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Maternal Mortality in the Gynecology-Obstetric Department at the Yalgado Ouedraogo University Hospital Center (CHUYO), Burkina Faso: About 181 Cases Collected from January 1<sup>st</sup>to December 31<sup>st</sup>2016

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Open Journal of Obstetrics and Gynecology 2020年第5期10卷 714-722页

作者： Sibraogo Kiemtoré Béwendin Evelyne Komboigo André Simporé Hyacinthe Zamané Xavier Kaboré Mikael Zoundi boubacar touré Francoise Millogo Blandine Thiéba Joseph Ki Zerbo University OuagadougouBurkina Faso Department of Obstetrics Gynecology in Yalgado Ouedraogo University Hospital Center OuagadougouBurkina Faso Nazi Boni University Bobo-DioulassoBurkina Faso

Objective: To study maternal mortality in the obstetrics and gynecology department at Yalgado Ouedraogo teaching Hospital Center. Patients and Methods: We conducted a cross-sectional retrospective and descriptive study of 181 cases of maternal deaths during study period. The parameters studied were sociodemographic characteristics, the causes of death, the clinical data and the contributing factors. Results: The maternal mortality ratio was 2624 per 100,000 live births. The mean age of death was 26.79 with extremes of 15 years to 40 years. Direct obstetric causes accounted for 58% dominated by hypertension and complications, hemorrhage during pregnancy and postpartum, and obstetric infections. The indirect obstetric causes were 42% dominated by non-obstetric infections and chronic anemias. In addition to the delay in consultation and delay in care, the lack of antenatal care was the contributing factor to maternal deaths. Conclusion: Maternal mortality remains a public health problem in view of its high ratio. The reduction of this scourge will inevitably go through a health insurance that will allow the supply of quality care.

关键词： Maternal Mortality Causes Contributing Factors CHU YO

Endocranial Suppurations of Sinus Origin: Ratio of 3 Cases in Children at the Hospital in Mali

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Open Journal of Pediatrics 2021年第3期11卷 517-531页

作者： Bourama Kané Korotoumou Wélé Diallo Mohamed Maba Traoré boubacar Mami touré Mahamadou Dama Mody Abdoulaye Camara Guédiouma Dembélé Daouda Sissoko Oumar Coulibaly Mamadou Traoré Pediatrics Department of Mali Hospital Bamako Mali Medical Imaging Service Bamako Mali Neurosurgery Department of the Mali Hospital Bamako Mali Pediatric Service of the Commune Reference Health Center V Bamako Mali

Introduction: Intracranial suppurations are neoformed purulent collections including, in decreasing order, cerebral abscesses, subdural empyemas and extradural empyemas. Otorhinolaryngologic infections are one of the main causes, especially in older children and adolescents. We report 3 clinical cases of endocranial suppurations treated at the Mali Hospital. Clinical Cases: 1) Observation 1. IK was a 14-year-old boy, who was hospitalized in our department for fever, headache and left hemiplegia. The emergency brain scan showed a right frontal and interhemispheric subdural empyema associated with multifocal sinusitis. Surgical drainage associated with ceftriaxone: 100 mg/Kg/d in direct intravenous (DI), metronidazole: 10 mg/Kgs/12hours in slow intravenous (SI) for 15 days, gentamycin: 3 mg/Kgs/d in SI for 3 days, paracetamol 15 mg/Kgs/6hours in SI, 10% glucose serum: 100 ml/Kg/d were given. The bacteriological analysis of the pus came back sterile. The postoperative period was calm. 2) Observation 2. This was a 14-year-old boy with a history of headaches who was admitted to our department for left hemiplegia. An emergency brain scan showed a right pre-suppurative encephalitis associated with a right fronto-ethmoidal and maxillary sinusitis. He was put on ceftriaxone 100 mg/kg/d in DI for 21 days, gentamycin: 3 mg/Kg/d in SI for 3 days;metronidazole: 10 mg/kg/12hours in SI for 21 days, paracetamol: 15 mg/kg/6hours in SI. After 3 weeks of medical treatment, a follow-up brain scan revealed an interhemispheric and right subdural empyema. Surgical drainage was associated with the triple antibiotic therapy initially instituted. The bacteriological analysis of the pus was sterile. The postoperative course was calm. 3) Observation 3. N.M was an 11-year-old boy, who was admitted with fever and left hemiplegi

关键词： Sinusitis Endocranial Suppurations Mali Hospital

Non-Chemotherapy Medullary Aplasia in the Pediatric Oncology Unit of the Gabriel touré Teaching Hospital, Bamako

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Open Journal of Pediatrics 2023年第6期13卷 798-806页

作者： Pierre Togo Ibrahim Ahamadou Tati Simaga Abdoul Karim Doumbia Fousseyni Traoré Oumar Coulibaly Djénéba Konaté Salif Zigmé Adama Dembélé Mohamed Elmouloud Cissé Belco Maïga Karamoko Sacko Hawa Gouro Diall boubacar Ali touré Amadou touré Yacouba Aba Coulibaly Aminata Doumbia Hawa Konaré Kalirou Traoré Souleymane Sagara Abdoul Aziz Diakité Fatoumata Dicko Cheick Bougadari Traoré boubacar Togo Department of Pediatrics Gabriel Touré Teaching Hospital Bamako Mali National Institute for Training in Health Sciences Bamako Mali Center for Research and Fight against Sickle Cell Disease Bamako Mali Pathological Anatomy Department Point G Teaching Hospital Bamako Mali

Objectives: The main objective was to study the epidemiological, diagnostic and therapeutic aspects of medullary aplasia (MA). Methods: This was a prospective and descriptive retro study conducted from January 1, 2008 to December 31, 2018 in the pediatric oncology unit of the pediatrics department of the Gabriel touré teaching Hospital in Bamako. Results: We collected 29 children’s cases out of 1632 admissions during the study period, representing a frequency of 1.8% and an incidence of 2.6 cases per year. The sex ratio was 2.6. The 11 - 15 age group accounted for 45%, with an average age of 8.93 years. The majority of fathers (55.2%) and mothers (62.1%) had received no education;they were mainly farmers (62.1%) and housewives (86.2%). The average consultation time was 92.21 days. Anemia was the reason for consultation in 69% of cases. Pallor was present on admission in 96.5%;infectious syndrome accounted for 79.3%, anemic syndrome for 51.7% and hemorrhagic syndrome for 27.6%;the three syndromes were associated in 27.6%. Malaria was associated with bone marrow aplasia in 58.6%. Anemia was present in 93.1%, neutropenia in 65.5% and thrombocytopenia in 86.2%. All had received a labile blood product (LBP) transfusion, and 24 (83%) had received antibiotics. Patients were treated with corticosteroids (58.6%), androgens (20.7%) and immunosuppressants (20.7%). The death rate was 34.6%. At last count, 15 (83%) had discontinued treatment, 2 (11%) were undergoing treatment and 1 (6%) was in remission. Conclusion: Effective treatment of MA requires improved technical facilities and better economic conditions for parents.

关键词： Medullar Aplasia Children Bamako

Ruptured Ectopic Pregnancy: Epidemiology and Management in the General Surgery Department of the Ignace Deen National Hospital, Conakry University Hospital

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Open Journal of Obstetrics and Gynecology 2024年第4期14卷 503-508页

作者： Barry Mamadou Sakoba Barry boubacar Guirassy Mariam touré Aboubacar Diallo Aissatou Taran Department of General Surgery Ignace Deen National Hospital/Conakry University Hospital Conakry Guinea Faculty of Health Sciences and Technology Gamal Abdel Nasser University of Conakry Conakry Guinea

Introduction: The aim of this study was to contribute to improving the quality of GEUR management in the general surgery department and in the maternity ward of the Ignace Deen national hospital, Conakry University Hospital. Methodology: This was a retrospective, descriptive study lasting two years (January 1, 2020 to December 31, 2022), carried out in the general surgery and gyneco-obstetrics departments of the Ignace Deen national hospital, Conakry University Hospital. We included all patients with a ruptured ectopic pregnancy who received surgical treatment during the study period. Results: We collected 13,524 cases of surgical interventions in the two services, among them, we recorded 89 cases or 0.66% GEUR. The average age of the patients was 24.26 years. Brides were the most represented with 80.96% of cases. Women practicing a liberal profession were 51.69% (n = 46) and housewives 26.97% (n = 24). Clinically, amenorrhea was noted in all patients, i.e. 100%, abdominal-pelvic pain in 95.2% (n = 85) of cases, metrorrhagia in 94.08% (n = 84), abdominal-pelvic sensitivity in 97.44% (n = 87) of cases and anemia in 85.39% of cases. The GEUR was ampullary in 69.66% (n = 62) cases. Salpingectomy was performed in 90.72% (n = 81). The surgical outcomes were satisfactory in 98.87% (n = 88) of cases. We recorded one case of surgical site infection. We have not recorded any deaths. The average length of hospitalization was 4 days. Conclusion: GEUR is relatively high in our context. A good understanding of the prognostic factors of GEUR, awareness and family planning could reduce GEUR.

关键词： Ruptured Ectopic Pregnancy Epidemiology and Management

Splenectomy: Indications in the General Surgery Department of Ignace Deen Hospital

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Surgical Science 2024年第4期15卷 219-224页

作者： Mamadou Sakoba Barry boubacar Barry Sandaly Diakité Aboubacar touré Aissatou Taran Diallo General Surgery Department Ignace Deen National Hospital at Conakry University Hospital Conakry Guinea Faculty of Health Sciences and Technology Gamal Abdel Nasser University of Conakry Conakry Guinea

Introduction: Splenectomy is the surgical removal of the spleen. It can be performed during various pathologies, ranging from abdominal trauma to hemoglobinopathies. The progress made in the knowledge of the immune functions of the spleen and the fear of post-splenectomy infectious complications have favored the development of surgical or non-surgical splenic preservation techniques calling into question the dogma of splenectomy. The aim of this study was to determine the indications for splenectomy. Methodology: This was a retrospective, descriptive study lasting 5 years in the general surgery department of the Ignace Deen National Hospital. All files of splenectomized patients were included, our variables were clinical, therapeutic and progressive. Results: We collected 42 cases of splenectomies out of the 2478 surgical procedures performed, representing 1.7% of the department’s surgical activities. The average age was 44 years. The age group of 41 to 50 years was the most represented, i.e. 26% (n = 11) of cases. Sex ratio = 1. Abdominal pain was the reason for consultation in patients, i.e. 100% (n = 42) of cases. The antecedents were dominated by recurrent malaria with 52.3% (n = 22) of cases, then recurrent anemia in 21% (n = 9), and 16.7% (n = 7) had sickle cell disease. Splenomegaly was found in 31 patients, or 73.6%. Ultrasound was performed in all patients. The indications for splenectomy were: isolated splenomegaly with risk of rupture (38%, n = 16), hypersplenism (26%, n = 11) and trauma to the spleen (19.04%, n = 8). Total splenectomy was performed in all cases. The surgical consequences were favorable in 85.7%, (n = 36) with morbidity of 14% (n = 6) and mortality of 9.52% (n = 4). The average length of hospitalization was 10.4 days with extremes of 1 and 22 days. Conclusion: Splenectomy constitutes a relatively common surgical procedure in our context. The indications for splenectomy were isolated splenomegaly with risk of rupture, hypersplenism and tra

关键词： Splenectomy Indications Ignace Deen

Post-COVID-19 Late Pulmonary Embolism in a Young Woman about a Case

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Open Journal of Emergency Medicine 2020年第4期8卷 79-85页

作者： Abdoulaye touré Joseph Donamou Amadou Yalla Camara boubacar Atigou Dramé Ousmane Aminata BAH Anesthesia-Intensive Care Unit Ignace Deen Hospital Conakry Guinea Anesthesia-Intensive Care Unit Donka Hospital Conakry Guinea Army Reference Imaging Center (CIRA) Conakry Guinea Chair of Biophysics and Medical Radiology-Imaging FSTS-University of Conakry Conakry Guinea

COVID-19 appears to be associated with a disproportionate risk of thrombosis. The occurrence of thrombosis is a frequent complication of many medical and surgical conditions. Their prevention by LMWH is the option of choice as well as their early diagnosis in this pandemic context. In addition, several recent observations support that severe pulmonary embolism is very common in hospitalized patients with COVID-19. We report the case of late pulmonary embolism in a 26-year-old patient with a medical history of (SARS-CoV2) and newly discovered diabetes. The clinical examination found exertional dyspnea, intense chest pain, blood pressure at 145/85mmHg, heart rate at 129 bpm, respiratory rate at 25 cycles/min, blood sugar at 1.45 g/l, oxygen saturation at 92%. In front of this clinical picture, the thoracic CT angiography to ask shows a pulmonary embolism of the right segmental and sub-segmental branches less marked on the left, involving the lingular and basal branches; the management was limited to anticoagulation associated with rehabilitation sessions (respiratory physiotherapy).

关键词： Resuscitation SARS-CoV2 Thromboembolism Ignace Deen

Effectiveness of the Suprainguinal Ultrasound-Guided Block for the Management of Postoperative Pain after Application of a Total Hip Prosthesis

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Open Journal of Anesthesiology 2021年第10期11卷 306-315页

作者： Joseph Donamou Abdoulaye touré Amadou Yalla Camara Bangoura Almamy Camara M’Mah Lamine Camara Mariama Mohamed Diallo Thierno Sadou Drame boubacar Atigou touré Aboubacar Anesthesia-Intensive Care Unit Donka National Hospital Conakry Guinea Anesthesia-Intensive Care Unit National Ignace Deen Hospital Conakry Guinea General and Visceral Surgery Department Ignace Deen National Hospital Conakry Guinea

Objective: To assess the effectiveness of ultrasound-guided supraginguinal block (SIB) in the management of pain after total hip replacement. Material and Methods: This was a prospective, randomized, single-blind controlled study carried out in the anesthesia-intensive care unit of the Donka National Hospital in Conakry, over a period of 06 months (01/01/2020 to 30/06/2020). It concerned 32 patients: 16 patients in the “ultrasound-guided SIB” group and 16 patients in the “standard analgesia” group. Results: The pain scores assessed by the simple verbal scale and collected at the different time intervals (6H, 12H, 24H, 36H, 48H) showed mean scores 3 in the standard analgesia group (P Conclusion: Our study demonstrated that echo-guided SIB provided better analgesia compared to standard analgesia for the management of postoperative pain after total hip replacement.

关键词： Ultrasound-Guided Suprainguinal Block Total Hip Replacement Postoperative Pain Conakry

Thyroidectomy: Frequency and Indications in the General Surgery Department of the Hôpital National Ignace Deen/CHU de Conakry

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International Journal of Otolaryngology and Head & Neck Surgery 2024年第3期13卷 157-167页

作者： Mamadou Sakoba Barry Mamadou Mouctar Ramata Diallo Houssein Fofana Vignin Baudouin Kpossou boubacar Barry Aboubacar touré Aissatou Taran Diallo General Surgery Department H&#244pital National Ignace Deen/CHU de Conakry Conakry Guinea Faculté des Sciences and Techniques de la Sant&#233-Universit&#233 Gamal Abdel Nasser de Conakry Conakry Guinea ENT Department Mamou Regional Hospital Mamou Guinea

Introduction: Thyroidectomy is a surgical procedure to remove all or part of the thyroid gland. The aim of this study was to report the results of thyroidectomy in the general surgery department of the Hôpital national Ignace Deen/CHU de Conakry. Methodology: This was a retrospective study, of seven (07) years (January 1, 2016 - August 31, 2023), in the General Surgery Department of the Ignace Deen National Hospital-CHU in Conakry. We included all records of patients admitted and operated on for thyroidectomy and with up-to-date medical records. The variables were epidemiological, clinical and therapeutic. Results: During the study period, we recorded 3221 cases of surgery, including 40 thyroidectomies (1.24% of cases). The average age was 42.4 years. Women were the most represented, with a sex ratio of 0.16. The reason for consultation was anterior cervical swelling in 86% (n = 25) of cases, followed by signs of cervical compression 21% (n = 6) and signs of thyrotoxicosis 31% (n = 9). Indications for thyroidectomy were dominated by homogeneous goitres in 69% (n = 20) of cases, basedow’s disease in 20.7% (n = 6) and nodular goitres in 6.9% (n = 2) of cases. The surgical procedures were lobo-isthmectomies in 72.4% (n = 21), subtotal thyroidectomies 13.8% (n = 4), total thyroidectomies 10.3% (n = 3). Postoperative follow-up was straightforward in 69% (n = 20). Complications included haemorrhage in 20.7% (n = 6) and recurrence in 6.9% (n = 2). The average hospital stay was 7 days. Conclusion: Thyroidectomy is a relatively frequent surgical procedure in our department. Indications are dominated by homogeneous goitres. Morbidity is related to hemorrhage. Rigorous hemostasis could improve the quality of thyroidectomy.

关键词： Thyroidectomy Indication Ignace Deen

Management of Post-Operative Pain after Gyneco-Obstetrical Surgery: Practice of Transversus Abdominis Plane Bloc (Tap Block) Echoguide at the Ignace Deen National Hospital

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Open Journal of Anesthesiology 2021年第10期11卷 316-324页

作者： Donamou Joseph Bangoura Almamy touré Abdoulaye Camara Amadou Yalla Traoré Abdourahamane Dine Camara M’Mah Lamine Camara M’Mah Lamine Dramé boubacar Atigou Camara Mariama Mohamed Orou Yerima Therese touré Aboubacar Anesthesia-Intensive Care Unit Donka National Hospital Conakry Guinea Anesthesia-Intensive Care Unit National Ignace Deen Hospital Conakry Guinea Medico-Surgical Emergency Department Donka National Hospital Conakry Guinea General and Visceral Surgery Department Ignace Deen National Hospital Conakry Guinea

Objectives: To describe the practice of ultrasound-guided TAP in the management of postoperative pain after gyneco-obstetric surgery. Methods: This was a descriptive prospective study carried out at the Gynecology-Obstetrics department of the Ignace Deen National Hospital over a period of three (03) months from February 01, 2020 to April 31, 2020. Results: In total, we collected 95 patients. These patients had a mean age of 30 ± 9.5 years. The ASA I class was the most represented with 76% of the cases and the cesarean was the most performed intervention. Regarding the assessment of the pain score by the simple verbal scale (SVE) postoperatively at rest, the mean SLE scores at H6 were 0.17 ± 0.38;at H12 of 1.15 ± 0.62;at H24 of 0.84 ± 0.51;at H36 0.45 ± 0.52 and at H48 0.09 ± 0.29. On mobilization, the mean pain scores were 0.77 ± 0.51 at H6, at H12 1.89 ± 0.61;at H24 of 1.53 ± 0.56;at H36 of 1 ± 0.29 and at H48 of 0.82 ± 0.44. The majority of our patients (66.3%) had a mobilization time of less than 24 hours. The mean length of stay was 3.1 ± 1.3 days and most patients (82%) were satisfied with the management of their pain by ultrasound-guided TAP block. Conclusion: Ultrasound-guided TAP is an effective technique for the management of postoperative pain in gyneco-obstetrics surgery. Its integration in a context of multimodal analgesia could improve the management of postoperative pain in gynecological obstetrics.

关键词： Postoperative Pain TAP Block Ultrasound Guidance Gyneco-Obstetrics