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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

Management and Prognosis of Early Postpartum Hemorrhage in African Low Setting Health

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Open Journal of Obstetrics and Gynecology 2018年第1期8卷 1-9页

作者： Youssouf traoré Ibrahima Téguété Amadou Bocoum mamadou traoré Seydou Dao Marion Koko Bomini Niani Mounkoro Amadou Dolo Department of Gynecology and Obstetrics Gabriel Touré Teaching Hospital Bamako Mali Department of Gynecology and Obstetrics Yopougon Teaching Hospital Abidjan Cote d’Ivoire

Early postpartum hemorrhage is one of the major causes of maternal death in the world especially in developing countries. Its management often relieves resuscitation that is often difficult to set up in our countries and sometimes based on invasive and mutilate surgery. Objectives: The purpose of this survey was to report frequency of this pathology, to describe its management and the factors that influence the prognosis of early postpartum hemorrhage in low setting health in Africa. Method: Authors conducted a prospective study that analyzed early postpartum hemorrhage in the motherhoods of Gabriel Touré teaching hospital and community five health reference center of the district of Bamako. It took place from January, 2015 to December, 2016. The study concerned all the cases of early postpartum hemorrhage according to WHO definition. Statistical tests used were X2 or Fisher test, its 95% confidence interval (CI95%), p value was significant if Results: Early postpartum hemorrhage frequency has been 0.7% (62 cases for 8.885 deliveries). Sixty nine and one percent (69.1%) of patients have been blood fluid transfused. Obstetric treatment dominated by uterine revision (30.7%). Hysterorraphy (4.0%), hysterectomy (3.0%), suture of uterus injuries (15.7%), hypo gastric artery ligature (2.0%) and B-Lynch compression suture (2.0%) have been the main practiced surgical operations. No satisfy blood transfusion need was 26.9%. The main risk factors of early PPH were high parity (p = 0009;RR = 3.04;CI95% [2.80 - 5.11]), prolonged labor (p = 0004;RR = 4.00;CI95% [3.06 - 10.02]), oxytocin/prostaglandin use (p = 0003;RR = 1.47;CI95% [1.17 - 3.16]). Eleven of maternal occurred (11.8%). Conclusion: Early postpartum hemorrhage is still a severe event in developing countries especially. Its management sometime consisted to invasive cares. Maternal prognosis that is influenced by unsatisfied blood need and late management is marked by high lethality.

关键词： Early Postpartum Hemorrhage Risk Factors Surgery Maternal Death

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 pro

关键词： Monitoring Diabetes Foot Risk Mali

I4EU(Industry 4.0 for European Union)--An European Initiative to Develop Training Activity

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计算机教育 2021年第12期 189-194页

作者： mamadou K.traoré David Chen Yves Ducq Bruno Vallespir Anne Zouggar Julien François the University of Bordeaux Bordeaux33405France

This paper presents an on-going European ERASMUS project to develop training programs and tools for Industry *** an introduction on the background and objective of the project,the paper will give an overview on the structure,partners and organization of the *** on the State-of-the-art,the targeted intellectual outputs(IOs)will be presented in detail and the set of planned activities to achieve IOs are *** project progress and preliminary results are shown and the concluding summary will be given at the end of the paper.

关键词： Industry 4.0 key competences training European Union ERASMUS+

Kati Chu BSS External Genital Organ Delivery Syndrome: Inguinal Pedicle Flap Plasty

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Surgical Science 2021年第11期12卷 357-364页

作者： Koniba Keita Sidiki Keita Oulematou Coulibaly Abdoulaye Diarra Fodé Mory Keita Boubacar Kone Lassina traoré salia Coulibaly Amadou traoré Assitan Kone Amadou Kassogué Issa traoré Oumou traoré Ismael Konaré Daouda Diallo Drissa traoré Bacary T. Dembélé General Surgery Department Hospital BSS Kati Mali General Surgery “A” Department Hospital Point-G Bamako Mali Reference Health Centre of the Commune VI Bamako Mali Medical Imaging Department Hospital BSS Kati Mali General Surgery Department Hospital Gabriel Toure Bamako Mali Urology Department Hospital BSS Kati Mali Anesthesia Resuscitation Department Hospital BSS Kati Mali General Surgery “B” Department Hospital Point-G Bamako Mali

Fournier’s syndrome is a poly microbial necrotizing fasciitis, of severe evolution of the perineum and external genitals. Objectives: We report the experience of the service in the management of Fournier gangrene of the external genital organs by inguinal flap pediculated in front of the loss of significant substances of the scrotum. Patients and method: This was a mono-centric retrospective study from January 2008 to August 2021 in the General Surgery Department of the Bocar Sidi Sall University Hospital (CHU BSS) in Kati. It focused on patients treated for Fournier gangrene of external genitals. The variables studied were age, sex, blood count, germs encountered, the antibiogram, duration of evolution, reconstruction of the scrotum by pedicle flap, and morbidity. Results: During the study period we collected 5 cases of Fournier gangrene of external genitals in the service. The average age was 57.6 years and all the patients were male. The average duration of evolution was 5 days for an average age of 57.6 years. All patients were male. Echerichia coli (E. coli)

关键词： Fournier’s Gangrene Scrotum Inguinal Pedicular Flap

Maternal-Fetal Prognosis of the Prophylactic Cesaarian versus Emergency Cesaarian at the Reference Health Center of Commune V of Bamako District, Mali

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Surgical Science 2020年第10期11卷 329-341页

作者： Cheickna Sylla Soumano Oumar traoré Alassane traoré Alou Samaké Saleck Doumbia Saoudatou Tall Belco Tamboura Sitapha Dembélé Seydou Z. Dao Ibrahima Teguété Youssouf traoré Niani Mounkoro mamadou traoré Amadou Ingré Dolo Department of Gynecology and Obstetrics Reference Health Centre of Commune V Bamako Mali Department of Obstetrics and Gynecology Koutiala Reference Health Centre Sikasso Mali Faculty of Medicine and Odontostomatology University of Sciences Techniques and Technologies Bamako Mali Mali Hospital Bamako Mali Department of Gynecology and Obstetrics Reference Health Centre of Commune VI Bamako Mali Department of Gynecology and Obstetrics Hospital of Kayes Kayes Mali Department of Gynecology and Obstetrics Reference Health Centre of Commune II Bamako Mali Department of Gynecology and Obstetrics Gabriel Touré University Hospital Bamako Mali

Objectives: The goal was to assess the risk factors for emergency cesarean section versus prophylactic caesarean section. Materials and Methods: This was a descriptive analytical cross-sectional study of the Type Cas/Witnesses at the Reference Health Centre of Commune V of the District of Bamako in Mali. The sample consisted of 100 cases for 200 controls (1 case for 2 controls) with retrospective collection of data for the period from January 1 to July 11, 2011 (6 months and 11 days). Results: During the study period, out of a total of 3559 deliveries, we recorded 2,794 vaginal deliveries, 78.50% and 765 caesarean sections or 21.50%. Of the 765ceras, we performed 353 emergency caesarean sections or 46.15% and 412 prophylactic caesarean sections 53.85%. We have selected 100 prophylactic caesarean section files and 200 emergency caesarean section files. The average age of the patients was 27.41 years-5.84 with extreme ages of 14 to 40 years. 100% of our patients (Cas) had performed at least one antenatal consultation compared to 83.5% of the parturients evacuated (Witnesses). The most frequently cited reasons for evacuation were: acute fetal suffering, non-cephalic presentation and excessive uterine height with 30%, 17.5% and 12% respectively. The bulk of the caesarean section indications were dominated by dystocies with 90% in cases compared to 65% in Witnesses, followed by acute fetal suffering with 30% in Witnesses. We recorded 30% perinatal deaths among Witnesses compared to 1% in Cases. We recorded 16 uterine ruptures in the Witnesses among which 2 hysterectomies and 14 hystererraphia. Conclusion: Prophylactic caesarean section improves maternal and perinatal prognosis more than emergency caesarean section.

关键词： Caesarean Frequency Evacuation Maternal-Fetal Prognosis

Congenital Gangrene in a Premature Newborn: A Case Report

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Open Journal of Pediatrics 2021年第3期11卷 393-397页

作者： Assetou Cissouma mamadou B. Coulibaly Djibril Kassogué Hachimi A. Poma Moussa Diassana Bathio traoré Aly Diallo Layes Touré Ternan traoré Moussa Kanté Abdoulaye Kissima-traoré Pediatric Service Sikasso Hospital Sikasso Mali Pediatric Surgery Service Sikasso Hospital Sikasso Mali Pediatric Service Timbuktu Hospital Timbuktu Mali Surgery General Service Sikasso Hospital Sikasso Mali Orthopedic and Trauma Surgery Service Sikasso Hospital Sikasso Mali Anesthesia and Intensive Care Service Sikasso Hospital Sikasso Mali Cardiology Service Sikasso Hospital Sikasso Mali

Introduction: Congenital limb gangrene is a rare pathology. In the majority of cases, no cause is identified and its treatment is not codified. Observation: 29-week premature newborn, female from poorly followed twin pregnancy. Clinical examination at admission found an unstable neonate, the presence of necrosis of the left hand and forearm well limited, with absent humeral pulse and absence of hand movement. Surgical treatment was scheduled for amputation of the limb after the agreement of the parents whose postoperative follow-ups were simple. Conclusion: Congenital gangrene remains a rare entity in neonatology.

关键词： Gangrene Upper Limb Newborn Prematurity

Impact and Management under Extracorporeal Circulation of a Patient with Renal Insufficiency on Dialysis with a High-Flow Arteriovenous Fistula in the Cardiac Surgery Department of the Angers Teaching Hospital about a Case and Review of the Literature

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Open Journal of Thoracic Surgery 2023年第1期13卷 1-5页

作者： Abdoulaye Kanté Bréhima Coulibaly mamadou Diakité mamadou A. Keita Bakary Keita Drissa traoré Nouhoum Ongoïba Patrice Binuani Christophe Baufreton Department of Thoracic and CardiovascularSurgery CHU Point G Bamako Mali Cardiac Surgery Department of the University Hospital of Angers Angers France Cardiology Department CHU Point G Bamako Mali Commune II Reference Health Center Bamako Mali

Arteriovenous fistulas have a substantial impact on systemic hemodynamics, however their effect on extracorporeal circulation is not well understood. We report our clinical observation on the management under extracorporeal circulation of a patient with renal insufficiency with a high-flow arteriovenous fistula. This is a 59-year-old man who was referred to us for surgical treatment of ischemic coronary artery disease in a context of anuric chronic renal failure. Hypothermia at 32°C is started from the start in CEC due to hyperflow at the level of the arteriovenous fistula. We performed two coronary artery bypasses of the marginal and IVA via the two internal thoracic arteries. The patient is hemofiltered in order to avoid hyperkalaemia and possibly avoid fluid overload related to filling per CEC. The clamping time was 71 minutes and the SCC lasted 141 minutes. There was no homologous transfusion in the operating room. It turns out that the input/output balance is zero at the end of the CEC. The postoperative course was simple.

关键词： Coronaryartery by Pass Grafting High Flow Arteriovenous Fistula Extracorporeal Circulation Hypothermia

Prevalence of Types of Arterial Hypertension in Pregnant Women at the Maternity Ward of the Centre Médical Communal Les Flamboyants Conakry Guinea

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Open Journal of Nephrology 2023年第3期13卷 234-245页

作者： Amadou Yaya Diallo Kadiatou mamadou Bobo Barry mamadou Malal Diallo Soriba Bangoura Bangoura Diallo Fatoumata Binta Oury Diallo mamadou Yacine Bah Aly traoré Mohamed Lamine Kaba Department of Nephrology and Haemodialysis CHU Donka Conakry Guinea Centre Médical Communal les Flamboyants Conakry Guinea

Introduction: Arterial hypertension (AH) during pregnancy is defined as systolic blood pressure greater than or equal to 140 mm Hg and/or diastolic blood pressure greater than or equal to 90 mm Hg on two (2) successive visits separated by at least 4 hours in a woman who has been at rest for 10 to 15 minutes in the seated position and then in the left lateral decubitus position. The aim of this study was to determine the prevalence and types of arterial hypertension among pregnant women in the maternity ward of the CMC les Flamboyants. Methods: This was a prospective descriptive study lasting six (6) months, from 1 October 2021 to 31 March 2022, of all pregnant women and/or parturients admitted to the maternity ward of the CMC les Flamboyants with a resting blood pressure (BP) greater than or equal to 140/90 mm Hg during the study period. Results: During the study period, we recorded 707 cases of pregnant and/or parturient women, 50 (7.07%) of whom were hypertensive. The average age of the patients was 29 years, with extremes of 18 and 41 years. The 20 - 29 age group was the most affected, with 26 cases (52%). Headache, dizziness and oedema of the lower limbs were constant in all cases. The risk factors for arterial hypertension were dominated by familial hypertension in 19 cases (38%), multiple gestures in 17 cases (34%) and a history of gestational hypertension in 16 cases (32%). Gestational age between 28 and 36 weeks’ amenorrhoea was the most common, with 20 cases (40%). Type I hypertension was most common on admission, with 34 cases (68%), followed by type II hypertension, with 8 cases (16%). Pre-eclampsia was the most frequent maternal complication with 27 cases (54%) followed by eclampsia with 15 cases (30%). Fetal distress was the most frequent fetal complication, 19 cases (38%), followed by death in utero 9 cases (18%). Conclusion: Compliance with consultation programmes and correct patient follow-up could help reduce maternal-foetal complications.

关键词： Hypertension Pregnant Women Maternity Unit Conakry Guinea