retrospective descriptive study from April 1, 2019 to March 31, 2021 and prospective from April 1, 2021 to April 30, 2022, i.e. 3 years, which took place in the Pediatrics department of the Gabriel toure university hospital center. During this study, we identified 22 cases of stroke among 714 children with sickle cell disease. The frequency of stroke in this population is 3.08%. The age group from1 to 5 years was the most affected with 40.9%. The average age of the patients was 7 years with extremes ranging from 1 year to 15 years and a median of 5 years. The male gender was predominant with 54.5%, for a sex ratio of 1.2. Headaches were the most common neurological antecedents (63.5%). Half of the patients were diagnosed with sickle cell disease after the onset of the stroke. The installation of the deficit was progressive in 54.5% of cases. Consciousness disorders were the most frequent reason of consultation (27.2%), followed by convulsions (18.1%). The most common neurological signs were impaired consciousness and hemiparesis with 45.5% each. The stroke was ischemic in 100% of cases. There were 95.5% of SS forms and 4.5% of Sβ0thalassemia forms. Our patients had a hemoglobin level less than 7 g/dl in 57.1% of cases and between 7 and 9 g/dl in 42.8% of cases and hyperleukocytosis (leukocytes > 10,000/mm3) in 95.4% of cases. The Sylvian artery was the most affected (45.5%). The fatality rate was 22.7%.

关键词： Sickle Cell Anemia Vessels Brain Children

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