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Prevention of Venous Thromboembolism in General Surgery at Gabriel TouréUniversity Hospital in Mali

Surgical Science 2021年第3期12卷 67-75页

作者： Amadou Traoré Madiassa Konaté Abdoulaye Diarra Koniba Keïta Kadia Traoré Zakari Saye Youssouf Koné Boubacar Yoro Sidibé Amadou Maïga Amadou Bah Bouréima Kelly Tani Koné Boubacar Karembé Souleymane Thiam Assitan Koné Drissa Bagayogo Bakary Tientigui Dembélé Alhassane Traoré ibrahim diakité Lassana Kanté Adégné Togo Gabriel Touré University Hospital Bamako Mali

Through its impact on morbidity and mortality and the cost of medical care, Venous Thromboembolism (VTE) has a significant influence on the quality of care in a surgical environment. The objectives were to determine the risk of postoperative venous thromboembolism and to assess its prophylactic management in the general surgery department of Gabriel Toure University Hospital. This was a prospective observational study from May 01, 2018 to December 31, 2018. It included all patients of 18 years old and over, operated in regulated surgery, under general anesthesia in the department. For all of these patients, Caprini score was used to assess the risk of VTE. The ninth American College of Chest Physicians’ Consensus was used as guidelines to assess Thromboprophylaxis practices in the ward. The Caprini score was evaluated in 80 patients for 8 months. The average age was 50.2 years. The sex ratio was 0.48. The risk level of VTE was low in three patients (3.8%), moderate in 13 patients (16.3%), high in 34 patients (42.5%) and highest in 30 patients (37.5%). The main risk factors found were major surgery (87.5%), age > 40 years (72.5%), cancer (33.8%), bed rest (31.2%), obesity (27.5%) and minor surgery (12.5%). Early mobilization was performed in all patients. Pharmacologic prophylaxis was required in 80% of our patients but only 38.8% had received low molecular weight heparin. VTE complicated 5 procedures, including 3 cases of deep vein thrombosis of the limbs and 2 cases of pulmonary embolism who died. Venous thromboembolism is serious and common in surgical settings. Its prevention remains insufficient in our context.

关键词： Venous Thromboembolism Prevention Surgery Mali

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Diverticular Fistula of the Female Urethra on Lithiasis at the District Health Center (CSREF) in Communeii, Bamako, Mali

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Surgical Science 2019年第3期10卷 83-88页

作者： Tounkara Idrissa Diarra Abdoulaye Traoré Amadou Coulibaly B. Bakary Kanté Abdoulaye Dembélé Dabéré Ives Thiam Souleymane Ouattara Kassoum Kanté Lassana Konate Madiassa Koné Assitan Ongoiba Oumar Sangaré Modibo Dembélé Bakary Tiètiki diakité ibrahim Sidibé Yoro Bah Amadou Coulibaly Yakaria Togo Adégné Diallo Gangaly Chirurgie générale du Centre de santé de référence de la commune II de Bamako Mali Chirurgie générale du Centre Hospitalier Universitaire de Kati Mali Chirurgie générale Centre Hospitalier Universitaire Gabriel TOURE de Bamako Mali Chirurgie générale du Centre Hospitalier Universitaire du POINT G de Bamako Mali Hopital régional de Gao Mali Hopital régional de Tombouctou Mali

The diverticulum of the female urethra or sub-urethral pouch is in the form of a cul-de-sac lined with mucous membrane through the muscular layer of the urethra. Thus, it is a site of stasis, urinary infection, formation of calculus or even malignant tumor. The diverticula of the urethra or sub-urethral pouches in women have a prevalence of 0.5% to 6% depending on the series. We report the case of a 61-year-old patient operated for a diverticulum on fistulized urethra complicated lithiasis. Our patient had five pregnancies and five births when she consulted for dysuria, urinary burns evolving since a year. The urogenital examination revealed a partially stenotic urethral meatus and a 3-cm large fistulized intravaginal peri-urethral mass allowing urine leak. The mass was painful and hard at palpation. We performed transvaginal diverticulectomy. The follow-up was simple and the probe was removed two weeks after the surgery. An atomo-pathological examination of the resected diverticulum concluded an aspect compatible with lithiasis urethritis.

关键词： Diverticulum Urethral Fistula Lithiasis Bamako

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Primitive Umbilical Endometriosis in a Young Woman at the District Health Center (CSREF) in Commune II in Bamako

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Surgical Science 2019年第3期10卷 89-93页

Umbilical endometriosis, also called Villar’s nodule, has rarely been described in the literature. It represents only 0.5% to 1% of all cases of endometriosis. We report a case in a 28-year-old nulligest, nulliparous woman who consulted at the CSREF CII in Bamako. The diagnosis was suspected with the presence of umbilical swelling with cyclic, painful, dark hemorrhage of firm consistency. We performed an omphalectomy with an uncomplicated postoperative course. She was released from the hospital three days post-surgery. Anatomo-pathological examination of the resected specimen confirmed the diagnosis of umbilical endometriosis.

关键词： Umbilical Endometriosis Young Woman Bamako Mali

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Giant Hernia with Incarceration

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Surgical Science 2021年第12期12卷 399-403页

作者： Amadou Maïga Amadou Bah ibrahim diakité Zakari Saye Boubacar Y. Sidibé Bathio Traoré Moussa Diassana Siaka Konaté Arouna A. Doumdia Tani Koné Aly B. Diallo Amadou A. Traoré Mamadou Diallo Bakary T. Dembélé Oumou H. Saadé Moussa Kanté Madiassa Konaté Souleymane Dembélé Moussa Samaké Moussa Konaté Lassana Kanté Alhassane Traoré Service de chirurgie générale h&#244pital universitaire Bamako Mali Service de chirurgie générale h&#244pital de Sikasso Sikasso Mali Centre de référence de la Commune VI Bamako Mali

Introduction: Giant hernias induce changes which reduce the quality of life of patients and make their surgical management complex. Adequate preoperative preparation of the patient guarantees good postoperative progress. It is necessary to avoid resorting to a technique of separation of the compartments during the cure. Here we report the case of a patient who benefited a successful cure using the Ramirez technique. Observation: We report the case of a 60-year-old patient admitted to an outpatient clinic for abdominal swelling evolving for 30 years without the notion of trauma gradually increasing in volume. The interrogation and physical examination led to the diagnosis of a giant white line hernia with incarceration. A preoperative assessment and a preanesthetic consultation were carried out. Intraoperatively, the cecum, transverse colon, sigmoid, jejunum and greater omentum were incarcerated in the bag. After adhesiolysis we proceeded to resect the bag and cure it using the Ramirez technique. The consequences were simple and the patient was discharged on day 4 after her dressing and was seen on day 15, 1 month, 3 months and 1 year. The patient benefited from the placement of an abdominal compression sheath for 3 months. Conclusion: Success in the management of prosthetic material in the absence of prosthetic material depends on good preoperative preparation and the mastery of certain surgical techniques.

关键词： Giant Hernia General Surgery CHU Gabriel Touré

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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

作者： Traoré Amadou Konaté Madiassa Diarra Abdoulaye Tounkara Idrissa Saye Zakari Doumbia Arouna Bah Amadou Sidibé Boubacar Yoro Maïga Amadou KonéTani Thiam Souleymane Karembé Boubacar Kelly Bouréima Traoré Kadia Kéita Koniba Bouaré Yacouba Koné Assitan diakité ibrahim Dembélé Bakary Tientigui Traoré Alhassane TogoAdégné

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Damage to the External Genitalia by Traction Following Assault and Battery at the C.H.U Gabriel Touré: About a Case

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Surgical Science 2023年第2期14卷 55-60页

作者： Karembé Boubacar Traoré Boureima Tounkara Idrissa Diarra Issaka Coulibaly Mamadou Tidiani Soumaré Modibo Dianguina Coulibaly Abdoulaye Camara Aboubacar Touré Aboubacar Sanogo Seydou Fall ibrahim diakité Mané Diarra Mouminy Traoré Abdoulaye Diarra Drissa diakité Mamadou Lamine Départment of Surgery CHU Gabriel Touré Bamako Mali

Trauma to the external genitalia by tearing is rare. We report the case of a 30-year-old patient, admitted to the emergency room for trauma of the external genitalia by traction following a blow and intentional injury. The authors highlight the lesions that can occur during this type of trauma and insist on the systematic search for urethral and cavernous lesions. Conclusion: Trauma to the external genitalia by intentional assault and battery is rare in our context. They occur most often in a young person and are frequently associated with damage to the corpora cavernosa and urethra.

关键词： Trauma External Genitalia Traction

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Routine Screening for Cervical Cancer

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Open Journal of Obstetrics and Gynecology 2021年第7期11卷 922-928页

作者： Alassane Traoré Aphou Sallé Koné Sima Mamadou Amadou Bocoum Mamadou Bakary Coulibaly Koninba Diabaté Adama diakité Kanté ibrahim Seydou Mariko Idrissa Mama Diarra Service de gynécologie H&ocirc pital du Mali Bamako Mali Service de radiothérapie H&ocirc pital du Mali Bamako Mali Service de gynécologie-obstétrique Centre hospitalier et universitaire du Point G Bamako Mali Service de gynécologie-obstétrique Centre hospitalier et universitaire Gabriel Touré Bamako Mali

Objective: To describe the screening for uterine cancer by visual methods. Method: We conducted a prospective and descriptive study over a period of 12 months from January to December 2020. Direct observation of providers and interview of patients were performed for data collection. Results: Out of 3400 patients, 1024 were enrolled for the study, or 30.11%. The average age of the patients was 41 years with the extremes of 17 to 87 years. Women aged 40 to 45 were the most represented with 58.78%, (n = 602). Housewives 85.83% (n = 879), they had a primary education level in 71.09% of cases (n = 728), the vast majority were married 92.28% (n = 945). Multiparous represented 58.78% (n = 602) of the sample, nulliparous 18.26% (n = 187), women living in rural areas 30.17% (n = 309), in urban areas 69.82% (n = 715). The test was positive in 43 patients (4.19%) but squamocylindrical junction was not visible in 17% of cases. The preparation of acetic acid and lugol: good preparation in 100% of cases;

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Etiological Factors of Infective Endocarditis in Children Aged 1 Month to 15 Years Hospitalised in the Paediatric Department of CHU Gabriel Touréof Bamako (Mali)

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World Journal of Cardiovascular Surgery 2022年第2期12卷 13-20页

作者： Maiga Belco Sacko Karamoko Konaté Djéneba diakité Abdoul Aziz Dembélé Adama Cissé Mohamed Elmouloud DansoKo Nassira Traoré Kalilou Togo Pierre Doumbia Abdou Karim Traoré Fousseini diakité Fatoumata Léonie Sidibé Lalla Maiga Leila Ahmadou ibrahim Coulibaly Oumar Diall Hawa Sylla Mariam Department of Pediatrics CHU Gabriel Touré Bamako Mali

Introduction: In emerging countries where studies are rarer, the epidemiological profile of infective endocarditis resembles that of developed countries at the beginning of the antibiotic era. There is little data available in Mali on this subject, motivating this study, the aim of which was to study the etiological factors of infective endocarditis in children aged between 1 month and 15 years hospitalised in the paediatric department of the CHU Gabriel Touré. Patients and Methods: We conducted a cross-sectional and descriptive study, which took place from August 2018 to August 2019 (13 months), in children aged between 1 month and 15 years hospitalised in the paediatric department of the Gabriel Touré University Hospital with an ultrasound- confirmed cardiac disease and a temperature above 38°C. Results: The hospitalization rate was 0.4%. The average age was 11 months, the sex ratio was 1.35. Respiratory distress (63.6%) and fever (30.3%) were the most common reasons for referral. Congenital heart disease (87.9%) and dyspnoea on feeding (24.2%) were the most common medical histories. IVC was the most frequent congenital heart disease (36.4%). The mean temperature was 39.1°C. Blood cultures were taken in 24 patients (72.7%) and were positive in 27.3%. Staphylococcus aureus was found in 55.6% of cases. Trans-thoracic ultrasound found vegetations in 03 cases. According to the modified DUKE criteria, the diagnosis of endocarditis was retained in 27.30%. The evolution was marked by a high case fatality rate (45.45%). Conclusion: Endocarditis is an uncommon disease in children with a pulmonary portal of entry and Staphylococcus aureus as the main germ. Its mortality remains high.

关键词： Infective Endocarditis Etiological Factors Pediatrics Bamako

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Estimation of Glomerular Filtration Rate: Which Formula to Apply in G-Spot Subjects Aged 1 - 17 Years?

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Open Journal of Nephrology 2021年第3期11卷 397-402页

作者： Hamadoun Yattara Djibril Mamadou Couliblay Nouhoum Coulibaly Pamela Samiza Seydou Sy Arboncana Maiga Djeneba Diallo Moustapha Tanagra Alkaya Touré Magara Samaké Niagalé diakité Aboubacar Sidiki Fofana ibrahim Izetiengou Maiga Sahare Fongoro Nephrology and Hemodialysis Department of the Point G University Hospital Bamako Mali Medical biology Laboratory Service of the Point G University Hospital Bamako Mali Nephrology Department of the Regional Hospital of Kayes Kayes Mali

Introduction: Morbidity and mortality in paediatric practice is dominated in Africa by malaria, diarrhoeal diseases and acute respiratory infections. Aim: In order to evaluate the Glomerular Filtration Rate (GFR) with the formulas commonly used by medical laboratories, we proposed to undertake this study. Patients and Method: This was a descriptive, prospective and cross-sectional study conducted at the PA and KA medical biology laboratory in Bamako Hamdalaye ACI 2000 in collaboration with the medical biology and hospital hygiene laboratory service at the Point G University Hospital. Results: During the study period, we recruited 360 subjects, 189 of whom were male (52.5%) and 171 female (47.5%). The mean age was 8.75 ± 4.8 years with extremes of 1 and 17 years. Subjects aged 15 to 17 years were the most numerous. The reference means GFR of the subjects according to age was with the SCHWARTZ formula 179.16 ± 50.47 with extremes of 173.93 and 184.39;with CKD-Epi 37.63 ± 11.25 with extremes of 36.46 and 38.79;with MAYO 107.87 ± 18.11 with extremes of 105.99 and 109.75 and MDRD 350.83 ± 251.15 with extremes of 324.79 and 376.86. Conclusion: The Mayo formula showed a better distribution around the mean than other formulas for estimating the glomerular filtration rate.

关键词： Glomerular Filtration Rate Reference Value Young Subjects

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Pulmonary Complications in Children with Sickle Cell Disease Followed at the Pediatric Department of Gabriel Toure University Hospital

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Open Journal of Pediatrics 2022年第1期12卷 89-99页

作者： Mohamed E. Cissé Abdoul A. diakité Adama Dembélé Belco Maiga Pierre Togo Nicole A. Kpakoutou Oumar Coulibaly Karamoko Sacko Tiaria M. Sanogo Hawa Diall Fousseyni Traoré Abdoul K. Doumbia Djenèba Konaté Fatoumata L. diakité ibrahim Ahamadou Lalla N. Sidibé Amadou Touré Fatoumata Dicko-Traoré Boubacar Togo Mariam Sylla Pediatric Department of Gabriel Toure University Hospital Bamako Mali

Objective: To study the pulmonary complications of major sickle cell syndromes in children aged 6 months to 15 years followed at the Department of Pediatrics of Gabriel Toure University Hospital. Materials and methods: This was a retrospective study from January 1st, 2017 to February 28, 2018 and a prospective study from March 1, 2018 to December 31, 2019, concerning sickle cell disease children followed at the Gabriel Touré University Hospital. All children with sickle cell disease confirmed by hemoglobin electrophoresis, aged 6 months to 15 years with a pulmonary complication and admitted to pediatrics were included. Were not included: 1) Infants and children with sickle cell disease not presenting a pulmonary complication coming only to their routine follow-up. 2) Sickle cell patients over 16 years of age and those whose parents do not consent. 3) Those who have not done electrophoresis. Results: During the study period, we were able to include 45 sickle cell children with a pulmonary complication. The frequency of pulmonary complications was 13.76%, involving homozygotes in 91.11% of cases. The age group 6 - 10 years predominated with 46.66% and the sex ratio was 0.45. Vaso-occlusive crisis was the most frequent reason for consultation with 35.56%. Respiratory distress (80%), fever (66.67%), crepitus rales (64.44%) and chest pain (60%) were the most frequent clinical signs. The main pulmonary complication was acute chest syndrome with 86.67%. Treatment was based on hydration (91.91%), analgesics (91.91%) and antibiotics (73.33%). Lethality was 4.44%. Conclusion: Pulmonary complications of sickle cell disease are serious and constitute the main cause of mortality in our context.

关键词： Sickle Cell Disease Children Lungs Complications

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