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Management of Hypertension (HTN) in a Cardiology Department in Bamako (Mali): Financial Aspects

World Journal of Cardiovascular Diseases 2019年第6期9卷 394-403页

作者： Hamidou Oumar Ba Ichaka Menta Ibrahima Sangaré Noumou Sidibé Youssouf Camara Souleymane Coulibaly Hamidou Camara Cheick Hamala Fofana Aladji Traoré Adama Sogodogo Mamadou Touré Kéita Asmaou Maiga Doumbia Coumba thiam Adama Daou Kassoum Mamourou Sanogo University Hospital Gabriel Touré Bamako Mali University Hospital Sidy Bocar Sall Kati Mali University Hospital Mother Children Bamako Mali National Center for Disease Fighting Bamako Mali

Background: Studies on financial aspects of High blood pressure management are rare and old without differentiating categories of expenses. On the other hand there is an evolution in health system with the introduction of a medical insurance. Objective: We performed this study to estimate costs related to insurance status. Methodology: The prospective study on patients aged 15 years and older extended from 01 May to 31 August 2016 and was carried out in the cardiology department of the University Hospital Gabriel Touré. Only newly detected or untreated hypertensive patients were included. Sociodemographic data, those on physical examination and financial management (transport, consultation, labor tests and purchase of drugs) were collected. Regarding costs, patients were directly asked about: how much did you spend for transport, consultation, labor tests and drugs? Data analysis was carried out by comparing patients with health insurance (Ins+) and those without it (Ins?). The recorded data were inserted in a MS Access database, preliminarily processed by MS Excel and imported to SPSS version 20 for analysis. Results: Mean total cost of care was 57,018 FCFA [50,139 - 63,897] (around 92 USD). It was 50,072 [42,182 - 57,963] for the Ins? group against 79,670 [66,777 - 92,563] for the Ins+ group with a p value 0.0001. Highest amounts for spending were for cardiovascular medication and labor tests with means of 19,255 FCFA (32 USD) and 18,813 FCFA (30 USD). Mean consultation fee was significantly higher for Ins+ patients: 4064 FCFA with IC (95%) [3210 - 4917] versus 3124 with IC (95%) [2774 - 3474] for Ins? patients and p = 0.018. For ECG, however, mean costs were higher for Ins? patients with 6460 [5944 - 6976] against 5115 [4871 - 5360] for Ins+ patients, p = 0.001. Conclusion: Health insurance has few subscribers compared to patients requiring medical care. It increases the global costs of care while facilitating access to care for those who benefit from it.

关键词： Hypertension New Patients Untreated Patients Costs Cardiology Bamako

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HPV Genotypes of Senegalese Women Attending Radiotherapy

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Open Journal of Biophysics 2018年第2期8卷 85-94页

作者： M. Soumboundou I. thiam K. Doh M. M. Dieng C. Dial C. Malesys P. M. Guaye A. Z. Thioune A. Dem M. Diarra C. R. Lafrasse Laboratoire Physique Pharmaceutique FMPO Université Cheikh Anta Diop de Dakar Sénégal Laboratoire Radiobiologie Cellulaire et moléCulaire de Lyon 1 Université Claude Bernard Lyon Contry France Service Biophysique Médical UFR Santé Thiès Sénégal Hopital Pour Enfants de Diamniadio Dakar Sénégal Laboratoire d’anatomie et de cytologie pathologiques de l’Hô pital Aristide Le Dantec Dakar Sénégal Service cancérologie et radiothérapie Institut Joliot Curie de l’Hô pital Aristide Le Dantec Dakar Sénégal Laboratoire d’anatomie et de cytologie pathologiques de l’Hô pital Général de Grand Yoff Dakar Sénégal

Objectives: This work was carried out in order to determine the profile of different HPV genotypes in a population of women attending radiotherapy (RT). Material and Methods: This is a retrospective study. Sixty paraffin blocks were chosen by simple random method upon 1015 blocks of cervix cancer diagnosed in Senegal’s public hospitals laboratories of anatomopathology. The strains of HPV genotyping were done with polymerase chain reaction (PCR) multiplex using primers MY09-MY11, GP5+ and GP6+. Results: Among the sixty examined blocks, DNA extraction was unsatisfactory in three cases. All women were infected with HPV high risk (HR). The different HPV genotypes isolated were HPV 16 (49/96%), 18 (8/16%), 35 (7/14%), 45 (4/8%), and 58 (2/4%). It was a single infection in 36 cases (70, 60%), co-infection in 11 cases (21, 60%) and a multi-infection in 4 cases (7, 80%). Conclusion: The prevalence of HPV found in our series is comparable to that found in the world. To complete this study, a large population of Senegalese patients with uterine cervix cancer (CC) and HPV genotype, is needed to determine if HPV genotypes could be considered as a prognostic marker in patients with uterine CC after RT.

关键词： HPV Cervix Cancer Genotype Radiotherapy Senegal

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Positive Surgical Margins (PSM) after Open Retropubic Radical Prostatectomy: Evaluation of Patient Survival

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Open Journal of Urology 2021年第7期11卷 282-288页

作者： Babacar Sine Abdoulaye Ndiath Ndéye Aissatou Bagayogo Alioune Sarr Amath thiam Cyrille Ze Ondo Ousmane Sow El Hadji Malick Diaw Moussa Séne Babou Sakho Cheikh Bécaye Gassama Ibrahima Ngom Yaya Sow Babacar Diao Alain Khassim Ndoye Urology Andrology Department of Aristide Le Dantec Hospital Dakar Sénégal Urology Andrology Department of Ouakam Military Hospital Dakar Sénégal

Background: Many patients who have had radical prostatectomy for prostate cancer may present with microscopic extraprostatic extension of the disease. Positive surgical margins are a common pathological finding in this subgroup of patients. To report the epidemiological, clinical and therapeutic aspects of PSM after radical prostatectomy (RP) and to evaluate the follow-up of patients. Patients and methods: A single-center retrospective descriptive study of patients who underwent radical prostatectomy between June 1, 2004 and December 31, 2019 was conducted. Patients who had radical prostatectomy with PSM on pathology report were included. The parameters studied were age, initial prostate specific antigen (PSA), Gleason and International Society of Uropathology (ISUP) scores, cTNM and pTNM stages, operative technique, PSA levels after surgery, adjuvant treatment and patient survival. Results: Eighty-six (86) radical prostatectomies were performed. PSM was found in 23 patients (26.7%). The mean age of the patients was 63.7 ± 6.1 years. The mean preoperative total PSA was 31.5 ng/mL (6.31 - 146 ng/mL). Prostate biopsy showed only prostatic adenocarcinoma. Thoracic-abdominopelvic CT was performed in all patients. Prostate cancers were found at the localized stage in 12 patients and locally advanced in 11 patients. A classification adjustment was obtained after pathological examination of the surgical specimen. The ISUP score 3 and 1 on the surgical specimen were in the majority with 9 and 7 patients respectively. After the recurrence, all patients who consented received hormone therapy, which was either medical with Goserelin and Triptorelin (7 patients) or surgical with testicular pulpectomy (1 patient). PSA was undetectable (Conclusion: RP with PSM is a fai

关键词： Prostate Cancer Surgical Margins Survival

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Diagnostic Rigid Urethrocystoscopy: Indications, Results and Pain Assessment

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Open Journal of Urology 2020年第8期10卷 239-244页

作者： Ousmane Sow Abdoulaye Ndiath Aboubacar Traore Alioune Sarr Babacar Sine Modou Ndiaye Yassin Sayerh Cyrille Ze Ondo Amath thiam Ndiaga Seck Ndour El Hadj Malick Daw Ndeye Aissatou Bagayogo Yaya Sow Boubacar Fall Babacar Diao Papa Ahmed Fall Alain Khassim Ndoye Urology-Andrology Department Aristide Le Dantec Hospital Dakar Senegal Urology-Andrology Department De la Paix Hospital Ziguinchor Senegal Urology-Andrology Department Dalal Jamm Hospital Dakar Senegal

Background: Over the last 50 years, endourology has revolutionized urological practices worldwide. This is not so in many urological centers in West Africa. Although, some centers have made progress in the level of urological services that they offer;many of such centers provide rigid urethrocystoscopy services. Rigid urethrocystoscopy is an endoscopic examination that explores the urethra, bladder and prostate in men. Aims: We report the indications, results and pain assessment of rigid urethrocystoscopy in our center. Patients and Methods: We carried out a retrospective, descriptive, monocentric study in our center between January 2016 and June 2018. The study included all patients who had a rigid urethrocystoscopy under local anaesthesia. We studied the following parameters: sex, age, indications for the examination, outcomes and the pain assessment. Results: Five hundred and forty-one patients were included. The sex-ratio was 1.49. The mean age was 49.47 ± 18.48 years (12 years and 91 years). Lower urinary tract symptoms (29%) and hematuria (28%) were the most common indications. The rigid urethrocystoscopy was normal in 26.8% of patients. Bladder tumors (21.2%) were the most frequent lesions. In men, prostate tumors were more common (21%) followed by bladder tumors (17.9%), while in women, bladder tumors (26.3%) were predominant followed by cystopathy lesions (12.4%).The mean Simple Verbal Scale (SVS) score was 1.25 in women and 2.1 in men. Conclusion: Rigid urethrocystoscopy was relatively well tolerated by our patients. Hematuria was the primary indication and the main etiologies were bladder and prostate tumors.

关键词： Rigid Urethrocystoscopy Bladder Tumors Hematuria

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Epidemio-Clinical, Therapeutic and Evolutive Aspects of Aortic Dissection in the Cardiology Department in Poin “G” Hospital University Center Bamako

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World Journal of Cardiovascular Diseases 2018年第8期8卷 424-430页

作者： Samba Sidibé Coumba Adiaratou thiam Abdoul Karim Sacko Mamadou Diakite Mariam Dagnoko Souleymane Coulibaly Nouhoum Diallo Hamidou Omar Ba Ibrahima Sangaré Somnoma Jean-Baptiste Tougouma Massama Konaté Oumar Daouda Koné Mamadou Touré Mariam Sako Ichaka Menta Illo Bela Diall Boubakar Diallo Cardiology Department Point “G” Hospital University Center Bamako Mali Cardiology Department Hospital Kati Bamako Mali Cardiology Department Gabriel TOURE Hospital University Center Bamako Mali Higher Institute of Health Sciences Nazi Boni de Bobo Dioulasso University Bobo Dioulasso Burkina Faso Cardiology Department Hospital Mali Bamako Mali Medical Department of Institute for Studies and Research Bamako Mali

Objective: The work aimed at describing an epidemioclinical, therapeutic and evolutionary characteristics of patients hospitalized for aortic dissection in the cardiology department in Point “G” Hospital University Center in Bamako—Mali. Methodology: It was a descriptive cross-sectional study from January 2010 to February 2017 in the CHU Point G cardiology department, including all patients hospitalized during this period. Results: Of 6912 hospitalized patients, 23 patients were concerned by aortic dissection. The prevalence of aortic dissection was 0.33%. The most affected age group was 50 - 69 (43.5%) of patients. The predominance was male with a sex ratio of 4.75. The cardiovascular risk factors were high blood pressure (73.9%) and smoking (60.9%). The major functional signs were chest pain (65.2%) and dyspnea (65.2%). Asphygmy (56.5%) and breath of aortic insufficiency (60.9%) were the dominant physical signs. The electrocardiogram recorded sinus tachycardia with 86.9% of patients. The radiographic of the frontal thorax showed mediastina widening (73.9%). At echocardiography, dilatation of the ascending aorta was described with 73.9% and the intimal veil (47.8%). Pericardial effusion was observed with 26.1% of patients. In the thoracic angioscan, the aortic dissection gave 43.5% for type A and 56.5% for type B. The aneurysm of the aorta was abdominal with 21.7%, ascending portion (13.0%) and descending with 8.7%. Complications were dominated by heart failure (47.8%) and aneurysm of the aorta (34.8%). The lethality was 52.2%. Conclusion: Aortic dissection is a medical and surgical emergency with poor prediction.

关键词： Aortic Dissection Cardiology Point G Hospital

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Epidemioclinics, Etiologies and Prognosis of Cardiogene Shock State in the Intensive Care Unit of the Cardiology Department of the G-Spot Hospital

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World Journal of Cardiovascular Diseases 2021年第1期11卷 20-24页

作者： Mariam Sako Massama Konaté Boubacar Sonfo Samba Sidibé Nouhoum Diallo Fatoumata Diarra Mamadou Diakité Coumba Adiaratou thiam Asmao Keita Ibrahima Sangaré Hamidou Omar Bâ Youssouf Camara Yves Roland Koumaré Alou Sangaré Boureïma Dembélé Ami Diarra Souleymane Coulibaly Ichacka Minta Cardiology Department Point “G” Hospital University Center Bamako Mali Cardiology Department Hospital MALI Bamako Mali Cardiology Department Hospital KATI Bamako Mali Cardiology Department Hospital LUXEMBOURG Bamako Mali Cardiology Department Gabriel Touré Hospital University Center Bamako Mali

Objective: The work aimed to describe the etiological and evolutionary aspects of cardiogenic shock in the intensive care unit of the cardiology department (USIC) of the G-spot hospital in Bamako, Mali. Materials and Methods: This was a descriptive cross-sectional study from January 1, 2018 to April 30, 2019 that included all patients admitted to the USIC during this period. Each patient benefited from individual data support with systematic recording of socio-demographic, clinical, complementary and therapeutic data and analyzed with the SOFTWARE SPSS 20.0 French version. Results: The study involved 40 patients out of 311 patients hospitalized in USIC, representing a hospital frequency of 12.86%. Males were the most affected (60%) with a sex ratio of 1.50. The modal class was 41 - 60 years with extremes at 18 years and 89 years. Cardiovascular risk factors were dominated by HTA (27.50%), diabetes and tobacco, each with 22.50%. The general signs were tachycardia (90%), oxygen desaturation (77.50%), impregnable blood pressure (62.50%), agitation (52.50%) and an oliguria (70%). At the electrocardiogram the rhythm was sinus (80%), it was an atrial fibrillation (15%), a ventricular tachycardia (10%) and signs of coronary ischemia (necrosis in 35% and ST over shifted in 20% of cases). At cardiac doppler ultrasound,the left ventricle was dilated (50%), the right cavities dilated (30%), segmental kinetic disorder (40%), the left ventricular systolic function (FEVG) impaired (75%) and valve disease (10%). Biology noted hyper-creatinemia (65%), hyper-glycemia (12.50%), anemia and hyponatremia with 20% frequency each. Among etiology, ischemic heart disease accounted for 57.50% followed by pulmonary embolism 20%, dilated valve cardiomyopathy 7.50% and chronic pulmonary heart 2.50%. The trend in the majority of cases was unfavorable with 60% of deaths. Chronic pulmona

关键词： Cardiogenic Shock Etiology Prognostic USIC Hospital Point G

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污水厂中有机磷的赋存形态、生物有效性及强化去除

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中国给水排水 2023年第4期39卷 12-17页

作者：张钰婷尚巍邱顺添郑兴灿孙永利李鹏峰顾淼王金丽隋克俭葛铜岗吕小佳天津大学环境科学与工程学院天津300072 中国市政工程华北设计研究总院有限公司天津300381

现阶段以生物与化学协同为主的除磷技术,使出水总磷中磷酸盐含量较低,但大部分溶解性有机磷(Dissolved organic phosphorus,DOP)难以得到有效去除,出水DOP残留量占总磷的52%~93.1%。有机磷不但能够为藻类提供磷源,而且在常规污水处理系... 详细信息

现阶段以生物与化学协同为主的除磷技术,使出水总磷中磷酸盐含量较低,但大部分溶解性有机磷(Dissolved organic phosphorus,DOP)难以得到有效去除,出水DOP残留量占总磷的52%~93.1%。有机磷不但能够为藻类提供磷源,而且在常规污水处理系统中难以完全去除,这给再生水处理技术提出了新的挑战。以揭示DOP潜在风险、强化DOP深度去除为目标,综合阐述了污水处理厂中DOP的赋存形态及生物有效性,为科学认识DOP的环境效应提供理论依据;通过介绍深度处理过程中DOP强化去除研究进展,可为今后城市污水处理厂提标改造和实现出水总磷超低量排放提供思路和方法。

关键词：城市污水有机磷生物有效性强化去除方法

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Assessment of Common Dental Indices and Need for Periodontal Treatment in the Cardiology Outpatients Unit at the University Hospital Gabriel Touré(UH-GT) in Bamako

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World Journal of Cardiovascular Diseases 2020年第3期10卷 131-143页

作者： Hamidou Oumar Ba Ibrahima Sangaré Youssouf Camara Sidibé Noumou Daou Ousmane Maiga Asmaou Kéita Touré Mamadou Coulibaly Souleymane Sidibé Samba Konaté Massama Doumbia Coumba thiam Sonfo Boubacar Diakité Mamadou Menta Ichaka Ilo Bella Diall Ahmed Ba Boubacar Ba Sanogo Kassoum Mamourou Service de Cardiologie CHU Gabriel Touré Bamako Mali Service de Cardiologie CHU Kati Bamako Mali CHU Odontostomatologie Bamako Mali Service de Cardiologie CHU Mère-Enfant Bamako Mali Service de Cardiologie du CHU Point G Bamako Mali Service de Médecine Interne et d’Endocrinologie Hôpital du Mali Bamako Mali

Introduction: Little is known through the literature about dental status of patients seen in cardiology department, motivating this study which aims to assess most dental indices of outpatients and the need for periodontal treatment. Methodology: It was a cross-sectional study from November 2016 to April 2017 in the cardiology outpatient unit of the University Hospital Gabriel Touré (UH-GT) in Bamako. Included were all patients with minimum 24 teeth and willing to be involved in the study. History, cardiovascular parameters and dental examination by a resident in Odontostomatology were performed for each patient. Data were analyzed using SPSS 18, quantitative as means and standard deviation (SD) and categorical as proportions. Khi-2 Test, analysis of variance were applied with a significance level set at 0.05. All patients give their verbal consent after being informed about the procedures in the study. Results: Our sample involved 100 patients (66% female, mean age of 54.12 ± 16.150 and patients ≥ 60 years most represented with 50% for male and 37.9 for female patients. Tooth brush use was practiced by 100% and 98.5% respectively for male and female patients and twice daily brushing by 97.1% of male and 97% of female patients. Brushing duration was less than 3 minutes for 35.3% and 31.8% of respectively male and female patients. Plaque index and calculus index were in the male group with respectively 0.79 and 1.06 for male and 0.63 and 0.79 for female (p = 0.047 and 0.020). Mean Decayed Missed and Filled Teeth (DFMT) index showed a significantly increase from 0.22 in the age group under 30 to 0.68 for that other 60 years. Only 2.9% and 9.1% of respectively male and female patients had community paradontal index for treatment needs (CPITN) classe 0. The need for treatment was TN1 meaning instruction to an oral cavity hygiene, similar for both sex (55.9 and 57.6 respectively for male and female patients) and highest in the age-group 30 - 44 increased to 70%. The need

关键词： Dental Indices Cardiology Outpatients Bamako

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Congenital Adrenal Hyperplasia: Diagnostic Features in a Limited Resource Country, Senegal

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Open Journal of Pediatrics 2020年第1期10卷 137-146页

作者： B. Niang F. Ly A. Ba A. Mbaye D. Boiro P. M. Faye Y. J. Dieng A. Sow A. Thiongane I. D. Ba L. thiam A. L. Fall O. Ndiaye Albert Royer National Children Hospital University of Dakar Dakar Senegal Pikine Hospital Centre University of Dakar Dakar Senegal Dalal Diam Hospital Centre University of Dakar Dakar Senegal Abass Ndao Hospital Centre University of Dakar Dakar Senegal La Paix Hospital University of Ziguinchor Ziguinchor Senegal

Introduction:?Congenital adrenal hyperplasia (CAH) is a group of autosomal recessive diseases characterized by enzymatic deficiencies in the biosynthesis of adrenal steroids. The most common 21-hydroxylase deficiency is characterized by a cortisol deficiency and an excess of androgens, with or without aldosterone deficiency. In our countries, in the absence of neonatal screening, the diagnosis is most often late leading to life-threatening complications. The aim of this study was to describe the diagnostic features of CAH at the Albert Royer National Children’s Hospital (ARNCH) in Dakar.?Patients and method:?We conducted a retrospective, descriptive study carried out at the pediatric endocrinology department of ARNCH from 2015 to 2019. All children aged under 15 with a form of CAH were included. Socio-demographic data, family history, clinical and biochemical data at presentation were collected. Patients were noted as presenting with Disorder of Sexual Development (DSD) with dehydration, DSD without dehydration, dehydration without DSD, precocious puberty. The Prader’s scale was used to determine the degree of external virilization. These data were entered and analyzed with Epi Info version 7.2.?Results:?A total of 32 patients were included, representing 74.41% of the causes of disorder of sexual development (DSD) and 84.21% of the causes of adrenal insufficiency. These were 27 girls (84.37%) and 5 boys (15.63%). The mean age was 19 ± 34.6 months. DSD was the main finding (87.5%). It was associated with dehydration in 22 cases (68.75%). 21-hydroxylase deficiency represented 93.75% of the cases with salt wasting in 73.33% of the cases.?Conclusion:?The diagnosis of CAH was delayed leading to life-threatening adrenal crises. In the absence of neonatal screening for CAH in Senegal, there is a need to train healthcare workers to recognize neonates with DSD early and refer them timeously for specialist care.

关键词： Congenital Adrenal Hyperplasia Disorder of Sexual Development Adrenal Insufficiency Senegal

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Evolutionary Profile of Graves’ Disease in Children at Albert Royer National Children Hospital in Dakar

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Open Journal of Pediatrics 2019年第2期9卷 119-125页

作者： Babacar Niang Lamine thiam Fatou Ly Indou Dème Ly Djibril Boiro Amadou Sow Aliou Thiongane Aliou Abdoulaye Ndongo Aminata Mbaye Younoussa Keita Abou Ba Idrissa Demba Ba Yaay Joor Dieng Dienaba Fafa Cissé Papa Matar Faye Amadou Lamine Fall Ousmane Ndiaye Albert Royer National Children Hospital Center Dakar Senegal La Paix Hospital Ziguinchor Senegal Pediatric Ward University Hospital Center of Pikine Dakar Senegal Pediatric Ward University Hospital Center of Abass Ndao Dakar Senegal Pediatric Ward University Hospital Center of Aristide Le Dantec Dakar Senegal

Graves’ disease is the most common cause of hyperthyroidism. Adequate management is an area of controversy, especially when it comes to children. The objective of our study was to assess the outcome of Graves’ disease treatment in Albert Royer Children Hospital of Dakar. This was a retrospective study conducted from 2001 to 2015, and which involved all children between 0 to 15 years of age who were being monitored in the Albert Royer National Children Hospital. The evolutionary modalities were: stability, remission, failure, relapse, lost to follow-up and death. The data were analyzed with SPSS software version 20.0. For the comparisons, the KHI 2 or Fisher test was used with a significance threshold (p < 0.05). During the study period, 88 children were enrolled. The average age was 8.6 years [ranging from 8 months to 15 years]. The consultation delay was 11.36 months. In our study, 61.4% of the patients were regular in the follow-up, the observance was good in 40.9% of the cases and 19 patients (21.6%) were lost to follow-up. Clinical courses of 69 children after treatment with Carbimazole for 37 months were promising in 21 cases (30.43%), with 17 cases of remission (24.63%) and 4 cases of stability (5.8%). Age older than 10, the initial ATD dose greater than 1 mg/kg/day and the initial free T4 lower than 50 pmol/l were significantly associated with remission with a p value of 0.01;0.024 and 0.004.

关键词： Graves’ Disease Child Antithyroid Drug Remission Senegal

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