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Basedowian Orbitopathy Without Thyreotoxicosis : A Case Report from Sikasso Hospital

Open Journal of Ophthalmology 2023年第3期13卷 273-279页

作者： Cheickna Nomoko Adama Dembele Moro Sidibe Karim Diarra Moussa Sidibé Niamé touré Moussa Abdou touré Oulematou Soucko Ousmane Fané Daouda Goita Oumar Diallo Djonny Jonas Dembele Mamadou Adama Togo Kadiatou Ba Koita Abdoulaye nouhoum Coulibaly Cheick Fantamady Tounkara nouhoum touré Abdoulaye Konaté Abdoulaye Napo Nana Kadidia Fofana Regional Hospital of Sikasso Sikasso Mali Alliance for the Development of Community Ophthalmology (ADOC) Bamako Mali Referral Health Center for Commune 3 in the District of Bamako Bamako Mali African Tropical Ophthalmology Institute Bamako Mali Referral Health Center for Commune 4 in the District of Bamako Bamako Mali

Basedowian orbitopathy is an autoimmune disease representing the most frequent extra-thyroidal manifestation. Its pathophysiology is imperfectly elucidated and is the result of cross-reactivity between thyroid antigens and orbital tissue. It is most frequently seen in the context of hyperthyroidism (basedow’s disease or Graves’ disease), sometimes hypothyroidism (Hashimoto’s thyroiditis), or euthyroidism. Diagnosis is often straightforward, but management remains difficult. The introduction of simple medical treatment exposes the patient to the risk of recurrence. In Sikasso, there have been few studies of Graves’ disease. The aim of this study was to describe the clinical, therapeutic and evolutionary features of Graves’ disease in Sikasso Hospital. The patient was a 35-year-old woman with no previous history of Graves’ disease and no history of alcohol or tobacco intoxication, consulting for bilateral exophthalmos with moderate pain for 1 year. Endocrine tests were normal (euthyroidism), as was orbital-cerebral MRI, which revealed stage II exophthalmos with no sellar or supra-saltar abnormalities. The main complication was exposure to keratitis. Our patient was treated with corticosteroids. The evolution was favorable under treatment, with no recurrence after one year’s follow-up. Graves’ disease is the most common cause of hyperthyroidism, but this should not obscure the diagnosis of euthyroidism, as demonstrated in this case report. Exophthalmos remains the main ophthalmological clinical manifestation.

关键词： Euthyroidism Basedowian Orbitopathy Orbital-Cerebral MRI Corticoster-oid Therapy

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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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Meningioma of the Optical Nerves in a Case at the Hospitalier Center of Saint Denis in Ile de France

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Open Journal of Ophthalmology 2023年第1期13卷 23-29页

作者： Adama Dembele Moro Sidibe Ibrahim Conaré Mamadou Kolé Sidibé Larcheveque Florence Seror Julien Abdoulaye Napo Daouda Goita Oumar Diallo Djonny Jonas Dembele Mamadou Adama Togo Kadiatou Ba Koita Abdoulaye nouhoum Coulibaly Cheick Fantamady Tounkara nouhoum touré Abdoulaye Konaté Jeannette Traore Sanoussi Bamani Lamine Traoré Japhet Popanou Théra Regional Hospital of Sikasso Sikasso Mali Alliance for the Development of Community Ophthalmology (ADOC) Bamako Mali African Tropical Ophthalmology Institute Bamako Mali Hospital Center Saint Denis France

Summary: Optic nerve tumors are rare tumors, representing 3% - 5% of intracranial tumors developing mainly along the optic nerve and/or the chiasm. Optic nerve meningiomas are histologically benign tumors whose severity is linked to diagnostic and especially therapeutic difficulties. The Optic nerve meningioma is the second leading cause of optic nerve tumor after glioma. Observation: We report the case of a 49-year-old woman from South Asia, who consults an ophthalmology department for progressive visual loss in her right eye for about a year with her glasses and would like to renew her optical correction. Having no particular medical history apart from left unilateral blindness is known for approximately 15 years. Magnetic Resonance Imaging (IRM) cerebral found a tissue mass with a clear outline and polylobules on the left temporo-peduncular. Through this case, we describe the circumstances of discovery of the disease, the clinical characteristics, as well as our diagnostic approach. Conclusion: In the majority of cases, these are benign tumours, the circumstances of which are discovered in multiple ways. A mostly unilateral and non-improvable loss of visual acuity must attract our attention. Renewing glasses may be the reason for discovering the disease. Today Magnetic Resonance Imaging (IRM) remains an important and capital examination for the diagnosis and monitoring of this pathology.

关键词： Meningioma Optic Nerve Decreased Visual Acuity IRM

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Anatomical Study of MRI Optic Chiasm at the Bamako Anatomy Laboratory

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Forensic Medicine and Anatomy Research 2020年第2期8卷 11-17页

作者： Babou Ba Siaka Diakité Abdoulaye Kanté Tata touré Moumouna Koné nouhoum Ongoiba Abdel Karim Koumaré Siaka Sidibé Laboratoire d’Anatomie et de Morphologie Clinique FMOS BamakoMali Service de Radiologie CHU Point GBamakoMali Service de Chirurgie“B” CHU Point GBamakoMali

Roughly quadrangular, the chiasma presents many morphological variations. The optical chiasm, odd and symmetrical structure of the optical pathways, is a required passage of the axons of neurons for the visual pathways. Any modification of its morphology evokes a pathological process, generally tumoral. The quality of MRI images rivals that of anatomical slices. So the MRI is essential for the study of the chiasma. The aim of this work was to study the morphometry of the optic chiasm in patients addressed for cerebral MRI to the imaging department of the university hospital of the POINT-G, during the period from July 29, to November 30, 2016. All patients who had a normal examination of the optic chiasma, numbering 15, were included in this study. In 86.66% of cases the chiasma had a quadrilateral form. Its average length was 8.73 mm and its average width was 13 mm. The average thickness was 4.13 mm.

关键词： Optical Chiasma MRI Laboratory Anatomy

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3D Vector Reconstruction of the Neck Skeleton from the Anatomical Sections of Korean Visible Human at the Anatomical Laboratory of Paris Descartes

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Forensic Medicine and Anatomy Research 2021年第4期9卷 41-53页

作者： Abdoulaye Kanté Mariam Daou Jean François Uhl Vincent Delmas Babou Ba Tata touré Ousmane touré Moumouna Koné Demba Yatera Youssouf Sidibé Drissa Traoré Bréhima Coulibaly nouhoum Ongoïba Anatomy Laboratory University of Paris 5 Paris France Anatomy Laboratory University of Sciences Techniques and Technologies of Bamako Bamako Mali Department of Neurology Gabriel Touré University Hospital in Bamako Bamako Mali Faculty of Medicine and Odontostomatology Bamako Mali

Aim: To perform a vector 3D reconstruction of the neck skeleton from the anatomical sections of the “Korean Visible Human” for educational purposes. Material and Methods: The anatomical subject was a 33-year-old Korean male who died of leukemia. It measured 164 cm and weighed 55 kgs. The anatomical cuts were made in 2010 after an MRI and a CT scan. A special saw (cryomacrotome) made it possible to make cuts on the frozen body of 0.2 mm thick or 5960 slices. Sections numbered 1500 to 2000 (500 neck sections) were used for this study. Manual contouring segmentation of each anatomical element of the anterior neck area was done using Winsurf software version 3.5 on a PC. Results: Our vector 3D neck model includes the following: cervical vertebrae, hyoid bone, sternum manubrium and clavicles. This vector model has been integrated into the virtual dissection table Diva3d, a new educational tool used by universities and medical schools to learn anatomy. This model was also put online on the Sketchfab website and printed in 3D using an ENDER 3 printer. Conclusion: This original work is a remarkable educational tool for the study of the skeleton of the neck and can also serve as a 3D atlas for simulation purposes for training therapeutic gestures.

关键词： Neck Skeleton Korean Visible Human 3D Vector Modeling Virtual Dissection Table Diva3d Teaching

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A Rare Anomaly of the Left Renal Vein in the Laboratory of Anatomy of Bamako(Mali)

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Forensic Medicine and Anatomy Research 2019年第1期7卷 31-35页

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

Aim: The purpose of this work was to describe the left renal retro-aortic vein. Methodology: A case of left renal retro-aortic vein was discovered on a corpse of male, 45-year-old adult during the dissections to the laboratory of anatomy of the Faculty of Medicine of Bamako. The way at first was a xypho-pubic median and two side abdominal sections under costal and inguinal. The side sections under costal went of the median section to sides by following the costal edge. The inguinal side sections went of the median section to the anterior and superior iliac thorns. The abdominal wall was opened and reclined by every quoted. The small intestine and the colonist were resected with their meso. The renal pedicle was dissected on each side. The abdominal aorta and the inferior vena cava were dissected by the diaphragm up to the headland. Arteries and iliac veins were also dissected. Results: On male corpse, 45 years old, we discovered a left renal retro-aortic vein in horizontal route, and the trunk of the left renal vein was formed by the confluence of three veins at the level of the left renal hilum. The left renal vein passed almost horizontally below the left renal artery. It passed then behind the abdominal aorta to end in the inferior vena cava at the level of its left side face. The right renal vein had a normal aspect. Conclusion: The left renal retro-aortic vein is one of the variants of the anomalies of the system cellar inferior. The left renal retro-aortic vein could be responsible for renal aplasia.

关键词： Left Renal Retro-Aortic Vein Anatomy Retroperitoneal Surgery

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Omphalocele Diagnosis Problem in Rural Environment

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Surgical Science 2024年第8期15卷 501-506页

作者： Kanté Sékou Diallo Siaka touré Cheick Amed Sékou Ousmane I. touré Coulibaly Ibrahim Traoré Drissa Bengaly Brehima Sanogo Soulemane Togola Birama Ouattara Drissa Saye Jack Ongoïba nouhoum Koumaré Abdel Karim Service de Chirurgie B CHU Point G Bamako Mali Facult de Mdecine de lUSTTB Bamako Mali

Introduction: An omphalocele is a congenital malformation due to a failure of closure of the umbilical ring with exteriorization of the abdominal viscera covered by the translucent and avascular amniotic membrane. We report a case of giant omphalocele unrecognized at birth followed by a review of the literature. Observation: This was a 4-year-old girl admitted to the department for umbilical swelling that had been present since birth. Clinical and paraclinical examinations made it possible to objectivize a post-omphalocele hernia with hepatic content plus ectopic accession of the left ureter, the surgical procedure consisted of reintroducing the liver associated with a cure of the hernia + ureterovesical reimplantation. Conclusion: Omphalocele is a congenital malformation, antenatal diagnosis is possible during morphological ultrasound from the 12th week.

关键词： Omphalocele Ectopic Left Ureter

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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).

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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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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