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surgical science 2024年第4期15卷 195-206页

作者： Tounkara cheickna Cisse Amadou Beydi samake Hamidou Diarra Issaka sanogo Modibo Diarra Bogoba Doumbia seydou Yena sadio Department of General surgery of the Reference Health Center of Commune I Bamako Mali Directorate of social and Health services of the Armed Forces of Mali Department of Public Health of the Faculty of Medicine and Odontology-stomatology Bamako Mali Department of surgery Mali Hospital Bamako Mali

The objectives of this work were to evaluate the surgical activities carried out in the general surgery department of the Reference Health Center of Commune I of Bamako, to describe the sociodemographic characteristics of the operated patients, to determine the main pathologies encountered and to evaluate qualitatively the result of the treatment. In order to improve performance, and the quality of care, and to identify common pathologies in the surgical department, we undertook a retrospective study on surgical activities from January 2009 to December 2010. At the end of this study, out of 474 men and 187 women (equal sex ratio 2.53);we were able to determine the frequency of surgical pathologies. Farmers, housewives and pupils/students were the most represented with 25.9% respectively;20% and 13.3%. The most frequently observed pathologies were wall hernia (44.8%), prostate adenoma (12%) and acute appendicitis (10.5%). The average length of hospitalization was 3.43 days. Infectious complications affected 25 patients (3.8% of cases) and a death rate of 0.45% (i.e. 3 patients). The average cost of care was 53,500 FCFA. Indeed, the reality of surgical practice in health centers was not the same because of the level of skills of practicing surgeons.

关键词： Assessment surgical Activities 2 Years Reference Health Center of Commune I Bamako

Ambulatory Uretrocystoscopy in the Urology Andrology Department of Grand Mbour Hospital

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Open Journal of Urology 2024年第2期14卷 61-70页

作者： saint Charles Nabab Kouka Ramatoulaye Ly Ngor Mack Thiam Modou Diop Cisse Mouhamed Cheikh Diop Yoro Diallo cheickna s.lla Department of Urology Faculty of Health Sciences University Iba Der Thiam of Thies Thies Senegal

Background: Urethrocystoscopy is a method of endoscopic exploration that allows direct visualization of the urethra and bladder for diagnosis or treatment of diseases of the lower urinary tract. Purpose: To determine the epidemiological profile of patients who underwent urethrocystoscopy and to present the indications and the results of this endoscopic examination. Patients and Methods: This is a retrospective, descriptive study of all patients who underwent outpatient urethrocystoscopy in the Urology and Andrology department of Grand Mbour hospital. The epidemiological data of the patients, the indications, the results of the endoscopic exploration and the additional procedures performed were entered and analyzed with Excel 2016. We performed descriptive statistics. Results: Of the 216 patients who underwent outpatient urethrocystoscopy, we counted 179 men (82.87%) and 37 women (17.13%). The sex ratio was 4.84. The mean age of the patients was 53.71 ± 18.76 years (age range 17 to 91 years). The main indications were lower urinary tract disorders (60.18%) and hematuria (28.70%). Endoscopic exploration revealed prostatic tumor in 69 patients (31.9%), 29 cases of bladder tumors (13.4%) and 19 cases of bilharzia cystitis (8.8%). The urethrocystoscopy was normal in 32 patients (14.8%). Conclusion: Urethrostoscopy is an endoscopic exploration examination that can be performed on an outpatient basis. Lower tract urinary disorders and hematuria were the main indications.

关键词： Urethrocystoscopy Outpatient Indications Diagnosis Mbour

Perception and Management of Hemorroid Disease at the CsREF of the Commune Bamako Mali

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surgical science 2024年第2期15卷 89-97页

作者： Tounkara cheickna Diarra Mohamed Hassimy Diarra Issaka sanogo Keita Bakary Dembele Bakary Tientigui Traore Alhassane Togo Pierre Adégné Lassana Kante Department of General surgery The Cs Ref of Commune I of Bamako Bamako Mali Department of General surgery The Gabriel TOURE University Hospital in Bamako Bamako Mali

This work was a prospective transversal study over 6 (six) months from May 2 to December 31, 2017 at the Reference Health Center of Commune I and the Chérif la Confessional Health Center in Bamako. The aim was to study the knowledge, attitudes and behavioral practices linked to hemorrhoids in Commune I of the Bamako district, to evaluate the frequency of hemorrhoidal disease, to determine the knowledge, attitudes and behavioral practices linked to hemorrhoids among patients, their companions and traditional therapists in Commune I of the district of Bamako and the factors which influence the motivations and decisions to resort to medical-surgical care and traditional medicine in patients suffering from hemorrhoids in order to analyze the results of the management of hemorrhoidal disease at Cs Ref CI. We collected 36 patients with hemorrhoidal disease, 25 caregivers and 15 traditional hemorrhoidal disease therapists. The sex ratio was 1.25 for patients;6.5 for traditional therapists and 1.5 for accompanying people. The average age of the patients was 32.75 years;49 years for traditional therapists and 28.76 years for those accompanying them. 55.6% of patients claim to know about hemorrhoidal disease;100% of traditional therapists and 80% of accompanying people. The dietary factor of hemorrhoidal disease was mentioned by 90% of patients;66.7% of traditional therapists and 100% of caregivers. Most patients initially resorted to traditional treatment out of fear of surgery and its after-effects. The patients were treated medically and surgically.

关键词： Hemorrhoidal Disease Caregivers Traditional Therapists Patients surgery Cs Ref CI

Prostate Cancer in the Thies Region, senegal: Epidemiological, Diagnostic and Therapeutic Aspects

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Open Journal of Urology 2024年第2期14卷 71-82页

作者： saint Charles Nabab Kouka Linda Bentefouet Mohamed Jalloh Ngor Mack Thiam Modou Faye Modou Diop Mohamed Cisse Amy Diame Yoro Diallo cheickna s.lla Department of Urology Faculty of Health Sciences University Iba Der Thiam of Thies Thies Senegal Department of Anatomy Pathology Faculty of Health Sciences University Iba Der Thiam of Thies Thies Senegal Department of Urology University Cheikh Anta Diop De Dakar Dakar Senegal

Introduction: Prostate cancer is the leading urological cancer. It is the most common cancer in men over 50. Objective: To determine the epidemiological, diagnostic and therapeutic characteristics of prostate cancer in hospitals in the Thiès region. Patients and Methods: We conducted a descriptive study from January 1sup>stsup>, 2015 to December 31sup>stsup>, 2020. We included all cases of primary prostate cancer confirmed on histology. Results: We collected data on 318 cases of primary prostate cancer during the study period. Mean patient age was 72.7 years (Range: 49;94 years). Family history of prostate cancer was found in 22 patients (6.91%). The average consultation time was 18.6 months. The circumstances of discovery were dominated by obstructive voiding disorders (97.16%). Digital Rectal examination was suggestive in 55.40% of patients. PsA level was above 20 ng/ml in 76.7% of patients. Prostatic adenocarcinoma was the only histological type (100%). Localized cancer represented 7.2% and locally advanced cancer occurred in 36.5% of cases, while metastatic cancer accounted for 56.3%. Radical prostatectomy was performed in 3.18% of cases. Mortality rate was estimated at 8.50% after 1 year. Conclusion: Prostate cancer is the leading urological cancer in the Thies region. It is characterized by the predominance of locally advanced and metastatic forms.

关键词： Prostate Cancer Epidemiology Histology Metastasis Mortality Thies

Postoperative Complications in the General surgery Department of the Cs Ref of Commune I of the District of Bamako Mali

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surgical science 2024年第6期15卷 409-419页

作者： Tounkara cheickna samake Hamidou Dembele Lamine Diarra Issaka Togola Modibo sanogo Modibo Dembele Bakary Tientigui Traore Alhassane Togo Adégné Pierre Kante Lassana Department of General surgery Reference Health Center of Commune I of Bamako Bamako Mali Directorate of social and Health services of the Armies Bamako Mali Department of General surgery CHU Gabriel Tour Bamako Mali

Postoperative complications represent important indicators for the quality of surgical care. The objectives of this work were to study post-operative complications in the general surgery department of the Cs ref of commune I in Mali, to determine the frequency of post-operative complications, to identify the factors of occurrence, to describe the clinical aspects, diagnostic and therapeutic in order to assess the additional cost linked to post-operative complications. This study was prospective, carried out in the general surgery department on 300 cases of surgical interventions. It covered all patients aged at least 15 years, operated on and hospitalized or not, and who presented complications during the 30 days postoperatively. Patients under the age of 15 were not included (our general surgery department is not a pediatric surgery department). We collected 300 patients among whom 199 (66.33%) were men and 101 (33.66%) women, i.e. a sex ratio = 1.9. The average age was 38 years with extremes of 15 and 87 years. The main initial diagnoses were: acute appendicitis, peritonitis, occlusions, wall hernias, hemorrhoids, uterine prolapse, uterine myomas, ovarian cysts and acute cholecystitis. Emergencies represented 43% (N = 129) of interventions with 6.98% post-operative complications (POC). Postoperative complications were dominated by surgical site infections, 75% of cases (N = 20), wall hemorrhage 5% (N = 1), testicular necrosis 5% (N = 1) and testicular calcification 5% (N = 1), wire rejection 5% (N = 1) and death 5% (N = 1). The management of postoperative complications was surgical in 95% and medical in 100%. Their occurrence extended the hospital stay by 3.65 days and increased the average cost of care by 60541.85 CFA francs. The mortality index lowered by efficient management of complications (IMAGE) calculated in relation to deaths was 95% of cases. Anemia, AsA score ≥ III, Alteimeir II and IV classes, duration of surgery and post-operative hospitalization were

关键词： Complications Post Opératoires Chirurgie Cs Ref CI Bamako Mali

Clinical and Therapeutic Aspects of Inguinal Hernia in Children in the General surgery Department of Reference Health Center in Commune I of Bamako Mali

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surgical science 2024年第2期15卷 54-63页

作者： Tounkara cheickna samake Hamidou simpara Mama Diarra Issaka sanogo Modibo sidibe souleymane Togola Modibo Dembele Bakary Tientigui Coulibaly Yacaria Togo Pierre Adégné Kante Lassana Department of General surgery the Reference Health Center of Commune I Bamako Mali Directorate of social Health service the Armed Forces of Mali Bamako Mali Department of Pediatric surgery Mali Hospital Bamako Mali Department of General surgery the Gabriel TOURE University Hospital Bamako Mali Department of Pediatric surgery Gabriel TOURE University Hospital Bamako Mali

Inguinal hernia in children is a congenital pathology in children linked to the persistence of the peritoneo-vaginal canal in children and the NüCK canal in girls;persisting into adulthood. This work aimed to study inguinal hernia in children in the general surgery department of the Reference Health Center of Commune I of the Bamako District;to determine the frequency of inguinal hernia;describe the epidemiological, clinical and therapeutic aspects of inguinal hernias and in order to evaluate the cost of treatment. This was a prospective study from April 2017 to March 2018 during which 60 children with an inguinal hernia were collected. Inguinal hernias in children represented 9.23% of patients operated on in the department. The average age was 59.23 months with extremes of one month and 180 months and a standard deviation of 49.23 years. The male sex was dominant with a sex ratio equal to 9:1. The notion of prematurity was found in 11.7% and was associated with a testicle not in place in 1.7% of cases. 41.7% of our patients were referred by a doctor and 66.7% of patients presented with painless, intermittent inguino-scrotal swelling (83.3% of cases). The hernia was discovered before one week of life in 50% of cases. Inguinal swelling was absent in 11.7% but observed intraoperatively. The inguinal hernia was unilateral in 91.7% of cases and 70% of hernias were discovered by the parents during pushing efforts. The inguinal hernia was located on the right in 61.7% of cases. The hernia swelling was soft, painless, impulsive and reducible in 78.3% of cases. The swelling was inguino-scrotal in 58.3% of cases. The hernia was simple in 95% of patients and hernial strangulation was observed in 3 cases or 5% of cases. 98.3% of patients were AsA I. The treatment was carried out openly in all our patients including closure of the vaginal peritoneal canal in 95% of cases under general anesthesia in 98.3% of cases. The morbidity rate was 8.4% (surgical site infection: 6.7% of ca

关键词： Inguinal Hernia Child surgery Cs Ref C I Bamako Mali

study of Hemorrhoid Disease in the Department of General surgery of the Cs Ref of the Commune I Bamako

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surgical science 2024年第2期15卷 36-47页

作者： Tounkara cheickna Diarra Issaka sanogo Modibo Togola Modibo Camara Ladji soma Dembele Bakary Tientigui Traore Alhassane Togo Adégné Pierre Kante Lassana Ouattara Zanafon Diallo Gangaly Department of General surgery The Reference Health Center in Commune I Bamako Mali Department of General surgery The Gabriel Toure University Hospital Bamako Mali Department of Urology The Gabriel Toure University Hospital Bamako Mali

This work was a retrospective prospective study carried out in the general surgery department of the Cs ref of commune I from January 2009 to December 2012. Our study aimed to determine the hospital frequency of hemorrhoidal disease, to identify the contributing factors, describe the clinical and therapeutic aspects and analyze the surgical consequences. We collected 73 patients with an average age of 37.8 years (range: 19 years and 77 years) with a sex ratio of 2.5 in favor of men. We operated on 49 patients or 67.1% of cases. 71.2% of our patients were married and lived in Bamako. schoolchildren and middle managers made up 39.8% of cases. 82.2% of patients were seen in ordinary consultation and 69.9% complained of progressive anal pain in 66.7% of cases. This pain was triggered by defecation in 88.2% of our patients. The contributing factors were dominated by constipation (53.4%), working in a seated position (41.1%) and a sedentary lifestyle (16.4%) of cases. stage IV external hemorrhoids and hemorrhoidal thrombosis represented 53.8% of surgical indications. The most used surgical technique was that of Milligan-Morgan, i.e. 51.9% of cases and 45.2% of patients treated medically received a combination of transit regulator, venotonics and analgesics. The surgical aftermath was marked by hemorrhage (3 cases), delayed healing (5 cases), urinary retention (1 case) and scarring anal stenosis (1 case). The morbidity rate was 5.48% of cases and a zero mortality rate. The average length of hospitalization was 2 days with extremes of 1 and 5 days.

关键词： Hemorrhoid surgery Cs Ref C I Bamako Mali

Nephroblastoma in Adults about a Clinical Case

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surgical science 2024年第2期15卷 81-88页

作者： Tounkara cheickna Coulibaly Amara Malle Oumar Amadou Bréhima Bolo Coulibaly Bagoyoko Kaloga Daye samake Hamidou Berthe Honoré Jean-Baptiste Gabriel Diakite Mamadou Lamine Department of General surgery Hospital Center “Mother Child” Luxembourg Bamako Mali Directorate of Army Health services Kati Mali Department of Urology and Andrology Point G University Hospital Bamako Mali

Nephroblastoma is the most common malignant renal tumor in children and is related to an abnormal proliferation of cells resembling those of the embryonic kidney (metanephroma), hence the terminology;embryonal tumor. These are tumors that remain and remain unstudied in Mali because they are common in adults in our context. Its annual incidence is estimated at approximately 1/10,000 births. Nephroblastoma is a rare or even exceptional tumor in adults. The clinical manifestation was a large swelling of the right hypochondrium;abdominal pain for a year;unquantified fever, hypertension, initial hematuria associated with burning during urination and anemia. The main clinical manifestation remained fever and abdominal pain. This renal tumor posed a diagnostic problem which was previously labeled as a mesenteric tumor in our general surgery department. The diagnosis was made by imaging: CT and magnetic resonance imaging. The treatment is multidisciplinary and combines chemotherapy, surgery with or without radiotherapy. The prognosis is poor due to late diagnosis and less effectiveness of chemotherapy compared to the child. survival did not exceed a year and a half because the renal tumor in our patient was surgically overcome. We report a case of nephroblastoma in an 86-year-old patient with unfavorable histology (hematogenous metastases), operated on in the general surgery department and whose postoperative course was simple and who was referred to oncology for treatment.

关键词： Nephroblastoma Malignant Kidney Tumor Treatment Adult Mali

Digestive surgical Emergencies at the “Mother Child”Hospital Center Luxembourg in Mali

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surgical science 2024年第5期15卷 299-310页

作者： cheickna Tounkara Amara Coulibaly Yaya Ongoiba Aboubakrine s.lla Abdoul Karim simaga Bréhima B. Coulibaly Aminata Dabo souleymane Dembele samake Hamidou sidiki Keita sékou Bréhima Koumare soumaïla Keita Bakary Tientigui Dembele Zimogo Zié sanogo Djibril sangare Department of General surgery and Anesthesia-Resuscitation of the “ Mother Child&#8221 Hospital Center Luxembourg Bamako Mali social Health service of the Armed Forces of Mali Bamako Mali Department of General surgery “ A&#8221 and Cardiovascular of Point G University Hospital Bamako Mali Department of General surgery of CHU Gabriel TOURE Bamako Mali

Digestive surgical emergencies concern all patients admitted urgently, for whom a decision for surgical intervention may be necessary within 24 hours. They are on guard duty day and night. To carry out this work, we set ourselves the objectives of: 1) studying digestive surgical emergencies in the general surgery department of the “Mother Child” Le Luxembourg hospital in Bamako, Mali;2) Determine the frequency of digestive surgical emergencies, 3) Describe the clinical and therapeutic aspects, and 4) Analyze the results of treatment. From November 1, 2022 to October 31, 2023, the general surgery department of the “Mother Child” Luxembourg Hospital Center in Bamako, Mali, carried out 139 digestive surgical emergencies whose files were usable;75 men and 64 women, a sex ratio of 1.2. The 20 - 40 years old age group was the most represented, at 40.29%. The average age was 39 years;the extremes 16 years and 93 years with a standard deviation of 21.65 years. The reference concerned 51.08% of our patients. Abdominal pain was the main reason for consultation (100% of cases). In the majority of cases, the physical examination made it possible to make the diagnosis. Faced with certain clinical cases, we requested ultrasound (109/139), AsP (46/139) and CT (15/139). The main etiology was acute appendicitis with 42.45% of cases. The frequency of digestive surgical emergencies was 10.71% of all activities in the general surgery department of the “Mère Enfant” Le Luxembourg hospital center in Bamako. All our patients were seen in consultation by an anesthesiologist before entering the operating room. The surgical consequences were complicated in 11.51% of cases with 7.91% deaths. surgical site infections accounted for 12.5% of postoperative complications. Eleven deaths were noted, representing 68.75% of complications and 7.91% of our sample. Acute peritonitis was the cause of death in 100% of cases. The average cost of care was 329,000 FCFA.

关键词： Emergency Digestive surgery Post-Operative Complication

A Novel Three-staged Generative Model for skeletonizing Chinese Characters with Versatile styles

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Journal of Computer science & Technology 2023年第6期38卷 1250-1271页

作者：田业川徐颂华 cheickna s.lla school of Mathematics and statistics Xi’an Jiaotong UniversityXi’an 710000China Martin Tuchman school of Management New Jersey Institute of TechnologyNewark 07101U.S.A.

skeletons of characters provide vital information to support a variety of tasks,e.g.,optical character recogni-tion,image restoration,stroke segmentation and extraction,and style learning and ***,automatically skele-tonizing Chinese characters poses a steep computational challenge due to the large volume of Chinese characters and their versatile styles,for which traditional image analysis approaches are error-prone and *** deep learning based approach requires a heavy amount of manual labeling efforts,which imposes serious limitations on the precision,robust-ness,scalability and generalizability of an algorithm to solve a specific *** tackle the above challenge,this paper introduces a novel three-staged deep generative model developed as an image-to-image translation approach,which signifi-cantly reduces the model's demand for labeled training *** new model is built upon an improved G-net,an en-hanced X-net,and a newly proposed *** compellingly demonstrated by comprehensive experimental results,the new model is able to iteratively extract skeletons of Chinese characters in versatile styles with a high quality,which noticeably outperforms two state-of-the-art peer deep learning methods and a classical thinning algorithm in terms of F-measure,Hausdorff distance,and average Hausdorff distance.

关键词： skeletonization of characters three-staged skeletonization X-net