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Evaluation of the Quality of Prenatal Consultation in Rural Area of Mali, Case of Kadiolo Health District

Open Journal of Clinical Diagnostics 2020年第1期10卷 49-64页

作者： Fane Seydou Sissoko Abdoulaye Kanté Ibrahima Bocoum Amadou Sima Mamadou Sanogo Abdoulaye Traore Soumana Oumar Sanogo Siaka Amara Traore Mamadou Salia Traore Alassane Saleck Doumbia Mamadou keita Salem Yargueit Traore youssouf Tegueté Ibrahima Mounkoro Niani Gynecology-Obstetrics Service University Teaching Hospital Gabriel Touré Bamako Mali Hospital Mother-Child the Luxembourg Bamako Mali University Teaching Hospital of Point G Bamako Mali Referral Health Center of Kadiolo Bamako Mali Referral Health Center of Commune V Bamako Mali Hospital of Mali Bamako Mali Referral Health Center of Commune VI Bamako Mali

Every woman has the right to receive satisfactory quality prenatal care in reproductive health. Giving a life while remaining alive and without sequelae must be the slogan of any gynecologist - obstetrician and midwife, as well as any health worker. It was a descriptive cross-sectional study dealing with the evaluation of the quality of prenatal consultations at the Kadiolo referral health center (or RHC). Adevis Donabedian’s model for assessing the quality of care and services served as a benchmark. According to Donabedian quality means good technical care, with good interpersonal relationships, and adequate and comfortable premises. This study took place from April 24 to December 04, 2017 and aimed to assess the current level of the quality of prenatal consultations at the Kadiolo referral health center, to study the structures in place including infrastructure and personnel, to specify the procedures and to determine their results. This work has permitted us to classify the RHC of Kadiolo at level III with 85%, which means that the references evaluated were satisfactory, with the level of 75% to 94%. In terms of structure, a pricing system was deemed affordable by the opinion of pregnant women. The analysis of the level of the human dimension revealed that the health center was level III. The pregnant women were satisfied with the reception which was good in 76% of the cases, as well as with the quality of the respect of the privacy in 96% and confidentiality in 95%. Despite the satisfaction of pregnant women, gaps remain to be filled in concerning the quality of the services received at the Kadiolo referral health center so as to reach level IV.

关键词： Pregnancy Prenatal Consultation Quality of Care and Services Risk Factors Kadiolo Referral Health Center Mali

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Endometrial Status and Embryonic Implantation about 150 Cases at the Medically Assisted Procreation Laboratory “Le Diafounou”

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Open Journal of Medical Imaging 2023年第3期13卷 92-100页

作者： Mamadou Dembélé Alassane Kouma Ilias Guindo Souleymane Sanogo Zoumana Cheick Berete Ousmane Traoré Mamadou N’Diaye Brahima Doumbia Oncoumba Diarra Issa Cissé Aboubacar Sidiki N’diaye Bandiougou Doucouré youssouf Yalcouyé Adama Diaman keita Siaka Sidibe Faculty of Medicine and Odonto-Stomatology of Bamako (FMOS) Bamako Mali Medical Imaging Department Kati University Hospital Kati Mali Department of Education and Research in Public Health (DERSP) Bamako Mali

Background: The endometrium is the tissue that lines the inside of the uterus. It undergoes multiple changes during the menstrual cycle and prepares to welcome the fertilized egg. Endovaginal ultrasound is a first-line examination in the assessment of female infertility. Objective: We aimed to determine the impact of endometrial status by endovaginal ultrasound on the outcome of embryo transfers. Subjects and Methods: This was a prospective cross-sectional study of 150 women collected between January and October 2020 at the “Le Diafounou” medically assisted procreation laboratory. Were included in the study, women presenting for desire of pregnancy and having continued the treatment until the transfer of fresh or frozen embryos. An uterine score was used. This score took into account the thickness of endometrium, it is coffee bean aspect, the presence of the notch, the echogenicity of the endometrium, the pulsatility index, the presence of the flow at the end of diastole and sub-endometrial flow. Ultrasounds were performed using a General Electric logic 500, logic 9 and Voluson E8 device. The data was entered into Excel and then analyzed using SPSS version 21. Results: 150 women were selected for the study. 83 women or 55.3% were between 17 and 35 years old and 44.7% were over 35 years old with an upper limit of 50 years old. The number of women who became pregnant was 69% or 46%. The average thickness of the endometrium was 11.40 mm with extremes of 4.65 mm and 18.6 mm. There was a correlation between the thickness of the endometrium and obtaining a pregnancy (p i.e. 88.7%. The pulsatility index was relatively low for those who started a pregnancy, i.e. 90%. The high pulsatility index is one of the reasons for the failure of embryo implantation. The correlation was significant (p = 0.009). 141 women had no notch in the uterine arteries, i.e. 94%. 94 women or 62.7% had a triple line endometrium or typical coffee bean appearance. End-diastolic flow was observed in 12

关键词： Endometrial Status Embryonic Implantation Medically Assisted Procreation

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Hemoglobinopathy and Systemic Lupus: A Rare Association

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

作者： Assétou Kaya Soukho Ibrahima Amadou Dembele Djenebou Traore Nounga Romuald Nyanke Djibril Sy Abasse 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 Alassane Traore Department of Internal Medicine Point G University Teaching Hospital Bamako Mali

The authors report a case of systemic lupus associated with a composite heterozygosis SC with thalassemic 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 ears, 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 associated with β thalassemia. 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

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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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External Branch of the Superior Laryngeal Nerve: Anatomy and Operating Hurts

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International Journal of Otolaryngology and Head & Neck Surgery 2018年第6期7卷 388-395页

作者： Abdoulaye Kanté Babou Ba youssouf Sidibé Drissa Ouattara Bréhima Bengaly Bréhima Coulibaly Drissa Traoré Mariam Daou Tata Touré Siaka Diallo Amady Diakalia Coulibaly Mamadou Alymami keita Souleymane Sanogo Djibril Traoré Moustapha Issa Magané Ousmane Ibrahim Touré Idrissa Tounkara Abdoulaye Diarra Bakary keita Timbely Guidérè Birama Togola Nouhoum Ongoï ba Service of Surgery CHU Bamako Mali Laboratory of Anatomy of the Faculty of Medicine and Odontostomatology Bamako Mali ENT and Head and Neck Surgery Department CHU Mother-Child “Luxembourg” Bamako Mali Service of Neurology CHU Gabriel Touré Bamako Mali Department of Stomatology and Maxillofacial Surgery CHU-CNOS Bamako Mali Service of General Surgery CHU Gabriel Touré Bamako Mali Service of Anesthesia and Resuscitation CHU Gabriel Touré Bamako Mali

Purpose: Our purpose was to describe the anatomy of the external branch of the upper laryngeal nerve and to estimate the frequency of nerves at risk during the total thyroidectomies sub. Methodology: We realized in the CHU Point G in Bamako a forward-looking study over a period going from September 1st, 2016 till December 31st, 2017. All the patients operated by thyroidectomies subtotals for mild goiters were included to whom a systematic location of the external branch of the superior laryngeal nerve in the space avascular of Reeve was realized. Cancers and other thyroid pathologies were not included. Results: We counted and operated 120 cases of mild goiters. The external branch of the superior laryngeal nerve was seen and dissected in 80.8%;it was not seen in 19.2%. According to the classification of Cernea: the type 2 was found in 80.8% of the cases with him under typical 2b in 47.5% and under type 2a in 40 (33.3%). The global frequency of lesion of the external branch of the upper laryngeal nerve was 10.8% at 9 patients among whom 6 who presented a BENLS of Type Ni. Conclusion: The external branch of the upper laryngeal nerve of type 2 presents a risk of wound because the surgeon treats the upper pedicle at the level of the critical centimeter place over the upper pole of the thyroid. The identification of the nerve during the thyroid surgery is the solution of choice.

关键词： External Branch of the Laryngeal Superior Nerve Anatomy Thyroid Surgery

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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 pro

关键词： Monitoring Diabetes Foot Risk Mali

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Giant Cervical Kystic Lymphangioma in Children: Surgical Management of a Case

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International Journal of Otolaryngology and Head & Neck Surgery 2019年第1期8卷 1-6页

作者： youssouf Sidibé Abdoulaye Kanté Amady Coulibaly Rokia Koné Mamadou Koné Fatoumata Léonie Franç ois Diakité Drissa Ouattara Abdoul Wahab Haidara Boubacar Sanogo Sidiki Dao N’faly Konate Kadiatou Singaré Doumbia Samba Karim Timbo Mohamed keita Alhousseini Ag Mohamed ENT and Head and Neck Surgery Department CHU Mother-Child “Luxembourg” Bamako Mali ENT and Head and Neck Surgery Department CHU Gabriel Touré Bamako Mali Faculty of Medicine and Odontostomatology Bamako Mali Service of Surgery “B” CHU Point G Bamako Mali Department of Stomatology and Maxillofacial Surgery CHU-CNOS Bamako Mali Dermatology Department of the National Center for Disease Control Support (CNAM) Bamako Mali Service of Paediatrics CHU Gabriel Touré Bamako Mali

Introduction: Cervical cystic lymphangiomas are rare benign dysembryoplastic tumors of lymphatic origin. Its severity in the child is due on one hand to their fast evolution and the compression of the way aerodigestive and on the other hand, by the classical difficulty of their excision. The purpose of this work was to report a case of giant cervical cystic lymphangioma in a child to discuss the difficulties associated with its management in our context. Observation: This was a 3-year-old female child who was admitted to the ENT department of CHU “Luxembourg” for right lateral cervical swelling. The clinical examination had noted a large anterior-latero cervical swelling of soft, renitent, painless palpation, movable in relation to the superficial and deep plane, measuring about 20 cm × 17 cm, the skin was healthy. It wasn’t particularity to the rest of the physical examination. The diagnosis of giant cervical cystic lymphangioma was discussed. Thorough excision of the swelling by right lateral cervicotomy was performed. Anatomopathological examination of the operative specimen confirmed the diagnosis. The postoperative course was simple and the evolution was favorable. Conclusion: Cervical cystic lymphangiomas are rare. Their management involves surgery, with short and long-term post-operative outcomes are often excellent.

关键词： Kystic Lymphangioma Cervical Child Bamako

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Blows and Voluntary Wounds of the Emergency Unite in Gabriel Toure Teaching Hospital in Bamako

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Surgical Science 2018年第9期9卷 334-343页

作者： Mangané Moustapha Diop Thierno Madane Almeimoune Abdoul Hamidou keita Soumaila Dembelé Aladji Seydou youssouf Sogoba Konaté Madiassa Koita Siriman Traoré Amadou Issa Amadou Badimi Siaka Abdoulaye Kanté Diallo Sadio Sangaré Harouna Dembelé Bakary Tientigui Togo Adegné Diango Djibo Mahamane Department of Anesthesiology and ICU H&#244 pital Gabriel Touré Bamako Mali Department of General Surgery H&#244 pital du Point G Bamako Mali Department of Anesthesiology H&#244 pital IOTA Bamako Mali Department of Neurosurgery H&#244 pital Gabriel Touré Bamako Mali Department of General Surgery H&#244 pital Gabriel Touré Bamako Mali Department of Anesthesiology and ICU H&#244 pital Mère-Enfant Bamako Mali Department of Pediatric Surgery H&#244 pital Gabriel Touré Bamako Mali

Introduction: Voluntary assault and injuries are acts that damage the physical and psychological integrity of a human being. WHO in its global report on violence and health estimates that in 2000, 1.6 million people worldwide died as a result of self-harm, interpersonal or collective violence, resulting in an overall rate adjusted by age of 28.8 per 100,000 population. Because of the seriousness of this phenomenon and the heavy socio-economic and health consequences that they generate, it seemed important to us to undertake this study, which aimed to study the deliberate injuries in the emergency unite of the Gabriel Touré Teaching Hospital in Bamako. Material and methods: This was a descriptive and cross-sectional study with a prospective study from September 1st, 2016 to August 31st, 12 months, covering 295 patients, including any patient received for voluntary injury consultation with a workable medical record and/or a full investigation record with or without requisition. Our data were collected on individual survey cards and subsequently analyzed with Word, Excel, IBM SPSS Statistics 22 software. Results: The majority of victims of assault and bodily injury were male with 83.1%;with a sex ratio of 4.9, the 18 to 28 age group was the most concerned with 163 cases of the 295 cases in our study, 55.2%. The extremes were 6 and 100 years old with an ectype at 11.08. The most affected ethnic group was Bambara with 38.6% (n = 114) followed by Fulani with 15.6% (n = 46). Students were the most affected at 24.7% (n = 73), followed by traders at 10%. The victims coming from outside Bamako are the most predominant with 22.4% (n = 66) followed by those of commune IV of Bamako 15.6% (n = 46). In 92.2% of the cases the mechanism was direct with n = 272. Of the lesions recorded in our study, wounds came first with 53.2% of cases. Radiography was the most used imaging at 44.7% (n = 89) followed by computed tomography at 34.7% (n = 69). The hemoperitoneum objectified by abdomin

关键词： Blows Wounds EU Gabriel Touré University Hospital

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Direct Cost of Severe Malaria Treatment Borne by the Families of Children Aged 0 - 5 Years at the Fana Reference Health Centre, Mali

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Health（健康） 2022年第12期

作者： Solomane Traore Abdourahamane Haidara youssouf Samake Tegué Guindo Moussa keita

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Mutations in Spike Gene of SARS-CoV-2 that Are Associated with a Higher Viral Load: A Clinical Case Study

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Case Reports in Clinical Medicine 2022年第11期11卷 474-486页

作者： Ibrahim keita Garan Dabo Lassina Doumbia youssouf Diarra Ibrahim Traoré Mariam Traoré Lansana Sangaré Yacouba Toloba Mahamadou Alpha Diallo Djeneba Sy Andres H. Gutierrez Aliou Sissako Ibrahim Guindo Mohamed Diallo Akory Ag Iknane Anne S. De Groot Ousmane Aliou Koita Laboratoire de Biologie Moléculaire Appliquée Université des Sciences Techniques et des Technologies de Bamako Bamako Mali Hô pital du Mali Ministère de la Santé Publique et du Développement Social Bamako Mali Centre Hospitalo-Universitaire du Point G Ministère de la Santé Publique et du Développement Social Bamako Mali EpiVax Inc. Providence USA Institut National de Santé Publique Ministère de la Santé Publique et du Développement Social Bamako Mali Center for Vaccines and Immunology College of Veterinary Medicine University of Georgia Athens USA

Background: Quantitative PCR (qPCR) can be used to detect and quantify a load of a pathogen. It is a good indicator of the degree of transmissibility. While performing routine qPCR, we observed an unusually short cycle threshold (Ct) value of SARS-CoV-2 for a clinical specimen obtained in Bamako, Mali. This prompted us to sequence the short-cycle SARS-CoV-2 sample to identify potential mutations in the Spike gene (S gene) gene. Methods: Post-infection, Quantitative Reverse Transcription (qRT-PCR) was performed over a defined time course to estimate the Ct of the SARS-CoV-2 specimen collected from the patient. Sanger sequencing was done on the entire fragment of the S gene to identify mutations. Findings: Sanger sequencing revealed mutations in the lineage of interest, designated B.1.525 by Pango, and also known as “Eta” using the nomenclature defined by WHO. This variant was originally found in Nigeria and Italy. The four novel mutations identified in Eta (D228N, Y451N, I1172M, and C1250F) were otherwise observed with a low frequency worldwide. Although the initial Ct was 10 in the case study patient, he did not exhibit severe symptoms of SARS-CoV-2, for example, pneumonia. However, we observed a longer viral clearance period than usual, of 3 weeks. We note that as compared to SARS-CoV-2 samples obtained during the first peaks of SARS-CoV-2 infection in Mali, when the infection was at its peak in March 2020 (Ct = 30.4), circulating strains evaluated at the time the Eta sample was obtained demonstrated a lower mean Ct (Ct = 24). Conclusions: The short cycle threshold associated with this variant, and the temporal association with a decrease in the mean Ct in the region of Bamako, may indicate higher levels of transmissibility due to a circulating variant. This variant is a lineage of interest designated B.1.525 by Pango or Eta by WHO.

关键词： SARS-CoV-2 Variant Eta Ct Value Mali

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