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Management of Tracheal Stenosis in Sub-Saharan Medicalized Context: Real Challenge about Two Clinical Cases

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International Journal of Otolaryngology and Head & Neck Surgery 2023年第3期12卷 151-162页

作者： Kassim Diarra Demba Coulibaly Nfaly kon.té Boubacary Guindo adama Coulibaly Mahamadou Sidibé adama Dao Naoma Cissé Fatogoma Issa kon. Kalifa Coulibaly Youssouf Sidibe Siaka Soumaoro Moussa Bourama Keita Doumbia Kadidiatou Singaré Mohamed Amadou Keita ENT and Head and Neck Surgery Department University Hospital Center “Gabriel Touré” Bamako Mali Department of Anesthesia Resuscitation University Hospital Center Gabriel Toure Bamako Mali Imaging Department University Hospital Center “Gabriel Touré” Bamako Mali ENT and Head and Neck Surgery Department University Hospital Center “Le Luxembourg” Bamako Mali

Introduction: Post-intubation tracheal stenosis (STPI) is a complication of ventilatory assistance by intubation and/or tracheotomy. Her frequency is estimated between 10% to 20%. The treatment of choice remains surgery. It is based on tracheal resection-anastomosis which guarantees satisfactory and reliable long-term results. Objectives: To determine the frequency of post-intubation tracheal stenosis, to specify the diagnostic and therapeutic methods, to determine the complications and the evolution. Material and methods: This was a study carried out in the ENT and head and neck surgery department of the University Hospital Center Gabriel TOURE. Our study focused on two (02) cases of post-intubation tracheal stenosis (STPI) collected during a period of 1 year (January 2021 to December 2021). Results: They are all acquired, secondary to an intubation. The two (02) cases benefited from a tracheal anastomosis resection, the indications of which were specified and the results and complications evaluated. Conclusion: Our results show that resection anastomosis remains the reference treatment for STPI.

关键词： Tracheal Stenosis Intubation Tracheostomy

Management of Trauma to the External Genitalia at the Nianankoro-Fomba Hospital in Segou Mali

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Open Journal of Urology 2022年第6期12卷 376-382页

作者： Sory Ibrahim kon. Abdoulaye Kassogué Brehima Samaké Mahamoudou Keita Tidiani Traore Abdoulaye Nouhoum Coulibaly Mamadou adama Togo Thierno Boubacar Bagayoko adama Bah Aminata Fofana Alpha Sanogo Damissa Coulibaly Sidi Modibo Doucouré Honoré Jean Gabriell Berthé Urology Department The Nianankoro Fomba Hospital Ségou Mali Paediatric Ward The Nianankoro Fomba Hospital Ségou Mali General Surgery Department The Nianankoro Fomba Hospital Ségou Mali Obstetrics and Gynaecology Department The Nianankoro Fomba Hospital Ségou Mali Ophthalmology Department The Nianankoro Fomba Hospital Ségou Mali Forensic Medicine Department The Nianankoro Fomba Hospital Ségou Mali ENT Department The Nianankoro Fomba Hospital Ségou Mali Cardiology Department The Nianankoro Fomba Hospital Ségou Mali Department of General Medicine The Nianankoro Fomba Hospital Ségou Mali Social Security Fund Ségou Mali Department of Urology CHU du Point G Bamako Mali

Trauma to the male genitalia is not very common and mainly affects a young population. There is probably a particular instinct in men to defend their external genitalia;indeed, in the flaccid state, the penis is little exposed, and fairly well protected and its mobility allows it to move with the impact of trauma and thus reduce the vulnating force. Open trauma is rare, as is testicular dislocation, the most common being closed trauma. Testicular trauma is an uncommon accident that affects young people. Trauma is most often caused by road and traffic accidents. Animal bites are rare, as is genital self-mutilation related to a psychiatric disorder. Surgical exploration is the rule except in cases of moderate testicular trauma. Our objective was to report our experience in an emergency context where treatment is poorly codified and to review the literature. We recorded four patients with external genitalia trauma managed in the urology department from April 2013 to March 2022. Our patients were children with open genitalia trauma following a traffic accident, scrotal injuries were encountered in three patients, and additional penile injuries in one patient. All patients were treated surgically. The follow-up was straightforward.

关键词： Trauma Genitalia Open Segou

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 kon. Sima Mamadou Amadou Bocoum Mamadou Bakary Coulibaly kon.nba 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;

Anatomy of the Gall-Bladder in the Ultrasound about 1000 Cases

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Forensic Medicine and Anatomy Research 2019年第2期7卷 44-49页

作者： Bréhima Coulibaly Abdoulaye Kanté Abdoulaye kon. Bréhima Bengaly Babou Ba Youlouza Coulibaly Oncoumba Diarra adama Seriba Diarra Drissa Traoré Mariam Daou Nouhoum Ongoiba Service of Surgery B.CHU Point G BamakoMali Laboratory of Anatomy of the Faculty of Medicine and Odontostomatology BamakoMali Imaging Department CHU Point G BamakoMali Service of Neurology.CHU Gabriel Touré BamakoMali

Aim: The aim of this work is to determine the dimensions and the capacity of the gall-bladder by ultrasound. Methodology: We realized a descriptive study over 2 years (from January, 2015 till December, 2017). It concerned an ultrasound exploration of the gall-bladder. The studied population was healthy voluntary subjects visible and on an empty stomach for 12 hours, without history of abdominal trauma and abdominal operating scar. The carrying subjects of the tracks of abdominal trauma or of abdominal operating scar were not included. Results: The average age was of 39 years ± 12.16 with extreme of 10 years and 89 years. It was 500 women (50%) and of 500 men (50%) with a sex ratio of 1. To 450 subjects (45%) the width of the gall-bladder of the subjects varied between 21 and 30. The average was 22.63 mm ± 7.9. Extremes were from 9 to 55 mm. The measurements made by the three sonographers showed no significant difference. The sensitivity of ultrasound in the visualization of the gallbladder was 100%. The length of the gall-bladder was between 61 and 70 mm. The average was 65.35 ± 14.48. Extremes were 26 and 142 mm. Conclusion: This original study shows the normal dimensions of the gall-bladder to Malian.

关键词： Anatomy Gall-Bladder Ultrasound Bamako-Mali

Reliability of Medical Imaging in the Pre-Therapeutic Assessment of Acute Intestinal Obstruction at the Centre Hospitalier Universitaire Du Point “G”.

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Open Journal of Medical Imaging 2022年第3期12卷 147-156页

作者： Abdoulaye kon. Mahamadou Daou Youssouf kon. Moussa Traoré Moussa kon.té Ouncoumba Diarra Ibrahima Coulibaly Youssouf Diawara Amadou Doumbia Cheick Oumar Touré Kassim Sidibé Mody A. Camara Oumar Aba Ata Mahamadou Diallo adama Diaman Keita Salia Coulibaly Zimogo Zié Sanogo Siaka Sidibe Faculty of Medicine and Odontostomatology Bamako Mali Medical Imaging Department of the University Hospital of Point G Bamako Mali Radiology Department of the Jacques Boutard Hospital Saint-Yrieix-la-Perche France Medical Imaging Department of GABRIEL TOURE Hospital Bamako Mali Radiology Department of CSREF Commune III Bamako Mali Medical Imaging Service Health Center of Ref Commune VI Bamako Mali Medical Imaging Service Health Center of Ref Commune IV Bamako Mali DCSSA Kati Mali Medical Imaging Department of Mali Hospital Bamako Mali Medical Imaging Department of Kati Hospital Bamako Mali Department of General Surgery of Point G University Hospital Bamako Mali

Introduction: Acute intestinal obstruction is a serious pathology, a surgical emergency for which medical imaging plays an important role in the management. We initiated this work in order to study the contribution of imaging in the diagnosis of acute intestinal obstruction at the Point-G University Hospital. Patients and Methods: This was a prospective, descriptive and analytical study of 96 patients collected at the radiology and medical imaging department of CHU Point-G from January 2018 to January 2019. Results: The age of our patients varied from 11 to 86 years, with an average of 36 years old. There was a male predominance of 64.6% against 35.4% for women, i.e., a sex ratio of 1.82. Previous surgery was found in 61.5% of our patients. The pain was present in all patients. An unprepared abdominal X-ray was performed in 89.6% of patients. Hydroaerobic levels were found in 96.5% of patients. Abdominopelvic CT scans were performed on 12 patients, all of whom were diagnosed with occlusion. These positive diagnostic findings were consistent with intraoperative findings in 92% of cases. The causes were dominated by bridges in 46 patients and tumors in 9 patients. Signs of severity on CT were dominated by signs of distress of the upstream bile ducts in 8.3%. Exactly 8% of our patients spontaneously resumed transit, 91% received surgical treatment and 1% died before surgery. The outcome was favorable in 80 patients (83.3%) and poor with death in 16 patients (16.7%). Conclusion: Acute intestinal obstruction remains a serious pathology for which the X-ray of the PSA is often the only radiological examination performed in an emergency. However, abdominopelvic CT seems to us to be widely indicated thanks to its contribution both to the positive diagnosis and to the diagnosis of severity and etiology. However, this imaging technique is widely underused in our practice because of its high cost and lack of availability.

关键词： Medical Imaging Acute Intestinal Obstruction Abdominal CT Reliability

Feasibility of Scanopelvimetry in the Medical Imaging Department of the University Hospital of Point “G”.

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Open Journal of Medical Imaging 2022年第3期12卷 157-164页

作者： Abdoulaye kon. Moussa kon.té Youssouf kon. Moussa Traore Youssouf Diawara Ibrahima Coulibaly Ouncoumba Diarra Fatoumata Kalapo Amadou Doumbia Kassim Sidibe Cheick Oumar Touré Oumar Aba Ata Mody A. Camara Mamadou Sima Coulibaly Salia Mahamadou Diallo adama Diaman Keita Siaka Sidibé Faculty of Medicine and Odontostomatology Bamako Mali Medical Imaging Department of the University Hospital of Point G Bamako Mali Radiology Department of the Jacques Boutard Hospital Saint-Yrieix-la-Perche France Medical Imaging Department of GABRIEL TOURE Hospital Bamako Mali Radiology Department of CSREF Commune III Bamako Mali Medical Imaging Service Health Center of Ref Commune VI Bamako Mali DCSSA Kati Mali Medical Imaging Service Health Center of Ref Commune IV Bamako Mali Medical Imaging Service of the Mali Hospital Bamako Mali. Surgery of Gynecology-Obstetrics CHU Point G Bamako Mali Medical Imaging Department CHU BSS Kati Mali

Purpose: The purpose of our study was to describe the technique of scanopelvimetry used in the radiology department of the Point G University Hospital, to specify the indications of scanopelvimetry in the department and to evaluate the cost of radiopelvimetry. Patients and Method: This was a prospective, cross-sectional study that took place over a 12-month period from January 1 to December 31, 2018. It focused on pregnant women in whom scanopelvimetry was performed in the medical imaging department of Point G University Hospital during the study period. Results: Out of 8615 CT examinations performed in the radiology department, we collected 65 cases of scanopelvimetry, i.e., 0.7% of the CT examinations. Primigravida and paucigravida dominated the study (40% each). In 60% of the pregnant women the height was less than 150 cm. The most frequent indication for CT scanning was clinical pelvic narrowing (50%). In 80% of the cases, the scanopelvimetry was performed after 37 weeks of amenorrhea. A predominance of narrowing of the superior strait was noted (40%). 4.6% of the pregnant women had a Magnin index of less than 20. CT scanopelvimetry is a feasible examination in our context but the level of demand is low because of the high cost of the examination (49500 fca). Conclusion: In light of the results obtained, we can say that CT pelvimetry allows us to predict the probable route of delivery and thus we can reduce the risk of fetomaternal morbidity and mortality to improve maternal and child health.

关键词： Scanopelvimetry Prognosis Magnin Index Delivery

The Bronchiolitis in Paediatric Emergencies at the University Teaching Hospital of Gabriel Touré

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Open Journal of Pediatrics 2022年第2期12卷 396-412页

作者： adama Dembélé Abdoul Karim Doumbia Belco Maïga Mohamed Elmouloud Cissé Younoussa kon. Pierre Togo Oumar Coulibaly Karamoko Sacko Djéneba kon.té Hawa Diall Lala Ndrainy Sidibé kon. Oumou Fatoumata Leonie Diakité Fatoumata Dicko Abdoul Aziz Diakité Mariam Sylla Boubacar Togo Department of Paediatrics University Teaching Hospital of Gabriel Touré Bamako Mali

Introduction: Bronchiolitis is a generally benign condition characterised by acute inflammation, oedema and necrosis of the epithelial cells lining the small airways, and increased mucus production. Symptoms usually begin with rhinitis and cough, which may progress to tachypnoea, wheezing, and rales. The most common etiology is a respiratory syncytial virus (RSV). Bronchiolitis occupies an important place among Acutes Respiratory Infections (ARI) and represented the fifth cause of hospitalisation in the paediatric emergency department of the Gabriel Touré University Hospital in 2008 with a frequency of 10% and a mortality rate of 3.2%. This shows that we are constantly confronted with the management of this pathology. The objective of our study was to study the epidemiological, clinical, and therapeutic aspects of bronchiolitis in the paediatric emergency room of the Gabriel Touré University Hospital. Materials and Method: This was a prospective cross-sectional and descriptive study from April 1, 2018, to March 31, 2020, i.e. 2 years in infants aged 1 to 23 months. Data were collected using an individual survey form by questioning parents and physically examining patients. Results: During the study period, we were able to collect 342 patients meeting our inclusion criteria out of 4207 hospitalized patients, or a frequency of 8.1%. The age range of 1 to 5 months represented 64.9%. The sex ratio was 1.2. The most common reason for consultation was respiratory discomfort (86.8%). Most patients (46%) were hospitalised during the period from September to November. In the majority of cases (74%), patients consulted within five days of the onset of symptoms. The physical examination was mainly dominated by signs of respiratory struggle, fever (51.8%), and sibilants (37%) on auscultation. Complications associated with bronchiolitis were mainly respiratory infections with 57.6% of cases. The main management steps were: nasopharyngeal decontamination (78.9%), oxygen therapy (

关键词： Bronchiolitis Epidemiology Clinic Pediatrics

Contribution of Computed Tomography in the Diagnosis of Pulmonary Lesions Due to Coronavirus Disease (SRAS-CoV-2), COVID-19

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Open Journal of Radiology 2022年第3期12卷 68-77页

作者： Abdoulaye kon. Saloum Gandéga Youssouf kon. Moussa Traoré Moussa kon.té Jean Paul Dembélé Ouncoumba Diarra Ibrahima Coulibaly Youssouf Diawara Cheick Oumar Touré Kassim Sidibé Mody A. Camara Oumar Aba Ata Yacouba Toloba Jean Steiner Mahamadou Diallo adama Diaman Keita Salia Coulibaly Siaka Sidibe Faculty of Medicine and Odontostomatology Bamako Mali Medical Imaging Department of the Pasteur Polyclinic Bamako Mali Medical Imaging Department of the Robert BALLANGER Hospital AulnaySB Ile de France France Radiology Department of the Jacques Boutard Hospital Saint-Yrieix-la-Perche France Medical Imaging Department of GABRIEL TOURE Hospital Bamako Mali Medical Imaging Department of the University Hospital of Point G Bamako Mali Infectious Disease Department of the University Hospital of Point G Bamako Mali Radiology Department of CSREF Commune III Bamako Mali Medical Imaging Service Health Center of Ref Commune IV Bamako Mali DCSSA Kati Mali Medical Imaging Department of Mali Hospital Bamako Mali Pneumology Department of the University Hospital of Point G Bamako Mali Medical Imaging Department of Kati Hospital Kati Mali

Our study was carried out at Robert BALLANGER Hospital, its aim was to determine the contribution of the scanner in the diagnosis of COVID-19. It was a prospective descriptive study during the first wave of the COVID-19 epidemic in France. Patients were referred to the medical imaging department for a thoracic CT scan without contrast injection or an angioscanner in the context of a suspected COVID-19 pneumopathy or pulmonary embolism. The study involved both sexes, the male sex was with 55.20% and sex ratio of 1.24. In our study 50% of our patients had a comorbid factor, of which diabetes and hypertension were the most represented with 33% and 17%. The RT PRC test is considered the gold standard in the diagnosis of COVID-19 disease. This test was positive in 63.62% of our patients. CT imaging played a key role in the management of COVID-19 pneumonia because chest CT scans found lesions consistent with COVID-19 pneumonia in 71% of patients. The depoliated lung lesion was present in 87% of our patients, with sub pleural topography and minimal parenchymal involvement predominating. In our study, the chest CT scan had a higher sensitivity and a lower specificity than the PCR test.

关键词： Contribution CT COVID-19 SARS-CoV-2 Diagnosis Lungs France

Seizures in Children under Five in a Pediatric Ward: Prevalence, Associated Factors and Outcomes

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Open Journal of Pediatrics 2021年第4期11卷 627-635页

作者： Abdoul Karim Doumbia Oumou kon. Guédiouma Dembélé adama Dembelé Oumar Coulibaly Hawa Gouro Diall Karamoko Sacko Amadou Touré Pierre Togo Abdoul Aziz Diakité Mohamed Elmouloud Cissé Belco Maiga Djeneba kon.té Fatoumata Léonie Diakité Lala N’drainy Sidibe Fousseyni Traoré adama Bah Djibril Kassogue Boubacar Togo Madou Traoré Department of Pediatrics at CHU Gabriel Touré Bamako Mali National Institute of Public Health Bamako Mali Mohammed VI Perinatal Clinic Bamako Mali

Introduction: convulsion is a frequent cause of neurological and cognitive sequelae and then of epilepsy. The objective of this work was to describe the socio-demographic, clinical, therapeutic, and evolutionary aspects. Methodology: This was a descriptive retrospective study carried out in the general pediatrics department of CHU-Gabriel Touré. It took place over a period of 02 years from January 2017 to December 2018. We included all children aged 1 to 59 months hospitalized in the ward for convulsion. Results: During the study period, 2653 children aged 2 months to 59 months were hospitalized in the general pediatric ward. We included 288 medical records of children who presented with a seizure on admission. Convulsions represented 11% of pediatric hospitalizations from 1 month to 59 months. The average age was 29 months. Fever was present in 86% of patients. The cerebrospinal fluid (CSF) test was positive in 38 patients. Hypoglycemia was present in 14 patients. Serum calcium was low in 3 patients. The most implicated etiologies were malaria 70%, meningitis 20%, and dehydration 13%. Management consisted of airway clearance, oxygen therapy as needed, and administration of diazepam (54%). Antibiotics were prescribed in 77% of cases and antimalarials in 70%. The average length of hospital stay was 8 days with extremes of 1 and 30 days. The outcome was favorable in 95% of cases. Sequelae were observed in 5% of cases and one case of death was observed. Conclusion: Acute convulsions are one of the most common causes of hospitalization in children under 5 years old. The causes were dominated by infectious diseases (mal

关键词： Convulsions Child Infant Prognosis Sub-Saharan Africa