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Human Rabies Still Exists in Urban and Peri-Urban Areas in Mali—National Data-Base Analysis of the Capital of Mali from 2007 to 2017

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Open Journal of Internal Medicine 2019年第2期9卷 19-25页

作者： Abdel Kader Traore Assetou Soukho Kaya Ousmane Kone Youssouf Fofana Mamadou Cissoko zakaria keita Makan Fofana Aichatou Margueritte Diarra Department of Internal Medicine Universitary Hospital of Point GBamakoMali RIWA/REAO/MALI Rabies in West Africa(RIWA)Mali RIWA/REAO INTERNATIONALRabies in West Africa(RIWA)Mali PARACON Pan-African Rabies Control NetworkBamakoMali Service of Epidemiology-Department of Comunotary Health National Institute of Public HealthINRSPBamakoMali Department of Internal Medicine University Hospital Mother-Child LuxembourgBamakoMali Disease Prevention and Control Division National Directorate of HealthMinistry of Health and Social AffairsBamakoMali Management of Small and Medium Enterprises BamakoMali

From 2007 to 2017 sixty-three (63) new cases of human rabies have been identified in Mali on an estimated total population in 2017 of 17,650,195 inhabitants. This is an incidence of 0.32 cases for 100,000 inhabitants. All these cases occurred in urban areas and involved the two sexes. The age group most affected was the one less than 20 years old. The majority of the victims (73.1%) were pre-schools, school-aged pupils and housewives. In 97% of the cases, the animal in question was a dog and the type of exposure of the bite. Eighty-two percent (82%) of the victims had received no local medical treatment or the post exposure quasi prophylaxis treatment. The median duration between the first symptoms and death among the cases of human rabies was 3 to 7 days. The median duration between the occurrence of the first signs and death was four (4) days. No virological confirmation had been conducted on the patients. The rage disease is retained as a priority disease, since the adoption of the strategy of “integrated monitoring of the disease and response” in 2008. However, in spite of the efforts made, progress still remains to be effected to assess the actual impact of rabies in Mali.

关键词： Rabies Urban Area Mali

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Anemia in the Elderly: Frequency and Etiologies at University Hospital Center of Point G

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Open Journal of Clinical Diagnostics 2019年第4期9卷 115-125页

作者： Sy Djibril Traore Abdel Kader Kaya Assetou Soukho Traore Djenebou Gozo Jean-Jonathan Cocou keita zakaria Dembele Ibrahima Amadou Cissoko Mamadou keita Kaly Sangare Barry Boubacar Malle Mamadou Sy Seydou Dembele Mamadou Traore Hamar Alassane Department of Internal Medicine of University Hospital Center of Point G BamakoMali General Secretary of the Association“Rabies in West Africa—Mali” BamakoMali Department of Nephrology of University Hospital Center of Point G BamakoMali

Introduction: Older people are exposed to particular health problems that must be taken into account, including anemia defined by the World Health Organization (WHO) in people aged 65 and over hemoglobin < 13 g/dl in men and < 12 g/dl in women. Objectives: To determine the frequency of anemia, to describe its clinical and paraclinical aspects, and to determine the etiologies. Material and Methods: We conducted a cross-sectional study with prospective data collection that took place in the Department of Internal Medicine of the Point G CHU in Mali from January 1st, 2018 to August 31st, 2018, covering all elderly patients. At least 65 years old hospitalized and/or having consulted and presenting with anemia. Anemia was defined as Hb < 13 g/dl in men and < 12 g/dl in women (WHO definition). Biological markers were collected at admission. Results: Anemia was observed in 42 patients in 160 elderly patients, a prevalence of 26%, the age of our patients ranged from 65 to 90 years. The sex ratio was 1.33. Fifty percent (50%) of the patients had high blood pressure as antecedents. Weight loss was found in 69% of cases;47.6% of patients had dyspnea on admission. Tachycardia was the physical sign associated with anemia present in 85.7% of them. The mean hemoglobin level was 9.2 g/dl ± 2.03: thus 50% of the subjects had microcytic and or hypochromic anemia. The etiologies found were infectious in 31.0% of cases, inflammatory in 31.0% of cases, renal in 14.2% of cases. Chronic hemorrhage, acute haemorrhage, hemolysis accounted for 2.4% each. We observed 9.5% of unexplained causes. Conclusion: The frequency of anemia is high. Nearly half of the geriatric population has anemia. The lack of means and the nonperformance of the technical platform to perform all examinations in the etiological research of anemia have a significant impact on the rate of unexplained anemias.

关键词： Anemia Elderly Internal Medicine CHU Point G

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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 problem because of its frequency, its direct and in

关键词： Monitoring Diabetes Foot Risk Mali

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Zinner’s Syndrome: A Confusing Diagnosis in the Face of Chronic Disabling Perineoscrotal Pain in the Young Subject, about a Case

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Case Reports in Clinical Medicine 2021年第5期10卷 141-145页

作者： Ntambwe Nkashama Jean-Louis Mouhssine Errehan Kwizera Juvenal Mamoutou Mody keita Lakmichi Mohamed Amine Dahami zakaria Moudouni Mohamed Sarf Ismail Service d’Urologie Chu Mohamed Vi De Marrakech Marrakech Maroc

Zinner syndrome is a rare congenital malformation related to an abnormality in the development of the Wolffian duct, the clinical picture of which consists of a triad of unilateral renal agenesis, ipsilateral seminal vesicle cyst, and obstruction of the ejaculatory duct. Chronic perineoscrotal pain may be an indication of the diagnosis of Zïnner syndrome to some extent. We report the observation of a 23-year-old patient, married and father of one child, who presented with chronic perineo-scrotal pain revealing on morphological assessment (ultrasound, uroscanner, prostatic MRI) a cystic formation of the seminal vesicle, left renal agenesis with an empty left renal compartment. Given the patient’s refusal of any surgical procedure, treatment consisted of echo-guided puncture of the seminal vesicle cyst bringing back 30 cc of a seroviscous liquid whose analysis revealed spermatozoa, without atypical cells, compatible with a cyst. The clinical evolution was marked by a progressive remission of the scrotal pain with a delay of several months.

关键词： Agenesis Congenital Malformation Kidney Perineoscrotal Pain Seminal Vesicles Zinner’s Syndrome

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