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Etiological Factors of Infective Endocarditis in Children Aged 1 Month to 15 Years Hospitalised in the Paediatric Department of CHU Gabriel Touréof Bamako (Mali)

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World Journal of Cardiovascular Surgery 2022年第2期12卷 13-20页

作者： Maiga Belco Sacko Karamoko Konaté Djéneba diakité Abdoul Aziz Dembélé Adama Cissé Mohamed Elmouloud DansoKo Nassira Traoré Kalilou Togo Pierre Doumbia Abdou Karim Traoré Fousseini diakité fatoumata léonie Sidibé lalla Maiga leila Ahmadou Ibrahim Coulibaly Oumar Diall Hawa Sylla Mariam Department of Pediatrics CHU Gabriel Touré Bamako Mali

Introduction: In emerging countries where studies are rarer, the epidemiological profile of infective endocarditis resembles that of developed countries at the beginning of the antibiotic era. There is little data available in Mali on this subject, motivating this study, the aim of which was to study the etiological factors of infective endocarditis in children aged between 1 month and 15 years hospitalised in the paediatric department of the CHU Gabriel Touré. Patients and Methods: We conducted a cross-sectional and descriptive study, which took place from August 2018 to August 2019 (13 months), in children aged between 1 month and 15 years hospitalised in the paediatric department of the Gabriel Touré University Hospital with an ultrasound- confirmed cardiac disease and a temperature above 38°C. Results: The hospitalization rate was 0.4%. The average age was 11 months, the sex ratio was 1.35. Respiratory distress (63.6%) and fever (30.3%) were the most common reasons for referral. Congenital heart disease (87.9%) and dyspnoea on feeding (24.2%) were the most common medical histories. IVC was the most frequent congenital heart disease (36.4%). The mean temperature was 39.1°C. Blood cultures were taken in 24 patients (72.7%) and were positive in 27.3%. Staphylococcus aureus was found in 55.6% of cases. Trans-thoracic ultrasound found vegetations in 03 cases. According to the modified DUKE criteria, the diagnosis of endocarditis was retained in 27.30%. The evolution was marked by a high case fatality rate (45.45%). Conclusion: Endocarditis is an uncommon disease in children with a pulmonary portal of entry and Staphylococcus aureus as the main germ. Its mortality remains high.

关键词： Infective Endocarditis Etiological Factors Pediatrics Bamako

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Hemangioblastoma Incidentally Discovered at CT Scan in Bamako: About a Case

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Open Journal of Medical Imaging 2024年第3期14卷 123-127页

作者： Traore Ousmane N’Diaye Mamadou Dembélé Mamadou Dembélé Adama diakité Siaka Sidibé Mansa Drissa Camara Nagnoumague Keita Adama Diaman Department of Radiology and Medical Imaging The Marie Curie Medical Clinic Bamako Mali Faculty of Medicine and Odontostomatology The University of Science Techniques and Technologies Bamako Mali Department of Radiology and Medical Imaging The University Hospital Center of Point G Bamako Mali

Hemangioblastomas are benign vascular tumors of the brain. These are rare tumors, usually located in the cerebellum and most often affecting young adults. The aim was to study the value of CT in the management of hemangioblastoma through observation. We report the case of a 38-year-old patient referred to the radiology and Medical Imaging Department of the Marie Curie Medical Clinic in Bamako, Mali, for an orbito-cerebral CT scan in a context of bilateral eyelid edema. The examination was performed using multi-slice computed tomography (16 slices) with reconstruction in the 3 planes of space without and with the injection of an iodinated contrast agent. The CT scan was crucial in making the diagnosis of hemangioblastoma incidentally, which allowed for adequate management. The patient was operated on, and the radiological outcome was favorable, without significant cystic formation, after postoperative control and clinical signs were resolved. CT can be an interesting alternative in countries like ours despite MRI being the examination of choice in hemangioblastomas.

关键词： Hemangioblastoma CT Scan Incidental Discovery and Bamako

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Splenectomy: Indications in the General Surgery Department of Ignace Deen Hospital

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Surgical Science 2024年第4期15卷 219-224页

作者： Mamadou Sakoba Barry Boubacar Barry Sandaly diakité Aboubacar Touré Aissatou Taran Diallo General Surgery Department Ignace Deen National Hospital at Conakry University Hospital Conakry Guinea Faculty of Health Sciences and Technology Gamal Abdel Nasser University of Conakry Conakry Guinea

Introduction: Splenectomy is the surgical removal of the spleen. It can be performed during various pathologies, ranging from abdominal trauma to hemoglobinopathies. The progress made in the knowledge of the immune functions of the spleen and the fear of post-splenectomy infectious complications have favored the development of surgical or non-surgical splenic preservation techniques calling into question the dogma of splenectomy. The aim of this study was to determine the indications for splenectomy. Methodology: This was a retrospective, descriptive study lasting 5 years in the general surgery department of the Ignace Deen National Hospital. All files of splenectomized patients were included, our variables were clinical, therapeutic and progressive. Results: We collected 42 cases of splenectomies out of the 2478 surgical procedures performed, representing 1.7% of the department’s surgical activities. The average age was 44 years. The age group of 41 to 50 years was the most represented, i.e. 26% (n = 11) of cases. Sex ratio = 1. Abdominal pain was the reason for consultation in patients, i.e. 100% (n = 42) of cases. The antecedents were dominated by recurrent malaria with 52.3% (n = 22) of cases, then recurrent anemia in 21% (n = 9), and 16.7% (n = 7) had sickle cell disease. Splenomegaly was found in 31 patients, or 73.6%. Ultrasound was performed in all patients. The indications for splenectomy were: isolated splenomegaly with risk of rupture (38%, n = 16), hypersplenism (26%, n = 11) and trauma to the spleen (19.04%, n = 8). Total splenectomy was performed in all cases. The surgical consequences were favorable in 85.7%, (n = 36) with morbidity of 14% (n = 6) and mortality of 9.52% (n = 4). The average length of hospitalization was 10.4 days with extremes of 1 and 22 days. Conclusion: Splenectomy constitutes a relatively common surgical procedure in our context. The indications for splenectomy were isolated splenomegaly with risk of rupture, hypersplenism and tra

关键词： Splenectomy Indications Ignace Deen

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Predictive Factors of Renal Damage during Sickle Cell Disease at the Hematology-Oncology Department of Donka University Hospital

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Open Journal of Nephrology 2024年第3期14卷 302-312页

作者： Moussa Traoré Ansoumane Sayon Kanté Marthe Sidibé Mamady diakité Mohammed lamine Tégui Camara Foussény diakité Mamadou Saliou Baldé Ibrahima Chérif Mustapha Komrabai-Kanu Mohammed lamine Kaba Nephrology-Hemodialysis Department of Donka University Hospital Conakry Guinea Hematology-Oncology Department of Donka University Hospital Conakry Guinea Hematology-Oncology Department of Ignace Deen University Hospital Conakry Guinea Medical Care Clinic Freetown Sierra-Leone

Introduction: Sickle cell disease, which is the most common hereditary hemoglobinopathy in the world, attacks all body systems, particularly the kidneys. The view of this study was to investigate the predictive factors of kidney damage during sickle cell disease. Materials and methods: It was a retrospective, descriptive and analytical study on files of sickle cell patients hospitalized in the Hematology-Oncology Department of Donka University Hospital during a period from January 1, 2016 to December 31, 2019. Records of sickle cell patients with one or more renal abnormalities were retained. Sickle cell patients without kidney damage were also selected for a comparative study. Only patients without sickle cell disease were excluded. Results: Seventy-five (75) medical records were collected during the study period. From these cases, thirteen (13) records with kidney disease were observed, a frequency of 17%. The mean age of patients was 24.2 years for extremes of 10 and 65 years. The sex ratio was 1.6 in favor of men. The SSFA2 form was the most represented with 92%. 24-hour proteinuria was measured in 13 patients between whom 6 patients (46.2%) had a proteinuria level ≤ 1 g. Eight (8) patients (61.5%) were in stage 1 of chronic kidney disease. The most common type of renal involvement was tubulo-interstitial nephropathy with 8 patients (61.5%). Bivariate analysis showed that elevated serum creatinine (P 2 form of the sickness (P Conclusion: After the observation of an increased serum creatinine and urea, a predominance observation of the SSFA2 form, it should be possible to target patients for whom screening for kidney damage should henceforth be systematic.

关键词： Kidney Damage Predictive Factors Sickle Cell Disease Donka

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Pleomorphic Adenoma of the Salivary Glands: Two Atypical locations

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International Journal of Otolaryngology and Head & Neck Surgery 2024年第3期13卷 251-257页

作者： Sidibé Youssouf Diarra Abraham Samaké Djibril Sanogo Boubacar Traoré Abdoul Moumine Diarra Kassim Coulibaly Bourama diakité Youssouf Keita Mohamed Amadou Department of ENT and Head and Neck Surgery Mother-Child University Hospital “ Le Luxembourg&#8221 Bamako Mali Faculty of Medicine and Odontostomatology Bamako Mali Department of ENT and Head and Neck Surgery The Mali-Gavardo Hospital Bamako Mali Ministry of Higher Education and Scientific Research Bamako Mali ENT and Head and Neck Surgery Department of the Commune V Reference Health Center (CSRef CV) Bamako Mali Department of ENT and Head and Neck Surgery at CHU Gabriel Touré Bamako Mali Department of Anatomy and Pathological Cytology Gabriel Tour&#233 University Hospital Center Bamko Mali Department of Oral Surgery Sikasso Regional Hospital Sikasso Mali

Pleomorphic adenoma is the most common tumor of the salivary glands, accounting for approximately 50% of salivary gland lesions. It develops mainly in the salivary glands: parotid (80%), submaxillary (10%), sublingual (1%) and in the accessory oral-pharyngeal glands (9%). The aim of this work was to report 2 cases of pleomorphic adenoma of atypical location and then to discuss the difficulties linked to its diagnostic and therapeutic management in the Malian context. They were a 40-year-old man and a 72-year-old woman. They were admitted to the ENT department of the “luxembourg Mere-infant” hospital for oropharyngeal swelling for the first and swelling of the palate for the second. The clinical expression was a swelling in both cases, of a hard, mobile consistency with healthy mucosa on their surface. The remainder of the physical examination was unremarkable. The diagnosis of a tumor of the oropharynx and palate was made following clinical radiological examinations. The histopathological examination of the surgical specimen made it possible to make the diagnosis of pleomorphic adenoma of the palate and the left palatine tonsil. The follow-up surgery was straightforward, with a favorable outcome. Pleomorphic adenomas are relatively rare benign tumors of the accessory salivary glands;their clinical expression remains swelling. Therapeutic management is surgery and the diagnosis is confirmed by histopathological examination.

关键词： Pleomorphic Adenoma Palate Tonsil 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 recommend

关键词： Antibiotic Prescription Hospitalization Child

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Interest of Non-Invasive Markers (APRI, FIB-4) for Assessing Hepatic Fibrosis in Patients with Chronic Viral Hepatitis B without Cytolysis and with low Viral Replication

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Open Journal of Gastroenterology 2024年第5期14卷 192-201页

作者： Mamadou diakité Kouassi Olivier Claver Koffi Amadou Koné Akoun Fabrice Aké Oury Diallo Ahmadou Stellart Jean M. Brou Anassi Jean-Baptiste Okon Department of Medicine and Hepato-Gastroenterology Teaching Hospital of Bouak&#233 Bouak&#233 C&#244te d&#8217Ivoire Faculty of Medical Sciences Alassane Ouattara University Bouak&#233 C&#244te d&#8217Ivoire

Background and Objectives: The indication for treatment in HBsAg-positive patients with low viral load and normal transaminases requires an assessment of fibrosis. In resource-limited settings, free hepatic fibrosis evaluation tests can aid in therapeutic decision-making. Our study aims to demonstrate the utility of assessing hepatic fibrosis using non-invasive markers (APRI and FIB-4) in patients with chronic B viral hepatitis without cytolytic activity and low viral replication in our context. Patients and Methods: This is a retrospective cross-sectional study conducted between January 2018 and December 2021 at the University Hospital Center of Bouaké. Included were all patients aged ≥18 with normal transaminases (Results: Our study included 241 patients, with a mean age of 36.19 years (±10.52 years) and a male predominance of 52%. The mean FibroScan® value was 6.44 ± 2.3 kPa, and 68 patients (28.22%) had fibrosis >7 kPa. To exclude significant fibrosis (FS Conclusion: A significant proportion of HBV-infected patients with normal AlT and low viral load have active liver disease. Both FIB-4 and APRI biological scores are useful in identifying individuals without significant fibrosis with a good negative predictive value (>50%).

关键词： HBV Infection APRI FIB-4 Impulse Elastography BouakéUniversity Hospital

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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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Dyslipidemia in Adults with Type 2 Diabetes in a Rural Community in Ganadougou, Mali: A Cross-Sectional Study

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Journal of Diabetes Mellitus 2024年第2期14卷 133-152页

作者： Abdoulaye Diawara Djibril Mamadou Coulibaly Drissa Kone Mama A. Traore Drissa Konaté Dicko S. Bazi Oumar Kassogue Djeneba Sylla fatoumata Gniné Fofana Oudou Diabaté Mariam Traore Ibrahim Antoine Nieantao Kaly Keїta Mamadou Diarra Olivia Smith Jian li Cheickna Cisse Talib Yusuf Abbas Crystal Zheng Segun Fatumo Kassim Traore Mamadou Wele Mahamadou diakité Seydou O. Doumbia Jeffrey G. Shaffer University of Sciences Techniques and Technologies of Bamako Bamako Mali National Federation of Community Health Associations Bamako Mali Department of Tropical Medicine Medical Microbiology & Pharmacology John A. Burns School of Medicine University of Hawaii Manoa Honolulu USA Department Biostatistics and Data Science School of Public Health and Tropical Medicine Tulane University New Orleans USA Department of Biotechnology and Computer Science Burhani College Mazgaon Mumbai India School of Medicine Tulane University New Orleans USA Medical Research Council Uganda Virus Research Institute Entebbe Uganda london School of Hygiene and Tropical Medicine London UK Departement of Biochemistry and Genetics Duquesne University College of Medicine Pittsburgh USA

Dyslipidemia is a disorder where abnormally lipid concentrations circulate in the bloodstream. The disorder is common in type 2 diabetics (T2D) and is linked with T2D comorbidities, particularly cardiovascular disease. Dyslipidemia in T2D is typically characterized by elevated plasma triglyceride and low high-density lipoprotein cholesterol (HDl-C) levels. There is a significant gap in the literature regarding dyslipidemia in rural parts of Africa, where lipid profiles may not be captured through routine surveillance. This study aimed to characterize the prevalence and demo-graphic profile of dyslipidemia in T2D in the rural community of Ganadougou, Mali. We performed a cross-sectional study of 104 subjects with T2D in Ganadougou between November 2021 and March 2022. Demographic and lipid profiles were collected through cross-sectional surveys and serological analyses. The overall prevalence of dyslipidemia in T2D patients was 87.5% (91/104), which did not differ by sex (P = .368). High low-density lipoprotein cholesterol (lDl-C) was the most common lipid abnormality (78.9%, [82/104]). Dyslipidemia was associated with age and hypertension status (P = .013 and.036, respectively). High total and high lDl-C parameters were significantly associated with hypertension (P = .029 and .006, respectively). In low-resource settings such as rural Mali, there is a critical need to improve infrastructure for routine dyslipidemia screening to guide its prevention and intervention approaches. The high rates of dyslipidemia observed in Gandadougou, consistent with concomitant increases in cardiovascular diseases in Africa suggest that lipid profile assessments should be incorporated into routine medical care for T2D patients in African rural settings.

关键词： Cholesterol Cross-Sectional Study Dyslipidemia lipids Mali Type 2 Diabetes

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Epidemiological Profile of Newborns Who Died during Their Hospitalization in the Neonatology Unit, Mali Hospital

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Open Journal of Pediatrics 2022年第2期12卷 424-432页

作者： Korotoumou Wéllé Diallo Bourama Kané Aboubacar Sangaré Kadidiatou Touré fatoumata léonie François diakité Mamadou Traoré Mohamed Maba Traoré Mamadou Berthé Mariam Maiga Abdoul Aziz diakité fatoumata Dicko Traoré Department of Pediatrics Mali Hospital Bamako Mali Department of Pediatrics Gabriel Touré University Hospital Bamako Mali Reference Health Center of Commune V Bamako Mali Department of Medical Imaging Mali Hospital Bamako Mali National Institute of Public Health Bamako Mali Reference Health Center of Commune VI Bamako Mali

Introduction: Neonatal mortality is a serious problem, particularly in developing countries. Objective: To study the epidemiological and clinical profiles of newborns who died during their hospitalization in the neonatology unit of the hospital in Mali. Methodology: This was a prospective study over a 12-month period (January 1 to December 31, 2020) including all newborns aged 0 - 28 days who died during their hospitalization. Results: A total of 424 neonates were hospitalized in neonatology, 54 died, or 12.73%. Newborns aged 0 - 7 days at admission were the most represented at 79.63% and 94.4% were full-term babies. The male gender was dominant with a ratio of 1.17. The following characteristics were frequently observed in the mothers: not educated (46.3%), poor 75.9%, living in urban areas (68%), housewives 75.4%, and having had less than 4 antenatal care visits (53.7%). For babies, respiratory distress and hyperthermia were the most common reasons for hospitalization (37% and 22.2%, respectively), with 40% being resuscitated at birth. Infection and perinatal anoxia were the most frequent diagnoses, respectively 96.3% and 37%. The death occurred within the first three days of hospitalization in 60% of cases. Conclusion: In order to reduce the mortality rate in our facilities, monitoring of pregnancy and delivery, and correct management of newborns both at birth and in the pediatric wards are important.

关键词： Newborn Death Hospital in Mali

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