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Perioperative Materno-Fetal Morbimortality Related to the Caesarean in the hospital Setting in Mali

Open Journal of Obstetrics and Gynecology 2020年第12期10卷 1693-1701页

作者： Samaké Broulaye Massaoulé Tchaou Blaise Adélin Goita Lassina Kassogué André Bocoum Amadou Beye Seydina Alioune Monkam Yamadjeu Goliath Kéta Bakary Dabo Aminata Traoré Youssouf Tall Fadima Kouréissi Dicko Hamadoun Kéita Mohamed Tékété Ibrahim department of intensive care unit at the university hospital gabriel touré Bamako Mali department of Anesthesia-Resuscitation and Emergency University and Departmental Hospital Center Borgou Alibori Parakou Benin department of Gyneocology at the university hospital gabriel touré Bamako Mali department of Emergency care and intensive care unit at the university hospital Kati Mali department of intensive care unit at the university hospital Point G Bamako-Mali Bamako Mali

Introduction: During childbirth by Caesarean, several types of anesthesia can be used. The Caesarean, the most practiced surgical delivery technique in obstetrics, has a risk for complications for both the pregnant women and newborns. Objective: To evaluate the importance of the complications due to Caesarean in the Teaching hospital Gabriel Toure. Patient and Methods: We conducted a cross sectional survey in the departments of intensive care unit and gyneco-obstetric from January to August 2017 in the University hospital Gabriel Touré of Bamako. Our study population was pregnant women who gave birth to children by Caesarean. We included all cases of preventive and emergent Caesarean under loco-regional or general anesthesia. Data were compiled from the obstetrical files of the patients, the anesthetic consultation registry and the databasis of the department of gyneco-obstetric. The test of khi2 of Pearson was used for the comparison of our results with a value of p The consent of the patients or parents was gotten. The survey didn’t include a potentially dangerous act.

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Traumatic Perforation of the Small Intestine in General Surgery of the CHU gabriel touré

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Surgical Science 2017年第9期8卷 414-421页

作者： Alhassane Traoré Bakary Tientigui Dembélé Ibrahima Diakité Adégné Togo Lassana Kanté Amadou Traoré Madiassa Konaté Boubacar Karembé Abdoulaye Diarra Amadou Bah Boubacar Sidibé Tany Koné Astan Koné Nouténé Koné Djibo Mahamane Diango Gangaly Diallo department of General Surgery CHU gabriel touré Bamako Mali department of Anesthesia and intensive care CHU Gabriel Touré Bamako Mali

Goal: To determine hospital frequency, to describe the clinical and therapeutic aspects and to determine the prognosis. Patients and Methods: This was a retrospective and prospective study carried out in the General Surgery department from 1 January 1999 to 31 December 2015. Inclusion criteria: 1) open or closed trauma of the abdomen with perforation of the small bowel;2) clinical examination (abdominal pain, vomiting, fever, abdominal contracture, evisceration, intraoperative findings);3) paraclinical examinations: pneumoperitoneum on the abdominal X-ray without preparation (ASP) and CT scan. Exclusion Criteria: Abdominal trauma without perforation of the small bowel. We selected 128 patients operated for traumatic perforation of the small bowel. The data was entered and analyzed using Word, Excel 2007 and Statistical Package and Social Science Windows 16.0. The statistical analysis consisted in the calculation of the different frequencies of the variables studied. We used the Khi2 test with significance level P Results: We recorded 119 men versus 9 women and the sex ratio was 13.22. The mean age was 25 years with extremes varying between 15 and 70 years. The majority of patients 57.7% (74 cases) came from the capital, 46.1% (59 cases) were workers, 26.6% (34 cases) of the students. The average time to admission was 29 hours. The main etiologies were road traffic accidents 36.7% (47 cases), stabbing 21.9% (28 cases), firearm 14.8% (19 cases), and sports accidents 10.1% (13 cases). The main clinical signs were abdominal pain 48.44% (62 cases), abdominal contracture 60% (76 cases), disappearance of pre-liver dullness 66.36% (84 cases), and Douglas painful 74.4% (94 cases). The abdominal X-ray without preparation (A.S.P) allowed to objectify a pneumoperitoneum in 45.31% and the scanner a liquid effusion in 45.31% with the associated lesions in 37.5% (48 cases). The surgical treatment consisted of 60.15% suture excision (77 cases), 25% anastomosis resection (32 cases)

关键词： Abdominal Trauma Small Perforation Surgery Mali

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hospital Acquired Infections at the Service of Pediatric Surgery in gabriel touréAcademic hospital, Bamako, Mali

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Open Journal of Pediatrics 2020年第1期10卷 185-193页

作者： Y. Coulibaly O. Kone I. Amadou T. H. M. Diop O. Coulibaly A. Doumbia B. Kamaté H. Ouologuem D. Konaté M. Coulibaly B. Maiga M. I. Mangané Pediatric Surgery CHU Gabriel Touré Bamako Mali Community Health Divisions INRSP Bamako Mali Anesthesia intensive care University Hospital Gabriel Touré Bamako Mali department of Pediatrics CHU Gabriel Touré Bamako Mali

Introduction:?Health care-associated infection is an infection acquired during the care delivered in the hospital or in any other care establishment which was neither present, nor in incubation at the admission of the patient or at the time of delivering the care or which does not manifest itself only after the patient has been discharged or an infection contracted by the professional in the course of his duties. Objectives:?To identify mean causative germs?and to determine their sensitivity to antibiotics and to identify the risk factors of?health care-associated infection.?Material and methods:?It was about a prospective longitudinal study conducted from November 1, 2017 to April 1, 2018?(6 months) in all children admitted to the pediatric surgery service. Non-consenting parents and outpatient necrosectomy case have not been included in this study.?Results:?This study included 200 patients, of whom 30 experienced the hospital acquired infections with an infection rate of 15%. The surgical site infection was the most common type, with 16 cases (53.3%), followed by burns in 13 cases (43.3%) and urinary tract infection in 1 case (3.3%). The average age of patients with infection was 56.33 ± 48.66 months with extremes of 1 and 180 months. The sex ratio was 1.30 for infected patients and was 1.83 for uninfected patients. The main bacteria responsible for surgical site infection were: Escherichia coli?(4 cases), Acinetobacter baumanii?(3 cases), Klebsiella pneumoniae?(2 cases), Staphylococcus aureus?(2 cases), Enterobacter cloacae?(1 case), Pseudomonas aeruginosa (1 case) and Enterobacter faecalis?(1 case). Among burn patients, the most frequent germs were: Acinetobacter baumanii?(7 cases), Klebsiella pneumoniae?(6 cases), Staphylococcus aureus?(6 cases), Escherichia coli?(4 cases), Pseudomonas aeruginosa?(2 cases) and Enterobacter faecalis?(2 cases). Escherichia coli?was?noted only in the case of urinary tract infection. Antibiotics tested were: amoxicillin, amoxicilli

关键词： Infection Germs Sensitivities Risk Factors Child Mali

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Management of Arterial Hypotension Induced by Spinal Anesthesia during Cesarean Section at the Parakou university hospital in Benin in 2020: Ephedrine versus Noradrenaline

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Open Journal of Anesthesiology 2022年第12期12卷 351-367页

作者： Blaise Adelin Tchaou Samaké Broulaye Massaoulé Dossou Bodjrènou Marjolaine Oriane Brouh Yapo department of Anesthesia-intensive care and Emergencies University and Departmental Hospital Center of Borgou/Alibori Parakou Benin department of intensive care unit at the university hospital gabriel touré Bamako Mali department of Anesthesia-intensive care and Pediatric Emergencies Mother-Child Hospital of Bingerville Bingerville C&ocirc te d’Ivoire

Background: Spinal anesthesia (SA) is a preferred anesthetic technique for childbirth through caesarean section. It causes a sympathetic block responsible for low blood pressure which can be prevented or treated with vasopressors. Aim: This research aims to compare the effect of Noradrenaline with that of Ephedrine in the management of arterial hypotension caused by SA during Caesarean act. Study method: It was a cross-sectional study with two comparative settings which took place at the Teaching hospital of Parakou from April 15th to August 15th 2020. It included all parturients who underwent a caesarian act and received spinal anesthesia. To prevent hypotension two groups were formed. The first group parturient received Noradrenaline (10 γ) as prophylactic and the second group received Ephedrine (10 mg) before anesthesia. The main evaluation criteria were the time before the hypotension occurs and, the secondary endpoint was the number of hypotension episode. The two groups were compared using the usual statistical tests. The study received the approval of the Local Ethical committee of university of Parakou. Results: Two hundred and four parturients were compiled with 102 in each group. The mean age was 28.37 ± 6.15 years with extremes of 16 and 45 years. The main indications for Caesarean section were respectively iterative Caesarean section (46.57%) for scheduled Caesarean section and acute fetal distress (15.69%) for emergency Caesarean section. The incidence of hypotension was 38.24%. The mean delay of occurrence of hypotension was significantly longer in adrenaline group (19.90 min) than ephedrine group (12.53 min) with P = 0.001. According to the secondary endpoint the number of episodes of hypotension, number of tachycardia, and the total doses of each vasopressor were significantly lower in adrenaline group than in the ephedrine group. Conclusion: The use of Noradrenaline according to the established protocol demonstrated its efficie

关键词： Spinal Anesthesia Caesarean Section Hypotension Ephedrine Noradrenaline

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Risk Factor for Malnutrition in Children Aged 6 to 59 Months hospitalized in a Pediatric Ward in the South of the Sahara

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Open Journal of Pediatrics 2021年第3期11卷 329-338页

作者： A. A. Diakité A. Diall B. Maïga A. Dembélé F. L. Diakité B. Coulibaly L. N. Sidibé A. K. Doumbia O. Coulibaly P. Togo G. Dembélé A. Diall M. Sylla department of Pediatrics Gabriel Touré University Hospital Bamako Mali

Malnutrition is a major public health problem in Mali, along with the country’s political and security instability. We initiated this work with the objective of determining the frequency as well as the risk factors favoring the occurrence of malnutrition in children aged 6 - 59 months hospitalized in the pediatrics department of the Gabriel Touré University Hospital in Bamako, country reference service to identify potential interventions to plan. A cross-sectional study was carried out over a period of 4 months. A bivariate logistic regression analysis allowed us to identify risk factors with degree of significance if p 0.05. During the study period, 2888 children were hospitalized, including 348 aged 6 to 59 months, or a frequency of 12.04%. One in two children was malnourished, i.e. a frequency of 50%. It more frequently

关键词： Malnutrition Contributing Factors Pediatrics

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Hemorrhagic Stroke: About a Pediatric Case

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Open Journal of Pediatrics 2021年第4期11卷 804-809页

作者： Abdoul Karim Doumbia Oumar Coulibaly Hawa Gouro Diall Guediouma Dembélé Agaly Hamadassaliha Fatou S. Mangara Pierre Togo Adama Dembélé Belco Maiga Karamoko Sacko Abdoul Aziz Diakité Boubacar Togo department of Pediatrics of the university hospital gabriel touré Bamako Mali department of Pediatrics Mali Hospital Bamako Mali department of Neurosurgery of the university hospital gabriel touré Bamako Mali

Stroke is a rare but serious condition with high mortality and morbidity. We report the case of a 10-year-old child with no known pathological history who was transferred to the pediatric department for hemorrhagic stroke. He had been hospitalized 6 days earlier in a peripheral center for a tonic-clonic seizure accompanied by loss of consciousness and fever. Clinical examination revealed meningeal syndrome, facial paralysis, right hemiparesis, ataxia with disturbed balance, aphasia, and a peripapillary hemorrhage on the fundus. A cerebral computed tomography (CT) scan showed a hemorrhagic stroke with ventricular flooding. A lumbar puncture was performed and a hematic cerebrospinal fluid (CSF) with 12 leukocytes and 8000 red blood cells was obtained. The evolution was marked by the extinction of the infectious and meningeal syndromes, the regression of the pyramidal syndrome and the persistence of the dysarthria justifying a neuropsychological and speech therapy follow-up. Several challenges (diagnostic, therapeutic) exist in the management of children with stroke. Prospective studies with a larger sample are needed to fill the observed gaps.

关键词： Hemorrhagic Stroke Pediatrics Intracerebral Hemorrhage Subarachnoid Hemorrhage Malaria Mali

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Management of Acute Myeloblastic Leukaemia (AML) Treated with intensive Chemotherapy: Experience in a Single Centre

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Open Journal of Pediatrics 2024年第2期14卷 401-411页

作者： Abdoul Karim Doumbia Hawa Konaré Tati Simaga Pierre Togo Oumoulkairi Nana Kouma Hawa Gouro Diall Oumar Coulibaly Adama Dembélé Mohamed Elmouloud Cissé Karamoko Sacko Belco Maiga Aminata Doumbia Kalirou Traoré Ibrahima Cissé Boury Traoré Abdoul Aziz Diakité Fousseyni Traoré Boubacar Togo department of Pediatrics University Hospital Gabriel Touré Bamako Mali

Introduction: Acute myeloblastic leukaemia (AML) is a haematological malignancy with a poor prognosis, despite significant therapeutic progress. This study presents the results of AML management in Mali according to GFAOP recommendations. Methodology: This was a retrospective, cross-sectional study. It included patients aged 0 - 15 years treated in the paediatric oncology unit for AML and followed up between January 2016 and December 2020. Results: During the study period, 85 cases of acute leukaemia were diagnosed in the paediatric oncology unit (including 51 cases of ALL), of which 34 cases of AML were included in this study. The majority were boys (59%). The mean age was 8 years, with extremes of 18 months and 15 years. The mean time to diagnosis was 68 days. In 79% of cases, patients were referred by 1st or 2nd level hospitals. Anaemia was observed in 91% of cases, an infectious syndrome in 68%, haemorrhage in 56% and a tumour syndrome in 85%. The haemogram showed hyperleukocytosis in 15% of cases, thrombocytosis in 22% and severe anaemia in 73%. Death occurred in 85% of cases, most often in the context of sepsis or haemorrhage. Conclusion: AML is probably underestimated in Mali and diagnosis delayed, which may be explained by patient-related factors (lack of knowledge, financial constraints) and a cumbersome referral system. These results suggest the need to implement an appropriate diagnostic and therapeutic strategy, with strong involvement of the political authorities.

关键词： Acute Myeloblastic Leukaemia Children Mali

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Torsion of Ovarian Tumor in the Elderly: About a Case

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Surgical Science 2020年第4期11卷 69-73页

作者： Amadou Bah Ibrahima Diakite Amadou Maiga Boubacar Yoro Sidibe Madiassa Konaté Zakari Saye Boureima Kelly Tany Koné Siaka Konate Arouna A. Doumbia Bathio Traore Boubacar Karembe Mohamed Lamine Diakite Amadou A. Traoré Abdoulaye Diarra Moustapha Issa Mangane Abdoul Hamidou Almeimoune Bakary T. Dembélé Alhassane Traoré Lassana Kanté Adégné Pierre Togo General Surgery department University Hospital of Gabriel Touré Bamako Mali Anesthesia and Reanimation department University Hospital of Gabriel Touré Bamako Mali

We report a case of torsion of an ovarian tumor in a 68-year-old woman with no medical and surgical history. The diagnosis was made in front of an intermittently painful pelvic mass. The treatment consisted of a left annexectomy;the anatomopathological examination revealed a fibro-inflammatory and hemorrhagic cyst. Postoperative results were simple with a 12-month follow-up.

关键词： Tumor Ovary Cyst Surgery

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Prevention of Venous Thromboembolism in General Surgery at gabriel touréuniversity hospital in Mali

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Surgical Science 2021年第3期12卷 67-75页

作者： Amadou Traoré Madiassa Konaté Abdoulaye Diarra Koniba Keïta Kadia Traoré Zakari Saye Youssouf Koné Boubacar Yoro Sidibé Amadou Maïga Amadou Bah Bouréima Kelly Tani Koné Boubacar Karembé Souleymane Thiam Assitan Koné Drissa Bagayogo Bakary Tientigui Dembélé Alhassane Traoré Ibrahim Diakité Lassana Kanté Adégné Togo gabriel touré university hospital Bamako Mali

Through its impact on morbidity and mortality and the cost of medical care, Venous Thromboembolism (VTE) has a significant influence on the quality of care in a surgical environment. The objectives were to determine the risk of postoperative venous thromboembolism and to assess its prophylactic management in the general surgery department of gabriel toure university hospital. This was a prospective observational study from May 01, 2018 to December 31, 2018. It included all patients of 18 years old and over, operated in regulated surgery, under general anesthesia in the department. For all of these patients, Caprini score was used to assess the risk of VTE. The ninth American College of Chest Physicians’ Consensus was used as guidelines to assess Thromboprophylaxis practices in the ward. The Caprini score was evaluated in 80 patients for 8 months. The average age was 50.2 years. The sex ratio was 0.48. The risk level of VTE was low in three patients (3.8%), moderate in 13 patients (16.3%), high in 34 patients (42.5%) and highest in 30 patients (37.5%). The main risk factors found were major surgery (87.5%), age > 40 years (72.5%), cancer (33.8%), bed rest (31.2%), obesity (27.5%) and minor surgery (12.5%). Early mobilization was performed in all patients. Pharmacologic prophylaxis was required in 80% of our patients but only 38.8% had received low molecular weight heparin. VTE complicated 5 procedures, including 3 cases of deep vein thrombosis of the limbs and 2 cases of pulmonary embolism who died. Venous thromboembolism is serious and common in surgical settings. Its prevention remains insufficient in our context.

关键词： Venous Thromboembolism Prevention Surgery Mali

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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 Koné Pierre Togo Oumar Coulibaly Karamoko Sacko Djéneba Konaté Hawa Diall Lala Ndrainy Sidibé Koné 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

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