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Endocranial Suppurations of Sinus Origin: Ratio of 3 Cases in Children at the Hospital in Mali

Open Journal of Pediatrics 2021年第3期11卷 517-531页

作者： Bourama Kané Korotoumou Wélé Diallo Mohamed Maba Traoré Boubacar Mami Touré Mahamadou Dama mody Abdoulaye Camara Guédiouma Dembélé Daouda Sissoko Oumar Coulibaly Mamadou Traoré Pediatrics Department of Mali Hospital Bamako Mali Medical Imaging Service Bamako Mali Neurosurgery Department of the Mali Hospital Bamako Mali Pediatric Service of the Commune Reference Health Center V Bamako Mali

Introduction: Intracranial suppurations are neoformed purulent collections including, in decreasing order, cerebral abscesses, subdural empyemas and extradural empyemas. Otorhinolaryngologic infections are one of the main causes, especially in older children and adolescents. We report 3 clinical cases of endocranial suppurations treated at the Mali Hospital. Clinical Cases: 1) Observation 1. IK was a 14-year-old boy, who was hospitalized in our department for fever, headache and left hemiplegia. The emergency brain scan showed a right frontal and interhemispheric subdural empyema associated with multifocal sinusitis. Surgical drainage associated with ceftriaxone: 100 mg/Kg/d in direct intravenous (DI), metronidazole: 10 mg/Kgs/12hours in slow intravenous (SI) for 15 days, gentamycin: 3 mg/Kgs/d in SI for 3 days, paracetamol 15 mg/Kgs/6hours in SI, 10% glucose serum: 100 ml/Kg/d were given. The bacteriological analysis of the pus came back sterile. The postoperative period was calm. 2) Observation 2. This was a 14-year-old boy with a history of headaches who was admitted to our department for left hemiplegia. An emergency brain scan showed a right pre-suppurative encephalitis associated with a right fronto-ethmoidal and maxillary sinusitis. He was put on ceftriaxone 100 mg/kg/d in DI for 21 days, gentamycin: 3 mg/Kg/d in SI for 3 days;metronidazole: 10 mg/kg/12hours in SI for 21 days, paracetamol: 15 mg/kg/6hours in SI. After 3 weeks of medical treatment, a follow-up brain scan revealed an interhemispheric and right subdural empyema. Surgical drainage was associated with the triple antibiotic therapy initially instituted. The bacteriological analysis of the pus was sterile. The postoperative course was calm. 3) Observation 3. N.M was an 11-year-old boy, who was admitted with fever and left hemiplegi

关键词： Sinusitis Endocranial Suppurations Mali Hospital

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Clinical and Therapeutic Aspects of Genital Prolapse at Hôpital du Mali about 100 Cases

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Open Journal of Obstetrics and Gynecology 2023年第1期13卷 121-132页

作者： Mamadou Bakary Coulibaly mody Abdoulaye Camara Alassane Traoré Mamadou Keïta Bourama Kané Abdramane Togo Issa Ongoiba Kalba Tembiné Amadou Sidibé Baba Fané Ibrahima Tégueté Youssouf Traoré Gynecology Department of Hô pital du Mali Bamako Mali Medical Imaging Department of Hô pital du Mali Bamako Mali Referral Health Center of Commune VI of the District of Bamako Bamako Mali Pediatrics Department of Hô pital du Mali Bamako Mali Anesthesia and Intensive Care Unit Hô pital du Mali Bamako Mali Biomedical Department of Hô pital du Mali Bamako Mali Department of Gynecology Obstetrics UTH Gabriel Touré Bamako Mali

To study the epidemio-clinical aspects, and the therapeutic attitudes of genital prolapse (GP) in the gynecology department of Hôpital du Mali (HDM). This is a descriptive retro-prospective study over five (5) years from January 2015 to December 2019, conducted in the gynecology department of HDM. We had collected 100 cases of GP out of 989 surgeries, with a frequency of 9.89%. The age group of 60 years and over accounted for 33% of our patients, with a mean age of 50 years. Multiparous were the most affected (89%). The notion of obstructed labor was observed in 52% of patients. The most found reason for consultation was the feeling of lump in a vagina, with 65%. Grade III according to BADEN-WALKER classification system (BWCS) concerned 72% of our patients. Triple perineal surgery and hysterectomy involved 56% of our patients. Spinal anesthesia was performed in 96% of cases. Per and postoperative complications were dominated by urinary retention in 4% and by infection of the surgical site in 2%. The average hospital stay was 3.2 days. We recorded 88% of satisfied patients after the intervention. No deaths were recorded during the study. The management of genital prolapse remains essentially surgical;it requires a semiological analysis and a mastery of the surgical technique.

关键词： Genital Prolapse Therapeutic Attitudes Hôpital du Mali

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Clinical and Therapeutic Aspects of Giant Fibroids at the Hôpital du Mali about 30 Cases

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Open Journal of Obstetrics and Gynecology 2020年第6期10卷 778-789页

作者： Mamadou B. Coulibaly Alassane Traore mody A. Camara Abdrahamane Togo Adama Sangaré Issa Ongoiba Kalba Timbine Amadou Sidibé Apérou Guindo Niani Mounkoro Ibrahim Teguete Youssouf Traore Moustaphe Toure Service of Gynecology of the Hopital du Mali Bamako Mali Service of Medical Imaging of the Hopital du Mali Bamako Mali Service of Anesthesia and Resuscitation of the Hopital du Mali Bamako Mali Service of Gynecology-Obstetrics of Gabriel TOURE Teaching Hospital Bamako Mali

The fibroids affect 20% to 25% of women of reproductive age and are 3 to 9 times more common in black women. We’ll talk about giant fibroids (GFs) when uterine height reaches or exceeds the navel. We have initiated this study in order to report the epidemioclinical and therapeutic aspects of giant fibroids at the Hopital du Mali. A descriptive retro-prospective study, conducted in the service of gynecology of the Hopital du Mali from November 2017 to December 2018 were included in this study, any patients, regardless of their age, having developed a fibroid, the uterin e height of the patient reaching or exceeding the umbilicus on physical examination and who were on surgical treatment. We had collected 30 cases of GFs out of the 92 patients who had undergone myomectomies, with a frequency of 32.60%. The age group 25 - 29 years accounted for 46.6% with an average age of 35 years. Housewives represented 50% and nulligravida made up 33% of our patients. Desire to become pregnant was the main reason for consultation in 34.4% of cases. The uterine height was between 25 and 29 cm on physical examination in 46.66% of cases. Myomectomy was performed in 76.64% and hysterectomy in 23.3% of cases. The size of the nuclei after surgery was over 25 cm in 48.66% of our patients. Conclusion: The giant fibroid (GF) is a common cause of myomectomy. The treatment is either hysterectomy or myomectomy and

关键词： Giant Fibroma Care Surgery Hôpital du Mali

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Hypothyroidism in Conakry: Epidemiological, Clinical and Therapeutic Aspects

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Open Journal of Internal Medicine 2022年第1期12卷 38-45页

作者： Amadou Kaké Djibril Sylla Alpha Mamadou Diallo Mamadou Mansour Diallo Diallo Kourouma Amadou Diango Mamadou Alpha Diallo Elhadj Zainoul Bah Mamadou Cherif Diallo Kadija Dieng mody Abdoulaye Barry Naby Moussa Baldé Department of Endocrinology and Metabolic Diseases Donka University Hospital Conakry Guinea Department of Internal Medicine Donka University Hospital Conakry Guinea

Hypothyroidism is a frequent endocrine disorder that can occur at any age and predominantly affects women. The etiologies are diverse and may vary according to the geographical and socio-demographic context. The objective of our work was to describe the epidemiological, clinical and therapeutic characteristics of hypothyroidism in Conakry, Guinea. Materials and Method: This was a descriptive study with prospective data collection, over the period from December 2016 to May 2021. It focused on patients seen at the endocrinology consultation of Conakry University Hospital. Epidemiological, clinical, etiological, therapeutic, and evolutionary variables of patients diagnosed or followed-up for hypothyroidism were collected and analyzed. The diagnosis of hypothyroidism was defined by elevated TSH and/or decreased FT4/FT3. Results: Out of a total of 290 patients who consulted for thyroid pathology, hypothyroidism concerned 49 patients, i.e. , a frequency of 14%. Women were the most affected with a sex ratio of 0.13. The mean age of patients was 48.65 ± 19.93 years with extremes of 2 years and 80 years. Hypo-metabolic syndrome was the main clinical sign and was manifested mainly by constipation found in 48.89% of cases. TSH was elevated in all cases with a mean level of 24.56 ± 14.17 mIU/ml. Hypertension was the most frequently associated pathology (57%). Three etiological groups of hypothyroidisms were found. These were thyroidectomy in 42.85% of cases, thyroiditis in 34.69% of cases and post synthetic antithyroid hypothyroidism. All patients were treated with L-thyroxin, with a favorable clinical course. Follow-up was regular in 16 patients (32.65%). Conclusion: Hypothyroidism is common in this population, and primarily affects women. Thyroid surgery was the main cause of hypothyroidism in this work.

关键词： Hypothyroidism Goiter Hashimoto Guinea

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Graves’ Disease in 100 Cases in Conakry: Epidemiological, Clinical, Therapeutic, and Evolutionary Aspects

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Open Journal of Endocrine and Metabolic Diseases 2022年第2期12卷 75-81页

作者： Naby Moussa Baldé Amadou Kaké Djibril Sylla Alpha Mamadou Diallo Mamadou Mansour Diallo Mamadou Alpha Diallo Amadou Diango Lanciné Kourouma Elhdj Zainoul Bah Mamadou Chérif Diallo Kadija Dieng mody Abdoulaye Barry Department of Endocrinology and Diabetes Donka Conakry University Hospital Conakry Guinea Department of Internal Medicine Donka Conakry University Hospital Conakry Guinea

Context and Objective: Graves’ disease is an autoimmune disorder of the thyroid gland that occurs in genetically predisposed individuals. It represents the most frequent cause of hyperthyroidism with a clear female predominance. The objective of our work was to report the sociodemographic, clinical, therapeutic, and evolutionary characteristics of Graves’ disease at the University Hospital of Conakry. Methods: This was a cross-sectional, descriptive study, over the period from December 2016 to June 2021, at the endocrinology consultation of Donka University Hospital. Epidemiological, clinical, therapeutic, and evolutionary variables of patients followed up for Graves’ disease were collected and analyzed. The diagnosis of Graves’ disease was based on the presence of clinical signs of thyrotoxicosis, diffuse goiter, exophthalmos, and or T-RAK positivity. Results: Graves’ disease was related to 33% of thyroid consultations and 64% of hyperthyroidism. The sex ratio M/F was 0.07. The median age of the patients was 39.4 ± 13 years. The main reason for consultation was thyrotoxicosis syndrome, dominated by cardiovascular signs (92%). TRAK was performed in 38 patients with a positive result in 89%, i.e., a mean level of 17.93 mUI/l. All patients were treated with synthetic antithyroid drugs, with a favorable clinical evolution. Surgery was considered in 4 patients after the stabilization of the thyroid function. The follow-up was considered regular in 49 patients (49%). Conclusion: Graves’ disease is the most frequent hyperthyroidism in Conakry with a clear predominance of women, especially young women. Efforts should be focused on improving diagnosis and the access to treatment for better patient compliance.

关键词： Autoimmunity Thyroid Graves’ Disease Conakry

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Etiological and Radiological Profile of Acute Lower Respiratory Infections during the Pre-COVID Period in the Paediatric Ward of the Teaching Hospital of Mali and in the Community Health Centre of Yirimadio in Bamako

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Open Journal of Pediatrics 2023年第2期13卷 262-275页

作者： Bourama Kané Mariam Maiga Oumou Koné Korotoumou Wélé Diallo Aboubacar Sangaré mody Abdoulaye Camara Mariam Doumbia Abdoul Karim Sangaré Bréhima Traoré Lassine G. Timbiné Ibrahima Cissé Ahmadou I. Dramé Bréhima Kouriba Department of Paediatrics CHU Hôpital du Mali Bamako Mali Paediatric Department of the Centre de Santé de Référence de la Commune VI Bamako Mali National Institute of Public Health Bamako Mali Medical imaging department of the CHU Hôpital du Mali Bamako Mali Charles Mérieux Infectious Diseases Centre Bamako Mali Centre de Santé Communautaire de Yirimadio Bamako Mali Department of Anaesthesia and Intensive Care CHU Hôpital du Mali Bamako Mali

Introduction: Every year, nearly 4 million people pass away from acute respiratory infections. 98% of such deaths are due to lower respiratory tract infections. Even though studies have been carried on lower respiratory infections x-ray aspects in Mali, very few studies have been done to reveal bacteriological and virological evidence of this disease. Materials and methods: It is about a descriptive prospective study carried out from January to December 2018 having involved patients of all ages, coming for medical consultation at the Yirimadio Community-based health center as well as children from 6 months to 15 years old coming at the pediatric department of UHC Hôpital du Mali for a lower respiratory infection. They had all undergone chest X-ray and a PCR. The purpose: of this work is to study etiological and x-ray aspects of acute lower respiratory infections at the Yirimadio Community-based Health Center and at the UHC pediatric department of Hôpital du Mali. Findings: From January to December 2018, we recorded a frequency of 1.19%. The age group 0 - 5 years was the most represented (64.5%) with a sex ratio of 0.97 for women. Cough was the most common clinical sign (98.7%) followed by fever (58.9%). Standard frontal chest X-ray was pathological in 70% of our patients. It was bronchitis in 75.4% of cases, pneumonia (13.5%), and bronchopneumonia (12.3%). PCR positive was in 83.9% of patients. It revealed a co-infection in more than half of the patients (52.5%), bacterial infection (16.1%) and viral infection (15.2%). Pathogens isolated ranked by frequency were Streptococcus pneumoniaa (87.6%) followed by Staphylococcus aureus (24.9%) and human rhinovirus (17%). The most common viral causes were human rhinovirus (17%), followed by influenza A and B virus (7%) and human parainfluenza virus (7%). Conclusion: It stemed from the study that lower respiratory infections were mainly due to Streptococcus pneumonea and human rhinovirus during pre-COVID at the Yirimadio Comm

关键词： Lower Respiratory Infections Etiologies Children Mali

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MRI Contribution in the Diagnosis of Non-Traumatic Medular Compressions at the Mali Hospital of about 179 Cases

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Open Journal of Medical Imaging 2020年第4期10卷 186-195页

作者： mody Abdoulaye Camara Mamadou N’Diaye Mamadou Bakary Coulibaly Mohamed Maba Traore Hawa Diarra Boubacar Mama Toure Abourahman Abdillahi Nour Salia Coulibaly Ilias Guindo Madani Ouologuem Sounkalo Traore Mahamane Mariko Aphou Sallé Kone Moussa Konate Siaka Sidibe Medical Imaging Department of Mali Hospital Bamako Mali Radiology Unit of the Bamako Infirmary Hospital Bamako Mali Gynecology Department of Mali Hospital Bamako Mali Medical Imaging Department at Kati University Hospital Bamako Mali Neurology Unit of the Bamako Infirmary Hospital Bamako Mali Radiology Unit of the Reference Health Center of the Commune V Bamako Mali Medical Imaging Department of CHME Luxembourg Bamako Mali Radiotherapy Department of Mali Hospital Bamako Mali Radiology Department of CHU POINT G Bamako Mali

Slow spinal compressions are due to the development of an expansive process in the spinal canal. It is a very common pathology, the diagnosis of which is mainly clinical. However, magnetic resonance imaging occupies an essential place in the site diagnosis and etiological research in the management. Non-traumatic spinal cord compression is a diagnostic and therapeutic emergency, requiring early and appropriate management. MRI is the benchmark imaging examination for this pathology. No similar previous MRI study in Mali. We undertook this work with the aim to determine the place of MRI in the diagnosis of spinal cord compressions in Mali hospital. Method and Patients: This was a descriptive retrospective study, carried out at the hospital’s medical imaging department from January 1, 2017 to December 31, 2018 (02 years). It involved all patients, regardless of sex and age, sent for an MRI examination of the spine, and in whom spinal cord compression was diagnosed. We used a 0.35T low-field MRI machine with solid-state antennas. Results: We collected 179 cases of spinal cord compression MRI out of 585 spinal MRI performed, (frequency of 30.59%). The average age was 53.5 years with a male predominance (sex ratio 3.7). Motor disorders were the most common reason for examination (41%). We used the T1 T2 sagittal and T2 axial sequences. IV injection of gadolinium was performed in 48% of patients. The topographic lesions were: cervical (54.7%), thoracic (31.3%) and several segments (9.5%). The lesions concerned the compartments: extradural (79.3%), intradural (4.5%), and intramedullary (16.2%). The processes were degenerative (57.5%). tumorous (29.6%), infectious (12.3%) and vascular (0.6%). Conclusion: MRI is the benchmark imaging test for the management of non-traumatic spinal cord injury. Myelo-CT can be an alternative in the absence or in case of MRI contraindication.

关键词： Spinal Cord Compression Non Traumatic MRI Mali Hospital

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Diagnostic Itinerary of Patients Monitored for Thyroid Disease at the Conakry University Hospital in 2022

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Open Journal of Endocrine and Metabolic Diseases 2024年第9期14卷 165-177页

作者： Elhadj Zainoul Bah Alpha Mamadou Diallo Kadidiatou Bah Mamadou Dian Mamoudou Diallo Abdoul Mazid Diallo Mamadou Alpha Diallo Mamadou Chérif Diallo Mamadou Mansour Diallo mody Abdoulaye Barry Oumar Telly Sow Kadija Dieng Amadou Kaké Amadou Bah Faculty of Health Sciences and Technology Gamal Abdel Nasser University of Conakry Conakry Republic of Guinea Department of Endocrinology Metabolic Diseases and Nutrition Donka University Hospital Conakry Republic of Guinea Ministry of Health and Public Hygiene Conakry Republic of Guinea Regional Health Inspection of Lab Conakry Republic of Guinea

Introduction: Thyroid pathologies are either the cause or a consequence of certain pathologies with which they interact, manifesting themselves through a polymorphic and non-specific clinic. They affect different devices and/or systems, making the clinical picture more complex or even a delay in diagnosis and treatment. These latter aspects, being then multidimensional, could be preceded by a very specific patient itinerary for the diagnosis and management of cases of thyroid gland pathologies. Methods: This was a descriptive cross-sectional study whose data were collected from May 1 to October 30, 2022. It focused on patients followed for thyroid diseases at the Conakry University Hospital. The objectives were to describe the patient’s journey before their diagnosis of thyroid disease. Results: The subjects were 86.1% women with a mean age of 43.7 ± 28 years. Of the total, 67.85% had a comorbidity including diabetes and/or hypertension/heart disease. They are followed for goiters/simple nodules (22.78%), hypothyroidism (16.46%) and hyperthyroidism (60.76%). They spend at least 9 months before resorting to a healthcare facility. The general medicine services of the Conakry University Hospital are the first recourse (51.9%) of these subjects. They consult 2 to 4 times before the diagnosis is suggested. Hyperthyroidism, hypothyroidism and goiters/simple nodules spend 5.4;6.4 and 13.7 months respectively before the diagnosis is made. 31.6% were hospitalized and treated mainly for malaria (19.0%), hypertension (13.1%), salmonellosis (13.1%) and diabetes (8.3%). A third of patients used traditional therapy before being in contact with the endocrinology department by referral (73.4%). Conclusion: This study made it possible to show a pre-diagnostic pathway which has a particular character concerning patients followed for thyroid pathologies in Guinea.

关键词： Itinerary Diagnosis Thyroid Conakry

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Diabetes Mellitus and COVID-19 at Abass Ndao Hospital Epidemic Treatment Center (ETC)

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Open Journal of Endocrine and Metabolic Diseases 2022年第4期12卷 91-102页

作者： Diallo Ibrahima Mané Diédhiou Demba Ndour Michel Assane Sow Djiby Diallo Adja Tacko Mané Dieng Mouhamed Gadji Fatou Kiné Thioye El Hadji Mamadou Moussa Bassène Joseph Ndiaye Ndeye Fama mody Sarr Anna Ndour Mbaye Maimouna Medical Clinic II Abass Ndao Hospital Center Cheikh Anta Diop University of Dakar Dakar Senegal

Introduction: SARS-COV2 infection is a major public health problem and diabetes mellitus is a serious factor. The objective was to determine the characteristics of COVID-19 in diabetics at the Epidemic Treatment Center (ETC) of the Abass Ndao Hospital Center. Observation: This was a retrospective, descriptive and analytical study carried out at Abass Ndao Hospital from March 01, 2021 to September 31, 2021. We evaluated the epidemiological, clinical and evolutionary characteristics. Results: Among 333 patients infected with COVID-19, 203 were diabetic (60.96%). The sex ratio was 0.70 and the mean age 60.18 years. Diabetes was type 2 (84.2%) and inaugural (15.8%). Arterial hypertension was the main comorbidity (86.96% of cases). The RT-PCR test was positive in 86.21% of cases. The main clinical signs were: asthenia (90.14%), dyspnea (78.81%), cough (52.21%) and body aches (52.21%). Oxygen saturation was alanced in 71.43% with an average blood sugar of 2.02 ± 4 g/l. At the paraclinical, the D dimer was ≥1000 ng/l (71.52%) and the C-reactive protein ≥100 mg/l (32.01%). Chest CT scan found mild to moderate (55.17%), severe (21.67%) and critical (17.24%) lung lesions. Pulmonary embolism was found in 4 diabetics. The treatment of diabetes was represented by insulin therapy (85.82%) and oral antidiabetics (24.11%). Anti-COVID-19 treatment was dominated by azithromycin (89.11%), corticosteroid therapy (92.11%), anticoagulants (99%), hydroxychloroquine (21.29%). Mortality was found in 14.36% (n = 29) and significantly correlated with age ≥ 60 years (OR = 3.013 [1.266 - 7.173], P = 0.005), short duration of hospitalization (OR = 3.154 [1.149 - 8.663], P = 0.009), C-reactive protein > 100 mg/l (OR = 6.370 [2.704 - 15.006], P < 0.001), lung saturation < 90% (OR = 6.331 [2.633 - 15.222], P [3.367 - 18.322], P Conclusion: Diabetes is one of the most important comorbidities linked to the severity of SARS-CoV-2 infection. The seriousness factors in this field remain age ≥ 60 years,

关键词： Abass Ndao Diabetes Mellitus ETC SARS-CoV-2 Senegal

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Practice of Glycemic Self-Monitoring in Diabetic Patients Followed at the Endocrinology Department of Donka University Hospital in Guinea

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Open Journal of Endocrine and Metabolic Diseases 2024年第2期14卷 33-38页

作者： Mamadou Dian Mamoudou Diallo Mamadou Mansour Diallo Mamadou Chérif Diallo Alpha Mamadou Diallo Kadija Dieng Abdoul Mazid Diallo mody Abdoulaye Barry Kadidiatou Bah El’Hadj Zainoul Bah Mamadou Alpha Diallo Ibrahima Condé Ousmane Kourouma Amadou Kaké Diabetology Unit Labe Regional Hospital Labé Guinea Faculty of Health Sciences and Techniques Gamal Abdel Nasser University of Conakry Conakry Guinea Endocrinology and Diabetology Department of Donka University Hospital Conakry Guinea Pediatrics Department of Donka University Hospital Conakry Guinea

Diabetes is a chronic pathology whose evolution is marked by micro and macroangiopathic complications. Optimal management can prevent the onset of complications and improve patients’ quality of life. Objectives: To determine the frequency of self-monitoring of blood glucose and to describe the errors found during self-monitoring in diabetic patients followed at the Endocrinology Department of Donka University Hospital in Guinea. Materials and methods: Descriptive cross-sectional study carried out between August and September 2020 involving diabetic patients followed up at the Endocrinology and Diabetology Department of the Donka National Hospital, CHU Conakry. Results: A total of 301 patients were enrolled, with an average age of 44.24 ± 21.01 years. 64.12% were female. Type 2 diabetes predominated in 64% of cases. The mean duration of diabetes was 6.14 ± 4.67 years, and 75.08% of patients lived in urban areas. Patients were on insulin in 36.21% of cases, insulin and biguanides (26.25%), hypoglycemic sulfonamide and biguanides (19.27%) and biguanides in 18.27% of cases. The frequency of self-monitoring of blood glucose was 43%, and 38% of patients made errors, notably reusing lancets (60%), not checking the expiration date (55.65%) and not washing their hands (48%). Conclusion: This study shows that self-monitoring of blood glucose is not performed by the majority of patients. Numerous errors were identified during blood glucose testing. Continued therapeutic education on the use of blood glucose meters will help empower patients and improve their quality of life.

关键词： Self-Monitoring of Blood Glucose Diabetes Conakry University Hospital

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