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Predictive Values of Platelets Count and Spleen Diameter in the Diagnosis of Esophageal Varices in Black African Cirrhotic Patients

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Open Journal of Gastroenterology 2020年第12期10卷 317-328页

作者： Jean Baptiste Okon Fabrice Ake Mamadou Diakite Olivier Kouadio Koffi Amadou Kone Hepato-Gastroenterology Department University Hospital Center of Bouake Bouake Ivory Coast

Background: Gastrointestinal hemorrhage from ruptured esophageal varices is of concern in Africa where gastrointestinal fibroscopy for diagnosis is lacking. Purpose: To determine the performance of the length of the spleen, of the platelet count in the diagnosis of esophageal varices (OVs) by specifying the diagnostic thresholds in order to facilitate the prophylaxis of varicose hemorrhages in black African cirrhotic patients. Material and Method: This was a prospective study with a descriptive and analytical aim on cirrhotic patients hospitalized at the university hospital of Bouake (Ivory Coast) from 2017 to 2019. The patients included in the study were the cirrhotic of black race hospitalized having carried out an abdominal ultrasound with measurement of the spleen diameter (SD), an eso-gastro-duodenal endoscopy, and a blood count with platelet count (PC). The first primary endpoint was the diagnosis of esophageal varices in cirrhosis. Cirrhosis was retained by the combination of clinical, biological, ultrasound and endoscopic arguments. The OVs were distributed according to size and the presence of red signs. The platelet count, and the measurement of the spleen to calculate the PC/SD ratio were the second endpoint. The secondary endpoints studied were, the viral and ethyl etiologies of the cirrhosis, the Chlid-Pugh prognostic score. Performance was assessed using the ROC curve. The difference was significant for p less than 0.05. Results: The study included 101 patients;they were 79 men (78.2%) and 22 women (21.8%). The mean age of the cirrhotic patients was 48 ± 14. Esophageal varices were present in (n = 93;92%) of cases. The different etiologies were hepatitis B virus (HBV) (n = 65;78.3%), hepatitis C virus (HCV) (n = 21;25, 3%), and alcohol (n = 6;7.2%). Platelet count (PC) 130 mm) and PC/SD ratio < 1000 were significantly related to the pres

关键词： Non-Invasive Methods Platelets Count Spleen Diameter Esophageal Varices

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Mortality Factors for Cirrhotics in an Ivorian University Hospital (Ivory Coast)

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Open Journal of Gastroenterology 2020年第9期10卷 231-241页

作者： Jean Baptiste Okon Mamadou Diakite Fabrice Ake Olivier Koffi Kouadio Amadou Kone Hepato-Gastroenterology Department University Hospital Center of Bouake Bouake Ivory Coast

Background: Cirrhosis, an ineluctable development of chronic liver disease, still has high mortality throughout the world despite many advances in physiopathology and therapy. This high mortality is closely related to the unpredictable course of cirrhosis with numerous complications. Objective: To evaluate the predictive factors of death during cirrhosis. Materials and methods: This is an observational, descriptive study on cirrhotic patients hospitalized in the hepatology unit of the Center Hospitalier Universitaire in Bouake (Ivory Coast) during the period from January 01, 2018 to December 31, 2019. The study focused on the data collected in the medical files (paper format) of hospitalized cirrhotics and the death register of the service. The diagnosis of cirrhosis and the death of the cirrhotic were the main criteria for judgment. The secondary criteria defined were: history of cirrhosis, reasons for consultation, clinical signs, biological signs, complications of cirrhosis and the treatment received. The relationship between the parameters was expressed as an odds ratio (OR) with a 95% confidence interval (CI) and the significance threshold fixed at p 0.05. Results: The study retained 206 files of cirrhotics including 146 men and 60 women.

关键词： Cirrhosis Hepatocellular Carcinoma Mortality CHU Bouake

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Factors Associated with the Applicability of EPAGE (European Panel on the Appropriateness of Gastrointestinal Endoscopy) and the Suitability of Indications for Eso-Gastroduodenal Endoscopy in a West African Country

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Open Journal of Gastroenterology 2021年第10期11卷 173-183页

作者： Jean Baptiste Okon Fabrice Ake Mamadou Diakite Olivier Koffi Kouadio Amadou Kone University Hospital Center of Bouake Bouake Ivory Coast

Background: EGDF’s reference examination for exploring the digestive tract has seen steadily increasing demands over the past few years. The exam can be expensive and often poorly tolerated. Its prescription must take the cost/be- nefit and its relevance into account. The EPAGE criteria were developed to allow the appropriate selection of endoscopic procedures. Objective: To determine the factors associated with the applicability and appropriateness of the EGDF indications by the EPAGE criteria in our context in order to limit the number of inadequate EGDFs. Material and Method: Prospective cross- sectional study on the applicability of EPAGE (European Panel on the Appropriateness of Gastrointestinal Endoscopy) and the relevance of the indications for Eso-Gastro-Duodenal Fibroscopy (EGDF) according to the criteria of the EPAGE in two large public hospitals located in the central region of Ivory Coast over a period of 8 months from September 2019 to May 2020. The following parameters (age, sex, history and comorbidities of the patient, the indication of EGDF, the qualifica

关键词： EPAGE EGDF Indications Relevance Ivory Coast

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Epidemio-Clinical, Therapeutic and Evolutive Aspects of Aortic Dissection in the Cardiology Department in Poin “G” Hospital University Center Bamako

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World Journal of Cardiovascular Diseases 2018年第8期8卷 424-430页

作者： Samba Sidibé Coumba Adiaratou Thiam Abdoul Karim Sacko Mamadou Diakite Mariam Dagnoko Souleymane Coulibaly Nouhoum Diallo Hamidou Omar Ba Ibrahima Sangaré Somnoma Jean-Baptiste Tougouma Massama Konaté Oumar Daouda Koné mamadou Touré Mariam Sako Ichaka Menta Illo Bela Diall Boubakar Diallo Cardiology Department Point “G” Hospital University Center Bamako Mali Cardiology Department Hospital Kati Bamako Mali Cardiology Department Gabriel TOURE Hospital University Center Bamako Mali Higher Institute of Health Sciences Nazi Boni de Bobo Dioulasso University Bobo Dioulasso Burkina Faso Cardiology Department Hospital Mali Bamako Mali Medical Department of Institute for Studies and Research Bamako Mali

Objective: The work aimed at describing an epidemioclinical, therapeutic and evolutionary characteristics of patients hospitalized for aortic dissection in the cardiology department in Point “G” Hospital University Center in Bamako—Mali. Methodology: It was a descriptive cross-sectional study from January 2010 to February 2017 in the CHU Point G cardiology department, including all patients hospitalized during this period. Results: Of 6912 hospitalized patients, 23 patients were concerned by aortic dissection. The prevalence of aortic dissection was 0.33%. The most affected age group was 50 - 69 (43.5%) of patients. The predominance was male with a sex ratio of 4.75. The cardiovascular risk factors were high blood pressure (73.9%) and smoking (60.9%). The major functional signs were chest pain (65.2%) and dyspnea (65.2%). Asphygmy (56.5%) and breath of aortic insufficiency (60.9%) were the dominant physical signs. The electrocardiogram recorded sinus tachycardia with 86.9% of patients. The radiographic of the frontal thorax showed mediastina widening (73.9%). At echocardiography, dilatation of the ascending aorta was described with 73.9% and the intimal veil (47.8%). Pericardial effusion was observed with 26.1% of patients. In the thoracic angioscan, the aortic dissection gave 43.5% for type A and 56.5% for type B. The aneurysm of the aorta was abdominal with 21.7%, ascending portion (13.0%) and descending with 8.7%. Complications were dominated by heart failure (47.8%) and aneurysm of the aorta (34.8%). The lethality was 52.2%. Conclusion: Aortic dissection is a medical and surgical emergency with poor prediction.

关键词： Aortic Dissection Cardiology Point G Hospital

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Epidemiological and Clinical Aspects of Bladder Tumours at the Nianankoro Fomba Hospital in Segou in the Urology Department

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Open Journal of Urology 2022年第5期12卷 294-303页

作者： Sory Ibrahim Kone Honoré Jean Gabriel Berthe Aly Douro Tembely Zanafon Ouattara mamadou Lamine diakite Urology Department Nianankoro Fomba Hospital Ségou Mali Department of Urology CHU Point G Bamako Mali Department of Urology CHU Gabriel TOURE Bamako Mali Department of Urology CHU Gabriel TOURE Bamako Mali

Objectives: To study the epidemiological, diagnostic and prognostic aspects of bladder tumours in Segou Hospital. Patients and Methods: We conducted a descriptive cross-sectional study of bladder tumours over the period from 1 April 2012 to 1 April 2017, in the urology department of the Nianankoro Fomba Hospital in Segou. The first three years were used for patient recruitment, and the last two years for follow-up of the patients in the series. Results: Over a period of three years, we collected 165 cases of bladder tumours hospitalised out of 1308 hospitalisations from 7007 consultations, i.e. 12.6% of hospitalisations and 2.3% of consultations. The sex ratio was 1.2 in favour of men. A history of treated bilharzia was reported in 78.8% of cases and untreated bilharzia in 9.1% of cases. Haematuria was the most common reason for consultation. The majority of our patients were at stage T4 and T3 at the time of diagnosis, i.e. 53.3% and 44.3% respectively. Most patients consulted within 13 to 24 months after the first sign, i.e. 44.8%. Conclusion: The prognosis is still clouded by the delay in management. All the patients diagnosed had a bladder tumour infiltrating the muscle.

关键词： Bladder Tumour Bladder Cancer Epidemiological and Clinical Aspects

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Ureteroscopy with Holmium: YAG Laser—A Initial Study in the Urology Department of the Pr Bocar Sidy Sall University Hospital of Kati

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Open Journal of Urology 2024年第4期14卷 207-216页

作者： Amadou Kassogue Idrissa Sissoko Daouda Sangare Moussa Salifou Diallo Hamed Sylla Mahamadou Traore Boureima Coulibaly Salia Coulibaly Modibo diakite Modibo Togola Fadima Tall Ilias Guindo Ben Naoum Kamel mamadou Lamine diakite Urology Department University Hospital of Pr Bocar Sidy Sall Kati Mali Radiology Department University Hospital of Pr Bocar Sidy Sall Kati Mali Anesthesy and Reanimation Department University Hospital of Pr Bocar Sidy Sall Kati Mali Urology Department University Hospital Nimes France Urology Department University Hospital of Point G Bamako Mali

Introduction: Ureteroscopy is a minimally invasive endoscopic surgery which provides access to the ureter, pyelon and calyceal cavities via the urethra and the bladder. Laser ureteroscopy uses the laser as an energy source to treat the stone and eliminate it naturally. Minimally invasive endoscopic methods are struggling to become popular in sub-Saharan African countries, especially for the upper urinary tract. The objective of our work was to report the results of our first laser ureteroscopy experience in the department. Materials and Methods: This was a prospective and descriptive study running from December 1, 2023 to February 19, 2024. Included in our study was any case of upper urinary tract stone operated by Laser ureteroscopy. The characteristics of the lithiasis were determined by CT scan. Sterilization of urine was verified by carrying out a cytobacteriological examination of urine. Ureteral lithiasis was approached by semi-rigid ureteroscopy. Renal lithiasis was immediately addressed by flexible ureteroscopy. Ureteroscopy was coupled with a Holmium YAG laser. A double J ureteral catheter was placed after the operation. A 230 µm laser fiber was used in each case with a generator with a power of 35 watts (Storz Calculase III type). An access sheath was used in all cases of flexible ureteroscopy. The parameters studied were: sociodemographic characteristics, lithiasis (site, size, number, density, topography), type of anesthesia, duration of laser use, duration of intervention, postoperative outcomes. Data entry and analysis were carried out using the software (Word 2016 and SPSS). Result: We collected 30 cases of laser ureteroscopy. The average age was 37 years with extremes of 9 and 79 years. The male gender was more represented. The most common age group was 24-39 years old. Renal colic was the most frequent reason for admission, 12 patients (40%). On physical examination, lumbar tenderness was present in 47% (14 patients). ECBU was positive in 4 patients (13%). CT scan was performed in all our patient

关键词： Ureteroscopy Semi-Rigid Flexible Holmium YAG Laser

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Clinical, Therapeutic and Evolutionary Profiles of Hypertensive Emergencies in the Cardiology Department of the Ignace Deen National Hospital (Conakry)

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World Journal of Cardiovascular Diseases 2023年第12期13卷 827-836页

作者： Balde Elhadj Yaya Bah mamadou Bassirou Barry Ibrahima Sory Kone Alpha Keita Fatoumata Binta Soumaoro Morlaye Toure Aboubacar Doumbouya Amadou Dioulde Sylla Ibrahima Sory diakite Souleymane Balde mamadou Dadhi Cardiology Department of the Ignace Deen Hospital Conakry Guinea

Introduction: Hypertensive emergencies are a reality in the cardiology department of the Ignace Deen National Hospital. The aim of this study was to determine the clinical, therapeutic and evolutionary profile of hypertensive emergencies in the cardiology department of the Ignace Deen National Hospital. Methods: This was a longitudinal descriptive study of patients admitted to the cardiology department of the Ignace Deen National Hospital for hypertensive emergencies, over a period of six (6) months from 1 October 2020 to 31 March 2021. Results: Among the 638 patients admitted to the cardiology department during the study period, 102 cases of hypertensive emergencies were identified, representing a frequency of 15.99%. The mean age of the patients was 56.65 ± 13.33 years, with extremes of 23 and 90 years, and the sex ratio was 1.91 in favour of men. The associated cardiovascular risk factors were: age (76.47%), smoking (41.18%), sedentary lifestyle (31.37%), obesity (16.67%), dyslipidaemia (12.75%), diabetes (11.76%) and excessive alcohol consumption (11.76%). The various clinical pictures found were: acute pulmonary oedema 39 cases (38.23%), acute coronary syndrome 31 cases (30.39%), stroke 17 cases (16.67%), hypertensive encephalopathy 11 cases (10.78%), acute renal failure 3 cases (2.94%) and aortic dissection 1 case (0.98%). The drugs used on admission were calcium antagonists (Nicardipine 10mg) in 58 cases (56.86%), diuretics (Furosemide 20mg) in 44 cases (43.13%), nitrates (Risordan 20mg) in 39 cases (38.23%) and beta-blockers in 31 cases (30.39%). In terms of outcome, 88 (86.27%) patients had improved. However, 12 (11.76%) deaths were recorded. Conclusion: Hypertensive emergencies are a worrying condition with a high prevalence in the cardiology department of the Ignace Deen National Hospital.

关键词： Emergency Hypertension Prevalence National Hospital Ignace Deen

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Management of Urological Emergencies at the Nianankoro Fomba Hospital in Segou: A Case Report of 72 Patients

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Open Journal of Urology 2022年第5期12卷 242-247页

作者： Sory I. Kone Mohamed Traore Ibrahim Yattara Tièmoko Traore Karifala Haidara Frank M. Omam mamadou T. Coulibaly Honoré J. G. Berthe mamadou L. diakite Urology Department Nianankoro Fomba Hospital Ségou Mali Liberal Bamako Mali Department of Urology CHU Gabriel TOURE Bamako Mali Department of Urology CHU du point G Bamako Mali

PURPOSE: Our aim was to present the diagnostic and therapeutic aspects of urological emergencies in a regional hospital. MATERIAL AND METHODS: We conducted a prospective study over a period of 6 months (April 2021 to September 2021) collecting all the emergencies received by the on-call urology team at the Nianankoro Fomba Hospital in Segou. This team was led by a DES in urology under the supervision of a urological surgeon. We were interested in age, sex of patients, diagnosis, number of patients hospitalised and type of surgery performed in emergency. RESULTS: We registered 72 patients. The mean age of our patients was 58.8 years with extremes of 6 and 90 years. Acute bladder retention was represented in 61% and total haematuria in 24%. Renal colic was reported in 8%. Acute prostatitis was reported in 4% of cases, and acute pyelonephritis in 1%. Urogenital trauma accounted for 6%. CONCLUSION: Although underestimated, in our context, the management of urological emergencies remains a regular activity of the urology department in view of the number of patients managed. Bladder drainage remains the most frequent procedure.

关键词： Urological Emergency Nianankoro Fomba Hospital Diagnosis Treatment

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Case of Incomplete Ureteral Duplication Complicated with Lithiasis and Right Uretero-Hydronephrosis

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Surgical Science 2023年第7期14卷 502-506页

作者： Cheickna Tounkara Amadou Maiga Boubacar Yoro Sidibe Tani Kone Samake Hamidou Kaloga Daye Bagayoko Oumar Amadou Malle Jean Batiste Honoré Berthe mamadou Lamine diakite Department of General Surgery Luxembourg Hospital Bamako Mali Department of General Surgery CHU Gabriel Touré Bamako Mali Department of Urology Surgery CHU Point-G Bamako Mali

Ureteral duplication is congenital malformative uropathy that occurs most often in children. Complete ureteral duplication is defined by a kidney that has two ureters with two orifices that communicate to the bladder through two ureteral meati. It is an anatomical variant that remains rare. Its early discovery is due to a lack of diagnostic means, hence the occurrence of long-term complications. To this end, we observe an increased importance of the morbidity linked to the late diagnosis of this duplicity. We report a case of incomplete ureteral duplication complicated by ureterohydronephrosis on lithiasis wedged in the uretero-vesical junction of one of the ureters in its lower portion which required uretero-lithotomy with bladder reimplantation of the ureters. Our aim was to show the importance of the morbidity associated with late diagnosis of this anomaly and the incidence of infection and complications that this pathology poses as a problem. This was a clinical case of fortuitous discovery managed by a general surgeon in the general surgery department of the hospital “Mère Enfant” Le Luxembourg Bamako Mali. The suites were simple.

关键词： Ureteral Duplication Congenital Malformation Adult

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Epidemiological, Clinical and Therapeutic Aspects of Bladder Tumors in a Schistosomiasis-Endemic Country

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Open Journal of Urology 2024年第3期14卷 151-159页

作者： Amadou Kassogue Idrissa Sissoko Alkadri Diarra Moussa Salifou Diallo Daouda Sangare Boureima Coulibaly Philippe Togo Albacaye Sember Mahamadou Traore Salia Coulibaly mamadou Lamine diakite Urology Department Pr Bocar Sidy Sall University Hospital Kati Mali Urology Department Luxembourg University Hospital Bamako Mali Medical Imaging Department Pr Bocar Sidy Sall University Hospital Kati Mali Urology Department Point G University Hospital Bamako Mali

Introduction: Bladder tumors are common in our country;Mali is a bilharzial endemic country. In our context, urinary bilharzia is common, and bladder tumors arouse particular interest in the field of urological oncology, because of their frequency, their diagnosis, their difficulty in management and their histological particularity. The objective of our work was to study the epidemiological, clinical and therapeutic aspects of bladder tumors. Materials and Methods: This is a cross-sectional, descriptive study with a retrospective and prospective collection that took place over 3 years from January 1, 2020 to December 31, 2022. Results: We identified 316 cases of bladder tumors during this period. Bladder tumors are a common pathology representing 35.95% of all hospitalized patients, and occupying the 1st rank of tumors in urology in the Urology Department of the Pr Bocar Sidy Sall University Hospital in Kati. Bladder tumors were more common in men with 56.33%. The average age of our patients was 50 years ± 25.8 years and the extreme ages were 20 and 87 years. Urinary schistosomiasis, considered a predisposing factor, was found in 66.78% of cases in our patients as a history. Transurethral resection of the bladder was performed in 100% of our patients, nephrostomy in 1.90% of cases, ureterostomy in 1.58% of cases, Bricker type urinary diversion in 1.27% of cases, and a neobladder in 0.32% of cases. Squamous cell carcinoma is the dominant histological type (88.29%). The postoperative outcome was 99% favorable after resection. Conclusion: Bladder tumors were mainly tumors infiltrating the bladder muscle. The main risk factor was urinary bilharzia. Squamous cell carcinoma is the most common histological type with a diagnostic delay, thus limiting radical treatment after resection of the bladder tumor.

关键词： TURB Squamous Cell Carcinoma Urinary Schistosomiasis

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