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Epidemiological, Clinical, Therapeutic, and Evolutionary Aspects of Heart Failure in the Medical Department at Gao Regional Hospital

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World Journal of Cardiovascular Diseases 2024年第5期14卷 309-321页

作者： Coulibaly Alhousseny Dollo ibrahim guindo Hamadoun Sidibé Lamine Mariko Souleymane Traoré Bassirima Dao Karim guindo ibrahim Togo Mamadou Sidibé Samba Sangaré ibrahima Ba Hamidou Oumar Ichiaka Menta Departement of Medicine Gao Hospital Gao Mali Departement of Medicine Mopti Regional Hospital Mopti Mali Departement of Medicine Tombouctou Hospital Tombouctou Mali Departement of Cardiology CHU Gabriel TOURE Bamako Mali

Introduction: Heart failure is a major public health pandemic, particularly in Africa, where its prevalence continues to increase. In northern Mali, few data exist, hence the interest of this study with the objective of studying the epidemiological, clinical and therapeutic and evolutionary aspects of Heart failure at the regional hospital of Gao. Patients and Methods: This was a cross-sectional, descriptive study that took place from July 2022 to June 2023 in the medical department at Gao Hospital. Results: The hospital prevalence of heart failure was 44.1%. The mean age was 47.30 ± 20 years (range: 16-88). Hypertension was the most common with 46.1%, followed by a sedentary lifestyle, and diabetes with 18.2% and 8.3% respectively;NYHA stage III-IV dyspnea was found in 83.9%. Reduced EF heart failure was present in 110 patients (76.9%), seventeen cases with moderately reduced EF (11.9%) and sixteen patients had preserved EF (11.2%). Global heart failure was the dominant (91.6%). The main etiologies of heart failure were dominated by hypertensive heart disease in 46 patients (32.2%), followed by postpartum cardiomyopathy with 43 cases (30.1%), primary dilated cardiomyopathy in 18 patients (12.6%), ischemic heart disease in 16 patients with 11.2%. Seven cases of valvular heart disease, or 4.9%. The evolution was favorable under treatment in 104 patients or 72.7%. In-hospital mortality was 14.7%. Conclusion: Heart failure is a common condition in sub-Saharan Africa, particularly in our country.

关键词： Heart Failure Epidemioclinical Progressive Gao Hospital

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Pulmonary Hypoplasia: A Rare Cause of Chronic Cough in TB Endemic Area

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Open Journal of Respiratory Diseases 2019年第1期9卷 18-25页

作者： Ouattara Khadidia Kanoute Tenin Baya Bocar Soumaré Dianguina Kamian Youssouf Mama Sidibé Youssouf Fofana Aminata Traoré Mohamed Maba guindo ibrahim Sidibe Fatoumata Dakouo Aimé Paul Sanogo Fatoumata Bintou Bamba Salimata Coulibaly Lamine Yossi Oumar Kone Drissa Samba Toloba Yacouba Department of Pneumology University Teaching Hospital of Point G Bamako Mali Department of ENT Secondary Hospital “Luxembourg” Bamako Mali Department of ENT Nianakoro Fomba Hospital Ségou Mali Department of Radiology Hospital of Mali Bamako Mali

Pulmonary hypoplasia is a rare disease characterized by a defect of lung development more often unilateral. The diagnosis requires several exams to eliminate other causes of pulmonary retraction. We report two cases at the department of pneumophtisiology of the University Teaching Hospital of Point G. The first case is a young adult who was complaining of a chronic cough. Etiological investigation required several exams including spirometry and Computed tomographic scan (CT scan). After elimination of all suspected causes of pulmonary opacity, the diagnosis of pulmonary hypoplasia was retained. The second case is a 2-year-old girl who was born with congenital cardiopathy whose respiratory complications were increasing during her childhood and respiratory explorations discovered pulmonary agenesis. Pulmonary hypoplasia is rare in our medical practice, but attention must be drawn to a retractile pulmonary opacity in young age after elimination of all infectious causes in TB endemic area.

关键词： A Chronic Cough Pulmonary Hypoplasia Bamako

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Mutations in Spike Gene of SARS-CoV-2 that Are Associated with a Higher Viral Load: A Clinical Case Study

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Case Reports in Clinical Medicine 2022年第11期11卷 474-486页

作者： ibrahim Keita Garan Dabo Lassina Doumbia Youssouf Diarra ibrahim Traoré Mariam Traoré Lansana Sangaré Yacouba Toloba Mahamadou Alpha Diallo Djeneba Sy Andres H. Gutierrez Aliou Sissako ibrahim guindo Mohamed Diallo Akory Ag Iknane Anne S. De Groot Ousmane Aliou Koita Laboratoire de Biologie Moléculaire Appliquée Université des Sciences Techniques et des Technologies de Bamako Bamako Mali Hô pital du Mali Ministère de la Santé Publique et du Développement Social Bamako Mali Centre Hospitalo-Universitaire du Point G Ministère de la Santé Publique et du Développement Social Bamako Mali EpiVax Inc. Providence USA Institut National de Santé Publique Ministère de la Santé Publique et du Développement Social Bamako Mali Center for Vaccines and Immunology College of Veterinary Medicine University of Georgia Athens USA

Background: Quantitative PCR (qPCR) can be used to detect and quantify a load of a pathogen. It is a good indicator of the degree of transmissibility. While performing routine qPCR, we observed an unusually short cycle threshold (Ct) value of SARS-CoV-2 for a clinical specimen obtained in Bamako, Mali. This prompted us to sequence the short-cycle SARS-CoV-2 sample to identify potential mutations in the Spike gene (S gene) gene. Methods: Post-infection, Quantitative Reverse Transcription (qRT-PCR) was performed over a defined time course to estimate the Ct of the SARS-CoV-2 specimen collected from the patient. Sanger sequencing was done on the entire fragment of the S gene to identify mutations. Findings: Sanger sequencing revealed mutations in the lineage of interest, designated B.1.525 by Pango, and also known as “Eta” using the nomenclature defined by WHO. This variant was originally found in Nigeria and Italy. The four novel mutations identified in Eta (D228N, Y451N, I1172M, and C1250F) were otherwise observed with a low frequency worldwide. Although the initial Ct was 10 in the case study patient, he did not exhibit severe symptoms of SARS-CoV-2, for example, pneumonia. However, we observed a longer viral clearance period than usual, of 3 weeks. We note that as compared to SARS-CoV-2 samples obtained during the first peaks of SARS-CoV-2 infection in Mali, when the infection was at its peak in March 2020 (Ct = 30.4), circulating strains evaluated at the time the Eta sample was obtained demonstrated a lower mean Ct (Ct = 24). Conclusions: The short cycle threshold associated with this variant, and the temporal association with a decrease in the mean Ct in the region of Bamako, may indicate higher levels of transmissibility due to a circulating variant. This variant is a lineage of interest designated B.1.525 by Pango or Eta by WHO.

关键词： SARS-CoV-2 Variant Eta Ct Value Mali

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Overview of Child Otological Care at the Reference Health Center of Commune V, Bamako

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International Journal of Otolaryngology and Head & Neck Surgery 2023年第4期12卷 203-213页

作者： Djibril Samaké Kadidia Bagayoko Neuilly Ghislaine Tafo Ngniée Siaka Soumaoro Boubacary guindo Fatogoma Issa Koné Sinaly Thiocary Yatemelou Dara Fatoumata Konaté ibrahim Diébakaté Kadidiatou Singaré Samba Karim Timbo Mohamed Amadou Kéïta ENT and Head and Neck Surgery Department Commune V Reference Health Center Bamako Mali

Aim: To profile the diagnostic and the care provided for otological conditions in children. Method: This was a prospective cross-sectional study carried out from March 1, 2022 to May 30, 2022 at the ENT Unit of the Reference Health Center of Commune V (Bamako). This study concerned the records of children with an otological condition. They were at their first consultation within the unit. The month of March was devoted to recruitment. The follow-up was done until the end of May. The parameters studied included epidemiological, clinical and therapeutic aspects. Results: We identified 184 children suffering from otological conditions out of a total of 559 patients that consulted during March 2022, i.e. an hospital prevalence of 32.9%. This study found ear infections in 60.3%. Earwax and epidermal plugs accounted for 32.60%. Traumatic injuries were 4.3%. Pre-lingual deafness was found in 1.1% of cases. Antibiotics were used for treatment in 66.3% of children without any complications detected. Conclusion: The otological affections of the child were frequent with a predominance of otitis.

关键词： Otological Disorders Otitis Child Care

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Systemic Lupus Erythematosus Complicated by Pericarditis: A Case Report from the guindo Clinic in Bamako, Mali

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Open Journal of Pediatrics 2023年第1期13卷 16-20页

作者： Kalirou Traoré Karamoko Sacko Souleymane Mariko Belco Maiga Hawa Konaré Adama Dembélé Mohamed Cissé Fousseyni Traoré ibrahim Dollo Fatoumata Traore Arouna Ouattara Aminata Doumbia Mamadou Traore Djeneba Konate Pierre Togo Abdoul Karim Doumbia Gassama Diaby Abdoul Aziz Diakité Ali guindo Fatoumata Dicko Mariam Sylla Boubacar Togo Department of Pediatrics Gabriel TOURE University Hospital Bamoko Mali guindo Clinic of Bamako Bamoko Mali Mopti Hospital Mopti Mali Reference Health Center of Commune V Bamoko Mali Bamako Dermatology Hospital Bamoko Mali

Juvenile systemic lupus erythematosus is a rare entity, affecting children under 16 years of age. Girls are more often affected than boys and the female predominance increases significantly with age. The initial manifestations are highly variable with an insidious and progressive onset. Non-specific symptoms include fever, anorexia, weight loss and asthenia. Pericarditis is the most common cardiac manifestation in systemic lupus erythematosus (SLE), occurring in 10% to 40% of cases. The biological elements of the diagnosis and follow-up of pediatric SLE are identical to those of adults and are based on regular measurement of complement, native anti-DNA antibodies, and inflammatory findings. Treatment is essentially based on corticosteroid therapy.

关键词： Lupus Child Pericarditis Clinic guindo Bamako Mali

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Audiometric Profile of Deafness at the University Hospital Center Gabriel Toure of Bamako

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International Journal of Otolaryngology and Head & Neck Surgery 2020年第1期9卷 38-45页

作者： Kassim Diarra Boubacary guindo Youssouf Sidibé N’faly Konaté ibrahim Fofana Drissa Kaloga Bagayoko Fatogoma Issa Koné Siaka Soumaoro Doumbia Kadidiatou Singare Samba Karim Timbo Mohamed Amadou Keita ENT and Head and Neck Surgery Department CHU Gabriel Toure Bamako Mali ENT and Head and Neck Surgery Department CHU Mother-Child “Luxembourg” Bamako Mali Department of Anesthesia Resuscitation CHU Mother-Child “Luxembourg” Bamako Mali

Objective: To determine the audiometric profile of deafness in our practice. Materials and Methods: Longitudinal prospective study was conducted out in the ENT department and cervicofacial surgery of Gabriel Toure University Hospital in Bamako, we made an exhaustive sampling of all the patients who consulted for hearing loss, tinnitus, vertigo, hiring report, medical expertise and whose deafness was confirmed to tonal audiometry with an age greater than or equal to 15 years. It was spread over 10 months (June 2016 to March 2017). A total of 200 patients were collected. Exclusion criteria were all patients under 15 years of age as well as deafness related to earwax or foreign bodies, and refusal to participate in the study Results: During our study period, 6055 outpatients were admitted out of which 734 patients underwent audiometric testing and 200 patients (3.30%) met our criteria. The male sex was the most represented with a rate of 60%. The sex ratio was 1.5 or 3 men for 2 women. The 15 to 25 age group was the most represented at 37.5%. The average age was 37.18 years old with extremes ranging from 15 to 83 years old. Pupils/students were the most represented with a rate of 29.5%, followed by housewives in 23%, farmers in 10.5% and military in 10%. As antecedent 26% of our patients had a chronic otitis media (OMC), against 23% who had no antecedent otological and 17% had a traumatic antecedent. Bilateral deafness was the most common with a rate of 64.5%. The mode of progressive appearance was the most frequent in 74.5%. As functional signs 46.22% of our patients had a hearing loss associated with tinnitus. Otoscopic examination was pathological in 34.5% of our patients. Mixed deafness was the most common in 43.35%, followed by perception deafness in 32.19% and transmission deafness 24.46%. Mean deafness was the most common with a rate of 48.91%, was severe in 20.22%, mild in 18.31%, deep in 11.47% and cophotic in 01.09%. Asymmetrical curves were the most found in 65.89% of our patients. Conclusion: Deafness is

关键词： Deafness Tonal Audiometry Bamako

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Clinical and Therapeutic Aspects of Giant Fibroids at the Hôpital du Mali about 30 Cases

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Open Journal of Obstetrics and Gynecology 2020年第6期10卷 778-789页

作者： Mamadou B. Coulibaly Alassane Traore Mody A. Camara Abdrahamane Togo Adama Sangaré Issa Ongoiba Kalba Timbine Amadou Sidibé Apérou guindo Niani Mounkoro ibrahim Teguete Youssouf Traore Moustaphe Toure Service of Gynecology of the Hopital du Mali Bamako Mali Service of Medical Imaging of the Hopital du Mali Bamako Mali Service of Anesthesia and Resuscitation of the Hopital du Mali Bamako Mali Service of Gynecology-Obstetrics of Gabriel TOURE Teaching Hospital Bamako Mali

The fibroids affect 20% to 25% of women of reproductive age and are 3 to 9 times more common in black women. We’ll talk about giant fibroids (GFs) when uterine height reaches or exceeds the navel. We have initiated this study in order to report the epidemioclinical and therapeutic aspects of giant fibroids at the Hopital du Mali. A descriptive retro-prospective study, conducted in the service of gynecology of the Hopital du Mali from November 2017 to December 2018 were included in this study, any patients, regardless of their age, having developed a fibroid, the uterin e height of the patient reaching or exceeding the umbilicus on physical examination and who were on surgical treatment. We had collected 30 cases of GFs out of the 92 patients who had undergone myomectomies, with a frequency of 32.60%. The age group 25 - 29 years accounted for 46.6% with an average age of 35 years. Housewives represented 50% and nulligravida made up 33% of our patients. Desire to become pregnant was the main reason for consultation in 34.4% of cases. The uterine height was between 25 and 29 cm on physical examination in 46.66% of cases. Myomectomy was performed in 76.64% and hysterectomy in 23.3% of cases. The size of the nuclei after surgery was over 25 cm in 48.66% of our patients. Conclusion: The giant fibroid (GF) is a common cause of myomectomy. The treatment is either hysterectomy or myomectomy and depends on the indications.

关键词： Giant Fibroma Care Surgery Hôpital du Mali

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Small Bowel Obstruction Induced by Phytobezoar: A Case Report in Innocent Abdomen and Literature Review

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Surgical Science 2021年第6期12卷 187-195页

作者： Bréhima Traoré Djibril Traoré Modibo Coulibaly Oumar guindo Abdoulaye Traoré Fodé Mory Keita Kiffery ibrahim Keita Korotimi Mallé Pierre Coulibaly Aly Boubacar Diallo Dramane Cissé Dramane Samaké Pierre A. Togo 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 Anesthesia and Resuscitation H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Surgery Polyclique des Armées de Kati Koulikoro Mali Department of Gynecology and Obstetrics H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of General Surgery H&ocirc pital Régional de Sikasso Sikasso Mali Department of Medicine H&ocirc pital Sominé DOLO de Mopti Mopti Mali Faculty of Medicine and Odonto Stomatology University of Sciences Technics and Technologies de Bamako Bamako Mali

Introduction: 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. Herein, we report a case of small bowel obstruction (SBO) following excessive consumption of wild grapes with no previous abdomen medical or surgical history. Presentation of case: A 65-year-old male farmer presented with cessation of materials and gas associated with vomiting of food and then bilious. The abdomen was bloated and painful on palpation with a moving, painful mass in the left iliac fossa. The hypothesis of acute occlusion of the colon was retained and confirmed on the X-Ray which showed a dilation of small bowel with air-fluid levels. The diagnostic of acute SBO was retained. We performed urgently a median laparotomy. We found the dilation of the loops from the jejunum to the sigmoid colon with a compact mass at the sigmoid colon of 15 cm in length and 6 cm in diameter. We proceeded to crush the mass that was made up with wild grape seed fecal, and push it back to the rectum. The phytobezoar made up with wild grape seeds was extracted through the anus with the fingers after anal dilation. After extraction of the bezoar, the patient’s complaints completely subsided. Discussion: SBO is a frequent emergency surgical pathology. SBO induced by phytobezoar often occurs in patients with abdomen surgery history. However, it is particularly rare in virgin abdomen. Conclusion: This case report aims to raise awareness of phytobezoar as a cause of SBO in elderly even though without abdomen surgery history.

关键词： Small Bowel Obstruction Phytobezoars Innocent Abdomen

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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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Abdominal Trauma Management: About 62 Cases at the Department of General Surgery of Hôpital SominéDOLO de Mopti, Mali

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Surgical Science 2021年第6期12卷 204-210页

作者： Djibril Traoré Bréhima Traoré Fodé Mory Keita Dramane Cissé Modibo Coulibaly Mory Koné Abdoul Karim Djimdé Kiffery ibrahim Korotimi Mallé Abdoulaye Traoré Oumar guindo Mathias Diassana Pierre M. Coulibaly Bakary T. Dembélé Pierre A. Togo Department of General Surgery H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Surgery Polyclinique des armées Kati Mali Department of Biomedical Laboratory H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Anesthesia and Resuscitation H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Public Health H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Gynecology and Obstetrics H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of General Surgery CHU Gabriel Touré Bamako Mali

We undertook a prospective and descriptive observational study on abdominal trauma from February 1, 2016 to August 31, 2017. The aim of this work was to identify the typology and management of abdominal trauma cases in our surgery department. Overall, abdominal trauma represented 3.54% (62/1751) of all surgeries during the study period. Among the 62 cases, men accounted for 59 and women for 3. The sex ratio was 19.67. The mean age was 24 ± 15 years. Road accidents were the most represented with 43.5% of cases. The couple of signs, hypovolemic shock and abdominal pain and decrease on blood pressure were the prominent clinical symptoms with 100.0%, and 50.0% of cases, respectively. Abdominal ultrasound and abdominal x-ray without contrast were performed in 67.0% and 18.0% of cases, respectively. Abdominal trauma was divided into two entities: contusion 68% and wounds 32%. Medical treatment was sufficient in 23.00% of cases. Laparotomy as a surgical approach was performed in 77.0% of cases. Local hemostasis plus drainage (27.08%), splenectomy (25.00%), suture (14.58%), hemostasis by tamponade (8.33%) and colostomy (2.08%) were undertaken as surgical procedures when it came to deal with contusions. Debridement of wounds plus suture and hemostasis by tamponade was performed in 18.73% and 4.16 cases, respectively. The most observed lesions were those of the spleen with 27.42% and those of the small bowel with 24.19%. The postoperative follow-up was straightforward in 83.33% of cases. The overall mortality was 4.17%.

关键词： Trauma-Abdomen-Emergency-Hôpital Sominé DOLO de Mopti

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