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Epidemiological, Clinical, Therapeutic, and Evolutionary Aspects of Heart Failure in the Medical Department at Gao Regional Hospital

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World Journal of Cardiovascular Diseases 2024年第5期14卷 309-321页

作者： Coulibaly Alhousseny Dollo Ibrahim Guindo Hamadoun Sidibé Lamine Mariko Souleymane Traoré Bassirima dao karim Guindo Ibrahim Togo Mamadou Sidibé Samba Sangaré Ibrahima Ba Hamidou Oumar Ichiaka Menta Departement of Medicine Gao Hospital Gao Mali Departement of Medicine Mopti Regional Hospital Mopti Mali Departement of Medicine Tombouctou Hospital Tombouctou Mali Departement of Cardiology CHU Gabriel TOURE Bamako Mali

Introduction: Heart failure is a major public health pandemic, particularly in Africa, where its prevalence continues to increase. In northern Mali, few data exist, hence the interest of this study with the objective of studying the epidemiological, clinical and therapeutic and evolutionary aspects of Heart failure at the regional hospital of Gao. Patients and Methods: This was a cross-sectional, descriptive study that took place from July 2022 to June 2023 in the medical department at Gao Hospital. Results: The hospital prevalence of heart failure was 44.1%. The mean age was 47.30 ± 20 years (range: 16-88). Hypertension was the most common with 46.1%, followed by a sedentary lifestyle, and diabetes with 18.2% and 8.3% respectively;NYHA stage III-IV dyspnea was found in 83.9%. Reduced EF heart failure was present in 110 patients (76.9%), seventeen cases with moderately reduced EF (11.9%) and sixteen patients had preserved EF (11.2%). Global heart failure was the dominant (91.6%). The main etiologies of heart failure were dominated by hypertensive heart disease in 46 patients (32.2%), followed by postpartum cardiomyopathy with 43 cases (30.1%), primary dilated cardiomyopathy in 18 patients (12.6%), ischemic heart disease in 16 patients with 11.2%. Seven cases of valvular heart disease, or 4.9%. The evolution was favorable under treatment in 104 patients or 72.7%. In-hospital mortality was 14.7%. Conclusion: Heart failure is a common condition in sub-Saharan Africa, particularly in our country.

关键词： Heart Failure Epidemioclinical Progressive Gao Hospital

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Podiatric Risk Assessment in Diabetic Patients at University Hospital Center of Point G

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Open Journal of Endocrine and Metabolic Diseases 2019年第8期9卷 85-94页

作者： Sy Djibril Traoré Abdel Kader Soukho Assétou Kaya Traoré Djenebou Thomas Ingrid Gladys Keita Zakaria Dembelé Ibrahima Amadou Cissoko Mamadou Sangaré Barry Boubacar Togo Mamadou Keita Kaly Keita Adramé Tolo Nagou Camara Boua daoud dao karim Doumbia Alassane Alfousseni Saliou Mahamadou Fofana Youssouf Mallé Mamadou Traoré Abdramane Sangaré Drissa Cissé Sékou Mamadou Berthé Brehima Boly Sanogo Abasse Sy Seydou Dembélé Mamadou Traoré Hamar Alassane Department of Internal Medicine of University Hospital Center of Point G Bamako Mali Association “Rabies in West Africa—Mali” Bamako Mali Internal Medicine Service Kati Hospital Koulikoro Mali Department of Internal Medicine Nianankoro Fomba Hospital Segou Mali Department of Medicine Regional Hospital Gao Mali Department of Medicine Regional Hospital Sikasso Mali Department of Medicine University Hospital Center Gabriel Toure Bamako Mali Department of Internal Medicine Hospital Center Mother-Child Luxemburg Bamako Mali Department of Medicine Fousseyni Daou Hospital Kayes Mali Department of Nephrology University Hospital Center of Point G Bamako Mali

Introduction: Diabetes, a chronic pathology, is the source of many acute and chronic complications whose treatment requires many daily constraints that can have a serious impact on the quality of life of the patient and his family. The diabetic foot is a real public health problem which is still dominated by a very high lower limb amputation rate even in countries with high socioeconomic status. The diabetic foot classically results from the association of three entangled mechanisms which are neuropathy, arteriopathy and infection. Objectives: To determine the frequency of arterial disease, neuropathy, and other aggravating factors that influence the podiatry risk, and to proceed with the gradation of the podiatry risk. Methodology: This was a cross-sectional study concerning the period from July 1 to October 31, 2017, covering all diabetic patients received in consultation and hospitalization in the Internal Medicine Department of the G-University Hospital Center. Results: Our study included 50 patients (35 women for 15 men) out of 95 diabetic patients receiving a frequency of 52.6%, with a sex ratio of 0.42. The average age of our patients was 54.38 ± 13.98 years. Overweight/obesity found in 44% of patients. The average Body Mass Index (BMI) of our patients was 27.16 kg/m2. Patients with diabetes less than 5 years old represented 56% with an average duration of 5.39 ± 5.34 years. The mode of discovery of diabetes was polyuria-polydipsia syndrome in 56% of cases. Type 2 diabetes represented 74% of patients. Among the patients who had performed the HbA1C test, 80.77% were not well balanced. The antecedent of macrosomia in women accounted for 77.1%. Patients who did not know foot hygiene recommendations accounted for 82%. Among the identified podiatry risk factors, diabetic neuropathy accounted for 73.8%, and arterial disease was 32.3%. Grade 1 patients in our study accounted for 52% (gradation of foot risk). Conclusion: The diabetic foot is a major public health problem because of its frequency, its direct and in

关键词： Monitoring Diabetes Foot Risk Mali

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Spontaneous External Digestive Fistula of Tuberculosis Origin, Medical Treatment: About a Case at the Timbuktu Hospital

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Surgical Science 2021年第1期12卷 17-22页

作者： Oumar Ongoïba Idrissa Tounkara Thiam Souleymane Charles Dara Jacques Saye karim dao Djibril Kassogué Timbuktu Mali Regional Hospital Mali Timbuktu Mali Reference Health Center of Commune II Bamako Mali Gao Regional Hospital Gao Mali Point G University Hospital Center Bamako Mali

In the literature, the management of enterocutaneous fistula of tuberculosis origin is rare. The aim of this work was to report a case of external digestive fistula of tuberculosis origin in a 10-year-old girl in northern Mali in a situation of armed conflict. She was a 10-year-old patient who was admitted to our general surgery ward for external digestive fistula evolving for more than (4) four years, at admission the general. The karnofsky index was at 40%, she could not sit or hold a cup to drink water. A 3 cm enterocutaneous fistula deafened foul-smelling liquid stools, on clinical examination, the conjunctivas were pale, the lips were dry, the eyes were sunk in the eye sockets, the ribs visible from a distance. The paraclinical aspects (Itra-Dermo-Reaction (IDR) to tubercria, anatomopathology) were positive, specifying the place of medical treatment and evolution under medical treatment. Digestive fistula of tuberculosis origin is a rare condition in surgical settings.

关键词： Spontaneous External Digestive Fistula Non-Surgical Treatment Timbuktu

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Maternal and Perinatal Prognosis of Arterial Hypertension and Pregnancy in a Peripheral Health Center in Mali

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Open Journal of Obstetrics and Gynecology 2024年第5期14卷 855-867页

作者： Samaké Alou Diarra Lasseny Keita Mamadou Haidara Dramane Haidara Mamadou Diallo Mamadou Konaté Moussa Maiga Mariam MS Ag Med Elméhdi Elansari Kassogue Djibril dao Seydou Zana Samake Hawa Konate karim Dembele Bertin Coulibaly Moussa Mariko Seydou Colette Dohinnon Reference Health Center in Commune VI of the Bamako District Bamako Mali Bamako Dermatology Hospital (HDB) Bamako Mali Kalaban Coro Reference Health Center Bamako Mali Timbuktu Hospital Timbuktu Mali Reference Health Center of Commune II of the Bamako district Bamako Mali Reference Health Center in Commune V of the Bamako district Bamako Mali National Institute for Training in Health Sciences Bamako Mali Mali Hospital Bamako Mali

Introduction: Maternal mortality constitutes a public health problem and its rate is an indicator of a country’s development. Among the causes of maternal and perinatal death, high blood pressure associated with pregnancy occupies a significant part. It represents 5% of direct maternal deaths. Objective: to study the maternal and perinatal prognosis of high blood pressure during pregnancy in the Tenenkou reference health center in Mali. Methodology: This was a descriptive, analytical and retrospective cross-sectional study over a period of twelve months from January 1, 2021 to December 31, 2021 and involving 144 cases of high blood pressure associated with pregnancy. Results: We obtained a frequency of 11.75%. The majority of patients 70.9% were aged between 20 - 35 years. The important risk factor found was young age. During our study, 46.5% of patients had performed at least one CPN and only 13.9% performed 04 CPN. Pre-eclampsia was the most common type of high blood pressure during pregnancy, i.e. 61.1%. Eclampsia and retroplacental hematoma were the most common maternal complications, respectively 27.8% and 11.1%. The most common fetal complications were premature births and fetal distress with 20.9% and 17.4% respectively. Conclusion: Hypertension associated with pregnancy still remains a major cause of maternal-fetal morbidity and mortality in our context where diagnosis is often late. The main clinical form was preeclampsia. Eclampsia and retroplacental hematoma were the most frequent maternal complications. Fetal complications were mainly prematurity and fetal distress.

关键词： Pregnancy High Blood Pressure Prognosis

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Maternal Fetal Prognosis: Pregnancy and Delivery in Women of 40 Years Old and Over in a Second Reference Hospital in Bamako

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Open Journal of Obstetrics and Gynecology 2024年第4期14卷 509-519页

作者： Samaké Alou Diarra Lasseny Keita Mamadou Haidara Dramane Haidara Mamadou Diallo Mamadou Konaté Moussa Maiga Mariam Mohamed Saydi Ag Med Elmehdi Elansari Kassogue Djibril Seydou Zana dao Samake Hawa Konate karim Dembele Bertin Coulibaly Moussa Mariko Seydou Collarete Dohino Reference Health Center of Commune VI of the Bamako District Bamako Mali Bamako Dermatology Hospital (BDH) Bamako Mali Kalaban Coro Reference Health Center Bamako Mali Timbuktu Hospital Timbuktu Mali Reference Health Center of Commune II of the Bamako District Bamako Mali Reference Health Center in Commune V of the Bamako District Bamako Mali National Institute for Training in Health Sciences Bamako Mali Mali Hospital Bamako Mali

Introduction: Late pregnancies are considered a public health problem linked to maternal mortality due to their complications. These risks, which worsen with maternal age, should be better known and taken into account in monitoring these pregnancies. Objective: To evaluate the impact of age on the prevalence of obstetric and neonatal complications among parturients of 40 years old and over. Methodology: This was an 11-year retrospective analytical case control study from January 1, 2007 to December 31, 2017. The study population was female patients of 40 years old or older for cases and female patients younger than 40 years of control case. Results: In total, we collected 640 cases of parturients of 40 years old and over out of a total of 84,234 deliveries during the study period;i.e. a frequency of 0.76%. Spontaneous abortion increased in patients of 40 and over with 8.28%. Hypertension and diabetes were higher of women of 40 and over, 52.65%. Concerning the method of admission: 55% of parturients of 40 and over were referrals. Incidents occurring among women of 40 and over were more pronounced than in control cases. Complications during vaginal delivery, cervical tear, perineal tear, uterine dehiscence and uterine rupture are high in our cases, i.e. 11.88%;3.59%;2.19%;2.66. During our study, depending on the type of delivery, the cesarean rate was much higher among women of 40 and over than among control cases, i.e. 54.22% versus 12.24%. Hemorrhages in the 3rd trimester were the main indications for cesarean section. Hemorrhages in the 3rd trimester were more frequent with women of 40 and over, i.e. 10.47%;5.94% versus 1.74% and 0.42%. As for the different types of malformations in parturients, women under 40 years old fetal malformations were absent in 92.29%, on the other hand they were more frequent in patients with 40 years and over, i.e. a normal frequency of 36.72%. Conclusion: Pregnancy at a late age exposes the elderly patient and the newborn to several risks. During this study, an increase in maternal-

关键词： Advanced Maternal Age Childbirth Risk Mali

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Epidemiological-Clinical Aspects of Uterine Leiomyoma at the Reference Health Center of Commune VI of the Bamako District

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Open Journal of Obstetrics and Gynecology 2024年第5期14卷 674-681页

作者： Alou Samaké Lasseny Diarra Mamadou Keita Dramane Haidara Mamadou Haidara Coulibaly Soumana Mamadou Diallo Moussa Konaté Mariam Maiga MS Ag Med Elméhdi Elansari Kassogue Djibril dao Seydou Zana Samake Hawa Konate karim Dembele Bertin Coulibaly Moussa Mariko Seydou Colette Dohino Reference Health Center of Commune VI of the Bamako District Bamako Mali Bamako Dermatology Hospital (HDB) Bamako Mali Kalaban Coro Reference Health Center Bamako Mali Hangadoumbo Moulaye Touré Hospital in Gao Gao Mali Timbuktu Hospital Tomboctou Mali Reference Health Center of Commune II of the Bamako District Bamako Mali Reference Health Center in Commune V of the Bamako District Bamako Mali National Institute for Training in Health Sciences Bamako Mali Mali Hospital Bamako Mali

Introduction: Uterine fibroid is a mixed mesenchymal tumor, developing from smooth muscle cells of the myometrium, separated by connective tissue. The majority of fibroids are asymptomatic and do not require any intervention or other exploratory measures. However, in some cases fibroids are symptomatic, their treatment should aim to improve symptoms and quality of life. Objectives: Describe the epidemiological-clinical aspects of uterine fibroids in the gynecology and obstetrics department of the reference health center of commune VI of the Bamako district. Methodology: This was a retrospective descriptive study carried out over a period of one year. It concerns all patients seen in consultation in the gynecology and obstetrics department of the reference health center of commune VI. Results: during the study period, the uterine fibroid frequency was 1.80%. During this same period, fibroids represented 5.59% of gyneco-obstetric pathologies operated on in the department. The 30 - 45 year old age group was the most represented with a frequency of 75.63%. The average age was 36.87 years ± 6.2 years with extremes of 25 and 63 years. Married women were the most represented 97.48%. The vast majority of our patients 95.8% were not postmenopausal. The multigravidas were the most represented, i.e. 37.50% with a large part of the pauciparous 41.29%. In our patients, 96.64% had a clinical symptom on their fibroid with the main reason for consultation being the sensation of a pelvic mass in 97.48%. We recorded three cases of infertility as associated factors. Ultrasound was performed in all patients. The location of the myxomatous nuclei was subserosal in the majority in 42.86% and with multiple nodules in 84.85% of cases. The main indication for myomectomy was the failure of medical treatment in 86.49% of cases. Surgical treatment was mainly a myomectomy 93.30%, a hysterectomy was indicated in 6.70%. No cases of death were recorded. Conclusion: Uterine fibroid is a gynecological pathology that exists in our department;its f

关键词： Myomas Surgery Myomectomy

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Induced Resistance to <i>Striga hermonthica</i>in Sorghum by Gamma Irradiation

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American Journal of Plant Sciences 2020年第10期11卷 1545-1561页

作者： Minimassom P. Nikièma Djibril Yonli Harimialimalala J. Rabefiraisana Adel Ali Nofou Ouédraogo Hamidou Traoré Hamidou Y. A. Yanogo karim dao Mahamadou Sawadogo Ljupcho Jankuloski Ingelbrecht Ivan Mukhtar Ali Ghanim Abdelbagi Institut de l’Environnement et de Recherches Agricoles (INERA) Ouagadougou Burkina Faso Faculty of Sciences University of Antananarivo Antananarivo Analamanga Madagascar Plant Breeding and Genetics Laboratory Joint FAO/IAEA Division of Nuclear Techniques in Food and Agriculture Department of Nuclear Sciences and Applications (NAFA) International Atomic Energy Agency (IAEA) Seibersdorf Austria Université Joseph Ki-Zerbo Ouagadougou Burkina Faso NAFA IAEA Vienna International Center Vienna Austria

Striga species affect the potential productivity of cereals in sub-Saharian Africa due to the lack of durable Striga-resistance in host crops. This study aimed at inducing the new source of resistance in sorghum using gamma irradiation. Dry seeds of three Sorghum varieties;Grinkan, ICV1049 and Sariaso14 were gamma-irradiated with 200 Gy, 300 Gy, 400 Gy and 500 Gy. Screening strategies involved a 2-year field and greenhouse experiments, where mutant Sorghum families, their parents and resistant control were artificially infected with Striga hermonthica seeds. Field screenings revealed induced genetic variability among them, forty families significantly reduced the number of emerged Striga plants or showed good Sorghum grain yield performance despite the infection by S. hermonthica ecotype from Burkina Faso. The induced putative resistant mutants were identified across the four applied gamma-irradiation doses. Greenhouse experiment confirmed Striga resistance in seven mutant Sorghum families leading to no emergence of Burkina’s S. hermonthica ecotype along with high resistance index (RI) and low Striga damage score. Among them, two mutants SA38M5 and IC47M5 withstood S. hermonthica eco

关键词： Sorghum Induced Mutation Striga Resistance

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Evaluation of Practice of Prescription of the Corticotherapy in the Department of Internal Medicine of the University Hospital of Point G from 2009 to 2013

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Open Journal of Internal Medicine 2019年第3期9卷 89-96页

作者： Abdel Kader Traoré Assétou Soukho Kaya Djibril Sy Djenebou Traoré Alassane Doumbia Ilo Diall Nangou Tolo Hadiza Amadou Kaï lou karim dao Boua daou Camara Ganda Soumaré Mamadou Dembélé Hamar Alassane Traoré Department of Internal Medecine University Hospital of Point G Bamako Mali Department of Cardiology University Hospital of Point G Bamako Mali

Introduction: It is estimated that about 0.2% to 0.5% of French populations received a long-term systemic corticosteroid therapy. In Mali, from March, 2007 to February, 2008, in National Center for Disease Control and Prevention, 19.2% of hospitalized patients (24/125) received long-term corticosteroid therapy. Until now, the department of internal medicine of the university hospital of Point G hasn’t done any research on the corticosteroid therapy specially. Therefore, we initiated this work to evaluate our practice of prescription of corticosteroid. The target of the study was to evaluate practical activity of prescription of corticosteroid of internal medicine. Methods: Based on all hospitalized patient materials of the department of internal medicine of Point G regional university central hospital during January 2009-December 2013, we initiated this retrospective and descriptive study. This study was based on all hospitalized patients receiving corticosteroid in the time of researching, without distinguishing their sex or age. Results: During the period of study, the department of internal medicine of point G regional central hospital had received 2155 patients;64 were eligible: prevalence of 2.97%. Most patients were female, accounting for 87.5% with a sex-ratio of 0.14. The average age of our patients was 39.11 ± 16.92 years, ranging from 14 to 97 years. Physicians enrolled in the study Specialized Diploma (DES) and Internal represented 79.7% of prescribers. As pretreatment assessment, only 2 patients (3.12%) had carried out all of the standard balance (NFS, electrolytes, calcium, blood glucose and serum protein). The most common glucocorticoide was prednisone. Solid tumors represented 31.25% (20 cases) of the diseases treated, followed by systemic lupus erythematosus with 15.62% (10 cases). In addition, there are two cases of adrenals insufficiency (3.1%). In Point G internal medicine, pre-therapy evaluation and methods about corticosteroids therapy were insufficient and different.

关键词： Pratiques Corticothérapies Médecine Interne Bamako Mali

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Evaluation of Antibiotic Prescribing in the Pediatric Department of Gabriel TouréTeaching Hospital, Bamako, Mali

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Open Journal of Pediatrics 2024年第3期14卷 645-656页

作者： Pierre Togo Hawa Konaré Mariam Maïga Karamoko Sacko Djénéba Konaté Abdoul karim Doumbia Adama Dembélé Oumar Coulibaly Aminata Sangaré Mohamed Elmouloud Cissé Fousseyni Traoré Belco Maïga Ibrahim Ahamadou Aminata Doumbia Lala N’Drany Sidibé Amadou Touré Yacouba Aba Coulibaly Kalirou Traoré Tati Simaga Souleymane Sagara Leyla Bagna Maïga Bory Traoré Abdoul Aziz Diakité Fatoumata Dicko Mariam Sylla Sounkalo dao Boubacar Togo Paediatric Department Gabriel Tour&#233 Teaching Hospital Bamako Mali Pediatric Department Distric VI Reference Health Center Bamako Mali Infectious Diseases Department Point G Teaching Hospital Bamako Mali

Objectives: The main objective was to evaluate antibiotic prescribing in the Department of Pediatrics at Gabriel Touré teaching hospital. Methods: This was a prospective descriptive study conducted from September 1 to November 31, 2018, in the Department of Pediatrics at Gabriel Touré teaching hospital. All children aged 0 to 15 years hospitalized for any pathology during the study period and having received at least one antibiotic had been included. Results: We collected 445 children’s records out of 1032 admissions during the study period, representing a hospital frequency of 43.1%. The sex ratio was 1.3%. The 2 - 5 age group accounted for 48.1%. Fever was the reason for consultation in 45.6% of cases. Patients’ general condition was altered in 60% of cases. The fathers were blue-collar workers in 65.4% and the mothers housewives in 85%, and had no education in 42.9% and 64.5% respectively. Hepatomegaly was present in 18.2%, splenomegaly in 9.6% and peripheral adenopathy in 3.1%. The site of infection was pulmonary in 37.6% and ENT in 9.2%. Bacterial infection was assumed on admission in 54% of cases, and meningitis in 57.7%. The discharge diagnosis was malaria in 54.6%, severe acute malnutrition in 18.6% and meningitis in 6.7%. The death rate was 3.8%. Neutrophilic leukocytosis was present in 47.3% of patients. CRP was positive in 85% of patients. Blood cultures taken in 27.6% of patients were positive in 5. CSF analysis in 30% of patients showed elevated leukocytes in 6.5%. No cultures were positive. Antibiotic prescription was justified by infectious hypotheses in 43.1% of patients. β-lactam antibiotics were prescribed in 98.6%. Antibiotic therapy was not adapted to national/international recommendations in 68.3% of cases, and was not justified in 16.3% of cases on D5 of hospitalization. Conclusion: Antibiotic use was justified in more than half of patients, but remained inadequate in almost two-thirds of cases, in line with national and international recommendations.

关键词： Antibiotic Prescription Hospitalization Child

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Evaluation of the Frequency of Prolonged Fevers and Exploration of Their Etiologies in the Internal Medicine Department of the Point “G” University Hospital in Bamako from 2009 to 2013

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Open Journal of Internal Medicine 2019年第3期9卷 97-103页

作者： Abdel Kader Traoré Assétou Soukho Kaya Djenebou Traoré Djibril Sy Youssouf Fofana Ibahima Amadou Dembélé Mamadou Saliou Boua daoud Camara karim dao Mamadou Cissoko Kaly Ké ï ta Barry Boubacar Sangaré Mamadou Mallé Alassane A. Doumbia Nagou Tolo Hadiza A. Kaï lou Mamadou Dembélé Hamar Alassane Traoré Deparment of Internal Medicine University Hospital of Point “G” Bamako Mali Department of Internal Medicine of Children and Mothers Le Luxembourg University Hospital Bamako Mali Internal Medicine Service Nianankoro Fomba Hospital Ségou Mali

Objective: The aim was to evaluate the frequency of prolonged fevers and to determine their etiologies. Methods: We carried out a cross-sectional study extending from the period of 2009 to 2013 in the Internal Medicine department of the “G” Point University Hospital in Bamako. Included were all records of hospitalized patients with a central temperature greater than 37°C in the morning and 37°C in the evening, resting for 15 minutes, fasting for more than 2 hours, and absence of antipyretic treatment. We include all the patients of the study period with fever greater than 37.5°C in the morning and 37.8°C in the evening, resting for 15 minutes, fasting for more than 2 hours, and absence of antipyretic treatment, which have more than 21 days and measured on several occasions. The data were collected on a survey sheet. Data entry and analysis was done on SPSS software. Results: We recorded 243 fever cases out of 2155 hospitalizations, a prevalence rate of 11.2%. There were 128 men and 115 women with an average age of 43 years (range, 15 to 84 years), a modal class of 37 to 47 years, and a sex ratio of 1.11. The infectious etiologies accounted for 81% followed by neoplastic causes 09.6% and inflammatory 01.2% of cases. HIV infection was found in 26.4% of patients, malaria 13.5% and urinary tract infections 10.2%). Gram negative bacilli 88% consisted mainly of Escherichia coli (56%) and Klebsiella pneumoniae (20%).

关键词： Fever Acute Prolonged Fevers Frequency Etiologies Internal Medicine Mali

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