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Management of Subtalar Fractures-Dislocations at Ségou Hospital in Mali: A 7 Cases Series

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Surgical Science 2020年第4期11卷 51-60页

作者： Mahamadou Diallo Abdoul Kadri Moussa Layes Toure Louis Traoré Cheick Oumar Sanogo Terna Traore seydina alioune beye Abdrahamane Toure Making Mounkoro Mahamadou Kane Tiéman Coulibaly Orthopedic-Trauma Service Nianankoro Fomba Hospital Ségou Mali Orthopedic-Trauma Service Gabriel Touré Hospital Bamako Mali Orthopedic-Trauma Service Sikasso Hospital Sikasso Mali Orthopedic-Trauma Service Kati Hospital Kati Mali Anesthesia-Resuscitation Service Nianankoro Fomba Hospital Ségou Mali

Introduction: Subtalar or peritalian dislocation is rare;it represents 15% of peritalian injuries. The aim of this study was to describe the radioclinical and therapeutic characteristics and to assess the functional result. Patients and Methods: This study is about a continuous descriptive and prospective study over a period of 5 years. It has been conducted from March 2013 to February 2018 at the Ségou Hospital, a second referral hospital in Mali. The functional results were evaluated by the score of the American Orthopedic Foot and Ankle Society (AOFAS). Results: Seven cases of subtalar dislocation fractures were diagnosed in six male patients with an average age of 38 years (36 to 47 years old). In five cases the etiology of the trauma was a motorcycle accident and a fall from height. The lesion was bilateral in one case. The average time to care was 3 hours (1 to 9 hours). There was one case of open dislocation fracture with talus enucleation. The dislocation was medial in 6 cases and lateral in one case. It was pure in three cases. The treatment was orthopedic in 2 cases and surgical in 5 cases. The post-operative complications were complicated by an infection of the operative site in one case. The average length of hospital stay was 4 days. The functional result was excellent in 2 cases;good in 2 cases, fair in 2 cases and poor for 1 case. Conclusion: Subtalar dislocation is a rare and serious lesion of the posterior tarsus. The long-term prognosis depends on the earliness of treatment and the severity of the associated injuries.

关键词： Fracture Dislocation Subtalar Prognosis Treatment

Prognosis of the Patients in Resuscitation Field in Mali

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Open Journal of Anesthesiology 2019年第12期9卷 213-220页

作者： Broulaye Massaoule Samake1] Andre Kassogue1] Blaise Adelin Tchaou1] Aichata Konate1] Fadima Koureissi Tall1] Lassina Goita1] seydina alioune beye1] Hamadoun Dicko1] Mamadou Karim Toure1] Mohamed Keita1] Dieneba Doumbia1] Service of Anesthesia and Resuscitation Teaching Hospital Gabriel Toure BamakoMali 2Service of AnesthesiaResuscitation and EmergenciesAcademic Hospitable Center and Department of the Bourgou/AliboriParakouBenin 3Service of AnesthesiaResuscitation and Emergency of the Academic Hospitable Center of KatiKatiMali 4Service of AnesthesiaResuscitation and the Emergencies of the Center Hospitable Academic Point GBamakoMali 5Service of Anesthesia Resuscitation and Emergency of the Academic Hospitable Center LuxemburgBamakoMali

Introduction: The patients whose vital prognosis is immediately threatened by one or several serious organs failures and consecutive to various pathologies are admitted in resuscitations (IUC). The rates of morbi-mortality are raised in Africa. Objective: To study the prognostic factors. Patient and Methods: It was about a transverse survey from January 2015 to April 2016 in the unit of polyvalent resuscitation of the service of anesthesia resuscitation of the academic hospital center of Gabriel Toure. It included all patient admitted for medico-surgical pathologies of more than three hours of hospitalization. It was about a consecutive recruitment of case. The Chi2 and Fisher tests were used for the comparison of our results with a p value = 0.05 considered as meaningful. The consent of the patients or parents was gotten. The survey didn’t include a potentially dangerous act. Results: During the period, 624 patients have been collected of which: 50.4% were medical pathologies, 19.4% surgical pathologies and 30.2% of gynéco-obstetric pathologies. At least a complication had occurred in 11.2%. Mortality was of 27%. The sex-ratio was of 0.51. The middle age was of 31.88 ± 17, 2 years with extremes of 2 years and 80 years. The met complications were: the scab, the syndrome of acute respiratory distress (ARD), the urinary infection, the pneumopathie, the shock, thrust hypertensive, stops cardio circulatory with respectively 35.1%, 26.6%, 22.3%, 6.4% and 3.2%. The middle length of stays was of 4.83 ± 5.32 days with extremes of 1 day to 29 days. Conclusion: The complications under hospitalization in unit (IUC) of resuscitation in Mali are a major challenge in term of prevention and management. The potentially non serious pathologies complicate themselves and compromise the vital prognosis.

关键词： Morbimortality Resuscitation Academic Hospitable Center Mali

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

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

作者： Diallo Boubacar Coulibaly Nouhoum Dicko Hammadoun Berthe Modibo beye seydina alioune Niangado Rokiatou Bassirou Keita Mohamed Coulibaly Youssouf Department of Anaesthesia-Resuscitation and Emergencies CHU Point G Bamako Mali Department of Nephrology and Haemodialysis CHU Point G Bamako Mali

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

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

Outcome of the Post-Operative Patients’ Admissions in the Field of Resuscitation in Mali

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Open Journal of Anesthesiology 2020年第3期10卷 73-79页

作者： Samaké Broulaye Massaoulé beye seydina alioune Tchaou Blaise Adélin Kassogué André Tall Fadima Koureissi Keita Mohamed Service of Anesthesia Resuscitation Academic Hospital Gabriel Touré Bamako Mali Service of Anesthesia Resuscitation Academic Hospital Point G. Bamako Mali Service of Anesthesia Resuscitation and Emergencies Academic Hospitable Center and Department of the Bourgou/Alibori Parakou Benin Service of Anesthesia Resuscitation Academic Hospital Kati Bamako Mali

Introduction: In spite of the use of the less and less invasive and the more and more effective techniques and the use of fast rehabilitation conditions of the patients in surgery, the post-operative complications (POC) stay the main reasons of admission in resuscitation service. Objective: To determine the post-operative outcome of the patients admitted in resuscitation. Patient and method: It was about a retrospective and transverse survey from June 2017 to May 2018 in the service of polyvalent resuscitation of the academic hospital center of Gabriel Touré. Have been included the patients operated for surgical or obstetric gynecology—pathologies admitted in resuscitation for post-operative complications established or potential precocious or late. The used statistical test was the Chi2 with p Results: During the period, 514 patients have been admitted in resuscitation of which 140 cases of post-operatively represented 27.2% of the admissions. Under hospitalization 35.7% of patients have presented a complication. The middle age of patients was 37.72 ± 20.9 years. The sex ratio was 0.70. The middle length of interventions was 122 ± 83 min with extremes going from 20 to 434 min. The predominant admission motive was hemodynamic instability. The delay of appearance intervening of the complications was 3 days in 94%. The predominant complications were: respiratory (32%), infectious (28%) and Cardiovascular (20%). The middle length of hospitalization was of 3.36 ± 2.90 days. The death rate was 15%. The complications were related age, the class of Alteme?er, the ASA, and the perioperative undesirable events with p Conclusion: The post-operative admissions in resuscitation are frequent including several factors of morbi-mortality. A better management per and postoperative of the patients operated would reduce the death rate. The profile mark is the one of a patient admitted for hemodynamic instability.

关键词： Post-Operative Admission Outcome Resuscitation Academic Hospital Gabriel Touré

Hydroelectrolytic Disorders in Cerebroleted Patients in the Intensive Care Unit of Gabriel TouréTeaching Hospital

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Neuroscience & Medicine 2020年第2期11卷 45-51页

作者： Diop Thierno Madane Mangané Moustapha Issa Almeimoune Abdoul Hamidou Mariko Mahamane beye seydina alioune Dembele Alaji Seidou Coulibaly Mahamadoun Ouattara Kassoum Kaloga Mahamane Asseye Siriman Koita Ebongue Sandrine Diango Djibo Mahamane Department of Anesthesia-Intensive Care and Emergency Gabriel Toure Teaching Hospital Bamako Mali Department of Imagery Luxembourg Teaching Hospital Bamako Mali Department of Anesthesia-Intensive Care and Emergency PG Teaching Hospital Bamako Mali Anesthesia Department Ophthalmological Institute West African University Hospital Bamako Mali Department of Anesthesia-Intensive Care and Emergency Luxembourg Teaching Hospital Bamako Mali

A cerebrole is a patient with a neurological deficit of central origin;these patients very often present disorders of the ion concentration, hence the need for hospitalization in intensive care. The aim of our study was to study hydro-electrolyte disorders in brain-damaged patients, to describe the clinical aspects, to identify the contributing factors and to determine the prognosis of these patients in the intensive care unit of gabriel touré teaching hospital. Material and Methods: It was a prospective cross-sectional study, descriptive of a period of 11 months going from June 2015 to April 2016 in the intensive care unit of CHU Gabriel TOURE we included all the cerebral patients admitted in intensive care in which hydro-ionic disorders have detected on arrival or during hospitalization. Data were collected through transfer sheets, a survey sheet and medical records. Data entry and analysis were done respectively on SPSS software (version 19) and Microsoft Word Starter 2010 software. Results: During our study, out of 450 hospitalization patients, we identified 110 brain-damaged patients and 75 patients were retained in our study, i.e. a prevalence of 16.6%. Male was predominant with 72% with a sex ratio of 2.5 the age group 20 - 50 years was majority with 45.3%, the average age was 38.49 years. The majority of patients (58.7%) were admitted from the emergency department. The most common reason for admission was impairment of consciousness in 94.7% (Table 1) of cases and the Glasgow admission score was less than or equal to 8 in 58.7% (Table 1) of patients. Hydro-electrolyte disturbances were present in 93.3% of patients on admission. Hyponatremia was the most common disorder with 56% (42 cases). Followed by hyperkalaemia 10.7% (8 cases), hypernatremia 9.3% (7 cases), at hypocalcemia 9.3% (7 cases), associated disorders 8% (6 cases). Brain CT was performed in 52% of the patients. In our study, malaria was the most common etiology o

关键词： Hydro-Electrolyte Disorders Cerebroleses Resuscitation Teaching Hospital Gabriel Toure

Therapeutic Aspects of Chronic Bone Infections and Management Challenges

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Open Journal of Orthopedics 2014年第2期4卷 21-26页

作者： Charles Diémé Lamine Sarr alioune Badara Guèye Ndeye Fatou Coulibaly André Sané Abdoulaye Ndiaye seydina Sèye Department of Orthopaedic and Trauma Surgery Aristide Le Dantec Teaching Hospital Dakar Sénégal Department of Orthopaedic and Trauma Surgery Aristide Le Dantec Teaching Hospital Dakar Sénégal.

This study aims to investigate various aspects of the treatment of chronic bone infections and the challenges in their management. The characterization of treatment of 73 patients with chronic bone infection was reported. The four management challenges including consultation delay, immune depression, extreme variety of clinical manifestations and non-use of CT or MRI were discussed in this study. We conducted a retrospective study at Aristide Le Dantec Hospital on 90 cases of chronic bone infection in 73 patients. The mean duration of symptoms before consultation was 36 months. More than half of the patients had a productive fistula at the first consultation. Sickle cell anemia was found in 6 patients. Multiple lesions were found in 10 patients;and long bones were affected in 90% of cases. The bacterial culture was positive in 93.15%. Staphylococcus aureus was the most isolated germ (68.35%). Seventy-two out of seventy-three patients were operated on. The procedure depended on anatomical and radiological lesions. Surgical treatment was associated with antibiotherapy which was firstly probabilistic and secondarily adapted to the results of bacterial culture. A favorable trend was found in 41 patients (56.16%). 32 cases of adverse effects were noted (43.83%), and 27 patients had recurrence after a favorable outcome. Several complications and sequelae were observed demonstrating the tenacity of these chronic infections.

关键词： Chronic Bone Infection Management Challenges

Perioperative Materno-Fetal Morbimortality Related to the Caesarean in the Hospital Setting in Mali

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Open Journal of Obstetrics and Gynecology 2020年第12期10卷 1693-1701页

作者： Samaké Broulaye Massaoulé Tchaou Blaise Adélin Goita Lassina Kassogué André Bocoum Amadou beye seydina alioune Monkam Yamadjeu Goliath Kéta Bakary Dabo Aminata Traoré Youssouf Tall Fadima Kouréissi Dicko Hamadoun Kéita Mohamed Tékété Ibrahim Department of Intensive Care Unit at the University Hospital Gabriel Touré Bamako Mali Department of Anesthesia-Resuscitation and Emergency University and Departmental Hospital Center Borgou Alibori Parakou Benin Department of Gyneocology at the University hospital Gabriel Touré Bamako Mali Department of Emergency Care and Intensive Care Unit at the University hospital Kati Mali Department of Intensive Care Unit at the University Hospital Point G Bamako-Mali Bamako Mali

Introduction: During childbirth by Caesarean, several types of anesthesia can be used. The Caesarean, the most practiced surgical delivery technique in obstetrics, has a risk for complications for both the pregnant women and newborns. Objective: To evaluate the importance of the complications due to Caesarean in the Teaching hospital Gabriel Toure. Patient and Methods: We conducted a cross sectional survey in the departments of intensive care unit and gyneco-obstetric from January to August 2017 in the University hospital Gabriel Touré of Bamako. Our study population was pregnant women who gave birth to children by Caesarean. We included all cases of preventive and emergent Caesarean under loco-regional or general anesthesia. Data were compiled from the obstetrical files of the patients, the anesthetic consultation registry and the databasis of the department of gyneco-obstetric. The test of khi2 of Pearson was used for the comparison of our results with a value of p The consent of the patients or parents was gotten. The survey didn’t include a potentially dangerous act.