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Initial Experience with Open Heart Surgery in Sub-Saharan Africa:Challenges in Mali with Minimum Standards for Practice

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World Journal of Cardiovascular Surgery 2019年第9期9卷 108-118页

作者： Seydou Togo Moussa Abdoulaye Ouattara Abdoul Aziz Maiga Moussa Bazongo Issa Boubacar Maiga Cheik Ahmed Sekou Toure Ibrahim Coulibaly Sounkalo Diop Allaye Ombotimbe Sitta Illiassou Souleymane Coulibaly Mamadou Solo Koita Koumba Nelly Dora Ignanga Sanibe Dramane Kone Moussa Oscar Kamano Fatoumata konate Adama Issa Kone Amadou Sidibe Ahmadou Drame Nouhoum Oueloguem Bourama Kane Boubacar Drame Sekou Koumare Zimogo Zie Sanogo Sadio Yena Department of Thoracic and Cardiovascular Surgery Mali HospitalBamakoMali Department of Anesthesiology and Critical Care Mali HospitalBamakoMali Department of Cardiologie Mali HospitalBamakoMali Department of Pediatrics Mali HospitalBamakoMali Department of Biomedical Laboratory Mali HospitalBamakoMali Department of Surgery“A” Point G HospitalBamakoMali

Introduction: There has been limited experience with Open Heart Surgeries (OHS) in Sub-Saharan Africa. In west Africa especially in Mali, most fledgling centers are unable to overcome the myriad of challenges encountered in establishing OHS though there is a high prevalence of surgically correctable heart diseases. The aim of this paper is to review our initial experience of our first cases in developing OHS program and discuss the challenges and prospects that need to be overcome to further develop it. Methods: A total of 6 patients who underwent OHS during the first “cardiac mission” in July 2016 were included in this retrospective study. The medical records of the patients were examined and data on age, sex, diagnosis, EuroSCORE, type of surgery, cardiopulmonary bypass details, complications and length of hospital stay were extracted. Results: Six patients with a male to female ratio of 1, ages ranging between 12 and 35 years (mean of 22.5 ± 12 years) were studied. The mean of EuroSCORE was 6 ± 41. Pericardial patch closure of isolated atrial septal defect was performed in one patient. One patient had mitral valve repair for rheumatic mitral regurgitation consisting of chordal shortening with a tricuspid valvuloplasty. Three patients had mitral valve replacement with tricuspid valvuloplasty. Four patients had mitral valve replacement. Sixty-day mortality?was 0%. Conclusion: Safe conduct of open heart surgery in Mali Hospital setting is feasible. Grant financial aid is required for rapid growth of Open-Heart Surgery in this part of Sub-Saharan Africa.

关键词： Open-Heart Surgery Mali Africa

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Profile and Antibiotic Sensitivity of Acute Pyelonephritis in Children at Gabriel Toure Teaching Hospital, Bamako

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Open Journal of Pediatrics 2020年第1期10卷 94-108页

作者： Djeneba konate Lala N’Driany Sidibe Karamoko Sacko Bakary Kone Adama Kone Aminata Doumbia Fatoumata Tiero Pierre Togo Fatouamata Leonie Diakite Abdoul Karim Doumbia Belco Maiga Fousseyni Traore Aamadou Toure Hawa Diall Mohamed Elmouhouloud Cisse Adama Dembele Oumar Coulibaly Yacouba Aba Coulibaly H.Konare Isabelle Traore Guediouma Dembele Issiaka Kone Leyla Maiga Ibrahima Ahamadou Abdoul Aziz Diakite Boubacar Togo Mariam Sylla Fatoumata Dicko-Traore Pediatric Department CHU Gabriel ToureBamakoMali Pediatric Unit Hospital Center Mother-ChildLuxembourgLuxembourg

Background: Very common symptom in children, fever, perhaps a warning sign of more or less severe pathology, rapidly progressive, including an invasive bacterial infection such as acute pyelonephritis (APN). The aim of this work was to study the bacteriological profile and antibiotic sensitivity of APN in children. Methods: A prospective study involving any infant or child aged 3 months to 15 years with an acute fever (≥38°C) in which a urine test strip was performed in the pediatric department of the teaching hospital Gabriel Toure between April 1st and May 15th, 2019 (45 days). Results: 124 children were included out of 244 febrile patients. Infants (3 - 23 months) predominated (52.8%) with a sex ratio of 2. Seventy-five percent of children came directly from home and 30.6% were on antibiotic prior to admission. The urine bag sample was taken in 55.6% and the urine was macroscopically cloudy in 32.3%. Stigmas of urinary tract infection at the urinary strip were present in 56.5%. Confirmation of acute pyelonephritis (APN) by CytoBacteriological Urine Examination (CBUE) was 29% with Escherichia coli (63.9%) or Enterococcus faecalis (30.5%). Sensitivity was excellent for ciprofloxacin and imipenem (100%). The overall resistance was greater for gentamicin, cotrimoxazole, ceftriaxone, cefotaxime and amoxicillin-clavulanic acid (Threshold: 17.9% - 95.6%). APN was associated with bacteremia in 2.8% with hospitalization for 45.2% and mortality of 11.1% (due to severe acute malnutrition, severe dehydration and multifocal infection). Conclusion: The APN, daily activity of pediatrician in Bamako, is observed in one third of febrile children associated with a major life-threatening condition of risk factors, then the likely antibiotherapy could be amikacin in our context.

关键词： APN Fever Child Bamako

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Non Hodgkin Lymphomas (NHL) in the Pediatric Oncology Unit of the Gabriel TouréTeaching Hospital, Bamako Mali

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Open Journal of Pediatrics 2019年第4期9卷 309-316页

作者： B.Togo P.Togo O.Kone F.Traore A.K.Doumbia A.Toure A.A.Diakite O.Coulibaly H.Diall1 B.Maiga K.Sacko A.Dembele Y.A.Coulibaly D.konate M.E.Cisse A.A.Ba F.L.Diakite L.N.Sidib A.Doumbia H.Konare L.B.Maiga C.B.Traore Department of Pediatrics Gabriel TouréTeaching HospitalBamakoMali National Institute of Research in Public health BamakoMali Pathology Service of Point G Teaching Hospital BamakoMali

Background :Non-Hodgkin lymphomas are the first childhood cancer in sub-Saharan Africa. Objective: The purpose of this study was to assess non-Hodgkin lymphomas cases in our setting. Methodology: A retrospective and descriptive study carried out in the pediatric oncology unit of the Gabriel Touré Teaching Hospital Bamako over 10 years from 1st January 2005 to 31th December 2015. Results: We exploited 274 (21.6%) cases of Non-Hodgkin Lymphoma out of 1295 cancer cases registered, the age group 6 - 10 years was the most represented (46.4%);the male sex was predominant with a sex-ratio of 1.8;digestive signs were the most common signs of discovery (44.2%) followed by maxillary swelling (42.7%);the majority of patients (52.9%) consulted between 1 and 3 months after the onset of signs;the malnutrition rate was 39.8%, of which 24.1% were severe cases and 15.7% were moderate rate. Abdominal localization was the most common (43.1%) followed by maxillofacial localization (33.9%). Almost all were Burkitt type cytology (92.7%), the majority (73.4%) were in Murphy stage III. Almost all (96%) had received chemotherapy and the modified LMB 01 protocol was widely used (62.4%). The majority of patients (85%) were chemosensitive at day 7 or after the third cyclophosphamide injection but at the end of induction only 31% were in complete remission. Gastrointestinal toxicity was the most common (37.13%) followed by hematologic toxicity 35.09 %;9.12 % of patients were lost of follow-up and 22.26% died. Tumor progression was the most common cause of death (60.66%) followed by infection (21.31%). Conclusion: In light of these findings, the late diagnosis and the poor management of NHL, as well as the limited ability to primarily treat metabolic complications, explain the high case-fatality rate, hence the important role of early diagnosis and treatment multidisciplinary.

关键词： Childhood Lymphomas Gabriel TOURE Teaching Hospital Mali

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Epidemio-Clinical Characteristics of Perinatal Anoxia and Immediate Outcome of Patients at Hospital Teaching Gabriel Toure of Bamako

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Open Journal of Pediatrics 2019年第4期9卷 326-336页

作者： L.N.Sidibe H.Diall1,D.konate O.Coulibaly F.L.Diakite K.Sacko F.Traore O.H.Diallo L.Maiga I.Ahamadou I.Traore I.Kone1,B.Maiga P.Togo A.K.Doumbia A.Toure E.M.Cisse A.Dembele Y.A.Coulibaly A.Doumbie A.Konare1,A.A.Diakite B.Togo M.Sylla F.DickoTraore Department of Pediatrics CHU Gabriel ToureBamakoMali Faculty of Medicine and Odonto-Stomatology of Mali BamakoMali

Introduction: Neonatal asphyxia (NA) is one of the most likely causes of neuro-developmental abnormalities in children. In Mali it is responsible for half of the early deaths and the third of neonatal mortality. Updated data would help understand and improve intervention strategies to reduce mortality. Objective: It is the study of epidemiological and clinical characteristics, the immediate outcome and the factors associated with newborn (NB) mortality with NA. Material and Methods: This was a prospective cross-sectional study from June 27th to September 3rd 2016 about the NBs admitted for NA in the Hospital Teaching Gabriel Touré of Bamako. The clinical and biological data including the prognosis were collected from the health records of women, the liaison sheets and the medical file. The analysis was done using the software Epi info version 3.5.1. Results: 76 NBs were included which represented 23.45% of hospitalizations. The majority (89.5%, n = 68) were admitted to less than 24 hours of life for NA grade III according to the Sarnat classification (43.4%, n = 33). The average age of mothers was 24.17 ± 5.5 years. Almost half (41.3%, n = 31) were primigravida. The most common obstetrical event was dystocia (64.5%, n = 49). The prognosis was poor in grade III anoxia in our patients (56%) of deaths. Conclusion: The périnatal anoxia (PA) is a major health issue in Mali because of its frequency and severity. Monitoring of pregnancies, delivery assisted by skillful and qualified personnel, mastery of neonatal resuscitation techniques are good means of prevention.

关键词： Anoxia Newborn Epidemiology Clinical Outcome

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卡塔尔Al Janoub体育场

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当代建筑 2020年第6期 76-83页

作者： Annarita Papeschi Andreas Urff Antonio Monserrat Cynthia Du Edgar Payan Ermis Chavaltzi Fernando Poucell Ganesh Nimmala George King Ho-Ping Hsia Irene Guerra Jan Klaska Junyi Wang Karim Muallem Karoly Markos Ming Cheong Moa Carlsson Mohamed Al-Jubori Nastassia Linau Paulo Flores Peter Irmscher Rafael Portillo Stephane Vallotton Thomas Soo Vincent konate Yeena Yun Wen-Kai Li(Kevin) Luke Hayes(摄) 无不详扎哈·哈迪德建筑事务所 Hufton+Crow

随着卡塔尔之星国家足联阿米尔杯决赛的举办,Al Janoub体育场于2019年5月16日正式揭幕——这也是为2022年卡塔尔世界杯建造的第一个新体育场。Zaha Hadid建筑事务所和Aecom从2013年3月起便开始了体育场及周边新区的设计。作为2022年世... 详细信息

随着卡塔尔之星国家足联阿米尔杯决赛的举办,Al Janoub体育场于2019年5月16日正式揭幕——这也是为2022年卡塔尔世界杯建造的第一个新体育场。Zaha Hadid建筑事务所和Aecom从2013年3月起便开始了体育场及周边新区的设计。作为2022年世界杯的场地之一,Al Janoub体育场将举行联赛的小组赛和四分之一决赛。该体育场位于多哈以南23 km的Al Wakrah市,可直接从首都乘坐Red Line地铁线抵达。

关键词：建筑事务所体育场世界杯地铁线阿米尔卡塔尔

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