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Serious Myasthenia at the Department of Internal Medicine of Point G University Teaching Hospital: A Clinical Case

Neuroscience & Medicine 2019年第3期10卷 207-212页

作者： Assétou Kaya Soukho Djenebou Traoré Adramé Keita Djibril Sy Guida Landouré Seybou Hassane Diallo Youssouf Fofana Kaly Keita Mamadou Mallé Ibrahima Amadou Dembélé Drissa sangaré Mamadou Cissoko Barry Boubacar sangaré Mamadou Dembélé Abdel Kader Traoré Hamar Alassane Traoré Department of Internal Medicine Point G University Teaching Hospital Bamako Mali Department of Neurology Point G University Teaching Hospital Bamako Mali Department of Neurology GABRIEL TOURE University Teaching Hospital Bamako Mali Department of Internal Medicine Mother-Child Hospital “Luxembourg” Bamako Mali

Introduction: Myasthenia is a rare and disabling autoimmune disease. Few studies were devoted to this pathology. We report a clinical case of myasthenia in the Department of Internal Medicine at the Point G University Teaching Hospital. Observation: This is a 41-year-old patient of Malian origin, a trader with a history of hemorrhoidectomy in 2011 and familial hypertension, was admitted on August 19, 2014, for muscle weakness, dysphonia, and dysphagia. The disease started 1 year before admission at the department with progressive muscle weakness of the upper limbs aggravated by repetitive movements and spreading to the head “drooping head” and inferior limbs, associated with general fatigue, dysphonia and selective dysphagia for solid foods. The diagnosis of myasthenia was maintained based on the clinical signs such as ptosis, bilateral diplopia, and weakness with lower limbs muscle strength rated at 3/5, and confirmed with confirmatory exams;a positive anti-acetylcholine receptor antibody (RIA), the post-synaptic neuromuscular conduction block at ENMG and the positive neostigmine pharmacological test. The patient received Neostigmine (prostagmine) 0.5 mg one ampoule in IM/day and Prednisone at a dosage of 1 mg/kg/day. The evolution was marked by a moderate improvement of the symptomatology afterward the patient was evacuated to Tunisia on family request where he received a course of immunoglobulin 2 g/kg in 2 days. The evolution in Tunisia was favorable. The patient returned in Mali and death occurred after 2 months in a context of respiratory distress. Conclusion: Myasthenia is a rare but serious disease requiring careful management and monitoring to reduce respiratory complications.

关键词： Myasthenia Immunoglobulin Internal Medicine Point G Hospital

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Assessment of Wastewater Management and Health Impacts in African Secondary Cities: Case of Dimbokro (Côte D’Ivoire)

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Journal of Geoscience and Environment Protection 2016年第8期4卷 15-25页

作者： Sandotin Lassina Coulibaly Drissa sangaré Sylvain Kouakou Akpo Seydou Coulibaly Habib Ben Bamba Lacina Coulibaly Unité de recherche en Biotechnologie et Ingénierie de l’Environnement Université Nangui Abrogoua Abidjan C&#244te D’Ivoire Service Hydraulique et Assainissement TERRABO Ingénieur Conseil Abidjan C&#244te D’Ivoire

The majority of population growth in developing countries will occur in secondary cities where there is limited access to clean water and sanitation. Wastewater management priorities in these cities will be different from those in larger cities and developed countries. For this reason, it is important to assess wastewater management in these cities of sub-Saharan Africa. This study assessed clean water supply, wastewater and faecal sludge management and associated health risks in Dimbokro, C?te D’Ivoire. The study was performed in March 2015 in 12 neighborhoods with a total of 703 households. In these neighborhoods, the questions were addressed and discussed with household head. The study revealed that the households of the city were structured on three topology habitats: residential (5%), economic (42%) and evolutive or yards housing (53%). For water supply, 99.4% of the households used water from SODECI, the local public water supply network, while the remaining 0.6% of surveyed household obtained water from wells. Domestic wastewater, used for doing laundry, dishwashing and showering, was disposed of in the following ways: directly into the street (33%), septic tank (23%), backyards (18%), storm drain (16%), sewer network (6%), pit latrine (3%) or into soakaway (2%). In addition, untreated wastewater was sometimes discharged into the N’Ziriver by certain households. 52% of households surveyed emptied latrines manually and 48 % used mechanic drain services. The most frequent diseases occurring in the households were Malaria (63%), Diarrhoea (13%) and Typhoid fever (9%) in the households of the city. In the light of this study, the municipal authorities of Dimbokro should provide the city with wastewater systems that drain to a central outlet system where the waste-water can be easily treated before final disposal for reuse in agriculture.

关键词： Diseases Households Faecal Sludge N’Zi River Secondary Cities Wastewater

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Etiological and Evolutionary Profile of Anemia in Patients Hospitalized in the Internal Medicine Unit of the Fousseyni Daou Hospital in Kayes

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Open Journal of Internal Medicine 2023年第1期13卷 51-61页

作者： sangaré drissa Cissé Sékou Mamadou Guindo Youssouf Abdoulaye Diawara Diakité Niagalé Boly Berthé Bréhima Keita Kaly Issa Diallo Traore Djenebou Soucko Kaya Assetou Internal Medicine Unit Kayes Hospital Kayes Mali National Center for Scientific and Technological Research (CNRST) Bamako Mali Cardiology Unit Kayes Hospital Kayes Mali Imaging Unit Kayes Hospital Kayes Mali Nephrology Unit Kayes Hospital Kayes Mali Army Health Service Bamako Mali Point G Hospital Internal Medicine Department Bamako Mali Faculty of Medicine of Bamako Bamako Mali

Introduction: Anemia is one of the most common public health problems in the world and affects all ages. Objective: To describe the etiological and evolutionary profile of anemia in patients hospitalized in the Internal Medicine Unit of the Fousseyni Daou Hospital in Kayes. Methodology: It was a descriptive and cross-sectional study with retrospective data collection which took place from January 1 to December 31, 2020 at the Internal Medicine Unit of the Fousseyni Daou Hospital in Kayes. It covered all anemic patients hospitalized during the study period. Results: We identified 91 cases of anemia out of 200 patients admitted to the Unit that is a hospital prevalence of 45.5%. The age group of 26 to 35 years was the most represented, that is to say 29 cases (31.87%) with an average age of 43.55 years ± 17.48 years, the female sex predominated, 51 cases (56.04%) with a sex ratio of 0.78. Housewives represented 41 cases (45.05%). The majority of patients resided in rural areas 48 cases (52.75%). The main manifestations were: asthenia 75 cases (78.02%), vertigo 68 cases (74.72%), dyspnea 62 cases (68.13%), headaches 59 cases (64.83%), palpitations 55 cases (60.44%), conjunctival pallor 53 cases (58.24%), tachycardia 43 cases (47.25%), systolic murmur 18 cases (19.78%) and IMO 11 cases (12.09%). The associated pathologies were: infected diabetic wounds 25.27%, followed by bacterial pleuro-pneumopathy 18.68%. Biologically, microcytic anemia was the most frequent 49 cases (53.84%), followed by normocytic anemia 35 cases (38.46%) and macrocytic anemia 7 cases (7.7%). Anemia was hypochromic, 53 cases (58.24%) were more encountered compared to normochromic anemia 38 cases (41.76%). The anemia was: severe in 43 cases (47.25%), moderate 29 cases (31.87%) and mild 19 cases (20.88%). Inflammatory anemia is the most common etiological diagnosis in 60% of cases, followed by vitamin B12 deficiency anemia observed in 21% of patients and then blood diseases in 7.33% of cases. The main causes of death were HIV (50%) and kidney fail

关键词： Anemia Etiology Evolution Internal Medicine Fousseyni Daou Hospital Kayes Mali

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Surgical Treatment of Recent Traumatic Epiphyseal Detachments of the Distal Femur in the Orthopedic and Traumatological Surgery Department of the CHU Bocar Sidy Sall de Kati: About 20 Cases

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Surgical Science 2023年第5期14卷 338-346页

作者： Souleymane Diallo Sory Ibrahim Tambassi Kaly Tounkara Terna Traore Kalifa Coulibaly Aboubacar Diallo Soumana Traore Aboubacar Sidiki sangaré Salif Kone drissa Kaloga Bagayoko Cheick Oumar Sanogo Department of Orthopedics and Traumatology CHU Pr Bocar Sidy Sall of Kati Kati Mali Department of Orthopedics and Traumatology Etablissement Public Hospitalier Sikasso Sikasso Mali Department of Anesthesia and Intensive Care University Hospital of Luxembourg Bamako Mali

Introduction: To our knowledge, no scientific study has been conducted at the university hospital of Kati on recent traumatic epiphyseal detachment fractures of the distal femur. However, every day, children present in consultation for knee trauma. Conjugal plate fractures are by definition single to children. Any break in any solution of continuity of this plate is called an epiphyseal fracture or detachment. Objectives: To evaluate the results of surgical treatment of traumatic epiphyseal in detachments of the distal femur recent in children and adolescents. Patients and Method: This was a 13-month prospectively collected longitudinal descriptive study from September 1, 2016 to September 30, 2017. We identified and reviewed 20 medical records of recent traumatic epiphyseal detachments of the distal femur. The parameters studied were sociodemographic, lesion, surgical technique and evolutionary. Results: During the study period, the most affected group age was 12 to 17 years (85%) with an average of 14.65 ± 1.61 years (6 and 20 years). The victims were male (95%). The most frequent etiology was road traffic accident (95%), with a mean time to care of 26.42 ± 10.21 hours and Type II was frequently encountered (85%) with 35% of immediate complications. Cross-bracketing was the most commonly used surgical technique (85%). The result was good (65%). Conclusion: This study allowed us to observe a significant hospital incidence of epiphyseal detachment fractures of the distal femur. Cross pinning was the most commonly used surgical technique with fewer complications (35%) and a satisfactory result in 90% of cases.

关键词： Fractures Epiphyseal Detachments Distal End of Femur Pinning

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Epidemiological, Clinical, Bacteriological Profile of Urinary Tract Infection in the Internal Medicine Unit of the Fousseyni Daou Hospital in Kayes

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Open Journal of Internal Medicine 2023年第1期13卷 62-75页

作者： sangaré drissa Cissé Sékou Mamadou Guindo Youssouf Abdoulaye Diawara Diakité Niagalé Boly Berthé Bréhima Keita Kaly Issa Diallo Traore Djenebou Kaya Assetou Soucko Internal Medicine Unit Kayes Hospital Kayes Mali National Center for Scientific and Technological Research (CNRST) Bamako Mali Cardiology Unit Kayes Hospital Kayes Mali Imaging Unit Kayes Hospital Kayes Mali Nephrology Unit Kayes Hospital Kayes Mali Army Health Service Bamako Mali Point G Hospital Internal Medicine Department Bamako Mali Faculty of Medicine of Bamako Bamako Mali

Introduction: Urinary tract infection is one of the most frequent public health problems in the world and concerns all ages. Objective: To describe the epidemiological, clinical and biological profile of urinary tract infection in the internal medicine unit of the Fousseyni Daou hospital in Kayes. Methodology: It was a descriptive and cross-sectional study with retrospective data collection which took place from January 1 to December 31, 2020 at the Internal Medicine Unit of the Fousseyni Daou Hospital in Kayes. It covered all outpatients and hospitalized patients presenting with a urinary tract infection during the study period. Results: We identified 79 cases of urinary tract infection out of 145 requests for ECBU, that is a positivity rate of 53.10% and out of a total of 1883 admissions that is a hospital prevalence of 4.19%. The age groups of 36 to 45 years and 46 to 55 years were more represented in 28 cases (35.44%) and 25 cases (31.64%) with an average age of 45 years ± 10. The female sex was predominant, 42 cases (53.16%) with a sex ratio of 0.88. Housewives were more represented 28 cases (34.44%). The majority of patients resided in rural areas 49 cases (62.03%). The history was dominated by the following pathologies: hypertension 48.10%, diabetes 36.70% and gastropathy 30.37%. The main clinical manifestations were: Urinary burning 67 cases (84.81%), Dysuria 65 cases (82.27%), Pelvic pain 59 cases (74.68%), Fever 57 cases (72.15%). The epidemiological profile of the isolated strains was dominated by enterobacteriaceae, followed by gram-positive cocci and gram-negative bacilli. The main bacteria responsible for urinary tract infections in order of frequency: Escherichia coli (45.56%), Klebsiella pneumoniae (11.39%), Pseudomonas aeruginosa (8.86%), Staphylococcus aureus (7.59%), Streptococcus sp (6.33%), Enterobacter cloacae (3.79%), Acinetobacter sp (3.79%). The study of the susceptibility and resistance profiles of the isolated strains showed significant sensitivity of enterobacteriaceae to colistin and

关键词： Urinary Tract Infection Epidemiology Clinic Bacteriology Internal Medicine Fousseyni Daou Hospital Kayes Mali

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Profile of Urinary Tract Infections in the Elderly in the Internal Medicine Department of the University Hospital Center of Point G, Bamako, Mali

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Open Journal of Nephrology 2021年第2期11卷 217-229页

作者： Drissa sangaré Magara Samaké Nanko Doumbia Aboubacar Sidiki Fofana Sékou Mamadou Cissé Seydou Sy Atabième Kodio Moctar Coulibaly Sah dit Baba Coulibaly Djibril Sy Kaya Assétou Soucko Mamadou Dembélé Saharé Fongoro Department of Medicine and Medical Specialty The Fousseyni Daou Hospital Kayes Mali Faculty of Medicine of Bamako Bamako Mali Nephrology Unit of Fousseyni Daou Hospital Kayes Mali Medicine Department of Mali Hospital Bamako Mali Nephrology Department of the University Hospital Center of Point G Bamako Mali Nephrology Unit of Mali Gavardo Hospital Bamako Mali Nephrology Unit of Somino Dolo Hospital Mopti Mali Internal Medicine Department of the University Hospital Center of Point G Bamako Mali

Introduction: Urinary tract infections (UTI) are frequent and of polymorphous clinical symptomatology in elderly subjects both in and out of hospital. In Mali, to our knowledge, no study concerning UTIs in the elderly has been conducted, hence the interest in this innovative work. Objectives: To determine the prevalence and clinical and paraclinical aspects of urinary tract infections in the elderly. Materials and Methods: This was a prospective descriptive and cross-sectional study from September 1, 2013 to August 31, 2014, i.e. duration of 12 months. All patients aged 65 years and over, hospitalized or ambulatory in the internal medicine department with a documented urinary tract infection were included. Results: We collected and examined 194 patients. The cytobacteriological study of urine (CBSU) was positive in 28 patients, i.e. a prevalence of 14.43%. The male sex represented 59.8% of the cases, the sex ratio was equal to 1.46. The age groups between 65 - 69 and 70 - 74 years were the most affected, respectively 28.57% and 39.28%. The main clinical signs were: asthenia, anorexia, dependence, fever, urinary burning, dysuria. Hospitalization was associated with urinary tract infection with P = 0.01. The group of enterobacteria were incriminated in 75% of cases. Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa represented 39.28%, 14.28% and 10.71% of cases. Urinary tract infections were represented by pyelonephritis, acute prostatitis, orchi-epididymitis and simple cystitis. Conclusion: Urinary tract infection is frequent in the elderly, its clinical presentation is polymorphic and enterobacteria are the most incriminated group of bacteria.

关键词： Urinary Tract Infection Elderly Subject Internal Medicine Point G Hospital Mali

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Podiatric Risk Assessment in Diabetic Patients at University Hospital Center of Point G

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Open Journal of Endocrine and Metabolic Diseases 2019年第8期9卷 85-94页

作者： Sy Djibril Traoré Abdel Kader Soukho Assétou Kaya Traoré Djenebou Thomas Ingrid Gladys Keita Zakaria Dembelé Ibrahima Amadou Cissoko Mamadou sangaré Barry Boubacar Togo Mamadou Keita Kaly Keita Adramé Tolo Nagou Camara Boua Daoud Dao Karim Doumbia Alassane Alfousseni Saliou Mahamadou Fofana Youssouf Mallé Mamadou Traoré Abdramane sangaré drissa Cissé Sékou Mamadou Berthé Brehima Boly Sanogo Abasse Sy Seydou Dembélé Mamadou Traoré Hamar Alassane Department of Internal Medicine of University Hospital Center of Point G Bamako Mali Association “Rabies in West Africa—Mali” Bamako Mali Internal Medicine Service Kati Hospital Koulikoro Mali Department of Internal Medicine Nianankoro Fomba Hospital Segou Mali Department of Medicine Regional Hospital Gao Mali Department of Medicine Regional Hospital Sikasso Mali Department of Medicine University Hospital Center Gabriel Toure Bamako Mali Department of Internal Medicine Hospital Center Mother-Child Luxemburg Bamako Mali Department of Medicine Fousseyni Daou Hospital Kayes Mali Department of Nephrology University Hospital Center of Point G Bamako Mali

Introduction: Diabetes, a chronic pathology, is the source of many acute and chronic complications whose treatment requires many daily constraints that can have a serious impact on the quality of life of the patient and his family. The diabetic foot is a real public health problem which is still dominated by a very high lower limb amputation rate even in countries with high socioeconomic status. The diabetic foot classically results from the association of three entangled mechanisms which are neuropathy, arteriopathy and infection. Objectives: To determine the frequency of arterial disease, neuropathy, and other aggravating factors that influence the podiatry risk, and to proceed with the gradation of the podiatry risk. Methodology: This was a cross-sectional study concerning the period from July 1 to October 31, 2017, covering all diabetic patients received in consultation and hospitalization in the Internal Medicine Department of the G-University Hospital Center. Results: Our study included 50 patients (35 women for 15 men) out of 95 diabetic patients receiving a frequency of 52.6%, with a sex ratio of 0.42. The average age of our patients was 54.38 ± 13.98 years. Overweight/obesity found in 44% of patients. The average Body Mass Index (BMI) of our patients was 27.16 kg/m2. Patients with diabetes less than 5 years old represented 56% with an average duration of 5.39 ± 5.34 years. The mode of discovery of diabetes was polyuria-polydipsia syndrome in 56% of cases. Type 2 diabetes represented 74% of patients. Among the patients who had performed the HbA1C test, 80.77% were not well balanced. The antecedent of macrosomia in women accounted for 77.1%. Patients who did not know foot hygiene recommendations accounted for 82%. Among the identified podiatry risk factors, diabetic neuropathy accounted for 73.8%, and arterial disease was 32.3%. Grade 1 patients in our study accounted for 52% (gradation of foot risk). Conclusion: The diabetic foot is a major public health problem because of its frequency, its direct and in

关键词： Monitoring Diabetes Foot Risk Mali

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