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Study of Factors Associated with Maternal Deaths at Timbuktu hospital in mali

Open Journal of Obstetrics and Gynecology 2024年第9期14卷 1471-1487页

作者： Coulibaly Moussa Kassogué Djibril Samaké Alou Sy Ousmane Poda Ghislain Dolo Akoro Sogoba Seydou Cissouma Assetou Kassogué Abdoulaye Maiga Mariam Mariko Souleymane Ongoiba Oumar Traoré Bassirima Kané Babou Traoré Halima Taoudeni Regional Health Directorate Tombouctou Mali department of pediatrics Timbuktu Hospital Timbuktu Mali department of pediatrics District Hospital Commune VI Bamako Mali WHO Bamako Mali department of pediatrics CHU Point G Bamako Mali department of pediatrics Sikasso Hospital Sikasso Mali department of pediatrics Nianankoro Fomba Sgou Hospital Segou Mali

Introduction: Despite progress in universal health coverage, maternal mortality remains a concern for developing countries, including mali. The problem is not due only to a lack of health services but to a combination of factors that need to be identified to give hope to women of childbearing age. Objective: Determine the factors associated with maternal mortality in the Timbuktu region of mali. Methodology: Retrospective, descriptive, cross-sectional and analytical study from January 1, 2018 to December 31, 2022 using a questionnaire and an interview guide to determine the factors associated with maternal mortality in the Timbuktu region of mali. Results: A total of 112 maternal deaths were recorded between 2018 and 2022. The average age of the women who died was 26 years (standard deviation 7.6 years). The 14 – 23-year-old age group is the most affected (43.8%). 66.1% of women came from rural areas. Illiteracy (77.7%), lack of ANC (54.5%), distance of households from health facilities (76%) and insecurity (52.7%) have been identified as factors contributing to maternal mortality. Conclusion: This study reported a high prevalence of maternal mortality rates that may be associated with women’s socioeconomic conditions. Actions must be developed to integrate CPN into an advanced strategy for women living in rural areas in mali.

关键词： Maternal Mortality Timbuktu hospital mali

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Resistant Pulmonary TB-HIV Co-Infection in an Infant: About a Case

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Open Journal of pediatrics 2024年第2期14卷 420-425页

作者： Mariam Maiga Pierre Togo Tati Simaga Mariam Traoré Moussa Konaté Mamadou Diallo Alou Samaké Mamadou Keïta Korotoumou Wélé Diallo Djibril Kassogué pediatrics department Distric VI Reference Health Center Bamako Mali Paediatrics department Gabriel Touré Teaching Hospital Bamako Mali pediatrics department Mali Hospital Bamako Mali Paediatrics department Timbuktu Regional Hospital Bamako Mali

Diagnosis of childhood tuberculosis (TB) is difficult, especially in resource-limited countries where the number of reported cases of TB-HIV co-infection continues to rise. This co-infection poses a diagnostic and therapeutic problem for caregivers. We report a case of rifampicin-resistant HIV-TB pulmonary coinfection in a 19-month-old infant.

关键词： Tuberculosis Rifampicin Resistance HIV Infants

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Management of Acute Myeloblastic Leukaemia (AML) Treated with Intensive Chemotherapy: Experience in a Single Centre

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Open Journal of pediatrics 2024年第2期14卷 401-411页

作者： Abdoul Karim Doumbia Hawa Konaré Tati Simaga Pierre Togo Oumoulkairi Nana Kouma Hawa Gouro Diall Oumar Coulibaly Adama Dembélé Mohamed Elmouloud Cissé Karamoko Sacko Belco Maiga Aminata Doumbia Kalirou Traoré Ibrahima Cissé Boury Traoré Abdoul Aziz Diakité Fousseyni Traoré Boubacar Togo department of pediatrics University Hospital Gabriel Touré Bamako Mali

Introduction: Acute myeloblastic leukaemia (AML) is a haematological malignancy with a poor prognosis, despite significant therapeutic progress. This study presents the results of AML management in mali according to GFAOP recommendations. Methodology: This was a retrospective, cross-sectional study. It included patients aged 0 - 15 years treated in the paediatric oncology unit for AML and followed up between January 2016 and December 2020. Results: During the study period, 85 cases of acute leukaemia were diagnosed in the paediatric oncology unit (including 51 cases of ALL), of which 34 cases of AML were included in this study. The majority were boys (59%). The mean age was 8 years, with extremes of 18 months and 15 years. The mean time to diagnosis was 68 days. In 79% of cases, patients were referred by 1st or 2nd level hospitals. Anaemia was observed in 91% of cases, an infectious syndrome in 68%, haemorrhage in 56% and a tumour syndrome in 85%. The haemogram showed hyperleukocytosis in 15% of cases, thrombocytosis in 22% and severe anaemia in 73%. Death occurred in 85% of cases, most often in the context of sepsis or haemorrhage. Conclusion: AML is probably underestimated in mali and diagnosis delayed, which may be explained by patient-related factors (lack of knowledge, financial constraints) and a cumbersome referral system. These results suggest the need to implement an appropriate diagnostic and therapeutic strategy, with strong involvement of the political authorities.

关键词： Acute Myeloblastic Leukaemia Children mali

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Therapeutic Compliance of Hypertensive Patients Followed in Ambulatory in the Cardiology department of Kati University hospital

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World Journal of Cardiovascular Diseases 2024年第5期14卷 333-342页

作者： Boubacar Sonfo Coumba Thiam Mariam Sako Massama Konaté Youssouf Camara Mamadou Touré Boubacar Diarra Diakaridja Sacko Samba Sidibé Bassan Diarra Hamidou Camara Asmaou Keita Konimba Diarra Hamidou Oumar Bâ Ibrahima Sangaré Youssouf Guindo Sanoussi Daffe Daouda Fofana Souleymane Coulibaly Ichaka Menta department of Cardiology University Hospital Bocar Sidy Sall Kati Mali department of Cardiology University Hospital of Point G Bamako Mali department of Cardiology Mali Hospital Bamako Mali department of Cardiology University Hospital Mother-Child Luxembourg Bamako Mali department of Cardiology University Hospital Gabriel Tour&#233 Bamako Mali department of Cardiology Kayes Hospital Kayes Mali

Introduction: High blood pressure is a major public health problem worldwide due to its frequency and cardiovascular complications. Adherence to treatment for chronic diseases is a global problem. The aim was to study therapeutic adherence in hypertensive patients followed in ambulatory. Materials and Methods: This was a cross-sectional, descriptive study with prospective recruitment that took place from July 1 to December 31, 2022 (6 months) in the cardiology department of the university hospital of Kati. The variables studied were sociodemographic data, cardiovascular risk factors, comorbidities, the possession of insurance and compliance (the Girerd questionnaire was used to assess adherence). Results: A total of 1182 patients were consulted, including 887 for hypertension, a frequency of 75%. Fifty-six patients were included in the study. The average age was 58.18 ± 13.25 years with extremes of 30 and 80 years. There was a female predominance (75%) with a sex ratio of 0.3. The majority of patients lived in urban areas (89.3%). Out-of-school patients accounted for 44.6%, more than half of patients or 55.4% had no income, patients with medical coverage accounted for 67.9% of cases. The main risk factors were physical inactivity (25%) followed by smoking 14.3%. More than 71% of patients had a compliance problem and the main reasons were forgetting to take the drug with 73.2%, followed by delayed treatment of 50% and drug discontinuation of 28.6%. Conclusion: Compliance is a real challenge and a major public health issue. This study allowed us to find a real problem of compliance in our hypertensive patients. There was a statistically significant relationship between drug adherence and forgetting to take the drug and drug discontinuation.

关键词： Hypertensive Therapeutic Adherence University hospital of Kati

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Pericarditis in Cardiology at a Regional hospital

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World Journal of Cardiovascular Diseases 2024年第9期14卷 581-587页

作者： Coulibaly Souleymane Traoré Djénébou Konaté Massama B. A. Hamidou Oumar Guindo Aissata Yves Roland Koumaré Sidibé Samba Sako Mariam Sanogo Alpha Kodio Aniéssa Mahamadou Yaya Kéita Diakité Mamadou Menta Ichaka department of Cardiology CHU Point G Bamako Mali department of Internal Medicine CHU Point G Bamako Mali mali hospital Medical department Bamako Mali department of Cardiology Gabriel Tour University Hospital Bamako Mali department of Cardiology Nianankoro Fomba Hospital Sgou Mali

Introduction: Pericarditis is an inflammation of the pericardium with or without pericardial fluid effusion. Its prevalence is difficult to determine given the many forms that are not symptomatic. In Africa, its prevalence was 6.3% in Gabon in 2020 and 7.2% in mali in 2022. In Europe, an Italian study estimates the incidence of acute pericarditis at 27.7 cases per 100,000 people per year. In another study conducted in Finland over a period of 9 years, the incidence of pericarditis requiring hospitalisation was 3.32 cases per 100,000 people per year. The aim of our study was to describe the clinical and paraclinical characteristics of pericarditis observed in the cardiology department of the regional hospital in mali. Methodology: This was a single centre cross-sectional study from 30 January 2018 to 30 June 2020 in the cardiology department of the Ségou regional hospital. All consenting patients, regardless of age or sex hospitalised in the department for pericarditis confirmed on cardiac ultrasound were included. Data were collected using an individual patient follow-up form recording sociodemographic, clinical, biological, electrocardiographic and echocardiographic data, as well as the course of the disease. Results: Out of 879 patients hospitalized, the hospital frequency was 7.28%. Females predominated, with a sex ratio of 0.42. More than half the patients were aged 45 or younger (59.4%). The mean age of patients was 41.8 ± 18.1 years. Cardiovascular risk factors were dominated by hypertension and smoking (46.9% and 12.5% respectively). The reasons for consultation were dyspnoea (84.3%), chest pain (54.7%), cough (71.9%) and fever (34.4%). Physical signs included muffled heart sounds (76.6%), tachycardia (70.3%), pericardial friction (17.2%) and signs of peripheral stasis in 53.1% of cases. We observed elevated C-reactive protein (CRP) in 57.8% of cases, hypercreatininaemia in 37.5% and positive HIV serology in 3.1%. The major radiographic signs were cardiomegal

关键词： Pericarditis Epidemiology Clinic Nianankoro Fomba hospital Ségou

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Contribution of Stress Testing to the Management of Ischemic Heart Disease in mali

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World Journal of Cardiovascular Diseases 2024年第2期14卷 77-87页

作者： Youssouf Camara Hamidou Oumar Ba Ibrahima Sangaré Boubacar Sonfo Coumba Adiaratou Thiam Mahamadou Sékou Diakité Koniba Diarra Karamba Touré Massama Konaté Ichaka Menta Cardiology department University Hospital Professeur Bocar Sidi Sall Kati Kati Mali Cardiology department University Hospital Gabriel Touré Bamako Mali Cardiology department Mali Hospital Bamako Mali

Introduction: Exercise stress testing (on a treadmill or ergometer bicycle) is an important test in cardiology for diagnosing myocardial ischemia. This test in mali is still in its beginning compared to other countries in the sub-region. The lack of data in mali prompted this study, which aimed to evaluate the indications of this activity and its diagnostic contribution to cardiology in mali. Materials and Methods: This was a retrospective, descriptive study. The study was conducted at the “TOUCAM” medical clinic in Kati based on the analysis of stress test reports between January 2016 and August 2022. Result: During the study period, we documented 73 patients who underwent exercise testing on a bicycle ergometer for suspected coronary heart disease. The mean age of our patients was 47.5 ± 13.8 years (14 and 79 years). Males accounted for the majority (78.1%). The sex ratio is 3.5. More than half of our patients were overweight or obese (77.1%). Hypertension and diabetes affected 52.1% and 25.8% of patients, respectively. 20.8% of patients had coronary artery disease. renin-angiotensin-aldosterone system blockers (56.8%) and beta-blockers (51.3%). The main indications were chest pain (63.0%) and ischemia detection (15.1%). A modified STEEP protocol was used. The majority of our patients (71.2%) achieved at least 85% of their maximum theoretical heart rate. The main reason for the termination of the study was fatigue (57.3%). The average duration was 11.3 ± 4.2 minutes. 24.7% thought the stress tests were positive and 17.8% thought they were controversial. Conclusion: This study demonstrates the importance of stress testing in the diagnosis and treatment of ischemic heart disease, especially in settings where we have very limited access to coronary angiography.

关键词： Stress Test Ischemic Heart Disease mali

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Morbidity and Mortality of Newborns in a Context of Limited Resources in Tombouctou, mali

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Open Journal of pediatrics 2024年第5期14卷 841-850页

作者： Kassogué Djibril Cissouma Assétou Kassogué Abdoulaye Boré Boubacar Sogoba Robert Diallo Zoumana Maiga Talfi Dolo Akoro Sogoba Seydou Touré Lahaou Maiga Mariam Samaké Alou Mariko Souleymane Ongoiba Oumar Sanogo Oumar Traoré Bassirima Paediatrics department Timbuktu Hospital Timbuktu Mali Paediatrics department Sikasso Hospital Sikasso Mali Paediatrics department Nianankoro Fomba Hospital Sgou Mali department of Obstetrics and Gynaecology CHU du Point G Bamako Mali department of Paediatrics Commune VI District Hospital Bamako Mali

Introduction: Worldwide, 2.3 million children died in the first 20 days after birth in 2022, according to the WHO. In mali, according to the sixth Demographic and Health Survey, the neonatal mortality rate was estimated at 33% live births in 2018. The Timbuktu region had the highest neonatal mortality rate in the country with 44%. The objective of this work was to study the causes of neonatal morbidity and mortality and related factors in the paediatrics department of Timbuktu hospital. Materials and method: This was a descriptive, cross-sectional study conducted from 1 January to 31 December 2023 in the neonatology unit of the paediatrics department of Timbuktu hospital, including all newborns admitted to hospital. Results: Our study took place over 12 months, during which 618 admissions were made to the paediatric ward, including 244 newborns, i.e. 39.48%. The majority of newborns (86.5%) were admitted in the first week of life. The mean age was 3 days, with a sex ratio of 1.1 for males. Weight under 2500 g was 54.1% for an average weight of 2372 g. The main mode of admission was transfer from the hospital maternity unit (62%). The main reasons for admission were acute foetal distress (27.9%) and prematurity (26.2%). The average age of the mothers was 24, with extremes of 15 and 49. The mothers were housewives (87.3%), uneducated and primiparous (59% and 36.5% respectively);only 40.2% had made more than 3 antenatal care visits. Newborns born by vaginal delivery accounted for 80.7% and those born by caesarean section for 19.3%. The risk of infection was present in 52.5% of cases. The three leading causes of hospitalisation were birth asphyxia (40.2%), neonatal infection (32.4%) and prematurity (25%). The mortality rate was 21.7%. The main causes of death were prematurity (39.6%), birth asphyxia (32.1%) and neonatal infection (24.5%). Conclusion: Neonatal morbidity and mortality remain a concern in Timbuktu. Despite the unfavourable security situation, morbidity and

关键词： Morbidity Mortality Newborns Timbuktu

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Epidemiological and Anatomo Path Ological Aspects of Stomach Cancers at the Koutiala District hospital

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Surgical Science 2024年第7期15卷 444-450页

作者： Mahamadou Coulibaly Souleymane Sanogo Samuel Kletigui Dembélé Moussa Diassana Brehima Ballo Cheick Aka Waigalo Bréhima Bengaly Birama Togola Drissa Traoré Nouhoum Ongoiba Faculty of Medicine University of Science Technique and Technologies of Bamako Bamako Mali department of Surgery Koutiala Hospital Bamako Mali department of Surgery University Hospital Center Point G Bamako Mali department of Surgery Tominian Hospital Tominian Mali department of Surgery Sikasso Hospital Sikasso Mali

Aim: This paper aims to evaluate the epidemiological and pathological aspects of stomach cancer at Koutiala District hospital. Methods: This was a retrospective study carried out in the General Surgery department of the Koutiala District hospital Health Centre. The records of patients admitted for stomach cancer in the period from August 1, 2017 to December 31, 2022 were collected. Patients who underwent surgery for stomach cancer were included in the study. Patients who had not undergone surgery were excluded. Results: We collected records from 40 patients operated on for stomach cancer. The median age was 58.4 years ± 5.7. Men were in the majority with 72.5% The sex ratio was 2.6. The incidence rate of stomach cancer in the general population in the circle was 4.9 cases per 100,000 population. Patients had a history of gastric ulcer in 90%, Helicobacter pylori infection in 47.5% and a notion of excessive salt consumption in 47.5%. The median duration of disease progression was 5 years ± 2.3. The seat was antro-pyloric in 77.5%. The cancer was ulcerative budding in 23 patients. Adenocarcinoma was the histological type in all patients. The cancer was classified as stage III in 30 cases and stage IV in 10 cases. Palliative surgical treatment was the most performed (47.5%). Postoperative morbidity was 15% and mortality was 42.5% at one year. Conclusion: Stomach cancer is common in the ward. Most patients consult at the stage of metastasis. Palliative surgery remains the most practical. Postoperative morbidity and mortality is very high.

关键词： Epidemiology Stomach Cancer Koutiala

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Clinical and Therapeutic Aspects of Inguinal Hernia in Children in the General Surgery department of Reference Health Center in Commune I of Bamako mali

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Surgical Science 2024年第2期15卷 54-63页

作者： Tounkara Cheickna Samake Hamidou Simpara Mama Diarra Issaka Sanogo Modibo Sidibe Souleymane Togola Modibo Dembele Bakary Tientigui Coulibaly Yacaria Togo Pierre Adégné Kante Lassana department of General Surgery the Reference Health Center of Commune I Bamako Mali Directorate of Social Health Service the Armed Forces of Mali Bamako Mali department of Pediatric Surgery Mali Hospital Bamako Mali department of General Surgery the Gabriel TOURE University Hospital Bamako Mali department of Pediatric Surgery Gabriel TOURE University Hospital Bamako Mali

Inguinal hernia in children is a congenital pathology in children linked to the persistence of the peritoneo-vaginal canal in children and the NüCK canal in girls;persisting into adulthood. This work aimed to study inguinal hernia in children in the general surgery department of the Reference Health Center of Commune I of the Bamako District;to determine the frequency of inguinal hernia;describe the epidemiological, clinical and therapeutic aspects of inguinal hernias and in order to evaluate the cost of treatment. This was a prospective study from April 2017 to March 2018 during which 60 children with an inguinal hernia were collected. Inguinal hernias in children represented 9.23% of patients operated on in the department. The average age was 59.23 months with extremes of one month and 180 months and a standard deviation of 49.23 years. The male sex was dominant with a sex ratio equal to 9:1. The notion of prematurity was found in 11.7% and was associated with a testicle not in place in 1.7% of cases. 41.7% of our patients were referred by a doctor and 66.7% of patients presented with painless, intermittent inguino-scrotal swelling (83.3% of cases). The hernia was discovered before one week of life in 50% of cases. Inguinal swelling was absent in 11.7% but observed intraoperatively. The inguinal hernia was unilateral in 91.7% of cases and 70% of hernias were discovered by the parents during pushing efforts. The inguinal hernia was located on the right in 61.7% of cases. The hernia swelling was soft, painless, impulsive and reducible in 78.3% of cases. The swelling was inguino-scrotal in 58.3% of cases. The hernia was simple in 95% of patients and hernial strangulation was observed in 3 cases or 5% of cases. 98.3% of patients were ASA I. The treatment was carried out openly in all our patients including closure of the vaginal peritoneal canal in 95% of cases under general anesthesia in 98.3% of cases. The morbidity rate was 8.4% (surgical site infection: 6.7% of ca

关键词： Inguinal Hernia Child Surgery Cs Ref C I Bamako mali

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Effect of nourishing Yin and purging fire Chinese herbal mixture on delaying light-induced premature puberty in rats

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Journal of Traditional Chinese Medicine 2024年第1期44卷 95-102页

作者： SUN Yanyan XUE Yuanyuan SUN Wen WANG Yonghong YU Jian department of Traditional Chinese Medicine Children's Hospital of Fudan UniversityShanghai 201102China department of pediatrics Zibo Central HospitalZibo 255000China

OBJECTIVE:To elucidate the mechanism of the nourishing Yin and purging fire Chinese herbal mixture(NYPF)in delaying light-induced premature puberty in ***:Twenty-one days old female SpragueDawley rats were randomly assigned to normal group(N),long light exposure group(L),NYPF and normal saline group(NS).Rats in the L,NYPF and NS groups were exposed to 16 h:350 lux light/8 h:dark,while rats in the N group were exposed to 12 h:50 lux light/12 h:*** and normal saline was administered to the rats in the NYPF group or NS group,respectively,from day *** rats in every group were sacrificed at 9 *** day 28(P28),on the day when rat's vulva opened in the L group(L-VO),on the day when the first estrous interphase occurred in rats of L group(L-E1),and on the day when the second estrous interphase occurred in rats of L group(L-E2),***:On day 34,all rats in the L group,80%of rats in the NS group,40%of rats in the N group,and 20%of rats in the NYPF group showed complete opening of the *** P28,m RNA level of hypothalamic kisspeptin(Kiss-1)in the L group was significantly higher than that in the N group(P<0.05).The rats in the L and NS groups had significantly lower hypothalamic argininephenylalanine-amide(RFamide)-related peptide 3(RFRP-3)m RNA levels than those in the N group(P<0.05),whereas RFRP-3 m RNA level was significantly higher in the NYPF group than that in the L group(P<0.05).At L-VO,the ovarian index of the L and NS groups was significantly higher than that of the N group(P<0.05)and estradiol(E2)level of the NYPF group was significantly lower than that of the N and NS groups(P<0.05);hypothalamic Kiss-1 m RNA level in the L and NS groups was significantly higher than that in the N and NYPF groups(P<0.05),whereas hypothalamic RFRP-3 m RNA level in the L,NYPF,and NS groups was significantly lower than that in the N group(P<0.05).At L-E1,E2 level of the L and NS groups was significantly higher than that of the N group(P<0.01),wher

关键词： light puberty precocious kisspeptins RFRP-3 melatonin Nourishing Yin and Purging Fire

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