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Lipid Profile among the Diabetic and Non-Diabetic Obese Patients

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

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Screening of Foot at Risk in Diabetic Patients

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Open Journal of Internal Medicine 2019年第3期9卷 62-71页

作者： Djenebou traore Djeneba Sylla Sow Massama Konaté Ousmane sidibé Modibo Mariko Djibril Sy Bah traoré Karim Dao Amadou Koné Nanko Doumbia Nouhoum Ouologuem Yacouba Lazard Diallo Boua Daoud Camara Nongoba Sawadogo Ibrahima Amadou Dembélé Barry Boubacar Sangaré Mamadou Cissoko Mahamadou Saliou Youssouf Fofana Mamadou Mallé Mamadou Togo Adramé Keita Abdramane traoré Nagou Tolo Madani Ouologuem Abdel Kader traoré assa traoré sidibé Department of Internal Medicine The University Teaching Hospital of Point G Bamako Mali Department of Internal Medicine and Endocrinology The Mali Hospital Bamako Mali CHR Internal Medicine Department of Kaya Kaya Burkina Faso Department of Internal Medicine The Mother and Children Hospital “Luxembourg” Bamako Mali Department Internal Medicine The Hospital of Kati Bamako Mali

Introduction: The term “diabetic foot” refers to all conditions that affect the foot and are directly related to the impact of diabetes. Objective: Screen the foot at risk in diabetic patients at the hospital of Mali. Methods: It was a cross-sectional study from January 1st, 2016 to June 30, 2016, at the Department of Internal Medicine and endocrinology of the Hospital of Mali. It was focused on all hospitalized diabetic patients. Results: Thirty-two (32) patients had a foot at risk among 76 diabetic patients during the study period representing 42.10%. The sex ratio was 0.52. Type 2 diabetes accounted for 82%. A glycemic imbalance (HBA1C > 7%) was observed in 88.15%. Eighteen percent (18%) of patients had a history of ulceration or amputation;33% were walking barefoot;78.9% had tingles in the foot;31.6% had intermittent claudication;64.5% had foot cleanliness;8% claw toes;42% had abolition or reduction of superficial tenderness to monofilament and 21% had mixed foot (neuropathy + arteriopathy). In our study, 58.9% of patients had no risk of podiatry. Conclusion: Screening of foot at risk is essential in the management of diabetes because it determines the podiatric risk enabling to minimize future functional disabilities.

关键词： Foot at Risk Diabetes Hospital of Mali

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Simple calculator to estimate the medical cost of diabetes in sub-Saharan Africa

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World Journal of Diabetes 2015年第16期6卷 1312-1322页

作者： Koffi Alouki Hélène Delisle Stéphane Besancon Naby Baldé assa sidibé-traoré Joseph Drabo Francois Djrolo Jean-Claude Mbanya Serge Halimi Department of Nutrition Faculty of MedicineUniversity of MontrealDowntown Station Santé-Diabète (NGO) Mali Chapter Endocrinology Department Donka Teaching Hospital Internal Medicine Department Bamako University Hospital Internal Medicine Department Ouagadougou University Hospital Endocrinology Department National University Health Centre Department of Internal Medicine and Specialties Faculty of Medicine and Biomedical SciencesUniversity of Yaoundé I University Joseph Fourier and University Hospital Centre

AIM: To design a medical cost calculator and show that diabetes care is beyond reach of the majority particularlypatients with complications.METHODS: Out-of-pocket expenditures of patients for medical treatment of type-2 diabetes were estimated based on price data collected in Benin,Burkina Faso,Guinea and Mali. A detailed protocol for realistic medical care of diabetes and its complications in the African context was defined. Care components were based on existing guidelines,published data and clinical experience. Prices were obtained in public and private health facilities. The cost calculator used Excel. The cost for basic management of uncomplicated diabetes was calculated per person and per year. Incremental costs were also computed per annum for chronic complications and per episode for acute complications. RESULTS: Wide variations of estimated care costs were observed among countries and between the public and private healthcare system. The minimum estimated cost for the treatment of uncomplicated diabetes(in the public sector) would amount to 21%-34% of the country's gross national income per capita,26%-47% in the presence of retinopathy,and above 70% for nephropathy,the most expensive complication. CONCLUSION: The study provided objective evidence for the exorbitant medical cost of diabetes considering that no medical insurance is available in the study countries. Although the calculator only estimates the cost of inaction,it is innovative and of interest for several stakeholders.

关键词： Diabetes Non-communicable diseases Africa Advocacy Cost-of-illness

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Endocrine and Cytogenetic Profile of Variations in Genital Development: Series of 9 Cases at the Mali Hospital

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Open Journal of Endocrine and Metabolic Diseases 2020年第5期10卷 77-87页

作者： Mohamed Lamine Mariko Djénéba Sylla Sow Djénébou traoré Claire Bouvattier Moctar Bah Djibril Youssouf traoré Mahamadou traore assa traoré sidibe Endocrinology-Diabetology Unit Department of Medicine Sikasso Hospital Sikasso Mali Department of Medicine and Endocrinology-Diabetology Mali Hospital Bamako Mali Department of Internal Medicine Point G University Hospital Bamako Mali Endocrinology of Reproduction Service University Hospital of Bicêtre Paris France Department of Cytogenetics and Reproductive Biology INRSP Bamako Mali

We carried out a retrospective and descriptive study in the Medicine and Endocrinology service of the Mali Hospital from January 2015 to December 2018. Nine cases of anomalies in sexual differentiation were referred for pubertal delay, growth retardation, gynecomastia, micropenis or infertility. Outcomes: The average age was 14 years;5 patients were declared female at birth;2 were married without children;7 patients came from the region of Kayes;8 patients consulted for pubertal delay;1 patient presented with association of a blind vagina and 2 bilateral inguinal gonads. 3 of 4 patients declared male at birth had a micropenis;2 patients had gynecomastia with a history of hypospadias. Ultrasound and biological data showed a clinical-hormonal picture of hypergonadotropic hypogonadism in 6 patients, 1 case of hypogonadotropic hypogonadism with hypercorticism and 2 cases with normal gonadotropic axis;two cases of azoospermia. Karyotypic analysis showed: 3 cases of SK, 2 cases of Klinefelter Syndrome, 2 cases of Androgen Insensitivity Syndrome and 2 cases of male 46 XX syndrome including one with sry negative. Conclusion: The precise diagnosis of anomalies in sexual differentiation remains complicated in Mali, due to the inadequacy of the technical platform. Diagnosis must be made at an early stage to allow normal growth, puberty and satisfactory fertility. Taking charge of the medical treatment possibly associated with plastic surgery could give good results.

关键词： Variations in Genital Development Endocrine Profile Cytogenetics

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Total Thyroidectomy in Multinodular Goiter: An African Experience

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Surgical Science 2015年第12期6卷 527-531页

作者： Moussa Abdoulaye Ouattara Seydou Togo Ibrahima Sankaré Kadiatou Singaré Sekou Koumaré Issa Maiga Allaye Ombotibé Jacques Saye assa traoré Nouhoum Diani Zimogo Ziè Sanogo Sadio Yena Department of Thoracic Surgery Hospital of Mali Bamako Mali Department of Otorhinolaryngology Gabriel Touré Teaching Hospital Bamako Mali Department of General Surgery “A” Point G Teaching Hospital Bamako Mali Department of Endocrinology Hospital of Mali Bamako Mali Department of Anesthesia Hospital of Mali Bamako Mali

Introduction: Total thyroidectomy is an operation that involves the surgical removal of the whole thyroid gland, with the preservation of the parathyroid glands. The aim of the present study was to assess the complication rates of total thyroidectomy on benign indication and first-time thyroid surgery and investigate the early outcome after opotherapy. Materials and Methods: In this retrospective study, patients who underwent total thyroidectomy for benign multinodular goiter in the department of thoracic surgery in our Hospital from January 2012 to December 2014 were included. In postoperative time, we evaluated surgical complication, histopathological examination and opotherapy. Results: A total 53 patients underwent total thyroidectomy for multmodular goiter;they were 49 (92.45%) bilateral and 4 (7.55%) unilateral (recurrence). The mean age was 47 years and mean diameter of goiter was 10.75 cm. Among the patients 88.68% were females and 11.32% were male. Preoperative hormonal statuses were (70%) in euthyroid and (30%) hyperthyroid following surgery complications like transient laryngeal nerve palsy (3.77%), transient hypocalcemia (7.55%), hematoma (1.9%) and wound infection (1.9%). On histopathological examination of the surgical specimen, 5.7% were reported to be malignant. Six month following surgery 92.45% of patients was a good hormonal balance. Conclusion: Total thyroidectomy for multinodular goiter has a low morbidity and mortality;this procedure olves both the problem of recurrence of disease and reintervention. The opotherapy is doable with a good hormonal balance.

关键词： Multi-Nodular Goiter Total Thyroidectomy Complication

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