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Analysis of Maternal Deaths in Suburban of Dakar, Senegal

Open Journal of Obstetrics and Gynecology 2021年第5期11卷 523-528页

作者： abdoul Aziz Diouf Omar Gassama Moussa diallo Mohamed T. Diadhiou Simon Birame Ndour Mamour Gueye Alassane Diouf Pikine National Hospital Thiaroye Dakar Senegal Aristide Le Dantec Teatching Hospital Dakar Senegal Phillipe Maguilen Senghor Hospital Yoff Dakar Senegal

Objective: Maternal mortality remains a major concern in developing countries. This survey aims to suggest strategic plans that would help decrease maternal and perinatal mortality in the suburbs. It is a descriptive study that shows the different causes of maternal deaths during pregnancy and puerperium period. Methods: It is a retrospective descriptive study done between January 1st 2016 and the 31st of December 2018. We have collected information on all deaths due to mortality issues in Five (5) maternity clinics around Dakar. The record shows that teach centre have an average of 4000 deliveries per year. The data collected from the hospital records were inputted using Sphinx software (version 5). These data were analysed using Epi Info software (version 3.5). After analysing these data, recommendations were made to minimize the different causes of maternal deaths. Results: We recorded 154 maternal deaths out of 32,420 live births. The direct causes of maternal deaths were a result of preeclampsia and its complications (31.2%), postpartum haemorrhage (24.7%), abruption placentae (20.8%) and obstructed labour (7.8%). The indirect causes were mainly sickle cell disease (1.3%), heart disease (1.3%) and gynaecological cancers (1.3%). Maternal deaths were also associated with fetal loss in 47.4% of 153 maternal deaths, need for blood transfusion 59% while none of the reference structures in the suburbs of Dakar has a blood bank;with a need for admission in intensive care unit was noted as 40%.

关键词： Maternal Mortality Preeclampsia Haemorrhage Emergency Obstetric and Neonatal Care Senegal

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Is Laparoscopy Still Necessary in the Management of Tubal Infertility?

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Open Journal of Obstetrics and Gynecology 2021年第2期11卷 63-69页

作者： abdoul Aziz Diouf Moussa diallo Mame Diarra Ndiaye Aminata Niass Mamour Guèye Gnaza Tchindebe Anna Dia Magatte Mbaye Alassane Diouf Pikine National Hospital Center Dakar Senegal Philippe Maguilen Senghor Health Center Dakar Senegal

Objectives: To compare between hysterosalpingography (HSG) and laparoscopic findings in patients tested for infertility and thereby to determine the significance of the latter examination. Methods: This was a descriptive study performed in two Gynecology departments in the Dakar (Senegal). Included were 84 patients with suspicious tubal-infertility who underwent HSG followed by laparoscopy. The Kappa (K) statistics was used to clarify the concordance between HSG vs. laparoscopy findings. Results: Kappa concordance between HSG and laparoscopy showed the followings: 0.08 for proximal tubal obstructions (poor agreement), 0.40 for distal tubal obstructions (moderate agreement), and -0.08 for peritoneal adhesions (no agreement). Laparoscopy revealed pelvic adhesions in 84% of cases, pelvic endometriosis in 12% of cases, and apparently normal tubes in 12%. According to the distal tubal operability score, 16.6% of the lesions were classified as stage 4 and 23.8% at stage 1. Conclusion: HSG and laparoscopy findings did not agree in patients with tubal infertility, and thus, laparoscopy should be employed, especially when HSG showed abnormal findings. HSG has a low diagnostic value in adhesions.

关键词： Hysterosalpingography Laparoscopy Infertility Pelvic Adhesions

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Results of the First 10 Cases of Coronary Bypass Surgery in Senegal

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World Journal of Cardiovascular Surgery（心血管外科国际期刊） 2024年第4期 45页

作者： Papa Amath Diagne Jean Claude Ndiogou Dione Papa Ousmane Ba Momar Sokhna Diop El Hadji Boubacar Ba Momar Dioum Marième Soda Mbaye Moussa Seck Diop Mory Camara Abdou Lahad Mbengue Abdou Aziz Thiaw abdoul Khoudoss diallo Moussa Mareme Samba Dialtabé Ibrahima Guéssé Ba Anta Mbaye Sall Papa Salmaneba Amadou Gabriel Ciss

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Evaluation of the Surgical Treatment of Patella Fractures in 17 Cases in the Orthopedic-Traumatology Department of the University Hospital Center of Donka, Republic of Guinea

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Open Journal of Orthopedics 2023年第9期13卷 391-396页

作者： abdoulaye Camara abdoul Karim Balde Nouhou Mangué Camara Léopold Lamah Mamadou Moustapha diallo Alhassane Barry Fatoumata Camara Ibrahima Marie Camara Service d’Orthopédie-Traumatologie du Centre Hospitalier Universitaire de Donka Conakry Republic of Guinea

Objectives: To determine the epidemiological, therapeutic and evolutionary aspects. Methodology: This was a retrospective study, from January 1, 2016 to December 31, 2018, on the files of patients aged 16 and over, admitted for patella fractures, treated surgically and followed up in our service. Results: The study involved 17 patients including 15 men (88.24%) and 02 women (11.76%) with an average age of 36.65 years. Workers were the most represented (29.42%);AVP were the leading cause of these fractures (52.94%). The fractures were open in 70.58% of cases. Associated lesions were dominated by femur fractures in 29.42%. Duparc type II was the most encountered bone lesion with 47.06% of cases. All our patients benefited from regional anesthesia. Bracing was the most used surgical treatment in 58.83%;the anterior approach was performed in all our patients. Four (04) cases of knee stiffness, two (02) postoperative infections and skin necrosis complicated the short and medium term consequences. After a two-year follow-up, radiologically one case of pseudarthrosis and one case of patellofemoral osteoarthritis were noted. According to the Bosman score, we found 17.65% excellent, 47.06% good and 35.29% poor functional results. Conclusion: Patella fractures are relatively rare. Treatment is primarily surgical for transverse and/or displaced fractures;Bracing is the osteosynthesis technique of choice. However, knee stiffness, pseudarthrosis and patellofemoral osteoarthritis are not uncommon.

关键词： Fractures Patella Bracing Patellofemoral Osteoarthritis

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Epidemiology and Management of Heart Failure in the Medicine Department of Tombouctou Hospital

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World Journal of Cardiovascular Diseases 2023年第3期13卷 105-113页

作者： Bassirima Traoré Souleymane Mariko Samba Sidibé Karamoko Kantako Mariam Sako Massama Konaté Nouhoum diallo abdoul Karim Sacko Kalifa diallo Youssouf Kassambara Djibril Kassogue Oumar Ongoiba Oumar Sanogo Ichaka Menta Souleymane Coulibaly Department of Medicine Tombouctou Hospital Tombouctou Mali Department of Cardiology Point G University Hospital Bamako Mali Department of Cardiology Mali Hospital Bamako Mali Department of Cardiology CHU Gabriel TOURE Bamako Mali

Introduction: Heart failure is a complex syndrome and very frequently observed and secondary to the outcome of many advanced heart diseases. It is made up of a set of symptoms that reflect the tissue and visceral consequences of heart failure. The objective was to determine the hospital prevalence and to describe the management of heart failure in the medical department of Tombouctou hospital in Mali. Methods: This is a descriptive cross-sectional study with retrospective data collection, carried out over 24 months and involving the analysis of 266 records of patients hospitalized for heart failure. Results: The frequency of heart failure was 17.6% with a female predominance. The average age was 48 years with extremes of 16 and 90 years. Cardiovascular risk factors were dominated by high blood pressure with 38%. Global heart failure was the mode of discovery in 72.2% of cases. The etiologies were dominated by hypertensive dilated cardiomyopathy in 36.8% and peripartum cardiomyopathy in 32% of cases. The majority of our patients benefited from diuretic treatment, i.e. 95.9% frequency;with a favorable evolution in 96.2% of cases. We recorded 10 deaths, i.e. a lethality of 3.7%. We report some difficulties encountered during our security study because Tombouctou is a war zone and the lack of a technical platform for biology such as (BNP or NT-proBNP). Conclusion: Heart failure is a real public health problem. Its prevalence is increasing due to the aging of the population and especially the poor management of arterial hypertension in our context.

关键词： Heart Failure Epidemiology Etiology Treatment Tombouctou Hospital

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Bilateral Fracture of the Base of the Fifth Metatarsal. A Case Report and Review of the Literature

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Surgical Science 2020年第2期11卷 32-38页

作者： Mahamadou diallo Layes Toure Louis Traoré abdoul Kadri Moussa Seydina Alioune Beye Mosséré Camara Mahamadou Kane Tiéman Coulibaly Orthopedic-Trauma Service Nianankoro Fomba Hospital Ségou Mali Orthopedic-Trauma Service Sikasso Hospital Sikasso Mali Orthopedic-Trauma Service Gabriel Touré Hospital Bamako Mali Anesthesia-Resuscitation Service Nianankoro Fomba Hospital Ségou Mali Medical Imaging Service Nianankoro Fomba Hospital Ségou Mali.

We report an unusual case of basic bilateral fracture of fifth metatarsals in a 48 years old post-menopausal woman. She had previously been treated for arterial high blood pressure, parathyroidectomy and rheumatoid arthritis by a long corticotherapy treatment. The lesion was caused by an indirect mechanism in an overweight context. The diagnosis of a pseudarthrosis of the base of the fifth metatarsals was maintained after 7-month treatment. The patient received a treatment of both pseudarthrosis. The post-operative periods were simple. After a 9-month follow-up, the treatment allowed consolidation with painless feet allowing her to resume work.

关键词： Fracture Bilateral Fifth Metatarsal

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Eosinophilic Gastroenteritis in Tropical Area: about 6 Cases from Senegal

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Open Journal of Gastroenterology 2022年第8期12卷 204-211页

作者： Ibrahima diallo Mouhamadou Ndiaye abdoul Sow Awa Ndao Fall Omar Touré Cheikh Abdoukhadre Fall Bineta Ndiaye Fatou Fall Sara Boury Gning Departement of Internal Medicine and Hepatogastroenterology H&ocirc pital Principal de Dakar Dakar Sénégal Internal Medicine Department H&ocirc pital Principal de Dakar Sénégal

The aetiologies of hypereosinophilia are dominated by digestive parasitosis and drug intake. In the tropics, because of the frequency of parasitosis, eosinophilic digestive pathologies of primary origin, which are rare, may be overlooked. We report 6 cases of eosinophilic gastroenteritis with polymorphic digestive manifestations testifying to the different locations of eosinophilic infiltration in the digestive parietal layer. Three patients had ascites rich in eosinophils, indicative of serous involvement, while the other two had a muscular form, and the last a mucosal involvement. The evolution was favourable in all cases with corticosteroid therapy, but a recurrence was noted in 4 cases when treatment was stopped.

关键词： Eosinophilic Gastroenteritis Ascites Digestive Eosinophilic Infiltration Senegal

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Epidemiological, Clinical Aspects and Treatment of Victims of Sexual Abuse in the Gynecology and Obstetrics Department of Pikine National Hospital in 183 Cases

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Open Journal of Obstetrics and Gynecology 2020年第4期10卷 558-570页

作者： Moussa diallo Babacar Biaye abdoul Aziz Diouf Aminata Niass Cyr Espérence Gombet Codou Sène Anna Dia Astou Coly Niassy diallo Fatoumata Bineta diallo Hadja Maimouna Barro Daff Khalifa Fall Khalifa Gueye Alassane Diouf Gynecological and Obstetric Clinic of Aristide Hospital Le Dantec of Dakar Dakar Senegal

Introduction: Sexual abuse or sexual assault is part of violence against women, as is physical violence, female genital mutilation and forced marriage. According to the Criminal Code, this is any sexual offense committed with violence, coercion, threat or surprise on the person of others. It is a criminal act punishable by the laws in force in almost every country in the world. Study Objectives: 1) draw up an epidemiological profile of female victims of sexual abuse;2) develop the treatment protocol. Methodology: This is a 7-year descriptive retrospective study from January 1, 2010 to December 31, 2016 at the Center Hospitalier National de Pikine (Dakar). Included in this study were all of the patients admitted during our investigation period who were the victims of suspected or certain sexual abuse, with or without requisition. For each case, the following parameters were studied: the epidemiological characteristics (age, gestation, parity and place of residence), the circumstances of the attack (time and place), the characteristics of the aggressor (age, link with the victim, number of aggressor), the type of sexual contact, the possible lesions found during the physical examination (genital and extra-genital), the mode of admission, the delay of the consultation, the attitude after the sexual abuse, the gynecological and obstetrical status of the victim, the repercussions and psychological follow-up, the paraclinical assessment, the treatments administered. Data were collected using a survey form and analyzed with SPSS software. Results: During the study period, 183 victims of sexual abuse were received and treated at the level of our structure out of a total of 39,760 patients, representing a frequency of 0.46%. The age of the victims varied between 2 and 36 years with an average of 13 years. The 11 to 15 age group was the most represented. Students were the most represented among victims of sexual abuse (87.4%). Workers represented 9.3% of the victims. Infants

关键词： Sexual Abuse Trauma Care

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Ovarian Pregnancy: A Case Report

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Open Journal of Obstetrics and Gynecology 2021年第11期11卷 1446-1451页

作者： Hadja Maïmouna Barro Daff Brahima Donigolo Aïssatou Mbodji Khalifa Babacar Mansour Fall Youssoupha Touré Moussa diallo abdoul Aziz Diouf Alassane Diouf Cheikh Anta Diop University of Dakar Gynecological and Obstetrical Clinic Public Institution Aristide-Le Dantec Hospital Da-kar Senegal Department of Obstetrics and Gynecology University Hospital of Pikine Thiaroye Pikine Senegal

Background: Ovarian pregnancy is a rare entity of ectopic pregnancy, with a prevalence in the literature estimated between 1/2500 to 1/5000 births. The majority of ovarian pregnancies are diagnosed in the 1st trimester due to the noisy symptomatology. However, in small proportions, they may continue into the 2nd or 3rd trimester, making their diagnosis more difficult. Aim: We report a case of ovarian pregnancy in a 26-year-old patient, discovered intraoperatively as a large unruptured ovarian mass. Case report: A 26-year-old woman referred to the maternity ward for management of fetal death in utero at 31 weeks of amenorrhea associated with overlying placenta previa. Ultrasound performed in the department, was in favor of an abdominal pregnancy stopped at 31 SA with a placenta that seemed to adhere to the posterior wall of the uterus, which was empty. A Laparotomy was performed, on exploration, a large right ovarian mass was found, the site of the pregnancy. A right adnexectomy, after adhesiolysis, was performed. The incision of the operative part revealed a macerated female fetus. The clinical evolution was favorable. Conclusion: We report on a case of unruptured ovarian pregnancy, discovered in the 3rd trimester of pregnancy. The ultrasound diagnosis of an ovarian pregnancy beyond the 2nd trimester remains a challenge, the management remains surgical.

关键词： Ectopic Pregnancy Ovarian Pregnancy Adnexal Mass

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Hemorrhages in the First Trimester of Pregnancy: Etiological Aspect and Management at the Maternity Ward of the Ignace Deen National Hospital of the University Hospital of Conakry

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Open Journal of Obstetrics and Gynecology 2022年第8期12卷 719-730页

作者： Fatoumata Bamba diallo Elhadj Mamoudou Bah Massa Keita Mamadou Sanoussy Barry abdoul Aziz Balde Mamadou Dian Balde Ibrahima Sory Balde Telly Sy University Department of Gynecology-Obstetrics Donka National Hospital Conakry Guinea University Department of Gynecology-Obstetrics Ignace Deen National Hospital Conakry Guinea

Aims: Hemorrhages in the first trimester of pregnancy constitute a public health problem in developing countries with maternal mortality which is still very high. This is the most common reason for consultation in early pregnancy. The objectives of this study were to describe the sociodemographic characteristics of the patients, identify the etiologies, describe the management and evaluate the maternal prognosis in patients presenting with hemorrhage in the first trimester of pregnancy. Methods: This was a descriptive-type prospective study lasting 12 months from January 1 to December 31, 2020, carried out at the maternity ward of Ignace Deen National Hospital. Results: During the study period, we recorded 163 cases of hemorrhage in the first trimester of pregnancy out of 5478 deliveries, i.e. a frequency of 2.97%. The main incriminated etiologies were spontaneous abortion (46.62%), ectopic pregnancy (28.22%), hydatidiform mole (16.56%), threatened abortion (5.52%) and pregnancy stopped (3.06%). The socio-demographic profile of the patients was that of a woman in the age group of 26 - 30 years (33.12%), married (79.14%), with secondary level (35.58%), exercising a liberal profession (36.19%) and nulliparous (60.12%). More than half of the patients came directly from home (57.66%) with metrorrhagia (44.78%) and abdominal pain (33.12%) as reasons for consultation. The gestational age between 7-11SA was more represented (82.82%). Manual intrauterine aspiration (58.89%) and salpingectomy (28.22%) were the most practiced therapeutic procedures. We transfused 10.42% of patients and 20.85% received medical treatment. The maternal prognosis was good in 47.87%. The main complications recorded were anemia (38.65%) and the state of shock (10.42%). Conclusion: Hemorrhages in the first trimester of pregnancy represent an important cause of maternal morbidity in developing countries. The improvement of the maternal prognosis would pass by the early consultation in front of any ca

关键词： Pregnancy First Trimester Hemorrhage Etiologies Management Ignace Deen Guinea

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