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Small Bowel Obstruction: Epidemiological, Clinical and Therapeutic Aspects in the General Surgery Department of Hôpital SominéDOLO de Mopti

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Surgical Science 2021年第6期12卷 196-203页

作者： Bréhima Traoré Modibo Coulibaly Djibril Traoré Oumar Guindo Fodé Mory Keita nouhoum Samassekou Abdoulaye Traoré Souleymane Sanogo Korotimi Mallé Kiffery Ibrahim Keita Pierre Coulibaly Aly Boubacar diallo Dramane Cissé Dramane Samaké Lassana Kanté Department of General Surgery H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Biomedical Laboratory H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Public Health H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Surgery Polyclinique des armées Kati Mali Department of Anesthesia-Resuscitation H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Medical Imagery CHU Luxembourg Bamako Mali Department of Gynecology-Obstetrics H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Surgery H&ocirc pital de Sikasso Sikasso Mali Department of Medicine H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of General Surgery of CHU du Point-G Bamako Mali

Small bowel obstruction (SBO) is defined as a complete and persistent cessation of the transit of materials and gases. It occurs in a segment of the digestive tract located between the pylorus and the colorectal junction. We report an observational study which aims to describe the epidemiological, clinical and therapeutic aspects of small bowel obstruction. This study was carried out in the General Surgery Department of Hôpital Sominé DOLO de Mopti from October 1, 2016 to October 1, 2018. A total of 114 patients were recorded for whom the diagnosis was related to an occlusion. The median age was 37 years with extremes ranging from 6 months to 90 years. Male sex was predominant with a sex-ratio of 1.8. The frequency of small bowel occlusions over all occlusions was 74.03%. The most encountered clinical signs were as followed: abdominal pain (100%), vomiting (88.6%), cessation of materials and gas (79.9%) and meteorism (62.3%). All patients underwent medical imaging, the most common of which was an abdomen without preparation X-ray (AWP). On the etiological level, the main causes found postoperatively were: flanges and adhesion (55.2%), strangulated hernias (28.0%), acute intussusception (6.1%), small bowel volvulus (3.5%) and small bowel tumor (1.6%). Releasing the bridles was the most common surgery process (28.0%). The morbidity of the immediate follow-up was (13.1%) and the mortality was (7.0%). This high mortality is due to ignorance of the signs of seriousness and the socio-cultural barrier (decision of the patriarch to agree to a surgical intervention), the late use of hospital facility and the limited financial capability of the patients.

关键词： Occlusions of the Small Intestine Etiology Surgical Treatment Hôpital Sominé DOLO de Mopti

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Basedowian Orbitopathy Without Thyreotoxicosis : A Case Report from Sikasso Hospital

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Open Journal of Ophthalmology 2023年第3期13卷 273-279页

作者： Cheickna Nomoko Adama Dembele Moro Sidibe Karim Diarra Moussa Sidibé Niamé Touré Moussa Abdou Touré Oulematou Soucko Ousmane Fané Daouda Goita Oumar diallo Djonny Jonas Dembele Mamadou Adama Togo Kadiatou Ba Koita Abdoulaye nouhoum Coulibaly Cheick Fantamady Tounkara nouhoum Touré Abdoulaye Konaté Abdoulaye Napo Nana Kadidia Fofana Regional Hospital of Sikasso Sikasso Mali Alliance for the Development of Community Ophthalmology (ADOC) Bamako Mali Referral Health Center for Commune 3 in the District of Bamako Bamako Mali African Tropical Ophthalmology Institute Bamako Mali Referral Health Center for Commune 4 in the District of Bamako Bamako Mali

Basedowian orbitopathy is an autoimmune disease representing the most frequent extra-thyroidal manifestation. Its pathophysiology is imperfectly elucidated and is the result of cross-reactivity between thyroid antigens and orbital tissue. It is most frequently seen in the context of hyperthyroidism (basedow’s disease or Graves’ disease), sometimes hypothyroidism (Hashimoto’s thyroiditis), or euthyroidism. Diagnosis is often straightforward, but management remains difficult. The introduction of simple medical treatment exposes the patient to the risk of recurrence. In Sikasso, there have been few studies of Graves’ disease. The aim of this study was to describe the clinical, therapeutic and evolutionary features of Graves’ disease in Sikasso Hospital. The patient was a 35-year-old woman with no previous history of Graves’ disease and no history of alcohol or tobacco intoxication, consulting for bilateral exophthalmos with moderate pain for 1 year. Endocrine tests were normal (euthyroidism), as was orbital-cerebral MRI, which revealed stage II exophthalmos with no sellar or supra-saltar abnormalities. The main complication was exposure to keratitis. Our patient was treated with corticosteroids. The evolution was favorable under treatment, with no recurrence after one year’s follow-up. Graves’ disease is the most common cause of hyperthyroidism, but this should not obscure the diagnosis of euthyroidism, as demonstrated in this case report. Exophthalmos remains the main ophthalmological clinical manifestation.

关键词： Euthyroidism Basedowian Orbitopathy Orbital-Cerebral MRI Corticoster-oid Therapy

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Refractive State and Macular Abnormalities at Oct in Albino at Chu Iota

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Open Journal of Ophthalmology 2023年第3期13卷 267-272页

作者： Assiatou Simaga Mohamed Kolé Sidibé Ibrahima Conaré Nana Wangara Seydou diallo Founè Keïta Adama Dembélé Nephthali Gnangourou nouhoum Guirou Seydou Bakayoko Kalilou Ibrahim Gakou Hamidou Ibrahim Diepkilé Jeremy Dembélé Institute of Ophthalmology and Tropical Africa (IOTA) Bamako Mali

Introduction: A rare genetic disease, albinism is globally characterized by specific deficits of the visual system associated with a variable hypopigmentation phenotype depending on the disruption of melanin production [1]. It is linked to a hereditary defect in the biosynthesis of melanin. Disease results in a generalized decrease in the pigmentation of the appendages, skin and eyes [2]. The aim of this study is to determine the different refractive errors and the different macular anomalies during the OCT examination in oculocutaneous albinism at the CHU-IOTA. Patients and Method: We conducted a prospective study in patients over 10 years of age with oculocutaneous or ocular albinism who consulted at the CHU-IOTA between July 1, 2020, and September 30, 2021. Results: Over the period, 105 cases of oculocutaneous albinism were collected out of a total of 42,024 consultations, which corresponds to a frequency of 0.2%. The average age was 26.2 years, (11 years to 48 years). The sex ratio was 1.6. Astigmatism was the most found refractive error in 50.48% of cases, followed by myopia in 29.52% of cases and farsightedness in 20% of cases. The macular thickness between 251 - 350 was the most commonly found in both eyes, i.e. 47.25% on the right and 53.55% on the left. The bulging macula was the most frequent pathology on the OCT at the level of the two eyes, i.e. 41.42% on the right and 50.6% on the left. Conclusion: Following the visual impairments linked to albinism, early optical care and access to OCT are necessary. Thus the accompaniment of a subject with albinism and associations of albinism must be global and meet specific needs, in order to prevent or avoid ocular complications.

关键词： Refractive Defects Macula OCT Albinos CHU-IOTA

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Erectile Dysfunction in Chronic Hemodialysis Patients at the University Hospital Center of Point-G in Mali

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Open Journal of Clinical Diagnostics 2020年第1期10卷 29-40页

作者： Seydou Sy Magara Samaké Hamadoun Yattara Moctar Coulibaly Ibrahima Koné Aboubacar Sidiki Fofana Djénèba diallo Atabieme Kodio Modi Sidibé nouhoum Coulibaly Alkaya Touré Djibril Sy Moustapha Tangara Saharé Fongoro Nephrology and Haemodialysis Department of the CHU of Point G Bamako Mali Faculty of Medicine University of Bamako Bamako Mali Nephrology Unit of the Fousseyni DAOU Hospital of Kayes Kayes Mali Nephrology Unit of Mali GAVARDO Hospital Bamako Mali Nephrology Unit of the Regional Hospital of Mopti Mopti Mali Internal Medicine Service at the University Hospital Center of Point G Bamako Mali

Introduction: Erectile Dysfunction (ED) is defined as the inability to achieve or maintain an erection sufficient for sexual intercourse. The frequency of erectile dysfunction in patients with kidney failure is estimated at 50% to 70%. The objective of this work was to determine the frequency of sexual dysfunction in chronic hemodialysis patients, to evaluate the psycho-social impact and to describe hormonal disturbances. Patients and Methods: This was a descriptive prospective study carried out from 3 April to 31 August 2017 in the nephrology and haemodialysis department of the Point G University Hospital. She has been interested in men over the age of 18 who have been on chronic hemodialysis for more than a year. Sexual dysfunction was assessed using the questionnaire: International Index of Erectile Function (IIEF-5). Results: Sixty-five patients were included. Forty-six (70.8%) had severe (30.8%), moderate (13.8%) and mild (26.2%) ED. 56.9% of patients had libido disorders, with decreased sexual desire (38.5%);absent sexual desire (18.5%). Sexual desire was normal in 43.1% of patients. Sexual activity was absent in 20 patients (30.8%). Sexual rigidity was reduced in 28 patients (43.1%) and normal in 24 patients (36.9%). The mean age of our patients was 42.55 years with a median age of 40 years and extremes of 23 and 74 years. Eighty percent were married. Nine patients (13.8%) were using sildenafil-based medications. Antihypertensives were prescribed in 93.9% and erythropoietin in 30.8% of patients. The main impact groups were anxiety (53.8%), fear of failure (27.7%), insomnia (7.7%) and anxiety (6.1%). And defence mechanisms included: understanding (54.7%);isolation (24.6%);repression (7.7%);quarrel (7.7%);and divorce in 1 case (1.5%). The occurrence of ED was related to hypotestosterolemia (p = 0.030), and between low libido and testosterone (p = 0.001). Nutritional status was satisfactory in 78.4% of our patients. Moderate and at and severe undernutrition was

关键词： Erectile Dysfunction Renal Failure Dialysis Mali

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A Rare Anomaly of the Left Renal Vein in the Laboratory of Anatomy of Bamako(Mali)

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Forensic Medicine and Anatomy Research 2019年第1期7卷 31-35页

作者： Abdoulaye Kanté Babou Ba Bréhima Bengaly Mariam Daou Bréhima Coulibaly Drissa Ouattara Siaka Diakité Moumouna Koné Tata Touré Cheickh Tidiane diallo Ousmane Ibrahim Touré Drissa Traoré nouhoum Ongoiba Service of Surgery B.CHU Point G BamakoMali Laboratory of Anatomy of the Faculty of Medicine BamakoMali Service of Neurology CHU Gabriel TouréBamakoMali

Aim: The purpose of this work was to describe the left renal retro-aortic vein. Methodology: A case of left renal retro-aortic vein was discovered on a corpse of male, 45-year-old adult during the dissections to the laboratory of anatomy of the Faculty of Medicine of Bamako. The way at first was a xypho-pubic median and two side abdominal sections under costal and inguinal. The side sections under costal went of the median section to sides by following the costal edge. The inguinal side sections went of the median section to the anterior and superior iliac thorns. The abdominal wall was opened and reclined by every quoted. The small intestine and the colonist were resected with their meso. The renal pedicle was dissected on each side. The abdominal aorta and the inferior vena cava were dissected by the diaphragm up to the headland. Arteries and iliac veins were also dissected. Results: On male corpse, 45 years old, we discovered a left renal retro-aortic vein in horizontal route, and the trunk of the left renal vein was formed by the confluence of three veins at the level of the left renal hilum. The left renal vein passed almost horizontally below the left renal artery. It passed then behind the abdominal aorta to end in the inferior vena cava at the level of its left side face. The right renal vein had a normal aspect. Conclusion: The left renal retro-aortic vein is one of the variants of the anomalies of the system cellar inferior. The left renal retro-aortic vein could be responsible for renal aplasia.

关键词： Left Renal Retro-Aortic Vein Anatomy Retroperitoneal Surgery

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Staphylococcus xylosus Isolation of Conjunctival Secretions in an 8-Year-Old Child at Sikasso Hospital (Mali): About a Case

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Open Journal of Medical Microbiology 2022年第2期12卷 49-55页

作者： Moro Sidibe Abdoulaye Napo Adama Dembele Oumar Kassogué Oumar diallo Djonny Jonas Dembele Mamadou Adama Togo Kadiatou Ba Koita Abdoulaye nouhoum Coulibaly Abdoulaye Konaté Jeannette Traore Fatoumata N’Diaye Japhet Popanou Thera Lamine Traore Sikasso Regional Hospital Sikasso Mali Alliance for the Development of Community Ophthalmology (ADCO) Bamako Mali Institute of Tropical Ophthalmology of Africa Bamako Mali Sikasso Medical Biology Laboratory (BIOSIK) Sikasso Mali

Staphylococcus xylosus is a species of bacteria belonging to the genus Staphylococcus. This genus currently includes several species and subspecies. We distinguish between 2 groups: the group of coagulase-positive staphylococci (CoPS) and coagulase-negative staphylococci (CoNS), a larger group that includes more than forty species and subspecies. Among the CoNS, Staphylococcus xylosus occupies a special place because it is frequently isolated from meats, dairy products, and agricultural environments. It is commonly used in fermentation due to its primary role in the flavor and color development of fermented products. It is a commensal bacterium of the skin of small mammals and farm animals, where it constitutes the majority of flora. In this species, there are a large number of strains, including phenotypes and genotypes. Although S. xylosus is actually a recognized non-pathogenic species, a few strains can be potentially dangerous. They can thus be responsible for mastitis and dermatitis in cattle. With the multiplicity of breeding farms, the consumption of livestock products and the increasingly frequent contact of humans with animals a few rare cases of human opportunistic infections have also been reported in the literature. These include pyelonephritis, endocarditis, urinary, lymphatic, and lymph node infections, contamination of orthopedic materials and catheters. Thereby, we report the case of a lingering and chronic infection of the lacrimal tract by Staphylococcus xylosus in an 8-year-old child in the Ophthalmology Department of Sikasso hospital in Mali.

关键词： Staphylococcus xylosus Infection Sikasso Hospital Mali

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Epidemiological and Clinical Profile of Patients Undergoing Primary Nephrological Consultation at the Fousseyni DAOU Hospital in Kayes, Mali

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Open Journal of Nephrology 2022年第1期12卷 142-153页

作者： Magara Samaké Seydou Sy Aboubacar Sidiki Fofana Hamadoun Yattara Sah Dit Baba Coulibaly Djénéba diallo Nanko Doumbia Moctar Coulibaly Kodio Atabieme Djénéba Maiga Aboudou Messoum Dolo nouhoum Coulibaly Saharé Fongoro Nephrology Unit Fousseyni DAOU Hospital Kayes Mali National Center for Scientific and Technological Research (CNRST) Bamako Mali Nephrology and Hemodialysis Department Point G Teaching Hospital Bamako Mali Faculty of Medicine of Bamako University of Bamako Bamako Mali Nephrology Unit Somine DOLO Hospital Mopti Mali Department of Medicine Mali Hospital Bamako Mali Nephrology Unit Mali GAVARDO Hospital Sebenicoro Bamako Mali Nephrology Unit Sikasso Hospital Sikasso Mali

Introduction: The first nephrological consultation is often late, even in developed countries. This delay is related to the insidious nature of renal disease, the lack of qualified personnel and structures for the management of these conditions and the context of chronic insecurity in our country. In Kayes, there is no data related to the first consultations of patients with the nephrologist, hence the interest of this study, which aimed to describe the epidemiological and clinical characteristics of patients undergoing a first nephrological consultation in Kayes hospital. Materials and methods: This was a retrospective, descriptive study conducted from January 1 to December 31, 2020 at the nephrology unit of the Fousseyni DAOU hospital in Kayes. All patients received for nephrological consultation for whom a medical record was made were included. The following data were collected and analyzed: the specialty of the medical referent, the reason for consultation, sociodemographic characteristics and the renal assessment of patients. Patients who consulted for non-nephrological pathologies and those who had no medical record were not included. Results: We collected the records of 346 patients, composed of 180 (52%) women and 166 (48%) men, i.e. a sex ratio of 0.92. The age group [20 - 40 years] was the most represented, 107 cases or 30.9%, with a mean age of 48.84 ± 21.33 years and extremes of 1 and 90 years. Housewives were the most consulted population, 149 cases (41.33%). Patients consulted more between the months of January and February, 116 cases (33.5%), this period was followed by the months of October-December, July-September and April-June with respectively 94 cases (27.2%), 76 cases (22.0%) and 60 cases (17.3%). The patients were referred by the general practitioner in 59.5% (209 cases), specialist doctor, 26.0% (90 cases). The patients came mainly from hospital practitioners, 172 cases (49.7%), private clinic and practice 81 cases (23.4%), community health c

关键词： Primary Consultation Nephrology Kayes Mali

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Prevalence of Refractive Errors among School Children Aged 5 to 15 Years Old at CHU-IOTA

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Surgical Science 2024年第8期15卷 480-491页

作者： Kadiatou Ba Aichata Tall Mory Coulibaly Cheick Sogodogo Zoumana Bagayogo Aoua Ibrahim Toure Ousmane Toure Brainima Coulibaly Fatoumata Tata Sidibe Aly Konipo Roucky Sangare Seydou diallo Moro Sidibe Oumar diallo Assiatou Simaga Gounon Saye Modibo Sissoko Mamadou Kole Sidibe Sidi Diarra nouhoum Guirou Abdoulaye Napo Adama Guindo University Hospital Center Institute of Tropical Ophthalmology of Africa (CHU-IOTA) Bamako Bamako Mali Ophthalmology Department Sikasso Regional Hospital Sikasso Mali Ophthalmology Department Luxembourg Mother-Child Hospital in Bamako Bamako Mali

Introduction: Undetected refractive errors constitute a health problem among school children who cannot take advantage of educational opportunities. The authors studied the prevalence of refractive errors in school children aged 5 to 15 at CHU-IOTA. Patients and Method: This is a prospective, descriptive cross-sectional study carried out in the ophthalmic-pediatrics department of CHU-IOTA, from October to November 2023. Results: We received 340 school children aged 5 to 15, among whom 111 presented ametropia, i.e. a prevalence of 32.65%. The average age was 11.42 ± 2.75 years and a sex ratio of 0.59. The average visual acuity was 4/10 (range 1/10 and 10/10). We found refractive defects: astigmatism 73.87%, hyperopia 23.87% of cases and myopia 2.25%. The decline in distance visual acuity was the most common functional sign. Ocular abnormalities associated with ametropia were dominated by allergic conjunctivitis (26.13%) and papillary excavation (6.31%) in astigmatics;allergic conjunctivitis (9.01%) and papillary excavation (7.20%) in hyperopic patients;turbid vitreous (0.90%), myopic choroidosis (0.45%) and allergic conjunctivitis (0.45%) in myopes. Conclusion: Refractive errors constitute a reality and a major public health problem among school children.

关键词： Refractive Errors Prevalence Child CHU-IOTA

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Prevalence of Ocular Trauma at the Reference Health Center (CSREF) of Kati

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Surgical Science 2024年第5期15卷 371-380页

作者： Kadiatou Ba Aichata Tall Brainima Coulibaly Sadio Cissoko Bakary Danfaga Moro Sidibe Seydou diallo Oumar diallo Fatoumata Tata Sidibe Aly Konipo Mory Coulibaly Ousmane Touré Aoua I. Touré Cheick Sogodogo Ibrahim Bamenta Gounon Saye Modibo Sissoko Mamadou Kole Sidibe Sidi Diarra nouhoum Guirou Lamine Traoré University Hospital Center Institute of Tropical Ophthalmology of Africa Bamako Bamako Mali Ophthalmology Department Kati Reference Health Center Koulikoro Mali Ophthalmology Department Sikasso Regional Hospital Sikasso Mali Ophthalmology Department Luxembourg Mother-Child Hospital in Bamako Bamako Mali Ophthalmology Department Somin&#233 Dolo Mopti Regional Hospital in Mopti Mopti Mali National Eye Health Program Bamako Mali

Introduction: The authors wanted to study the prevalence of ocular trauma in the ophthalmology unit of the CSREF of Kati. Patients and method: This is a retrospective study, covering the period from January to December 2015, carried out in the ophthalmology unit of the CSREF in Kati. Results: The sample consisted of 568 patients, or 6.82% of ophthalmological consultations. Children aged 0 to 14 years accounted for 154 (27.11%) of the trauma cases. Bruises constitute the main circumstance (58.1%) of eye trauma, followed by domestic accidents (15.6%). Closed globe ocular trauma was the main type of trauma (61.6%), followed by ocular adnexal trauma (30.1%) and open globe trauma (8.3%) in which the penetrating wound was the lesion, the least common (2.6%) but the most serious. Medical treatment was the most used therapeutic modality in 82.4% of cases, followed by surgery with 17.6% of cases. The evolution of the lesions after treatment was favorable in 85.6% of cases and unfavorable in 14.4% of cases. Complications were observed in 5.8% of cases and sequelae in 8.6% of cases. Conclusion: Ocular trauma constitutes an important reason for ophthalmological consultation at the CSREF of Kati. The severity of some of these lesions requires frequent recourse to surgery. The complexity of the treatment should encourage us to favor preventive measures.

关键词： Eye Trauma Prevalence CSREF Kati

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Omphalocele Diagnosis Problem in Rural Environment

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Surgical Science 2024年第8期15卷 501-506页

作者： Kanté Sékou diallo Siaka Touré Cheick Amed Sékou Ousmane I. Touré Coulibaly Ibrahim Traoré Drissa Bengaly Brehima Sanogo Soulemane Togola Birama Ouattara Drissa Saye Jack Ongoïba nouhoum Koumaré Abdel Karim Service de Chirurgie B CHU Point G Bamako Mali Facult de Mdecine de lUSTTB Bamako Mali

Introduction: An omphalocele is a congenital malformation due to a failure of closure of the umbilical ring with exteriorization of the abdominal viscera covered by the translucent and avascular amniotic membrane. We report a case of giant omphalocele unrecognized at birth followed by a review of the literature. Observation: This was a 4-year-old girl admitted to the department for umbilical swelling that had been present since birth. Clinical and paraclinical examinations made it possible to objectivize a post-omphalocele hernia with hepatic content plus ectopic accession of the left ureter, the surgical procedure consisted of reintroducing the liver associated with a cure of the hernia + ureterovesical reimplantation. Conclusion: Omphalocele is a congenital malformation, antenatal diagnosis is possible during morphological ultrasound from the 12th week.

关键词： Omphalocele Ectopic Left Ureter

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