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Evaluation of Antibiotic Prescribing in the Pediatric Department of Gabriel TouréTeaching Hospital, Bamako, Mali

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Open Journal of Pediatrics 2024年第3期14卷 645-656页

作者： Pierre Togo Hawa Konaré Mariam Maïga Karamoko sacko Djénéba Konaté Abdoul Karim doumbia Adama Dembélé Oumar Coulibaly Aminata sangaré Mohamed Elmouloud Cissé Fousseyni Traoré Belco Maïga Ibrahim Ahamadou Aminata doumbia Lala N’Drany sidibé Amadou Touré Yacouba Aba Coulibaly Kalirou Traoré Tati simaga souleymane sagara Leyla Bagna Maïga Bory Traoré Abdoul Aziz Diakité Fatoumata Dicko Mariam sylla sounkalo Dao Boubacar Togo Paediatric Department Gabriel Tour&#233 Teaching Hospital Bamako Mali Pediatric Department Distric VI Reference Health Center Bamako Mali Infectious Diseases Department Point G Teaching Hospital Bamako Mali

Objectives: The main objective was to evaluate antibiotic prescribing in the Department of Pediatrics at Gabriel Touré teaching hospital. Methods: This was a prospective descriptive study conducted from september 1 to November 31, 2018, in the Department of Pediatrics at Gabriel Touré teaching hospital. All children aged 0 to 15 years hospitalized for any pathology during the study period and having received at least one antibiotic had been included. Results: We collected 445 children’s records out of 1032 admissions during the study period, representing a hospital frequency of 43.1%. The sex ratio was 1.3%. The 2 - 5 age group accounted for 48.1%. Fever was the reason for consultation in 45.6% of cases. Patients’ general condition was altered in 60% of cases. The fathers were blue-collar workers in 65.4% and the mothers housewives in 85%, and had no education in 42.9% and 64.5% respectively. Hepatomegaly was present in 18.2%, splenomegaly in 9.6% and peripheral adenopathy in 3.1%. The site of infection was pulmonary in 37.6% and ENT in 9.2%. Bacterial infection was assumed on admission in 54% of cases, and meningitis in 57.7%. The discharge diagnosis was malaria in 54.6%, severe acute malnutrition in 18.6% and meningitis in 6.7%. The death rate was 3.8%. Neutrophilic leukocytosis was present in 47.3% of patients. CRP was positive in 85% of patients. Blood cultures taken in 27.6% of patients were positive in 5. CsF analysis in 30% of patients showed elevated leukocytes in 6.5%. No cultures were positive. Antibiotic prescription was justified by infectious hypotheses in 43.1% of patients. β-lactam antibiotics were prescribed in 98.6%. Antibiotic therapy was not adapted to national/international recommendations in 68.3% of cases, and was not justified in 16.3% of cases on D5 of hospitalization. Conclusion: Antibiotic use was justified in more than half of patients, but remained inadequate in almost two-thirds of cases, in line with national and international recommend

关键词： Antibiotic Prescription Hospitalization Child

Effectiveness and Tolerance of Tenofovir Disoproxil Fumarate in sub-saharan Viral B Cirrhotic Patients

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Open Journal of Gastroenterology 2019年第2期9卷 43-47页

作者： doumbia K.Wife samaké sow H.Wife Coulibaly M.Y.Dicko A.M.Diallo sanogo s.D.Wife sidibe A.Kondé M.C.Tounkara D.sangare A.Konaté M.T.Diarra M.Y.Maiga Hepato-Gastroenterology Department CHU GabrielBamakoMali

Tenofovir reduces viral load during viral cirrhosis B and improves prognosis. The aim of this study was to evaluate the effectiveness and safety of Tenofovir during the treatment of viral B cirrhosis. The study was retrospective and prospective on patients with viral B cirrhosis treated with Tenofovir in the Hepato-Gastroenterology Department of University Hospital Gabriel Touré in Bamako (Mali) and evaluated between three and six months after the start of treatment. We included 89 patients. The mean age was 44.5 ± 16 years with extremes of 18 and 90 years. The sex ratio was 1.2. At inclusion all patients had a detectable viral load with an average of 2651.96 ± 1495.85 IU/ml. Follow-up viral load was undetectable in 84.3% with patients between 3 and 6 months of treatment. The average detectable viral load was only 27.04 ± 21.05 IU/ml. There was also an improvement in hepatocellular function and few side effects. Conclusion: This study shows the interest of Tenofovir in the treatment of viral cirrhosis B with very few adverse effects.

关键词： Cirrhosis Tenofovir HBV

Traumatic Perforation of the small Intestine in General surgery of the CHU Gabriel Touré

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surgical science 2017年第9期8卷 414-421页

作者： Alhassane Traoré bakary Tientigui Dembélé Ibrahima Diakité Adégné Togo Lassana Kanté Amadou Traoré Madiassa Konaté Boubacar Karembé Abdoulaye Diarra Amadou Bah Boubacar sidibé Tany Koné Astan Koné Nouténé Koné Djibo Mahamane Diango Gangaly Diallo Department of General surgery CHU Gabriel Touré Bamako Mali Department of Anesthesia and Intensive Care CHU Gabriel Touré Bamako Mali

Goal: To determine hospital frequency, to describe the clinical and therapeutic aspects and to determine the prognosis. Patients and Methods: This was a retrospective and prospective study carried out in the General surgery Department from 1 January 1999 to 31 December 2015. Inclusion criteria: 1) open or closed trauma of the abdomen with perforation of the small bowel;2) clinical examination (abdominal pain, vomiting, fever, abdominal contracture, evisceration, intraoperative findings);3) paraclinical examinations: pneumoperitoneum on the abdominal X-ray without preparation (AsP) and CT scan. Exclusion Criteria: Abdominal trauma without perforation of the small bowel. We selected 128 patients operated for traumatic perforation of the small bowel. The data was entered and analyzed using Word, Excel 2007 and statistical Package and social science Windows 16.0. The statistical analysis consisted in the calculation of the different frequencies of the variables studied. We used the Khi2 test with significance level P Results: We recorded 119 men versus 9 women and the sex ratio was 13.22. The mean age was 25 years with extremes varying between 15 and 70 years. The majority of patients 57.7% (74 cases) came from the capital, 46.1% (59 cases) were workers, 26.6% (34 cases) of the students. The average time to admission was 29 hours. The main etiologies were road traffic accidents 36.7% (47 cases), stabbing 21.9% (28 cases), firearm 14.8% (19 cases), and sports accidents 10.1% (13 cases). The main clinical signs were abdominal pain 48.44% (62 cases), abdominal contracture 60% (76 cases), disappearance of pre-liver dullness 66.36% (84 cases), and Douglas painful 74.4% (94 cases). The abdominal X-ray without preparation (A.s.P) allowed to objectify a pneumoperitoneum in 45.31% and the scanner a liquid effusion in 45.31% with the associated lesions in 37.5% (48 cases). The surgical treatment consisted of 60.15% suture excision (77 cases), 25% anastomosis resection (32 cases)

关键词： Abdominal Trauma small Perforation surgery Mali

Appendicular Abscess: Epidemio-Clinical and Therapeutic Aspects in the General surgery Department of the Reference Health Center of Commune III (*** CIII) of the District of Bamako

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surgical science 2023年第2期14卷 77-83页

作者： Karembé Boubacar Tounkara Idrissa Diarra Issaka soumaré Modibo Dianguina Traoré Boureima sanogo seydou Diallo Moctar Camara Aboubacar Touré Aboubacar Coulibaly Abdoulaye Fall Ibrahim Diakité Mané Diarra Mouminy Diarra Drissa Traoré Abdoulaye Coulibaly Yacaria Kanté Lassana Dembélé bakary Tientigui Togo Adégné Départment of surgery CHU Gabriel Touré Bamako Mali

Objectives: The main goal of this study is to determine the hospital frequency of appendicular abscess, to describe the diagnostic and therapeutic aspects and to analyze the postoperative follow-up. Methodology: This was a descriptive and analytical prospective study from January 1, 2020 to June 30, 2021 including patients admitted to our department for appendicular abscess diagnosed pre- and or intraoperatively and confirmed to histology. Results: We collected 30 appendicular abscesses that accounted for 18.75% of emergency interventions. The 16 - 25 age group was the most represented at 53%. The average age was 24 years with extremes of 10 and 58 years. The male sex was mostly represented (60%) with a sex ratio of 1.5. The majority of our patients were students (53.3%). The main clinical signs found were abdominal pain and vomiting (100%). The pain was localized in the Right Iliac Fossa (RIF) in 80% of cases. Fever was present in all our patients with a temperature between 38˚C and 38.5˚C. The physical examination found pain with defense of the right iliac fossa in 93.3% of cases. A painful mass was present in 27 patients (90%). Treatment consisted of appendectomy with abscess drainage in all patients. Postoperative follow-up was simple in 83.3% of cases;we recorded three cases (10%) of parietal suppuration, one case of fistula (3.3%) and one death. Conclusion: Appendicular abscess is a medical-surgical emergency frequent surgery in our context because of the delay in diagnosis. It is a condition with low morbidity and mortality subject to early diagnosis and prompt and appropriate treatment.

关键词： Abscess Appendix surgery

Case Report: Autoimmune Pancreatitis: About a Case in Hepato-Gastroenterology Department of Mother-Child Hospital in Bamako/Mali

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Health 2020年第10期12卷 1379-1382页

作者： sanra Déborah sanogo Moussa Y. Dicko Ganda soumaré Kadiatou doumbia Hourouma sow Makan s. Tounkara Youssouf Kassambara Hamadoun Guindo A. Maiga A. Kondé Abdoulaye Diarra Ilias Guindo Drissa Katilé Ouatou Mallé Anselme Konate Moussa T. Diarra Bougouzié sanogo Moussa Y. Maiga Gastroenterology Department Point G University Hospital Bamako Mali Gastroenterology Department Gabriel Touré University Hospital Bamako Mali Gastroenterology Department Mother-Child Hospital Bamako Mali surgery Department BSS University Hospital Bamako Mali

Autoimmune pancreatitis is a distinct form of chronic pancreatitis. It is a chronic pancreatitis distinct from alcohol, genetic or idiopathic impairment and involves possible autoimmune mechanisms. The diagnosis of autoimmune pancreatitis is based on a body of biological, histological and radiological arguments. Also called sclerosing lymphoplasmacytic pancreatitis, it is one of the causes of chronic pancreatitis. The risk factor for the onset of cancer that it represents and its sensitivity to corticosteroids make it a pathology requiring special management. We report a case of autoimmune pancreatitis in a 35-year-old patient.

关键词： Autoimmune Pancreatitis Young Woman Diagnosis Mali

sigmoid Colon Volvulus: surgical Management at Kati Bss Hospital (Mali)

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surgical science 2019年第3期10卷 76-82页

作者： Koniba Keita Abdoulaye Diarra salia Coulibaly sidiki Keita Issa Traore Moussa doumbia Fadima Tall Daouda Diallo Oulematou Coulibaly Assitan Kone Boubacar Kone Daouda Konate Amadou Kassongue Moussa salifou Diallo Ismael Konare Drissa Traore Nouhoum Ongoiba General surgery Department Kati Mali Medical Imaging Department Kati Mali Anesthesia Resuscitation Department Kati Mali Ophthalmology Department of Kati Kati Mali Department of Urology of Kati Kati Mali

The objective of this study was to describe the therapeutic aspects and to evaluate the surgery results of sigmoid Volvulus in the Kati (MALIA) General surgery Department. Patients and Methods: This was a descriptive study conducted in our General surgery Department. It took place in two phases for six years: A retrospective phase from January 1st, 2010 to December 31st, 2015 and a prospective phase from January 1st, 2016 to December 31st, 2017. This study has been approved by the Ethics Committee. It’s concerned all the patients operated in the department for colon Volvulus. Results: We collected 70 patients’ files. The sigmoid Volvulus represented 7.8% of emergency surgery activities and 37.2% of intestinal obstruction. The male sex predominated with 98.57% against 1.43% of the female sex. The average age was 42.11 years old with limits of 18 to 70. The average deadline evolution was 2.53 days with limits of 1 to 3. The sigmoidectomy with immediate anastomosis was performed in 66% of patients, colectomy with 2-times anastomosis: according to Hartman 20% and Bouilly Volkman 11%, detorsion with colopexy 3%. The early morbidity rate was 5.71%. The average duration of hospitalization was 10.8 days with limits of 5 to 40 days. Two deaths were recorded. Conclusion: sigmoid Volvulus is frequent in young adult sex male in Africa. We did not find any significant difference between the surgical technique and the advent of complications. The Colectomy with immediate anastomosis seems to be ideal to us that anytime the conditions are appropriate.

关键词： Volvulus sigmoid Colectomy surgery

Evaluation of the Quality of Prenatal Consultation in Rural Area of Mali, Case of Kadiolo Health District

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Open Journal of Clinical Diagnostics 2020年第1期10卷 49-64页

作者： Fane seydou sissoko Abdoulaye Kanté Ibrahima Bocoum Amadou sima Mamadou sanogo Abdoulaye Traore soumana Oumar sanogo siaka Amara Traore Mamadou salia Traore Alassane saleck doumbia Mamadou Keita salem Yargueit Traore Youssouf Tegueté Ibrahima Mounkoro Niani Gynecology-Obstetrics service University Teaching Hospital Gabriel Touré Bamako Mali Hospital Mother-Child the Luxembourg Bamako Mali University Teaching Hospital of Point G Bamako Mali Referral Health Center of Kadiolo Bamako Mali Referral Health Center of Commune V Bamako Mali Hospital of Mali Bamako Mali Referral Health Center of Commune VI Bamako Mali

Every woman has the right to receive satisfactory quality prenatal care in reproductive health. Giving a life while remaining alive and without sequelae must be the slogan of any gynecologist - obstetrician and midwife, as well as any health worker. It was a descriptive cross-sectional study dealing with the evaluation of the quality of prenatal consultations at the Kadiolo referral health center (or RHC). Adevis Donabedian’s model for assessing the quality of care and services served as a benchmark. According to Donabedian quality means good technical care, with good interpersonal relationships, and adequate and comfortable premises. This study took place from April 24 to December 04, 2017 and aimed to assess the current level of the quality of prenatal consultations at the Kadiolo referral health center, to study the structures in place including infrastructure and personnel, to specify the procedures and to determine their results. This work has permitted us to classify the RHC of Kadiolo at level III with 85%, which means that the references evaluated were satisfactory, with the level of 75% to 94%. In terms of structure, a pricing system was deemed affordable by the opinion of pregnant women. The analysis of the level of the human dimension revealed that the health center was level III. The pregnant women were satisfied with the reception which was good in 76% of the cases, as well as with the quality of the respect of the privacy in 96% and confidentiality in 95%. Despite the satisfaction of pregnant women, gaps remain to be filled in concerning the quality of the services received at the Kadiolo referral health center so as to reach level IV.

关键词： Pregnancy Prenatal Consultation Quality of Care and services Risk Factors Kadiolo Referral Health Center Mali

Varicocele and spermogram Abnormality: About 264 Cases at the Fertilia Medical Clinic in Bamako

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Open Journal of Medical Imaging 2023年第3期13卷 84-91页

作者： Mamadou Dembélé Alassane Kouma Ilias Guindo souleymane sanogo Zoumana Cheick Berete Ousmane Traoré Mamadou N’diaye Brahima doumbia Oncoumba Diarra Issa Cissé Aboubacar sidiki N’diaye Bandiougou Doucouré Youssouf Yalcouyé Adama Diaman Keita siaka sidibe Faculty of Medicine and Odonto-stomatology of Bamako (FMOs) Bamako Mali Medical Imaging Department Kati University Hospital Kati Mali Department of Education and Research in Public Health (DERsP) Bamako Mali

Aims: To determine the impact of varicocele on the result of the spermogram in a group of hypo-fertile or infertile men. Patients and Method: This was a cross-sectional, descriptive study concerning 264 men collected between February 2020 and March 2022 at the Fertilia medical clinic in Bamako. The study population consisted of consenting male subjects presenting for infertility. All of our patients had already done a spermogram, they then benefited from a scrotal Doppler ultrasound. The scrotal echo-doppler was completed by an abdominal and pelvic echography in search of a possible etiology, in particular a renal cancer, a thrombosis of the renal or spermatic vein, a retroperitoneal mass or a nutcraker syndrome. Testicular volume was measured on ultrasound according to Lambert’s formula (length × width × height × 0.71). A volume = 16 ml was considered normal. Results: 264 patients were recruited in ours. The average age was 33 years with extremes ranging from 25 to 65 years. 149 patients or 56.44% were between 30 and 45 years old. 213 patients or 80.68% had primary infertility. All the patients, i.e. 100%, had a sperm anomaly and dilation of the pampiniform plexus veins. The most common sperm abnormalities were oligoasthenoteratozoospermia, which concerned 214 patients, or 81%, followed by azoospermia (40 patients, or 15%) and oligospermia (10 patients, or 4%). 213 patients or 80.68% had a Hirshen grade II varicocele, 45 patients or 17% had grade I and 06 patients or 2.27% had grade III. Among the 6 patients, 04 had left testicular atrophy and 2 bilateral atrophy. The venous reflux was more accentuated on the left than on the right. Conclusion: Varicocele is significantly found in men with infertility. sperm alterations concern both the concentration of spermatozoa, their mobility and their vitality. Even if the mechanism of alteration of the sperm parameters is not well elucidated, our study made it possible to make the link between the dilation of the veins of th

关键词： Ultrasound Male Infertility Varicocele Oligoasthenoteratozoospermia

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