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Biermer’s Disease at the Donka National Hospital in Guinea—Epidemio-Clinical, Therapeutic and Evolutionary Aspect in the Internal Medicine Department

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Open Journal of Internal Medicine 2023年第3期13卷 218-224页

作者： Thierno Amadou Wann Mamadou Sarifou Diallo Djenabou Diallo Kadiatou Diallo Mamadou Lamine Yaya Bah Mamadou Diakhaby Mohamed cissoko Amadou Kaké Djibril Sylla Department of Internal Medicine Teaching Hospital of Conakry Conakry Guinea Department of Hepato-Gastroenterology University Hospital of Conakry Conakry Guinea

Introduction: Biermer’s disease is an autoimmune disease characterized by a lack of absorption of vitamin B12 in connection with the production of antibodies (A) destroying the intrinsic factor (IF) which allows the absorption of vitamin B12 (cobalamin). These clinical manifestations are polymorphic and severe in our context. The objective of this work is to identify the epidemiological-clinical, therapeutic and evolutionary characteristics of Biermer’s disease in Guinean population. Materials and methods: This was a retrospective of patient files followed for Biermer’s disease at the internal medicine department of Donka National Hospital from January 2012 to December 2021. Results: Eight patients were included including 5 women and 3 men. The average age of the patients was 48 years old. The diagnostic delay was 3.6 years on average. All our patients had bioclinical anemia (8 cases, i.e. 100%) followed by epigastralgia in 4 cases (50%), neurological damage such as sensitive polyneuropathy in 3 cases (37.5%). Four patients had acquired melanoderma (50%). Hypovitaminosis B12 was found in 4 patients. The myelogram performed in three patients (37.5%) found medullary megaloblastosis. One patient had Hashimoto’s disease associated with Biermer’s disease in endoscopy, (FOGD) found fundica trophy on macroscopy in 4 cases (50%). Treatment consisted of B12 vitamin therapy in all cases with a favorable clinical and biological outcome. Conclusion: Biermer’s disease remains common in Africa and is characterized at a younger age in addition to the severity of clinical and biological manifestations. The care consists of taking vitamin B12 which remains accessible in our context.

关键词： Biermer’s Disease Donka Aspects Epidemiological-Clinical Therapeutics

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Boari Kuss Technique for Iatrogenic Ureter Injury on Single Kidney at C.H.U le Luxembourg about a Case and Review of the Literature

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Open Journal of Urology 2024年第11期14卷 554-561页

作者： Alkadri Diarra Pape Kanoute Aristo Tsayem Amadou Kassogué Badara cissoko Mamoutou dit Mody Keita Dramane Cissé Felix Sanogo Richie Dioguey Calmer Seydou Younoussa Coulibaly Harouna Simido Urology Department CHU Mother Child Luxembourg Bamako Mali

Introduction: Ureteral lesions, most often iatrogenic, generally follow pelvic surgery. They are serious and can be life-threatening. Uretero-vesical reimplantation using the BOARI technique, modified by KUSS, was popularized in humans in 1954, and appears to be the most appropriate treatment for lesions of the lower ureter with significant loss of substance. Observation: We report in this work a case of iatrogenic ligation of the pelvic ureter on a single functional kidney (of fortuitous discovery) during gynecological surgery, having led to an Alteration of the General State (important Urinoma and collapse of the renal function) and treated by the surgical technique of BOARI KUSS at the urology department of the CHU Le Luxembourg. Follow-up and postoperative follow-up were excellent. Conclusion: Surgical repair of the ureter is very often indicated in cases of stenosis or iatrogenic lesions of the ureter. The BOARI KUSS technique is a good choice in cases of significant loss of substance due to injury to the lower ureter. Gynecological surgery is the main source of these lesions, and the prognosis of the treatment depends on how early the diagnosis is made, the anatomical condition of the ureter and the expertise of the surgical team.

关键词： Reimplantation BOARI KUSS Technique Iatrogenic Lesion Loss of Substance Lower Ureter

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Screening of Foot at Risk in Diabetic Patients

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Open Journal of Internal Medicine 2019年第3期9卷 62-71页

作者： Djenebou Traore Djeneba Sylla Sow Massama Konaté Ousmane Sidibé Modibo Mariko Djibril Sy Bah Traoré Karim Dao Amadou Koné Nanko Doumbia Nouhoum Ouologuem yacouba Lazard Diallo Boua Daoud Camara Nongoba Sawadogo Ibrahima Amadou Dembélé Barry Boubacar Sangaré Mamadou cissoko Mahamadou Saliou Youssouf Fofana Mamadou Mallé Mamadou Togo Adramé Keita Abdramane Traoré Nagou Tolo Madani Ouologuem Abdel Kader Traoré Assa Traoré Sidibé Department of Internal Medicine The University Teaching Hospital of Point G Bamako Mali Department of Internal Medicine and Endocrinology The Mali Hospital Bamako Mali CHR Internal Medicine Department of Kaya Kaya Burkina Faso Department of Internal Medicine The Mother and Children Hospital “Luxembourg” Bamako Mali Department Internal Medicine The Hospital of Kati Bamako Mali

Introduction: The term “diabetic foot” refers to all conditions that affect the foot and are directly related to the impact of diabetes. Objective: Screen the foot at risk in diabetic patients at the hospital of Mali. Methods: It was a cross-sectional study from January 1st, 2016 to June 30, 2016, at the Department of Internal Medicine and endocrinology of the Hospital of Mali. It was focused on all hospitalized diabetic patients. Results: Thirty-two (32) patients had a foot at risk among 76 diabetic patients during the study period representing 42.10%. The sex ratio was 0.52. Type 2 diabetes accounted for 82%. A glycemic imbalance (HBA1C > 7%) was observed in 88.15%. Eighteen percent (18%) of patients had a history of ulceration or amputation;33% were walking barefoot;78.9% had tingles in the foot;31.6% had intermittent claudication;64.5% had foot cleanliness;8% claw toes;42% had abolition or reduction of superficial tenderness to monofilament and 21% had mixed foot (neuropathy + arteriopathy). In our study, 58.9% of patients had no risk of podiatry. Conclusion: Screening of foot at risk is essential in the management of diabetes because it determines the podiatric risk enabling to minimize future functional disabilities.

关键词： Foot at Risk Diabetes Hospital of Mali

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妊娠晚期服用地西泮对新生儿的影响

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世界核心医学期刊文摘（儿科学分册） 2006年第2期2卷 10-11页

作者： Swortfiguer D. cissoko H. Giraudeau B. 李开

Introduction. -Since benzodiazepines (BZD) are largely prescribed during pregnancy, the Regional Pharmacovigilance Center (RPVC) of Tours regularly deals with questions about the risk of their administration to pregnantwomen and the monitoring of the newborns exposed in utero to these drugs. During the third trimester, we recommend a switch in the BZD maternal treatment to oxazepam, which has an intermediary half-life and no active metabolite, and a hospitalisation of the newborn in order to monitor his respiratory rate. The purpose of our study was to evaluate the neonatal consequences of BZD used at the end of pregnancy and to analysed if our recommendations were taken into account and if they were appropriate. Methods. -From 1989 to the end of 2002, we studied the files in which women had received a BZD during the 30 days prior to delivery. We analysed maternal treatments, the outcome of pregnancy and the development of the newborn, the therapeutically attitude recommended and whether or not it was respected. Results. -A total of 73 files were selected. Seventy neonates were born to 73 women. The newborns were hospitalised (73% ) and they developed adverse reactions possibly related to the use of BZD (51,5% ) : an impregnation syndrome (42% ) characterized by hypotonia and hypoventilation, and a with drawal syndrome (20% ) with tremulations as the main symptom. Conclusion. -Considering the most frequent neonatal manifestations, hospitalization and the respiratory monitoring recommended by the RPVC seemed adequate. However, the switch to oxazepam was seldom done and its advantages should be pointed out.

关键词：新生儿疾病妊娠晚期地西泮服用住院治疗活性代谢产物孕期服药作者分析吸入综合征戒断综合征

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Progressive Characteristics of HIV Infection in the Elderly in the Cohort of the Internal Medicine Department of the Points G University Hospital, Bamako. Mali

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Advances in Infectious Diseases 2023年第1期13卷 109-116页

作者： Abdoulaye Mamadou Traore Garan Dabo Mamadou cissoko Charles Dara Djenebou Traoré Ibrahim Dollo Djibril Sy Assétou Soukho Mamadou Dembélé Daouda Kassoum Minta Abdel Kader Traore Hamar Alassane Traore Department of Infectious Diseases CHU du Point G Bamako Mali Department of Medecine CHU “Hôpital du Mali” Bamako Mali Department of Internal Medicine CHU du Point G Bamako Mali

Few data are available on HIV infection in the elderly and they are an important population in our different cohorts in view of the improvement in the quality of care over the last ten years. Objective: to determine the clinical and immunovirological characteristics as well as the acceptance of antiretroviral drugs in this patient population. This is a cohort study of the files of PLHIV (People living with HIV) aged 50 years or more, followed in the Internal Medicine Department of the Point G University Hospital between January 2007 and December 2012. Results: Out of 161 HIV-infected patients in the cohort, 38 were aged 50 years or older, of whom 11 met the criteria and were included. The median age was 55 years, 90.9% of whom were in the [50 - 59 years] age group, with 63.6% being women (sex ratio = 0.57). At admission, 3 patients (27.3%) had prurigo and 2 (18.2%) had oral-pharyngeal candidiasis. At inclusion, 45.5% of patients were classified as WHO stage 2 and one as WHO stage 4. All were on ARVs, including 10 on 1st line HIV-1 and 1 on HIV-2. On triple therapy, the average weight gain was 5.1 kg at D15 and 6.84 kg at M6. However, at M12 there was a weight loss of 1.04 kg. The mean CD4 T cell gain was +102/mm3 at M6 and +188/mm3 at 12 months. At D0, mean viral load = 565024.75 copies/mm3 [99 - 1100000] in 4/11. At M12, two patients had undetectable viral loads. Conclusion: The prevalence of HIV in elderly subjects is certainly underestimated. Thanks to triple antiretroviral therapy, PLHIV are aging with HIV but screening is not systematically proposed during consultations in elderly subjects. It is necessary to reinforce communication about HIV at all ages.

关键词： HIV Elderly Clinical Immunovirology

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Antibioprophylaxy by the Surgery Staff in the Teaching Hospital Gabriel Touréin Mali

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Surgical Science 2015年第3期6卷 138-142页

作者： Bakary Tientigui Dembélé Alhassane Traoré Adégné Togo Lassana Kanté Ibrahim Diakité Amadou Traoré Bourama Emmanuel cissoko Madiassa Konaté Boubacar Karembé Yacaria Coulibaly Soumeila Keita Mamby Keita Souleymane Diallo Gangaly Diallo Faculty of Medicine and Odonto-Stomatology Bamako Mali Department of General Surgery CHU Gabriel Touré Bamako Mali Department of Biology and Laboratory CHU Gabriel Touré Bamako Mali

This prospective survey was conducted from February to December 2014 about the use ceftriaxone (ceftriaz) for antibioprophylaxy concerning 300 patients by the surgery staff in the Gabriel Touré Teaching Hospital in Mali. The quantity of drug used was based on the weight of the patient. One dose was administrated in intravenous at the anesthesiology induction time. For more than 2 hours of intervention time, 4 (1.3%) patients received a second dose. The majority of cases (189, 63%) were out of emergency (emergency cases—111, 37%). The mean age was 41.6 years (range: 3 - 95 years). The patients were classed Altmeir II 203 (67.7%) and Altmeir I 97 (32.3%). The NNISS score 0 concerned 101 (33.6%) and NNISS 1 in 180 (60%) patients. The factors of risky were anemia (38;12.7%), diabetes (6;2%), and HIV (3;1%). The mean of intervention duration was 56.8?±?27.5 minutes. Four cases of intervention site infection were encountered caused by?Pseudomonas?aeruginosa?in 2 patients;?Escherichia coli?(1 case), and?Staphylococcus aureus?(1 case). Conclusion: Antibioprohylaxy is not the only way to prevent infections but it stays necessary. The respect of hygien and aseptic measures should be used to reduce the rate of intervention site infection.

关键词： Antibioprophylaxy Infection Risky Factors Surgery

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Clinical and Epidemiological Aspects of Hepatocellular Carcinoma at the Internal Medicine Department of Point “G” Teaching Hospital in Mali

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Open Journal of Gastroenterology 2023年第7期13卷 250-255页

作者： Ganda Soumaré Sanra Déborah Sanogo Abdoulaye Maiga Ouatou Mallé Mamadou Mallé Ibrahima A. Dembélé Mamadou cissoko Mamadou M. Coulibaly Assétou Kaya Soukho Mamadou Dembélé Abdel Kader Traoré Alassane Traore Hamar Alassane Traore Gastroenterology Department CHU du Point G Bamako Mali Internal Medicine Department CHU du Point G Bamako Mali

Liver cancer is the malignant transformation of liver cells. It develops in 90% of cases of cirrhosis, more rarely on chronic non-cirrhotic liver disease, and exceptionally in a healthy liver. This study aimed to investigate the clinical aspects of Hepatocellular Carcinoma (HCC). It was a retrospective descriptive study covering 10 years, focusing on HCC cases seen in outpatient and inpatient settings at the Internal Medicine Department. We recorded 153 cases out of 7021 patient records, resulting in a hospital frequency of 2.17%. The male-to-female ratio was 3.5. The mean age was 52.37 ± 14.34 years. The most common presenting complaint was pain in 16.3% of cases. A history of jaundice was found in 25.5% of cases. Alcohol consumption was observed in 15.38% of cases. The main physical sign found was hepatomegaly in 76% of cases. HBsAg was positive in 33.3% of cases. Alpha-fetoprotein levels were above 400 IU/ml in 50.81% of cases. Patients classified as CHILD PUGH A represented 39.72% of cases. Abdominal ultrasound revealed portal thrombosis associated with heterogeneous multinodular hepatomegaly in 11% of cases. Cytology confirmed HCC in four out of six patients who underwent the examination. We recorded 63 deaths out of 111 hospitalized patients. Complications included encephalopathy, hematemesis, and ascites in 48 patients. Hepatocellular carcinoma remains a significant public health issue. Its predominance in men and its occurrence in adults with factors such as viral infections and ethylism mean that prevention of this pathology could greatly reduce its incidence.

关键词： Hepatocellular Carcinoma (HCC) Point G University Hospital Bamako Mali

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Anemia in the Elderly: Frequency and Etiologies at University Hospital Center of Point G

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Open Journal of Clinical Diagnostics 2019年第4期9卷 115-125页

作者： Sy Djibril Traore Abdel Kader Kaya Assetou Soukho Traore Djenebou Gozo Jean-Jonathan Cocou Keita Zakaria Dembele Ibrahima Amadou cissoko Mamadou Keita Kaly Sangare Barry Boubacar Malle Mamadou Sy Seydou Dembele Mamadou Traore Hamar Alassane Department of Internal Medicine of University Hospital Center of Point G BamakoMali General Secretary of the Association“Rabies in West Africa—Mali” BamakoMali Department of Nephrology of University Hospital Center of Point G BamakoMali

Introduction: Older people are exposed to particular health problems that must be taken into account, including anemia defined by the World Health Organization (WHO) in people aged 65 and over hemoglobin < 13 g/dl in men and < 12 g/dl in women. Objectives: To determine the frequency of anemia, to describe its clinical and paraclinical aspects, and to determine the etiologies. Material and Methods: We conducted a cross-sectional study with prospective data collection that took place in the Department of Internal Medicine of the Point G CHU in Mali from January 1st, 2018 to August 31st, 2018, covering all elderly patients. At least 65 years old hospitalized and/or having consulted and presenting with anemia. Anemia was defined as Hb < 13 g/dl in men and < 12 g/dl in women (WHO definition). Biological markers were collected at admission. Results: Anemia was observed in 42 patients in 160 elderly patients, a prevalence of 26%, the age of our patients ranged from 65 to 90 years. The sex ratio was 1.33. Fifty percent (50%) of the patients had high blood pressure as antecedents. Weight loss was found in 69% of cases;47.6% of patients had dyspnea on admission. Tachycardia was the physical sign associated with anemia present in 85.7% of them. The mean hemoglobin level was 9.2 g/dl ± 2.03: thus 50% of the subjects had microcytic and or hypochromic anemia. The etiologies found were infectious in 31.0% of cases, inflammatory in 31.0% of cases, renal in 14.2% of cases. Chronic hemorrhage, acute haemorrhage, hemolysis accounted for 2.4% each. We observed 9.5% of unexplained causes. Conclusion: The frequency of anemia is high. Nearly half of the geriatric population has anemia. The lack of means and the nonperformance of the technical platform to perform all examinations in the etiological research of anemia have a significant impact on the rate of unexplained anemias.

关键词： Anemia Elderly Internal Medicine CHU Point G

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Corneal Blindness Caused by Accidental Ocular Use of Chlorhexidine (Hexz) Gel in Two Newborn Born in the Health District of Kati in Mali

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Open Journal of Ophthalmology 2023年第1期13卷 83-90页

作者： Kadiatou Ba Moro Sidibe Bakary Danfaga Sadio cissoko Aichata Tall Oumar Diallo Assiatou Simaga Nouhoum Guirou Abdoulaye Napo Adama Dembele Abdoulaye Nouhoum Coulibaly Aoua Ibrahima Toure Mamadou Adama Togo Chiaka Sanogo Seydou Bakayoko Fatoumata Sylla Lamine Traore Sanoussi Bamani Institute of Tropical Ophthalmology of Africa (IOTA) Bamako Mali Regional Hospital of Sikasso Mali/Alliance for the Development of Community Ophthalmology (ADOC) Bamako Mali Kati Reference Health Center Koulikoro Mali Alliance for the Development of Community Ophthalmology (ADOC) Bamako Mali

Introduction: Corneal opacities in children are relatively common. In children, it is urgent because of the risk of irreversible amblyopia. The causes of these blindnesses vary considerably according to the regions of the world. Chlorhexidine digluconate is a broad-spectrum antiseptic directed against gram-positive and gram-negative bacteria. It has been used as an antiseptic for more than 50 years, both in humans and in animals. However, despite these benefits, it can cause serious damage if applied to the eyes. Incidents of eye damage with 7.1% chlorhexidine have been reported to WHO across Africa. Observation: We report and write two cases of bilateral corneal blindness caused by accidental ocular use of chlorhexidine (HEXZ) GEL 7.1% in two newborns in the health district of Kati in MALI. The ophthalmological examination had revealed corneal opacity, conjunctival hyperaemia and limbic ischemia greater than 50% in 1 eye out of 4, corresponding to stage IV of the ROPPER HALL classification;2 eyes out of 4 were at stage III and 1 eye out of 4 was at stage I of the same classification. Conclusion: It is essential to ensure correct use of chlorhexidine digluconate gel 7%. It is an antiseptic which should not be used on the ocular and auditory mucous membranes, at the risk of most often permanent burns.

关键词： Chlorhexidine Opacity Cornea Kati

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妊娠晚期接触β肾上腺素能阻滞剂后的新生儿转归

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世界核心医学期刊文摘（儿科学分册） 2005年第10期1卷 37-38页

作者： cissoko H. Jonville-Béra A.-P. Swortfiguer D. E. Autret-Leca 郭战宏 Ctr. Reg. Pharmacovigilance P. Service de Pharmacologie CHRU 2 boulevard Tonnel lé 37044 Tours Cedex 01 France

Objectives. -To analyse neonatal effects after in utero betablockers exposure and the pertinence of recommendations delivered by our team. Population and met hods. -We report 44 pregnancies exposed to betablockers during the late pregnan cy including the period of delivery about which the Regional Pharmacovigilance C enter of Tours (CRPV) was questionned. Results. -Among the 39 children for whom we know the follow up, 22 had neonatal adverse effects of which 19 could be exp lained by in utero exposure to betablockers i.e. an hypoglycaemia (11 times), a bradycardia (six times), a bradycardia and hypoglycemia (one time) and an hypote nsion (one time). A drug-related effect was retained for eleven newborns (27%) and another etiology could be evoked in the eight others. The risk of neonatal adverse effects seems to increase in newborns exposed to labetalol (5/11), to be taxolol (1/2) or to propranolol (2/6) or when the dose is high. The eight newbor ns who had intrauterine growth retardation were generally more often exposed to atenolol than eutrophic newborns. Four babies had malformations. Conclusions. - Our recommendation was an hospitalization 44 times (100%) to monitor heart rate , blood pressure and glycemia. When the follow-up is known, hospitalization was performed in 88%of the cases. Glycemia, heart rate and blood pressure were mon itored in all the hospitalized children and in three of the five not hospitalize d children. Our recommendation seems particularly justified with regard to hypog lycemia which is often asymptomatic but whose consequences can be severe. Atenol ol often provider of intrauterine growth retardation and labetalol more often at the origin of neonatal adverse effects are probably to avoid during pregnancy.

关键词：妊娠晚期拉贝洛尔 β阻滞剂药物警戒心动过缓普萘洛尔阿替洛尔倍他洛尔监测心率不良反应

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