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

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 diakit. 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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Pericarditis in Cardiology at a Regional Hospital

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World Journal of Cardiovascular Diseases 2024年第9期14卷 581-587页

作者： Coulibaly Souleymane Traoré Djénébou Konaté Massama B. A. Hamidou Oumar Guindo Aissata Yves Roland Koumaré Sidibé Samba Sako Mariam Sanogo Alpha Kodio Aniéssa mahamadou Yaya Kéita diakit. Mamadou Menta Ichaka Department of Cardiology CHU Point G Bamako Mali Department of Internal Medicine CHU Point G Bamako Mali Mali Hospital Medical Department Bamako Mali Department of Cardiology Gabriel Tour University Hospital Bamako Mali Department of Cardiology Nianankoro Fomba Hospital Sgou Mali

Introduction: Pericarditis is an inflammation of the pericardium with or without pericardial fluid effusion. Its prevalence is difficult to determine given the many forms that are not symptomatic. In Africa, its prevalence was 6.3% in Gabon in 2020 and 7.2% in Mali in 2022. In Europe, an Italian study estimates the incidence of acute pericarditis at 27.7 cases per 100,000 people per year. In another study conducted in Finland over a period of 9 years, the incidence of pericarditis requiring hospitalisation was 3.32 cases per 100,000 people per year. The aim of our study was to describe the clinical and paraclinical characteristics of pericarditis observed in the cardiology department of the regional hospital in Mali. Methodology: This was a single centre cross-sectional study from 30 January 2018 to 30 June 2020 in the cardiology department of the Ségou regional hospital. All consenting patients, regardless of age or sex hospitalised in the department for pericarditis confirmed on cardiac ultrasound were included. Data were collected using an individual patient follow-up form recording sociodemographic, clinical, biological, electrocardiographic and echocardiographic data, as well as the course of the disease. Results: Out of 879 patients hospitalized, the hospital frequency was 7.28%. Females predominated, with a sex ratio of 0.42. More than half the patients were aged 45 or younger (59.4%). The mean age of patients was 41.8 ± 18.1 years. Cardiovascular risk factors were dominated by hypertension and smoking (46.9% and 12.5% respectively). The reasons for consultation were dyspnoea (84.3%), chest pain (54.7%), cough (71.9%) and fever (34.4%). Physical signs included muffled heart sounds (76.6%), tachycardia (70.3%), pericardial friction (17.2%) and signs of peripheral stasis in 53.1% of cases. We observed elevated C-reactive protein (CRP) in 57.8% of cases, hypercreatininaemia in 37.5% and positive HIV serology in 3.1%. The major radiographic signs were cardiomegal

关键词： Pericarditis Epidemiology Clinic Nianankoro Fomba Hospital Ségou

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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 diakit. 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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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（糖尿病） 2024年第2期 133页

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Childhood Idiopathic Nephrotic Syndrome: A Single-Center Hospital Study

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Open Journal of Pediatrics 2022年第5期12卷 832-840页

作者： Abdoul Karim Doumbia Tati Simaga Adama Dembélé mahamadou Salihou Baldé Hawa G. Diall Pierre Togo Aminata Doumbia Belco Maiga Karamoko Sacko Fatoumata Léonie diakit. Oumou Koné Oumar Coulibaly Ibrahim Ahamadou Mohamed Elmouloud Cissé Guédiouma Dembelé Fousseyni Traoré Hawa Konaré Amadou Touré Djènèba Konaté Lala N’Drainy Sidibé Leyla Maiga Abdoul Aziz diakit. Boubacar Togo Department of Pediatrics of CHU Gabriel Touré Bamako Mali

Introduction: Idiopathic nephrotic syndrome (INS) is one of the leading causes of childhood morbidity worldwide. This study was undertaken to complete the epidemiological, clinical, therapeutic and evolutionary aspects of NIS in hospitalized patients. Methodology: We conducted a retrospective study of patients with childhood NIS who had been admitted to our department from January 2017 to December 2018. Diagnosis, remission and relapse of idiopathic NS were defined according to the recommendations of the French Society of Pediatric Nephrology. We included all patients aged 2 to 14 years presenting a NIS picture. Results: During the study period, 35 patients with idiopathic NS had been hospitalized, representing a frequency of 1% of patients hospitalized in the department. The sex ratio was 2.22. The average age of the patients was 7.5 ± 3.5 years. Generalized edema was observed in all our patients. Arterial hypertension (36%) and abdominal pain (24%), hematuria (9%) were the main associated signs. Malnutrition was present in 66%, urinary tract infection in 20% and malaria in 24%. Cortico-sensitivity was obtained in 86% of patients, 14% were cortico-resistant and 11% were cortico-dependent. Relapses (6%) had been observed among cortico-sensitive patients. The mortality rate was 11%. Conclusion: This study calls for more trials to better elucidate prognostic indicators and develop better therapeutic approaches adapted to epidemio-clinical contexts.

关键词： INS Children Corticosteroids

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Panorama of Autoimmune and Autoinflammatory Diseases in Internal Medicine at the University Hospital Center (UHC) of the Point G

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Open Journal of Internal Medicine 2021年第2期11卷 91-108页

作者： Soukho Assétou Kaya Keïta Kaly Sy Djibril Traoré Djénébou Dembélé Ibrahim Amadou Mallé Mamadou Cissoko Mamadou Sangaré Barry Boubacar Oumar Keïta Adramé Keïta Mamadou Nyanké Romuald Diarra Bacary Cissé Idrissa Ahmadou diakit. mahamadou Dembélé Mamadou Traoré Abdel Kader Traoré Hamar Alassane Department of Internal Medicine at the University Hospital Center of the Point G Bamako Mali Faculty of Medicine and Odontostomatology (FMOS) University of Sciences Techniques and Technologies of Bamako (USSTB) Bamako Mali Department of Rheumatology at the University Hospital Center of the Point G Bamako Mali University of Clinical Research Center (UCRC) at the University Hospital Center of the Point G Bamako Mali Faculty of Medicine Kankou Moussa University (UKM) Bamako Mali

Introduction: Panorama studies of autoimmune and auto-inflammatory diseases are still very little carried out in Africa and particularly in Mali. The objective of this descriptive study with retrospective collection was to describe the epidemiological and clinical profile of all autoimmune and auto-inflammatory diseases in the department of internal medicine at the University Hospital Center of the Point G. Methods: This was a descriptive study with a retrospective survey of the records of patients hospitalized for autoimmune and auto-inflammatory diseases in the department of internal medicine at the CHU of Point G for a study period of 15 years from January 1, 2005 to December 31, 2019. We included in the study all patients hospitalized for autoimmune and auto-inflammatory diseases. Results: During the study period (January 31, 2005 to December 31, 2019), 6383 patients were hospitalized in internal medicine at the University Hospital Center of the Point G, of which 317 patients presented with autoimmune and/or auto-inflammatory disease with an average annual hospital recruitment rate of 21 ± 7.87 cases per year. The female sex accounted for 64.98% with a sex ratio of 0.54. The mean age of patients was 35.27 ± 16.27 years and the extreme ages were 07 and 79 years. Out of the 317 medical records included according to our inclusion criteria, there were 07 cases of association between autoimmune disease and autoinflammatory disease, i.e. 14 cases of autoimmune and autoinflammatory diseases. A total of 331 autoimmune diseases and/or auto-inflammatory diseases were collected, i.e. a frequency of 5.19%, including 291 cases of autoimmune diseases (221 cases of organ-specific autoimmune diseases and 70 cases of systemic autoimmune diseases) and 40 cases of autoinflammatory diseases (no case of monogenic forms, 08 cases of “systemic” polygenic forms and 32 cases of “organ-specific” polygenic forms). Organ-sp

关键词： Autoimmune Disease Autoinflammatory Disease Internal Medicine Mali

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Traumatic Digestive Perforation in the Hospital of Sikasso: Epidemio-Clinical and Therapeutic Aspects

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Surgical Science 2023年第6期14卷 405-413页

作者： Moussa Diassana Bathio Traoré Aly Boubacar Diallo Mamadou Bernad Coulibaly Doh Sylla Amadou Maiga Aboubacar Karambé Amadou Bah Aboubacar Yoro Sidibé Layes Touré Ternan Traoré Ousmane Dembelé Salif Traoré Moussa Kanté Mamadou Sangaré Kokoroba Sidibé Youssouf diakit. mahamadou Coulibaly Moro Sidibé Soumaila Alama Traoré Moussa Samaké Nana Kadidia Fofana Bakary Tientigui Dembélé General Surgery Department of the Sikasso Hospital Sikasso Mali General Surgery Department CHU Gabriel-Touré Bamako Mali Traumatology Department of the Sikasso Hospital Sikasso Mali Urology Department of the Sikasso Hospital Sikasso Mali Anesthesia and Resuscitation Department of the Sikasso Hospital Sikasso Mali Odontostomatology Department Sikasso Hospital Sikasso Mali Surgery Department Koutiala Reference Center Koutiala Mlai Ophthalmology Department Sikasso Hospital Sikasso Mali Gyneco-Obstetrics Department Sikasso Mali Surgery Department Bamako District Hospital Bamako Mali Commune IV District Hospital Bamako Mali

Traumatic digestive perforation is the pathological opening of the wall of a hollow organ of the digestive tract (esophagus, stomach, small intestine, large intestine, rectum, and extrahepatic bile ducts) following trauma. Injuries to the digestive viscera, especially from trauma, have been known since antiquity. Aristotle recognized that a slight blow can cause an intestinal injury. Perforation of a hollow organ of the digestive sphere results in peritonitis, which in this case is the consequence of an infection of the peritoneal cavity by spreading of the digestive contents. The aim of the work was to describe the epidemiological, clinical and therapeutic aspects of traumatic digestive perforation. Patients and method: The study was retrospective and descriptive from January 1, 2016 to December 31, 2020, in the general surgery department of the hospital of Sikasso (Mali). Patients operated for traumatic digestive perforation were included. Results: The clinical records of 42 patients were collected. Traumatic digestive perforations represented 12.3% of patients hospitalized for abdominal trauma. The average age of the patients was 26.6 years, with a sex ratio of 6:1. The most frequent etiology was road traffic accidents with 38% of patients. The average delay of consultation was 5 days. Abdominal pain was present in 38 patients, vomiting in 17 patients. On physical examination, the most frequent signs were abdominal contracture in 61.9% of patients, and disappearance of pre-hepatic dullness in 54.7% of patients. On rectal examination, the douglas was bulging and painful in 21 patients. X-ray of the abdomen without preparation showed pneumoperitoneum in 54.1% of patients. Excision, suture and peritoneal lavage were performed in 31 patients. The postoperative course was marked by parietal suppurations in 5 patients, a digestive fistula in 2 patients and 4 cases of death (9.5%). Conclusion: Traumatic digestive perforation is a frequent pathology in surgery. Road acci

关键词： Perforation Digestive Traumatic Sikasso (Mali)

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Breast Cancer in Young Women about 87 Cases in the General Surgery Department CHU Gabriel Touré

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Surgical Science 2022年第11期13卷 506-517页

作者： Maïga Amadou Saye Zakari Sidibé Boubacar Yoro diakit. Ibrahima Bah Amadou Diallo mahamadou Diallo Aly Boubacar Traoré Bathio Moussa Diassana Koné Tani Doumbia Arouna Adama Traoré Amadou Diallo Mamadou Traoré Djibril Konaté Moussa Saadé Oumou Hélène Kanté Lassana Konaté Madiassa Dembélé Souleymane Samaké Moussa Keita Mory Dembélé Bakary Tientigui Traoré Alhassane Togo Adégné Department of General Surgery University Hospital Bamako Mali Department of General Surgery Sikasso Hospital Sikasso Mali Department of Orthopedic Traumatology University Hospital Bamako Mali Department of General Surgery University Hospital Bamako Mali Reference Center of Commune VI Bamako Mali General Surgery Department Mopti Hospital Mopti Mali

Our objectives were to determine the frequency of breast cancer in young women, to determine the risk factors for breast cancer in young women, to detail the diagnostic process of the disease, to determine the different therapeutic strategies. This was a retrospective and descriptive study going from January 2005 to December 2021, a period of 17 years. The study involved 87 women with an average age of 33.2 years. Patients consulted 66 times or 75.9% for breast mass. The size of the tumor was greater than or equal to 5 cm in 62 patients;it was localized in the supero external quadrant 41 times or 47.1%. Molecular classification revealed the following results: Luminal A 21.4%;receptive (HER2) positive 28.6%, and triple negative 42.9%. Stage II was the most represented with 47.4%. Histology found infiltrating carcinoma of non-specific type in 76 patients. The treatment was mastectomy axillary dissection in 66 patients, quadrantectomy + axillary dissection in 6 cases (6.9%) associated with radiotherapy in 6 patients, chemotherapy was performed in 79 of our patients and hormone therapy in 10 patients. Conclusion: Breast cancer is frequent in our country. Patients generally consult us at a late stage. The possibility of determining certain receptors and carrying out certain non-surgical treatments on site would improve the prognosis.

关键词： Breast Cancer Young Woman Receptors Diagnosis Prognosis Mali

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Sociodemographic and Clinical Aspects of Climacteric Syndrome of Menopause in the City of Kati in Mali Involving 113 Women

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Open Journal of Obstetrics and Gynecology 2023年第12期13卷 1938-1948页

作者： Daouda Camara Seydou Fané Yacouba Sylla Aly Daouda Oulogem Bintou Samaké Abdoulaye Sidibé Simaga Ismaël Soumana Oumar Traoré Saye Amaguiré Déssé Diarra Amadou Bocoum Koné Diakaridia Keita Sema mahamadou Coulibay Haidara Ramatoullaye Ibrahima Téguetté Youssouf Traoré Major Moussa diakit. Referral Health Centre in Kati Kati Mali Gabriel Touré University Hospital Bamako Mali Fana Referral Health Centre Koulikoro Mali Joint Reference Health Centre V Bamako Mali Joint Reference Health Centre IV Bamako Mali Commune I/Bamako Referral Health Centre Bamako Mali Kalaban Coro Referral Health Centre Koulikoro Mali Koulikoro Referral Health Centre Koulikoro Mali

Objective: This paper aims to study the sociodemographic and clinical aspects of menopausal climacteric syndrome in the city of Kati in Mali. Patients and Methods: This was a quantitative descriptive and cross-sectional study, conducted in the city of Kati from February 1 to July 31, 2021. We included 112 menopausal women. Women were selected from a household survey using the sampling step. We were interested in conjugal, family and professional life, self-esteem and the state of health of women in general. Results: More than half of the women in our study were already postmenopausal (52.2%);the mean age was 50.5 years with the extremes ranging from 41 to 62 years. The majority of them were married (69.9%), housewives (43.4%) and Bambara (53.1%). The most common climacteric syndromes were: joint pain (65.5%), hot flashes (62.8%) and night sweats (56.6%). Genital-urinary syndromes (42.5%) were dominated by decreased libido (41.7%), urinary disorder (23%) and vaginal dryness (14.6%). Genitalia-urinary syndromes increased the frequency of disagreements;Pearson’s Chi-square = 33.63;ddl = 1;P = 0.001. There was a statistically significant relationship between night sweat, genital-urinary syndromes, joint pain, and increased disease frequency with, respectively: Pearson’s chi-square = 4.660;ddl = 1;P = 0.031;Fisher’s exact test, P = 0.001, Pearson’s Chi-square = 8.434;ddl = 1;P = 0.004. There was no statistically significant relationship between climacteric syndrome and family life, work life and self-esteem. Changes in the professional relationship between women and their co-workers included, respectively: arguments (50%);disagreements (25%) and disobedience (25%). Conclusion: Menopause deteriorates the quality of life of women who suffer in silence, hence the need to pay special attention to them.

关键词： Menopause Climacteric Syndrome Quality of Life Kati Mali

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Traumatic Digestive Perforation in the Hospital of Sikasso: Epidemio-Clinical and Therapeutic Aspects

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Surgical Science（外科学） 2023年第6期

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