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Epidemiological, Clinical, Therapeutic, and Evolutionary Aspects of Heart Failure in the Medical Department at Gao Regional Hospital

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World Journal of Cardiovascular Diseases 2024年第5期14卷 309-321页

作者： Coulibaly Alhousseny Dollo Ibrahim Guindo Hamadoun Sidibé Lamine Mariko Souleymane Traoré bassirima Dao Karim Guindo Ibrahim Togo Mamadou Sidibé Samba Sangaré Ibrahima ba hamidou oumar Ichiaka Menta Departement of Medicine Gao Hospital Gao Mali Departement of Medicine Mopti Regional Hospital Mopti Mali Departement of Medicine Tombouctou Hospital Tombouctou Mali Departement of Cardiology CHU Gabriel TOURE Bamako Mali

Introduction: Heart failure is a major public health pandemic, particularly in Africa, where its prevalence continues to increase. In northern Mali, few data exist, hence the interest of this study with the objective of studying the epidemiological, clinical and therapeutic and evolutionary aspects of Heart failure at the regional hospital of Gao. Patients and Methods: This was a cross-sectional, descriptive study that took place from July 2022 to June 2023 in the medical department at Gao Hospital. Results: The hospital prevalence of heart failure was 44.1%. The mean age was 47.30 ± 20 years (range: 16-88). Hypertension was the most common with 46.1%, followed by a sedentary lifestyle, and diabetes with 18.2% and 8.3% respectively;NYHA stage III-IV dyspnea was found in 83.9%. Reduced EF heart failure was present in 110 patients (76.9%), seventeen cases with moderately reduced EF (11.9%) and sixteen patients had preserved EF (11.2%). Global heart failure was the dominant (91.6%). The main etiologies of heart failure were dominated by hypertensive heart disease in 46 patients (32.2%), followed by postpartum cardiomyopathy with 43 cases (30.1%), primary dilated cardiomyopathy in 18 patients (12.6%), ischemic heart disease in 16 patients with 11.2%. Seven cases of valvular heart disease, or 4.9%. The evolution was favorable under treatment in 104 patients or 72.7%. In-hospital mortality was 14.7%. Conclusion: Heart failure is a common condition in sub-Saharan Africa, particularly in our country.

关键词： Heart Failure Epidemioclinical Progressive Gao Hospital

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Contribution of Stress Testing to the Management of Ischemic Heart Disease in Mali

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World Journal of Cardiovascular Diseases 2024年第2期14卷 77-87页

作者： Youssouf Camara hamidou oumar ba Ibrahima Sangaré Boubacar Sonfo Coumba Adiaratou Thiam Mahamadou Sékou Diakité Koniba Diarra Karamba Touré Massama Konaté Ichaka Menta Cardiology Department University Hospital Professeur Bocar Sidi Sall Kati Kati Mali Cardiology Department University Hospital Gabriel Touré Bamako Mali Cardiology Department Mali Hospital Bamako Mali

Introduction: Exercise stress testing (on a treadmill or ergometer bicycle) is an important test in cardiology for diagnosing myocardial ischemia. This test in Mali is still in its beginning compared to other countries in the sub-region. The lack of data in Mali prompted this study, which aimed to evaluate the indications of this activity and its diagnostic contribution to cardiology in Mali. Materials and Methods: This was a retrospective, descriptive study. The study was conducted at the “TOUCAM” medical clinic in Kati based on the analysis of stress test reports between January 2016 and August 2022. Result: During the study period, we documented 73 patients who underwent exercise testing on a bicycle ergometer for suspected coronary heart disease. The mean age of our patients was 47.5 ± 13.8 years (14 and 79 years). Males accounted for the majority (78.1%). The sex ratio is 3.5. More than half of our patients were overweight or obese (77.1%). Hypertension and diabetes affected 52.1% and 25.8% of patients, respectively. 20.8% of patients had coronary artery disease. renin-angiotensin-aldosterone system blockers (56.8%) and beta-blockers (51.3%). The main indications were chest pain (63.0%) and ischemia detection (15.1%). A modified STEEP protocol was used. The majority of our patients (71.2%) achieved at least 85% of their maximum theoretical heart rate. The main reason for the termination of the study was fatigue (57.3%). The average duration was 11.3 ± 4.2 minutes. 24.7% thought the stress tests were positive and 17.8% thought they were controversial. Conclusion: This study demonstrates the importance of stress testing in the diagnosis and treatment of ischemic heart disease, especially in settings where we have very limited access to coronary angiography.

关键词： Stress Test Ischemic Heart Disease Mali

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Nephroblastoma in Adults about a Clinical Case

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Surgical Science 2024年第2期15卷 81-88页

作者： Tounkara Cheickna Coulibaly Amara Malle oumar Amadou Bréhima Bolo Coulibaly bagoyoko Kaloga Daye Samake hamidou Berthe Honoré Jean-baptiste Gabriel Diakite Mamadou Lamine Department of General Surgery Hospital Center “Mother Child” Luxembourg Bamako Mali Directorate of Army Health Services Kati Mali Department of Urology and Andrology Point G University Hospital Bamako Mali

Nephroblastoma is the most common malignant renal tumor in children and is related to an abnormal proliferation of cells resembling those of the embryonic kidney (metanephroma), hence the terminology;embryonal tumor. These are tumors that remain and remain unstudied in Mali because they are common in adults in our context. Its annual incidence is estimated at approximately 1/10,000 births. Nephroblastoma is a rare or even exceptional tumor in adults. The clinical manifestation was a large swelling of the right hypochondrium;abdominal pain for a year;unquantified fever, hypertension, initial hematuria associated with burning during urination and anemia. The main clinical manifestation remained fever and abdominal pain. This renal tumor posed a diagnostic problem which was previously labeled as a mesenteric tumor in our general surgery department. The diagnosis was made by imaging: CT and magnetic resonance imaging. The treatment is multidisciplinary and combines chemotherapy, surgery with or without radiotherapy. The prognosis is poor due to late diagnosis and less effectiveness of chemotherapy compared to the child. Survival did not exceed a year and a half because the renal tumor in our patient was surgically overcome. We report a case of nephroblastoma in an 86-year-old patient with unfavorable histology (hematogenous metastases), operated on in the general surgery department and whose postoperative course was simple and who was referred to oncology for treatment.

关键词： Nephroblastoma Malignant Kidney Tumor Treatment Adult Mali

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Therapeutic Compliance of Hypertensive Patients Followed in Ambulatory in the Cardiology Department of Kati University Hospital

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World Journal of Cardiovascular Diseases 2024年第5期14卷 333-342页

作者： Boubacar Sonfo Coumba Thiam Mariam Sako Massama Konaté Youssouf Camara Mamadou Touré Boubacar Diarra Diakaridja Sacko Samba Sidibé bassan Diarra hamidou Camara Asmaou Keita Konimba Diarra hamidou oumar Bâ Ibrahima Sangaré Youssouf Guindo Sanoussi Daffe Daouda Fofana Souleymane Coulibaly Ichaka Menta Department of Cardiology University Hospital Bocar Sidy Sall Kati Mali Department of Cardiology University Hospital of Point G Bamako Mali Department of Cardiology Mali Hospital Bamako Mali Department of Cardiology University Hospital Mother-Child Luxembourg Bamako Mali Department of Cardiology University Hospital Gabriel Tour&#233 Bamako Mali Department of Cardiology Kayes Hospital Kayes Mali

Introduction: High blood pressure is a major public health problem worldwide due to its frequency and cardiovascular complications. Adherence to treatment for chronic diseases is a global problem. The aim was to study therapeutic adherence in hypertensive patients followed in ambulatory. Materials and Methods: This was a cross-sectional, descriptive study with prospective recruitment that took place from July 1 to December 31, 2022 (6 months) in the cardiology department of the university hospital of Kati. The variables studied were sociodemographic data, cardiovascular risk factors, comorbidities, the possession of insurance and compliance (the Girerd questionnaire was used to assess adherence). Results: A total of 1182 patients were consulted, including 887 for hypertension, a frequency of 75%. Fifty-six patients were included in the study. The average age was 58.18 ± 13.25 years with extremes of 30 and 80 years. There was a female predominance (75%) with a sex ratio of 0.3. The majority of patients lived in urban areas (89.3%). Out-of-school patients accounted for 44.6%, more than half of patients or 55.4% had no income, patients with medical coverage accounted for 67.9% of cases. The main risk factors were physical inactivity (25%) followed by smoking 14.3%. More than 71% of patients had a compliance problem and the main reasons were forgetting to take the drug with 73.2%, followed by delayed treatment of 50% and drug discontinuation of 28.6%. Conclusion: Compliance is a real challenge and a major public health issue. This study allowed us to find a real problem of compliance in our hypertensive patients. There was a statistically significant relationship between drug adherence and forgetting to take the drug and drug discontinuation.

关键词： Hypertensive Therapeutic Adherence University Hospital of Kati

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Echocardiographic Aspects of Type 2 Diabetics Patients Hospitalized in the Medicine and Endocrinology Department of the Mali Hospital

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World Journal of Cardiovascular Diseases 2024年第3期14卷 129-139页

作者： Konaté Massama Mamadou Touré Mariam Sako Samba Sidibé Souleymane Mariko Djeneba Sylla Sow Elhaj Mahamane Maiga Coumba Adiaratou Thiam Youssouf Camara hamidou oumar ba Asmao Keita Maiga Djenebou Traoré Zoumana Traoré Souleymane Coulibaly bah Traoré Modibo Mariko Nouhoum Ouologuem Amadou Koné Ichaka Menta Faculty of Medicine and Dentistry bamako USTTB Department of Medicine Hospital of Mali Bamako Mali Department of Cardiology CHU Gabriel TOURE Bamako Mali Department of Cardiology CHU Point G Bamako Mali Department of Medicine Hospital of Timbuktu Bamako Mali Department of Cardiology Hospital of Kati Bamako Mali Department of Cardiology CHU Mother and Child bamako Bamako Mali Department of Internal Medicine CHU Point G Bamako Mali

Introduction: Cardiovascular disease is the leading cause of death in diabetics. The objective of our study was to investigate the echocardiographic aspects of type 2 diabetics. Patients and Method: Descriptive and cross-sectional study of 12 months from June 2020 to June 2021. We included hospitalized type 2 diabetics who underwent transthoracic cardiac ultrasound in the Department of Medicine and Endocrinology at the Mali Hospital. Results: We collected 128 type 2 diabetics. The predominance was male with a sex ratio of 1.2. The mean age of patients was 60.06 ± 11.54 years with extremes of 28 and 84 years. Echocardiographic abnormalities were dominated by abnormal relaxation of left ventricle in 62.5%, increased of left ventricle mass in 54.7% and left atrium dilation in 28.1%. Patients with type 2 diabetes mellitus and hypertension had more left atrium dilation with a p of 0.02. Disorders of global kinetics and systolic dysfunction were more prevalent in smoking patients with statistically significant associations, respectively, p = 0.02;p = 0.03. Dyslipidemia had a statistically significant association with segmental kinetic disorders with a p of 0.008. Duration of diabetes greater than 5 years was associated with left atrium dilation and p-value was 0.04. Conclusion: Diabetes is responsible for cardiovascular manifestations that can be identified with transthoracic echocardiography. Its performance in diabetic patients makes it possible to refine the patient’s management.

关键词： Diabetes Echocardiography Mali Hospital

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Screening, Treatment and Control of High Blood Pressure on Five Sites in Mali

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World Journal of Cardiovascular Diseases 2024年第5期14卷 322-332页

作者： Mamadou Touré Sagara Ibrahima Youssouf Camara hamidou oumar Bâ Ibrahima Sangaré Djénébou Traoré Noumou Sidibé Fousseyni Samassékou Massama Konaté Coumba Thiam Doumbia Asmaou Maiga Réné-Marie Dakouo hamidou Camara Sako Mariam Sidibé Samba Adama Sogodogo Boubacar Diarra Boubacar Sonfo Aladji Traoré Mamadou Diakité Ilo Bella Diall Ichaka Menta Departement of Cardiology University Hospital Gabriel Tour&#233 Bamako Mali Departement of Cardiology Cardiology University Hospital Sidy Bocar Sall Kati Mali Internal Medecine University Hospital Point G Bamako Mali Departement of Cardiology Cardiology University Hospital &#8220H&#244pital du Mali&#8221 Bamako Mali Departement of Cardiology Cardiology University Hospital Mother-Children Bamako Mali

Introduction: High blood pressure is defined as blood pressure greater than or equal to 140 mm Hg for systolic and or 90 mm Hg for diastolic. It constitutes a major public health problem, the leading chronic disease in the world. The objective was to determine the prevalence, treatment rate and control of hypertension. Methods: This was a cross-sectional and descriptive study which took place over a period of 6 months in a hospital environment and in the general population. Results: Of the 1000 participants, 637 had hypertension, giving a prevalence of 63.70% with a female predominance. Thirty-three percent (33%) were unaware of their high blood pressure. The age group 60 and more was the most represented (44%). A proportion of 33 and 23.20 were overweight and obese participants, respectively. Male subjects were more overweight than female, unlike obesity which was more common among female subjects. Sixty-two percent (62%) of hypertensives were treated, of whom 44% were non-compliant. The excessively high cost and consumption of medications as needed were the main factors in therapeutic non-compliance. Twenty-two percent (22%) of all hypertensive patients and 35% of treated hypertensive patients were controlled. Women were more treated but less observant and less controlled than men. Therapeutic coverage and combination therapy rates were lower in rural areas. Hypertensives who had a high level of education were better treated and controlled than those who had no level. Conclusion: High blood pressure remains a real public health problem in Mali. It is more common in people aged 60 and over and in females. One in three hypertensives were unaware of their hypertension. The majority received antihypertensive treatments, but only a minority of them had their hypertension controlled.

关键词： High Blood Pressure Screening Control Rate Mali

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Venous Thromboembolic Disease in a Regional Hospital in Mali

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World Journal of Cardiovascular Diseases 2023年第12期13卷 837-844页

作者： Coulibaly Souleymane Taoré Djénébou Sidibé Samba Sako Mariam Guindo Aissata Sanogo Alpha Kodio Aniéssa Dao Aissata B. A. hamidou oumar Diakité Mamadou Konaté Massama Menta Ichaka Cardiology Department CHU Point G Bamako Mali Department of Internal Medicine CHU Point G Bamako Mali Cardiology Department Nianankoro Fomba Hospital in Ségou Ségou Mali Cardiology Department CHU Gabriel Touré Bamako Mali Mali Hospital Medicine Service Bamako Mali

Introduction: Venous thromboembolism (VTE) is a nosological group which mainly includes deep vein thrombosis (DVT) and pulmonary embolism (PE), it is frequently associated with high morbidity and mortality. We initiated this study with the aim of studying VTE in a cardiological hospital environment in a regional hospital in Mali. Methodology: This was a descriptive study with prospective recruitment over 1 year from June 20, 2019 to June 20, 2020, covering patients hospitalized and followed in consultation in the cardiology department of the Ségou regional hospital in Mali. Results: We collected 31 cases of VTE out of 366 patients, representing a frequency of 8.47%. The sex ratio was 0.88. VTE risk factors were dominated by immobilization (29.03%), pregnancy and postpartum (16.12%), heart failure (16.12%). The reason for consultation was dyspnea (93.54%) followed by chest pain (83.87%). On admission the clinical manifestations were tachycardia (74.19%), tachypnea (90.32%), muffled heart sounds (70.96%), global heart failure syndrome (51.6%). According to VTE probability scores;51.61% of patients had an intermediate clinical probability according to the simplified Wells score for PE and 54.84% had an intermediate clinical probability for the simplified Geneva score for DVT. D-Dimers were only performed in 12 patients (38.70%) and were elevated in all. A chest CT angiogram showed PE in 90% of patients (n = 28/31). Venous Doppler ultrasound of the lower limbs showed venous thrombosis in 3 patients. Conclusion: Venous thromboembolism, although underdiagnosed, is common in our health structures. Prevention, particularly heparinoprophylaxis and early recovery in a hospital environment, remains the effective means of combating this condition.

关键词： Venous Thrombosis Pulmonary Embolism Nianankoro Fomba Hospital Ségou

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Acute Coronary Syndrome of Young Subjects at the Luxembourg Mother-Child University Hospital in bamako

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World Journal of Cardiovascular Diseases 2024年第3期14卷 157-165页

作者： Mamadou Toure Mariam Dagnogo Massama Konate Mariam Sako Daouda Fofana Hamma Sankare Almou A. Diall Modibo Doumbia baba I. Diarr Mady Sow Abdoul Wahhab Terra Coumba A. Thiam Boubacar Sonfo Boubacar Diarra Asmaou Keita Ousmane Traore hamidou O. ba Ichaka Menta Cardiology Department CHU-Mother Child Bamako Mali Cardiology Department CHU-Gabriel Tour&#233 Bamako Mali Faculty of Medicine University of Sciences Technics and Technologies of Bamako Bamako Mali Center Andre FESTOC Department of Cardiac Surgery of Bamako Mali Bamako Mali

Introduction: Acute coronary syndrome is often the first event of coronary disease of young subjects. Objective: To study sociodemographic, clinical, paraclinical, therapeutic and evolutionary aspects of acute coronary syndrome of young subjects. Patients and Methods: Descriptive cross-sectional study with prospective recruitment from October 01, 2020 to March 31, 2022. Were included all patients admitted for acute coronary syndrome whose age was less or equal to 45 years and who had undergone coronary angiography at the Mother-Child University Hospital on Luxembourg from bamako. Results: During the study period, we collected 60 patient files out of 198. These 60 patient files met our inclusion criteria. Hospital frequency was 30.30%. Average age of patients was 40.43 ± 3.9 years. Sex ratio M/F was 5.3. Main cardiovascular risk factor was smoking tobacco (23.42%), followed by dyslipidemia (13.92%). Functional signs were dominated by angina 62% followed by dyspnea 25.3%. Persistent ST-segment elevation on electrocardiogram was present in 76.4%. Left ventricular systolic dysfunction was present in 26.5%. Time to first medical contact was more than 12 hours in 62.7% of cases. Radial approach was adopted in 94% of cases. Coronary angiography was pathological in 85% (n = 51) of cases. Lesions were single-vessel disease in 47.1% and culprit artery was anterior interventricular in 51% of cases. Dual anti-platelet aggregation was aspirin and ticagrelor in 91.8% of cases. Angioplasty was performed in all patients who had significant abnormalities at coronary angiography. In-hospital mortality was 3.9%. Conclusion: Acute coronary syndromes exist in young Africans with a male predominance. Main cardiovascular risk factor is smoking tobacco. Coronary lesions are single vessel disease in the majority of case. Most of patients meet medical team after 12 hours. Time to first medical contact is a main challenge in our country.

关键词： Acute Coronary Syndrome Young Subjects Coronary Angiography CHU Luxembourg bamako

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Percutaneous Coronary Intervention in Acute Coronary Syndromes at the Mother-Child University Hospital Luxembourg in bamako

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World Journal of Cardiovascular Diseases 2024年第4期14卷 288-294页

作者： Mamadou Toure Hamma Sankare baba I. Diarra Mariam Dagnogo Modibo Doumbia Abdoul W. Terra Samba Sidibe Coumba A. Thiam Boubacar Sonfo Boubacar Diarra Asmaou Keita Ousmane Traore Daouda Fofana Almou A. Diall Mady Sow Massama Konate hamidou O. ba Ichaka Menta Cardiology Department CHU-Mother Child Bamako Mali Cardiology Department CHU-Gabriel Tour&#233 Bamako Mali Faculty of Medicine University of Sciences Techniques and Technologies of Bamako Bamako Mali Department of Cardiac Surgery Center Andre FESTOC Bamako Mali Cardiology Department CHU-Point G Bamako Mali

Introduction: Acute coronary syndromes (ACS) are a diagnostic and therapeutic emergency. Objective: Studying the feasibility, difficulties and results of coronary angioplasty in acute coronary syndromes at the Luxembourg Mother-Child University Hospital in bamako. Patients and Methods: Cross-sectional, descriptive study with prospective recruitment over 18 months from September 2020 to February 2022. All patients aged at least 18 years old admitted for SCA and having undergone PCI during the study period were included. Result: We collected 249 patients for SCA, of whom 160 underwent angioplasty, either an angioplasty/SCA ratio of 0.64. The average age of the patients was 59.54 ± 11.62 with extremes of 32 and 92 years. The age group of 45 to 65 years was the most representative. The predominance was male, sex ratio of 2.4. The main cardiovascular risk factors were high blood pressure (58.23%) and diabetes (45.78%). Persistent ST-segment elevation on the electrocardiogram was present in 71.48%. The treatment time was more than 12 hours after the first medical contact in 95.5%. The approach was radial in 96.5% of cases. Coronarography was pathological in 91.16% of our patients. The lesions were tri-truncular in 34.13% with the anterior inter ventricular as culprit artery in 72% of cases. The majority of patients (64%) had undergone angioplasty with implantation of an active stent. Angioplasty was performed successfully in 98% and per procedural mortality was 1.87%. Only 6.45% of ACS with ST elevation benefited from primary angioplasty. Conclusion: Percutaneous coronary intervention is performed routinely in our center with satisfactory results. Difficulties exist, related to the diagnostic delay of ACS and the high cost of angioplasty.

关键词： Acute Coronary Syndromes Coronary Angiography Angioplasty Mother-Child University Hospital Luxembourg bamako Mali

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Prevalence of Ocular Trauma at the Reference Health Center (CSREF) of Kati

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Surgical Science 2024年第5期15卷 371-380页

作者： Kadiatou ba Aichata Tall Brainima Coulibaly Sadio Cissoko bakary Danfaga Moro Sidibe Seydou Diallo oumar Diallo Fatoumata Tata Sidibe Aly Konipo Mory Coulibaly Ousmane Touré Aoua I. Touré Cheick Sogodogo Ibrahim bamenta Gounon Saye Modibo Sissoko Mamadou Kole Sidibe Sidi Diarra Nouhoum Guirou Lamine Traoré University Hospital Center Institute of Tropical Ophthalmology of Africa Bamako Bamako Mali Ophthalmology Department Kati Reference Health Center Koulikoro Mali Ophthalmology Department Sikasso Regional Hospital Sikasso Mali Ophthalmology Department Luxembourg Mother-Child Hospital in Bamako Bamako Mali Ophthalmology Department Somin&#233 Dolo Mopti Regional Hospital in Mopti Mopti Mali National Eye Health Program Bamako Mali

Introduction: The authors wanted to study the prevalence of ocular trauma in the ophthalmology unit of the CSREF of Kati. Patients and method: This is a retrospective study, covering the period from January to December 2015, carried out in the ophthalmology unit of the CSREF in Kati. Results: The sample consisted of 568 patients, or 6.82% of ophthalmological consultations. Children aged 0 to 14 years accounted for 154 (27.11%) of the trauma cases. Bruises constitute the main circumstance (58.1%) of eye trauma, followed by domestic accidents (15.6%). Closed globe ocular trauma was the main type of trauma (61.6%), followed by ocular adnexal trauma (30.1%) and open globe trauma (8.3%) in which the penetrating wound was the lesion, the least common (2.6%) but the most serious. Medical treatment was the most used therapeutic modality in 82.4% of cases, followed by surgery with 17.6% of cases. The evolution of the lesions after treatment was favorable in 85.6% of cases and unfavorable in 14.4% of cases. Complications were observed in 5.8% of cases and sequelae in 8.6% of cases. Conclusion: Ocular trauma constitutes an important reason for ophthalmological consultation at the CSREF of Kati. The severity of some of these lesions requires frequent recourse to surgery. The complexity of the treatment should encourage us to favor preventive measures.

关键词： Eye Trauma Prevalence CSREF Kati

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