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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 c

关键词： Mastectomy Axillary Dissection Lymphocele Padding

Hyperalgesic Lumbosciatica Symptomatic of a Spinal Schwannoma: A Case Report

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Open Journal of Modern Neurosurgery 2022年第2期12卷 61-66页

作者： Magatte Gaye Omar thiam Cherif Mouhamed Dial Lounceny Fatoumata Barry Mohameth Faye Nantene doumbia Youssoupha Sakho Department of Neurosurgery Hopital General Grand Yoff Dakar Senegal Department of Pathology Hopital General Grand Yoff Dakar Senegal

Introduction: Spinal schwannomas also known as neurinomas are often benign slow growing lesion that may develop from Schwann cells of the spinal roots, it is a nerve sheath tumor. The authors reported a case of a patient presenting a hyperalgesic lumbosciatica symptomatic of a spinal schwannoma. Observation: A 36-year-old female patient, with a history of asthma under treatment was admitted to our department because of one year lasting of an intermittent fashion bilateral L5 hyperalgesic lumbosciatica. The initial examination has shown back muscles contractures and a segmental deficit of the right lower limb in L5 and S1, but no genital or sphincter disorders were noted. The lumbosacral CT scan was without particularity but the magnetic resonance imaging (MRI) revealed an intradural, extra medullary lesion at the level of L1-L2. A monobloc resection of the lesion was done. The follow-up is good. Pathology concluded in schwannoma WHO grade I classification. Conclusion: Lumbar neurinoma that grows slowly is most often manifested by a radiculalgia often hyperalgesic and disabling. MRI is the examination of choice to make the diagnosis and complete removal is possible.

关键词： Lumbosciatica MRI Spinal Tumor Neurinoma Surgery

Management of Hypertension (HTN) in a Cardiology Department in Bamako (Mali): Financial Aspects

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World Journal of Cardiovascular Diseases 2019年第6期9卷 394-403页

作者： Hamidou Oumar Ba Ichaka Menta Ibrahima Sangaré Noumou Sidibé Youssouf Camara Souleymane Coulibaly Hamidou Camara Cheick Hamala Fofana Aladji Traoré Adama Sogodogo Mamadou Touré Kéita Asmaou Maiga doumbia coumba thiam Adama Daou Kassoum Mamourou Sanogo University Hospital Gabriel Touré Bamako Mali University Hospital Sidy Bocar Sall Kati Mali University Hospital Mother Children Bamako Mali National Center for Disease Fighting Bamako Mali

Background: Studies on financial aspects of High blood pressure management are rare and old without differentiating categories of expenses. On the other hand there is an evolution in health system with the introduction of a medical insurance. Objective: We performed this study to estimate costs related to insurance status. Methodology: The prospective study on patients aged 15 years and older extended from 01 May to 31 August 2016 and was carried out in the cardiology department of the University Hospital Gabriel Touré. Only newly detected or untreated hypertensive patients were included. Sociodemographic data, those on physical examination and financial management (transport, consultation, labor tests and purchase of drugs) were collected. Regarding costs, patients were directly asked about: how much did you spend for transport, consultation, labor tests and drugs? Data analysis was carried out by comparing patients with health insurance (Ins+) and those without it (Ins?). The recorded data were inserted in a MS Access database, preliminarily processed by MS Excel and imported to SPSS version 20 for analysis. Results: Mean total cost of care was 57,018 FCFA [50,139 - 63,897] (around 92 USD). It was 50,072 [42,182 - 57,963] for the Ins? group against 79,670 [66,777 - 92,563] for the Ins+ group with a p value 0.0001. Highest amounts for spending were for cardiovascular medication and labor tests with means of 19,255 FCFA (32 USD) and 18,813 FCFA (30 USD). Mean consultation fee was significantly higher for Ins+ patients: 4064 FCFA with IC (95%) [3210 - 4917] versus 3124 with IC (95%) [2774 - 3474] for Ins? patients and p = 0.018. For ECG, however, mean costs were higher for Ins? patients with 6460 [5944 - 6976] against 5115 [4871 - 5360] for Ins+ patients, p = 0.001. Conclusion: Health insurance has few subscribers compared to patients requiring medical care. It increases the global costs of care while facilitating access to care for those who benefit from it.

关键词： Hypertension New Patients Untreated Patients Costs Cardiology Bamako

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

Assessment of Common Dental Indices and Need for Periodontal Treatment in the Cardiology Outpatients Unit at the University Hospital Gabriel Touré(UH-GT) in Bamako

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World Journal of Cardiovascular Diseases 2020年第3期10卷 131-143页

作者： Hamidou Oumar Ba Ibrahima Sangaré Youssouf Camara Sidibé Noumou Daou Ousmane Maiga Asmaou Kéita Touré Mamadou Coulibaly Souleymane Sidibé Samba Konaté Massama doumbia coumba thiam Sonfo Boubacar Diakité Mamadou Menta Ichaka Ilo Bella Diall Ahmed Ba Boubacar Ba Sanogo Kassoum Mamourou Service de Cardiologie CHU Gabriel Touré Bamako Mali Service de Cardiologie CHU Kati Bamako Mali CHU Odontostomatologie Bamako Mali Service de Cardiologie CHU Mère-Enfant Bamako Mali Service de Cardiologie du CHU Point G Bamako Mali Service de Médecine Interne et d’Endocrinologie Hôpital du Mali Bamako Mali

Introduction: Little is known through the literature about dental status of patients seen in cardiology department, motivating this study which aims to assess most dental indices of outpatients and the need for periodontal treatment. Methodology: It was a cross-sectional study from November 2016 to April 2017 in the cardiology outpatient unit of the University Hospital Gabriel Touré (UH-GT) in Bamako. Included were all patients with minimum 24 teeth and willing to be involved in the study. History, cardiovascular parameters and dental examination by a resident in Odontostomatology were performed for each patient. Data were analyzed using SPSS 18, quantitative as means and standard deviation (SD) and categorical as proportions. Khi-2 Test, analysis of variance were applied with a significance level set at 0.05. All patients give their verbal consent after being informed about the procedures in the study. Results: Our sample involved 100 patients (66% female, mean age of 54.12 ± 16.150 and patients ≥ 60 years most represented with 50% for male and 37.9 for female patients. Tooth brush use was practiced by 100% and 98.5% respectively for male and female patients and twice daily brushing by 97.1% of male and 97% of female patients. Brushing duration was less than 3 minutes for 35.3% and 31.8% of respectively male and female patients. Plaque index and calculus index were in the male group with respectively 0.79 and 1.06 for male and 0.63 and 0.79 for female (p = 0.047 and 0.020). Mean Decayed Missed and Filled Teeth (DFMT) index showed a significantly increase from 0.22 in the age group under 30 to 0.68 for that other 60 years. Only 2.9% and 9.1% of respectively male and female patients had community paradontal index for treatment needs (CPITN) classe 0. The need for treatment was TN1 meaning instruction to an oral cavity hygiene, similar for both sex (55.9 and 57.6 respectively for male and female patients) and highest in the age-group 30 - 44 increased to 70%. The need

关键词： Dental Indices Cardiology Outpatients Bamako

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

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

Double Emergency Pulmonary Embolism and Aortic Dissection: About a Clinical Case

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World Journal of Cardiovascular Diseases 2020年第8期10卷 550-557页

作者： coumba thiam Boubacar Sonfo Youssouf Camara Souleymane Sanogo Hamidou Oumar Bâ Sidibé Samba Massama Konaté Asmaou Keita Sako Mariam Mahamadou Cissé Ibrahima Sangaré Massama Camara Menta Ichaka Cardiology Department of CHU Kati Bamako Mali Imaging Department CHU Mère-Enfant Bamako Mali Cardiology Department CHU Gabriel Touré Bamako Mali Cardiology Department CHU Point G Bamako Mali Internal Medicine Service Mali Hospital Bamako Mali Cardiology Department CHU Mère-Enfant Bamako Mali

Introduction: Pulmonary embolism and aortic dissection are two formidable cardiovascular emergencies. Their exceptional association has a poor prognosis with very high mortality. The aim of our study was to report the case of a 31-year-old patient with pulmonary embolism associated with De Bakey’s type I aortic dissection, admitted to the cardiology department of Kati University Hospital. Case Presentation: We report the case of a young patient of 31 with no known cardiovascular history, on estrogen-progestogen contraception for 10 years, who consults for a left basal thoracic pain of increasing intensity, a whitish productive cough, hemoptysis and dyspnea stage III. She was admitted to the cardiology department, transthoracic cardiac ultrasound objectified aortic insufficiency, dissection of the aorta, the presence of the intimal flap, the false and the true channel, dilation of the right cavities with HTAP. The chest CT scan revealed bilateral lobar and segmental pulmonary embolism, De Bakey’s type I aortic dissection. Medical treatment was instituted for hemodynamic stabilization at the end of sending her to a center specializing in cardiovascular surgery for better management; unfortunately she succumbed before the preparations for her evacuation were finished. Conclusion: The pulmonary embolism associated with aortic dissection constitutes a medical emergence of rare incidence in a cardiological environment;if the diagnosis was quickly made in our patient, the lack of technical platform m

关键词： Pulmonary Embolism Aortic Dissection CHU Kati

Pediatric Hypertension (HTN) Assessed by Various Methods: A Study among Pediatric Inpatients in University Hospital Gabriel Touré(UH-GT)

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World Journal of Cardiovascular Diseases 2020年第3期10卷 144-154页

作者： Hamidou Oumar Ba Youssouf Camara Ibrahima Sangare Maiga Belco Diakite Mamadou A. Dembele Fofana Cheick Hamala Toure Mamadou Hamidou Camara Sogodogo Adama Traore Aladji Sidibe Samba Sidibe Noumou doumbia coumba thiam Maiga Asmaou Kéita Konate Massama Sonfo Boubacar Menta Ichaka Ilo Bella Diall Togo Boubacar Diarra Mamadou Bocary Service de Cardiologie CHU Gabriel Touré Bamako Mali Service de Cardiologie CHU Kati Bamako Mali Service de Pédiatrie CHU Gabriel Touré Bamako Mali Service de Cardiologie du CHU Point G Bamako Mali Service de Cardiologie CHU Mère-Enfant Bamako Mali Service de Médecine Interne et d’Endocrinologie Hôpital du Mali Bamako Mali

Introduction: It is known for decades that a correlation among child blood pressure and adult pressure exist. There are few publications on Hypertension (HTN) in pediatric area. We therefore conducted this study to estimate the extension of HTN among children and looking for associated factors. Methods: Blood pressure was assessed using the references released by the National institutes of health in the United States, those of the French Society of Pediatric Nephrology and z-score. We used the auscultation method with appropriate cuff adapted to the child’s upper arm. We got for each arm 3 blood pressure measures taken children seated or lying on the back and mean blood pressure was calculated and used for the evaluation of the pressure level. The arm with the higher blood pressure was considered for the study. Socio-demographical and clinical data were collected anonymously on a formulary and then inserted in a Microsoft Access Database. Analysis was done using Statistical Package for the Social Sciences (SPSS) software using appropriate tests. Results: The study involved 154 patients (boys:girls = 56.5:43.5) aged 3 to 16 years. Patients of 11 years and older made 57.1% of the sample. Most patients suffered from severe malaria (35.1%, glomerular and heart diseases with respectively 16.2% and 9.1%. The global proportion of hypertensive patients was 27%, 39% and 5.2% respectively based on references of the French society of nephrology, those of the 4th report of the NHBPEP and standard deviation. Looking for associated factors with hypertension the logistic regression found no predictor for hypertension using pressure cut-offs values based on the French society of nephrology and those of the 4th report of the National High Blood Pressure Education Programm (NHBPEP). Conclusion: Children must be checked for hypertension to avoid organ damage and later cardiovascular complications. Blood pressure assessment should be preferably done on outpatients as the role of the st

关键词： Hypertension Pediatric Bamako

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