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Ruptured Ectopic Pregnancy: Epidemiology and management in the General Surgery Department of the ignace Deen National Hospital, Conakry University Hospital

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Open Journal of Obstetrics and Gynecology 2024年第4期14卷 503-508页

作者： Barry mamadou Sakoba Barry boubacar Guirassy ma.iam touré Aboubacar Diallo Aissatou Taran Department of General Surgery Ignace Deen National Hospital/Conakry University Hospital Conakry Guinea Faculty of Health Sciences and Technology Gamal Abdel Nasser University of Conakry Conakry Guinea

introduction: The aim of this study was to contribute to improving the quality of GEUR management in the general surgery department and in the maternity ward of the ignace Deen national hospital, Conakry University Hospital. Methodology: This was a retrospective, descriptive study lasting two years (January 1, 2020 to December 31, 2022), carried out in the general surgery and gyneco-obstetrics departments of the ignace Deen national hospital, Conakry University Hospital. We included all patients with a ruptured ectopic pregnancy who received surgical treatment during the study period. Results: We collected 13,524 cases of surgical interventions in the two services, among them, we recorded 89 cases or 0.66% GEUR. The average age of the patients was 24.26 years. Brides were the most represented with 80.96% of cases. Women practicing a liberal profession were 51.69% (n = 46) and housewives 26.97% (n = 24). Clinically, amenorrhea was noted in all patients, i.e. 100%, abdominal-pelvic pain in 95.2% (n = 85) of cases, metrorrhagia in 94.08% (n = 84), abdominal-pelvic sensitivity in 97.44% (n = 87) of cases and anemia in 85.39% of cases. The GEUR was ampullary in 69.66% (n = 62) cases. Salpingectomy was performed in 90.72% (n = 81). The surgical outcomes were satisfactory in 98.87% (n = 88) of cases. We recorded one case of surgical site infection. We have not recorded any deaths. The average length of hospitalization was 4 days. Conclusion: GEUR is relatively high in our context. A good understanding of the prognostic factors of GEUR, awareness and family planning could reduce GEUR.

关键词： Ruptured Ectopic Pregnancy Epidemiology and management

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Splenectomy: indications in the General Surgery Department of ignace Deen Hospital

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Surgical Science 2024年第4期15卷 219-224页

作者： mamadou Sakoba Barry boubacar Barry Sandaly Diakité Aboubacar touré Aissatou Taran Diallo General Surgery Department Ignace Deen National Hospital at Conakry University Hospital Conakry Guinea Faculty of Health Sciences and Technology Gamal Abdel Nasser University of Conakry Conakry Guinea

introduction: Splenectomy is the surgical removal of the spleen. it can be performed during various pathologies, ranging from abdominal trauma to hemoglobinopathies. The progress made in the knowledge of the immune functions of the spleen and the fear of post-splenectomy infectious complications have favored the development of surgical or non-surgical splenic preservation techniques calling into question the dogma of splenectomy. The aim of this study was to determine the indications for splenectomy. Methodology: This was a retrospective, descriptive study lasting 5 years in the general surgery department of the ignace Deen National Hospital. All files of splenectomized patients were included, our variables were clinical, therapeutic and progressive. Results: We collected 42 cases of splenectomies out of the 2478 surgical procedures performed, representing 1.7% of the department’s surgical activities. The average age was 44 years. The age group of 41 to 50 years was the most represented, i.e. 26% (n = 11) of cases. Sex ratio = 1. Abdominal pain was the reason for consultation in patients, i.e. 100% (n = 42) of cases. The antecedents were dominated by recurrent malaria with 52.3% (n = 22) of cases, then recurrent anemia in 21% (n = 9), and 16.7% (n = 7) had sickle cell disease. Splenomegaly was found in 31 patients, or 73.6%. Ultrasound was performed in all patients. The indications for splenectomy were: isolated splenomegaly with risk of rupture (38%, n = 16), hypersplenism (26%, n = 11) and trauma to the spleen (19.04%, n = 8). Total splenectomy was performed in all cases. The surgical consequences were favorable in 85.7%, (n = 36) with morbidity of 14% (n = 6) and mortality of 9.52% (n = 4). The average length of hospitalization was 10.4 days with extremes of 1 and 22 days. Conclusion: Splenectomy constitutes a relatively common surgical procedure in our context. The indications for splenectomy were isolated splenomegaly with risk of rupture, hypersplenism and tra

关键词： Splenectomy indications ignace Deen

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Thyroidectomy: Frequency and indications in the General Surgery Department of the Hôpital National ignace Deen/CHU de Conakry

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international Journal of Otolaryngology and Head & Neck Surgery 2024年第3期13卷 157-167页

作者： mamadou Sakoba Barry mamadou Mouctar Ramata Diallo Houssein Fofana Vignin Baudouin Kpossou boubacar Barry Aboubacar touré Aissatou Taran Diallo General Surgery Department H&#244pital National Ignace Deen/CHU de Conakry Conakry Guinea Faculté des Sciences and Techniques de la Sant&#233-Universit&#233 Gamal Abdel Nasser de Conakry Conakry Guinea ENT Department Mamou Regional Hospital Mamou Guinea

introduction: Thyroidectomy is a surgical procedure to remove all or part of the thyroid gland. The aim of this study was to report the results of thyroidectomy in the general surgery department of the Hôpital national ignace Deen/CHU de Conakry. Methodology: This was a retrospective study, of seven (07) years (January 1, 2016 - August 31, 2023), in the General Surgery Department of the ignace Deen National Hospital-CHU in Conakry. We included all records of patients admitted and operated on for thyroidectomy and with up-to-date medical records. The variables were epidemiological, clinical and therapeutic. Results: During the study period, we recorded 3221 cases of surgery, including 40 thyroidectomies (1.24% of cases). The average age was 42.4 years. Women were the most represented, with a sex ratio of 0.16. The reason for consultation was anterior cervical swelling in 86% (n = 25) of cases, followed by signs of cervical compression 21% (n = 6) and signs of thyrotoxicosis 31% (n = 9). indications for thyroidectomy were dominated by homogeneous goitres in 69% (n = 20) of cases, basedow’s disease in 20.7% (n = 6) and nodular goitres in 6.9% (n = 2) of cases. The surgical procedures were lobo-isthmectomies in 72.4% (n = 21), subtotal thyroidectomies 13.8% (n = 4), total thyroidectomies 10.3% (n = 3). Postoperative follow-up was straightforward in 69% (n = 20). Complications included haemorrhage in 20.7% (n = 6) and recurrence in 6.9% (n = 2). The average hospital stay was 7 days. Conclusion: Thyroidectomy is a relatively frequent surgical procedure in our department. indications are dominated by homogeneous goitres. Morbidity is related to hemorrhage. Rigorous hemostasis could improve the quality of thyroidectomy.

关键词： Thyroidectomy indication ignace Deen

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Contribution of Stress Testing to the management of ischemic Heart Disease in ma.i

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World Journal of Cardiovascular Diseases 2024年第2期14卷 77-87页

作者： Youssouf Camara Hamidou Oumar Ba ibrahima Sangaré boubacar Sonfo Coumba Adiaratou Thiam mahamadou Sékou Diakité Koniba Diarra Karamba touré massama Konaté ichaka Menta Cardiology Department University Hospital Professeur Bocar Sidi Sall Kati Kati Mali Cardiology Department University Hospital Gabriel Touré Bamako Mali Cardiology Department Mali Hospital Bamako Mali

introduction: Exercise stress testing (on a treadmill or ergometer bicycle) is an important test in cardiology for diagnosing myocardial ischemia. This test in ma.i is still in its beginning compared to other countries in the sub-region. The lack of data in ma.i prompted this study, which aimed to evaluate the indications of this activity and its diagnostic contribution to cardiology in ma.i. materials and Methods: This was a retrospective, descriptive study. The study was conducted at the “TOUCAM” medical clinic in Kati based on the analysis of stress test reports between January 2016 and August 2022. Result: During the study period, we documented 73 patients who underwent exercise testing on a bicycle ergometer for suspected coronary heart disease. The mean age of our patients was 47.5 ± 13.8 years (14 and 79 years). males accounted for the majority (78.1%). The sex ratio is 3.5. More than half of our patients were overweight or obese (77.1%). Hypertension and diabetes affected 52.1% and 25.8% of patients, respectively. 20.8% of patients had coronary artery disease. renin-angiotensin-aldosterone system blockers (56.8%) and beta-blockers (51.3%). The main indications were chest pain (63.0%) and ischemia detection (15.1%). A modified STEEP protocol was used. The majority of our patients (71.2%) achieved at least 85% of their ma.imum theoretical heart rate. The main reason for the termination of the study was fatigue (57.3%). The average duration was 11.3 ± 4.2 minutes. 24.7% thought the stress tests were positive and 17.8% thought they were controversial. Conclusion: This study demonstrates the importance of stress testing in the diagnosis and treatment of ischemic heart disease, especially in settings where we have very limited access to coronary angiography.

关键词： Stress Test ischemic Heart Disease ma.i

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Therapeutic Compliance of Hypertensive Patients Followed in Ambulatory in the Cardiology Department of Kati University Hospital

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World Journal of Cardiovascular Diseases 2024年第5期14卷 333-342页

作者： boubacar Sonfo Coumba Thiam ma.iam Sako massama Konaté Youssouf Camara mamadou touré boubacar Diarra Diakaridja Sacko Samba Sidibé Bassan Diarra Hamidou Camara Asmaou Keita Konimba Diarra Hamidou Oumar Bâ ibrahima Sangaré Youssouf Guindo Sanoussi Daffe Daouda Fofana Souleymane Coulibaly ichaka Menta Department of Cardiology University Hospital Bocar Sidy Sall Kati Mali Department of Cardiology University Hospital of Point G Bamako Mali Department of Cardiology Mali Hospital Bamako Mali Department of Cardiology University Hospital Mother-Child Luxembourg Bamako Mali Department of Cardiology University Hospital Gabriel Tour&#233 Bamako Mali Department of Cardiology Kayes Hospital Kayes Mali

introduction: High blood pressure is a major public health problem worldwide due to its frequency and cardiovascular complications. Adherence to treatment for chronic diseases is a global problem. The aim was to study therapeutic adherence in hypertensive patients followed in ambulatory. materials and Methods: This was a cross-sectional, descriptive study with prospective recruitment that took place from July 1 to December 31, 2022 (6 months) in the cardiology department of the university hospital of Kati. The variables studied were sociodemographic data, cardiovascular risk factors, comorbidities, the possession of insurance and compliance (the Girerd questionnaire was used to assess adherence). Results: A total of 1182 patients were consulted, including 887 for hypertension, a frequency of 75%. Fifty-six patients were included in the study. The average age was 58.18 ± 13.25 years with extremes of 30 and 80 years. There was a female predominance (75%) with a sex ratio of 0.3. The majority of patients lived in urban areas (89.3%). Out-of-school patients accounted for 44.6%, more than half of patients or 55.4% had no income, patients with medical coverage accounted for 67.9% of cases. The main risk factors were physical inactivity (25%) followed by smoking 14.3%. More than 71% of patients had a compliance problem and the main reasons were forgetting to take the drug with 73.2%, followed by delayed treatment of 50% and drug discontinuation of 28.6%. Conclusion: Compliance is a real challenge and a major public health issue. This study allowed us to find a real problem of compliance in our hypertensive patients. There was a statistically significant relationship between drug adherence and forgetting to take the drug and drug discontinuation.

关键词： Hypertensive Therapeutic Adherence University Hospital of Kati

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Therapeutic Profile and Prognostic Factors of Patients Suffering from Upper Digestive Bleeding at Sikasso Regional Hospital

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Open Journal of Gastroenterology 2024年第9期14卷 300-312页

作者： Oumar Traoré Abdoul Salam Diarra Dramane touré Tawfiq Abu Amadou Boubeye maïga Kadiatou Cissé Saïdon touré Mohomedine touré Aboudou Dolo Youana Koné madou Traoré mamadou Togo Kalba Péliaba mamadou Samaké Hamadoun Sangho Service of internal Medicine Regional Hospital Sikasso Mali National Center for Scientific and Technological Research Bamako Mali Department of Pediatric Health Referral Center of Kalaban Coro Koulikoro Mali Private Practice for Family and Emergency Medicine Casablanca Morocco Service of Nephrology Regional Hospital Sikasso Mali Department of infectious Disease Regional Hospital Sikasso Mali Service de Mdecine interne CHU Gabriel Tour Bamako Mali Service dHpato-Gastro-Entrologie CHU Gabriel Tour Bamako Mali Department of Public Health Faculty of Medicine and Odontostomatology University of Sciences Techniques and Technologies of Bamako Bamako Mali

introduction: Upper digestive hemorrhage is one of the main digestive emergencies and remains a major cause of morbidity and mortality in ma.i. The aim of this study was to describe the therapeutic profile and outcome of patients suffering from upper digestive haemorrhage. Methodology: This was a prospective study carried out in the internal medicine department of the Sikasso Regional Hospital from August 2022 to July 2023. All adult patients presenting with upper digestive haemorrhage and having given their consent, were included. Data were analyzed using SPSS version 21 software. Results: Sixty-three patients were enrolled. The mean age was 49.7 ± 18.99 years, with a male-female sex ratio of 2.2. Ruptured esophageal varices (37.5%) and peptic ulcer (25%) were the main etiologies. Pharmacological treatment was dominated by proton pump inhibitors (85.7%). Hemostasis endoscopy accounted for 3.17%. The evolution was marked by hemorrhagic arrest (69.84%), recurrence of hemorrhage (11.11%) and death (19.04%), the main cause of which was hemorrhagic shock (58.3%). We found no statistically significant relationship between prognosis and etiologies (P = 0.11), and length of hospital stay (P = 0.18). Conclusion: Hemostasis endoscopy remains a challenge for Sikasso Hospital. A holistic strategy of communication and community awareness-raising, combined with adequate technical facilities, will help to improve patient care and outcomes.

关键词： Digestive Hemorrhage Digestive Endoscopy Treatment Outcome

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Morbidity and Mortality of Newborns in a Context of Limited Resources in Tombouctou, ma.i

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Open Journal of Pediatrics 2024年第5期14卷 841-850页

作者： Kassogué Djibril Cissouma Assétou Kassogué Abdoulaye Boré boubacar Sogoba Robert Diallo Zoumana maiga Talfi Dolo Akoro Sogoba Seydou touré Lahaou maiga ma.iam Samaké Alou ma.iko Souleymane Ongoiba Oumar Sanogo Oumar Traoré Bassirima Paediatrics Department Timbuktu Hospital Timbuktu Mali Paediatrics Department Sikasso Hospital Sikasso Mali Paediatrics Department Nianankoro Fomba Hospital Sgou Mali Department of Obstetrics and Gynaecology CHU du Point G Bamako Mali Department of Paediatrics Commune VI District Hospital Bamako Mali

introduction: Worldwide, 2.3 million children died in the first 20 days after birth in 2022, according to the WHO. in ma.i, according to the sixth Demographic and Health Survey, the neonatal mortality rate was estimated at 33% live births in 2018. The Timbuktu region had the highest neonatal mortality rate in the country with 44%. The objective of this work was to study the causes of neonatal morbidity and mortality and related factors in the paediatrics department of Timbuktu hospital. materials and method: This was a descriptive, cross-sectional study conducted from 1 January to 31 December 2023 in the neonatology unit of the paediatrics department of Timbuktu hospital, including all newborns admitted to hospital. Results: Our study took place over 12 months, during which 618 admissions were made to the paediatric ward, including 244 newborns, i.e. 39.48%. The majority of newborns (86.5%) were admitted in the first week of life. The mean age was 3 days, with a sex ratio of 1.1 for males. Weight under 2500 g was 54.1% for an average weight of 2372 g. The main mode of admission was transfer from the hospital maternity unit (62%). The main reasons for admission were acute foetal distress (27.9%) and prematurity (26.2%). The average age of the mothers was 24, with extremes of 15 and 49. The mothers were housewives (87.3%), uneducated and primiparous (59% and 36.5% respectively);only 40.2% had made more than 3 antenatal care visits. Newborns born by vaginal delivery accounted for 80.7% and those born by caesarean section for 19.3%. The risk of infection was present in 52.5% of cases. The three leading causes of hospitalisation were birth asphyxia (40.2%), neonatal infection (32.4%) and prematurity (25%). The mortality rate was 21.7%. The main causes of death were prematurity (39.6%), birth asphyxia (32.1%) and neonatal infection (24.5%). Conclusion: Neonatal morbidity and mortality remain a concern in Timbuktu. Despite the unfavourable security situation, morbidity and

关键词： Morbidity Mortality Newborns Timbuktu

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Screening, Treatment and Control of High Blood Pressure on Five Sites in ma.i

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World Journal of Cardiovascular Diseases 2024年第5期14卷 322-332页

作者： mamadou touré Sagara ibrahima Youssouf Camara Hamidou Oumar Bâ ibrahima Sangaré Djénébou Traoré Noumou Sidibé Fousseyni Samassékou massama Konaté Coumba Thiam Doumbia Asmaou maiga Réné-ma.ie Dakouo Hamidou Camara Sako ma.iam Sidibé Samba Adama Sogodogo boubacar Diarra boubacar Sonfo Aladji Traoré mamadou Diakité ilo Bella Diall ichaka Menta Departement of Cardiology University Hospital Gabriel Tour&#233 Bamako Mali Departement of Cardiology Cardiology University Hospital Sidy Bocar Sall Kati Mali internal Medecine University Hospital Point G Bamako Mali Departement of Cardiology Cardiology University Hospital &#8220H&#244pital du Mali&#8221 Bamako Mali Departement of Cardiology Cardiology University Hospital Mother-Children Bamako Mali

introduction: High blood pressure is defined as blood pressure greater than or equal to 140 mm Hg for systolic and or 90 mm Hg for diastolic. it constitutes a major public health problem, the leading chronic disease in the world. The objective was to determine the prevalence, treatment rate and control of hypertension. Methods: This was a cross-sectional and descriptive study which took place over a period of 6 months in a hospital environment and in the general population. Results: Of the 1000 participants, 637 had hypertension, giving a prevalence of 63.70% with a female predominance. Thirty-three percent (33%) were unaware of their high blood pressure. The age group 60 and more was the most represented (44%). A proportion of 33 and 23.20 were overweight and obese participants, respectively. male subjects were more overweight than female, unlike obesity which was more common among female subjects. Sixty-two percent (62%) of hypertensives were treated, of whom 44% were non-compliant. The excessively high cost and consumption of medications as needed were the main factors in therapeutic non-compliance. Twenty-two percent (22%) of all hypertensive patients and 35% of treated hypertensive patients were controlled. Women were more treated but less observant and less controlled than men. Therapeutic coverage and combination therapy rates were lower in rural areas. Hypertensives who had a high level of education were better treated and controlled than those who had no level. Conclusion: High blood pressure remains a real public health problem in ma.i. it is more common in people aged 60 and over and in females. One in three hypertensives were unaware of their hypertension. The majority received antihypertensive treatments, but only a minority of them had their hypertension controlled.

关键词： High Blood Pressure Screening Control Rate ma.i

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Evaluation of Antibiotic Prescribing in the Pediatric Department of Gabriel touréTeaching Hospital, Bamako, ma.i

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Open Journal of Pediatrics 2024年第3期14卷 645-656页

作者： Pierre Togo Hawa Konaré ma.iam maïga Karamoko Sacko Djénéba Konaté Abdoul Karim Doumbia Adama Dembélé Oumar Coulibaly Aminata Sangaré Mohamed Elmouloud Cissé Fousseyni Traoré Belco maïga ibrahim Ahamadou Aminata Doumbia Lala N’Drany Sidibé Amadou touré Yacouba Aba Coulibaly Kalirou Traoré Tati Simaga Souleymane Sagara Leyla Bagna maïga Bory Traoré Abdoul Aziz Diakité Fatoumata Dicko ma.iam Sylla Sounkalo Dao boubacar Togo Paediatric Department Gabriel Tour&#233 Teaching Hospital Bamako Mali Pediatric Department Distric VI Reference Health Center Bamako Mali infectious Diseases Department Point G Teaching Hospital Bamako Mali

Objectives: The main objective was to evaluate antibiotic prescribing in the Department of Pediatrics at Gabriel touré teaching hospital. Methods: This was a prospective descriptive study conducted from September 1 to November 31, 2018, in the Department of Pediatrics at Gabriel touré teaching hospital. All children aged 0 to 15 years hospitalized for any pathology during the study period and having received at least one antibiotic had been included. Results: We collected 445 children’s records out of 1032 admissions during the study period, representing a hospital frequency of 43.1%. The sex ratio was 1.3%. The 2 - 5 age group accounted for 48.1%. Fever was the reason for consultation in 45.6% of cases. Patients’ general condition was altered in 60% of cases. The fathers were blue-collar workers in 65.4% and the mothers housewives in 85%, and had no education in 42.9% and 64.5% respectively. Hepatomegaly was present in 18.2%, splenomegaly in 9.6% and peripheral adenopathy in 3.1%. The site of infection was pulmonary in 37.6% and ENT in 9.2%. Bacterial infection was assumed on admission in 54% of cases, and meningitis in 57.7%. The discharge diagnosis was malaria in 54.6%, severe acute malnutrition in 18.6% and meningitis in 6.7%. The death rate was 3.8%. Neutrophilic leukocytosis was present in 47.3% of patients. CRP was positive in 85% of patients. Blood cultures taken in 27.6% of patients were positive in 5. CSF analysis in 30% of patients showed elevated leukocytes in 6.5%. No cultures were positive. Antibiotic prescription was justified by infectious hypotheses in 43.1% of patients. β-lactam antibiotics were prescribed in 98.6%. Antibiotic therapy was not adapted to national/international recommendations in 68.3% of cases, and was not justified in 16.3% of cases on D5 of hospitalization. Conclusion: Antibiotic use was justified in more than half of patients, but remained inadequate in almost two-thirds of cases, in line with national and international recommend

关键词： Antibiotic Prescription Hospitalization Child

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Epidemiology and Prognosis of Hepatocellular Carcinoma (HCC) in the internal Medicine Department of the Bouake University Hospital (Côte d’ivoire)

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Open Journal of Gastroenterology 2024年第9期14卷 289-299页

作者： Nguessan Michel Konan Stéphane Yapa Lauret Kouassi Tiépé Rokia Ouattara Kadidiata touré Fiacre Abbé Georges Stéphane Koffi Bourhaïma Ouattara Department of internal Medicine Treichville Teaching Hospital Abidjan Cte dIvoire Medical Sciences Training and Research Unit Flix Houphouet Boigny University Abidjan Cte dIvoire Department of internal Medicine Teaching Hospital of Bouake Bouake Cte dIvoire Medical Sciences Training and Research Unit Alassane Ouattara University Bouake Cte dIvoire

Background and Objective: Hepatocellular carcinoma (HCC) is a public health problem due to its high incidence and high mortality rate. The epidemiology and prognosis of this disease is poorly documented in Bouake. The aim of the study was to describe the epidemiological aspects and identify the predictors of death in patients hospitalized for HCC in the internal Medicine Department of the Bouake University Hospital in order to improve patient management. material and Methods: We conducted a cross-sectional study from 1 January 2020 to 31 December 2022 in the internal Medicine Department of Bouake University Hospital, involving 160 patients. Results: The prevalence of HCC was 3.6%, the mean age was 48.86 ± 14.5 years with extremes of 14 and 90 years and the sex ratio was 2.90. Viral hepatitis B was observed in 81% of patients, with HBs Ag positivity in 71.2%. The performance status of WHO was ≥ 2 in 93.2% of cases. HCC was discovered at advanced stage respectively in 51% for BCLC C and 47.8% for BCLC D stage. The nodules were multiple (89.3%), and superior to 3 cm. The hospital mortality was 20% and BCLC D stage of HCC was significantly associated with death (p = 0.04) in the univariate analysis. The BCLC D stage of HCC was significantly associated with death. Length of stay inferior to 5 days (OR = 0.77;Ci 95: 0.61 - 0.96) and hepatic encephalopathy (OR = 1.39;Ci 95: 1.10 - 1.77), were the two independent predictors of mortality. Conclusion: HCC mainly affected young men infected with chronic viral hepatitis B. Short length of stay and hepatic encephalopathy were independent predictors of mortality.

关键词： Liver Cancer Viral Hepatitis Death West Africa

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