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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

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

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

Ultrasound in Ti-Rads Classification of Thyroid Nodules at the Marie Curie Medical Clinic

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Open Journal of Medical Imaging 2024年第3期14卷 114-122页

作者： Traore Ousmane diakité Siaka Sidibe Drissa Mansa N’Diaye Mamadou Diallo Aissata Bagayoko Ousmane lansenou Camara Nagnoumague Coulibaly Modibo Cisse Issa Dembele Mamadou Sidibe Assan Traore Keita Adama Diaman Department of Radiology and Medical Imaging The Marie Curie Medical Clinic Bamako Mali Department of Radiology and Medical Imaging The Point G University Hospital Center Bamako Mali Teaching Researcher at the Faculty of Medicine and Odontostomatology The University of Sciences and Technologies of Bamako/USSTB Bamako Mali Department of Radiology and Medical Imaging The Health Center of the Military Camp Bamako Mali Medical Office Didinitata Bamako Mali

Introduction: A thyroid nodule is a localized hypertrophy within the thyroid parenchyma. The aim of our study was to study the benefit of ultrasound in the Ti-rads classification of thyroid nodules. Methodology: This was a prospective study with a descriptive aim, with prospective collection, which took place over a period of 17 months at the “Marie Curie” medical clinic. The ultrasound machine used was a Voluson E8 from 2011 and the examinations were carried out by two radiologists and two experienced sonographers. The parameters studied were sociodemographic data;clinical data and ultrasound aspects of the Ti-rads classification in the management of nodules. Results: We collected 235 patients out of 738 patients referred to the service for a cervical ultrasound, i.e. a frequency of 31.84% of cases. There was a female predominance with 95.7% of cases and a sex ratio of 0.04. The average age of our patients was 50 years. We found on cervical ultrasound: Isthmo-lobar glandular hyperplasia in 99 patients, i.e. a frequency of 42.1%. The Ti-rads 3 classification was the most represented in 69.4% of cases. The benignity criterion represented 85.6% of cases in our patients and the malignancy criterion represented 14.4% of cases. Conclusion: The precise description of a thyroid nodule provided by ultrasound (Ti-rads) is essential in the management of nodules.

关键词： Ultrasound Thyroid Nodules Ti-Rads “Marie Curie” Medical Clinic

Management of Acute Myeloblastic leukaemia (AMl) Treated with Intensive Chemotherapy: Experience in a Single Centre

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Open Journal of Pediatrics 2024年第2期14卷 401-411页

作者： Abdoul Karim Doumbia Hawa Konaré Tati Simaga Pierre Togo Oumoulkairi Nana Kouma Hawa Gouro Diall Oumar Coulibaly Adama Dembélé Mohamed Elmouloud Cissé Karamoko Sacko Belco Maiga Aminata Doumbia Kalirou Traoré Ibrahima Cissé Boury Traoré Abdoul Aziz diakité Fousseyni Traoré Boubacar Togo Department of Pediatrics University Hospital Gabriel Touré Bamako Mali

Introduction: Acute myeloblastic leukaemia (AMl) is a haematological malignancy with a poor prognosis, despite significant therapeutic progress. This study presents the results of AMl management in Mali according to GFAOP recommendations. Methodology: This was a retrospective, cross-sectional study. It included patients aged 0 - 15 years treated in the paediatric oncology unit for AMl and followed up between January 2016 and December 2020. Results: During the study period, 85 cases of acute leukaemia were diagnosed in the paediatric oncology unit (including 51 cases of All), of which 34 cases of AMl were included in this study. The majority were boys (59%). The mean age was 8 years, with extremes of 18 months and 15 years. The mean time to diagnosis was 68 days. In 79% of cases, patients were referred by 1st or 2nd level hospitals. Anaemia was observed in 91% of cases, an infectious syndrome in 68%, haemorrhage in 56% and a tumour syndrome in 85%. The haemogram showed hyperleukocytosis in 15% of cases, thrombocytosis in 22% and severe anaemia in 73%. Death occurred in 85% of cases, most often in the context of sepsis or haemorrhage. Conclusion: AMl is probably underestimated in Mali and diagnosis delayed, which may be explained by patient-related factors (lack of knowledge, financial constraints) and a cumbersome referral system. These results suggest the need to implement an appropriate diagnostic and therapeutic strategy, with strong involvement of the political authorities.

关键词： Acute Myeloblastic leukaemia Children Mali

Acute Pneumonia Characteristics in Children under Five Years of Age in Bamako, Mali

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Open Journal of Pediatrics 2019年第1期9卷 7-18页

作者： fatoumata Dicko-Traoré Abdoul Karim Doumbia Mariam Sylla Mariatou Traoré Djènèba Konaté fatoumata léonie diakité Karamoko Sacko Belco Maiga Hawa Diall Oumar Coulibaly Pierre Togo Fousseyni Traoré Abdoul Aziz diakité Yacouba Toloba Department of Pediatrics CHU Gabriel Touré Bamako Mali Faculty of Medicine and Odontostomatology Bamako Mali Department of Pneumology CHU Point G Bamako Mali

Pneumonia is the most common cause of mortality in child under five years of age. The objective of the study was to assess socio-demographic and clinical characteristics of children under 5 hospitalized for pneumonia. Material and method: We conducted a 6 months prospective study from June 1st, 2016 to December 31st, 2016 in the general pediatric service in the Pediatric Department of Gabriel Touré Teaching Hospital in Bamako, the capital city of Mali. Result: We have selected 63 cases of pneumonia according to our definition criteria, i.e. 2.2% of hospitalizations for children aged 1 to 59 months. The average age was 14 months. Infants under 2 years accounted for 82.53%. The sex ratio was 1.2. Seventy eight percent came from an unfavorable socio-economic background. The majority of mothers were uneducated (71.42%). Breastfeeding was exclusive up to 6 months in 50.79% of patients. Vaccination according to the national program was not up to date in 27% of patients. The average consultation time was 18 days. On admission, 81% of the patients had a fever, 93.64% had a tachypnea and 58.73% had crackling rales at pulmonary auscultation. Hypoxemia was present in 58.73%. Severe anemia was present in 79.36%. Radiologically, opacity was found in 42 patients (66.66%). The blood culture was positive in 8.3%. Beta-lactams were first-line prescribed in all patients. The case fatality rate was 9.52%. The factors associated with mortality were age less than 14 months (p = 0.08), adverse socio-economic conditions (p = 0.0003) and the presence of hypoxemia at the entrance (p = 0.01). Conclusion: Pneumonia remains major cause of morbidity and mortality in our context. Emphasis should be put on preventive measures.

关键词： Acute Pneumonia Children Mortality Mali

A unified 3D space-based navigation model for seamless navigation in indoor and outdoor

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International Journal of Digital Earth 2021年第8期14卷 985-1003页

作者： Jinjin Yan Sisi Zlatanova Abdoulaye diakité College of Intelligent Systems Science and Engineering Harbin Engineering UniversityHarbinPeople’s Republic of China GRID School of Built EnvironmentFaculty of ArtsDesign and ArchitectureUniversity of New South WalesSydneyAustralia

Seamless navigation has attracted lots of attention and many methods have been reported in the literature or made available as commercial *** process of navigation can be interpreted as a continuous movement of 3D objects from one unoccupied 3D indoor/outdoor space to *** a technical perspective,a 3D navigation model is one of the critical components that should be available to perform successful navigation.A major approach to build a unified navigation model to support seamless path computation is linking indoor navigation networks to outdoor road/street-based *** of different sources of indoor and outdoor navigation networks,the major approach fails to build up true seamless navigation *** regards to this,we propose a unified 3D space-based navigation model(U3DSNM).The presented model ensures all types of spaces for navigation(indoor,semi-indoor,semi-outdoor,and outdoor)have the same representation,management methods,and network derivation approach,thereby building up unified navigation networks to support seamless navigation paths *** model can be linked to the international standards(data models)that are also based on spaces,such as IndoorGMl and the on-going version of CityGMl *** navigation path planning cases show the feasibility of U3DSNM.

关键词： Indoor outdoor 3D space seamless navigation navigation model

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 diakité 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

Migration of a Progestin Implant into a Pulmonary Artery: Observation of a Case at the Reference Health Center of Commune III of the District of Bamako in Mali

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Open Journal of Obstetrics and Gynecology 2024年第9期14卷 1431-1436页

作者： Hamady Sissoko Souma Kodio Hamidou Albachar Cheickna Sylla Salif Diarra Sidy Moctar diakité Mohamed Traoré Souleymane Traoré Ibrahim Fomba Ouncoumba Diarra Nana Bah Drissa Diarra Mahamoudou Coulibaly Bocary Sidi Koné Hawa Samaké Ahmadou Coulibaly Mamadou Traoré Seydou Z. Dao Sitapha Dembélé Samou Diarra Konimba Koné Alou Samaké Sanogo Siaka Amara Reference Health Centre of Commune III of the District of Bamako Bamako Mali Department of Gynecology and Obstetrics Gabriel Toure University Hospital Center in Bamako Bamako Mali Department of Gynecology and Obstetrics Kalaban Coro Reference Health Centre Bamako Mali Mohamed VI Perinatal Clinic Bamako Mali Reference Health Centre of Commune V of the District of Bamako Bamako Mali Point-G Obstetrics and Gynecology Department of University Hospital Center Bamako Mali Reference Health Centre of Commune II of the District of Bamako Bamako Mali H Department of Gynecology and Obstetrics of the Fousseyni Daou Hospital in Kayes Kayes Mali Reference Health Centre of Commune VI of the District of Bamako Bamako Mali

It was a 36-year-old patient, 5th Pregnancy, 5th Delivery, 4 live children, and I deceased, had a consultation in the department for the removal of implants. Questioning revealed that she had had the implant three years ago without medical follow-up. It was in view of the difficulties in extracting the capsule that the chest X-ray and CT scan carried out concluded that the implant had migrated into a branch of the left pulmonary artery. Therapeutic abstention has been the attitude of cardiovascular surgeons.

关键词： Migration Implant Pulmonary Artery Bamako

Isolated Ventricular Septal Defect: Ultrasound, Therapeutic and Evolutionary Aspects of 85 Cases in the Cardiology Department of the Ignace Deen National Hospital in Conakry

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World Journal of Cardiovascular Diseases 2024年第8期14卷 465-479页

作者： Mamadou Bassirou Bah Amadou Diouldé Doumbouya Elhdj Yaya Balde Mamadou Aliou Balde Alpha Kone Ibrahima Sory Sylla Mamadou Dian Bah Aboulaye Bah Mamadou Diallo Thierno Siradjo Balde Abdoulaye Camara Morlaye Soumaoro Ibrahima Sory Barry Souleymane diakité Mamadou Dadhi Balde Cardiology Department of the Ignace Deen Hospital Conakry Guinea Cardiology Department Donka Hospital Conakry Guinea

Introduction: Ventricular septal defect (VSD) is the most common congenital heart disease of all congenital heart defects. The aim of this study was to investigate the echographic, therapeutic and evolutionary aspects of ventricular septal defects (VSD) in the general cardiology department of the Hôpital National Ignace Deen. Methods: A retrospective data collection was carried out from January 2018 to December 2023 including 85 cases of isolated IVC was performed. The variables studied were epidemiological, clinical, paraclinical, therapeutic and evolutionary. Results: Of the 320 patients seen during the study period for congenital heart disease, 85 (26.556%) were isolated IVCs. Age at diagnosis ranged from 3 months to 16 years, with an average age of 3.59 years. The most represented ethnic group was the Fulani (50.58%). The 8.24% came from consanguineous marriage versus 22.35%. 91.76% of children had a history of bronchitis. The most common clinical signs found were systolic murmur (90.58%), growth retardation (51.76%). Only 4 cases (4.70%) had a malformation associated with IVC represented by DiGeorges disease (2.35%) and trisomy 21 (2.35%). Nearly half the patients had type IIb VIC (44.71%). The other half were represented by type 1 (18.82%), type IIa (20%), type III (10.59%) and type IV (5.88%). According to site more than two-thirds of VICs (71.64%) were perimembranous in location, followed by infundibular (16.47%) and muscular (11.76%) VICs. In our study 55.29% presented an indication for both surgical intervention and medical treatment, while 16.47% required only medical treatment. In contrast, 28.23% were placed under exclusive surveillance. Of the 47 patients for whom surgery was indicated, 29 (61.17%) underwent surgical repair, while 18 (38.83%) were awaiting confirmation for surgery. Conclusion: VIC is the most common congenital heart disease. An early detection strategy and the establishment of specialized centers could improve the outcome of these chil

关键词： Ventricular Septal Defect Congenital Heart Disease Ignace Deen