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Factors Associated to Cataract Surgery Failure at Kankan Regional Hospital

International Journal of Clinical Medicine 2022年第10期13卷 441-451页

作者： Fremba Camara Sonassa Diané Alpha ibrahima Baldé Mory Camara ibrahim diakité Safiatou Camara Department of Ophthalmology (Kankan Regional Hospital) Kankan Republic of Guinea Faculty of Health Sciences and Techniques (Gamal Abdel Nasser University of Conakry) Conakry Republic of Guinea Joint Medical-Surgical Center Battalion Headquarters (Camp Samory Touré) Conakry Republic of Guinea

Introduction: Cataract surgery has undergone many changes with the size of incision progressively decreasing over time with an incision of 12.0 mm for intracapsular cataract extraction to 2.2 - 2.8 mm in phacoemulsification. However, phacoemulsification due to high cost and equipment maintenance cannot be employed widely in developing countries. The phacoalternative or Manual small-incision cataract surgery (MSICS) offers similar advantages with the merits of wider applicability, less time consuming, a shorter learning curve, and lower cost. Haven’t not being without complications like any other surgery We have identified the factors influencing the outcome of phacoalternative cataract surgery in order to improve our quality of care for our patients suffering from blindness induced by the world’s first leading cause of legal blindness. We have identified the factors influencing the outcome of cataract surgery. Patients and Methods: This was a prospective observational study of the descriptive type lasting six (6) months from March 1 to August 30, 2020 including all patients operated on for cataracts and having lower visual acuity at 3/10. The operating form included demographic data, the patient’s personal ophthalmological history, postoperative visual acuity, per and postoperative complications and the type of pathology involved. The analysis was carried out using epi-info 7.***.0.1 software. Results: During this study period, we collected 61 cases of failure of cataract surgery out of a total of 1182 operated eyes, i.e. a frequency of 5.16%. Women represented more than half of the sample with 74%. Almost all of our patients, i.e. 96.72%, were over the age of 60. Loss of visual acuity was the main complaint in all our patients, i.e. 100% followed by photophobia with 24.4% of cases. Arterial hypertension present in 8.20% of patients was the most common comorbidity in our series followed by diabetes with 4.92%. 18 patients (29.5%) presented early postoperative complica

关键词： Cataract Small Incision Complications Failure

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Association of Metastasis and Axillary Lymph Node Tuberculosis in Breast Cancer: Clinical Case and Review of the Literature

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Advances in Breast Cancer Research 2022年第2期11卷 101-108页

作者： Seydou Pamateck Boubacar Yoro Sidibe ibrahim diakité Zakari Saye Iriss A. Darar Arouna Adama Doumbia Adégné Togo Department of General Surgery CHU Gabriel Toure Bamako Mali

The coexistence of tuberculosis with axillary lymph node metastases in breast carcinoma is rare. Axillary lymph node metastasis is the most important factor in the staging of breast carcinoma, and the number of axillary lymph nodes metastasizing changes the stage. Since tuberculosis also produces lymph node enlargement, this can mimic or complicate the staging of a malignant disease. Dual organ pathology can lead to interpretation difficulties and inappropriate treatment of tuberculosis as well as breast carcinoma. Additionally, fine needle aspiration cytology (FNAC) of such cases can be misleading if only one of the diseases is detected. We report two cases of infiltrating carcinoma of the nonspecific type of the breast in two women aged 35 and 55 where tuberculosis was found in the axillary lymph nodes in addition to metastases. As the present case led to the fortuitous discovery of tuberculosis with tumor metastasis, it reinforces the possibility of a coexisting lesion in the minds of pathologists, especially in areas endemic to tuberculosis.

关键词： Breast Carcinoma Tuberculosis Lymph Node Association

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Treatment of Operative Pain in Visceral Cancer Surgery at CHU Gabriel Toure

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Surgical Science 2017年第1期8卷 47-51页

作者： Dembélé Bakary Tientigui Traoré Alhassane Togo Adégné Kante Lassana diakité ibrahim Konate Madiassa Traore Amadou diakité Boubacar Bah Amadou Sidibé Yoro Koné Tany Diop Thiorno Madani Django Djibo Diallo Gangaly Department of General Surgery CHU Gabriel-Touré Bamako Mali

The objectives were to determine the frequency of pain in cancer patients and its intensity in cancer pathologies and to evaluate the evolution of pain intensity after analgesic treatment;the effectiveness of its management study involved 121 cases of operated gastrointestinal cancers, which accounted for 85.82% (141) of operated cancers and 16.78% (721) of all operated patients;the average age of our patients was 49.93 years with extremes 17 and 78 years. Standard deviation: 15.75;with a sex ratio of 1.46. The majority of our patients had WHO III (54/121) or 44.6%;46.3% (56/121) of patients were in stage IV of the TNM classification. The main digestive cancers were cancer of the esophagus 4 cases (3.3%);of the stomach 61 cases (50.4%);of the pancreas 7 cases (5.8%);of the liver 4 cases (3.3%);gall bladder 2 cases (1.6%);colon 33 cases (27.3%);rectum 6 cases (4.9%) and hail 4 cases (3.3%). The average pain intensities were 3 to 6 hour;2 to 24 hour;1.6 to 48 hour;and 1.2 to 72 hour. The majority of our patients had a treatment protocol involving nefopam, and paracetamol was 58%. The pain was exacerbated especially during exercise. Vomiting and vein burning were the main side effects encountered.

关键词： Pain Cancer Bamako Surgery Mali

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Synchronous Volvulus of the Sigmoid Colon and the Transverse Colon: A Case Report at Gabriel Toure University Hospital in Mali

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Surgical Science 2021年第9期12卷 313-318页

作者： Traoré Amadou Konaté Madiassa Diarra Abdoulaye Tounkara Idrissa Saye Zakari Doumbia Arouna Bah Amadou Sidibé Boubacar Yoro Maïga Amadou Koné Tani Thiam Souleymane Karembé Boubacar Kelly Bouréima Traoré Kadia Kéita Koniba Bouaré Yacouba Koné Assitan diakité ibrahim diakité ibrahim Dembélé Bakary Tientigui Traoré Alhassane Togo Adégné General Surgery Department Gabriel Touré University Hospital Bamako Mali Surgery Department Kati University Hospital Kati Mali Reference Health Center of Commune III Bamako Mali

Synchronous transverse and sigmoid colon volvulus are very rare. We report the case of a 23-year-old man who underwent emergency surgery for sigmoid colon volvulus. An intraoperative finding of transverse colon volvulus associated with sigmoid colon volvulus was made. Left and transverse colectomy was performed followed by colorectal anastomosis. The postoperative period was uneventful. Synchronous volvulus of the transverse and sigmoid colon is a surgical emergency. The clinical signs are not specific and the discovery is often intraoperative. It is necessary to know how to evoke the diagnosis in a case of sigmoid colon volvulus, to avoid inadequate management with dramatic consequences.

关键词： Volvulus Synchronous Colon Sigmoid Transverse Surgery 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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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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Fascist Leg Necrosis at the Bocar Sidi Sall University Hospital (BSS) in Kati (Mali)

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Surgical Science 2022年第3期13卷 119-123页

作者： Abdoulaye Diarra Assitan Koné Amadou Traoré Koniba Kéïta Idrissa Tounkara Tounkara Issa Traoré Oumou Traoré Boubacar Karembé Madiassa Konaté Oulématou Coulibaly Modibo Togola Daouda Diallo Alhassane Traoré Bkary Tientigui Dembélé ibrahim diakité Adégné Togo Department of General Surgery Kati University Hospital Kati Mali Department of General Surgery CHU Gabriel Touré Bamako Mali Department of Anesthesia and Resuscitation CHU of Kati Kati Mali

Necrotizing fasciitis is a bacterial dermo-hypodermitis of necrotizing type with involvement of the superficial fascia of the muscles. We report the case of a 50-year-old patient with necrotizing fasciitis of the left leg following erysipelas. Clinical Case: A 50-year-old patient, received at the emergency department for necrotizing wound of the left leg, evolving for 25 days. The examination of the patient made it possible to find: an alteration of the general condition with a WHO score classified stage II. A necrotizing wound of the lower 2/3 of the left leg and the dorsal side of the left foot allowing pus to flow in places, the pedious pulse was well perceived, lymphadenopathy at the root of the homolateral thigh. The complete blood count made it possible to objectify a predominantly neutrophil hyperleukocytosis greater than 10,000/mm3. We first carried out a complete debridement of the necrotic tissues, in a second time we took the patient back to do the autocutaneous graft. The surgical follow-up was simple. Conclusion: Necrotizing fasciitis is a serious infection, management is multidisciplinary.

关键词： Necrotizing Fasciitis Lower Limb Kati Mali

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Giant Lactant Adenoma: About a Case

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Surgical Science 2022年第12期13卷 561-565页

作者： Amadou Bah Amadou Maiga Boubacar Y. Sidibé ibrahim diakité Tani Koné Zakari Saye Arouna Doumbia Amadou Traoré Madiassa Konaté Pierre Coulibaly Amadou A. Traoré Bakary T. Dembélé Lassana Kanté Boubacar Karembé Assitan Koné Andre Kassogue Amidou Almeimoune Adegne Togo General Surgery Department CHU Gabriel Touré Bamako Mali Resuscitation Anesthesia Department CHU Gabriel Touré Bamako Mali

Affecting young women, lactating adenoma is a rare benign tumor of the breast. It is seen mainly in the third trimester of pregnancy and in the postpartum period. Clinically, it is a solid mass, mobile typically benign but its character of rapid evolution is reminiscent of phyllodes tumors, sarcomas and galactoceles. The definitive diagnosis is histological. We report a case of lactating adenoma in a 26-year-old lactating woman, third procedure, second pare, with a history of tumor resection of the outer quadrants of the left breast, 9 months ago, whose histology evoked a fibrotic disease, cystic breast associating non-specific subacute mastitis with suppuration. Received for recurrence of a tumor in the left breast which was the site of a polylobed mass of about 10/5 cm occupying 3/4 of the breast with mobile ipsilateral axillary adenopathies. A micro tru-cut biopsy was performed and the histology was in favor of a lactating breast adenoma with no signs of malignancy. She underwent surgical excision, the consequences of which were simple.

关键词： Lactating Adenoma Breast Histological Malignancy Surgical Excision

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Traumatic Diaphragmatic Injury at Gabriel Toure University Hospital, Mali

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Surgical Science 2022年第3期13卷 110-118页

作者： Amadou Traoré Madiassa Konaté Abdoulaye Diarra Idrissa Tounkara Mohamed Traoré Arouna Doumbia Amadou Bah Boubacar Yoro Sidibé Amadou Maïga Tani Koné Boubacar Karembé Zakari Saye Koniba Kéita Yacouba Bouaré Assitan Koné ibrahim diakité Lassana Kanté Bakary Tientigui Dembélé Alhassane Traoré Adégné Togo General Surgery Department of Gabriel Touré University Hospital Bamako Mali Surgery Department of Kati University Hospital Kati Mali Reference Health Center of Commune II Bamako Mali Reference Health Center of Commune III Bamako Mali

Traumatic diaphragmatic injury (TDI) is rare and is most often the result of a traffic road accident (TRA) or an assault. We initiated this study with the aims of determining the epidemiological, clinical and therapeutic aspects of TDI at Gabriel Toure University Hospital. This was a retrospective study from January 1999 to June 2021 that included all patients who presented a diaphragmatic injury consecutive to abdominal and/or thoracic trauma. In 22 years and 6 months, 46 cases of TDI were collected. They represented 0.17% of hospitalizations, 0.26% of surgical emergencies and 5.5% of thoraco-abdominal traumas. The average age was 31.69 years with a sex ratio of 3.2. Criminal stabbings accounted for 56.5% and TRA for 19.6%. Penetrating injuries accounted for 78.3% of cases. The parietal lesion was thoracic in 21 cases (45.7%), abdominal in 19 cases (41.3%) and thoraco-abdominal in 6 cases (13%). The chest X-ray, performed in 15 patients, showed an intrathoracic gas bubble (4 cases) and hemothorax (6 cases). Diagnosis of diaphragmatic lesion was preoperative in 21.7% (10 cases). The diaphragmatic breach was on the left side in 65.2% (30 cases) and the average size was 3.17 cm. Laparotomy was performed in 89.1%, thoracotomy in 4.4% and thoraco-laparotomy in 6.5% of cases. The surgical procedure consisted of reduction of the herniated viscera in 15.2% (7 cases) and closure of the diaphragmatic breach with non-absorbable sutures in 82.6% (36 cases). Chest tube drainage was performed in 73.9%. The average length of hospital stay was 9.8 days. Mortality was 13.04%. Conclusion: Traumatic diaphragmatic injury is rare but its frequency is increasing in our country. It most often affects the young man victim of assault or TRA. This type of trauma is rarely isolated;you have to think about it in case of any thoraco-abdominal trauma. The treatment is surgical. The prognosis depends on the severity of the associated lesions.

关键词： Diaphragmatic Injury Trauma Surgery Gabriel Toure

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Factors Associated to Cataract Surgery Failure at Kankan Regional Hospital

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International Journal of Clinical Medicine 2022年第10期

作者： fremba camara sonassadiané² alpha ibrahima baldé mory camara ibrahim diakité safiatou camara

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