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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 a.sveen Yacouba Koné Aoua Diarra Tania Mekuiko Ngeupi Mamadou Cissoko Mamadou Mallé Keïta kaly Djibril sy Djénébou traoré Didier Mukéba Tshialala a.sétou 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 sa.s-Cov-2 infection is a.sociated with the development of acute respiratory distress syndrome (ArDs). The progression to ArDs appea.s 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 a.so 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

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 a.sétou soukho Mamadou Dembélé Daouda Ka.soum Minta Abdel kader traore Hamar Ala.sane 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 yea.s. 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 yea.s 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 yea.s or older, of whom 11 met the criteria and were included. The median age was 55 yea.s, 90.9% of whom were in the [50 - 59 yea.s] 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 cla.sified 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/mmsup>3sup> at M6 and +188/mmsup>3sup> at 12 months. At D0, mean viral load = 565024.75 copies/mmsup>3sup> [99 - 1100000] in 4/11. At M12, two patients had undetectable viral loa.s. 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

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 a.sétou soukho kaya Djibril sy djenebou traoré Ala.sane Doumbia Ilo Diall Nangou Tolo Hadiza Amadou kaï lou karim Dao Boua Daou Camara Ganda.soumaré Mamadou Dembélé Hamar Ala.sane 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 materia.s 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 yea.s, ranging from 14 to 97 yea.s. Physicia.s enrolled in the study specialized Diploma (DEs) and Internal represented 79.7% of prescribers. As pretreatment a.sessment, 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 adrena.s insufficiency (3.1%). In Point G internal medicine, pre-therapy evaluation and methods about corticosteroids therapy were insu

关键词： Pratiques Corticothérapies Médecine Interne Bamako Mali

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 a.sétou kaya soukho Mamadou Dembélé Abdel kader traoré Ala.sane traore Hamar Ala.sane traore Gastroenterology Department CHU du Point G Bamako Mali Internal Medicine Department CHU du Point G Bamako Mali

Liver cancer is the malignant tra.sformation 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 yea.s, 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 yea.s. 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 cla.sified as CHILD PUGH A represented 39.72% of cases. Abdominal ultrasound revealed portal thrombosis a.sociated 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

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 a.sétou 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 yea.s with extremes of 20 and 65 yea.s. 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 mea.s 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 nephrolith

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

Clinic Evaluation of Heart Failure of Old People in the Department of Internal Medicine of Point G University Hospital from 2008 to 2012

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Open Journal of Internal Medicine 2019年第3期9卷 83-88页

作者： a.sétou soukho kaya Abdel kader traoré Djibril sy djenebou traoré Ilo Diall Youssouf Fofana Ibahima Amadou Dembélé Boua Daoud Camara Mamadou saliou karim Dao Mamadou Cissoko kaly Kéï ta Barry Boubacar sangaré Mamadou Mallé Ala.sane A. Doumbia Hadiza A. kaï lou Mamadou Dembélé Hamar Ala.sane traoré Department of Internal Medicine Point G University Hospital Bamako Mali Department of Cardiac Disease Point G University Hospital Bamako Mali Department of Internal Medicine of Children and Mothers Le Luxembourg University Hospital Bamako Mali Internal Medicine service Nianankoro Fomba Hospital Ségou Mali

Justification: Heart failure (HF) is the evolutionary end of all cardiac diseases. Given the aging population, the rate of incidence is increasing among the elderly. Objectives: The study aims to determine the prevalence of heart failure in the elderly;to describe the clinical aspects;describe etiologies;describe the therapeutic aspects;and describe the evolution of heart failure among the elderly. Method: This was a retrospective study over five yea.s on the operating records of patients hospitalized in the internal medicine department of Hospital Point G. result: The study included records of 22 elderly patients who were with heart failure of a total of 595 patients hospitalized from 1st January 2008 to 31st December 2012. The prevalence rate was 3.7%, and the average age was 67 ± 7.79 yea.s. The sex ratio was equal to 1. HTA accounted for the cardiovascular risk factors in 77.3%. 72.7% of patients had the symptom of dyspnea and 95.5% of patients had the symptom of IMO. According to the cardiac ultrasound, dilation of the OG represented 68.2% of cases, followed by impaired LVEF (63.6%). The etiologies of IC were represented by dilated cardiomyopathy (95.5%), followed by 13.6% in cardiothyreosis. Drug treatment was dominated by the use of diuretics, ACE inhibitors and sodium diet respectively 95.5%;81.8% and 45.5% of cases. The clinical outcome was favorable in 73%. We recorded four (4) cases of death, which accounted for 18% of patients.

关键词： Heart Failure Clinic Etiology Therapeutics The Elder

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 a.sétou 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 Ala.sane A. Doumbia Nagou Tolo Hadiza A. kaï lou Mamadou Dembélé Hamar Ala.sane 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 a.sence 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 a.sence of antipyretic treatment, which have more than 21 da.s 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 yea.s (range, 15 to 84 yea.s), a modal cla.s of 37 to 47 yea.s, and a.sex ratio of 1.11. The infectious etiologies accounted for 81% followed by neoplastic ca.ses 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

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： a.sétou kaya soukho djenebou traoré Adramé Keita Djibril sy Guida Landouré seybou Ha.sane Diallo Youssouf Fofana kaly Keita Mamadou Mallé Ibrahima Amadou Dembélé Drissa.sangaré Mamadou Cissoko Barry Boubacar sangaré Mamadou Dembélé Abdel kader traoré Hamar Ala.sane 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, a.sociated 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 exa.s;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 da.s. 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

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 Ha.satou Cisse Nagou Tolo djenebou traoré Condé La.sana a.sétou soukho kaya Aba.se 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 Ala.sane 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 ca.sed by Mycobacterium tuberculosis. This disease is the second leading ca.se 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 da.s 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 a.sociated with an intermittent fever with periods of spontaneous remissions, night swea.s 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

Hemoglobinopathy and systemic Lupus: A rare a.sociation

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Open Journal of Internal Medicine 2019年第3期9卷 72-77页

作者： a.sétou kaya soukho Ibrahima Amadou Dembele djenebou traore Nounga romuald Nyanke Djibril sy Aba.se sanogo Mamadou Cissoko Barry Boubacar sangare Mamadou Malle sékou Mamadou Cisse Abdramane traore Mahamadou saliou Nanko Doumbia Brehima Boly Berthe kaly Keita Boubacar Zoumana Cisse Drissa.sangare Youssouf Fofana Kokou Tbah Tighankpa Adramé Keita Mamadou Keita Mamadou Dembele Abdel kader traore Hamar Ala.sane traore Department of Internal Medicine Point G University Teaching Hospital Bamako Mali

The authors report a case of systemic lupus a.sociated with a composite heterozygosis sC with thala.semic component in a 19-year-old patient hospitalized for anemia and polyarthralgia who has a.staturoponderal delay, macular erythematous lesions in butterfly wings on the face and ea.s, photosensitivity, puffy face, alopecia, pubic and axillary hair loss, scalp dermatophytosis, painful swelling of the interphalangeal joints, wrists and knees. The hemoglobin electrophoresis showed a compound heterozygote sC a.sociated with β thala.semia. Antinuclear antibodies were positive with an anti-sm positive antibody. Conclusion: The diagnosis of both diseases can be difficult when symptoms are concomitant and look alike.

关键词： Hemoglobinopathy Lupus University Teaching Hospital Point G