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

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

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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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Perception and Management of Hemorroid Disease at the CSREF of the Commune Bamako Mali

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Surgical Science 2024年第2期15卷 89-97页

作者： Tounkara Cheickna Diarra Mohamed Hassimy Diarra Issaka Sanogo Keita Bakary Dembele Bakary Tientigui Traore Alhassane Togo Pierre Adégné Lassana Kante department of General Surgery The Cs Ref of Commune I of Bamako Bamako Mali department of General Surgery The Gabriel TOURE University Hospital in Bamako Bamako Mali

This work was a prospective transversal study over 6 (six) months from May 2 to December 31, 2017 at the Reference Health center of Commune I and the Chérif la Confessional Health center in Bamako. The aim was to study the knowledge, attitudes and behavioral practices linked to hemorrhoids in Commune I of the Bamako district, to evaluate the frequency of hemorrhoidal disease, to determine the knowledge, attitudes and behavioral practices linked to hemorrhoids among patients, their companions and traditional therapists in Commune I of the district of Bamako and the factors which influence the motivations and decisions to resort to medical-surgical care and traditional medicine in patients suffering from hemorrhoids in order to analyze the results of the management of hemorrhoidal disease at Cs Ref CI. We collected 36 patients with hemorrhoidal disease, 25 caregivers and 15 traditional hemorrhoidal disease therapists. The sex ratio was 1.25 for patients;6.5 for traditional therapists and 1.5 for accompanying people. The average age of the patients was 32.75 years;49 years for traditional therapists and 28.76 years for those accompanying them. 55.6% of patients claim to know about hemorrhoidal disease;100% of traditional therapists and 80% of accompanying people. The dietary factor of hemorrhoidal disease was mentioned by 90% of patients;66.7% of traditional therapists and 100% of caregivers. Most patients initially resorted to traditional treatment out of fear of surgery and its after-effects. The patients were treated medically and surgically.

关键词： Hemorrhoidal Disease Caregivers Traditional Therapists Patients Surgery CS Ref CI

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Factors Associated with Mortality in Children Aged 1 Month to 15 Years hospitalized in the Pediatric Ward of the Kalaban-Coro Reference Health center: Cross-Sectional Study

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Open Journal of Pediatrics 2024年第5期14卷 800-813页

作者： Abdoul Salam Diarra Mohamed Diarra Dramane Touré Tawfiq Abu Beyadari Balilé Harber Maimouna Kanté Issa Guindo Belco Maiga Karamoko Sacko Kalirou Traoré Fatoumata Dicko Mamadou Togo Kalba Pélieba Mariam Sylla Mamadou Samaké Hamadoun Sangho National center for Scientific and Technological Research Bamako Mali department of Pediatric Health Referral Center of Kalaban Coro Koulikoro Mali Pediatric department of the Mopti Referral Health center Mopti Mali Private Practice for Family and Emergency Medicine Casablanca Morocco Paediatric Ward of Nianankoro Fomba hospital Segou Mali Paediatric Ward Referral Health Center of Common V Bamako Mali Administration department Health Referral Center of Kalaban Coro Koulikoro Mali department of Paediatrics Gabriel Toure University Hospital Bamako Mali department of Internal Medicine CHU Gabriel Tour Bamako Mali Service dHpato-Gastro-Entrologie Gabriel Toure University Hospital Bamako Mali department of Public Health Faculty of Medicine and Odontostomatology University of Sciences Techniques and Technologies of Bamako Bamako Mali

Introduction: Infant and child mortality is a worldwide concern, but developing countries such as Mali are more affected. The aim of this study was to investigate morbidity and factors associated with mortality in children aged 1 month to 15 years. Methodology: This was a cross-sectional study which took place from January 1 to December 31, 2020 covering children aged 1 month to 15 years hospitalized at the Kalaban-Coro CSRéf. Data were entered into Excel and analyzed using SPSS version 20 software. Results: Five hundred children aged 1 months to 15 years were included. The age range 1 to 5 years (53.6%) and male sex (58.2%) were the most represented. Malaria (72.2%), acute respiratory infections (6.2%) and diarrhea/dehydration (3%) were the main morbidities. Mortality was estimated at 10.6%, and the two main causes of death were malaria (56.6%) and acute respiratory infections (7.54%). Univariate analysis revealed a statistically significant association between the dependent variable (death) and age (p Conclusion: This study confirms the high rate of infant and child morbidity and mortality in our health facilities. Strengthening human resources and intensifying behavior-change communication can help reverse the trend.

关键词： Children Aged 1 Months to 15 Years Morbidity Factors Associated with Mortality Morbidity

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Ear Cholesteatoma Surgery in South Sahara: Our Experience in Bamako

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International Journal of Otolaryngology and Head & Neck Surgery 2024年第4期13卷 293-303页

作者： Kassim Diarra Oumou Coulibaly Yaya Dembele Nfaly Konaté Sidibe Youssouf Saydi Ag Mohamed Harouna Sanogo Abraham Diarra Ibrahim Fofana Moussa Bourama Keita Youssouf Traore Fatogoma Issa Koné Boubacary Guindo Siaka Soumaoro Doumbia Kadidiatou Singare Mohamed Amadou Keita ORLCCF department Gabriel Toure University Hospital Bamako Mali ORLCCF Unit Kati Army Polyclinics Kati Mali ENT-CCF department CHU Luxembourg Bamako Mali ORLCCF Service of the Reference center of Commune VI Sogoniko Bamako Mali

In Mali, cholesteatoma surgery remains a challenge due to the limited number of otological practitioners, and the low socio-economic level of patients reflecting the difficulties in performing CT or MRI for post-operative follow-up. We therefore initiated this work with the objective of analyzing, through a broad bibliographic review, the clinical, paraclinical, topographical, therapeutic and progressive aspects of a series of ear cholesteatoma. Materials and Method: This was a retrospective and prospective, descriptive study that took place in the ENT and head and neck surgery department of the gabriel Touré university hospital over 36 months from November 2020 to October 2023. These were patients admitted to the department for chronic cholestematous otitis media. Result: In total, we collected 34 files of patients admitted for cholesteatoma. This represented 9% of cases compared to all otological surgeries carried out during the same period, i.e. 362 cases. The average age of our patients was 35.31 years, with extremes ranging from 7 years to 80 years, there were 24 men and 10 women, i.e. a M/F ratio of 2.4. The average time to diagnosis was 7 years. The main functional signs were dominated by chronic fetid purulent otorrhea associated with hypoacusis in 94.6% of cases. One case of meningeal complication and three cases of cerebral empyema were reported. Clinically, a postero-superior and marginal tympanic perforation was observed in 53%, a retraction pocket in 5.9%, the sentinel polyp in 9%, and a non-marginal tympanic perforation in 32%. Pure-tone audiometry performed preoperatively for all patients showed conductive hearing loss in 83%. In 82% of cases we created a recess with the creation of a mini box. An ossiculoplasty was performed immediately with fragments of cartilage. The postoperative course found the disappearance of otorrhea (88.23%), the persistence of otorrhea in one case, two cases of facial paralysis, and one case of tinnitus. We did not identify

关键词： Cholesteatoma CT TTO TTF

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Chronic Hepatitis B Virus Infection: Biological Parameters in Patients Treated with Tenofovir Disoproxil Fumarate

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Open Journal of Gastroenterology 2024年第4期14卷 145-151页

作者： Sanra Déborah Sanogo Moussa Y. Dicko Lamine N’Diaye Ousmane Diarra Drissa Katilé Abdoulaye Maiga Ouatou Mallé Sabine Drabo Makan S. Tounkara Hourouma Sow Kadiatou Doumbia Anselme Konaté Moussa T. Diarra Hepato-Gastroenterology department Centre Hospitalier Universitaire Du Point G Bamako Mali Hepato-Gastroenterology department Gabriel Toure University Hospital Bamako Mali Hepato-Gastroenterology Unit Csref Commune V Bamako Mali

Chronic hepatitis B causes a liver disease characterized by inflammation of the liver parenchyma. The aim of this study was to investigate the evolution of biological parameters in patients treated with Tenofovir for chronic B infection at the Commune V referral health center in Bamako. We obtained a prevalence of 14.15%. The most represented age group was 31 - 40 years, with 36.8%. The sex ratio was 1.44 in favour of men. Viral load was undetectable after 18 months of treatment in 25 patients (42.37%). Tenofovir, the 1st-line drug in Mali, is effective on the biological parameters monitored in patients.

关键词： Viral Hepatitis B Tenofovir Biological Parameters

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Prevalence, Maternal and Perinatal Prognosis of Breech Delivery Compared to That of the Vertex in 242 Cases for 484 Controls at Ségou hospital in Malti

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Open Journal of Obstetrics and Gynecology 2024年第9期14卷 1414-1421页

作者： Tidiani Traoré Famakan Kané Abdoulaye Kassogué Seydou Traoré Seydou Z. Dao Balilé Harber Sabré Koné Kassoum Sidibé Brahima Donigolo Babou Traoré Adama Coulibaly Abdrhamane Diarisso Alima Sidibé Mamadou Sima Augustin Théra Youssouf Traoré Ibrahima Teguété Niani Mounkoro Ministry of Health in Bamako Nianakoro Fomba Hospital Segou Mali Regional Health department of Segou District Hospital Bla Mali Regional Health department of Koutiala Reference Health Center Koutiala Mali Regional Health department of Bamako Reference Health Center Commune II Bamako Mali Ministry of Health in Bamako Fousseyni Daou Hospital Kayes Mali Ministry of Health in Bamako Point G University Hospital Center Bamako Mali Ministry of Health in Bamako Gabriel Toure University Hospital Center Bamako Mali

Introduction: Breech birth has always been a subject of great interest because of its risks of perinatal morbidity and mortality. Aim: The aim of our study was to compare the maternal and perinatal prognosis of breech delivery with that of vertex delivery. Patients and Method: This was a retrospective case-control analytical study carried out in the obstetrics and gynaecology department of Ségou hospital over a 2-year period from 1 January 2020 to 31 December 2021, involving 242 breech deliveries compared with 484 top deliveries with a live single foetus without foetal malformation of gestational age ≥ 35 SA. The statistical tests used were: chi² (p Results: The frequency of breech delivery was 3.3%, with a predominance of caesarean section for breech presentation (64.88%) compared with 32.85% for vertex (P: 0.00;CI: (0.191 - 0.367). The perinatal prognosis of fetuses with breech presentations was marked by a higher rate of neonatal asphyxia (Apgar score Conclusion: Breech birth is relatively rare in our department. It carries a higher risk of maternal morbidity and neonatal morbidity than breech delivery. However, the vital prognosis for the mother was identical in both groups.

关键词： Delivery Breech Vertex Prognosis Mali

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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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Hysterectomies for Gynaecological Pathology: 56 Cases at the Segou Regional hospital in Mali

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Open Journal of Obstetrics and Gynecology 2024年第9期14卷 1363-1373页

作者： Tidiani Traoré Famakan Kané Abdoulaye Kassogué Seydou Traoré Seydou Z. Dao Balilé Harber Sory Diallo Kassoun Sidibé Brahima Donigolo Babou Traoré Adama Coulibaly Abdrahamane Diarisso Alima Sidibé Mamadou Sima Augustin Théra Youssouf Traoré Ibrahima Teguété Niani Mounkoro Ministry of Health in Bamako Nianakoro Fomba Hospital Segou Mali Regional Health department of Segou District Hospital Bla Mali Regional Health department of Koutiala Reference Health Center Koutiala Mali Regional Health department of Bamako Reference Health Center Commune II Bamako Mali Ministry of Health in Bamako Fousseyni Daou Hospital Kayes Mali Ministry of Health in Bamako Point G University Hospital Center Bamako Mali Ministry of Health in Bamako Gabriel Toure University Hospital Center Bamako Mali

Introduction: Hysterectomy is a surgical procedure involving partial or total removal of the uterus. It is the most common gynaecological surgery in the world. Objective: To describe the epidemio-clinical and prognostic aspects of gynaecological hysterectomies. Patients and methods: This was an 18-month retrospective prospective descriptive study with a six-month follow-up period from 1 December 2020 to 31 May 2022 carried out in the gynaecology department of the Segou regional hospital. Results: Fifty-six (56) hysterectomies were performed out of 118 gynaecological surgical procedures (47.45%). The mean age was 47 ± 11.77 years. Large multiparous women were the most common (50%), with an average parity of 4.58. The main indications were uterine fibroids (30.4%), precancerous lesions of the cervix (17.85%) and uterine prolapse (17.85%). The abdominal route was the most commonly used surgical route (82.14%). Hysterectomy was total in 100% of cases and associated with bilateral adnexectomy in 48.2% of cases. The intra- and post-operative prognosis was satisfactory in 94.6% of cases. No deaths were recorded. The average length of stay was 3.28 days, irrespective of the surgical approach. Three cases of dyspareunia were noted among those who had resumed sexual activity.

关键词： Hysterectomy Gynaecological Pathology Mali

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Migration of a Progestin Implant into a Pulmonary Artery: Observation of a Case at the Reference Health center of Commune III of the District of Bamako in Mali

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Open Journal of Obstetrics and Gynecology 2024年第9期14卷 1431-1436页

作者： Hamady Sissoko Souma Kodio Hamidou Albachar Cheickna Sylla Salif Diarra Sidy Moctar Diakité Mohamed Traoré Souleymane Traoré Ibrahim Fomba Ouncoumba Diarra Nana Bah Drissa Diarra Mahamoudou Coulibaly Bocary Sidi Koné Hawa Samaké Ahmadou Coulibaly Mamadou Traoré Seydou Z. Dao Sitapha Dembélé Samou Diarra Konimba Koné Alou Samaké Sanogo Siaka Amara Reference Health Centre of Commune III of the District of Bamako Bamako Mali department of Gynecology and Obstetrics Gabriel Toure University Hospital Center in Bamako Bamako Mali department of Gynecology and Obstetrics Kalaban Coro Reference Health Centre Bamako Mali Mohamed VI Perinatal Clinic Bamako Mali Reference Health Centre of Commune V of the District of Bamako Bamako Mali Point-G Obstetrics and Gynecology department of university hospital center Bamako Mali Reference Health Centre of Commune II of the District of Bamako Bamako Mali H department of Gynecology and Obstetrics of the Fousseyni Daou hospital in Kayes Kayes Mali Reference Health Centre of Commune VI of the District of Bamako Bamako Mali

It was a 36-year-old patient, 5th Pregnancy, 5th Delivery, 4 live children, and I deceased, had a consultation in the department for the removal of implants. Questioning revealed that she had had the implant three years ago without medical follow-up. It was in view of the difficulties in extracting the capsule that the chest X-ray and CT scan carried out concluded that the implant had migrated into a branch of the left pulmonary artery. Therapeutic abstention has been the attitude of cardiovascular surgeons.

关键词： Migration Implant Pulmonary Artery Bamako

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