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Contribution to the Study of Hemorrhages in the Third Trimester of Pregnancy, Etiology and Management

Open Journal of Obstetrics and Gynecology 2022年第4期12卷 323-336页

作者： Seydou Mariko pierre coulibaly Bréhima Traoré Nanko dit Seydou Bagayogo Souleymane D. Sanogo Tiounkani Augustin Théra Mamadou Traoré Nanko Doumbia Department of Gynecology Mali Hospital Bamako Mali Department of Obstetrics Gynecology Sominé Dolo Hospital in Mopti Mali Department of General Surgery Sominé Dolo Hospital in Mopti Mali Department of Obstetrics Gynecology The University Hospital Center (CHU) of Point “G” Bamako Mali Reference Health Center of Commune V Bamako Mali Faculty of Medicine and Odontostomatology Bamako Mali Department of Medicine Mali Hospital Bamako Mali

Third trimester bleeding is a common concern in obstetrics. The main objective of this work was to study the management of hemorrhages in the third trimester of pregnancy in the maternity ward of the Sominé Dolo hospital in Mopti. Our prospective descriptive cross-sectional survey type study conducted at the maternity ward of Sominé Dolo hospital in Mopti over a period from January 1, 2017 to December 31, 2017 included 94 cases collected. During this period we had performed 1485 deliveries including 94 cases of pregnancies complicated by 3rd trimester hemorrhage, a frequency of 6.33%. The main cause of hemorrhage in the third trimester was represented by placenta preavia 42.6% followed by retroplacental hematoma 28.7%, uterine rupture 26.6% and association Placenta preavia and retroplacental hematoma 2.1%. The type of intervention depended on the cause of the hemorrhage and the maternal and fetal condition. More than half of the cases of uterine rupture 52% had benefited from a hysterorrhaphy during a laparotomy (n = 13/25) against 48% from hysterectomy (n = 12/25). Caesarean section was performed in 87.5% (n = 35/40) against 12.5% vaginal delivery (n = 5/40) in case of placenta preavia. In the end, in 74% of cases (n = 20/27) of retroplacental hematoma, first-line cesarean section was performed. The maternal prognosis was represented by a mortality rate of 12% (n = 11/94) and morbidity dominated by hypovolemic shock 48.9% (n = 22/94), infections 28.8% (n = 13/94) and coagulopathy 11.1% (n = 5/94). The fetal prognosis was very poor. More than half (55%) of the newborns had succumbed against 45% of the newly born. In 55.3% of cases neonatal mortality occurred antenatally. Neonatal morbidity was represented by prematurity, i.e. 20.2% (n = 19/94) and low birth weight, i.e. 22.3% (n = 21/94).

关键词： Hemorrhage Pregnancy 3rd Trimester Management Prognosis

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Quality of Antenatal Care at the Referral Health Center of the Fourth Commune of Bamako District

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Open Journal of Obstetrics and Gynecology 2023年第3期13卷 609-624页

作者： Amaguiré Saye Dessé Diarra Sirima Diarra Brahima Dembele Abdou Guire Souleymane Dembele Yéli Dianessi Moussa Samake Seydou Mariko Seydou Fomba Diakaridia Kone Abdoul Razakou Dicko pierre coulibaly Daouda Camara Hamidou Toure Mama Sy Konake Obstetrics and Gynecology Service Commune IV Reference Health Center Bamako Mali Obstetrics and Gynecology Department of Bamako Mali Hospital Bamako Mali Department of Study and Research in Public Health Faculty of Medicine and Odontostomatology USTTB Bamako Mali Reference Health Center of Commune I Bamako Mali Obstetrics and Gynecology Department of the Somine DOLO Hospital Mopti Mali Reference Health Center of Kati Kati Mali

Purpose: To contribute to the improvement of the quality of prenatal consultation at the reference health center of the commune IV of the district of Bamako. Patients Methods: This was a qualitative cross-sectional study to assess the quality of prenatal consultation that took place from December 1, 2017 to January 31, 2018. It included 139 pregnant women whose consultations were monitored by the investigator and then the women were interviewed upon discharge from the facility to collect their opinions on the services they received. Results: The age group of 20 to 29 years was the most represented with 60.44%. In our study, 50% of our patients were managed by midwives. Among the antecedents constituting the risk factors sought in pregnant women, scar uterus was more frequent with 33.93% followed by arterial hypertension with 14.28% and multiparity with 7.14%. Conclusion: This study shows that the evaluation of the quality of services is an absolute necessity for the improvement of services in integrated reproductive health care centers.

关键词： Quality Prenatal Consultation Bamako Mali

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Small Bowel Obstruction Induced by Phytobezoar: A Case Report in Innocent Abdomen and Literature Review

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Surgical Science 2021年第6期12卷 187-195页

作者： Bréhima Traoré Djibril Traoré Modibo coulibaly Oumar Guindo Abdoulaye Traoré Fodé Mory Keita Kiffery Ibrahim Keita Korotimi Mallé pierre coulibaly Aly Boubacar Diallo Dramane Cissé Dramane Samaké pierre A. Togo Department of General Surgery H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Biomedical Laboratory H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Public Health H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Anesthesia and Resuscitation H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Surgery Polyclique des Armées de Kati Koulikoro Mali Department of Gynecology and Obstetrics H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of General Surgery H&ocirc pital Régional de Sikasso Sikasso Mali Department of Medicine H&ocirc pital Sominé DOLO de Mopti Mopti Mali Faculty of Medicine and Odonto Stomatology University of Sciences Technics and Technologies de Bamako Bamako Mali

Introduction: Small bowel obstruction (SBO) is defined as a complete and persistent cessation of the transit of materials and gases. It occurs in a segment of the digestive tract located between the pylorus and the colorectal junction. Herein, we report a case of small bowel obstruction (SBO) following excessive consumption of wild grapes with no previous abdomen medical or surgical history. Presentation of case: A 65-year-old male farmer presented with cessation of materials and gas associated with vomiting of food and then bilious. The abdomen was bloated and painful on palpation with a moving, painful mass in the left iliac fossa. The hypothesis of acute occlusion of the colon was retained and confirmed on the X-Ray which showed a dilation of small bowel with air-fluid levels. The diagnostic of acute SBO was retained. We performed urgently a median laparotomy. We found the dilation of the loops from the jejunum to the sigmoid colon with a compact mass at the sigmoid colon of 15 cm in length and 6 cm in diameter. We proceeded to crush the mass that was made up with wild grape seed fecal, and push it back to the rectum. The phytobezoar made up with wild grape seeds was extracted through the anus with the fingers after anal dilation. After extraction of the bezoar, the patient’s complaints completely subsided. Discussion: SBO is a frequent emergency surgical pathology. SBO induced by phytobezoar often occurs in patients with abdomen surgery history. However, it is particularly rare in virgin abdomen. Conclusion: This case report aims to raise awareness of phytobezoar as a cause of SBO in elderly even though without abdomen surgery history.

关键词： Small Bowel Obstruction Phytobezoars Innocent Abdomen

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Giant Lactant Adenoma: About a Case

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Surgical Science 2022年第12期13卷 561-565页

作者： Amadou Bah Amadou Maiga Boubacar Y. Sidibé Ibrahim Diakité Tani Koné Zakari Saye Arouna Doumbia Amadou Traoré Madiassa Konaté pierre coulibaly Amadou A. Traoré Bakary T. Dembélé Lassana Kanté Boubacar Karembé Assitan Koné Andre Kassogue Amidou Almeimoune Adegne Togo General Surgery Department CHU Gabriel Touré Bamako Mali Resuscitation Anesthesia Department CHU Gabriel Touré Bamako Mali

Affecting young women, lactating adenoma is a rare benign tumor of the breast. It is seen mainly in the third trimester of pregnancy and in the postpartum period. Clinically, it is a solid mass, mobile typically benign but its character of rapid evolution is reminiscent of phyllodes tumors, sarcomas and galactoceles. The definitive diagnosis is histological. We report a case of lactating adenoma in a 26-year-old lactating woman, third procedure, second pare, with a history of tumor resection of the outer quadrants of the left breast, 9 months ago, whose histology evoked a fibrotic disease, cystic breast associating non-specific subacute mastitis with suppuration. Received for recurrence of a tumor in the left breast which was the site of a polylobed mass of about 10/5 cm occupying 3/4 of the breast with mobile ipsilateral axillary adenopathies. A micro tru-cut biopsy was performed and the histology was in favor of a lactating breast adenoma with no signs of malignancy. She underwent surgical excision, the consequences of which were simple.

关键词： Lactating Adenoma Breast Histological Malignancy Surgical Excision

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Small Bowel Obstruction: Epidemiological, Clinical and Therapeutic Aspects in the General Surgery Department of Hôpital SominéDOLO de Mopti

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Surgical Science 2021年第6期12卷 196-203页

作者： Bréhima Traoré Modibo coulibaly Djibril Traoré Oumar Guindo Fodé Mory Keita Nouhoum Samassekou Abdoulaye Traoré Souleymane Sanogo Korotimi Mallé Kiffery Ibrahim Keita pierre coulibaly Aly Boubacar Diallo Dramane Cissé Dramane Samaké Lassana Kanté Department of General Surgery H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Biomedical Laboratory H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Public Health H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Surgery Polyclinique des armées Kati Mali Department of Anesthesia-Resuscitation H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Medical Imagery CHU Luxembourg Bamako Mali Department of Gynecology-Obstetrics H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Surgery H&ocirc pital de Sikasso Sikasso Mali Department of Medicine H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of General Surgery of CHU du Point-G Bamako Mali

Small bowel obstruction (SBO) is defined as a complete and persistent cessation of the transit of materials and gases. It occurs in a segment of the digestive tract located between the pylorus and the colorectal junction. We report an observational study which aims to describe the epidemiological, clinical and therapeutic aspects of small bowel obstruction. This study was carried out in the General Surgery Department of Hôpital Sominé DOLO de Mopti from October 1, 2016 to October 1, 2018. A total of 114 patients were recorded for whom the diagnosis was related to an occlusion. The median age was 37 years with extremes ranging from 6 months to 90 years. Male sex was predominant with a sex-ratio of 1.8. The frequency of small bowel occlusions over all occlusions was 74.03%. The most encountered clinical signs were as followed: abdominal pain (100%), vomiting (88.6%), cessation of materials and gas (79.9%) and meteorism (62.3%). All patients underwent medical imaging, the most common of which was an abdomen without preparation X-ray (AWP). On the etiological level, the main causes found postoperatively were: flanges and adhesion (55.2%), strangulated hernias (28.0%), acute intussusception (6.1%), small bowel volvulus (3.5%) and small bowel tumor (1.6%). Releasing the bridles was the most common surgery process (28.0%). The morbidity of the immediate follow-up was (13.1%) and the mortality was (7.0%). This high mortality is due to ignorance of the signs of seriousness and the socio-cultural barrier (decision of the patriarch to agree to a surgical intervention), the late use of hospital facility and the limited financial capability of the patients.

关键词： Occlusions of the Small Intestine Etiology Surgical Treatment Hôpital Sominé DOLO de Mopti

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Clinical and Therapeutic Aspects of Inguinal Hernia in Children in the General Surgery Department of Reference Health Center in Commune I of Bamako Mali

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Surgical Science 2024年第2期15卷 54-63页

作者： Tounkara Cheickna Samake Hamidou Simpara Mama Diarra Issaka Sanogo Modibo Sidibe Souleymane Togola Modibo Dembele Bakary Tientigui coulibaly Yacaria Togo pierre Adégné Kante Lassana Department of General Surgery the Reference Health Center of Commune I Bamako Mali Directorate of Social Health Service the Armed Forces of Mali Bamako Mali Department of Pediatric Surgery Mali Hospital Bamako Mali Department of General Surgery the Gabriel TOURE University Hospital Bamako Mali Department of Pediatric Surgery Gabriel TOURE University Hospital Bamako Mali

Inguinal hernia in children is a congenital pathology in children linked to the persistence of the peritoneo-vaginal canal in children and the NüCK canal in girls;persisting into adulthood. This work aimed to study inguinal hernia in children in the general surgery department of the Reference Health Center of Commune I of the Bamako District;to determine the frequency of inguinal hernia;describe the epidemiological, clinical and therapeutic aspects of inguinal hernias and in order to evaluate the cost of treatment. This was a prospective study from April 2017 to March 2018 during which 60 children with an inguinal hernia were collected. Inguinal hernias in children represented 9.23% of patients operated on in the department. The average age was 59.23 months with extremes of one month and 180 months and a standard deviation of 49.23 years. The male sex was dominant with a sex ratio equal to 9:1. The notion of prematurity was found in 11.7% and was associated with a testicle not in place in 1.7% of cases. 41.7% of our patients were referred by a doctor and 66.7% of patients presented with painless, intermittent inguino-scrotal swelling (83.3% of cases). The hernia was discovered before one week of life in 50% of cases. Inguinal swelling was absent in 11.7% but observed intraoperatively. The inguinal hernia was unilateral in 91.7% of cases and 70% of hernias were discovered by the parents during pushing efforts. The inguinal hernia was located on the right in 61.7% of cases. The hernia swelling was soft, painless, impulsive and reducible in 78.3% of cases. The swelling was inguino-scrotal in 58.3% of cases. The hernia was simple in 95% of patients and hernial strangulation was observed in 3 cases or 5% of cases. 98.3% of patients were ASA I. The treatment was carried out openly in all our patients including closure of the vaginal peritoneal canal in 95% of cases under general anesthesia in 98.3% of cases. The morbidity rate was 8.4% (surgical site infection: 6.7% of cases and hematoma: 1.7%). The immediate consequen

关键词： Inguinal Hernia Child Surgery Cs Ref C I Bamako Mali

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Abdominal Trauma Management: About 62 Cases at the Department of General Surgery of Hôpital SominéDOLO de Mopti, Mali

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Surgical Science 2021年第6期12卷 204-210页

作者： Djibril Traoré Bréhima Traoré Fodé Mory Keita Dramane Cissé Modibo coulibaly Mory Koné Abdoul Karim Djimdé Kiffery Ibrahim Korotimi Mallé Abdoulaye Traoré Oumar Guindo Mathias Diassana pierre M. coulibaly Bakary T. Dembélé pierre A. Togo Department of General Surgery H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Surgery Polyclinique des armées Kati Mali Department of Biomedical Laboratory H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Anesthesia and Resuscitation H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Public Health H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Gynecology and Obstetrics H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of General Surgery CHU Gabriel Touré Bamako Mali

We undertook a prospective and descriptive observational study on abdominal trauma from February 1, 2016 to August 31, 2017. The aim of this work was to identify the typology and management of abdominal trauma cases in our surgery department. Overall, abdominal trauma represented 3.54% (62/1751) of all surgeries during the study period. Among the 62 cases, men accounted for 59 and women for 3. The sex ratio was 19.67. The mean age was 24 ± 15 years. Road accidents were the most represented with 43.5% of cases. The couple of signs, hypovolemic shock and abdominal pain and decrease on blood pressure were the prominent clinical symptoms with 100.0%, and 50.0% of cases, respectively. Abdominal ultrasound and abdominal x-ray without contrast were performed in 67.0% and 18.0% of cases, respectively. Abdominal trauma was divided into two entities: contusion 68% and wounds 32%. Medical treatment was sufficient in 23.00% of cases. Laparotomy as a surgical approach was performed in 77.0% of cases. Local hemostasis plus drainage (27.08%), splenectomy (25.00%), suture (14.58%), hemostasis by tamponade (8.33%) and colostomy (2.08%) were undertaken as surgical procedures when it came to deal with contusions. Debridement of wounds plus suture and hemostasis by tamponade was performed in 18.73% and 4.16 cases, respectively. The most observed lesions were those of the spleen with 27.42% and those of the small bowel with 24.19%. The postoperative follow-up was straightforward in 83.33% of cases. The overall mortality was 4.17%.

关键词： Trauma-Abdomen-Emergency-Hôpital Sominé DOLO de Mopti

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Management of Acute Myeloblastic Leukaemia (AML) Treated with Intensive Chemotherapy: Experience in a Single Centre

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Open Journal of Pediatrics 2024年第2期14卷 401-411页

作者： Abdoul Karim Doumbia Hawa Konaré Tati Simaga pierre Togo Oumoulkairi Nana Kouma Hawa Gouro Diall Oumar coulibaly Adama Dembélé Mohamed Elmouloud Cissé Karamoko Sacko Belco Maiga Aminata Doumbia Kalirou Traoré Ibrahima Cissé Boury Traoré Abdoul Aziz Diakité Fousseyni Traoré Boubacar Togo Department of Pediatrics University Hospital Gabriel Touré Bamako Mali

Introduction: Acute myeloblastic leukaemia (AML) is a haematological malignancy with a poor prognosis, despite significant therapeutic progress. This study presents the results of AML management in Mali according to GFAOP recommendations. Methodology: This was a retrospective, cross-sectional study. It included patients aged 0 - 15 years treated in the paediatric oncology unit for AML and followed up between January 2016 and December 2020. Results: During the study period, 85 cases of acute leukaemia were diagnosed in the paediatric oncology unit (including 51 cases of ALL), of which 34 cases of AML were included in this study. The majority were boys (59%). The mean age was 8 years, with extremes of 18 months and 15 years. The mean time to diagnosis was 68 days. In 79% of cases, patients were referred by 1st or 2nd level hospitals. Anaemia was observed in 91% of cases, an infectious syndrome in 68%, haemorrhage in 56% and a tumour syndrome in 85%. The haemogram showed hyperleukocytosis in 15% of cases, thrombocytosis in 22% and severe anaemia in 73%. Death occurred in 85% of cases, most often in the context of sepsis or haemorrhage. Conclusion: AML is probably underestimated in Mali and diagnosis delayed, which may be explained by patient-related factors (lack of knowledge, financial constraints) and a cumbersome referral system. These results suggest the need to implement an appropriate diagnostic and therapeutic strategy, with strong involvement of the political authorities.

关键词： Acute Myeloblastic Leukaemia Children Mali

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Evaluation of Antibiotic Prescribing in the Pediatric Department of Gabriel TouréTeaching Hospital, Bamako, Mali

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Open Journal of Pediatrics 2024年第3期14卷 645-656页

作者： pierre Togo Hawa Konaré Mariam Maïga Karamoko Sacko Djénéba Konaté Abdoul Karim Doumbia Adama Dembélé Oumar coulibaly Aminata Sangaré Mohamed Elmouloud Cissé Fousseyni Traoré Belco Maïga Ibrahim Ahamadou Aminata Doumbia Lala N’Drany Sidibé Amadou Touré Yacouba Aba coulibaly Kalirou Traoré Tati Simaga Souleymane Sagara Leyla Bagna Maïga Bory Traoré Abdoul Aziz Diakité Fatoumata Dicko Mariam Sylla Sounkalo Dao Boubacar Togo Paediatric Department Gabriel Tour&#233 Teaching Hospital Bamako Mali Pediatric Department Distric VI Reference Health Center Bamako Mali Infectious Diseases Department Point G Teaching Hospital Bamako Mali

Objectives: The main objective was to evaluate antibiotic prescribing in the Department of Pediatrics at Gabriel Touré teaching hospital. Methods: This was a prospective descriptive study conducted from September 1 to November 31, 2018, in the Department of Pediatrics at Gabriel Touré teaching hospital. All children aged 0 to 15 years hospitalized for any pathology during the study period and having received at least one antibiotic had been included. Results: We collected 445 children’s records out of 1032 admissions during the study period, representing a hospital frequency of 43.1%. The sex ratio was 1.3%. The 2 - 5 age group accounted for 48.1%. Fever was the reason for consultation in 45.6% of cases. Patients’ general condition was altered in 60% of cases. The fathers were blue-collar workers in 65.4% and the mothers housewives in 85%, and had no education in 42.9% and 64.5% respectively. Hepatomegaly was present in 18.2%, splenomegaly in 9.6% and peripheral adenopathy in 3.1%. The site of infection was pulmonary in 37.6% and ENT in 9.2%. Bacterial infection was assumed on admission in 54% of cases, and meningitis in 57.7%. The discharge diagnosis was malaria in 54.6%, severe acute malnutrition in 18.6% and meningitis in 6.7%. The death rate was 3.8%. Neutrophilic leukocytosis was present in 47.3% of patients. CRP was positive in 85% of patients. Blood cultures taken in 27.6% of patients were positive in 5. CSF analysis in 30% of patients showed elevated leukocytes in 6.5%. No cultures were positive. Antibiotic prescription was justified by infectious hypotheses in 43.1% of patients. β-lactam antibiotics were prescribed in 98.6%. Antibiotic therapy was not adapted to national/international recommendations in 68.3% of cases, and was not justified in 16.3% of cases on D5 of hospitalization. Conclusion: Antibiotic use was justified in more than half of patients, but remained inadequate in almost two-thirds of cases, in line with national and international recommendations.

关键词： Antibiotic Prescription Hospitalization Child

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Potential for Green Hydrogen Production from Biomass, Solar and Wind in Togo

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Smart Grid and Renewable Energy 2022年第2期13卷 17-27页

作者： Mawunyo Simon pierre Kitegi Yendoube Lare Ousmane coulibaly WASCAL Alumni School of Informatics for Climate Change Ouagadougou Burkina Faso Solar Energy Laboratory Physics Department Université de Lomé Lomé Togo Laboratory of Physics and Environment Chemistry School of Informatics for Climate Change Université Joseph Ki-Zerbo Ouagadougou Burkina Faso

Potential of green hydrogen producing from biomass, solar and wind in Togo has been performed. The availability of these three resources has been depicted with maps showing them per cantons in Togo, thus, by using the datasets from ESA Biomass Climate Change Initiative, the global solar atlas and the global wind atlas. The conversions rates used were: for solar resource, 3% of land was allocated for the analysis after removing the exclusions with a conversion rate of 52.5 kWh/kg of hydrogen;for biomass hydrogen, the conversion rate of 13.4 kg BS/kg H2 was assumed. Wind resources at 50 m above ground were not sufficient to evaluate the potential as it is lower than class 3 winds. QGIS version 3.6.4 and R version 4.0.4 were used. Results showed that biomass is the leading resource for producing green hydrogen from renewable energy resources;with good impact in these two cantons: Bassar, Gobe/ Eketo/Gbadi N’Kugna. However, this resource is still decreasing and in some cantons it is null.

关键词： Green Hydrogen Potential Solar Wind Biomass Climate Change

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