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Open Journal of Clinical Diagnostics 2024年第1期14卷 1-6页

作者： Ibrahima Amadou Dembele Abrar-Ahmad Zulfiqar Romuald Nounga Nyanke Sékou Landoure Stéphane Loique Djeugoue Adama Sinayoko Nouhoum Kone Paul Antoni Amadou Nouroudine Rosunee Ahsveen Yacouba Koné Aoua Diarra Tania Mekuiko Ngeupi Mamadou Cissoko Mamadou Mallé Keïta Kaly Djibril Sy Djénébou Traoré Didier Mukéba Tshialala assétou soukho kaya Emmanuel Andres Internal Medicine Department Medical Clinic B University Hospital Center of Strasbourg Strasbourg France Internal Medicine Department University Hospital Center Point G Bamako Mali Faculty of Medicine and Odontostomatology University of Sciences Techniques and Technologies of Bamako Bamako Mali Faculty of Medicine Pharmacy and Public Health University of Mbuji-Mayi Democratic Republic of Congo

Introduction: The severity of Sars-Cov-2 infection is associated with the development of acute respiratory distress syndrome (ARDS). The progression to ARDS appears to be driven by a major inflammatory mechanism potentially sensitive to corticosteroids. Observation: This article describes the case of an elderly patient was admitted to emergency departments for intense asthenia, accompanied by motor diarrhoea, dyspnoea with desaturation in ambient air, in a context of strong suspicion of infection linked to COVID-19. The article also reviews the existing literature on the diagnosis and treatment of this severe form of the disease. Conclusion: Corticosteroids, and in particular dexamethasone, have been shown to be effective in the management of patients with COVID-19, an oxygen-releasing disease.

关键词： COVID-19 Diabetes Mellitus Elderly person Corticosteroids Internal Medicine

Evaluation of Practice of Prescription of the Corticotherapy in the Department of Internal Medicine of the University Hospital of Point G from 2009 to 2013

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Open Journal of Internal Medicine 2019年第3期9卷 89-96页

作者： Abdel Kader Traoré assétou soukho kaya Djibril Sy Djenebou Traoré Alassane Doumbia Ilo Diall Nangou Tolo Hadiza Amadou Kaï lou Karim Dao Boua Daou Camara Ganda Soumaré Mamadou Dembélé Hamar Alassane Traoré Department of Internal Medecine University Hospital of Point G Bamako Mali Department of Cardiology University Hospital of Point G Bamako Mali

Introduction: It is estimated that about 0.2% to 0.5% of French populations received a long-term systemic corticosteroid therapy. In Mali, from March, 2007 to February, 2008, in National Center for Disease Control and Prevention, 19.2% of hospitalized patients (24/125) received long-term corticosteroid therapy. Until now, the department of internal medicine of the university hospital of Point G hasn’t done any research on the corticosteroid therapy specially. Therefore, we initiated this work to evaluate our practice of prescription of corticosteroid. The target of the study was to evaluate practical activity of prescription of corticosteroid of internal medicine. Methods: Based on all hospitalized patient materials of the department of internal medicine of Point G regional university central hospital during January 2009-December 2013, we initiated this retrospective and descriptive study. This study was based on all hospitalized patients receiving corticosteroid in the time of researching, without distinguishing their sex or age. Results: During the period of study, the department of internal medicine of point G regional central hospital had received 2155 patients;64 were eligible: prevalence of 2.97%. Most patients were female, accounting for 87.5% with a sex-ratio of 0.14. The average age of our patients was 39.11 ± 16.92 years, ranging from 14 to 97 years. Physicians enrolled in the study Specialized Diploma (DES) and Internal represented 79.7% of prescribers. As pretreatment assessment, only 2 patients (3.12%) had carried out all of the standard balance (NFS, electrolytes, calcium, blood glucose and serum protein). The most common glucocorticoide was prednisone. Solid tumors represented 31.25% (20 cases) of the diseases treated, followed by systemic lupus erythematosus with 15.62% (10 cases). In addition, there are two cases of adrenals insufficiency (3.1%). In Point G internal medicine, pre-therapy evaluation and methods about corticosteroids therapy were insu

关键词： Pratiques Corticothérapies Médecine Interne Bamako Mali

Clinical and Epidemiological Aspects of Hepatocellular Carcinoma at the Internal Medicine Department of Point “G” Teaching Hospital in Mali

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Open Journal of Gastroenterology 2023年第7期13卷 250-255页

作者： Ganda Soumaré Sanra Déborah Sanogo Abdoulaye Maiga Ouatou Mallé Mamadou Mallé Ibrahima A. Dembélé Mamadou Cissoko Mamadou M. Coulibaly assétou kaya soukho Mamadou Dembélé Abdel Kader Traoré Alassane Traore Hamar Alassane Traore Gastroenterology Department CHU du Point G Bamako Mali Internal Medicine Department CHU du Point G Bamako Mali

Liver cancer is the malignant transformation of liver cells. It develops in 90% of cases of cirrhosis, more rarely on chronic non-cirrhotic liver disease, and exceptionally in a healthy liver. This study aimed to investigate the clinical aspects of Hepatocellular Carcinoma (HCC). It was a retrospective descriptive study covering 10 years, focusing on HCC cases seen in outpatient and inpatient settings at the Internal Medicine Department. We recorded 153 cases out of 7021 patient records, resulting in a hospital frequency of 2.17%. The male-to-female ratio was 3.5. The mean age was 52.37 ± 14.34 years. The most common presenting complaint was pain in 16.3% of cases. A history of jaundice was found in 25.5% of cases. Alcohol consumption was observed in 15.38% of cases. The main physical sign found was hepatomegaly in 76% of cases. HBsAg was positive in 33.3% of cases. Alpha-fetoprotein levels were above 400 IU/ml in 50.81% of cases. Patients classified as CHILD PUGH A represented 39.72% of cases. Abdominal ultrasound revealed portal thrombosis associated with heterogeneous multinodular hepatomegaly in 11% of cases. Cytology confirmed HCC in four out of six patients who underwent the examination. We recorded 63 deaths out of 111 hospitalized patients. Complications included encephalopathy, hematemesis, and ascites in 48 patients. Hepatocellular carcinoma remains a significant public health issue. Its predominance in men and its occurrence in adults with factors such as viral infections and ethylism mean that prevention of this pathology could greatly reduce its incidence.

关键词： Hepatocellular Carcinoma (HCC) Point G University Hospital Bamako Mali

Renal Failure of Lithiasis Origin: Frequency and Management in the Nephrology and Haemodialysis Department of the Point G University Hospital in Mali

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Open Journal of Nephrology 2022年第3期12卷 276-292页

作者： Seydou Sy Magara Samaké Aboubacar Sidiki Fofana Atabieme Kodio Oligue Prudence Oman Djibril Sy Hamadoun Yattara Djénèba Diallo Sah Dit Baba Coulibaly Nouhoum Coulibaly Modi Sidibé Alkaya touré Moustapha Tangara Mamadou Lamine Diakité assétou soukho kaya Saharé Fongoro Nephrology and Hemodialysis Department University Teaching Hospital of Point-G Bamako Mali Faculty of Medicine and Odontostomatology University of Sciences Techniques and Technologies of Bamako Bamako Mali Nephrology Unit Fousseyni Daou Hospital in Kayes Kayes Mali National Center for Scientific and Technological Research (CNRST) Bamako Mali Department of Internal Medicine University Teaching Hospital of Point-G Bamako Mali Department of Urology University Teaching Hospital of Point-G Bamako Mali

Background: The term urinary lithiasis (UL) from the Greek “lithos” refers to the disease characterised by the result of abnormal precipitation of normal constituents of the urine within the urinary tract. The aim of this work was to determine the frequency of obstructive renal failure (ORF) of lithiasis origin and to describe the therapeutic indications. Methods: This was a retrospective prospective study in patients hospitalised in the nephrology department of Point G University Hospital for ORF of lithiasis origin over a 26-month period from 1 January 2018 to 1 February 2020 inclusive. Results: Among 1898 hospitalized patients, 32 met the inclusion criteria, i.e. a frequency of 1.7%. The male sex was 68.75% with a sex ratio of 2.2. The mean age was 48.38 ± 13.423 years with extremes of 20 and 65 years. Dysuria and urinary bilharzia were the main uro-nephrological antecedents, accounting for 25% of the cases each. Pain syndrome was the main functional sign, accounting for 100%. Ultrasound of the urinary tract (n = 28) showed stones in 92.85%. These stones were bilateral in 22.22% of cases. The dilatation was pyelocalic in 14 cases (51.8%). The uroscanner showed a pyelic location of the stones in both kidneys;42.1% on the right and 33.3% on the left. Hydronephrosis was the most common dilatation: 37.8% on the right and 29.7% on the left. Renal lithiasis was complicated by acute kidney injury (ARI) in 17 cases (53.1%) versus 15 cases (46.9%) of chronic kidney disease (CKD). Urethral catheter was the means of drainage in 24 (75%) followed by nephrostomy in 8 cases (25%). Nephrolithotomy accounted for 9.4% of cases. The case fatality rate was 28.12% (9 cases). Deaths occurred in the context of uraemic coma 6 cases and cardiorespiratory arrest 3 cases. Conclusions: The management of urinary lithiasis complicated by renal failure calls for the correction of hydrolytic disorders, drainage of the excretory tract and treatment of the stone, of which percutaneous nephrolith

关键词： Renal Failure Urinary Lithiasis Nephrology University Teaching Hospital of Point-G

Serious Myasthenia at the Department of Internal Medicine of Point G University Teaching Hospital: A Clinical Case

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Neuroscience & Medicine 2019年第3期10卷 207-212页

作者： assétou kaya soukho Djenebou Traoré Adramé Keita Djibril Sy Guida Landouré Seybou Hassane Diallo Youssouf Fofana Kaly Keita Mamadou Mallé Ibrahima Amadou Dembélé Drissa Sangaré Mamadou Cissoko Barry Boubacar Sangaré Mamadou Dembélé Abdel Kader Traoré Hamar Alassane Traoré Department of Internal Medicine Point G University Teaching Hospital Bamako Mali Department of Neurology Point G University Teaching Hospital Bamako Mali Department of Neurology GABRIEL TOURE University Teaching Hospital Bamako Mali Department of Internal Medicine Mother-Child Hospital “Luxembourg” Bamako Mali

Introduction: Myasthenia is a rare and disabling autoimmune disease. Few studies were devoted to this pathology. We report a clinical case of myasthenia in the Department of Internal Medicine at the Point G University Teaching Hospital. Observation: This is a 41-year-old patient of Malian origin, a trader with a history of hemorrhoidectomy in 2011 and familial hypertension, was admitted on August 19, 2014, for muscle weakness, dysphonia, and dysphagia. The disease started 1 year before admission at the department with progressive muscle weakness of the upper limbs aggravated by repetitive movements and spreading to the head “drooping head” and inferior limbs, associated with general fatigue, dysphonia and selective dysphagia for solid foods. The diagnosis of myasthenia was maintained based on the clinical signs such as ptosis, bilateral diplopia, and weakness with lower limbs muscle strength rated at 3/5, and confirmed with confirmatory exams;a positive anti-acetylcholine receptor antibody (RIA), the post-synaptic neuromuscular conduction block at ENMG and the positive neostigmine pharmacological test. The patient received Neostigmine (prostagmine) 0.5 mg one ampoule in IM/day and Prednisone at a dosage of 1 mg/kg/day. The evolution was marked by a moderate improvement of the symptomatology afterward the patient was evacuated to Tunisia on family request where he received a course of immunoglobulin 2 g/kg in 2 days. The evolution in Tunisia was favorable. The patient returned in Mali and death occurred after 2 months in a context of respiratory distress. Conclusion: Myasthenia is a rare but serious disease requiring careful management and monitoring to reduce respiratory complications.

关键词： Myasthenia Immunoglobulin Internal Medicine Point G Hospital

Tubercular Uveitis in the Event of HIV Infection about a Case

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Journal of Tuberculosis Research 2019年第4期7卷 253-258页

作者： Abdramane Traoré Hamsatou Cisse Nagou Tolo Djenebou Traoré Condé Lassana assétou soukho kaya Abasse Sanogo Bréhima B. Berthé Ibrahima Amadou Dembélé Mahamadou Saliou Djibril Sy Nanco Doumbia Sekou Mamadou Cissé Boubacar Zana Cisse Mamadou Dembélé Abdel Kader Traoré Hamar Alassane Traoré Department of Medicine Sidy Bocar Sall Kati Hospital Koulikoro Mali Department of Internal Medicine at CHU Point G Bamako Mali Department of Internal Medicine of CHU Gabriel touré Bamako Mali Internal Medicine Service of the Mali Hospital Bamako Mali

Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis. This disease is the second leading cause of infectious mortality in the world after infection with the human immunodeficiency virus. We report a case of multifocal tuberculosis with neuromuscular and ocular localization in an HIV-1 immunosuppressed patient in clinical and virological failure following therapeutic discontinuation due to non-compliance. This is a 43-year-old immunocompromised HIV1 patient with a history of cerebral toxoplasmosis in 2016 who consulted for right hemiplegia. These symptoms would go back to about 3 days marked by a deficit of progressive installation of the right hemicorps preceded by diffuse headaches, of moderate intensity without triggering factor radiating to the eyes associated with an intermittent fever with periods of spontaneous remissions, night sweats and chills, non-selective anorexia, non-increasing physical asthenia and unquantified weight loss. Management was 8-month antituberculous treatment, combining the first two months isoniazid (INH), rifampicin (RMP), pyrazinamide (PZN) and ethambutol (EMB), then the next 6 months (INH) and rifampicin (RMP). The reintroduction of the same antiretroviral protocol and a reinforcement of the therapeutic education made it possible to observe a decrease of the viral load. Treatment of ocular involvement was instituted with Timosol 1 drop in the eyes morning and evening and Diclocid 1 mg/ml: 1 drop in the eyes in the morning.

关键词： Tucerculose/Uveitis

Evaluation of the Frequency of Prolonged Fevers and Exploration of Their Etiologies in the Internal Medicine Department of the Point “G” University Hospital in Bamako from 2009 to 2013

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Open Journal of Internal Medicine 2019年第3期9卷 97-103页

作者： Abdel Kader Traoré assétou soukho kaya Djenebou Traoré Djibril Sy Youssouf Fofana Ibahima Amadou Dembélé Mamadou Saliou Boua Daoud Camara Karim Dao Mamadou Cissoko Kaly Ké ï ta Barry Boubacar Sangaré Mamadou Mallé Alassane A. Doumbia Nagou Tolo Hadiza A. Kaï lou Mamadou Dembélé Hamar Alassane Traoré Deparment of Internal Medicine University Hospital of Point “G” Bamako Mali Department of Internal Medicine of Children and Mothers Le Luxembourg University Hospital Bamako Mali Internal Medicine Service Nianankoro Fomba Hospital Ségou Mali

Objective: The aim was to evaluate the frequency of prolonged fevers and to determine their etiologies. Methods: We carried out a cross-sectional study extending from the period of 2009 to 2013 in the Internal Medicine department of the “G” Point University Hospital in Bamako. Included were all records of hospitalized patients with a central temperature greater than 37°C in the morning and 37°C in the evening, resting for 15 minutes, fasting for more than 2 hours, and absence of antipyretic treatment. We include all the patients of the study period with fever greater than 37.5°C in the morning and 37.8°C in the evening, resting for 15 minutes, fasting for more than 2 hours, and absence of antipyretic treatment, which have more than 21 days and measured on several occasions. The data were collected on a survey sheet. Data entry and analysis was done on SPSS software. Results: We recorded 243 fever cases out of 2155 hospitalizations, a prevalence rate of 11.2%. There were 128 men and 115 women with an average age of 43 years (range, 15 to 84 years), a modal class of 37 to 47 years, and a sex ratio of 1.11. The infectious etiologies accounted for 81% followed by neoplastic causes 09.6% and inflammatory 01.2% of cases. HIV infection was found in 26.4% of patients, malaria 13.5% and urinary tract infections 10.2%). Gram negative bacilli 88% consisted mainly of Escherichia coli (56%) and Klebsiella pneumoniae (20%).

关键词： Fever Acute Prolonged Fevers Frequency Etiologies Internal Medicine Mali

Clinic Evaluation of Heart Failure of Old People in the Department of Internal Medicine of Point G University Hospital from 2008 to 2012

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Open Journal of Internal Medicine 2019年第3期9卷 83-88页

作者： assétou soukho kaya Abdel Kader Traoré Djibril Sy Djenebou Traoré Ilo Diall Youssouf Fofana Ibahima Amadou Dembélé Boua Daoud Camara Mamadou Saliou Karim Dao Mamadou Cissoko Kaly Kéï ta Barry Boubacar Sangaré Mamadou Mallé Alassane A. Doumbia Hadiza A. Kaï lou Mamadou Dembélé Hamar Alassane Traoré Department of Internal Medicine Point G University Hospital Bamako Mali Department of Cardiac Disease Point G University Hospital Bamako Mali Department of Internal Medicine of Children and Mothers Le Luxembourg University Hospital Bamako Mali Internal Medicine Service Nianankoro Fomba Hospital Ségou Mali

Justification: Heart failure (HF) is the evolutionary end of all cardiac diseases. Given the aging population, the rate of incidence is increasing among the elderly. Objectives: The study aims to determine the prevalence of heart failure in the elderly;to describe the clinical aspects;describe etiologies;describe the therapeutic aspects;and describe the evolution of heart failure among the elderly. Method: This was a retrospective study over five years on the operating records of patients hospitalized in the internal medicine department of Hospital Point G. Result: The study included records of 22 elderly patients who were with heart failure of a total of 595 patients hospitalized from 1st January 2008 to 31st December 2012. The prevalence rate was 3.7%, and the average age was 67 ± 7.79 years. The sex ratio was equal to 1. HTA accounted for the cardiovascular risk factors in 77.3%. 72.7% of patients had the symptom of dyspnea and 95.5% of patients had the symptom of IMO. According to the cardiac ultrasound, dilation of the OG represented 68.2% of cases, followed by impaired LVEF (63.6%). The etiologies of IC were represented by dilated cardiomyopathy (95.5%), followed by 13.6% in cardiothyreosis. Drug treatment was dominated by the use of diuretics, ACE inhibitors and sodium diet respectively 95.5%;81.8% and 45.5% of cases. The clinical outcome was favorable in 73%. We recorded four (4) cases of death, which accounted for 18% of patients.

关键词： Heart Failure Clinic Etiology Therapeutics The Elder

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

Hemoglobinopathy and Systemic Lupus: A Rare association

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Open Journal of Internal Medicine 2019年第3期9卷 72-77页

作者： assétou kaya soukho Ibrahima Amadou Dembele Djenebou Traore Nounga Romuald Nyanke Djibril Sy Abasse Sanogo Mamadou Cissoko Barry Boubacar Sangare Mamadou Malle Sékou Mamadou Cisse Abdramane Traore Mahamadou Saliou Nanko Doumbia Brehima Boly Berthe Kaly Keita Boubacar Zoumana Cisse Drissa Sangare Youssouf Fofana Kokou Tbah Tighankpa Adramé Keita Mamadou Keita Mamadou Dembele Abdel Kader Traore Hamar Alassane Traore Department of Internal Medicine Point G University Teaching Hospital Bamako Mali

The authors report a case of systemic lupus associated with a composite heterozygosis SC with thalassemic component in a 19-year-old patient hospitalized for anemia and polyarthralgia who has a staturoponderal delay, macular erythematous lesions in butterfly wings on the face and ears, photosensitivity, puffy face, alopecia, pubic and axillary hair loss, scalp dermatophytosis, painful swelling of the interphalangeal joints, wrists and knees. The hemoglobin electrophoresis showed a compound heterozygote SC associated with β thalassemia. Antinuclear antibodies were positive with an anti-Sm positive antibody. Conclusion: The diagnosis of both diseases can be difficult when symptoms are concomitant and look alike.

关键词： Hemoglobinopathy Lupus University Teaching Hospital Point G