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Diabetic Foot: Epidemiological, Therapeutic and Evolutionary Aspects in the Department of Medicine and Endocrinology of the Hospital in Mali, Mali

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Journal of Diabetes Mellitus 2022年第1期12卷 18-27页

作者： Nanko Doumbia Adama Alexis Diarra Seydou Mariko Drissa Sangare Danfaga Bakary Nouhoum Ouologuem Samaké Magara Sekou Mamadou Cisse Mamady Coulibaly Mahamadou Saliou Bakary Dembele Yacouba L. Diallo Amadou Kone Modibo Mariko Bah traore Massama Konate Djenebou traore Djeneba Sylla Kaya Assetou Soucko assa traore Department of Medicine of the Mali Hospital Bamako Mali National Center for Scientific and Technological Research (CNRST) Bamako Mali Kati Reference Center Kati Mali Gynaecology Department of the Mali Hospital Bamako Mali Department of Medicine and Medical Specialty of the Fousseyni Daou Hospital Kayes Mali Nephrology Unit of the Fousseyni DAOU Hospital Kayes Mali Health and Social Affairs Department of the National Police Bamako Mali Internal Medicine Department of the Gabriel Toure University Hospital Bamako Mali Faculty of Medicine Bamako Mali Internal Medicine Service of the Point G University Hospital Bamako Mali

Introduction: The diabetic foot remains a public health problem due to its high frequency, difficult and costly management. The aim of this study was to determine the epidemiological, therapeutic and evolutionary aspects of the diabetic foot in a hospital setting in Bamako. Methodology: This is a retrospective, descriptive, cross-sectional and monocentric study conducted between September 1, 2011 and December 31, 2015 on diabetic patients aged 14 years and older arriving in our department with a foot infection. Results: We identified 94 cases of diabetic foot infection out of a total of 828 hospitalized patients, a prevalence of 11.35%. The age range 41 - 60 years represented 57 cases (60.6%), the extreme ages were 14 and 81 years. Men (38.3%), women (61.7%) with a sex ratio of 0.62%. Housewives 50%, illiterate 51 cases (54.3%), low economic standard of living 40 cases (42.6%), presence of osteitis 40 cases (42.6%), foot at stage D Grade3 28 cases (29.8%). Management was medical in 48 cases (51.1%), treatment with insulin 58 cases (61.7%), Amoxicillin + Metronidazole used 36 cases (38.29%). Amputation was performed in 35 cases (37.2%). Deaths concerned 5 patients (9.6%) with hypoglycemia as the main cause in 4 cases. Conclusion: Diabetic foot is a frequent complication of diabetes. The establishment of a multidisciplinary team should contribute to the improvement of the prognosis of the diabetic foot in a management center.

关键词： Diabetic Foot Epidemiology Therapeutics Evolution Mali Hospital

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Diabetic Foot: Epidemiological and Clinical Aspects in the Department of Medicine and Endocrinology of the Hospital of Mali, Mali

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Journal of Diabetes Mellitus 2021年第4期11卷 159-170页

作者： Nanko Doumbia Danfaga Bakary Nouhoum Ouologuem Drissa Sangare Adams Alexis Diarra Magara Samaké Sekou Mamadou Cisse Mamady Coulibaly Mahamadou Saliou Bakary Dembele Yacouba L. Diallo Amadou Kone Modibo Mariko Bah traore Massama Konate Djenebou traore Djeneba Sylla Kaya Assetou Soucko assa traore Department of Medicine of the Mali Hospital Bamako Mali National Center for Scientific and Technological Research (CNRST) Bamako Mali Kati Reference Center Kati Mali Department of Medicine and Medical Specialty of the Fousseyni Daou Hospital Kayes Mali Nephrology Unit of the Fousseyni DAOU Hospital in Kayes Kayes Mali Health and Social Affairs Department of the National Police Bamako Mali Internal Medicine Department of the CHU du Point G Bamako Mali Faculty of Medicine of Bamako Mali

Introduction: Diabetes is a heterogeneous group of metabolic diseases characterized by chronic hyperglycemia resulting from a defect in the secretion and/or action of insulin, diagnosed by the observation of high levels of glucose in the blood, responsible in the long term for vascular and nervous complications. The diabetic foot is the set of pathological manifestations affecting the foot in relation to the diabetic disease. Approximately 5% of diabetics present a chronic lesion of the foot. Objective: To describe the epidemiological and clinical aspects of the diabetic foot in the medicine/endocrinology department of the Mali hospital. Methodology: This was a retrospective descriptive study from November 2011 to December 2015. It focused on diabetic patients hospitalized in the department with a foot wound and aged 14 years and over. Results: The study involved 94 patients out of 828 hospitalized, a prevalence of 11.35%. Our series included 36 (38.3%) men and 58 (61.7%) women, i.e. a sex ratio of 0.61%. The mean age was 42.66 years with extremes of 14 and 81 years. Type 2 diabetes was present in 95% of the patients with a duration of evolution of more than 5 years in 60.6% of the cases. The mechanism of occurrence of the wounds was minor trauma in 54 cases (57.4%). Self-medication was the primary treatment in 70 patients (74.5%). More than 50% of the patients wore unsuitable footwear. Clinical and para-clinical examinations revealed isolated neuropathy in 37 cases (39.4%), necrotic wound in 37 cases (39.19%), poor glycemic control: HbA1c > 7% (98.9%), absence of osteitis (57.4%), normal Doppler ultrasound 45 cases (45.7%), stenosing arteriopathy 11 cases (22.3%), non-stenosing 3 cases (20.2%), germs present 56 cases (59.6%) including 21 cases (22.4%) of Staphylococcus aureus. Conclusion: Diabetes and diabetic foot constitute a real public health problem. They are responsible for dreadful and sometimes disabling complications.

关键词： Diabetic Foot Epidemiology Clinic Bamako

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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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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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