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Cardio-Renal Syndrome: Epidemiological Aspect in the Medicine Department of Tombouctou Hospital

World Journal of Cardiovascular Diseases 2022年第2期12卷 123-132页

作者： Bassirima Traore Samba Sidibé Souleymane Mariko Karamoko Kantako Massama Konaté Kalifa diallo Nouhoum Diallo Mariam Sako Abdoul Karim Sacko Youssouf Kassambara Ichaka Menta Souleymane Coulibaly Department of Medicine Tombouctou Hospital Tombouctou Mali Cardiology Department of the Point G University Hospital Bamako Mali Cardiology Department Mali Hospital Bamako Mali Cardiology Department CHU Gabriel TOURE Bamako Mali

Introduction: Cardio-renal syndrome is a pathophysiological disorder of the heart and kidneys in which chronic or acute dysfunction of one can lead to chronic or acute dysfunction of the other. The objective of this study was to determine the prevalence of cardio-renal syndrome in the Medical Department of the Tombouctou Hospital in Mali. Methods: It is about a descriptive transversal study carried out over 18 months, from January 01st, 2020 to June 30th, 2021 and relating to the analysis of 75 files of patients hospitalized for heart failure and with impaired renal function. Results: The frequency of cardio-renal syndrome was 6.4% with a predominance of men (sex ratio: 2). Hypertension was the most widely described risk factor (50.6%). The history was dominated by chronic heart failure (14.6%) and diabetes (6.6%). The average age was 58 with extremes of 18 and 90. The main aetiologies were dilated cardiomyopathy (46.6%) and ischemic heart disease (20%). Symptoms were dominated by dyspnea (90.6%) and edema of the lower limbs and face (74.6%) accompanied by cough (74.6%). Anemia was noted in 15 patients (20%). The mean clearance (MDRD) was at 32 ml/min. Doppler echocardiography found left ventricular dilation (66.6%), lower left ventricular systolic fraction (64%) and kinetic abnormalities (20%). The kidney ultrasound performed in 9 patients returned to normal in 8 cases and in 1 patient the kidneys were small. Eight deaths (10.6%) were noted. Conclusion: Cardio-renal syndrome is a common feature in which mixed failure is observed in the unfavorable course of heart disease and nephropathy. Its prevalence is unfortunately under evaluated in cardiological settings in Africa and particularly in Mali, hence the interest of a more advanced study.

关键词： Cardio-Renal Syndrome Epidemiology Tombouctou Hospital

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Epidemiology and Management of Heart Failure in the Medicine Department of Tombouctou Hospital

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World Journal of Cardiovascular Diseases 2023年第3期13卷 105-113页

作者： Bassirima Traoré Souleymane Mariko Samba Sidibé Karamoko Kantako Mariam Sako Massama Konaté Nouhoum Diallo Abdoul Karim Sacko Kalifa diallo Youssouf Kassambara Djibril Kassogue Oumar Ongoiba Oumar Sanogo Ichaka Menta Souleymane Coulibaly Department of Medicine Tombouctou Hospital Tombouctou Mali Department of Cardiology Point G University Hospital Bamako Mali Department of Cardiology Mali Hospital Bamako Mali Department of Cardiology CHU Gabriel TOURE Bamako Mali

Introduction: Heart failure is a complex syndrome and very frequently observed and secondary to the outcome of many advanced heart diseases. It is made up of a set of symptoms that reflect the tissue and visceral consequences of heart failure. The objective was to determine the hospital prevalence and to describe the management of heart failure in the medical department of Tombouctou hospital in Mali. Methods: This is a descriptive cross-sectional study with retrospective data collection, carried out over 24 months and involving the analysis of 266 records of patients hospitalized for heart failure. Results: The frequency of heart failure was 17.6% with a female predominance. The average age was 48 years with extremes of 16 and 90 years. Cardiovascular risk factors were dominated by high blood pressure with 38%. Global heart failure was the mode of discovery in 72.2% of cases. The etiologies were dominated by hypertensive dilated cardiomyopathy in 36.8% and peripartum cardiomyopathy in 32% of cases. The majority of our patients benefited from diuretic treatment, i.e. 95.9% frequency;with a favorable evolution in 96.2% of cases. We recorded 10 deaths, i.e. a lethality of 3.7%. We report some difficulties encountered during our security study because Tombouctou is a war zone and the lack of a technical platform for biology such as (BNP or NT-proBNP). Conclusion: Heart failure is a real public health problem. Its prevalence is increasing due to the aging of the population and especially the poor management of arterial hypertension in our context.

关键词： Heart Failure Epidemiology Etiology Treatment Tombouctou Hospital

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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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Acute Renal Failure in COVID-19 Patients in Intensive Care at the CHU du Point G in Mali

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Open Journal of Nephrology 2023年第4期13卷 385-394页

作者： diallo Boubacar Coulibaly nouhoum Dicko Hammadoun Berthe Modibo Beye Seydina Alioune Niangado Rokiatou Bassirou Keita Mohamed Coulibaly Youssouf Department of Anaesthesia-Resuscitation and Emergencies CHU Point G Bamako Mali Department of Nephrology and Haemodialysis CHU Point G Bamako Mali

Introduction: SARS-CoV-2 (Severe Acute Respiratory Syndrome Corona-virus 2) causes an acute respiratory disease with interstitial and alveolar pneumonia, which can affect several organs including the kidneys [1] [2] [3]. As Mali is no stranger to this pandemic, we report our experience of the management of cases of kidney failure observed in the COVID-19 intensive care unit at the Point G University Hospital Centre (CHU). The aim of this work was to characterise acute renal failure in COVID-19 patients in intensive care, describing the management methods used and determining the vital prognosis. Materials and Methods: This was a retrospective descriptive study, covering an 18-month period from April 2020 to September 2021. We included all patients admitted to the COVID-19 intensive care unit on the basis of a positive RT-PCR and/or the presence of ground-glass images on thoracic computed tomography. Results: We selected 232 patients admitted for COVID-19. Acute Renal Failure (ARF) developed in 71 patients (30.6%). The stages of AKI according to KDIGO were Stage 1 in 28.2%, Stage 2 in 18.3% and Stage 3 in 53.5%. The mean age was 63.96 years, with a standard deviation of 16.6, and males accounted for the majority (71.8%). Organic ARF was found in 80.3% of cases. Risk factors and comorbidities for ARF included advanced age (60.6%), male sex (71.8%), hypertension (52.1%), diabetes (21.1%), invasive mechanical ventilation (71.8%) and septic shock (56.3%). Extra renal purification (haemodialysis) was used in 29.6% of patients. Admission to intensive care ranged from 7 days to 14 days in 43.7% of cases. More than half the patients (52.1%) were in critical condition on admission. Death occurred in 76.1% of patients. Conclusion: ARF appears to occur more frequently in patients with severe COVID-19. It is associated with a poor prognosis.

关键词： COVID-19 Acute Renal Failure Intensive Care Unit

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Current management of liver diseases and the role of multidisciplinary approach

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World Journal of Hepatology 2022年第11期14卷 1920-1930页

作者： nouhoum Bouare Department of Assurance Quality and Biosafety/Biosecurity National Institute of Public HealthBamako 1771Mali

Liver is an organ having extremely diversified functions,ranging from metabolic and synthetic to detoxification of harmful chemicals.The multifunctionality of the liver in principle requires the multidisciplinary and pluralistic interventions for its management.Several studies have investigated liver function,dysfunction and clinic.This editorial work discusses new ideas,challenges and perspectives of current research regarding multidisciplinary and pluralistic management of liver diseases.In one hand the discussions have carried out on the involvement of extracellular vesicles,Na^(+)/H^(+) exchangers,severe acute respiratory syndrome coronavirus 2 and Epstein–Barr virus infections,Drug-induced liver injury,sepsis,pregnancy,and food supplements in hepatic disorders.In the other hand this study has discussed hepatocellular carcinoma algorithms and new bio-chemical and imaging experiments pertaining to liver diseases.Relevant articles with an impact index value">0"from reference citation analysis,which is an open multidisciplinary citation analysis database based on artificial intelligence technology,have served for the study’s argumentation.This work may be a useful tool for the clinical practice and research in managing and investigating liver disorders.

关键词： Liver management Liver function Liver dysfunction Liver clinic Liver diagnosis Multidisciplinary approach

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Self-Medication during Eye Affections among Consultant Patients at Chu-Iota

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Open Journal of Ophthalmology 2023年第2期13卷 256-262页

作者： Assiatou Simaga Mohamed Kolé Sidibé Nana Wangara Seydou diallo Ibrahima Conaré Founè Keïta Adama Dembélé nouhoum Guirou Seydou Bakayoko Institute of Ophthalmology and Tropical Africa (IOTA) Bamako Mali

Introduction: According to the World Health Organization (WHO), self-medication consists in the fact that an individual resorts to a drug, on his own initiative or that of a loved one, with the aim of treating an ailment or a symptom that he identified himself without having recourse to a health professional. Self-medication involves the use of medicinal products by the consumer to treat self-recognized disorders or symptoms, or the intermittent or continued use of a medication prescribed by a physician for chronic or recurring diseases or symptoms. The aim of this study is to determine the different characteristics of ophthalmic self-medication at the CHU-IOTA. Patients and Method: We conducted a prospective study in patients of any age who resorted to ophthalmological self-medication before the first consultation or during the ophthalmological care of consulting patients at the CHU-IOTA between January 1 and July 31, 2021. Results: Over the period, 521 cases of ophthalmological self-medication were collected out of a total of 24,512 consultations, which corresponds to a frequency of 2.12%. The average age was 37.7 years, [2 months - 78]. The sex ratio was 0.50. Economic factors were the main factor mentioned, 66.79%. Corticosteroids accounted for 45.26% of the pharmacological class with dexamethasone/neomycin eye drops being the most widely used, i.e. 22.94%. The most common complication was corticosteroid-induced ocular hypertension on ametropia, i.e. 15.54%. Our patients were 68.13% educated. Among his educated patients 53.35% had no knowledge of the products. Conclusion: Given the harm associated with this practice, awareness and information campaigns aimed at the population, caregivers and pharmacists or pharmacy vendors are necessary in order to reduce the frequency of the practice of self-medication.

关键词： Self-Medication Conditions Eye CHU-IOTA

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Bilateral Central Serous Chorioretinopathy (CRSC) in Pregnancy Complicated with Retroplacental Hematoma: About a Case

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Open Journal of Ophthalmology 2023年第1期13卷 13-22页

作者： Daouda Goita Moro Sidibe Mala Sylla Nana Wangara Mamadou Kolé Sidibe Adama Dembele Gounon Saye Abdoulaye Napo nouhoum Guirou Adama Guindo Mamadou Adama Togo Abdoulaye nouhoum Coulibaly Oumar diallo Japhet Popanou Thera Lamine Traore BOUGOUNI Reference Health Center Bougouni Mali Sikasso Regional Hospital Mali/Alliance for the Development of Community Ophthalmology (ADOC) Bamako Mali Institute of Tropical Ophthalmology of Africa Bamako Mali/Alliance for the Development of Community Ophthalmology (ADOC) Bamako Mali Alliance for the Development of Community Ophthalmology (ADOC) Bamako Mali National Eye Health Program Bamako Mali

Introduction: Central serous chorioretinopathy (CSCR) is associated with serous sensorineural retinal detachment in the macular region. The condition that affects the male gender more than their female counterpart results from focal leakage disturbance of retinal pigment epithelial cells and choroidal abnormalities. The corticosteroid is highlighted as one of the major factors that promote the occurrence of CSCR. Stress and pregnancy, especially in the third trimester, have also been reported by some authors. Central serous chorioretinopathy associated with pregnancy complicated by retroplacental hematoma is a rare event. Observation: We report the case of a pregnant woman at approximately 34 weeks of amenorrhea who presented a sudden and severe drop in visual acuity on a pregnancy complicated by retroplacental hematoma and delivered by cesarean section. The diagnosis was based on clinical arguments associated with photos of the retina made by the MII Ret Cam device (Made In India, Retinoscope Camera) highlighting the lifting of the macular region. Ophthalmological monitoring without medical or physical treatment was instituted. At two months of progression without treatment, bilateral visual acuity was 10/10. Conclusion: Central serous chorioretinopathy and pregnancy is not unusual;however, its bilateral and brutal form in a context of pregnancy complicated by retroplacental hematoma is rare. Despite this favorable evolution, monitoring remains necessary in order to prevent recurrences and complications.

关键词： MII Ret Cam Central Serous Chorioretinitis Retroplacental Hematoma

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Volvulus Acute of the Colonist Sigmoid to Mopti:Diagnostic and Therapeutic Aspects

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Surgical Science 2018年第11期9卷 446-453页

作者： Bréhima Bengaly Abdoulaye Kanté Drissa Ouattara Bréhima Coulibaly Drissa Traoré Birama Togola Babou Ba Souleymane Sanogo Siaka diallo Djibril Traoré Moustapha Issa Magané Mariam Daou nouhoum Ongoiba Service of Surgery B CHU Point GBamakoMali Service of General Surgery Somine Dolo of Mopti HospitalMali Laboratory of Anatomy of the Faculty of Medicine and Odontostomatology BamakoMali Service of Anesthesia and Resuscitation CHU Gabriel TouréBamakoMali Service of Neurology CHU Gabriel TouréBamakoMali

In 7 years, we brought together 100 cases of volvulus of the colon sigmoid to the hospital Sominé Dolo of Mopti among which the handle volvule was found without necrosis in 66 cases and necrosis 34 cases. Seventy-six patients benefited from a sigmoidectomy followed by a colorectal anatomize at a time, twenty one patients of an intervention of Hartmann. A surgical distortion was realized at 3 patients. All the patients operated by these last two techniques had a restoring of the digestive continuity for an average deadline of 90 days. The post-operative complications consisted of 11 cases of parietal suppuration and a case of evisceration. The average duration of follow-up was of 210 days. The post-operative mortality was 14%. It was about a state of toxic shock with visceral multi-failure (n = 13), and of a pulmonary embolism (n = 1). The treatment of the volvulus requires a fast diagnostic and therapeutic coverage. The best treatment consists of a resection of the sigmoid as a matter of urgency followed by an immediate anastomosis if the following conditions are carried achieved: state general voucher, experimented surgeon and if the resuscitation meadow, per and post-operative can be assured.

关键词： Pelvic Colonist Volvulus Treatment Mopti Mali

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Congenital Heart Disease: Epidemiological and Echocardiography Aspects in the Cardiology Department of Tombouctou Hospital, Mali

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World Journal of Cardiovascular Diseases 2020年第12期10卷 839-846页

作者： Souleymane Mariko Samba Sidibé Massama Konaté Karamoko Kantako Charles Dara Djibril Kassogué Zoumana diallo Konimba Sanogo Nouhoum Diallo Aniessa Kodio Mariam Sako Abdoul Karim Sacko Coumba A. Thiam Mamadou Diakité Souleymane Coulibaly Ichaka Menta Cardiology Department Tombouctou Hospital Tombouctou Mali Cardiology Department of the University Hospital Center Point G Bamako Mali Cardiology Department Mali Hospital Bamako Mali Médical Department Tombouctou Hospital Tombouctou Mali Cardiology Department Ségou Hospital Ségou Mali Cardiology Department of the University Hospital Center Kati Mali Cardiology Department of University Hospital Center Bamako Mali

Congenital heart diseases are abnormalities of heart that occur during intrauterine life. Our work aimed to study the epidemiological and echocardiographic aspects of congenital heart disease with Cardiology Department of the Tombouctou hospital. This was a descriptive cross-sectional study from November 2018 to December 31, 2019 on Doppler echocardiography reports from patients admitted to the Cardiology department. The probes used were 3.5 and 5 MHz on an Esaote Mylab40 device. The inclusion criteria concerned patients of both sexes under the age of 16, hospitalized or followed in the cardiology department for cardiac symptoms and having benefited from a cardiac Doppler ultrasound. Results: During the study period, 370 echocardiographic examinations were performed and revealed 20 cases of congenital heart disease with a prevalence of 5.45%. The female sex was the majority 13/7 cases which makes a sex ratio of 0.54. Heart murmurs were the main reason for requesting cardiac Doppler ultrasound with the 13 out of 20 cases of congenital heart disease (65%). Interventricular communication was represented by 15 cases (75%). Congenital heart disease is a reality in Africa. Its frequency and reported series are underestimated due to the inaccessibility of Doppler echocardiography.

关键词： Congenital Heart Disease Cardiology Tombouctou

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Palpebral Reconstruction in a Secondary Ophthalmology Center in Mali: About a Case

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Surgical Science 2023年第2期14卷 97-103页

作者： Dembélé Adama Sidibe Moro Sidibe Oumar Dembele Ahmadou Poma Hachimi Amadou Abdoulaye Konaté Oumar diallo Djonny Jonas Dembele Mamadou Adama Togo Kadiatou Ba Koita Abdoulaye nouhoum Coulibaly Cheick Fantamady Tounkara nouhoum Touré Napo Abdoulaye Régional Hospital of Sikasso Sikasso Mali Alliance for the Development of Community Ophthalmology (ADOC) Bamako Mali Center Médical Jean Marie Cissé Sikasso Mali

Introduction: Significant trauma to the periocular region can seriously damage ocular structures and their adnexa. The eyelids can be damaged during these traumas. The most frequent lesions are lacerations, the surgical treatment of which is generally simple. In some cases, there are complex traumas where there is a loss of tissue, which is difficult to treat. We report the case of a 26-year-old young man, farmer with no medical and surgical history, referred by the odontostomatology and maxillofacial surgery department for burns to the left hemi face by the exhaust pipe of his motorbike which occurred following a public road accident (AVP). Observation: A 26-year-old young man with no medical-surgical history, visual acuity was 5/10 with good mobility of the globe. In collaboration with the maxillofacial surgeon, a graft of the hemi face was performed using a flap from the inner side of the thigh first. In the second time we carried out a recovery by a flap which consisted in taking a supra-superciliary flap and suturing it at the level of the palpebral edges which, in spite of a fragile vitality of the tissues. Conclusion: The reconstruction of the eyelid is a real problem in our service because of the technical platform and the availability of consumables, which limits us in the choice of the operating technique.

关键词： Road Accident Hemi-Face Burn Eyelid Reconstruction

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