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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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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 mai

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

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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 se

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

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Diabetic Foot: Epidemiological, Therapeutic and Evolutionary Aspects in the Department of Medicine and Endocrinology of the Hospital in Mali, Mali

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Journal of Diabetes Mellitus 2022年第1期12卷 18-27页

作者： Nanko Doumbia Adama Alexis Diarra Seydou Mariko Drissa Sangare Danfaga Bakary Nouhoum Ouologuem Samaké Magara Sekou Mamadou Cisse Mamady Coulibaly Mahamadou Saliou Bakary Dembele Yacouba L. Diallo Amadou Kone Modibo Mariko Bah Traore Massama Konate Djenebou Traore Djeneba Sylla kaya assetou soucko assa Traore Department of Medicine of the Mali Hospital Bamako Mali National Center for Scientific and Technological Research (CNRST) Bamako Mali Kati Reference Center Kati Mali Gynaecology Department of the Mali Hospital Bamako Mali Department of Medicine and Medical Specialty of the Fousseyni Daou Hospital Kayes Mali Nephrology Unit of the Fousseyni DAOU Hospital Kayes Mali Health and Social Affairs Department of the National Police Bamako Mali Internal Medicine Department of the Gabriel toure University Hospital Bamako Mali Faculty of Medicine Bamako Mali Internal Medicine Service of the Point G University Hospital Bamako Mali

Introduction: The diabetic foot remains a public health problem due to its high frequency, difficult and costly management. The aim of this study was to determine the epidemiological, therapeutic and evolutionary aspects of the diabetic foot in a hospital setting in Bamako. Methodology: This is a retrospective, descriptive, cross-sectional and monocentric study conducted between September 1, 2011 and December 31, 2015 on diabetic patients aged 14 years and older arriving in our department with a foot infection. Results: We identified 94 cases of diabetic foot infection out of a total of 828 hospitalized patients, a prevalence of 11.35%. The age range 41 - 60 years represented 57 cases (60.6%), the extreme ages were 14 and 81 years. Men (38.3%), women (61.7%) with a sex ratio of 0.62%. Housewives 50%, illiterate 51 cases (54.3%), low economic standard of living 40 cases (42.6%), presence of osteitis 40 cases (42.6%), foot at stage D Grade3 28 cases (29.8%). Management was medical in 48 cases (51.1%), treatment with insulin 58 cases (61.7%), Amoxicillin + Metronidazole used 36 cases (38.29%). Amputation was performed in 35 cases (37.2%). Deaths concerned 5 patients (9.6%) with hypoglycemia as the main cause in 4 cases. Conclusion: Diabetic foot is a frequent complication of diabetes. The establishment of a multidisciplinary team should contribute to the improvement of the prognosis of the diabetic foot in a management center.

关键词： Diabetic Foot Epidemiology Therapeutics Evolution Mali Hospital

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Diabetic Foot: Epidemiological and Clinical Aspects in the Department of Medicine and Endocrinology of the Hospital of Mali, Mali

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Journal of Diabetes Mellitus 2021年第4期11卷 159-170页

作者： Nanko Doumbia Danfaga Bakary Nouhoum Ouologuem Drissa Sangare Adams Alexis Diarra Magara Samaké Sekou Mamadou Cisse Mamady Coulibaly Mahamadou Saliou Bakary Dembele Yacouba L. Diallo Amadou Kone Modibo Mariko Bah Traore Massama Konate Djenebou Traore Djeneba Sylla kaya assetou soucko assa Traore Department of Medicine of the Mali Hospital Bamako Mali National Center for Scientific and Technological Research (CNRST) Bamako Mali Kati Reference Center Kati Mali Department of Medicine and Medical Specialty of the Fousseyni Daou Hospital Kayes Mali Nephrology Unit of the Fousseyni DAOU Hospital in Kayes Kayes Mali Health and Social Affairs Department of the National Police Bamako Mali Internal Medicine Department of the CHU du Point G Bamako Mali Faculty of Medicine of Bamako Mali

Introduction: Diabetes is a heterogeneous group of metabolic diseases characterized by chronic hyperglycemia resulting from a defect in the secretion and/or action of insulin, diagnosed by the observation of high levels of glucose in the blood, responsible in the long term for vascular and nervous complications. The diabetic foot is the set of pathological manifestations affecting the foot in relation to the diabetic disease. Approximately 5% of diabetics present a chronic lesion of the foot. Objective: To describe the epidemiological and clinical aspects of the diabetic foot in the medicine/endocrinology department of the Mali hospital. Methodology: This was a retrospective descriptive study from November 2011 to December 2015. It focused on diabetic patients hospitalized in the department with a foot wound and aged 14 years and over. Results: The study involved 94 patients out of 828 hospitalized, a prevalence of 11.35%. Our series included 36 (38.3%) men and 58 (61.7%) women, i.e. a sex ratio of 0.61%. The mean age was 42.66 years with extremes of 14 and 81 years. Type 2 diabetes was present in 95% of the patients with a duration of evolution of more than 5 years in 60.6% of the cases. The mechanism of occurrence of the wounds was minor trauma in 54 cases (57.4%). Self-medication was the primary treatment in 70 patients (74.5%). More than 50% of the patients wore unsuitable footwear. Clinical and para-clinical examinations revealed isolated neuropathy in 37 cases (39.4%), necrotic wound in 37 cases (39.19%), poor glycemic control: HbA1c > 7% (98.9%), absence of osteitis (57.4%), normal Doppler ultrasound 45 cases (45.7%), stenosing arteriopathy 11 cases (22.3%), non-stenosing 3 cases (20.2%), germs present 56 cases (59.6%) including 21 cases (22.4%) of Staphylococcus aureus. Conclusion: Diabetes and diabetic foot constitute a real public health problem. They are responsible for

关键词： Diabetic Foot Epidemiology Clinic Bamako

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Basedowian Orbitopathy Without Thyreotoxicosis : A Case Report from Sikasso Hospital

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Open Journal of Ophthalmology 2023年第3期13卷 273-279页

作者： Cheickna Nomoko Adama Dembele Moro Sidibe Karim Diarra Moussa Sidibé Niamé touré Moussa Abdou touré Oulematou soucko Ousmane Fané Daouda Goita Oumar Diallo Djonny Jonas Dembele Mamadou Adama Togo Kadiatou Ba Koita Abdoulaye Nouhoum Coulibaly Cheick Fantamady tounkara Nouhoum touré Abdoulaye Konaté Abdoulaye Napo Nana Kadidia Fofana Regional Hospital of Sikasso Sikasso Mali Alliance for the Development of Community Ophthalmology (ADOC) Bamako Mali Referral Health Center for Commune 3 in the District of Bamako Bamako Mali African Tropical Ophthalmology Institute Bamako Mali Referral Health Center for Commune 4 in the District of Bamako Bamako Mali

Basedowian orbitopathy is an autoimmune disease representing the most frequent extra-thyroidal manifestation. Its pathophysiology is imperfectly elucidated and is the result of cross-reactivity between thyroid antigens and orbital tissue. It is most frequently seen in the context of hyperthyroidism (basedow’s disease or Graves’ disease), sometimes hypothyroidism (Hashimoto’s thyroiditis), or euthyroidism. Diagnosis is often straightforward, but management remains difficult. The introduction of simple medical treatment exposes the patient to the risk of recurrence. In Sikasso, there have been few studies of Graves’ disease. The aim of this study was to describe the clinical, therapeutic and evolutionary features of Graves’ disease in Sikasso Hospital. The patient was a 35-year-old woman with no previous history of Graves’ disease and no history of alcohol or tobacco intoxication, consulting for bilateral exophthalmos with moderate pain for 1 year. Endocrine tests were normal (euthyroidism), as was orbital-cerebral MRI, which revealed stage II exophthalmos with no sellar or supra-saltar abnormalities. The main complication was exposure to keratitis. Our patient was treated with corticosteroids. The evolution was favorable under treatment, with no recurrence after one year’s follow-up. Graves’ disease is the most common cause of hyperthyroidism, but this should not obscure the diagnosis of euthyroidism, as demonstrated in this case report. Exophthalmos remains the main ophthalmological clinical manifestation.

关键词： Euthyroidism Basedowian Orbitopathy Orbital-Cerebral MRI Corticoster-oid Therapy

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