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Varicocele and Spermogram Abnormality: About 264 Cases at the Fertilia Medical Clinic in Bamako

Open Journal of Medical Imaging 2023年第3期13卷 84-91页

作者： Mamadou Dembélé Alassane Kouma Ilias Guindo Souleymane Sanogo Zoumana Cheick Berete Ousmane Traoré Mamadou N’diaye Brahima Doumbia Oncoumba Diarra Issa Cissé Aboubacar Sidiki N’diaye Bandiougou Doucouré Youssouf Yalcouyé Adama Diaman keita Siaka Sidibe Faculty of Medicine and Odonto-Stomatology of Bamako (FMOS) Bamako Mali Medical Imaging Department Kati University Hospital Kati Mali Department of Education and Research in Public Health (DERSP) Bamako Mali

Aims: To determine the impact of varicocele on the result of the spermogram in a group of hypo-fertile or infertile men. Patients and Method: This was a cross-sectional, descriptive study concerning 264 men collected between February 2020 and March 2022 at the Fertilia medical clinic in Bamako. The study population consisted of consenting male subjects presenting for infertility. All of our patients had already done a spermogram, they then benefited from a scrotal Doppler ultrasound. The scrotal echo-doppler was completed by an abdominal and pelvic echography in search of a possible etiology, in particular a renal cancer, a thrombosis of the renal or spermatic vein, a retroperitoneal mass or a nutcraker syndrome. Testicular volume was measured on ultrasound according to Lambert’s formula (length × width × height × 0.71). A volume = 16 ml was considered normal. Results: 264 patients were recruited in ours. The average age was 33 years with extremes ranging from 25 to 65 years. 149 patients or 56.44% were between 30 and 45 years old. 213 patients or 80.68% had primary infertility. All the patients, i.e. 100%, had a sperm anomaly and dilation of the pampiniform plexus veins. The most common sperm abnormalities were oligoasthenoteratozoospermia, which concerned 214 patients, or 81%, followed by azoospermia (40 patients, or 15%) and oligospermia (10 patients, or 4%). 213 patients or 80.68% had a Hirshen grade II varicocele, 45 patients or 17% had grade I and 06 patients or 2.27% had grade III. Among the 6 patients, 04 had left testicular atrophy and 2 bilateral atrophy. The venous reflux was more accentuated on the left than on the right. Conclusion: Varicocele is significantly found in men with infertility. Sperm alterations concern both the concentration of spermatozoa, their mobility and their vitality. Even if the mechanism of alteration of the sperm parameters is not well elucidated, our study made it possible to make the link between the dilation of the veins of th

关键词： Ultrasound Male Infertility Varicocele Oligoasthenoteratozoospermia

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Secondary Hypertension in Sub-Saharan African Populations: A Retrospective Study between 2011 and 2016 at Regional Hospital of Saint-Louis, Senegal

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Open Journal of Nephrology 2016年第3期6卷 93-97页

作者： Yaya Kane Joel Simon Manga Diatou Gueye Dia Maiga Moussa Zeinabou Tondi Ahmed Tall Lemrabott Maria Faye Sidy Mouhamed Seck Mouhamadou Moustapha Cisse Alex Ismael keita Kalilou Diallo El Hadj Fary Ka Abdou Niang Boucar Diouf Nephrology-Cardiology and Internal Medicine Department Assane Seck University Ziguinchor Sénégal Nephrology and Internal Medicine Department Gaston Berger University Saint-Louis Sénégal Nephrology Department Abdou Moumouni University Niamey Niger Nephrology Department Teaching Hospital Aristide Le Dantec Dakar Senegal

Introduction: High blood pressure (HBP) is a worldwide health issue responsible of high cardiovascular morbidity and mortality. Even though essential HBP is far the most frequently reported in patients, secondary causes must be known because of their severity and the possibility of aetiological treatment. No recent epidemiological data are available about secondary causes of HBP in black African populations. The aim of this study was to describe aetiological patterns of secondary HBP in patients followed at Saint-Louis Hospital. Patients and Method: We conducted a retrospective and descriptive study in regional hospital of Saint-Louis. All patients aged ≥15 years old admitted from January 1st 2011 to January 31st 2015 in internal medicine, nephrology, emergency and cardiology departments were included. Clinical, paraclinical data and patients outcomes were collected from medical records. Hypertension was defined according to JNC8 criteria. Secondary HBP was considered if explorations identified a clear aetiology to hypertension. Statistical analysis was done with Excel 2010 and STATA 12.0. Results: We included 9253 patients with mean age of 35 ± 12 years (15 - 83 years) and sex-ratio of 1.6. Overall 67.5% of patients had hypertension and secondary causes were found in 10.5% of them. The majority of patients presented clinical symptoms suggesting a secondary cause of HBP and first-line laboratory explorations were normal in half of cases. Renal diseases were responsible for 79.1% of secondary HBP cases mainly dominated by glomerulonephritis (22.6%), vascular nephropathies (18.7%) and autosomal dominant polycystic kidney disease (5.8%). They were followed by preeclampsia (13.6%) and endocrinal aetiologies such as hyperthyroidism (5.8%), hypercorticism (0.5%), pheochromcytoma (0.5%), primary hyperparathyroidism (0.4%) and Conn’s adenoma (0.1%). Combination of ≥3 antihypertensive drugs was necessary in 71.5% of cases and surgical treatment was performed in three patient

关键词： Secondary High Blood Pressure Internal Medicine Black Africans

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Ultrasound Causes of Female Infertility at the Fertilia Medical Clinic in Bamako

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Open Journal of Medical Imaging 2023年第3期13卷 107-113页

作者： Mamadou Dembele Alassane Kouma Ilias Guindo Zoumana Cheick Berete Souleymane Sanogo Mamadou N'diaye Brahima Doumbia Oncoumba Diarra Ousmane Traore Issa Cisse Aboubacar Sidiki N’ Diaye Badiougou Doucoure Youssouf Yalcouye Adama Diaman keita Siaka Sidibe Radiology Department Faculty of Medicine and Odonto-Stomatology of Bamako (FMOS) Bamako Mali Radiology Unit Fertilia Medical Clinic Bamako Mali Department of Education and Research in Public Health (DERSP) FMOS Bamako Mali

Aims: Infertility is a major problem in our current societies and the Fertilia medical clinic in Bamako is a center for medical assistance in procreation (MAP) where there is an increasingly growing demand for ultrasound. The objective of our study was to investigate the ultrasound causes likely to prevent the occurrence of pregnancy in a group of infertile and subfertile women. Subjects and Methods: This was a 5-year cross-sectional and prospective study, between January 2017 and January 2022, which involved 250 women wishing to become pregnant (infertile or subfertile), who came for pelvic ultrasound or follicular monitoring and who agreed to participate in our study. The parameters used were ultrasound reports including uterine, ovarian and tubal pathologies. It should be noted that in some cases no ultrasound cause of infertility was found. Data were entered and analyzed in SPSS. Results: 250 women were recruited into our. The average age was 32 years with extremes ranging from 17 to 51 years. 179 patients or 71.6% were between 17 and 35 years old. 139 patients or 55.6% had secondary infertility against 44.4% primary infertility. 202 patients or 80.8% had at least one ultrasound lesion and 48 patients or 19.2% had no significant ultrasound abnormality. The most represented ultrasound lesions were of uterine origin with 72.20%, 23.7% ovarian lesions and 04% tubal lesions. Uterine lesions were dominated by myomas, adenomyosis, endometrial polyps, uterine malformations and synechiae. As for ovarian lesions we noted cysts, polycystic ovary syndrome (PCOS), ovarian endometriosis, non-follicular ovaries and tubal ultrasound lesions showed unilateral or bilateral hydrosalpinx. Conclusion: In our study, ultrasound was an invaluable contribution to the diagnosis of the causes likely to explain subfertility and infertility in our respondents. She highlighted uterine, ovarian and tubal lesions, some of which could be corrected and pregnancies ensued.

关键词： Ultrasound Female Infertility Myomas Polycystic Ovaries Hydrosalpinx

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Strangulation of the Penis by a Ring in Children: About a Case

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Case Reports in Clinical Medicine 2023年第8期12卷 279-284页

作者： Klétigui Samuel Dembélé Korotimi Malle Issiaka Diarra Mahamadou keita Amara Dembele Mamadou Adama Diallo Karifala Haidara Mahamadou Coulibaly Moussa Abdoulaye Diarra Sadio Camara Siaka Konate Dramane Fomba Djibrila Kanthe Dramane Cisse Ousmane Abdoul Aziz Dicko Tominian Reference Health Center Tominian Mali Regional Directorate of Ségou Ségou Mali Commune I Reference Health center Bamako Mali General Surgery Department and Urology Department Nianakoro Fomba Hospital in Ségou Ségou Mali Koutiala Reference Health Center Koutiala Mali Bla Reference Health Center Bla Mali Kolondiéba Reference Health Center Kolondièba Mali Markala Reference Health Center Markala Mali Urology Department Somine DOLO Hospital in Mopti Mopti Mali

Strangulation of the penis by a ring is a rare but quite common event in children and is potentially serious. We found it important to report this case in order to share our experience on the management of penis rings. It was a 9-year-old child, with no particular medical-surgical history, nor any notion of known family defect, brought to the emergency room by his parents for intense pain in the penis associated with incessant crying. In front of which a clinical examination made it possible to conclude with penile strangulation by a metal ring. Our course of action was the ablation of the ring with non-medical forceps associated with local and general care. No complications were observed during treatment. The immediate consequences were simple and the patient was followed for 4 months.

关键词： Strangulation Penis Tominian

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Thyroid Disease at the University Hospital of Conakry, Guinea

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Open Journal of Internal Medicine 2019年第4期9卷 105-111页

作者： Amadou Kaké Mamadou Mansour Diallo Djibril Sylla Alpha Mamadou Diallo Ibrahima Camara Abdoulaye keita Thierno Amadou Wann Kadija Dieng Mamadou Alpha Diallo Elhadj Zaï noul Bah Mohamed Yakharé Camara Abdoulaye Bayo Naby Moussa Baldé Department of Endocrinology and Metabolic Diseases Donka University Hospital Conakry Guinea Department of Internal Medicine Donka University Hospital Conakry Guinea Department of ENT Donka University Hospital Conakry Guinea.

Objectives: To describe the epidemiological, clinical and therapeutic characteristics of thyroid disease at the University Hospital of Conakry, Guinea. Methods: This was a descriptive study with prospective data collection, carried out over the period of December 2016 to April 2019 at the endocrinology outpatient consultation at the University Hospital of Conakry. All the epidemiological, clinical and therapeutic data of the patients followed-up for thyroid disease were collected, analyzed and classified according to the epidemiological, clinical and therapeutic profile. The functional, morphological and autoimmune aspects of the thyroid gland were studied. Results: Out of a total of 3.517 endocrinology consultations during the study period, 204 patients were diagnosed with thyroid disease (180 women and 24 men, F/H ratio: 7.5). The average age was 47 ± 16 years. A total of 90 patients (44.33%) had hyperthyroidism, including 52 cases of Graves-Basedow disease (57.6%) and 24 cases of toxic multi-nodular goiter (32.6%). Hypothyroidism was confirmed in 25 patients (11%);about half (48%) of them had a complete thyroid surgery. The treatment of hyperthyroidism was exclusively done by synthetic antithyroid drugs, except 5 cases of Hashimoto disease with transient initial hyperthyroidism phase. Hypothyroidism was treated by hormone replacement therapy. Thyroidectomy, partial (n = 5) or total (n = 12), was performed for aesthetic discomfort (n = 6), cervical compression (n = 8) and suspicion of thyroid cancer (n = 3). Follow-up was considered regular in 40 cases (44%). Conclusion: Thyroid disease was frequent in this study conducted in Conakry and its clinical features were very diverse, dominated by hyperthyroidism mainly due to Grave disease. However, diagnostic and therapeutic strategies were hindered by the limitation in availability of biological and morphological explorations.

关键词： Goiter Hyperthyroidism Hypothyroidism Guinea

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Fracture of the Penis: About a Case of Delay in Management at the Nianankoro Fomba Hospital in Segou-Mali

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Open Journal of Urology 2022年第2期12卷 136-145页

作者： Sory I. Kone B. Samake M. keita T. B. Bagayoko A. Bah A. Kassogue A. Sanogo A. N. Coulialy M. Togo D. Coulibaly T. Traore A. Fofana Urology Department Nianankoro Fomba Hospital Segou Mali General Surgery Department Nianankoro Fomba Hospital Ségou Mali Forensic and Occupational Medicine Department Nianankoro Fomba Hospital Ségou Mali Pediatrics Department Nianankoro Fomba Hospital Ségou Mali Cardiology Department Nianankoro Fomba Hospital Ségou Mali Ophthalmology Department Nianankoro Fomba Hospital Ségou Mali Internal Medicine Department Nianankoro Fomba Hospital Ségou Mali Obstetrics and Gynaecology Department Nianankoro Fomba Hospital Ségou Mali ENT Department Nianankoro Fomba Hospital Ségou Mali

Introduction: Fracture of the penis is a rare uro-andrological emergency defined as the rupture of the tunica albuginea of the erect penis most often during sexual intercourse. Surgical exploration and repair of the albuginea breach as soon as possible are the standard treatment. However, in our African context, early diagnosis and management are negatively influenced by the delay in consultation due to modesty. Our objective was to describe the clinical and therapeutic aspects of the fracture of the penis seen late in the African context and to compare it with the literature review. Presentation of the case: Our aim was to report our experience in the management of late-onset fracture of the penis, after more than 48 hours of evolution, by reporting the observation of a 54-year-old patient, who had a false coitus, treated in the urology department of the Nianankoro Fomba Hospital. The physical examination revealed a deformation of the penis following the formation of a large hematoma with a characteristic eggplant appearance. Therapeutically, a suture of the albuginea was performed with simple follow-up. Conclusion: This case study shows a delay in the management of this emergency due to the reluctance of the patient to be consulted as soon as possible for reasons of modesty. A delayed emergency surgical management was the only therapeutic alternative and the coronal incision with degloving was the only way to approach the voluminous hematoma related to the delay in management.

关键词： Penis Fracture Corpora Cavernosa Albuginea Nianankoro Fomba Hospital

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Evolutionary and Prognostic Aspects of Thrombolysed Patients for Acute Coronary Syndrome ST+ at CHU Ernesto Guevara De La Serna. Las Tunas (Cuba)

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World Journal of Cardiovascular Diseases 2020年第7期10卷 437-445页

作者： Boubacar Sonfo Hamidou Oumar Bâ Youssouf Camara Coumba Thiam Ibrahima Sangaré Massama Konaté Sidibé Samba Sako Mariam Asmaou keita Coulibaly Souleymane Ilo Bella Diall Menta Ichaka Amadou Khalil Traoré Yudelquis Ojeda Riquenes Maikel Santos Medina Cardiology Department of CHU Kati Bamako Mali Cardiology Department CHU Gabriel Touré Bamako Mali Internal Medicine Service Mali Hospital Bamako Mali Cardiology Department CHU Point G Bamako Mali Cardiology Department CHU Mère-Enfant Bamako Mali Cardiology Department CHU Ernesto Guevara Las Tunas Cuba

Introduction: Acute myocardial infarction (IDM) occupies the first place in terms of mortality, among ischemic pathologies. Thrombolysis in the case of medical treatment for acute myocardial infarction (AMI) is undoubtedly the most revolutionary performed to date in this context, with a significant reduction in the mortality rate. The aim of our study was to describe the epidemiological aspects, the criteria for myocardial reperfusion post thrombolysis, the complications during thrombolysis and the complications of acute myocardial infarction in the cardiology department of the CHU Ernesto Guevara De La Serna of Las Tunas (Cuba). Methods: A retrospective cross-sectional descriptive study was carried out from June 2009 to December 2011. The patients hospitalized during this period in the USIC (coronary intensive care unit) for SCA ST(+) were included in the study. The variables studied were: Age, sex, myocardial reperfusion criteria, complications during thrombolysis and complications of myocardial infarction. Results: A total of 207 patients were included. The male sex represented 72.5% of the cases, giving a sex ratio of 2.63. The age group > 60 years was predominant with 54.2% of the cases. Thrombolysed patients represented 65.2% of the cases. Myocardial reperfusion criteria were observed in the majority of thrombolysed patients: relief of precordial pain (77%), regression of the ST segment to

关键词： Acute Coronary Syndrome Thrombolysis CHU Las Tunas Cuba

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Endometrial Status and Embryonic Implantation about 150 Cases at the Medically Assisted Procreation Laboratory “Le Diafounou”

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Open Journal of Medical Imaging 2023年第3期13卷 92-100页

作者： Mamadou Dembélé Alassane Kouma Ilias Guindo Souleymane Sanogo Zoumana Cheick Berete Ousmane Traoré Mamadou N’Diaye Brahima Doumbia Oncoumba Diarra Issa Cissé Aboubacar Sidiki N’diaye Bandiougou Doucouré Youssouf Yalcouyé Adama Diaman keita Siaka Sidibe Faculty of Medicine and Odonto-Stomatology of Bamako (FMOS) Bamako Mali Medical Imaging Department Kati University Hospital Kati Mali Department of Education and Research in Public Health (DERSP) Bamako Mali

Background: The endometrium is the tissue that lines the inside of the uterus. It undergoes multiple changes during the menstrual cycle and prepares to welcome the fertilized egg. Endovaginal ultrasound is a first-line examination in the assessment of female infertility. Objective: We aimed to determine the impact of endometrial status by endovaginal ultrasound on the outcome of embryo transfers. Subjects and Methods: This was a prospective cross-sectional study of 150 women collected between January and October 2020 at the “Le Diafounou” medically assisted procreation laboratory. Were included in the study, women presenting for desire of pregnancy and having continued the treatment until the transfer of fresh or frozen embryos. An uterine score was used. This score took into account the thickness of endometrium, it is coffee bean aspect, the presence of the notch, the echogenicity of the endometrium, the pulsatility index, the presence of the flow at the end of diastole and sub-endometrial flow. Ultrasounds were performed using a General Electric logic 500, logic 9 and Voluson E8 device. The data was entered into Excel and then analyzed using SPSS version 21. Results: 150 women were selected for the study. 83 women or 55.3% were between 17 and 35 years old and 44.7% were over 35 years old with an upper limit of 50 years old. The number of women who became pregnant was 69% or 46%. The average thickness of the endometrium was 11.40 mm with extremes of 4.65 mm and 18.6 mm. There was a correlation between the thickness of the endometrium and obtaining a pregnancy (p i.e. 88.7%. The pulsatility index was relatively low for those who started a pregnancy, i.e. 90%. The high pulsatility index is one of the reasons for the failure of embryo implantation. The correlation was significant (p = 0.009). 141 women had no notch in the uterine arteries, i.e. 94%. 94 women or 62.7% had a triple line endometrium or typical coffee bean appearance. End-diastolic flow was observed in 12

关键词： Endometrial Status Embryonic Implantation Medically Assisted Procreation

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Retrospective Study of 23 Cases of Psoriasis Association with HIV Infection Observed in the Department of Dermatology-STD in the University Hospital of Donka Conakry Guinea

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Journal of Cosmetics, Dermatological Sciences and Applications 2018年第1期8卷 1-5页

作者： M. keita M. M. Soumah T. M. Tounkara D. Sylla B. F. Diané F. B. Sako H. Baldé M. Cissé Department of Dermatology-STD in the University Hospital of Donka Conakry Guinea Department of Intensives Cares Medico-Surgeon Urgences in the University Hospital of Donka Conakry Guinea Department of Tropical Infection Diseases in the University Hospital of Donka Conakry Guinea

Introduction :The psoriasis is one of the inflammatory dermatoses with unknown etiology, with chronic evolution having episodic appearance and disappearance. Its prevalence in HIV patients varied from 2% to 5% in most of the times. Objective of this study was to describe the demographic, clinical and therapeutic characteristics of psoriasis patients infected with HIV. Methods: It is a descriptive retrospective study done from January 2003 to December 2013 based on the information from the hospital card of hospitalized patients and outpatients taken care in the department of Dermatology-STD for psoriasis at the University hospital center in Donka Conakry. We included all the cases of psoriasis associated with HIV infection diagnosed from clinical and paraclinical elements. Results: We recorded 23 (24.73%) cases of psoriasis associated with HIV infection among 93 patients observed for psoriasis in which there are 4 cases of psoriasis vulgaris, 10 cases of erythrodermic psoriasis and 9 cases of arthropathic form among these numbers. We had 7 women and 16 men. The medium age of our patients was 44.5 ± 12 years [27 - 62 years]. The delayed duration time of consultation varied from 30 to more than 180 days. The psoriasis was the circumstance of the discovery of the HIV infection among 55% of cases. The pruritus was the functional sign which is the most frequent in 20 cases among 23 cases and 71.4% of cases were accompanied with pain. Family history was found in 7.10% of cases. Anxiety was the dominant factor cause in 42% and the infection 38%. The cutaneous alteration was noted in all patients;92.9% of patients had nails alteration and intertrigineous association in 78.6% of cases. The clinical forms found were psoriasis vulgaris 4/23 cases, arthropathic psoriasis 9/23 cases, erythrodermic psoriasis 10/23. More than half (13/23) cases of our patients were diagnosed stage III of the classification of WHO. The complicated forms like erythrodermic and arthropathic psoriasis

关键词： Psoriasis HIV Infection Epidemiology Clinical Therapeutic Guinea

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Management of Trauma to the External Genitalia at the Nianankoro-Fomba Hospital in Segou Mali

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Open Journal of Urology 2022年第6期12卷 376-382页

作者： Sory Ibrahim Koné Abdoulaye Kassogué Brehima Samaké Mahamoudou keita Tidiani Traore Abdoulaye Nouhoum Coulibaly Mamadou Adama Togo Thierno Boubacar Bagayoko Adama Bah Aminata Fofana Alpha Sanogo Damissa Coulibaly Sidi Modibo Doucouré Honoré Jean Gabriell Berthé Urology Department The Nianankoro Fomba Hospital Ségou Mali Paediatric Ward The Nianankoro Fomba Hospital Ségou Mali General Surgery Department The Nianankoro Fomba Hospital Ségou Mali Obstetrics and Gynaecology Department The Nianankoro Fomba Hospital Ségou Mali Ophthalmology Department The Nianankoro Fomba Hospital Ségou Mali Forensic Medicine Department The Nianankoro Fomba Hospital Ségou Mali ENT Department The Nianankoro Fomba Hospital Ségou Mali Cardiology Department The Nianankoro Fomba Hospital Ségou Mali Department of General Medicine The Nianankoro Fomba Hospital Ségou Mali Social Security Fund Ségou Mali Department of Urology CHU du Point G Bamako Mali

Trauma to the male genitalia is not very common and mainly affects a young population. There is probably a particular instinct in men to defend their external genitalia;indeed, in the flaccid state, the penis is little exposed, and fairly well protected and its mobility allows it to move with the impact of trauma and thus reduce the vulnating force. Open trauma is rare, as is testicular dislocation, the most common being closed trauma. Testicular trauma is an uncommon accident that affects young people. Trauma is most often caused by road and traffic accidents. Animal bites are rare, as is genital self-mutilation related to a psychiatric disorder. Surgical exploration is the rule except in cases of moderate testicular trauma. Our objective was to report our experience in an emergency context where treatment is poorly codified and to review the literature. We recorded four patients with external genitalia trauma managed in the urology department from April 2013 to March 2022. Our patients were children with open genitalia trauma following a traffic accident, scrotal injuries were encountered in three patients, and additional penile injuries in one patient. All patients were treated surgically. The follow-up was straightforward.

关键词： Trauma Genitalia Open Segou

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