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

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

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Prognostic Factors for Acute Heart Failure (AHF) in the Cardiology Intensive Care Unit (ICU) of the University Hospital Point G (UH Pt G)

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World Journal of Cardiovascular Diseases 2019年第1期9卷 42-50页

作者： Camara Youssouf Ba Hamidou Oumar Sangare Ibrahima Toure Karamba Coulibaly Souleymane Sacko Abdoul Karim Coulibaly Alfousseyni Diallo Nouhoum Sidibe Samba daou adama Menta Ichaka Diall Ilo Bella Diallo Boubakar Abdoulaye University Hospital Sidy Bocar Sall Kati Mali University Hospital Gabriel Touré Bamako Mali University Hospital Point G Bamako Mali Disease Fighting Centers Bamako Mali

Background and Aim: The absence of data in our context motivates this study aiming to determine the frequency of AHF at the ICU, assess the in-hospital evolution of the disease and to find out poor *** and Methods: It was an observational and descriptive study covering the time from January 1, 2014 to March 30, 2017 involving all inpatient records in ICU. From January 2014 to December 2017, collected data included those on socio-demographic, history of diseases and physical examination, and some labor dataincluding Pro BNP, serum creatinine, blood ionogram,?cardiac enzymes and blood count. Also data electrocardiography, echocardiography and in-hospital evolution were collected. Statistical Analysis:Statistical analysis was performed using SPSS (IBM Inc) version 18. Results: AHF occured in 47.36% with a mean age of 58.74 ± 18.407 and extremes of 17 and 90 years, women representing 53.1% (sex ratio Male:Female = 0.88). Hypertension and diabetes were the predominant cardiovascular risk factors with respectively 67.4% and 18.4%. At admission?44%, 37.7% and 17.9% of patients were respectively hypertensive,?normotensive and hypotensive. The clinical expression was mainly global heart failure with 42.6% followed by left heart failure and right heart failure with respectively 37% and 20.4%. The coronary syndromes (all forms) was the first cause of ICA with 34% of cases followed by pulmonary embolism and hypertension with respectively 25.3% and 24.1%. Mean hospital stay was 5.61 ± 3.527 days (1 to 25 days). Complications were recorded in 18.5% of patients with cardiogenic shock in half of all cases. In multi-variate analysis, only hypotension at admission was shown to be the independent factor of poor prognosis with p = 0.016 and OR = 4.453 (1.322 - 14.996). Conclusion: As a common manifestation heart failure can be rapidly fatal in presence of collapsus or hypotension at admission. These factors should be accurately managed to reduce mortality, which remains

关键词： Acute Heart Failure Prognostic Factors Cardiology Intensive Care Unit Bamako

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Assessing the Effects of Land Use/Land Cover Change on Groundwater Recharge in a Sudano-Sahelian Zone: Case of Koda Catchment, Mali, West Africa

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Journal of Geoscience and Environment Protection 2022年第8期10卷 39-54页

作者： Oumou Diancoumba adama Toure Ibrahima daou Seriba Konare Taoufik Hermassi Mohamed Kotti Hamadoun Bokar Nourredine Galoul Zoubeida Bargaoui Ecole Normale Supérieure de Bamako (ENSup) Département Sciences de la Vie et de la Terre (DER-SVT) Bamako Mali Ecole Nationale d’Ingénieurs Abderrahmane Baba Touré (ENI-ABT) Bamako Mali Institut Polytechnique Rural de Formation et de Recherche Appliquée de Katibougou (IPR/IFRA de Katibougou) Koulikoro Mali Institut National des Recherches en Génie Rural Eau et Forêts (I.N.R.G.R.E.F) Tunis Tunisie Ecole Nationale d’Ingénieurs de Tunis ENIT Tunis Tunisie

Groundwater is the main source of water in the studied area;therefore, it is significantly requested in all the activities of the inhabitants. These natural resources are affected by some drivers especially Land Use/Land Cover (LULC) and Climate Change. A Land Use/Land Cover (LULC) dynamics study is crucial for any global environmental change evaluation. For instance, for a given place, its change could affect considerably water cycle components. Therefore, the knowledge of the effects of LULC on groundwater recharge is then the key in water resources management system, in particular for the decision makers of the Koda Catchment where the scarcity of the water availability for agriculture is real. The spatiotemporal variation of the different units of LULC present in the catchment has been examined in this study. The Envi 4.5 Software coupled with ArcGIS using the Supervised Classification method, was applied to subset Landsat images from 1990 to 2016. Five (5) major LULC categories, cultivated land, bare land, herbaceous savannah, shrubby savannah and degraded savannah, were identified in the catchment. In a parallel direction, the groundwater recharge has been estimated through the conceptual Gardenia model for the same period 1990-2016. The results showed that the portion of cultivated land and bare land increased (14.9% and 23.5% respectively) while, the portion of savannah decreased: herbaceous savannah by 24.4%, degraded savannah by 10.32% and Shrubby Savannah by 3.6%. Savannah areas in Koda catchment is converted to agricultural land and urban area due to human activities. The decline of 8.4% in groundwater recharge might become so far obvious in the future if the current rate of deforestation continues in the Koda catchment. There is a need to closely monitor the changes in LULC for sustainable development. The results of this study could help to well understand the recharge pattern across Koda catchment under a changing LULC.

关键词： LULC Change Groundwater Recharge Gardenia Model GIS Koda Catchment Mali

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Effect of Polyethylene Terephthalate Plastic Waste on the Physico-Mechanical and Thermal Characteristics of Stabilized Laterite Bricks

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Open Journal of Applied Sciences 2023年第6期13卷 910-920页

作者： Aboubacar Sidiki Toure Moussa Tamboura Antoine Padou Diarra adama Coulibaly Dodo Kayentao Kélétigui daou Mah Fatoumata Traore Faculty of Sciences and Techniques (FST) Materials Chemistry Laboratory University of Science Techniques and Technologies of Bamako Bamako Mali National Research and Experimentation Center in Building and Public Works (CNREX-BTP) Soil Mechanics and Road Engineering Laboratory Ministry of Transport and Equipment Bamako Mali National School of Engineers-Abderhamane Baba TOURE (ENI-ABT) Applied Thermal Laboratory University of Science Techniques and Technologies of Bamako Bamako Mali

The present work investigated the effect of polyethylene terephthalate (PET) plastic waste on the physico-mechanical and thermal properties of cement-stabilized laterite bricks to see the durability of the modified bricks (CSLB). Samples were formulated by mixing laterite, cement, and different percentages of PET (0%, 3%, 5%, and 7%) by volume. The bricks were produced using the M7MI Hydraform standard interlocking block and kept in the shade for a curing period of 28 days. The addition of 3% to 5% PET to the laterite stabilized with 10% cement results in a decrease in both dry and wet compressive strength, which is determined using the Controlab compression machine. However, the obtained results are in concordance with the standards. The thermal conductivity of CSLB, determined using the box method with the EI700 measurement cell, decreases as the PET content of the mixture increases. A decrease in bulk density from 1.67 to 1.58 g/cm3 was observed.

关键词： Plastic Waste Polyethylene Terephthalate Laterite Bricks Cement Stabilization Thermal Conductivity

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Modified Concrete Using Polyethylene Terephthalate Plastic Waste as a Partial Replacement for Coarse Aggregate

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Open Journal of Applied Sciences 2023年第6期13卷 896-909页

作者： Dodo Kayentao Moussa Tamboura Antoine Padou Diarra Mah Fatoumata Traore adama Coulibaly Aboubacar Sidiki Toure Mohamed L. O. Diawara Kélétigui daou Faculty of Sciences and Techniques (FST) University of Sciences Techniques and Technologies of Bamako Bamako Mali National Research and Experimentation Center for Buildings and Public Works (CNREX-BTP) Bamako Mali National School of Engineering Abderhamane Baba TOURE (ENI-ABT) Bamako Mali

The present work evaluated the properties of modified concrete using polyethylene terephthalate (PET) bottle waste as a partial replacement for coarse aggregate. Modified concrete samples were designed using a water/cement (W/C) ratio of 0.50 and varying percentages of PET replacement (3%, 7%, 10%, and 15% by volume). Dreux Gorisse’s formulation approach was used to make the final products, and the mechanical properties of the samples were determined using Controlab presses. This modified concrete with PET chips has shown that with a 10% replacement of PET chips, the fresh density decreases by 3.56%, and the hardened state density decreases by 2.01%. The water absorption and thermal conductivity of the formulated concretes decreased. However, the results showed that the slump of these fresh concretes increased as the percentage of plastic aggregate replacement increased. Based on the results, incorporating PET aggregates into concrete contributes to good workability, and lightweight concrete structures, and provides some thermal comfort in concrete structures.

关键词： PET Waste Concrete Dreux Gorisse Approach Thermal Conductivity Mechanical Properties of Modified Concrete

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Anatomy of the Gall-Bladder in the Ultrasound about 1000 Cases

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Forensic Medicine and Anatomy Research 2019年第2期7卷 44-49页

作者： Bréhima Coulibaly Abdoulaye Kanté Abdoulaye Koné Bréhima Bengaly Babou Ba Youlouza Coulibaly Oncoumba Diarra adama Seriba Diarra Drissa Traoré Mariam daou Nouhoum Ongoiba Service of Surgery B.CHU Point G BamakoMali Laboratory of Anatomy of the Faculty of Medicine and Odontostomatology BamakoMali Imaging Department CHU Point G BamakoMali Service of Neurology.CHU Gabriel Touré BamakoMali

Aim: The aim of this work is to determine the dimensions and the capacity of the gall-bladder by ultrasound. Methodology: We realized a descriptive study over 2 years (from January, 2015 till December, 2017). It concerned an ultrasound exploration of the gall-bladder. The studied population was healthy voluntary subjects visible and on an empty stomach for 12 hours, without history of abdominal trauma and abdominal operating scar. The carrying subjects of the tracks of abdominal trauma or of abdominal operating scar were not included. Results: The average age was of 39 years ± 12.16 with extreme of 10 years and 89 years. It was 500 women (50%) and of 500 men (50%) with a sex ratio of 1. To 450 subjects (45%) the width of the gall-bladder of the subjects varied between 21 and 30. The average was 22.63 mm ± 7.9. Extremes were from 9 to 55 mm. The measurements made by the three sonographers showed no significant difference. The sensitivity of ultrasound in the visualization of the gallbladder was 100%. The length of the gall-bladder was between 61 and 70 mm. The average was 65.35 ± 14.48. Extremes were 26 and 142 mm. Conclusion: This original study shows the normal dimensions of the gall-bladder to Malian.

关键词： Anatomy Gall-Bladder Ultrasound Bamako-Mali

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Reliability of Medical Imaging in the Pre-Therapeutic Assessment of Acute Intestinal Obstruction at the Centre Hospitalier Universitaire Du Point “G”.

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Open Journal of Medical Imaging 2022年第3期12卷 147-156页

作者： Abdoulaye Koné Mahamadou daou Youssouf Koné Moussa Traoré Moussa Konaté Ouncoumba Diarra Ibrahima Coulibaly Youssouf Diawara Amadou Doumbia Cheick Oumar Touré Kassim Sidibé Mody A. Camara Oumar Aba Ata Mahamadou Diallo adama Diaman Keita Salia Coulibaly Zimogo Zié Sanogo Siaka Sidibe Faculty of Medicine and Odontostomatology Bamako Mali Medical Imaging Department of the University Hospital of Point G Bamako Mali Radiology Department of the Jacques Boutard Hospital Saint-Yrieix-la-Perche France Medical Imaging Department of GABRIEL TOURE Hospital Bamako Mali Radiology Department of CSREF Commune III Bamako Mali Medical Imaging Service Health Center of Ref Commune VI Bamako Mali Medical Imaging Service Health Center of Ref Commune IV Bamako Mali DCSSA Kati Mali Medical Imaging Department of Mali Hospital Bamako Mali Medical Imaging Department of Kati Hospital Bamako Mali Department of General Surgery of Point G University Hospital Bamako Mali

Introduction: Acute intestinal obstruction is a serious pathology, a surgical emergency for which medical imaging plays an important role in the management. We initiated this work in order to study the contribution of imaging in the diagnosis of acute intestinal obstruction at the Point-G University Hospital. Patients and Methods: This was a prospective, descriptive and analytical study of 96 patients collected at the radiology and medical imaging department of CHU Point-G from January 2018 to January 2019. Results: The age of our patients varied from 11 to 86 years, with an average of 36 years old. There was a male predominance of 64.6% against 35.4% for women, i.e., a sex ratio of 1.82. Previous surgery was found in 61.5% of our patients. The pain was present in all patients. An unprepared abdominal X-ray was performed in 89.6% of patients. Hydroaerobic levels were found in 96.5% of patients. Abdominopelvic CT scans were performed on 12 patients, all of whom were diagnosed with occlusion. These positive diagnostic findings were consistent with intraoperative findings in 92% of cases. The causes were dominated by bridges in 46 patients and tumors in 9 patients. Signs of severity on CT were dominated by signs of distress of the upstream bile ducts in 8.3%. Exactly 8% of our patients spontaneously resumed transit, 91% received surgical treatment and 1% died before surgery. The outcome was favorable in 80 patients (83.3%) and poor with death in 16 patients (16.7%). Conclusion: Acute intestinal obstruction remains a serious pathology for which the X-ray of the PSA is often the only radiological examination performed in an emergency. However, abdominopelvic CT seems to us to be widely indicated thanks to its contribution both to the positive diagnosis and to the diagnosis of severity and etiology. However, this imaging technique is widely underused in our practice because of its high cost and lack of availability.

关键词： Medical Imaging Acute Intestinal Obstruction Abdominal CT Reliability

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Volvulus of the Sigmoid Colon without Necrosis: Therapeutic Aspects in Hospital Fousseyni daou Hospital in Kayes, Mali

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Surgical Science 2022年第12期13卷 592-599页

作者： Lamine Issaga Traore Sidy Sangare Mamaye Kouyate Gaoussou Sogoba Drissa Katile adama S. Diakite Lassana Goita Sadio Dembele Djibril Traore Drissa Traore General Surgery Department of the Fousseyni daou Hospital Kayes Mali National Center for Scientific Research and Technology (CNRST) Bamako Mali Pediatric Surgery Department of the Fousseyni daou Hospital Kayes Mali Gastro-Hepato-Enterology Unit of the Fousseyni daou Hospital Kayes Mali Urology Department of Fousseyni daou Hospital Kayes Mali Anesthesia and Intensive Care Unit at Fousseyni daou Hospital Kayes Mali General Surgery Department of Somine DOLO Hospital Mopti Mali General Surgery Department of the University Hospital of Point G Bamako Mali

The volvulus of the sigmoid is known since ancient Egypt. In the 5th century BC, hippocrates laid the foundations for its management. The first observation of this condition was not reported until 1836 by Von Rokitansky, and then in 1859, Melchior described its physiopathological consequences. It was the Norwegian Brusgaard who reported, for the first time, in 1947, the effectiveness of a non-operative treatment. Purpose: Describe morbidity, mortality and the impact of co-morbidity factors on the choice of operative techniques. Patients and Methods: This is a retrospective cross-sectional study performed at the Fousseyni daou Hospital in Kayes from January 2014 to December 2021. We included all patients operated for sigmoid volvulus without necrosis. The parameters studied were the comorbidity factor, surgical modalities, morbidity and mortality. Results: We collected 31 patients, of whom 29 were men and 2 were women, for a sex ratio of 14.5. The mean age was 55 years with extremes (29 - 78 years). Sigmoidectomy with colorectal anastomosis was performed in 19 cases (61.3%), the average age of these patients was 46.16 years, the comorbidity factor was 1 case (3.2%), the postoperative course was simple in 12 cases (63.1%), the morbidity was 6 cases (26.3%) and mortality 1 case (3.2%). Untwisting with colopexy was performed in 11 cases (35.5%), the average age was 65.91 years, comorbidities were present in 9 cases (82%), the postoperative course was simple in 9 cases (82%), morbidity was 1 case (9%) and mortality 1 case (9%). Hartman colostomy was performed in 1 case (3.2%), the age was 60 years, the morbidity was nil. Overall, the postoperative course was simple in 22 cases (71%), the overall morbidity was 7 cases (22.6%) and mortality 2 cases (6.4%). Conclusion: At the end of our study, we can note that the choice of the operative technique for the volvulus of the sigmoid without necrosis can be influenced by the presence of major comorbidity and the morbi-mortality

关键词： Volvulus without Necrosis Surgical Technique Comorbidity Morbidity Mortality

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Ulcero-Necrotic Wound: Socio-Economic Impact, Kayes, Mali

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Surgical Science 2022年第6期13卷 280-287页

作者： Lamine Issaga Traore Sidy Sangare Gaoussou Sogoba Mamaye Kouyate Abdoulaye Cisse Bakary Skeita Sadio Dembele Lassina Goita adama Sdiakité Mariam Sanogo Moussa Camara Drissa Traore Department of General Surgery of the Hospital Fousseyni daou de Kayes Kayes Mali Department of Pediatric Surgery of the Hospital Fousseyni daou de Kayes Kayes Mali Department of Dermatology and Venereology of the Hospital Fousseyni daou de Kayes Kayes Mali Infectious Diseases Unit of the Hospital Fousseyni daou de Kayes Kayes Mali Department of Anesthesia and Intensive Care of the Hospital Fousseyni daou de Kayes Kayes Mali Departmenturology of the Hospital Fousseyni daou de Kayes Kayes Mali Department of Social of the Hospital Fousseyni daou de Kayes Kayes Mali Department of General Surgery of the Hospital CHU du Point “G” Kayes Mali

The issue of wound care has always played an important role in the practice of medicine. This is evidenced by Ambroise Paré’s decision to publish his first work on this subject, “La manière de traiter les Plaies” (The Way of Treating Wounds) in 1545. Objective: To evaluate the therapeutic methods we practice and to describe the impact of the pathology on socio-economic and professional development. Patients and Method: This was a retrospective study carried out at the Fousseyni daou Hospital in Kayes from January 1, 2018, to December 31, 2020. We included all patients with an ulcero-necrotic wound on immunocompetent terrain hospitalized in the department. Patients with ulcerative necrotic wounds of diabetes, HIV, or cancerous origin were not included. The parameters studied were: etiologies, local care, sequelae, and socio-economic and professional aspects. Results: We collected 57 patients of whom 43 were men and 14 were women, i.e. a sex ratio of 3. The mean age was 40.7 years with a standard deviation of 8.4 with extremes (7 years and 80 years). The average consultation time was 25.1 days. The most represented socio-professional stratum was agropastoralism in 37 cases (65%). The predominant etiological factor was neglected traumatic wounds in 34 cases (59.6%). The site was the lower limb in 39 cases (68.5%). The germ found was Staphylococcus aureus in 21 cases (36.8%). The particularity during local care was the use of table sugar in 9 cases (15.7%) and maggot therapy in 2 cases (3.5%). Hyperthermia was the clinical sign of aggravation in 22 cases (38.6%) and we diagnosed 2 cases (3.5%) of tetanus. The mortality rate was 15.7% (9 cases) and 30 cases (52.7%) of sequelae after recovery. The average length of hospitalization was 38 days. Hospital care was provided by the social welfare service in 35 cases (61.4%). Nineteen (19) patients (39.5%) were unable to resume their socio-professional activity. Conclusion: Ulcero-necrotic wounds are complex to manage and can h

关键词： Ulcero-Necrotic Wound Surgery Disability Socio-Economic

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Prevalence, Maternal and Perinatal Prognosis of Breech Delivery Compared to That of the Vertex in 242 Cases for 484 Controls at Ségou Hospital in Malti

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Open Journal of Obstetrics and Gynecology 2024年第9期14卷 1414-1421页

作者： Tidiani Traoré Famakan Kané Abdoulaye Kassogué Seydou Traoré Seydou Z. Dao Balilé Harber Sabré Koné Kassoum Sidibé Brahima Donigolo Babou Traoré adama Coulibaly Abdrhamane Diarisso Alima Sidibé Mamadou Sima Augustin Théra Youssouf Traoré Ibrahima Teguété Niani Mounkoro Ministry of Health in Bamako Nianakoro Fomba Hospital Segou Mali Regional Health Department of Segou District Hospital Bla Mali Regional Health Department of Koutiala Reference Health Center Koutiala Mali Regional Health Department of Bamako Reference Health Center Commune II Bamako Mali Ministry of Health in Bamako Fousseyni Daou Hospital Kayes Mali Ministry of Health in Bamako Point G University Hospital Center Bamako Mali Ministry of Health in Bamako Gabriel Toure University Hospital Center Bamako Mali

Introduction: Breech birth has always been a subject of great interest because of its risks of perinatal morbidity and mortality. Aim: The aim of our study was to compare the maternal and perinatal prognosis of breech delivery with that of vertex delivery. Patients and Method: This was a retrospective case-control analytical study carried out in the obstetrics and gynaecology department of Ségou hospital over a 2-year period from 1 January 2020 to 31 December 2021, involving 242 breech deliveries compared with 484 top deliveries with a live single foetus without foetal malformation of gestational age ≥ 35 SA. The statistical tests used were: chi² (p Results: The frequency of breech delivery was 3.3%, with a predominance of caesarean section for breech presentation (64.88%) compared with 32.85% for vertex (P: 0.00;CI: (0.191 - 0.367). The perinatal prognosis of fetuses with breech presentations was marked by a higher rate of neonatal asphyxia (Apgar score Conclusion: Breech birth is relatively rare in our department. It carries a higher risk of maternal morbidity and neonatal morbidity than breech delivery. However, the vital prognosis for the mother was identical in both groups.

关键词： Delivery Breech Vertex Prognosis Mali

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