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Surgical Repair of Growing Skull Fracture: A Case Report

Case Reports in Clinical Medicine 2022年第3期11卷 79-83页

作者： Youssouf Sogoba Seybou Hassane Diallo Moussa Diallo Drissa Kanikomo Boubacar Sogoba Oumar Coulibaly Mahamadou Dama Mamadou Salia Diarra Oumar Diallo Youssoufa Maiga Department of Neurosurgery Gabriel Touré Teaching Hospital Bamako Mali Department of Neurology Gabriel Touré Teaching Hospital Bamako Mali Department of Neurosurgery H&ocirc pital du mali Bamako Mali Department of Neurosurgery H&ocirc pital Luxambourg Bamako Mali

Background: Growing skull fractures (GSF) are a rare complication of pediatric head trauma that comprises post-traumatic skull defect associated with an underlying dural tear and an intact arachnoid membrane. They are often misdiagnosed, and delay in management can lead to progression of the disease with neurological sequelae. GSF are rare and their incidence has been estimated as 0.05% - 1% of all pediatric skull fractures. This low incidence and the subtlety of its presentation often make diagnosis challenging with consequent delay in management. Surgery is recommended to treat GSF and involved dural repair with or without cranioplasty. In this paper, we report a case of a patient with GSF in whom the surgical repair was successful with good cosmetic and functional outcome. Case Report: A 12 months old girl was admitted to our neurosurgical department with right parietal swelling that had been gradually enlarging over 3 months. The history of the disease began when the girl was 1 month old with a fall with cranial impact resulting in head trauma with initial loss of consciousness. At presentation the girl was alert with normal consciousness. Clinical examination revealed the deformed skull with large pulsatile and painless swelling lesion in the right parietal region and hemiparesis on the left side. The CT scan revealed type 3 GSF including parietal bone diastasis with hypodense fluid collection that mimicked the leptomeningeal and porencephalic cyst. Surgical repair was performed. The post-operative course was uneventful and the child was discharged home five days after surgical intervention. Conclusion: GSF can lead to serious neurologic complications. Therefore educating parents on this potential outcome and close follow-up with clinical and imaging screening is recommended to screen children at risk for the development of the disease.

关键词： Growing Skull Fracture Head Trauma dural Tear

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A Case Report of 3C Syndrome and Literature Review

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Case Reports in Clinical Medicine 2022年第1期11卷 8-12页

作者： Drissa Kanikomo Youssouf Sogoba Moussa Diallo Mamadou Salia Diarra Oumar Coulibaly Boubacar Sogoba Mahamadou Dama Mamady Coulibaly Mamadou Diallo Department of Neurosurgery Gabriel Touré Teaching Hospital Bamako Mali Department of Neurosurgery Luxembourg Hospital Bamako Mali Department of Neurosurgery H&ocirc pital du mali Bamako Mali

Ritscher-Schinzel syndrome, or 3C (cranio-cerebello-cardiac) syndrome is a developmental disorder characterized by cranio-facial, cerebellar and cardiac anomalies. It is a rare disease with an incidence of 1/1,000,000 inhabitants, and was first described by Ritscher-Schinzel in 1987. 3C syndrome is an autosomal recessive disease caused by a mutation on the long arm of chromosome 8 to 8q24.13, the KIAA0196 locus, the strumpellin protein gene. The cardiac and cerebral anomalies are most often leading cause of death at an early age and people with 3C syndrome rarely exceed 40 years. In this paper, we report a case of Ritscher-Schinzel in 3-month-old boy who was admitted to our neurosurgical department in September 2020. Clinical examination revealed a macrocrania with head circumference at 47 cm. There was a prominence of forehead and occiput, the root of the nose which was flat, hypertelorism and micrognatism. The CT scan revealed Dandy WALKER malformation with cystic dilation of the 4th ventricle, an aplasia of the cerebellar vermis associated with a tretraventricular hydrocephalus.

关键词： Cardiac Anomalies Ritscher-Schinzel Syndrome 3C

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Abdominal Trauma Management: About 62 Cases at the Department of General Surgery of Hôpital SominéDOLO de Mopti, mali

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Surgical Science 2021年第6期12卷 204-210页

作者： Djibril Traoré Bréhima Traoré Fodé Mory Keita Dramane Cissé Modibo Coulibaly Mory Koné Abdoul Karim Djimdé Kiffery Ibrahim Korotimi Mallé Abdoulaye Traoré Oumar Guindo Mathias Diassana Pierre M. Coulibaly Bakary T. Dembélé Pierre A. Togo Department of General Surgery H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Surgery Polyclinique des armées Kati Mali Department of Biomedical Laboratory H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Anesthesia and Resuscitation H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Public Health H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of Gynecology and Obstetrics H&ocirc pital Sominé DOLO de Mopti Mopti Mali Department of General Surgery CHU Gabriel Touré Bamako Mali

We undertook a prospective and descriptive observational study on abdominal trauma from February 1, 2016 to August 31, 2017. The aim of this work was to identify the typology and management of abdominal trauma cases in our surgery department. Overall, abdominal trauma represented 3.54% (62/1751) of all surgeries during the study period. Among the 62 cases, men accounted for 59 and women for 3. The sex ratio was 19.67. The mean age was 24 ± 15 years. Road accidents were the most represented with 43.5% of cases. The couple of signs, hypovolemic shock and abdominal pain and decrease on blood pressure were the prominent clinical symptoms with 100.0%, and 50.0% of cases, respectively. Abdominal ultrasound and abdominal x-ray without contrast were performed in 67.0% and 18.0% of cases, respectively. Abdominal trauma was divided into two entities: contusion 68% and wounds 32%. Medical treatment was sufficient in 23.00% of cases. Laparotomy as a surgical approach was performed in 77.0% of cases. Local hemostasis plus drainage (27.08%), splenectomy (25.00%), suture (14.58%), hemostasis by tamponade (8.33%) and colostomy (2.08%) were undertaken as surgical procedures when it came to deal with contusions. Debridement of wounds plus suture and hemostasis by tamponade was performed in 18.73% and 4.16 cases, respectively. The most observed lesions were those of the spleen with 27.42% and those of the small bowel with 24.19%. The postoperative follow-up was straightforward in 83.33% of cases. The overall mortality was 4.17%.

关键词： Trauma-Abdomen-Emergency-Hôpital Sominé DOLO de Mopti

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Epidemiological, Clinical and Therapeutic Aspects of Spinal Pathology in Military People in a Country at War

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Open Journal of Modern Neurosurgery 2022年第1期12卷 39-46页

作者： Mamadou Salia Diarra Mohamed El Hassimi Cissé Izoudine B. Koumaré Oumar Diallo Drissa Kanikomo Military Neurosurgery Unit Infirmerie H&#244 pital de Bamako (IHB) Bamako Mali Neurosurgery Department H&#244 pital Mère-Enfant-Bamako USTT-B (Université des Sciences des Techniques et des Technologies de Bamako) Bamako Mali Neurosurgery Department H&#244 pital du mali USTT-B Bamako Mali Neurosurgery Department H&#244 pital Gabriel Touré USTT-B Bamako Mali

Introduction: Lumbar and sciatic pain are frequent motives of disability in military people in mali. As spine surgery isn’t recognized enough, our study aims to analyze etiologies, epidemiology, clinical features and... 详细信息

Introduction: Lumbar and sciatic pain are frequent motives of disability in military people in Mali. As spine surgery isn’t recognized enough, our study aims to analyze etiologies, epidemiology, clinical features and surgical standards in order to improve troop abilities. Methodology: Our descriptive and retrospective study has included 31 operated military patients who underwent medical or surgical procedures between 2010 and 2018 in the Military Neurology/Neurosurgery Unit and Mère-Enfant Hospital Neurosurgery department. Results: Among 553 seen in consultation, fifty percent were between 30 and 50 years old. Main motive was sciatic pain (65.5%). Seventy eight percent of our patients were field militaires and sub-officers, and 83.2% were males. All of them have benefited a CT scan or MRI with medical treatment in rheumatology or neurology. Thirty-one patients underwent spine surgery and were included in the study, so 6% (mean age: 43.52 years, 90.3% males). Lumbar spine surgery represented 54.8% of cases with lumbar canal stenosis in 64.5% of cases. It appeared that spondylolisthésis with isthmic fracture was frequent (12.9%), and traumatic cervical spine fractures were dominant in 2012. Instrumented arthrodesis was performed for 41.9% of patients, lumbar discectomy for 32.3% and laminectomies for 22.6%. Degenerative etiology was found in 77.4% of cases and we’ve noticed a good outcome in 93.5% of operated cases. Conclusion: Spinal pathology in military people in mali i

关键词： Military Spine Spondylolisthesis mali

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Management and Outcome of Acute Subdural Hematoma in Gabriel TouréHospital

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Open Journal of Emergency Medicine 2022年第1期10卷 48-53页

作者： Youssouf Sogoba Drissa Kanikomo Quenum Kouassi Jean Marie Kisito Moussa Diallo Bakary Dembélé Boubacar Sogoba Djènè Kourouma Izoudine Blaise Koumaré Seybou Hassane Diallo Hamidou Almeimoune Moustapha Mangané Thierno Madane Diop Oumar Coulibaly Mamadou Salia Diarra Mahamadou Dama Oumar Diallo Youssoufa Maiga Djibo Mahamane Diango Department of Neurosurgery Gabriel Touré Teaching Hospital Bamako Mali Neurosurgeon University of Parakou Parakou Benin Department of Neurology Gabriel Touré Teaching Hospital Bamako Mali Department of Emergency Care Gabriel Touré Teaching Hospital Bamako Mali Department of Neurosurgery H&#244 pital du mali Bamako Mali Department of Neurosurgery H&#244 pital Luxambourg Bamako Mali

Background: Traumatic Brain Injury (TBI) is a major health problem worldwide. It is the main cause of trauma mortality. Acute subdural hematoma (ASDH) has a reputation for being the most serious of all posttraumatic head injuries. Its frequency is estimated to be 1% to 5% of all head injuries and 22% of severe head injuries. The aim of this study was to assess the epidemiological, clinical and prognosis aspects of ASDH in our department. Material and Methods: This prospective study, from January to December 2019, included 57 patients admitted to the Gabriel Touré Teaching Hospital for ASDH. Patients underwent detailed clinical and radiological evaluation and ASDH was diagnosed by non-contrast computed tomography (CT) scan. Functional outcome was evaluated 6 months after injury by Glasgow Outcome Scale. Results: during the study period, 662 patients were admitted for TBI including 57 (8.61%) cases of ASDH. The mean age was 34 years with extremes of 2 and 77 years. There was a male predominance with 52 (91.2%). The main cause of trauma was motor vehicle accidents in 38 (66.6%) patients. According to the Glasgow coma scale (GCS), 33 (57.9%) patients were classified mild (Table 2). The thickness of the hematoma was more than 1 cm in 13 (22.8%) patients and less than 1 cm in 44 (77%) patients. Surgical treatment was performed in 13 (22.8%) patients. The outcome was favorable in 30 (52.6%) patients and the mortality rate was 33.3%. Conclusion: ASDH remains a difficult challenge because of the high mortality. The mortality rate remains high particularly in patient with poor GCS score at admission.

关键词： Acute Subdural Hematoma Traumatic Brain Injury Outcome

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ECG and Echocardiographic Findings of Female Hypertension (fHTN) in the Cardiology Department of the University Hospital Gabriel Touré (UH-GT)

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World Journal of Cardiovascular Diseases 2023年第10期13卷 646-656页

作者： Hamidou Oumar Bâ Ibrahima Sangaré Youssouf Camara Kassim Kamaté Tawoufik Tchedre Georges Rosario Christian Millogo Djénébou Traoré Noumou Sidibé Fousseyni Samassékou Massama Konaté Coumba Thiam Doumbia Asmaou Maiga Réné-Marie Dakouo Hamidou Camara Adama Sogodogo Boubacar Diarra Mamadou Touré Boubacar Sonfo Aladji Traoré Mamadou Diakité Ilo Bella Diall Ichaka Menta Cardiology University Hospital Gabriel Touré Bamako Mali Cardiology University Hospital Sidy Bocar Sall Kati Mali Cardiology University Hospital Yalgado Ouédraogo Ouagadougou Burkina-Faso Internal Medecine University Hospital Point G Bamako Mali Cardiology University Hospital “H&ocircpital du Mali” Bamako Mali Cardiology University Hospital Mother-Children Bamako Mali

Introduction: In our setting there is a lack of publications on female hypertension in general population motivating this study to look for electro- and echocardiographic findings of female hypertension. Methods: We performed a cross-sectional study during 6 months in the cardiology department of the UH-GT including 324 female patients aged 18 and more seen in the outpatient unit and by whom the diagnosis of hypertension was set. All patients consented to be study participants after receiving clearly information about the study and that care giving will not be affected by their eventual refusal. Data collection has been done with all needed confidentiality rules. A survey formular was used to collect data in order to record them in an Access database. Analysis was done using IBM SPSS software. Quantitative data are presented as mean with standard deviation and qualitative as proportion. Level of significance for statistic test was set at 5%. Results: during the study time 324 among 524 hypertensive patients visited our outpatient unit giving a prevalence of fHTN of 61.8%. The means for age, body mass index (BMI) in female hypertensive patients were respectively 52 ± 14.461 years and 27.35 ± 06.585 Kg/m2. Main ECG findings were left ventricular hypertrophy (LVH) and sinus tachycardia with respectively 93.6% and 46.4% followed by isolated ventricular extrasystole with 33.7%. Echocardiography findings included LVH, relative wall thickness (RWT) and reduced ejection fraction (EF) in respectively 41.05%, 37.35% and 21.91%. The left ventricular mass (LV) mass and geometry were abnormal in 44.4% and 37.3%. Remodeling as geometry modification (18.2%) and mitral flow Type 2 (90.4%) have been the most abnormal findings. Conclusion: Hypertension induced modifications mainly LVH in ECG and Echocardiography in female patients less than encountered among male hypertensive patients.

关键词： Hypertension Female ECG Echocardiography mali

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Epidemiological and Clinical Profile of Cervix Cancer at Bamako Radiotherapy Center

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Open Journal of Obstetrics and Gynecology 2019年第1期9卷 92-97页

作者： A. Diakité A. S. Koné Y. L. Diallo K. Diabaté I. M. Diarra M. Ndiaye M. A. Camara M. M. Traoré A. Traoré F. M. Sidibé S. Sidibé Radiotherapy Center H&ocirc pital du mali Bamako Mali Service of Medicine and Endocrinology H&ocirc pital du mali Bamako Mali Infirmary Hospital of Bamako Bamako Mali Service of Radiology H&ocirc pital du mali Bamako Mali Service of Gynecology H&ocirc pital du mali Bamako Mali Service of Hemato-Oncology CHU du Point G Bamako Mali Service of Radiology CHU du Point G Bamako Mali

Cervical cancer remains a major public health problem in Africa, particularly in mali. The goal of this work was to investigate the epidemiological and clinical aspects of cervix cancer seen at the radiation therapy center. This was a descriptive study on the retrospective collection of data on patients found in the Radiation Therapy Centre of Bamako, for invasive cervical cancer be-tween April 2014 and April 2017. The average age of our population was 52 ± 12.5 years with extremes ranges from 18 to 95 years. The most represented age group was [50 - 65 years] with 44.2%. The predominant histological type was squamous carcinoma (CE) with 94.2%. Bleeding were found in almost all patients, most often associated with foul smelling hydrorrhea;80.3% of our patients were stage III and 12.9% of stage IV according to the IFGO classifi-cation. Cervix cancer remains a major public health problem in mali. The di-agnosis is often late, therefore, resulting in late care and unfavorable progno-sis. Sensitization, vulgarization of vaccination and systematization of screen-ing could be helpful in the fight against this cancer.

关键词： Epidemiology Clinic Cervix Cancer

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Mutations in Spike Gene of SARS-CoV-2 that Are Associated with a Higher Viral Load: A Clinical Case Study

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Case Reports in Clinical Medicine 2022年第11期11卷 474-486页

作者： Ibrahim Keita Garan Dabo Lassina Doumbia Youssouf Diarra Ibrahim Traoré Mariam Traoré Lansana Sangaré Yacouba Toloba Mahamadou Alpha Diallo Djeneba Sy Andres H. Gutierrez Aliou Sissako Ibrahim Guindo Mohamed Diallo Akory Ag Iknane Anne S. De Groot Ousmane Aliou Koita Laboratoire de Biologie Moléculaire Appliquée Université des Sciences Techniques et des Technologies de Bamako Bamako Mali Hô pital du mali Ministère de la Santé Publique et du Développement Social Bamako Mali Centre Hospitalo-Universitaire du Point G Ministère de la Santé Publique et du Développement Social Bamako Mali EpiVax Inc. Providence USA Institut National de Santé Publique Ministère de la Santé Publique et du Développement Social Bamako Mali Center for Vaccines and Immunology College of Veterinary Medicine University of Georgia Athens USA

Background: Quantitative PCR (qPCR) can be used to detect and quantify a load of a pathogen. It is a good indicator of the degree of transmissibility. While performing routine qPCR, we observed an unusually short cycle threshold (Ct) value of SARS-CoV-2 for a clinical specimen obtained in Bamako, mali. This prompted us to sequence the short-cycle SARS-CoV-2 sample to identify potential mutations in the Spike gene (S gene) gene. Methods: Post-infection, Quantitative Reverse Transcription (qRT-PCR) was performed over a defined time course to estimate the Ct of the SARS-CoV-2 specimen collected from the patient. Sanger sequencing was done on the entire fragment of the S gene to identify mutations. Findings: Sanger sequencing revealed mutations in the lineage of interest, designated B.1.525 by Pango, and also known as “Eta” using the nomenclature defined by WHO. This variant was originally found in Nigeria and Italy. The four novel mutations identified in Eta (D228N, Y451N, I1172M, and C1250F) were otherwise observed with a low frequency worldwide. Although the initial Ct was 10 in the case study patient, he did not exhibit severe symptoms of SARS-CoV-2, for example, pneumonia. However, we observed a longer viral clearance period than usual, of 3 weeks. We note that as compared to SARS-CoV-2 samples obtained during the first peaks of SARS-CoV-2 infection in mali, when the infection was at its peak in March 2020 (Ct = 30.4), circulating strains evaluated at the time the Eta sample was obtained demonstrated a lower mean Ct (Ct = 24). Conclusions: The short cycle threshold associated with this variant, and the temporal association with a decrease in the mean Ct in the region of Bamako, may indicate higher levels of transmissibility due to a circulating variant. This variant is a lineage of interest designated B.1.525 by Pango or Eta by WHO.

关键词： SARS-CoV-2 Variant Eta Ct Value mali

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Artificial Induction of Labor with Misoprostol: Maternal and Fetal Prognosis at the Referral Health Center of Commune I of the District of Bamako

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Open Journal of Obstetrics and Gynecology 2021年第2期11卷 70-79页

作者： Mamadou Bakary Coulibaly Alassane Traoré Mody Abdoulaye Camara Mamadou Sima Bourama Kané Kalba Tembiné Ibrahima Tégueté Youssouf Traoré Department of Gynecology of Hô pital du mali Bamako Mali Service of Anesthesia and Resuscitation of Hô pital du mali Bamako Mali Service of Gynecology-Obstetrics CHU Point G Bamako Mali Service of Pediatric of Hô pital du mali Bamako Mali Service of Medical Imaging of Hô pital du mali Bamako Mali Service of Gynecology-Obstetrics CHU Gabriel Toure Bamako Mali

Artificial induction of labor (AIL) is the set of techniques intended to induce childbirth in order to reduce maternal-fetal mortality. The aim of this paper was to study the maternal and fetal prognosis after the artificial induction of labor with misoprostol. It was a descriptive prospective study conducted from September 1, 2018 to February 28, 2019 at the maternity unit of the Referral Health Center (RHC) in commune I of Bamako. It was about any pregnant woman at term who had received misoprostol as part of the artificial induction of labor. 102 cases of artificial induction with misoprostol 200 μg were collected out of 3641 deliveries, or a frequency of 2.8%. The age group 28 - 32 years accounted for 56.86% with an average age of 28.8 years. Multiparous represented 54.90% of the number. The history of diabetes and hypertension involved 37.25% of the pregnant women. The main indication was premature rupture of membranes (PRM) (40.2%). Induction was performed between the 37th and 41st week of amenorrhea (69.6%). The trigger index according to BISHOP was greater than 7 (50.98%). Induction was done only with 3/4 of misoprostol tablet 200 μg (43.14%). The average labor time was 7 hours (89.22%). The vaginal birth concerned 92.16% of pregnant women. An APGAR10 was noted in 97.85% of newborns after 05 minutes. AIL with misoprostol was practiced at the Center. The main indication was the premature rupture of the membranes. It improves the maternal and fetal prognosis.

关键词： Induction Misoprostol Maternal and Fetal Prognosis Commune I

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Vaginal Caesarean Section: A Review of Indications in mali

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Open Journal of Obstetrics and Gynecology 2023年第6期13卷 1068-1074页

作者： Famakan Kane Soumaila Diallo Soumana Boire Alima Sidibe Jean Martin Zino Baba Bah Sadio Camara Lassina Ibringo Moussa Abdoulaye Diarra Bourama Lassina Dembele Mahamadou Diassana Tidiane Traore Centre de Santé de Référence de Bla Ségou Mali Centre de Santé de Référence de Niono Ségou Mali Centre de Santé de Référence de Kayes Kayes Mali Clinique la Conception Thiès Sénégal Hô pital Sominé Dolo de Mopti Mopti Mali Hô pital Fousseyni Daou de Kayes Kayes Mali Hô pital Niankoro Fomba de Ségou Ségou Mali

Introduction: The vaginal caesarean described since the 19th century remains unknown to many practitioners. The publications available on the subject are rare. The objective of this review is to report the experience of our team in mali on vaginal cesarean section. Materials and Methods: This is a documentary review of a series of 5 cases on the practice of vaginal caesarean section at the Sominé Dolo Hospital and Reference Health Center of the Sanitary District of Bla in mali between 2005 and 2022. Results: We performed a vaginal caesarean section on 5 patients in this series. The indications were retroplacental hematoma in 2/5 cases including 1 with a live fetus, eclampsia crisis in 1/5 cases, dystocia on uterine prolapse in 1/5 cases and beating cord prolapse in 1/5 cases. In the 5 cases, the pregnancy was not at term. In 3/5 cases, cesarean section was indicated to save the non-term fetus with a very low possibility of success by classic cesarean section and in 2/5 cases for maternal rescue with fetal death in utero. 2 live newborns were released in satisfactory condition, 1 died after 6 hours of life. Antibiotic therapy was not necessary in the majority of cases. The average length of hospitalization was 3 days. Conclusion: The circumstances of the realization of the vaginal cesarean section in our series of studies remain frequent in the practice of modern obstetrics. The short duration of hospitalization and the low use of antibiotics can contribute to the reduction of the medical cost of caesarean section in low-income countries, such as mali.

关键词： Vaginal Cesarean Indications mali

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