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Management of Hypertension (HTN) in a Cardiology Department in bamako (Mali): Financial Aspects

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World Journal of Cardiovascular Diseases 2019年第6期9卷 394-403页

作者： Hamidou Oumar ba Ichaka Menta Ibrahima Sangaré Noumou Sidibé Youssouf Camara Souleymane Coulibaly Hamidou Camara Cheick Hamala Fofana Aladji Traoré Adama Sogodogo mamadou Touré Kéita Asmaou Maiga Doumbia Coumba Thiam Adama Daou Kassoum Mamourou Sanogo University Hospital Gabriel Touré Bamako Mali University Hospital Sidy Bocar Sall Kati Mali University Hospital Mother Children Bamako Mali National Center for Disease Fighting Bamako Mali

background: Studies on financial aspects of High blood pressure management are rare and old without differentiating categories of expenses. On the other hand there is an evolution in health system with the introduction of a medical insurance. Objective: We performed this study to estimate costs related to insurance status. Methodology: The prospective study on patients aged 15 years and older extended from 01 May to 31 August 2016 and was carried out in the cardiology department of the University Hospital Gabriel Touré. Only newly detected or untreated hypertensive patients were included. Sociodemographic data, those on physical examination and financial management (transport, consultation, labor tests and purchase of drugs) were collected. Regarding costs, patients were directly asked about: how much did you spend for transport, consultation, labor tests and drugs? Data analysis was carried out by comparing patients with health insurance (Ins+) and those without it (Ins?). The recorded data were inserted in a MS Access database, preliminarily processed by MS Excel and imported to SPSS version 20 for analysis. Results: Mean total cost of care was 57,018 FCFA [50,139 - 63,897] (around 92 USD). It was 50,072 [42,182 - 57,963] for the Ins? group against 79,670 [66,777 - 92,563] for the Ins+ group with a p value 0.0001. Highest amounts for spending were for cardiovascular medication and labor tests with means of 19,255 FCFA (32 USD) and 18,813 FCFA (30 USD). Mean consultation fee was significantly higher for Ins+ patients: 4064 FCFA with IC (95%) [3210 - 4917] versus 3124 with IC (95%) [2774 - 3474] for Ins? patients and p = 0.018. For ECG, however, mean costs were higher for Ins? patients with 6460 [5944 - 6976] against 5115 [4871 - 5360] for Ins+ patients, p = 0.001. Conclusion: Health insurance has few subscribers compared to patients requiring medical care. It increases the global costs of care while facilitating access to care for those who benefit from it.

关键词： Hypertension New Patients Untreated Patients Costs Cardiology bamako

Hypertension in Clinical Practice: Control Rate in Short Term and Associated Factors in the Cardiology Department of the University Hospital Gabriel Touré(UH-GT) in bamako (Mali)

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World Journal of Cardiovascular Diseases 2018年第6期8卷 288-297页

作者： Hamidou Oumar ba Ichaka Menta Ibrahima Sangare Youssouf Camara Noumou Sidibe Souleymane Coulibaly Djénébou Traoré Réné Dakouo Samba Samaké Aladji Traoré Samba Sidibé mamadou Cissouma Cheick Hamala Fofana Lamine Sidibe Kassoum Mamourou Sanogo University Hospital Gabriel Touré Bamako Mali University Hospital Kati Kati Mali University Hospital Point G Bamako Mali University Hospital of Mali Bamako Mali

Introduction: Hypertension (HTN) is for many decades a worldwide major risk factor for cardiovascular ***, hypertension control rates are globally low in the world. Studies on observance have been published in Mali but there is to our knowledge no published data about HTN control rate. We therefore conducted this study to assess the control rate in short term after 3 months management and to look for factors associated with HTN control. Materials and Methods: This study designed as prospective was conducted in the cardiology department of the University Hospital Gabriel Touré (UH-GT) from March 24 to September 24, 2017. All outpatients aged 18 years and more who came for visit and with hypertension as diagnose were involved. All patients have consented to participate in the study. Sociodemographic and data on physical examination including measures for BP, height, weight, waist circumference (WC) and direct costs as reported by the patients were recorded. Patients were asked about medication discontinuation and if yes why and then they were informed about the need to take regularly medication. The concept of chronic disease was explained to them. A formulary served to collect data that were inserted into a Microsoft Access database and analyzed using SPSS version 18. After describing of sociodemographics and continuous variables, crosstabs and finally a logistic regression was performed to look for blood pressure control predictors. Results: There was no statistical difference in sociodemographics between older and newly diagnosed patients. At 3 months globally 40.90% (31.1 for old Patients and 09.8% for newPatients) of the sample were controlled (Figure 1). For old patients, hypertension control rate at inclusion was 12.78% and reached 49.44% at 3 months (Figure 2). After logistic regression only HTN duration was significant predictor with Odd-ratio of 0.365 [0.213 - 0.624] 95% CI and p-value patients as reference). During the study period therapeutic r

关键词： Hypertension Control Rate Old Patient New Patient Medication bamako Outpatient

CT Scans and Delays in Diagnosis of Stroke in Senegal’s Regional Hospitals: A Multicenter Study of 655 Cases

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Open Journal of Medical Imaging 2020年第2期10卷 96-104页

作者： Hamidou Deme Nfally badji Léra Géraud Akpo Oumou Dieng Abdoulaye Dione Diop Fallou Galass Niang Mouhamadou Hamine Toure Ibrahima Faye Malick Diouf Aicha Ndichout Marie Mbengue Cherif Mohamadou Aidara mamadou Ly Ousmane Sano Ndiaga Matar Gaye Ousmane Cissé Abdoulaye Ndoye Diop Aissata Ly ba Sokhna ba Diop El Hadj Niang Radiology Department of the Aristide Le Dantec Hospital in Dakar Dakar Senegal Radiology Department of the CHNU de Fann in Dakar Dakar Senegal Neurology Department of the Fann University Hospital in Dakar Dakar Senegal Radiology Department of the Albert Royer Children’s Hospital of Fann in Dakar Dakar Senegal

Stroke represents the 2nd cause of mortality and 1st cause of physical disability in the adult population. In Senegal, it represents 30% of hospitalization and 2/3 of the mortality in the department of neurology in the capital city, Dakar. Objective: To specify the types of stroke and to evaluate diagnostic delays in Senegal’s regional hospitals. Materials and Methods: This was a retrospective, cross-sectional, descriptive, multicentric study for 4 years (from 2014 to 2017) including any patient presenting a clinical suspicion with a CT scan confirmation of stroke in one of the 9 regional hospitals in Senegal with a recruitment period of 6 months per hospital. CT scans were performed with a 16 slices machine in 6 hospitals, 4 slices in 2 hospitals and 2 slices in 1 hospital. We studied the types and location of strokes, the associated signs and the time from stroke onset to admission and the time from admission to CT scan. Results: 655 patients were retained including 322 men and 333 women for an M/F ratio of 0.96. The average age was 63 years (range: 7 years, 112 years). High blood pressure was noted in 59.2% of patients and diabetes in 10.7% of patients. Strokes were ischemic in 76% of cases involving the middle cerebral artery in 73% of cases and hemorrhagic in 24%, of which 80.7% were deep localized. A mass effect was noted in 7.5% of cases, an engagement in 6.9% of cases and ventricular hemorrhage in 2.7% of cases. The delay between the onset of the deficit and admission was less than 6 hours in 10.6% of patients. The time between the onset of stroke and admission to hospital was specified in 416 patients (63.5%) of the study population, it was less than 6 hours in 10.6% of patients, between 6 hours and 24 hours for 29.3% and more than 24 hours for 60.1%. Between admission and the CT scan, the time was precise in 459 patients (70%), it was less than 6 hours in 37.9%, between 6 hours and 24 hours in 43.6 % and more than

关键词： Stroke CT Scans Diagnostic Delays

Corneal Blindness Caused by Accidental Ocular Use of Chlorhexidine (Hexz) Gel in Two Newborn Born in the Health District of Kati in Mali

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Open Journal of Ophthalmology 2023年第1期13卷 83-90页

作者： Kadiatou ba Moro Sidibe bakary Danfaga Sadio Cissoko Aichata Tall Oumar Diallo Assiatou Simaga Nouhoum Guirou Abdoulaye Napo Adama Dembele Abdoulaye Nouhoum Coulibaly Aoua Ibrahima Toure mamadou Adama Togo Chiaka Sanogo Seydou bakayoko Fatoumata Sylla Lamine Traore Sanoussi bamani Institute of Tropical Ophthalmology of Africa (IOTA) Bamako Mali Regional Hospital of Sikasso Mali/Alliance for the Development of Community Ophthalmology (ADOC) Bamako Mali Kati Reference Health Center Koulikoro Mali Alliance for the Development of Community Ophthalmology (ADOC) Bamako Mali

Introduction: Corneal opacities in children are relatively common. In children, it is urgent because of the risk of irreversible amblyopia. The causes of these blindnesses vary considerably according to the regions of the world. Chlorhexidine digluconate is a broad-spectrum antiseptic directed against gram-positive and gram-negative bacteria. It has been used as an antiseptic for more than 50 years, both in humans and in animals. However, despite these benefits, it can cause serious damage if applied to the eyes. Incidents of eye damage with 7.1% chlorhexidine have been reported to WHO across Africa. Observation: We report and write two cases of bilateral corneal blindness caused by accidental ocular use of chlorhexidine (HEXZ) GEL 7.1% in two newborns in the health district of Kati in MALI. The ophthalmological examination had revealed corneal opacity, conjunctival hyperaemia and limbic ischemia greater than 50% in 1 eye out of 4, corresponding to stage IV of the ROPPER HALL classification;2 eyes out of 4 were at stage III and 1 eye out of 4 was at stage I of the same classification. Conclusion: It is essential to ensure correct use of chlorhexidine digluconate gel 7%. It is an antiseptic which should not be used on the ocular and auditory mucous membranes, at the risk of most often permanent burns.

关键词： Chlorhexidine Opacity Cornea Kati

Socio-Economic Impacts of Primary Open-Angle Glaucoma in Rural Environment in Mali

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Open Journal of Ophthalmology 2022年第4期12卷 430-437页

作者： Moro Sidibe Abdoulaye Napo Adama Dembele Daouda Goita Oumar Diallo Djonny Jonas Dembele mamadou Adama Togo Kadiatou ba Koita Abdoulaye Nouhoum Coulibaly Cheick Fantamady Tounkara Nouhoum Toure Abdoulaye Konaté Jeannette Traore Fatoumata N’diaye Lamine Traore Japhet Popanou Thera Regional Hospital of Sikasso Sikasso Mali Alliance for the Development of Community Ophthalmology (ADOC) Bamako Mali African Tropical Ophthalmology Institute Bamako Mali

Primary open-angle glaucoma (POAG) is an optic neuropathy that affects the patient’s quality of life. The present study aims to write the socio-economic factors influencing the management of glaucomatous patients in rural areas. This was a retrospective, descriptive cross-sectional study, carried out from October 19 to 31, 2017 in a rural town. The variables studied were age, sex, occupation, level of knowledge about the disease and its treatment, average monthly income, accessibility of eye care service, health insurance membership, degree of severity of the disease. The frequency of POAG was 5.68%. The average age of the patients was 52 years old with extremes ranging from 25 to 73 years old;the female sex was the most represented with 19 cases out of 36 or 52.77%. 66.67% of our patients were at their first ophthalmological consultations. Health insurance coverage was 2.78%. The average monthly income was 10,000 to 25,000 FCFA in 58.33%. More than half of our glaucomatous patients, 63.89%, think they are affected by their disease. 80% of patients are unaware that they have eye disease. Many lost vision in one or both eyes and were unaware of the disease affecting their eyes. Accessibility to health services and their costs seem to be a factor, in addition to illiteracy.

关键词： Glaucoma Postman Rural Environment Socio-Economic

Factors of Nephroblastomas’ Relapse in Children at the Academic Hospital Gabriel Toure, bamako, Mali

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Open Journal of Pediatrics 2020年第1期10卷 131-136页

作者： Djénèba Konaté Coulibaly Yacaria Doumbia Abdoul Karim Doumbia Aliou Amadou Issa Oumar M. Coulibaly Traoré Fousseyni K. Traoré Kamaté Bénoi Djiré mamadou Kassoum Coulibaly Youssouf Traoré Abdramane Togo Pierre Koné Oumou Togo Boubacar Service of Pediatrics Teaching Hospital Gabriel Touré Bamako Mali Service of Pediatric Surgery Teaching Hospital Gabriel Touré Bamako Mali National Public Health Research Institute Bamako Mali

Introduction:?The factors of nephroblastomas’ relapse are a set of elements playing a role in the reappearance of cancer cells in the same place of the kidney or in other regions of the body after a 5-year remission.?Objectives:?To determine the frequency and the factors of nephroblastomas’ relapse in the pediatric oncology unit and pediatric surgery of the academic hospital Gabriel Touré. Materials and methods:?This was a retrospective study carried out from January 1, 2005 to December 31, 2019 in all children treated for nephroblastoma relapses in the pediatric oncology unit and in the pediatric surgery service.?Results:?In 15 years, we have managed 182 cases of nephroblastoma, of which 128 cases were declared in complete remission after 5 years and 12 cases presented a recurrence. The relapses factors were: capsular break, intraoperative tumor rupture, presence of an associated malformation, surgery without neoadjuvant chemotherapy and tumor surgical stage (p??0.05). Patients’ age at diagnosis, sex, number of neoadjuvant and adjuvant chemotherapy sessions and histological type were not decisive (p?> 0.05).?Conclusion:?Relapses are more and more frequent in cases of nephroblastoma. The correct use of the protocol would avoid these recurrences.

关键词： Nephroblastoma Relapse Factors Children Mali

Petrological and Structural Approach to Understanding the Mechanism of Formation and Development of Paleoproterozoic Calc-Alkaline Volcanic Rocks of West Africa’s Craton: An Example of the Mako and Foulde Groups (Kedougou Inlier in Western Senegal)

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International Journal of Geosciences 2015年第7期6卷 675-691页

作者： Adrien Gozo Mahamadane Diène Dinna Pathé Diallo Edmond Dioh mamadou Gueye Papa Moussa Ndiaye Département de Géologie Université Cheikh Anta Diop Dakar Senegal Institut des Sciences de la Terre Université Cheikh Anta Diop Dakar Senegal Institut Fondamental d’Afrique Noire (IFAN) Université Cheikh Anta Diop Dakar Senegal

The calc-alkaline volcanic formations in the western part of the Kedougou-Kenieba inlier crop out in three complexes: the Foulde in the North and the areas of Mako and baniomba in the South. These complexes which either combine with the tholeiites or cut across the sedimentary formations are composed of thin veins and massive lava flows. They have many petrographic similarities and show chemical characteristics that resemble those of island-arc rocks. At the tectonic level, the D1 deformation phase preceding the formation of the basins and the transpressive tectonics including an oblique convergence may account for the structural evolution of the Mako volcanic belt. Its occurrence in different basins may be evidenced by the composition of some lithophilic components like the Sr, ba, U, Rb and the composition of clinopyroxenes enriched in TiO2, FeO, Na2O in the Foulde calc-alkaline volcanic rocks that developed in a sedimentary environment.

关键词： Volcanism Calc-Alkaline Kedougou-Kenieba Inlier Tectonic Stress Transpressive Tectonics

External Branch of the Superior Laryngeal Nerve: Anatomy and Operating Hurts

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International Journal of Otolaryngology and Head & Neck Surgery 2018年第6期7卷 388-395页

作者： Abdoulaye Kanté babou ba Youssouf Sidibé Drissa Ouattara Bréhima Bengaly Bréhima Coulibaly Drissa Traoré Mariam Daou Tata Touré Siaka Diallo Amady Diakalia Coulibaly mamadou Alymami Keita Souleymane Sanogo Djibril Traoré Moustapha Issa Magané Ousmane Ibrahim Touré Idrissa Tounkara Abdoulaye Diarra bakary Keita Timbely Guidérè Birama Togola Nouhoum Ongoï ba Service of Surgery CHU Bamako Mali Laboratory of Anatomy of the Faculty of Medicine and Odontostomatology Bamako Mali ENT and Head and Neck Surgery Department CHU Mother-Child “Luxembourg” Bamako Mali Service of Neurology CHU Gabriel Touré Bamako Mali Department of Stomatology and Maxillofacial Surgery CHU-CNOS Bamako Mali Service of General Surgery CHU Gabriel Touré Bamako Mali Service of Anesthesia and Resuscitation CHU Gabriel Touré Bamako Mali

Purpose: Our purpose was to describe the anatomy of the external branch of the upper laryngeal nerve and to estimate the frequency of nerves at risk during the total thyroidectomies sub. Methodology: We realized in the CHU Point G in bamako a forward-looking study over a period going from September 1st, 2016 till December 31st, 2017. All the patients operated by thyroidectomies subtotals for mild goiters were included to whom a systematic location of the external branch of the superior laryngeal nerve in the space avascular of Reeve was realized. Cancers and other thyroid pathologies were not included. Results: We counted and operated 120 cases of mild goiters. The external branch of the superior laryngeal nerve was seen and dissected in 80.8%;it was not seen in 19.2%. According to the classification of Cernea: the type 2 was found in 80.8% of the cases with him under typical 2b in 47.5% and under type 2a in 40 (33.3%). The global frequency of lesion of the external branch of the upper laryngeal nerve was 10.8% at 9 patients among whom 6 who presented a BENLS of Type Ni. Conclusion: The external branch of the upper laryngeal nerve of type 2 presents a risk of wound because the surgeon treats the upper pedicle at the level of the critical centimeter place over the upper pole of the thyroid. The identification of the nerve during the thyroid surgery is the solution of choice.

关键词： External Branch of the Laryngeal Superior Nerve Anatomy Thyroid Surgery

Renal Failure of Lithiasis Origin: Frequency and Management in the Nephrology and Haemodialysis Department of the Point G University Hospital in Mali

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Open Journal of Nephrology 2022年第3期12卷 276-292页

作者： Seydou Sy Magara Samaké Aboubacar Sidiki Fofana Atabieme Kodio Oligue Prudence Oman Djibril Sy Hamadoun Yattara Djénèba Diallo Sah Dit baba Coulibaly Nouhoum Coulibaly Modi Sidibé Alkaya Touré Moustapha Tangara mamadou Lamine Diakité Assétou Soukho Kaya Saharé Fongoro Nephrology and Hemodialysis Department University Teaching Hospital of Point-G Bamako Mali Faculty of Medicine and Odontostomatology University of Sciences Techniques and Technologies of Bamako Bamako Mali Nephrology Unit Fousseyni Daou Hospital in Kayes Kayes Mali National Center for Scientific and Technological Research (CNRST) Bamako Mali Department of Internal Medicine University Teaching Hospital of Point-G Bamako Mali Department of Urology University Teaching Hospital of Point-G Bamako Mali

background: The term urinary lithiasis (UL) from the Greek “lithos” refers to the disease characterised by the result of abnormal precipitation of normal constituents of the urine within the urinary tract. The aim of this work was to determine the frequency of obstructive renal failure (ORF) of lithiasis origin and to describe the therapeutic indications. Methods: This was a retrospective prospective study in patients hospitalised in the nephrology department of Point G University Hospital for ORF of lithiasis origin over a 26-month period from 1 January 2018 to 1 February 2020 inclusive. Results: Among 1898 hospitalized patients, 32 met the inclusion criteria, i.e. a frequency of 1.7%. The male sex was 68.75% with a sex ratio of 2.2. The mean age was 48.38 ± 13.423 years with extremes of 20 and 65 years. Dysuria and urinary bilharzia were the main uro-nephrological antecedents, accounting for 25% of the cases each. Pain syndrome was the main functional sign, accounting for 100%. Ultrasound of the urinary tract (n = 28) showed stones in 92.85%. These stones were bilateral in 22.22% of cases. The dilatation was pyelocalic in 14 cases (51.8%). The uroscanner showed a pyelic location of the stones in both kidneys;42.1% on the right and 33.3% on the left. Hydronephrosis was the most common dilatation: 37.8% on the right and 29.7% on the left. Renal lithiasis was complicated by acute kidney injury (ARI) in 17 cases (53.1%) versus 15 cases (46.9%) of chronic kidney disease (CKD). Urethral catheter was the means of drainage in 24 (75%) followed by nephrostomy in 8 cases (25%). Nephrolithotomy accounted for 9.4% of cases. The case fatality rate was 28.12% (9 cases). Deaths occurred in the context of uraemic coma 6 cases and cardiorespiratory arrest 3 cases. Conclusions: The management of urinary lithiasis complicated by renal failure calls for the correction of hydrolytic disorders, drainage of the excretory tract and treatment of the stone, of which percutaneous nephrolith

关键词： Renal Failure Urinary Lithiasis Nephrology University Teaching Hospital of Point-G