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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 cases and hematoma: 1.7%). The immediate consequen

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

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Epidemiological, Clinical, Therapeutic, and Evolutionary Aspects of Heart Failure in the Medical department at Gao Regional Hospital

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World Journal of Cardiovascular diseases 2024年第5期14卷 309-321页

作者： Coulibaly Alhousseny dollo Ibrahim Guindo Hamadoun Sidibé Lamine Mariko Souleymane Traoré Bassirima dao Karim Guindo Ibrahim Togo Mamadou Sidibé Samba Sangaré Ibrahima Ba Hamidou Oumar Ichiaka Menta departement of Medicine Gao Hospital Gao Mali departement of Medicine Mopti Regional Hospital Mopti Mali departement of Medicine Tombouctou Hospital Tombouctou Mali departement of Cardiology CHU Gabriel TOURE Bamako Mali

Introduction: Heart failure is a major public health pandemic, particularly in Africa, where its prevalence continues to increase. In northern Mali, few data exist, hence the interest of this study with the objective of studying the epidemiological, clinical and therapeutic and evolutionary aspects of Heart failure at the regional hospital of Gao. Patients and Methods: This was a cross-sectional, descriptive study that took place from July 2022 to June 2023 in the medical department at Gao Hospital. Results: The hospital prevalence of heart failure was 44.1%. The mean age was 47.30 ± 20 years (range: 16-88). Hypertension was the most common with 46.1%, followed by a sedentary lifestyle, and diabetes with 18.2% and 8.3% respectively;NYHA stage III-IV dyspnea was found in 83.9%. Reduced EF heart failure was present in 110 patients (76.9%), seventeen cases with moderately reduced EF (11.9%) and sixteen patients had preserved EF (11.2%). Global heart failure was the dominant (91.6%). The main etiologies of heart failure were dominated by hypertensive heart disease in 46 patients (32.2%), followed by postpartum cardiomyopathy with 43 cases (30.1%), primary dilated cardiomyopathy in 18 patients (12.6%), ischemic heart disease in 16 patients with 11.2%. Seven cases of valvular heart disease, or 4.9%. The evolution was favorable under treatment in 104 patients or 72.7%. In-hospital mortality was 14.7%. Conclusion: Heart failure is a common condition in sub-Saharan Africa, particularly in our country.

关键词： Heart Failure Epidemioclinical Progressive Gao Hospital

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Anal Pathologies: What Management at the Reference Health Center of Bamako’s Commune V?

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Open Journal of Gastroenterology 2024年第3期14卷 87-92页

作者： Sanra déborah Sanogo Moussa Y. dicko Ousmane diarra Abou A. diarra drissa Katilé Abdoulaye Maiga Ouatou Mallé Sabine drabo Makan S. Tounkara Hourouma Sow Kadiatou doumbia Anselme Konaté Moussa T. diarra Hepato-Gastroenterology department CHU Point G Bamako Mali service d’hépato-gastroentérologie CHU Gabriel Touré Bamako Mali Hepato-Gastroenterology Unit CSREF Commune V Bamako Mali

Anal pathologies are conditions affecting the anal margin and the anal canal. The aim of our study was to update data on anal diseases. Non-specific, it can reveal an emergency, a serious illness, a chronic disease or a benign condition. It was a prospective, descriptive and analytical study from April 2022 to March 2023, carried out in the hepato-gastroenterology unit of the Centre de Santé de Référence de la commune V du district de Bamako in Mali. Out of seven hundred and forty-nine (749) patients seen in consultation, 98 had anal pathology, i.e. a prevalence of 13.08%. The mean age was 40 ± 15.15 years and the sex ratio was 1.5. Hemorrhoidal disease and anal fissure were the most frequent pathologies in 66.4% and 24.4% of cases respectively. Medical treatment was initiated in 91.9% of patients with hemorrhoidal disease and 91.7% with anal fissure. Anal pathologies are common in young male patients. In our context, they are dominated by benign conditions.

关键词： Anal Pathologies Hemorrhoidal disease Anal Fissure

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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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Echocardiographic Aspects of Type 2 diabetics Patients Hospitalized in the Medicine and Endocrinology department of the Mali Hospital

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World Journal of Cardiovascular diseases 2024年第3期14卷 129-139页

作者： Konaté Massama Mamadou Touré Mariam Sako Samba Sidibé Souleymane Mariko djeneba Sylla Sow Elhaj Mahamane Maiga Coumba Adiaratou Thiam Youssouf Camara Hamidou Oumar Ba Asmao Keita Maiga djenebou Traoré Zoumana Traoré Souleymane Coulibaly Bah Traoré Modibo Mariko Nouhoum Ouologuem Amadou Koné Ichaka Menta Faculty of Medicine and dentistry Bamako USTTB Department of Medicine Hospital of Mali Bamako Mali department of Cardiology chu gabriel toure Bamako Mali department of Cardiology chu Point G Bamako Mali department of Medicine Hospital of Timbuktu Bamako Mali department of Cardiology Hospital of Kati Bamako Mali department of Cardiology chu Mother and Child Bamako Bamako Mali department of Internal Medicine chu Point G Bamako Mali

Introduction: Cardiovascular disease is the leading cause of death in diabetics. The objective of our study was to investigate the echocardiographic aspects of type 2 diabetics. Patients and Method: descriptive and cross-sectional study of 12 months from June 2020 to June 2021. We included hospitalized type 2 diabetics who underwent transthoracic cardiac ultrasound in the department of Medicine and Endocrinology at the Mali Hospital. Results: We collected 128 type 2 diabetics. The predominance was male with a sex ratio of 1.2. The mean age of patients was 60.06 ± 11.54 years with extremes of 28 and 84 years. Echocardiographic abnormalities were dominated by abnormal relaxation of left ventricle in 62.5%, increased of left ventricle mass in 54.7% and left atrium dilation in 28.1%. Patients with type 2 diabetes mellitus and hypertension had more left atrium dilation with a p of 0.02. disorders of global kinetics and systolic dysfunction were more prevalent in smoking patients with statistically significant associations, respectively, p = 0.02;p = 0.03. dyslipidemia had a statistically significant association with segmental kinetic disorders with a p of 0.008. duration of diabetes greater than 5 years was associated with left atrium dilation and p-value was 0.04. Conclusion: diabetes is responsible for cardiovascular manifestations that can be identified with transthoracic echocardiography. Its performance in diabetic patients makes it possible to refine the patient’s management.

关键词： diabetes Echocardiography Mali Hospital

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Septic Hip Arthritis at chu gabriel toure: Therapeutic and Evolutionary Aspects

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Surgical Science 2023年第3期14卷 162-169页

作者： Abdoul Kadri Moussa Mahamadou diallo Layes Touré Mamadou B. Traoré Tiéman Coulibaly Adegné Togo service d’orthopédie-traumatologie chu gabriel toure Faculté de Médecine et d’Odontostomatologie (FMOS) Bamako Mali

Introduction: Septic hip arthritis involves the functional prognosis of the hip in case of joint destruction. The aim of this work was to evaluate the hospital frequency, to determine the therapeutic and evolutionary aspects of septic arthritis of the hip at the trauma orthopedic department of chu gabriel toure Bamako. Methods: This was a descriptive, monocentric, cross-sectional study of patients with septic hip arthritis, managed from January 2010 to december 2019. Results: We collected 48 patients. Gender male was represented 58.3% with a sex ratio of 1.4. The average age of our patients was 17.02, with extremes of 7 and 80. Septic hip arthritis was observed in a chronic mode in 87.5% (more than 3 weeks). diagnosis was based on clinical, bacteriological and imaging. Trauma was incriminated in 5 cases (10.4%). The radiographic assessment at the time of the consultation was normal in 66.7% of cases. Staphylococcus aureus was the most common germ with 47.9%, and the culture was sterile in 10.4%. Septic hip arthritis was complicated in 18.75% of cases. Antibiotic therapy was probabilistic with the combination of ciprofloxacin and metronidazole in 24 cases (50%). Watson Jones antero-lateral arthrotomy was performed in 35.71%. We observed 66.6% complications. After an average decrease of 41.6 months, functional results were good in 58.3%. Conclusion: Septic hip arthritis is a serious condition of the child and adolescent. diagnosis must be early;management must also be early, multidisciplinary and adapted to minimize sequelae.

关键词： Hip Arthritis Septic Treatment Evolution Mali

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Fracture of the Humeral Palette in Adult Patient: Therapeutic and Evolutive Aspect at gabriel Touré Hospital: About 35 Cases

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Surgical Science 2023年第4期14卷 271-276页

作者： Mahamadou diallo Abdoul Kadri Moussa Kalifa Coulibaly Layes Touré Mahamadou dama Mamadou Bassirou Traoré Cheick Oumar Sanogo Terna Traoré Famakan doumbia Mamadou diallo Amadou Maiga Adégné Pierre Togo Tiéman Coulibaly service d’orthopédie-traumatologie CHU Gabriel Touré Bamako Mali

Introduction: Fractures of the humeral pallet occur between the distal insertion of the anterior brachial muscle and the joint space of the elbow. It represents 2% of all elbow fractures. These lower humeral fractures present a therapeutic challenge to trauma. These fractures are in the majority of joint cases and can be accompanied by loss of substance, which makes their functional prognosis random despite the application of the main therapeutic principles: exact reduction with possible bone graft;stable osteosynthesis, usually allowing early rehabilitation. This work focused on identifying therapeutic aspects and assessing treatment outcomes. Material and Methods: This was a descriptive cross-sectional study of patients with a fracture of the humeral palette from January 2015 to december 2019 at the orthopaedic Trauma department chu gabriel Touré Bamako. Results: We collected 35 cases of fractures of the humeral palette. The average age was 39.25 years with extremes of 22 and 74 years. The male gender predominated (71.4%) with a sex ratio of 2.5. Etiologies were dominated by falls with 19 cases (54.3%) and stroke with 13 cases (37.1%). The standard X-ray of the face and profile of the elbow was performed in all our patients. The most frequent types of anatomoradiology were supra condylar fractures type A in 16 cases (45.7%), supra and inter condylar fractures type C in 15 cases (42.9%);4 cases of uni condylar fractures type B (11.4%). Associated lesions were observed in 42.85%. Surgical treatment was performed in 80% of cases. Complications were dominated by elbow stiffness in 18 cases (51.42%), secondary displacement in 5 cases (14.28%), ossifications in 4 cases (11.42%). At an average decrease of 3.2 years our results were considered good in 45.7%. Conclusion: Fractures of the humeral palette are relatively common with associated lesions. The complexity of the fracture with associated lesions makes treatment difficult with unpredictable evolution.

关键词： Fracture Humeral Palette Anatomopathology Treatment Evolution Bamako Mali

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Surgical Management of Recent Traumatic Epiphyseal Fractures-detachments of the distal Femur at gabriel TouréUniversity Hospital

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Surgical Science 2023年第2期14卷 61-71页

作者： Mahamadou diallo Abdoul Kadri Moussa Layes toure Kalifa Coulibaly Mamadou Bassirou Traoré Cheick Oumar Sanogo Terna Traoré Mamadou diallo Amadou Maiga Adégné Togo service d’orthopédie-traumatologie CHU Gabriel Touré Bamako Mali service d’orthopédie-traumatologie Etablissement Hospitalier Publique Sikasso Sikasso Mali service d’orthopédie traumatologie CHU de Kati Kati Mali service de Neurochirurgie CHU Gabriel Touré Bamako Mali service de chirurgie générale CHU Gabriel Touré Bamako Mali

Traumatic epiphyseal detachment fractures of the distal end of the femur are a rare lesion whose severity is linked to disabling sequelae such as limb length inequality or most often axial deviation. In this report, surgical treatment aims to reconstruct the anatomy of the distal femur, to avoid secondary displacements and to allow early mobilization of the knee. Surgery carried out mainly by the technique of plugging in or screwing, opened or better still closed, can be a source of complications including migration of pins, infections, knee stiffness, and growth disorders. The aim of this work was to describe their epidemiological, anatomo-clinical, therapeutic and evolutionary aspects in the department of orthopedics-Traumatology at the chu gabriel toure. It was a retrospective study over 30 months from July 2019 to december 2021. In fact, it concerned 42 patients with traumatic epiphyseal detachment of the distal femur occurring within 21 days or less, on a healthy knee with cartilage fertile treated surgically and followed in the department. However, the diagnosis of traumatic epiphyseal detachment of the distal femur was retained thanks to the clinical examination and supplemented by radiographic images of the knee from the front and from the side. The treatment was surgical. The functional results were evaluated according to the functional criteria of the Eastern orthopedic Traumatology Society (SOTEST). Forty-two patients included 32 boys and 10 girls of average age of 12 years with extremes of 8 years and 16 years. The lesions were classified according to the Salter Harris classification. We noted 24% type I (n = 10), type II 71% (n = 30), type III 2% (n = 1), type IV 2% (n = 1). Union was achieved in all patients within an average of 6 weeks with extremes of 4 and 12 weeks. The functional result was considered good in 20% of cases and very good in 80%. Traumatic epiphyseal detachment fractures of the distal end of the femur are a rare lesion whose severity is linked to disabling sequelae such as limb len

关键词： Epiphyseal detachment distal Femur Treatment Surgical

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Serological Profile of Hepatitis d Virus (Hepatitis delta) in the Hepato-Gastro-Enterology department of chu gabriel toure

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Open Journal of Gastroenterology 2024年第3期14卷 93-98页

作者： Sanra déborah Sanogo Kadiatou doumbia Hourouma Sow Moussa Younoussou dicko Youssouf Oumarou Abdoulaye Berthé Sabine drabo Luc Sidibé Makan Siré Tounkara Abdoulaye Maiga Ouatou Mallé Ganda Soumaré Anselme Konaté Moussa Tièmoko diarra Hepato-Gastroenterology department CHU Point G Bamako Mali Hepato-Gastroenterology department CHU Gabriel Touré Bamako Mali department of Internal Medicine Centre Hospitalier Universitaire Communautaire de Bangui Bangui Central African Republic

Infection with the defective hepatitis d virus (HdV) co-infects or superinfects a patient carrying hepatitis B virus (HBV). delta virus infection is relatively common. The seriousness of infection with the hepatitis d virus (HdV), a virus defective in a patient carrying the hepatitis B virus (HBV), lies in its aggravating effect on the associated viral hepatitis B. Our aim was to study the serological profile of HdV in HBsAg-positive patients. As this study was fragmentary, we initiated this study with the aim of investigating the serological profile of HdV in HBsAg-positive patients. This was a descriptive and analytical cross-sectional study that ran from March 2019 to February 2020, a 12-month period. It focused on the population of patients seen and screened positive for HBsAg. We obtained a frequency of 10%. The mean age of our patients was 41.8 ± 13.09 years. The sex ratio was 4.5. VHd RNA was detected in 50% of patients. In 100% of cases, the presence of VHd RNA was associated with advanced fibrosis according to the APRI score, but without any statistically significant link. All HBV-infected patients should be screened for anti-HdV Ac. HdV infection leads to rapid progression to complications of liver disease.

关键词： HBsAg VHd RNA Liver disease

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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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