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Study on Compliance with Radiation Protection Rules in the Medical Imaging Department of Pr Bocar Sidy Sall Hospital of Kati (Mali)

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Open Journal of Radiology 2022年第4期12卷 239-257页

作者： Issa Diarra Salia coulibaly Ilias Guindo Cheick Oumar Keita Soumaïla Diallo Souleymane Sanogo Hawa Diarra Boubacar Sonfo Aboubacar Sidiky N’diaye Youssouf Kone bourama Diarra Medical Imaging Department The CHU Pr Bocar Sidy Sall Kati Mali Medical Imaging Department Perinatal Clinic Mohamed VI Bamako Mali Medical Imaging Department The Mother-Child Hospital Luxembourg Bamako Mali Medical Imaging Department The Hospital of Mali Bamako Mali Pasteur Polyclinic Bamako Mali Centre Hospitalier Jacques Boutard Saint Yrieix La Perche France Centre de Radiologie Diagnostique et Interventionnelle CRDI Bamako Mali

Objective: Evaluate the level of compliance with radiation protection rules in the medical imaging department of the University Hospital Center (CHU) of Kati. Methodology: This was a cross-sectional and descriptive study carried out in the medical imaging department of Pr Bocar Sidy Sall (BSS) Hospital of Kati. A questionnaire was developed and sent to the staff of the medical imaging department. The assessment focused on the radiation protection of personnel, radiation protection measures for patients, the delimitation and signage of zoning as well as the application of radiation protection principles. Results: Twenty-one people participated in the study, 90% of whom were men. The 30 - 39 age group was predominant with 61.90%. 33.33% of the staff knew the principles of radiation protection;86% of our sample knew the basic rules of radiation protection. The majority of the staff in the imaging department (61.90%) had a perfect knowledge of protective equipment. For 76% of our workforce, the limits of the radiation doses received are regulated in Mali. 76% of those surveyed have not taken any additional training in radiation protection. The doors are closed during the X-ray examination for 76.19% of the respondents and 95% of the staff put themselves behind the sealed screen during the examination. For 81% of the respondents, the design of the premises met radiation protection standards. 62% of practitioners have a dosimeter and 80% of them wear it during their shift. For 62% of our sample, the change of the dosimeter is quarterly. The systematic request for DDR (date of last menstrual period) in women and the adaptation of the delivered dose to the patient’s morphology was only carried out by 65% of practitioners. The majority of staff (81%) did not benefit from medical surveillance, while for 55% of respondents the level of radiation protection in the establishment was average. Conclusion: This study enabled us to highlight the shortcomings in terms of radiation pr

关键词： Radiation Protection Compliance X-Rays Dosimetry

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Epidemioclinical Profile of Premature Infants at the Neonatology Unit of the Mali Hospital 2012-2015

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Open Journal of Pediatrics 2021年第3期11卷 490-502页

作者： bourama Kané Mamadou Berthé Guédiouma Dembélé Korotoumou Wélé Diallo Diakaridia Koné Fatou Diawara Fanta Sidibé Oumou Koné Mamadou coulibaly Mariam Maiga Mariam Sylla Department of Pediatrics Mali Hospital Bamako Mali National Institute of Public Health Bamako Mali Reference Health Centre of the Commune I Bamako Mali Gynaecological and Obstetric Service Mali Hospital Bamako Mali Paediatrics Department of the Centre de Santé de Référence de la Commune VI Bamako Mali Gabriel TOURE University Hospital Bamako Mali

Introduction: A newborn is preterm when it is born before 37 weeks of amenorrhoea. Preterm births account for 11.1% of live births worldwide, 60% of which are in South Asia and sub-Saharan Africa. Preterm birth is the leading cause of neonatal mortality and the second leading cause of mortality in children under 5 years of age. The aim of this study was to investigate prematurity in the neonatology unit of the Mali Hospital. Materials and Methods: This was a cross-sectional, descriptive study from January 2012 to December 2015 of premature newborns from 28 to 36 weeks of amenorrhea in the neonatology unit of Mali Hospital. Results: From January 2012 to December 2015, we recorded 1692 inpatient newborns, including 614 preterm newborns, a frequency of 36.29%. The sex ratio was 1.43 in favor of boys. The average age of the mothers was 23.9 years with a minimum of 15 and a maximum of 47 years. The majority were housewives (92.7%). The pregnancy was poorly monitored in 51.8% of the mothers. The average gestational age was 32.9 days with extremes of 25 and 36 days. The most frequent mode of delivery was vaginal delivery (93.2%), with late prematurity in 51.5%, moderate prematurity (24.4%), extreme prematurity (18.7%) and very premature (5.4%). The mean birth weight was 1464 g with a standard deviation of 485 g and 2751 g. Prematurity was associated with neonatal infection in 49.4% of newborns, perinatal anoxia (13.9%) and hypotrophy (2.6%). The most frequent maternal risk factors were fever (83.4%), twinship (38.9%) and high blood pressure (8.6%). The average length of hospitalization was 9.75 days with extremes of 0 and 68 days. We recorded a cure rate of 57.7%, a death rate of 35.7% and a dropout rate

关键词： Epidemioclinical Profile Prematurity Mali Hospital

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Endocranial Suppurations of Sinus Origin: Ratio of 3 Cases in Children at the Hospital in Mali

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Open Journal of Pediatrics 2021年第3期11卷 517-531页

作者： bourama Kané Korotoumou Wélé Diallo Mohamed Maba Traoré Boubacar Mami Touré Mahamadou Dama Mody Abdoulaye Camara Guédiouma Dembélé Daouda Sissoko Oumar coulibaly Mamadou Traoré Pediatrics Department of Mali Hospital Bamako Mali Medical Imaging Service Bamako Mali Neurosurgery Department of the Mali Hospital Bamako Mali Pediatric Service of the Commune Reference Health Center V Bamako Mali

Introduction: Intracranial suppurations are neoformed purulent collections including, in decreasing order, cerebral abscesses, subdural empyemas and extradural empyemas. Otorhinolaryngologic infections are one of the main causes, especially in older children and adolescents. We report 3 clinical cases of endocranial suppurations treated at the Mali Hospital. Clinical Cases: 1) Observation 1. IK was a 14-year-old boy, who was hospitalized in our department for fever, headache and left hemiplegia. The emergency brain scan showed a right frontal and interhemispheric subdural empyema associated with multifocal sinusitis. Surgical drainage associated with ceftriaxone: 100 mg/Kg/d in direct intravenous (DI), metronidazole: 10 mg/Kgs/12hours in slow intravenous (SI) for 15 days, gentamycin: 3 mg/Kgs/d in SI for 3 days, paracetamol 15 mg/Kgs/6hours in SI, 10% glucose serum: 100 ml/Kg/d were given. The bacteriological analysis of the pus came back sterile. The postoperative period was calm. 2) Observation 2. This was a 14-year-old boy with a history of headaches who was admitted to our department for left hemiplegia. An emergency brain scan showed a right pre-suppurative encephalitis associated with a right fronto-ethmoidal and maxillary sinusitis. He was put on ceftriaxone 100 mg/kg/d in DI for 21 days, gentamycin: 3 mg/Kg/d in SI for 3 days;metronidazole: 10 mg/kg/12hours in SI for 21 days, paracetamol: 15 mg/kg/6hours in SI. After 3 weeks of medical treatment, a follow-up brain scan revealed an interhemispheric and right subdural empyema. Surgical drainage was associated with the triple antibiotic therapy initially instituted. The bacteriological analysis of the pus was sterile. The postoperative course was calm. 3) Observation 3. N.M was an 11-year-old boy, who was admitted with fever and left hemiplegi

关键词： Sinusitis Endocranial Suppurations Mali Hospital

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Clinical and Therapeutic Aspects of Genital Prolapse at Hôpital du Mali about 100 Cases

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Open Journal of Obstetrics and Gynecology 2023年第1期13卷 121-132页

作者： Mamadou Bakary coulibaly Mody Abdoulaye Camara Alassane Traoré Mamadou Keïta bourama Kané Abdramane Togo Issa Ongoiba Kalba Tembiné Amadou Sidibé Baba Fané Ibrahima Tégueté Youssouf Traoré Gynecology Department of Hô pital du Mali Bamako Mali Medical Imaging Department of Hô pital du Mali Bamako Mali Referral Health Center of Commune VI of the District of Bamako Bamako Mali Pediatrics Department of Hô pital du Mali Bamako Mali Anesthesia and Intensive Care Unit Hô pital du Mali Bamako Mali Biomedical Department of Hô pital du Mali Bamako Mali Department of Gynecology Obstetrics UTH Gabriel Touré Bamako Mali

To study the epidemio-clinical aspects, and the therapeutic attitudes of genital prolapse (GP) in the gynecology department of Hôpital du Mali (HDM). This is a descriptive retro-prospective study over five (5) years from January 2015 to December 2019, conducted in the gynecology department of HDM. We had collected 100 cases of GP out of 989 surgeries, with a frequency of 9.89%. The age group of 60 years and over accounted for 33% of our patients, with a mean age of 50 years. Multiparous were the most affected (89%). The notion of obstructed labor was observed in 52% of patients. The most found reason for consultation was the feeling of lump in a vagina, with 65%. Grade III according to BADEN-WALKER classification system (BWCS) concerned 72% of our patients. Triple perineal surgery and hysterectomy involved 56% of our patients. Spinal anesthesia was performed in 96% of cases. Per and postoperative complications were dominated by urinary retention in 4% and by infection of the surgical site in 2%. The average hospital stay was 3.2 days. We recorded 88% of satisfied patients after the intervention. No deaths were recorded during the study. The management of genital prolapse remains essentially surgical;it requires a semiological analysis and a mastery of the surgical technique.

关键词： Genital Prolapse Therapeutic Attitudes Hôpital du Mali

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Operating Site Infections at General Surgery Department of Gabriel Toure Training Hospital

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Surgical Science 2015年第2期6卷 59-64页

作者： Bakary Tientigui Dembélé Alhassane Traoré Adégné Togo Lassana Kanté Ibrahim Diakité bourama Diarra Amadou Traoré Madiassa Konaté Boubacar Karembé Yacaria coulibaly Mamby Keita Souleymane Diallo Souleymane Diallo Gangaly Diallo Faculty of Medicine and Odonto-Stomatology Bamako Mali Department of General Surgery CHU Gabriel Touré Bamako Mali Department of Biology and Laboratory CHU Gabriel Touré Bamako Mali

The operating site infections constitute the major postoperative issue in surgery. Our objectives were to determine the hospital frequency, the risk factors, the involved germs as well as the cost generated by the operating site infections. Method: Our three months prospective survey run from September the 1st to November the 30th 2013 has included all department patients being operated on and hospitalized. The criteria have been set by CDC d’Atlanta. Results: 374 files were involved, among them 229 (61.2%) were emergencies and 145 (38.8%) were scheduled. The average age was 41 (extremes 7 and 95 standard deviation 17.46), the sex ratio 1.67. The infective risk according to Altmeier has found 17.5% type 1, 25.1% type 2, 11.2% type 3 and 46.3% type 4;according to NNISS, 96 (25.7) were NNISS 0;94 (51.9%) NNISS 1;80 (21.4%) NNISS 2;and 4 (1.1%) NNISS. In the Altmeier class I have not got antibiotic before infection signs appearances. Our overall rate of operating site infections was 7.9% (29 cases), with 24 (82.8%) emergency cases. According to Altmeier’s class of infective risk, the rate of operating site infections was 1.54% making 1 out of 65 type I patients;4.3% making 4 out of 93 type II patients;11.9% making 5 out of 42 type III patients;10.9% making 19 out of 174 type IV patients. According to NNISS, the infective risk has been assessed and was 2.08% for score 0, we have got 8.25% score 1, and 12.5% for score 2, and 25% for score 3. The bacteriology has been dominated by Escherichia colii(51.7), Proteus mirabilisi(13.8), and Klebsiella pneumoniaei(10.34). The germs have been resistant to the combination Amoxicillin-clavulanic Acid between 50% and 87% of cases. The most active antibiotics on the germs have been Cephalosporin, Polypeptides, and aminoglycosides. The hospital stay has been delayed to 12 days on average by operating site infections, making 2.5 times greater than those uninfected. The infection has increased the cost of management around 600 Euro.

关键词： Infections Operating Sites Bamako

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Emergency Caesarean Section in Adolescent Girls at the Referral Health Center in Commune I

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Open Journal of Obstetrics and Gynecology 2020年第2期10卷 298-310页

作者： Alassane Traore Mamadou B. coulibaly Soumana O. Traore Modibo D. Soumare Seydou Fane bourama Kane Mamadou Sima Saliou A. Traore Seydina A. Beye Yacouba L. Diallo Youssouf Traore Gynecology Service of Hopital du Mali Bam Bamako Mali Gynecology-Obstetrics Service Referral Health Center of Commune IV Bamako Mali Gynecology-Obstetrics Service Referral Health Center of Commune I Bamako Mali Gynecology-Obstetrics Service University Teaching Hospital (UTH) Gabriel Touré Bamako Mali Pediatric Service of Hopital du Mali Bamako Mali Gynecology Service UTH Point G Bamako Mali Anesthesia Resuscitation Service UTH Point G Bamako Mali Medicine and Endocrinology Service Hopital du Mali Bamako Mali

Teenage pregnancy is common in Mali due to the high rate of unwanted pregnancies and early marriages. The general objective of this study was to study emergency cesarean delivery in adolescent girls at the referral health center (RHC) in commune I of the district of Bamako. It was a descriptive study with prospective data collection from January 1 to December 31, 2018. Any adolescent girls in whom an emergency caesarean section was performed were included. The data were entered and analyzed on SPSS 20.3. Results: we have collected 616 adolescent parturients, 202 caesareans were performed in emergency, with a frequency of 32.8%. The average age was 17 with the extremes of 13 and 19. Early marriage was found out in 95.5% of our patients, 40 adolescent girls were primiparous (20%), 4 of whom had an inter-reproductive interval of less than a year. The main indications for cesarean section were fetal distress in 71 cases (35%), fetal-pelvic disproportion, scar uterus in the border pelvis (11% each), breech presentation in 15 cases (7%). Anemia (10.4%) was the main complication, followed by vascular pedicle attack (5.94%), infection of the operating site (1.5%) and a bladder wound (0.99%). Fetal mortality was 1.4% and neonatal 3.8%.?Conclusion:?the association between adolescence and caesarean section in emergency constitutes risk factors which increase maternal and neonatal morbidity and mortality. Fighting these factors improves the survival of the mother and the newborn.

关键词： Adolescent Cesarean Emergency Mortality

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Ear Cholesteatoma Surgery in South Sahara: Our Experience in Bamako

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International Journal of Otolaryngology and Head & Neck Surgery 2024年第4期13卷 293-303页

作者： Kassim Diarra Oumou coulibaly Yaya Dembele Nfaly Konaté Sidibe Youssouf Saydi Ag Mohamed Harouna Sanogo Abraham Diarra Ibrahim Fofana Moussa bourama Keita Youssouf Traore Fatogoma Issa Koné Boubacary Guindo Siaka Soumaoro Doumbia Kadidiatou Singare Mohamed Amadou Keita ORLCCF Department Gabriel Toure University Hospital Bamako Mali ORLCCF Unit Kati Army Polyclinics Kati Mali ENT-CCF Department CHU Luxembourg Bamako Mali ORLCCF Service of the Reference Center of Commune VI Sogoniko Bamako Mali

In Mali, cholesteatoma surgery remains a challenge due to the limited number of otological practitioners, and the low socio-economic level of patients reflecting the difficulties in performing CT or MRI for post-operative follow-up. We therefore initiated this work with the objective of analyzing, through a broad bibliographic review, the clinical, paraclinical, topographical, therapeutic and progressive aspects of a series of ear cholesteatoma. Materials and Method: This was a retrospective and prospective, descriptive study that took place in the ENT and head and neck surgery department of the Gabriel Touré University Hospital over 36 months from November 2020 to October 2023. These were patients admitted to the department for chronic cholestematous otitis media. Result: In total, we collected 34 files of patients admitted for cholesteatoma. This represented 9% of cases compared to all otological surgeries carried out during the same period, i.e. 362 cases. The average age of our patients was 35.31 years, with extremes ranging from 7 years to 80 years, there were 24 men and 10 women, i.e. a M/F ratio of 2.4. The average time to diagnosis was 7 years. The main functional signs were dominated by chronic fetid purulent otorrhea associated with hypoacusis in 94.6% of cases. One case of meningeal complication and three cases of cerebral empyema were reported. Clinically, a postero-superior and marginal tympanic perforation was observed in 53%, a retraction pocket in 5.9%, the sentinel polyp in 9%, and a non-marginal tympanic perforation in 32%. Pure-tone audiometry performed preoperatively for all patients showed conductive hearing loss in 83%. In 82% of cases we created a recess with the creation of a mini box. An ossiculoplasty was performed immediately with fragments of cartilage. The postoperative course found the disappearance of otorrhea (88.23%), the persistence of otorrhea in one case, two cases of facial paralysis, and one case of tinnitus. We did not identify

关键词： Cholesteatoma CT TTO TTF

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Antibioprophylaxy by the Surgery Staff in the Teaching Hospital Gabriel Touréin Mali

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Surgical Science 2015年第3期6卷 138-142页

作者： Bakary Tientigui Dembélé Alhassane Traoré Adégné Togo Lassana Kanté Ibrahim Diakité Amadou Traoré bourama Emmanuel Cissoko Madiassa Konaté Boubacar Karembé Yacaria coulibaly Soumeila Keita Mamby Keita Souleymane Diallo Gangaly Diallo Faculty of Medicine and Odonto-Stomatology Bamako Mali Department of General Surgery CHU Gabriel Touré Bamako Mali Department of Biology and Laboratory CHU Gabriel Touré Bamako Mali

This prospective survey was conducted from February to December 2014 about the use ceftriaxone (ceftriaz) for antibioprophylaxy concerning 300 patients by the surgery staff in the Gabriel Touré Teaching Hospital in Mali. The quantity of drug used was based on the weight of the patient. One dose was administrated in intravenous at the anesthesiology induction time. For more than 2 hours of intervention time, 4 (1.3%) patients received a second dose. The majority of cases (189, 63%) were out of emergency (emergency cases—111, 37%). The mean age was 41.6 years (range: 3 - 95 years). The patients were classed Altmeir II 203 (67.7%) and Altmeir I 97 (32.3%). The NNISS score 0 concerned 101 (33.6%) and NNISS 1 in 180 (60%) patients. The factors of risky were anemia (38;12.7%), diabetes (6;2%), and HIV (3;1%). The mean of intervention duration was 56.8?±?27.5 minutes. Four cases of intervention site infection were encountered caused by?Pseudomonas?aeruginosa?in 2 patients;?Escherichia coli?(1 case), and?Staphylococcus aureus?(1 case). Conclusion: Antibioprohylaxy is not the only way to prevent infections but it stays necessary. The respect of hygien and aseptic measures should be used to reduce the rate of intervention site infection.

关键词： Antibioprophylaxy Infection Risky Factors Surgery

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Profile of Newborns Hospitalized for Maternal Fetal Infection and Having a Positive CRP in the Pediatric Department of the Gabriel TouréCHU in Bamako, Mali

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Open Journal of Pediatrics 2021年第4期11卷 684-693页

作者： Oumar coulibaly Hawa Gouro Diall Guédiouma Dembélé Mamary coulibaly Fatoumata Léonie Françoise Diakité Lala Ndrayni Sidibé Leyla Maiga Ibrahima Ahamadou Abdoul Karim Doumbia Belco Maiga Adama Dembelé Pierre Togo Karamoko Sacko Mohamed Elmouloud Cissé Djeneba Konaté Fousseyni Traoré Aminata Doumbia Yacouba Aba coulibaly Amadou Touré bourama Kané Issa Amadou Touré Abdoul Aziz Diakité Traoré Fatoumata Dicko Traoré Mariam Sylla Boubacar Togo Department of Pediatrics CHU Gabriel Touré Bamako Mali Department of Pediatrics Mali Hospital Bamako Mali Department of Pediatric Surgery CHU Gabriel Touré Bamako Mali

Objective: Early bacterial neonatal infection (INBP) or maternofetal infection (early neonatal sepsis) remains a concern of the pediatrician due to diagnostic difficulties and its increased morbidity and mortality. No study has been done in Mali on the profile of newborns admitted for INBP with positive CRP, hence the initiation of this work with the aim of studying the epidemiological, biological and bacteriological profile of newborns with a bacterial maternal-fetal infection. Method: Longitudinal study descriptive (from 27 June to 3 September 2016) which concerned all newborns aged from 0 to 72 hours of life hospitalized for confirmed early bacterial neonatal infection with a positive C-reactive protein (CRP) in the neonatal department of the CHU Gabriel Touré. INBP was defined by the presence of maternal and neonatal infectious risk factors, positivity of CRP with a germ in the blood culture. Results: During the study period we included 244 newborns for probable maternofetal infection and who benefited from the CRP assay, 43 had a positive CRP, i.e. a frequency of 17.62%. The sex ratio was 2.30. The majority had a low birth weight ( g) in 69.8% of cases. Mothers were aged 18 to 35 in 93%. The majority were out of school

关键词： Early Bacterial Neonatal Infection Clinical Profile Neonatal Mortality

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Epidemioclinical Profile and Immediate Outcome of Low Birth Weight at the Reference Health Center in Commune VI of the District of Bamako, Mali

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Open Journal of Pediatrics 2023年第2期13卷 235-243页

作者： Mariam Maiga Oumar coulibaly Mariam Traore Hibrahima Diallo Korotoumou W. Diallo bourama Kane Alou Samake Mamadou Diallo Moussa Konate Mamadou Keita Mohamed Saydi Ag Med Elmehdi Elansari Diarra Sidy Moctar Mamadou Traore Djibril Kassogue Kadiatou Ba Pierre Togo Pediatric Service of the Reference Health Center of the Commune VI Bamako Mali Pediatric Department of CHU Gabriel Touré Bamako Mali Mali Hospital Bamako Mali Pediatric Service of the Reference Health Center of the Commune V Bamako Mali Timbuktu Regional Hospital Bamako Mali Pediatric Service of the Reference Health Center of the Commune II Bamako Mali

Introduction: Low birth weight is responsible for 9.1 million child deaths each year worldwide. It is the leading cause of perinatal and infant mortality. The objective of this work was to determine the epidemio-clinical profile as well as the future of low birth weight at the Reference Health Center of commune VI in the district of Bamako, Mali. Methods: Our study was descriptive and prospective over a year from April 1, 2018 to March 31, 2019. Data were taken from hospital records and newborn referral/evacuation forms. Data processing was performed using Epi Info software version 3.5.4 and Word. Results: The frequency of low birth weight was 34.94%. Multiparity accounted for 47.84%, sex ratio was 0.93, maternal arterial hypertension was present in 41.66%, genitourinary infection was in 58.37% and delivery was by low way in 86.12%. The majority of newborns had a gestational age between 28SA-33SA (56.52%) and a weight between 1501-1999 grams (47.36%). Mortality accounted for 18.66%. Conclusion: Low birth weight is common in our settings with modifiable risk factors. Practitioners must play on them to minimize its importance.

关键词： Low Birth Weight Future Risk Factors Bamako Mali

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