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Journal of Tuberculosis Research 2023年第2期11卷 67-73页

作者： Souleymane Coulibaly Marius Pembé Sanou Kassim Sidibe Ladji Mohamed Diaby lassina diallo Daouda Amara Traore Salif Kone Ami Diarra Salif Sow Abasse Sanogo Salif Satao Mamadou Cherif Kante Mahamadou Coulibaly Aminata Bagayoko Soumaila Keita Polyclinique des Armées Kati Mali Centre Médical Principal de la Gendarmerie Nationale Bamako Mali Centre Médico-Chirurgical des Armées Bamako Mali Service de Pneumologie CHU Point G Bamako Mali

Introduction: Spontaneous pneumothorax is a rare but serious complication of tuberculosis. Miliary tuberculosis (MT) is a severe form of tuberculosis secondary to hematogenous spread of Mycobacterium tuberculosis. Objective: To report a case of MT complicated by pneumothorax. Methodology: This was a 25-year-old patient, farmer, followed up at the Pneumo-phtisiology department of the CHU du Point G for MT whose condition was improving after the introduction of anti-tuberculosis chemotherapy. He consulted again after experiencing chest pain. Clinical and imaging revealed a Spontaneous pneumothorax complicating MT. The treatment combined anti-tuberculosis chemotherapy, chest drainage and respiratory physiotherapy. Outcome was favorable with improvement of clinical and radiological signs. Conclusion: Pneumothorax complicating MT requires a reflective diagnostic approach and rapid management to improve its prognosis.

关键词： Spontaneous Pneumothorax Miliary Tuberculosis Antituberculous Chemotherapy Pleural Drainage Respiratory Physiotherapy

Vaginal Caesarean Section: A Review of Indications in Mali

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Open Journal of Obstetrics and Gynecology 2023年第6期13卷 1068-1074页

作者： Famakan Kane Soumaila diallo Soumana Boire Alima Sidibe Jean Martin Zino Baba Bah Sadio Camara lassina Ibringo Moussa Abdoulaye Diarra Bourama lassina Dembele Mahamadou Diassana Tidiane Traore Centre de Santé de Référence de Bla Ségou Mali Centre de Santé de Référence de Niono Ségou Mali Centre de Santé de Référence de Kayes Kayes Mali Clinique la Conception Thiès Sénégal Hô pital Sominé Dolo de Mopti Mopti Mali Hô pital Fousseyni Daou de Kayes Kayes Mali Hô pital Niankoro Fomba de Ségou Ségou Mali

Introduction: The vaginal caesarean described since the 19th century remains unknown to many practitioners. The publications available on the subject are rare. The objective of this review is to report the experience of our team in Mali on vaginal cesarean section. Materials and Methods: This is a documentary review of a series of 5 cases on the practice of vaginal caesarean section at the Sominé Dolo Hospital and Reference Health Center of the Sanitary District of Bla in Mali between 2005 and 2022. Results: We performed a vaginal caesarean section on 5 patients in this series. The indications were retroplacental hematoma in 2/5 cases including 1 with a live fetus, eclampsia crisis in 1/5 cases, dystocia on uterine prolapse in 1/5 cases and beating cord prolapse in 1/5 cases. In the 5 cases, the pregnancy was not at term. In 3/5 cases, cesarean section was indicated to save the non-term fetus with a very low possibility of success by classic cesarean section and in 2/5 cases for maternal rescue with fetal death in utero. 2 live newborns were released in satisfactory condition, 1 died after 6 hours of life. Antibiotic therapy was not necessary in the majority of cases. The average length of hospitalization was 3 days. Conclusion: The circumstances of the realization of the vaginal cesarean section in our series of studies remain frequent in the practice of modern obstetrics. The short duration of hospitalization and the low use of antibiotics can contribute to the reduction of the medical cost of caesarean section in low-income countries, such as Mali.

关键词： Vaginal Cesarean Indications Mali

Laboratory Confirmation of Human Rabies by RT-PCR and qRT-PCR Bamako: Report of a Case in a 4-Year-Old Girl at the Mali Hospital

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Open Journal of Pediatrics 2022年第1期12卷 252-262页

作者： Garan Dabo Bourama Kane lassina Doumbia Korotoumou Wélé diallo Aboubacar Sangaré Guediouma Dembélé Sanata Sogoba Mamadou Traoré Ousmane Koita Daouda Kassim Minta Service de Médecine Hô pital du Mali Bamako Mali Department of Paediatrics Mali Hospital Bamako Mali Laboratory of Molecular and Applied Biology Bamako Mali Service de Santé Publique Hô pital du Mali Bamako Mali Pediatric service of the Commune Reference Health Center V Bamako Mali Infectious Diseases Department Centre Hospitalier Universitaire du Point G Bamako Mali

Rabies is a zoonotic disease of viral origin transmitted mainly to humans by biting or licking the injured skin of sick animals. It is an untreatable disease that is fatal once it has been declared. Worldwide, 59,000 cases of rabies-related deaths are recorded each year. The diagnosis of rabies is clinical, biological, and anatomopathological. The aim was to establish the laboratory confirmation capacity for human rabies in Mali. The patient, a Malian female, aged four years, was bitten by a dog around her house in district sixth of Bamako near national road number six in 2020. The patient visited the doctor after a two-month bite. However, she was neither referred to the health center for an effective therapeutic measure nor vaccination (post-exposure prophylaxis). The patient was presented with psychomotor excitation, hypersalivation, aerophobia, and hydrophobia symptoms and visited a Malian hospital named “Hospital of Mali”. The patient was admitted with a history of animal bites and symptoms of rabies, and the patient was classified as a probable rabies case. The patient was then referred to an infectious disease physician and hospitalized. After referring the patient to the infectious disease physician, the physician sent oral swab and cerebrospinal fluid (CSF) samples to confirm to the Laboratory of Applied Molecular Biology. Human rabies was confirmed (RT-PCR) by the zoonotic unit of the Laboratory of Applied Molecular Biology. Diagnosis and therapy of human rabies without post-exposure management after a dog bites were still challenging. It was possible to confirm the human rabies case in Mali by RT-PCR and qRT-PCR.

关键词： Dog Bite Human Rabies Diagnosis Mali

Mutations in Spike Gene of SARS-CoV-2 that Are Associated with a Higher Viral Load: A Clinical Case Study

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Case Reports in Clinical Medicine 2022年第11期11卷 474-486页

作者： Ibrahim Keita Garan Dabo lassina Doumbia Youssouf Diarra Ibrahim Traoré Mariam Traoré Lansana Sangaré Yacouba Toloba Mahamadou Alpha diallo Djeneba Sy Andres H. Gutierrez Aliou Sissako Ibrahim Guindo Mohamed diallo Akory Ag Iknane Anne S. De Groot Ousmane Aliou Koita Laboratoire de Biologie Moléculaire Appliquée Université des Sciences Techniques et des Technologies de Bamako Bamako Mali Hô pital du Mali Ministère de la Santé Publique et du Développement Social Bamako Mali Centre Hospitalo-Universitaire du Point G Ministère de la Santé Publique et du Développement Social Bamako Mali EpiVax Inc. Providence USA Institut National de Santé Publique Ministère de la Santé Publique et du Développement Social Bamako Mali Center for Vaccines and Immunology College of Veterinary Medicine University of Georgia Athens USA

Background: Quantitative PCR (qPCR) can be used to detect and quantify a load of a pathogen. It is a good indicator of the degree of transmissibility. While performing routine qPCR, we observed an unusually short cycle threshold (Ct) value of SARS-CoV-2 for a clinical specimen obtained in Bamako, Mali. This prompted us to sequence the short-cycle SARS-CoV-2 sample to identify potential mutations in the Spike gene (S gene) gene. Methods: Post-infection, Quantitative Reverse Transcription (qRT-PCR) was performed over a defined time course to estimate the Ct of the SARS-CoV-2 specimen collected from the patient. Sanger sequencing was done on the entire fragment of the S gene to identify mutations. Findings: Sanger sequencing revealed mutations in the lineage of interest, designated B.1.525 by Pango, and also known as “Eta” using the nomenclature defined by WHO. This variant was originally found in Nigeria and Italy. The four novel mutations identified in Eta (D228N, Y451N, I1172M, and C1250F) were otherwise observed with a low frequency worldwide. Although the initial Ct was 10 in the case study patient, he did not exhibit severe symptoms of SARS-CoV-2, for example, pneumonia. However, we observed a longer viral clearance period than usual, of 3 weeks. We note that as compared to SARS-CoV-2 samples obtained during the first peaks of SARS-CoV-2 infection in Mali, when the infection was at its peak in March 2020 (Ct = 30.4), circulating strains evaluated at the time the Eta sample was obtained demonstrated a lower mean Ct (Ct = 24). Conclusions: The short cycle threshold associated with this variant, and the temporal association with a decrease in the mean Ct in the region of Bamako, may indicate higher levels of transmissibility due to a circulating variant. This variant is a lineage of interest designated B.1.525 by Pango or Eta by WHO.

关键词： SARS-CoV-2 Variant Eta Ct Value Mali

Kati Chu BSS External Genital Organ Delivery Syndrome: Inguinal Pedicle Flap Plasty

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Surgical Science 2021年第11期12卷 357-364页

作者： Koniba Keita Sidiki Keita Oulematou Coulibaly Abdoulaye Diarra Fodé Mory Keita Boubacar Kone lassina Traoré Salia Coulibaly Amadou Traoré Assitan Kone Amadou Kassogué Issa Traoré Oumou Traoré Ismael Konaré Daouda diallo Drissa Traoré Bacary T. Dembélé General Surgery Department Hospital BSS Kati Mali General Surgery “A” Department Hospital Point-G Bamako Mali Reference Health Centre of the Commune VI Bamako Mali Medical Imaging Department Hospital BSS Kati Mali General Surgery Department Hospital Gabriel Toure Bamako Mali Urology Department Hospital BSS Kati Mali Anesthesia Resuscitation Department Hospital BSS Kati Mali General Surgery “B” Department Hospital Point-G Bamako Mali

Fournier’s syndrome is a poly microbial necrotizing fasciitis, of severe evolution of the perineum and external genitals. Objectives: We report the experience of the service in the management of Fournier gangrene of the external genital organs by inguinal flap pediculated in front of the loss of significant substances of the scrotum. Patients and method: This was a mono-centric retrospective study from January 2008 to August 2021 in the General Surgery Department of the Bocar Sidi Sall University Hospital (CHU BSS) in Kati. It focused on patients treated for Fournier gangrene of external genitals. The variables studied were age, sex, blood count, germs encountered, the antibiogram, duration of evolution, reconstruction of the scrotum by pedicle flap, and morbidity. Results: During the study period we collected 5 cases of Fournier gangrene of external genitals in the service. The average age was 57.6 years and all the patients were male. The average duration of evolution was 5 days for an average age of 57.6 years. All patients were male. Echerichia coli (E. coli)

关键词： Fournier’s Gangrene Scrotum Inguinal Pedicular Flap

Contribution of Ambulatory Blood Pressure Monitoring to the Management of Arterial Hypertension at Blaise CompaoréUniversity Hospital

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World Journal of Cardiovascular Diseases 2017年第12期7卷 442-450页

作者： Yibar Kambiré Georges Kinda Georges R.C. Milllogo lassina Konaté Issa diallo K. Jonas Kologo Jean-Baptiste Tougouma Germain D. Mandi R. Aristide Yaméogo Salifou Yaogo Caleb Tindano André K. Samadoulougou Patrice Zabsonré Department of Medicine and Medical Specialties Blaise COMPAORE University Hospital Ouagadougou Burkina Faso Department of Health Sciences University of Ouagadougou Ouagadougou Burkina Faso Cardiology Department Yalgado Ouédraogo University Hospital Ouagadougou Burkina Faso Cardiology Department Souro Sanou University Hospital Bobo-Dioulasso Burkina Faso

Background: Hypertension is a major public health concern in Burkina Faso. Its management relies on in-office medical setting blood pressure monitoring which is known to be an imperfect diagnosis tool. Objective: This study aims to assess the contribution of ambulatory blood pressure monitoring in the management of hypertension at Blaise Compaoré University Hospital. Methods: A monocentric descriptive retrospective study was conducted in the cardiology outpatient unit of Blaise Compaoré University Hospital. Patients aged at least 18 years who underwent ambulatory blood pressure monitoring between March 2013 and June 2015 were enrolled. Hypertension was defined as follows: average blood pressure over 24 hours > 130/80 mmHg, or diurnal blood pressure > 135/85 mmHg, or nocturnal blood pressure >120/70 mmHg. Data were analyzed using the SPSS 20.0 software. The threshold for significance was set at 5% for a validity interval at 95%. Chi square test was used for?the statistical analysis. Results: A total of 122 patients were enrolled. The main reasons for ambulatory monitoring were the evaluation of hypertensive therapy (51.6%) and the diagnosis confirmation (39.3%). The results of the ambulatory monitoring found 61.4% of the patients with hypertension and 37.7% with normal blood pressure. A treatment adjustment was made for 36.1% of the patients;an initiation of antihypertensive therapy was undertaken for 24.6%, an abstention from drug therapy was recommended?for 23.8%,?and the pursuit of previous treatment for 13.1% of the patients. Conclusion: Ambulatory blood pressure monitoring should be used more often in order to optimize the management of hypertension in our current practice.

关键词： Hypertension Diagnosis Treatment Ambulatory Monitoring Africa