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Appendicular Abscess: Epidemio-Clinical and Therapeutic Aspects in the General Surgery Department of the Reference Health Center of Commune III (C.s.ref CIII) of the District of Bamako

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Surgical Science 2023年第2期14卷 77-83页

作者： Karembé Boubacar Tounkara Idrissa diarra Issaka Soumaré Modibo Dianguina Traoré Boureima Sanogo Seydou Diallo Moctar Camara Aboubacar Touré Aboubacar Coulibaly Abdoulaye Fall Ibrahim Diakité Mané diarra Mouminy diarra drissa Traoré Abdoulaye Coulibaly Yacaria Kanté Lassana Dembélé Bakary Tientigui Togo Adégné Départment of Surgery CHU Gabriel Touré Bamako Mali

Objectives: The main goal of this study is to determine the hospital frequency of appendicular abscess, to describe the diagnostic and therapeutic aspects and to analyze the postoperative follow-up. Methodology: This was a descriptive and analytical prospective study from January 1, 2020 to June 30, 2021 including patients admitted to our department for appendicular abscess diagnosed pre- and or intraoperatively and confirmed to histology. Results: We collected 30 appendicular abscesses that accounted for 18.75% of emergency interventions. The 16 - 25 age group was the most represented at 53%. The average age was 24 years with extremes of 10 and 58 years. The male sex was mostly represented (60%) with a sex ratio of 1.5. The majority of our patients were students (53.3%). The main clinical signs found were abdominal pain and vomiting (100%). The pain was localized in the Right Iliac Fossa (RIF) in 80% of cases. Fever was present in all our patients with a temperature between 38˚C and 38.5˚C. The physical examination found pain with defense of the right iliac fossa in 93.3% of cases. A painful mass was present in 27 patients (90%). Treatment consisted of appendectomy with abscess drainage in all patients. Postoperative follow-up was simple in 83.3% of cases;we recorded three cases (10%) of parietal suppuration, one case of fistula (3.3%) and one death. Conclusion: Appendicular abscess is a medical-surgical emergency frequent surgery in our context because of the delay in diagnosis. It is a condition with low morbidity and mortality subject to early diagnosis and prompt and appropriate treatment.

关键词： Abscess Appendix Surgery

Epidemiological-Clinical and Therapeutic Aspects of Acute Appendicitis at the Reference Health Center of Commune III (C.S.Ref CIII) of the District of Bamako

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Surgical Science 2023年第1期14卷 30-37页

作者： Karembé Boubacar Tounkara Idrissa Soumaré Modibo Dianguina diarra Issaka diarra Mouminy Touré Aboubacar Traoré Boureima Camara Aboubacar Sanogo Seydou Fall Ibrahim Coulibaly Abdoulaye Traoré Abdoulaye diarra drissa Diakité Mané Coulibaly Yacaria Kanté Lassana Dembélé Bakary Tientigui Togo Adégné Départment of Surgery CHU Gabriel Touré Bamako Mali

Objectives: It was to determine the epidemiological-clinical and therapeutic aspects of acute appendicitis at the Reference Health Center of Commune III of the district of Bamako. Methodology: This was a prospective study from January 1 to December 31, 2020 including patients operated for acute appendicitis and confirmed at histology and cases of abscess and appendicular plastron. Results: We collected 60 cases of acute appendicitis. They accounted for 17.29% of surgical indications. The average age of our patients was 25.5 years. The male sex was the most represented at 63% with a sex ratio of 1.72. The Pain in the right iliac fossa was the most represented reason for consultation with 76.7%. It was at the type of bite 70% of the cases. On physical examination the defense of the right iliac fossa was present in 96.7%. Digestive signs were marked by nausea 28.4% (17 patients) and vomiting 25% (15 patients). The digital rectal exam was painful to the right of the Douglas fir in 76.7% of our patients. In biology a complete blood count (CBC) performed in all our patients has objectified hyper leukocytosis in 80% of cases. The reactive protein (CRP) performed in 36 patients was elevated with values between 18 and 46 mg/ml. The imaging performed was an abdominal ultrasound that found a roundel image of the appendix with increased size in 65%. Surgical treatment consisted of classical Mac Burney appendectomy in 54 patients (90%). The gesture performed was an appendectomy in all our patients. All our appendectomy parts were sent for pathological examination. This examination classified the parts as non-specific appendicitis in 60%, phlegmonous appendicitis in 22% and catarrhal appendicitis in 18% of cases. Surgical follow-up was simple in 98.4% (59 patients) and morbidity was marked by digestive fistula in one patient. We recorded one case of death (1.6%). Conclusion: Acute appendicitis remains the most common surgical emergency in commune III of the district of Bamako. It is a pathology that can be found at all ages of

关键词： Appendicitis Surgery Anatomical Pathology

Maternal and Perinatal Prognosis of the Cesarean at Chu Point G, Bamako, Mali

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Open Journal of Obstetrics and Gynecology 2021年第11期11卷 1461-1469页

作者： Coulibaly Ahmadou Seydou Z. Dao Cissouma Assétou Sima Mamadou Kanté Ibrahim Ousmane Mamadou S. Traoré Koné Konimba diarra drissa Sissoko Hamadi Théra Thiounkani Traore Youssouf Obstetric Gynecology Department of the University Hospital Center (CHU) Point G Bamako Mali Obstetric Gynecology Department of the Reference Health Center of Commune II Bamako Mali Pediatric Department of Sikasso Hospital Sikasso Mali Obstetric Gynecology Service of the Reference Health Center of Commune III Bamako Mali Obstetric Gynecology Department of the University Hospital (CHU) Gabriel Touré Bamako Mali

Objective: In light of numerous obstetric evacuations to the Point G University Hospital and taking into account the practice of cesarean section for many years in the service, it seemed necessary to us to make our contribution to the study of cesarean section by putting emphasis on maternal and perinatal prognosis in the Obstetric Gynecology Department of the Point G university hospital. Method and materials: We conducted a retrospective cross-sectional study in the Gynecology and Obstetrics Department of the Point G University Hospital, from January 01, 2018 to December 31, 2018. The Point G University Hospital is a 3rd level center of reference in the field of obstetrics in Mali. There is no neonatal ward. The study included all women who gave birth in the gynecology and obstetrics department during the study period. All prophylactic and emergency Caesarean section records during the period in which management took place in the ward were included. The records of patients who had a prophylactic or emergency cesarean section in other health facilities and non-usable records were not included. Data were collected using a pre-established survey form. The variables analyzed were socio-epidemiological, clinical and prognostic. Data were analyzed using IBM SPSS software version 16.00. The Chi2 test and Fischer’s exact test were used to highlight risk factors. The significance level retained was p

Anal Pathologies: What Management at the Reference Health Center of Bamako’s Commune V?

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Open Journal of Gastroenterology 2024年第3期14卷 87-92页

作者： Sanra Déborah Sanogo Moussa Y. Dicko Ousmane diarra Abou A. diarra drissa Katilé Abdoulaye Maiga Ouatou Mallé Sabine Drabo Makan S. Tounkara Hourouma Sow Kadiatou Doumbia Anselme Konaté Moussa T. diarra Hepato-Gastroenterology Department CHU Point G Bamako Mali Service d’hépato-gastroentérologie CHU Gabriel Touré Bamako Mali Hepato-Gastroenterology Unit CSREF Commune V Bamako Mali

Anal pathologies are conditions affecting the anal margin and the anal canal. The aim of our study was to update data on anal diseases. Non-specific, it can reveal an emergency, a serious illness, a chronic disease or a benign condition. It was a prospective, descriptive and analytical study from April 2022 to March 2023, carried out in the hepato-gastroenterology unit of the Centre de Santé de Référence de la commune V du District de Bamako in Mali. Out of seven hundred and forty-nine (749) patients seen in consultation, 98 had anal pathology, i.e. a prevalence of 13.08%. The mean age was 40 ± 15.15 years and the sex ratio was 1.5. Hemorrhoidal disease and anal fissure were the most frequent pathologies in 66.4% and 24.4% of cases respectively. Medical treatment was initiated in 91.9% of patients with hemorrhoidal disease and 91.7% with anal fissure. Anal pathologies are common in young male patients. In our context, they are dominated by benign conditions.

关键词： Anal Pathologies Hemorrhoidal Disease Anal Fissure

The Factors of the Failure in the Treatment of Congenital Equinus Clubfoot Varus by the Ponseti Method at the Reference Health Care Center (CSREF) of Commune III of Bamako

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Surgical Science 2023年第5期14卷 398-404页

作者： Seydou Sanogo Soumaila Diallo Boubacar Karembé Lassine Cissé Almami Kire Moussa Cissé Abdoulaye Coulibaly Aboubacar Touré Boureima Traoré Moustapha Yossi Moussa Samaké drissa diarra Mohamed Traore Seydou Mariko Mariko Issa Fomba Layes Touré Adégné Togo Department of Orthopedic-Traumatology CSREF CIII Bamako Mali

Clubfoot malformation is the most common serious congenital anomaly affecting the foot in children. Its treatment by the Ponseti method is simple, profitable and widely used in the world. Objective: The objective of this study was to identify the factors of the failure of its treatment by the Ponseti method. Material and Method: We carried out a retrospective and descriptive study of cases of congenital equinus clubfoot varus at the Reference Health Care Center of Commune III of Bamako over 26 months from September 2020 to November 2022. Data were treated with the utmost anonymity. Result: This study was performed on 44 children seen for clubfoot: male (68%) and female (32%), with a sex ratio of 2.1. We obtained 13 cases of recidivism including 7 boys and 6 girls. We found 21 cases of unilateral and 23 bilateral;among which 9 recurrences were found against 4 in the unilateral forms. 85% of recurrences did not have good adherence to the splint and 62% did not come regularly for follow-up consultation. We obtained 33 children with idiopathic clubfeet (75%) with a recurrence of 24%, and 7 children with secondary clubfeet with 71 % recurrence. There was no recurrence in the postural type. Among the recurrences, 38.5% started treatment between 1 and 6 months, 23.1% from 0 to 1 month and 15.4% at 2 years and more. 85% of recurrences had a Pirani score between 4.5 to 6 at the start of treatment and 15% at a score of 2.5 to 4. Conclusion: The factors of the failure of the Ponseti method are mainly non-compliance with treatment, secondary clubfeet, and a high Pirani score at the start of treatment.

关键词： Chess’ Factors Club Foot Ponseti Method Pirani Score

Cervical Meningocele about 2 Operated Cases

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Open Journal of Modern Neurosurgery 2024年第1期14卷 1-7页

作者： Mohamed El Hassimi Cissé Mamadou Salia diarra N’Famara Sylla Abdoulaye Diop Izoudine Blaise Koumaré Théodore Habib Maxime Coulibaly Oumar Diallo drissa Kanikomo Neurosurgery Department of CHU Mère-Enfant “Le Luxembourg” Bamako Mali Neurosurgery Unit of Army Medico-Surgical Center of Bamako Bamako Mali Neurosurgery Department of CHNU de Fann Dakar Sénégal Neurosurgery Department of CHU Hospital du Mali Bamako Mali Neurosurgery Department of CHU Gabriel Touré Bamako Mali

Cervical meningoceles are the least common forms of spina bifida, representing between 4% to 8% of all spinal dysraphisms. They are not accompanied by neurological deficit in childhood but attached cord syndrome can occur with growth. Surgical treatment, in addition to avoiding rupture and correcting the aesthetic damage, will preserve neurological functions. We report 2 cases that we took care of. They are a 5-month-old infant and a 3-year-old girl. The first presented a 7 cm rounded meningocele pedunculated through the C1 lamina defect. The second presented an 8.6 cm polylobed meningocele pedunculated through the C2 lamina defect. They both underwent surgery with good progress.

关键词： Cervical Meningocele Spinal Dysraphism Spina Bifida

Chronic Hepatitis B Virus Infection: Biological Parameters in Patients Treated with Tenofovir Disoproxil Fumarate

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Open Journal of Gastroenterology 2024年第4期14卷 145-151页

作者： Sanra Déborah Sanogo Moussa Y. Dicko Lamine N’Diaye Ousmane diarra drissa Katilé Abdoulaye Maiga Ouatou Mallé Sabine Drabo Makan S. Tounkara Hourouma Sow Kadiatou Doumbia Anselme Konaté Moussa T. diarra Hepato-Gastroenterology Department Centre Hospitalier Universitaire Du Point G Bamako Mali Hepato-Gastroenterology Department Gabriel Toure University Hospital Bamako Mali Hepato-Gastroenterology Unit Csref Commune V Bamako Mali

Chronic hepatitis B causes a liver disease characterized by inflammation of the liver parenchyma. The aim of this study was to investigate the evolution of biological parameters in patients treated with Tenofovir for chronic B infection at the Commune V referral health center in Bamako. We obtained a prevalence of 14.15%. The most represented age group was 31 - 40 years, with 36.8%. The sex ratio was 1.44 in favour of men. Viral load was undetectable after 18 months of treatment in 25 patients (42.37%). Tenofovir, the 1st-line drug in Mali, is effective on the biological parameters monitored in patients.

关键词： Viral Hepatitis B Tenofovir Biological Parameters

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

Angiographic Features of Intracranial Aneurisms in Mali: A Preliminary Study of 105 Patients

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World Journal of Neuroscience 2023年第1期13卷 1-11页

作者： Mahamadou Dama Oumar Coulibaly Oumar Diallo Daouda Sissoko Hawa diarra Kalba Tembine Mamadou Salia diarra Madani Ouologem drissa Kanikomo Neurosurgery Department University Hospital of Mali Bamako Mali Radiology Department University Hospital of Mali Bamako Mali Anesthesiology Department University Hospital of Mali Bamako Mali Neurosurgery Department Hospital of Luxembourg Bamako Mali Unite of Neurology Infirmery of the Armies Bamako Mali Department of Neurosurgery Gabriel Touré Hospital Bamako Mali

Introduction: Rupture of intracranial aneurisms leads to severe morbidity and mortality. There are two modalities of treatment surgery and endovascular treatment. The diagnosis is made by angiography (DSA, CTA, RMA). The angiographic features used to assess the risk of the complications and choose the treatment modality are size, location and aneurism morphology. Materials and Methods: We reviewed and analyzed the computed tomographic angiography and magnetic resonance angiography of all patients admitted to the hospital of Mali with IAs from 2015 to 2021 either 7 years. Patients who were less than 18 years old, those with non-aneurysmal SAH, patients who request a discharge and those with an incomplete angiographic description of the IAs were excluded from the analysis. Results: We have collected 105 patients with 109 aneurysms. The sex ratio was 2/1 in favor of females. The mean age was 44.51 years with the range from 18 to 70 years. The presentation mode was subarachnoid hemorrhage (SAH) in 97% of cases. 76.19% had confirmed high blood pressure before the bleeding. 19.04% were diabetics. 98% of our patients have made a CT angiography and 2% have made MR angiography for the aneurysm diagnosis. 97.24% of aneurisms were located in the anterior part of the Willis circle. 39.44% of these aneurisms were the anterior communicating complex aneurysm. 27.52% of aneurysm had a small size, 42.20% had a medium size, 20.18% large size against 5.50% of the giant (Figure 3) and the middle cerebral artery was the most involved in the least. 95.41% of cases were saccular aneurysms against 4.59% fusiform. Conclusion: The angiographic feature of an intracranial aneurism in the Malian population may differ from other populations of the sub-region. The anterior communicating complex aneurysm is more common and the aneurism of the posterior part of the Willis circle is less common. We found the aneurism size ≥ 6 mm, ACA, MCA and Pcom more frequent.

关键词： Subarachnoid Hemorrhage Aneurism CT Angiography RMA