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Epidemiology and Histopathology of Cancers of the Upper Aerodigestive Tract in the ENT and Head and Neck Surgery Department of the Ignace Deen National Hospital

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International Journal of Otolaryngology and Head & Neck Surgery 2024年第4期13卷 259-274页

作者： Mamadou Mouctar Ramata Diallo Oumou Amadou Diallo Raphan Madi Kaba keita Ousmane Barry Abdoulaye keita Alpha Oumar Diallo Department of Otorhinolaryngology and Head and Neck Surgery Mamou Regional Hospital Mamou Guinea Faculty of Health Sciences and Techniques Gamal Abdel Nasser University of Conakry Conakry Guinea Department of Otorhinolaryngology and Head and Neck Surgery Ignace Deen National Hospital Conakry Guinea Department of Otorhinolaryngology and Head and Neck Surgery NZrkor Regional Hospital NZrkor Guinea Department of Otorhinolaryngology and Head and Neck Surgery Donka National Hospital Conakry Guinea

Introduction: Head and neck cancers represent a significant burden of cancer, collectively ranking fourth for cancer incidence and second for cancer mortality worldwide. Objective: To study the epidemiological and histopathological aspects of head and neck cancers in the ENT-CCF department of Ignace Deen National Hospital. Materials and Methods: This was a descriptive retrospective study covering a period of 5 years from September 1, 2016, to September 30, 2021. Results: We collected 43 cases of head and neck cancers, representing a hospital frequency of 1.85%. The mean age was 45.21 ± 13.23 years. Males predominated, accounting for 65.12%, compared to 34.88% for females, with a male-to-female ratio of 1.87. Housewives accounted for 27.90%, followed by farmers at 23.26% and traders/merchants at 18.60%, with 41.86% being uneducated. The main risk factors were tobacco (37.21%) and alcohol (34.88%). Pain (53.49%), dysphonia (51.16%), and dyspnea (39.53%) were the main presenting symptoms. Squamous cell carcinoma (74.42%) and large cell lymphoma (18.60%) were the most commonly cited histological types. Conclusion: Head and neck cancers remain relatively common in our country. Improving prognosis depends on early diagnosis of the condition, resuscitation resources, and prompt management.

关键词： Cancer Head and Neck Histopathology Ignace Deen National Hospital

Literature Review on Support for Children and Families Experiencing Parental Bereavement

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Open Journal of Nursing 2024年第4期14卷 139-163页

作者： Rurie Namiki keita Sasaki Iku Taniguchi Rie Wakimizu Department of Nursing Science Graduate School of Comprehensive Human Sciences University of Tsukuba Ibaraki Japan Department of Child Health Care Nursing Division of Health Innovation and Nursing Faculty of Medicine University of Tsukuba Ibaraki Japan

Purpose: This study aimed to understand the actual nursing support in a wide perspective by reviewing overseas literature on support for children who have experienced parental bereavement and their families. The goal was to identify future challenges in nursing support in clinical practice in Japan. Method: Literature searchable as of May 2023 was retrieved using PubMed, resulting in 11 relevant articles. Result: The results revealed the following: 1) For support provided to children, 13 codes were condensed into 5 subcategories and 4 categories. 2) For support provided to families, 36 codes were condensed into 11 subcategories and 4 categories. Conclusion: Open communication was found to be essential for supporting children and their families who have experienced parental bereavement. Moreover, involvement of multiple professions facilitated the provision of specialized support to address diverse needs of children and families, playing a crucial role in overcoming grief. Additionally, the effectiveness of support systems for bereaved families highlighted the need for nursing professionals in Japan to gain knowledge through learning opportunities and to establish a multi-disciplinary approach to support, thus indicating future challenges in nursing support.

关键词： Terminal Care Family Support Child Parental Death Palliative Care

External Otitis: Epidemiological, Clinical, Etiological, and Therapeutic Aspects at the Oto-Rhino-Laryngology Department of Mamou Regional Hospital

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International Journal of Otolaryngology and Head & Neck Surgery 2024年第3期13卷 213-224页

作者： Mamadou Mouctar Ramata Diallo Sayon Kourouma Oumou Amadou Diallo Ibrahima Diallo Francine Haba Alsény Cisse Raphan Madi Kaba keita Abdoulaye keita Alpha Oumar Diallo ENT Department Mamou Regional Hospital Mamou Guinea ENT Department Conakry Military Hospital Conakry Guinea ENT Department IgnaceDeen National Hospital Conakry Guinea ENT Department Donka National Hospital Conakry Guinea ENT Department Lab&#233 Regional Hospital Lab&#233 Guinea ENT Department N&#8217Z&#233r&#233kor&#233 Regional Hospital N&#8217Z&#233r&#233kor&#233 Guinea

Introduction: External otitis (OE) is an acute or chronic inflammation or infection of the external ear resulting from an imbalance in the external auditory canal secondary to microtrauma, maceration, eczema, or a foreign body in the external auditory canal. Objective: To study cases of external otitis at the Mamou Regional Hospital. Materials and Methods: This was a prospective descriptive study conducted over a period of six (6) months from July 1st to December 31st, 2016. It included all patients admitted to the ENT department of the Mamou Regional Hospital. Results: During the study period, 712 patients were admitted to the department for various pathologies, of which 103 met our selection criteria, representing a frequency of 14.46%. The mean age of the patients was 33.74 years with a range of 1 to 90 years. Males predominated in the sample, accounting for 59.22%. The vast majority of patients resided in urban areas, constituting 61.17% of the sample. In our study, all patients consulted for otalgia (100%), and over half (53.39%) for hypoacusis. We formally identified rhinitis in 66.66% of cases, while diabetes was found in only 4 patients (11.11%). Otomycosis was the most commonly identified condition (53.39%), followed by furuncles (33.98%). Ear drops containing antibiotics were administered to all patients, although 66.60% received antibiotic therapy. Conclusion: External otitis is a relatively common condition, particularly among children and the elderly. Diagnosis can be made based on pain upon traction of the pinna and pressure on the tragus.

关键词： External Otitis ENT Mamou Regional Hospital

Vaginal Cesarean Section, an Alternative to High-Risk Trigger on Scarred Uterus

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Open Journal of Obstetrics and Gynecology 2024年第7期14卷 979-982页

作者： Famakan Kane Mahamadou keita Yacouba Sylla Soumaila Diallo Diassana Mahamadou Traore Tidiane Hpital du District de Bla Bamako Mali Hpital du District Commune I Bamako Mali Hpital FOUSSEYNI DAOU de Kayes Bamako Mali Hpital NIANAKORO FOMBA de SEGOU Bamako Mali

The objective is to report a clinical case of vaginal cesarean section performed to expel a dead fetus in scarred uterus. For this indication, vaginal hysterectomy constitutes an alternative to vaginal expulsion with a high risk of uterine rupture and to classic abdominal cesarean section with risk of significant surgical trauma, particularly adhesions. However, this surgical technique, described since the 19th century, remains unknown to many practitioners and few publications exist on the subject throughout the world. Considered obsolete by some practitioners, it retains all its advantages in the practice of modern obstetrics. We report this case of expulsion of fetal death on a tri-scarred uterus performed by vaginal cesarean section at the Health District Reference Health Center (District Hospital) of Commune I in Bamako, Mali in a 37-year-old patient with a pregnancy of 27 weeks of amenorrhea.

关键词： Vaginal Cesarean Section Birth on Scarred Uterus In Utero Fetal Death

Otorhinolaryngological (ORL) and Cervicofacial Injuries Resulting from Road Accidents within the Otorhinolaryngology (ORL) Department of the Regional Hospital of Mamou

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International Journal of Otolaryngology and Head & Neck Surgery 2024年第1期13卷 16-28页

作者： Mamadou Mouctar Ramata Diallo Ibrahima Diallo Alsény Camara Mamadou Aliou Diallo Raphan Madi Kaba keita Abdoulaye Sow Alsény Cisse Sory Sacko Mamadou Gouraissiou Diallo Abdoulaye keita Alpha Oumar Diallo Ear Nose and Throat (ENT) Department Regional Hospital Mamou Mamou Guinea Ear Nose and Throat (ENT) Department National Hospital Donka Conakry Guinea Ear Nose and Throat (ENT) Department Regional Hospital N’zérékoré N’zérékoré Guinea Ear Nose and Throat (ENT) Department Regional Hospital Labé Labé Guinea Ear Nose and Throat (ENT) Department National Hospital Ignace Deen Conakry Guinea

Introduction: Otorhinolaryngological (ORL) and cervicofacial traumas encompass injuries affecting the neck, face, and ORL region, resulting from external influence. The objective of this study was to conduct an epidemiological and clinical analysis of ORL and cervicofacial injuries observed in victims of road accidents treated at the Otorhinolaryngology (ORL) department of the Regional Hospital of Mamou. Materials and Methods: This prospective and descriptive study was conducted over a period of 12 months, from January 1st to December 31st, 2021, within the Otorhinolaryngology (ORL) department of the Regional Hospital of Mamou. It included patients hospitalized for ORL and/or cervicofacial traumas resulting from road accidents during the study period. Results: A total of 348 cases were included, representing 36.22% of all traumas related to road accidents (AVP) within the Regional Hospital of Mamou. The average age of the patients was 26.44 years, with a sex ratio of 3.83, favoring males. The dominant socio-professional category was students, encompassing 32.47% of cases. Road accidents were mainly associated with motorcycle use (31.32% motorcycle-to-motorcycle, 24.43% motorcycle skidding, 13.51% motorcycle-pedestrian). Facial region injuries were the most common, accounting for 69.03% of cases, followed by rhinological injuries (17.28%) and otological injuries (13.69%). Associated injuries were predominantly closed head traumas (52.55%) and lower limb fractures (20.41%). Imaging was underutilized. Regarding surgical interventions, reconstructive surgery was the most predominant, accounting for 52.51% of cases, with a management timeframe of 30 minutes to 12 hours for 99.72% of patients. Conclusion: Road traffic accidents remain a serious public health issue, primarily affecting young males. Emphasis should be placed on road safety measures to reduce the frequency of these accidents.

关键词： ENT Injuries Road Accidents Regional Hospital of Mamou

Solitary Osteogenic Exostosis of the Femur Revealed by Recurring Acute Distal Thigh Pain: About a Case

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Open Journal of Pediatrics 2024年第4期14卷 719-726页

作者： Thierno Saïdou Barry Mohamed Lamine Sadou Sacko Balla keita Sory Sidimé Moussa Condé Daniel Agbo-Panzo Pediatric Surgery Department Donka National Hospital (HND) of the University Hospital of Conakry Gamal Abdel Nasser University of Conakry (UGANC) of Guinea Conakry Guinea Orthopedic and Trauma Surgery Department Donka National Hospital (HND) of the Conakry University Hospital Conakry Guinea

Introduction: Solitary exostoses are the most common benign tumors of the fertile metaphyses of the long bones of children. Their radiological diagnosis of metaphyseal bone growth must be confirmed on pathological examination. These tumors can remain asymptomatic for a long time and reveal themselves during a particularly vascular complication. The objective of this study was to describe the epidemiological, diagnostic, therapeutic and evolutionary aspects of these tumors. Patient and Observation: We report the case of a 15-year-old adolescent girl, with no particular pathological history, received in the pediatric surgery department of the Donka National Hospital (HND) of the Conakry University Hospital for recurrent acute painful swelling of the lower third of the left thigh in an afebrile context accompanied by lameness and stopping school for a few days (2 - 3 days). The symptoms appear to have evolved over the past 3 years and after physical activities. It regresses with rest, analgesics and non-steroidal anti-inflammatory drugs. The notion of trauma and sickle cell disease was not reported in the patient's clinical history. It is the persistence of the symptomatology which motivates the said consultation. On palpation, a small hard mass is noted at the expense of the internal metaphysis of the left distal femur. Deep palpation of this area causes a tingling sensation and during rapid mobilization of the knee. The remainder of the orthopedic examination was unremarkable. Standard x-ray of the femur shows a bony growth with a pointed tip from the distal metaphysis of the left femur. On surgical exploration, we noted a wedge-shaped exostosis oriented towards the vastus medialis muscle. Histological examination of the surgical specimen confirms osteogenic exostosis. There is no recurrence after 2 years. Conclusion: The distal femoral metaphysis is the most common location of solitary osteochondromas in children. Their definitive diagnosis requires the histology of

关键词： Osteogenic Exostosis Osteochondromas Fertile Long Bone Metaphyses Child

Ear Cholesteatoma Surgery in South Sahara: Our Experience in Bamako

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International Journal of Otolaryngology and Head & Neck Surgery 2024年第4期13卷 293-303页

作者： Kassim Diarra Oumou Coulibaly Yaya Dembele Nfaly Konaté Sidibe Youssouf Saydi Ag Mohamed Harouna Sanogo Abraham Diarra Ibrahim Fofana Moussa Bourama keita Youssouf Traore Fatogoma Issa Koné Boubacary Guindo Siaka Soumaoro Doumbia Kadidiatou Singare Mohamed Amadou keita ORLCCF Department Gabriel Toure University Hospital Bamako Mali ORLCCF Unit Kati Army Polyclinics Kati Mali ENT-CCF Department CHU Luxembourg Bamako Mali ORLCCF Service of the Reference Center of Commune VI Sogoniko Bamako Mali

In Mali, cholesteatoma surgery remains a challenge due to the limited number of otological practitioners, and the low socio-economic level of patients reflecting the difficulties in performing CT or MRI for post-operative follow-up. We therefore initiated this work with the objective of analyzing, through a broad bibliographic review, the clinical, paraclinical, topographical, therapeutic and progressive aspects of a series of ear cholesteatoma. Materials and Method: This was a retrospective and prospective, descriptive study that took place in the ENT and head and neck surgery department of the Gabriel Touré University Hospital over 36 months from November 2020 to October 2023. These were patients admitted to the department for chronic cholestematous otitis media. Result: In total, we collected 34 files of patients admitted for cholesteatoma. This represented 9% of cases compared to all otological surgeries carried out during the same period, i.e. 362 cases. The average age of our patients was 35.31 years, with extremes ranging from 7 years to 80 years, there were 24 men and 10 women, i.e. a M/F ratio of 2.4. The average time to diagnosis was 7 years. The main functional signs were dominated by chronic fetid purulent otorrhea associated with hypoacusis in 94.6% of cases. One case of meningeal complication and three cases of cerebral empyema were reported. Clinically, a postero-superior and marginal tympanic perforation was observed in 53%, a retraction pocket in 5.9%, the sentinel polyp in 9%, and a non-marginal tympanic perforation in 32%. Pure-tone audiometry performed preoperatively for all patients showed conductive hearing loss in 83%. In 82% of cases we created a recess with the creation of a mini box. An ossiculoplasty was performed immediately with fragments of cartilage. The postoperative course found the disappearance of otorrhea (88.23%), the persistence of otorrhea in one case, two cases of facial paralysis, and one case of tinnitus. We did not identify

关键词： Cholesteatoma CT TTO TTF

Digestive Surgical Emergencies at the “Mother Child̶1;Hospital Center Luxembourg in Mali

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Surgical Science 2024年第5期15卷 299-310页

作者： Cheickna Tounkara Amara Coulibaly Yaya Ongoiba Aboubakrine Sylla Abdoul Karim Simaga Bréhima B. Coulibaly Aminata Dabo Souleymane Dembele Samake Hamidou Sidiki keita Sékou Bréhima Koumare Soumaïla keita Bakary Tientigui Dembele Zimogo Zié Sanogo Djibril Sangare Department of General Surgery and Anesthesia-Resuscitation of the “ Mother Child&#8221 Hospital Center Luxembourg Bamako Mali Social Health Service of the Armed Forces of Mali Bamako Mali Department of General Surgery “ A&#8221 and Cardiovascular of Point G University Hospital Bamako Mali Department of General Surgery of CHU Gabriel TOURE Bamako Mali

Digestive surgical emergencies concern all patients admitted urgently, for whom a decision for surgical intervention may be necessary within 24 hours. They are on guard duty day and night. To carry out this work, we set ourselves the objectives of: 1) Studying digestive surgical emergencies in the general surgery department of the “Mother Child” Le Luxembourg hospital in Bamako, Mali;2) Determine the frequency of digestive surgical emergencies, 3) Describe the clinical and therapeutic aspects, and 4) Analyze the results of treatment. From November 1, 2022 to October 31, 2023, the general surgery department of the “Mother Child” Luxembourg Hospital Center in Bamako, Mali, carried out 139 digestive surgical emergencies whose files were usable;75 men and 64 women, a sex ratio of 1.2. The 20 - 40 years old age group was the most represented, at 40.29%. The average age was 39 years;the extremes 16 years and 93 years with a standard deviation of 21.65 years. The reference concerned 51.08% of our patients. Abdominal pain was the main reason for consultation (100% of cases). In the majority of cases, the physical examination made it possible to make the diagnosis. Faced with certain clinical cases, we requested ultrasound (109/139), ASP (46/139) and CT (15/139). The main etiology was acute appendicitis with 42.45% of cases. The frequency of digestive surgical emergencies was 10.71% of all activities in the general surgery department of the “Mère Enfant” Le Luxembourg hospital center in Bamako. All our patients were seen in consultation by an anesthesiologist before entering the operating room. The surgical consequences were complicated in 11.51% of cases with 7.91% deaths. Surgical site infections accounted for 12.5% of postoperative complications. Eleven deaths were noted, representing 68.75% of complications and 7.91% of our sample. Acute peritonitis was the cause of death in 100% of cases. The average cost of care was 329,000 FCFA.

关键词： Emergency Digestive Surgery Post-Operative Complication

Pleomorphic Adenoma of the Salivary Glands: Two Atypical Locations

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International Journal of Otolaryngology and Head & Neck Surgery 2024年第3期13卷 251-257页

作者： Sidibé Youssouf Diarra Abraham Samaké Djibril Sanogo Boubacar Traoré Abdoul Moumine Diarra Kassim Coulibaly Bourama Diakité Youssouf keita Mohamed Amadou Department of ENT and Head and Neck Surgery Mother-Child University Hospital “ Le Luxembourg&#8221 Bamako Mali Faculty of Medicine and Odontostomatology Bamako Mali Department of ENT and Head and Neck Surgery The Mali-Gavardo Hospital Bamako Mali Ministry of Higher Education and Scientific Research Bamako Mali ENT and Head and Neck Surgery Department of the Commune V Reference Health Center (CSRef CV) Bamako Mali Department of ENT and Head and Neck Surgery at CHU Gabriel Touré Bamako Mali Department of Anatomy and Pathological Cytology Gabriel Tour&#233 University Hospital Center Bamko Mali Department of Oral Surgery Sikasso Regional Hospital Sikasso Mali

Pleomorphic adenoma is the most common tumor of the salivary glands, accounting for approximately 50% of salivary gland lesions. It develops mainly in the salivary glands: parotid (80%), submaxillary (10%), sublingual (1%) and in the accessory oral-pharyngeal glands (9%). The aim of this work was to report 2 cases of pleomorphic adenoma of atypical location and then to discuss the difficulties linked to its diagnostic and therapeutic management in the Malian context. They were a 40-year-old man and a 72-year-old woman. They were admitted to the ENT department of the “Luxembourg Mere-infant” hospital for oropharyngeal swelling for the first and swelling of the palate for the second. The clinical expression was a swelling in both cases, of a hard, mobile consistency with healthy mucosa on their surface. The remainder of the physical examination was unremarkable. The diagnosis of a tumor of the oropharynx and palate was made following clinical radiological examinations. The histopathological examination of the surgical specimen made it possible to make the diagnosis of pleomorphic adenoma of the palate and the left palatine tonsil. The follow-up surgery was straightforward, with a favorable outcome. Pleomorphic adenomas are relatively rare benign tumors of the accessory salivary glands;their clinical expression remains swelling. Therapeutic management is surgery and the diagnosis is confirmed by histopathological examination.

关键词： Pleomorphic Adenoma Palate Tonsil Mali