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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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Lipid Profile among the Diabetic and Non-Diabetic Obese Patients

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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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Pulmonary Embolism: Epidemiological, Clinical, Therapeutic and Evolution Aspects in the Medicine Department of Hospital of Mali Bamako

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World Journal of Cardiovascular Diseases 2021年第4期11卷 242-248页

作者： Massama Konaté Mariam Sako Boubacar Sonfo Samba Sidibé Souleymane Mariko Djeneba Sylla Sow Coumba Adjaratou Thiam Djenebou traoré Hamidou Oumar Ba Asmaou Keita Maiga Ibrahima Sangare Mamadou Toure Souleymane Coulibaly Nouhoum Diallo bah traoré Modibo Mariko Nouhoum Ouologuem Amadou Koné Youssouf Camara Yacouba Lazare Diallo Nanko Doumbia Mahamadoun Coulibaly Ichaka Menta Faculty of Medicine and Dentistry (FMOS) of the University of Sciences Technique and Technology of Bamako (USTTB) Bamako Mali Medicine Department Hospital of Mali Bamako Mali Cardiology department CHU Point G Bamako Mali Cardiology Department Hospital of Kati Kati Mali Medicine Department Hospital of Tombouctou Tombouctou Mali Internal Medicine Department CHU Point G Bamako Mali Cardiology Department CHU Gabriel Toure Bamako Mali Cardiology Department CHU Mère Enfant Bamako Mali

Background: Pulmonary embolism (PE) is a severe form of venous thromboembolic disease. In Africa, prevalence of PE in hospitalized medical patients varies among studies. Objective: Aim of this work was to study the epidemiological, clinical, therapeutic and evolution aspects of PE in the medicine department of Mali’s Hospital Bamako-Mali. Methodology: This was a retrospective cross-sectional study carried out from January 01, 2017 to December 31, 2020 in the medicine department of Mali’s hospital Bamako, including all inpatients admitted for PE during the study period. Results: Of 1814 hospitalized patients, 54 patients had pulmonary embolism. Hospital frequency of pulmonary embolism was 2.97%. Predominance was female and sex-ratio M/F was 0.38. Mean age in our series was 54.24 ±1.19 years. Predisposing factors to pulmonary embolism were dominated by obesity 37%, high blood pressure 35.2% and history of cardiovascular disease 20.4%. Dominant signs were dyspnoea and chest pain in 83.3% and 70.4% of cases respectively. Probability of pulmonary embolism was high in 40.7% according to Wells score. Patients with right heart failure were 22.2%. EKG showed sinus tachycardia70.4% and S1Q3 aspect 7.4%. Heart right chambers were dilated at transthoracic echography 42.6%. Obstruction was bilateral at chest angio CT for 51.9% and proximal for 42.6%. Deep venous thrombosis was associated at EP in 16.6%. Treatment was low weight molecular heparin followed by vitamin K antagonist or direct oral anticoagulant. One patient was successfully treated by thrombolysis. Hospital mortality was 16.7%. Conclusion: PE is a serious disease probably underdiagnosed. It is responsible of important mortality.

关键词： Pulmonary Embolism Epidemiology Mali’s Hospital

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Evaluating the Influence of the Prostate Weight on the Morbidity and Mortality of Transvesical Open Prostatectomy: Prospective Analysis of 108 Cases in the Urology-Andrology Department of the Ignace Deen National Hospital in Conakry

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Open Journal of Urology 2024年第4期14卷 252-261页

作者： Thierno Oumar Diallo Alimou Diallo Alpha Oumar Barry Thierno Mamadou Oury Diallo Alseny bah Youssouf Keita Daouda Kanté Mamadou Bissiriou bah Demba Cissé Ibrahima bah Abdoulaye Bobo Diallo Oumar Raphiou bah Urology Department National Hospital of Ignace Deen Conakry University Conakry Guinea Urology Department Sino-Guinean Friendship Hospital Conakry University Conakry Guinea

Introduction: Open transvesical prostatectomy remains today one of the most effective approaches for the management of benign prostatic hyperplasia despite the fact that, this method is associated with multiple complications. The objective of this study was to evaluate the influence of prostate weight on the morbidity and mortality of transvesical prostatectomy for adenoma in the urology-andrology department of the Ignace Deen National Hospital. Materials and Methods: This was a prospective, longitudinal and analytical study lasting 6 months, from March 1, 2022 to August 31, 2022 including patients admitted and operated on by open transvesical prostatectomy by assessing the influence of prostate weight on the morbidity and mortality of transvesical adenomectomies. Results: 108 patients were included in our study, the average age of our patients was 70 ± 7.7 years, cultivators were the most represented profession with 38.89%, and hypertension was the most represented comorbidity with 75%. 33.06% of cases became complicated and surgical wound infection was the main complication with a frequency of 17.40%. Statistical analysis did not conclude that, the prostate weight does not have a statistically significant influence on the morbidity and mortality of transvesical open prostatectomy for benign prostatic hyperplasia. Conclusion: Prostate weight has no influence on the morbidity and mortality of transvesical prostate adenoma.

关键词： Benign Prostatic Hyperplasia (BPH) Adenomectomy Prostate Weight Complication

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Comparative Study of Transvesical and Retropubic Prostatic Adenomectomies in the Urology-Andrology Department of Ignace Deen University Hospital Center

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Open Journal of Urology 2024年第4期14卷 227-243页

作者： Lahoumbo Ricardo Gnammi Demba Cissé Vahina Alexandre Gamamou Daouda Kanté Mamadou Diawo bah El-Mouksitou Akinocho Sabi Couscous Hassiatou Abdul-Haqq bah-L’Imam Thierno Oumar Diallo Thierno Mamadou Oury Diallo Ibrahima bah Abdoulaye Bobo Diallo Oumar Raphiou bah Department of Urology-Andrology Ignace Deen UHC Conakry Republic of Guinea School of Public Health Free University of Brussels Brussels Belgium Medical Imaging Department Ambroise Pare Clinic Conakry Guinea

Objective: To compare the results of transvesical and retropubic prostatic adenomectomies at the Urology-Andrology Department of Conakry University Hospital. Methodology: This was a prospective multi-operator analytical study lasting 6 months. It included 70 patients operated on for benign prostatic hypertrophy (BPH), divided into 2 groups of 35 according to the retropubic or transvesical technique. The data was collected using a questionnaire and entered into the Epi info application. The analysis was initially descriptive and then univariate. To identify confounding factors, a multivariate analysis was performed. The application conditions of each test were checked before their application. A p-value Results: Upper adenomectomies represented 53.6% of surgeries performed for BPH. The average age was 73.2 years. The mean prostate volume was 117 ± 51.6 cc and the mean total PSA was 9.2 ± 11.4 ng/ml. The majority of patients had an ASA1 (60%) and ASA2 (37.1%) score. Spinal anesthesia, a double-current silicone probe with hinged hinge 22, and drainage of the prevesical space were carried out in all patients, i.e. 100%. The average overall blood loss was 229 ± 98.2 ml. It was lower in the group of patients operated via the retropubic route (187 ± 60.4 ml). The same was true for the duration of intervention (49.1 ± 7.17 vs 55.4 ± 7.9 min), the catheter wearing time (5.14 ± 0.97 vs 9.29 ± 2 .9 days) and the length of hospitalization (=6.26 ± 1.15 vs 12.1 ± 5.74 days). Conclusion: The retropubic technique has advantages over the transvesical one. These advantages are translated by a gain in the duration of the intervention, blood loss, catheter wearing time and length of hospitalization.

关键词： Upper Adenomectomies BPH Retropubic Approach Transvesical Approach Conakry

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Prostatic Adenomectomy and Comorbidities: Frequency and Management at the Urology Department of the Ignace Deen National Hospital in Conakry

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Open Journal of Urology 2024年第4期14卷 217-226页

作者： Demba Cisse Alpha Oumar Barry Morlaye Fatoumata Bangoura Alimou Diallo Mamadou Dian bah Youssouf Keita Daouda Kanté Thierno Mamadou Oury Diallo Mamadou Bissiriou bah Mamadou Diawo bah Abdoulaye Bobo Diallo Oumar Raphiou bah Maitre-Assistant à la Facult&#233 des Sciences et Techniques de la Sant&#233 Universit&#233 Gamal Abdel Nasser de Conakry Conakry Guin&#233e

Goal: To determine the type of comorbidity and highlight the complications of adenomectomy and comorbidities. Material and Methods: This is a prospective, descriptive, cross-sectional study lasting six (6) months, from July 1, 2022 to December 31, 2022. Patients with BPH on comorbidity condition taken care of during the study period AND have agreed to participate in the study. Results: During our study, 49 cases of benign prostatic hypertrophy with comorbidities were collected, representing a frequency of 29%. The average age ranges for the patients were 43 - 70 years. The age group most affected was 70 to 79 years old (38.80%). Nocturnal urinary frequency was the main reason for consultation present in all our patients. The most frequent comorbidity was hypertension, i.e. 83.70%. The PSA rate between 4 and 10 was the most represented, i.e. 42.86%. The prostate volume was between 61 and 100 ml in 40.82% of patients. Histology showed that it was a benign adenomatous hypertrophy of the prostate in 85.70% and a prostatic adenomyoma in 14.29%. Trans-bladder adenomectomy alone was the most performed technique, i.e. 49%, followed by trans urethral resection of the prostate, i.e. 38.80%. Retention of urine after removal of the catheter was the most observed complication, i.e. 12.20%. Conclusion: Benign prostatic hypertrophy with comorbidities constitutes a frequent association. Because their presence can affect effectiveness and lead to complications.

关键词： Prostatic Hypertrophy Comorbidities Conakry University Hospital

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Congenital Heart Disease Referred for Surgery: Analysis and Epidemiological Description in the Cardiology Department of CHU Ignace Deen

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World Journal of Cardiovascular Diseases 2024年第4期14卷 234-251页

作者： bah Mamadou Bassirou Diallo Mamadou Tahirou Doumbouya Amadou Dioulde Balde Elhadj Yaya Camara Abdoulaye Diallo Mamadou Balde Thierno Siradio bah Abdoulaye bah Mamadou Dian Samoura Sana Balde Mamadou Dadhi Cardiology Department of the Ignace Deen Hospital Conakry Guinea

Introduction: Congenital heart disease includes all cardiac and vascular malformations. It accounts for approximately one third of all congenital malformations and is a public health problem, particularly in developing countries. The aim of this study was to analyze the epidemiological, clinical and paraclinical aspects of congenital heart disease. Methods: This was a retrospective descriptive and analytical study based on the records of 135 patients referred for surgery and followed up in the cardiology department of the Ignace Deen University Hospital, collected in November 2022. Results: Hospital prevalence was 5%. The mean age was 71 months, ranging from 1 month to 19 years. The age group over 24 months was the most represented (62%). The M/F sex ratio was 1.36. Urban origin was predominant (58%). The rate of children not attending school or dropping out was high (16%). Siblings with fewer than 4 children were the most common (88%). A heart murmur was the most frequent sign (78%), followed by cyanosis (36%) and heart failure (29%). The association between heart murmurs and CHD was proven with a p-value Conclusion: CHDs represent the main indication for paediatric cardiac surgery and follow-up (95%). We stress the importance of implementing a screening and management strategy for congenital heart disease.

关键词： Congenital Heart Disease Cardiology Epidemiology Surgery Ignace Deen University Hospital

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Urogenital Complications of Groin Hernia Surgery: A Multicentre Study in Guinea

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Open Journal of Urology 2024年第3期14卷 173-178页

作者： Alimou Diallo Karifa Oulare Alpha Oumar Barry Thierno Oumar Diallo Daouda Kanté Ibrahima bah Abdoulaye Bobo Diallo Oumar Raphiou bah Department of Urology Sino-Guinean Friendship Hospital Faculty of Health Sciences and Technologies Gamal Abdel Nasser University of Conakry Conakry Guinea Department of Urology National Ignace Deen Hospital Faculty of Health Sciences and Technologies Gamal Abdel Nasser University of Conakry Conakry Guinea

Context and Objective: Groin hernia is a common pathology in visceral surgery (2nd rank after appendicitis), which affects approximately 4.6% of the African population. Restoring the normal anatomy of the groin region is one of the most benign interventions. However, uro-andrological complications are possible. This study aimed to contribute to the improvement of the management of urogenital complications of groin hernia surgery. Patients and Method: We carried out a prospective study of descriptive type with a duration of 6 months from 1 August 2021 to 31 January 2022. The data were collected using a pre-established survey sheet. The study covered several sites (public hospitals and private clinics) in Guinea. Results: The urogenital complications of the surgery of the hernia of the groin represented 15.22% or 14 cases out of 92 patients. The average age was 37.00 years with extremes of 20-69 years. Polygamists occupied the first place. The reason for consultation was dominated by decreased testicular volume (42.86%), followed by a desire to conceive (21.43%). Unilateral testicular atrophy represented 63.64%, bilateral 27.27%. We performed a left orchidectomy in one patient and a cystorraphy in another simple operative follow-up. The other cases consisting of testicular atrophy, due to lack of a suitable technical platform, did not benefit from any specific therapeutic treatment. Conclusion: Urogenital complications of groin hernia surgery are relatively common. Testicular atrophy was the main clinical complication. The left orchidectomy and cystorraphy were the therapeutic procedures performed.

关键词： Hernia of the Groin Herniorraphy Testicular Atrophy Orchidectomy Cystorraphy

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Relevance of Medical Imaging in the Pre-Therapeutic Evaluation of Acute Intestinal Obstruction at CIMED

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Open Journal of Medical Imaging 2024年第1期14卷 31-41页

作者： Mamoudou Camara Aly Mampan Koundouno Siré Nabe Toumin Camara Ousmane Aminata bah Center for Medical Imaging Exploration and Diagnostics University of Conakry Conakry Guinea General Surgery Department of the Kankan Regional Hospital Kankan Guinea Ministry of Health and Public Hygiene Conakry Guinea General Medicine Department of the Siguiri Prefectural Hospital Siguiri Guinea CIRA Conakry Guinea

Objective: We initiated this work with the aim of studying the contribution of imaging in the diagnosis of acute intestinal obstruction at CIMED. Patients and methods: This was a prospective, descriptive and analytical study involving 96 patients collected at the radiology and medical imaging department of CIMED, from January 2022 to January 2023. Result: The age of our patients varied between 11 and 86 years with an average age of 36 years. There was a male predominance of 64.6% compared to 35.4% for women, i.e. a sex ratio of 1.82. The notion of previous surgery was found in 61.5% of our patients. Pain was present in all patients. Radiography of the ASP was performed in 89.6% of patients. It showed hydro-aerial levels in 96.5% of patients. Abdominopelvic CT was performed in 12 patients and made it possible to make the diagnosis of occlusion in all patients. The results of the positive diagnosis were concordant with those intraoperatively in 92% of cases. 8% of our patients, compared to the treatment, spontaneously resumed their transit, 91% benefited from surgical treatment and 1% died before surgery. The outcome was favorable in 80 patients or 83.3%, poor with death in 16 patients or 16.7% of cases. Conclusion: Acute intestinal obstruction remains a serious pathology for which ASP radiography often remains the only radiological examination performed urgently. However, abdominopelvic CT seems widely indicated thanks to its contribution both for the positive diagnosis and for the serious and etiological diagnoses. However, this imaging technique is largely underused in our practice due to its high cost and lack of availability.

关键词： Imaging Acute Intestinal Obstruction CIMED

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