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Anatomical Dissection of the External Branch of the Superior Laryngeal Nerve to the Laboratory of Anatomy of the Faculty of Medicine of Bamako(Mali)

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Forensic Medicine and Anatomy Research 2018年第4期6卷 47-54页

作者： Abdoulaye Kante Youssouf Sidibe Babou Ba Brehima Bengaly Brehima Coulibaly Drissa Traore Drissa Ouattara Mariam Daou Tata Toure Siaka Diakite Moumouna Kone Siaka diallo Cheickh Tidiane diallo Ousmane Ibrahim Toure Birama Togola nouhoum Ongoiba Service of Surgery B CHU Point GBamakoMali Laboratory of Anatomy of the Faculty of Medicine and Odontostomatology BamakoMali ENT and Head and Neck Surgery Department CHU Mother-Child“Luxembourg”BamakoMali Service of Neurology CHU Gabriel ToureBamakMali

Aim: This study aimed at describing the anatomical variations of the external branch of the superior laryngeal nerve and at estimating the frequency of nerves at risk during the thyroid surgery. Methodology: We realized a forward-looking study from September, 2016 in May 31st, 2018 in the laboratory of anatomy of the Faculty of Medicine and Odontostomatology of Bamako in Mali. All the fresh anatomical subjects not carrying trauma and or a scar at the level of the previous region of the neck were held. The anatomical subjects were not included presenting a traumatic lesion and\or a scar of the previous region of the neck. Results: We realized 34 dissections of the external branch of the superior laryngeal nerve to 17 deathly subjects (11 men and 6 women with a sex-ratio of 1.8). The average age of the subjects was of 42 years (extremes: 18 and 70 years). Our study allowed highlighting in 100% of the cases, the external branch of the superior laryngeal nerve and the superior thyroid artery so to the right as to the left. On 34 dissected external branch of the superior laryngeal nerve, none had a previous route. However we found 28 nerves (82.4%) having a later route, stuck to the external face of the lower constrictor of the pharynx. These were not mixed with the superior thyroid artery and its branch of division and were situated outside the thyroid capsule. In 17.6% of the cases (6 cases), the nerve had a route mixed in the branch of the superior thyroid artery. These were found inside of the capsule (11.8% adhered to the artery and 5.8% crossed its branch of division). Conclusion: The risk of injury of the external laryngeal nerve during thyroid surgery procedure is never zero. It is more important on the left side.

关键词： External Laryngeal Nerve Superior Thyroid Artery Anatomy Thyroid Gland Surgery

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Bacteriological Profile of Pneumopathies in Chronic Renal Failure at the University Hospital Center of Point-G in Mali

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Open Journal of Clinical Diagnostics 2020年第1期10卷 18-28页

作者： Seydou Sy Magara Samaké Hamadoun Yattara Moctar Coulibaly Ba Oumou diallo Aboubacar Sidiki Fofana Djénéba diallo Atabieme Kodio Modi Sidibé nouhoum Coulibaly Alkaya Touré Djibril Sy Moustapha Tangara Saharé Fongoro Nephrology and Haemodialysis Department of the University Hospital Center (CHU) of Point G Bamako Mali Faculty of Medicine of Bamako University of Bamako Bamako Mali Nephrology Unit of the Fousseyni DAOU Hospital of Kayes Kayes Mali Nephrology Unit of Mali GAVARDO Hospital Bamako Mali Internal Medicine Service of the University Hospital Center of Point G (CHU du Point-G) Bamako Mali

Introduction: Chronic renal failure (CKD) is defined as a glomerular filtration rate (GFR) of less than 60 ml/min/1.73m2 for more than 3 months [1]. Infectious complications are a major source of morbidity in patients with chronic renal failure. In Mali, we have no data on pneumopathies in this population, hence the interest of this study. The objective of this work was to determine the frequency of pneumopathies in patients with chronic renal failure, describe the clinical radio-types, identify the microorganisms involved, and assess the renal prognosis of pneumopathies. Materials and Methods: This was an 18-month prospective and descriptive study from January 1, 2018 to June 30, 2019 conducted in the nephrology and hemodialysis department of the University Hospital of Point G. Included were patients hospitalized during our study period with CKD associated with pneumopathy on a chest X-ray. Not included were all patients hospitalized outside the study period, all CKD cases without pneumonia, patients with incomplete records, and non-consenting patients. Results: We examined 1111 patients, 35 of whom presented an image on chest X-ray related to pneumopathy, a frequency of 3.15% of cases. Twenty-one men (60%) and 14 women (40%) with a sex ratio of 1.5. The mean age was 46.8 ± 13.9 years with extremes of 23 and 76 years. The types of pneumopathy on the chest X-ray were: alveolar pneumopathy: 23 cases (65.7%), pleuropneumopathy: 10 cases (28.6%) and cavitary pneumopathy: 2 cases (5.7%). Cytobacteriological sputum examination was positive in 65.7%;leukocytes (68.6% of cases). The germs found were: Klebsiella pneumoniae (25.7% of cases), Escherica coli (11.4%), Pseudomonas aeruginosa (5.7%), Staphylococcus aureus (5.7%), Citrobacter freundi (5.7%), Enterococus sp. (2.9%), Enterobacter cloacae (2.9%), Candida albicans (5.7%). The search for acid-alcohol-resistant bacilli (BAAR) in sputum was positive in 4 cases (11.4%). There was an association between the results of cytobacteriological examination of sputum and the re

关键词： Renal Failure Dialysis Pneumopathy Mali

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Sigmoid Colon Volvulus: Surgical Management at Kati BSS Hospital (Mali)

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Surgical Science 2019年第3期10卷 76-82页

作者： Koniba Keita Abdoulaye Diarra Salia Coulibaly Sidiki Keita Issa Traore Moussa Doumbia Fadima Tall Daouda diallo Oulematou Coulibaly Assitan Kone Boubacar Kone Daouda Konate Amadou Kassongue Moussa Salifou diallo Ismael Konare Drissa Traore nouhoum Ongoiba General Surgery Department Kati Mali Medical Imaging Department Kati Mali Anesthesia Resuscitation Department Kati Mali Ophthalmology Department of Kati Kati Mali Department of Urology of Kati Kati Mali

The objective of this study was to describe the therapeutic aspects and to evaluate the surgery results of sigmoid Volvulus in the Kati (MALIA) General Surgery Department. Patients and Methods: This was a descriptive study conducted in our General Surgery Department. It took place in two phases for six years: A retrospective phase from January 1st, 2010 to December 31st, 2015 and a prospective phase from January 1st, 2016 to December 31st, 2017. This study has been approved by the Ethics Committee. It’s concerned all the patients operated in the department for colon Volvulus. Results: We collected 70 patients’ files. The Sigmoid Volvulus represented 7.8% of emergency surgery activities and 37.2% of intestinal obstruction. The male sex predominated with 98.57% against 1.43% of the female sex. The average age was 42.11 years old with limits of 18 to 70. The average deadline evolution was 2.53 days with limits of 1 to 3. The sigmoidectomy with immediate anastomosis was performed in 66% of patients, colectomy with 2-times anastomosis: according to Hartman 20% and Bouilly Volkman 11%, detorsion with colopexy 3%. The early morbidity rate was 5.71%. The average duration of hospitalization was 10.8 days with limits of 5 to 40 days. Two deaths were recorded. Conclusion: Sigmoid Volvulus is frequent in young adult sex male in Africa. We did not find any significant difference between the surgical technique and the advent of complications. The Colectomy with immediate anastomosis seems to be ideal to us that anytime the conditions are appropriate.

关键词： Volvulus Sigmoid Colectomy Surgery

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Environmental Risk Factors for Stomach Cancer in an African Setting about 193 Cases at the CHU Point G in Bamako/Mali

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Surgical Science 2021年第2期12卷 23-30页

作者： Souleymane Sanogo Drissa Traoré Mamadou Coulibaly Birama Togola Bréhima Bengaly Ousmane Ibréhima Touré Drissa Ouattara Bréhima Coulibaly Babou Ba Siaka diallo nouhoum Ongoiba Surgery B CHU Point G Bamako Mali USTTB Faculty of Medicine Bamako Mali Koutiala Regional Hospital Koutiala Mali

CHU (University Hospital Center) Point G: The department of surgery B is a surgical department of CHU Point G. The department is par excellence a reference department for cases of visceral surgery, cancer surgery, cardiovascular surgery, plastic and endocrinology surgery. As a reminder, the CHU Point G is the largest 3rd level referral hospital in Mali. Aim: To study the environmental risk factors of stomach cancer in the B surgery department of the Point G University Hospital in Bamako. Patients and Methods: We performed a cross-sectional study with retrospective collection from January 2008 to June 2018 (126 months). Results: We have identified 380 cases of digestive cancer, including 193 cases of stomach cancer or 50.79% of digestive cancers. The mean age of the patients was 57.21 ± 13 years. Male sex represented 55% (n = 106). Eating habits were dominated by the consumption of tô with potash (cereal paste) with 64.76% (n = 185). The main methods of preserving meat and fish were curing and smoking with 57.51% (n = 111). Chronic smoking was found in 24.35% (n = 47), alcohol + tobacco consumption in 2.59% (n = 5). The low socio-economic class represented 126 cases or 65.38%. Housewives and cultivators were respectively 37.82% (n = 73) and 227.97% (n = 54). 20.20% (n = 39) had a history of epigastric pain. Epigastralgia was the most common functional sign with 84.5% of cases (n = 169). An epigastric mass was found in 72 patients or 37.3%. Adenocarcinoma represented 97.4% (n = 188). Palliative surgery concerned the majority of our

关键词： Stomach Cancer Environmental Risk Factors African Setting CHU Point G

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Anatomy of the Brachial Plexus:A Rare Variation in the Laboratory of Anatomy of Bamako(Mali)

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Forensic Medicine and Anatomy Research 2019年第1期7卷 8-12页

作者： Babou Ba Abdoulaye Kanté Drissa Traoré Bréhima Bengaly Mariam Daou Bréhima Coulibaly Drissa Ouattara Siaka diallo Siaka Diakité Moumouna Koné Tata Touré Cheickh Tidiane diallo Ousmane Ibrahim Touré Birama Togola nouhoum Ongoiba Laboratory of Anatomy of the Faculty of Medicine and Odontostomatology BamakoMali Service of Surgery B.CHU Point G BamakoMali Service of Neurology CHU Gabriel TouréBamakoMali

The brachial plexus (BP), established by the lap twigs of the last four cervical nerves and the first thoracic nerve, assures the driving and sensory innervation of the thoracic member. We bring back a case of rare anatomical variation of the brachial plexus. It is a 34-year-old corpse dissected in the laboratory of anatomy of the Faculty of Medicine and Odontostomatology of Bamako in September 2017. The lap twig of the fourth cervical root (C4) participated in the constitution of the brachial plexus. The superior trunk was normally constituted. The average trunk was formed by the cervical roots C7 and C8 instead of only C7. And consequently the inferior trunk was constituted by the thoracic root T1. The posterior beam was only formed by the posterior branches of the superior and more average trunk. The medial beam was formed by all of the inferior trunk which did not give posterior branch for the formation of the posterior beam. The variations of the brachial plexus could entrain failures in the loco regional anesthesia of the brachial plexus.

关键词： Anatomy Brachial Plexus Variation Anesthesia Surgery

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Parathyroidectomy in Chronic Haemodialysis in the Nephrology and Haemodialysis Department at the University Hospital Center of Point G in Bamako, Mali

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Open Journal of Nephrology 2020年第2期10卷 135-143页

作者： Saharé Fongoro Hamadoun Yattara Seydou Sy Magara Samaké Djénèba diallo Moctar Coulibaly Fatoumata Modjéré Doumbia Djibril Samaké Moustapha Tangara Alkaya Touré Atabième Kodio nouhoum Coulibaly Nephrology and Haemodialysis Department of the University Hospital Centre of Point G Bamako Mali Faculty of Medicine University of Bamako Bamako Mali Nephrology Unit of the Fousseyni Daou Hospital in Kayes Kayes Mali Nephrology Unit of the Mali Gavardo Hospital in Sébénikoro Bamako Mali ORL Unit Reference Health Center of the Municipality V Bamako Bamako Mali

Introduction: Secondary hyperparathyroidism is a common complication in chronic hemodialysis patients. It is characterized by hypersecretion of parathormone by the parathyroid glands to maintain phosphocalcium homeostasis in response to hypocalcemia, lowering of 1.25 dihydroxy vitamin D3 and hyperphosphatemia. Objective: To analyze the results of parathyroidectomy (PTX) in cases of secondary hyperparathyroidism (HPTS), report the post-operative course and early and late complications. Patients and Methods: We conducted a retrospective study of ten (10) patients with chronic renal failure operated on at the CHU of Point G over a 32-month period, from January 1, 2016 to August 31, 2019. We analyzed the clinical, biological, radiological and histological parameters of the thyroid glands. Results: We have collected 33 cases of secondary hyperparathyroidism. Ten (10) patients met the inclusion criteria. They were 45 years old on average, seven (7) women and three (3) men, in dialysis for an average of 6.8 years before parathyroidectomy. Half of the initial kidney disease was of vascular origin (HTA). No cases of diabetic nephropathy were identified. Symptoms were in order of frequency: bone pain (60%), paresthesia (50%), functional impotence of the lower limbs (50%). Radiological signs included demineralisation (5 out of 6 cases) and brown tumour associated with a fracture (1 out of 6 cases). The most frequent indication for parathyroidectomy (100%) was persistence despite treatment of a serum PTH concentration above 1000 pg/ml. Subtotal PTX (7/8) was performed after cervical ultrasound in all patients. Histological analysis of the parathyroid glands showed adenoma (60%) and hyperplasia in 40% of cases. The evolution was marked by a progressive reduction of the parathormone level over twelve (12) months, without achieving normalization. This could be related to sub-dialysis (generator failure with reduction of dialysis time). There were no cases of complications or mo

关键词： Chronic Renal Failure Secondary Hyperparathyroidism Dialysis Parathyroidectomy

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First Consultation in Nephrology: Case of the Point G University Hospital (Bamako-Mali)

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Open Journal of Nephrology 2021年第3期11卷 412-421页

作者： Hamadoun Yattara nouhoum Coulibaly Djeneba diallo Mamadou Sanogo Seydou Sy Pamela Samiza Moustapha Tanagra Alakay Touré Magara Samaké Sah Dit Baba Coulibaly Aboubacar Sidiki Fofana Atabieme Kodio Saharé Fongoro Nephrology and Hemodialysis Department of the Point G University Hospital Bamako Mali Nephrology Department of the Regional Hospital of Kayes Kayes Mali

Understanding the first consultation of people with kidney disease seems to us to be essential to understand the attitude of the referring physician and the nephrologist. The aim was to find out to whom a patient with kidney disease should be referred in the first instance and for what reason? Hence the evaluation of the prevalence of the first consultation in the nephrology department of the Point G University Hospital in Bamako was made. Patients and Method: This was a prospective descriptive study which took place from July 2017 to June 2018 in the nephrology department of the Point G University Hospital. The study included all patients who came to the nephrology department for the first time during this period. Results: Between July 2017 and June 2018 at the nephrology and haemodialysis service of the G point University Hospital, we retained 643 out of 1031 patients who came for their first consultation, i.e. 62.36%. There were many patients aged between 41 and 50 years. The average age was 42.6 ± 5.03 years with extremes of 30 and 82 years. The sex ratio (M/F) was in favor of males, 1.14. The majority of patients were referred/evacuated from the referral health centres (57.6%). The majority of patients were referred/evacuated by general practitioners (70.5%). Cardiologists were the main specialists to refer/evacuate patients (21.2%). The main reasons for consultation that led to the first diagnostic hypotheses were: arterial hypertension for vascular nephropathy, glomerular syndrome for glomerular nephropathy, acute uraemia syndrome for acute renal failure, hydronephrosis for obstructive uropathy and finally diabetes for diabetic nephropathy. Conclusion: The first consultation in nephrology remains an important step in the management of renal disease, especially when the referral is an emergency. The percentage of referrals is dominated by general practitioners.

关键词： Renal Failure First Consultation Nephrology CHU du Point G

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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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Prevalence of Cardiovascular Risk Factors in Chronic Hemodialysis Patients at the University Hospital Center of Point G in Bamako, Mali

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Open Journal of Nephrology 2020年第2期10卷 125-134页

作者： Seydou Sy Magara Samaké Moctar Coulibaly Massama Konaté Djénèba diallo Hamadoun Yattara Aboubacar Sidiki Fofana Atabieme Kodio Modi Sidibé nouhoum Coulibaly Alkaya Touré Djibril Sy Moustapha Tangara Saharé Fongoro Nephrology and Haemodialysis Department of the CHU of Point G Bamako Mali Faculty of Medicine University of Bamako Bamako Mali Nephrology Unit of the Fousseyni DAOU Hospital of Kayes Kayes Mali Nephrology Unit of Mali GAVARDO Hospital Bamako Mali Cardiology Department of Mali Hospital Bamako Mali Internal Medicine Service at the University Hospital Center of Point G Bamako Mali

Introduction: A cardiovascular risk factor (FDRCV) is defined as a physiological, pathological or environmental attribute or characteristic that results in an increased likelihood of developing cardiovascular disease in the individual in whom it is detected. The objective of this study was to determine the prevalence of cardiovascular risk factors in hemodialysis patients on hemodialysis at the University Hospital of Point G. Patients and Methods: This was a cross-sectional descriptive study with prospective data collection from March 3, 2009 to March 5, 2010 (13 months). Included were all patients with end-stage renal disease (ESRD) receiving chronic hemodialysis in the Nephrology and Hemodialysis Department of the University Hospital of Point G during the study period. Results: Eighty-eight patients were enrolled. The M/F sex ratio was 1.26. The mean age was 41.32 years with extremes of 17 and 81 years. The classic cardiovascular risk factors in order of frequency were: hypertension (90.9%), sedentary lifestyle (71.6%), male sex (54.5%), age ≥ 55 years (21.6%), obesity (13.6%), diabetes (8%), tobacco (8%), alcohol (3.4%). Cardiovascular risk factors related to CKD were: anemia (98.9%), phosphocalcic disorders (85.2%), arteriovenous fistula (AVF) (80%), lipid abnormalities (36.5%), hydrosodium inflation (29.5%). Predominant cardiovascular complications were hypertensive heart disease (62.5%), acute pulmonary oedema (APO) (50%), rhythm disorders (23.9%), coronary insufficiency (18.2%). The mortality rate was 17%. Conclusion: Cardiovascular risk factors are frequent in chronic hemodialysis. They contribute to the excess mortality of these patients. Adequate management of these risk factors can slow down serious cardiovascular complications and reduce the risk of mortality in this fragile population.

关键词： Cardiovascular Risk Factors Haemodialysis Mali

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Estimation of Glomerular Filtration Rate: Which Formula to Apply in G-Spot Subjects Aged 1 - 17 Years?

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Open Journal of Nephrology 2021年第3期11卷 397-402页

作者： Hamadoun Yattara Djibril Mamadou Couliblay nouhoum Coulibaly Pamela Samiza Seydou Sy Arboncana Maiga Djeneba diallo Moustapha Tanagra Alkaya Touré Magara Samaké Niagalé Diakité Aboubacar Sidiki Fofana Ibrahim Izetiengou Maiga Sahare Fongoro Nephrology and Hemodialysis Department of the Point G University Hospital Bamako Mali Medical biology Laboratory Service of the Point G University Hospital Bamako Mali Nephrology Department of the Regional Hospital of Kayes Kayes Mali

Introduction: Morbidity and mortality in paediatric practice is dominated in Africa by malaria, diarrhoeal diseases and acute respiratory infections. Aim: In order to evaluate the Glomerular Filtration Rate (GFR) with the formulas commonly used by medical laboratories, we proposed to undertake this study. Patients and Method: This was a descriptive, prospective and cross-sectional study conducted at the PA and KA medical biology laboratory in Bamako Hamdalaye ACI 2000 in collaboration with the medical biology and hospital hygiene laboratory service at the Point G University Hospital. Results: During the study period, we recruited 360 subjects, 189 of whom were male (52.5%) and 171 female (47.5%). The mean age was 8.75 ± 4.8 years with extremes of 1 and 17 years. Subjects aged 15 to 17 years were the most numerous. The reference means GFR of the subjects according to age was with the SCHWARTZ formula 179.16 ± 50.47 with extremes of 173.93 and 184.39;with CKD-Epi 37.63 ± 11.25 with extremes of 36.46 and 38.79;with MAYO 107.87 ± 18.11 with extremes of 105.99 and 109.75 and MDRD 350.83 ± 251.15 with extremes of 324.79 and 376.86. Conclusion: The Mayo formula showed a better distribution around the mean than other formulas for estimating the glomerular filtration rate.

关键词： Glomerular Filtration Rate Reference Value Young Subjects

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