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Interest of Transcranial Doppler (TCD) in Emergency in Traumatic Brain Injury Patients at Gabriel Touré University Hospital, Bamako, Mali

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Open Journal of Emergency Medicine 2024年第3期12卷 114-121页

作者： Abdoulhamidou Almeimoune Moustapha Mangane Madane Thierno Diop Mahamadoun Coulibaly Amadou Gamby dramane sanogo Alfousseini Soumare Adama Coulibaly Ababacar Salaha Harouna Sangaré Diango Djibo Mahamane Department of Intensive Care Anesthesia and Emergency Medicine CHU Gabriel Toure Bamako Mali Faculty of Medicine and Odontostomatology University of Sciences Techniques and Technology of Bamako Bamako Mali Department of Intensive Care Anesthesia CHU Luxembourg Luxembourg City Luxembourg

Introduction: Transcranial Doppler is a simple, non-invasive and inexpensive examination which allows the assessment of cerebral perfusion. In countries with limited resources, which do not have a means of monitoring intracranial pressure, this examination offers hope of survival for patients with traumatic brain injury. This study was designed to investigate the incidence of early cerebral circulation abnormalities after traumatic brain injury using transcranial Doppler (TCD). Methodology: A descriptive and analytical study was conducted over one year, including patients with traumatic brain injury and an initial Glasgow Coma Scale (GCS) score of less than 15. Non-inclusion criteria: Stroke, brain tumor, cerebral abscess. Exclusion criteria: Inadequate insonation window. Results: Out of 854 traumatic brain injury patients admitted to the emergency department, 112 were included in the study. The average age was 30.14 years, with a sex ratio of 4.1. Initially, 83.5% had moderate traumatic brain injury, and 12.1% had severe traumatic brain injury. Brain CT scans were performed in 95.7% of the patients. Edematous-hemorrhagic contusion was observed in 95% of the patients. On initial TCD, the pulsatility index in the middle cerebral artery was greater than 1.3 in 49.4% of the patients. Diastolic velocity was less than 20 cm/s in 46.4% of cases, and mean velocity was greater than 150 cm/s in 8.7% of cases. In this group, low diastolic velocity indicated cerebral hypoperfusion suggestive of intracranial hypertension. When the pulsatility index was greater than 1.9, no patient had a normal diastolic velocity. Among patients with severe traumatic brain injury, 61.5% had an abnormal pulsatility index compared to 42.3% of patients with moderate traumatic brain injury. Conclusion: TCD is a simple tool for analyzing intracerebral hemodynamics.

关键词： Traumatic Brain Injury TCD Neuroresuscitation Sub-Saharan Africa

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Anesthetic Activities of Scheduled Surgery at CHU Gabriel Touré

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Open Journal of Anesthesiology 2021年第5期11卷 164-174页

作者： Mangané Moustapha Almeimoune Abdoul Hamidou Diop Thierno Madane Soumaré Alfousseini Koita Siriman sanogo dramane Gamby Amadou Siadaly Babaya Dembelé Aladji Seydou Diango Djibo Mahamane Department of Anesthesiology and ICU H&ocirc pital Gabriel Touré Bamako Mali Department of Anesthesiology and ICU H&ocirc pital Gabriel Touré Bamako Mali Department of Anesthesiology H&ocirc pital IOTA Bamako Mali Department of Anesthesiology and ICU H&ocirc pital Mè re-Enfant Bamako Mali

Concept: We opted for this study because the hospital unit Gabriel Touré was renovated with 7 surgical specialties. Our study was the very last study before the advent of coronavirus disease 2019 (COVID 19). Goal: Evaluate the anesthetic activities of the planned surgery at the University Hospital Center CHU Gabriel Touré. Method and Material: This was a descriptive prospective study carried out in the cold operating theater of the CHU Gabriel Touré from January to December 2018. It focused on all patients operated on for regulated surgery and who had benefited from anesthesia. Our data was entered and analyzed on SPSS 25 software. Word processing performed on Microsoft WORD® 2016 and graphics on Microsoft EXCEL® 2016. Results: During the study period 1700 patients were operated on in the operating room for scheduled surgery. The age range of 0 to 5 years accounted for (14.8%). The average age was 6.64 years;male predominance (52.6%) of operated patients with a sex ratio of 1.1. A history of general anesthesia was found in 62.1%. The classification of the American Anesthesia Society (ASA) ASA1 class represented 92.7%. Tonsillitis was the most common operative diagnosis (9.5%). Hernia cures and eventrations were the most common surgical technique (11.8%). General anesthesia was achieved in 65.3% of patients. Hypotension was the most common adverse event in the operating room, 44.5%. The intraoperative mortality was 0.11%. Conclusion: Our study covered the entire population anesthetized. It provided an update on the practice of anesthesia in the intensive care unit anesthesia. General anesthesia was the most used technique;a predominance of cardiovascular adverse events, occurring more often in induction and mainly favorable outcome with mortality intraoperative 0.11%. A growing presence of MAR and DES who had performed more than 30% of anesthesia.

关键词： Anesthetic Activities CHU Gabriel Touré Bamako

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Epidemio-Clinical and Uretrocystographic Profile of Pathologies of the Lower Urinary Tract at the Chu Pr Bss of Kati

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Open Journal of Medical Imaging 2023年第1期13卷 40-48页

作者： Ilias Guindo Souleymane sanogo Alassane Kouma dramane Bagayoko Issa Diarra Mamadou N’diaye Ouncoumba Diarra Amadou Kassogue Salia Coulibaly Adama Diaman Keita Medical Imaging Department Kati University Hospital Kati Mali Department of Radiology Luxembourg Mother-Child Hospital Bamako Mali Radiology Department Bamako Infirmary Bamako Mali Medical Imaging Service CS Ref of Commune III Bamako Mali Department of Urology University Hospital of Kati Kati Mali Department of Radiology and Nuclear Medicine Point “G” University Hospital Bamako Mali

Introduction: Pathologies of the lower urinary tract are common in urology composed of various conditions, responsible for urinary disorders. Despite the new methods, exploration in Africa is mainly based on retrograde urethrocystography (UCR). The main objective was to determine the importance of UCR in the diagnosis of pathologies of the lower urinary tract. Materials and Methods: This was a retrospective and descriptive study covering a period of 5 years (July 2016-June 2021). It involved all patients admitted to the ward for retrograde urethrocystography during the period. A remote-controlled table of the GE PRESTILIX 1600× type was used for the examinations. Results: At the end of our study we collected 100 cases of pathologies of the lower urinary tract out of a total of 112 RCUs performed or 89.28%. Pathologies of the lower urinary tract accounted for 78% of the UCRs in the department. The age group of (61 - 70) was the most affected with extremes from 1 year to 101 years. Non-specific urination disorders were the most common indications (43%), followed by acute urine retention (18%). Acquired urethral pathology was the most common (89%), followed by bladder neck disease 5% and posterior urethral valve with 4%, Bladder struggle was the most common associated sign (54%) with post-urination residue in 97% of patients. Conclusion: Pathologies of the lower urinary tract are relatively common in our region, dominated by urethral narrowings. Retrograde urethrocystography remains the reference examination in our control for the diagnosis of obstructive pathologies of the lower urinary tract while specifying the seat of the obstacle.

关键词： Pathologies of the Lower Urinary Tract UCR CHU Kati

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Small Bowel Obstruction: Epidemiological, Clinical and Therapeutic Aspects in the General Surgery Department of Hôpital SominéDOLO de Mopti

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Surgical Science 2021年第6期12卷 196-203页

作者： Bréhima Traoré Modibo Coulibaly Djibril Traoré Oumar Guindo Fodé Mory Keita Nouhoum Samassekou Abdoulaye Traoré Souleymane sanogo Korotimi Mallé Kiffery Ibrahim Keita Pierre Coulibaly Aly Boubacar Diallo dramane Cissé dramane Samaké Lassana Kanté Department of General Surgery H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Biomedical Laboratory H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Public Health H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Surgery Polyclinique des armées Kati Mali Department of Anesthesia-Resuscitation H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Medical Imagery CHU Luxembourg Bamako Mali Department of Gynecology-Obstetrics H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Surgery H&ocirc pital de Sikasso Sikasso Mali Department of Medicine H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of General Surgery of CHU du Point-G Bamako Mali

Small bowel obstruction (SBO) is defined as a complete and persistent cessation of the transit of materials and gases. It occurs in a segment of the digestive tract located between the pylorus and the colorectal junction. We report an observational study which aims to describe the epidemiological, clinical and therapeutic aspects of small bowel obstruction. This study was carried out in the General Surgery Department of Hôpital Sominé DOLO de Mopti from October 1, 2016 to October 1, 2018. A total of 114 patients were recorded for whom the diagnosis was related to an occlusion. The median age was 37 years with extremes ranging from 6 months to 90 years. Male sex was predominant with a sex-ratio of 1.8. The frequency of small bowel occlusions over all occlusions was 74.03%. The most encountered clinical signs were as followed: abdominal pain (100%), vomiting (88.6%), cessation of materials and gas (79.9%) and meteorism (62.3%). All patients underwent medical imaging, the most common of which was an abdomen without preparation X-ray (AWP). On the etiological level, the main causes found postoperatively were: flanges and adhesion (55.2%), strangulated hernias (28.0%), acute intussusception (6.1%), small bowel volvulus (3.5%) and small bowel tumor (1.6%). Releasing the bridles was the most common surgery process (28.0%). The morbidity of the immediate follow-up was (13.1%) and the mortality was (7.0%). This high mortality is due to ignorance of the signs of seriousness and the socio-cultural barrier (decision of the patriarch to agree to a surgical intervention), the late use of hospital facility and the limited financial capability of the patients.

关键词： Occlusions of the Small Intestine Etiology Surgical Treatment Hôpital Sominé DOLO de Mopti

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Peritonitis Management through Appendicular Perforation in the Department of Surgery Bougouni Hospital (Mali)

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Surgical Science 2020年第12期11卷 446-452页

作者： Sidiki Keita Koniba Keita Mahamadou Coulibaly Moussa Sissoko Lamine Soumare Oumar Sacko Sekou Koumaré Adama K. Koita Soumaîla Keita M. Doumbia dramane Zimogo Zié sanogo General Surgery “A” Department Hospital Point-G. Bamako Mali General Surgery Department Hospital BSS Kati Mali

Introduction: Appendicular peritonitis is a complication of acute appendicitis characterized by the spread of the infectious process in the peritoneal cavity thus achieving wide spread or localized purulent peritonitis;it’s a medico-surgical emergency. Our objectives are to determine the frequency, describe the clinical, therapeutic and prognostic aspects of peritonitis by appendicular perforations. Patients-Method: This was a 24-month retro, prospective, descriptive study from January 1, 2018 to December 31, 2019;conducted in the Bougouni Reference Health Center Surgery Unit. All patients of appendicular peritonitis at the Bougouni Reference Health Centre were included. Results: During the study period, 68 cases of generalized acute peritonitis including 30 appendicular peritonitis cases were collected. Appendicular peritonitis accounted for 44.1% of surgical procedures. Males accounted for 71.0% with a sex ratio of 1.2 at risk of men, the average age was 26.07 years. Abdominal pain and vomiting were the reasons for consultation in 86.7% and 76.7% of cases. Physical examination was used in most cases to make the diagnosis. X-ray of the abdomen without preparation, and abdominal ultrasound were performed systematically. Surgical treatment consisted of an appendectomy with peritoneal toilet followed by drainage. The average length of hospitalization was 8.8 days with extremes of 1 - 44 days. Hospital mortality was 3.3%;morbidity and high mortality were related to delayed consultation. Conclusion: Appendicular generalized acute peritonitis is a medical-surgical emergency with a high mortality rate associated with delayed management.

关键词： Appendicular Peritonitis Surgical Emergencies Appendectomy

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The Place of Blood Transfusion in the Management of Obstetric Emergencies in the Gynaecology and Obstetrics Department of the Reference Health Center of Fana (Mali)

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Open Journal of Obstetrics and Gynecology 2023年第4期13卷 780-791页

作者： Keita Sema Kone Bokary Sidi Fané Seydou Sylla Cheickna Samake Youssouf Traoré Momine Traoré Solomane Haidara Ramatoulaye Diabate Abdrahamane Sylla Yacouba Keita Mamadou Coulibaly Mahamoudou Haidara Mamadou Haidara dramane Camara Daouda Fomba dramane Kampo Mamadou Maiga Boubacar Dembele Sitapha Seydou Z. Dao sanogo Siaka Amara Obstetrics and Gynecology Department Fana Reference Health Centre Koulikoro Mali Mohamed VI Mother-Child Polyclinic in Bamako Bamako Mali Department of Obstetrics and Gynecology Gabriel TOURE University Hospital Bamako Mali Department of Gynecology and Obstetrics Reference Health Centre of Koulikoro Koulikoro Mali Diola Reference Health Centre Dioila Mali Obstetrics and Gynecology Department Reference Health Centre of Commune I Bamako Mali Obstetrics and Gynecology Department Commune VI Reference Health Centre Bamako Mali Department of Gynecology and Obstetrics Kalaban Coro Reference Health Centre Bamako Mali Department of Gynecology and Obstetrics Kati Reference Health Centre Kati Mali Obstetrics and Gynecology Department Marakala Reference Health Centre Markala Mali Department of Obstetrics and Gynecology Timbuktu Hospital Timbuktu Mali National Blood Transfusion Centre Bamako Mali Department of Obstetrics and Gynecology Fousseyni Daou Hospital Kayes Mali Obstetrics and Gynecology Department Reference Health Centre of Commune II Bamako Mali

This is a prospective and descriptive study carried out at the gynecology and obstetrics department of the reference health center of Fana from 01 May 2019 to 30 November or 7 months. The main objective was to study the role of blood transfusion in the management of obstetric emergencies. During the study period we recorded 434 cases of obstetric emergencies of which 116 cases required an emergency blood transfusion or 26.73%. The most frequently found indications for blood transfusion are hemorrhages of the immediate postpartum 46.6% followed by severe malaria on pregnancy 27.6%. Blood remains the most prescribed and available Labile blood product in the department. Maternal prognosis was improved in 92.2%.

关键词： Obstetric Emergencies Blood Transfusion Hemovigilance

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Men’s Knowledge, Attitudes and Perceptions on Family Planning in Tourourou Village, Gogui Rural Commune, Nioro Circle, Kayes Region of Mali

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Open Journal of Obstetrics and Gynecology 2023年第3期13卷 662-680页

作者： Alou Samaké Sitapha Dembele Mamadou Keita Cheickna Sylla dramane Haidara Mamadou Haidara Mamadou Diallo Moussa Konaté Mariam Maiga Mohamed Saydi Agmed Elméhdi Elansari Djibril Kassogué Seydou Zana Dao Hawa Samaké Abdoulaye Nouhoun Coulibaly Brehima Samaké Coulibaly Moussa Mariko Seydou Abdoulaye Cissé Séma Kéita Siaka Amara sanogo Seydou Fané Reference Health Center of Commune VI of the District of Bamako Bamako Mali Department of Gynecology-Obstetrics of Fousseyni Daou Hospital in Kayes Kayes Mali Centre Hospitalo-Universitaire Gabriel Toure Bamako Mali Timbuktu Hospital Bamako Mali Reference Health Centre of Commune V of the District of Bamako Bamako Mali Kalaban Coro Reference Health Center Bamako Mali Nianankoro Fomba Hospital of Segou Segou Mali Reference Health Center of Commune II of the District of Bamako Bamako Mali National Institute of Training in Health Sciences Bamako Mali Regional Health Directorate of Kayes Kayes Mali Fana Reference Health Center Koulikoro Mali

Introduction: The involvement of men in reproductive health programmes and more specifically in family planning has always been of concern to the various development actors at both national and international levels. Objective: To study the births, ideas and opinions of men on Family Planning in the village of Tourourou. Material and Methods: This was a prospective cross-sectional, descriptive and analytic study from February 1 to July 31, 2020 in the village of TOUROUROU on the Knowledge, Attitudes and Perceptions of Men on Family Planning. We included in our study, all men residing in TOUROUROU whose age is between 14 and 99 years, who agreed to participate in the study. Results: Our study involved 200 men. The 25 - 29 age group was the most represented with 25.5%. The Soninke had represented 41%. In our study, 97.5% of men had heard of family planning, 62% had spontaneously cited at least one modern contraceptive method, and the pill ranked first with 64.5%. Radio and friends were the most frequent sources of information with 57.5% and 54.5% respectively. Birth spacing was the most cited family planning goal by men in 43.5% of cases. Men supported the practice of family planning in 50.5% of cases. Conclusion: In the village of Tourourou men play a crucial role in decision-making concerning the health of the couple and the family, their effective involvement in Reproductive Health especially in Family Planning will contribute enormously to the improvement of the health of the family.

关键词： Knowledge Attitudes Perceptions Men Planning Family

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Initial Experience with Open Heart Surgery in Sub-Saharan Africa:Challenges in Mali with Minimum Standards for Practice

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World Journal of Cardiovascular Surgery 2019年第9期9卷 108-118页

作者： Seydou Togo Moussa Abdoulaye Ouattara Abdoul Aziz Maiga Moussa Bazongo Issa Boubacar Maiga Cheik Ahmed Sekou Toure Ibrahim Coulibaly Sounkalo Diop Allaye Ombotimbe Sitta Illiassou Souleymane Coulibaly Mamadou Solo Koita Koumba Nelly Dora Ignanga Sanibe dramane Kone Moussa Oscar Kamano Fatoumata Konate Adama Issa Kone Amadou Sidibe Ahmadou Drame Nouhoum Oueloguem Bourama Kane Boubacar Drame Sekou Koumare Zimogo Zie sanogo Sadio Yena Department of Thoracic and Cardiovascular Surgery Mali HospitalBamakoMali Department of Anesthesiology and Critical Care Mali HospitalBamakoMali Department of Cardiologie Mali HospitalBamakoMali Department of Pediatrics Mali HospitalBamakoMali Department of Biomedical Laboratory Mali HospitalBamakoMali Department of Surgery“A” Point G HospitalBamakoMali

Introduction: There has been limited experience with Open Heart Surgeries (OHS) in Sub-Saharan Africa. In west Africa especially in Mali, most fledgling centers are unable to overcome the myriad of challenges encountered in establishing OHS though there is a high prevalence of surgically correctable heart diseases. The aim of this paper is to review our initial experience of our first cases in developing OHS program and discuss the challenges and prospects that need to be overcome to further develop it. Methods: A total of 6 patients who underwent OHS during the first “cardiac mission” in July 2016 were included in this retrospective study. The medical records of the patients were examined and data on age, sex, diagnosis, EuroSCORE, type of surgery, cardiopulmonary bypass details, complications and length of hospital stay were extracted. Results: Six patients with a male to female ratio of 1, ages ranging between 12 and 35 years (mean of 22.5 ± 12 years) were studied. The mean of EuroSCORE was 6 ± 41. Pericardial patch closure of isolated atrial septal defect was performed in one patient. One patient had mitral valve repair for rheumatic mitral regurgitation consisting of chordal shortening with a tricuspid valvuloplasty. Three patients had mitral valve replacement with tricuspid valvuloplasty. Four patients had mitral valve replacement. Sixty-day mortality?was 0%. Conclusion: Safe conduct of open heart surgery in Mali Hospital setting is feasible. Grant financial aid is required for rapid growth of Open-Heart Surgery in this part of Sub-Saharan Africa.

关键词： Open-Heart Surgery Mali Africa

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Epidemio-Clinical and Uretrocystographic Profile of Pathologies of the Lower Urinary Tract at the Chu Pr Bss of Kati

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Open Journal of Medical Imaging（医学影像期刊） 2023年第1期

作者： Ilias Guindo Souleymane sanogo Alassane Kouma dramane Bagayoko Issa Diarra Mamadou N’diaye Ouncoumba Diarra Amadou Kassogue Salia Coulibaly Adama Diaman Keita

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The Place of Blood Transfusion in the Management of Obstetric Emergencies in the Gynaecology and Obstetrics Department of the Reference Health Center of Fana (Mali)

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Open Journal of Obstetrics and Gynecology（妇产科期刊） 2023年第4期

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