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Management of Trauma to the External Genitalia at the Nianankoro-Fomba Hospital in Segou Mali

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Open Journal of Urology 2022年第6期12卷 376-382页

作者： sory Ibrahim koné Abdoulaye Kassogué Brehima Samaké Mahamoudou Keita Tidiani Traore Abdoulaye Nouhoum Coulibaly Mamadou Adama Togo Thierno Boubacar Bagayoko Adama Bah Aminata Fofana Alpha Sanogo Damissa Coulibaly Sidi Modibo Doucouré Honoré Jean Gabriell Berthé Urology Department The Nianankoro Fomba Hospital Ségou Mali Paediatric Ward The Nianankoro Fomba Hospital Ségou Mali General Surgery Department The Nianankoro Fomba Hospital Ségou Mali Obstetrics and Gynaecology Department The Nianankoro Fomba Hospital Ségou Mali Ophthalmology Department The Nianankoro Fomba Hospital Ségou Mali Forensic Medicine Department The Nianankoro Fomba Hospital Ségou Mali ENT Department The Nianankoro Fomba Hospital Ségou Mali Cardiology Department The Nianankoro Fomba Hospital Ségou Mali Department of General Medicine The Nianankoro Fomba Hospital Ségou Mali Social Security Fund Ségou Mali Department of Urology CHU du Point G Bamako Mali

Trauma to the male genitalia is not very common and mainly affects a young population. There is probably a particular instinct in men to defend their external genitalia;indeed, in the flaccid state, the penis is little exposed, and fairly well protected and its mobility allows it to move with the impact of trauma and thus reduce the vulnating force. Open trauma is rare, as is testicular dislocation, the most common being closed trauma. Testicular trauma is an uncommon accident that affects young people. Trauma is most often caused by road and traffic accidents. Animal bites are rare, as is genital self-mutilation related to a psychiatric disorder. Surgical exploration is the rule except in cases of moderate testicular trauma. Our objective was to report our experience in an emergency context where treatment is poorly codified and to review the literature. We recorded four patients with external genitalia trauma managed in the urology department from April 2013 to March 2022. Our patients were children with open genitalia trauma following a traffic accident, scrotal injuries were encountered in three patients, and additional penile injuries in one patient. All patients were treated surgically. The follow-up was straightforward.

关键词： Trauma Genitalia Open Segou

Epidemiological Clinical Aspects and Medical Management of Sexual Assault in the Region of Ségou in Mali

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Open Journal of Obstetrics and Gynecology 2022年第3期12卷 209-221页

作者： Tidiani Traoré Thierno Boubacar Bagayoko Alpha Sanogo sory Ibrahime koné Seydou Traoré Kassoum Sidibe Bréhima Donigolo Bréhima Doumbia Seydou Z. Dao Famakan Kane Adama Bah Seydina Alioun Beye Amadou Bocou Seydou Fané Yossuf Traoré Ibrahim Téguété Nianankoro Fomba Hospital Ségou Mali Koutiala Reference Health Center Koutiala Mali Common Reference Health Center II Bamako Mali Bla Reference Health Center Bla Mali Anesthesia and Resuscitation Service Center Hospitalier Universitaire Point G Bamako Mali Gabriel Touré University Hospital Bamako Mali

Introduction: Sexual assault is an act of a sexual nature perpetrated on another person without their consent. Goal: To describe the epidemio-clinical aspects and the medical management of sexual assault in the Segou region. Methodology: This was a retro-prospective descriptive study from September 2010 to September 2018 on the alleged female victims of sexual assault registered in the Gynecology and Obstetrics departments of the hospital and the sanitary quarters of Ségou. Results: We recorded 107 cases of sexual assault out of 47,729 gynecological consultations, representing a hospital prevalence of 0.22%. The victims were between 10 and 15 years old in 48.59% of the cases. Students were the most represented with 53.27% (57/107) of cases. Genito-genital contact was recorded in 90.65% (97/107) of cases. Vulvo-perineal lesions were present in 44.86% (48/107) of survivors. Hymenial deflowering was the most frequent traumatic genital lesion accounting for 43.70% (21/48) of old cases and 27.00% (13/48) of recent cases. Sexual assault was committed by a single individual in 60.75% (65/107) of cases and by a friend of the victim in 21.5% (23/107) of cases. The survivors had consulted within 24 hours of the sexual assault in 53.27% (57/107) of the cases, the treatment was medical in 68.22% (73/107) and medical-surgical in 4.7% (5/107), post-exposure prophylaxis to the Human Immunodeficiency Virus (HIV) was performed in only 26.16% (28/107) of survivors. Conclusion: Sexual assault remains a concern although its frequency is low. This scourge mainly affects children and adolescents, and the lesions are mainly genitals.

关键词： Aspects Sexual Assaults Epidemio-Clinics Management Segou

Right Heart Failure Indicative of Ebstein’s Disease in Adulthood about a Case

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World Journal of Cardiovascular Diseases 2023年第9期13卷 613-618页

作者： Sana Samoura Alpha koné Ibrahima sory 2 Sylla Mamadou Bachir Bah Morlaye Soumaoro Aly Samoura Aboulaye Camara Ibrahima sory Barry Elhadj Yaya Balde Mariama Beavogui Mamadou Dadhi Balde Department of Cardiology Sino-Guinean Friendship Hospital Guinea Conakry Department of Cardiology CHU Ignace Deen National Hospital Guinea Conakry

Ebstein disease is a rare congenital malformation whose clinical presentation differs according to the anatomical form and age of the patient. In adults, it presents mainly in the form of right or global heart failure or rhythm disorders. Survival is exceptionally long in some forms. We report the case of a 70-year-old patient with Ebstein’s disease in right heart failure.

关键词： Ebstein’s Disease Right Heart Failure

Myocardial Perfusion Abnormalities in Patients with Hereditary Hypertrophic Cardiomyopathy: A Study of Three Cases and Review of the Literature

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World Journal of Cardiovascular Diseases 2023年第6期13卷 289-296页

作者： Ngardjibem Djita Ibrahima sory Sylla Mamadou Bassirou Bah Felix Collard Sana Samoura Mamadou Aliou Baldé Souleymane Diakité Ibrahima sory Barry Alpha koné Elhadj Yaya Baldé Mariame Béavogui Mamadou Dadhi Baldé Philippe Chevalier Department of Cardiology Alen&ccedilon Hospital Alen&ccedilon France Department of Cardiology CHU Ignace Deen Conakry Guinea Department of Cardiology Sino-Guinean Friendship Hospital Conakry Guinea Department of Cardiology CHU Lyon Lyon France

Introduction: Hypertrophic cardiomyopathy (HCM) belongs to the very heterogeneous group of cardiomyopathies. This study aimed to study myocardial perfusion abnormalities on scintigraphy and assess the risk of sudden death from ventricular arrhythmia in hereditary sarcomeric HCM. Patients and Methods: This is a retrospective and prospective descriptive study over 18 months (January 01, 2021, to July 31, 2022) on the records of patients over 18 with the diagnosis of hypertrophic sarcomeric cardiomyopathy with or without ventricular rhythm disorders and who have undergone myocardial scintigraphy. Results: Three patients were included. The average age of our patients was 66 years old. Dyspnea is the primary symptomatology found in our patients. One patient presented with syncope and unsustained ventricular tachycardia. His risk score for sudden death from ESC at five years is estimated at 6.45%, and the patient received an ICD in primary prevention. The average sudden death risk score of our patients was 3.78%. The mean LV wall thickness was 20 mm. The mean maximum left intraventricular gradient was 39 mmHg. Myocardial fibrosis was present in all our patients. Myocardial scintigraphy was normal in all cases. Conclusion: Hypertrophic cardiomyopathy is a very heterogeneous group of cardiomyopathies. The rhythmic risk is multifactorial and constitutes a significant prognostic factor.

关键词： Hypertrophic Cardiomyopathy Myocardial Scintigraphy Sudden Death Ven-tricular Arrhythmia

Dyspnea in a 26-Year-Old Woman with Fatal Left Atrial Myxoma

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World Journal of Cardiovascular Diseases 2023年第6期13卷 309-312页

作者： Ibrahima sory Sylla Mamadou Aliou Baldé Mamadou Bassirou Bah Sana Samoura Souleymane Diakité Alpha koné Ibrahima sory Barry Mariame Béavogui Djibril Sylla Elhadj Yaya Baldé Mamadi Condé Mamadou Dadhi Baldé Department of Cardiology Ignace Deen National Hospital Conakry Guinea Faculty of Health Sciences and Techniques Gamal Abdel Nasser University of Conakry Conakry Guinea Department of Cardiology Sino-Guinean Hospital Conakry Guinea Department of Internal Medicine CHU Conakry Guinea

Cardiac myxoma is one of the primary intracardiac tumours. We report the case of a left atrial myxoma in a 26-year-old female patient admitted for investigation of dyspnoea. Echocardiography led to the diagnosis of a giant hypermobile myxoma prolapsing into the left ventricle. The patient died before being evacuated for surgical treatment.

关键词： Myxoma Left Atrium Echocardiography

Knowledge of Patients and Their Accompanying Persons about Obliterative Arteriopathy of the Lower Limbs at Conakry University Hospital in 2022

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World Journal of Cardiovascular Diseases 2023年第9期13卷 511-519页

作者： Alpha koné Alpha Mamadou Diallo Sana Samoura Ibrahim sory Barry Diane Kapché Mamadou Bassirou Bah Mamadou Saliou Diallo Souleymane Diakité Ibrahima sory Sylla Elhadji Yaya Baldé Zézé Onivogui Nicolas Zoumanigui Mariame Beavogui Mamadou Dadhi Baldé Faculty of Health Sciences and Techniques Gamal Abdel Nasser University of Conakry Conakry Guinea Department of Cardiology Sino-Guinean Hospital Conakry Guinea Department of Diabetology and Endocrinology National Hospital Donka Conakry Guinea Department of Cardiology National Hospital Ignace Deen Conakry Guinea Department of Cardiology Mountain University of Bangangte Cameroon Bafousam Cameroon Department of Surgery Cardiovascular National Hospital Donka Conakry Guinea

Introduction: Obliterative arterial disease of the lower limbs is a marker of advanced atherosclerosis. It is one of the world’s most common cardiovascular diseases, present in one in five people over the age of 60, and carries an increased risk of morbidity and mortality. The aim of this study was to assess the knowledge of patients and their carers about obliterative arteriopathy of the lower limbs at Conakry University Hospital. Material and Methods: We conducted a descriptive cross-sectional study lasting 3 months, from March 12 to June 12, 2022 in the hospitals of the University Hospital of Conakry (Donka and Ignace Deen). Following free and informed consent, they were interviewed on the basis of a pre-established questionnaire. Socio-demographic data (age, gender, level of education) were collected, and knowledge of obliterative arterial disease of the lower limbs. Results: The study involved 159 people, comprising 106 patients (66.66%) and 53 accompanying persons (33.34%) in the hospitals of the University Hospital of Conakry (Donka and Ignace Deen). The 60 to 79 age group was the most represented (44.7%), with an average age of 55.4 ± 15.9 years and extremes of 20 to 84 years. Half (47.8%) had not attended school, and almost all (96.4%) of those who had attended school had a low level of education (primary and secondary). Almost all of them (91.2%) had never heard of AOMI. Only 5% identified at least one risk factor, diabetes, hypertension and smoking. Amputation was the most frequently identified complication. About 98% did not know that AOMI is associated with myocardial infarction and stroke, and 93.7% did not know of any complications. Almost all the participants (99.4%) had poor knowledge of the following complications. Conclusion: Obliterative arterial disease of the lower limbs could be prevented or delayed by screening and controlling risk factors. Our results show a huge deficit in knowledge of this pathology, including risk factors, preventive meas

关键词： Obliterative Arterial Disease of the Lower Limbs Knowledge Patients

Ebstein Anomaly: A Clinical Case Series among Adolescents in Guinea

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World Journal of Cardiovascular Diseases 2023年第4期13卷 228-235页

作者： Mamadou Bassirou Bah Elhadj Yaya Baldé Mamadou Aliou Baldé Thierno Siradjo Baldé Mariama Djalakhan Diallo Amadou Diouldé Doumbouya Ibrahima sory Sylla Alpha koné Ibrahima sory Barry Souleymane Diakité Sana Samoura Mamadou Diallo Abdoulaye Camara Mamadou Dadhi Baldé Cardiology Department Ignace Deen Hospital Conakry Guinea Cardiology Department Donka Hospital Conakry Guinea

Ebstein’s anomaly is a rare congenital heart disease. We report a series of 4 cases of Ebstein’s anomaly discovered in adolescents. The mean age was 13.75 ± 0.96, with 3 boys and one girl. Three were in heart failure. The EKG showed atrial hypertrophy (1 case), right bundle branch block (1 case), Wolff-Parkinson-White (1 case), and atrial fibrillation (1 case). Cardiomegaly was present in all patients with a mean cardiothoracic index of 0.77 ± 0.03. On echocardiography, the mean apical displacement of the tricuspid septal leaflet was 22.5 ± 3.30 mm/m2, the Celermajer index was Grade 2 in 2 patients and Grade 4 in 2 patients. Depletive medical treatment was prescribed to 3 patients. Anticoagulant therapy was initiated in one patient. Two are awaiting surgery. One death was recorded, it was at Grade 4 of the Celermajer index.

关键词： Ebstein Anomaly Adolescent Congenital Heart Disease Guinea

Takayasu Disease Revealed by Arterial Hypertension in a 47-Year-Old Man

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World Journal of Cardiovascular Diseases 2023年第7期13卷 341-348页

作者： Bah Mamadou Bassirou Baldé Thierno Hamidou Wann Thierno Amadou Baldé Elhadj Yaya Baldé Aissatou Tiguidanké koné Alpha Doumbouya Amadou Diouldé Diallo Hafsatou Barry Ibrahima sory Samoura Sana Diakité Souleymane Béavogui Mariam Baldé Mamadou Dadhi Cardiology Department Ignace Deen Hospital Conakry Guinea Department of Imaging Ignace Deen Hospital Conakry Guinea Department of Internal Medicine Donka Hospital Conakry Guinea Cardiology Department Donka Hospital Conakry Guinea

Takayasu disease is a chronic vasculitis of the large vessels. It is rare in sub- Saharan Africa and probably under-diagnosed. Arterial hypertension (AH) is a frequent finding. We report the case of a 46-year-old man with Takayasu disease revealed by hypertension. The American College of Rheumatology (ACR) criteria were used for diagnosis, with 4 out of 6 criteria. Echodoppler and angioscanner showed signs of left subclavian stenosis and circumferential, regular arterial thickening. He had a biological inflammatory syndrome. He was treated with prednisone and amlodipine. After 6 months of follow-up, he was diagnosed with tuberculosis and put on anti-tuberculosis treatment.

关键词： Takayasu Disease Hypertension Man

A Very Severe Obstructive Sleep Apnea Syndrome: In a Cause of Resistant Hypertension with One Sample Case

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World Journal of Cardiovascular Diseases 2021年第3期11卷 223-229页

作者： Baldé Elhadj Yaya Bah Mamadou Bassirou Barry Ibrahima sory Béavogui Mariama Sylla Ibrahima sory Baldé Mamadou Aliou koné Alpha Diallo Mamadou Camara Abdoulaye Baldé Siradiou Baldé Mamadou Dadhi Dièye Ousmane Condé Mamady Cardiology Department of the Ignace Deen Hospital Conakry Guinea Cardiology Department of Donka Hospital Conakry Guinea Sakina Clinic in Dakar Dakar Senegal

When blood pressure values remain above the target in a hypertensive patient treated concomitantly with three anti-hypertensive drugs including a diuretic, maximum well-tolerated doses, this is a resistant arterial hypertension. In this case, it is advisable to look for a secondary cause such as a drug intake that influencing the blood pressure or the presence of obstructive sleeping syndrome (OSAS). We report a clinical case of a patient with a high cardiovascular risk at the age of 50, hypertensive and diabetic, with dyslipidemia and obesity. He was on anti-hypertensive triple therapy at an optimal dose. Her diabetes was balanced with 6.4% glycated hemoglobin. Dyslipidemia has being treated. Despite healthy diet including a low sodium diet and weight loss, blood pres- sure target was not reached. With self-measurement, the mean arterial pressure was 180/110 mmHg and on ABPM it was 167/113 mmHg. The ventilatory polygraphy finds a severe OSA with an IAH = 56.6. Treatment with PCP (Con- tinuous positive pressure) allowed this patient to control blood pressure. The search for OSA should be systematic in face of resistant hypertension, in par- ticular in overweight or obese patients.

关键词： Obstructive Sleep Apnea Syndrome (OSAS) Resistant Hypertension Continuous Positive Airway Pressure (CPAP)