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Postoperative Complications in the General Surgery Department of the Cs Ref of Commune I of the District of bamako Mali

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Surgical Science 2024年第6期15卷 409-419页

作者： Tounkara Cheickna Samake Hamidou dembele Lamine Diarra Issaka Togola Modibo Sanogo Modibo dembele ba.a.y tientigui Traore Alhassane Togo Adégné Pierre Kante Lassana Department of General Surgery Reference Health Center of Commune I of Bamako Bamako Mali Directorate of Social and Health Services of the Armies Bamako Mali Department of General Surgery CHU Gabriel Tour Bamako Mali

Postoperative complications represent important indicators for the quality of surgical care. The objectives of this work were to study post-operative complications in the general surgery department of the Cs ref of commune I in Mali, to determine the frequency of post-operative complications, to identify the factors of occurrence, to describe the clinical aspects, diagnostic and therapeutic in order to assess the additional cost linked to post-operative complications. This study was prospective, carried out in the general surgery department on 300 cases of surgical interventions. It covered all patients aged at least 15 years, operated on and hospitalized or not, and who presented complications during the 30 days postoperatively. Patients under the age of 15 were not included (our general surgery department is not a pediatric surgery department). We collected 300 patients among whom 199 (66.33%) were men and 101 (33.66%) women, i.e. a sex ratio = 1.9. The average age was 38 years with extremes of 15 and 87 years. The main initial diagnoses were: acute appendicitis, peritonitis, occlusions, wall hernias, hemorrhoids, uterine prolapse, uterine myomas, ovarian cysts and acute cholecystitis. Emergencies represented 43% (N = 129) of interventions with 6.98% post-operative complications (POC). Postoperative complications were dominated by surgical site infections, 75% of cases (N = 20), wall hemorrhage 5% (N = 1), testicular necrosis 5% (N = 1) and testicular calcification 5% (N = 1), wire rejection 5% (N = 1) and death 5% (N = 1). The management of postoperative complications was surgical in 95% and medical in 100%. Their occurrence extended the hospital stay by 3.65 days and increased the average cost of care by 60541.85 CFA francs. The mortality index lowered by efficient management of complications (IMAGE) calculated in relation to deaths was 95% of cases. Anemia, ASA score ≥ III, Alteimeir II and IV classes, duration of surgery and post-operative hospitalization were

关键词： Complications Post Opératoires Chirurgie Cs Ref CI bamako Mali

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Perception and Management of Hemorroid Disease at the CSREF of the Commune bamako Mali

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Surgical Science 2024年第2期15卷 89-97页

作者： Tounkara Cheickna Diarra Mohamed Hassimy Diarra Issaka Sanogo Keita ba.a.y dembele ba.a.y tientigui Traore Alhassane Togo Pierre Adégné Lassana Kante Department of General Surgery The Cs Ref of Commune I of Bamako Bamako Mali Department of General Surgery The Gabriel TOURE University Hospital in Bamako Bamako Mali

This work was a prospective transversal study over 6 (six) months from May 2 to December 31, 2017 at the Reference Health Center of Commune I and the Chérif la Confessional Health Center in bamako. The aim was to study the knowledge, attitudes and behavioral practices linked to hemorrhoids in Commune I of the bamako district, to evaluate the frequency of hemorrhoidal disease, to determine the knowledge, attitudes and behavioral practices linked to hemorrhoids among patients, their companions and traditional therapists in Commune I of the district of bamako and the factors which influence the motivations and decisions to resort to medical-surgical care and traditional medicine in patients suffering from hemorrhoids in order to analyze the results of the management of hemorrhoidal disease at Cs Ref CI. We collected 36 patients with hemorrhoidal disease, 25 caregivers and 15 traditional hemorrhoidal disease therapists. The sex ratio was 1.25 for patients;6.5 for traditional therapists and 1.5 for accompanying people. The average age of the patients was 32.75 years;49 years for traditional therapists and 28.76 years for those accompanying them. 55.6% of patients claim to know about hemorrhoidal disease;100% of traditional therapists and 80% of accompanying people. The dietary factor of hemorrhoidal disease was mentioned by 90% of patients;66.7% of traditional therapists and 100% of caregivers. Most patients initially resorted to traditional treatment out of fear of surgery and its after-effects. The patients were treated medically and surgically.

关键词： Hemorrhoidal Disease Caregivers Traditional Therapists Patients Surgery CS Ref CI

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Clinical and Therapeutic Aspects of Inguinal Hernia in Children in the General Surgery Department of Reference Health Center in Commune I of bamako Mali

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Surgical Science 2024年第2期15卷 54-63页

作者： Tounkara Cheickna Samake Hamidou Simpara Mama Diarra Issaka Sanogo Modibo Sidibe Souleymane Togola Modibo dembele ba.a.y tientigui Coulibaly yacaria Togo Pierre Adégné Kante Lassana Department of General Surgery the Reference Health Center of Commune I Bamako Mali Directorate of Social Health Service the Armed Forces of Mali Bamako Mali Department of Pediatric Surgery Mali Hospital Bamako Mali Department of General Surgery the Gabriel TOURE University Hospital Bamako Mali Department of Pediatric Surgery Gabriel TOURE University Hospital Bamako Mali

Inguinal hernia in children is a congenital pathology in children linked to the persistence of the peritoneo-vaginal canal in children and the NüCK canal in girls;persisting into adulthood. This work aimed to study inguinal hernia in children in the general surgery department of the Reference Health Center of Commune I of the bamako District;to determine the frequency of inguinal hernia;describe the epidemiological, clinical and therapeutic aspects of inguinal hernias and in order to evaluate the cost of treatment. This was a prospective study from April 2017 to March 2018 during which 60 children with an inguinal hernia were collected. Inguinal hernias in children represented 9.23% of patients operated on in the department. The average age was 59.23 months with extremes of one month and 180 months and a standard deviation of 49.23 years. The male sex was dominant with a sex ratio equal to 9:1. The notion of prematurity was found in 11.7% and was associated with a testicle not in place in 1.7% of cases. 41.7% of our patients were referred by a doctor and 66.7% of patients presented with painless, intermittent inguino-scrotal swelling (83.3% of cases). The hernia was discovered before one week of life in 50% of cases. Inguinal swelling was absent in 11.7% but observed intraoperatively. The inguinal hernia was unilateral in 91.7% of cases and 70% of hernias were discovered by the parents during pushing efforts. The inguinal hernia was located on the right in 61.7% of cases. The hernia swelling was soft, painless, impulsive and reducible in 78.3% of cases. The swelling was inguino-scrotal in 58.3% of cases. The hernia was simple in 95% of patients and hernial strangulation was observed in 3 cases or 5% of cases. 98.3% of patients were ASA I. The treatment was carried out openly in all our patients including closure of the vaginal peritoneal canal in 95% of cases under general anesthesia in 98.3% of cases. The morbidity rate was 8.4% (surgical site infection: 6.7% of ca

关键词： Inguinal Hernia Child Surgery Cs Ref C I bamako Mali

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Study of Hemorrhoid Disease in the Department of General Surgery of the Cs Ref of the Commune I bamako

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Surgical Science 2024年第2期15卷 36-47页

作者： Tounkara Cheickna Diarra Issaka Sanogo Modibo Togola Modibo Camara Ladji Soma dembele ba.a.y tientigui Traore Alhassane Togo Adégné Pierre Kante Lassana Ouattara Zanafon Diallo Gangaly Department of General Surgery The Reference Health Center in Commune I Bamako Mali Department of General Surgery The Gabriel Toure University Hospital Bamako Mali Department of Urology The Gabriel Toure University Hospital Bamako Mali

This work was a retrospective prospective study carried out in the general surgery department of the Cs ref of commune I from January 2009 to December 2012. Our study aimed to determine the hospital frequency of hemorrhoidal disease, to identify the contributing factors, describe the clinical and therapeutic aspects and analyze the surgical consequences. We collected 73 patients with an average age of 37.8 years (range: 19 years and 77 years) with a sex ratio of 2.5 in favor of men. We operated on 49 patients or 67.1% of cases. 71.2% of our patients were married and lived in bamako. Schoolchildren and middle managers made up 39.8% of cases. 82.2% of patients were seen in ordinary consultation and 69.9% complained of progressive anal pain in 66.7% of cases. This pain was triggered by defecation in 88.2% of our patients. The contributing factors were dominated by constipation (53.4%), working in a seated position (41.1%) and a sedentary lifestyle (16.4%) of cases. Stage IV external hemorrhoids and hemorrhoidal thrombosis represented 53.8% of surgical indications. The most used surgical technique was that of Milligan-Morgan, i.e. 51.9% of cases and 45.2% of patients treated medically received a combination of transit regulator, venotonics and analgesics. The surgical aftermath was marked by hemorrhage (3 cases), delayed healing (5 cases), urinary retention (1 case) and scarring anal stenosis (1 case). The morbidity rate was 5.48% of cases and a zero mortality rate. The average length of hospitalization was 2 days with extremes of 1 and 5 days.

关键词： Hemorrhoid Surgery Cs Ref C I bamako Mali

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Digestive Surgical Emergencies at the “Mother Child”Hospital Center Luxembourg in Mali

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Surgical Science 2024年第5期15卷 299-310页

作者： Cheickna Tounkara Amara Coulibaly yaya Ongoiba Aboubakrine Sylla Abdoul Karim Simaga Bréhima B. Coulibaly Aminata Dabo Souleymane dembele Samake Hamidou Sidiki Keita Sékou Bréhima Koumare Soumaïla Keita ba.a.y tientigui dembele Zimogo Zié Sanogo Djibril Sangare Department of General Surgery and Anesthesia-Resuscitation of the “ Mother Child&#8221 Hospital Center Luxembourg Bamako Mali Social Health Service of the Armed Forces of Mali Bamako Mali Department of General Surgery “ A&#8221 and Cardiovascular of Point G University Hospital Bamako Mali Department of General Surgery of CHU Gabriel TOURE Bamako Mali

Digestive surgical emergencies concern all patients admitted urgently, for whom a decision for surgical intervention may be necessary within 24 hours. They are on guard duty day and night. To carry out this work, we set ourselves the objectives of: 1) Studying digestive surgical emergencies in the general surgery department of the “Mother Child” Le Luxembourg hospital in bamako, Mali;2) Determine the frequency of digestive surgical emergencies, 3) Describe the clinical and therapeutic aspects, and 4) Analyze the results of treatment. From November 1, 2022 to October 31, 2023, the general surgery department of the “Mother Child” Luxembourg Hospital Center in bamako, Mali, carried out 139 digestive surgical emergencies whose files were usable;75 men and 64 women, a sex ratio of 1.2. The 20 - 40 years old age group was the most represented, at 40.29%. The average age was 39 years;the extremes 16 years and 93 years with a standard deviation of 21.65 years. The reference concerned 51.08% of our patients. Abdominal pain was the main reason for consultation (100% of cases). In the majority of cases, the physical examination made it possible to make the diagnosis. Faced with certain clinical cases, we requested ultrasound (109/139), ASP (46/139) and CT (15/139). The main etiology was acute appendicitis with 42.45% of cases. The frequency of digestive surgical emergencies was 10.71% of all activities in the general surgery department of the “Mère Enfant” Le Luxembourg hospital center in bamako. All our patients were seen in consultation by an anesthesiologist before entering the operating room. The surgical consequences were complicated in 11.51% of cases with 7.91% deaths. Surgical site infections accounted for 12.5% of postoperative complications. Eleven deaths were noted, representing 68.75% of complications and 7.91% of our sample. Acute peritonitis was the cause of death in 100% of cases. The average cost of care was 329,000 FCFA.

关键词： Emergency Digestive Surgery Post-Operative Complication

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Knowledge Practical Attitude of Health Professionals on Breast Cancer at the Hospital of the District of the Commune IV of bamako

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Surgical Science 2024年第5期15卷 342-356页

作者： Moussa Samaké Souleymane B. Dembelé Sirama Diarra yely Dianessy Abdou Guiré Dorcas Laurel Sodjiné yede Amaguiré Saye Brahima dembele Birama Traoré Thierno Nadio Ibrahima Maiga Mahamane Dicko Modibo Diarra Siaka Konaté Amadou Maiga ba.a.y tientigui dembele Adégné Togo General Surgery Department of bamako District IV Hospital Bamako Mali Obstetric Gynecology Department of the bamako District IV Hospital Bamako Mali Department of Ophthalmology of the Hospital of the District of the Commune IV of bamako Bamako Mali Imaging Service of the bamako District IV Hospital Bamako Mali Anesthesia and Resuscitation Service of the Hospital of the District of the Commune IV of bamako Bamako Mali Internal Medicine Department of the District Hospital of Commune IV of bamako Bamako Mali General Surgery Department Kolondjeba Referral Health Centre Sikasso Mali General Surgery Department of the Gabriel Touré University Hospital Bamako Mali

Introduction: The level of knowledge and attitude of health professionals about breast cancer are important determinants. General objective: To study the knowledge, attitude and practice of health professionals of the hospital of the district of the commune IV on breast cancer. Methodology: This was a cross-sectional, prospective, descriptive, qualitative and quantitative study. The study period was from 01 October 2022 to December 2022. Results: In one week of survey, 110 health workers (intern, obstetrician nurse, general practitioners and specialists) received the survey sheet, 80 health workers informed it, a participation rate of 73%. The male sex was most represented at 63.75% with a sex ratio of 1.76. The average age was 39.59 years with extremes of 22 and 61 years. The clinical signs evoked by the participants were: breast nodule (81.25%), followed by breast discharge (48.75%). In relation to risk factors: interns and obstetrician nurses had no good knowledge, 51.72% of general practitioners had good knowledge, 43.48% of specialist doctors had good knowledge, and 5.88% of the wise had good knowledge. Conclusion: Breast cancer is a common pathology around the world, health professionals are at the forefront of the fight against breast cancer, and this fight cannot be effective without trained personnel.

关键词： Knowledge Attitude Practice Health Personnel Breast Cancer

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COVID-19 and the Vascular Elderly Subject: Illustration of Therapeutic Management with Corticosteroids in an Elderly Diabetic Patient with COVID-19

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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

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Bilharzia Appendicitis: Incidence in a Commune in Mali, about 3CAS

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Surgical Science 2024年第5期15卷 321-329页

作者： Souleymane Bingue Dembélé yely Dianessy Moussa Samake Abdou Guiré Siaka Konaté Ousmane Sy Boubacar yoro Sidibé Amadou Maïga Thiorno Nadio Boubacar Karembe Amaguiré Saye Sirama Diarra Dorcas Sodjiné yede Issiaka Diarra Ibrahima Maiga Mahamane Dicko Moussa Konaté Aliou Bina Diarra ba.a.y tientigui Dembélé General Surgery Department of the District Hospital of Commune IV of bamako Bamako Mali Kolondié ba Reference Health Centre Sikasso Mali Epidemiology and Clinical Research Bamako Mali General Surgery Department of Gabriel Touré University Hospital Bamako Mali Ophthalmology Department of the District Hospital of Commune IV of bamako Bamako Mali Gynecology and Obstetrics Department of the District Hospital of Commune IV of bamako Bamako Mali Commune I of the District of bamako Reference Health Centre Bamako Mali Imaging Department of the District Hospital of Commune IV of bamako Bamako Mali Commune VI of the District of bamako Reference Health Centre Bamako Mali Anotomy-Pathology Department of the G Point University Hospital Bamako Mali

Appendicitis bilharzia is a very rare condition and we report 3 cases of this pathology that sense clinical and biological similarities with bacterial appendicitis. The etiological diagnosis was exclusively histopathological, this allowed to highlight eggs of Schistosome in the appendicular wall in the three patients. The surgical treatment was supplemented by a specific medical treatment based on praziquantel. The surgical suites were simple for 2 patients, complicated by superficial parietal suppuration in a patient.

关键词： Bilharzial Appendicitis Endemic Histopathology Specific Antiparasitic Treatment

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Liver Abscesses in General Surgery at CsRef CI in bamako Mali

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Surgical Science 2023年第9期14卷 590-597页

作者： Cheickna Tounkara Hamidou Samake bambaké dembele Modibo Togola ba.a.y tientigui dembele Alhassane Traore Pierre Adégné Togo Lassana Kante Department of General Surgery of the Cs Ref of Commune I of bamako Bamako Mali Directorate of Social and Health Service of the Armed Forces Mali Bamako Mali Department of General Surgery of the CHU Gabriel TOURE of bamako Bamako Mali

Liver abscesses correspond to a newly formed cavity created by necrosis of the liver parenchyma induced by the pathogen. The aim of the present work was to study liver abscesses;determine the frequency;describe the clinical and paraclinical aspects, therapeutic and evolutionary modalities;determine the follow-up of treatment in order to assess the cost of treatment in the Reference Health Center of Commune I of bamako in Mali. This prospective study, involving 30 cases of liver abscess, took place over a period of 24 months from January 2015 to December 2016 in the general surgery department of the Cs Ref of commune I. The liver abscess is very often the consequence of amoebiasis which is rampant in the underprivileged population and it remains topical in surgical practice in Mali. Our hospital frequency was 0.081% with an average age of 34.40 years and extremes of 16 and 61 years;a sex ratio of 2.3 in favor of men. The main clinical signs were fever (56.7%), hepatalgia (73.3%) and hepatomegaly (26.7%). Hepatic collections objectified on abdominal ultrasound were located in the right lobe in 70% of cases and unique in 62%. Amebic serology carried out in 100% was negative in 20%;10% of cases had undergone surgical treatment. The consequences were simple for all our patients. The average cost of care, approximately 100,000 FCFA, was significantly higher than the minimum wage (28,460 FCFA) in Mali.

关键词： Liver Abscess Guided Ultrasound Puncture Surgery bamako Mali

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Differential Geochemical Features of Clinopyroxene from the Floodplain Sediments in yangtze and Hanjiang Rivers and Its Implication for Detrital Source Identification

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Journal of Earth Science 2014年第4期25卷 638-647页

作者： Jian yang Chang'an Li yufen Zhang N'dji dit Jacques dembele Faculty of Earth Sciences China University of Geosciences Key Laboratory of Biogeology and Envirnmental Geology of Ministry of Educations China University of Geosciences Institute of Geophysics and Geomatics China University of Geosciences

The evolution history of the yangtze River attracted increasing attention in recent years. Comparison of the properties of the floodplain sediments between the upper and lower reaches of the Three Gorges is of significance to identify the material detrital sources for the yangtze River basin. Clinopyroxene （Cpx） is the typical mineral widely distributed in the sediments of the yangtze River ba- sin. Cpx was extracted from the fine sediments with the grain size ranging from 0.063 to 0.125 mm in the upper and lower reaches of the Three Gorges. The sediments, from which the Cpx was extracted, were taken from the floodplains of the catchments of both the yangtze River and the Hanjiang River, as well as from the surface of the Zhoulao Core drilled in the center of the Jianghan basin where the two rivers flow through. Geochemistry of these Cpx was investigated, concerning the contents of major elements measured by electron probe microanalysis （EPMA） and the contents of trace elements analyzed by laser ablation inductively coupled plasma-mass spectrometry （LA-ICP-MS）. The Cpx in the yangtze River contains titaniferous augite which is sourced from the Panzhihua-Xichang region in South Sichuan Province, whereas the Cpx in the Hanjiang River is mainly from the surroundings without any titanif- erous augite. The REE analysis infers that the titaniferous augite is the diagnostic mineral of the upper yangtze River, and thus could be used as a tracer mineral to identify the detrital sources for the sedi- ments formed during the evolution of the yangtze River. The Cpx from the surface sediments of the Jianghan Plain （Zhoulao Core） shows comparable geochemical nature with that of the yangtze River, but is different in geochemistry from that of the Hanjiang River, implying that the modern sediments in the Jianghan Plain are mainly sourced from the upper yangtze River.

关键词： provenance yangtze River Hanjiang River clinopyroxene EPMA LA-ICP-MS geochemistry.

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