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Digestive Surgical Emergencies at the “Mother Child”Hospital Center Luxembourg in Mali

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Surgical Science 2024年第5期15卷 299-310页

作者： Cheickna Tounkara amara Coulibaly Yaya Ongoiba Aboubakrine Sylla Abdoul Karim Simaga Bréhima B. Coulibaly Aminata Dabo Souleymane dembele Samake Hamidou Sidiki Keita Sékou Bréhima Koumare Soumaïla Keita Bakary Tientigui dembele Zimogo Zié Sanogo Djibril Sangare Department of General Surgery and Anesthesia-Resuscitation of the “ Mother Child&#8221 Hospital Center Luxembourg Bamako Mali Social Health Service of the Armed Forces of Mali Bamako Mali Department of General Surgery “ A&#8221 and Cardiovascular of Point G University Hospital Bamako Mali Department of General Surgery of CHU Gabriel TOURE Bamako Mali

Digestive surgical emergencies concern all patients admitted urgently, for whom a decision for surgical intervention may be necessary within 24 hours. They are on guard duty day and night. To carry out this work, we set ourselves the objectives of: 1) Studying digestive surgical emergencies in the general surgery department of the “Mother Child” Le Luxembourg hospital in Bamako, Mali;2) Determine the frequency of digestive surgical emergencies, 3) Describe the clinical and therapeutic aspects, and 4) Analyze the results of treatment. From November 1, 2022 to October 31, 2023, the general surgery department of the “Mother Child” Luxembourg Hospital Center in Bamako, Mali, carried out 139 digestive surgical emergencies whose files were usable;75 men and 64 women, a sex ratio of 1.2. The 20 - 40 years old age group was the most represented, at 40.29%. The average age was 39 years;the extremes 16 years and 93 years with a standard deviation of 21.65 years. The reference concerned 51.08% of our patients. Abdominal pain was the main reason for consultation (100% of cases). In the majority of cases, the physical examination made it possible to make the diagnosis. Faced with certain clinical cases, we requested ultrasound (109/139), ASP (46/139) and CT (15/139). The main etiology was acute appendicitis with 42.45% of cases. The frequency of digestive surgical emergencies was 10.71% of all activities in the general surgery department of the “Mère Enfant” Le Luxembourg hospital center in Bamako. All our patients were seen in consultation by an anesthesiologist before entering the operating room. The surgical consequences were complicated in 11.51% of cases with 7.91% deaths. Surgical site infections accounted for 12.5% of postoperative complications. Eleven deaths were noted, representing 68.75% of complications and 7.91% of our sample. Acute peritonitis was the cause of death in 100% of cases. The average cost of care was 329,000 FCFA.

关键词： Emergency Digestive Surgery Post-Operative Complication

Maternal Deaths in Patients Evacuated to the Fousseyni Daou Hospital in Kayes over a Decade

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Open Journal of Obstetrics and Gynecology 2023年第8期13卷 1389-1398页

作者： Mahamadou Diassana Sitapha dembele Ballan Macalou Alima Sibibe Falaye Keita Mamadou Haidara Famakan Kane Cheickna Sylla Amadou Bocoum Sanogo Siaka amara Soumaila Traoré Department of Gynecology and Obstetrics Fousseyni Daou Hospital Kayes Mali Kayes Reference Health Centre Kayes Mali Reference Health Center of Kalaban-Coro Bamako Mali Bla Reference Health Centre Ségou Mali Department of Gynecology and Obstetrics Gabriel Toure University Hospital Center in Bamako Bamako Mali Department of Gynaecology and Obstetrics Regional Hospital of Sikasso Sikasso Mali

Introduction: Evacuation refers to the rapid transfer of a patient in an emergency, from one health center to another more equipped and better specialized. The objective of this study was to study maternal mortality in patients evacuated to the gynecology and obstetrics department at the Fousseyni Daou Hospital in Kayes over a period of 10 years. Materials and Methods: This was a descriptive, cross-sectional, retrospective study over nine years from January 1, 2011 to December 31, 2019 and prospective over one year from January 1, 2020 to December 31, 2020 involving all patients or parturients evacuated for obstetrical causes and died in the gynecology-obstetrics department of the Fousseyni Daou Hospital. Confidentiality and anonymity were respected. The processing and analysis of the statistical data was carried out using SPSS 20.0 software. Results: during our study period we identified 38,854 obstetric admissions including 6758 evacuations or 17.4%, among the 6758 cases of obstetric evacuations 284 died, a frequency of 4.2%. The maternal death audit committee of the Fousseyni Daou hospital in Kayes audited 101/284 cases (files) or 35.5% of which 64 maternal deaths (63.4%) were considered inevitable. In our study the 20 - 29 age group was more represented with 38%. 85% of the deceased patients lived in rural areas. In our series, 63.7% of the deceased patients had not had antenatal consultations (NPC). Eclampsia accounted for 26.8% of admissions diagnoses and 30.9% of causes of death. Seventy-two (72%) of deaths occurred postpartum, 15% perpartum and 13% prepartum. Direct obstetric causes were predominant at 65.1%. Conclusion: Indicators of maternal deaths among evacuated patients remain poor in our work. Maternal deaths were driven by socio-economic and cultural factors, but also by factors related to the health system.

关键词： Maternal Mortality Evacuation Kayes Hospital

Intestinal Invagination in Adults: About a Case at the “Mother-Child” Hospital Le Luxembourg in Mali

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Surgical Science 2023年第9期14卷 583-589页

作者： Cheickna Tounkara Oumar Amadou Malle amara Coulibaly A. Boubacar Maiga Sory Ibrahim Diawara Kassim Kayentao Bakary Tientigui dembele Alhassane Traore Adégné Pierre Togo Lassana Kante Department of general surgery of the Hospital “Mother Child” Le Luxembourg Bamako Mali University of Sciences of Techniques and Technologies of Bamako Mali (USTTB) Bamako Mali Department of General Surgery of the CHU Gabriel Touré Bamako Mali

Intussusception is a pathology of infants and young children. Its occurrence in adults is very unusual. In the vast majority of cases, it is secondary to a benign or malignant tumor. Small bowel malignancies are relatively rare, 1% - 5% of malignant tumors of the gastrointestinal tract. Acute intussusception, a rare pathology in adults, often presents with non-specific symptoms. Contrary to children, the organic origin remains preponderant in the elderly, where the origin of neoplasia must be suspected in first intention. We report the case of a 49-year-old patient admitted urgently from the Luxembourg “Mère Enfant” hospital center in Bamako, Mali, for an occlusive syndrome. Several abdomino-pelvic ultrasounds were performed in several clinics with mixed conclusions: Hydro-aeric distension and a cessation of matter and gas without a clearly visible mass (04/09/2022);Demonstration of the central hydro-aeric levels wider than high containing fine and regular folds corresponding to connivents whose aspect is in factor of left acute small intestine occlusion, to be completed by the surgical opinion (06/09/2022) and a third ultrasound showed a normal appearance of the liver, gallbladder, kidneys, pancreas, spleen, bladder and prostate;diffuse aero-colic distention without lesion of secondary appearance (21/11/2022). A frontal standing ASP dated 11/25/2022 showed hail-like hydro-aeric levels. Surgical management consisted of an open oncological resection of an obstructive bowel tumor with ileo-ileal invagination. The anatomopathological and immunohistochemical study of the surgical specimen concluded to diffuse small cell non-Hodgkin’s lymphoma, without vascular embolism. The resection limits pass into the healthy zone.

关键词： Acute Intestinal Intussusception Organic Etiology Digestive Lymphoma Mali

Socio-Epidemiological Aspects and Prognosis of Unassisted Deliveries Arriving at Fousseyni Daou Hospital in Kayes

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Open Journal of Obstetrics and Gynecology 2023年第2期13卷 360-371页

作者： Sitapha dembele Mahamadou Diassana Ballan Macalou Alima Sibibe Albachar Hamidou Daouda Fomba Mamadou Haidara Famakan Kane Cheickna Sylla Amadou Bocoum Sanogo Siaka amara Soumaila Traoré Department of Gynecology and Obstetrics of the Fousseyni DAOU Hospital Kayes Mali Kayes Reference Health Centre Kayes Mali Reference Health Center of Kalaban-Coro Bamako Mali Bla Reference Health Centre Ségou Mali Department of Gynecology and Obstetrics of the CHU GABRIEL TOURE Bamako Mali Department of Gynaecology and Obstetrics of the Regional Hospital of SIKASSO Bamako Mali

Introduction: The World Health Organization estimates that each year more than 20 million women suffer from the after-effects of unattended childbirth, of which 800 women die every day as a result of obstetric complications. Objective: Study the socio-epidemiological aspects and prognosis of unassisted deliveries arriving at the Fousseyni Daou De Kayes hospital. Materials and Methods: This was a descriptive, cross-sectional study with prospective collection, case-control that took place at the maternity ward of the Fousseyni Daou hospital in Kayes, from 1 January to 31 December 2021. Results: The frequency of unattended birth was 4.1%. The 30 - 35 age group was the most represented with 32.5%. In our study 58.1% of cases were out of school, 19.4% were primigestes and 39.4% were multiparous. In our series 60.6% of cases had given birth at home and 39.4% along the way. The majority of cases regretted having given birth without the assistance of qualified personnel in 45.6%. Maternal complications were dominated by perineal lesions in 14.4% of cases, haemorrhage of delivery in 25% of cases, severe anaemia in 30% of cases;16.7% of newborns were in poor condition, 13.6% were fresh stillbirths, 15.6% of newborns had obstetric trauma. The maternal death rate on arrival was 3%. Conclusion: The frequency of unassisted childbirth is high in the Kayes region. Its complications can be serious for both the mother and the newborn.

关键词： Childbirth Unassisted Prognosis Complications Kayes

The Place of Blood Transfusion in the Management of Obstetric Emergencies in the Gynaecology and Obstetrics Department of the Reference Health Center of Fana (Mali)

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Open Journal of Obstetrics and Gynecology 2023年第4期13卷 780-791页

作者： Keita Sema Kone Bokary Sidi Fané Seydou Sylla Cheickna Samake Youssouf Traoré Momine Traoré Solomane Haidara Ramatoulaye Diabate Abdrahamane Sylla Yacouba Keita Mamadou Coulibaly Mahamoudou Haidara Mamadou Haidara Dramane Camara Daouda Fomba Dramane Kampo Mamadou Maiga Boubacar dembele Sitapha Seydou Z. Dao Sanogo Siaka amara Obstetrics and Gynecology Department Fana Reference Health Centre Koulikoro Mali Mohamed VI Mother-Child Polyclinic in Bamako Bamako Mali Department of Obstetrics and Gynecology Gabriel TOURE University Hospital Bamako Mali Department of Gynecology and Obstetrics Reference Health Centre of Koulikoro Koulikoro Mali Diola Reference Health Centre Dioila Mali Obstetrics and Gynecology Department Reference Health Centre of Commune I Bamako Mali Obstetrics and Gynecology Department Commune VI Reference Health Centre Bamako Mali Department of Gynecology and Obstetrics Kalaban Coro Reference Health Centre Bamako Mali Department of Gynecology and Obstetrics Kati Reference Health Centre Kati Mali Obstetrics and Gynecology Department Marakala Reference Health Centre Markala Mali Department of Obstetrics and Gynecology Timbuktu Hospital Timbuktu Mali National Blood Transfusion Centre Bamako Mali Department of Obstetrics and Gynecology Fousseyni Daou Hospital Kayes Mali Obstetrics and Gynecology Department Reference Health Centre of Commune II Bamako Mali

This is a prospective and descriptive study carried out at the gynecology and obstetrics department of the reference health center of Fana from 01 May 2019 to 30 November or 7 months. The main objective was to study the role of blood transfusion in the management of obstetric emergencies. During the study period we recorded 434 cases of obstetric emergencies of which 116 cases required an emergency blood transfusion or 26.73%. The most frequently found indications for blood transfusion are hemorrhages of the immediate postpartum 46.6% followed by severe malaria on pregnancy 27.6%. Blood remains the most prescribed and available Labile blood product in the department. Maternal prognosis was improved in 92.2%.

关键词： Obstetric Emergencies Blood Transfusion Hemovigilance

Men’s Knowledge, Attitudes and Perceptions on Family Planning in Tourourou Village, Gogui Rural Commune, Nioro Circle, Kayes Region of Mali

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Open Journal of Obstetrics and Gynecology 2023年第3期13卷 662-680页

作者： Alou Samaké Sitapha dembele Mamadou Keita Cheickna Sylla Dramane Haidara Mamadou Haidara Mamadou Diallo Moussa Konaté Mariam Maiga Mohamed Saydi Agmed Elméhdi Elansari Djibril Kassogué Seydou Zana Dao Hawa Samaké Abdoulaye Nouhoun Coulibaly Brehima Samaké Coulibaly Moussa Mariko Seydou Abdoulaye Cissé Séma Kéita Siaka amara Sanogo Seydou Fané Reference Health Center of Commune VI of the District of Bamako Bamako Mali Department of Gynecology-Obstetrics of Fousseyni Daou Hospital in Kayes Kayes Mali Centre Hospitalo-Universitaire Gabriel Toure Bamako Mali Timbuktu Hospital Bamako Mali Reference Health Centre of Commune V of the District of Bamako Bamako Mali Kalaban Coro Reference Health Center Bamako Mali Nianankoro Fomba Hospital of Segou Segou Mali Reference Health Center of Commune II of the District of Bamako Bamako Mali National Institute of Training in Health Sciences Bamako Mali Regional Health Directorate of Kayes Kayes Mali Fana Reference Health Center Koulikoro Mali

Introduction: The involvement of men in reproductive health programmes and more specifically in family planning has always been of concern to the various development actors at both national and international levels. Objective: To study the births, ideas and opinions of men on Family Planning in the village of Tourourou. Material and Methods: This was a prospective cross-sectional, descriptive and analytic study from February 1 to July 31, 2020 in the village of TOUROUROU on the Knowledge, Attitudes and Perceptions of Men on Family Planning. We included in our study, all men residing in TOUROUROU whose age is between 14 and 99 years, who agreed to participate in the study. Results: Our study involved 200 men. The 25 - 29 age group was the most represented with 25.5%. The Soninke had represented 41%. In our study, 97.5% of men had heard of family planning, 62% had spontaneously cited at least one modern contraceptive method, and the pill ranked first with 64.5%. Radio and friends were the most frequent sources of information with 57.5% and 54.5% respectively. Birth spacing was the most cited family planning goal by men in 43.5% of cases. Men supported the practice of family planning in 50.5% of cases. Conclusion: In the village of Tourourou men play a crucial role in decision-making concerning the health of the couple and the family, their effective involvement in Reproductive Health especially in Family Planning will contribute enormously to the improvement of the health of the family.

关键词： Knowledge Attitudes Perceptions Men Planning Family