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Open Journal of Gastroenterology 2024年第3期14卷 93-98页

作者： Sanra Déborah Sanogo Kadiatou Doumbia Hourouma Sow Moussa Younoussou Dicko Youssouf Oumarou Abdoulaye Berthé Sabine Drabo Luc Sidibé Makan Siré Tounkara Abdoulaye Maiga Ouatou Mallé Ganda Soumaré Anselme Konaté Moussa Tièmoko Diarra Hepato-Gastroenterology department CHU Point G Bamako Mali Hepato-Gastroenterology department CHU Gabriel Touré Bamako Mali department of internal medicine Centre Hospitalier Universitaire Communautaire de Bangui Bangui Central African Republic

Infection with the defective hepatitis D virus (HDV) co-infects or superinfects a patient carrying hepatitis B virus (HBV). Delta virus infection is relatively common. The seriousness of infection with the hepatitis D virus (HDV), a virus defective in a patient carrying the hepatitis B virus (HBV), lies in its aggravating effect on the associated viral hepatitis B. Our aim was to study the serological profile of HDV in HBsAg-positive patients. As this study was fragmentary, we initiated this study with the aim of investigating the serological profile of HDV in HBsAg-positive patients. This was a descriptive and analytical cross-sectional study that ran from March 2019 to February 2020, a 12-month period. It focused on the population of patients seen and screened positive for HBsAg. We obtained a frequency of 10%. The mean age of our patients was 41.8 ± 13.09 years. The sex ratio was 4.5. VHD RNA was detected in 50% of patients. In 100% of cases, the presence of VHD RNA was associated with advanced fibrosis according to the APRI score, but without any statistically significant link. All HBV-infected patients should be screened for anti-HDV Ac. HDV infection leads to rapid progression to complications of liver disease.

关键词： HBsAg VHD RNA Liver Disease

Percutaneous Coronary Intervention in Acute Coronary Syndromes at the Mother-Child University Hospital Luxembourg in Bamako

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World Journal of Cardiovascular Diseases 2024年第4期14卷 288-294页

作者： Mamadou toure Hamma Sankare Baba I. Diarra Mariam Dagnogo Modibo Doumbia Abdoul W. Terra Samba Sidibe Coumba A. Thiam Boubacar Sonfo Boubacar Diarra Asmaou Keita Ousmane Traore Daouda Fofana Almou A. Diall Mady Sow Massama Konate Hamidou O. Ba Ichaka Menta Cardiology department CHU-Mother Child Bamako Mali Cardiology department CHU-Gabriel Tour&#233 Bamako Mali Faculty of medicine University of Sciences Techniques and Technologies of Bamako Bamako Mali department of Cardiac Surgery Center Andre FESTOC Bamako Mali Cardiology department CHU-Point G Bamako Mali

Introduction: Acute coronary syndromes (ACS) are a diagnostic and therapeutic emergency. Objective: Studying the feasibility, difficulties and results of coronary angioplasty in acute coronary syndromes at the Luxembourg Mother-Child University Hospital in Bamako. Patients and Methods: Cross-sectional, descriptive study with prospective recruitment over 18 months from September 2020 to February 2022. All patients aged at least 18 years old admitted for SCA and having undergone PCI during the study period were included. Result: We collected 249 patients for SCA, of whom 160 underwent angioplasty, either an angioplasty/SCA ratio of 0.64. The average age of the patients was 59.54 ± 11.62 with extremes of 32 and 92 years. The age group of 45 to 65 years was the most representative. The predominance was male, sex ratio of 2.4. The main cardiovascular risk factors were high blood pressure (58.23%) and diabetes (45.78%). Persistent ST-segment elevation on the electrocardiogram was present in 71.48%. The treatment time was more than 12 hours after the first medical contact in 95.5%. The approach was radial in 96.5% of cases. Coronarography was pathological in 91.16% of our patients. The lesions were tri-truncular in 34.13% with the anterior inter ventricular as culprit artery in 72% of cases. The majority of patients (64%) had undergone angioplasty with implantation of an active stent. Angioplasty was performed successfully in 98% and per procedural mortality was 1.87%. Only 6.45% of ACS with ST elevation benefited from primary angioplasty. Conclusion: Percutaneous coronary intervention is performed routinely in our center with satisfactory results. Difficulties exist, related to the diagnostic delay of ACS and the high cost of angioplasty.

关键词： Acute Coronary Syndromes Coronary Angiography Angioplasty Mother-Child University Hospital Luxembourg Bamako Mali

Acute Coronary Syndrome of Young Subjects at the Luxembourg Mother-Child University Hospital in Bamako

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World Journal of Cardiovascular Diseases 2024年第3期14卷 157-165页

作者： Mamadou toure Mariam Dagnogo Massama Konate Mariam Sako Daouda Fofana Hamma Sankare Almou A. Diall Modibo Doumbia Baba I. Diarr Mady Sow Abdoul Wahhab Terra Coumba A. Thiam Boubacar Sonfo Boubacar Diarra Asmaou Keita Ousmane Traore Hamidou O. Ba Ichaka Menta Cardiology department CHU-Mother Child Bamako Mali Cardiology department CHU-Gabriel Tour&#233 Bamako Mali Faculty of medicine University of Sciences Technics and Technologies of Bamako Bamako Mali Center Andre FESTOC Department of Cardiac Surgery of Bamako Mali Bamako Mali

Introduction: Acute coronary syndrome is often the first event of coronary disease of young subjects. Objective: To study sociodemographic, clinical, paraclinical, therapeutic and evolutionary aspects of acute coronary syndrome of young subjects. Patients and Methods: Descriptive cross-sectional study with prospective recruitment from October 01, 2020 to March 31, 2022. Were included all patients admitted for acute coronary syndrome whose age was less or equal to 45 years and who had undergone coronary angiography at the Mother-Child University Hospital on Luxembourg from Bamako. Results: During the study period, we collected 60 patient files out of 198. These 60 patient files met our inclusion criteria. Hospital frequency was 30.30%. Average age of patients was 40.43 ± 3.9 years. Sex ratio M/F was 5.3. Main cardiovascular risk factor was smoking tobacco (23.42%), followed by dyslipidemia (13.92%). Functional signs were dominated by angina 62% followed by dyspnea 25.3%. Persistent ST-segment elevation on electrocardiogram was present in 76.4%. Left ventricular systolic dysfunction was present in 26.5%. Time to first medical contact was more than 12 hours in 62.7% of cases. Radial approach was adopted in 94% of cases. Coronary angiography was pathological in 85% (n = 51) of cases. Lesions were single-vessel disease in 47.1% and culprit artery was anterior interventricular in 51% of cases. Dual anti-platelet aggregation was aspirin and ticagrelor in 91.8% of cases. Angioplasty was performed in all patients who had significant abnormalities at coronary angiography. In-hospital mortality was 3.9%. Conclusion: Acute coronary syndromes exist in young Africans with a male predominance. Main cardiovascular risk factor is smoking tobacco. Coronary lesions are single vessel disease in the majority of case. Most of patients meet medical team after 12 hours. Time to first medical contact is a main challenge in our country.

关键词： Acute Coronary Syndrome Young Subjects Coronary Angiography chu Luxembourg Bamako

Epidemiological, Clinical and Coronary Angiography Aspects of Acute Coronary Syndrome in the Cardiology department of the Hospital Mother-Child “Le Luxembourg”Mali

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World Journal of Cardiovascular Diseases 2024年第4期14卷 228-233页

作者： Sidibé Samba toure Mamadou Konate Massama Sankaré Hamma Traoré Ousmane Mahamat Guire Sadik Diall Mahan Ameri Dicko Bahaide Daffe Sanoussy Keita Asmaou Thiam Coumba Adiaratou Diarra Soumaila Menta Ichaka Cardiology department CHU-M&#232re Enfant Bamako Mali Cardiology department CHU-Point G Bamako Mali Faculty of medicine University of Sciences Techniques and Technologies of Bamako Bamako Mali Cardiology department CHU-Gabriel Tour&#233 Bamako Mali Cardiology department Mali Hospital Bamako Mali

Introduction: Cardiac catheterisation plays a fundamental role in the management of acute coronary syndrome. These explorations require heavy, complex and costly equipment and a large team of doctors, nurses and technicians with highly specialized training. Aims: To describe epidemiological, clinical and coronary angiography aspects of patients with acute coronary syndrome. Patients and Methods: Descriptive study from September 2019 to December 2023 in the Cardiology department of the Hôpital Mère-Enfant of Bamako. Inclusion criteria were patients admitted for coronary angiography with the diagnosis of acute coronary syndrome. Results: During the study period, 1253 patients underwent coronary angiography, 596 of whom had acute coronary syndrome as an indication, representing a hospital frequency of 47%. Sex-ratio was 2.10. Mean age of patients was 58.5 ± 11.39 years. ST elevation acute coronary syndrome was the most common indication with 63.92% of cases. High blood pressure was the main cardiovascular risk factor with 58.7% of cases, and radial access approach was used in 98% of cases. Coronary angiography was pathological in 91.70% of cases (n = 548). Patients with lesions of anterior interventricular artery were 73.73% of cases. Tritruncal lesions accounted for 40.63% of cases. Conclusion: ST elevation acute coronary syndrome is the most frequent manifestation of acute coronary syndrome. Anterior interventricular artery is most often the culprit lesion for our patients.

关键词： Coronary Angiography Acute Coronary Syndrome Bamako Mali

Echocardiographic Aspects of Type 2 Diabetics Patients Hospitalized in the medicine and Endocrinology department of the Mali Hospital

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World Journal of Cardiovascular Diseases 2024年第3期14卷 129-139页

作者： Konaté Massama Mamadou touré Mariam Sako Samba Sidibé Souleymane Mariko Djeneba Sylla Sow Elhaj Mahamane Maiga Coumba Adiaratou Thiam Youssouf Camara Hamidou Oumar Ba Asmao Keita Maiga Djenebou Traoré Zoumana Traoré Souleymane Coulibaly Bah Traoré Modibo Mariko Nouhoum Ouologuem Amadou Koné Ichaka Menta Faculty of medicine and Dentistry Bamako USTTB Department of Medicine Hospital of Mali Bamako Mali department of Cardiology chu gabriel tourE Bamako Mali department of Cardiology chu Point G Bamako Mali department of medicine Hospital of Timbuktu Bamako Mali department of Cardiology Hospital of Kati Bamako Mali department of Cardiology chu Mother and Child Bamako Bamako Mali department of internal medicine chu Point G Bamako Mali

Introduction: Cardiovascular disease is the leading cause of death in diabetics. The objective of our study was to investigate the echocardiographic aspects of type 2 diabetics. Patients and Method: Descriptive and cross-sectional study of 12 months from June 2020 to June 2021. We included hospitalized type 2 diabetics who underwent transthoracic cardiac ultrasound in the department of medicine and Endocrinology at the Mali Hospital. Results: We collected 128 type 2 diabetics. The predominance was male with a sex ratio of 1.2. The mean age of patients was 60.06 ± 11.54 years with extremes of 28 and 84 years. Echocardiographic abnormalities were dominated by abnormal relaxation of left ventricle in 62.5%, increased of left ventricle mass in 54.7% and left atrium dilation in 28.1%. Patients with type 2 diabetes mellitus and hypertension had more left atrium dilation with a p of 0.02. Disorders of global kinetics and systolic dysfunction were more prevalent in smoking patients with statistically significant associations, respectively, p = 0.02;p = 0.03. Dyslipidemia had a statistically significant association with segmental kinetic disorders with a p of 0.008. Duration of diabetes greater than 5 years was associated with left atrium dilation and p-value was 0.04. Conclusion: Diabetes is responsible for cardiovascular manifestations that can be identified with transthoracic echocardiography. Its performance in diabetic patients makes it possible to refine the patient’s management.

关键词： Diabetes Echocardiography Mali Hospital

Pleomorphic Adenoma of the Salivary Glands: Two Atypical Locations

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International Journal of Otolaryngology and Head & Neck Surgery 2024年第3期13卷 251-257页

作者： Sidibé Youssouf Diarra Abraham Samaké Djibril Sanogo Boubacar Traoré Abdoul Moumine Diarra Kassim Coulibaly Bourama Diakité Youssouf Keita Mohamed Amadou department of ENT and Head and Neck Surgery Mother-Child University Hospital “ Le Luxembourg&#8221 Bamako Mali Faculty of medicine and Odontostomatology Bamako Mali department of ENT and Head and Neck Surgery The Mali-Gavardo Hospital Bamako Mali Ministry of Higher Education and Scientific Research Bamako Mali ENT and Head and Neck Surgery department of the Commune V Reference Health Center (CSRef CV) Bamako Mali department of ENT and Head and Neck Surgery at chu gabriel touré Bamako Mali department of Anatomy and Pathological Cytology Gabriel Tour&#233 University Hospital Center Bamko Mali department of Oral Surgery Sikasso Regional Hospital Sikasso Mali

Pleomorphic adenoma is the most common tumor of the salivary glands, accounting for approximately 50% of salivary gland lesions. It develops mainly in the salivary glands: parotid (80%), submaxillary (10%), sublingual (1%) and in the accessory oral-pharyngeal glands (9%). The aim of this work was to report 2 cases of pleomorphic adenoma of atypical location and then to discuss the difficulties linked to its diagnostic and therapeutic management in the Malian context. They were a 40-year-old man and a 72-year-old woman. They were admitted to the ENT department of the “Luxembourg Mere-infant” hospital for oropharyngeal swelling for the first and swelling of the palate for the second. The clinical expression was a swelling in both cases, of a hard, mobile consistency with healthy mucosa on their surface. The remainder of the physical examination was unremarkable. The diagnosis of a tumor of the oropharynx and palate was made following clinical radiological examinations. The histopathological examination of the surgical specimen made it possible to make the diagnosis of pleomorphic adenoma of the palate and the left palatine tonsil. The follow-up surgery was straightforward, with a favorable outcome. Pleomorphic adenomas are relatively rare benign tumors of the accessory salivary glands;their clinical expression remains swelling. Therapeutic management is surgery and the diagnosis is confirmed by histopathological examination.

关键词： Pleomorphic Adenoma Palate Tonsil Mali

Knowledge Practical Attitude of Health Professionals on Breast Cancer at the Hospital of the District of the Commune IV of Bamako

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Surgical Science 2024年第5期15卷 342-356页

作者： Moussa Samaké Souleymane B. Dembelé Sirama Diarra Yely Dianessy Abdou Guiré Dorcas Laurel Sodjiné Yede Amaguiré Saye Brahima Dembele Birama Traoré Thierno Nadio Ibrahima Maiga Mahamane Dicko Modibo Diarra Siaka Konaté Amadou Maiga Bakary Tientigui Dembele Adégné Togo General Surgery department of Bamako District IV Hospital 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 Anesthesia and Resuscitation Service of the Hospital of the District of the Commune IV of Bamako 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 General Surgery department of the gabriel touré University Hospital Bamako Mali

Introduction: The level of knowledge and attitude of health professionals about breast cancer are important determinants. General objective: To study the knowledge, attitude and practice of health professionals of the hospital of the district of the commune IV on breast cancer. Methodology: This was a cross-sectional, prospective, descriptive, qualitative and quantitative study. The study period was from 01 October 2022 to December 2022. Results: In one week of survey, 110 health workers (intern, obstetrician nurse, general practitioners and specialists) received the survey sheet, 80 health workers informed it, a participation rate of 73%. The male sex was most represented at 63.75% with a sex ratio of 1.76. The average age was 39.59 years with extremes of 22 and 61 years. The clinical signs evoked by the participants were: breast nodule (81.25%), followed by breast discharge (48.75%). In relation to risk factors: interns and obstetrician nurses had no good knowledge, 51.72% of general practitioners had good knowledge, 43.48% of specialist doctors had good knowledge, and 5.88% of the wise had good knowledge. Conclusion: Breast cancer is a common pathology around the world, health professionals are at the forefront of the fight against breast cancer, and this fight cannot be effective without trained personnel.

关键词： Knowledge Attitude Practice Health Personnel Breast Cancer

Evolution of Viral Load in Patients Infected with HIV-1 at Point G University Hospital

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Open Journal of Medical Microbiology 2024年第1期14卷 66-76页

作者： A. Maiga D. Kone D. M. Coulibaly Ag M. Baraika A. Traore S. S. Diakite I. I. Maiga I. Konate A. I. Maiga Faculty of medicine and Odontostomatology of Bamako (FMOS) University of Science of Technical and Technology De Bamako Bamako Mali Laboratory of Medical Biology and Hospital Hygiene of Point-G University Hospital Bamako Mali Faculty of Pharmacy of Bamako (FaPh) University of Science of Technical and Technology De Bamako Bamako Mali Laboratory of the Luxembourg Mother-Child Hospital Bamako Mali National Institute of Public Health Bamako Mali National Institute for Training in Health Sciences Bamako Mali Laboratory of the Kati University Hospital Center Bamako Mali Infectious and Tropical Diseases department of Point-G University Hospital Bamako Mali Laboratory of chu gabriel touré Bamako Mali

Introduction: HIV, the human immunodeficiency virus, is the etiological agent of acquired immunodeficiency syndrome (AIDS). The aim of this study was to assess the evolution of the viral load in patients under treatment. Methodology: This was a study carried out from July 2017 to June 2022 at the Point G University Hospital laboratory. The determination of the viral load of patients was carried out by PCR on the ABOTT M2000sp/rt platform. Results: A total of 129 patients infected with HIV-1, aged 19 to 72 years with a mean age of 40.05 years ± 10.71;all on antiretroviral chemotherapy. The female gender predominated among our patients. The most common treatment regimen was 2INTI + 1INNTI with 72.9% followed by 2INTI + 1INI with 13.2%. As for the combinations of molecules, the combination TDF + 3TC + EFV and TDF + 3TC + DTG predominated, respectively 65.1% and 13.2%. 89.9% of our patients had undetectable viremia after 12 months of treatment (p < 0.005) with an average viral load which had evolved from 681315.65 copies/ml ± 1616908.484 to M0 at 5742.36 copies /ml ± 35756.883 at M12 (p Conclusion: Generally speaking, antiretroviral treatment had contributed to controlling viral loads, however the therapeutic combination TDF + 3TC + DTG had made it possible to obtain more patients with undetectable viremia instead.

关键词： HIV-1 Treatment Viral Load Point G University Hospital

Venous Thromboembolic Disease in a Regional Hospital in Mali

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World Journal of Cardiovascular Diseases 2023年第12期13卷 837-844页

作者： Coulibaly Souleymane Taoré Djénébou Sidibé Samba Sako Mariam Guindo Aissata Sanogo Alpha Kodio Aniéssa Dao Aissata B. A. Hamidou Oumar Diakité Mamadou Konaté Massama Menta Ichaka Cardiology department CHU Point G Bamako Mali department of internal medicine CHU Point G Bamako Mali Cardiology department Nianankoro Fomba Hospital in Ségou Ségou Mali Cardiology department CHU Gabriel Touré Bamako Mali Mali Hospital medicine Service Bamako Mali

Introduction: Venous thromboembolism (VTE) is a nosological group which mainly includes deep vein thrombosis (DVT) and pulmonary embolism (PE), it is frequently associated with high morbidity and mortality. We initiated this study with the aim of studying VTE in a cardiological hospital environment in a regional hospital in Mali. Methodology: This was a descriptive study with prospective recruitment over 1 year from June 20, 2019 to June 20, 2020, covering patients hospitalized and followed in consultation in the cardiology department of the Ségou regional hospital in Mali. Results: We collected 31 cases of VTE out of 366 patients, representing a frequency of 8.47%. The sex ratio was 0.88. VTE risk factors were dominated by immobilization (29.03%), pregnancy and postpartum (16.12%), heart failure (16.12%). The reason for consultation was dyspnea (93.54%) followed by chest pain (83.87%). On admission the clinical manifestations were tachycardia (74.19%), tachypnea (90.32%), muffled heart sounds (70.96%), global heart failure syndrome (51.6%). According to VTE probability scores;51.61% of patients had an intermediate clinical probability according to the simplified Wells score for PE and 54.84% had an intermediate clinical probability for the simplified Geneva score for DVT. D-Dimers were only performed in 12 patients (38.70%) and were elevated in all. A chest CT angiogram showed PE in 90% of patients (n = 28/31). Venous Doppler ultrasound of the lower limbs showed venous thrombosis in 3 patients. Conclusion: Venous thromboembolism, although underdiagnosed, is common in our health structures. Prevention, particularly heparinoprophylaxis and early recovery in a hospital environment, remains the effective means of combating this condition.

关键词： Venous Thrombosis Pulmonary Embolism Nianankoro Fomba Hospital Ségou

Ischemic Stroke Revealing Infective Endocarditis in a Young Subject: About a Clinical Case

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World Journal of Cardiovascular Diseases 2022年第4期12卷 209-215页

作者： Coumba Thiam Boubacar Sonfo Massama Konaté Mahan Ameri Abba Diall Asmaou Keita Mariam Sako Youssouf Camara Hamidou Oumar Bâ Ibrahima Sangaré Mamadou touré Samba Sidibé Massama Camara Simo Moyo Souleymane Coulibaly Ichaka Menta Cardiology department of Kati University Hospital Kati Mali internal medicine department of Mali Hospital Bamako Mali Cardiology department of the Mother-Child University Hospital Bamako Mali Cardiology department chu Point G Bamako Mali Cardiology department of the chu gabriel touré Bamako Mali

Introduction: Neurological complications are possible during infective endocarditis. They are often life-threatening and can be a source of sequelae. Case Presentation: We report the case of an 11-year-old patient admitted to the cardiology department of the chu-ME “LUXEMBOURG” in Bamako for functional impotence of the left hemibody, accompanied by fever and NYHA stage II dyspnea. The clinical examination on admission shows the poor general condition, normal consciousness, and sensory-motor deficit of the pyramidal type of the left hemibody. The cardiovascular examination notes a systolic murmur at the mitral focus, hepato-jugular reflux, hepatomegaly, and slight edema in the lower limbs. Brain CT showed localized hypodensity in favor of an ischemic stroke. The electrocardiogram shows a sinus rhythm. Transthoracic Doppler echocardiography revealed mitral insufficiency with vegetation of 17 × 14 mm on the anterior mitral valve, with left ventricular ejection fraction estimated at 75%. Dual antibiotic therapy associated with conventional treatment for heart failure was initiated. The clinical evolution was marked by the persistence of the deficit of the left upper limb, the cardiac Doppler echography of control after 6 weeks of treatment found the same vegetation. A discussion with the heart team with a view to a surgical cure has been initiated for the rest of the treatment. Conclusion: A motor deficit associated with fever related to an ischemic vascular accident should lead to a search for infective endocarditis on cardiac Doppler ultrasound.

关键词： Ischemic Stroke-Infectious Endocarditis-Young Subject