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Cardiovascular Risk Factors among Outpatients: An Alarming Sign of the Epidemiological Transition in Developing Country?

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World Journal of Cardiovascular Diseases 2021年第3期11卷 181-194页

作者： Modibo Coulibaly Dramane Samaké Sonfo Boubacar Lamine Sidibé Moussa Diawara Mamoudou Barry Valentin Sagara Bréhima Traoré Oumar Guindo bakary maiga Amagana Dolo Department of Biomedical Laboratory Hospital of Mopti Mopti Mali Department of Medicine Hospital of Mopti Mopti Mali Department of Cardiology Teaching Hospital of Kati Bamako Mali Department of Public Health Hospital of Mopti Mopti Mali Faculty of Medicine and Odonto Stomatology University of Science Technical and Technologies de Bamako Bamako Mali Faculty of Pharmacy University of Science Technical and Technologies de Bamako Bamako Mali

Background: Noncommunicable diseases are the leading cause of death in the world and low and middle-income countries suffer from preventable premature death. The aim of this study was to assess the risk factors for non- communicable disease (NCDs) in general and particular cardiovascular diseases (CVDs) among the outpatients of our department of medicine. Methods: We performed a cross-sectional study from April to December 2017 by the consecutive enrollment of outpatients who attended in our department of medicine of Hôpital Sominé DOLO de Mopti, Mali. Clinical and laboratory data were measured for cardiovascular risk assessment. Framingham Risk Score (FRS) and Systemic Coronary Risk Estimation (SCORES) were computed by using Framingham and SCORE equations. Metabolic syndrome was defined using the harmonized criteria from the International Diabetes Federation (IDF) and the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI). Data were captured in excel and analyzed with R version 4.0.3. The statistical significance was set at p = 0.05. Results: A total of 292 patients were enrolled in this study. The prevalence of traditional cardiovascular risk factors was 36.64%, 21.57%, 14.04%, and 13.01% for high blood pressure, hyperglycemia, smoking, and alcohol consumption, respectively. The metabolic syndrome accounted for 23.63%. The mean body mass index was 26.10 ± 7 kg/m2. The overall 10-year risk for cardiovascular events or death was 26.3% and 8.6% according to the FRS and SCORE equation, respectively. The 10-year risk of cardiovascular events according to the FRS was significantly higher in subjects aged 50 and above compared to subjects aged under 50 years, 34.46% vs 13.16%, p < 0.001. Likewis

关键词： Cardiovascular Risk Factors Framingham Risk Score SCORE Metabolic Syndrome

Parietal Infiltration for Postoperative Analgesia

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Surgical Science 2023年第2期14卷 72-76页

作者： Kanté Lassana Issiaka Diarra Idrissa Tounkara maiga Amadou Traore Amadou Madiassa Konaté Ibrahima Diakite Dembélé bakary Tientigui Alassane Traore Adegné Togo Faculty of Medicine and Odonto Stomatology (FMOS) General Surgery Department Gabriel Touré University Hospital Center Bamako Mali General Surgery Department of the Reference Health Center of Commune 1 of Bamako District Bamako Mali General Surgery Department of the Reference Health Center of Commune 2 of Bamako District Bamako Mali

The parietal component of pain occupies an important place in the management of postoperative analgesia. Parietal infiltration is a technique that fits into a concept of multimodal analgesia using several analgesic products simultaneously. This simple and reliable technique makes it possible to reduce the use of opioids and therefore their adverse effects;without increasing the risk of infection. It reduces the length of hospitalization.

关键词： Parietal Infiltration Analgesia Surgery

Intestinal Invagination in Adults: About a Case at the “Mother-Child” Hospital Le Luxembourg in Mali

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Surgical Science 2023年第9期14卷 583-589页

作者： Cheickna Tounkara Oumar Amadou Malle Amara Coulibaly A. Boubacar maiga Sory Ibrahim Diawara Kassim Kayentao bakary Tientigui Dembele Alhassane Traore Adégné Pierre Togo Lassana Kante Department of general surgery of the Hospital “Mother Child” Le Luxembourg Bamako Mali University of Sciences of Techniques and Technologies of Bamako Mali (USTTB) Bamako Mali Department of General Surgery of the CHU Gabriel Touré Bamako Mali

Intussusception is a pathology of infants and young children. Its occurrence in adults is very unusual. In the vast majority of cases, it is secondary to a benign or malignant tumor. Small bowel malignancies are relatively rare, 1% - 5% of malignant tumors of the gastrointestinal tract. Acute intussusception, a rare pathology in adults, often presents with non-specific symptoms. Contrary to children, the organic origin remains preponderant in the elderly, where the origin of neoplasia must be suspected in first intention. We report the case of a 49-year-old patient admitted urgently from the Luxembourg “Mère Enfant” hospital center in Bamako, Mali, for an occlusive syndrome. Several abdomino-pelvic ultrasounds were performed in several clinics with mixed conclusions: Hydro-aeric distension and a cessation of matter and gas without a clearly visible mass (04/09/2022);Demonstration of the central hydro-aeric levels wider than high containing fine and regular folds corresponding to connivents whose aspect is in factor of left acute small intestine occlusion, to be completed by the surgical opinion (06/09/2022) and a third ultrasound showed a normal appearance of the liver, gallbladder, kidneys, pancreas, spleen, bladder and prostate;diffuse aero-colic distention without lesion of secondary appearance (21/11/2022). A frontal standing ASP dated 11/25/2022 showed hail-like hydro-aeric levels. Surgical management consisted of an open oncological resection of an obstructive bowel tumor with ileo-ileal invagination. The anatomopathological and immunohistochemical study of the surgical specimen concluded to diffuse small cell non-Hodgkin’s lymphoma, without vascular embolism. The resection limits pass into the healthy zone.

关键词： Acute Intestinal Intussusception Organic Etiology Digestive Lymphoma Mali

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 bakary 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

Inguinal Hernia in Adults: Diagnostic and Therapeutic Aspects at Cs Ref CI Bamako Mali

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Surgical Science 2023年第7期14卷 507-516页

作者： Cheickna Tounkara Amadou maiga Bessy Samake Boubacar Yoro Sidibe Tani Kone Samake Hamidou Kaloga Daye Bagayoko Oumar Amadou Malle Alhassane Traore bakary Tientigui Dembele Pierre Adégné Togo Zanafon Ouattara Department of General Surgery of the Reference Health Center of Commune I Bamako Mali Department of General Surgery CHU Gabriel TOURE Bamako Mali Department of Urology Surgery Point G University Hospital Bamako Mali

The inguinal hernia is a very frequent surgical pathology in the world and it represents 95% of the hernias of the groin. This work aimed to determine the frequency of inguinal hernias, describe the clinical and therapeutic aspects of inguinal hernias, describe the morbidity and mortality related to inguinal hernias and evaluate the cost of treatment. Our study was conducted from January 2010 to December 2010 in the general surgery department of the Reference Health Center of Commune I in the district of Bamako. We collected 130 cases of inguinal hernias with a sex ratio of 15.25 in favor of the male sex. The mean age was 48.02 years (standard deviation: 17.53 years). Strangulated inguinal hernias accounted for 4.9% of abdominal surgical emergencies and 14.6% of all operated inguinal hernias. More than half of the patients (82%) were operated under local anesthesia. Clinical signs were marked by painless or irreducibly painful inguinal swelling. The diagnosis was clinical in all patients. Some patients benefited from a minimum blood assessment (rhesus grouping, glycaemia, hemoglobin level and hematocrit). The Shouldice technique was performed in 68% of patients. One case of organ resection was performed, i.e. 0.8% of cases. Morbidity was 4.6% due to wall abscess;0.8% scrotal hematoma type. We have not recorded any recurrence or death.

关键词： Inguinal Hernias Surgery Cs Ref CI Bamako (Mali)

Benin Goitre in the General Surgery Department at Teaching Hospital Gabriel Touré

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Surgical Science 2022年第1期13卷 15-22页

作者： Madiassa Konate Amadou Traore Moussa Samake Abdoulaye Diarra Boubacar Karembé Amadou Bah Boubacar Yoro Sidibé Kadiatou Doumbia Tany Koné Amadou maiga Zakari Saye Arouna Doumbia Ibrahim Diakite bakary T. Dembelé Alhassane Traore Lassana Kante Adegné Togo General Surgery at Teaching of Gabriel Toure Bamako Mali

Introduction: Goitre is an increase in the volume of the thyroid gland. Goiters may be congenital or acquired, diffuse or nodular, functional or non-functional, benign or malignant. Purpose: The objectives of this work were to study and determine the frequency of benign goitre in the general surgery department of CHU Gabriel Touré, and to study epidemiological, clinical and therapeutic aspects. Patients and Method: This was a retrospective and prospective study conducted in the general surgery department of CHU Gabriel Touré, from January 1999 to December 2019. Included in the study were all patients with benign goiter confirmed in histology, hospitalized and treated in the service. Patients with thyroid malignant tumours, strumite, thyroid tract cyst, cervical abscess and neck trauma were not retained. Socio-demographic, clinical, para-clinical, therapeutic and post-operative aspects were the study parameters. Word processing and tables were done with Microsoft Word and Excel 2016 software. Data analysis was performed with Epi info7 software, the statistical test used was the Khi2 test and a value of P 0.05 was considered statistically significant. Results: A total of 253 patient files were collected. Thyroidectomy represented 5.02% (253/5036) of surgical pr

关键词： Benign Goitre Epidemiological Clinical and Therapeutic Aspects

Digestive Pathologies during Chronic Renal Failure in the Nephrology and Haemodialysis Department at the University Hospital Center of Point G in Mali

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Open Journal of Clinical Diagnostics 2020年第1期10卷 41-48页

作者： Magara Samaké Seydou Sy Hamadoun Yattara Moctar Coulibaly Mamadou Badou Sanogo Aboubacar Sidiki Fofana Aboudou Messoum Dolo Djénéba maiga Djénéba Diallo Atabieme Kodio bakary Diarra Karamoko Djiguiba Djibril Sy Saharé Fongoro Nephrology Unit of the Fousseyni DAOU Hospital Kayes Mali Nephrology and Haemodialysis Department of the CHU of Point G Bamako Mali Faculty of Medicine of Bamako University of Bamako Bamako Mali Nephrology Unit of Mali GAVARDO Hospital Bamako Mali Nephrology Unit of the Sikasso Regional Hospital Sikasso Mali Nephrology Unit of the Mother and Child Hospital The Luxembourg Bamako Mali Internal Medicine Service of the University Hospital Center of Point G Bamako Mali

Introduction: Chronic kidney disease (CKD) is the progressive and irreversible loss of kidney function. It exposes to many complications, among which, digestive complications. In Mali, we do not have data on the prevalence of digestive pathologies in people with chronic renal failure, hence the interest of this study. Objective: To determine the prevalence of digestive pathologies and to describe their manifestations during chronic renal failure. Patients and Methods: This was a prospective cross-sectional study conducted from September 2016 to August 2017, a period of 12 months. Included were patients hospitalized in our department with CKD who received digestive endoscopy and/or liver serology. Results: Seventy-one patients underwent digestive endoscopy with oesogastroduodenal fibroscopy (60 patients), rectoscopy (6 patients) and anoscopy (5 patients), i.e. 15.9% of those hospitalized. The mean age of the patients was 48 ± 14 years with extremes of 15 and 84 years. The sample consisted of 59.2% men versus 40.8% women, for a sex ratio of 1.5. The functional signs are in order of frequency: vomiting (72.4%), anorexia (51.3%) and epigastralgia (48.7%). Terminal CKD by creatinine clearance accounted for 88.2% of cases, of which 47.4% were monitored by hemodialysis. Hepatitis C virus infection was present in 21.3% of cases, hepatitis B (18%) and HIV (7.5%). Endoscopic examinations were represented by fibroscopy (84.5%), rectoscopy (8.5%) and anuscopy (7%). The fibroscopic lesions were respectively gastric (96.8%), duodenal (14.1%) and esophageal (12.5%). They were dominated by gastritis (40.5%), duodeno-gastric reflux (16.4%), pyloric gap (12.6%). Rectoscopy found 4 cases of hemorrhoids, 2 cases of rectitis and no lesions were observed at anuscopy. Conclusion: The prevalence of these digestive manifestations and the endoscopic lesions encountered indicate the importance of digestive endoscopy and the performance of hepatic serologies in chronic renal failure patients w

关键词： Chronic Renal Failure Digestive Signs Mali

Satisfaction of Patients Operated on and Hospitalized in the Surgery Department of the Referral Health Center of Commune I in the District of Bamako (Resource-Limited Health District)

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Surgical Science 2024年第10期15卷 523-535页

作者： Diarra Lassény Sanogo Modibo Konaté Moussa Dembélé Nouhoum Kollé Diallo Mamadou Diakité Ibrahima Kalil Tounkara Idrissa Samaké Alou maiga Mariam M. S. Ag Med Elmehdi Elansari Keita Mamadou Touré Mamadou Karim Dembélé bakary Tientigui Bamako Dermatology Hospital (HDB) Bamako Mali Reference Health Center of Commune I Bamako Mali Reference Health Center of Commune VI Bamako Mali Reference Health Center of Commune II Bamako Mali Department of General Surgery University Hospital Center Gabriel Tour Bamako Mali Department of General Surgery Faculty of Medicine and Odonto-Stomatology of Bamako University Hospital Center Gabriel Tour Bamako Mali

Introduction: Evaluating the quality of care offered is a reliable indicator of the effectiveness of a health system. Developing countries are still lagging behind in implementing these principles. This work aims to evaluate the satisfaction of patients operated on and hospitalized in the surgery department at the municipality’s reference health center over a period of 6 months (June 2020 to December 2020). Materials and Methods: This is a quantitative, qualitative, transversal and evaluative study over a period of 6 months based on a self-administered questionnaire to patients who underwent surgery and were hospitalized in the surgery department of the reference health center of commune I upon leaving their hospitalization. The questions are structured around welcome, respect and privacy, care, accommodation conditions as well as overall satisfaction. Results: The survey included 260 patients, 60.8% of whom were male. The 31 - 40 year old age group was in the majority and the majority had completed primary education (42.3%). Married patients were the majority, i.e. 60.4% of cases. Patients were not insured in 66.5% of cases. Almost all of the patients surveyed found that the welcome, care, waiting time, respect and privacy were satisfactory. On the other hand, patients found the rooms and beds uncomfortable. Conclusion: The satisfaction survey reveals worrying data regarding the comfort of patients who must challenge caregivers in healthcare structures. Decision-makers should find useful information there to improve the quality of care.

关键词： Quality of Care Satisfaction Surgery CSRéf CI

Stomach Cancer in the General Surgery Departement at the Teaching Hospital Gabriel Toure

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Surgical Science 2022年第4期13卷 188-197页

作者： Madiassa Konate Amadou Traore Moussa Samake Abdoulaye Diarra Idrissa Tounkara Boubacar Karembé Amadou Bah Boubacar Yoro Sidibé Tany Koné Amadou maiga Zakari Saye Sana Kouriba Arouna Doumbia Ibrahim Diakite bakary T. Dembelé Alhassane Traore Lassana Kante Adegné Togo General Surgery at Teaching of Gabriel Toure Bamako Mali

Introduction: Stomach cancer is a malignant tumor developed at the expense of the gastric wall. Gastric cancer is a common cancer occupying the 5th rank of cancers in the world, or 5.7% of all cancers. Purpose: To study epidemiological, diagnostic, therapeutic, and prognostic aspects of stomach cancer. Methodology: This was a retrospective and prospective study, which was carried out in the General Surgery Department at the teaching hospital Gabriel Touré between January 1, 1999, and December 31, 2020, and all cases of stomach cancer were confirmed by histological examination. Result: We recorded 857 cases of stomach cancer or 40.1% of digestive cancers. The sex ratio was 1.6. The average age was 55 years ± 13 years. The main clinical signs were epigastralgia (98.6%), vomiting (93.34%), weight loss (96.03%), and anorexia (46.1%). It was adenocarcinoma (97.55%), and antropyloric location (78.64%). Patients were Stage IV (72.817%) cases. Among the 857 patients, 722 were operated on, accounting for 84.25% of the cases. Surgery was palliative in 60.66% and curative in 25.62%. Gastrectomy of 4/5 plus D2 type curage was the most performed in curative surgery. The median overall postoperative survival was 5 months. Conclusion: Stomach cancer is the most common digestive cancer in our department, the diagnosis is most often late, so palliative surgery occupies an important place.

关键词： Cancer Stomach Surgery Survival