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Epidemiological and Clinical Profile and Immediate Outcome of Neonates Transferred from the Maternity Unit to the Neonatology Unit of the CSREF in Commune V of Bamako District, Mali

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Open Journal of Pediatrics 2024年第3期14卷 547-557页

作者： Maimouna Kante Ya Traoré Balilé Harber Beydari Mamadou Traoré Issiaka Koné Diéneba Sacko Maimouna Haidara Korotoumou Bamba Assitan Farota Abdoulaye Kassogué mohamed Diarra Dramane touré Abdoul Salam Diarra Leyla Maïga Dicko Fatoumata Paediatric Ward CSR&#233f CV Bamako Mali Paediatric Ward of Nianankoro Fomba Hospital S&#233gou Mali Paediatric Ward of Kalaban CoroCSREF Bamako Mali Pediatric Department of the Mopti Reference Health Center Mopti Mali National Centre for Scientific and Technological Research Bamako Mali Paediatrics Department Mohamed VI Perinatal Clinic Bamako Mali Department of Paediatrics Gabriel Tour&#233 University Hospital Bamako Mali

Introduction: Neonatal mortality remains a major public health concern. According to the World Health Organisation (WHO), the number of newborns dying each year has fallen from 5 million in 1990 to 2.4 million in 2019. The aim of our study was to describe the main morbid conditions and their lethality in newborns admitted to the paediatric ward of the CSREF in Commune V. Methodology: We conducted a 12-month prospective descriptive and analytical study from August 2020 to July 2021. Results: During the 12 months of the study, out of 2654 neonates admitted to hospital, 216 met our inclusion criteria, i.e. 8%. Newborns admitted in the first few hours of life represented 99.54% of cases. Full-term newborns accounted for 65.74% of the total. Forty-eight percent of newborns had hypothermia on admission. The most common diagnosis was asphyxia in 55.56% of cases, followed by neonatal infection in 27.78% and prematurity in 10.65%. Death was recorded in 22.2% of cases. Asphyxia was the main cause of neonatal death, followed by prematurity in our context. Conclusion: Improving the prognosis of newborn babies will require a thorough understanding of neonatal pathologies and the implementation of a pre- and perinatal prevention policy.

关键词： Newborns Morbidity Mortality

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Causes and Prognosis of Cases of Acute Obstructive Renal Failure Managed at the Donka National Hemodialysis Center

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Open Journal of Nephrology 2024年第2期14卷 136-146页

作者： Amadou Yaya Diallo Mamadou Mouctar Diallo Mamadou Dian Barry Kadiatou Mamadou Bobo Barry Saikou Oumar Diallo Djenabou Diallo Soriba Bangoura Mamadou Malal Diallo Thierno Mamadou Oury Diallo mohamed lamine Kaba Alpha Oumar Bah Department of Nephrology-Hemodialysis CHU Donka Conakry Guinea Faculty of Health Sciences and Techniques Gamal Abdel Nasser University of the Republic of Guinea Conakry Guinea Department of Urology-Andrology CHU Ignace Deen Conakry Guinea

Introduction: Acute obstructive renal failure (AORF) is a frequent clinical situation, secondary to obstruction of the urinary excretory tract. Whatever the cause, urinary tract obstruction suddenly opposes glomerular filtration and is responsible for tubulointerstitial lesions. It accounts for 10% of acute renal failure (ARF). The aim of this study was to identify the causes and prognosis of cases of acute obstructive renal failure managed at the Centre National d’hémodialyse Donka. Material and Methods: This was a prospective descriptive study lasting 6 months, from September 1, 2022 to February 29, 2023. All patients undergoing haemodialysis for acute obstructive renal failure who agreed to participate in the study and whose medical records were complete were included. Results: During the course of the study, we registered 97 haemodialysis patients, including 20 cases (20.62%) of acute obstructive renal failure. The mean age of the patients was 57.8 ± 10.54 years, with a male predominance of 11 cases (55%) and a sex ratio of 1.22. The reasons for consultation were dominated by physical asthenia 11 cases (55%), lumbar pain 9 cases (50%), vomiting 6 cases (30%) and acute urine retention 6 cases (30%). Arterial hypertension 16 cases (80%) and urinary tract infection 10 cases (50%) were the most common antecedents. The etiologies of RAOI were dominated by lithiasis 10 cases (50%), neoplasia 6 cases (30%) and benign prostatic hypertrophy 3 cases (15%). mean creatinine was 1267.60 ± 710.76 μmol/l with extremes of 243 μmol/l and 2822 μmol/l, mean urea was 39.56 ± 18.36, hyperkalemia in 14 cases (70%) and hyponatremia in 8 cases (40%). After hemodialysis, 9 cases (45%) recovered renal function, 4 cases (20%) became chronic and 7 cases (35%) died. Conclusion: The frequency of AKI remains non-negligible in our department, and early detection and prompt management would considerably reduce the morbidity and mortality associated with this pathology.

关键词： Acute Obstructive Renal Failure Hemodialysis Prognosis Donka

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Factors Associated with Mortality in Children Aged 1 Month to 15 Years Hospitalized in the Pediatric Ward of the Kalaban-Coro Reference Health Center: Cross-Sectional Study

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Open Journal of Pediatrics 2024年第5期14卷 800-813页

作者： Abdoul Salam Diarra mohamed Diarra Dramane touré Tawfiq Abu Beyadari Balilé Harber Maimouna Kanté Issa Guindo Belco Maiga Karamoko Sacko Kalirou Traoré Fatoumata Dicko Mamadou Togo Kalba Pélieba Mariam Sylla Mamadou Samaké Hamadoun Sangho National Center for Scientific and Technological Research Bamako Mali Department of Pediatric Health Referral Center of Kalaban Coro Koulikoro Mali Pediatric Department of the Mopti Referral Health Center Mopti Mali Private Practice for Family and Emergency Medicine Casablanca Morocco Paediatric Ward of Nianankoro Fomba Hospital Segou Mali Paediatric Ward Referral Health Center of Common V Bamako Mali Administration Department Health Referral Center of Kalaban Coro Koulikoro Mali Department of Paediatrics Gabriel Toure University Hospital Bamako Mali Department of Internal Medicine CHU Gabriel Tour Bamako Mali Service dHpato-Gastro-Entrologie Gabriel Toure University Hospital Bamako Mali Department of Public Health Faculty of Medicine and Odontostomatology University of Sciences Techniques and Technologies of Bamako Bamako Mali

Introduction: Infant and child mortality is a worldwide concern, but developing countries such as Mali are more affected. The aim of this study was to investigate morbidity and factors associated with mortality in children aged 1 month to 15 years. Methodology: This was a cross-sectional study which took place from January 1 to December 31, 2020 covering children aged 1 month to 15 years hospitalized at the Kalaban-Coro CSRéf. Data were entered into Excel and analyzed using SPSS version 20 software. Results: Five hundred children aged 1 months to 15 years were included. The age range 1 to 5 years (53.6%) and male sex (58.2%) were the most represented. Malaria (72.2%), acute respiratory infections (6.2%) and diarrhea/dehydration (3%) were the main morbidities. Mortality was estimated at 10.6%, and the two main causes of death were malaria (56.6%) and acute respiratory infections (7.54%). Univariate analysis revealed a statistically significant association between the dependent variable (death) and age (p Conclusion: This study confirms the high rate of infant and child morbidity and mortality in our health facilities. Strengthening human resources and intensifying behavior-change communication can help reverse the trend.

关键词： Children Aged 1 Months to 15 Years Morbidity Factors Associated with Mortality Morbidity

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Eyelid Wounds: Epidemiological, Clinical and Etiological Aspects

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Open Journal of Ophthalmology 2024年第1期14卷 55-62页

作者： Aly Mbara Ka Jean Pierre Diagne Aissatou Aw El Hadji Malick Sy Soda Mbaye Hawo Madina Diallo Audrey Samra Aboubacry Sadikh Sow Joseph Matar Mass Ndiaye Ousmane Ndiaga Senghor lamine Ndiaye mohamed Ndiaye Serigne Sohibou Gaye Papa Amadou Ndiaye Ophthalmology Department of Abass Ndao Hospital Dakar Senegal Ophthalmology Department of Aristide Le Dantec Hospital Dakar Senegal

Purpose: The aim is to show epidemiological, clinical and etiological characteristics of palpebral wounds. Methodology: This was a retrospective study focusing on patients with an eyelid wound, over a 10-year period from 2012 to 2021. We collected and analyzed the data using Excel. Results: The frequency of eyelid wounds was 0.1%. The average age of our patients was 19.38 years with a range of 1 and 62 years. The sex ratio was 3.7. Eighty-one percent of patients lived in Dakar. Fifty-seven percent (57%) of patients consulted less than 24 hours after the trauma and 7% of patients on D1. The circumstances were brawls (11%), domestic accidents (9%), road accidents (6%), and work accidents (6%). We noted 1 case of dog bite. Thirteen patients presented with post-traumatic decreased visual acuity. Involvement of the isolated upper eyelid was noted in 40% of cases and both eyelids in 15% of cases. Involvement of the lacrimal ducts was noted in 17% of cases, and that of the free edge in 21% of cases. Eyelid wounds were associated with eyeball damage in 21% of cases. Various associated lesions were observed. Ninety-one percent of patients received surgical treatment. Three cases of superinfections, 1 case of conjunctival granuloma and 1 case of phthysis of the eyeball with postoperative retinal detachment were noted. Conclusion: Eyelid sores are relatively common in our context. They require rapid surgical treatment in order to preserve the functional and aesthetic prognosis. .

关键词： Eyelid Wounds Epidemiology Clinic Etiologies

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Iodine 131 Treatment in Graves’ Disease in a West African Country: Preliminary Study about 25 Cases in Senegal

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Open Journal of Biophysics 2024年第1期14卷 56-72页

作者： El Hadji Amadou lamine Bathily Serigne Moussa Badiane Mamoudou Salif Djigo Gora Thiaw Kalidou Gueye Ousseynou Diop Boucar Ndong Kokou Fofo Toussaint Adambounou Alphonse Rodrigue Djiboune Papa Mady Sy Mamadou Soumbounou mohamed Chekhma Louis Augustin Diaga Diouf Gora Mbaye Omar Ndoye Mounibé Diarra Mamadou Mbodj Nuclear Medicine Department General Hospital of Idrissa Pouye (HOGIP) Dakar Senegal Biophysical Laboratory Cheikh Anta Diop University (UCAD) Dakar Senegal Biophysical Laboratory Gaston Berger University (UGB) Saint-Louis Nuclear Medicine Department Hospital Dalal Jamm Dakar Senegal Biophysical Laboratory University of Lome Lome Togo Laboratory of Physical and Pharmaceutical Biophysics Cheikh Anta Diop University Dakar Senegal

Introduction: Graves’ disease is the most common cause of hyperthyroidism. Its treatment uses synthetic antithyroid drugs but the use of aggressive radical therapy such as surgery or non-aggressive therapy such as iodine-131 is not uncommon. Treatment of Graves’ disease with radioactive iodine or iratherapy is a simple, inexpensive, well-tolerated treatment. It was introduced in Senegal in 2016. We report through this work the preliminary assessment of the only nuclear medicine service in Senegal in the management of Graves’ disease by iodine-131. Patients and Methods: Retrospective study of the first cases of Graves’ disease treated with iratherapy in Senegal. Socio-demographic, clinical, paraclinical, therapeutic and evolutionary aspects were studied. Radiation protection rules have been implemented and contraception has been effective for six months in women of childbearing age. Results: 25 patients were collected with a mean age of 45 years, twenty women (80%), a family goiter in 24% and a psycho-affective context in 64% of cases. Thyrotoxicosis syndrome was associated with goiter in 68% of patients and exophthalmos in 64%. Thyroid ultrasound performed in 20 patients showed vascular goiter in 80% and thyroid scintigraphy in 3 patients, homogeneous and diffuse hyperfixation. TRAK dosed in 8 patients was still positive. All patients had received first-line medical treatment. The average duration of this treatment was more than 18 months in 92%. The empirically used iodine-131 activity averaged 15.35 mCi. Oral corticosteroid therapy was prescribed in 7 patients for the prevention of malignant orbitopathy. No early side effects were noted. The remission rate at 3 months was 52% and at 6 months was 88% to 92%. Conclusion: The effectiveness of radioactive iodine, in particular ablative doses in the treatment of hyperthyroidism, is no longer to be demonstrated. Taking into account our socioeconomic context, iratherapy should be a treatment of choice for hyperthyroidism

关键词： Graves’ Disease Iratherapy Iodine-131 Senegal

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Postoperative Complications in the General Surgery Department of the Cs Ref of Commune I of the District of Bamako Mali

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Surgical Science 2024年第6期15卷 409-419页

作者： Tounkara Cheickna Samake Hamidou Dembele lamine Diarra Issaka Togola Modibo Sanogo Modibo Dembele Bakary Tientigui Traore Alhassane Togo Adégné Pierre Kante Lassana Department of General Surgery Reference Health Center of Commune I of Bamako Bamako Mali Directorate of Social and Health Services of the Armies Bamako Mali Department of General Surgery CHU Gabriel Tour Bamako Mali

Postoperative complications represent important indicators for the quality of surgical care. The objectives of this work were to study post-operative complications in the general surgery department of the Cs ref of commune I in Mali, to determine the frequency of post-operative complications, to identify the factors of occurrence, to describe the clinical aspects, diagnostic and therapeutic in order to assess the additional cost linked to post-operative complications. This study was prospective, carried out in the general surgery department on 300 cases of surgical interventions. It covered all patients aged at least 15 years, operated on and hospitalized or not, and who presented complications during the 30 days postoperatively. Patients under the age of 15 were not included (our general surgery department is not a pediatric surgery department). We collected 300 patients among whom 199 (66.33%) were men and 101 (33.66%) women, i.e. a sex ratio = 1.9. The average age was 38 years with extremes of 15 and 87 years. The main initial diagnoses were: acute appendicitis, peritonitis, occlusions, wall hernias, hemorrhoids, uterine prolapse, uterine myomas, ovarian cysts and acute cholecystitis. Emergencies represented 43% (N = 129) of interventions with 6.98% post-operative complications (POC). Postoperative complications were dominated by surgical site infections, 75% of cases (N = 20), wall hemorrhage 5% (N = 1), testicular necrosis 5% (N = 1) and testicular calcification 5% (N = 1), wire rejection 5% (N = 1) and death 5% (N = 1). The management of postoperative complications was surgical in 95% and medical in 100%. Their occurrence extended the hospital stay by 3.65 days and increased the average cost of care by 60541.85 CFA francs. The mortality index lowered by efficient management of complications (IMAGE) calculated in relation to deaths was 95% of cases. Anemia, ASA score ≥ III, Alteimeir II and IV classes, duration of surgery and post-operative hospitalization were

关键词： Complications Post Opératoires Chirurgie Cs Ref CI Bamako Mali

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The Scrotoschisis about a Case in the Pediatric Surgery Department of the Donka National Hospital

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Open Journal of Pediatrics 2021年第2期11卷 238-242页

作者： Balla Keita Mamadou Alpha touré Mamadou Madiou Barry mohamed lamine Sacko et lamine Camara Pediatric Surgery Department of the Donka CHU National Hospital Conakry Guinea

Introduction: Scrotoschisis is a very rare congenital defect of the scrotum characterized by the exteriorization of one or two testes. We report a case of right scrotoschisis in a newborn as well as a review of the literature for an approach of probable etiology. Patient and Observation: A newborn baby of 8 hours of life, weighing 3200 g was referred to our department for a right scrotal defect with exteriorization of the testis associated with fluid swelling of the left bursa. The 18-year-old mother, primiparous and primigeste followed all the prenatal consultations with eutocic delivery. After clinical investigation the diagnosis of right scrotosisis and left hydrocele was retained. Surgical treatment was carried out by primary closure after orchidopexy and exploration of the contralateral bursa, the content of which was calcified meconium bathed in a yellowish liquid. The post-operative consequences were simple. Conclusion: Scrotoschisis is an extremely rare birth defect whose etiology is poorly understood. However, it could be the cause of meconium peritonitis secondary to a scarred fatal intestinal perforation.

关键词： Scrotoschisis Congenital Anomaly Etiology

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Intraventricular Hemorrhage, a Rare Complication of a Cerebral Tuberculoma: Study of a Case in the Neurology Department of the University Hospital of Conakry

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Case Reports in Clinical Medicine 2023年第1期12卷 1-8页

作者： Doumbouya Idrissa touré mohamed lamine Barry Djénabou Négué Diawara Karinka Traoré mohamed Cissé Fodé Abass Department of Neurology University Hospital of Conakry Conakry Guinea

Intraventricular haemorrhage (IVH) is an extremely rare and poorly described complication of central nervous system Tuberculosis (CNS-TB). In this study, we report the case of a 42-year-old man who presented with a weakness of the left hemibody with diffuse headache, altered consciousness associated with fever. No notion of contagion was noted. Brain computed tomography (CT) showed a hematoma in the occipital horns of the lateral ventricles with peri-lesional oedema of the right hemisphere;after injection of contrast product (CP), there were ring-shaped contrasts in the occipital horn of the lateral ventricle and the right thalamus. Angioscan showed no aneurysms or vascular anomalies. Chest X-ray showed micronodular opacities less than 1.5 cm in size in relation to miliary. Xpert MTB/RIF of sputum and cerebrospinal fluid (CSF) showed Mycobacterium tuberculosis (MT). The patient’s course was favourable under antihypertensive and antitubercular treatment. Conclusion: This case illustrates the diagnostic difficulties of CNS-TB due to the polymorphism of the clinical and radiological presentation of CNS-TB.

关键词： Intraventricular Haemorrhage Tuberculosis Tuberculoma

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Cerebral Malaria: Epidemiological, Clinical and Prognosis Aspects in the Anesthesia-Resuscitation Department CHU Ignace Deen

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Open Journal of Emergency Medicine 2023年第4期11卷 162-173页

作者： Abdoulaye touré Amadou Yalla Camara Almamy Bangoura M’mah lamine Camara mohamed Soumah Saramba Nabe Department of Anesthesia-Resuscitation University Hospital of Ignace Deen of Conakry Conakry Guinea Department of Medical and Surgical Emergency Donka University Hospital Conakry Guinea Department of Anesthesia-Resuscitation Donka University Hospital Conakry Guinea

Objective: To describe the epidemiological, clinical, paraclinical and prognostic aspects of cerebral malaria received in the anesthesia-resuscitation department. Methodology: This was a prospective descriptive type study carried out in the anesthesia-resuscitation department over a period of three (03) months (June 01 to August 31, 2022). All patients admitted for cerebral malaria were included. Sociodemographic, clinical and prognostic parameters were studied. Results: We collected 25 cases out of 105 admitted patients (23.8%). The average age was 27.6 ± 9.5 years with extremes of 11 and 50 years. The sex ratio was 0.7 (M/F). Students and housewives were in the majority, i.e. 52% and 24%. Neurological disorders were found on admission in all patients, dominated by impaired consciousness at 100% followed by convulsion (60%), prostration (44%), confusion (36%) associated with deep coma in (68%). Gross hemoglobinuria was present in (84%) of cases. On the blood count, anemia was present in (70%) of the patients followed by thrombocytopenia in more than half of the cases (60%) and transfusion was necessary in 19 cases. P Falciparum malaria was found in all patients (100%), the average parasite density was 60342.8 ± 30425.6 trophozoites/μl with extremes of 9000 to 100000 trophozoites/μl. All our patients were treated with intravenous injectable artesunate. Transfusion was performed in 76% of our patients. Eighty percent of the patients had benefited from dialysis. High oxygen therapy was performed in (92%) of cases. The average duration of hospitalization was 5.74 ± days with extremes of 1 to 17 days. Mortality was 48%. Conclusion: Cerebral malaria can take different clinical forms, the most important of which is cerebral involvement. Prompt initiation of appropriate resuscitation can reduce mortality.

关键词： Cerebral Malaria Mortality Resuscitation

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Management of Post-Operative Pain after Gyneco-Obstetrical Surgery: Practice of Transversus Abdominis Plane Bloc (Tap Block) Echoguide at the Ignace Deen National Hospital

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Open Journal of Anesthesiology 2021年第10期11卷 316-324页

作者： Donamou Joseph Bangoura Almamy touré Abdoulaye Camara Amadou Yalla Traoré Abdourahamane Dine Camara M’Mah lamine Camara M’Mah lamine Dramé Boubacar Atigou Camara Mariama mohamed Orou Yerima Therese touré Aboubacar Anesthesia-Intensive Care Unit Donka National Hospital Conakry Guinea Anesthesia-Intensive Care Unit National Ignace Deen Hospital Conakry Guinea Medico-Surgical Emergency Department Donka National Hospital Conakry Guinea General and Visceral Surgery Department Ignace Deen National Hospital Conakry Guinea

Objectives: To describe the practice of ultrasound-guided TAP in the management of postoperative pain after gyneco-obstetric surgery. Methods: This was a descriptive prospective study carried out at the Gynecology-Obstetrics department of the Ignace Deen National Hospital over a period of three (03) months from February 01, 2020 to April 31, 2020. Results: In total, we collected 95 patients. These patients had a mean age of 30 ± 9.5 years. The ASA I class was the most represented with 76% of the cases and the cesarean was the most performed intervention. Regarding the assessment of the pain score by the simple verbal scale (SVE) postoperatively at rest, the mean SLE scores at H6 were 0.17 ± 0.38;at H12 of 1.15 ± 0.62;at H24 of 0.84 ± 0.51;at H36 0.45 ± 0.52 and at H48 0.09 ± 0.29. On mobilization, the mean pain scores were 0.77 ± 0.51 at H6, at H12 1.89 ± 0.61;at H24 of 1.53 ± 0.56;at H36 of 1 ± 0.29 and at H48 of 0.82 ± 0.44. The majority of our patients (66.3%) had a mobilization time of less than 24 hours. The mean length of stay was 3.1 ± 1.3 days and most patients (82%) were satisfied with the management of their pain by ultrasound-guided TAP block. Conclusion: Ultrasound-guided TAP is an effective technique for the management of postoperative pain in gyneco-obstetrics surgery. Its integration in a context of multimodal analgesia could improve the management of postoperative pain in gynecological obstetrics.

关键词： Postoperative Pain TAP Block Ultrasound Guidance Gyneco-Obstetrics

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