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Obstetric Fistula: Epidemiological, Social and Therapeutic Aspects: Prospective Study of 196 Patients Admitted to the ZINDER Mother and Child Health Centre (CSME)

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Open Journal of Urology 2024年第2期14卷 95-103页

作者： Maazou Halidou Ousmane Manzo Zalika Lankoande Abdoulaye Kodo Harissou Adamou Oumarou Habou Abdoulaye idrissa Tassiou Ibrahim Nafiou Idi Soumana Amadou Department of Surgery University André Salifou Zinder Niger National Reference Center for Genital Fistulas Care Niamey Niger

Introduction: Obstetric fistula (OF) is an abnormal communication between the genital and urinary tracts and/or associated with a recto-vaginal communication resulting from prolonged dystocic delivery. It is a frequent pathology in underdeveloped countries. In Zinder no study has been carried out on obstetric fistula. The aim of this study was to evaluate the epidemiological, social impact and therapeutic aspects of obstetric fistula at the CSME of Zinder. Patient and Method: This was a descriptive cross-sectional study of obstetric fistula care at CSME during the period of (January 2018 to June 2020). Results: A total of 196 cases were collected over 30 months. This represents an annual incidence of 78.4 fistulas. The median age of the patients was 18.63 years, and more than 65% were over 20 years old. One hundred and ninety-one patients (97.45%) did not attend school, and 56.12% (n = 110) lived in polygamous households. One hundred and fifty-one women (n = 151), 77.04% had full assistance from their husband during the first four (4) months of the pathology. Twenty-four (12.24%) had been notified of repudiation. Obstetrical risk of dystocia was found in 39.79% (n = 78) of the patients, of whom 24.49% (n = 48) had a focused antenatal consultation (CPNR). The labour lasted more than 24 hours in 100%. The majority of women are multiparous and 60% had at least 2 pregnancies. vesicovaginal fistula is the main pathological type with 86.23%. Fistulas were closed in 83.16% and 68.87% exited without urine loss. Conclusion: Obstetric fistula is a devastating disease affecting girls and young women in Niger, as in other countries in Africa and Asia. It is a major concern worldwide and is a social tragedy because it is disabling and depressing.

关键词： Obstetric Fistula Epidemiology CSME Zinder

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Prevalence and Associated Factors of Postpartum Depression: A Study Conducted in Health Centres in Dakar (Senegal)

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Open Journal of Psychiatry 2024年第1期14卷 45-66页

作者： Sokhna Seck Momar Camara Racky Wade Kane Djeynaba Bassine Baldé El Hadj Makhtar Bâ Adama Koundoul idrissa Bâ Ibrahima Ndiaye Papa Lamine Faye Aida Sylla Service de psychiatrie Centre Hospitalier National Universitaire de Fann Dakar Sénégal

Introduction: Postpartum depression is the most common psychiatric disorder affecting women in the perinatal period. According to the WHO, it affects 10% - 15% of women who have just given birth. In Africa, and particularly in Senegal, epidemiological studies focusing exclusively on postpartum depression are rare or non-existent. For this reason, we conducted this screening study on postpartum depression to assess the socio-demographic characteristics and associated factors. Methods: This was a prospective cross- sectional study with descriptive and analytical aims. It was carried out in the twelve Dakar referral health centres during the period August 2021 to June 2022. Results: At the end of our survey we had recruited one hundred and twenty-two (122) participants with a PPD prevalence rate of 25.41%. The most common age group was 24 - 29 years. 40% of the participants were of Fulani ethnicity, followed by Wolof. Married women made up 93% of the sample. The school enrolment rate was 89%. Most participants were not in paid employment. Domestic violence was present in 14% of couples. 28% of mothers reported experiencing a stressful life event during their pregnancy. 22% of the women had a chronic medical condition, of which 55% had high blood pressure. 1% of the women reported a personal psychiatric history and 5% a family psychiatric history. Most women had between two and four healthy living children. The pregnancy was unwanted in 17% of cases and 12% of participants had a complication. 6% were dissatisfied with the quality of their antenatal care. The caesarean section rate was 18%. In terms of associated factors, eight factors were identified in a bivariate analysis: single marital status, lack of support from partner, domestic violence, conflict with in-laws, and the occurrence of a stressful life event during pregnancy, the presence of a personal medical history, lack of satisfaction with pregnancy follow-up, and mode of delivery by caesarean section. Conclusi

关键词： Postpartum Depression Prevalence Associated Factors Senegal

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Adult Urological Cancers at Zinder National Hospital

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Open Journal of Urology 2024年第5期14卷 267-276页

作者： Halidou Maazou Manzo M. S. Ousmane Chaibou Soumana Abdoulaye Kodo idrissa Seriba Abdoulrazak R. H. Zakou Soumana Amadou Department of Urology University of Zinder Zinder Niger Department of Urologie University of Niamey Niamey Niger Department of Mé dicale Oncology National H&#244pital of Zinder Zinder Niger Department of Anatomy Pathology Universit&#233 of Zinder Zinder Niger

The aim of this study was to present the epidemiological, clinical and therapeutic aspects of adult urological cancers in the department of urology at Zinder National Hospital. Patients and Methods: This was a cross-sectional study of adult primary urologic cancers during the period of January 2019 to December 2023. Data were obtained from the record of patients admitted to urology, and the medical oncology department. The parameters studied were;frequency, age, sex, urogenital distribution, anatomopathological type, and therapeutic aspects. Data were recorded on Excel 2013 and analyzed with Epi-info version 7.2.5. Results: Epidemiology: About 289 cancers were diagnosed through 6017 consultations during the period, corresponding to 4.80% of urological pathologies: prostate cancer (n = 221;76.47%), bladder cancer (n = 46;15.92%), kidney cancer (n = 13;04.5%), testis cancer (n = 09;03.11%). Median age of patients was 50.42 years. Prostate cancer: was Adenocarcinoma in 100% (n = 221) with Gleason scores > 7 (77.83%) and prostatique specific antigen (PSA) > 20 ng/ml in 90.04%. Extension evaluation 134 cases (60.63%). Treatment was chirurgical castration in (62.44%) and resistance to castration appeared between 8 and 11 months. Hospital mortality for prostate cancer was 16.29%. Bladder cancer was found in 46 cases with Sex ratio 7/1. Cystoscopy was performed for all. Histology revealed squamous cell carcinoma (n = 41;89.13%), and (n = 5;10.87%) urothelial. Endoscopic resection performed (n = 14;30.43%). Kidney cancers were 13 cases (10 men, 03 women). Nephrectomy was performed in (n = 8;61.54%) cases and Histology revealed renal cell cancer in 76.92%. Testicular cancers were diag 09 cases. History of cryptorchidism was found in 4 cases, 4-year infertility in 3 cases. Orchidectomy was done in all cases. Chemotherapy in 3 cases. Conclusion: urological cancers are frequent, dominated by prostate cancer. The endemicity of bilharziasis has increased squamous cell carcinoma. T

关键词： Urologic Cancers Epidemiology Histology Zinder

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Epidemiological, Clinical and Therapeutic Aspects of Bladder Tumors in a Schistosomiasis-Endemic Country

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Open Journal of Urology 2024年第3期14卷 151-159页

作者： Amadou Kassogue idrissa Sissoko Alkadri Diarra Moussa Salifou Diallo Daouda Sangare Boureima Coulibaly Philippe Togo Albacaye Sember Mahamadou Traore Salia Coulibaly Mamadou Lamine Diakite Urology Department Pr Bocar Sidy Sall University Hospital Kati Mali Urology Department Luxembourg University Hospital Bamako Mali Medical Imaging Department Pr Bocar Sidy Sall University Hospital Kati Mali Urology Department Point G University Hospital Bamako Mali

Introduction: Bladder tumors are common in our country;Mali is a bilharzial endemic country. In our context, urinary bilharzia is common, and bladder tumors arouse particular interest in the field of urological oncology, because of their frequency, their diagnosis, their difficulty in management and their histological particularity. The objective of our work was to study the epidemiological, clinical and therapeutic aspects of bladder tumors. Materials and Methods: This is a cross-sectional, descriptive study with a retrospective and prospective collection that took place over 3 years from January 1, 2020 to December 31, 2022. Results: We identified 316 cases of bladder tumors during this period. Bladder tumors are a common pathology representing 35.95% of all hospitalized patients, and occupying the 1st rank of tumors in urology in the Urology Department of the Pr Bocar Sidy Sall University Hospital in Kati. Bladder tumors were more common in men with 56.33%. The average age of our patients was 50 years ± 25.8 years and the extreme ages were 20 and 87 years. Urinary schistosomiasis, considered a predisposing factor, was found in 66.78% of cases in our patients as a history. Transurethral resection of the bladder was performed in 100% of our patients, nephrostomy in 1.90% of cases, ureterostomy in 1.58% of cases, Bricker type urinary diversion in 1.27% of cases, and a neobladder in 0.32% of cases. Squamous cell carcinoma is the dominant histological type (88.29%). The postoperative outcome was 99% favorable after resection. Conclusion: Bladder tumors were mainly tumors infiltrating the bladder muscle. The main risk factor was urinary bilharzia. Squamous cell carcinoma is the most common histological type with a diagnostic delay, thus limiting radical treatment after resection of the bladder tumor.

关键词： TURB Squamous Cell Carcinoma Urinary Schistosomiasis

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Damage to the External Genitalia by Traction Following Assault and Battery at the C.H.U Gabriel Touré: About a Case

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Surgical Science（外科学） 2023年第2期

作者： Karembé Boubacar Traoré Boureima tounkara idrissa Diarra Issaka Coulibaly Mamadou Tidiani Soumaré Modibo Dianguina Coulibaly Abdoulaye Camara Aboubacar Touré Aboubacar Sanogo Seydou Fall Ibrahim DiakitéMané Diarra Mouminy Traoré Abdoulaye Diarra Drissa Diakité Mamadou Lamine

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

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Surgical Science（外科学） 2023年第2期

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 DiakitéMané Diarra Mouminy Diarra Drissa Traoré Abdoulaye Coulibaly Yacaria Kanté Lassana Dembélé Bakary Tientigui TogoAdégné

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Hepatic Elastometry in the Management of Hepatitis B at National Hospital of Niamey

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Open Journal of Gastroenterology 2024年第9期14卷 313-321页

作者： Ousseini Fanta Hamidine Illa Moussa Saley Sahada Abdourahamane idrissa Fatouma Abdou Nafissatou Ali Cheik Rakia Abdou Boubé Abdou Djibo Ben Moctar Ky Lawagoulé Joseph Emile Daou Mamane Faculty of Health Sciences Abdou Moumouni University Niamey Niger Department of Hepato-Gastroenterology National Hospital of Niamey Niamey Niger Laboratoire de Recherche Clinique et Systme de Sant Niger Universit Andr Salifou of Zinder Zinder Niger Department of Hepato-Gastroenterology Zinder National Hospital Zinder Niger Department of Infectiology National Hospital of Niamey Niamey Niger Regional Hospital Centre of Niamey Niamey Niger Department of Hepato-Gastroenterology General Reference Hospital of Niamey Niamey Niger Department of Hepato-Gastroenterology The University Hospital Ouagadougou Burkina Faso Department of Internal Medicine General Reference Hospital of Niamey Niamey Niger

Introduction: Viral hepatitis B is a public health problem in Niger which is classified as a high endemicity area with a prevalence ranging from 8 to 17% depending on the studies [1] and that of HBV-related cirrhosis is about 40.26% in 2024. The decision to treat is based on a combination of three parameters: viral load, ALT values and the degree of hepatic fibrosis [2]. The latter is assessed by hepatic elastography (Fibroscan), which is a decisive factor in treatment. In Niger, until 2024, the decision to treat or not to treat a patient with HBV was based on the determination of viral load B and transaminases, and no work evaluating the contribution of this third element, liver elasticity, has been done, hence the interest of our study. Objective: To study the contribution of Fibroscan in measuring hepatic elasticity in the management of patients with HBV. Methodology: This was a prospective descriptive study conducted from January 05 to November 30, i.e. a period of 11 months, on clinically asymptomatic HBsAg-positive patients who had undergone FibroScan liver elasticity measurement. The examination was carried out by a hepatogastroenterologist who had received training in the Fibroscan. The median of ten measures of liver elasticity at the same point with an IQR of less than 30% was considered the valid measure and no or minimal fibrosis was defined as a value ˂7 Kpa, moderate fibrosis as a value between 7 and 10 kpa, severe fibrosis as a value greater than 10 Kpa, and the existence of cirrhosis as a value greater than 14 Kpa were analyzed using SPSS version 20 software. Results: Out of 398 patients monitored for HBV, 60 cases met the inclusion criteria, i.e., a frequency of 15.07%. The mean age of the patients was 35.63 years, with extremes of 18 and 70 years. They were predominantly male, with a sex ratio of 3.2. Married patients accounted for 61.67% (n = 37). Jaundice was absent in 91.67% (n = 55). The circumstances of discovery of HBV were the routine health

关键词： Hepatic Elasticity Fibroscan Fibrosis Hepatitis B Niger

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

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Surgical Science（外科学） 2023年第1期

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 DiakitéMané Coulibaly Yacaria Kanté Lassana Dembélé Bakary Tientigui Togo Adégné

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Ureteroscopy with Holmium: YAG Laser—A Initial Study in the Urology Department of the Pr Bocar Sidy Sall University Hospital of Kati

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Open Journal of Urology 2024年第4期14卷 207-216页

作者： Amadou Kassogue idrissa Sissoko Daouda Sangare Moussa Salifou Diallo Hamed Sylla Mahamadou Traore Boureima Coulibaly Salia Coulibaly Modibo Diakite Modibo Togola Fadima Tall Ilias Guindo Ben Naoum Kamel Mamadou Lamine Diakite Urology Department University Hospital of Pr Bocar Sidy Sall Kati Mali Radiology Department University Hospital of Pr Bocar Sidy Sall Kati Mali Anesthesy and Reanimation Department University Hospital of Pr Bocar Sidy Sall Kati Mali Urology Department University Hospital Nimes France Urology Department University Hospital of Point G Bamako Mali

Introduction: Ureteroscopy is a minimally invasive endoscopic surgery which provides access to the ureter, pyelon and calyceal cavities via the urethra and the bladder. Laser ureteroscopy uses the laser as an energy source to treat the stone and eliminate it naturally. Minimally invasive endoscopic methods are struggling to become popular in sub-Saharan African countries, especially for the upper urinary tract. The objective of our work was to report the results of our first laser ureteroscopy experience in the department. Materials and Methods: This was a prospective and descriptive study running from December 1, 2023 to February 19, 2024. Included in our study was any case of upper urinary tract stone operated by Laser ureteroscopy. The characteristics of the lithiasis were determined by CT scan. Sterilization of urine was verified by carrying out a cytobacteriological examination of urine. Ureteral lithiasis was approached by semi-rigid ureteroscopy. Renal lithiasis was immediately addressed by flexible ureteroscopy. Ureteroscopy was coupled with a Holmium YAG laser. A double J ureteral catheter was placed after the operation. A 230 µm laser fiber was used in each case with a generator with a power of 35 watts (Storz Calculase III type). An access sheath was used in all cases of flexible ureteroscopy. The parameters studied were: sociodemographic characteristics, lithiasis (site, size, number, density, topography), type of anesthesia, duration of laser use, duration of intervention, postoperative outcomes. Data entry and analysis were carried out using the software (Word 2016 and SPSS). Result: We collected 30 cases of laser ureteroscopy. The average age was 37 years with extremes of 9 and 79 years. The male gender was more represented. The most common age group was 24-39 years old. Renal colic was the most frequent reason for admission, 12 patients (40%). On physical examination, lumbar tenderness was present in 47% (14 patients). ECBU was positive in 4 patients

关键词： Ureteroscopy Semi-Rigid Flexible Holmium YAG Laser

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Synchronous Volvulus of the Sigmoid Colon and the Transverse Colon: A Case Report at Gabriel Toure University Hospital in Mali

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Surgical Science（外科学） 2021年第9期

作者： Traoré Amadou Konaté Madiassa Diarra Abdoulaye tounkara idrissa Saye Zakari Doumbia Arouna Bah Amadou Sidibé Boubacar Yoro Maïga Amadou KonéTani Thiam Souleymane Karembé Boubacar Kelly Bouréima Traoré Kadia Kéita Koniba Bouaré Yacouba Koné Assitan Diakité Ibrahim Dembélé Bakary Tientigui Traoré Alhassane TogoAdégné

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