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Epidemiological-Clinical Aspects of Uterine Leiomyoma at the Reference Health Center of Commune VI of the Bamako District

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Open Journal of Obstetrics and Gynecology 2024年第5期14卷 674-681页

作者： Alou Samaké Lasseny Diarra Mamadou Keita Dramane Haidara Mamadou Haidara Coulibaly Soumana Mamadou Diallo Moussa Konaté mariam maiga MS Ag Med Elméhdi Elansari Kassogue Djibril Dao Seydou Zana Samake Hawa Konate Karim Dembele Bertin Coulibaly Moussa Mariko Seydou Colette Dohino Reference Health Center of Commune VI of the Bamako District Bamako Mali Bamako Dermatology Hospital (HDB) Bamako Mali Kalaban Coro Reference Health Center Bamako Mali Hangadoumbo Moulaye Touré Hospital in Gao Gao Mali Timbuktu Hospital Tomboctou Mali Reference Health Center of Commune II of the Bamako District Bamako Mali Reference Health Center in Commune V of the Bamako District Bamako Mali National Institute for Training in Health Sciences Bamako Mali Mali Hospital Bamako Mali

Introduction: Uterine fibroid is a mixed mesenchymal tumor, developing from smooth muscle cells of the myometrium, separated by connective tissue. The majority of fibroids are asymptomatic and do not require any intervention or other exploratory measures. However, in some cases fibroids are symptomatic, their treatment should aim to improve symptoms and quality of life. Objectives: Describe the epidemiological-clinical aspects of uterine fibroids in the gynecology and obstetrics department of the reference health center of commune VI of the Bamako district. Methodology: This was a retrospective descriptive study carried out over a period of one year. It concerns all patients seen in consultation in the gynecology and obstetrics department of the reference health center of commune VI. Results: during the study period, the uterine fibroid frequency was 1.80%. During this same period, fibroids represented 5.59% of gyneco-obstetric pathologies operated on in the department. The 30 - 45 year old age group was the most represented with a frequency of 75.63%. The average age was 36.87 years ± 6.2 years with extremes of 25 and 63 years. Married women were the most represented 97.48%. The vast majority of our patients 95.8% were not postmenopausal. The multigravidas were the most represented, i.e. 37.50% with a large part of the pauciparous 41.29%. In our patients, 96.64% had a clinical symptom on their fibroid with the main reason for consultation being the sensation of a pelvic mass in 97.48%. We recorded three cases of infertility as associated factors. Ultrasound was performed in all patients. The location of the myxomatous nuclei was subserosal in the majority in 42.86% and with multiple nodules in 84.85% of cases. The main indication for myomectomy was the failure of medical treatment in 86.49% of cases. Surgical treatment was mainly a myomectomy 93.30%, a hysterectomy was indicated in 6.70%. No cases of death were recorded. Conclusion: Uterine fibroid is a gynecological pathology that exists in our department;its f

关键词： Myomas Surgery Myomectomy

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

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

作者： Bourama Kané Korotoumou Wéllé Diallo Aboubacar Sangaré Garan Dabo Mamadou Traoré Mohamed Maba Traoré mariam maiga Department of Pediatrics Mali Hospital Bamako Mali Department of Medicine Mali Hospital Bamako Mali Reference Health Center of Commune V Bamako Mali Medical Imaging Department Mali Hospital Bamako Mali Reference Health Center of Commune VI Bamako Mali

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

关键词： Congenital Lobar Emphysema Infant Pediatrics Mali Hospital

Clinical and Epidemiological Aspects of Severe Acute Malnourished Children from 6 to 59 Months Hospitalized in a Secondary Hospital in Mali

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Open Journal of Pediatrics 2023年第1期13卷 97-103页

作者： mariam maiga Hibrahima Diallo Tati Simaga mariam Traore Alou Samake Mamadou Diallo Moussa Konate Mamadou Keita Mamadou Traore Djibril Kassogue Oumou Kone Fatoumata Dicko Hawa G Diall Department of Pediatrics Reference Health Center of Commune VI Bamako MALI Department of Pediatrics CHU Gabriel TOURE Bamako MALI Department of Pediatrics Reference Health Center of Commune V Bamako MALI Timbuktu Regional Hospital Tombouctou MALI National Institute of Public Health Bamako MALI National Institute for Health Science Training Bamako MALI

Introduction: Malnutrition acts on the immune system and thus increases susceptibility to infections. Infections can weaken the body and cause malnutrition, so we speak of a vicious circle between malnutrition and infection. Objective: To study the clinical and epidemiological aspects of severe acute malnutrition in children aged 6 to 59 months. Methodology: This was a prospective and descriptive study extending from July 1, 2018 to June 30, 2019. All severely acute malnourished children aged 6 to 59 months were hospitalized at URENI whose parents or careers accepted their participation in the study. Results: Severe acute malnutrition was diagnosed in 398 of the 671 hospitalized children, i.e. 59.3%. The median age was 15.33 months (2 months - 59 months). The sex ratio was 1.03 (M = 50.8 F = 49.2). Eighty-seven percent of mothers were housewives. Parents were uneducated in 49.3% for mothers and 51.8% for fathers. Marasmus represented 93.5% of cases, children diagnosed with HIV+ represented 6.3% with exclusively HIV1 (100%). Pneumopathy was most frequently associated pathology with 33.4%. The duration of hospitalization was less than 7 days in 67.6% of cases and 93.3% of children had been successfully treated. The mortality rate was 4%. Conclusion: Malnutrition still remains a public health problem affecting mainly children aged 13 to 24 months, mainly from low-income families.

关键词： Severe Acute Malnutrition Children Hospitalized Mali

Maternal Fetal Prognosis: Pregnancy and Delivery in Women of 40 Years Old and Over in a Second Reference Hospital in Bamako

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Open Journal of Obstetrics and Gynecology 2024年第4期14卷 509-519页

作者： Samaké Alou Diarra Lasseny Keita Mamadou Haidara Dramane Haidara Mamadou Diallo Mamadou Konaté Moussa maiga mariam Mohamed Saydi Ag Med Elmehdi Elansari Kassogue Djibril Seydou Zana Dao Samake Hawa Konate Karim Dembele Bertin Coulibaly Moussa Mariko Seydou Collarete Dohino Reference Health Center of Commune VI of the Bamako District Bamako Mali Bamako Dermatology Hospital (BDH) Bamako Mali Kalaban Coro Reference Health Center Bamako Mali Timbuktu Hospital Timbuktu Mali Reference Health Center of Commune II of the Bamako District Bamako Mali Reference Health Center in Commune V of the Bamako District Bamako Mali National Institute for Training in Health Sciences Bamako Mali Mali Hospital Bamako Mali

Introduction: Late pregnancies are considered a public health problem linked to maternal mortality due to their complications. These risks, which worsen with maternal age, should be better known and taken into account in monitoring these pregnancies. Objective: To evaluate the impact of age on the prevalence of obstetric and neonatal complications among parturients of 40 years old and over. Methodology: This was an 11-year retrospective analytical case control study from January 1, 2007 to December 31, 2017. The study population was female patients of 40 years old or older for cases and female patients younger than 40 years of control case. Results: In total, we collected 640 cases of parturients of 40 years old and over out of a total of 84,234 deliveries during the study period;i.e. a frequency of 0.76%. Spontaneous abortion increased in patients of 40 and over with 8.28%. Hypertension and diabetes were higher of women of 40 and over, 52.65%. Concerning the method of admission: 55% of parturients of 40 and over were referrals. Incidents occurring among women of 40 and over were more pronounced than in control cases. Complications during vaginal delivery, cervical tear, perineal tear, uterine dehiscence and uterine rupture are high in our cases, i.e. 11.88%;3.59%;2.19%;2.66. During our study, depending on the type of delivery, the cesarean rate was much higher among women of 40 and over than among control cases, i.e. 54.22% versus 12.24%. Hemorrhages in the 3rd trimester were the main indications for cesarean section. Hemorrhages in the 3rd trimester were more frequent with women of 40 and over, i.e. 10.47%;5.94% versus 1.74% and 0.42%. As for the different types of malformations in parturients, women under 40 years old fetal malformations were absent in 92.29%, on the other hand they were more frequent in patients with 40 years and over, i.e. a normal frequency of 36.72%. Conclusion: Pregnancy at a late age exposes the elderly patient and the newborn to several risks. During this study, an increase in maternal-

关键词： Advanced Maternal Age Childbirth Risk Mali

Pneumothorax in Children: A Study of 47 Pediatric Cases at Mali Hospital 2017-2020

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Open Journal of Pediatrics 2022年第3期12卷 476-488页

作者： Korotoumou Wélé Diallo Bourama Kané Aboubacar Sangaré Mamadou Traoré Mohamed Maba Traoré Mamadou Berthé mariam maiga Amadou Ibrahim Dramé Department of Pediatrics Mali Hospital Bamako Mali Reference Health Center of Commune VI Bamako Mali Department of Anesthesia and Resuscitation Mali Hospital Bamako Mali Reference Health Center of Commune V Bamako Mali Department of Medical Imaging Mali Hospital Bamako Mali National Institute of Public Health Bamako Mali

Objectives: Pediatric pneumothorax, whether primary or secondary (infection, trauma, or iatrogenic), is sometimes life-threatening. We tried to determine the clinical characteristics of pediatric pneumothorax in Mali. Materials and Methods: We collected all pediatric patients (0 - 15 years) admitted for pneumothorax in the pediatric department of the Mali Hospital from January 2017 to December 2020. Results: During this period, a total of 5569 children aged 0 - 15 years were hospitalized, of whom 47 had pneumothorax or 0.84%. Children under 5 years of age were the most affected (80%). Dyspnea was the most common reason for hospitalization (95.7%). The causes of pneumothorax were (in order): infectious causes dominated by bullous dystrophies (70.2%), traumatic (25.5%), and iatrogenic (4.2%). Pneumothorax was compressive in 42.6%. The frequency of anemia was 79.3%. Surgical drainage was performed in 87.2% and almost all (97.6%) were treated with amoxicillin/clavulanic acid. The mean duration of hospitalization was 10.06 days (range: 0 - 35 days): 74.5% were cured while 25.5% died. Conclusions: We reconfirmed that pneumothorax is a pediatric emergency. Children under 5 years of age are the most affected. The main etiologies are infectious bronchopneumonia. The prevention and treatment of respiratory infections, the implementation of good bacteriological diagnostic tools, and the use of surgical video-thoracoscopy will reduce its mortality rate.

关键词： Pneumothorax-Secondary-Child-Hospital of Mali

Maternal and Perinatal Prognosis of Arterial Hypertension and Pregnancy in a Peripheral Health Center in Mali

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Open Journal of Obstetrics and Gynecology 2024年第5期14卷 855-867页

作者： Samaké Alou Diarra Lasseny Keita Mamadou Haidara Dramane Haidara Mamadou Diallo Mamadou Konaté Moussa maiga mariam MS Ag Med Elméhdi Elansari Kassogue Djibril Dao Seydou Zana Samake Hawa Konate Karim Dembele Bertin Coulibaly Moussa Mariko Seydou Colette Dohinnon Reference Health Center in Commune VI of the Bamako District Bamako Mali Bamako Dermatology Hospital (HDB) Bamako Mali Kalaban Coro Reference Health Center Bamako Mali Timbuktu Hospital Timbuktu Mali Reference Health Center of Commune II of the Bamako district Bamako Mali Reference Health Center in Commune V of the Bamako district Bamako Mali National Institute for Training in Health Sciences Bamako Mali Mali Hospital Bamako Mali

Introduction: Maternal mortality constitutes a public health problem and its rate is an indicator of a country’s development. Among the causes of maternal and perinatal death, high blood pressure associated with pregnancy occupies a significant part. It represents 5% of direct maternal deaths. Objective: to study the maternal and perinatal prognosis of high blood pressure during pregnancy in the Tenenkou reference health center in Mali. Methodology: This was a descriptive, analytical and retrospective cross-sectional study over a period of twelve months from January 1, 2021 to December 31, 2021 and involving 144 cases of high blood pressure associated with pregnancy. Results: We obtained a frequency of 11.75%. The majority of patients 70.9% were aged between 20 - 35 years. The important risk factor found was young age. During our study, 46.5% of patients had performed at least one CPN and only 13.9% performed 04 CPN. Pre-eclampsia was the most common type of high blood pressure during pregnancy, i.e. 61.1%. Eclampsia and retroplacental hematoma were the most common maternal complications, respectively 27.8% and 11.1%. The most common fetal complications were premature births and fetal distress with 20.9% and 17.4% respectively. Conclusion: Hypertension associated with pregnancy still remains a major cause of maternal-fetal morbidity and mortality in our context where diagnosis is often late. The main clinical form was preeclampsia. Eclampsia and retroplacental hematoma were the most frequent maternal complications. Fetal complications were mainly prematurity and fetal distress.

关键词： Pregnancy High Blood Pressure Prognosis

Study of Tuberculosis in Children Aged 1 Month to 15 Years in the Pediatric Ward of the Hospital of Mali 2015-2021

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Open Journal of Pediatrics 2022年第2期12卷 433-448页

作者： Bourama Kané Korotoumou Wéllé Diallo Aboubacar Sangaré Youssouf Dembélé Garan Dabo Mamadou Traoré Mohamed Maba Traoré Mamadou Berthé mariam maiga Department of Pediatrics Mali Hospital Bamako Mali Department of Medicine Mali Hospital Bamako Mali Reference Health Center of Commune V Bamako Mali Medical Imaging Department Mali Hospital Bamako Mali National Institute of Public Health Bamako Mali Reference Health Center of Commune VI Bamako Mali

Introduction: In 2020, an estimated 9.9 million people are living with tuberculosis worldwide, including 1.1 million children. Tuberculosis is the 2nd leading cause of death from infectious disease after COVID-19 and the 13th leading cause of death worldwide. Objective: To collect cases of tuberculosis in children aged 1 month to 15 years in order to study the epidemio-clinical aspects in the pediatric department of the Mali Hospital during the period 2015-2021. Materials and Methods: This was a descriptive, retrospective study from January 1, 2015, to December 31, 2020, and a prospective study from January 1 to December 31, 2021, among children aged 1 month to 15 years admitted for suspected tuberculosis in the pediatric ward of the Mali Hospital. Results: From January 2015 to December 2021, we collected 69 cases of tuberculosis among 9438 hospitalized children, i.e. a frequency of 0.73%. The average age was 6.16 years with extremes of 3 months and 15 years. The sex ratio was 1.1% in favor of boys. The majority of children were vaccinated against tuberculosis (88.4%). The most frequent symptoms were fever (76.8%) and weight loss (73.9%). The pulmonary form was the most frequent (54.9%). Bacteriological confirmation was done in 43.5% of our children. It was Mycobacterium tuberculosis in all confirmed cases. More than half of our children (65.2%) were treated with first-line anti-tuberculosis drugs for 6 months. We observed a cure in 42.0% of our patients and a case fatality rate of 39.1%. Conclusion: Tuberculosis in children is frequent in Mali Hospital despite good BCG vaccination coverage. Its mortality remains high and is maintained by malnutrition, HIV, and the emergence of resistant strains of bacilli.

关键词： Tuberculosis Children Mali Hospital

Become Immediate of Newborns Operated in the Neonatology Department of the Hospital and University Center Gabriel Toure of Bamako (Mali)

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Open Journal of Pediatrics 2022年第1期12卷 12-18页

作者： Oumar Coulibaly Hawa Gouro Diall Pierre Togo Hawa Camara Fatoumata Léonie Françoise Diakité Lala Ndrayni Sidibé Leyla maiga Ibrahima Ahamadou Abdoul Karim Doumbia Adama Dembelé Belco maiga Karamoko Sacko Mohamed Elmouloud Cissé Djeneba Konaté Fousseyni Traoré Yacouba Aba Coulibaly Issa Amadou Touré Hamadi Sissoko mariam maiga Alou Samake Bourama Kané Guédiouma Dembelé Abdoul Aziz Diakité Fatoumata Dicko Traoré mariam Sylla Boubacar Togo Neonatology Department of the Gabriel Touré CHU Bamako Mali Pediatric Surgery Department of the Gabriel Touré CHU Bamako Mali Reference Health Center of the Municipality III Bamako Mali Reference Health Center of the Municipality VI Bamako Mali Mali Hospital Bamako Mali

Neonatal surgical pathologies in developing countries are characterized by high mortality. The aim of this work was to describe the characteristics of the newborn and its surgical pathologies treated in the neonatal department of the Gabriel Touré University Hospital in Bamako (Mali). Patients and method: This is a retrospective study of 626 files of newborns hospitalized over a period of 3 years (January 2016 to December 2018) for a surgical pathology, whether operated on or not. We have studied the etiological, therapeutic and evolutionary aspects. Results: During the study period, we collected 626 patients who had surgical pathology, i.e. a frequency of 5.35%. The average therapeutic consultation time was 2 days with extremes (1 and 30 days). Pathologies of the abdominal wall and digestive tract represented 57.9% (n = 84) followed by pathologies of the spine 26.9% (n = 39). The mean treatment time was 4.5 days. Twenty-three point sixteen (23.16%) newborns could be operated on. The neonatal mortality rate was 12.4% (n = 18). Mortality was postoperative (100%) with a mean time to onset of 5 days. Abdominal wall pathologies were responsible for 8.7% (n = 13) of deaths. Conclusion: Surgical pathologies of the newborn are characterized by delayed treatment with high mortality. Improving their prognosis requires early diagnosis (prenatal diagnosis) and adequate management.

关键词： Newborn Surgical Pathologies Mortality

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

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

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

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

关键词： Lower Respiratory Infections Etiologies Children Mali