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Clinical and Therapeutic Aspects of Genital Prolapse at Hôpital du mali about 100 Cases

Open Journal of Obstetrics and Gynecology 2023年第1期13卷 121-132页

作者： Mamadou Bakary Coulibaly Mody Abdoulaye Camara Alassane Traoré Mamadou Keïta Bourama Kané Abdramane Togo Issa Ongoiba Kalba Tembiné Amadou Sidibé Baba Fané Ibrahima Tégueté Youssouf Traoré Gynecology Department of Hô pital du mali Bamako Mali Medical Imaging Department of Hô pital du mali Bamako Mali Referral Health Center of Commune VI of the District of Bamako Bamako Mali Pediatrics Department of Hô pital du mali Bamako Mali Anesthesia and Intensive Care Unit Hô pital du mali Bamako Mali Biomedical Department of Hô pital du mali Bamako Mali Department of Gynecology Obstetrics UTH Gabriel Touré Bamako Mali

To study the epidemio-clinical aspects, and the therapeutic attitudes of genital prolapse (GP) in the gynecology department of Hôpital du mali (HDM). This is a descriptive retro-prospective study over five (5) years from January 2015 to December 2019, conducted in the gynecology department of HDM. We had collected 100 cases of GP out of 989 surgeries, with a frequency of 9.89%. The age group of 60 years and over accounted for 33% of our patients, with a mean age of 50 years. Multiparous were the most affected (89%). The notion of obstructed labor was observed in 52% of patients. The most found reason for consultation was the feeling of lump in a vagina, with 65%. Grade III according to BADEN-WALKER classification system (BWCS) concerned 72% of our patients. Triple perineal surgery and hysterectomy involved 56% of our patients. Spinal anesthesia was performed in 96% of cases. Per and postoperative complications were dominated by urinary retention in 4% and by infection of the surgical site in 2%. The average hospital stay was 3.2 days. We recorded 88% of satisfied patients after the intervention. No deaths were recorded during the study. The management of genital prolapse remains essentially surgical;it requires a semiological analysis and a mastery of the surgical technique.

关键词： Genital Prolapse Therapeutic Attitudes Hôpital du mali

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Uterine Leiomyomas Surgery: Assessment of Five Years in the Gynecology Department of Hôpital du mali

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Open Journal of Obstetrics and Gynecology 2021年第9期11卷 1161-1171页

作者： Mamadou Bakary Coulibaly Alassane Traoré Mody Abdoulaye Camara Adama Sangaré Issa Ongoiba Mamadou Keïta Kalba Tembine Amadou Sidibé Ibrahim Teguete Youssouf Traore Service of Gynecology of Hô pital du mali Bamako Mali Service of Medical Imaging of Hô pital du mali Bamako Mali Gynecology-Obstetrics Unit of Referral Health Center of Commune VI Bamako Mali Service of Anesthesia and Resuscitation of Hô pital du mali Bamako Mali Service of Gynecology-Obstetrics Chu Gabriel Toure Bamako Mali

Uterine leiomyomas (myomas) are the most common benign tumors of the female genital tract. They affect 20% to 25% of women of childbearing age and are 3 to 9 times more common in black women. We initiated this study in order to report the socio-demographic aspects and the indications for leiomyomas surgery at Hôpital du mali. This was a retro-prospective descriptive study, conducted in the gynecology department of Hôpital du mali from January 1, 2015 to December 31, 2019. Any patients, regardless of their age, in whom a leiomyomas had been detected and surgically treated were included. We had collected 180 cases of surgery for leiomyomas out of 950 surgical procedures, with a frequency of 18.94%. The 36 - 45 age group represented 45% of our patients w

关键词： Uterine Leiomyomas Surgery Hôpital du mali

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Role of Laparoscopic Surgery in the Management of Female Infertility at the Department of Gynecology of Hôpital du mali

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Open Journal of Obstetrics and Gynecology 2020年第10期10卷 1430-1440页

作者： Mamadou Bakary Coulibaly Alassane Traoré Mody Abdoulaye Camara Bourama Kané Adama Sangaré Kalba Tembiné Ibrahima Tégueté Youssouf Traoré Service of Gynecology of Hopital du mali Bamako Mali Service of Medical Imaging of Hopital du mali Bamako Mali Service of Pediatric of Hopital du mali Bamako Mali Service of Anesthesia and Resuscitation of Hopital du mali Bamako Mali Service of Gynecology-Obstetrics CHU Gabriel TOURE Bamako Mali

Infertility is a socio-cultural drama in Africa, especially in mali and remains difficult for couples to overcome. Laparoscopy, also called minimally invasive surgery or keyhole surgery, is an operative technique that permits to explore the pelvis and perform an appropriate therapeutic procedure. The objective of our work was to assess the role of laparoscopic surgery in the treatment of female infertility at Hopital du mali. It was a retrospective descriptive study that was conducted over a period of 5 years (January 2013 to December 2018). Any patients followed for infertility and who underwent laparoscopic surgery in the gynecology department over a period of two (2) years were included. The outcome of laparoscopic surgery was evaluated in terms of conception of pregnancy. We had collected 103 infertile patients out of 2984, with a frequency of 3.45%. The mean age of our patients was 30.2 years. Housewives and out-of-school women accounted for 68.93% and 54.37% respectively. Nulligravida represented 41.75%. Regarding infertility, it was primary in 41.75% and secondary in 58.25%, with an average duration of 6.2 years. Systematic chlamydial serology was positive in 62.14% of our patients. Hysterosalpingography (HSG) revealed bilateral tubal obstruction in 53.33% of cases. Laparoscopy found tubal adhesions in 97.80% of cases. Adhesiolysis was the main procedure performed with 84.47% bilateral tubal patency achieved in the methylene blue test. Among our patients who had contracted a pregnancy (22.99%), 85% had carried their pregnancies to term. Tubal damage was the main cause of infertility. Adhesiolysis remains the main laparoscopic procedure for treatment.

关键词： Laparoscopic Surgery Infertility Hopital du mali

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Clinical and Therapeutic Aspects of Giant Fibroids at the Hôpital du mali about 30 Cases

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Open Journal of Obstetrics and Gynecology 2020年第6期10卷 778-789页

作者： Mamadou B. Coulibaly Alassane Traore Mody A. Camara Abdrahamane Togo Adama Sangaré Issa Ongoiba Kalba Timbine Amadou Sidibé Apérou Guindo Niani Mounkoro Ibrahim Teguete Youssouf Traore Moustaphe Toure Service of Gynecology of the Hopital du mali Bamako Mali Service of Medical Imaging of the Hopital du mali Bamako Mali Service of Anesthesia and Resuscitation of the Hopital du mali Bamako Mali Service of Gynecology-Obstetrics of Gabriel TOURE Teaching Hospital Bamako Mali

The fibroids affect 20% to 25% of women of reproductive age and are 3 to 9 times more common in black women. We’ll talk about giant fibroids (GFs) when uterine height reaches or exceeds the navel. We have initiated this study in order to report the epidemioclinical and therapeutic aspects of giant fibroids at the Hopital du Mali. A descriptive retro-prospective study, conducted in the service of gynecology of the Hopital du Mali from November 2017 to December 2018 were included in this study, any patients, regardless of their age, having developed a fibroid, the uterin e height of the patient reaching or exceeding the umbilicus on physical examination and who were on surgical treatment. We had collected 30 cases of GFs out of the 92 patients who had undergone myomectomies, with a frequency of 32.60%. The age group 25 - 29 years accounted for 46.6% with an average age of 35 years. Housewives represented 50% and nulligravida made up 33% of our patients. Desire to become pregnant was the main reason for consultation in 34.4% of cases. The uterine height was between 25 and 29 cm on physical examination in 46.66% of cases. Myomectomy was performed in 76.64% and hysterectomy in 23.3% of cases. The size of the nuclei after surgery was over 25 cm in 48.66% of our patients. Conclusion: The giant fibroid (GF) is a common cause of myomectomy. The treatment is either hysterectomy or myomectomy and

关键词： Giant Fibroma Care Surgery Hôpital du mali

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Sacrospinous Fixation in the Gynecology Department of Hôpital du mali

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Open Journal of Obstetrics and Gynecology 2021年第1期11卷 20-26页

作者： Traoré Alassane Sissoko Abdoulaye Coulibaly Mamadou Bakary Traoré Soumana Oumar Sima Mahamadou Bocoum Amadou Traoré Soumaila Touré Moustapha Tegueté Ibrahima Traoré Youssouf Obstetrics and Gynecology Department at Hopital du mali Bamako Mali Obstetrics and Gynecology Department at the Teaching Hospital Mère-Enfant Bamako Luxembourg Obstetrics and Gynecology Department at the Referral Health Center Commune V Bamako Mali Obstetrics and Gynecology Department at the Teaching Hospital Point G Bamako Mali Obstetrics and Gynecology Department at the Teaching Hospital Gabriel Touré Bamako Mali Obstetrics and Gynecology Department at the Regional Hospital of Sikasso Sikasso Mali

Sacrospinous fixation (SSF) or Richter’s intervention (RI) aims to treat genital prolapse by securing the posterior vaginal wall to the small sacrospinous ligament. It is performed by low approach and includes a dissection of the pararectal space, visual exposure of the sacrospinous ligament and a needle with strait needle holder with nonabsorbable threads. It is often associated with a more complex corrective procedure, including cystocele cure, vaginal hysterectomy and posterior myorrhaphy. The objective of this study is to report the results of SSF in the gynecology department of Hopital du mali. A descriptive study was conducted from September 2014 to September 2015 concerning 37 patients operated on for uterine prolapse (UP). All patients with grade III UP were included in our study in whom a unilateral hysterectomy (UH) and sacrospinous fixation (SSF) were performed. All the patients were scheduled. Preoperatively they had benefited from an assessment and a pre-anesthetic consultation. Hospitalization of at least 24 hours prior to the operation was required. Postoperative follow-up was two years with a physical examination at 3 months, 9 months and 15 months, and phone calls between physical consultations. during the study period, we performed 37 RIs. The mean age of the patients was 48 years with extremes of 41 to 73 years. The large multiparity was found out in 35 cases (94.59%), the pauciparous were two with 3 deliveries for each. Long labor of more than 18 hours was found out in 9 patients (24.32%) and home delivery in 13 cases (35.13%). The duration of the occurrence of prolapse was at least two years and 35 patients were going through menopause. The type of anesthesia used for the surgery was spinal anesthesia for all patients. The average duration of the operation was 90 minutes. Complications occurred in three patients or 8.10% of cases, two cases of acute urine retention and one case of hematoma of the para-rectal space. The medium time of hospital st

关键词： Sacrospinous Fixation Genital Prolapse Hôpital du mali

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Screening, Treatment and Control of High Blood Pressure on Five Sites in mali

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World Journal of Cardiovascular Diseases 2024年第5期14卷 322-332页

作者： Mamadou Touré Sagara Ibrahima Youssouf Camara Hamidou Oumar Bâ Ibrahima Sangaré Djénébou Traoré Noumou Sidibé Fousseyni Samassékou Massama Konaté Coumba Thiam Doumbia Asmaou Maiga Réné-Marie Dakouo Hamidou Camara Sako Mariam Sidibé Samba Adama Sogodogo Boubacar Diarra Boubacar Sonfo Aladji Traoré Mamadou Diakité Ilo Bella Diall Ichaka Menta Departement of Cardiology University Hospital Gabriel Tour&#233 Bamako Mali Departement of Cardiology Cardiology University Hospital Sidy Bocar Sall Kati Mali Internal Medecine University Hospital Point G Bamako Mali Departement of Cardiology Cardiology University Hospital &#8220H&#244pital du Mali&#8221 Bamako Mali Departement of Cardiology Cardiology University Hospital Mother-Children Bamako Mali

Introduction: High blood pressure is defined as blood pressure greater than or equal to 140 mm Hg for systolic and or 90 mm Hg for diastolic. It constitutes a major public health problem, the leading chronic disease in the world. The objective was to determine the prevalence, treatment rate and control of hypertension. Methods: This was a cross-sectional and descriptive study which took place over a period of 6 months in a hospital environment and in the general population. Results: Of the 1000 participants, 637 had hypertension, giving a prevalence of 63.70% with a female predominance. Thirty-three percent (33%) were unaware of their high blood pressure. The age group 60 and more was the most represented (44%). A proportion of 33 and 23.20 were overweight and obese participants, respectively. Male subjects were more overweight than female, unlike obesity which was more common among female subjects. Sixty-two percent (62%) of hypertensives were treated, of whom 44% were non-compliant. The excessively high cost and consumption of medications as needed were the main factors in therapeutic non-compliance. Twenty-two percent (22%) of all hypertensive patients and 35% of treated hypertensive patients were controlled. Women were more treated but less observant and less controlled than men. Therapeutic coverage and combination therapy rates were lower in rural areas. Hypertensives who had a high level of education were better treated and controlled than those who had no level. Conclusion: High blood pressure remains a real public health problem in mali. It is more common in people aged 60 and over and in females. One in three hypertensives were unaware of their hypertension. The majority received antihypertensive treatments, but only a minority of them had their hypertension controlled.

关键词： High Blood Pressure Screening Control Rate mali

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Epidemiological, Clinical and Coronary Angiography Aspects of Acute Coronary Syndrome in the Cardiology Department of the Hospital Mother-Child “Le Luxembourg”mali

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World Journal of Cardiovascular Diseases 2024年第4期14卷 228-233页

作者： Sidibé Samba Toure Mamadou Konate Massama Sankaré Hamma Traoré Ousmane Mahamat Guire Sadik Diall Mahan Ameri Dicko Bahaide Daffe Sanoussy Keita Asmaou Thiam Coumba Adiaratou Diarra Soumaila Menta Ichaka Cardiology Department CHU-M&#232re Enfant Bamako Mali Cardiology Department CHU-Point G Bamako Mali Faculty of Medicine University of Sciences Techniques and Technologies of Bamako Bamako Mali Cardiology Department CHU-Gabriel Tour&#233 Bamako Mali Cardiology Department Mali Hospital Bamako Mali

Introduction: Cardiac catheterisation plays a fundamental role in the management of acute coronary syndrome. These explorations require heavy, complex and costly equipment and a large team of doctors, nurses and technicians with highly specialized training. Aims: To describe epidemiological, clinical and coronary angiography aspects of patients with acute coronary syndrome. Patients and Methods: Descriptive study from September 2019 to December 2023 in the Cardiology Department of the Hôpital Mère-Enfant of Bamako. Inclusion criteria were patients admitted for coronary angiography with the diagnosis of acute coronary syndrome. Results: during the study period, 1253 patients underwent coronary angiography, 596 of whom had acute coronary syndrome as an indication, representing a hospital frequency of 47%. Sex-ratio was 2.10. Mean age of patients was 58.5 ± 11.39 years. ST elevation acute coronary syndrome was the most common indication with 63.92% of cases. High blood pressure was the main cardiovascular risk factor with 58.7% of cases, and radial access approach was used in 98% of cases. Coronary angiography was pathological in 91.70% of cases (n = 548). Patients with lesions of anterior interventricular artery were 73.73% of cases. Tritruncal lesions accounted for 40.63% of cases. Conclusion: ST elevation acute coronary syndrome is the most frequent manifestation of acute coronary syndrome. Anterior interventricular artery is most often the culprit lesion for our patients.

关键词： Coronary Angiography Acute Coronary Syndrome Bamako mali

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Laboratory Confirmation of Human Rabies by RT-PCR and qRT-PCR Bamako: Report of a Case in a 4-Year-Old Girl at the mali Hospital

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Open Journal of Pediatrics 2022年第1期12卷 252-262页

作者： Garan Dabo Bourama Kane Lassina Doumbia Korotoumou Wélé Diallo Aboubacar Sangaré Guediouma Dembélé Sanata Sogoba Mamadou Traoré Ousmane Koita Daouda Kassim Minta Service de Médecine Hô pital du mali Bamako Mali Department of Paediatrics mali Hospital Bamako Mali Laboratory of Molecular and Applied Biology Bamako Mali Service de Santé Publique Hô pital du mali Bamako Mali Pediatric service of the Commune Reference Health Center V Bamako Mali Infectious Diseases Department Centre Hospitalier Universitaire du Point G Bamako Mali

Rabies is a zoonotic disease of viral origin transmitted mainly to humans by biting or licking the injured skin of sick animals. It is an untreatable disease that is fatal once it has been declared. Worldwide, 59,000 cases of rabies-related deaths are recorded each year. The diagnosis of rabies is clinical, biological, and anatomopathological. The aim was to establish the laboratory confirmation capacity for human rabies in mali. The patient, a malian female, aged four years, was bitten by a dog around her house in district sixth of Bamako near national road number six in 2020. The patient visited the doctor after a two-month bite. However, she was neither referred to the health center for an effective therapeutic measure nor vaccination (post-exposure prophylaxis). The patient was presented with psychomotor excitation, hypersalivation, aerophobia, and hydrophobia symptoms and visited a malian hospital named “Hospital of mali”. The patient was admitted with a history of animal bites and symptoms of rabies, and the patient was classified as a probable rabies case. The patient was then referred to an infectious disease physician and hospitalized. After referring the patient to the infectious disease physician, the physician sent oral swab and cerebrospinal fluid (CSF) samples to confirm to the Laboratory of Applied Molecular Biology. Human rabies was confirmed (RT-PCR) by the zoonotic unit of the Laboratory of Applied Molecular Biology. Diagnosis and therapy of human rabies without post-exposure management after a dog bites were still challenging. It was possible to confirm the human rabies case in mali by RT-PCR and qRT-PCR.

关键词： Dog Bite Human Rabies Diagnosis mali

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Progressive Characteristics of HIV Infection in the Elderly in the Cohort of the Internal Medicine Department of the Points G University Hospital, Bamako. mali

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Advances in Infectious Diseases 2023年第1期13卷 109-116页

作者： Abdoulaye Mamadou Traore Garan Dabo Mamadou Cissoko Charles Dara Djenebou Traoré Ibrahim Dollo Djibril Sy Assétou Soukho Mamadou Dembélé Daouda Kassoum Minta Abdel Kader Traore Hamar Alassane Traore Department of Infectious Diseases CHU du Point G Bamako Mali Department of Medecine CHU “Hôpital du Mali” Bamako Mali Department of Internal Medicine CHU du Point G Bamako Mali

Few data are available on HIV infection in the elderly and they are an important population in our different cohorts in view of the improvement in the quality of care over the last ten years. Objective: to determine the clinical and immunovirological characteristics as well as the acceptance of antiretroviral drugs in this patient population. This is a cohort study of the files of PLHIV (People living with HIV) aged 50 years or more, followed in the Internal Medicine Department of the Point G University Hospital between January 2007 and December 2012. Results: Out of 161 HIV-infected patients in the cohort, 38 were aged 50 years or older, of whom 11 met the criteria and were included. The median age was 55 years, 90.9% of whom were in the [50 - 59 years] age group, with 63.6% being women (sex ratio = 0.57). At admission, 3 patients (27.3%) had prurigo and 2 (18.2%) had oral-pharyngeal candidiasis. At inclusion, 45.5% of patients were classified as WHO stage 2 and one as WHO stage 4. All were on ARVs, including 10 on 1st line HIV-1 and 1 on HIV-2. On triple therapy, the average weight gain was 5.1 kg at D15 and 6.84 kg at M6. However, at M12 there was a weight loss of 1.04 kg. The mean CD4 T cell gain was +102/mm3 at M6 and +188/mm3 at 12 months. At D0, mean viral load = 565024.75 copies/mm3 [99 - 1100000] in 4/11. At M12, two patients had undetectable viral loads. Conclusion: The prevalence of HIV in elderly subjects is certainly underestimated. Thanks to triple antiretroviral therapy, PLHIV are aging with HIV but screening is not systematically proposed during consultations in elderly subjects. It is necessary to reinforce communication about HIV at all ages.

关键词： HIV Elderly Clinical Immunovirology

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Etiological and Radiological Profile of Acute Lower Respiratory Infections during the Pre-COVID Period in the Paediatric Ward of the Teaching Hospital of mali and in the Community Health Centre of Yirimadio in Bamako

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Open Journal of Pediatrics 2023年第2期13卷 262-275页

作者： Bourama Kané Mariam Maiga Oumou Koné Korotoumou Wélé Diallo Aboubacar Sangaré Mody Abdoulaye Camara Mariam Doumbia Abdoul Karim Sangaré Bréhima Traoré Lassine G. Timbiné Ibrahima Cissé Ahmadou I. Dramé Bréhima Kouriba Department of Paediatrics CHU Hôpital du Mali Bamako Mali Paediatric Department of the Centre de Santé de Référence de la Commune VI Bamako Mali National Institute of Public Health Bamako Mali Medical imaging department of the CHU Hôpital du mali Bamako Mali Charles Mérieux Infectious Diseases Centre Bamako Mali Centre de Santé Communautaire de Yirimadio Bamako Mali Department of Anaesthesia and Intensive Care CHU Hôpital du Mali Bamako Mali

Introduction: Every year, nearly 4 million people pass away from acute respiratory infections. 98% of such deaths are due to lower respiratory tract infections. Even though studies have been carried on lower respiratory infections x-ray aspects in mali, very few studies have been done to reveal bacteriological and virological evidence of this disease. Materials and methods: It is about a descriptive prospective study carried out from January to December 2018 having involved patients of all ages, coming for medical consultation at the Yirimadio Community-based health center as well as children from 6 months to 15 years old coming at the pediatric department of UHC Hôpital du mali for a lower respiratory infection. They had all undergone chest X-ray and a PCR. The purpose: of this work is to study etiological and x-ray aspects of acute lower respiratory infections at the Yirimadio Community-based Health Center and at the UHC pediatric department of Hôpital du mali. Findings: From January to December 2018, we recorded a frequency of 1.19%. The age group 0 - 5 years was the most represented (64.5%) with a sex ratio of 0.97 for women. Cough was the most common clinical sign (98.7%) followed by fever (58.9%). Standard frontal chest X-ray was pathological in 70% of our patients. It was bronchitis in 75.4% of cases, pneumonia (13.5%), and bronchopneumonia (12.3%). PCR positive was in 83.9% of patients. It revealed a co-infection in more than half of the patients (52.5%), bacterial infection (16.1%) and viral infection (15.2%). Pathogens isolated ranked by frequency were Streptococcus pneumoniaa (87.6%) followed by Staphylococcus aureus (24.9%) and human rhinovirus (17%). The most common viral causes were human rhinovirus (17%), followed by influenza A and B virus (7%) and human parainfluenza virus (7%). Conclusion: It stemed from the study that lower respiratory infections were mainly due to Streptococcus pneumonea and human rhinovirus during pre-COVID at the Yirimadio Comm

关键词： Lower Respiratory Infections Etiologies Children mali

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