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Pulmonary Embolism: Epidemiological, Clinical, Therapeutic and Evolution Aspects in the Medicine Department of Hospital of Mali Bamako

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World Journal of Cardiovascular Diseases 2021年第4期11卷 242-248页

作者： Massama Konaté Mariam Sako Boubacar Sonfo Samba Sidibé Souleymane Mariko Djeneba Sylla Sow Coumba Adjaratou Thiam Djenebou Traoré Hamidou Oumar Ba Asmaou Keita Maiga Ibrahima Sangare Mamadou Toure Souleymane Coulibaly Nouhoum Diallo Bah Traoré Modibo Mariko Nouhoum Ouologuem Amadou Koné Youssouf Camara Yacouba Lazare Diallo Nanko Doumbia Mahamadoun Coulibaly Ichaka Menta Faculty of Medicine and Dentistry (FMOS) of the University of Sciences Technique and Technology of Bamako (USTTB) Bamako Mali Medicine Department Hospital of Mali Bamako Mali Cardiology department CHU Point G Bamako Mali Cardiology Department Hospital of Kati Kati Mali Medicine Department Hospital of Tombouctou Tombouctou Mali Internal Medicine Department CHU Point G Bamako Mali Cardiology Department CHU Gabriel Toure Bamako Mali Cardiology Department CHU Mère Enfant Bamako Mali

Background: Pulmonary embolism (PE) is a severe form of venous thromboembolic disease. In Africa, prevalence of PE in hospitalized medical patients varies among studies. Objective: Aim of this work was to study the epidemiological, clinical, therapeutic and evolution aspects of PE in the medicine department of Mali’s Hospital Bamako-Mali. Methodology: This was a retrospective cross-sectional study carried out from January 01, 2017 to December 31, 2020 in the medicine department of Mali’s hospital Bamako, including all inpatients admitted for PE during the study period. Results: Of 1814 hospitalized patients, 54 patients had pulmonary embolism. Hospital frequency of pulmonary embolism was 2.97%. Predominance was female and sex-ratio M/F was 0.38. Mean age in our series was 54.24 ±1.19 years. Predisposing factors to pulmonary embolism were dominated by obesity 37%, high blood pressure 35.2% and history of cardiovascular disease 20.4%. Dominant signs were dyspnoea and chest pain in 83.3% and 70.4% of cases respectively. Probability of pulmonary embolism was high in 40.7% according to Wells score. Patients with right heart failure were 22.2%. EKG showed sinus tachycardia70.4% and S1Q3 aspect 7.4%. Heart right chambers were dilated at transthoracic echography 42.6%. Obstruction was bilateral at chest angio CT for 51.9% and proximal for 42.6%. Deep venous thrombosis was associated at EP in 16.6%. Treatment was low weight molecular heparin followed by vitamin K antagonist or direct oral anticoagulant. One patient was successfully treated by thrombolysis. Hospital mortality was 16.7%. Conclusion: PE is a serious disease probably underdiagnosed. It is responsible of important mortality.

关键词： Pulmonary Embolism Epidemiology Mali’s Hospital

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Interest of the Padding in the Prevention of Lymphocele Production after Mastectomy with Axillary Dissection for Breast Cancer at Joliot Curie Cancer Center

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Journal of Cancer Therapy 2020年第12期11卷 824-831页

作者： Mohamed Ezzet Charfi Sidy Ka Jaafar thiam Adja coumba Diallo Papa Souleymane Dieng Ahmadou Dem Cheikh Anta Diop University Dakar Senegal

Introduction: The principal postoperative complication of mastectomies with axillary dissection is the lymphocele that can last many months after surgery. The purpose of our study was to prevent its formation using the padding. Methods: Sixty-one patients have been included in our study. The follow-up was 6 months. The patients were divided in two groups through a random draw (simple drainage and drainage associated with padding). All patients had a mastectomy with axillary dissection following the Madden technique. All quantities of lymphoceles during postoperative hospitalization and ambulatory care have been noted. Results: Twenty-five patients had benefited from the padding and 36 of a simple axillary drainage. Six months after the surgery, the patients benefitting from the padding had a quantity of lymphocele equal to half that of the control group (761.83 mL against 1373.60 mL;p = 0.01). During the postoperative hospitalization, the quantities were of 362.80 mL for the padding group versus 630.83 mL;p Conclusion: The production of postoperative lymphocele is heterogenous, varying from one patient to another. Nevertheless, the padding of the mastectomy compartment and of the axillary cavity allow

关键词： Mastectomy Axillary Dissection Lymphocele Padding

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Prevalence, Pattern and Evolution of Rheumatic Heart Disease: About 120 Cases at Mother-Children University Hospital Luxembourg (MC UHL), Bamako (Mali)

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World Journal of Cardiovascular Diseases 2018年第7期8卷 319-327页

作者： Ba Hamidou Oumar Maiga Asmaou Kéita Doumbia coumba thiam Maiga Salma Souleimane Sidibé Noumou Sangaré Ibrahima Camara Youssouf Sidibé Salimata Diallo Souleymane Menta Ichaka Diarra Mamadou Bocary CHU Gabriel Touré Bamako Mali CHU Mère Enfant le Luxembourg Bamako Mali CHU Sidy Bocar Sall Kati Mali

Introduction: Acute rheumatic fever (ARF) and its complications including rheumatic heart disease (RHD) remain one of the leading causes of cardiovascular disease worldwide. In our setting with no cardiac surgery, data on RHD are therefore important to point out the need for such structure. In this study, we therefore describe rheumatic disease in terms of prevalence, patients’ characteristics and management of patients. Methods: We performed a retrospective study from May to September 2012, involving children aged 3 to 15 years old and seen at the Mother and Child University Hospital Luxembourg (MC UHL). Included were all children diagnosed with RHD. The diagnosis of rheumatic fever (RF) was defined using the revised Jones criteria from 1992 and RHD defined according to the WHO/NIH joint criteria. Data of interview, clinical examination, complementary and those on evolution were recorded. Results: We found an hospital prevalence of 6.2%. Mean age was 15.33 years ± 6.005 (3 to 36), females representing 54.2% and students 70%. Mitral regurgitation (MR), Mitral Stenosis (MS) and concomitant MR + MS were most found RHD with resp. 43.3%, 15% and 13.3%. Complications occurred in 74.1% before surgery. An operative indication was set in 90% of all cases whereas only 36% underwent surgery. After surgery immediate complications were dominated by anemia (11.6%) and late ones by heart failure in 18.5% of cases. Conclusion: Despite advances in medical diagnostic approach and therapeutical progress which partly explained the relatively high prevalence, the evolution of rheumatic heart disease in our context is unfavorable due to the lack of a surgical management structure. While waiting for a cardiology institute, the focus should be on information and awareness in primary prevention.

关键词： Retrospective Acute Rheumatic Fever Rheumatic Heart Disease Bamako

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Contribution of Stress Testing to the Management of Ischemic Heart Disease in Mali

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World Journal of Cardiovascular Diseases 2024年第2期14卷 77-87页

作者： Youssouf Camara Hamidou Oumar Ba Ibrahima Sangaré Boubacar Sonfo coumba Adiaratou thiam Mahamadou Sékou Diakité Koniba Diarra Karamba Touré Massama Konaté Ichaka Menta Cardiology Department University Hospital Professeur Bocar Sidi Sall Kati Kati Mali Cardiology Department University Hospital Gabriel Touré Bamako Mali Cardiology Department Mali Hospital Bamako Mali

Introduction: Exercise stress testing (on a treadmill or ergometer bicycle) is an important test in cardiology for diagnosing myocardial ischemia. This test in Mali is still in its beginning compared to other countries in the sub-region. The lack of data in Mali prompted this study, which aimed to evaluate the indications of this activity and its diagnostic contribution to cardiology in Mali. Materials and Methods: This was a retrospective, descriptive study. The study was conducted at the “TOUCAM” medical clinic in Kati based on the analysis of stress test reports between January 2016 and August 2022. Result: During the study period, we documented 73 patients who underwent exercise testing on a bicycle ergometer for suspected coronary heart disease. The mean age of our patients was 47.5 ± 13.8 years (14 and 79 years). Males accounted for the majority (78.1%). The sex ratio is 3.5. More than half of our patients were overweight or obese (77.1%). Hypertension and diabetes affected 52.1% and 25.8% of patients, respectively. 20.8% of patients had coronary artery disease. renin-angiotensin-aldosterone system blockers (56.8%) and beta-blockers (51.3%). The main indications were chest pain (63.0%) and ischemia detection (15.1%). A modified STEEP protocol was used. The majority of our patients (71.2%) achieved at least 85% of their maximum theoretical heart rate. The main reason for the termination of the study was fatigue (57.3%). The average duration was 11.3 ± 4.2 minutes. 24.7% thought the stress tests were positive and 17.8% thought they were controversial. Conclusion: This study demonstrates the importance of stress testing in the diagnosis and treatment of ischemic heart disease, especially in settings where we have very limited access to coronary angiography.

关键词： Stress Test Ischemic Heart Disease Mali

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Vaginal Carriage of Group B Streptococcus in Pregnant Women in Rural Areas in Senegal

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Open Journal of Medical Microbiology 2023年第3期13卷 207-219页

作者： Babacar Ndiaye Fatoumata Diene Sarr Mam coumba Diouf Rokhaya Diop Hamidou thiam Mohamed Abass Yugo Rose Mbaye Amadou Alpha Sall Cheikh Loucoubar Abdoulaye Seck Medical Biology Laboratory Pasteur Institute of Dakar Dakar Senegal Epidemiology Clinical Research and Data Science Unit Pasteur Institute of Dakar Dakar Senegal Virology Unit Pasteur Institute of Dakar Dakar Senegal

Vaginal carriage of Group B Streptococcus (GBS) is a maternal and child health issue. Our objective was to determine the prevalence of GBS carriage;identify the factors associated with this carriage and determine the antibiotic sensitivity of the isolated strains. We conducted a cross-sectional and prospective study in rural Senegal (in the health district of Sokone). Socio-demographic, clinical and gynaeco-obstetrical data were collected. Vaginal swabs were taken by the midwives on specific settings in order to test for GBS and other High Risk Vaginal Bacteria (HRVB). Antibiotic susceptibility testing was done according to the recommendations of the CA SFM/EUCAST 2020. In total, 100 pregnant women were targeted and 97 pregnant women were included. Their age ranged from 18 to 40 years with 64.9% (63/97) of participants belonging to the “20 - 30” age group. The overall prevalence of Group B Streptococcus carriage was 15.5% (15/97). However, the proportion of women with at least one high risk infectious bacteria was 29.89% (29/97). No statistically significant differences were found between GBS carriage and the potential factors studied. However, the study also looked for the presence of other high-risk bacteria and coinfections were indeed found between GBS and E. coli and Staphylococcus aureus. Antibiotic susceptibility testing shows that GBS strains were fully susceptible to penicillin G, erythromycin, clindamycin, chloramphenicol, rifampicin and vancomycin. Sensitivities to norfloxacin and gentamycin were 73.3% and 86.7% respectively. In contrast, high resistance to tetracycline (86.7%) was observed. GBS carriage remains a major public health issue because of its consequences for the mother and the newborn. Correct screening and proper monitoring of strain susceptibility remain one of the most effective means of patient management and care.

关键词： Group B Streptococcus (Streptococcus agalactiae) Vaginal Carriage Antibiotic Susceptibility Senegal

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Modeling and Optimization of Interaction between Small Coastal Pelagic Fish, their Biological Predators and Fishermen

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Open Journal of Optimization 2021年第1期10卷 13-27页

作者： Ibrahima Diedhiou Salimata Gueye Diagne Fambaye Ngom Sow coumba Diallo Diop Ndiaga thiam Gabriel Birame Ndiaye Aissatou Fall Ndoye Gueye Cheikh Anta Diop University of Dakar (UCAD) Dakar Senegal Department of Mathematics and Computer Science (DMI) UCAD Dakar Senegal Oceanographic Research Center Dakar Thiaroye (CRODT) Dakar Senegal Direction of Maritime Fisheries (DPM) Dakar Senegal

Small coastal pelagic fish are one of the fish families most affected by sea fishing. This man-made phenomenon leads to an imbalance in the marine and coastal ecosystem and is one of the main causes of migration north and offshore of the ranges. We used the ordinary differential equations to model the interactions existing between small pelagic resources and fishermen. Modelling follows the same of the Lotka-Volterra equations with a difference in the number of variables. This study confirmed the instability of the marine ecosystem. The objective is first of all to model a system of three interacting individuals composed of two distinct types of predators and two types of prey, and then optimise this interaction with the aim of conserving biodiversity in the ecosystem under study. Determining the Jacobian matrix made it possible to calculate the reproduction rate basic (R0). The study of the strong connectedness has made it possible to reduce the number of variables without losing the objective of the study. A computer program implemented on the language computer python facilitated the visualisation of the results.

关键词： Small Coastal Pelagics Ordinary Differential Equations Modelling Optimisation Basic Reproduction Rate

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Hydrological Modelling of the Casamance River in Its Upstream Section (Basin at Kolda Level) to Predict Its Future States as a Function of Different Stresses

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Open Journal of Geology 2024年第2期14卷 143-154页

作者： coumba Ndiaye Saïdou Ndao Laboratory of Water and Environment Sciences and Technologies (LaSTEE) Polytechnic School of Thies (EPT) Thies Senegal UFR Sciences and Technologies (SET) University Iba Der Thiam of Thies (UIDT) Thies Senegal

Flow records for stations in the Casamance basin are incomplete. Several gaps were noted over the 1980-2021 study period, making this study tedious. The aim of this study is to assess the potential impact of climate change on the flow of the Casamance watershed at Kolda. To this end, hydrological series are simulated and then extended using the GR2M rainfall-runoff model, with a monthly time step. Projected climate data are derived from a multi-model ensemble under scenarios SSP2-4.5 (scenario with additional radiative forcing of 4.5 W/m2 by 2099) and SSP5-8.5 (scenario with additional radiative forcing of 8.5 W/m2 by 2099). An analysis of the homogeneity of the rainfall data series from the Kolda station was carried out using KhronoStat software. The Casamance watershed was then delimited using ArcGIS to determine the morphometric parameters of the basin, which will be decisive for the rest of the work. Next, monthly evapotranspiration was calculated using the formula proposed by Oudin et al. This, together with rainfall and runoff, forms the input data for the model. The GR2M model was then calibrated and cross-validated using various simulations to assess its performance and robustness in the Casamance watershed. The version of the model with the calibrated parameters will make it possible to extend Casamance river flows to 2099. This simulation of future flows with GR2M shows a decrease in the flow of the Casamance at Kolda with the two scenarios SSP2-4.5 and SSP5-8.5 during the rainy period, and almost zero flows during the dry season from the period 2040-2059.

关键词： Casamance Watershed Climate Change GR2M Climate Models

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Epidemiological, Clinical and Coronary Angiography Aspects of Acute Coronary Syndrome in the Cardiology Department of the Hospital Mother-Child “Le Luxembourg”Mali

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World Journal of Cardiovascular Diseases 2024年第4期14卷 228-233页

作者： Sidibé Samba Toure Mamadou Konate Massama Sankaré Hamma Traoré Ousmane Mahamat Guire Sadik Diall Mahan Ameri Dicko Bahaide Daffe Sanoussy Keita Asmaou thiam coumba Adiaratou Diarra Soumaila Menta Ichaka Cardiology Department CHU-M&#232re Enfant Bamako Mali Cardiology Department CHU-Point G Bamako Mali Faculty of Medicine University of Sciences Techniques and Technologies of Bamako Bamako Mali Cardiology Department CHU-Gabriel Tour&#233 Bamako Mali Cardiology Department Mali Hospital Bamako Mali

Introduction: Cardiac catheterisation plays a fundamental role in the management of acute coronary syndrome. These explorations require heavy, complex and costly equipment and a large team of doctors, nurses and technicians with highly specialized training. Aims: To describe epidemiological, clinical and coronary angiography aspects of patients with acute coronary syndrome. Patients and Methods: Descriptive study from September 2019 to December 2023 in the Cardiology Department of the Hôpital Mère-Enfant of Bamako. Inclusion criteria were patients admitted for coronary angiography with the diagnosis of acute coronary syndrome. Results: During the study period, 1253 patients underwent coronary angiography, 596 of whom had acute coronary syndrome as an indication, representing a hospital frequency of 47%. Sex-ratio was 2.10. Mean age of patients was 58.5 ± 11.39 years. ST elevation acute coronary syndrome was the most common indication with 63.92% of cases. High blood pressure was the main cardiovascular risk factor with 58.7% of cases, and radial access approach was used in 98% of cases. Coronary angiography was pathological in 91.70% of cases (n = 548). Patients with lesions of anterior interventricular artery were 73.73% of cases. Tritruncal lesions accounted for 40.63% of cases. Conclusion: ST elevation acute coronary syndrome is the most frequent manifestation of acute coronary syndrome. Anterior interventricular artery is most often the culprit lesion for our patients.

关键词： Coronary Angiography Acute Coronary Syndrome Bamako Mali

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Double Discordance with Pulmonary Stenosis: About a Clinical Case

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World Journal of Cardiovascular Diseases 2020年第12期10卷 825-830页

作者： Asmaou Keita Maiga Boubacar Sonfo Daffé Sanoussi Fofana Daouda Diallo Souleymane Terra Abdoul Wahab thiam coumba Ba Hamidou Touré Mamadou Camara Youssouf Mamadou Bocary Diarra Cardiology Department CHU Mère - Enfant Bamako Mali Cardiology Department of CHU Kati Bamako Mali Cardiology Department CHU Gabriel Touré Bamako Mali

Introduction: Double discordance or corrected transposition of the great vessels is a rare congenital heart disease. It is an atrioventricular and ventriculo-arterial mismatch. It is a complex and unusual form of congenital heart disease. Often asymptomatic, in its isolated form, bradycardia, murmur and cyanosis can be a mode of revelation. Case presentation: We report the case of an 11-year-old child, asymptomatic at birth, after he started to have dyspnea on exertion, recurrent bronchitis, motivating a cardiological consultation. On cardiac physical examination, the heart sounds regular, not rapid at 81 BPM with a grade 3-4/6 systolic murmur at the 4th left EIC (Intercostal space). EKG (electrocardiogram) shows PR interval at 0.20 seconds. Cardiac ultrasound reveals atrioventricular discordance, vascular malposition, anterior aorta, the two vessels placed side by side, minimal pulmonary insufficiency, a small leak at the levels of the mitral and tricuspid valves, dystrophic pulmonary valves with an average gradient of 91 mmHg, max at 158 mmHg. Regular follow-up has been recommended through the performance of a clinical examination and cardiac ultrasound. Conclusion: The double discordance can be asymptomatic, and survival can be long in the isolated forms, but the evolution is not always benign, especially in the associated forms. It depends on the function of the systemic right ventricle and associated abnormalities.

关键词： Double Discordance CHU ME Luxembourg Bamako

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Ischemic Stroke Revealing Infective Endocarditis in a Young Subject: About a Clinical Case

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World Journal of Cardiovascular Diseases 2022年第4期12卷 209-215页

作者： coumba thiam Boubacar Sonfo Massama Konaté Mahan Ameri Abba Diall Asmaou Keita Mariam Sako Youssouf Camara Hamidou Oumar Bâ Ibrahima Sangaré Mamadou Touré Samba Sidibé Massama Camara Simo Moyo Souleymane Coulibaly Ichaka Menta Cardiology Department of Kati University Hospital Kati Mali Internal Medicine Department of Mali Hospital Bamako Mali Cardiology Department of the Mother-Child University Hospital Bamako Mali Cardiology Department CHU Point G Bamako Mali Cardiology Department of the CHU Gabriel Touré Bamako Mali

Introduction: Neurological complications are possible during infective endocarditis. They are often life-threatening and can be a source of sequelae. Case Presentation: We report the case of an 11-year-old patient admitted to the cardiology department of the CHU-ME “LUXEMBOURG” in Bamako for functional impotence of the left hemibody, accompanied by fever and NYHA stage II dyspnea. The clinical examination on admission shows the poor general condition, normal consciousness, and sensory-motor deficit of the pyramidal type of the left hemibody. The cardiovascular examination notes a systolic murmur at the mitral focus, hepato-jugular reflux, hepatomegaly, and slight edema in the lower limbs. Brain CT showed localized hypodensity in favor of an ischemic stroke. The electrocardiogram shows a sinus rhythm. Transthoracic Doppler echocardiography revealed mitral insufficiency with vegetation of 17 × 14 mm on the anterior mitral valve, with left ventricular ejection fraction estimated at 75%. Dual antibiotic therapy associated with conventional treatment for heart failure was initiated. The clinical evolution was marked by the persistence of the deficit of the left upper limb, the cardiac Doppler echography of control after 6 weeks of treatment found the same vegetation. A discussion with the heart team with a view to a surgical cure has been initiated for the rest of the treatment. Conclusion: A motor deficit associated with fever related to an ischemic vascular accident should lead to a search for infective endocarditis on cardiac Doppler ultrasound.

关键词： Ischemic Stroke-Infectious Endocarditis-Young Subject

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