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Epidemiological-Clinical Aspects of Uterine Leiomyoma at the reference Health center of commune vi of the Bamako District

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Open Journal of Obstetrics and Gynecology 2024年第5期14卷 674-681页

作者： Alou Samaké Lasseny Diarra Mamadou Keita Dramane Haidara Mamadou Haidara Coulibaly Soumana Mamadou Diallo Moussa Konaté Mariam Maiga MS Ag Med Elméhdi Elansari Kassogue Djibril Dao Seydou Zana Samake Hawa Konate Karim Dembele Bertin Coulibaly Moussa Mariko Seydou Colette Dohino reference Health center of commune vi of the Bamako District Bamako Mali Bamako Dermatology Hospital (HDB) Bamako Mali Kalaban Coro reference Health center Bamako Mali Hangadoumbo Moulaye Touré Hospital in Gao Gao Mali Timbuktu Hospital Tomboctou Mali reference Health center of commune II of the Bamako District Bamako Mali reference Health center in commune V of the Bamako District Bamako Mali National Institute for Training in Health Sciences Bamako Mali Mali Hospital Bamako Mali

Introduction: Uterine fibroid is a mixed mesenchymal tumor, developing from smooth muscle cells of the myometrium, separated by connective tissue. The majority of fibroids are asymptomatic and do not require any intervention or other exploratory measures. However, in some cases fibroids are symptomatic, their treatment should aim to improve symptoms and quality of life. Objectives: Describe the epidemiological-clinical aspects of uterine fibroids in the gynecology and obstetrics department of the reference health center of commune vi of the Bamako district. Methodology: This was a retrospective descriptive study carried out over a period of one year. It concerns all patients seen in consultation in the gynecology and obstetrics department of the reference health center of commune vi. Results: during the study period, the uterine fibroid frequency was 1.80%. During this same period, fibroids represented 5.59% of gyneco-obstetric pathologies operated on in the department. The 30 - 45 year old age group was the most represented with a frequency of 75.63%. The average age was 36.87 years ± 6.2 years with extremes of 25 and 63 years. Married women were the most represented 97.48%. The vast majority of our patients 95.8% were not postmenopausal. The multigravidas were the most represented, i.e. 37.50% with a large part of the pauciparous 41.29%. In our patients, 96.64% had a clinical symptom on their fibroid with the main reason for consultation being the sensation of a pelvic mass in 97.48%. We recorded three cases of infertility as associated factors. Ultrasound was performed in all patients. The location of the myxomatous nuclei was subserosal in the majority in 42.86% and with multiple nodules in 84.85% of cases. The main indication for myomectomy was the failure of medical treatment in 86.49% of cases. Surgical treatment was mainly a myomectomy 93.30%, a hysterectomy was indicated in 6.70%. No cases of death were recorded. Conclusion: Uterine fibroid is a gynecological pathology that exists in our department;its f

关键词： Myomas Surgery Myomectomy

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Epidemioclinical Profile and Immediate Outcome of Low Birth Weight at the reference Health center in commune vi of the District of Bamako, Mali

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Open Journal of Pediatrics 2023年第2期13卷 235-243页

作者： Mariam Maiga Oumar Coulibaly Mariam Traore Hibrahima Diallo Korotoumou W. Diallo Bourama Kane Alou Samake Mamadou Diallo Moussa Konate Mamadou Keita Mohamed Saydi Ag Med Elmehdi Elansari Diarra Sidy Moctar Mamadou Traore Djibril Kassogue Kadiatou Ba Pierre Togo Pediatric Service of the reference Health center of the commune vi Bamako Mali Pediatric Department of CHU Gabriel Touré Bamako Mali Mali Hospital Bamako Mali Pediatric Service of the reference Health center of the commune V Bamako Mali Timbuktu Regional Hospital Bamako Mali Pediatric Service of the reference Health center of the commune II Bamako Mali

Introduction: Low birth weight is responsible for 9.1 million child deaths each year worldwide. It is the leading cause of perinatal and infant mortality. The objective of this work was to determine the epidemio-clinical profile as well as the future of low birth weight at the reference Health center of commune vi in the district of Bamako, Mali. Methods: Our study was descriptive and prospective over a year from April 1, 2018 to March 31, 2019. Data were taken from hospital records and newborn referral/evacuation forms. Data processing was performed using Epi Info software version 3.5.4 and Word. Results: The frequency of low birth weight was 34.94%. Multiparity accounted for 47.84%, sex ratio was 0.93, maternal arterial hypertension was present in 41.66%, genitourinary infection was in 58.37% and delivery was by low way in 86.12%. The majority of newborns had a gestational age between 28SA-33SA (56.52%) and a weight between 1501-1999 grams (47.36%). Mortality accounted for 18.66%. Conclusion: Low birth weight is common in our settings with modifiable risk factors. Practitioners must play on them to minimize its importance.

关键词： Low Birth Weight Future Risk Factors Bamako Mali

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Maternal Fetal Prognosis: Pregnancy and Delivery in Women of 40 Years Old and Over in a Second reference Hospital in Bamako

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Open Journal of Obstetrics and Gynecology 2024年第4期14卷 509-519页

作者： Samaké Alou Diarra Lasseny Keita Mamadou Haidara Dramane Haidara Mamadou Diallo Mamadou Konaté Moussa Maiga Mariam Mohamed Saydi Ag Med Elmehdi Elansari Kassogue Djibril Seydou Zana Dao Samake Hawa Konate Karim Dembele Bertin Coulibaly Moussa Mariko Seydou Collarete Dohino reference Health center of commune vi of the Bamako District Bamako Mali Bamako Dermatology Hospital (BDH) Bamako Mali Kalaban Coro reference Health center Bamako Mali Timbuktu Hospital Timbuktu Mali reference Health center of commune II of the Bamako District Bamako Mali reference Health center in commune V of the Bamako District Bamako Mali National Institute for Training in Health Sciences Bamako Mali Mali Hospital Bamako Mali

Introduction: Late pregnancies are considered a public health problem linked to maternal mortality due to their complications. These risks, which worsen with maternal age, should be better known and taken into account in monitoring these pregnancies. Objective: To evaluate the impact of age on the prevalence of obstetric and neonatal complications among parturients of 40 years old and over. Methodology: This was an 11-year retrospective analytical case control study from January 1, 2007 to December 31, 2017. The study population was female patients of 40 years old or older for cases and female patients younger than 40 years of control case. Results: In total, we collected 640 cases of parturients of 40 years old and over out of a total of 84,234 deliveries during the study period;i.e. a frequency of 0.76%. Spontaneous abortion increased in patients of 40 and over with 8.28%. Hypertension and diabetes were higher of women of 40 and over, 52.65%. Concerning the method of admission: 55% of parturients of 40 and over were referrals. Incidents occurring among women of 40 and over were more pronounced than in control cases. Complications during vaginal delivery, cervical tear, perineal tear, uterine dehiscence and uterine rupture are high in our cases, i.e. 11.88%;3.59%;2.19%;2.66. During our study, depending on the type of delivery, the cesarean rate was much higher among women of 40 and over than among control cases, i.e. 54.22% versus 12.24%. Hemorrhages in the 3rd trimester were the main indications for cesarean section. Hemorrhages in the 3rd trimester were more frequent with women of 40 and over, i.e. 10.47%;5.94% versus 1.74% and 0.42%. As for the different types of malformations in parturients, women under 40 years old fetal malformations were absent in 92.29%, on the other hand they were more frequent in patients with 40 years and over, i.e. a normal frequency of 36.72%. Conclusion: Pregnancy at a late age exposes the elderly patient and the newborn to several risks. During this study, an increase in maternal-

关键词： Advanced Maternal Age Childbirth Risk Mali

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Maternal and Perinatal Prognosis of Arterial Hypertension and Pregnancy in a Peripheral Health center in Mali

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Open Journal of Obstetrics and Gynecology 2024年第5期14卷 855-867页

作者： Samaké Alou Diarra Lasseny Keita Mamadou Haidara Dramane Haidara Mamadou Diallo Mamadou Konaté Moussa Maiga Mariam MS Ag Med Elméhdi Elansari Kassogue Djibril Dao Seydou Zana Samake Hawa Konate Karim Dembele Bertin Coulibaly Moussa Mariko Seydou Colette Dohinnon reference Health center in commune vi of the Bamako District Bamako Mali Bamako Dermatology Hospital (HDB) Bamako Mali Kalaban Coro reference Health center Bamako Mali Timbuktu Hospital Timbuktu Mali reference Health center of commune II of the Bamako district Bamako Mali reference Health center in commune V of the Bamako district Bamako Mali National Institute for Training in Health Sciences Bamako Mali Mali Hospital Bamako Mali

Introduction: Maternal mortality constitutes a public health problem and its rate is an indicator of a country’s development. Among the causes of maternal and perinatal death, high blood pressure associated with pregnancy occupies a significant part. It represents 5% of direct maternal deaths. Objective: to study the maternal and perinatal prognosis of high blood pressure during pregnancy in the Tenenkou reference health center in Mali. Methodology: This was a descriptive, analytical and retrospective cross-sectional study over a period of twelve months from January 1, 2021 to December 31, 2021 and involving 144 cases of high blood pressure associated with pregnancy. Results: We obtained a frequency of 11.75%. The majority of patients 70.9% were aged between 20 - 35 years. The important risk factor found was young age. During our study, 46.5% of patients had performed at least one CPN and only 13.9% performed 04 CPN. Pre-eclampsia was the most common type of high blood pressure during pregnancy, i.e. 61.1%. Eclampsia and retroplacental hematoma were the most common maternal complications, respectively 27.8% and 11.1%. The most common fetal complications were premature births and fetal distress with 20.9% and 17.4% respectively. Conclusion: Hypertension associated with pregnancy still remains a major cause of maternal-fetal morbidity and mortality in our context where diagnosis is often late. The main clinical form was preeclampsia. Eclampsia and retroplacental hematoma were the most frequent maternal complications. Fetal complications were mainly prematurity and fetal distress.

关键词： Pregnancy High Blood Pressure Prognosis

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Bilharzia Appendicitis: Incidence in a commune in Mali, about 3CAS

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Surgical Science 2024年第5期15卷 321-329页

作者： Souleymane Bingue Dembélé Yely Dianessy Moussa Samake Abdou Guiré Siaka Konaté Ousmane Sy Boubacar Yoro Sidibé Amadou Maïga Thiorno Nadio Boubacar Karembe Amaguiré Saye Sirama Diarra Dorcas Sodjiné Yede Issiaka Diarra Ibrahima Maiga Mahamane Dicko Moussa Konaté Aliou Bina Diarra Bakary Tientigui Dembélé General Surgery Department of the District Hospital of commune IV of Bamako Bamako Mali Kolondié ba Reference Health Centre Sikasso Mali Epidemiology and Clinical Research Bamako Mali General Surgery Department of Gabriel Touré University Hospital Bamako Mali Ophthalmology Department of the District Hospital of commune IV of Bamako Bamako Mali Gynecology and Obstetrics Department of the District Hospital of commune IV of Bamako Bamako Mali commune I of the District of Bamako reference Health Centre Bamako Mali Imaging Department of the District Hospital of commune IV of Bamako Bamako Mali commune vi of the District of Bamako reference Health Centre Bamako Mali Anotomy-Pathology Department of the G Point University Hospital Bamako Mali

Appendicitis bilharzia is a very rare condition and we report 3 cases of this pathology that sense clinical and biological similarities with bacterial appendicitis. The etiological diagnosis was exclusively histopathological, this allowed to highlight eggs of Schistosome in the appendicular wall in the three patients. The surgical treatment was supplemented by a specific medical treatment based on praziquantel. The surgical suites were simple for 2 patients, complicated by superficial parietal suppuration in a patient.

关键词： Bilharzial Appendicitis Endemic Histopathology Specific Antiparasitic Treatment

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Postoperative Complications in the General Surgery Department of the Cs Ref of commune I of the District of Bamako Mali

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Surgical Science 2024年第6期15卷 409-419页

作者： Tounkara Cheickna Samake Hamidou Dembele Lamine Diarra Issaka Togola Modibo Sanogo Modibo Dembele Bakary Tientigui Traore Alhassane Togo Adégné Pierre Kante Lassana Department of General Surgery Reference Health Center of Commune I of Bamako Bamako Mali Directorate of Social and Health Services of the Armies Bamako Mali Department of General Surgery CHU Gabriel Tour Bamako Mali

Postoperative complications represent important indicators for the quality of surgical care. The objectives of this work were to study post-operative complications in the general surgery department of the Cs ref of commune I in Mali, to determine the frequency of post-operative complications, to identify the factors of occurrence, to describe the clinical aspects, diagnostic and therapeutic in order to assess the additional cost linked to post-operative complications. This study was prospective, carried out in the general surgery department on 300 cases of surgical interventions. It covered all patients aged at least 15 years, operated on and hospitalized or not, and who presented complications during the 30 days postoperatively. Patients under the age of 15 were not included (our general surgery department is not a pediatric surgery department). We collected 300 patients among whom 199 (66.33%) were men and 101 (33.66%) women, i.e. a sex ratio = 1.9. The average age was 38 years with extremes of 15 and 87 years. The main initial diagnoses were: acute appendicitis, peritonitis, occlusions, wall hernias, hemorrhoids, uterine prolapse, uterine myomas, ovarian cysts and acute cholecystitis. Emergencies represented 43% (N = 129) of interventions with 6.98% post-operative complications (POC). Postoperative complications were dominated by surgical site infections, 75% of cases (N = 20), wall hemorrhage 5% (N = 1), testicular necrosis 5% (N = 1) and testicular calcification 5% (N = 1), wire rejection 5% (N = 1) and death 5% (N = 1). The management of postoperative complications was surgical in 95% and medical in 100%. Their occurrence extended the hospital stay by 3.65 days and increased the average cost of care by 60541.85 CFA francs. The mortality index lowered by efficient management of complications (IMAGE) calculated in relation to deaths was 95% of cases. Anemia, ASA score ≥ III, Alteimeir II and IV classes, duration of surgery and post-operative hospitalization were factors contributing to post-operative complica

关键词： Complications Post Opératoires Chirurgie Cs Ref CI Bamako Mali

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Study of Hemorrhoid Disease in the Department of General Surgery of the Cs Ref of the commune I Bamako

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Surgical Science 2024年第2期15卷 36-47页

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

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

关键词： Hemorrhoid Surgery Cs Ref C I Bamako Mali

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Review of Two Years of Surgical Activities of the General Surgery Department of the reference Health center of commune I of Bamako Mali

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Surgical Science 2024年第4期15卷 195-206页

作者： Tounkara Cheickna Cisse Amadou Beydi Samake Hamidou Diarra Issaka Sanogo Modibo Diarra Bogoba Doumbia Seydou Yena Sadio Department of General Surgery of the reference Health center of commune I Bamako Mali Directorate of Social and Health Services of the Armed Forces of Mali Department of Public Health of the Faculty of Medicine and Odontology-Stomatology Bamako Mali Department of Surgery Mali Hospital Bamako Mali

The objectives of this work were to evaluate the surgical activities carried out in the general surgery department of the reference Health center of commune I of Bamako, to describe the sociodemographic characteristics of the operated patients, to determine the main pathologies encountered and to evaluate qualitatively the result of the treatment. In order to improve performance, and the quality of care, and to identify common pathologies in the surgical department, we undertook a retrospective study on surgical activities from January 2009 to December 2010. At the end of this study, out of 474 men and 187 women (equal sex ratio 2.53);we were able to determine the frequency of surgical pathologies. Farmers, housewives and pupils/students were the most represented with 25.9% respectively;20% and 13.3%. The most frequently observed pathologies were wall hernia (44.8%), prostate adenoma (12%) and acute appendicitis (10.5%). The average length of hospitalization was 3.43 days. Infectious complications affected 25 patients (3.8% of cases) and a death rate of 0.45% (i.e. 3 patients). The average cost of care was 53,500 FCFA. Indeed, the reality of surgical practice in health centers was not the same because of the level of skills of practicing surgeons.

关键词： Assessment Surgical Activities 2 Years reference Health center of commune I Bamako

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

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

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

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

关键词： Antibiotic Prescription Hospitalization Child

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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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