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Maternal and Perinatal Prognosis of Arterial Hypertension and Pregnancy in a Peripheral Health Center in Mali

Open Journal of Obstetrics and Gynecology 2024年第5期14卷 855-867页

作者： Samaké Alou Diarra Lasseny Keita Mamadou haidara dramane haidara Mamadou Diallo Mamadou Konaté Moussa Maiga Mariam MS Ag Med Elméhdi Elansari Kassogue Djibril Dao Seydou Zana Samake Hawa Konate Karim Dembele Bertin Coulibaly Moussa Mariko Seydou Colette Dohinnon Reference Health Center in Commune VI of the Bamako District Bamako Mali Bamako Dermatology Hospital (HDB) Bamako Mali Kalaban Coro Reference Health Center Bamako Mali Timbuktu Hospital Timbuktu Mali Reference Health Center of Commune II of the Bamako district Bamako Mali Reference Health Center in Commune V of the Bamako district Bamako Mali National Institute for Training in Health Sciences Bamako Mali Mali Hospital Bamako Mali

Introduction: Maternal mortality constitutes a public health problem and its rate is an indicator of a country’s development. Among the causes of maternal and perinatal death, high blood pressure associated with pregnancy occupies a significant part. It represents 5% of direct maternal deaths. Objective: to study the maternal and perinatal prognosis of high blood pressure during pregnancy in the Tenenkou reference health center in Mali. Methodology: This was a descriptive, analytical and retrospective cross-sectional study over a period of twelve months from January 1, 2021 to December 31, 2021 and involving 144 cases of high blood pressure associated with pregnancy. Results: We obtained a frequency of 11.75%. The majority of patients 70.9% were aged between 20 - 35 years. The important risk factor found was young age. During our study, 46.5% of patients had performed at least one CPN and only 13.9% performed 04 CPN. Pre-eclampsia was the most common type of high blood pressure during pregnancy, i.e. 61.1%. Eclampsia and retroplacental hematoma were the most common maternal complications, respectively 27.8% and 11.1%. The most common fetal complications were premature births and fetal distress with 20.9% and 17.4% respectively. Conclusion: Hypertension associated with pregnancy still remains a major cause of maternal-fetal morbidity and mortality in our context where diagnosis is often late. The main clinical form was preeclampsia. Eclampsia and retroplacental hematoma were the most frequent maternal complications. Fetal complications were mainly prematurity and fetal distress.

关键词： Pregnancy High Blood Pressure Prognosis

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Maternal Fetal Prognosis: Pregnancy and Delivery in Women of 40 Years Old and Over in a Second Reference Hospital in Bamako

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Open Journal of Obstetrics and Gynecology 2024年第4期14卷 509-519页

作者： Samaké Alou Diarra Lasseny Keita Mamadou haidara dramane haidara Mamadou Diallo Mamadou Konaté Moussa Maiga Mariam Mohamed Saydi Ag Med Elmehdi Elansari Kassogue Djibril Seydou Zana Dao Samake Hawa Konate Karim Dembele Bertin Coulibaly Moussa Mariko Seydou Collarete Dohino Reference Health Center of Commune VI of the Bamako District Bamako Mali Bamako Dermatology Hospital (BDH) Bamako Mali Kalaban Coro Reference Health Center Bamako Mali Timbuktu Hospital Timbuktu Mali Reference Health Center of Commune II of the Bamako District Bamako Mali Reference Health Center in Commune V of the Bamako District Bamako Mali National Institute for Training in Health Sciences Bamako Mali Mali Hospital Bamako Mali

Introduction: Late pregnancies are considered a public health problem linked to maternal mortality due to their complications. These risks, which worsen with maternal age, should be better known and taken into account in monitoring these pregnancies. Objective: To evaluate the impact of age on the prevalence of obstetric and neonatal complications among parturients of 40 years old and over. Methodology: This was an 11-year retrospective analytical case control study from January 1, 2007 to December 31, 2017. The study population was female patients of 40 years old or older for cases and female patients younger than 40 years of control case. Results: In total, we collected 640 cases of parturients of 40 years old and over out of a total of 84,234 deliveries during the study period;i.e. a frequency of 0.76%. Spontaneous abortion increased in patients of 40 and over with 8.28%. Hypertension and diabetes were higher of women of 40 and over, 52.65%. Concerning the method of admission: 55% of parturients of 40 and over were referrals. Incidents occurring among women of 40 and over were more pronounced than in control cases. Complications during vaginal delivery, cervical tear, perineal tear, uterine dehiscence and uterine rupture are high in our cases, i.e. 11.88%;3.59%;2.19%;2.66. During our study, depending on the type of delivery, the cesarean rate was much higher among women of 40 and over than among control cases, i.e. 54.22% versus 12.24%. Hemorrhages in the 3rd trimester were the main indications for cesarean section. Hemorrhages in the 3rd trimester were more frequent with women of 40 and over, i.e. 10.47%;5.94% versus 1.74% and 0.42%. As for the different types of malformations in parturients, women under 40 years old fetal malformations were absent in 92.29%, on the other hand they were more frequent in patients with 40 years and over, i.e. a normal frequency of 36.72%. Conclusion: Pregnancy at a late age exposes the elderly patient and the newborn to several ri

关键词： Advanced Maternal Age Childbirth Risk Mali

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Epidemiological-Clinical Aspects of Uterine Leiomyoma at the Reference Health Center of Commune VI of the Bamako District

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Open Journal of Obstetrics and Gynecology 2024年第5期14卷 674-681页

作者： Alou Samaké Lasseny Diarra Mamadou Keita dramane haidara Mamadou haidara Coulibaly Soumana Mamadou Diallo Moussa Konaté Mariam Maiga MS Ag Med Elméhdi Elansari Kassogue Djibril Dao Seydou Zana Samake Hawa Konate Karim Dembele Bertin Coulibaly Moussa Mariko Seydou Colette Dohino Reference Health Center of Commune VI of the Bamako District Bamako Mali Bamako Dermatology Hospital (HDB) Bamako Mali Kalaban Coro Reference Health Center Bamako Mali Hangadoumbo Moulaye Touré Hospital in Gao Gao Mali Timbuktu Hospital Tomboctou Mali Reference Health Center of Commune II of the Bamako District Bamako Mali Reference Health Center in Commune V of the Bamako District Bamako Mali National Institute for Training in Health Sciences Bamako Mali Mali Hospital Bamako Mali

Introduction: Uterine fibroid is a mixed mesenchymal tumor, developing from smooth muscle cells of the myometrium, separated by connective tissue. The majority of fibroids are asymptomatic and do not require any intervention or other exploratory measures. However, in some cases fibroids are symptomatic, their treatment should aim to improve symptoms and quality of life. Objectives: Describe the epidemiological-clinical aspects of uterine fibroids in the gynecology and obstetrics department of the reference health center of commune VI of the Bamako district. Methodology: This was a retrospective descriptive study carried out over a period of one year. It concerns all patients seen in consultation in the gynecology and obstetrics department of the reference health center of commune VI. Results: during the study period, the uterine fibroid frequency was 1.80%. During this same period, fibroids represented 5.59% of gyneco-obstetric pathologies operated on in the department. The 30 - 45 year old age group was the most represented with a frequency of 75.63%. The average age was 36.87 years ± 6.2 years with extremes of 25 and 63 years. Married women were the most represented 97.48%. The vast majority of our patients 95.8% were not postmenopausal. The multigravidas were the most represented, i.e. 37.50% with a large part of the pauciparous 41.29%. In our patients, 96.64% had a clinical symptom on their fibroid with the main reason for consultation being the sensation of a pelvic mass in 97.48%. We recorded three cases of infertility as associated factors. Ultrasound was performed in all patients. The location of the myxomatous nuclei was subserosal in the majority in 42.86% and with multiple nodules in 84.85% of cases. The main indication for myomectomy was the failure of medical treatment in 86.49% of cases. Surgical treatment was mainly a myomectomy 93.30%, a hysterectomy was indicated in 6.70%. No cases of death were recorded. Conclusion: Uterine fibroid is a gynecologic

关键词： Myomas Surgery Myomectomy

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The Place of Blood Transfusion in the Management of Obstetric Emergencies in the Gynaecology and Obstetrics Department of the Reference Health Center of Fana (Mali)

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Open Journal of Obstetrics and Gynecology 2023年第4期13卷 780-791页

作者： Keita Sema Kone Bokary Sidi Fané Seydou Sylla Cheickna Samake Youssouf Traoré Momine Traoré Solomane haidara Ramatoulaye Diabate Abdrahamane Sylla Yacouba Keita Mamadou Coulibaly Mahamoudou haidara Mamadou haidara dramane Camara Daouda Fomba dramane Kampo Mamadou Maiga Boubacar Dembele Sitapha Seydou Z. Dao Sanogo Siaka Amara Obstetrics and Gynecology Department Fana Reference Health Centre Koulikoro Mali Mohamed VI Mother-Child Polyclinic in Bamako Bamako Mali Department of Obstetrics and Gynecology Gabriel TOURE University Hospital Bamako Mali Department of Gynecology and Obstetrics Reference Health Centre of Koulikoro Koulikoro Mali Diola Reference Health Centre Dioila Mali Obstetrics and Gynecology Department Reference Health Centre of Commune I Bamako Mali Obstetrics and Gynecology Department Commune VI Reference Health Centre Bamako Mali Department of Gynecology and Obstetrics Kalaban Coro Reference Health Centre Bamako Mali Department of Gynecology and Obstetrics Kati Reference Health Centre Kati Mali Obstetrics and Gynecology Department Marakala Reference Health Centre Markala Mali Department of Obstetrics and Gynecology Timbuktu Hospital Timbuktu Mali National Blood Transfusion Centre Bamako Mali Department of Obstetrics and Gynecology Fousseyni Daou Hospital Kayes Mali Obstetrics and Gynecology Department Reference Health Centre of Commune II Bamako Mali

This is a prospective and descriptive study carried out at the gynecology and obstetrics department of the reference health center of Fana from 01 May 2019 to 30 November or 7 months. The main objective was to study the role of blood transfusion in the management of obstetric emergencies. During the study period we recorded 434 cases of obstetric emergencies of which 116 cases required an emergency blood transfusion or 26.73%. The most frequently found indications for blood transfusion are hemorrhages of the immediate postpartum 46.6% followed by severe malaria on pregnancy 27.6%. Blood remains the most prescribed and available Labile blood product in the department. Maternal prognosis was improved in 92.2%.

关键词： Obstetric Emergencies Blood Transfusion Hemovigilance

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Men’s Knowledge, Attitudes and Perceptions on Family Planning in Tourourou Village, Gogui Rural Commune, Nioro Circle, Kayes Region of Mali

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Open Journal of Obstetrics and Gynecology 2023年第3期13卷 662-680页

作者： Alou Samaké Sitapha Dembele Mamadou Keita Cheickna Sylla dramane haidara Mamadou haidara Mamadou Diallo Moussa Konaté Mariam Maiga Mohamed Saydi Agmed Elméhdi Elansari Djibril Kassogué Seydou Zana Dao Hawa Samaké Abdoulaye Nouhoun Coulibaly Brehima Samaké Coulibaly Moussa Mariko Seydou Abdoulaye Cissé Séma Kéita Siaka Amara Sanogo Seydou Fané Reference Health Center of Commune VI of the District of Bamako Bamako Mali Department of Gynecology-Obstetrics of Fousseyni Daou Hospital in Kayes Kayes Mali Centre Hospitalo-Universitaire Gabriel Toure Bamako Mali Timbuktu Hospital Bamako Mali Reference Health Centre of Commune V of the District of Bamako Bamako Mali Kalaban Coro Reference Health Center Bamako Mali Nianankoro Fomba Hospital of Segou Segou Mali Reference Health Center of Commune II of the District of Bamako Bamako Mali National Institute of Training in Health Sciences Bamako Mali Regional Health Directorate of Kayes Kayes Mali Fana Reference Health Center Koulikoro Mali

Introduction: The involvement of men in reproductive health programmes and more specifically in family planning has always been of concern to the various development actors at both national and international levels. Objective: To study the births, ideas and opinions of men on Family Planning in the village of Tourourou. Material and Methods: This was a prospective cross-sectional, descriptive and analytic study from February 1 to July 31, 2020 in the village of TOUROUROU on the Knowledge, Attitudes and Perceptions of Men on Family Planning. We included in our study, all men residing in TOUROUROU whose age is between 14 and 99 years, who agreed to participate in the study. Results: Our study involved 200 men. The 25 - 29 age group was the most represented with 25.5%. The Soninke had represented 41%. In our study, 97.5% of men had heard of family planning, 62% had spontaneously cited at least one modern contraceptive method, and the pill ranked first with 64.5%. Radio and friends were the most frequent sources of information with 57.5% and 54.5% respectively. Birth spacing was the most cited family planning goal by men in 43.5% of cases. Men supported the practice of family planning in 50.5% of cases. Conclusion: In the village of Tourourou men play a crucial role in decision-making concerning the health of the couple and the family, their effective involvement in Reproductive Health especially in Family Planning will contribute enormously to the improvement of the health of the family.

关键词： Knowledge Attitudes Perceptions Men Planning Family

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Epidemiological and Clinical Profile and Immediate Outcome of Neonates Transferred from the Maternity Unit to the Neonatology Unit of the CSREF in Commune V of Bamako District, Mali

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Open Journal of Pediatrics 2024年第3期14卷 547-557页

作者： Maimouna Kante Ya Traoré Balilé Harber Beydari Mamadou Traoré Issiaka Koné Diéneba Sacko Maimouna haidara Korotoumou Bamba Assitan Farota Abdoulaye Kassogué Mohamed Diarra dramane Touré Abdoul Salam Diarra Leyla Maïga Dicko Fatoumata Paediatric Ward CSR&#233f CV Bamako Mali Paediatric Ward of Nianankoro Fomba Hospital S&#233gou Mali Paediatric Ward of Kalaban CoroCSREF Bamako Mali Pediatric Department of the Mopti Reference Health Center Mopti Mali National Centre for Scientific and Technological Research Bamako Mali Paediatrics Department Mohamed VI Perinatal Clinic Bamako Mali Department of Paediatrics Gabriel Tour&#233 University Hospital Bamako Mali

Introduction: Neonatal mortality remains a major public health concern. According to the World Health Organisation (WHO), the number of newborns dying each year has fallen from 5 million in 1990 to 2.4 million in 2019. The aim of our study was to describe the main morbid conditions and their lethality in newborns admitted to the paediatric ward of the CSREF in Commune V. Methodology: We conducted a 12-month prospective descriptive and analytical study from August 2020 to July 2021. Results: During the 12 months of the study, out of 2654 neonates admitted to hospital, 216 met our inclusion criteria, i.e. 8%. Newborns admitted in the first few hours of life represented 99.54% of cases. Full-term newborns accounted for 65.74% of the total. Forty-eight percent of newborns had hypothermia on admission. The most common diagnosis was asphyxia in 55.56% of cases, followed by neonatal infection in 27.78% and prematurity in 10.65%. Death was recorded in 22.2% of cases. Asphyxia was the main cause of neonatal death, followed by prematurity in our context. Conclusion: Improving the prognosis of newborn babies will require a thorough understanding of neonatal pathologies and the implementation of a pre- and perinatal prevention policy.

关键词： Newborns Morbidity Mortality

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Opinions of Students on the Contribution of the DIVA 3D Virtual Dissection Table to the Teaching of Anatomy at the Faculty of Medicine and Odontostomatology of Bamako

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Forensic Medicine and Anatomy Research 2024年第2期12卷 13-25页

作者： Abdoulaye Kanté Tata Touré Ousmane Toumany Chérif haidara Uhl Jean François Mariam Daou Mamadou A. Keita Bakary Keïta Bréhima Bengaly Drissa Traoré Adégné Togo Nouhoum Ongoïba Faculty of Medicine and Odontostomatology of Bamako Bamako Mali University of Paris Descartes Paris France Department of Neurology The Gabriel Tour&#233 University Hospital Bamako Mali Department of General Surgery The Kati Health Center Bamako Mali Anesthesia-Resuscitation Service Commune I Reference Health Center Bamako Bamako Mali Department of General Surgery The Gabriel Tour&#233 University Hospital Bamako Mali

Objective: Study the contribution of the DIVA 3D dissection table in the teaching of anatomy at the Faculty of Medicine and Odontology of Bamako. Material and Methods: This was a qualitative study carried out from November 1 to December 30, 2023 at the clinical and morphological anatomy laboratory of the Faculty of Medicine and Odontostomatology of Bamako. Included in this study were students who participated in practical and tutorial sessions. The variables studied during this study were: the previous performance of dissection on a cadaver by the students, the opinion of the students on dissection on a cadaver, the replacement of dissection on a cadaver by virtual dissection in the absence of a body, the level student satisfaction. Results: We surveyed 130 participants. The average age was 22 ± 0.2 years with extremes of 17 and 29 years. 95.3% of participants were students. According to 66.7% of participants, virtual dissection is a good palliative in the absence of a corpse. 95.3% of participants found using the virtual dissection table easy with an average of 7.88 ± 1.4. The overall assessment was well rated by 99.3% of participants. Conclusion: According to the results of this study, the virtual dissection table should be improved by integrating commented videos. The use of the DIVA 3D virtual dissection table during practical and tutorial sessions is well appreciated by the students. We believe that the teaching of anatomy using 3D digital technology should be included in the study programs of the Faculty of Medicine and Odontostomatology.

关键词： Student Opinion Contribution DIVA 3D Virtual Dissection Table Anatomy Teaching FMOS

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Strangulation of the Penis by a Ring in Children: About a Case

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Case Reports in Clinical Medicine 2023年第8期12卷 279-284页

作者： Klétigui Samuel Dembélé Korotimi Malle Issiaka Diarra Mahamadou Keita Amara Dembele Mamadou Adama Diallo Karifala haidara Mahamadou Coulibaly Moussa Abdoulaye Diarra Sadio Camara Siaka Konate dramane Fomba Djibrila Kanthe dramane Cisse Ousmane Abdoul Aziz Dicko Tominian Reference Health Center Tominian Mali Regional Directorate of Ségou Ségou Mali Commune I Reference Health center Bamako Mali General Surgery Department and Urology Department Nianakoro Fomba Hospital in Ségou Ségou Mali Koutiala Reference Health Center Koutiala Mali Bla Reference Health Center Bla Mali Kolondiéba Reference Health Center Kolondièba Mali Markala Reference Health Center Markala Mali Urology Department Somine DOLO Hospital in Mopti Mopti Mali

Strangulation of the penis by a ring is a rare but quite common event in children and is potentially serious. We found it important to report this case in order to share our experience on the management of penis rings. It was a 9-year-old child, with no particular medical-surgical history, nor any notion of known family defect, brought to the emergency room by his parents for intense pain in the penis associated with incessant crying. In front of which a clinical examination made it possible to conclude with penile strangulation by a metal ring. Our course of action was the ablation of the ring with non-medical forceps associated with local and general care. No complications were observed during treatment. The immediate consequences were simple and the patient was followed for 4 months.

关键词： Strangulation Penis Tominian

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High Moments Jarque-Bera Tests for Arbitrary Distribution Functions

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Applied Mathematics 2015年第4期6卷 707-716页

作者： Gane Samb Lo Oumar Thiam Mohamed Cheikh haidara Laboratoire de Statistique Théorique et Appliquée (LSTA) Université Pierre et Marie Curie Paris France LERSTAD Université Gaston Berger de Saint-Louis Saint-Louis Senegal

The Jarque-Bera’s fitting test for normality is a celebrated and powerful one. In this paper, we consider general Jarque-Bera tests for any distribution function (df) having at least 4k finite moments for k ≥ 2. The tests use as many moments as possible whereas the JB classical test is supposed to test only skewness and kurtosis for normal variates. But our results unveil the relations between the coeffients in the JB classical test and the moments, showing that it really depends on the first eight moments. This is a new explanation for the powerfulness of such tests. General Chi-square tests for an arbitrary model, not only normal, are also derived. We make use of the modern functional empirical processes approach that makes it easier to handle statistics based on the high moments and allows the generalization of the JB test both in the number of involved moments and in the underlying distribution. Simulation studies are provided and comparison cases with the Kolmogorov-Smirnov’s tests and the classical JB test are given.

关键词： Asymptotic Distribution Asymptotic Statistical Tests Normality Tests Functional Empirical Processes

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Direct Cost of Severe Malaria Treatment Borne by the Families of Children Aged 0 - 5 Years at the Fana Reference Health Centre, Mali

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Health 2022年第12期14卷 1307-1320页

作者： Solomane Traore Abdourahamane haidara Youssouf Samake Tegué Guindo Moussa Keita National Institute of Public Health (INSP) Bamako Mali Reference Health Centre (CSRéf) of Fana Koulikoro Mali

Introduction: Malaria is both a disease caused by poverty and a cause of poverty. Malaria is the leading cause of morbidity and mortality in Mali and is among the ten countries with the highest number of malaria cases and deaths. The objective was to estimate the direct economic cost borne by families in the treatment of severe malaria in children aged 0 - 5 years at the CSREF in Fana. Methodology: The study was cross-sectional, conducted from July 2017 to June 2018 with inclusion criteria and prospective data collection. The methodology was based on estimating the direct economic cost of severe malaria. Results: The sample consisted of 109 cases out of a total of 944 hospitalizations;59% of whom were boys and the 25 - 36 month age group was the most affected. The complications frequently encountered were severe anemia (50 cases) or 45.8%;convulsions (35 cases) or 32.1% and finally severe sepsis (8 cases) or 7.3%. The average direct cost was 25,324 Franc CFA (58.95 US Dollars) of which 66% represented the costs of medicines and consumables against 4% for the consultation. This cost was more than half the minimum wage in Mali. Conclusion: Despite the difficulties in estimating the cost in hospitals, the results obtained give us an estimate of the economic burden borne by families in the management of severe malaria cases among children in the district of Fana. Support is needed for parents in the fight against malaria in rural Mali.

关键词： Severe Malaria Direct Average Cost Fana District Health Center Mali

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