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Panorama of Autoimmune and Autoinflammatory Diseases in Internal Medicine at the University Hospital Center (UHC) of the Point G

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Open Journal of Internal Medicine 2021年第2期11卷 91-108页

作者： soukho assétou kaya Keïta Kaly Sy Djibril Traoré Djénébou Dembélé Ibrahim Amadou Mallé Mamadou Cissoko Mamadou Sangaré Barry Boubacar Oumar Keïta Adramé Keïta Mamadou Nyanké Romuald Diarra Bacary Cissé Idrissa Ahmadou Diakité Mahamadou Dembélé Mamadou Traoré Abdel Kader Traoré Hamar Alassane Department of Internal Medicine at the University Hospital Center of the Point G Bamako Mali Faculty of Medicine and Odontostomatology (FMOS) University of Sciences Techniques and Technologies of Bamako (USSTB) Bamako Mali Department of Rheumatology at the University Hospital Center of the Point G Bamako Mali University of Clinical Research Center (UCRC) at the University Hospital Center of the Point G Bamako Mali Faculty of Medicine Kankou Moussa University (UKM) Bamako Mali

Introduction: Panorama studies of autoimmune and auto-inflammatory diseases are still very little carried out in Africa and particularly in Mali. The objective of this descriptive study with retrospective collection was to describe the epidemiological and clinical profile of all autoimmune and auto-inflammatory diseases in the department of internal medicine at the University Hospital Center of the Point G. Methods: This was a descriptive study with a retrospective survey of the records of patients hospitalized for autoimmune and auto-inflammatory diseases in the department of internal medicine at the CHU of Point G for a study period of 15 years from January 1, 2005 to December 31, 2019. We included in the study all patients hospitalized for autoimmune and auto-inflammatory diseases. Results: During the study period (January 31, 2005 to December 31, 2019), 6383 patients were hospitalized in internal medicine at the University Hospital Center of the Point G, of which 317 patients presented with autoimmune and/or auto-inflammatory disease with an average annual hospital recruitment rate of 21 ± 7.87 cases per year. The female sex accounted for 64.98% with a sex ratio of 0.54. The mean age of patients was 35.27 ± 16.27 years and the extreme ages were 07 and 79 years. Out of the 317 medical records included according to our inclusion criteria, there were 07 cases of association between autoimmune disease and autoinflammatory disease, i.e. 14 cases of autoimmune and autoinflammatory diseases. A total of 331 autoimmune diseases and/or auto-inflammatory diseases were collected, i.e. a frequency of 5.19%, including 291 cases of autoimmune diseases (221 cases of organ-specific autoimmune diseases and 70 cases of systemic autoimmune diseases) and 40 cases of autoinflammatory diseases (no case of monogenic forms, 08 cases of “systemic” polygenic forms and 32 cases of “organ-specific” polygenic forms). Organ-specific autoimmune diseases were dominated by typ

关键词： Autoimmune Disease Autoinflammatory Disease Internal Medicine Mali

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Podiatric Risk assessment in Diabetic Patients at University Hospital Center of Point G

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Open Journal of Endocrine and Metabolic Diseases 2019年第8期9卷 85-94页

作者： Sy Djibril Traoré Abdel Kader soukho assétou kaya Traoré Djenebou Thomas Ingrid Gladys Keita Zakaria Dembelé Ibrahima Amadou Cissoko Mamadou Sangaré Barry Boubacar Togo Mamadou Keita Kaly Keita Adramé Tolo Nagou Camara Boua Daoud Dao Karim Doumbia Alassane Alfousseni Saliou Mahamadou Fofana Youssouf Mallé Mamadou Traoré Abdramane Sangaré Drissa Cissé Sékou Mamadou Berthé Brehima Boly Sanogo Abasse Sy Seydou Dembélé Mamadou Traoré Hamar Alassane Department of Internal Medicine of University Hospital Center of Point G Bamako Mali association “Rabies in West Africa—Mali” Bamako Mali Internal Medicine Service Kati Hospital Koulikoro Mali Department of Internal Medicine Nianankoro Fomba Hospital Segou Mali Department of Medicine Regional Hospital Gao Mali Department of Medicine Regional Hospital Sikasso Mali Department of Medicine University Hospital Center Gabriel Toure Bamako Mali Department of Internal Medicine Hospital Center Mother-Child Luxemburg Bamako Mali Department of Medicine Fousseyni Daou Hospital Kayes Mali Department of Nephrology University Hospital Center of Point G Bamako Mali

Introduction: Diabetes, a chronic pathology, is the source of many acute and chronic complications whose treatment requires many daily constraints that can have a serious impact on the quality of life of the patient and his family. The diabetic foot is a real public health problem which is still dominated by a very high lower limb amputation rate even in countries with high socioeconomic status. The diabetic foot classically results from the association of three entangled mechanisms which are neuropathy, arteriopathy and infection. Objectives: To determine the frequency of arterial disease, neuropathy, and other aggravating factors that influence the podiatry risk, and to proceed with the gradation of the podiatry risk. Methodology: This was a cross-sectional study concerning the period from July 1 to October 31, 2017, covering all diabetic patients received in consultation and hospitalization in the Internal Medicine Department of the G-University Hospital Center. Results: Our study included 50 patients (35 women for 15 men) out of 95 diabetic patients receiving a frequency of 52.6%, with a sex ratio of 0.42. The average age of our patients was 54.38 ± 13.98 years. Overweight/obesity found in 44% of patients. The average Body Mass Index (BMI) of our patients was 27.16 kg/m2. Patients with diabetes less than 5 years old represented 56% with an average duration of 5.39 ± 5.34 years. The mode of discovery of diabetes was polyuria-polydipsia syndrome in 56% of cases. Type 2 diabetes represented 74% of patients. Among the patients who had performed the HbA1C test, 80.77% were not well balanced. The antecedent of macrosomia in women accounted for 77.1%. Patients who did not know foot hygiene recommendations accounted for 82%. Among the identified podiatry risk factors, diabetic neuropathy accounted for 73.8%, and arterial disease was 32.3%. Grade 1 patients in our study accounted for 52% (gradation of foot risk). Conclusion: The diabetic foot is a major public health problem because of its frequency, its direct and in

关键词： Monitoring Diabetes Foot Risk Mali

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COVID-19 and the Vascular Elderly Subject: Illustration of Therapeutic Management with Corticosteroids in an Elderly Diabetic Patient with COVID-19

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Open Journal of Clinical Diagnostics 2024年第1期14卷 1-6页

作者： Ibrahima Amadou Dembele Abrar-Ahmad Zulfiqar Romuald Nounga Nyanke Sékou Landoure Stéphane Loique Djeugoue Adama Sinayoko Nouhoum Kone Paul Antoni Amadou Nouroudine Rosunee Ahsveen Yacouba Koné Aoua Diarra Tania Mekuiko Ngeupi Mamadou Cissoko Mamadou Mallé Keïta Kaly Djibril Sy Djénébou Traoré Didier Mukéba Tshialala assétou soukho kaya Emmanuel Andres Internal Medicine Department Medical Clinic B University Hospital Center of Strasbourg Strasbourg France Internal Medicine Department University Hospital Center Point G Bamako Mali Faculty of Medicine and Odontostomatology University of Sciences Techniques and Technologies of Bamako Bamako Mali Faculty of Medicine Pharmacy and Public Health University of Mbuji-Mayi Democratic Republic of Congo

Introduction: The severity of Sars-Cov-2 infection is associated with the development of acute respiratory distress syndrome (ARDS). The progression to ARDS appears to be driven by a major inflammatory mechanism potentially sensitive to corticosteroids. Observation: This article describes the case of an elderly patient was admitted to emergency departments for intense asthenia, accompanied by motor diarrhoea, dyspnoea with desaturation in ambient air, in a context of strong suspicion of infection linked to COVID-19. The article also reviews the existing literature on the diagnosis and treatment of this severe form of the disease. Conclusion: Corticosteroids, and in particular dexamethasone, have been shown to be effective in the management of patients with COVID-19, an oxygen-releasing disease.

关键词： COVID-19 Diabetes Mellitus Elderly person Corticosteroids Internal Medicine

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Clinical and Epidemiological Aspects of Hepatocellular Carcinoma at the Internal Medicine Department of Point “G” Teaching Hospital in Mali

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Open Journal of Gastroenterology 2023年第7期13卷 250-255页

作者： Ganda Soumaré Sanra Déborah Sanogo Abdoulaye Maiga Ouatou Mallé Mamadou Mallé Ibrahima A. Dembélé Mamadou Cissoko Mamadou M. Coulibaly assétou kaya soukho Mamadou Dembélé Abdel Kader Traoré Alassane Traore Hamar Alassane Traore Gastroenterology Department CHU du Point G Bamako Mali Internal Medicine Department CHU du Point G Bamako Mali

Liver cancer is the malignant transformation of liver cells. It develops in 90% of cases of cirrhosis, more rarely on chronic non-cirrhotic liver disease, and exceptionally in a healthy liver. This study aimed to investigate the clinical aspects of Hepatocellular Carcinoma (HCC). It was a retrospective descriptive study covering 10 years, focusing on HCC cases seen in outpatient and inpatient settings at the Internal Medicine Department. We recorded 153 cases out of 7021 patient records, resulting in a hospital frequency of 2.17%. The male-to-female ratio was 3.5. The mean age was 52.37 ± 14.34 years. The most common presenting complaint was pain in 16.3% of cases. A history of jaundice was found in 25.5% of cases. Alcohol consumption was observed in 15.38% of cases. The main physical sign found was hepatomegaly in 76% of cases. HBsAg was positive in 33.3% of cases. Alpha-fetoprotein levels were above 400 IU/ml in 50.81% of cases. Patients classified as CHILD PUGH A represented 39.72% of cases. Abdominal ultrasound revealed portal thrombosis associated with heterogeneous multinodular hepatomegaly in 11% of cases. Cytology confirmed HCC in four out of six patients who underwent the examination. We recorded 63 deaths out of 111 hospitalized patients. Complications included encephalopathy, hematemesis, and ascites in 48 patients. Hepatocellular carcinoma remains a significant public health issue. Its predominance in men and its occurrence in adults with factors such as viral infections and ethylism mean that prevention of this pathology could greatly reduce its incidence.

关键词： Hepatocellular Carcinoma (HCC) Point G University Hospital Bamako Mali

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Progressive Characteristics of HIV Infection in the Elderly in the Cohort of the Internal Medicine Department of the Points G University Hospital, Bamako. Mali

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Advances in Infectious Diseases 2023年第1期13卷 109-116页

作者： Abdoulaye Mamadou Traore Garan Dabo Mamadou Cissoko Charles Dara Djenebou Traoré Ibrahim Dollo Djibril Sy assétou soukho Mamadou Dembélé Daouda Kassoum Minta Abdel Kader Traore Hamar Alassane Traore Department of Infectious Diseases CHU du Point G Bamako Mali Department of Medecine CHU “Hôpital du Mali” Bamako Mali Department of Internal Medicine CHU du Point G Bamako Mali

Few data are available on HIV infection in the elderly and they are an important population in our different cohorts in view of the improvement in the quality of care over the last ten years. Objective: to determine the clinical and immunovirological characteristics as well as the acceptance of antiretroviral drugs in this patient population. This is a cohort study of the files of PLHIV (People living with HIV) aged 50 years or more, followed in the Internal Medicine Department of the Point G University Hospital between January 2007 and December 2012. Results: Out of 161 HIV-infected patients in the cohort, 38 were aged 50 years or older, of whom 11 met the criteria and were included. The median age was 55 years, 90.9% of whom were in the [50 - 59 years] age group, with 63.6% being women (sex ratio = 0.57). At admission, 3 patients (27.3%) had prurigo and 2 (18.2%) had oral-pharyngeal candidiasis. At inclusion, 45.5% of patients were classified as WHO stage 2 and one as WHO stage 4. All were on ARVs, including 10 on 1st line HIV-1 and 1 on HIV-2. On triple therapy, the average weight gain was 5.1 kg at D15 and 6.84 kg at M6. However, at M12 there was a weight loss of 1.04 kg. The mean CD4 T cell gain was +102/mm3 at M6 and +188/mm3 at 12 months. At D0, mean viral load = 565024.75 copies/mm3 [99 - 1100000] in 4/11. At M12, two patients had undetectable viral loads. Conclusion: The prevalence of HIV in elderly subjects is certainly underestimated. Thanks to triple antiretroviral therapy, PLHIV are aging with HIV but screening is not systematically proposed during consultations in elderly subjects. It is necessary to reinforce communication about HIV at all ages.

关键词： HIV Elderly Clinical Immunovirology

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Renal Failure of Lithiasis Origin: Frequency and Management in the Nephrology and Haemodialysis Department of the Point G University Hospital in Mali

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Open Journal of Nephrology 2022年第3期12卷 276-292页

作者： Seydou Sy Magara Samaké Aboubacar Sidiki Fofana Atabieme Kodio Oligue Prudence Oman Djibril Sy Hamadoun Yattara Djénèba Diallo Sah Dit Baba Coulibaly Nouhoum Coulibaly Modi Sidibé Alkaya touré Moustapha Tangara Mamadou Lamine Diakité assétou soukho kaya Saharé Fongoro Nephrology and Hemodialysis Department University Teaching Hospital of Point-G Bamako Mali Faculty of Medicine and Odontostomatology University of Sciences Techniques and Technologies of Bamako Bamako Mali Nephrology Unit Fousseyni Daou Hospital in Kayes Kayes Mali National Center for Scientific and Technological Research (CNRST) Bamako Mali Department of Internal Medicine University Teaching Hospital of Point-G Bamako Mali Department of Urology University Teaching Hospital of Point-G Bamako Mali

Background: The term urinary lithiasis (UL) from the Greek “lithos” refers to the disease characterised by the result of abnormal precipitation of normal constituents of the urine within the urinary tract. The aim of this work was to determine the frequency of obstructive renal failure (ORF) of lithiasis origin and to describe the therapeutic indications. Methods: This was a retrospective prospective study in patients hospitalised in the nephrology department of Point G University Hospital for ORF of lithiasis origin over a 26-month period from 1 January 2018 to 1 February 2020 inclusive. Results: Among 1898 hospitalized patients, 32 met the inclusion criteria, i.e. a frequency of 1.7%. The male sex was 68.75% with a sex ratio of 2.2. The mean age was 48.38 ± 13.423 years with extremes of 20 and 65 years. Dysuria and urinary bilharzia were the main uro-nephrological antecedents, accounting for 25% of the cases each. Pain syndrome was the main functional sign, accounting for 100%. Ultrasound of the urinary tract (n = 28) showed stones in 92.85%. These stones were bilateral in 22.22% of cases. The dilatation was pyelocalic in 14 cases (51.8%). The uroscanner showed a pyelic location of the stones in both kidneys;42.1% on the right and 33.3% on the left. Hydronephrosis was the most common dilatation: 37.8% on the right and 29.7% on the left. Renal lithiasis was complicated by acute kidney injury (ARI) in 17 cases (53.1%) versus 15 cases (46.9%) of chronic kidney disease (CKD). Urethral catheter was the means of drainage in 24 (75%) followed by nephrostomy in 8 cases (25%). Nephrolithotomy accounted for 9.4% of cases. The case fatality rate was 28.12% (9 cases). Deaths occurred in the context of uraemic coma 6 cases and cardiorespiratory arrest 3 cases. Conclusions: The management of urinary lithiasis complicated by renal failure calls for the correction of hydrolytic disorders, drainage of the excretory tract and treatment of the stone, of which percutaneous nephrolithotomy seems to be the modality of choice.

关键词： Renal Failure Urinary Lithiasis Nephrology University Teaching Hospital of Point-G

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Evaluation of Practice of Prescription of the Corticotherapy in the Department of Internal Medicine of the University Hospital of Point G from 2009 to 2013

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Open Journal of Internal Medicine 2019年第3期9卷 89-96页

作者： Abdel Kader Traoré assétou soukho kaya Djibril Sy Djenebou Traoré Alassane Doumbia Ilo Diall Nangou Tolo Hadiza Amadou Kaï lou Karim Dao Boua Daou Camara Ganda Soumaré Mamadou Dembélé Hamar Alassane Traoré Department of Internal Medecine University Hospital of Point G Bamako Mali Department of Cardiology University Hospital of Point G Bamako Mali

Introduction: It is estimated that about 0.2% to 0.5% of French populations received a long-term systemic corticosteroid therapy. In Mali, from March, 2007 to February, 2008, in National Center for Disease Control and Prevention, 19.2% of hospitalized patients (24/125) received long-term corticosteroid therapy. Until now, the department of internal medicine of the university hospital of Point G hasn’t done any research on the corticosteroid therapy specially. Therefore, we initiated this work to evaluate our practice of prescription of corticosteroid. The target of the study was to evaluate practical activity of prescription of corticosteroid of internal medicine. Methods: Based on all hospitalized patient materials of the department of internal medicine of Point G regional university central hospital during January 2009-December 2013, we initiated this retrospective and descriptive study. This study was based on all hospitalized patients receiving corticosteroid in the time of researching, without distinguishing their sex or age. Results: During the period of study, the department of internal medicine of point G regional central hospital had received 2155 patients;64 were eligible: prevalence of 2.97%. Most patients were female, accounting for 87.5% with a sex-ratio of 0.14. The average age of our patients was 39.11 ± 16.92 years, ranging from 14 to 97 years. Physicians enrolled in the study Specialized Diploma (DES) and Internal represented 79.7% of prescribers. As pretreatment assessment, only 2 patients (3.12%) had carried out all of the standard balance (NFS, electrolytes, calcium, blood glucose and serum protein). The most common glucocorticoide was prednisone. Solid tumors represented 31.25% (20 cases) of the diseases treated, followed by systemic lupus erythematosus with 15.62% (10 cases). In addition, there are two cases of adrenals insufficiency (3.1%). In Point G internal medicine, pre-therapy evaluation and methods about corticosteroids therapy were insufficient and different.

关键词： Pratiques Corticothérapies Médecine Interne Bamako Mali

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Serious Myasthenia at the Department of Internal Medicine of Point G University Teaching Hospital: A Clinical Case

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Neuroscience & Medicine 2019年第3期10卷 207-212页

作者： assétou kaya soukho Djenebou Traoré Adramé Keita Djibril Sy Guida Landouré Seybou Hassane Diallo Youssouf Fofana Kaly Keita Mamadou Mallé Ibrahima Amadou Dembélé Drissa Sangaré Mamadou Cissoko Barry Boubacar Sangaré Mamadou Dembélé Abdel Kader Traoré Hamar Alassane Traoré Department of Internal Medicine Point G University Teaching Hospital Bamako Mali Department of Neurology Point G University Teaching Hospital Bamako Mali Department of Neurology GABRIEL TOURE University Teaching Hospital Bamako Mali Department of Internal Medicine Mother-Child Hospital “Luxembourg” Bamako Mali

Introduction: Myasthenia is a rare and disabling autoimmune disease. Few studies were devoted to this pathology. We report a clinical case of myasthenia in the Department of Internal Medicine at the Point G University Teaching Hospital. Observation: This is a 41-year-old patient of Malian origin, a trader with a history of hemorrhoidectomy in 2011 and familial hypertension, was admitted on August 19, 2014, for muscle weakness, dysphonia, and dysphagia. The disease started 1 year before admission at the department with progressive muscle weakness of the upper limbs aggravated by repetitive movements and spreading to the head “drooping head” and inferior limbs, associated with general fatigue, dysphonia and selective dysphagia for solid foods. The diagnosis of myasthenia was maintained based on the clinical signs such as ptosis, bilateral diplopia, and weakness with lower limbs muscle strength rated at 3/5, and confirmed with confirmatory exams;a positive anti-acetylcholine receptor antibody (RIA), the post-synaptic neuromuscular conduction block at ENMG and the positive neostigmine pharmacological test. The patient received Neostigmine (prostagmine) 0.5 mg one ampoule in IM/day and Prednisone at a dosage of 1 mg/kg/day. The evolution was marked by a moderate improvement of the symptomatology afterward the patient was evacuated to Tunisia on family request where he received a course of immunoglobulin 2 g/kg in 2 days. The evolution in Tunisia was favorable. The patient returned in Mali and death occurred after 2 months in a context of respiratory distress. Conclusion: Myasthenia is a rare but serious disease requiring careful management and monitoring to reduce respiratory complications.

关键词： Myasthenia Immunoglobulin Internal Medicine Point G Hospital

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Tubercular Uveitis in the Event of HIV Infection about a Case

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Journal of Tuberculosis Research 2019年第4期7卷 253-258页

作者： Abdramane Traoré Hamsatou Cisse Nagou Tolo Djenebou Traoré Condé Lassana assétou soukho kaya Abasse Sanogo Bréhima B. Berthé Ibrahima Amadou Dembélé Mahamadou Saliou Djibril Sy Nanco Doumbia Sekou Mamadou Cissé Boubacar Zana Cisse Mamadou Dembélé Abdel Kader Traoré Hamar Alassane Traoré Department of Medicine Sidy Bocar Sall Kati Hospital Koulikoro Mali Department of Internal Medicine at CHU Point G Bamako Mali Department of Internal Medicine of CHU Gabriel touré Bamako Mali Internal Medicine Service of the Mali Hospital Bamako Mali

Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis. This disease is the second leading cause of infectious mortality in the world after infection with the human immunodeficiency virus. We report a case of multifocal tuberculosis with neuromuscular and ocular localization in an HIV-1 immunosuppressed patient in clinical and virological failure following therapeutic discontinuation due to non-compliance. This is a 43-year-old immunocompromised HIV1 patient with a history of cerebral toxoplasmosis in 2016 who consulted for right hemiplegia. These symptoms would go back to about 3 days marked by a deficit of progressive installation of the right hemicorps preceded by diffuse headaches, of moderate intensity without triggering factor radiating to the eyes associated with an intermittent fever with periods of spontaneous remissions, night sweats and chills, non-selective anorexia, non-increasing physical asthenia and unquantified weight loss. Management was 8-month antituberculous treatment, combining the first two months isoniazid (INH), rifampicin (RMP), pyrazinamide (PZN) and ethambutol (EMB), then the next 6 months (INH) and rifampicin (RMP). The reintroduction of the same antiretroviral protocol and a reinforcement of the therapeutic education made it possible to observe a decrease of the viral load. Treatment of ocular involvement was instituted with Timosol 1 drop in the eyes morning and evening and Diclocid 1 mg/ml: 1 drop in the eyes in the morning.

关键词： Tucerculose/Uveitis

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Evaluation of the Frequency of Prolonged Fevers and Exploration of Their Etiologies in the Internal Medicine Department of the Point “G” University Hospital in Bamako from 2009 to 2013

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Open Journal of Internal Medicine 2019年第3期9卷 97-103页

作者： Abdel Kader Traoré assétou soukho kaya Djenebou Traoré Djibril Sy Youssouf Fofana Ibahima Amadou Dembélé Mamadou Saliou Boua Daoud Camara Karim Dao Mamadou Cissoko Kaly Ké ï ta Barry Boubacar Sangaré Mamadou Mallé Alassane A. Doumbia Nagou Tolo Hadiza A. Kaï lou Mamadou Dembélé Hamar Alassane Traoré Deparment of Internal Medicine University Hospital of Point “G” Bamako Mali Department of Internal Medicine of Children and Mothers Le Luxembourg University Hospital Bamako Mali Internal Medicine Service Nianankoro Fomba Hospital Ségou Mali

Objective: The aim was to evaluate the frequency of prolonged fevers and to determine their etiologies. Methods: We carried out a cross-sectional study extending from the period of 2009 to 2013 in the Internal Medicine department of the “G” Point University Hospital in Bamako. Included were all records of hospitalized patients with a central temperature greater than 37°C in the morning and 37°C in the evening, resting for 15 minutes, fasting for more than 2 hours, and absence of antipyretic treatment. We include all the patients of the study period with fever greater than 37.5°C in the morning and 37.8°C in the evening, resting for 15 minutes, fasting for more than 2 hours, and absence of antipyretic treatment, which have more than 21 days and measured on several occasions. The data were collected on a survey sheet. Data entry and analysis was done on SPSS software. Results: We recorded 243 fever cases out of 2155 hospitalizations, a prevalence rate of 11.2%. There were 128 men and 115 women with an average age of 43 years (range, 15 to 84 years), a modal class of 37 to 47 years, and a sex ratio of 1.11. The infectious etiologies accounted for 81% followed by neoplastic causes 09.6% and inflammatory 01.2% of cases. HIV infection was found in 26.4% of patients, malaria 13.5% and urinary tract infections 10.2%). Gram negative bacilli 88% consisted mainly of Escherichia coli (56%) and Klebsiella pneumoniae (20%).

关键词： Fever Acute Prolonged Fevers Frequency Etiologies Internal Medicine Mali

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