Le Mali medical最新文献

Introduction: Constipation is a symptom that corresponds to an anomaly of the stools or their elimination: they are too bulky or too hard, too rare, or their elimination is painful, even incomplete.

Objective: was to determine the frequency, the contributing factors, the signs and the therapeutic methods of constipation in children in the pediatric department of the CHU Gabriel Touré.

Patients and method: This was a descriptive cross-sectional study with prospective collection from April 1, 2019 to January 31, 2020. All patients aged 0 to 15 who consulted in the pediatric department for constipation and responding to the Rome IV criteria.

Result: We registered 75 patients. The hospital frequency of 0.23%. The age group from one month to two years represented 61.3% of the patients, the average age was 27.7 +/- 43 months. The male gender predominated with 58.7%. Constipation alone was the most common reason for consultation with 62.6%. One stool per week was found in 77.3% of patients. Pain on defecation was found in 65.3% of patients. Constipation was functional in 69.3% of patients. Hirschsprung disease was the cause of organic constipation in 65.2% of patients. Laxatives were prescribed in 64% of patients at the consultation.

Conclusion: Constipation is a frequent pathology that affects children at all ages. It is of functional origin in most case.

Introduction: Asthma is the most common chronic disease of children. It is a leading cause of emergency room visits, hospitalization and school absenteeism. Asthma is a real public health problem. The prevalence of this disease is increasing worldwide.

Patients and method: We had conducted a prospective study, among children with asthma over a period of one year, from January 2018 to December 2018.

Results: We counted 105 asthmatic patients for a total of 14344 consultations, or a frequency of 0,73%. The sex ratio was 1,9, the age group 2-5 years was the most frequent, (52%), the age of the first attack was generally between 1 and 2 years, ( 75,24%). We observed that almost 22% of the attacks occurred in December (21,90%). Smoke and humidity were the main triggers. All the patients had benefited from nebulization with B 2 mimetics.

Conclusion: Education of asthmatic children, their families and the establishment of standard management protocols could significantly reduce asthma-related morbidity in our countries.

Breast cancer is the leading cancer in Mali. The objective of this study was to evaluate the risk factors of breast cancer associated with reproduction.

Patients and methods: We conducted a case-control study (January 2017 - September 2021) at the Gabriel Touré Teaching Hospital. The sample consisted of 200 cases and 400 controls. A multivariable logistic regression model was used to identify reproductive factors associated with breast cancer. Adjusted odds ratios (AOR) were produced with their 95% confidence intervals.

Results: The mean age of cases was 46.1 years ± 14.6 vs 33.1 years ± 12.1 for controls. Menopausal women constituted 37.5 % of cases vs only 4% in the controls group. Nulliparity and breastfeeding were negatively associated with breast cancer (p <0,001) while postmenopausal women had a8.09-fold increase in the risk of breast cancer.

Conclusion: Nulliparity, breastfeeding and menopause were the reproductive factors associated with breast cancer in Mali.

Objective: To estimate the neonatal mortality rate, causes and factors associated to newborn deaths in Diamaré in Cameroon.

Patients and methods: It was an analytical and retrospective cross-sectional study. The period of the study was from January 1^st 2018 to December 31^st 2019 in 11 health facilities in Diamaré. The Chi 2 test was used to analyze factors associated to neonatal mortality.

Results: A total of 208neonatal deaths out of 29,209 live births were recorded, representing a neonatal death rate of 71 per 100,000 live births. The study showed that neonatal mortality mainly occurred in the early neonatal period 178 cases (85.6%). Neonatal mortality was predominant among girls 121 cases (58.2%). The main reasons for admission linked to neonatal deaths were respiratory distress 44 (21.4%), prematurity 37 (18.0%) and fever 32 (15.5%). The factors associated with neonatal deaths were asphyxia (p=0.007) and neonatal infection (p=0.042) occurring during the ultra-early and late periods respectively.

Conclusion: The neonatal mortality rate was high in Diamaré. These deaths were associated with asphyxia and neonatal infection.

Context: Women's drug use is a taboo subject that remains poorly documented in our context, and the social environment plays an important role in this behaviour. The aim of this study was to investigate the social environment of female drug users treated at the Abidjan Addictology and Mental Hygiene Service (SAHM).

Materials and methods: We conducted a descriptive cross-sectional study of 35 female drug users screened by urine toxicology analysis and followed up from January 2019 to December 2022 at the SAHM in Abidjan. They were recruited using non-probability, exhaustive sampling.

Results: Female drug users were aged 15-20 years in 48.58% of cases and were pupils or students (51.43%). The respondents were poly-substance users (80%), dominated by cannabis (74.28%), benzodiazepines (34.28%) and cocaine (29.85%), which were used for self-therapeutic purposes (45.72%). The social environment was dominated by a poor family atmosphere (48.57%), the influence of peers (91.42%), the presence of smoking rooms close to home (57.14%) and the availability of psychoactive substances nearby (82.86%) and at affordable prices (74.28%).

Conclusion: Knowledge of the social environment of female drug users is important for implementing awareness-raising and prevention measures tailored to the target population in order to combat the stigmatisation they may suffer.

Objectives: The aim of this work was to study the prognostic factors of breast cancer and their correlation with survival in women in the General Surgery Department of the Gabriel Touré CHU in Bamako.

Materials and methods: This was a cohort study from January 2020 to December 2022, a period of 36 months.

Results: A total of 67 patients were registered. The mean age was 47.6 ±13.3 years; the mean time to consultation was 12.7 ±11.6 months. A breast mass was palpable in 82% of cases; its mean size was 7.18 cm±3,97. It was a non-specific infiltrating ductal carcinoma in 95.52% of cases. SBR grade 3 was found in 32.84%. Advanced stages (III and IV) accounted for 77.61% of cancers. The majority of cancers (50.74%) were triple-negative subtypes. Mastectomy with axillary dissection was performed in 95.52% of patients, with significant lymph node involvement in 35.82% of cases. Targeted therapy was performed in 7.46% of cases. Post-operative follow-up was straightforward in 89.09% of cases. Overall survival was 26.30 months with a median survival of 23.86 months. SBR3 grade and triple-negative subtype were the prognostic factors that significantly influenced survival.

Conclusion: Efficient management of breast cancer requires proper assessment of prognostic factors. Biomolecular factors SBR-EE and triple-negative had a strong correlation with survival.

Background: Routine immunization is a key strategy in the prevention of vaccine-preventable diseases. The objective of the study was to assess the knowledge and attitudes of mothers regarding the practice of vaccination in rural and urban areas.

Methods: This is a comparative descriptive cross-sectional study that took place in two health areas (urban and rural) over a period of three (3) months from October to December 2022. It involved mothers or guardians of children who came for routine vaccination.

Results: The mean age of the women was 28.76±6.85 years in urban areas and 26.51±7.37 years in rural areas. About 72.00% and 43.00% of the women in urban and rural areas, respectively, had given a good definition of vaccination. 88.00% of women in urban areas knew at least one EPI target disease, compared to 55.00% in rural areas. Only 31.00% of women in urban areas knew the vaccination schedule, compared to 12.00% in urban areas. Majority of women in urban (97.00%) and rural (67.00%) areas found it necessary to make up for missed immunization appointments in next sessions. Majority of them considered it necessary to send their children to the health center in the event of post-immunization symptoms (urban: 80.00%, rural: 53.00%).

Conclusion: A good knowledge and practice of vaccination would allow to protect children against vaccine preventable diseases.

Breast cancer is a public health issue worldwide. One of the main causes of death due to this disease is metastasis, which is understudied in our context. Thus, the objectives of this work were to: (1) estimate the frequency of synchronous metastatic breast cancer; (2) determine the overall survival rate; and (3) identify the main factors associated with metastatic breast cancer death in Malian women.

Patients and methods: We conducted a retrospective cohort study at Gabriel Touré Teaching hospital on breast cancer cases diagnosed during the period from January 1^st, 2018 to August 31^st, 2021. We included all pathologically confirmed of breast cancer with synchronous metastases. Descriptive statistics were used to analyze sociodemographic and clinical data. Identification of factors associated with metastatic breast cancer death was performed using univariate and multivariate Cox regression models to produce adjusted hazard ratios (AHR) with their 95% confidence intervals.

Results: During the study period, a total of 231 cases of breast cancer were diagnosed in our department; among them, 60 cases were synchronous metastatic breast cancer (26%). The mean age of these cases was 45.3 ±12.1 years old. The most common histological form was non-specific infiltrating carcinoma, 55 cases (91.7%). The main metastatic sites were lung alone, 26 cases (43.3%), liver alone, 12 cases (20.0%) and 16 cases (26.6%) had more than one metastatic sites. The overall 2-year survival was less than 20%. Factor associated with the risk of death was lung metastases; AHR = 4.22 [95% CI: 1.13 - 15.79].

Conclusion: Synchronous metastatic breast cancer was very common in our setting and a poor prognosis was observed in patients with lung metastasis.

Objective: To evaluate the prediction of esophageal varices by SEF measured by fibroscan® in cirrhotic patients followed at Cocody CHU.

Method: This was a cross-sectional study conducted at HGE at Cocody CHU for 5 years. Included records of compensated cirrhotics followed at HGE. The judgment criteria were the SEF and FOGD. R software version 4.2.1 was used for analysis and the khi 2 test or the exact Fischer test for the variables. To evaluate the diagnostic performance of the SEF for VO diagnosis, were compared; patients with and without VO on the one hand, and patients with and without large VO on the other hand. The respective predictive optimal OV and large OV diagnostic thresholds were determined from a ROC curve. The diagnostic performance of these optimal thresholds was evaluated by their Se, Sp, VPP, and VPN, RV+ and RV-.

Results: 75 patients were retained. The average age was 45.4 14.1 years. Half had OVs. The threshold for predicting the presence of VO was 13.7 kPa and for large VO was 17.1 kPa with an Se of 92% [79 ;98] and 75% [55 ;89]; an Sp of 84% [68;94] and 90% [55;99] respectively; an VPP of 85% [71; 97] and 96% [74; 98] and a VPN of 91% [77;97] and 56% [35;98] respectively with an accuracy (AUROC) of 92% [85; 98] (p<0.001) and 76% [66; 87] (p<0.001).

Conclusion: The liver elasticity score measured by fibroscan® has a good non-invasive diagnostic performance of esophageal varices and mean diagnostic performance of large varice at the respective thresholds of 13.7 and 17.1kPa.

The occurrence of schizophrenia in a family member does not only affect the patient, it has an impact on the entire family sphere. In view of this reality, we conducted a descriptive cross-sectional study involving a sample of 132 relatives of schizophrenic patients in Abidjan. The results of this study showed that.

-In the majority of cases (87.13%), family caregivers of schizophrenic patients were members of the nuclear family. These family carers who provided most of the care, worked for more than half (57.58%) of them in the informal sector, had at 72.22% a monthly income of less than 100,000 CFA francs (152,7 euro). All of our survey participants said they receive no outside help.

- In terms of degree of involvement of relatives, it appears that parents and siblings were the most involved at 78.29% in drug costs, at 73.49% in monitoring therapeutic compliance and at 61, 36% in providing assistance with the daily needs of their loved one with schizophrenia.

- Among the difficulties encountered by relatives in the care of schizophrenics, those with the highest frequencies are those of stigmatization (77.78%), financial exhaustion (73.33%), the fragility of health (62.22%), difficulties related to bed and food (53.33%) and lack of time for oneself (46.67%).

- The main psychological reactions recorded at the announcement of the diagnosis of schizophrenia among our respondents were: sadness (88.89%); discouragement (86.67%) and stress (77.78%). It was however noted that during the follow-up of the patients, the main attitudes recorded by our participants in the face of this situation were: reinforcement of affection (52.67%) and moral support (35.11%).