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Open Journal of Epidemiology 2024年第1期14卷 19-30页

作者： Oumou Amadou Diallo M’bemba Traore Mamadou Cire Barry Mamadou Mouctar Ramata Diallo Hasmiou Dia Alpha Oumar Diallo ENT department Ignace Deen National Hospital Conakry Guinea Paediatrics department Ignace Deen National Hospital Conakry Guinea ENT department Mamou Regional Hospital Mamou Guinea

Introduction: Acute otitis media is an acute inflammation of the mucosa of the middle ear cavities. It is often secondary to nasopharyngitis, which favors the passage of infection through the Eustachian tube to the middle ear. The aim of our study was to improve the management of AOM in the Paediatric department of the Hospital National Ignace Deen (Conakry). Patients and Methods: This was a prospective descriptive study lasting 6 months from 01 July to 31 December 2011;the study covered 525 cases out of a total of 6276 children, i.e. a frequency of 8.36%. Results: The most affected age group was 6 to 11 months. Males predominated (69.71%). 82.29% had a history of recurrent rhinopharyngitis. The most frequent reason for consultation was incessant crying (66.29%). Rhinopharyngitis and malaria were the most commonly associated pathologies (87.62% and 39.62% respectively). 72.19% of our patients were admitted with congestive AOM and received medical treatment. We recorded one case of otomastoiditis which was treated surgically. Conclusion: AOM is more common in children aged between 6 and 24 months. Good collaboration between paediatricians and ENT specialists is essential to reduce the morbidity of AOM.

关键词： Acute Otitis Media (AOM) Treatment Nasopharyngitis Eustachian Tube

Ureteroscopy with Holmium: YAG Laser—A Initial Study in the Urology department of the Pr Bocar Sidy Sall University Hospital of Kati

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Open Journal of Urology 2024年第4期14卷 207-216页

作者： Amadou Kassogue Idrissa Sissoko Daouda Sangare Moussa Salifou Diallo Hamed Sylla Mahamadou Traore Boureima Coulibaly Salia Coulibaly Modibo Diakite Modibo Togola Fadima Tall Ilias Guindo Ben Naoum Kamel Mamadou Lamine Diakite Urology department University Hospital of Pr Bocar Sidy Sall Kati Mali Radiology department University Hospital of Pr Bocar Sidy Sall Kati Mali Anesthesy and Reanimation department University Hospital of Pr Bocar Sidy Sall Kati Mali Urology department University Hospital Nimes France Urology department University Hospital of Point G Bamako Mali

Introduction: Ureteroscopy is a minimally invasive endoscopic surgery which provides access to the ureter, pyelon and calyceal cavities via the urethra and the bladder. Laser ureteroscopy uses the laser as an energy source to treat the stone and eliminate it naturally. Minimally invasive endoscopic methods are struggling to become popular in sub-Saharan African countries, especially for the upper urinary tract. The objective of our work was to report the results of our first laser ureteroscopy experience in the department. Materials and Methods: This was a prospective and descriptive study running from December 1, 2023 to February 19, 2024. Included in our study was any case of upper urinary tract stone operated by Laser ureteroscopy. The characteristics of the lithiasis were determined by CT scan. Sterilization of urine was verified by carrying out a cytobacteriological examination of urine. Ureteral lithiasis was approached by semi-rigid ureteroscopy. Renal lithiasis was immediately addressed by flexible ureteroscopy. Ureteroscopy was coupled with a Holmium YAG laser. A double J ureteral catheter was placed after the operation. A 230 µm laser fiber was used in each case with a generator with a power of 35 watts (Storz Calculase III type). An access sheath was used in all cases of flexible ureteroscopy. The parameters studied were: sociodemographic characteristics, lithiasis (site, size, number, density, topography), type of anesthesia, duration of laser use, duration of intervention, postoperative outcomes. Data entry and analysis were carried out using the software (Word 2016 and SPSS). Result: We collected 30 cases of laser ureteroscopy. The average age was 37 years with extremes of 9 and 79 years. The male gender was more represented. The most common age group was 24-39 years old. Renal colic was the most frequent reason for admission, 12 patients (40%). On physical examination, lumbar tenderness was present in 47% (14 patients). ECBU was positive in 4 patients

关键词： Ureteroscopy Semi-Rigid Flexible Holmium YAG Laser

Endoscopic Internal Urethrotomy in the Treatment of Male Urethral Stenosis in the Urology-Andrology department of KARA Teaching Hospital (Togo)

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Open Journal of Urology 2024年第1期14卷 20-26页

作者： Musapudi Éric Mbuya Komi Hola Sikpa Edoe Viyome Sewa Messan Semefa Agbedey Gnimdou Botcho Kodjo Tengue Tchilabalo Matchonna Kpatcha Urology and Andrology department Kara Teaching Hospital Kara Togo Urology and Andrology department Hubert Koutoukou Maga National Teaching Hospital Cotonou Benin Surgery department University Clinics of Lubumbashi Lubumbashi DRC Aneho Prefectural Hospital Center Aneho Togo Urology and Andrology department Kpalime Prefectural Hospital Center Kpalime Togo Urology and Andrology department Sokodé Regional Hospital Center Sokodé Togo Urology and Andrology department Sylvanus Olympio Teaching Hospital Lomé Togo

Introduction: Endoscopic internal urethrotomy (EIU) is a method for stricture opening using transurethral incision by direct visualisation of the urethral channel, resulting in a widening of the urinary canal with the aim of improving the quality of bladder emptying. The aim of the study was to evaluate the indication and results of EIU in the treatment of stenosis of the male urethra in the Urology-Andrology department of Kara Teaching Hospital. Methodology: This was a cross-sectional descriptive study with retrospective data collection in the Urology-Andrology department of Kara Teaching Hospital. It involved 21 records of patients with urethral stenosis treated by endoscopic internal urethrotomy (EIU) in the said department during the period from January 2021 to September 2023. The following variables were evaluated: age, circumstance of discovery, site, length, number, etiology of the urethral stenosis and evolution of the patients. Results: The mean age of the patients was 59.2 ± 11.7 years. Infectious etiology of stenosis was predominant with 10 patients (47.6%) followed by trauma with 5 cases (23.8%). The bulbar urethra was the most frequently observed site, with 11 cases (52.4%). The length was mostly less than 2 cm in 12 patients (57.1%). Stenosis was unique in 14 patients (66.7%). The mean postoperative follow-up time was 3.2 months. The result was immediately better in 11 patients (52.4%) and it was poor in 8 patients (38.1%) who required maintenance dilation sessions.

关键词： Internal Urethrotomy Urethral Stenosis Kara Togo

Acute Kidney Injury in the Nephrology department of the Brazzaville University Hospital: Epidemiological, Clinical and Evolutionary Aspects

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Open Journal of Nephrology 2024年第2期14卷 196-215页

作者： Daniel Tony Eyeni Sinomono Gael Honal Mahoungou Eric Gabdzali Ngabé Audrey Missamou Mavi Bouloupy Richard Loumingou department of Nephrology Brazzaville University Hospital Brazzaville Congo department of Nephrology Adolphe Ciss General Hospital Pointe Noire Congo

Introduction: Acute kidney injury (AKI) is defined as a sudden and reversible deterioration in renal function. It is a life-threatening condition in hospitalized patients. Our objectives were to determine the prevalence of AKI in a nephrology department, list the causes, describe the evolutionary profile and identify the factors associated with death. Patients and Methods: We reviewed the records of patients hospitalised between 1 January 2016 and 31 October 2020 in the nephrology department of Brazzaville University Hospital. We included patients aged at least 18 years whose discharge diagnosis included the item AKI. Study variables were socio-demographic data, clinical and paraclinical signs, stage and type of AKI, etiology and evolutionary profile. Results: Of the 1823 patients hospitalised, 244 (13.38%) were hospitalised for AKI. Of these, 60.2% were boys and 39.8% girls, with an average age of 47 19 years. The average consultation time was 10 6.5 days. AKI was stage 3 in 69.57% of cases. It was functional, organic and obstructive in the order of 55.28%, 36.02% and 8.69%. Dialysis was indicated in 62 patients (38.51%) and performed in 24 patients (14.9%). In-hospital mortality was 27.95%, with an average hospital stay of 9.6 5.8 days. Metabolic acidosis and anemia were the main causes of death in 14.28% and 4.35% of patients respectively. Factors associated with death were male sex, socioeconomic level, coma, indication for dialysis and absence of dialysis, with a p Conclusion: AKI is more common in young adult males. Mortality is relatively low. Improving prognosis requires early management and access to dialysis.

关键词： AKI Epidemiology Diagnosis Evolution Brazzaville

Study of Hemorrhoid Disease in the department of General Surgery of the Cs Ref of the Commune I Bamako

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Surgical Science 2024年第2期15卷 36-47页

作者： Tounkara Cheickna Diarra Issaka Sanogo Modibo Togola Modibo Camara Ladji Soma Dembele Bakary Tientigui Traore Alhassane Togo Adégné Pierre Kante Lassana Ouattara Zanafon Diallo Gangaly department of General Surgery The Reference Health Center in Commune I Bamako Mali department of General Surgery The Gabriel Toure University Hospital Bamako Mali department of Urology The Gabriel Toure University Hospital Bamako Mali

This work was a retrospective prospective study carried out in the general surgery department of the Cs ref of commune I from January 2009 to December 2012. Our study aimed to determine the hospital frequency of hemorrhoidal disease, to identify the contributing factors, describe the clinical and therapeutic aspects and analyze the surgical consequences. We collected 73 patients with an average age of 37.8 years (range: 19 years and 77 years) with a sex ratio of 2.5 in favor of men. We operated on 49 patients or 67.1% of cases. 71.2% of our patients were married and lived in Bamako. Schoolchildren and middle managers made up 39.8% of cases. 82.2% of patients were seen in ordinary consultation and 69.9% complained of progressive anal pain in 66.7% of cases. This pain was triggered by defecation in 88.2% of our patients. The contributing factors were dominated by constipation (53.4%), working in a seated position (41.1%) and a sedentary lifestyle (16.4%) of cases. Stage IV external hemorrhoids and hemorrhoidal thrombosis represented 53.8% of surgical indications. The most used surgical technique was that of Milligan-Morgan, i.e. 51.9% of cases and 45.2% of patients treated medically received a combination of transit regulator, venotonics and analgesics. The surgical aftermath was marked by hemorrhage (3 cases), delayed healing (5 cases), urinary retention (1 case) and scarring anal stenosis (1 case). The morbidity rate was 5.48% of cases and a zero mortality rate. The average length of hospitalization was 2 days with extremes of 1 and 5 days.

关键词： Hemorrhoid Surgery Cs Ref C I Bamako Mali

Evaluation of Antibiotic Prescribing in the Pediatric department of Gabriel TouréTeaching Hospital, Bamako, Mali

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Open Journal of Pediatrics 2024年第3期14卷 645-656页

作者： Pierre Togo Hawa Konaré Mariam Maïga Karamoko Sacko Djénéba Konaté Abdoul Karim Doumbia Adama Dembélé Oumar Coulibaly Aminata Sangaré Mohamed Elmouloud Cissé Fousseyni Traoré Belco Maïga Ibrahim Ahamadou Aminata Doumbia Lala N’Drany Sidibé Amadou Touré Yacouba Aba Coulibaly Kalirou Traoré Tati Simaga Souleymane Sagara Leyla Bagna Maïga Bory Traoré Abdoul Aziz Diakité Fatoumata Dicko Mariam Sylla Sounkalo Dao Boubacar Togo Paediatric department Gabriel Tour&#233 Teaching Hospital Bamako Mali Pediatric department Distric VI Reference Health Center Bamako Mali Infectious Diseases department Point G Teaching Hospital Bamako Mali

Objectives: The main objective was to evaluate antibiotic prescribing in the department of Pediatrics at Gabriel Touré teaching hospital. Methods: This was a prospective descriptive study conducted from September 1 to November 31, 2018, in the department of Pediatrics at Gabriel Touré teaching hospital. All children aged 0 to 15 years hospitalized for any pathology during the study period and having received at least one antibiotic had been included. Results: We collected 445 children’s records out of 1032 admissions during the study period, representing a hospital frequency of 43.1%. The sex ratio was 1.3%. The 2 - 5 age group accounted for 48.1%. Fever was the reason for consultation in 45.6% of cases. Patients’ general condition was altered in 60% of cases. The fathers were blue-collar workers in 65.4% and the mothers housewives in 85%, and had no education in 42.9% and 64.5% respectively. Hepatomegaly was present in 18.2%, splenomegaly in 9.6% and peripheral adenopathy in 3.1%. The site of infection was pulmonary in 37.6% and ENT in 9.2%. Bacterial infection was assumed on admission in 54% of cases, and meningitis in 57.7%. The discharge diagnosis was malaria in 54.6%, severe acute malnutrition in 18.6% and meningitis in 6.7%. The death rate was 3.8%. Neutrophilic leukocytosis was present in 47.3% of patients. CRP was positive in 85% of patients. Blood cultures taken in 27.6% of patients were positive in 5. CSF analysis in 30% of patients showed elevated leukocytes in 6.5%. No cultures were positive. Antibiotic prescription was justified by infectious hypotheses in 43.1% of patients. β-lactam antibiotics were prescribed in 98.6%. Antibiotic therapy was not adapted to national/international recommendations in 68.3% of cases, and was not justified in 16.3% of cases on D5 of hospitalization. Conclusion: Antibiotic use was justified in more than half of patients, but remained inadequate in almost two-thirds of cases, in line with national and international recommend

关键词： Antibiotic Prescription Hospitalization Child

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

Liposarcoma Retro-Peritoneal in the General Surgery department of the Hospital of the District of the Commune IV

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Surgical Science 2024年第7期15卷 430-437页

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

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

关键词： Retroperitoneal Liposarcoma Diagnostic Delay

Serological Profile of Hepatitis D Virus (Hepatitis Delta) in the Hepato-Gastro-Enterology department of Chu Gabriel Toure

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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

Audits of Death in HIV-Infected Children and Adolescents Followed up in the Pediatric department of the Regional Teaching Hospital of Borgou/Alibori from 2005 to 2020

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Open Journal of Pediatrics 2024年第2期14卷 285-296页

作者： Alphonse Noudamadjo Mohamed Falilatou Agbeille Dénagan Kévin Amoussou Médétinmè Gérard Kpanidja Lahanatou Séidou Chantal Chabi Réckya Kilaya Julien Didier Adédémy Agossou Joseph Mother and Child department Faculty of Medicine University of Parakou Parakou Benin Pediatric department Regional Teaching Hospital of Borgou/Alibori Parakou Benin

Introduction: Human immunodeficiency virus (HIV) is a major public health problem with high morbidity and mortality among children. The objective of this work was to audit the deaths of children and adolescents with HIV infection followed up in the pediatric department of the Regional Teaching Hospital of Borgou/Alibori (CHUDB/A) the from 2005 to 2020. Patients and Method: This was a retrospective and descriptive study conducted in the pediatric department of CHUD/B-A in Parakou. All children with HIV infection who died from January 1, 2005 to August 31, 2020 were included. Data collection was carried out in three stages: a phase of medical records processing, a phase of community survey and a phase of death audits. The variables studied were sociodemographic, clinical, biological, therapeutic and evolutionary. Results: Over the study period, the data of 464 infected children were recorded, including 92 deaths, representing a case fatality rate of 19.83%. Severe acute malnutrition (69.23%), gastro-intestinal tract infections (43.58%) and serious opportunistic pulmonary infections (24.36% pulmonary tuberculosis and 19.23% pneumocystis) were the main causes of death. The main dysfunctions found were: the delayed diagnosis of HIV infection (79.35%), the absence or delay in consultation when the child’s clinical condition deteriorates (32.61% and 47.83%), delayed initiation of antiretroviral treatment (42.39%) and non-adherence to treatment (38.04%). Non-adherence to treatment was predominant in adolescents (90.49%). Conclusion: Specific interventions for early detection, adequate nutritional care, psychosocial support for adolescents and mothers of children are necessary to reduce mortality due to HIV among children and adolescents.

关键词： HIV Death Children Adolescents Dysfunctions Benin