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Surgical Science 2021年第1期12卷 17-22页

作者： Oumar Ongoïba Idrissa Tounkara thiam souleymane Charles Dara Jacques Saye Karim Dao Djibril Kassogué Timbuktu Mali Regional Hospital Mali Timbuktu Mali Reference Health Center of Commune II Bamako Mali Gao Regional Hospital Gao Mali Point G University Hospital Center Bamako Mali

In the literature, the management of enterocutaneous fistula of tuberculosis origin is rare. The aim of this work was to report a case of external digestive fistula of tuberculosis origin in a 10-year-old girl in northern Mali in a situation of armed conflict. She was a 10-year-old patient who was admitted to our general surgery ward for external digestive fistula evolving for more than (4) four years, at admission the general. The karnofsky index was at 40%, she could not sit or hold a cup to drink water. A 3 cm enterocutaneous fistula deafened foul-smelling liquid stools, on clinical examination, the conjunctivas were pale, the lips were dry, the eyes were sunk in the eye sockets, the ribs visible from a distance. The paraclinical aspects (Itra-Dermo-Reaction (IDR) to tubercria, anatomopathology) were positive, specifying the place of medical treatment and evolution under medical treatment. Digestive fistula of tuberculosis origin is a rare condition in surgical settings.

关键词： Spontaneous External Digestive Fistula Non-Surgical Treatment Timbuktu

Clinical and Therapeutic Aspects of Inguinal Hernia at the Reference Health Centre of Commune II of the District of Bamako

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Surgical Science 2022年第5期13卷 265-271页

作者： Idrissa Tounkara Boubacar Karembe souleymane thiam Sayon Diakite Abdoulaye Diarra Amadou Traore Konimba Keita Oumar Ongoiba Moussa Sanogo Moussa L. Coulibaly Bakary Tientigui Dembele Adégné Togo Reference Health Center of Commune II Bamako Mali Commune III Reference Health Centre Bamako Mali University Hospital Center of Gao Gao Mali University Hospital Center of Kati Kati Mali University Hospital of Gabriel Touré Bamako Mali Regional Hospital of Tombouctou Tombouctou Mali

Objective: To study the diagnostic and therapeutic aspects of uncomplicated inguinal hernias in the general surgery unit of CSRéf CII. Method: This was a prospective, descriptive, single-centre study from 1 January 2016 to 31 December 2016 of 84 patients operated on for inguinal hernias in the general surgery unit of CSRéf CII. Results: Inguinal hernia accounted for 8% of surgical consultations and hernia repair accounted for 30.22% of surgical procedures. Hernia repair accounted for 30.22% of surgical procedures. The male sex was the most represented with a ratio of 7.40. The average age of our patients was 43.19 years. Recurrence occurred in 10% of cases. The right side was most affected in 71.43% of cases, 19.05% on the left side in;it was bilateral in 09.52%. Local anaesthesia was used in 67.86% of our patients, general anaesthesia in 13.09% of cases and locoregional anaesthesia in 19.05% of cases. The hernia was external oblique in 75% of cases. Shouldice’s technique was the most used with 88%;Bassini’s technique was used in 7% and Mac Vay’s in 5% of cases. The postoperative course was simple in 96.43% of cases, with an early postoperative morbidity rate of 3.57%, one case of wall abscess and two cases of parietal haematoma. No deaths were observed during our study. Conclusion: The new methods of tension-free cure should be used more and more by our users in our facilities.

关键词： Inguinal Hernias Strangulation Management CSRéf CII

Contribution of High Sensible C-Reactive Protein (hsCRP) in the Assessment of the Risk of Onset of Type 2 Diabetes and Its Cardiovascular Complications

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Journal of Diabetes Mellitus 2024年第2期14卷 95-107页

作者： Maïmouna Touré Léopold Ngor Sène Jean Pierre Diagne Demba Diédhiou souleymane thiam Abdou Khadir Sow Mor Diaw Aïssatou Seck Salimata Diagne Houndjo Abdoulaye Ba Abdoulaye Samb Fatou Diallo-Agne Modou Oumy Kane Laboratoire de Physiologie et d’ Explorations Fonctionnelles Physiologiques Facult&#233 de M&#233decine de Pharmacie et d&#8217OdontoStomatologie (FMPOS) Universit&#233 Cheikh Anta Diop (UCAD) Dakar S&#233n&#233gal IRL3189 &#8220Environnement Sant&#233 Soci&#233t&#233&#8221 CNRS CNRST Bamako-UCAD Facult&#233 de M&#233decine de Pharmacie et d&#8217OdontoStomatologie (FMPOS) Universit&#233 Cheikh Anta Diop (UCAD) Dakar S&#233n&#233gal Laboratoire Privé de Biologie General Kaolack S&#233n&#233gal Centre Hospitalier Universitaire (CHU) Abasse Ndao Universit&#233 Cheikh Anta Diop (UCAD) Dakar S&#233n&#233gal Laboratoire de Biochimie et de Biologie molé culaire Facult&#233 de M&#233decine de Pharmacie et d&#8217OdontoStomatologie (FMPOS) Universit&#233 Cheikh Anta Diop (UCAD) Dakar S&#233n&#233gal Laboratoire de Physiologie Pharmaceutique Facult&#233 de M&#233decine de Pharmacie et d'OdontoStomatologie (FMPOS) Universit&#233 Cheikh Anta Diop (UCAD) Dakar S&#233n&#233gal

Background: Type 2 diabetes is a metabolic disease characterized by chronic hyperglycemia. The latter plays an essential role in inflammation by stimulating the production of pro-inflammatory cytokines or by increasing their secretion by an oxidative mechanism. These cytokines control the hepatic synthesis of an inflammatory protein called C-Reactive Protein (CRP). High or average values of CRP would have a predictive value of cardiovascular diseases and type 2 diabetes. The relationship between low CRP values and the risk of developing type 2 diabetes and its cardiovascular complications is not sufficiently studied. The hsCRP could serve as a predictive biomarker of risk of onset, follow-up and prognosis for type 2 diabetes and its cardiovascular complications. To answer this problem, we conducted this study, the aim of which was to study the predictive role of hsCRP in the risk of occurrence of type 2 diabetes and its cardiovascular complications. Materials and Methods: This is a prospective and cross-sectional case-control study involving 200 participants including 100 control women and 100 women with type 2 diabetes (mean age was respectively 49.89 years ± 8.26 & 51.92 years ± 7.18;p = 0.066). The interviews were conducted on the basis of a questionnaire. Physical examination collected biometric data and cardiovascular constants. The biochemical parameters such as hsCRP were analyzed by an automated Abbott device. Results: We noted that hsCRP was significantly higher in type 2 diabetic subjects compared to control subjects (p (rho = 0.40, p systolic blood pressure (rho = 0.30, p = 0.003), diastolic blood pressure (rho = 0.28, p = 0.006), total body fat (rho = 0.48, p Conclusion: hsCRP has a prognostic value in the evaluation of cardiovascular risk. It seems to play an important role in the pathogenesis of type 2 diabetes mellitus and its cardiovascular complications. It could thus be considered as a biomarker for the screening, monitoring and prognosis of type 2

关键词： hsCRP Biomarker Inflammation Type 2 Diabetes

Appendicular Abscess in General Surgery at the Bocar Sidi Sall University Hospital in Kati

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Surgical Science 2020年第12期11卷 479-485页

作者： Abdoulaye Diarra Koniba Keita Amadou Traoré Assitan Koné Idrissa Tounkara Issa Traore souleymane thiam Fadima K. Tall Daouda Diallo Madiassa Konate Aboubacar Koné Deborah Sanra Sanogo Ismaël Konare Alhassane Traoré Adégné Togo Department of General Surgery CHU of Kati Kati Mali General Surgery Department CHU Gabriel Touré Bamako Mali Department of Anesthesia and Resuscitation CHU of Kati Kati Mali Gastroenterology Department Point G Hospital Bamako Mali

Introduction: Appendicular abscess is a progressive complication of acute appendicitis in which the spread of infection is contained by the greater omentum and the slender loops resulting in the formation of a true septate abscess of the large peritoneal cavity. Materials and Methods: This was a retrospective study from January 2010 to December 2019 carried out at the Bocar Sidi Sall University Hospital in Kati (CHU BSS in Kati) in general surgery. It concerned all patients operated on for appendicular abscess in the department. Results: 75 cases of appendicular abscess were collected, which represented 5.76% of surgical emergencies and 25% of acute appendicitis. The average age of the patients was 29 years. The male sex represented 67% of our patients with a sex ratio of 2. The average consultation time was 5 days. Abdominal pain was noted in all patients. It was localized in the right iliac fossa in 80% (n = 60) and diffuse in 2.7% of cases (n = 2). It was accompanied by nausea and vomiting in 93% of cases (n = 70), urinary disorders in 20% (n = 15), fever in 94% (n = 71), cessation of materials and gas in 1.33% (n = 1). Abdominal ultrasound was performed in 86% (n = 65). It made it possible to suggest a peri-appendicular effusion. Biological examination revealed a neutrophilic hyperleukocytosis greater than 20,000/mm3 in 47 patients, or 63%. All the patients were operated on by laparotomy (Marc Burney or midline subumbilical) under general anesthesia. The length of hospitalization was 6 days. We have not recorded any deaths. Morbidity was 8% (n = 6) represented by parietal suppuration. The postoperative course was straightforward in 92% of cases (n = 69). Conclusion: Appendicular abscess is a frequent medico-surgical emergency, the prognosis of which depends greatly on early diagnosis and adequate and immediate management.

关键词： Appendicular Abscess Surgery Kati Mali

Abdominoperineal Resection in Rectal Cancer in General Surgery Department at Gabriel Toure University Hospital

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Surgical Science 2019年第1期10卷 16-23页

作者： Amadou Traore Abdoulaye Diarra Madiassa Konate souleymane thiam Soumaila Keita Tani Kone Boubacar Karembe Assitan Kone Boubacar Sidibe Amadou Bah Amadou Maiga Ibrahim Diakite Bakary Tientigui Dembele Alhassane Traore Adegne Togo Lassana Kante Moussa Samake Moustapha Issa Mangane Thierno Madane Diop Mamadou Salia Diarra Adama Diakite Gangaly Diallo Gabriel Toure University Hospital BamakoMali

The objectives: Were to determine the hospital frequency of abdominoperineal resection (APR);to determine mortality and morbidity rates and to assess oncologic outcomes. Method and patients: We performed a retrospective study between 2008 and 2013 in general surgery department at Gabriel Toure University Hospital (UH) which included all patients admitted for rectal cancer confirmed by pathological examination, and having undergone an APR. Results: We have collected 17 cases which accounted for 65.38% of curative resections of rectal cancer. The sex-ratio was 0.89 and the averageage was 49.53 years. The average tumor distance from the anal verge was 4.59 ± 1.7 cm. All patients had adenocarcinoma of the rectum. The histopathologic grade was well in 7 cases, moderate and poor in 5 cases each. According to the pathologic TNM classification, 13 patients were classified T4, 14 patients N+. APR was associated with hysterectomy and partial colpectomy in 4 cases. The average duration of interventions was 202.06 ± 25.68 minutes. The average duration of hospitalization was 18.24 ± 04.89 days. The postoperative mortality and morbidity rates were 5.88% and 29.42%, respectively. Local recurrence was observed in 6 patients and liver metastasis in 2 patients. The overall survival rate was 37.5% at 2 years and 18.75% at 5 years. Conclusion: APR still occupies an important place in our practice. Our results could be improved by the recent introduction of neoadjuvant radio chemotherapy in Mali.

关键词： Abdominoperineal Cancer Mali Rectum Resection Surgery

Prevention of Venous Thromboembolism in General Surgery at Gabriel TouréUniversity Hospital in Mali

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Surgical Science 2021年第3期12卷 67-75页

作者： Amadou Traoré Madiassa Konaté Abdoulaye Diarra Koniba Keïta Kadia Traoré Zakari Saye Youssouf Koné Boubacar Yoro Sidibé Amadou Maïga Amadou Bah Bouréima Kelly Tani Koné Boubacar Karembé souleymane thiam Assitan Koné Drissa Bagayogo Bakary Tientigui Dembélé Alhassane Traoré Ibrahim Diakité Lassana Kanté Adégné Togo Gabriel Touré University Hospital Bamako Mali

Through its impact on morbidity and mortality and the cost of medical care, Venous Thromboembolism (VTE) has a significant influence on the quality of care in a surgical environment. The objectives were to determine the risk of postoperative venous thromboembolism and to assess its prophylactic management in the general surgery department of Gabriel Toure University Hospital. This was a prospective observational study from May 01, 2018 to December 31, 2018. It included all patients of 18 years old and over, operated in regulated surgery, under general anesthesia in the department. For all of these patients, Caprini score was used to assess the risk of VTE. The ninth American College of Chest Physicians’ Consensus was used as guidelines to assess Thromboprophylaxis practices in the ward. The Caprini score was evaluated in 80 patients for 8 months. The average age was 50.2 years. The sex ratio was 0.48. The risk level of VTE was low in three patients (3.8%), moderate in 13 patients (16.3%), high in 34 patients (42.5%) and highest in 30 patients (37.5%). The main risk factors found were major surgery (87.5%), age > 40 years (72.5%), cancer (33.8%), bed rest (31.2%), obesity (27.5%) and minor surgery (12.5%). Early mobilization was performed in all patients. Pharmacologic prophylaxis was required in 80% of our patients but only 38.8% had received low molecular weight heparin. VTE complicated 5 procedures, including 3 cases of deep vein thrombosis of the limbs and 2 cases of pulmonary embolism who died. Venous thromboembolism is serious and common in surgical settings. Its prevention remains insufficient in our context.

关键词： Venous Thromboembolism Prevention Surgery Mali

Diverticular Fistula of the Female Urethra on Lithiasis at the District Health Center (CSREF) in Communeii, Bamako, Mali

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Surgical Science 2019年第3期10卷 83-88页

作者： Tounkara Idrissa Diarra Abdoulaye Traoré Amadou Coulibaly B. Bakary Kanté Abdoulaye Dembélé Dabéré Ives thiam souleymane Ouattara Kassoum Kanté Lassana Konate Madiassa Koné Assitan Ongoiba Oumar Sangaré Modibo Dembélé Bakary Tiètiki Diakité Ibrahim Sidibé Yoro Bah Amadou Coulibaly Yakaria Togo Adégné Diallo Gangaly Chirurgie générale du Centre de santé de référence de la commune II de Bamako Mali Chirurgie générale du Centre Hospitalier Universitaire de Kati Mali Chirurgie générale Centre Hospitalier Universitaire Gabriel TOURE de Bamako Mali Chirurgie générale du Centre Hospitalier Universitaire du POINT G de Bamako Mali Hopital régional de Gao Mali Hopital régional de Tombouctou Mali

The diverticulum of the female urethra or sub-urethral pouch is in the form of a cul-de-sac lined with mucous membrane through the muscular layer of the urethra. Thus, it is a site of stasis, urinary infection, formation of calculus or even malignant tumor. The diverticula of the urethra or sub-urethral pouches in women have a prevalence of 0.5% to 6% depending on the series. We report the case of a 61-year-old patient operated for a diverticulum on fistulized urethra complicated lithiasis. Our patient had five pregnancies and five births when she consulted for dysuria, urinary burns evolving since a year. The urogenital examination revealed a partially stenotic urethral meatus and a 3-cm large fistulized intravaginal peri-urethral mass allowing urine leak. The mass was painful and hard at palpation. We performed transvaginal diverticulectomy. The follow-up was simple and the probe was removed two weeks after the surgery. An atomo-pathological examination of the resected diverticulum concluded an aspect compatible with lithiasis urethritis.

关键词： Diverticulum Urethral Fistula Lithiasis Bamako

Synchronous Volvulus of the Sigmoid Colon and the Transverse Colon: A Case Report at Gabriel Toure University Hospital in Mali

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Surgical Science 2021年第9期12卷 313-318页

作者： Traoré Amadou Konaté Madiassa Diarra Abdoulaye Tounkara Idrissa Saye Zakari Doumbia Arouna Bah Amadou Sidibé Boubacar Yoro Maïga Amadou Koné Tani thiam souleymane Karembé Boubacar Kelly Bouréima Traoré Kadia Kéita Koniba Bouaré Yacouba Koné Assitan Diakité Ibrahim Diakité Ibrahim Dembélé Bakary Tientigui Traoré Alhassane Togo Adégné General Surgery Department Gabriel Touré University Hospital Bamako Mali Surgery Department Kati University Hospital Kati Mali Reference Health Center of Commune III Bamako Mali

Synchronous transverse and sigmoid colon volvulus are very rare. We report the case of a 23-year-old man who underwent emergency surgery for sigmoid colon volvulus. An intraoperative finding of transverse colon volvulus associated with sigmoid colon volvulus was made. Left and transverse colectomy was performed followed by colorectal anastomosis. The postoperative period was uneventful. Synchronous volvulus of the transverse and sigmoid colon is a surgical emergency. The clinical signs are not specific and the discovery is often intraoperative. It is necessary to know how to evoke the diagnosis in a case of sigmoid colon volvulus, to avoid inadequate management with dramatic consequences.

关键词： Volvulus Synchronous Colon Sigmoid Transverse Surgery Mali

Primitive Umbilical Endometriosis in a Young Woman at the District Health Center (CSREF) in Commune II in Bamako

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Surgical Science 2019年第3期10卷 89-93页

Umbilical endometriosis, also called Villar’s nodule, has rarely been described in the literature. It represents only 0.5% to 1% of all cases of endometriosis. We report a case in a 28-year-old nulligest, nulliparous woman who consulted at the CSREF CII in Bamako. The diagnosis was suspected with the presence of umbilical swelling with cyclic, painful, dark hemorrhage of firm consistency. We performed an omphalectomy with an uncomplicated postoperative course. She was released from the hospital three days post-surgery. Anatomo-pathological examination of the resected specimen confirmed the diagnosis of umbilical endometriosis.

关键词： Umbilical Endometriosis Young Woman Bamako Mali

A review of interoperability assessment models

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Journal of Zhejiang University-Science C(Computers and Electronics) 2013年第9期14卷 663-681页

作者： Reza REZAEI thiam-kian CHIEW Sai-peck LEE Faculty of Computer Science & Information Technology University of Malaya

Interoperability is the ability of systems to provide services to and accept services from other systems,and to use the services exchanged so as to operate together in a more effective *** fact that interoperability can be improved means that the metrics for measuring interoperability can be *** the purpose of measuring the interoperability between systems,an interoperability assessment model is *** paper deals with the existing interoperability assessment models.A comparative analysis among these models is provided to evaluate the similarities and differences in their philosophy and *** analysis yields a set of recommendations for any party that is open to the idea of creating or improving an interoperability assessment model.

关键词： Interoperability Assessment Measurement