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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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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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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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Comparative Study between Patients Treated with Conventional Radiotherapy and IMRT with Chemotherapy for Stage III - IVA Nasopharyngeal Carcinoma: A Single Institution Retrospective Report

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Journal of Cancer Therapy 2023年第12期14卷 451-464页

作者： Mamady Keita Juan Li Malick bah Mamadou Aliou Diallo Alhassane Ismaël Touré Abou Camara Bangaly traoré Abdoulaye Keita Wenbing Shen Department of Radiotherapy The Fourth Affiliated Hospital of Hebei Medical University Shijiazhuang China Cancer Department of Donka National Hospital Conakry Guinea Faculty of Health Sciences and Techniques of Gamal Abdel Nasser University of Conakry Conakry Guinea Department of ENT-CFS Donka National Hospital Conakry Guinea

Introduction: Nasopharyngeal carcinomas are the most radiation-sensitive tumours, and radiotherapy alone provides better local control. Objectives: To evaluate the clinical efficacy and acute and late toxicities of two different treatment regimens for locally advanced nasopharyngeal carcinoma. Methods: From 2014 to 2017, 150 cases of stage III and 68 cases of stage IVA nasopharyngeal carcinoma were treated. Of these, 137 received conventional radiotherapy plus chemotherapy, and 81 received intensity-modulated radiotherapy plus chemotherapy. Chemotherapy was given either as induction, concurrent or adjuvant therapy. Survival rates were calculated according to Kaplan Meier and compared with the Log-rank test. The RTOG or EORTC criteria were used to assess acute and late toxicities. Results: The median follow-up time was 21.5 months, and the 2-year locoregional relapse-free survival, distant metastases-free survival, and overall survival rates in the conventional radiotherapy plus chemotherapy group were 76%, 71% and 77%, respectively;in the intensity-modulated radiotherapy plus chemotherapy group, they were 97%, 84%, and 100%, respectively. The difference in survival between the two groups was significant (χ2 = 5.06, P = 0.028). The incidence of grade 2 and 3 xerostomia one year after radiotherapy was 45.1% and 30.9% versus 33.3% and 0%. Conclusion: Compared with conventional radiotherapy plus chemotherapy, intensity-modulated radiotherapy plus chemotherapy offers better locoregional relapse-free survival and overall survival in patients with stage III and IVA nasopharyngeal carcinoma, and may significantly reduce the occurrence of radiation-induced xerostomia.

关键词： Nasopharyngeal Carcinoma Conventional Radiotherapy Intensity Modulated Radiotherapy Chemotherapy Prognosis

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Maternal and Perinatal Prognosis of Artificial Induction of Labor with Misoprostol at the Reference Health Center of Commune 2 in Mali

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Open Journal of Obstetrics and Gynecology 2022年第4期12卷 267-275页

作者： Tidiani traoré Seydou Z. Dao Seydou traoré Adoul Azize Togo Bakary Abou traoré Ahmadou Coulibaly Ibrahim Ousmane Kanté Kassoum Sidibé Thierno Boubacar Bagayoko Alpha Sanogo Famakan Kané Adama bah Ibrahima Donigolo Babou traoré Adama Coulibaly Abdrahamane Diarisso Youssouf traoré Ibrahima Teguété Augustin Tiongani Théra Nianankoro Fomba Hospital Ségou Mali Common Reference Health Center II Bamako Mali Koutiala Reference Health Center Koutiala Mali Point G University Hospital Center Bamako Mali Bla Reference Health Center Bla Mali Center Hospitalier Universitaire Gabriel Touré Bamako Mali

Introduction: The artificial induction of labor is increasingly common. Objective: Evaluate the maternal-fetal prognosis of artificial induction with misoprostol at the referral health center of the commune II. Methods: This is a cross-sectional, prospective, descriptive and analytical study which took place from September 1, 2019 to December 31, 2020. Included in the study were pregnant women carrying an evolving or terminated single-fetal pregnancy of at least 28 WA in cephalic presentation on a healthy uterus. The trigger has been made with 50 μg misoprostol administered sublingually into the posterior vaginal fornix. The dose was renewed as needed every 6 hours, until sufficient uterine contractions were obtained without exceeding 200 μg. Results: The frequency of artificial induction of labor was 1.25%. Indications were dominated by premature rupture of membranes (29.8%), overdue (19.1%), high blood pressure (19.1%), suitability of pregnant women (14.9%) and terminated pregnancies (10.6%). The vaginal delivery rate was 85.1% The Apgar score was greater than or equal to 7 in 83.3% of cases at the 1stminute. Maternal morbidity was marked by postpartum hemorrhage due to uterine atony in 4.3% cases. No maternal and neonatal deaths were noted. Conclusion: Induction of labor with misoprostol is a safe and effective method if careful selection of patients is made.

关键词： Childbirth Induction Artificial Misoprostol Prognosis

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Frequency of the Cardiovascular Complications during the Chronic Renal Insufficiency with the Service of Nephrology of the National Hospital Donka

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World Journal of Cardiovascular Diseases 2020年第7期10卷 425-431页

作者： Fousseny Diakité Mamadou Saliou Baldé Ibrahima Sory Barry Moussa traoré Alpha Boubacar bah Fenela Mipimbou Mohamed Lamine Kaba Alpha Oumar bah Unit of Nephrology-Hemodialysis of the National Hospital Donka Guinea Unit of Cardiology of the National Hospital Ignace Deen Guinea

Introduction: Cardiovascular disease has become a major concern for the nephrologist as it is the leading cause of morbidity and mortality in patients with chronic kidney disease, and affects all stages of the disease, including the earliest stages of the disease. The goal of this work was to determine the frequency of cardiovascular complications during chronic kidney failure. Patients and methods: This was a six-month, descriptive cross-sectional study from March 01 to August 31, 2018. It covered all patients with chronic kidney disease hospitalized in the ward during the study period. Included were all chronic kidney failure patients with at least one cardiac and/or vascular complication diagnosed either on clinical examination, and/or paraclinical examination (Electrocardiogram or cardiac ultrasound, vessel echodoppler, scan). Results: During the study period, 84 out of 378 patients or 22.22% had at least one cardiovascular complication. Cardiovascular complications were hypertrophy of the left ventricle with 49/84 (44 at Electrocardiogram and 5 at cardiac echodoppler), valvulopathy with 33.33%, stroke with 50% of cases, obliterating arterial disease of the lower limbs 25%, hypokinetic dilated cardiomyopathy with 9/36 cases and pericarditis with 2/36. Conclusion: Cardiovascular complications affect both sexes and all ages. They were dominated by enlarged left ventricle, valvulopathy and dilated cardiomyopathy.

关键词： Cardiovascular Complications Chronic Kidney Failure Donka Conakry

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Bipolar Transurethral Resection of the Prostate: Short-Term Outcome Evaluation in Regional Hospital in Senegal

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Open Journal of Urology 2023年第4期13卷 114-121页

作者： Thierno Oumar Diallo Demba Cissé Aboubacar traoré Alimou Diallo Youssouf Keita Thierno Mamadou Oury Diallo Boubacar Fall Oumar Raphiou bah Urology Department Regional Hospital Kolda Senegal Urology Department National Hospital of Ignace Deen Conakry University Conakry Guinea Urology Department De la Paix Hospital Ziguinchor Senegal

Introduction: Transurethral resection of the prostate is still the most popular procedure that use for the surgical treatment of lower urinary tract symptoms due to benign prostatic obstruction in developed countries. Bipolar transurethral resection of the prostate (B-TURP) is a recent technique in our urological practice. The aim of this study was to evaluate our preliminary results on the use of a B-TURP in Kolda (Senegal) in a benign prostatic hyperplasia (BPH). Materials and Methods: This was a 15-month, retrospective and descriptive study from June 2021 to August 31, 2022. It examined the records of patients who had BPH requiring surgical treatment and who received Bipolar transurethral resection of the prostate (B-TURP) during the study period at the Kolda Regional Hospital in Senegal. We used a Karl STORZ bipolar endoscopy column with a 26 sheath and 30˚ optics. The parameters studied were the civil status of the patients, the clinical and para-clinical data as well as the operative indications. The data were entered and analyzed using Epi-info 3.***.1.1. Results: A total of 31 patients underwent bipolar transurethral resection of the prostate during the study period. The mean age of patients was 68.5 ± 12.6 years (range, 56 - 77 years). The mean total PSA was 4 ± 2.3 ng/ml (range, 0.5 - 11 ng/ml). The mean prostate size assessed by ultrasound was 54 ± 12.3 ml (range, 30 - 90 ml). The operative indication was dominated by BPH with impact on the upper urinary tract. The mean of bladder irrigation time was 21.4 ± 3.9 hours (range, 12 - 26 hours). In the immediate post-operative period, blood transfusions were performed in 2 patients (6.5%). In the medium-term follow-up, we noted one 1 (3.2%) case of urine retention requiring bladder catheterization. Conclusion: Bipolar Transurethral resection of the prostate B-TURP in saline system is efficacious and safe. The results of this preliminary study of B-TURP are satisfactory with a low complication rate. B-TURP decreases the duration of the hospitalization and the

关键词： Benign Prostatic Hyperplasia (BPH) Bipolar Transurethral Resection of Prostate Complications

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Epidemiological Clinical Aspects and Medical Management of Sexual Assault in the Region of Ségou in Mali

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Open Journal of Obstetrics and Gynecology 2022年第3期12卷 209-221页

作者： Tidiani traoré Thierno Boubacar Bagayoko Alpha Sanogo Sory Ibrahime Koné Seydou traoré Kassoum Sidibe Bréhima Donigolo Bréhima Doumbia Seydou Z. Dao Famakan Kane Adama bah Seydina Alioun Beye Amadou Bocou Seydou Fané Yossuf traoré Ibrahim Téguété Nianankoro Fomba Hospital Ségou Mali Koutiala Reference Health Center Koutiala Mali Common Reference Health Center II Bamako Mali Bla Reference Health Center Bla Mali Anesthesia and Resuscitation Service Center Hospitalier Universitaire Point G Bamako Mali Gabriel Touré University Hospital Bamako Mali

Introduction: Sexual assault is an act of a sexual nature perpetrated on another person without their consent. Goal: To describe the epidemio-clinical aspects and the medical management of sexual assault in the Segou region. Methodology: This was a retro-prospective descriptive study from September 2010 to September 2018 on the alleged female victims of sexual assault registered in the Gynecology and Obstetrics departments of the hospital and the sanitary quarters of Ségou. Results: We recorded 107 cases of sexual assault out of 47,729 gynecological consultations, representing a hospital prevalence of 0.22%. The victims were between 10 and 15 years old in 48.59% of the cases. Students were the most represented with 53.27% (57/107) of cases. Genito-genital contact was recorded in 90.65% (97/107) of cases. Vulvo-perineal lesions were present in 44.86% (48/107) of survivors. Hymenial deflowering was the most frequent traumatic genital lesion accounting for 43.70% (21/48) of old cases and 27.00% (13/48) of recent cases. Sexual assault was committed by a single individual in 60.75% (65/107) of cases and by a friend of the victim in 21.5% (23/107) of cases. The survivors had consulted within 24 hours of the sexual assault in 53.27% (57/107) of the cases, the treatment was medical in 68.22% (73/107) and medical-surgical in 4.7% (5/107), post-exposure prophylaxis to the Human Immunodeficiency Virus (HIV) was performed in only 26.16% (28/107) of survivors. Conclusion: Sexual assault remains a concern although its frequency is low. This scourge mainly affects children and adolescents, and the lesions are mainly genitals.

关键词： Aspects Sexual Assaults Epidemio-Clinics Management Segou

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Traumatic Digestive Perforation in the Hospital of Sikasso: Epidemio-Clinical and Therapeutic Aspects

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Surgical Science 2023年第6期14卷 405-413页

作者： Moussa Diassana Bathio traoré Aly Boubacar Diallo Mamadou Bernad Coulibaly Doh Sylla Amadou Maiga Aboubacar Karambé Amadou bah Aboubacar Yoro Sidibé Layes Touré Ternan traoré Ousmane Dembelé Salif traoré Moussa Kanté Mamadou Sangaré Kokoroba Sidibé Youssouf Diakité Mahamadou Coulibaly Moro Sidibé Soumaila Alama traoré Moussa Samaké Nana Kadidia Fofana Bakary Tientigui Dembélé General Surgery Department of the Sikasso Hospital Sikasso Mali General Surgery Department CHU Gabriel-Touré Bamako Mali Traumatology Department of the Sikasso Hospital Sikasso Mali Urology Department of the Sikasso Hospital Sikasso Mali Anesthesia and Resuscitation Department of the Sikasso Hospital Sikasso Mali Odontostomatology Department Sikasso Hospital Sikasso Mali Surgery Department Koutiala Reference Center Koutiala Mlai Ophthalmology Department Sikasso Hospital Sikasso Mali Gyneco-Obstetrics Department Sikasso Mali Surgery Department Bamako District Hospital Bamako Mali Commune IV District Hospital Bamako Mali

Traumatic digestive perforation is the pathological opening of the wall of a hollow organ of the digestive tract (esophagus, stomach, small intestine, large intestine, rectum, and extrahepatic bile ducts) following trauma. Injuries to the digestive viscera, especially from trauma, have been known since antiquity. Aristotle recognized that a slight blow can cause an intestinal injury. Perforation of a hollow organ of the digestive sphere results in peritonitis, which in this case is the consequence of an infection of the peritoneal cavity by spreading of the digestive contents. The aim of the work was to describe the epidemiological, clinical and therapeutic aspects of traumatic digestive perforation. Patients and method: The study was retrospective and descriptive from January 1, 2016 to December 31, 2020, in the general surgery department of the hospital of Sikasso (Mali). Patients operated for traumatic digestive perforation were included. Results: The clinical records of 42 patients were collected. Traumatic digestive perforations represented 12.3% of patients hospitalized for abdominal trauma. The average age of the patients was 26.6 years, with a sex ratio of 6:1. The most frequent etiology was road traffic accidents with 38% of patients. The average delay of consultation was 5 days. Abdominal pain was present in 38 patients, vomiting in 17 patients. On physical examination, the most frequent signs were abdominal contracture in 61.9% of patients, and disappearance of pre-hepatic dullness in 54.7% of patients. On rectal examination, the douglas was bulging and painful in 21 patients. X-ray of the abdomen without preparation showed pneumoperitoneum in 54.1% of patients. Excision, suture and peritoneal lavage were performed in 31 patients. The postoperative course was marked by parietal suppurations in 5 patients, a digestive fistula in 2 patients and 4 cases of death (9.5%). Conclusion: Traumatic digestive perforation is a frequent pathology in surgery. Road accident was the main cause. The treatment is essent

关键词： Perforation Digestive Traumatic Sikasso (Mali)

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Intradialytic Hypertension and Associated Factors in Chronic Hemodialysis at the National Hemodidiadiasis Center in Donka, Guinea

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Open Journal of Nephrology 2020年第1期10卷 34-42页

作者： Fousseny Diakité Mamadou Saliou Baldé Alpha Koné Moussa traoré Ibrahima Chérif Alpha Boubacar bah Mohamed Tassilmy Diaby Alpha Oumar bah Mohamed Lamine Kaba Nephrology-Hemodialysis Service Donka National Hospital Conakry Guinea Service of Cardiology National Hospital of Ignatius Deen Conakry Guinea

Introduction: Dialytic high blood pressure (DHBP), although often ignored, is now recognized as a recurring and persistent phenomenon in a subgroup of hemodialysized patients. Its occurrence is associated with an increased risk of hospitalization and death. The objective of the study was to determine the prevalence of intradialytic hypertension and the factors associated with it. Methods: Study was cross-sectional, monocentric, descriptive and analytical over a three-month period from April 22 to July 22, 2019. Included were all patients 18 years of age or older, chronic hemodialysis for at least three months, with intra-dialytic high blood pressure. The blood pressure machine used for the majority of patients was an electronic “OMRON” blood pressure monitor. Epidemiological, clinical, para clinical and dialysis parameters were studied. The data were collected, captured and analyzed using IBM SPSS Statistics Version 20 software. The factors associated with intradialytic high blood pressure were searched using a univariate logistic regression model. The significance threshold for all statistical tests has been set at 5%. Results: Of our 131 patients, 53 had intradialytic hypertension, a frequency of 40.5%. The time of (DHBP) occurrence was more frequent at the 3rd and 2nd hour, 94.34% and 86.79%, respectively. The average age of patients was 45.51 years with extremes ranging from 19 to 70 years. The average Systolic Blood Pressure (SBP) before dialysis was 148 mm Hg ?16.62 and the average Diastolic Blood Pressure (DBP) before dialysis was 88 mm Hg ?12.50. Pre-dialysis Blood Pressure—140/90 mm Hg was noted in 18 cases, or 34.0%. The intradialytic average SBP was 164 mm Hg ?17.25 with extremes of 121 to 202 mm Hg. The intradialytic average DBP was 92 mm Hg ?12.52 with extremes 67 to 124 mm Hg. The main risk factors associated with intra-dialytic hyperation were: Age range (40 - 50 years), Duration on dialysis (Conclusion: This study, the first of its kind in Guinea, was able to determine the frequency of intradialyt

关键词： Risk Factors Intradialytic Hypertension Donka Guinea

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