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Caesarean Section in the mother and child University hospital of N’Djamena: Indications and Prognosis

Open Journal of Obstetrics and Gynecology 2024年第9期14卷 1463-1470页

作者： Gabkika Bray Madoué Mahamat Alhadi Chene Saleh Abdesalam Neramadji Doumbé Félicité Foumsou Lhagadang NDjamena Faculty of Human Health Sciences NDjamena Chad. NDjamena mother and child University hospital NDjamena Chad.

Introduction: Caesarean section is a surgical procedure which allows childbirth after opening the abdominal wall and the uterus. Objective: To study caesarean section in the N’Djamena mother and child University hospital (NMCUH). Patients and Method: This was a cross-sectional, analytic descriptive study over a 5-month period from 10 January to 10 June 2023, focusing on caesarean sections section in the N’Djamena mother and child University hospital (NMCUH). Studied variables were epidemiological, clinical and prognostic. Patients were divided according to the classification of Robson into 10 groups. Results: During the study period, we recorded 724 caesareans sections among 3,565 deliveries, giving a rate of 20.3%. The age group from 25 to 29 represented 39.2%. The average age was 31.2 ± 2.8 years, with extreme ranging from 14 to 44 years. Nulliparous women accounted for 42% and 26% had at least one previous caesarean section (n = 188). Patients with full-term pregnancies (37 - 40 gestational weeks + 6 days) represented 64.1%. Emergency caesareans accounted for 92.8% (n = 672). Robson’s group 1 was noted to be 40.3%. Hemorrhage was the main intraoperative complication, with 7.2%. In post-operatively, anemia was the main complication at 23.8%. We recorded 16 maternal deaths, giving a maternal death rate of 2.2%. Live newborns accounted for 81.1%. Conclusion: Caesarean section is a common procedure in the CHUME maternity unit. The main indications are those of Robson’s group I. Caesarean sections are associated with both maternal and fetal complications.

关键词： Caesarean Section Indications Prognosis NMCUH Tchad

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Delay for Performing Laparotomy for Extra Uterine Pregnancy in N’Djamena mother and child University hospital

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Open Journal of Obstetrics and Gynecology 2024年第4期14卷 520-527页

作者： Gabkika Bray Madoué Saleh Abdelsalam Khadidja Mahayadine Salah Serfeurbe Pefah Foumsou Lhagadang Faculty of Human Health Sciences of N’ Djamena N&#8217Djamena Chad N’ Djamena Mother and Child University Hospital N&#8217Djamena Chad

Background: Ectopic pregnancy is defined as any pregnancy developed outside the uterine cavity. Objective: to study the relationship between the duration of laparotomy for EP and maternal prognosis. Patients and method. This was a prospective analytical study performed during a period of six (06) months, from May 1st to October 30, 2023, on delay time to perform laparotomy for EP in N’Djamena mother and child University hospital (NMCUH). We included in this series all patients admitted for EP managed by laparotomy. Data were collected using Word software and analyzed using SPSS 18.0 version 2018. The p value statistical test was used to compare variables (p significant if ≤5%). Results: We recorded 92 cases of EP out of 5751 pregnancies, giving a frequency of 1.6%. Among patients diagnosed with EP, 76/92 (82.6%) had an indication of laparotomy. In 90.8%, the EP was ruptured. On admission, the diagnosis of EP was made within 1 hour in 15.8% of cases. The time to sign the consent allowing doctor to operate was >1 hour in 14.5% of cases. The operating room was unavailable in 34.2% of cases, with an unavailability of >1 hour in 17.1% of cases. Total salpingectomy was performed in 93.4%. Salpingotomy was performed in 6.6%. The lethality rate was 3.9% with significant value when the delay after indication and admission in the operating room is >1 (p value = 0.03). Conclusion: Various factors, such as the search for blood products, the time loss to sign the consent form and the unavailability of the operating room, delay the laparotomy, influence maternal prognosis. Anticipation on these factors is necessary in order to limit the proportion of delays.

关键词： Delay Laparotomy NMCUH Chad

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Contribution of Imagery in the Diagnosis of Multisystemic Sarcoidosis in the Service Radiology Department of the mother and child hospital “Le Luxembourg” in Bamako: A Case Report

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Open Journal of Medical Imaging 2024年第3期14卷 79-85页

作者： Mariko Mahamane Camara Mamoudou Keita Aboubacar Sidiki N’Diaye Mahamadou Camara Mody Abdoulaye Fofana Youssouf Traoré Mohamed Maba Sidibé Siaka Sanogo Souleymane Keita Adama Diaman Department of Radiology Mother and Child Hospital Luxembourg Bamako Mali Medical Imaging Exploration and Diagnostic Center Conakry Guinea Assistant at the Faculty of Health Sciences and Techniques at the Gamal Abdel Nasser University of Conakry Department of Radiology Military Hospital of Bamako Bamako Mali Department of Radiology Mali Hospital Bamako Mali Department of Radiology Point G Hospital Bamako Mali

The aim of this study was to report a case of multi-visceral sarcoidosis at the mother-child hospital Center (CHME) “Le Luxembourg” in Bamako, Mali. Observation: This is a patient aged 62 at the time of consultation, a housewife, residing in the Banconi district, who was referred to us for thoracic-abdominopelvic imaging for chronic liver disease. After several diagnostic errors, the thoracic-abdominopelvic CT scan and liver MRI performed in our center showed, at the thoracoabdominal level, bilateral diffuse pulmonary micronodules and bilateral mediastinal-hilar lymphadenopathy;on the abdominal level, a dysmorphic liver with plaques of steatosis and a granular appearance of the liver parenchyma without periportal fibrosis. These imaging data combined with those from the liver nodule biopsy and biology confirmed the diagnosis of sarcoidosis type II. Treatment with corticosteroids gave satisfactory results and the patient recovered after 18 months. Clinical and CT monitoring 2 years from the start of the disease and 2 months from the end of treatment showed complete resolution of the lesions. Conclusion: The multi-visceral location of sarcoidosis is an entity whose diagnosis remains difficult;diagnostic and interventional imaging has an important place in its management.

关键词： Sarcoidosis Multi Visceral Imaging CHME Luxembourg

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Epidemiological Aspects of Stillbirth and Neonatal Deaths in the Delivery Room at the Libreville mother-child University hospital from 2019 to 2022

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Open Journal of Pediatrics 2024年第1期14卷 1-10页

作者： Eliane Kuissi Kamgaing Jacques Albert Bang Ntamack Opheelia Makoyo Komba Raïssa Koumba Maniaga Steeve Minto’o Rogombe Pascal Loulouga Badinga Aude Lembet Mikolo Simon Ategbo Department of Neonatal Medicine Jeanne Ebori Foundation Mother-Child University Hospital (JEFMCUH) of Libreville Libreville Gabon Department of Gynaecology and Obstetrics Jeanne Ebori Foundation (JEFMCUH) of Libreville Libreville Gabon Department of Paediatrics University of Health Sciences Libreville Gabon

Introduction: Stillbirths are estimated at 2 million each year, of which more than 40% occur during labour. Our objective was to study the epidemiological aspects of stillbirth and neonatal deaths in the delivery room in our health facility. Patients and methods: Prospective, descriptive and analytical study, conducted at the Jeanne Ebori Foundation mother-child University hospital over 4 years (January 2019-December 2022). All neonatal deaths in the delivery room or foetal death in utero, were included. Results: Among the 18,346 deliveries performed, 512 newborns were declared dead in the delivery room (27.9‰ live births), divided into in utero foetal death (19.0‰) and immediate neonatal death (8.9‰). The mean age was 34.3 weeks of amenorrhea. The rate of preterm birth was 60.4%. The sex ratio was 1.1. The average weight was 2186.6. The main causes were vascular (46.1%), foetal (20.2%), adnexal (17.1%) and asphyxia per partum (16.6%). Foetal causes were more likely to result in IUFD than other causes (OR = 6.4 [2.4 - 15.7], p childbirth-related causes remains worrying. Better monitoring of pregnancy and labour will minimize this prevalence in our hospital.

关键词： Stillbirth Neonatal Death Delivery Room Epidemiology Libreville-Gabon

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Digestive Surgical Emergencies at the “mother child”hospital Center Luxembourg in Mali

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Surgical Science 2024年第5期15卷 299-310页

作者： Cheickna Tounkara Amara Coulibaly Yaya Ongoiba Aboubakrine Sylla Abdoul Karim Simaga Bréhima B. Coulibaly Aminata Dabo Souleymane Dembele Samake Hamidou Sidiki Keita Sékou Bréhima Koumare Soumaïla Keita Bakary Tientigui Dembele Zimogo Zié Sanogo Djibril Sangare Department of General Surgery and Anesthesia-Resuscitation of the “ Mother Child&#8221 Hospital Center Luxembourg Bamako Mali Social Health Service of the Armed Forces of Mali Bamako Mali Department of General Surgery “ A&#8221 and Cardiovascular of Point G University Hospital Bamako Mali Department of General Surgery of CHU Gabriel TOURE Bamako Mali

Digestive surgical emergencies concern all patients admitted urgently, for whom a decision for surgical intervention may be necessary within 24 hours. They are on guard duty day and night. To carry out this work, we set ourselves the objectives of: 1) Studying digestive surgical emergencies in the general surgery department of the “mother child” Le Luxembourg hospital in Bamako, Mali;2) Determine the frequency of digestive surgical emergencies, 3) Describe the clinical and therapeutic aspects, and 4) Analyze the results of treatment. From November 1, 2022 to October 31, 2023, the general surgery department of the “mother child” Luxembourg hospital Center in Bamako, Mali, carried out 139 digestive surgical emergencies whose files were usable;75 men and 64 women, a sex ratio of 1.2. The 20 - 40 years old age group was the most represented, at 40.29%. The average age was 39 years;the extremes 16 years and 93 years with a standard deviation of 21.65 years. The reference concerned 51.08% of our patients. Abdominal pain was the main reason for consultation (100% of cases). In the majority of cases, the physical examination made it possible to make the diagnosis. Faced with certain clinical cases, we requested ultrasound (109/139), ASP (46/139) and CT (15/139). The main etiology was acute appendicitis with 42.45% of cases. The frequency of digestive surgical emergencies was 10.71% of all activities in the general surgery department of the “Mère Enfant” Le Luxembourg hospital center in Bamako. All our patients were seen in consultation by an anesthesiologist before entering the operating room. The surgical consequences were complicated in 11.51% of cases with 7.91% deaths. Surgical site infections accounted for 12.5% of postoperative complications. Eleven deaths were noted, representing 68.75% of complications and 7.91% of our sample. Acute peritonitis was the cause of death in 100% of cases. The average cost of care was 329,000 FCFA.

关键词： Emergency Digestive Surgery Post-Operative Complication

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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

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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

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Practice of Upper Gastrointestinal Endoscopy at the mother-child hospital in Bamako/MALI: About 465 Cases

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Open Journal of Gastroenterology 2020年第11期10卷 295-300页

作者： Sanra Déborah Sanogo Moussa Y. Dicko Ganda Soumaré Kadiatou Doumbia Hourouma Sow Makan S. Tounkara Youssouf Kassambara Hamadoun Guindo A. Maiga A. Kondé Abdoulaye Diarra Ilias Guindo Drissa Katilé Ouatou Mallé Anselme Konate Moussa T. Diarra Bougouzié Sanogo Moussa Y. Maiga Gastroenterology Department Point G University Hospital Bamako Mali Gastroenterology Department Gabriel Touré University Hospital Bamako Mali Surgery Department BSS University Hospital Bamako Mali Gastroenterology Department Mother-Child Hospital Bamako Mali

Introduction: Upper gastrointestinal (GI) endoscopy is an examination that involves exploring the upper part of the digestive tract using an endoscope. Our study was aimed to evaluate the practice of Upper GI endoscopy at the mother-child hospital in Mali. Patients and Methods: This was a descriptive retrospective study on reports of Upper GI endoscopy results in the digestive endoscopy unit at the mother-child hospital in Bamako from January to December 2018. Results: Endoscopy was performed in 465 patients including 231 males and 234 females. The sex ratio was 0.98. Patients were aged 46.69 years old on average with the extremes of 8 and 90 years old. Epigastralgia was the main referral in 50.5%. Endoscopy was normal in 24.7%. The main diagnostics were duodenogastric reflux in 32.5% and gastritis in 14.4%. Conclusion: The practice of Upper GI endoscopy at the mother-child hospital in Mali has allowed the exploration of the upper digestive tract to contribute to the diagnosis of esogastroduodenal lesions.

关键词： Upper GI Endoscopy Indications mother-child hospital Mali

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Case Report: Autoimmune Pancreatitis: About a Case in Hepato-Gastroenterology Department of mother-child hospital in Bamako/Mali

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Health 2020年第10期12卷 1379-1382页

作者： Sanra Déborah Sanogo Moussa Y. Dicko Ganda Soumaré Kadiatou Doumbia Hourouma Sow Makan S. Tounkara Youssouf Kassambara Hamadoun Guindo A. Maiga A. Kondé Abdoulaye Diarra Ilias Guindo Drissa Katilé Ouatou Mallé Anselme Konate Moussa T. Diarra Bougouzié Sanogo Moussa Y. Maiga Gastroenterology Department Point G University Hospital Bamako Mali Gastroenterology Department Gabriel Touré University Hospital Bamako Mali Gastroenterology Department Mother-Child Hospital Bamako Mali Surgery Department BSS University Hospital Bamako Mali

Autoimmune pancreatitis is a distinct form of chronic pancreatitis. It is a chronic pancreatitis distinct from alcohol, genetic or idiopathic impairment and involves possible autoimmune mechanisms. The diagnosis of autoimmune pancreatitis is based on a body of biological, histological and radiological arguments. Also called sclerosing lymphoplasmacytic pancreatitis, it is one of the causes of chronic pancreatitis. The risk factor for the onset of cancer that it represents and its sensitivity to corticosteroids make it a pathology requiring special management. We report a case of autoimmune pancreatitis in a 35-year-old patient.

关键词： Autoimmune Pancreatitis Young Woman Diagnosis Mali

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Oeis Syndrome (Cloacal Exstrophy): About Two Cases Treated at the mother and child Teaching hospital in Cotonou (Benin)

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Open Journal of Pediatrics 2020年第3期10卷 535-541页

作者： Antoine Séraphin Gbenou Beaudelaire Romulus Assan Joseph Akodjenou Nicole Tchiakpe Enianloko Monsoïa Gildas Yasségoungbé Michel Armand Fiogbe Pediatric Surgery Department University Hospital of Mother and Child Lagune Cotonou Benin Anaethesiology and Resuscitation Department University Hospital of Mother and Child Lagune Cotonou Benin Neonatal Department University Hospital of Mother and Child Lagune Cotonou Benin University Clinic of Pediatric Surgery CNHU-HKM Cotonou Benin

Introduction: OEIS syndrome, the most severe form of exstrophy-epispadias complex, is characterized by the existence of an omphalocele, a bladder exstrophy, an anal imperforation and a spina bifida. Case Presentation: Two clinical cases admitted at the first day of life in neonatology department are reported;one was born by caesarean section, weighing 2500 g and the other one vaginally with a weight at 1890 g. The first child’s mother was a primigravid, primiparous and the second mother was multiparous. Prenatal ultrasound was performed in one case. The clinical examination found two exstrophied hemi-bladders with two productive ureteral meatus, separated by a double intestinal orifice, a manifestation of anal imperforation, omphalocele, spina bifida and lumbar vertebral malformations;which corresponds to a typical form of OEIS syndrome. One of the babies had an associated clubfoot. The karyotype could not be performed. Both were dead;the first in the early postoperative period, the second one at 16 days of life without surgery. Conclusion: OEIS syndrome is a rare condition and represents a therapeutic challenge in developing countries. Promoting prenatal diagnosis is essential.

关键词： OEIS Syndrome Cloacal Exstrophy Newborn Prenatal Diagnosis

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