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

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

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Duplication of the Urethra in Boys: A Case Report

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Open Journal of Urology 2024年第6期14卷 353-358页

作者： Mamadou Tidiani Coulibaly Falaye Sissoko Moumine Diarra Adama Toutou Diallo Issa Amadou Amadou Berthé sory koné CHU Gabriel Tour Urology Department Bamako University of Science Technology and Engineering Bamako Mali Lafiabougou Reference Health Center Bamako University of Science Technology and Engineering Bamako Mali CHU Gabriel Tour Pediatric Surgery Bamako University of Science Technology and Engineering Bamako Mali Korofina Reference Health Center Bamako University of Science Technology and Engineering Bamako Mali Segou Regional Hospital Bamako University of Science Technology and Engineering Bamako Mali

Supernumerary urethra in boys is a very rare anatomical entity. Sagittal urethral duplications are classified into four groups: epispadias, hypospadias, fusiform and Y-shaped urethra. The most widely used classification is that of Effmann and Lebowitz, which describes 6 types, one of the rarest being the ‘Y’ subtype IIA2, which corresponds to a duplicated urethral path from the vesical neck to an ectopic perineal or anal outlet. We report here the case of a 4-year-old child presenting with subtype IIA2 with a perineal orifice and no other urinary disorders.

关键词： Duplicity Ureter Malformation

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Projected Changes in the Climate Zoning of Côte d’Ivoire

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Atmospheric and Climate Sciences 2024年第1期14卷 62-84页

作者： Mamadou Diarrassouba Adama Diawara Assi Louis Martial Yapo Benjamin Komenan Kouassi Fidèle Yoroba Kouakou Kouadio Dro Touré Tiemoko Dianikoura ibrahim koné Arona Diedhiou Laboratory of Sciences Matter Environment and Solar Energy (LASMES) University Félix Houphou&#235t-Boigny Abidjan C&#244te d’Ivoire Geophysical Station of Lamto (GSL) N’douci C&#244te d’Ivoire Laboratory of Fundamental and Applied Physics University Nangui Abrogoua Abidjan C&#244te d’Ivoire Université Grenoble Alpes (UGA) Institut des Géosciences de l’Environnement (IGE) Institut de Recherche pour le Développement (IRD) Centre National de Recherche Scientifique (CNRS) Institut National Polytechnique (INP) Grenoble France African Centre of Excellence on Climate Change Biodiversity and Sustainable Agriculture (ACE-CCBAD)/University Felix Houphou&#235t-Boigny (UFHB) Abidjan C&#244te d’Ivoire

This study assesses the projected changes in the climate zoning of Côte d’Ivoire using the hierarchical classification of principal components (HCPC) method applied to the daily precipitation data of an ensemble of 14 CORDEX-AFRICA simulations under RCP4.5 and RCP8.5 scenarios. The results indicate the existence of three climate zones in Côte d’Ivoire (the coastal, the centre and the north) over the historical period (1981-2005). Moreover, CORDEX simulations project an extension of the surface area of drier climatic zones while a reduction of wetter zones, associated with the appearance of an intermediate climate zone with surface area varying from 77,560 km2 to 134,960 km2 depending on the period and the scenario. These results highlight the potential impacts of climate change on the delimitation of the climate zones of Côte d’Ivoire under the greenhouse gas emission scenarios. Thus, there is a reduction in the surface areas suitable for the production of cash crops such as cocoa and coffee. This could hinder the country’s economy and development, mainly based on these cash crops.

关键词： Climate Projection Climate Zone Principal Component Analysis Hierarchical Classification on Principal Components CORDEX Côte d’Ivoire

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Ear Cholesteatoma Surgery in South Sahara: Our Experience in Bamako

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International Journal of Otolaryngology and Head & Neck Surgery 2024年第4期13卷 293-303页

作者： Kassim Diarra Oumou Coulibaly Yaya Dembele Nfaly konaté Sidibe Youssouf Saydi Ag Mohamed Harouna Sanogo Abraham Diarra ibrahim Fofana Moussa Bourama Keita Youssouf Traore Fatogoma Issa koné Boubacary Guindo Siaka Soumaoro Doumbia Kadidiatou Singare Mohamed Amadou Keita ORLCCF Department Gabriel Toure University Hospital Bamako Mali ORLCCF Unit Kati Army Polyclinics Kati Mali ENT-CCF Department CHU Luxembourg Bamako Mali ORLCCF Service of the Reference Center of Commune VI Sogoniko Bamako Mali

In Mali, cholesteatoma surgery remains a challenge due to the limited number of otological practitioners, and the low socio-economic level of patients reflecting the difficulties in performing CT or MRI for post-operative follow-up. We therefore initiated this work with the objective of analyzing, through a broad bibliographic review, the clinical, paraclinical, topographical, therapeutic and progressive aspects of a series of ear cholesteatoma. Materials and Method: This was a retrospective and prospective, descriptive study that took place in the ENT and head and neck surgery department of the Gabriel Touré University Hospital over 36 months from November 2020 to October 2023. These were patients admitted to the department for chronic cholestematous otitis media. Result: In total, we collected 34 files of patients admitted for cholesteatoma. This represented 9% of cases compared to all otological surgeries carried out during the same period, i.e. 362 cases. The average age of our patients was 35.31 years, with extremes ranging from 7 years to 80 years, there were 24 men and 10 women, i.e. a M/F ratio of 2.4. The average time to diagnosis was 7 years. The main functional signs were dominated by chronic fetid purulent otorrhea associated with hypoacusis in 94.6% of cases. One case of meningeal complication and three cases of cerebral empyema were reported. Clinically, a postero-superior and marginal tympanic perforation was observed in 53%, a retraction pocket in 5.9%, the sentinel polyp in 9%, and a non-marginal tympanic perforation in 32%. Pure-tone audiometry performed preoperatively for all patients showed conductive hearing loss in 83%. In 82% of cases we created a recess with the creation of a mini box. An ossiculoplasty was performed immediately with fragments of cartilage. The postoperative course found the disappearance of otorrhea (88.23%), the persistence of otorrhea in one case, two cases of facial paralysis, and one case of tinnitus. We did not identify

关键词： Cholesteatoma CT TTO TTF

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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

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Double Arthrodesis, Postero-Medial Release and Posterior Tibial Transfer in One Step in Paralytic Inveterate Equine Varus Foot

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Surgical Science 2023年第2期14卷 122-130页

作者： Kalifa Coulibaly Cheick Oumar Sanogo sory ibrahim Tambassi Aboubacar Diallo Soumana Traore Laye Toure Orthopaedic Trauma Department Kati University Hospital Koulikoro Mali Orthopedic Trauma Department Sikasso Regional Hospital Sikasso Mali

Introduction: Varus equine foot deformity is common in developing countries. The management of these deformities is surgical in adults. Several surgical techniques have been described with more or less satisfactory results. To our knowledge, no study has been performed on the simultaneous association of double arthrodesis, posteromedial release, and posterior tibial transfer in a single operation in inveterate paralytic varus equines feet. The purpose of this work was to evaluate the results obtained. Patients and Method: This was a retrospective descriptive study from January 01, 2018 to December 31, 2021. It concerned inveterate paralytic varus equines feet operated on by the simultaneous association in a single operative time of double arthrodesis of the foot, posteromedial release of the back foot and transfer of the posterior tibial muscle to the lateral cuneiform. We identified seven patients with a mean age of 22.1 years with extremes of 11 years and 36 years. There were three males and four females. The cause of the deformity was neurological in all cases. All patients had painful walking discomfort and shoeing difficulties. The average time to management was 13.3 years with extremes of 4 and 25 years. The chronology of the interventional steps was posteromedial release, arthrodesis, and transfer of the posterior tibial muscle to the lateral cuneiform. The average postoperative follow-up was 21.7 months with extremes of 6 and 48 months. The parameters studied were the duration of the procedure, complications related to the procedure, muscle strength at the last recoil, consolidation of the arthrodesis, residual pain, patient activity, gait perimeter, stepping, ankle mobility, residual deformity, footwear, protrusion of the transferred tendon, and the possibility of walking on the heel. Final results were graded according to the Angus and Cowell criteria. Results: No intraoperative complications were noted. An early superficial infection of the surgical site

关键词： Arthrodesis Foot Ankle Posterior Tibial Muscle Equine Varus

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Epidemiological and Clinical Aspects of Bladder Tumours at the Nianankoro Fomba Hospital in Segou in the Urology Department

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Open Journal of Urology 2022年第5期12卷 294-303页

作者： sory ibrahim kone Honoré Jean Gabriel Berthe Aly Douro Tembely Zanafon Ouattara Mamadou Lamine Diakite Urology Department Nianankoro Fomba Hospital Ségou Mali Department of Urology CHU Point G Bamako Mali Department of Urology CHU Gabriel TOURE Bamako Mali Department of Urology CHU Gabriel TOURE Bamako Mali

Objectives: To study the epidemiological, diagnostic and prognostic aspects of bladder tumours in Segou Hospital. Patients and Methods: We conducted a descriptive cross-sectional study of bladder tumours over the period from 1 April 2012 to 1 April 2017, in the urology department of the Nianankoro Fomba Hospital in Segou. The first three years were used for patient recruitment, and the last two years for follow-up of the patients in the series. Results: Over a period of three years, we collected 165 cases of bladder tumours hospitalised out of 1308 hospitalisations from 7007 consultations, i.e. 12.6% of hospitalisations and 2.3% of consultations. The sex ratio was 1.2 in favour of men. A history of treated bilharzia was reported in 78.8% of cases and untreated bilharzia in 9.1% of cases. Haematuria was the most common reason for consultation. The majority of our patients were at stage T4 and T3 at the time of diagnosis, i.e. 53.3% and 44.3% respectively. Most patients consulted within 13 to 24 months after the first sign, i.e. 44.8%. Conclusion: The prognosis is still clouded by the delay in management. All the patients diagnosed had a bladder tumour infiltrating the muscle.

关键词： Bladder Tumour Bladder Cancer Epidemiological and Clinical Aspects

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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

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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

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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)

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