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Bacteriology of Healthcare-Associated Infections in the gynecology and obstetrics department of chu Gabriel Touré

Open Journal of obstetrics and gynecology 2019年第10期9卷 1336-1346页

作者： Amadou Bocoum Seydou Fané Youssouf Traoré Siaka Amara Sanogo Ibrahim Kanté Aminata Kouma Mamadou Sima Abdoulaye Sissoko Ibrahima Ongoiba Soumana Oumar Traore Ibrahima Tegueté Maténé Sacko Daouda Camara Alassane Traoré Assitan Wane Niani Mounkoro Amadou Dolo gynecology-obstetrics department of chu G. Touré Bamako Mali gynecology-obstetrics Service of chu of Point G Bamako Mali gynecology-obstetrics department of chu of kati Bamako Mali gynecology-obstetrics Service of Referral Health Center of kati Kati Mali gynecology-obstetrics Service of Referral Health Center of Commune V Bamako Mali Gynécology-Obstétrics department of chu of Mali Bamako Mali.

Introduction: Healthcare-associated infections (HAIs) are a public health issue. An infection is said to be associated with the care if it occurs during or after the care of a patient, and if it was neither present nor incubation at the beginning of the care. Objective: The purpose of this work was to study the bacteriology of infections associated with obstetric care in the gynecology-obstetrics department of chu Gabriel Touré. Patients and Methods: This is an epidemiological, descriptive, analytical study conducted in the gynecology-obstetrics department of the chu Gabriel Touré, from April 11th, 2016 to August 29th, 2016 (5 months). Data collection focused on the clinical and laboratory characteristics of healthcare-associated infections in patients during their hospitalization. Included in the study were any patients hospitalized in the gynecology and obstetrics department who agreed to participate in the study. The criteria used to diagnose the associated infection were those of the Atlanta CDC. Operative wound monitoring was done up to the 30th postoperative day. Results: We have recorded 200 patients, out of whom 138 were operated on and 23 cases of bacterial infection associated with care (11.50%). The average age of the patients was 32.52 years ± 13.36 years against 29.36 years ± 10.28 years for the patients who did not present the infection. Seven point five percent of the evacuated patients had an infection associated with care. The most common types of infection were surgical site infection (60.86%), urinary tract infection (26.08%), endometritis and sepsis with 13.04% each. The isolated organisms were all resistant to Amoxicillin, to Amoxicillin + Clavulanic acid (88.88%) and to Ciprofloxacin (77.77%). The average duration of hospitalization for patients who developed the infection was 14.70 days. The lethality was 1.50%. The average cost of management of patients who developed the surgical site infection was 119,837 FCFA. Conclusion: The bacterial infe

关键词： Bacterial Infection Resistances Gabriel Touré University Hospital Antibiotics obstetrics

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Epidemiological and Prognostic Aspects of Obesity and Pregnancy in the gynecology-obstetrics department at the Sylvanus Olympio University Hospital Center (chu SO) in Lomé

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Open Journal of obstetrics and gynecology 2023年第1期13卷 88-96页

作者： Komlan Alessi Andele Ameyo Ayoko Ketevi Baguilane Douaguibe Akila Bassowa Dédé Régine Diane Ajavon Kodjo Fiagnon Abdoul Samadou Aboubakari Koffi Akpadza department of gynecology and obstetrics Sylvanus Olympio University Hospital Center Lome Togo department of gynecology and obstetrics Campus University Hospital Center Lome Togo department of gynecology and obstetrics Regional Hospital Center Kara Togo department of gynecology and obstetrics Kara University Hospital Center Kara Togo

Introduction: Obesity and pregnancy is a major public health problem worldwide, both maternal and fetal. Objective: This is to describe the epidemiological and prognostic aspects of obesity and pregnancy in the gynecology-obstetrics department at the Sylvanus Olympio University Hospital Center (chu SO) in Lomé. Methodology: This was a descriptive cross-sectional study concerning obesed pregnant women. The survey was conducted from the 1st to the 30th of June 2022 at the chu SO. Results: We enrolled 55 obese pregnant women. The frequency of obesity and pregnancy was 5.14%. Resellers were represented at 41.8%. The average age was 31 years old. As risk factors, 85.5% claimed to have a fatty diet and 76% did not practice sports. The gestational pathologies found during pregnancy were hypertension in 47.4% of cases, preeclampsia in 24.6% and gestational diabetes in 7%. Caesarean section was the way of delivery in 63.6% of cases and those who gave birth vaginally presented a tear of the soft tissues in 85% of cases. Birth weight was abnormal (low weight and excess weight) in 61.8% of cases. Conclusion: The association between obesity and pregnancy constitutes an important risk factor for the mother and the fetus.

关键词： Obesity Pregnancy chu SO Togo

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Epidemiological, Diagnostic and Therapeutic Aspects of Breast Cancer in the gynecology and obstetrics department of the chu Gabriel Touré from 2020 to 2022

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Advances in Breast Cancer Research 2023年第3期12卷 97-113页

作者： Sirama Diarra Moussa Samake Amaguiré Saye Brehima Dembélé Birama Traoré Souleymane B. Dembélé Déssé Diarra Yely Dianéssy Abdou Guiré Bakarou Kamate gynecology and obstetrics department of the District Hospital of Commune IV Bamako Mali General Surgery department of the Commune IV District Hospital Bamako Mali obstetrics gynecology Service of the CSREF of San Bamako Mali Anatomo-Pathology and Cytology department of the Point G University Hospital Bamako Mali

In Mali, breast cancer remains a real health problem in the absence of an adequate and adapted health policy for their early diagnosis and their often late or even non-existent treatment. Objectives: This study aimed to study the epidemiological, diagnostic, and therapeutic aspects of breast cancer to write the clinical aspects of breast cancer in the gynecology-obstetrics department of the chu Gabriel Touré from 2020 to 2022. Methodology: This was a retrospective and descriptive study of 219 cases of breast cancer that were diagnosed in the gynecology and obstetrics department of the chu Gabriel Touré in Bamako, from 2020 to 2022. Results: The annual frequency was 77.2 cases per year, the average age 45.55 years with extremes of 16 to 85 years;housewives represented 92.7%;multiparas were reported at 57%. Considering the history, the personal history of benign breast pathology was 55.6%. Regarding the localization, the left breast was the most affected with 53.9%, and the tumor was found in the supero-external quadrant in 53.9%. The cancer was metastatic in 81.28%. The diagnosis biopsy + histology contributed to 98.6%. The histological type was invasive carcinoma of non-specific type in 95%. As for the histoprognostic grade of SBR studied, grade II was predominant at 46%, grade III at 34.95%. The therapeutic strategy was chemotherapy in 83.1%. Neoadjuvant chemotherapy followed by surgery in 10%, primary surgery in 6.4%, radiotherapy in 0.5%. Conclusion: The major challenges in the fight against breast cancer in Mali remain a better organization of the system for early diagnosis, the establishment of a screening program, early diagnosis in women from the age of 40 and also adequate care.

关键词： Epidemiology Diagnosis Therapeutics Breast Cancer Bamako (Mali)

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Surgical Treatment of Recent Traumatic Epiphyseal Detachments of the Distal Femur in the Orthopedic and Traumatological Surgery department of the chu Bocar Sidy Sall de kati: About 20 Cases

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Surgical Science 2023年第5期14卷 338-346页

作者： Souleymane Diallo Sory Ibrahim Tambassi Kaly Tounkara Terna Traore Kalifa Coulibaly Aboubacar Diallo Soumana Traore Aboubacar Sidiki Sangaré Salif Kone Drissa Kaloga Bagayoko Cheick Oumar Sanogo department of Orthopedics and Traumatology CHU Pr Bocar Sidy Sall of Kati Kati Mali department of Orthopedics and Traumatology Etablissement Public Hospitalier Sikasso Sikasso Mali department of Anesthesia and Intensive Care University Hospital of Luxembourg Bamako Mali

Introduction: To our knowledge, no scientific study has been conducted at the university hospital of kati on recent traumatic epiphyseal detachment fractures of the distal femur. However, every day, children present in consultation for knee trauma. Conjugal plate fractures are by definition single to children. Any break in any solution of continuity of this plate is called an epiphyseal fracture or detachment. Objectives: To evaluate the results of surgical treatment of traumatic epiphyseal in detachments of the distal femur recent in children and adolescents. Patients and Method: This was a 13-month prospectively collected longitudinal descriptive study from September 1, 2016 to September 30, 2017. We identified and reviewed 20 medical records of recent traumatic epiphyseal detachments of the distal femur. The parameters studied were sociodemographic, lesion, surgical technique and evolutionary. Results: During the study period, the most affected group age was 12 to 17 years (85%) with an average of 14.65 ± 1.61 years (6 and 20 years). The victims were male (95%). The most frequent etiology was road traffic accident (95%), with a mean time to care of 26.42 ± 10.21 hours and Type II was frequently encountered (85%) with 35% of immediate complications. Cross-bracketing was the most commonly used surgical technique (85%). The result was good (65%). Conclusion: This study allowed us to observe a significant hospital incidence of epiphyseal detachment fractures of the distal femur. Cross pinning was the most commonly used surgical technique with fewer complications (35%) and a satisfactory result in 90% of cases.

关键词： Fractures Epiphyseal Detachments Distal End of Femur Pinning

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The Maternal Deaths at the obstetrics and Gynaecology department of the Ignace Deen National Hospital, University Teaching Hospital (chu) Conakry, Guinea

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Open Journal of obstetrics and gynecology 2019年第5期9卷 597-603页

作者： Boubacar Siddi Diallo Mamadou Hady Diallo Ousmane Balde Ibrahima Sylla Ibrahima Conte Abdourahmane Diallo Oumou Hawa Bah Saran Camara Ibrahima Sory Balde Telly Sy Yolande Hyjazi Namory Keita University department of gynecology-obstetrics Donka National Hospital Conakry Guinea University department of gynecology-obstetrics Ignace Deen National Hospital Conakry Guinea

Objectives: 1) To calculate the ratio of maternal mortality. 2) To describe the socio-demographic characteristics of deceased patients. 3) To identify the main causes of maternal deaths. Methodology: This was a retrospective study of the 12-month period from January 1st to December 31st, 2015 performed at the Gynaecology obstetrics department of the Ignace Deen National Hospital, Conakry, Guinea. The study included women who died during pregnancy, childbirth, and in its peripheries according to WHO’s maternal death report. Results: We collected 38 cases of maternal deaths out of 4404 live births, accounting a ratio of 863 per 100,000 live births. The socio-demographic characteristics of these 38 patients were: 20 - 24 years of age (26%), married (78%), housewives (37%), students (44%), and nulliparous (29%), no prenatal follow-up (47%), and home-birth (49%). The 1st and 3rd type of delay amounted for 40% and 53%, respectively. Patients consulted after 12 hours after symptom-onsets accounted 47%, whereas those before 6 hours accounted for 19%, suggesting the delay of first medication. The final diagnosis and diagnosis at admission coincided in 69% of cases. The emergency kit was available for all. The opinion of a specialist was available in 16 patients. Blood was available in 40% of the patients who required it. Death caused by conditions directly related to pregnancy/delivery accounted for 71%. Haemorrhage was the most frequent cause of death. Death occurred within the first 24 hours of admission in 73% of cases. Conclusion: We here shed light on the maternal death in this area. Although we did not demonstrate the method/procedure to reduce this high rate of maternal mortality, the present study may provide a fundamental data to reduce maternal death in this area.

关键词： Review Maternal Deaths

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Care Taking of Obstetric Emergencies in the department of Gynaecology and obstetrics at Donka National Hospital, University Teaching Hospital (chu) of Conakry, Guinea

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Open Journal of obstetrics and gynecology 2019年第5期9卷 604-611页

作者： Boubacar Siddi Diallo Ibrahima Sory Balde Ibrahima Conte Mamadou Hady Diallo Ousmane Balde Ibrahima Sylla Abdourahmane Diallo Oumou Hawa Bah Fatoumata Binta Sow Telly Sy Yolande Hyjazi Namory Keita University department of gynecology-obstetrics Donka National Hospital Conakry Guinea University department of gynecology-obstetrics Ignace Deen National Hospital Conakry Guinea

Objectives: The objectives of this work were to calculate the frequency of obstetrical emergencies, to describe the socio-demographic profile of women admitted for obstetric emergencies, to identify the main emergencies, to describe the care taking of emergencies and to establish the maternal foetal prognosis of obstetric emergencies. Methodology: It was a 6-month descriptive prospective study conducted in the obstetrics and Gynaecology department of the Donka National Hospital, chu Conakry, Guinea. The study took place from July 1st to December 31st, 2005. The data collected were entered and corrected using the Word and Excel 2010 software and then transferred to the Epi Info software version 7 for analysis. The results are presented in the form of tables, figures and texts using Word and Excel software, commented on, discussed and compared to current literature data. The limitations of the study: The poor filling of the partograph has been the main problem of our study. Results: The frequency of obstetric emergencies was 19% in the department. The socio-demographic profile was that of a woman aged 15 to 24 (46.4%), married (92%), housewives (38.1%), out of school (49.5%), nulliparous (34.3%), without prenatal follow-up (47.37%), coming from home (56%), evacuated (44%). The main emergencies are dominated by haemorrhage (34.5%) followed by HTA Arterial hypertension and eclampsia (25.7%). The therapeutic attitude was based on clinical data and was dominated by caesarean section (70%). General anaesthesia was performed in 75% of cases and 1.6% benefited from local anaesthesia. The demand for blood was honoured in 19% of the cases. The maternal morbidity was dominated by anaemia (66.7%) and a lethality of 4%. After the 5th minute, 47% of the newborns had APGAR greater than 7. The neonatal mortality rate was 21%. Conclusion: To avoid and/or reduce obstetric emergencies, it is necessary to detect and treat risk factors during referrals, properly monitor child labor, refu

关键词： Obstetric Emergency Care Taking

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Uterine Rupture: Epidemiological Aspects, Etiologies and Maternal-Fetal Prognosis in the Obstetric gynecology department of the Donka chu Conakry National Hospital, Guinea

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Open Journal of obstetrics and gynecology 2019年第4期9卷 521-528页

作者： Boubacar Siddi Diallo Ibrahima Sory Balde Ibrahima Conte Mamadou Hady Diallo Ousmane Balde Ibrahima Sylla Abdourahmane Diallo Oumou Hawa Bah Loua Avit Telly Sy Namory Keita University department of gynecology-obstetrics Donka National Hospital Conakry Guinea University department of gynecology-obstetrics Ignace Deen National Hospital Conakry Guinea

Objectives: The objectives of this work were to calculate the frequency of the uterine rupture, to describe the epidemiological profile, to identify the etiologies and to establish the maternal prognosis and foetal. Methodology: It was about a descriptive survey with compilation of the data in two phases: a retrospective spreading on one period of 6 years and the other forecasting of 1 one year achieved to the service of Obstetric gynecology of the hospital National Donka, Fallen from Conakry, Guinea. Results: We recorded 24.030 childbirths of which 188 cases of uterine rupture either a frequency of 0.78, which represents an uterine rupture for 128 childbirths. The epidemiological profile was the one of a woman of 24 to 28 years (31.91%), housewives (69.14%), without prenatal follow-up (47.87%), big multipare (37.76%) and évacuées (78.78%). The motives of consultation have been dominated by the hémorragie (95.74%). The rupture was of transverse type in the majority of the case (63.82%). The hysterorraphy was the most performed surgical procedure which is 85.10% followed by the total sub hysterectomy in 10.63%. The newborns of birth weight superior or equal to 4000 g represent 25.53%. The maternal morbidity has been dominated by the anemia of the postpartum (60%). We recorded a rate of maternal létalité of 12.76%. The maternal deaths were due to the hemorrhage in 78.57%. The living newborns endured a respiratory distress in 9.57% and those stillborn represent 87.23%. The etiologies of uterine rupture were dominated by fetal-pelvic disproportions 48.93% followed by an iatrogenic uterine rupture 22.33%. Conclusion: The reduction of this uterine rupture rate would pass by the recentered prenatal consultation offered, the one of obstetric cares and complete néonataux of emergency, the discount to level of the beneficiaries of the basic structures so that they can discover the cases in time susceptible to drag a rupture to evacuate better in time and the promptness in the

关键词： Uterine Rupture Etiologie Prognosis

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Delivery Complications of the Single Fat Large Foetus (Macrosomia) with Teenagers at the obstetrics and Gynaecology department of the Donka National Hospital, University Teaching Hospital (chu) of Conakry, Guinea

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Open Journal of obstetrics and gynecology 2019年第5期9卷 624-630页

作者： Boubacar Siddi Diallo Mamadou Hady Diallo Ousmane Balde Ibrahima Sylla Ibrahima Conte Abdourahmane Diallo Oumou Hawa Bah Mouctar Sylla Ibrahima Sory Balde Telly Sy Namory Keita University department of gynecology-obstetrics Donka National HospitalConakryGuinea University department of gynecology-obstetrics Ignace Deen National HospitalConakryGuinea

Objectives: The objectives of this work were to: 1) Calculate the delivery frequency of the large foetus with complications to teenagers;2) Describe the epidemiological profile of these teenagers;3) Identify the risk factors of the large foetus and to establish the maternal prognosis and foetus. Methodology: This was a prospective descriptive 6-month study performed at the obstetrics and Gynaecology department of the Donka National Hospital, chu of Conakry, Guinea. We chose a regular amplitude of one year and we got the following slices: 16 years, 17 years, 18 years. Results: We recorded 14.23% (801/5629) teenage deliveries of which 9.4% (75/801) deliveries are single fat fetus and 93.3% (70/75) of them developed complications. The epidemiological profile was that of an 18 years old teenager (61.4%), single (58.6%), professional (44.3%), out of school (57.1%), primiparous (68.6%), having performed 3 - 4 CPN (47.1%), coming from home (65.7%) and carrying a full term pregnancy (100%) and having delivered by high way medical assistance (52.9%). Risk factors were dominated by the male foetus (75.7%). Maternal morbidity was dominated by cervico-perineal tears 28.6%. The recorded maternal mortality was 4.3%. The 3 cases of maternal deaths were caused by the hemorrhage. The APGAR score at the first minute was in 51.4% between 4 and 6;at the 5th minute in 80% between 7 and 10. The most common foetal complication was acute foetal distress 44.3%. Foetal lethality was 12.8%. Conclusion: Here, we demonstrated the teenage pregnancy and macrosomia in this area. We did not show how we can improve this situation based on the data;however, describing this situation may be of use as a fundamental data to make a better antenatal checkup and teenager-education.

关键词： Teenager Large Foetus Complications

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Appendicular Abscess in General Surgery at the Bocar Sidi Sall University Hospital in kati

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Surgical Science 2020年第12期11卷 479-485页

作者： Abdoulaye Diarra Koniba Keita Amadou Traoré Assitan Koné Idrissa Tounkara Issa Traore Souleymane Thiam Fadima K. Tall Daouda Diallo Madiassa Konate Aboubacar Koné Deborah Sanra Sanogo Ismaël Konare Alhassane Traoré Adégné Togo department of General Surgery CHU of Kati Kati Mali General Surgery department CHU Gabriel Touré Bamako Mali department of Anesthesia and Resuscitation CHU of Kati Kati Mali Gastroenterology department Point G Hospital Bamako Mali

Introduction: Appendicular abscess is a progressive complication of acute appendicitis in which the spread of infection is contained by the greater omentum and the slender loops resulting in the formation of a true septate abscess of the large peritoneal cavity. Materials and Methods: This was a retrospective study from January 2010 to December 2019 carried out at the Bocar Sidi Sall University Hospital in kati (chu BSS in kati) in general surgery. It concerned all patients operated on for appendicular abscess in the department. Results: 75 cases of appendicular abscess were collected, which represented 5.76% of surgical emergencies and 25% of acute appendicitis. The average age of the patients was 29 years. The male sex represented 67% of our patients with a sex ratio of 2. The average consultation time was 5 days. Abdominal pain was noted in all patients. It was localized in the right iliac fossa in 80% (n = 60) and diffuse in 2.7% of cases (n = 2). It was accompanied by nausea and vomiting in 93% of cases (n = 70), urinary disorders in 20% (n = 15), fever in 94% (n = 71), cessation of materials and gas in 1.33% (n = 1). Abdominal ultrasound was performed in 86% (n = 65). It made it possible to suggest a peri-appendicular effusion. Biological examination revealed a neutrophilic hyperleukocytosis greater than 20,000/mm3 in 47 patients, or 63%. All the patients were operated on by laparotomy (Marc Burney or midline subumbilical) under general anesthesia. The length of hospitalization was 6 days. We have not recorded any deaths. Morbidity was 8% (n = 6) represented by parietal suppuration. The postoperative course was straightforward in 92% of cases (n = 69). Conclusion: Appendicular abscess is a frequent medico-surgical emergency, the prognosis of which depends greatly on early diagnosis and adequate and immediate management.

关键词： Appendicular Abscess Surgery kati Mali

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Fascist Leg Necrosis at the Bocar Sidi Sall University Hospital (BSS) in kati (Mali)

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Surgical Science 2022年第3期13卷 119-123页

作者： Abdoulaye Diarra Assitan Koné Amadou Traoré Koniba Kéïta Idrissa Tounkara Tounkara Issa Traoré Oumou Traoré Boubacar Karembé Madiassa Konaté Oulématou Coulibaly Modibo Togola Daouda Diallo Alhassane Traoré Bkary Tientigui Dembélé Ibrahim Diakité Adégné Togo department of General Surgery kati University Hospital Kati Mali department of General Surgery chu Gabriel Touré Bamako Mali department of Anesthesia and Resuscitation chu of kati Kati Mali

Necrotizing fasciitis is a bacterial dermo-hypodermitis of necrotizing type with involvement of the superficial fascia of the muscles. We report the case of a 50-year-old patient with necrotizing fasciitis of the left leg following erysipelas. Clinical Case: A 50-year-old patient, received at the emergency department for necrotizing wound of the left leg, evolving for 25 days. The examination of the patient made it possible to find: an alteration of the general condition with a WHO score classified stage II. A necrotizing wound of the lower 2/3 of the left leg and the dorsal side of the left foot allowing pus to flow in places, the pedious pulse was well perceived, lymphadenopathy at the root of the homolateral thigh. The complete blood count made it possible to objectify a predominantly neutrophil hyperleukocytosis greater than 10,000/mm3. We first carried out a complete debridement of the necrotic tissues, in a second time we took the patient back to do the autocutaneous graft. The surgical follow-up was simple. Conclusion: Necrotizing fasciitis is a serious infection, management is multidisciplinary.

关键词： Necrotizing Fasciitis Lower Limb kati Mali

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