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The Complications of Cesarean Section at teaching hospital gabriel toure, Bamako Mali

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Open Journal of Obstetrics and Gynecology 2020年第4期10卷 546-557页

作者： Abdoulaye Sissoko Alassane Traore Ibrahim Kante Amadou Bocoum Soumana Oumar Traore Seydou Fane Daniel Dembele Aminata Kouma Mamadou Sima Fatoumata K. Tounkara Amadou Fomba Ibrahima Teguete Youssouf Traore Soumaila Keita Niani Moukoro teaching hospital gabriel toure Bamako Mali teaching hospital Bamako Mali teaching hospital Point G Bamako Mali District hospital Commune V Bamako Mali teaching hospital Kati Bamako Mali Research Center CHU of Quebec University of Laval Quebec Canada

Cesarean operation permits to save the mother and fetus. However, in developing countries as ours, complications related to this cesarean are not to be neglected. It constitutes an important cause of maternal and fetal morbidity and mortality. Here we rapport the experience of our structure about the complications of cesarean. Objectives: The objectives of this study were to study the complications the complications of cesarean section at teaching hospital gabriel toure, Bamako Mali. Materials and methods: We have carried out a cross sectional analytic study from January 1st?2003 to December 31st?2013. All the patients who gave birth by cesarean operation in gynecology-obstetric service of teaching hospital gabriel toure were included during this period of study. Descriptive statistics were used, Chi-square test Pearson, and?Cochran Armitage test have?been used to calculate the P-value of trend. We performed multivariate analyses with a high alpha threshold of 10%, and then logistic regression multivariate. Results: We have registered 28,376 deliveries with 9509 cases of cesarean (33.5%) and a complication cesarean rate of 32% (3049/9509). The main risk factors for cesarean operation completions were adolescence primiparity, obesity, the non-realization of antenatal care, evacuations and co-morbidities. Intraoperative complications were dominated by hemorrhage 8.3% and bladder lesion 1.1%, whereas anemia (58.8%) and parietal infection (21.1%) dominated the postoperative complications table. The evacuation (Odds Ratio adjusted (ORa) = 1.96) as well pre-eclampsia/eclampsia?(ORa = 2.34) and the sicle cell disease (ORa = 9.99) were the main influencing factors of material death. Praevia placenta (ORa = 1.75) abruption placenta (ORa = 11.08) and fetal malformation (ORa = 2.21) dominated the influencing factors of perinatal death. Conclusion:?The cesarean complications rates were high in our improvement of the quality of antenatal care.?The reorganization and revitalizati

关键词： Cesarean Complication Risk Factors Morbidity Mortality

Profile and Antibiotic Sensitivity of Acute Pyelonephritis in Children at gabriel toure teaching hospital, Bamako

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Open Journal of Pediatrics 2020年第1期10卷 94-108页

作者： Djeneba Konate Lala N’Driany Sidibe Karamoko Sacko Bakary Kone Adama Kone Aminata Doumbia Fatoumata Tiero Pierre Togo Fatouamata Leonie Diakite Abdoul Karim Doumbia Belco Maiga Fousseyni Traore Aamadou toure Hawa Diall Mohamed Elmouhouloud Cisse Adama Dembele Oumar Coulibaly Yacouba Aba Coulibaly H.Konare Isabelle Traore Guediouma Dembele Issiaka Kone Leyla Maiga Ibrahima Ahamadou Abdoul Aziz Diakite Boubacar Togo Mariam Sylla Fatoumata Dicko-Traore Pediatric Department CHU Gabriel ToureBamakoMali Pediatric Unit Hospital Center Mother-ChildLuxembourgLuxembourg

Background: Very common symptom in children, fever, perhaps a warning sign of more or less severe pathology, rapidly progressive, including an invasive bacterial infection such as acute pyelonephritis (APN). The aim of this work was to study the bacteriological profile and antibiotic sensitivity of APN in children. Methods: A prospective study involving any infant or child aged 3 months to 15 years with an acute fever (≥38°C) in which a urine test strip was performed in the pediatric department of the teaching hospital gabriel toure between April 1st and May 15th, 2019 (45 days). Results: 124 children were included out of 244 febrile patients. Infants (3 - 23 months) predominated (52.8%) with a sex ratio of 2. Seventy-five percent of children came directly from home and 30.6% were on antibiotic prior to admission. The urine bag sample was taken in 55.6% and the urine was macroscopically cloudy in 32.3%. Stigmas of urinary tract infection at the urinary strip were present in 56.5%. Confirmation of acute pyelonephritis (APN) by CytoBacteriological Urine Examination (CBUE) was 29% with Escherichia coli (63.9%) or Enterococcus faecalis (30.5%). Sensitivity was excellent for ciprofloxacin and imipenem (100%). The overall resistance was greater for gentamicin, cotrimoxazole, ceftriaxone, cefotaxime and amoxicillin-clavulanic acid (Threshold: 17.9% - 95.6%). APN was associated with bacteremia in 2.8% with hospitalization for 45.2% and mortality of 11.1% (due to severe acute malnutrition, severe dehydration and multifocal infection). Conclusion: The APN, daily activity of pediatrician in Bamako, is observed in one third of febrile children associated with a major life-threatening condition of risk factors, then the likely antibiotherapy could be amikacin in our context.

关键词： APN Fever Child Bamako

Hematological Profile of Newborns hospitalized for Neonatal Bacterial Infection in the Neonatology of the Pediatric Department of gabriel toure teaching hospital Bamako, Mali

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Open Journal of Pediatrics 2020年第1期10卷 1-11页

作者： F. L. F. Diakité A. A. Diakité O. Coulibaly H. Diall A. Bocoum L. N. Sidibé D. Konaté K. Sacko B. Maiga F. Traoré P. Togo A. Dembélé A. K. Doumbia N. L. Traoré H. Konaré M. E. Cissé A. Touré Y. A. Coulibaly M. Sylla M. Baby F. Dicko-Traoré Department of Pediatrics CHU Gabriel Toure Bamako Mali National Center for Blood Transfusion Bamako Mali

The blood count is an easily achievable routine exam and will it have specifics in the event of a neonatal bacterial infection? Hence, the present study with the objective of determining the profile of the hemogram of newborns hospitalized for early bacterial neonatal infection. Material and methods: This was a cross-sectional study that took place from June 27 to September 03, 2016 in the neonatology department of teaching hospital gabriel toure. Included were all neonates hospitalized for early neonatal bacterial infection (ENBI) and who had a blood count. Results: We included 227 patients, 64.8% of whom were premature. The sex ratio was 1.4. The infants were less than 24 hours old in 93.6% of the cases. The mean hemoglobin level was 16.435 g/dl [8.8 - 22.26]. Erythrocytopenia was found in 18.5% of cases. Anemia was present in 17% of newborns. The average leukocyte was 15.228·103/mm3 [1.4 - 72]. Hyperleukocytosis and leukopenia were found in 12.32% and 6.6% respectively. Neutropenia and lymphopenia were present in 14.5% and 30.8%. There was a correlation between leukocytosis of negative blood cultures (23/27) (p = 0.030). For Neutrophils, neutrophilia was more observed in term neonates and neutropenia in premature infants (p = 0.03). Monocytosis was present in 13.6% of cases. One quarter (25.5%) of newborns had thrombocytopenia. Conclusion: Hematological variations did not allow a specific profile of newborns hospitalized for early neonatal bacterial infection to be identified.

关键词： Hematological Profile Newborns Early Bacterial Neonatal Infection

Epidemio-Clinical Characteristics of Perinatal Anoxia and Immediate Outcome of Patients at hospital teaching gabriel toure of Bamako

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Open Journal of Pediatrics 2019年第4期9卷 326-336页

作者： L.N.Sidibe H.Diall1,D.Konate O.Coulibaly F.L.Diakite K.Sacko F.Traore O.H.Diallo L.Maiga I.Ahamadou I.Traore I.Kone1,B.Maiga P.Togo A.K.Doumbia A.toure E.M.Cisse A.Dembele Y.A.Coulibaly A.Doumbie A.Konare1,A.A.Diakite B.Togo M.Sylla F.DickoTraore Department of Pediatrics CHU Gabriel ToureBamakoMali Faculty of Medicine and Odonto-Stomatology of Mali BamakoMali

Introduction: Neonatal asphyxia (NA) is one of the most likely causes of neuro-developmental abnormalities in children. In Mali it is responsible for half of the early deaths and the third of neonatal mortality. Updated data would help understand and improve intervention strategies to reduce mortality. Objective: It is the study of epidemiological and clinical characteristics, the immediate outcome and the factors associated with newborn (NB) mortality with NA. Material and Methods: This was a prospective cross-sectional study from June 27th to September 3rd 2016 about the NBs admitted for NA in the hospital teaching gabriel Touré of Bamako. The clinical and biological data including the prognosis were collected from the health records of women, the liaison sheets and the medical file. The analysis was done using the software Epi info version 3.5.1. Results: 76 NBs were included which represented 23.45% of hospitalizations. The majority (89.5%, n = 68) were admitted to less than 24 hours of life for NA grade III according to the Sarnat classification (43.4%, n = 33). The average age of mothers was 24.17 ± 5.5 years. Almost half (41.3%, n = 31) were primigravida. The most common obstetrical event was dystocia (64.5%, n = 49). The prognosis was poor in grade III anoxia in our patients (56%) of deaths. Conclusion: The périnatal anoxia (PA) is a major health issue in Mali because of its frequency and severity. Monitoring of pregnancies, delivery assisted by skillful and qualified personnel, mastery of neonatal resuscitation techniques are good means of prevention.

关键词： Anoxia Newborn Epidemiology Clinical Outcome

Hypertension (Htn) among Young People of 18 to 35 Years Old in Cardiology Department of gabriel toure University teaching hospital

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World Journal of Cardiovascular Diseases 2018年第1期8卷 11-17页

作者： Ichaka Menta Hamidou O. Ba Kassoum M. Sanogo Cardiology Department of “Gabrièl Touré” University teaching hospital Bamako Mali

Few studies have been conducted on hypertension among youth in Mali?hence the interest of our study aimed to clarify certain aspects what are not taken account yet in previous studies.?Objective: Determine the clinical and para-clinical characteristics of hypertension among 18 to 35 years old young people.?Methods:?This cross-sectional and retrospective study of 24 months from January 1st, 2009 to December 31st, 2010?in the cardiology department of the gabriel Touré UTH.?Results:?We identified 132 cases during the study period out of 2146 cases of hypertension with a prevalence of 6.1%. The female gender represented 81.8%, with a sex ratio of 45.59, 1% of patients had an unknown family history of hypertension. The age group of 31 to 35 years accounted for 43.9%. The circumstances of discovery were dominated by exertional dyspnea (37.9%). Body mass index was normal in 45.5% of patients. The higher BMI was more common in female patients with 39.39% (p?= 0.045). In the sample,53% of patients had a systolic blood pressure between 140?and 159 mmHg and 38.6% had diastolic blood pressure ≥ 110 mmHg with no significant difference (p?> 0.5). The high creatinine level was found in 18.18% of our patients. The ECG?found?84.6%?of left ventricular hypertrophy among cavitary hypertrophies. The echocardiography has found cavitary?dilatation in 40.04% of cases;it concerned the left ventricle in 25.71%. Also 18.57% of our patients had impaired left ventricular systolic function. Among the complications found in our patients, kidney failure led with 56%.?Conclusion:?Hypertension is not a rare event among young population even with a normal body mass index. It is often discovered during complications that can be dreadful.

关键词： Hypertension Young People Complications

Blows and Voluntary Wounds of the Emergency Unite in gabriel toure teaching hospital in Bamako

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Surgical Science 2018年第9期9卷 334-343页

作者： Mangané Moustapha Diop Thierno Madane Almeimoune Abdoul Hamidou Keita Soumaila Dembelé Aladji Seydou Youssouf Sogoba Konaté Madiassa Koita Siriman Traoré Amadou Issa Amadou Badimi Siaka Abdoulaye Kanté Diallo Sadio Sangaré Harouna Dembelé Bakary Tientigui Togo Adegné Diango Djibo Mahamane Department of Anesthesiology and ICU H&#244 pital gabriel Touré Bamako Mali Department of General Surgery H&#244 pital du Point G Bamako Mali Department of Anesthesiology H&#244 pital IOTA Bamako Mali Department of Neurosurgery H&#244 pital gabriel Touré Bamako Mali Department of General Surgery H&#244 pital gabriel Touré Bamako Mali Department of Anesthesiology and ICU H&#244 pital Mère-Enfant Bamako Mali Department of Pediatric Surgery H&#244 pital gabriel Touré Bamako Mali

Introduction: Voluntary assault and injuries are acts that damage the physical and psychological integrity of a human being. WHO in its global report on violence and health estimates that in 2000, 1.6 million people worldwide died as a result of self-harm, interpersonal or collective violence, resulting in an overall rate adjusted by age of 28.8 per 100,000 population. Because of the seriousness of this phenomenon and the heavy socio-economic and health consequences that they generate, it seemed important to us to undertake this study, which aimed to study the deliberate injuries in the emergency unite of the gabriel Touré teaching hospital in Bamako. Material and methods: This was a descriptive and cross-sectional study with a prospective study from September 1st, 2016 to August 31st, 12 months, covering 295 patients, including any patient received for voluntary injury consultation with a workable medical record and/or a full investigation record with or without requisition. Our data were collected on individual survey cards and subsequently analyzed with Word, Excel, IBM SPSS Statistics 22 software. Results: The majority of victims of assault and bodily injury were male with 83.1%;with a sex ratio of 4.9, the 18 to 28 age group was the most concerned with 163 cases of the 295 cases in our study, 55.2%. The extremes were 6 and 100 years old with an ectype at 11.08. The most affected ethnic group was Bambara with 38.6% (n = 114) followed by Fulani with 15.6% (n = 46). Students were the most affected at 24.7% (n = 73), followed by traders at 10%. The victims coming from outside Bamako are the most predominant with 22.4% (n = 66) followed by those of commune IV of Bamako 15.6% (n = 46). In 92.2% of the cases the mechanism was direct with n = 272. Of the lesions recorded in our study, wounds came first with 53.2% of cases. Radiography was the most used imaging at 44.7% (n = 89) followed by computed tomography at 34.7% (n = 69). The hemoperitoneum objectified by abdomin

关键词： Blows Wounds EU gabriel Touré University hospital

Study of Cofactors Associated with Precancerous High-Grade Cervical Lesions at the teaching hospital gabriel Touré, 2010 to 2015

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Surgical Science 2019年第9期10卷 328-337页

作者： Fané Seydou Bocoum Amadou Sissoko Abdoulaye Traoré Soumana Oumar Sanogo Siaka Amara Mamadou Sima Kouma Aminata Traoré Alassane Tegueté Ibrahima Traoré Youssouf Mounkoro Niani teaching hospital gabriel toure Bamako Mali

Introduction: High grade dysplasia of the cervix has a high incidence and can progress to cervical cancer. The aim was to study cofactors associated with high-grade cervical dysplasia. Methodology: This was a retrospective case-control study without matching. Women with high grade dysplasia were the cases while those with a normal screening test represented the controls. The study took place at the gabriel Touré University hospital Center in Bamako. We included 351 cases and 420 controls. The capture and analysis were performed using the SPSS 20 software. A univariate and multivariate logistic regression analysis was performed for the analysis of risk cofactors. The statistical tests used were the odds ratio and its confidence interval and the statistical significance threshold was set at p Results: In univariate analysis, the co-factors statistically significantly associated with the occurrence of high-grade dysplasia were parity 0.6 (0.5 - 0.9), gestational 0.7 (0.5 - 0.9), smoking of the spouse 3.4 (1.1 - 11.3), the non-schooling 1.4 (1.2 - 2.1). In multivariate analysis after adjusting for confounding factors, two co-factors have significantly increased the risk of high-grade dysplasia: lack of schooling 1.4 (1.2 - 2.0) and polygamy 1.5 (1.4 - 2.5). Conclusion: At the end of this study, polygamy and lack of schooling were the main risk factors. The prevention of cervical cancer will go through the education of girls and women as well as communication for behavioral change and social change.

关键词： High Grade Dysplasia Cofactor Cervical Cancer teaching hospital gabriel Touré

Surgical Complications of Pica Syndrome: About 03 Cases

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Open Journal of Pediatrics 2020年第1期10卷 159-167页

作者： A. Doumbia Y. Coulibaly I. Amadou M. Keita O. Coulibaly B. Kamaté M. K. Djiré M. Y. Coulibaly S. Camara H. Diall B. Maiga D. Konaté K. Sacko Service of Pediatric Surgery Teaching Hospital Gabriel Toure Bamako Mali Service of General Pediatric Teaching Hospital Gabriel Toure Bamako Mali

The Pica syndrome is an eating disorder characterized by an excessive or abnormal desire to consume a non-nourishing substance which can be relatively harmless, or potentially harmful for the health. It is a rare affection secondary to the accumulation of diverse nature foreign bodies inside the digestive tract and more especially at the stomach level. Gastro-intestinal localization is the most frequent, and can remain long time asymptomatic. Treatment is surgical. We report 3 cases of digestive complication of Pica syndrome. The first one was operated for gastric perforation due to nail (53 nails, a pin and bands of tape recorder cassette ingested), the second one for trichobezoar and the last had a subocclusion by pieces of granite.

关键词： Pica Syndrome Complications Bezoar Child Mali

Congenital Left Mesenteric-Parietal Hernia Associated to a Small Bowel Volvulus: About a Case

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Open Journal of Pediatrics 2020年第3期10卷 404-410页

作者： Coulibaly Yacaria Doumbia Aliou Amadou Issa Coulibaly Oumar Moussa Kamaté Benoi Djiré Mohamed Kassoum Tanapo Kalifa Service of Pediatric Surgery Teaching Hospital Gabriel Toure Bamako Mali

Introduction: The left mesenterico-parietal hernia or left paraduodenal hernia is an anomaly of intestinal rotation which may be responsible for intestinal obstruction. It is rare. Observation: A 5-year-old boy was admitted for abdominal pain with episodes of vomiting and cessation of matters and gases. After clinical and paraclinical investigations, the diagnosis of occlusion was accepted and the child was operated. Exploration revealed a mesenterico-parietal hernia with a retrocolic sac measuring 11 cm of collar and a deep of 18 cm containing a twisted bowel. After reduction of the content, we untwisted the small intestine and released adhesions. The hernial sac was partially resected and the defect was closed. Operating outcomes were simple. Conclusion: The mesenterico-parietal hernia is a cause of organic intestinal obstruction. Although of congenital origin, it can have a late clinical manifestation. It should be considered in case of episodes of repetitive abdominal pain and vomiting to avoid complications.

关键词： Mesenterico-Parietal Hernia Small Bowel Volvulus Child Mali