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Splenectomy: Indications in the General Surgery Department of Ignace Deen Hospital

Surgical Science 2024年第4期15卷 219-224页

作者： mamadou Sakoba Barry Boubacar Barry Sandaly diakité Aboubacar Touré Aissatou Taran Diallo General Surgery Department Ignace Deen National Hospital at Conakry University Hospital Conakry Guinea Faculty of Health Sciences and Technology Gamal Abdel Nasser University of Conakry Conakry Guinea

Introduction: Splenectomy is the surgical removal of the spleen. It can be performed during various pathologies, ranging from abdominal trauma to hemoglobinopathies. The progress made in the knowledge of the immune functions of the spleen and the fear of post-splenectomy infectious complications have favored the development of surgical or non-surgical splenic preservation techniques calling into question the dogma of splenectomy. The aim of this study was to determine the indications for splenectomy. Methodology: This was a retrospective, descriptive study lasting 5 years in the general surgery department of the Ignace Deen National Hospital. All files of splenectomized patients were included, our variables were clinical, therapeutic and progressive. Results: We collected 42 cases of splenectomies out of the 2478 surgical procedures performed, representing 1.7% of the department’s surgical activities. The average age was 44 years. The age group of 41 to 50 years was the most represented, i.e. 26% (n = 11) of cases. Sex ratio = 1. Abdominal pain was the reason for consultation in patients, i.e. 100% (n = 42) of cases. The antecedents were dominated by recurrent malaria with 52.3% (n = 22) of cases, then recurrent anemia in 21% (n = 9), and 16.7% (n = 7) had sickle cell disease. Splenomegaly was found in 31 patients, or 73.6%. Ultrasound was performed in all patients. The indications for splenectomy were: isolated splenomegaly with risk of rupture (38%, n = 16), hypersplenism (26%, n = 11) and trauma to the spleen (19.04%, n = 8). Total splenectomy was performed in all cases. The surgical consequences were favorable in 85.7%, (n = 36) with morbidity of 14% (n = 6) and mortality of 9.52% (n = 4). The average length of hospitalization was 10.4 days with extremes of 1 and 22 days. Conclusion: Splenectomy constitutes a relatively common surgical procedure in our context. The indications for splenectomy were isolated splenomegaly with risk of rupture, hypersplenism and tra

关键词： Splenectomy Indications Ignace Deen

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Predictive Factors of Renal Damage during Sickle Cell Disease at the Hematology-Oncology Department of Donka University Hospital

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Open Journal of Nephrology 2024年第3期14卷 302-312页

作者： Moussa Traoré Ansoumane Sayon Kanté marthe Sidibé mamady diakité Mohammed Lamine Tégui Camara Foussény diakité mamadou Saliou Baldé Ibrahima Chérif Mustapha Komrabai-Kanu Mohammed Lamine Kaba Nephrology-Hemodialysis Department of Donka University Hospital Conakry Guinea Hematology-Oncology Department of Donka University Hospital Conakry Guinea Hematology-Oncology Department of Ignace Deen University Hospital Conakry Guinea Medical Care Clinic Freetown Sierra-Leone

Introduction: Sickle cell disease, which is the most common hereditary hemoglobinopathy in the world, attacks all body systems, particularly the kidneys. The view of this study was to investigate the predictive factors of kidney damage during sickle cell disease. materials and methods: It was a retrospective, descriptive and analytical study on files of sickle cell patients hospitalized in the Hematology-Oncology Department of Donka University Hospital during a period from January 1, 2016 to December 31, 2019. Records of sickle cell patients with one or more renal abnormalities were retained. Sickle cell patients without kidney damage were also selected for a comparative study. Only patients without sickle cell disease were excluded. Results: Seventy-five (75) medical records were collected during the study period. From these cases, thirteen (13) records with kidney disease were observed, a frequency of 17%. The mean age of patients was 24.2 years for extremes of 10 and 65 years. The sex ratio was 1.6 in favor of men. The SSFA2 form was the most represented with 92%. 24-hour proteinuria was measured in 13 patients between whom 6 patients (46.2%) had a proteinuria level ≤ 1 g. Eight (8) patients (61.5%) were in stage 1 of chronic kidney disease. The most common type of renal involvement was tubulo-interstitial nephropathy with 8 patients (61.5%). Bivariate analysis showed that elevated serum creatinine (P 2 form of the sickness (P Conclusion: After the observation of an increased serum creatinine and urea, a predominance observation of the SSFA2 form, it should be possible to target patients for whom screening for kidney damage should henceforth be systematic.

关键词： Kidney Damage Predictive Factors Sickle Cell Disease Donka

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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

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Hemangioblastoma Incidentally Discovered at CT Scan in Bamako: About a Case

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Open Journal of Medical Imaging 2024年第3期14卷 123-127页

作者： Traore ousmane N’Diaye mamadou Dembélé mamadou Dembélé Adama diakité Siaka Sidibé mansa Drissa Camara Nagnoumague Keita Adama Diaman Department of Radiology and Medical Imaging The Marie Curie Medical Clinic Bamako Mali Faculty of Medicine and Odontostomatology The University of Science Techniques and Technologies Bamako Mali Department of Radiology and Medical Imaging The University Hospital Center of Point G Bamako Mali

Hemangioblastomas are benign vascular tumors of the brain. These are rare tumors, usually located in the cerebellum and most often affecting young adults. The aim was to study the value of CT in the management of hemangioblastoma through observation. We report the case of a 38-year-old patient referred to the radiology and Medical Imaging Department of the marie Curie Medical Clinic in Bamako, mali, for an orbito-cerebral CT scan in a context of bilateral eyelid edema. The examination was performed using multi-slice computed tomography (16 slices) with reconstruction in the 3 planes of space without and with the injection of an iodinated contrast agent. The CT scan was crucial in making the diagnosis of hemangioblastoma incidentally, which allowed for adequate management. The patient was operated on, and the radiological outcome was favorable, without significant cystic formation, after postoperative control and clinical signs were resolved. CT can be an interesting alternative in countries like ours despite MRI being the examination of choice in hemangioblastomas.

关键词： Hemangioblastoma CT Scan Incidental Discovery and Bamako

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Interest of Non-Invasive markers (APRI, FIB-4) for Assessing Hepatic Fibrosis in Patients with Chronic Viral Hepatitis B without Cytolysis and with Low Viral Replication

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Open Journal of Gastroenterology 2024年第5期14卷 192-201页

作者： mamadou diakité Kouassi Olivier Claver Koffi Amadou Koné Akoun Fabrice Aké oury Diallo Ahmadou Stellart Jean M. Brou Anassi Jean-Baptiste Okon Department of Medicine and Hepato-Gastroenterology Teaching Hospital of Bouak&#233 Bouak&#233 C&#244te d&#8217Ivoire Faculty of Medical Sciences Alassane Ouattara University Bouak&#233 C&#244te d&#8217Ivoire

Background and Objectives: The indication for treatment in HBsAg-positive patients with low viral load and normal transaminases requires an assessment of fibrosis. In resource-limited settings, free hepatic fibrosis evaluation tests can aid in therapeutic decision-making. our study aims to demonstrate the utility of assessing hepatic fibrosis using non-invasive markers (APRI and FIB-4) in patients with chronic B viral hepatitis without cytolytic activity and low viral replication in our context. Patients and Methods: This is a retrospective cross-sectional study conducted between January 2018 and December 2021 at the University Hospital Center of Bouaké. Included were all patients aged ≥18 with normal transaminases (Results: our study included 241 patients, with a mean age of 36.19 years (±10.52 years) and a male predominance of 52%. The mean FibroScan® value was 6.44 ± 2.3 kPa, and 68 patients (28.22%) had fibrosis >7 kPa. To exclude significant fibrosis (FS Conclusion: A significant proportion of HBV-infected patients with normal ALT and low viral load have active liver disease. Both FIB-4 and APRI biological scores are useful in identifying individuals without significant fibrosis with a good negative predictive value (>50%).

关键词： HBV Infection APRI FIB-4 Impulse Elastography BouakéUniversity Hospital

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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 ma.a.a.ou 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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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 recommend

关键词： Antibiotic Prescription Hospitalization Child

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Ultrasound in Ti-Rads Classification of Thyroid Nodules at the marie Curie Medical Clinic

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Open Journal of Medical Imaging 2024年第3期14卷 114-122页

作者： Traore ousmane diakité Siaka Sidibe Drissa mansa N’Diaye mamadou Diallo Aissata Bagayoko ousmane Lansenou Camara Nagnoumague Coulibaly Modibo Cisse Issa Dembele mamadou Sidibe Assan Traore Keita Adama Diaman Department of Radiology and Medical Imaging The Marie Curie Medical Clinic Bamako Mali Department of Radiology and Medical Imaging The Point G University Hospital Center Bamako Mali Teaching Researcher at the Faculty of Medicine and Odontostomatology The University of Sciences and Technologies of Bamako/USSTB Bamako Mali Department of Radiology and Medical Imaging The Health Center of the Military Camp Bamako Mali Medical Office Didinitata Bamako Mali

Introduction: A thyroid nodule is a localized hypertrophy within the thyroid parenchyma. The aim of our study was to study the benefit of ultrasound in the Ti-rads classification of thyroid nodules. Methodology: This was a prospective study with a descriptive aim, with prospective collection, which took place over a period of 17 months at the “marie Curie” medical clinic. The ultrasound machine used was a Voluson E8 from 2011 and the examinations were carried out by two radiologists and two experienced sonographers. The parameters studied were sociodemographic data;clinical data and ultrasound aspects of the Ti-rads classification in the management of nodules. Results: We collected 235 patients out of 738 patients referred to the service for a cervical ultrasound, i.e. a frequency of 31.84% of cases. There was a female predominance with 95.7% of cases and a sex ratio of 0.04. The average age of our patients was 50 years. We found on cervical ultrasound: Isthmo-lobar glandular hyperplasia in 99 patients, i.e. a frequency of 42.1%. The Ti-rads 3 classification was the most represented in 69.4% of cases. The benignity criterion represented 85.6% of cases in our patients and the malignancy criterion represented 14.4% of cases. Conclusion: The precise description of a thyroid nodule provided by ultrasound (Ti-rads) is essential in the management of nodules.

关键词： Ultrasound Thyroid Nodules Ti-Rads “marie Curie” Medical Clinic

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A unified 3D space-based navigation model for seamless navigation in indoor and outdoor

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International Journal of Digital Earth 2021年第8期14卷 985-1003页

作者： Jinjin Yan Sisi Zlatanova Abdoulaye diakité College of Intelligent Systems Science and Engineering Harbin Engineering UniversityHarbinPeople’s Republic of China GRID School of Built EnvironmentFaculty of ArtsDesign and ArchitectureUniversity of New South WalesSydneyAustralia

Seamless navigation has attracted lots of attention and many methods have been reported in the literature or made available as commercial *** process of navigation can be interpreted as a continuous movement of 3D objects from one unoccupied 3D indoor/outdoor space to *** a technical perspective,a 3D navigation model is one of the critical components that should be available to perform successful navigation.A major approach to build a unified navigation model to support seamless path computation is linking indoor navigation networks to outdoor road/street-based *** of different sources of indoor and outdoor navigation networks,the major approach fails to build up true seamless navigation *** regards to this,we propose a unified 3D space-based navigation model(U3DSNM).The presented model ensures all types of spaces for navigation(indoor,semi-indoor,semi-outdoor,and outdoor)have the same representation,management methods,and network derivation approach,thereby building up unified navigation networks to support seamless navigation paths *** model can be linked to the international standards(data models)that are also based on spaces,such as IndoorGML and the on-going version of CityGML *** navigation path planning cases show the feasibility of U3DSNM.

关键词： Indoor outdoor 3D space seamless navigation navigation model

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Pericarditis in Cardiology at a Regional Hospital

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World Journal of Cardiovascular Diseases 2024年第9期14卷 581-587页

作者： Coulibaly Souleymane Traoré Djénébou Konaté massama B. A. Hamidou oumar Guindo Aissata Yves Roland Koumaré Sidibé Samba Sako mariam Sanogo Alpha Kodio Aniéssa ma.a.a.ou Yaya Kéita diakité mamadou Menta Ichaka Department of Cardiology CHU Point G Bamako Mali Department of Internal Medicine CHU Point G Bamako Mali mali Hospital Medical Department Bamako Mali Department of Cardiology Gabriel Tour University Hospital Bamako Mali Department of Cardiology Nianankoro Fomba Hospital Sgou Mali

Introduction: Pericarditis is an inflammation of the pericardium with or without pericardial fluid effusion. Its prevalence is difficult to determine given the many forms that are not symptomatic. In Africa, its prevalence was 6.3% in Gabon in 2020 and 7.2% in mali in 2022. In Europe, an Italian study estimates the incidence of acute pericarditis at 27.7 cases per 100,000 people per year. In another study conducted in Finland over a period of 9 years, the incidence of pericarditis requiring hospitalisation was 3.32 cases per 100,000 people per year. The aim of our study was to describe the clinical and paraclinical characteristics of pericarditis observed in the cardiology department of the regional hospital in mali. Methodology: This was a single centre cross-sectional study from 30 January 2018 to 30 June 2020 in the cardiology department of the Ségou regional hospital. All consenting patients, regardless of age or sex hospitalised in the department for pericarditis confirmed on cardiac ultrasound were included. Data were collected using an individual patient follow-up form recording sociodemographic, clinical, biological, electrocardiographic and echocardiographic data, as well as the course of the disease. Results: out of 879 patients hospitalized, the hospital frequency was 7.28%. Females predominated, with a sex ratio of 0.42. More than half the patients were aged 45 or younger (59.4%). The mean age of patients was 41.8 ± 18.1 years. Cardiovascular risk factors were dominated by hypertension and smoking (46.9% and 12.5% respectively). The reasons for consultation were dyspnoea (84.3%), chest pain (54.7%), cough (71.9%) and fever (34.4%). Physical signs included muffled heart sounds (76.6%), tachycardia (70.3%), pericardial friction (17.2%) and signs of peripheral stasis in 53.1% of cases. We observed elevated C-reactive protein (CRP) in 57.8% of cases, hypercreatininaemia in 37.5% and positive HIV serology in 3.1%. The major radiographic signs were cardiomegal

关键词： Pericarditis Epidemiology Clinic Nianankoro Fomba Hospital Ségou

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