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Management and Prognosis of Early Postpartum Hemorrhage in African Low Setting Health

Open Journal of Obstetrics and Gynecology 2018年第1期8卷 1-9页

作者： Youssouf traoré Ibrahima Téguété Amadou Bocoum Mamadou traoré Seydou Dao Marion Koko Bomini Niani Mounkoro Amadou Dolo Department of Gynecology and Obstetrics Gabriel Touré Teaching Hospital Bamako Mali Department of Gynecology and Obstetrics Yopougon Teaching Hospital Abidjan Cote d’Ivoire

Early postpartum hemorrhage is one of the major causes of maternal death in the world especially in developing countries. Its management often relieves resuscitation that is often difficult to set up in our countries and sometimes based on invasive and mutilate surgery. Objectives: The purpose of this survey was to report frequency of this pathology, to describe its management and the factors that influence the prognosis of early postpartum hemorrhage in low setting health in Africa. Method: Authors conducted a prospective study that analyzed early postpartum hemorrhage in the motherhoods of Gabriel Touré teaching hospital and community five health reference center of the district of Bamako. It took place from January, 2015 to December, 2016. The study concerned all the cases of early postpartum hemorrhage according to WHO definition. Statistical tests used were X2 or Fisher test, its 95% confidence interval (CI95%), p value was significant if Results: Early postpartum hemorrhage frequency has been 0.7% (62 cases for 8.885 deliveries). Sixty nine and one percent (69.1%) of patients have been blood fluid transfused. Obstetric treatment dominated by uterine revision (30.7%). Hysterorraphy (4.0%), hysterectomy (3.0%), suture of uterus injuries (15.7%), hypo gastric artery ligature (2.0%) and B-Lynch compression suture (2.0%) have been the main practiced surgical operations. No satisfy blood transfusion need was 26.9%. The main risk factors of early PPH were high parity (p = 0009;RR = 3.04;CI95% [2.80 - 5.11]), prolonged labor (p = 0004;RR = 4.00;CI95% [3.06 - 10.02]), oxytocin/prostaglandin use (p = 0003;RR = 1.47;CI95% [1.17 - 3.16]). Eleven of maternal occurred (11.8%). Conclusion: Early postpartum hemorrhage is still a severe event in developing countries especially. Its management sometime consisted to invasive cares. Maternal prognosis that is influenced by unsatisfied blood need and late management is marked by high lethality.

关键词： Early Postpartum Hemorrhage Risk Factors Surgery Maternal Death

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Penile Skin Flap Urethroplasty for Urethral Stenosis at SominéDOLO Hospital of Mopti (MALI)

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Open Journal of Urology 2021年第7期11卷 240-250页

作者： Dramane Cissé Honoré Jean Gabriel Berthé Abdoulaye traoré Mamadou Lamine Diakité Modibo Coulibaly Mory Koné Djibril traoré Bréhima traoré Diamilatou Thiam Mamadou Tidiani Coulibaly Alkadri Diarra Amadou Kassogué Moussa Salifou Diallo Oumar Guindo Université des Sciences des Techniques et des Technologies de Bamako Bamako Mali Hô pital Sominé DOLO de Mopti Mopti Mali CHU du Point G Bamako Bamako Mali Direction Régionale de la Santé de Mopti Mopti Mali CHU Gabriel TOURE Bamako Bamako Mali CHU Luxembourg Bamako Mali CHU Kati Kati Mali

Introduction: Penile skin flap urethroplasty is a technique for replacing or enlarging an obstructed urethra. We aim to report our experience in the practice of this surgical technique. Patients and method: This was a prospective and descriptive study of penile skin flap urethroplasty indicated for urethral stenosis between January 2014 and December 2019. Results: A total of 21 penile skin flap urethroplasties for urethral stenosis were performed. The average age was 38.6 years old. The stenosis was of sclero-inflammatory origin in 15 cases (71.43%). It was of bulbo-perineal, penile, and penile-bulbar topography in about a third each. A history of urethral surgery was reported in 80.95% of the cases. The average length of the stenosis was 6.8 cm. Mundy circular skin flap urethroplasty about 15 cases (71.43%), and Quartey rectangular skin penile flap urethroplasty about 6 cases (28.57%) were the surgical techniques performed. The postoperative follow-up was favorable in 19 cases (90.48%). Two cases of urethral fistula (9.52%) underwent the 2nd urethroplasty. Urination at 1 year was satisfactory. No relapse has been reported to date. However, 4 patients (19.04%) reported asthenic ejaculation, and 1 patient (4.76%) a marked decrease in sexual pleasure. Conclusion: This surgical technique is effective in terms of voiding when the surgical indications are well chosen. The sexual aspect must be taken into account and the intervention only offered to those who really need it.

关键词： Urethral Stenosis Urethroplasty Pedicled Flap

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Pneumothorax in Children: A Study of 47 Pediatric Cases at Mali Hospital 2017-2020

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Open Journal of Pediatrics 2022年第3期12卷 476-488页

作者： Korotoumou Wélé Diallo Bourama Kané Aboubacar Sangaré Mamadou traoré Mohamed Maba traoré Mamadou Berthé Mariam Maiga Amadou Ibrahim Dramé Department of Pediatrics Mali Hospital Bamako Mali Reference Health Center of Commune VI Bamako Mali Department of Anesthesia and Resuscitation Mali Hospital Bamako Mali Reference Health Center of Commune V Bamako Mali Department of Medical Imaging Mali Hospital Bamako Mali National Institute of Public Health Bamako Mali

Objectives: Pediatric pneumothorax, whether primary or secondary (infection, trauma, or iatrogenic), is sometimes life-threatening. We tried to determine the clinical characteristics of pediatric pneumothorax in Mali. Materials and Methods: We collected all pediatric patients (0 - 15 years) admitted for pneumothorax in the pediatric department of the Mali Hospital from January 2017 to December 2020. Results: During this period, a total of 5569 children aged 0 - 15 years were hospitalized, of whom 47 had pneumothorax or 0.84%. Children under 5 years of age were the most affected (80%). Dyspnea was the most common reason for hospitalization (95.7%). The causes of pneumothorax were (in order): infectious causes dominated by bullous dystrophies (70.2%), traumatic (25.5%), and iatrogenic (4.2%). Pneumothorax was compressive in 42.6%. The frequency of anemia was 79.3%. Surgical drainage was performed in 87.2% and almost all (97.6%) were treated with amoxicillin/clavulanic acid. The mean duration of hospitalization was 10.06 days (range: 0 - 35 days): 74.5% were cured while 25.5% died. Conclusions: We reconfirmed that pneumothorax is a pediatric emergency. Children under 5 years of age are the most affected. The main etiologies are infectious bronchopneumonia. The prevention and treatment of respiratory infections, the implementation of good bacteriological diagnostic tools, and the use of surgical video-thoracoscopy will reduce its mortality rate.

关键词： Pneumothorax-Secondary-Child-Hospital of Mali

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Small Bowel Obstruction: Epidemiological, Clinical and Therapeutic Aspects in the General Surgery Department of Hôpital SominéDOLO de Mopti

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Surgical Science 2021年第6期12卷 196-203页

作者： Bréhima traoré Modibo Coulibaly Djibril traoré Oumar Guindo Fodé Mory Keita Nouhoum Samassekou Abdoulaye traoré Souleymane Sanogo Korotimi Mallé Kiffery Ibrahim Keita Pierre Coulibaly Aly Boubacar Diallo Dramane Cissé Dramane Samaké Lassana Kanté Department of General Surgery H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Biomedical Laboratory H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Public Health H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Surgery Polyclinique des armées Kati Mali Department of Anesthesia-Resuscitation H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Medical Imagery CHU Luxembourg Bamako Mali Department of Gynecology-Obstetrics H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Surgery H&ocirc pital de Sikasso Sikasso Mali Department of Medicine H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of General Surgery of CHU du Point-G Bamako Mali

Small bowel obstruction (SBO) is defined as a complete and persistent cessation of the transit of materials and gases. It occurs in a segment of the digestive tract located between the pylorus and the colorectal junction. We report an observational study which aims to describe the epidemiological, clinical and therapeutic aspects of small bowel obstruction. This study was carried out in the General Surgery Department of Hôpital Sominé DOLO de Mopti from October 1, 2016 to October 1, 2018. A total of 114 patients were recorded for whom the diagnosis was related to an occlusion. The median age was 37 years with extremes ranging from 6 months to 90 years. Male sex was predominant with a sex-ratio of 1.8. The frequency of small bowel occlusions over all occlusions was 74.03%. The most encountered clinical signs were as followed: abdominal pain (100%), vomiting (88.6%), cessation of materials and gas (79.9%) and meteorism (62.3%). All patients underwent medical imaging, the most common of which was an abdomen without preparation X-ray (AWP). On the etiological level, the main causes found postoperatively were: flanges and adhesion (55.2%), strangulated hernias (28.0%), acute intussusception (6.1%), small bowel volvulus (3.5%) and small bowel tumor (1.6%). Releasing the bridles was the most common surgery process (28.0%). The morbidity of the immediate follow-up was (13.1%) and the mortality was (7.0%). This high mortality is due to ignorance of the signs of seriousness and the socio-cultural barrier (decision of the patriarch to agree to a surgical intervention), the late use of hospital facility and the limited financial capability of the patients.

关键词： Occlusions of the Small Intestine Etiology Surgical Treatment Hôpital Sominé DOLO de Mopti

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Farmers’ Perception and Impact of Rice Yellow Mottle Disease on Rice Yields in Burkina Faso

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Agricultural Sciences 2015年第9期6卷 943-952页

作者： Valentin S. E. traoré Bouma James Néya Mouhameth Camara Vernon Gracen Samuel K. Offei Oumar traoré Institut de l’Environnement et de Recherches Agricoles (INERA) Ouagadougou Burkina Faso Institut Supérieur de Formation Agricole et Rurale (ISFAR) Université de Thiès Bambey Sénégal West African Centre for Crop Improvement (WACCI) University of Ghana Legon Ghana

Rice improvement for disease resistance has scarcely involved farmers’ knowledge in Sub-Saharan Africa. A participatory rural appraisal was conducted in two main rice cultivation areas in Burkina Faso to assess farmers’ awareness of rice production constraints with emphasis on rice yellow mottle disease (RYMD) and its management. Farmers’ preference for rice varieties to be used in the breeding program was also assessed. Major concerns for rice cultivation as perceived by farmers were water shortage and RYMD. However, relative importance of each constraint depended on the survey areas, RYMD being prominent at Banzon while water shortage predominated at Mogtedo. Mogtedo farmers preferred rice variety FKR19 because of its tolerance to drought. At Banzon, farmers’ first criterion was taste which was reflected in the choice of variety FKR18. Yield was also a major criterion in both areas, positioning NERICA varieties FKR56N, FKR62N, and FKR60N among the top preferred varieties. Farmers mentioned RYMD as the most important rice disease. Most farmers used varietal shifts or pesticide treatments for RYMD management. RYMD incidence reached 28% in average at Banzon over the 2012-2013 main growing seasons. In rice varieties FKR56N, FKR62N and TS2, diseased plants yielded 79.3% less than the healthy ones. Accordingly, based on disease incidence, overall yield loss in the study area was estimated at 22.3%. Altogether, rice production can be significantly increased by taking RYMD into account in a participatory rice breeding strategy.

关键词： Farmers’ Knowledge Disease Management Preferred Varieties Yield Loss

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Modified Atomic Orbital Theory of the O⁺ Ion Originating from 2D⁰ and 4S⁰ Metastable States

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Journal of Applied Mathematics and Physics 2022年第6期10卷 1873-1886页

作者： Malick Sow Fatou Ndoye Babou Diop Alassane traoré Abdou Diouf Boubacar Sow Department of Physics Atoms Lasers Laboratory Faculty of Sciences and Technologies University Cheikh Anta Diop Dakar Senegal

We report in this paper energy positions of the 2D0_2s22p2(1D)nd(2F);2D0_2s22p2(1D)nd(2D);2D0_2s22p2(1D)nd(2P);2D0_2s22p2(1D)ns(2D);2D0_2s22p3(3D)np(2P);2D0_2s22p3(3D0)np(2F), and 4S0_2s22p3(5S0)np(4P) Rydberg series in the photoionization spectra originating from 2D0 and 4S0 metastable states of O+ ion. Calculations are performed up to n = 20 using the Modified Orbital Atomic Theory (MAOT) [1]. The present results are compared to the experimental data of Aguilar et al. [2] which are the only available values. The accurate data presented in this work may be a useful guideline for future experimental and other theoretical studies.

关键词： Semiempirical Calculations Modified Orbital Atomic Theory Electron Correlation Calculations Atoms and Ions Rydberg Series Quantum Defect

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Study of Tuberculosis in Children Aged 1 Month to 15 Years in the Pediatric Ward of the Hospital of Mali 2015-2021

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Open Journal of Pediatrics 2022年第2期12卷 433-448页

作者： Bourama Kané Korotoumou Wéllé Diallo Aboubacar Sangaré Youssouf Dembélé Garan Dabo Mamadou traoré Mohamed Maba traoré Mamadou Berthé Mariam Maiga Department of Pediatrics Mali Hospital Bamako Mali Department of Medicine Mali Hospital Bamako Mali Reference Health Center of Commune V Bamako Mali Medical Imaging Department Mali Hospital Bamako Mali National Institute of Public Health Bamako Mali Reference Health Center of Commune VI Bamako Mali

Introduction: In 2020, an estimated 9.9 million people are living with tuberculosis worldwide, including 1.1 million children. Tuberculosis is the 2nd leading cause of death from infectious disease after COVID-19 and the 13th leading cause of death worldwide. Objective: To collect cases of tuberculosis in children aged 1 month to 15 years in order to study the epidemio-clinical aspects in the pediatric department of the Mali Hospital during the period 2015-2021. Materials and Methods: This was a descriptive, retrospective study from January 1, 2015, to December 31, 2020, and a prospective study from January 1 to December 31, 2021, among children aged 1 month to 15 years admitted for suspected tuberculosis in the pediatric ward of the Mali Hospital. Results: From January 2015 to December 2021, we collected 69 cases of tuberculosis among 9438 hospitalized children, i.e. a frequency of 0.73%. The average age was 6.16 years with extremes of 3 months and 15 years. The sex ratio was 1.1% in favor of boys. The majority of children were vaccinated against tuberculosis (88.4%). The most frequent symptoms were fever (76.8%) and weight loss (73.9%). The pulmonary form was the most frequent (54.9%). Bacteriological confirmation was done in 43.5% of our children. It was Mycobacterium tuberculosis in all confirmed cases. More than half of our children (65.2%) were treated with first-line anti-tuberculosis drugs for 6 months. We observed a cure in 42.0% of our patients and a case fatality rate of 39.1%. Conclusion: Tuberculosis in children is frequent in Mali Hospital despite good BCG vaccination coverage. Its mortality remains high and is maintained by malnutrition, HIV, and the emergence of resistant strains of bacilli.

关键词： Tuberculosis Children Mali Hospital

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Tubercular Uveitis in the Event of HIV Infection about a Case

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Journal of Tuberculosis Research 2019年第4期7卷 253-258页

作者： Abdramane traoré Hamsatou Cisse Nagou Tolo Djenebou traoré Condé Lassana Assétou Soukho Kaya Abasse Sanogo Bréhima B. Berthé Ibrahima Amadou Dembélé Mahamadou Saliou Djibril Sy Nanco Doumbia Sekou Mamadou Cissé Boubacar Zana Cisse Mamadou Dembélé Abdel Kader traoré Hamar Alassane traoré Department of Medicine Sidy Bocar Sall Kati Hospital Koulikoro Mali Department of Internal Medicine at CHU Point G Bamako Mali Department of Internal Medicine of CHU Gabriel Touré Bamako Mali Internal Medicine Service of the Mali Hospital Bamako Mali

Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis. This disease is the second leading cause of infectious mortality in the world after infection with the human immunodeficiency virus. We report a case of multifocal tuberculosis with neuromuscular and ocular localization in an HIV-1 immunosuppressed patient in clinical and virological failure following therapeutic discontinuation due to non-compliance. This is a 43-year-old immunocompromised HIV1 patient with a history of cerebral toxoplasmosis in 2016 who consulted for right hemiplegia. These symptoms would go back to about 3 days marked by a deficit of progressive installation of the right hemicorps preceded by diffuse headaches, of moderate intensity without triggering factor radiating to the eyes associated with an intermittent fever with periods of spontaneous remissions, night sweats and chills, non-selective anorexia, non-increasing physical asthenia and unquantified weight loss. Management was 8-month antituberculous treatment, combining the first two months isoniazid (INH), rifampicin (RMP), pyrazinamide (PZN) and ethambutol (EMB), then the next 6 months (INH) and rifampicin (RMP). The reintroduction of the same antiretroviral protocol and a reinforcement of the therapeutic education made it possible to observe a decrease of the viral load. Treatment of ocular involvement was instituted with Timosol 1 drop in the eyes morning and evening and Diclocid 1 mg/ml: 1 drop in the eyes in the morning.

关键词： Tucerculose/Uveitis

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Acute Pneumonia Characteristics in Children under Five Years of Age in Bamako, Mali

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Open Journal of Pediatrics 2019年第1期9卷 7-18页

作者： Fatoumata Dicko-traoré Abdoul Karim Doumbia Mariam Sylla Mariatou traoré Djènèba Konaté Fatoumata Léonie Diakité Karamoko Sacko Belco Maiga Hawa Diall Oumar Coulibaly Pierre Togo Fousseyni traoré Abdoul Aziz Diakité Yacouba Toloba Department of Pediatrics CHU Gabriel Touré Bamako Mali Faculty of Medicine and Odontostomatology Bamako Mali Department of Pneumology CHU Point G Bamako Mali

Pneumonia is the most common cause of mortality in child under five years of age. The objective of the study was to assess socio-demographic and clinical characteristics of children under 5 hospitalized for pneumonia. Material and method: We conducted a 6 months prospective study from June 1st, 2016 to December 31st, 2016 in the general pediatric service in the Pediatric Department of Gabriel Touré Teaching Hospital in Bamako, the capital city of Mali. Result: We have selected 63 cases of pneumonia according to our definition criteria, i.e. 2.2% of hospitalizations for children aged 1 to 59 months. The average age was 14 months. Infants under 2 years accounted for 82.53%. The sex ratio was 1.2. Seventy eight percent came from an unfavorable socio-economic background. The majority of mothers were uneducated (71.42%). Breastfeeding was exclusive up to 6 months in 50.79% of patients. Vaccination according to the national program was not up to date in 27% of patients. The average consultation time was 18 days. On admission, 81% of the patients had a fever, 93.64% had a tachypnea and 58.73% had crackling rales at pulmonary auscultation. Hypoxemia was present in 58.73%. Severe anemia was present in 79.36%. Radiologically, opacity was found in 42 patients (66.66%). The blood culture was positive in 8.3%. Beta-lactams were first-line prescribed in all patients. The case fatality rate was 9.52%. The factors associated with mortality were age less than 14 months (p = 0.08), adverse socio-economic conditions (p = 0.0003) and the presence of hypoxemia at the entrance (p = 0.01). Conclusion: Pneumonia remains major cause of morbidity and mortality in our context. Emphasis should be put on preventive measures.

关键词： Acute Pneumonia Children Mortality Mali

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Infectious Complications after Cesarean Delivery: Trends of Incidences, Risk Factors, and Prognosis in a Third Health Level Center in Africa. Case of Gabriel TouréTeaching Hospital

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Open Journal of Obstetrics and Gynecology 2018年第1期8卷 10-19页

作者： Youssouf traoré Ibrahima Téguété Amadou Bocoum Malado Gamby Sidy traore Soumaila Sanogo Seydou Zana Dao Mamadou S. traoré Niani Mounkoro Department of Gynecology and Obstetrics Gabriel Touré Teaching Hospital Bamako Mali Department of Gynecology and Obstetrics Commune II Health Center Bamako Mali Department of Gynecology and Obstetrics Point G Teaching Hospital Bamako Mali

Post cesarean infections are the main sources of fever in the postpartum. We have undertaken this study in an African health setting where conditions of working are different from those in developed countries. Objectives: The objectives of this survey were to appreciate incidences, risk factors and prognosis of post cesarean infections. Method: We conducted a randomized historical cohort study in the department of gynecology and obstetrics of Gabriel Touré teaching hospital from 2010 to 2015. Data have been analyzed using X2 or Fisher test according their application conditions, p value Results: From 2010 to 2015 we performed 15,963 deliveries within 5263 cesareans sections (32.97%). According to all the deliveries, the global frequency of infection fluctuates from 1.5% in 2010 to 2.1% in 2015. The main risks that influenced the occurrence of post cesarean infections were: the context of cesarean section (RR = 2.05;CI95% (1.35 - 3.11);p 0.01), the prolonged labor (RR = 1.38;CI95% (1.05 - 1.81);p 0.01), the length of cesarean (RR = 3.00;CI95% (1.89 - 4.90);p 0.01), and genital bleeding (RR = 1.50;CI95% (1.10 - 1.90);p 0.01). The complications reported were endometritis (43.55%), wound infection (18.11%), breast infection (32.05%), puerperal psychosis (9 cases). We recorded six cases of pelviperitonitis and three cases of sepsis. Four cases of maternal death due to septic shock have been recorded (1.43%). Conclusion: Post cesarean infections constitute a real problem of public health in developing countries. In our survey, the main factors of infections have been context of cesarean, prolonged labor and length of cesarean. Endometritis, breast infection and wound infection are the major complications after cesarean section. The respect of protocol of the management of patients should permit to prevent this deadly complication.

关键词： Fever Postpartum Cesarean Endometritis Risk Factor Death Mali

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