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World Journal of Cardiovascular Diseases 2019年第7期9卷 458-466页

作者： Ibrahima sangaré Hamidou Oumar Ba Youssouf Camara Ichaka Menta Rokiatou Mété Noumou Sidibé Souleymane Coulibaly Fousseyni Coulibaly Aladji Traoré Illo Diall lydia berenice sita sangaré Boubakar Diallo Kassoum Mamourou Sanogo University Hospital Gabriel Touré Cardiology Bamako Mali University Hospital Sidy Bocar Sall Cardiology Kati Mali University Hospital Point G Cardiology Bamako Mali University Hospital for Odontostomatology Bamako Mali

Objective: To study cardiovascular cardiac and echocardiographic features in high-level footballers and sedentary women in Bamako. Materials and Methods: This was a cross-sectional study conducted in Bamako from April 2015 to March 2016 among 14 to 35 years old high-level footballers and a group of untrained women. Data including socio-demographic, physical examination, ECG record and echocardiogram was inserted in Microsoft Excel and analyzed with IBM SPSS. Chi Square and Fisher statistical tests were used to compare our results. The significance level was p 0.05. Results: Forty-three female subjects, 51% being sedentary were recruited. Mean age, weight and height were significantly higher in sportswomen than in sedentary women with respectively p of <0.0001, 0.003 and 0.036. Bradycardia was found in sports subjects in 28.6% and sedentary tachycardia in 18.2%. Left ventricular hypertrophy and dilatation and left atrial dilatation were predominant in sportswomen. Conclusion: Bradycardia, left ventricle hypertrophy and dilatation were found more in sportswomen. These changes acquired through physical training are aspects of cardiac adaptation that we found in our sample. Other aspects were not found probably due to the small size of the sample.

关键词： ECG Echocardiography Footballers Women Sedentary Bamako

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

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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

Epidemiological, Clinical, Therapeutic, and Evolutionary Aspects of Heart Failure in the Medical Department at Gao Regional Hospital

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World Journal of Cardiovascular Diseases 2024年第5期14卷 309-321页

作者： Coulibaly Alhousseny Dollo Ibrahim Guindo Hamadoun Sidibé Lamine Mariko Souleymane Traoré Bassirima Dao Karim Guindo Ibrahim Togo Mamadou Sidibé Samba sangaré Ibrahima Ba Hamidou Oumar Ichiaka Menta Departement of Medicine Gao Hospital Gao Mali Departement of Medicine Mopti Regional Hospital Mopti Mali Departement of Medicine Tombouctou Hospital Tombouctou Mali Departement of Cardiology CHU Gabriel TOURE Bamako Mali

Introduction: Heart failure is a major public health pandemic, particularly in Africa, where its prevalence continues to increase. In northern Mali, few data exist, hence the interest of this study with the objective of studying the epidemiological, clinical and therapeutic and evolutionary aspects of Heart failure at the regional hospital of Gao. Patients and Methods: This was a cross-sectional, descriptive study that took place from July 2022 to June 2023 in the medical department at Gao Hospital. Results: The hospital prevalence of heart failure was 44.1%. The mean age was 47.30 ± 20 years (range: 16-88). Hypertension was the most common with 46.1%, followed by a sedentary lifestyle, and diabetes with 18.2% and 8.3% respectively;NYHA stage III-IV dyspnea was found in 83.9%. Reduced EF heart failure was present in 110 patients (76.9%), seventeen cases with moderately reduced EF (11.9%) and sixteen patients had preserved EF (11.2%). Global heart failure was the dominant (91.6%). The main etiologies of heart failure were dominated by hypertensive heart disease in 46 patients (32.2%), followed by postpartum cardiomyopathy with 43 cases (30.1%), primary dilated cardiomyopathy in 18 patients (12.6%), ischemic heart disease in 16 patients with 11.2%. Seven cases of valvular heart disease, or 4.9%. The evolution was favorable under treatment in 104 patients or 72.7%. In-hospital mortality was 14.7%. Conclusion: Heart failure is a common condition in sub-Saharan Africa, particularly in our country.

关键词： Heart Failure Epidemioclinical Progressive Gao Hospital

Therapeutic Compliance of Hypertensive Patients Followed in Ambulatory in the Cardiology Department of Kati University Hospital

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World Journal of Cardiovascular Diseases 2024年第5期14卷 333-342页

作者： Boubacar Sonfo Coumba Thiam Mariam Sako Massama Konaté Youssouf Camara Mamadou Touré Boubacar Diarra Diakaridja Sacko Samba Sidibé Bassan Diarra Hamidou Camara Asmaou Keita Konimba Diarra Hamidou Oumar Bâ Ibrahima sangaré Youssouf Guindo Sanoussi Daffe Daouda Fofana Souleymane Coulibaly Ichaka Menta Department of Cardiology University Hospital Bocar Sidy Sall Kati Mali Department of Cardiology University Hospital of Point G Bamako Mali Department of Cardiology Mali Hospital Bamako Mali Department of Cardiology University Hospital Mother-Child Luxembourg Bamako Mali Department of Cardiology University Hospital Gabriel Tour&#233 Bamako Mali Department of Cardiology Kayes Hospital Kayes Mali

Introduction: High blood pressure is a major public health problem worldwide due to its frequency and cardiovascular complications. Adherence to treatment for chronic diseases is a global problem. The aim was to study therapeutic adherence in hypertensive patients followed in ambulatory. Materials and Methods: This was a cross-sectional, descriptive study with prospective recruitment that took place from July 1 to December 31, 2022 (6 months) in the cardiology department of the university hospital of Kati. The variables studied were sociodemographic data, cardiovascular risk factors, comorbidities, the possession of insurance and compliance (the Girerd questionnaire was used to assess adherence). Results: A total of 1182 patients were consulted, including 887 for hypertension, a frequency of 75%. Fifty-six patients were included in the study. The average age was 58.18 ± 13.25 years with extremes of 30 and 80 years. There was a female predominance (75%) with a sex ratio of 0.3. The majority of patients lived in urban areas (89.3%). Out-of-school patients accounted for 44.6%, more than half of patients or 55.4% had no income, patients with medical coverage accounted for 67.9% of cases. The main risk factors were physical inactivity (25%) followed by smoking 14.3%. More than 71% of patients had a compliance problem and the main reasons were forgetting to take the drug with 73.2%, followed by delayed treatment of 50% and drug discontinuation of 28.6%. Conclusion: Compliance is a real challenge and a major public health issue. This study allowed us to find a real problem of compliance in our hypertensive patients. There was a statistically significant relationship between drug adherence and forgetting to take the drug and drug discontinuation.

关键词： Hypertensive Therapeutic Adherence University Hospital of Kati

Screening, Treatment and Control of High Blood Pressure on Five Sites in Mali

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World Journal of Cardiovascular Diseases 2024年第5期14卷 322-332页

作者： Mamadou Touré Sagara Ibrahima Youssouf Camara Hamidou Oumar Bâ Ibrahima sangaré Djénébou Traoré Noumou Sidibé Fousseyni Samassékou Massama Konaté Coumba Thiam Doumbia Asmaou Maiga Réné-Marie Dakouo Hamidou Camara Sako Mariam Sidibé Samba Adama Sogodogo Boubacar Diarra Boubacar Sonfo Aladji Traoré Mamadou Diakité Ilo Bella Diall Ichaka Menta Departement of Cardiology University Hospital Gabriel Tour&#233 Bamako Mali Departement of Cardiology Cardiology University Hospital Sidy Bocar Sall Kati Mali Internal Medecine University Hospital Point G Bamako Mali Departement of Cardiology Cardiology University Hospital &#8220H&#244pital du Mali&#8221 Bamako Mali Departement of Cardiology Cardiology University Hospital Mother-Children Bamako Mali

Introduction: High blood pressure is defined as blood pressure greater than or equal to 140 mm Hg for systolic and or 90 mm Hg for diastolic. It constitutes a major public health problem, the leading chronic disease in the world. The objective was to determine the prevalence, treatment rate and control of hypertension. Methods: This was a cross-sectional and descriptive study which took place over a period of 6 months in a hospital environment and in the general population. Results: Of the 1000 participants, 637 had hypertension, giving a prevalence of 63.70% with a female predominance. Thirty-three percent (33%) were unaware of their high blood pressure. The age group 60 and more was the most represented (44%). A proportion of 33 and 23.20 were overweight and obese participants, respectively. Male subjects were more overweight than female, unlike obesity which was more common among female subjects. Sixty-two percent (62%) of hypertensives were treated, of whom 44% were non-compliant. The excessively high cost and consumption of medications as needed were the main factors in therapeutic non-compliance. Twenty-two percent (22%) of all hypertensive patients and 35% of treated hypertensive patients were controlled. Women were more treated but less observant and less controlled than men. Therapeutic coverage and combination therapy rates were lower in rural areas. Hypertensives who had a high level of education were better treated and controlled than those who had no level. Conclusion: High blood pressure remains a real public health problem in Mali. It is more common in people aged 60 and over and in females. One in three hypertensives were unaware of their hypertension. The majority received antihypertensive treatments, but only a minority of them had their hypertension controlled.

关键词： High Blood Pressure Screening Control Rate Mali

Evaluation of Antibiotic Prescribing in the Pediatric Department of Gabriel TouréTeaching Hospital, Bamako, Mali

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Open Journal of Pediatrics 2024年第3期14卷 645-656页

作者： Pierre Togo Hawa Konaré Mariam Maïga Karamoko Sacko Djénéba Konaté Abdoul Karim Doumbia Adama Dembélé Oumar Coulibaly Aminata sangaré Mohamed Elmouloud Cissé Fousseyni Traoré Belco Maïga Ibrahim Ahamadou Aminata Doumbia Lala N’Drany Sidibé Amadou Touré Yacouba Aba Coulibaly Kalirou Traoré Tati Simaga Souleymane Sagara Leyla Bagna Maïga Bory Traoré Abdoul Aziz Diakité Fatoumata Dicko Mariam Sylla Sounkalo Dao Boubacar Togo Paediatric Department Gabriel Tour&#233 Teaching Hospital Bamako Mali Pediatric Department Distric VI Reference Health Center Bamako Mali Infectious Diseases Department Point G Teaching Hospital Bamako Mali

Objectives: The main objective was to evaluate antibiotic prescribing in the Department of Pediatrics at Gabriel Touré teaching hospital. Methods: This was a prospective descriptive study conducted from September 1 to November 31, 2018, in the Department of Pediatrics at Gabriel Touré teaching hospital. All children aged 0 to 15 years hospitalized for any pathology during the study period and having received at least one antibiotic had been included. Results: We collected 445 children’s records out of 1032 admissions during the study period, representing a hospital frequency of 43.1%. The sex ratio was 1.3%. The 2 - 5 age group accounted for 48.1%. Fever was the reason for consultation in 45.6% of cases. Patients’ general condition was altered in 60% of cases. The fathers were blue-collar workers in 65.4% and the mothers housewives in 85%, and had no education in 42.9% and 64.5% respectively. Hepatomegaly was present in 18.2%, splenomegaly in 9.6% and peripheral adenopathy in 3.1%. The site of infection was pulmonary in 37.6% and ENT in 9.2%. Bacterial infection was assumed on admission in 54% of cases, and meningitis in 57.7%. The discharge diagnosis was malaria in 54.6%, severe acute malnutrition in 18.6% and meningitis in 6.7%. The death rate was 3.8%. Neutrophilic leukocytosis was present in 47.3% of patients. CRP was positive in 85% of patients. Blood cultures taken in 27.6% of patients were positive in 5. CSF analysis in 30% of patients showed elevated leukocytes in 6.5%. No cultures were positive. Antibiotic prescription was justified by infectious hypotheses in 43.1% of patients. β-lactam antibiotics were prescribed in 98.6%. Antibiotic therapy was not adapted to national/international recommendations in 68.3% of cases, and was not justified in 16.3% of cases on D5 of hospitalization. Conclusion: Antibiotic use was justified in more than half of patients, but remained inadequate in almost two-thirds of cases, in line with national and international recommendations.

关键词： Antibiotic Prescription Hospitalization Child

A Rebalancing Framework for Classification of Imbalanced Medical Appointment No-show Data

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Journal of Data and Information Science 2021年第1期6卷 178-192页

作者： Ulagapriya Krishnan Pushpa sangar Department of Computer Science and Engineering St.Peter’s Institute of Higher Education and ResearchChennaiIndia

Purpose: This paper aims to improve the classification performance when the data is imbalanced by applying different sampling techniques available in Machine Learning.Design/methodology/approach: The medical appointment no-show dataset is imbalanced, and when classification algorithms are applied directly to the dataset, it is biased towards the majority class, ignoring the minority class. To avoid this issue, multiple sampling techniques such as Random Over Sampling(ROS), Random Under Sampling(RUS), Synthetic Minority Oversampling TEchnique(SMOTE), ADAptive SYNthetic Sampling(ADASYN), Edited Nearest Neighbor(ENN), and Condensed Nearest Neighbor(CNN) are applied in order to make the dataset balanced. The performance is assessed by the Decision Tree classifier with the listed sampling techniques and the best performance is identified.Findings: This study focuses on the comparison of the performance metrics of various sampling methods widely used. It is revealed that, compared to other techniques, the Recall is high when ENN is applied CNN and ADASYN have performed equally well on the Imbalanced data.Research limitations: The testing was carried out with limited dataset and needs to be tested with a larger dataset.Practical implications: This framework will be useful whenever the data is imbalanced in real world scenarios, which ultimately improves the performance.Originality/value: This paper uses the rebalancing framework on medical appointment no-show dataset to predict the no-shows and removes the bias towards minority class.

关键词： Imbalanced data Sampling methods Machine learning Classification

Etiological and Radiological Profile of Acute Lower Respiratory Infections during the Pre-COVID Period in the Paediatric Ward of the Teaching Hospital of Mali and in the Community Health Centre of Yirimadio in Bamako

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Open Journal of Pediatrics 2023年第2期13卷 262-275页

作者： Bourama Kané Mariam Maiga Oumou Koné Korotoumou Wélé Diallo Aboubacar sangaré Mody Abdoulaye Camara Mariam Doumbia Abdoul Karim sangaré Bréhima Traoré Lassine G. Timbiné Ibrahima Cissé Ahmadou I. Dramé Bréhima Kouriba Department of Paediatrics CHU Hôpital du Mali Bamako Mali Paediatric Department of the Centre de Santé de Référence de la Commune VI Bamako Mali National Institute of Public Health Bamako Mali Medical imaging department of the CHU Hôpital du Mali Bamako Mali Charles Mérieux Infectious Diseases Centre Bamako Mali Centre de Santé Communautaire de Yirimadio Bamako Mali Department of Anaesthesia and Intensive Care CHU Hôpital du Mali Bamako Mali

Introduction: Every year, nearly 4 million people pass away from acute respiratory infections. 98% of such deaths are due to lower respiratory tract infections. Even though studies have been carried on lower respiratory infections x-ray aspects in Mali, very few studies have been done to reveal bacteriological and virological evidence of this disease. Materials and methods: It is about a descriptive prospective study carried out from January to December 2018 having involved patients of all ages, coming for medical consultation at the Yirimadio Community-based health center as well as children from 6 months to 15 years old coming at the pediatric department of UHC Hôpital du Mali for a lower respiratory infection. They had all undergone chest X-ray and a PCR. The purpose: of this work is to study etiological and x-ray aspects of acute lower respiratory infections at the Yirimadio Community-based Health Center and at the UHC pediatric department of Hôpital du Mali. Findings: From January to December 2018, we recorded a frequency of 1.19%. The age group 0 - 5 years was the most represented (64.5%) with a sex ratio of 0.97 for women. Cough was the most common clinical sign (98.7%) followed by fever (58.9%). Standard frontal chest X-ray was pathological in 70% of our patients. It was bronchitis in 75.4% of cases, pneumonia (13.5%), and bronchopneumonia (12.3%). PCR positive was in 83.9% of patients. It revealed a co-infection in more than half of the patients (52.5%), bacterial infection (16.1%) and viral infection (15.2%). Pathogens isolated ranked by frequency were Streptococcus pneumoniaa (87.6%) followed by Staphylococcus aureus (24.9%) and human rhinovirus (17%). The most common viral causes were human rhinovirus (17%), followed by influenza A and B virus (7%) and human parainfluenza virus (7%). Conclusion: It stemed from the study that lower respiratory infections were mainly due to Streptococcus pneumonea and human rhinovirus during pre-COVID at the Yirimadio Community-based health center and UHC Hôpital du Mal

关键词： Lower Respiratory Infections Etiologies Children Mali

Congenital Lobar Emphysema in an Infant: A Case Report from the University Hospital of Mali

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Open Journal of Pediatrics 2022年第2期12卷 453-459页

作者： Bourama Kané Korotoumou Wéllé Diallo Aboubacar sangaré Garan Dabo Mamadou Traoré Mohamed Maba Traoré 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 Reference Health Center of Commune VI Bamako Mali

Congenital lobar emphysema is characterized by distress due to hyperinflation of the affected lung lobe(s). We report the case of a 2-month-old infant with congenital left lower lobe emphysema. A 2-month-old female infant, born at term without incident, was hospitalized for respiratory distress. On a postnatal day 15, respiratory distress occurred. On admission, he weighed 3400 g and was apyretic. He had a polypnea of 58 cycles/min and a oxygen saturation of hemoglobin of 90% on room air. A chest radiograph revealed hyperclarity of the left lung. Chest CT revealed left lower lobe emphysema. He underwent a left lower lobectomy. The postoperative course was uneventful. He was discharged from the hospital 7 days after surgery without sequelae. Physicians should be aware that congenital lobar emphysema can present with respiratory distress in infants. A chest CT scan confirms the diagnosis. Surgical treatment is effective.

关键词： Congenital Lobar Emphysema Infant Pediatrics Mali Hospital

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