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Clinic Evaluation of Heart Failure of Old People in the department of Internal medicine of Point G University Hospital from 2008 to 2012

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Open Journal of Internal medicine 2019年第3期9卷 83-88页

作者： Assétou Soukho Kaya Abdel Kader Traoré Djibril Sy Djenebou Traoré Ilo Diall Youssouf Fofana Ibahima Amadou Dembélé Boua Daoud Camara Mamadou Saliou Karim Dao Mamadou Cissoko Kaly Kéï ta Barry Boubacar Sangaré Mamadou Mallé Alassane A. Doumbia Hadiza A. Kaï lou Mamadou Dembélé Hamar Alassane Traoré department of Internal medicine Point G University Hospital Bamako Mali department of Cardiac Disease Point G University Hospital Bamako Mali department of Internal medicine of Children and Mothers Le Luxembourg University Hospital Bamako Mali Internal medicine Service Nianankoro Fomba Hospital Ségou Mali

Justification: Heart failure (HF) is the evolutionary end of all cardiac diseases. Given the aging population, the rate of incidence is increasing among the elderly. Objectives: The study aims to determine the prevalence of heart failure in the elderly;to describe the clinical aspects;describe etiologies;describe the therapeutic aspects;and describe the evolution of heart failure among the elderly. Method: This was a retrospective study over five years on the operating records of patients hospitalized in the internal medicine department of Hospital Point G. Result: The study included records of 22 elderly patients who were with heart failure of a total of 595 patients hospitalized from 1st January 2008 to 31st December 2012. The prevalence rate was 3.7%, and the average age was 67 ± 7.79 years. The sex ratio was equal to 1. HTA accounted for the cardiovascular risk factors in 77.3%. 72.7% of patients had the symptom of dyspnea and 95.5% of patients had the symptom of IMO. According to the cardiac ultrasound, dilation of the OG represented 68.2% of cases, followed by impaired LVEF (63.6%). The etiologies of IC were represented by dilated cardiomyopathy (95.5%), followed by 13.6% in cardiothyreosis. Drug treatment was dominated by the use of diuretics, ACE inhibitors and sodium diet respectively 95.5%;81.8% and 45.5% of cases. The clinical outcome was favorable in 73%. We recorded four (4) cases of death, which accounted for 18% of patients.

关键词： Heart Failure Clinic Etiology Therapeutics The Elder

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Diabetic Foot: Epidemiological, Therapeutic and Evolutionary Aspects in the department of medicine and Endocrinology of the Hospital in Mali, Mali

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Journal of Diabetes Mellitus 2022年第1期12卷 18-27页

作者： Nanko Doumbia Adama Alexis Diarra Seydou Mariko Drissa Sangare Danfaga Bakary Nouhoum Ouologuem Samaké Magara Sekou Mamadou Cisse Mamady Coulibaly Mahamadou Saliou Bakary Dembele Yacouba L. Diallo Amadou Kone Modibo Mariko Bah Traore Massama Konate Djenebou Traore Djeneba Sylla Kaya Assetou Soucko Assa Traore department of medicine of the Mali Hospital Bamako Mali National Center for Scientific and Technological Research (CNRST) Bamako Mali Kati Reference Center Kati Mali Gynaecology department of the Mali Hospital Bamako Mali department of medicine and Medical Specialty of the Fousseyni Daou Hospital Kayes Mali Nephrology Unit of the Fousseyni DAOU Hospital Kayes Mali Health and Social Affairs department of the National Police Bamako Mali Internal medicine department of the Gabriel Toure University Hospital Bamako Mali Faculty of medicine Bamako Mali Internal medicine Service of the Point G University Hospital Bamako Mali

Introduction: The diabetic foot remains a public health problem due to its high frequency, difficult and costly management. The aim of this study was to determine the epidemiological, therapeutic and evolutionary aspects of the diabetic foot in a hospital setting in Bamako. Methodology: This is a retrospective, descriptive, cross-sectional and monocentric study conducted between September 1, 2011 and December 31, 2015 on diabetic patients aged 14 years and older arriving in our department with a foot infection. Results: We identified 94 cases of diabetic foot infection out of a total of 828 hospitalized patients, a prevalence of 11.35%. The age range 41 - 60 years represented 57 cases (60.6%), the extreme ages were 14 and 81 years. Men (38.3%), women (61.7%) with a sex ratio of 0.62%. Housewives 50%, illiterate 51 cases (54.3%), low economic standard of living 40 cases (42.6%), presence of osteitis 40 cases (42.6%), foot at stage D Grade3 28 cases (29.8%). Management was medical in 48 cases (51.1%), treatment with insulin 58 cases (61.7%), Amoxicillin + Metronidazole used 36 cases (38.29%). Amputation was performed in 35 cases (37.2%). Deaths concerned 5 patients (9.6%) with hypoglycemia as the main cause in 4 cases. Conclusion: Diabetic foot is a frequent complication of diabetes. The establishment of a multidisciplinary team should contribute to the improvement of the prognosis of the diabetic foot in a management center.

关键词： Diabetic Foot Epidemiology Therapeutics Evolution Mali Hospital

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Epidemiological, Clinical, Paraclinical and Evolutionary Aspects of Urinary Tract Infection in Diabetics Hospitalized at the department of medicine of Abass Ndao Hospital from January 01, 2018, to December 31, 2018

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Advances in Infectious Diseases 2022年第2期12卷 203-215页

作者： Ndeye Fatou Ngom Djiby Sow Demba Diedhiou Michel Assane Ndour Cheikh Tacko Diop Fulgence Abdou Faye Ousseynou Ka Anna Sarr Maimouna Ndour Mbaye department of medicine Faculty of Health and Sustainable Development Alioune Diop University of Bambey Bambey Senegal Faculty of medicine Cheikh Anta Diop University Dakar Senegal Internal medicine department Abass Ndao Hospital Dakar Senegal department of Community Health Faculty of the Health and Sustainable Development Alioune Diop University of Bambey Bambey Senegal

Introduction: Urinary tract infection (UTI) is a major public health problem because of its morbidity and mortality. It occurs with increased frequency during diabetes. The objective of this work was to study the frequency and etiologies of urinary tract infections in diabetics hospitalized at the department of medicine of Abass Ndao Hospital. Patients and Methods: This work was a cross-sectional, descriptive, and analytical study conducted from January 01, 2018, to December 31, 2018. It focused on hospitalized diabetic patients with urinary tract infection. Epidemiological, clinical, and evolutionary data of UTI were evaluated. Results: One hundred and twenty-eight (128) diabetic patients had a cytobacteriological urine exam (CUE). 44 of who had a positive CUE (34.4%). The age group [60 - 69] years was the most represented (31.8%). Women predominated (61.4%) with a sex ratio (m/f) of 0.63. Abdominal pain was the most frequent reason for consultation, followed by polydipsia. Fever was recorded in 21 patients (47.7%). Type 2 diabetes was found in most patients (70.5%). Glycemia above 2g/l was found in 34 patients (89.5%). Anemia accounted for more than half of the patients with 29 cases (65.9%). Leukocytosis was noted in 28 patients (63.6%) and a positive CRP in 33 patients (75%). An increase in urea-creatinine was noted in 23 cases (52.3%). The results of the CUE revealed Escherichia coli as predominant (43.2%, n = 19), followed by Candida with 22.7% (n = 10). Antibiotic therapy was given to all patients. The mostly used antibiotic in the treatment of UTI was Cefotaxime 27.3% (n = 12). Older age and female gender were associated with the presence of E. coli. Four (4) deaths were recorded (9%). They were all male over the age of 65. Conclusion: UTI in diabetes is an important cause of morbidity and mortality. The development and implementation of a prevention and management program are essential.

关键词： Urinary Tract Infection Diabetes Risk Factors Mortality Senegal

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Diabetic Foot: Epidemiological and Clinical Aspects in the department of medicine and Endocrinology of the Hospital of Mali, Mali

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Journal of Diabetes Mellitus 2021年第4期11卷 159-170页

作者： Nanko Doumbia Danfaga Bakary Nouhoum Ouologuem Drissa Sangare Adams Alexis Diarra Magara Samaké Sekou Mamadou Cisse Mamady Coulibaly Mahamadou Saliou Bakary Dembele Yacouba L. Diallo Amadou Kone Modibo Mariko Bah Traore Massama Konate Djenebou Traore Djeneba Sylla Kaya Assetou Soucko Assa Traore department of medicine of the Mali Hospital Bamako Mali National Center for Scientific and Technological Research (CNRST) Bamako Mali Kati Reference Center Kati Mali department of medicine and Medical Specialty of the Fousseyni Daou Hospital Kayes Mali Nephrology Unit of the Fousseyni DAOU Hospital in Kayes Kayes Mali Health and Social Affairs department of the National Police Bamako Mali Internal medicine department of the CHU du Point G Bamako Mali Faculty of medicine of Bamako Mali

Introduction: Diabetes is a heterogeneous group of metabolic diseases characterized by chronic hyperglycemia resulting from a defect in the secretion and/or action of insulin, diagnosed by the observation of high levels of glucose in the blood, responsible in the long term for vascular and nervous complications. The diabetic foot is the set of pathological manifestations affecting the foot in relation to the diabetic disease. Approximately 5% of diabetics present a chronic lesion of the foot. Objective: To describe the epidemiological and clinical aspects of the diabetic foot in the medicine/endocrinology department of the Mali hospital. Methodology: This was a retrospective descriptive study from November 2011 to December 2015. It focused on diabetic patients hospitalized in the department with a foot wound and aged 14 years and over. Results: The study involved 94 patients out of 828 hospitalized, a prevalence of 11.35%. Our series included 36 (38.3%) men and 58 (61.7%) women, i.e. a sex ratio of 0.61%. The mean age was 42.66 years with extremes of 14 and 81 years. Type 2 diabetes was present in 95% of the patients with a duration of evolution of more than 5 years in 60.6% of the cases. The mechanism of occurrence of the wounds was minor trauma in 54 cases (57.4%). Self-medication was the primary treatment in 70 patients (74.5%). More than 50% of the patients wore unsuitable footwear. Clinical and para-clinical examinations revealed isolated neuropathy in 37 cases (39.4%), necrotic wound in 37 cases (39.19%), poor glycemic control: HbA1c > 7% (98.9%), absence of osteitis (57.4%), normal Doppler ultrasound 45 cases (45.7%), stenosing arteriopathy 11 cases (22.3%), non-stenosing 3 cases (20.2%), germs present 56 cases (59.6%) including 21 cases (22.4%) of Staphylococcus aureus. Conclusion: Diabetes and diabetic foot constitute a real public health problem. They are responsible for

关键词： Diabetic Foot Epidemiology Clinic Bamako

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Serious Myasthenia at the department of Internal medicine of Point G University Teaching Hospital: A Clinical Case

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Neuroscience & medicine 2019年第3期10卷 207-212页

作者： Assétou Kaya Soukho Djenebou Traoré Adramé Keita Djibril Sy Guida Landouré Seybou Hassane Diallo Youssouf Fofana Kaly Keita Mamadou Mallé Ibrahima Amadou Dembélé Drissa Sangaré Mamadou Cissoko Barry Boubacar Sangaré Mamadou Dembélé Abdel Kader Traoré Hamar Alassane Traoré department of Internal medicine Point G University Teaching Hospital Bamako Mali department of Neurology Point G University Teaching Hospital Bamako Mali department of Neurology GABRIEL TOURE University Teaching Hospital Bamako Mali department of Internal medicine Mother-Child Hospital “Luxembourg” Bamako Mali

Introduction: Myasthenia is a rare and disabling autoimmune disease. Few studies were devoted to this pathology. We report a clinical case of myasthenia in the department of Internal medicine at the Point G University Teaching Hospital. Observation: This is a 41-year-old patient of Malian origin, a trader with a history of hemorrhoidectomy in 2011 and familial hypertension, was admitted on August 19, 2014, for muscle weakness, dysphonia, and dysphagia. The disease started 1 year before admission at the department with progressive muscle weakness of the upper limbs aggravated by repetitive movements and spreading to the head “drooping head” and inferior limbs, associated with general fatigue, dysphonia and selective dysphagia for solid foods. The diagnosis of myasthenia was maintained based on the clinical signs such as ptosis, bilateral diplopia, and weakness with lower limbs muscle strength rated at 3/5, and confirmed with confirmatory exams;a positive anti-acetylcholine receptor antibody (RIA), the post-synaptic neuromuscular conduction block at ENMG and the positive neostigmine pharmacological test. The patient received Neostigmine (prostagmine) 0.5 mg one ampoule in IM/day and Prednisone at a dosage of 1 mg/kg/day. The evolution was marked by a moderate improvement of the symptomatology afterward the patient was evacuated to Tunisia on family request where he received a course of immunoglobulin 2 g/kg in 2 days. The evolution in Tunisia was favorable. The patient returned in Mali and death occurred after 2 months in a context of respiratory distress. Conclusion: Myasthenia is a rare but serious disease requiring careful management and monitoring to reduce respiratory complications.

关键词： Myasthenia Immunoglobulin Internal medicine Point G Hospital

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Frequency of Cardiovascular Risk Factors in Systemic Lupus Erythematosus: A Case-Control Study in a department of Internal medicine in Sub-Saharan Africa

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Open Journal of Internal medicine 2020年第1期10卷 1-12页

作者： Maï mouna Sow Baï dy Sy Kane Abdourahmane Samba Awa Cheikh Ndao Nafissatou Diagne Boundia Djiba Mouhamed Dieng Atoumane Faye Abdoulaye Pouye Internal medicine department Aristide Le Dantec Teaching Hospital Dakar Senegal Biochemistry department Aristide Le Dantec Teaching Hospital Dakar Senegal

Background: The morbidity and mortality of systemic lupus erythematosus are largely due to accelerated atherosclerosis. This is partly related to the high prevalence of traditional cardiovascular risk factors. The aim of our study was to determine the frequency of these factors in lupus patients compared to a control population in a department of internal medicine. Methods: We realized a case-control study in patients with systemic lupus erythematosus according to ACR criteria in 1997. Patients were matched by age and gender with controls subjects without autoimmune disease. We studied the frequency of traditional cardiovascular risk factors in both populations. The study was done in the department of internal medicine of Aristide Le Dantec teaching Hospital, in Senegal, during the period from August 2017 to December 2018. The statistical analysis was performed with SPSS 23.0 software and the level of significance was retained for a p-value Results: We recruited 100 subjects including 50 patients and 50 controls. The mean age was 33.5 ± 11.3 years in cases and 33.3 ± 11.3 years in controls. Dyslipidemia was significantly associated with systemic lupus erythematosus (p = 0.009). Levels of triglycerides (p Conclusion: Traditional cardiovascular risk factors including dyslipidemia and hyperuricemia were more common in patients. Similarly, renal failure was associated with lupus.

关键词： Cardiovascular Risk Factors Systemic Lupus Erythematosus Sub-Saharan Africa

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New Perspectives for Workflow Analysis in the Health Italian Sector through Discrete Event Simulation: The Case of a department of Laboratory medicine

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Intelligent Information Management 2015年第3期7卷 93-106页

作者： Adriano Torri Oscar Tamburis Teresa Abbate Alessandro Pepino department of Electrical Engineering and Information Technologies University Federico II Naples Italy department of Veterinary medicine and Animal Productions University Federico II Naples Italy

The management systems currently used in the Italian healthcare sector provide fragmented and incomplete information on this system and are generally unlikely to give accurate information on the performances of the healthcare processes. The present paper introduces a combined discrete event simulation (DES)/business process management (BPM) approach as innovative means to study the workflow of the activities within the department of Laboratory medicine of the “San Paolo” Hospital in Naples (Italy). After a first “As-Is” analysis to identify the current workflows of the system and to gather information regarding its behaviour, a following DES-based “What-If” analysis is implemented to figure out alternative work hypotheses in order to highlight possible modifications to the system’s response under varying operating conditions and improve its overall performances. The structure of the simulation program is explained and the results of the scenario analysis are discussed. The paper starts with a brief exploration of the use of DES in healthcare and ends with general observations on the subject.

关键词： Healthcare Management Performance Evaluation Discrete Event Simulation Business Process Management department of Laboratory medicine

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Factors Associated with Prolonged Poor Glycemic Control in Type 2 Diabetes Mellitus (T2DM) Patients Followed in the department of Internal medicine at the Yalgado Ouedraogo Teaching Hospital, Ouagadougou (Burkina Faso)

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Open Journal of Internal medicine 2021年第1期11卷 1-26页

作者： Solo Traoré Oumar Guira Lassané Zoungrana Yempabou Sagna Réné Bognounou Constant B. Paré Désiré L. Dabourou Lassina Séré Daniel Zemba Laurette S. Dembélé Patricia D. Somé Patrice P. C. Savadogo Aline Tondé Tiéno Hervé Joseph Y. Drabo Training and Research Unit in Health Sciences Joseph Ki ZERBO University Ouagadougou Burkina Faso department of Internal medicine Yalgado Ouedraogo Teaching Hospital Ouagadougou Burkina Faso Higher Institute of Health Sciences/Nazi Boni University Bobo Dioulasso Burkina Faso Institute for Research in Health Sciences/National Center for Scientific and Technical Research Ouagadougou Burkina Faso department of Internal medicine Tengandogo Teaching Hospital Ouagadougou Burkina Faso department of Internal medicine Bogodogo Teaching Hospital Ouagadougou Burkina Faso

Background: Achieving and maintaining glycemic targets are a challenge for health practitioners around the world. We aimed to study the factors associated with prolonged poor diabetes control in the cohort of T2DM patients monitored and treated in the Department of Internal Medicine at the Yalgado OUEDRAOGO Teaching Hospital in Ouagadougou in order to optimize therapeutic education in these patients. Methodology: This was a descriptive and analytical cross-sectional study combining retrospective data collection from the last year of patient follow-up and prospective collection of some information. The study included all diabetic patients, aged at least 18 years old, followed and treated in the Department of Internal Medicine at the Yalgado OUEDRAOGO Teaching Hospital between January 1, 2010 and December 31, 2018 following a systematic random sampling with a sampling step of 10. The variables collected were sociodemographic, anthropometric, lifestyle, cardiovascular risk factors and diabetes-related characteristics. To determine the risk factors associated with prolonged poor glycemic control, we performed modeling using logistic regression. All variables associated with prolonged poor glycemic control, in bivariate logistic regression with a p-value less than 0.20 were included in the full model. Later, we used a stepwise descending method to obtain the final model, which was then tested by a receiver operating characteristic (ROC) curve. The significance threshold was set at 5%. Raw and fitted Odds-Ratio (OR) and 95% confidence interval were presented. Results: 270 patients were included. Prolonged poor control of diabetes mellitus was observed in 73.70%. The mean age was 55.97 years (SD: ±11.52) and the sex ratio was 0.6 in favor of female. The mean time since diabetes mellitus diagnoses was 5.85 years (SD: ±5.15). A monthly ga

关键词： Type 2 Diabetes Mellitus Prolonged Poor Control Prevalence Associated Factors Burkina Faso

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Cancer and Covid-19 in the department of Internal medicine and Medical Oncology at the National Teaching Hospital Hubert Koutoukou Maga of Cotonou, about 4 Cases: A Review of the Literature

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Open Journal of Internal medicine 2021年第4期11卷 298-309页

作者： Azon Kouanou Angèle Agbodandé Kouessi Anthelme Sokadjo Yves Morel Missiho Mahoutin Semassa Ghislain Faladé Adélakoun Ange Géoffroy Murhula Katabana Delphin Kouanou Olamidé Marlene Marie Dénise Ahoussoussi Cornelly Tokpanoudé Elodie Zannou Djimon Marcel Internal medicine-Medical Oncology Unity of the National Teaching Hospital Center (NTHC)-Hubert Kougougou Maga (HKM) of Cotonou Cotonou Benin Internal medicine department University Clinics Bukavu (U.O.B) Democratic Republic of the Congo

Coronavirus Disease-19 (COVID-19) manifests itself by a respiratory attack that can go from mild to severe forms. The factors favoring the severe forms are age, arterial hypertension, diabetes mellitus, and cancer. We report 4 cases of COVID-19 on cancer, followed in the department of Internal medicine and Medical Oncology of National Teaching Hospital Center Hubert Kougougou Maga (NTHC-HKM). Case 1: A hypertensive 65-year-old female patient with a severe form of COVID-19 on an FIGO (International Federation of Gynecology and Obstetrics) IVB endometrioid adenocarcinoma with pulmonary metastasis: unfavorable evolution under treatment with death. Case 2: A 56-year-old hypertensive patient with severe COVID-19 with pulmonary metastatic recurrence of SBRIII, HER2 positive invasive ductal carcinoma of the left breast: favorable evolution with cure of COVID-19, subsequent death related to active tumor. Case 3: A 37-year-old patient with a moderate form of COVID-19 with hepatocellular carcinoma complicating post alcoholic cirrhosis, CHILD C: favorable evolution with cure of COVID-19, patient lost to follow-up. Case 4: A 56-year-old patient, hypertensive, type II diabetic, presenting a severe form of COVID-19 on a field of ovarian serous adenocarcinoma of high grade FIGO IV A with pleuropulmonary metastasis: favorable evolution with cure of COVID-19, subsequent stroke, patient followed in palliative home hospitalization. The diagnosis of COVID-19 in cancer with pulmonary metastases is difficult. The pulmonary location of tumors seems to be a factor favoring severe forms.

关键词： COVID-19 Cancer NTHC-HKM

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Frequency and Factors Associated with Erectile Dysfunction in People Living with HIV Managed in the department of Internal medicine at the departmental Hospital University of Borgou (DHU-B) in 2017

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Open Journal of Internal medicine 2022年第2期12卷 112-120页

作者： Dovonou Comlan Albert Alassani Adébayo Attinsounon Cossi Angelo Mama Cissé Ibrahim Sake Alassan Khadidjatou Faculty of medicine University of Parakou Parakou Benin

Introduction: Highly active antiretroviral treatment has considerably reduced the morbidity and mortality associated with HIV infection. However, we are witnessing the emergence of cardiovascular and metabolic diseases. The aim of this work is to study erectile dysfunction (ED) and the associated factors with HIV positive people managed DHU-B. Methods: This was a cross-sectional, descriptive and analytical study covering the period from March 1, 2017 to June 31, 2017. The study involved HIV-positive patients 18 years old and above, male, under antiretroviral treatment and have given their consent. ED was assessed by the IIEF5 score (International Index of Erectile Function). The data collected had been recorded and processed with the EPI INFO software (Version 7.2). The significance level was 5%. Results: A total of 280 patients were included in the study. The average age was 42 ± 10.04 years with extremes of 23 and 67 years. The prevalence of ED was 52.14%. Among patients with ED, 41% had severe ED. Factors associated with ED in multivariate analysis were: age over 40 years, anxiety, depression, arterial hypertension, lipodystrophy, multiple sexual partners and protease inhibitor therapy. Conclusion: ED concerns half of HIV-infected patients followed in the Internal medicine department. It is therefore essential to provide more comprehensive care, both clinically and psychologically, in order to improve the quality of life of people living with HIV.

关键词： Erectile Dysfunction Associated Factors HIV Parakou Benin

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