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Ureteroscopy with Holmium: YAG Laser—A Initial Study in the Urology Department of the Pr Bocar Sidy Sall University Hospital of Kati

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Open Journal of Urology 2024年第4期14卷 207-216页

作者： Amadou Kassogue Idrissa Sissoko Daouda Sangare Moussa Salifou Diallo Hamed Sylla Mahamadou Traore Boureima Coulibaly Salia Coulibaly Modibo Diakite Modibo Togola Fadima Tall ilias Guindo Ben Naoum Kamel Mamadou Lamine Diakite Urology Department University Hospital of Pr Bocar Sidy Sall Kati Mali Radiology Department University Hospital of Pr Bocar Sidy Sall Kati Mali Anesthesy and Reanimation Department University Hospital of Pr Bocar Sidy Sall Kati Mali Urology Department University Hospital Nimes France Urology Department University Hospital of Point G Bamako Mali

Introduction: Ureteroscopy is a minimally invasive endoscopic surgery which provides access to the ureter, pyelon and calyceal cavities via the urethra and the bladder. Laser ureteroscopy uses the laser as an energy source to treat the stone and eliminate it naturally. Minimally invasive endoscopic methods are struggling to become popular in sub-Saharan African countries, especially for the upper urinary tract. The objective of our work was to report the results of our first laser ureteroscopy experience in the department. Materials and Methods: This was a prospective and descriptive study running from December 1, 2023 to February 19, 2024. Included in our study was any case of upper urinary tract stone operated by Laser ureteroscopy. The characteristics of the lithiasis were determined by CT scan. Sterilization of urine was verified by carrying out a cytobacteriological examination of urine. Ureteral lithiasis was approached by semi-rigid ureteroscopy. Renal lithiasis was immediately addressed by flexible ureteroscopy. Ureteroscopy was coupled with a Holmium YAG laser. A double J ureteral catheter was placed after the operation. A 230 µm laser fiber was used in each case with a generator with a power of 35 watts (Storz Calculase III type). An access sheath was used in all cases of flexible ureteroscopy. The parameters studied were: sociodemographic characteristics, lithiasis (site, size, number, density, topography), type of anesthesia, duration of laser use, duration of intervention, postoperative outcomes. Data entry and analysis were carried out using the software (Word 2016 and SPSS). Result: We collected 30 cases of laser ureteroscopy. The average age was 37 years with extremes of 9 and 79 years. The male gender was more represented. The most common age group was 24-39 years old. Renal colic was the most frequent reason for admission, 12 patients (40%). On physical examination, lumbar tenderness was present in 47% (14 patients). ECBU was positive in 4 patients

关键词： Ureteroscopy Semi-Rigid Flexible Holmium YAG Laser

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Clinical and Anatomo-Pathological Study of Digestive Polyps at Point G Teaching Hospital

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Open Journal of Gastroenterology 2023年第3期13卷 111-116页

作者： Sanra Déborah Sanogo Marcelle Paule Tayue Ganda Soumaré Ouatou Mallé Abdoulaye Maiga Luc Sidibé Hourouma Sow Kadiatou Samaké Moussa Y. Dicko Abdoulaye Diarra ilias Guindo Bakarou Kamaté Cheickh B. Traoré Hepatogastroenterology Department Point G University Hospital Bamako Mali Anatomical Pathology Department Point G University Hospital Bamako Mali Hepatogastroenterology Department Gabriel Touré University Hospital Bamako Mali CHU Bocar Sidy Sall Bamako Mali

Introduction: The aim of our study was to describe the aspects clinical and pathology of digestive polyps. Methods: This was a descriptive and analytical study with retrospective and prospective collection from January 2014 to September 2020, i.e. a duration of 72 months. Our study focused on all cases of non-cancerous digestive pathologies. The data were collected from registers, medical files and reports from the anatomy and pathological cytology department of the Point G University Hospital. All of this data was entered on an individual survey form. This sheet includes demographic data, qualitative and quantitative variables. Results: We conducted a study of 131 cases of digestive polyps. The frequency of digestive polyps was 3.65%. The mean age of our patients was 44.6 ± 21 years with extremes of 2 years and 79 years, with a male predominance and a sex ratio of 1.01. The biopsy was the type of sample most represented in 77.1%. The digestive polyps were located in stomach in 37.4%;the colon in 27.5% then the rectum 21.4%. The polyp sessile accounted for 65.6%. Histological examination revealed that adenomatous polyps were predominant in 77% of cases, followed by juvenile polyps in 9.2%, then hyperplastic polyps in 6.2%. Low grade dysplasia was found in adenomatous polyps in 61.53% and high grade found in 38.4%. Gastritis due to Helicobacter pylori (Hp) was found in 16% of cases. Conclusion: Digestive polyps are common in the general population. The prognosis is linked to the risk of neoplastic degeneration of adenomas.

关键词： Digestive Polyps Clinical Anatomopathology

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Ultrasound Causes of Female Infertility at the Fertilia Medical Clinic in Bamako

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Open Journal of Medical Imaging 2023年第3期13卷 107-113页

作者： Mamadou Dembele Alassane Kouma ilias Guindo Zoumana Cheick Berete Souleymane Sanogo Mamadou N'diaye Brahima Doumbia Oncoumba Diarra Ousmane Traore Issa Cisse Aboubacar Sidiki N’ Diaye Badiougou Doucoure Youssouf Yalcouye Adama Diaman Keita Siaka Sidibe Radiology Department Faculty of Medicine and Odonto-Stomatology of Bamako (FMOS) Bamako Mali Radiology Unit Fertilia Medical Clinic Bamako Mali Department of Education and Research in Public Health (DERSP) FMOS Bamako Mali

Aims: Infertility is a major problem in our current societies and the Fertilia medical clinic in Bamako is a center for medical assistance in procreation (MAP) where there is an increasingly growing demand for ultrasound. The objective of our study was to investigate the ultrasound causes likely to prevent the occurrence of pregnancy in a group of infertile and subfertile women. Subjects and Methods: This was a 5-year cross-sectional and prospective study, between January 2017 and January 2022, which involved 250 women wishing to become pregnant (infertile or subfertile), who came for pelvic ultrasound or follicular monitoring and who agreed to participate in our study. The parameters used were ultrasound reports including uterine, ovarian and tubal pathologies. It should be noted that in some cases no ultrasound cause of infertility was found. Data were entered and analyzed in SPSS. Results: 250 women were recruited into our. The average age was 32 years with extremes ranging from 17 to 51 years. 179 patients or 71.6% were between 17 and 35 years old. 139 patients or 55.6% had secondary infertility against 44.4% primary infertility. 202 patients or 80.8% had at least one ultrasound lesion and 48 patients or 19.2% had no significant ultrasound abnormality. The most represented ultrasound lesions were of uterine origin with 72.20%, 23.7% ovarian lesions and 04% tubal lesions. Uterine lesions were dominated by myomas, adenomyosis, endometrial polyps, uterine malformations and synechiae. As for ovarian lesions we noted cysts, polycystic ovary syndrome (PCOS), ovarian endometriosis, non-follicular ovaries and tubal ultrasound lesions showed unilateral or bilateral hydrosalpinx. Conclusion: In our study, ultrasound was an invaluable contribution to the diagnosis of the causes likely to explain subfertility and infertility in our respondents. She highlighted uterine, ovarian and tubal lesions, some of which could be corrected and pregnancies ensued.

关键词： Ultrasound Female Infertility Myomas Polycystic Ovaries Hydrosalpinx

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Varicocele and Spermogram Abnormality: About 264 Cases at the Fertilia Medical Clinic in Bamako

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Open Journal of Medical Imaging 2023年第3期13卷 84-91页

作者： Mamadou Dembélé Alassane Kouma ilias Guindo Souleymane Sanogo Zoumana Cheick Berete Ousmane Traoré Mamadou N’diaye Brahima Doumbia Oncoumba Diarra Issa Cissé Aboubacar Sidiki N’diaye Bandiougou Doucouré Youssouf Yalcouyé Adama Diaman Keita Siaka Sidibe Faculty of Medicine and Odonto-Stomatology of Bamako (FMOS) Bamako Mali Medical Imaging Department Kati University Hospital Kati Mali Department of Education and Research in Public Health (DERSP) Bamako Mali

Aims: To determine the impact of varicocele on the result of the spermogram in a group of hypo-fertile or infertile men. Patients and Method: This was a cross-sectional, descriptive study concerning 264 men collected between February 2020 and March 2022 at the Fertilia medical clinic in Bamako. The study population consisted of consenting male subjects presenting for infertility. All of our patients had already done a spermogram, they then benefited from a scrotal Doppler ultrasound. The scrotal echo-doppler was completed by an abdominal and pelvic echography in search of a possible etiology, in particular a renal cancer, a thrombosis of the renal or spermatic vein, a retroperitoneal mass or a nutcraker syndrome. Testicular volume was measured on ultrasound according to Lambert’s formula (length × width × height × 0.71). A volume = 16 ml was considered normal. Results: 264 patients were recruited in ours. The average age was 33 years with extremes ranging from 25 to 65 years. 149 patients or 56.44% were between 30 and 45 years old. 213 patients or 80.68% had primary infertility. All the patients, i.e. 100%, had a sperm anomaly and dilation of the pampiniform plexus veins. The most common sperm abnormalities were oligoasthenoteratozoospermia, which concerned 214 patients, or 81%, followed by azoospermia (40 patients, or 15%) and oligospermia (10 patients, or 4%). 213 patients or 80.68% had a Hirshen grade II varicocele, 45 patients or 17% had grade I and 06 patients or 2.27% had grade III. Among the 6 patients, 04 had left testicular atrophy and 2 bilateral atrophy. The venous reflux was more accentuated on the left than on the right. Conclusion: Varicocele is significantly found in men with infertility. Sperm alterations concern both the concentration of spermatozoa, their mobility and their vitality. Even if the mechanism of alteration of the sperm parameters is not well elucidated, our study made it possible to make the link between the dilation of the veins of th

关键词： Ultrasound Male Infertility Varicocele Oligoasthenoteratozoospermia

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MRI Contribution in the Diagnosis of Non-Traumatic Medular Compressions at the Mali Hospital of about 179 Cases

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Open Journal of Medical Imaging 2020年第4期10卷 186-195页

作者： Mody Abdoulaye Camara Mamadou N’Diaye Mamadou Bakary Coulibaly Mohamed Maba Traore Hawa Diarra Boubacar Mama Toure Abourahman Abdillahi Nour Salia Coulibaly ilias Guindo Madani Ouologuem Sounkalo Traore Mahamane Mariko Aphou Sallé Kone Moussa Konate Siaka Sidibe Medical Imaging Department of Mali Hospital Bamako Mali Radiology Unit of the Bamako Infirmary Hospital Bamako Mali Gynecology Department of Mali Hospital Bamako Mali Medical Imaging Department at Kati University Hospital Bamako Mali Neurology Unit of the Bamako Infirmary Hospital Bamako Mali Radiology Unit of the Reference Health Center of the Commune V Bamako Mali Medical Imaging Department of CHME Luxembourg Bamako Mali Radiotherapy Department of Mali Hospital Bamako Mali Radiology Department of CHU POINT G Bamako Mali

Slow spinal compressions are due to the development of an expansive process in the spinal canal. It is a very common pathology, the diagnosis of which is mainly clinical. However, magnetic resonance imaging occupies an essential place in the site diagnosis and etiological research in the management. Non-traumatic spinal cord compression is a diagnostic and therapeutic emergency, requiring early and appropriate management. MRI is the benchmark imaging examination for this pathology. No similar previous MRI study in Mali. We undertook this work with the aim to determine the place of MRI in the diagnosis of spinal cord compressions in Mali hospital. Method and Patients: This was a descriptive retrospective study, carried out at the hospital’s medical imaging department from January 1, 2017 to December 31, 2018 (02 years). It involved all patients, regardless of sex and age, sent for an MRI examination of the spine, and in whom spinal cord compression was diagnosed. We used a 0.35T low-field MRI machine with solid-state antennas. Results: We collected 179 cases of spinal cord compression MRI out of 585 spinal MRI performed, (frequency of 30.59%). The average age was 53.5 years with a male predominance (sex ratio 3.7). Motor disorders were the most common reason for examination (41%). We used the T1 T2 sagittal and T2 axial sequences. IV injection of gadolinium was performed in 48% of patients. The topographic lesions were: cervical (54.7%), thoracic (31.3%) and several segments (9.5%). The lesions concerned the compartments: extradural (79.3%), intradural (4.5%), and intramedullary (16.2%). The processes were degenerative (57.5%). tumorous (29.6%), infectious (12.3%) and vascular (0.6%). Conclusion: MRI is the benchmark imaging test for the management of non-traumatic spinal cord injury. Myelo-CT can be an alternative in the absence or in case of MRI contraindication.

关键词： Spinal Cord Compression Non Traumatic MRI Mali Hospital

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Endometrial Status and Embryonic Implantation about 150 Cases at the Medically Assisted Procreation Laboratory “Le Diafounou”

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Open Journal of Medical Imaging 2023年第3期13卷 92-100页

作者： Mamadou Dembélé Alassane Kouma ilias Guindo Souleymane Sanogo Zoumana Cheick Berete Ousmane Traoré Mamadou N’Diaye Brahima Doumbia Oncoumba Diarra Issa Cissé Aboubacar Sidiki N’diaye Bandiougou Doucouré Youssouf Yalcouyé Adama Diaman Keita Siaka Sidibe Faculty of Medicine and Odonto-Stomatology of Bamako (FMOS) Bamako Mali Medical Imaging Department Kati University Hospital Kati Mali Department of Education and Research in Public Health (DERSP) Bamako Mali

Background: The endometrium is the tissue that lines the inside of the uterus. It undergoes multiple changes during the menstrual cycle and prepares to welcome the fertilized egg. Endovaginal ultrasound is a first-line examination in the assessment of female infertility. Objective: We aimed to determine the impact of endometrial status by endovaginal ultrasound on the outcome of embryo transfers. Subjects and Methods: This was a prospective cross-sectional study of 150 women collected between January and October 2020 at the “Le Diafounou” medically assisted procreation laboratory. Were included in the study, women presenting for desire of pregnancy and having continued the treatment until the transfer of fresh or frozen embryos. An uterine score was used. This score took into account the thickness of endometrium, it is coffee bean aspect, the presence of the notch, the echogenicity of the endometrium, the pulsatility index, the presence of the flow at the end of diastole and sub-endometrial flow. Ultrasounds were performed using a General Electric logic 500, logic 9 and Voluson E8 device. The data was entered into Excel and then analyzed using SPSS version 21. Results: 150 women were selected for the study. 83 women or 55.3% were between 17 and 35 years old and 44.7% were over 35 years old with an upper limit of 50 years old. The number of women who became pregnant was 69% or 46%. The average thickness of the endometrium was 11.40 mm with extremes of 4.65 mm and 18.6 mm. There was a correlation between the thickness of the endometrium and obtaining a pregnancy (p i.e. 88.7%. The pulsatility index was relatively low for those who started a pregnancy, i.e. 90%. The high pulsatility index is one of the reasons for the failure of embryo implantation. The correlation was significant (p = 0.009). 141 women had no notch in the uterine arteries, i.e. 94%. 94 women or 62.7% had a triple line endometrium or typical coffee bean appearance. End-diastolic flow was observed in 12

关键词： Endometrial Status Embryonic Implantation Medically Assisted Procreation

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Sociodemographic and Scanographic Aspects of Primary Bronchopulmonary Cancer in a Hospital in Mali

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Open Journal of Medical Imaging 2021年第4期11卷 104-114页

作者： Mody Abdoulaye Camara Moussa Abdoulaye Ouattara Hawa Diarra Mohamed Maba Traore Boubacar Mama Toure Nouhoum Simpara Néné Koumare Mamadou Ndiaye Salia Coulibaly Abdoulaye Kone Moussa Konate ilias Guindo Konate Zakaria Mamadou Bakary Coulibaly Seydou Coulibaly Siaka Sidibe Department of Medical Imaging of the Mali Hospital Bamako Mali Department of Thoracic Surgery of the Mlai Hospital Bamako Mali Pediatric Unit at the Common Reference Health Center VI Bamako Mali Department of Medical Imaging of the CHU of Kati Bamako Mali Bamako Infirmary Hospital Bamako Mali Medical Imaging Department of CHME Luxembourg Bamako Mali Department of Gynecology of the Mali Hospital Bamako Mali

Summary: A malignant tumour that develops from the bronchial epithelium and then invades the lungs. It ranks third after colorectal and breast cancer. In Mali, computed tomography (CT) is the main imaging tool used at all stages of treatment. We had initiated this study with the objective of specifying the place of CT in the diagnosis of primary bronchopulmonary cancer at the hospital of Mali. Method: This is a prospective and descriptive study conducted by the Medical Imaging and Thoracic Surgery departments at Mali Hospital from March 2014 to February 2015. All the patients who have benefited from a CT scan and presenting at least one histologically confirmed bronchopulmonary tumor were included. Results: We were recruiting 60 patients with bronchopulmonary cancers out of 500 referred for a thoracic CT scan performed, a frequency of 12%. There was one male patient with a sex ratio of 4H/1F. The average age was 60 years. The history of smoking was 85%. The symptoms were dominated by general condition (63.33%), cough (25%) and haemoptysis (58.33%). CT scans were performed in all patients. The lesions were located more in the lower lobes (71%). The tumours were: heterogeneous tissue density (70%), spiculated contours (80%), and the histology was more non-small cell carcinoma. Conclusion: The incidence of bronchopulmonary cancer is very high and its prognosis is poor at an advanced stage. The evaluative role of CT and biopsy guidance has given it a place of choice in its management. The diagnosis of certainty remains histology.

关键词： Sociodemographic and Scanographic Aspects of Primary Bronchopulmonary Cancer in a Hospital in Mali

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Uro-Scanner Aspects of Bladder Tumours at the Mali Hospital about 17 Cases

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Open Journal of Medical Imaging 2021年第4期11卷 93-103页

作者： Mody Abdoulaye Camara Mohamed Maba Traore Hawa Diarra Adama Dao Boubacar Mama Toure Mamadou Ndiaye Salia Coulibaly Kone Abdoulayye Mariko Mahamane Cisse Issa Konate Moussa ilias Guindo Konate Zakaria Nouhoum Simpara Seydou Coulibaly Néné Koumaré Siaka Sidibe Medical Imaging Department of the Mali Hospital Bamako Mali Medical Imaging Department at the CHU Gabriel Touré Bamako Mali Bamako Infirmary Hospital Bamako Mali Medical Imaging Department of the CHU Point G Bamako Mali Medical Imaging Department of CHME Luxembourg Bamako Mali Medical Imaging Department of the CHU of Kati Bamako Mali Pediatric Unit of Reference Health Center of Commune VI Bamako Mali

Introduction: Bladder tumours are frequent, have a poor prognosis and are the second most common genitourinary tumour in men. In Mali, recent statistical data on the prevalence of bladder tumours show a progression with 6.71% in 2006. The euro scanner is used in the diagnostic workup. The work was initiated in order to specify the role of the scanner in the diagnosis of these tumors. Patients and Methods: Prospective descriptive study was carried out in the medical imaging department of Mali Hospital from February to November 2018. Were included any patient with a bladder tumour on euro scanner. The patients had benefited from a preliminary preparation and a renal biological assessment in order to eliminate renal insufficiency. Our examinations were performed with a Siemens 16-slice scanner. These were axial slices performed without, with iodine injection from the pulmonary base to the pubic bones. Results: We had collected 17 patients out of 541 scans i.e. a frequency of 3.76%. The age range of 21 to 40 years was 58.8% with an average age of 25 years. The antecedents (ATCD) found were urinary bilharzia (47%) and smoking (17%). The clinic was dominated by haematuria. It was associated with a bladder mass (52%) and dysuria (23.52%). The CT scan showed a budding appearance, a size greater than 3 cm (82%), infiltration of peri-vesical fat (47.05%), and adenopathy (94%). Associated lesions were: utero-hydronephrosis (58.82%) and metastases (bone and liver in 11.76% of cases each). Conclusion: They are frequent and the history of urinary bilharziasis remains the main risk factor in endemic countries. CT scans are essential in the management of this disease. The diagnosis of certainty remains histology.

关键词： Bladder Tumour Uro-CT Mali Hospital

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英国脱欧后美欧贸易投资关系及其变化

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金融发展研究 2020年第5期 35-37页

作者：沙耶拉·伊利亚斯·阿赫塔王宇(译) 美国国际贸易和国际金融中国人民银行研究局

由于英国正式脱欧,美国与欧洲的贸易和投资关系快速变化。从贸易角度看,商品贸易中欧盟地位有所下降,成为美国第三大商品出口市场和第二大进口来源市场,美欧之间的贸易商品构成也发生了变化;服务贸易中由于英国所占份额最大,英国脱欧也... 详细信息

由于英国正式脱欧,美国与欧洲的贸易和投资关系快速变化。从贸易角度看,商品贸易中欧盟地位有所下降,成为美国第三大商品出口市场和第二大进口来源市场,美欧之间的贸易商品构成也发生了变化;服务贸易中由于英国所占份额最大,英国脱欧也将影响美欧之间的服务贸易额。从投资角度看,美欧仍是彼此最大的外国直接投资的来源地和目的地。

关键词：美国欧盟脱欧贸易投资

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口服和静脉铁剂替代治疗对于炎性肠病患者肠道微生物和代谢组学的改变截然不同

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英国医学杂志中文版 2017年第9期20卷 416-416页

作者： Thomas Lee Thomas Clavel Kirill Smirnov Annemarie Schmidt ilias Lagkouvardos Aiesia Walker Marianna Lucio Bernhard Michalke Philippe Schmitt-Kopplin Richard Fedorak Dirk Hailer 毛玲娜宋震亚不详浙江大学医学院附属第二医院全科医学科

目的缺铁是炎性肠病（IBD）患者常见的并发症，但口服铁剂治疗被认为可能加重IBD症状。我们进行一项开放临床研究，比较口服铁剂治疗与静脉铁剂治疗的作用。方法人选31例克罗恩病（CD）、22例溃疡性结肠炎（UC）和19例非炎性病变患者作... 详细信息

目的缺铁是炎性肠病（IBD）患者常见的并发症，但口服铁剂治疗被认为可能加重IBD症状。我们进行一项开放临床研究，比较口服铁剂治疗与静脉铁剂治疗的作用。方法人选31例克罗恩病（CD）、22例溃疡性结肠炎（UC）和19例非炎性病变患者作为对照。受试者随机接受口服硫酸亚铁治疗（PO）或者静脉注射蔗糖铁剂治疗（Iv）3个月，评价干预前后的临床指标、肠道菌群及代谢组学变化。结果口服和静脉治疗都能改善缺铁，静脉治疗后铁蛋白水平更高。疾病的活动度与铁剂治疗方法无关。IBD的肠道菌群有明显的个体间差异，梭菌属丰度和比例降低。代谢物分析也能明显区分CD、UC和对照组。约有一半的受试者在接受铁剂替代治疗后出现明显的细菌种属的多样性转变，其中CD者最为敏感。除铁剂替代治疗可导致个体．菌种属的特异性变化外，口服铁剂治疗还引起普氏粪杆菌、布氏瘤胃球菌、多利亚芽孢杆菌和产气柯氏杆菌属的操作分类单元（operationaltaxonomicunits，OTUs）丰度下降。代谢组学分析发现，Iv和PO治疗后胆固醇代谢相关的宿主底物水平有明显的改变。结论铁剂治疗可以导致IBD的肠道菌群结构和代谢产物改变。虽然临床结局类似，口服与静脉铁剂治疗对肠道菌群种属和代谢产物的改变有所不同。

关键词：静脉铁剂炎性肠病患者微生物肠道

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