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Treatment of Pelvic Limb Fractures in a Hospital of 2^e Reference in Mali

Surgical Science 2023年第5期14卷 347-354页

作者： Souleymane Diallo Sory Ibrahim Tambassi Bilal Bore Terna traore Kalifa Coulibaly Laye Touré Ibrahima Djire Aboubacar Sidiki Sangare Salif Kone Drissa Kaloga Bagayogo Aboucar Diallo Souleymane Kone Mamadou Konaté soumana traoré Cheick Oumar Sanogo Ahmadou Ibrahim Drame Abdoulaye G. Diarra Orthopedic Surgery and Traumatology Unit Tombouctou Hospital Tombouctou Mali Department of Orthopedic Surgery and Traumatology CHU BSS of Kati Kati Mali Department of Orthopedic Surgery and Traumatology Sikasso Hospital Sikasso Mali Department of Neurosurgery Mali Hospital Bamako Mali Department of Anesthesia and Resuscitation CHU Mère Enfant “Le Luxemburg” Bamako Mali Department of Surgical Hospital in Mopti Mopti Mali Department of Anesthesia and Resuscitation Mali Hospital Bamako Mali Department of General Surgery CHU of Kati Kati Mali

Introduction: A fracture is a solution in the continuity of a bone. Pelvic limb fractures may involve one or more of the bones. They constitute a real public health problem, which requires the identification of the factors inherent to this phenomenon for better prevention, but also for quality management of fractures and sequelae. Objectives: Were to describe the epidemiological, clinical and therapeutic profile of pelvic limb fractures in Timbuktu Hospital. Patients and Method: We conducted a prospective, descriptive study in the Surgery Department of Timbuktu Hospital, covering a period of one year from January 1 to December 31, 2017. We collected 39 patients who presented with fractures of the pelvic limbs, who were hospitalized and monitored throughout our study. Results: We obtained a hospital frequency of 2.86% limb fractures. Among the 39 patients included in our study, the male sex was predominant in 69.2% of cases, the average age of our patients was 20.5 years. Pupils and students were in the majority in 48.7% of cases. Road traffic accidents were the most common cause of fracture with 59.0% of cases. The tibia was the most affected segment in 38.5% of cases. Surgical treatment was predominant in 64.0% of cases. We obtained very good results in 94.87% of cases. Conclusion: Limb fractures remain frequent due to road traffic accidents. Osteosynthesis treatment provides a good result with fewer complications.

关键词： Fractures Pelvic Limb Surgical

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Management of Spinal Injuries Secondary to Rockfall in Traditional Mines

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Surgical Science 2023年第2期14卷 104-110页

作者： Coulibaly Kalifa traoré Youssouf Tambassi Sory Ibrahim Sanogo Cheick Oumar Diallo Aboubacar traoré soumana traoré Issa Djerma Issa Orthopedic Trauma Department of Kati University Hospital Koulikoro Mali Neurosurgery Department of the University Hospital of Kati Koulikoro Mali

Introduction: Spinal injuries represent the whole of the mechanisms responsible for vertebral, disco-ligamentary and spinal cord injuries. Spinal cord injury is life-threatening and is responsible for functional consequences that make the subsequent socio-economic integration of victims difficult. In developing countries, spinal injuries in traditional gold mining are becoming more and more frequent. Purpose: The purpose of this study was to describe the anatomopathological aspects and the results of surgical treatment of spinal injuries secondary to traditional mine collapses at the University Hospital of Kati. Patients and Methods: This was a prospective, descriptive study over 18 months, from November 2017 to May 2019. Included in this study were patients operated on for spinal trauma secondary to rockfall in traditional mines. The neurological status was assessed in each patient since admission to the department using the Fränkel score. Decompression by laminectomy combined with titanium device placement was preferred in lumbar, thoracic and thoraco-lumbar surgery. We performed an anterior cervical spine approach with SENEGAS plate placement in cervical injuries. Motor physiotherapy was associated whenever recovery was not complete. At a minimum follow-up of 6 months, all our patients were re-evaluated by the Fränkel score. Results: The mean age was 31 years with extremes of 10 and 49 years. The majority of patients were men, 95%. Twenty patients underwent surgery. According to the spinal segments, the cervical spine was affected in 05 cases, the thoracic spine in 08 cases and the lumbar spine in 17 cases. The neurological examination revealed tetraplegia (n = 5), paraplegia (n = 12) and paraparesis (n = 3). According to the types of lesions, we collected 12 cases of fractures, 4 cases of fracture-luxations and 04 cases of pure luxations. According to the site, the fracture was uni-articular (n = 3), corporal (n = 15) and transverse apophyseal (n = 1). According to the type of line, the fracture was s

关键词： Trauma Spine Traditional Gold Mining Mali

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Lesional and Therapeutic Aspects of Tibial Plateau Fractures at the BSS University Hospital Center in Kati

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Surgical Science 2022年第10期13卷 471-479页

作者： Coulibaly Kalifa Sanogo Cheick Oumar Tambassi Sory Ibrahim Diallo Aboubacar traoré soumana Touré Laye Moussa Abdoul Kadri Diallo Mahamadou Diallo Cheickh Tidiane Keïta Mohamed Orthopaedic Trauma Department of the Kati University Hospital Koulikoro Mali Orthopaedic Trauma Department Sikasso Hospital Sikasso Mali Orthopedic Trauma Department of Gabriel Touré University Hospital Bamako Mali

Introduction: Tibial plateau fractures are solutions of continuity of the epiphyseal-metaphyseal block of the upper end of the tibia of which at least one line enters the joint. They threaten the stability and mobility of the knee and can compromise walking and standing. These fractures are on the increase, especially affecting young and active subjects. Orthopedic treatment is a rare indication apart from non-displaced or slightly displaced forms. Surgical treatment is required in displaced forms, particularly in depression fractures. The aim of this work was to report the lesional and therapeutic aspects of tibial plateau fractures in our department. Patients and Method: Patients and method: This was a retrospective study over 36 months from January 2019 to December 2021. Included in this study were patients treated for a tibial plateau fracture in our department and followed up for at least 10 months. The epidemiological and clinical data analyzed were age, sex, affected side, etiology, mechanism of injury, pathological anatomy and associated lesions. The fractures were classified according to the classification of Duparc and Ficat. The slightly or non-displaced forms were treated orthopedically while the displaced forms were treated surgically. The minimum follow-up was 10 months. The results were evaluated by the anatomical criteria according to Mazas and Duparc and functional according to Merle d’Aubigné. Results: The authors collected 71 cases of tibial plateau fractures. They accounted for 4.0% of all limb fractures, 5.8% of lower limb fractures and 33.8% of knee fractures in our service. The male sex was the most represented at 78.9% with a sex ratio of 3.7. The age group of [20 - 40] years was the most affected, i.e., 53.5%. The average age was 41 years with extremes of 17 and 82 years. The left side was affected (n = 47) and the right side (n = 24). Road traffic accident was the main cause. The mechanism of injury was mainly represented by lateral and sagittal compressions. Lateral unituberosity and bi

关键词： Fractures Tibial Plateau Pathology Osteosynthesis

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Sociodemographic and Clinical Aspects of Climacteric Syndrome of Menopause in the City of Kati in Mali Involving 113 Women

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Open Journal of Obstetrics and Gynecology 2023年第12期13卷 1938-1948页

作者： Daouda Camara Seydou Fané Yacouba Sylla Aly Daouda Oulogem Bintou Samaké Abdoulaye Sidibé Simaga Ismaël soumana Oumar traoré Saye Amaguiré Déssé Diarra Amadou Bocoum Koné Diakaridia Keita Sema Mahamadou Coulibay Haidara Ramatoullaye Ibrahima Téguetté Youssouf traoré Major Moussa Diakité Referral Health Centre in Kati Kati Mali Gabriel Touré University Hospital Bamako Mali Fana Referral Health Centre Koulikoro Mali Joint Reference Health Centre V Bamako Mali Joint Reference Health Centre IV Bamako Mali Commune I/Bamako Referral Health Centre Bamako Mali Kalaban Coro Referral Health Centre Koulikoro Mali Koulikoro Referral Health Centre Koulikoro Mali

Objective: This paper aims to study the sociodemographic and clinical aspects of menopausal climacteric syndrome in the city of Kati in Mali. Patients and Methods: This was a quantitative descriptive and cross-sectional study, conducted in the city of Kati from February 1 to July 31, 2021. We included 112 menopausal women. Women were selected from a household survey using the sampling step. We were interested in conjugal, family and professional life, self-esteem and the state of health of women in general. Results: More than half of the women in our study were already postmenopausal (52.2%);the mean age was 50.5 years with the extremes ranging from 41 to 62 years. The majority of them were married (69.9%), housewives (43.4%) and Bambara (53.1%). The most common climacteric syndromes were: joint pain (65.5%), hot flashes (62.8%) and night sweats (56.6%). Genital-urinary syndromes (42.5%) were dominated by decreased libido (41.7%), urinary disorder (23%) and vaginal dryness (14.6%). Genitalia-urinary syndromes increased the frequency of disagreements;Pearson’s Chi-square = 33.63;ddl = 1;P = 0.001. There was a statistically significant relationship between night sweat, genital-urinary syndromes, joint pain, and increased disease frequency with, respectively: Pearson’s chi-square = 4.660;ddl = 1;P = 0.031;Fisher’s exact test, P = 0.001, Pearson’s Chi-square = 8.434;ddl = 1;P = 0.004. There was no statistically significant relationship between climacteric syndrome and family life, work life and self-esteem. Changes in the professional relationship between women and their co-workers included, respectively: arguments (50%);disagreements (25%) and disobedience (25%). Conclusion: Menopause deteriorates the quality of life of women who suffer in silence, hence the need to pay special attention to them.

关键词： Menopause Climacteric Syndrome Quality of Life Kati Mali

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Sacrospinous Fixation in the Gynecology Department of Hôpital du Mali

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Open Journal of Obstetrics and Gynecology 2021年第1期11卷 20-26页

作者： traoré Alassane Sissoko Abdoulaye Coulibaly Mamadou Bakary traoré soumana Oumar Sima Mahamadou Bocoum Amadou traoré Soumaila Touré Moustapha Tegueté Ibrahima traoré Youssouf Obstetrics and Gynecology Department at Hopital du Mali Bamako Mali Obstetrics and Gynecology Department at the Teaching Hospital Mère-Enfant Bamako Luxembourg Obstetrics and Gynecology Department at the Referral Health Center Commune V Bamako Mali Obstetrics and Gynecology Department at the Teaching Hospital Point G Bamako Mali Obstetrics and Gynecology Department at the Teaching Hospital Gabriel Touré Bamako Mali Obstetrics and Gynecology Department at the Regional Hospital of Sikasso Sikasso Mali

Sacrospinous fixation (SSF) or Richter’s intervention (RI) aims to treat genital prolapse by securing the posterior vaginal wall to the small sacrospinous ligament. It is performed by low approach and includes a dissection of the pararectal space, visual exposure of the sacrospinous ligament and a needle with strait needle holder with nonabsorbable threads. It is often associated with a more complex corrective procedure, including cystocele cure, vaginal hysterectomy and posterior myorrhaphy. The objective of this study is to report the results of SSF in the gynecology department of Hopital du Mali. A descriptive study was conducted from September 2014 to September 2015 concerning 37 patients operated on for uterine prolapse (UP). All patients with grade III UP were included in our study in whom a unilateral hysterectomy (UH) and sacrospinous fixation (SSF) were performed. All the patients were scheduled. Preoperatively they had benefited from an assessment and a pre-anesthetic consultation. Hospitalization of at least 24 hours prior to the operation was required. Postoperative follow-up was two years with a physical examination at 3 months, 9 months and 15 months, and phone calls between physical consultations. During the study period, we performed 37 RIs. The mean age of the patients was 48 years with extremes of 41 to 73 years. The large multiparity was found out in 35 cases (94.59%), the pauciparous were two with 3 deliveries for each. Long labor of more than 18 hours was found out in 9 patients (24.32%) and home delivery in 13 cases (35.13%). The duration of the occurrence of prolapse was at least two years and 35 patients were going through menopause. The type of anesthesia used for the surgery was spinal anesthesia for all patients. The average duration of the operation was 90 minutes. Complications occurred in three patients or 8.10% of cases, two cases of acute urine retention and one case of hematoma of the para-rectal space. The medium time of hospital stay was 5 days. The anatomical result was satisfa

关键词： Sacrospinous Fixation Genital Prolapse Hôpital du Mali

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Maternal and Fetal Prognosis of Uterine Rupture in the Health District of Koutiala

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Open Journal of Obstetrics and Gynecology 2020年第9期10卷 1187-1196页

作者： Cheickna Sylla soumana Oumar traoré Sitapha Dembele Seydou Z. Dao Mamadou traoré Amadou Boucoum Seydou Fané Ibrahima Tegueté Youssouf traoré Niani Mounkoro Department of Obstetrics and Gynecology Koutiala Reference Health Centre Sikasso Mali Faculty of Medicine and Odontostomatology University of Science Technology and Technology of Bamako Bamako Mali Department of Gynecology and Obstetrics Reference Health Centre of Commune V Bamako Mali Department of Obstetrics and Gynecology Kayes Hospital Kayes Mali Department of Gynecology and Obstetrics Commune II Reference Health Centre Bamako Mali Department of Gynecology and Obstetrics Gabriel Touré University Hospital Bamako Mali

Introduction: Uterine rupture is a complete or incomplete non-surgical continuity solution of the wall of the gravid uterus. Indeed, it is a Affection obstetrical condition whose maternal-fetal prognosis is poor in terms of morbidity and mortality. Objectives: To assess the risk factors for uterine rupture in the Koutiala Health District. Methods: This was a descriptive and analytical cross-sectional prospective collection study from January 1, 2019 to December 31, 2019, a 12-month period. In our study, all patients admitted to the maternity ward were included during the study period for which the diagnosis of uterine rupture was made. Results: Out of a total of deliveries, we recorded 27 cases of uterine rupture, a frequency of 1.04%. The average age of our patients was 32 years with extremes of 19 and 45 years. We notice 92.6% of uterine ruptures during the transfer. Almost 3/4 of our parturients were out of school 70.4% versus 11.1% in primary school and 18.5% in secondary school. The majority of patients affected by uterine rupture came from rural areas 85.2%. Only 14.8% were from Koutiala city. The admission time to the Koutiala Reference Health Centre was 2 hours 30 minutes in 50.85% of our patients with extremes of 15 minutes and 4 hours 30 min. The average parity was 6.30 - 3036;large multiparous accounted for 63% in our sample followed by multiparous 18.5%. As for pregnancy fo

关键词： Uterine Rupture Maternal and Fetal Prognosis

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Epidemio-Clinical Approach and Prognosis of Teenage Delivery in the Commune VI Du District of Bamako in Mali

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Open Journal of Obstetrics and Gynecology 2020年第10期10卷 1492-1512页

作者： soumana Oumar traoré Cheickna Sylla Alou Samaké Saleck Doumbia Saudatou Tall Ibrahima Tegueté Youssouf traoré Niani Mounkoro Mamadou traoré Amadou I. Dolo Faculty of Medicine and Odontostomatology University of Sciences Techniques and Technologies of Bamako Bamako Mali Gynecology-Obstetrics Department Reference Health Centre of Commune V Bamako Mali Department of Gynecology-Obstetrics Koutiala Reference Center Sikasso Mali Department of Gynecology-Obstetrics Reference Health Centre of Commune VI Bamako Mali Department of Gynecology and Obstetrics Gabriel Touré University Hospital Bamako Mali

Objective: To describe the epidemiological aspects, clinical characteristics, aspects of childbirth and to determine the maternal and perinatal prognosis during the delivery of adolescent girls at the reference health centre of commune VI of the district of Bamako in Mali. Materials and Methods: This was a descriptive, cross-sectional, analytical case-control study from January 1 to December 31, 2018, or 12 months with prospective data collection. Results: During the study period from January 01 to December 31, 2018, we recorded 1768 teenage deliveries out of a total of 9012 deliveries, a frequency of 19.61%. The average age of the cases was 17.4 ± 1 years. Single adolescent girls accounted for 14.67% (OR = 3.05, P = 0.001) unintended pregnancies (11.67% vs. 2.3%;P

关键词： Childbirth Teenage Girls Maternal-Fetal Prognosis

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Perinatal Deaths in Rural a Health Area, Case of the Health District of Kadiolo, Mali

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Surgical Science 2019年第11期10卷 385-397页

作者： Seydou Fané Amadou Bocoum Youssouf traoré Abdoulaye Sissoko Ibrahima Tegueté Mamadou Sima Mamadou Salia traoré Tiounkani Augustin Thera Yaya Sylla Alassane traoré soumana Oumar traoré Aminata Kouma Niani Mounkoro Gabriel Toure Teaching Hospital Center-Gynecology-Obstetrical Service Bamako Mali Hospital mère enfant le Luxembourg Bamako Mali Point G Teaching Hospital Center of Bamako Bamako Mali Referral Health Center of Kadiolo Sikasso Mali Mali Hospital Bamako Mali Reference Health Center of Commune 6 of Bamako District Bamako Mali Kati Hospital Kati Mali

The perinatal mortality is a public health issue in developing countries. In fact, the perinatal death rate seems the highest in a Malian rural area. The objective of this work was to study the perinatal mortality in a rural area of Mali (Kadiolo). Methodology: It was a cross-sectional descriptive study conducted in Kadiolo over 12 months. The study took place from April 1, 2016 to March 31, 2017. We have included in our study all dead fetuses in gestational age ≥ 28 weeks of amenorrhea (WA) or weight ≥ 500 grams (g) and infants died during the first week of life. Mothers who have experienced a perinatal death were included. Results: During the 12 months of study period, we have recorded a total of 2212 births out of which we have collected 205 perinatal deaths, a perinatal mortality rate of 205/2212 with 93 per 1000. The stillbirth rate was 152/2212 with 69‰ and the early neonatal mortality rate was 53/2212 with 24‰. The sociodemographic characteristic of the patients was: patient who has been evacuated 71.70%, unschooled 77.1%, coming out of the city Kadiolo 76%, young women 65% and patient who did not receive antenatal care 35%. Conclusion: Our study confirms the high rates of perinatal deaths in rural areas. The implementation of a coherent and efficient care strategy should help in reducing the still high rates.

关键词： Perinatal Deaths Dystocia Rural Environment Mali

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Study of Cofactors Associated with Precancerous High-Grade Cervical Lesions at the Teaching Hospital Gabriel Touré, 2010 to 2015

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Surgical Science 2019年第9期10卷 328-337页

作者： Fané Seydou Bocoum Amadou Sissoko Abdoulaye traoré soumana Oumar Sanogo Siaka Amara Mamadou Sima Kouma Aminata traoré Alassane Tegueté Ibrahima traoré Youssouf Mounkoro Niani Teaching Hospital Gabriel Toure Bamako Mali

Introduction: High grade dysplasia of the cervix has a high incidence and can progress to cervical cancer. The aim was to study cofactors associated with high-grade cervical dysplasia. Methodology: This was a retrospective case-control study without matching. Women with high grade dysplasia were the cases while those with a normal screening test represented the controls. The study took place at the Gabriel Touré University Hospital Center in Bamako. We included 351 cases and 420 controls. The capture and analysis were performed using the SPSS 20 software. A univariate and multivariate logistic regression analysis was performed for the analysis of risk cofactors. The statistical tests used were the odds ratio and its confidence interval and the statistical significance threshold was set at p Results: In univariate analysis, the co-factors statistically significantly associated with the occurrence of high-grade dysplasia were parity 0.6 (0.5 - 0.9), gestational 0.7 (0.5 - 0.9), smoking of the spouse 3.4 (1.1 - 11.3), the non-schooling 1.4 (1.2 - 2.1). In multivariate analysis after adjusting for confounding factors, two co-factors have significantly increased the risk of high-grade dysplasia: lack of schooling 1.4 (1.2 - 2.0) and polygamy 1.5 (1.4 - 2.5). Conclusion: At the end of this study, polygamy and lack of schooling were the main risk factors. The prevention of cervical cancer will go through the education of girls and women as well as communication for behavioral change and social change.

关键词： High Grade Dysplasia Cofactor Cervical Cancer Teaching Hospital Gabriel Touré

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Epidemiology, the Main Reasons and Maternal-Fetal Complications of Unassisted Childbirth in the Health District of V Bamako Commune, Mali

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Open Journal of Obstetrics and Gynecology 2020年第10期10卷 1381-1395页

作者： soumana Oumar traoré Cheickna Sylla Saleck Doumbia Alou Samaké Amadou Bocoum Seydou Fané Rokiatou Torian Sangaré Fatoumata Keita Ibrahima Tegueté Youssouf traoré Niani Mounkoro Mamadou traoré Amadou Ingré Dolo Obstetric Gynecology Department The Reference Health Centre of Commune V Bamako Mali Obstetric Gynecology Department The Koutiala Reference Health Centre Koutiala Mali Obstetric Gynecology Department The Commune VI Reference Health Centre Bamako Mali Obstetric Gynecology Department The Gabriel Touré University Hospital Centre Bamako Mali

Objective: To describe the epidemiological aspects, to determine the reasons leading women to give birth outside of health facilities and to determine the maternal prognosis. Patients and Methods: This was a cross-sectional, analytical, quantitative and qualitative descriptive study over a period from 1 June to 31 December 2016 (7 months) on unassisted childbirth in the health district of commune V of Bamako. Results: We recorded 70 unsured deliveries, a frequency of 1.04% out of a total of 6719 deliveries. The extreme ages were 15 years and 41 years with an average age of 28 years. 90% of the birth attendants were married and 10% were single. The women's profession: 48% were housewives, 11% saleswomen, 13% hairdressers, 4% female teachers. Education level: 71% were uneducated and 29% educated. Among those who are educated, their level was primary in 50%, secondary in 32% and higher in 18%. 42% had done antenatal consultation. The main reasons: ignorance of work 44.3%;religious beliefs and societal burdens 10.0%;fear of caesarean section 4.3%;late-night birth labour 5.7%;lack of financial and/or transport means 17.1%; distance from the locality 2.9%;insecurity 2.9%. Maternal and perinatal prognosis: complications were mostly hemorrhagic and concerned 27 (39%) patients. These included uterine atony (13 cases), placental retention (8 cases), soft part lesions (6 cases). We have not recorded any m

关键词： Childbirth Unsured Reasons

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