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Contribution of Stress Testing to the Management of Ischemic Heart Disease in Mali

World Journal of Cardiovascular Diseases 2024年第2期14卷 77-87页

作者： Youssouf Camara Hamidou Oumar Ba Ibrahima Sangaré Boubacar Sonfo Coumba Adiaratou Thiam Mahamadou Sékou Diakité koniba Diarra karamba Touré Massama konaté Ichaka Menta Cardiology Department University Hospital Professeur Bocar Sidi Sall Kati Kati Mali Cardiology Department University Hospital Gabriel Touré Bamako Mali Cardiology Department Mali Hospital Bamako Mali

Introduction: Exercise stress testing (on a treadmill or ergometer bicycle) is an important test in cardiology for diagnosing myocardial ischemia. This test in Mali is still in its beginning compared to other countries in the sub-region. The lack of data in Mali prompted this study, which aimed to evaluate the indications of this activity and its diagnostic contribution to cardiology in Mali. Materials and Methods: This was a retrospective, descriptive study. The study was conducted at the “TOUCAM” medical clinic in kati based on the analysis of stress test reports between January 2016 and August 2022. result: During the study period, we documented 73 patients who underwent exercise testing on a bicycle ergometer for suspected coronary heart disease. The mean age of our patients was 47.5 ± 13.8 years (14 and 79 years). Males accounted for the majority (78.1%). The sex ratio is 3.5. More than half of our patients were overweight or obese (77.1%). Hypertension and diabetes affected 52.1% and 25.8% of patients, respectively. 20.8% of patients had coronary artery disease. renin-angiotensin-aldosterone system blockers (56.8%) and beta-blockers (51.3%). The main indications were chest pain (63.0%) and ischemia detection (15.1%). A modified STEEP protocol was used. The majority of our patients (71.2%) achieved at least 85% of their maximum theoretical heart rate. The main reason for the termination of the study was fatigue (57.3%). The average duration was 11.3 ± 4.2 minutes. 24.7% thought the stress tests were positive and 17.8% thought they were controversial. Conclusion: This study demonstrates the importance of stress testing in the diagnosis and treatment of ischemic heart disease, especially in settings where we have very limited access to coronary angiography.

关键词： Stress Test Ischemic Heart Disease Mali

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Epidemiological Study of Ametropia at the CHU-BSS of kati

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Surgical Science 2024年第9期15卷 507-513页

作者： Daouda konaté Bréhima Mariko Sanata Sogoba Maimouna Yattara Lucienne Dembélé Daouda Doumbia Abdramane traoré Claude Oumar Bernard Camara Aminata kouma koniba.keita Abdoulaye Napo Fatoumata Sylla Lamine traoré Bocar Sidy Sall University Hospital (CHU-BSS) of kati Kati Mail University Hospital-Institute of Tropical Ophthalmology of Africa (CHU-IOta) Bamako Mali Mali Hospital Bamako Mali International Center of Ophthalmology of Mali (CIOM) Bamako Mali National Eye Care Program Bamako Mali

Introduction: Ametropias or refractive errors are pathologies commonly encountered in ophthalmology characterized by the projection on the retina of a blurry image. There are several types of ametropia and each of them has a specific means of correction. In the literature, numerous data have been reported on the issue through studies that were mostly carried out on infant populations. To better treat ametropia in a more formal way, it is important to know their general characteristics within a larger population, hence the present investigation, the aim of which is to carry out an epidemiological study of ametropia at the kati University Hospital-BSS. Materials and Methods: The study was carried out at kati University Hospital-BSS between January 1 and December 31, 2022 and included 663 ametropic patients of all ages. results: During the study period, 663 cases of ametropia were diagnosed out of 1678 new consultations, representing an incidence of 39.51%. Patients aged between 21 and 40 years were more affected. Depending on the type, these ametropias were dominated by compound astigmatism with 68.75% followed by isolated hyperopia and isolated astigmatism. Visual fatigue was the most mentioned reason for consultation. The female gender was in the majority with 70.9%. Low ametropia (Discussion: The growing visual needs of young people, especially with new information and communication technologies, would push them to consult the ophthalmologist more, and therefore to want optical correction in the event of a refractive anomaly, which would partly explain their high frequency in this age group. Conclusion: It is important to know the general characteristics of ametropia in the general population in order to improve the quality of life of patients affected by it through efficient therapeutic solutions.

关键词： Epidemiology Ametropia University Hospital kati

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Postoperative Occlusion of the Small Bowel with Flanges and/or Adhesions in General Surgery of kati BSS CHU

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Surgical Science 2018年第9期9卷 293-299页

作者： Abdoulaye Diarra koniba.keita Amadou traore Assitan koné issa traore idrissa tounkara Abdoulaye kante Fadima k.tall Daouda Diallo Moustaph issa Magané Madiassa konate Aboubacar koné Deborah Sanra Sanogo Ismael konare Alhassane traoré General Surgery Department KatiMali Anesthesia Service and resuscitation Department KatiMali Gastroenterology Department KatiMali

Objectives were to determine the frequency, describe the epidemiological and clinical aspects, therapeutic and analyze the postoperative course. Methodology: This was a retrospective study that covered 08 years (January 2009-December 2017). Inclusion criteria: all patients operated for obstruction of the small bowel by hail and/or flanging. Exclusion criteria: other types of occlusion and non-operated patients. result: We recorded a total of 162 cases of hail obstruction by adhesions and/or flanges at 2.87%. The average age was 32.04, the sex ratio was 1.2. The average consultation time was 4 days. Abdominal pain associated with stopping of material and gas was present in all our patients. X-ray of the abdomen without preparation carried out in all the patients made it possible to objectify in 150 patients (92.6%) of the hydro-hail levels. Inoperative occlusion of hail on flange was present in 80 patients (49.4%). Occlusion of the small bowel on flange and adhesion was present in 69 patients. Adhesion obstruction of hail accounted for 6.8% (11 cases). The most commonly used surgical technique was flange resection in 91 patients (56.2%). The follow-up was simple in 151 patients (93.2%). Mortality was 1.2% of cases, i.e. 2 deaths. The average duration of hospitalization was 6 days. Conclusion: Occlusion of the small bowel by flanging and/or adherence is a surgical emergency whose prognosis depends on early management.

关键词： Postoperative Occlusion Hail Bridle/Adherence Mali

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Primary Cerebral Lymphoma: About 22 Cases with Literature review

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Journal of Cancer Therapy 2016年第7期7卷 500-504页

作者： Adama Diakité Aphou Salle koné idrissa Mama Diarra koniba Diabaté tayeb kebdani Noureddine Benjaafar Pole de radiothérapie Institut National d’Oncologie CHU Ibn Sina Rabat Maroc

Primitive cerebral lymphoma (PCL) is a rare entity often poorly known. They are defined as extra nodal tumor interesting the CNS, brain and eye, and this in the absence of systemic lymphoma disease and brain metastases. The favoring factor is established immunosuppression which is explained by an increase in the incidence related to HIV. The basis of treatment is chemotherapy with consolidation radiotherapy. We report the experience of the National Institute of Oncology in rabat in management of this disease.

关键词： Primitive Cerebral Lymphoma Chemotherapy radiotherapy

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Fascist Leg Necrosis at the Bocar Sidi Sall University Hospital (BSS) in kati (Mali)

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Surgical Science 2022年第3期13卷 119-123页

作者： Abdoulaye Diarra Assitan koné Amadou traoré koniba.kéïta.idrissa.tounka.a.tounka.a.issa.tra.ré Oumou traoré Boubacar karembé Madiassa konaté Oulématou Coulibaly Modibo Togola Daouda Diallo Alhassane traoré Bkary Tientigui Dembélé Ibrahim Diakité Adégné Togo Department of General Surgery kati University Hospital Kati Mali Department of General Surgery CHU Gabriel Touré Bamako Mali Department of Anesthesia and resuscitation CHU of kati Kati Mali

Necrotizing fasciitis is a bacterial dermo-hypodermitis of necrotizing type with involvement of the superficial fascia of the muscles. We report the case of a 50-year-old patient with necrotizing fasciitis of the left leg following erysipelas. Clinical Case: A 50-year-old patient, received at the emergency department for necrotizing wound of the left leg, evolving for 25 days. The examination of the patient made it possible to find: an alteration of the general condition with a WHO score classified stage II. A necrotizing wound of the lower 2/3 of the left leg and the dorsal side of the left foot allowing pus to flow in places, the pedious pulse was well perceived, lymphadenopathy at the root of the homolateral thigh. The complete blood count made it possible to objectify a predominantly neutrophil hyperleukocytosis greater than 10,000/mm3. We first carried out a complete debridement of the necrotic tissues, in a second time we took the patient back to do the autocutaneous graft. The surgical follow-up was simple. Conclusion: Necrotizing fasciitis is a serious infection, management is multidisciplinary.

关键词： Necrotizing Fasciitis Lower Limb kati Mali

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Appendicular Abscess in General Surgery at the Bocar Sidi Sall University Hospital in kati

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Surgical Science 2020年第12期11卷 479-485页

作者： Abdoulaye Diarra koniba.keita Amadou traoré Assitan koné idrissa tounkara issa traore Souleymane Thiam Fadima k. tall Daouda Diallo Madiassa konate Aboubacar koné Deborah Sanra Sanogo Ismaël konare Alhassane traoré Adégné Togo Department of General Surgery CHU of Kati Kati Mali General Surgery Department CHU Gabriel Touré Bamako Mali Department of Anesthesia and resuscitation CHU of Kati Kati Mali Gastroenterology Department Point G Hospital Bamako Mali

Introduction: Appendicular abscess is a progressive complication of acute appendicitis in which the spread of infection is contained by the greater omentum and the slender loops resulting in the formation of a true se... 详细信息

rong>Introduction:rong> Appendicular abscess is a progressive complication of acute appendicitis in which the spread of infection is contained by the greater omentum and the slender loops resulting in the formation of a true septate abscess of the large peritoneal cavity. rong>Materials and Methods:rong> This was a retrospective study from January 2010 to December 2019 carried out at the Bocar Sidi Sall University Hospital in kati (CHU BSS in kati) in general surgery. It concerned all patients operated on for appendicular abscess in the department. rong>results:rong> 75 cases of appendicular abscess were collected, which represented 5.76% of surgical emergencies and 25% of acute appendicitis. The average age of the patients was 29 years. The male sex represented 67% of our patients with a sex ratio of 2. The average consultation time was 5 days. Abdominal pain was noted in all patients. It was localized in the right iliac fossa in 80% (n = 60) and diffuse in 2.7% of cases (n = 2). It was accompanied by nausea and vomiting in 93% of cases (n = 70), urinary disorders in 20% (n = 15), fever in 94% (n = 71), cessation of materials and gas in 1.33% (n = 1). Abdominal ultrasound was performed in 86% (n = 65). It made it possible to suggest a peri-appendicular effusion. Biological examination revealed a neutrophilic hyperleukocytosis greater than 20,000/mm3 in 47 patients, or 63%. All the patients were operated on by laparotomy (Marc Burney or midline subumbilical) under general anesthesia. The length of hospitalization was 6 days. We have not recorded any deaths. Morbidity was 8% (n = 6) represented by parietal suppuration. The postoperative course was straightforward in 92% of cases (n = 69). rong>Conclusion:rong> Appendicular abscess is a frequent medico-surgical emergency, the prognosis of which depends greatly on early diagnosis and adequate and immediate management.

关键词： Appendicular Abscess Surgery kati Mali

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Liver Abscesses: What Diagnostics and Therapeutics in the kati reference Health Center (Mali)?

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Surgical Science 2018年第9期9卷 344-350页

作者： Abdoulaye Diarra koniba.keita Amadou traore Assitan koné Madiassa konate idrissa tounkara Mamadou A. keita issa traore Modibo Togola Fadima k. tall Daouda Diallo Moustaph issa Magane Deborah Sanra Sanogo Aboubacar koné Ibrahim Diakite Alhassane traore Adégné Togo General Surgery Department Kati Mali Anesthesia Service and resuscitation Department Kati Mali Gastroenterology Department Kati Mali

The objectives were to determine the frequency of hepatic abscess, and to describe the clinical and para-clinical aspects and the therapeutic modalities. Method and material: This is a prospective study covering 24 months (January 2016-December 2017). results: This was a prospective study of 30 cases of liver abscess, ranging from January 2016 to December 2017, a period of 12 months. Inclusion criteria: What were included in this study were all patients hospitalized and treated for liver abscess. Criteria for non-inclusion: Abscess cases have not been treated in the service. The sex ratio was 2.3 and the average age was 35 years old. The main clinical signs were: fever (56.7%), hepatitis (73.3%) and hepatomegaly (26.7%). Hepatic collections objected to abdominal ultrasonography were localized in the right lobe in 70%. Surgical treatment was performed in 10% of cases. Medical treatment alone was performed in the majority of cases (56.7%);eclocated puncture was required in 10 cases (33.3%). The follow-up was simple in all our patients and we did not register deaths;the average duration of treatment was 5 days. Conclusion: Topical pathology in surgical practice in our country, liver abscess is common in our department;medical treatment is curative in the absence of complications.

关键词： Abscess Liver Mali

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rare Case of Acute Peritonitis by Perforation of an Appendicular Schistosomiasis at the CHU BSS in kati

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Surgical Science 2020年第12期11卷 385-392页

作者： koniba.keita Abdoulaye Diarra Sidiki keita Oulématou Coulibaly Assitan koné Salia Coulibaly Amadou traoré idrissa tounkara Lamine Soumaré Mamadou Diallo Bourama Togola Drissa traoré Pierre A. Togo Department of General Surgery CHU BSS Kati Mali Department of General Surgery CHU Point-G Bamako Mali reference health center of the commune VI of the district of Bamako Bamako Mali Medical Imaging Department CHU BSS Kati Mali General Surgery Department CHU Gabriel Touré Bamako Mali

Perforation of a pseudo appendicular tumor of bilharzial origin (bilharzia) is a rare etiology of acute peritonitis. His diagnosis is histopathological. The existence of comorbid malaria and surgical pathology is frequent in having a positive thick drop with Schistosoma mansoni eggs in his stool. After 3 months, the patient is doing well. In conclusion, we recommend the histopathological analysis of the surgical specimen after appendectomy and the detection of haematozoa for malaria in any case of fever in a surgical environment.

关键词： Acute Peritonitis Bilharzia Ileocecal Appendix

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Ileal Occlusion on Bezoars at kati BSS Hospital

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Surgical Science 2019年第1期10卷 39-43页

作者： keita koniba Abdoulaye Diarra Sidiki keita issa traore Salia Coulibaly Fadima tall Daouda Diallo Oulematou Coulibaly Assitan kone Boubacar kone Mahamadou Bacary Coulibaly Daouda konate Ismael konare Drissa traore General Surgery Department Kati Mali Medical Imaging Department Kati Mali Anesthesia resuscitation Department Kati Mali Ophthalmology Department Kati Mali

Bowel occlusions by bezoars are rare pathologies. They are due to an ob-struction of the intestinal lumen by a solid mass of fruits or undigested vegetable fibers. They are seasonal (wild fruit season from March to June) in the Sahel Zone. We report a case of small bowel obstruction in a 35-year-old rural man after swallowing a significant amount of wild grapes (Lannea microcarpa). We proceeded to the resection of the occluded ileal segment and performed an ileal terminal ileal anastomosis. There weren’t any complications during the postoperative site.

关键词： Bezoars Occlusion Jejunum Season

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traumatic Diaphragmatic Injury at Gabriel Toure University Hospital, Mali

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Surgical Science 2022年第3期13卷 110-118页

作者： Amadou traoré Madiassa konaté Abdoulaye Diarra idrissa tounkara Mohamed traoré Arouna Doumbia Amadou Bah Boubacar Yoro Sidibé Amadou Maïga tani koné Boubacar karembé Zakari Saye koniba.kéita Yacouba Bouaré Assitan koné Ibrahim Diakité Lassana kanté Bakary Tientigui Dembélé Alhassane traoré Adégné Togo General Surgery Department of Gabriel Touré University Hospital Bamako Mali Surgery Department of kati University Hospital Kati Mali reference Health Center of Commune II Bamako Mali reference Health Center of Commune III Bamako Mali

traumatic diaphragmatic injury (TDI) is rare and is most often the result of a traffic road accident (tra) or an assault. We initiated this study with the aims of determining the epidemiological, clinical and therapeutic aspects of TDI at Gabriel Toure University Hospital. This was a retrospective study from January 1999 to June 2021 that included all patients who presented a diaphragmatic injury consecutive to abdominal and/or thoracic trauma. In 22 years and 6 months, 46 cases of TDI were collected. They represented 0.17% of hospitalizations, 0.26% of surgical emergencies and 5.5% of thoraco-abdominal traumas. The average age was 31.69 years with a sex ratio of 3.2. Criminal stabbings accounted for 56.5% and tra for 19.6%. Penetrating injuries accounted for 78.3% of cases. The parietal lesion was thoracic in 21 cases (45.7%), abdominal in 19 cases (41.3%) and thoraco-abdominal in 6 cases (13%). The chest X-ray, performed in 15 patients, showed an intrathoracic gas bubble (4 cases) and hemothorax (6 cases). Diagnosis of diaphragmatic lesion was preoperative in 21.7% (10 cases). The diaphragmatic breach was on the left side in 65.2% (30 cases) and the average size was 3.17 cm. Laparotomy was performed in 89.1%, thoracotomy in 4.4% and thoraco-laparotomy in 6.5% of cases. The surgical procedure consisted of reduction of the herniated viscera in 15.2% (7 cases) and closure of the diaphragmatic breach with non-absorbable sutures in 82.6% (36 cases). Chest tube drainage was performed in 73.9%. The average length of hospital stay was 9.8 days. Mortality was 13.04%. Conclusion: traumatic diaphragmatic injury is rare but its frequency is increasing in our country. It most often affects the young man victim of assault or tra. This type of trauma is rarely isolated;you have to think about it in case of any thoraco-abdominal trauma. The treatment is surgical. The prognosis depends on the severity of the associated lesions.

关键词： Diaphragmatic Injury trauma Surgery Gabriel Toure

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