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Surgical Science 2023年第9期14卷 575-582页

作者： Cheickna Tounkara amadou Maiga Boubacar Yoro Sidibe Tani Kone Hamidou Samake Kaloga Daye Bagayoko Oumar amadou Malle Jean Baptiste Honoré Berthe Mamadou lamine Diakite Department of General Surgery of the “Mother Child” Hospital Luxembourg Bamako Mali General Surgery Department of Gabriel TOURE Hospital Bamako Mali Urology Department of Point-G Hospital CHU Bamako Mali

Ureteral duplication is a congenital malformative uropathy that occurs most often in children. Complete ureteral duplication is defined by a kidney that has two ureters with two orifices that communicate to the bladder through two ureteral meati. It is an anatomical variant that remains rare. Its early discovery is due to a lack of diagnostic means, hence the occurrence of long-term complications. To this end, we observe an increased importance of the morbidity linked to the late diagnosis of this duplicity. Our objective was to show the importance of the morbidity linked to the late diagnosis of this anomaly, the incidence of the infection and the complications that this pathology poses as a problem. It was a clinical case of fortuitous discovery taken care of by a general surgeon in the general surgery department of the hospital “Mother Child” Le Luxembourg Bamako Mali. We report a case of complete ureteral duplication complicated by ureterohydronephrosis on a lithiasis wedged in the uretero-vesical junction of one of the left ureters in its lower portion which required a uretero-lithotomy with bladder reimplantation of the left ureters and secondly to a uretero-lithotomy with bladder reimplantation after two months. The postoperative course was simple.

关键词： Ureteral duplication Congenital malformation Duplicity Adult Bamako Mali

Diagnosis of Male Hypogonadism: Experience of a Subsaharan African Endocrinology Department: Transversal Study from January 1^st, 2020 to July 31^st, 2022

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Open Journal of Endocrine and Metabolic Diseases 2023年第11期13卷 217-226页

作者： Nafy Ndiaye Ngone Diaba Diack Yakham Mohamed Leye Mouhamed Mbar Niang amadou lamine Cisse Yousra Benani Abdoulaye Leye Internal Medicine/Endocrinology-Diabetology Department Teaching Hospital of Pikine Cheikh Anta Diop University Dakar Senegal

Introduction: Hypogonadism should be suspected in a man who has symptoms and signs of testosterone deficiency. Clinical manifestations depend on the severity and duration of testosterone deficiency, whether the testicular deficit is concerning only androgen synthesis, spermatogenesis, or both. The objective of our study was to evaluate the clinical and aetiological characteristics of male hypogonadism in Dakar’s suburb. Patients and methods: We conducted a transversal study from January 1st, 2020 to July 31st, 2022. We included all male patients aged at least 14 years old with hypogonadism confirmed by a low level of early-morning free testosterone based on two different dosages. For all patients included, sociodemographic and diagnostic parameters were collected by using a pre-established registration form. Results: In total, 20 patients were selected. The average age was 36.3 years old [14 - 62 years old]. Half of the patients were overweight. Five patients had an abdominal circumference greater than 94 cm (37 inches). The other comorbidities found in our patients were type 2 diabetes (n = 1), hypertension (n = 1) and primary hypercholesterolemia in 2 patients. The functional signs reported by the patients were: couple’s infertility in 17 patients, decreased libido in 14 patients, erectile dysfunction in 13 patients, premature ejaculation in 2 patients and anejaculation in 4 patients. The physical examination revealed a bilateral testicular atrophy in 17 patients and a unilateral testicular atrophy in 2 patients;no patient had varicocele or urethral meatus abnormalities. Ten patients presented a micropenis. A eunuchoid morphotype was present in 6 patients and a short stature was noted in 2 patients. It was peripheral hypogonadism (HH) in 18 patients and hypogonadotropic hypogonadism (Hh) in 2 patients. The hypogonadotropic hypogonadism was isolated in both cases. The testicular echography confirmed testicular atrophy and showed cryptorchidism

关键词： Diagnostic Hypogonadism Male Senegal

Acute Fevers in the Medical Unit of the Medical-Surgical Emergency Department of the Donka National Hospital

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Open Journal of Internal Medicine 2023年第2期13卷 95-103页

作者： Djibril Sylla amadou Kake Thierno amadou Wann Mohamed lamine Yaya Bah Akomou Lydia Koba Mohamed Cirékeita Mamadou Diakhaby Lansana Diaby Sèmèvo Claudiane Toffon Internal Medicine Department of the Donka National Hospital Conakry Guinea Medical and Surgical Emergency Department of the Donka National Hospital Conakry Guinea

Introduction: Fever is a high core temperature ≥ 37.5°C in the morning and 37.8°C in the evening. It is acute when it evolves from 0 to 20 days. Very common in clinical practice, the etiological diagnosis, particularly in developing and tropical countries, is often a challenge for clinicians due to their diversity and the limited availability of diagnostic tools. There is a wide spectrum of etiological diagnoses including infectious causes and non-infectious causes. The aim of this study was to investigate the etiology of fevers acute at the medical unit in the medico-surgical emergency department of the Donka National Hospital. Methods: This was a descriptive cross-sectional study lasting 03 months (January 01, 2022 to March 31, 2022). We included in this study all patients seen in the medical unit, whose age ≥ 18 years, without distinction of sex, from any origin, with an axillary temperature ≥ 37.5°C in the morning and 37.8°C in the evening, evolving from 0 to 20 days, hospitalized or followed on an outpatient basis, and having given verbal consent. Results: Of a total of 1087 patients seen, 466 had an acute fever. The mean age was 40.04 ± 18.91 years (18 and 96 years). The female sex (58.15%) was predominant with a sex ratio of 0.72. Malaria (50.86%) was the main diagnosis. The treatment consisted of compressed paracetamol (59.01%), arthemether + lumefantrine (50.85%). Conclusion: The incidence of acute fevers is high in the medical unit of the medico-surgical emergency department of the Donka National Hospital. Malaria was the main pathology. Treatment was etiological and symptomatic. This high incidence could be explained by the fact that Guinea is an endemic malaria zone. A study taking into account other etiological factors would be of great interest.

关键词： Acute Fever Medical Unit Emergency Department Donka National Hospital (HND)

Case of Incomplete Ureteral Duplication Complicated with Lithiasis and Right Uretero-Hydronephrosis

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Surgical Science 2023年第7期14卷 502-506页

作者： Cheickna Tounkara amadou Maiga Boubacar Yoro Sidibe Tani Kone Samake Hamidou Kaloga Daye Bagayoko Oumar amadou Malle Jean Batiste Honoré Berthe Mamadou lamine Diakite Department of General Surgery Luxembourg Hospital Bamako Mali Department of General Surgery CHU Gabriel Touré Bamako Mali Department of Urology Surgery CHU Point-G Bamako Mali

Ureteral duplication is congenital malformative uropathy that occurs most often in children. Complete ureteral duplication is defined by a kidney that has two ureters with two orifices that communicate to the bladder through two ureteral meati. It is an anatomical variant that remains rare. Its early discovery is due to a lack of diagnostic means, hence the occurrence of long-term complications. To this end, we observe an increased importance of the morbidity linked to the late diagnosis of this duplicity. We report a case of incomplete ureteral duplication complicated by ureterohydronephrosis on lithiasis wedged in the uretero-vesical junction of one of the ureters in its lower portion which required uretero-lithotomy with bladder reimplantation of the ureters. Our aim was to show the importance of the morbidity associated with late diagnosis of this anomaly and the incidence of infection and complications that this pathology poses as a problem. This was a clinical case of fortuitous discovery managed by a general surgeon in the general surgery department of the hospital “Mère Enfant” Le Luxembourg Bamako Mali. The suites were simple.

关键词： Ureteral Duplication Congenital Malformation Adult

Acute Peritonitis at the CSRef of the Commune I in the District of Bamako: Signs, Diagnosis and Treatment

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Surgical Science 2023年第10期14卷 626-636页

作者： Cheickna Tounkara Oumar amadou Malle Modibo Togola Hamidou Samake lamine Soumare Sékou Koumare Zimogo Zié Sanogo Djibril Sangare Department of General Surgery of the Reference Health Center of Commune I Bamako Mali Directorate of the Social Health Service of the Armed Forces of Mali Bamako Mali Department of General Surgery “A” of Point G Hospital Bamako Mali

Acute generalized peritonitis is an acute inflammation of the peritoneum. It is most often secondary to perforation of the digestive organ and/or the spread of an intra-abdominal septic focus. The absence of a study on peritonitis in a reference health center motivated us for this work. The aim of this study was to study the inadequacies that could be seen in the management of peritonitis in the CSRef(s). We carried out a retrospective study of 40 patients received at the CSRéf of commune I for acute generalized peritonitis from 2011 to 2012. The average age was 30.1 years with a standard deviation of 3.4;extremes ranging from 14 years to 60 years and a Sex ratio = 1.22 (22 men out of 18 women). Abdominal pain was the main reason for consultation (present in all our patients). In most cases, clinical examination alone made it possible to make the diagnosis. Surgical treatment depended on the etiology (appendectomy associated with washing-drainage was the most commonly performed surgical procedure). All our patients received general anesthesia. The average length of hospitalization was 7 days with extremes ranging from 1 to 15 days. We noted a Morbidity rate of 22.5%, dominated by wall abscesses and a mortality of 2.5%. The delay in consultation and referrals constitutes a factor in mortality and high morbidity.

关键词： Peritonitis Surgery Csref CI Bamako Mali

Kohonen’s Algorithm Applied to the Scintigraphic Image for an Aid in the Diagnosis of Prostate Cancer Metastasis

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Open Journal of Medical Imaging 2022年第2期12卷 37-47页

作者： Boucar Ndong El Hadji amadou lamine Bathily Mamoudou Salif Djigo Mamadou lamine Mboup François Kaly Kanta Ka Ousseynou Diop Ibrahima Thiam Gora Mbaye Omar Ndoye Mamadou Mbodj Biophysics and Nuclear Medicine Laboratory Cheikh Anta Diop University Dakar Senegal Sustainable Development and Society Doctoral School Thies University Thies Senegal Laboratoire du traitement de l’information/ESP/UCAD Senegal Radiotherapy Department of the National Hospital University Center Dalal Jamm Guédiawaye Dakar Sénégal Physics Pharmaceutical Laboratory Cheikh Anta Diop University Dakar Senegal

To partition the scintigraphic image, several methods are used, among which is Kohonen’s self-organizing map algorithm. The objective of this study was to perform an ascending hierarchical classification (HAC) on the results of the Kohonen self-organizing map. This makes it possible to carry out the second phase necessary for the elaboration of the classifier by grouping the neurons as well as possible into 3 classes then by reconstituting the scintigraphic image from the 3 classes. This partition proceeds by successive groups, thus merging at each iteration two subsets of neurons using a measure of similarity which is Ward’s method. In this method, the algorithm aggregates the nearest neurons into classes. This allows us to obtain a dendrogram that looks like a tree. And this one needs to be cut. And to have an adequate cut-off level, we have established the variation of the Davies Bouldin index as a function of the number of classes. The minimum value of this index gave the optimal number of classes which corresponded to 3 in the study. These three groups A, B, C have a variable intensity. This intensity can be high, it can be medium or low. The high, medium and low intensities corresponded respectively to metastases for class A, to degenerative or inflammatory phenomena for class B and to normal radiopharmaceutical uptake for class C. To confirm this strong suspicion, we performed reconstructions using a filter. And after this reconstruction, we had images like at the entrance. And for the interpretation of these images, we used a visual metric. This enabled us to note that for the interval [0 - 50[, the image is not contrasted and no lesion could be detected. Over the interval [50 - 200[, we observed the distribution of the radiopharmaceutical over the entire skeletal whole body. On this reconstruction interval, the visual metric shows hypofixation in the bladder and areas suspected of metastases. Over the interval [200 - 250[, we detected hyperfixations linked

关键词： Neural Networks Hierarchical Ascending Classification Scintigraph

Evaluation of the Effectiveness and Nature of Analgesia in the Medical-Surgical Emergency Department of CHU-Donka

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Open Journal of Emergency Medicine 2023年第4期11卷 155-161页

作者： amadou Yalla Camara Abdoulaye Touré Almamy Bangoura M’mah lamine Camara Thierno Sadou Diallo Boubacar Atigou Dramé Joseph Donamou Department of Medical and Surgical Emergency CHU-Donka National Hospital Conakry Guinea Anesthesia and Intensive Care Unit Ignace Deen National Hospital Conakry Guinea Department of Anaesthesia and Intensive Care Donka National Hospital Conakry Guinea

Introduction: Pain assessment is an essential step towards pain relief. In our context, however, it is insufficient in emergency departments. The aim was to assess the nature and effectiveness of the analgesia used in the emergency department of the CHU-Donka. Method: This was a single-centre prospective observational study conducted over one month (November 2020) in the medical-surgical emergency department of CHU-Donka. All patients aged 18 or over admitted to the emergency department with moderate to severe acute pain were included. Results: We enrolled 880 patients, 615 of whom (69.88%) were in pain. Males predominated (65.2%), with a sex ratio of 1.87. The average age was 44.78 ± 16.41 years, with extremes ranging from 18 to 85 years. The most represented age group was 18 - 34 years, with 66.18%. Initial assessment of pain by nursing staff in 3 cases. Initial assessment of pain by the investigator was 100%, 74% moderate and 26% severe. No reassessment of pain by nursing staff. Reassessment by the interviewer was 100% and found 5% no pain, 61% mild pain, 24% moderate pain and 10% severe pain. With an average numerical scale of 3.77 ± 2.61 and extremes from 0 to 10. Average length of stay was 2.85 ± 1.48 hours, with extremes ranging from 45 minutes to 8 hours. Analgesia was administered with paracetamol alone (43.58%), combined with tramadol or nefopam. No patient received morphine. Conclusion: This study revealed a lack of pain assessment in our department.

关键词： Pain Assessment Emergencies Numerical Scale CHU-Donka

Case Report for Two Hemodialysed Patients Diagnosed for COVID-19 at the Donka National Hemodialysis Center

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Open Journal of Nephrology 2020年第3期10卷 241-244页

作者： Mamadou Saliou Baldé Abdoulaye Touré amadou Yalla Camara Joseph Donamou Aly Traoré Boubacar Atigou Drame M’mah lamine Camara Almamy Bangoura Mariam Mohamed Camara Mohamed lamine Kaba Department of Nephrology-Hemodialysis Hospital National Donka Conakry Guinea Department of Reanimation Hospital Ignace Deen Conakry Guinea Department of Reanimation Hospital National Donka Conakry Guinea

In December 2019, coronavirus disease (COVID-19) due to infection with the novel SARS-CoV-2 virus began to break out. Hemodialysis patients are at high risk because of the co-morbidities. We report the clinical and biological characteristics of two patients who developed COVID-19 infection in our dialysis center in Donka National Hospital. None of the patients had contact with an infected person. The age was 38 and 54 years. The symptoms common to both patients were: fatigue, diarrhea, fever. Lymphopenia was present in both patients. None of them had a chest X-ray or chest scan because they were positive for the test before admission.

关键词： Hemodialysis COVID-19 Coronavirus Donka

HIV Infection in Senegalese Prisons: Prevalence and Associated Factors

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Advances in Infectious Diseases 2020年第2期10卷 130-139页

作者： Selly Ba Mouhamadou Koï ta Ibrahima lamine Diop Papa amadou Niang-Diallo Aï ssatou Gueye Cheikh T. Ndour Safiatou Thiam Division for HIV/AIDS Control Ministry of Health Dakar Senegal Intra Health International Dakar Senegal Agency for the Promotion of Entrepreneurship among Populations in Senegal (APAPS) Dakar Senegal National AIDS Control Program Dakar Senegal Laboratory of Bacteriology Aristide le Dantec Hospital Dakar Senegal

HIV/AIDS is a serious health problem among prisoners and constitutes a big challenge for prison administration services, public health services and governments. Aims: Determine the prevalence of HIV infection among prisoners and describe associated factors. Population and Methods: This was a descriptive and analytical cross-sectional study conducted from December 2015 to October 2016. A sample of 600 prisoners was randomly interviewed nationwide. They were selected directly from the sample frame from across the country and proportionally from all sites. Pre-established questionnaires providing information on the sociodemographic and biological characteristics of prisoners were used for the collection of data. Data entry and analysis were performed using EXCEL and SPSS 18 software. Results: The survey was based on a randomised sample of 600 prisoners, 593 of whom accepted blood extraction for the HIV testing. The series was mainly composed of males (89%). The median age was 33 years (18 - 69). The level of education among respondents was 60%. Regarding marital status, the proportion of married prisoners was 51.8%. Almost three-quarters (71.5%) were at their first imprisonment and 51.8% were on preventive detention. The reasons for imprisonment varied and were dominated by drug use (35.3%), while only 4.6% confessed that they continued using drugs while in prison. 97.8% of prisoners have had a sexual experience. Their median age was 19 years at their first sexual interc

关键词： HIV Infection Prison Associated Factors Senegal

Management of Post-Operative Pain after Gyneco-Obstetrical Surgery: Practice of Transversus Abdominis Plane Bloc (Tap Block) Echoguide at the Ignace Deen National Hospital

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Open Journal of Anesthesiology 2021年第10期11卷 316-324页

作者： Donamou Joseph Bangoura Almamy Touré Abdoulaye Camara amadou Yalla Traoré Abdourahamane Dine Camara M’Mah lamine Camara M’Mah lamine Dramé Boubacar Atigou Camara Mariama Mohamed Orou Yerima Therese Touré Aboubacar Anesthesia-Intensive Care Unit Donka National Hospital Conakry Guinea Anesthesia-Intensive Care Unit National Ignace Deen Hospital Conakry Guinea Medico-Surgical Emergency Department Donka National Hospital Conakry Guinea General and Visceral Surgery Department Ignace Deen National Hospital Conakry Guinea

Objectives: To describe the practice of ultrasound-guided TAP in the management of postoperative pain after gyneco-obstetric surgery. Methods: This was a descriptive prospective study carried out at the Gynecology-Obstetrics department of the Ignace Deen National Hospital over a period of three (03) months from February 01, 2020 to April 31, 2020. Results: In total, we collected 95 patients. These patients had a mean age of 30 ± 9.5 years. The ASA I class was the most represented with 76% of the cases and the cesarean was the most performed intervention. Regarding the assessment of the pain score by the simple verbal scale (SVE) postoperatively at rest, the mean SLE scores at H6 were 0.17 ± 0.38;at H12 of 1.15 ± 0.62;at H24 of 0.84 ± 0.51;at H36 0.45 ± 0.52 and at H48 0.09 ± 0.29. On mobilization, the mean pain scores were 0.77 ± 0.51 at H6, at H12 1.89 ± 0.61;at H24 of 1.53 ± 0.56;at H36 of 1 ± 0.29 and at H48 of 0.82 ± 0.44. The majority of our patients (66.3%) had a mobilization time of less than 24 hours. The mean length of stay was 3.1 ± 1.3 days and most patients (82%) were satisfied with the management of their pain by ultrasound-guided TAP block. Conclusion: Ultrasound-guided TAP is an effective technique for the management of postoperative pain in gyneco-obstetrics surgery. Its integration in a context of multimodal analgesia could improve the management of postoperative pain in gynecological obstetrics.

关键词： Postoperative Pain TAP Block Ultrasound Guidance Gyneco-Obstetrics