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Jejuno-Ileal Ruptures after Blunt Abdominal Trauma at the Teaching Hospital of Bouake

Surgical Science 2022年第3期13卷 124-134页

作者： Kouakou Ibrahim Anzoua Kouamé Bernadin Kouakou Mamadou Traoré Kalou Ismael Leh Bi Alassane Binaté Venance Dago Aloka blaise Amos Kouakou Amos Serge ekra Roger Lebeau Bamourou Diané Department of General and Digestive Surgery Teaching Hospital of Bouake Bouake C&#244te d’Ivoire

Objective: The aim of this study is to determine the causes, pattern, management, and outcome of jejunal-ileal rupture following blunt abdominal trauma at the teaching Hospital of Bouake. Methods: The study included 27 patients who underwent laparotomy for jejunoileal injuries from blunt abdominal trauma at the Teaching Hospital of Bouake over a period of 14 years from January 2007 to December 2020. A retrospective study was conducted and the patients were analyzed with respect to patient demographics data, cause, injury mechanisms, presentation, anatomical distribution, diagnostic methods, associated injuries, treatment and outcomes. Results: During the 14 year period from 2007 to 2020, 27 patients with blunt small bowel injuries were treated at our Teaching Hospital. That is 2.9% of all blunt abdominal trauma. Male to female ratio was 4.4:1 and the average age was 26.3 years (range: 15 and 50 years). The majority (66.7% 18 cases) were Victims of road traffic accident. Median delay between injury and arrival at hospital for these patients was 10.1 hours (range: 1 - 72 h). A single intestinal injury was present in 22 patients, while 5 patients suffered from 2 injuries. There were 32 perforations of the small intestine in 27 patients with two perforations being transection. All perforations were located on the antimesenteric border of the intestine. Out of the 32 jejuno-ileal ruptures 18 were located on the jejunum while 14 were located on the ileum. Associated intra-abdominal injuries were present in 6 patients and nineteen associated extra-abdominal injuries were present in 10 (70.4%) patients. A one-stage therapeutic strategy was performed in 20 cases (74.1%) and a two-stage strategy was performed in seven cases (25.9%). Intestinal continuity was restored 93.8 days later (range 60 and 140 days). The average length of hospital stay of the operated patients was 11.4 days. The operative morbidity was 25.9%. Conclusion: Jejuno-ileal ruptures are rare and characterized

关键词： Rupture Jejunum Ileum Blunt Abdominal Trauma Peritonitis Hemoperitoneum

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Intracranial Calcified extradural Hematoma about a Case

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Open Journal of Modern neurosurgery 2023年第2期13卷 69-73页

作者： Drissa Kanikomo Moussa Diallo André Tokpa Youssouf Sogoba Izoudine blaise Koumaré Mamadou Salia Diarra Boubacar Sogoba Oumar Diallo Mahamadou Dama Oumar Coulibaly Mamady Coulibaly Abdoulaye Kanikomo Department of neurosurgery Teaching Hospital Gabriel Toure Bamako Mali Department of neurosurgery Teaching Hospital of Bouake Bouake Cote d’Ivoire Department of neurosurgery Luxembourg Hospital of Bamako Bamako Mali Department of neurosurgery Mali Hospital Bamako Mali

Introduction: extradural hematoma is a common pathology in our department. The natural history of small-volume hematoma is usually towards resorption. In rare cases, the hematoma calcifies and compresses the brain. We report an extradural hematoma in a 15-year-old boy who had a road traffic accident on February 2011. The brain CT-scan performed the following day revealed a small right frontal extradural hematoma. During hospitalization, he had a fever of 40 degrees with convulsions and the blood culture isolated the coagulase-negative staphylococci and Group D streptococci. When his conscience was restored, hemiparesis and dysarthria were observed. The control brain CT-scan performed 2 weeks after the trauma showed early resorption of the hematoma. Two months after the trauma, the brain CT-scan showed calcification of the hematoma. He underwent surgery in April 2011 to remove the calcification. The sequels were hemiparesis and posttraumatic epilepsy. Conclusion: The evolution of a small non-operated extradural hematoma can be done towards calcification thus requiring surgery.

关键词： extradural Hematoma Calcification

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Preliminary Research Study for Antibiotics in eggs Produced and Sold in Bamako, Mali

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Food and nutrition Sciences 2022年第3期13卷 252-258页

作者： Dalané Bernadette Coulibaly Mohamed el Béchir naco Dougoutigui Tangara Fatoumata Tata Sow Fanta Kaba Camara Hamadoun Abba Toure Madani Mariko blaise Dackouo Seydou Moussa Coulibaly Benoit Yaranga Koumare Faculty of Pharmacy of Bamako/University of Technical and Technological Sciences of Bamako Bamako Mali national Health Laboratory Bamako Mali national Food Safety Agency Bamako Mali

The quality of agri-food products, in particular those of poultry origin, has now become an imperative. Because of the antibiotics used in poultry production, we are seeing the presence of antibiotic residues in products from poultry farming, especially eggs. Residues in eggs do not always comply with regulatory requirements, which can have harmful consequences for consumers such as: risk of allergies or risk of antibiotic resistance. This study was carried out with the aim of evaluating the presence of residues of veterinary antibiotics in eggs produced and marketed in the district of Bamako and surroundings. All samples were analyzed using the Premi ®Test which is a rapid detection kit for antibiotic residues in different materials. We collected 900 eggs from 10 farms and 10 markets in Bamako. Out of 900 eggs, 228 were tested. One hundred and eighty-nine (189) eggs tested negative for the presence of antibiotic residues, i.e. 82.9%;on the other hand, 39 were positive, i.e. 17.1%. This study clearly shows the presence of antibiotic residues in eggs from farms and various markets in Bamako and the surrounding area. This will allow us to continue our study at a later date to identify the types of antibiotic and to dose them.

关键词： Antibiotic Residues eggs Mali

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Prognosis of the Patients in Resuscitation Field in Mali

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Open Journal of Anesthesiology 2019年第12期9卷 213-220页

作者： Broulaye Massaoule Samake Andre Kassogue blaise Adelin Tchaou Aichata Konate Fadima Koureissi Tall Lassina Goita Seydina Alioune Beye Hamadoun Dicko Mamadou Karim Toure Mohamed Keita Dieneba Doumbia Service of Anesthesia and Resuscitation Teaching Hospital Gabriel Toure BamakoMali Service of Anesthesia Resuscitation and EmergenciesAcademic Hospitable Center and Department of the Bourgou/AliboriParakouBenin Service of Anesthesia Resuscitation and Emergency of the Academic Hospitable Center of KatiKatiMali Service of Anesthesia Resuscitation and the Emergencies of the Center Hospitable Academic Point GBamakoMali Service of Anesthesia Resuscitation and emergency of the Academic Hospitable Center Luxemburg BamakoMali

Introduction:The patients whose vital prognosis is immediately threatened by one or several serious organs failures and consecutive to various pathologies are admitted in resuscitations(IUC).The rates of morbi-mortality are raised in ***:To study the prognostic *** and Methods:It was about a transverse survey from January 2015 to April 2016 in the unit of polyvalent resuscitation of the service of anesthesia resuscitation of the academic hospital center of Gabriel *** included all patient admitted for medico-surgical pathologies of more than three hours of *** was about a consecutive recruitment of *** Chi^(2) and Fisher tests were used for the comparison of our results with a p value=0.05 considered as *** consent of the patients or parents was *** survey didn’t include a potentially dangerous ***:During the period,624 patients have been collected of which:50.4%were medical pathologies,19.4%surgical pathologies and 30.2%of gynéco-obstetric *** least a complication had occurred in 11.2%.Mortality was of 27%.The sex-ratio was of *** middle age was of 31.88±17,2 years with extremes of 2 years and 80 *** met complications were:the scab,the syndrome of acute respiratory distress(ARD),the urinary infection,the pneumopathie,the shock,thrust hypertensive,stops cardio circulatory with respectively 35.1%,26.6%,22.3%,6.4%and 3.2%.The middle length of stays was of 4.83±5.32 days with extremes of 1 day to 29 ***:The complications under hospitalization in unit(IUC)of resuscitation in Mali are a major challenge in term of prevention and *** potentially non serious pathologies complicate themselves and compromise the vital prognosis.

关键词： Morbimortality Resuscitation Academic Hospitable Center Mali

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Management and Outcome of Acute Subdural Hematoma in Gabriel TouréHospital

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Open Journal of emergency Medicine 2022年第1期10卷 48-53页

作者： Youssouf Sogoba Drissa Kanikomo Quenum Kouassi Jean Marie Kisito Moussa Diallo Bakary Dembélé Boubacar Sogoba Djènè Kourouma Izoudine blaise Koumaré Seybou Hassane Diallo Hamidou Almeimoune Moustapha Mangané Thierno Madane Diop Oumar Coulibaly Mamadou Salia Diarra Mahamadou Dama Oumar Diallo Youssoufa Maiga Djibo Mahamane Diango Department of neurosurgery Gabriel Touré Teaching Hospital Bamako Mali neurosurgeon University of Parakou Parakou Benin Department of neurology Gabriel Touré Teaching Hospital Bamako Mali Department of emergency Care Gabriel Touré Teaching Hospital Bamako Mali Department of neurosurgery H&#244 pital du Mali Bamako Mali Department of neurosurgery H&#244 pital Luxambourg Bamako Mali

Background: Traumatic Brain Injury (TBI) is a major health problem worldwide. It is the main cause of trauma mortality. Acute subdural hematoma (ASDH) has a reputation for being the most serious of all posttraumatic head injuries. Its frequency is estimated to be 1% to 5% of all head injuries and 22% of severe head injuries. The aim of this study was to assess the epidemiological, clinical and prognosis aspects of ASDH in our department. Material and Methods: This prospective study, from January to December 2019, included 57 patients admitted to the Gabriel Touré Teaching Hospital for ASDH. Patients underwent detailed clinical and radiological evaluation and ASDH was diagnosed by non-contrast computed tomography (CT) scan. Functional outcome was evaluated 6 months after injury by Glasgow Outcome Scale. Results: During the study period, 662 patients were admitted for TBI including 57 (8.61%) cases of ASDH. The mean age was 34 years with extremes of 2 and 77 years. There was a male predominance with 52 (91.2%). The main cause of trauma was motor vehicle accidents in 38 (66.6%) patients. According to the Glasgow coma scale (GCS), 33 (57.9%) patients were classified mild (Table 2). The thickness of the hematoma was more than 1 cm in 13 (22.8%) patients and less than 1 cm in 44 (77%) patients. Surgical treatment was performed in 13 (22.8%) patients. The outcome was favorable in 30 (52.6%) patients and the mortality rate was 33.3%. Conclusion: ASDH remains a difficult challenge because of the high mortality. The mortality rate remains high particularly in patient with poor GCS score at admission.

关键词： Acute Subdural Hematoma Traumatic Brain Injury Outcome

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Treatment of neglected elbow Dislocations by Z-Lengthening of the Triceps Brachii

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Open Journal of Orthopedics 2022年第4期12卷 142-152页

作者： M’Bra Kouamé Innocent Kouassi Kouamé Jean-eric Yao Loukou blaise AkobéJean Regis Achie Sery Bada Justin Léopold KouassiAya Adélaïde natacha Krah Koffi Leopold Michel Kodo Traumatology and Orthopedics Surgery of the University Hospital of Bouaké Bouaké C&ocirc te d’Ivoire

Introduction: neglected elbow dislocations are much more common in developing and underdeveloped countries. The main reason for the delay in diagnosis is that patients initially seek treatment from traditional healers. These will immobilize the elbow in extension, which will lead to the retraction of the triceps muscle and collateral ligaments. Patients and Method: We carried out a prospective study over five years (2014-2019). The study involved patients with unreduced elbow dislocation older than 21 days. All patients with a dislocated fracture and those whose x-ray showed joint fusion were not included in the study. We collected 26 patients, 20 men and 6 women with an average age of 27.5 years (17 and 45 years). The average consultation time was 8.9 months (3 - 13). The approach was posterior about 8 cm above the olecranon and 2 cm below the olecranon, the ulnar nerve was identified and isolated. The triceps tendon was cut in a Z from its myotendin junction to the beak of the olecranon, and then lengthened. Results: The patients were reviewed after a mean follow-up of 24 months (12 - 36). The Mayo Clinic’s average elbow performance index was 77.1 (60 - 85), with 19 good and 6 average results. The mean flexion was 114°(100°- 135°) and the mean extension deficit was 31.15°(10°- 55°). The average range of motion was 82.5°(60°- 120°). We did not find a correlation between the duration of the lesion and functional recovery (p > 0.05). The Wilcoxon test showed that surgery significantly improved the overall range of motion of the elbow (p = 0.001). Discussion: Based on this study, open reduction with tendon lengthening should remain a treatment option regardless of the age and chronicity of the dislocation.

关键词： elbow Dislocation neglected Triceps Plasty Posterior Approach

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黑色素瘤伴亚急性原发性纤维蛋白溶解

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世界核心医学期刊文摘（皮肤病学分册） 2006年第4期2卷 18-19页

作者： blaise S. Rumeau-Trividic M. Le Brun V. 周少娜 Department of Medicine CHU Michallon B.P.217 38043 Grenoble Cedex 09 France

Background: Surgery is the first treatment of a pigmented skin lesion when a melanoma is suspected. This excision is most of the time realized by the dermatologist as well as the second time surgery. Bleeding at the surgical site may have numerous aetiologies. Fibrinolysis is a rare but dramatic event. Case report: We report a case with delayed bleeding after excision of a melanoma. The patient was re-operated and a major haemorrhage followed so that a transfusion of blood and fresh frozen plasma was necessary. The biological investigations concluded to a subacute primitive fibrinolysis associated with the melanoma. The patient was first considered to have completely recovered when a blood-borne liver metastasis diffusion rapidly occurred. The patient deceased within a few months from a hepatic encephalopathy with hepatic metastases. Discussion: We find only a few published cases of melanoma with fibrinolysis. Its association with other abnormalities, like a partial factor XIII deficiency, made these abnormalities even more difficult to identify. The relation between the subacute fibrinolysis, the melanoma and the liver infiltrative metastasis is difficult to establish.

关键词：黑色素瘤纤维蛋白溶解肝转移冷冻血肝性脑病色素性切除术皮肤科医师血源性外科手术

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Multiple Myeloma: Modification and Adaptation of Plasma Cell Morphology Algorithm for the Prognosis of Congolese Patient

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Open Journal of Blood Diseases 2022年第2期12卷 29-38页

作者： Jean Pierre Mufuta ntolo Ritha nyembu Kibambe Luc Kapia Lunkamba Paola Bilonda Kalonji blaise Sumbu Gustave Ilunga ntita Jean Marie Mbuyi Muamba Jérémie Muwonga Madidi Donatien Kayembe nzongola Department of Medical Biology Ngaliema Clinic Kinshasa Democratic Republic of the Congo Clinical Biology Service University Clinics of Kinshasa Kinshasa Democratic Republic of the Congo University of Kinshasa Kinshasa Democratic Republic of the Congo Department of Rheumatology University Clinics of Kinshasa Kinshasa Democratic Republic of the Congo

Objectives: To determine the multiple myeloma (MM) prognostic formulas applicable in Congolese with many aberrant and/or immature plasma cells according to GOASGUen’s plasma cell morphology algorithm (PMA). Methods: The prospective, observational and descriptive study was carried out at the ngaliema Clinic in Kinshasa from July 2016 to December 2019. The variables studied were the plasma cell types and the prognosis groups according to GOASGUen and ZAnDeCKI. The nucleolus, the chromatin and the n/C ratio of 2 for each plasma cell encountered in multiple myeloma are examined in order by asking three successive questions as follows: 1) Is the nucleolus present? If yes, we denote 1;if not, note 0;2) Is the chromatin thin? If yes, we score 1;if not we score 0;3) The n/C ratio is greater than 6, if so, 1 is noted;if not, we note 0. We obtain a number with 3 successive digits preceded by the letter P for each plasma cell. Results: The overall rate of immature plasma cells and aberrant plasma cells in MM among Congolese was high at 26.6%. Their integration in the prognostic formulas showed for group A" = 22 patients, group B" = 5 patients and group C" = 32 patients. examination of plasma cell types in the deceased showed that 14/17 had a P001 plasma cell count ≥ 15%. Conclusion: The high rate of aberrant and/or immature plasma cells, the P001 plasma cell type at a rate ≥ 15%, found mostly in group C" with poor prognosis, are responsible for the aggressive nature of MM in Congolese Blacks.

关键词： Plasma Cell Morphology Algorithm Plasma Cell Types Aberrant Plasma Cells Immature Plasma Cells Multiple Myeloma

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Prevalence, Indications and Morbidity of Caesarean Sections in a Referral Hospital of the Health Voucher Program: The Case of Garoua Regional Hospital in the northern Region of Cameroon

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Open Journal of Obstetrics and Gynecology 2023年第12期13卷 1949-1964页

作者： Mbarnjuk Aoudi Stéphane Kabko Mbargang Georges ngalame Alphonse nyong Ourtchingh Clovis Mangala nkwele Fulbert Anicet Gakdang Ladibe Tameh Theodore Yangsi neng Humphry Tatah Koudjou blaise Halle-ekane Gregory edie Department of Gynecology & Obstetrics Faculty of Medicine and Biomedical Sciences University of Garoua Garoua Cameroon Gynecology & Obstetrics Unit Garoua General Hospital Garoua Cameroon Department of Surgery and Specialties Faculty of Health Sciences University of Buea Buea Cameroon Douala Gyneco-Obstetric and Pediatric Hospital Faculty of Health Sciences (FHS) University of Buea Buea Cameroon Gynecology & Obstetrics Unit Maroua Regional Hospital Maroua Cameroon nkongsamba Regional Hospital Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Cameroon nkongsamba Regional Hospital Faculty of Health Sciences University of Bamenda Bamenda Cameroon Douala General Hospital Dean Faculty of Health Sciences (FHS) University of Buea Buea Cameroon

Caesarean section (CS) is a surgical procedure performed to remove a fetus from the mother’s uterus through an incision on the abdominal wall, then on the uterine wall. The indications of CS vary not only between countries, but also from one hospital to another and from one team to another within the same hospital. Despite advances in asepsis and anesthesia/resuscitation technics, there are still complications of varying severity inherent to the gravid-puerperal state on one hand and the technics used on the other, irrespective of the operative indication. Thus, the present study was carried out with the objectives of determining the prevalence, identifying the indications, and evaluating the morbidity linked to caesarean sections in our environment. Cameroon has also set up a health voucher program in its northern region, aimed at reducing maternal and fetus morbidity and mortality. The program aims to improve financial access in antenatal care and deliveries, including caesarean sections, in this low-income region of the country. We conducted a descriptive cross-sectional study with retrospective data collection, from February 1, 2022, to May 31, 2022. We included all women who gave birth by caesarean section. In our study series, out of 905 parturient admissions into the Department of Obstetrics and Gynecology, 226 were caesarian cases. The overall frequency of CS during our study period was 25%. Fetal indications were dominated by cephalopelvic disproportion and non-reassuring fetal heart in 17.3% and 13.7% of cases respectively. Intraoperative complications were dominated by hemorrhage (15.5%). In our study, we noted an 11.1% of prevalence perinatal mortality. Cameroon is a low-income country with limited financial resources, especially in the northern region. The health voucher program has improved financial access to caesarean sections for parturient in northern Cameroon, and consequently to emergency obstetric and neonatal care.

关键词： Caesarean Section Health Voucher Cephalon-Pelvic Disproportion Hemorrhage

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弓形体性脉络膜视网膜炎的非典型后果——巨大黄斑裂孔

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美国医学会眼科杂志（中文版） 2006年第1期18卷 47-48页

作者： Pierre blaise Yvette Comhaire Jean Marie Rakic 冯云（译）赵光喜（校）

弓形体病是免疫活性个性感染性视网膜炎的最常见病因，鼠弓形体的患病率在世界各地不尽相同。在美国，对其患病率的判断从20%到70%不等。在这些阳性人群中，只有1%残留在临床意义的脉络膜视网膜瘢痕。眼弓形体病往往是一种良性自限性... 详细信息

弓形体病是免疫活性个性感染性视网膜炎的最常见病因，鼠弓形体的患病率在世界各地不尽相同。在美国，对其患病率的判断从20%到70%不等。在这些阳性人群中，只有1%残留在临床意义的脉络膜视网膜瘢痕。眼弓形体病往往是一种良性自限性病变。它也可以引起中心或全部的视力丧失。受影响的眼睛有近四分之一存在法定盲。

关键词：脉络膜视网膜炎眼弓形体病黄斑裂孔非典型巨大常见病因免疫活性世界各地鼠弓形体临床意义

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