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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

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MRI Contribution in the Diagnosis of Non-Traumatic Medular Compressions at the Mali Hospital of about 179 Cases

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Open Journal of Medical Imaging 2020年第4期10卷 186-195页

作者： Mody Abdoulaye Camara Mamadou N’Diaye Mamadou Bakary Coulibaly Mohamed Maba Traore Hawa Diarra Boubacar Mama Toure Abourahman Abdillahi Nour Salia Coulibaly Ilias Guindo Madani Ouologuem Sounkalo Traore Mahamane Mariko Aphou Sallé Kone Moussa Konate Siaka Sidibe Medical Imaging Department of Mali Hospital Bamako Mali Radiology Unit of the Bamako Infirmary hospital Bamako Mali Gynecology Department of Mali Hospital Bamako Mali Medical Imaging Department at Kati University hospital Bamako Mali Neurology Unit of the Bamako Infirmary hospital Bamako Mali Radiology Unit of the Reference Health Center of the Commune V Bamako Mali Medical Imaging Department of CHME Luxembourg Bamako Mali Radiotherapy Department of Mali Hospital Bamako Mali Radiology Department of CHU POINT G Bamako Mali

Slow spinal compressions are due to the development of an expansive process in the spinal canal. It is a very common pathology, the diagnosis of which is mainly clinical. However, magnetic resonance imaging occupies an essential place in the site diagnosis and etiological research in the management. Non-traumatic spinal cord compression is a diagnostic and therapeutic emergency, requiring early and appropriate management. MRI is the benchmark imaging examination for this pathology. No similar previous MRI study in mali. We undertook this work with the aim to determine the place of MRI in the diagnosis of spinal cord compressions in Mali Hospital. Method and Patients: This was a descriptive retrospective study, carried out at the hospital’s medical imaging department from January 1, 2017 to December 31, 2018 (02 years). It involved all patients, regardless of sex and age, sent for an MRI examination of the spine, and in whom spinal cord compression was diagnosed. We used a 0.35T low-field MRI machine with solid-state antennas. Results: We collected 179 cases of spinal cord compression MRI out of 585 spinal MRI performed, (frequency of 30.59%). The average age was 53.5 years with a male predominance (sex ratio 3.7). Motor disorders were the most common reason for examination (41%). We used the T1 T2 sagittal and T2 axial sequences. IV injection of gadolinium was performed in 48% of patients. The topographic lesions were: cervical (54.7%), thoracic (31.3%) and several segments (9.5%). The lesions concerned the compartments: extradural (79.3%), intradural (4.5%), and intramedullary (16.2%). The processes were degenerative (57.5%). tumorous (29.6%), infectious (12.3%) and vascular (0.6%). Conclusion: MRI is the benchmark imaging test for the management of non-traumatic spinal cord injury. Myelo-CT can be an alternative in the absence or in case of MRI contraindication.

关键词： Spinal Cord Compression Non Traumatic MRI Mali Hospital

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Hypertension in Clinical Practice: Control Rate in Short Term and Associated Factors in the Cardiology Department of the University hospital Gabriel Touré(UH-GT) in Bamako (mali)

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World Journal of Cardiovascular Diseases 2018年第6期8卷 288-297页

作者： Hamidou Oumar Ba Ichaka Menta Ibrahima Sangare Youssouf Camara Noumou Sidibe Souleymane Coulibaly Djénébou Traoré Réné Dakouo Samba Samaké Aladji Traoré Samba Sidibé Mamadou Cissouma Cheick Hamala Fofana Lamine Sidibe Kassoum Mamourou Sanogo University hospital Gabriel Touré Bamako Mali University hospital Kati Kati Mali University hospital Point G Bamako Mali University hospital of mali Bamako Mali

Introduction: Hypertension (HTN) is for many decades a worldwide major risk factor for cardiovascular disease.However, hypertension control rates are globally low in the world. Studies on observance have been published in mali but there is to our knowledge no published data about HTN control rate. We therefore conducted this study to assess the control rate in short term after 3 months management and to look for factors associated with HTN control. Materials and Methods: This study designed as prospective was conducted in the cardiology department of the University hospital Gabriel Touré (UH-GT) from March 24 to September 24, 2017. All outpatients aged 18 years and more who came for visit and with hypertension as diagnose were involved. All patients have consented to participate in the study. Sociodemographic and data on physical examination including measures for BP, height, weight, waist circumference (WC) and direct costs as reported by the patients were recorded. Patients were asked about medication discontinuation and if yes why and then they were informed about the need to take regularly medication. The concept of chronic disease was explained to them. A formulary served to collect data that were inserted into a Microsoft Access database and analyzed using SPSS version 18. After describing of sociodemographics and continuous variables, crosstabs and finally a logistic regression was performed to look for blood pressure control predictors. Results: There was no statistical difference in sociodemographics between older and newly diagnosed patients. At 3 months globally 40.90% (31.1 for old Patients and 09.8% for newPatients) of the sample were controlled (Figure 1). For old patients, hypertension control rate at inclusion was 12.78% and reached 49.44% at 3 months (Figure 2). After logistic regression only HTN duration was significant predictor with Odd-ratio of 0.365 [0.213 - 0.624] 95% CI and p-value patients as reference). During the study period therapeutic regimen remained unchanged in 73.1% (44.4 for old

关键词： Hypertension Control Rate Old Patient New Patient Medication Bamako Outpatient

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Epidemioclinical Profile of Premature Infants at the Neonatology Unit of the Mali Hospital 2012-2015

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Open Journal of Pediatrics 2021年第3期11卷 490-502页

作者： Bourama Kané Mamadou Berthé Guédiouma Dembélé Korotoumou Wélé Diallo Diakaridia Koné Fatou Diawara Fanta Sidibé Oumou Koné Mamadou Coulibaly Mariam Maiga Mariam Sylla Department of Pediatrics Mali Hospital Bamako Mali National Institute of Public Health Bamako Mali Reference Health Centre of the Commune I Bamako Mali Gynaecological and Obstetric Service Mali Hospital Bamako Mali Paediatrics Department of the Centre de Santé de Référence de la Commune VI Bamako Mali Gabriel TOURE University hospital Bamako Mali

Introduction: A newborn is preterm when it is born before 37 weeks of amenorrhoea. Preterm births account for 11.1% of live births worldwide, 60% of which are in South Asia and sub-Saharan Africa. Preterm birth is the leading cause of neonatal mortality and the second leading cause of mortality in children under 5 years of age. The aim of this study was to investigate prematurity in the neonatology unit of the Mali Hospital. Materials and Methods: This was a cross-sectional, descriptive study from January 2012 to December 2015 of premature newborns from 28 to 36 weeks of amenorrhea in the neonatology unit of Mali Hospital. Results: From January 2012 to December 2015, we recorded 1692 inpatient newborns, including 614 preterm newborns, a frequency of 36.29%. The sex ratio was 1.43 in favor of boys. The average age of the mothers was 23.9 years with a minimum of 15 and a maximum of 47 years. The majority were housewives (92.7%). The pregnancy was poorly monitored in 51.8% of the mothers. The average gestational age was 32.9 days with extremes of 25 and 36 days. The most frequent mode of delivery was vaginal delivery (93.2%), with late prematurity in 51.5%, moderate prematurity (24.4%), extreme prematurity (18.7%) and very premature (5.4%). The mean birth weight was 1464 g with a standard deviation of 485 g and 2751 g. Prematurity was associated with neonatal infection in 49.4% of newborns, perinatal anoxia (13.9%) and hypotrophy (2.6%). The most frequent maternal risk factors were fever (83.4%), twinship (38.9%) and high blood pressure (8.6%). The average length of hospitalization was 9.75 days with extremes of 0 and 68 days. We recorded a cure rate of 57.7%, a death rate of 35.7% and a dropout rate of 6.7%.

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Pneumothorax in Children: A Study of 47 Pediatric Cases at Mali Hospital 2017-2020

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Open Journal of Pediatrics 2022年第3期12卷 476-488页

作者： Korotoumou Wélé Diallo Bourama Kané Aboubacar Sangaré Mamadou Traoré Mohamed Maba Traoré Mamadou Berthé Mariam Maiga Amadou Ibrahim Dramé Department of Pediatrics Mali Hospital Bamako Mali Reference Health Center of Commune VI Bamako Mali Department of Anesthesia and Resuscitation Mali Hospital Bamako Mali Reference Health Center of Commune V Bamako Mali Department of Medical Imaging Mali Hospital Bamako Mali National Institute of Public Health Bamako Mali

Objectives: Pediatric pneumothorax, whether primary or secondary (infection, trauma, or iatrogenic), is sometimes life-threatening. We tried to determine the clinical characteristics of pediatric pneumothorax in mali. Materials and Methods: We collected all pediatric patients (0 - 15 years) admitted for pneumothorax in the pediatric department of the Mali Hospital from January 2017 to December 2020. Results: During this period, a total of 5569 children aged 0 - 15 years were hospitalized, of whom 47 had pneumothorax or 0.84%. Children under 5 years of age were the most affected (80%). Dyspnea was the most common reason for hospitalization (95.7%). The causes of pneumothorax were (in order): infectious causes dominated by bullous dystrophies (70.2%), traumatic (25.5%), and iatrogenic (4.2%). Pneumothorax was compressive in 42.6%. The frequency of anemia was 79.3%. Surgical drainage was performed in 87.2% and almost all (97.6%) were treated with amoxicillin/clavulanic acid. The mean duration of hospitalization was 10.06 days (range: 0 - 35 days): 74.5% were cured while 25.5% died. Conclusions: We reconfirmed that pneumothorax is a pediatric emergency. Children under 5 years of age are the most affected. The main etiologies are infectious bronchopneumonia. The prevention and treatment of respiratory infections, the implementation of good bacteriological diagnostic tools, and the use of surgical video-thoracoscopy will reduce its mortality rate.

关键词： Pneumothorax-Secondary-Child-hospital of mali

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Congenital Lobar Emphysema in an Infant: A Case Report from the University hospital of mali

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Open Journal of Pediatrics 2022年第2期12卷 453-459页

作者： Bourama Kané Korotoumou Wéllé Diallo Aboubacar Sangaré Garan Dabo Mamadou Traoré Mohamed Maba Traoré Mariam Maiga Department of Pediatrics Mali Hospital Bamako Mali Department of Medicine Mali Hospital Bamako Mali Reference Health Center of Commune V Bamako Mali Medical Imaging Department Mali Hospital Bamako Mali Reference Health Center of Commune VI Bamako Mali

Congenital lobar emphysema is characterized by distress due to hyperinflation of the affected lung lobe(s). We report the case of a 2-month-old infant with congenital left lower lobe emphysema. A 2-month-old female infant, born at term without incident, was hospitalized for respiratory distress. On a postnatal day 15, respiratory distress occurred. On admission, he weighed 3400 g and was apyretic. He had a polypnea of 58 cycles/min and a oxygen saturation of hemoglobin of 90% on room air. A chest radiograph revealed hyperclarity of the left lung. Chest CT revealed left lower lobe emphysema. He underwent a left lower lobectomy. The postoperative course was uneventful. He was discharged from the hospital 7 days after surgery without sequelae. Physicians should be aware that congenital lobar emphysema can present with respiratory distress in infants. A chest CT scan confirms the diagnosis. Surgical treatment is effective.

关键词： Congenital Lobar Emphysema Infant Pediatrics Mali Hospital

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Epidemiological Profile of Newborns Who Died during Their hospitalization in the Neonatology Unit, Mali Hospital

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Open Journal of Pediatrics 2022年第2期12卷 424-432页

作者： Korotoumou Wéllé Diallo Bourama Kané Aboubacar Sangaré Kadidiatou Touré Fatoumata Léonie François Diakité Mamadou Traoré Mohamed Maba Traoré Mamadou Berthé Mariam Maiga Abdoul Aziz Diakité Fatoumata Dicko Traoré Department of Pediatrics Mali Hospital Bamako Mali Department of Pediatrics Gabriel Touré University Hospital Bamako Mali Reference Health Center of Commune V Bamako Mali Department of Medical Imaging Mali Hospital Bamako Mali National Institute of Public Health Bamako Mali Reference Health Center of Commune VI Bamako Mali

Introduction: Neonatal mortality is a serious problem, particularly in developing countries. Objective: To study the epidemiological and clinical profiles of newborns who died during their hospitalization in the neonatology unit of the hospital in mali. Methodology: This was a prospective study over a 12-month period (January 1 to December 31, 2020) including all newborns aged 0 - 28 days who died during their hospitalization. Results: A total of 424 neonates were hospitalized in neonatology, 54 died, or 12.73%. Newborns aged 0 - 7 days at admission were the most represented at 79.63% and 94.4% were full-term babies. The male gender was dominant with a ratio of 1.17. The following characteristics were frequently observed in the mothers: not educated (46.3%), poor 75.9%, living in urban areas (68%), housewives 75.4%, and having had less than 4 antenatal care visits (53.7%). For babies, respiratory distress and hyperthermia were the most common reasons for hospitalization (37% and 22.2%, respectively), with 40% being resuscitated at birth. Infection and perinatal anoxia were the most frequent diagnoses, respectively 96.3% and 37%. The death occurred within the first three days of hospitalization in 60% of cases. Conclusion: In order to reduce the mortality rate in our facilities, monitoring of pregnancy and delivery, and correct management of newborns both at birth and in the pediatric wards are important.

关键词： Newborn Death hospital in mali

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Study of Tuberculosis in Children Aged 1 Month to 15 Years in the Pediatric Ward of the hospital of mali 2015-2021

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Open Journal of Pediatrics 2022年第2期12卷 433-448页

作者： Bourama Kané Korotoumou Wéllé Diallo Aboubacar Sangaré Youssouf Dembélé Garan Dabo Mamadou Traoré Mohamed Maba Traoré Mamadou Berthé Mariam Maiga Department of Pediatrics Mali Hospital Bamako Mali Department of Medicine Mali Hospital Bamako Mali Reference Health Center of Commune V Bamako Mali Medical Imaging Department Mali Hospital Bamako Mali National Institute of Public Health Bamako Mali Reference Health Center of Commune VI Bamako Mali

Introduction: In 2020, an estimated 9.9 million people are living with tuberculosis worldwide, including 1.1 million children. Tuberculosis is the 2nd leading cause of death from infectious disease after COVID-19 and the 13th leading cause of death worldwide. Objective: To collect cases of tuberculosis in children aged 1 month to 15 years in order to study the epidemio-clinical aspects in the pediatric department of the Mali Hospital during the period 2015-2021. Materials and Methods: This was a descriptive, retrospective study from January 1, 2015, to December 31, 2020, and a prospective study from January 1 to December 31, 2021, among children aged 1 month to 15 years admitted for suspected tuberculosis in the pediatric ward of the Mali Hospital. Results: From January 2015 to December 2021, we collected 69 cases of tuberculosis among 9438 hospitalized children, i.e. a frequency of 0.73%. The average age was 6.16 years with extremes of 3 months and 15 years. The sex ratio was 1.1% in favor of boys. The majority of children were vaccinated against tuberculosis (88.4%). The most frequent symptoms were fever (76.8%) and weight loss (73.9%). The pulmonary form was the most frequent (54.9%). Bacteriological confirmation was done in 43.5% of our children. It was Mycobacterium tuberculosis in all confirmed cases. More than half of our children (65.2%) were treated with first-line anti-tuberculosis drugs for 6 months. We observed a cure in 42.0% of our patients and a case fatality rate of 39.1%. Conclusion: Tuberculosis in children is frequent in Mali Hospital despite good BCG vaccination coverage. Its mortality remains high and is maintained by malnutrition, HIV, and the emergence of resistant strains of bacilli.

关键词： Tuberculosis Children Mali Hospital

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Diabetic Foot: Epidemiological, Therapeutic and Evolutionary Aspects in the Department of Medicine and Endocrinology of the hospital in mali, mali

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

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

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

关键词： Diabetic Foot Epidemiology Therapeutics Evolution Mali Hospital

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Uro-Scanner Aspects of Bladder Tumours at the Mali Hospital about 17 Cases

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Open Journal of Medical Imaging 2021年第4期11卷 93-103页

作者： Mody Abdoulaye Camara Mohamed Maba Traore Hawa Diarra Adama Dao Boubacar Mama Toure Mamadou Ndiaye Salia Coulibaly Kone Abdoulayye Mariko Mahamane Cisse Issa Konate Moussa Ilias Guindo Konate Zakaria Nouhoum Simpara Seydou Coulibaly Néné Koumaré Siaka Sidibe Medical Imaging Department of the Mali Hospital Bamako Mali Medical Imaging Department at the CHU Gabriel Touré Bamako Mali Bamako Infirmary hospital Bamako Mali Medical Imaging Department of the CHU Point G Bamako Mali Medical Imaging Department of CHME Luxembourg Bamako Mali Medical Imaging Department of the CHU of Kati Bamako Mali Pediatric Unit of Reference Health Center of Commune VI Bamako Mali

Introduction: Bladder tumours are frequent, have a poor prognosis and are the second most common genitourinary tumour in men. In mali, recent statistical data on the prevalence of bladder tumours show a progression with 6.71% in 2006. The euro scanner is used in the diagnostic workup. The work was initiated in order to specify the role of the scanner in the diagnosis of these tumors. Patients and Methods: Prospective descriptive study was carried out in the medical imaging department of Mali Hospital from February to November 2018. Were included any patient with a bladder tumour on euro scanner. The patients had benefited from a preliminary preparation and a renal biological assessment in order to eliminate renal insufficiency. Our examinations were performed with a Siemens 16-slice scanner. These were axial slices performed without, with iodine injection from the pulmonary base to the pubic bones. Results: We had collected 17 patients out of 541 scans i.e. a frequency of 3.76%. The age range of 21 to 40 years was 58.8% with an average age of 25 years. The antecedents (ATCD) found were urinary bilharzia (47%) and smoking (17%). The clinic was dominated by haematuria. It was associated with a bladder mass (52%) and dysuria (23.52%). The CT scan showed a budding appearance, a size greater than 3 cm (82%), infiltration of peri-vesical fat (47.05%), and adenopathy (94%). Associated lesions were: utero-hydronephrosis (58.82%) and metastases (bone and liver in 11.76% of cases each). Conclusion: They are frequent and the history of urinary bilharziasis remains the main risk factor in endemic countries. CT scans are essential in the management of this disease. The diagnosis of certainty remains histology.

关键词： Bladder Tumour Uro-CT Mali Hospital

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