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Maternal Fetal Prognosis: Pregnancy and Delivery in Women of 40 Years Old and Over in a Second reference Hospital in Bamako

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Open Journal of Obstetrics and Gynecology 2024年第4期14卷 509-519页

作者： Samaké Alou Diarra Lasseny Keita Mamadou Haidara Dramane Haidara Mamadou Diallo Mamadou Konaté Moussa Maiga Mariam Mohamed Saydi Ag Med Elmehdi Elansari Kassogue Djibril Seydou Zana Dao Samake Hawa Konate Karim Dembele Bertin Coulibaly Moussa Mariko Seydou Collarete Dohino reference health center of commune vI of the Bamako District Bamako Mali Bamako Dermatology Hospital (BDH) Bamako Mali Kalaban Coro reference health center Bamako Mali Timbuktu Hospital Timbuktu Mali reference health center of commune II of the Bamako District Bamako Mali reference health center in commune v of the Bamako District Bamako Mali National Institute for Training in health Sciences Bamako Mali Mali Hospital Bamako Mali

Introduction: Late pregnancies are considered a public health problem linked to maternal mortality due to their complications. These risks, which worsen with maternal age, should be better known and taken into account in monitoring these pregnancies. Objective: To evaluate the impact of age on the prevalence of obstetric and neonatal complications among parturients of 40 years old and over. Methodology: This was an 11-year retrospective analytical case control study from January 1, 2007 to December 31, 2017. The study population was female patients of 40 years old or older for cases and female patients younger than 40 years of control case. Results: In total, we collected 640 cases of parturients of 40 years old and over out of a total of 84,234 deliveries during the study period;i.e. a frequency of 0.76%. Spontaneous abortion increased in patients of 40 and over with 8.28%. Hypertension and diabetes were higher of women of 40 and over, 52.65%. Concerning the method of admission: 55% of parturients of 40 and over were referrals. Incidents occurring among women of 40 and over were more pronounced than in control cases. Complications during vaginal delivery, cervical tear, perineal tear, uterine dehiscence and uterine rupture are high in our cases, i.e. 11.88%;3.59%;2.19%;2.66. During our study, depending on the type of delivery, the cesarean rate was much higher among women of 40 and over than among control cases, i.e. 54.22% versus 12.24%. Hemorrhages in the 3rd trimester were the main indications for cesarean section. Hemorrhages in the 3rd trimester were more frequent with women of 40 and over, i.e. 10.47%;5.94% versus 1.74% and 0.42%. As for the different types of malformations in parturients, women under 40 years old fetal malformations were absent in 92.29%, on the other hand they were more frequent in patients with 40 years and over, i.e. a normal frequency of 36.72%. Conclusion: Pregnancy at a late age exposes the elderly patient and the newborn to several ri

关键词： Advanced Maternal Age Childbirth Risk Mali

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Maternal and Perinatal Prognosis of Arterial Hypertension and Pregnancy in a Peripheral health center in Mali

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Open Journal of Obstetrics and Gynecology 2024年第5期14卷 855-867页

作者： Samaké Alou Diarra Lasseny Keita Mamadou Haidara Dramane Haidara Mamadou Diallo Mamadou Konaté Moussa Maiga Mariam MS Ag Med Elméhdi Elansari Kassogue Djibril Dao Seydou Zana Samake Hawa Konate Karim Dembele Bertin Coulibaly Moussa Mariko Seydou Colette Dohinnon reference health center in commune vI of the Bamako District Bamako Mali Bamako Dermatology Hospital (HDB) Bamako Mali Kalaban Coro reference health center Bamako Mali Timbuktu Hospital Timbuktu Mali reference health center of commune II of the Bamako district Bamako Mali reference health center in commune v of the Bamako district Bamako Mali National Institute for Training in health Sciences Bamako Mali Mali Hospital Bamako Mali

Introduction: Maternal mortality constitutes a public health problem and its rate is an indicator of a country’s development. Among the causes of maternal and perinatal death, high blood pressure associated with pregnancy occupies a significant part. It represents 5% of direct maternal deaths. Objective: to study the maternal and perinatal prognosis of high blood pressure during pregnancy in the Tenenkou reference health center in Mali. Methodology: This was a descriptive, analytical and retrospective cross-sectional study over a period of twelve months from January 1, 2021 to December 31, 2021 and involving 144 cases of high blood pressure associated with pregnancy. Results: We obtained a frequency of 11.75%. The majority of patients 70.9% were aged between 20 - 35 years. The important risk factor found was young age. During our study, 46.5% of patients had performed at least one CPN and only 13.9% performed 04 CPN. Pre-eclampsia was the most common type of high blood pressure during pregnancy, i.e. 61.1%. Eclampsia and retroplacental hematoma were the most common maternal complications, respectively 27.8% and 11.1%. The most common fetal complications were premature births and fetal distress with 20.9% and 17.4% respectively. Conclusion: Hypertension associated with pregnancy still remains a major cause of maternal-fetal morbidity and mortality in our context where diagnosis is often late. The main clinical form was preeclampsia. Eclampsia and retroplacental hematoma were the most frequent maternal complications. Fetal complications were mainly prematurity and fetal distress.

关键词： Pregnancy High Blood Pressure Prognosis

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Epidemiological-Clinical Aspects of Uterine Leiomyoma at the reference health center of commune vI of the Bamako District

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Open Journal of Obstetrics and Gynecology 2024年第5期14卷 674-681页

作者： Alou Samaké Lasseny Diarra Mamadou Keita Dramane Haidara Mamadou Haidara Coulibaly Soumana Mamadou Diallo Moussa Konaté Mariam Maiga MS Ag Med Elméhdi Elansari Kassogue Djibril Dao Seydou Zana Samake Hawa Konate Karim Dembele Bertin Coulibaly Moussa Mariko Seydou Colette Dohino reference health center of commune vI of the Bamako District Bamako Mali Bamako Dermatology Hospital (HDB) Bamako Mali Kalaban Coro reference health center Bamako Mali Hangadoumbo Moulaye Touré Hospital in Gao Gao Mali Timbuktu Hospital Tomboctou Mali reference health center of commune II of the Bamako District Bamako Mali reference health center in commune v of the Bamako District Bamako Mali National Institute for Training in health Sciences Bamako Mali Mali Hospital Bamako Mali

Introduction: Uterine fibroid is a mixed mesenchymal tumor, developing from smooth muscle cells of the myometrium, separated by connective tissue. The majority of fibroids are asymptomatic and do not require any intervention or other exploratory measures. However, in some cases fibroids are symptomatic, their treatment should aim to improve symptoms and quality of life. Objectives: Describe the epidemiological-clinical aspects of uterine fibroids in the gynecology and obstetrics department of the reference health center of commune vI of the Bamako district. Methodology: This was a retrospective descriptive study carried out over a period of one year. It concerns all patients seen in consultation in the gynecology and obstetrics department of the reference health center of commune vI. Results: during the study period, the uterine fibroid frequency was 1.80%. During this same period, fibroids represented 5.59% of gyneco-obstetric pathologies operated on in the department. The 30 - 45 year old age group was the most represented with a frequency of 75.63%. The average age was 36.87 years ± 6.2 years with extremes of 25 and 63 years. Married women were the most represented 97.48%. The vast majority of our patients 95.8% were not postmenopausal. The multigravidas were the most represented, i.e. 37.50% with a large part of the pauciparous 41.29%. In our patients, 96.64% had a clinical symptom on their fibroid with the main reason for consultation being the sensation of a pelvic mass in 97.48%. We recorded three cases of infertility as associated factors. Ultrasound was performed in all patients. The location of the myxomatous nuclei was subserosal in the majority in 42.86% and with multiple nodules in 84.85% of cases. The main indication for myomectomy was the failure of medical treatment in 86.49% of cases. Surgical treatment was mainly a myomectomy 93.30%, a hysterectomy was indicated in 6.70%. No cases of death were recorded. Conclusion: Uterine fibroid is a gynecologic

关键词： Myomas Surgery Myomectomy

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Migration of a Progestin Implant into a Pulmonary Artery: Observation of a Case at the reference health center of commune III of the District of Bamako in Mali

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Open Journal of Obstetrics and Gynecology 2024年第9期14卷 1431-1436页

作者： Hamady Sissoko Souma Kodio Hamidou Albachar Cheickna Sylla Salif Diarra Sidy Moctar Diakité Mohamed Traoré Souleymane Traoré Ibrahim Fomba Ouncoumba Diarra Nana Bah Drissa Diarra Mahamoudou Coulibaly Bocary Sidi Koné Hawa Samaké Ahmadou Coulibaly Mamadou Traoré Seydou Z. Dao Sitapha Dembélé Samou Diarra Konimba Koné Alou Samaké Sanogo Siaka Amara reference health Centre of commune III of the District of Bamako Bamako Mali Department of Gynecology and Obstetrics Gabriel Toure University Hospital Center in Bamako Bamako Mali Department of Gynecology and Obstetrics Kalaban Coro Reference Health Centre Bamako Mali Mohamed vI Perinatal Clinic Bamako Mali reference health Centre of commune v of the District of Bamako Bamako Mali Point-G Obstetrics and Gynecology Department of University Hospital center Bamako Mali reference health Centre of commune II of the District of Bamako Bamako Mali H Department of Gynecology and Obstetrics of the Fousseyni Daou Hospital in Kayes Kayes Mali reference health Centre of commune vI of the District of Bamako Bamako Mali

It was a 36-year-old patient, 5th Pregnancy, 5th Delivery, 4 live children, and I deceased, had a consultation in the department for the removal of implants. Questioning revealed that she had had the implant three years ago without medical follow-up. It was in view of the difficulties in extracting the capsule that the chest X-ray and CT scan carried out concluded that the implant had migrated into a branch of the left pulmonary artery. Therapeutic abstention has been the attitude of cardiovascular surgeons.

关键词： Migration Implant Pulmonary Artery Bamako

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Anal Pathologies: What Management at the reference health center of Bamako’s commune v?

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Open Journal of Gastroenterology 2024年第3期14卷 87-92页

作者： Sanra Déborah Sanogo Moussa Y. Dicko Ousmane Diarra Abou A. Diarra Drissa Katilé Abdoulaye Maiga Ouatou Mallé Sabine Drabo Makan S. Tounkara Hourouma Sow Kadiatou Doumbia Anselme Konaté Moussa T. Diarra Hepato-Gastroenterology Department CHU Point G Bamako Mali Service d’hépato-gastroentérologie CHU Gabriel Touré Bamako Mali Hepato-Gastroenterology Unit CSREF Commune V Bamako Mali

Anal pathologies are conditions affecting the anal margin and the anal canal. The aim of our study was to update data on anal diseases. Non-specific, it can reveal an emergency, a serious illness, a chronic disease or a benign condition. It was a prospective, descriptive and analytical study from April 2022 to March 2023, carried out in the hepato-gastroenterology unit of the Centre de Santé de Référence de la commune v du District de Bamako in Mali. Out of seven hundred and forty-nine (749) patients seen in consultation, 98 had anal pathology, i.e. a prevalence of 13.08%. The mean age was 40 ± 15.15 years and the sex ratio was 1.5. Hemorrhoidal disease and anal fissure were the most frequent pathologies in 66.4% and 24.4% of cases respectively. Medical treatment was initiated in 91.9% of patients with hemorrhoidal disease and 91.7% with anal fissure. Anal pathologies are common in young male patients. In our context, they are dominated by benign conditions.

关键词： Anal Pathologies Hemorrhoidal Disease Anal Fissure

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Review of Two Years of Surgical Activities of the General Surgery Department of the reference health center of commune I of Bamako Mali

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Surgical Science 2024年第4期15卷 195-206页

作者： Tounkara Cheickna Cisse Amadou Beydi Samake Hamidou Diarra Issaka Sanogo Modibo Diarra Bogoba Doumbia Seydou Yena Sadio Department of General Surgery of the reference health center of commune I Bamako Mali Directorate of Social and health Services of the Armed Forces of Mali Department of Public health of the Faculty of Medicine and Odontology-Stomatology Bamako Mali Department of Surgery Mali Hospital Bamako Mali

The objectives of this work were to evaluate the surgical activities carried out in the general surgery department of the reference health center of commune I of Bamako, to describe the sociodemographic characteristics of the operated patients, to determine the main pathologies encountered and to evaluate qualitatively the result of the treatment. In order to improve performance, and the quality of care, and to identify common pathologies in the surgical department, we undertook a retrospective study on surgical activities from January 2009 to December 2010. At the end of this study, out of 474 men and 187 women (equal sex ratio 2.53);we were able to determine the frequency of surgical pathologies. Farmers, housewives and pupils/students were the most represented with 25.9% respectively;20% and 13.3%. The most frequently observed pathologies were wall hernia (44.8%), prostate adenoma (12%) and acute appendicitis (10.5%). The average length of hospitalization was 3.43 days. Infectious complications affected 25 patients (3.8% of cases) and a death rate of 0.45% (i.e. 3 patients). The average cost of care was 53,500 FCFA. Indeed, the reality of surgical practice in health centers was not the same because of the level of skills of practicing surgeons.

关键词： Assessment Surgical Activities 2 Years reference health center of commune I Bamako

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Hysterectomies for Gynaecological Pathology: 56 Cases at the Segou Regional Hospital in Mali

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Open Journal of Obstetrics and Gynecology 2024年第9期14卷 1363-1373页

作者： Tidiani Traoré Famakan Kané Abdoulaye Kassogué Seydou Traoré Seydou Z. Dao Balilé Harber Sory Diallo Kassoun Sidibé Brahima Donigolo Babou Traoré Adama Coulibaly Abdrahamane Diarisso Alima Sidibé Mamadou Sima Augustin Théra Youssouf Traoré Ibrahima Teguété Niani Mounkoro Ministry of health in Bamako Nianakoro Fomba Hospital Segou Mali Regional health Department of Segou District Hospital Bla Mali Regional health Department of Koutiala Reference Health Center Koutiala Mali Regional health Department of Bamako Reference Health Center Commune II Bamako Mali Ministry of health in Bamako Fousseyni Daou Hospital Kayes Mali Ministry of health in Bamako Point G University Hospital Center Bamako Mali Ministry of health in Bamako Gabriel Toure University Hospital Center Bamako Mali

Introduction: Hysterectomy is a surgical procedure involving partial or total removal of the uterus. It is the most common gynaecological surgery in the world. Objective: To describe the epidemio-clinical and prognostic aspects of gynaecological hysterectomies. Patients and methods: This was an 18-month retrospective prospective descriptive study with a six-month follow-up period from 1 December 2020 to 31 May 2022 carried out in the gynaecology department of the Segou regional hospital. Results: Fifty-six (56) hysterectomies were performed out of 118 gynaecological surgical procedures (47.45%). The mean age was 47 ± 11.77 years. Large multiparous women were the most common (50%), with an average parity of 4.58. The main indications were uterine fibroids (30.4%), precancerous lesions of the cervix (17.85%) and uterine prolapse (17.85%). The abdominal route was the most commonly used surgical route (82.14%). Hysterectomy was total in 100% of cases and associated with bilateral adnexectomy in 48.2% of cases. The intra- and post-operative prognosis was satisfactory in 94.6% of cases. No deaths were recorded. The average length of stay was 3.28 days, irrespective of the surgical approach. Three cases of dyspareunia were noted among those who had resumed sexual activity.

关键词： Hysterectomy Gynaecological Pathology Mali

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Overview of Child Otological Care at the reference health center of commune v, Bamako

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International Journal of Otolaryngology and Head & Neck Surgery 2023年第4期12卷 203-213页

作者： Djibril Samaké Kadidia Bagayoko Neuilly Ghislaine Tafo Ngniée Siaka Soumaoro Boubacary Guindo Fatogoma Issa Koné Sinaly Thiocary Yatemelou Dara Fatoumata Konaté Ibrahim Diébakaté Kadidiatou Singaré Samba Karim Timbo Mohamed Amadou Kéïta ENT and Head and Neck Surgery Department Commune V Reference Health Center Bamako Mali

Aim: To profile the diagnostic and the care provided for otological conditions in children. Method: This was a prospective cross-sectional study carried out from March 1, 2022 to May 30, 2022 at the ENT Unit of the reference health center of commune v (Bamako). This study concerned the records of children with an otological condition. They were at their first consultation within the unit. The month of March was devoted to recruitment. The follow-up was done until the end of May. The parameters studied included epidemiological, clinical and therapeutic aspects. Results: We identified 184 children suffering from otological conditions out of a total of 559 patients that consulted during March 2022, i.e. an hospital prevalence of 32.9%. This study found ear infections in 60.3%. Earwax and epidermal plugs accounted for 32.60%. Traumatic injuries were 4.3%. Pre-lingual deafness was found in 1.1% of cases. Antibiotics were used for treatment in 66.3% of children without any complications detected. Conclusion: The otological affections of the child were frequent with a predominance of otitis.

关键词： Otological Disorders Otitis Child Care

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Liposarcoma Retro-Peritoneal in the General Surgery Department of the Hospital of the District of the commune Iv

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Surgical Science 2024年第7期15卷 430-437页

作者： Moussa Samaké Souleymane Bingué Dembelé Yely Dianessy Abdou Guiré Dorcas Laurel Sodjiné Yede Youssouf Boiré Mahamane Dicko Mantia Sara Nouhoum Sanogo Amaguiré Saye Sirama Diarra Brahima Dembele Thierno Nadio Ibrahima Maiga Modibo Diarra Siaka Konaté Birama Cheick Traoré Boubacar Diassana Bathio Traoré Amadou Maiga Boubacar Yoro Sidibé Adégné Togo General Surgery Department of Bamako District Iv Hospital Bamako Mali Anesthesia and Resuscitation Service of the Hospital of the District of the commune Iv of Bamako Bamako Mali Anatomopathology Department of the CHU of Point G Bamako Mali Obstetric Gynecology Department of the Bamako District Iv Hospital Bamako Mali Department of Ophthalmology of the Hospital of the District of the commune Iv of Bamako Bamako Mali Imaging Service of the Bamako District Iv Hospital Bamako Mali Internal Medicine Department of the District Hospital of commune Iv of Bamako Bamako Mali General Surgery Department Kolondjeba Referral Health Centre Sikasso Mali Gynecology and Obstetrics Department of the San reference health center Segou Mali General Surgery Department of Sikasso Hospital Sikasso Mali General Surgery Department of the Gabriel Tour University Hospital Bamako Mali

Retroperitoneal soft tissue sarcomas in the retroperitoneal/intra-abdominal regions represent 10% - 15% of all cases of soft tissue sarcoma. Liposarcomas, which are the most common histological type, account for 20% - 45% of retroperitoneal/intra-abdominal sarcoma cases, and 20% of liposarcomas cases are primary retroperitoneal liposarcomas. Surgical resection in case of malignancy remains the treatment of choice for liposarcomas, according to the guidelines of most major international companies. Our goal was to improve the management of retroperitoneal liposarcoma. This was a 65-year-old patient, with no medical or surgical history, who was referred to us for abdominal swelling, in whom clinical and paraclinical examination found retroperitoneal liposarcoma stage Iv, and the surgical treatment consisted in making a tumor reduction. Conclusion: Retro-peritoneal liposarcoma is an undervalued malignant tumor, and the diagnosis is often late.

关键词： Retroperitoneal Liposarcoma Diagnostic Delay

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Factors Associated with Mortality in Children Aged 1 Month to 15 Years Hospitalized in the Pediatric Ward of the Kalaban-Coro reference health center: Cross-Sectional Study

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Open Journal of Pediatrics 2024年第5期14卷 800-813页

作者： Abdoul Salam Diarra Mohamed Diarra Dramane Touré Tawfiq Abu Beyadari Balilé Harber Maimouna Kanté Issa Guindo Belco Maiga Karamoko Sacko Kalirou Traoré Fatoumata Dicko Mamadou Togo Kalba Pélieba Mariam Sylla Mamadou Samaké Hamadoun Sangho National center for Scientific and Technological Research Bamako Mali Department of Pediatric Health Referral Center of Kalaban Coro Koulikoro Mali Pediatric Department of the Mopti Referral health center Mopti Mali Private Practice for Family and Emergency Medicine Casablanca Morocco Paediatric Ward of Nianankoro Fomba Hospital Segou Mali Paediatric Ward Referral Health Center of Common V Bamako Mali Administration Department Health Referral Center of Kalaban Coro Koulikoro Mali Department of Paediatrics Gabriel Toure University Hospital Bamako Mali Department of Internal Medicine CHU Gabriel Tour Bamako Mali Service dHpato-Gastro-Entrologie Gabriel Toure University Hospital Bamako Mali Department of Public health Faculty of Medicine and Odontostomatology University of Sciences Techniques and Technologies of Bamako Bamako Mali

Introduction: Infant and child mortality is a worldwide concern, but developing countries such as Mali are more affected. The aim of this study was to investigate morbidity and factors associated with mortality in children aged 1 month to 15 years. Methodology: This was a cross-sectional study which took place from January 1 to December 31, 2020 covering children aged 1 month to 15 years hospitalized at the Kalaban-Coro CSRéf. Data were entered into Excel and analyzed using SPSS version 20 software. Results: Five hundred children aged 1 months to 15 years were included. The age range 1 to 5 years (53.6%) and male sex (58.2%) were the most represented. Malaria (72.2%), acute respiratory infections (6.2%) and diarrhea/dehydration (3%) were the main morbidities. Mortality was estimated at 10.6%, and the two main causes of death were malaria (56.6%) and acute respiratory infections (7.54%). Univariate analysis revealed a statistically significant association between the dependent variable (death) and age (p Conclusion: This study confirms the high rate of infant and child morbidity and mortality in our health facilities. Strengthening human resources and intensifying behavior-change communication can help reverse the trend.

关键词： Children Aged 1 Months to 15 Years Morbidity Factors Associated with Mortality Morbidity

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