Le Mali medical最新文献

Objectives: To determine the prevalence of hepatitis B virus (HBV) infection in children (contact subjects) of chronic HBsAg (index subjects) and to investigate the factors associated with this infection in these children.

Patients and methods: this was a retrospective cross-sectional study of HBsAg positive patients (index subjects), whose families (contact subjects: spouses and children) were routinely screened for HBV infection.

Results: The median age of our 44 subjects was 43.1 ± 7.49 years. The average number of children per index subject was 2.3 ± 1.1. The median age of the 92 children was 9.3± 4.55 (1 to 15 years) and 43 (44.8%) were vaccinated against HBV. The prevalence of HBV infection was 24%. The independent factors associated with HBV infection in children were HBV DNA for index subjects> 2000 IU/ml (OR = 11.5; p = 0.001), the existence of HBV in both parents (OR = 7.9; p = 0.03) and no HBV vaccination in children (OR = 30.9; p = 0.003).

Conclusion: Immunization coverage of children of index subjects was insufficient. In addition to vertical transmission, the risk of intrafamilial transmission was high in the presence of at least one of the three associated factors.

Objective: The objective of this study was to evaluate the impact and complications related to self-medication among patients admitted to the Maradi RHC.

Methodology: We conducted a cross-sectional, descriptive and analytical study at the Maradi RHC, in the referral department from June 30 to September 30, 2021, by means of an interview.

Results: A total of 254 patients were interviewed. The frequency of self-medication at the Maradi CHR was 3.63%. The majority of the patients surveyed were women (53.94%). The average age was 42 years. Among them, 63.39% were attending Koranic school and 38.19% were housewives. Street vendors and traditional practitioners were the main suppliers of self-medication drugs, respectively 45.28% and 30.31%. The most commonly used products were traditional medicines, analgesics, antibiotics and anti-malarial (47.63%, 26.37%, 22.44% and 16.92% respectively). The lack of financial means and accessibility of treatment were the main reasons for this practice. Digestive diseases were the most frequent pathology group. Jaundice was the first complication related to self-medication, followed by urticaria and Lyell's syndrome. Following management, 8% (n=20) patients were discharged cured and 6% (n=15) had died.

Conclusion: Self-medication is a rapidly growing practice, favored by many factors despite the many risks that can arise from it. In order to prevent these risks, an awareness program is necessary to make the population adhere to a change of behavior.

Introduction: Thyroid nodules are distressing pathology because of the fear of malignant tumor. It is a common condition but often overlooked by patients. Surgery has an essential place in the treatment, but its performance is correlated with ultrasound data. The objective was to report the probable malignant characteristics of thyroid nodules through ultrasound analysis.

Patients and method: This was a descriptive and analytical retrospective study over a period of 6 years, carried out in the department of Oto-Rhino-Laryngology and Cervico-Facial Surgery of the Hospital Center of Soavinandriana Antananarivo Madagascar. Were included, patients with a cervical ultrasound result preceding the thyroidectomy and an anatomopathologic result of the surgical specimen. The parameters studied were the epidemiological profiles, the clinical data, the ultrasound data, the biological assessments and the anatomopathological results.

Results: We listed 150 patients whose mean age was 46.56 years and a sex ratio of 0,11. The malignant thyroid nodule was found in 17 patients or 11,33% of cases. The significant ultrasound aspectsin favor of a malignant thyroid nodule were respectively: poorly limited character [p=0.0002], hypoechoic appearance [p=0.0087], hypervascularization [p=0.0094]. The other moderately suspicious ultrasound characters were represented by the presence of tiny calcification [p=0.2185], the existence of satellite cervical adenopathy [p=0.1982] and peripheral halo [p=0.4502]. The histological type of malignant nodule was dominated by papillary carcinoma (58.82%) and gallbladder carcinoma (23.52%). The ultrasound and pathological concordance was 62.66% of cases.

Conclusion: The precise description of a thyroid nodule provided by ultrasound is essential in the management of a nodular goiter.

Introduction: waste electrical and electronic equipment (WEEE), with its health and environmental issues, has become a public health problem exposing workers to toxic compounds causing respiratory problems.

Objective: To study the relationship between professional exposure to WEEE and the occurrence of respiratory problems in Bamako in 2019.

Material and methods: This was a 6-month cross-sectional, analytical study carried out in the city of Bamako in 2019 and involved 159 WEEE manipulators. Data were collected using a tablet (2). Univariate and multivariate analyzes were performed using SPSS version 22 with the significance level of 0.05. Odds Ratio (OR) were presented with their 95% confident interval (OR[95%CI]).

Results: The overall prevalence of respiratory disorders was 67.3% among WEEE handlers. It was noted that the removal of the coating of electronic wires (OR[95%CI]=25.93[2.30;291.53]), recent weight loss outside of a diet (OR[95% CI]=7,43[1.68;32.85]) and the infrequent hand washing with soap after the toilet (OR[95% CI]=11.50[2.07; 63.89]) represented a higher risk of (2) breathing problems.

Conclusion: These results show that D3E handlers have a lot of risky behavior for respiratory problems. This study could be used to implement strategies to reduce the impact of D3E.

The objective was to assess the risk factors for and to suggest therapeutic aspects.

Materials and methods: We carried out a case-control study at the Bougouni Reference health center in 2019.

Results: From January to December 31, 2019; out of 1161 deliveries, 43 uterine rupture were recorded, 3.7% corresponding to one uterine rupture for 27 deliveries. Patients 35 years and older were more affected by uterine rupture (44.2%) with OR_aIC95% = 6.3 [1.5 - 26.3]. Obstetric evacuations had an OR_aIC95% = 25.6 [7.8-83.7]. All of the patients were housewives (97.7%) versus (82.3%) controls with ORaIC95% = 8.9 (1.1-69). Pauciparous and multiparous had an OR_aIC95% = 6.2 [1.8 - 20.3] and 4.1 [1.3 - 12.9], respectively. The uterine scar (20.9%) of cases versus 8.1% of controls had a 95% OR_aIC95% = 2.9 [1.1 - 8.7]. Indeed the absence of ANC was a risk factor, OR_aIC95% = 3.0 [1.3 - 6.9]. The time to uterine rupture was < 6 hours in 95%. In fact 34 complete uterine rupture (79.1%) and 9 incomplete uterine rupture (20.9) were noted. Only 2.3% of cases gave birth vaginally. Treatment of uterine rupture was based on surgery (100%) supplemented by shock (51.2%) of cases and infection (100%) of cases.

Conclusion: Uterine rupture is common in our countries under medical care. Its effective prevention involves strategies aimed at acting on risk factors.

Objectives: To analyze the main causes and risk factors of death in intensive care.

Patients and method: Prospective observational study in the intensive care units in Hospital Principal of Dakar from July to December 2018 including all patients who died 24 hours after admission. Demographic, clinical, severity (IGSII, APACHE II, MPM) and organ failure (SOFA, LODS) scores were collected. A multiparametric comparison was made between deceased and surviving patients.

Results: The overall mortality was 25.86% correlated with the probability of death (MPM): 26.4%. The mean age was 50.98 [8-94 years] with a sex ratio of 1.15. The majority of deaths (79.26%) occurred outside of duty hours and 70.7% had at least one medical history. The mean severity scores were for IGSII 40.12 +/- 17.25 and for APACHE II 18.31 +/- 8.49. The mean visceral failure scores were for SOFA 7.02 +/- 4.44 and for LODS 5.73 +/- 3.35. Complications were dominated by nosocomial infections (48.78%) and are responsible for 37.8% of deaths. The mean length of stay was 7.30 days +/- 7.46. Age, the existence of organ failure, the use of vasopressors, the occurrence of nosocomial infections and the absence of a senior doctor were correlated with mortality.

Conclusion: The intensive care unit mortality rate is 25.86%. Advanced age, the existence of organ failures and the occurrence of a nosocomial infection are factors in the occurrence of death.

We report the case of a 32-year-old man presentedwithleftpre-auricularswellingthathad been evolving for twomonths. Physical examination found a fixed inflammatory parotid mass. Ultrasound of the parotid region found a mixed parotid nodule with liquid redominance. The swelling was drained. Histological examination of a biopsy specimen of the parotid gland revealed an epithelioid granuloma with caseous necrosis. The patient is then treated with anti-tuberculosis with a favorable result.

Introduction: In Senegal, the main causes of death are the pneumonia, the diarrhea and the malaria. The malnutrition is an underlying factor in more than a third of the deaths, because it returns the more vulnerable children to the serious illnesses. The general objective of this research is to study the availability and the price of medicine in the therapeutic care of the children of less than 5 years old in the region of Dakar in Senegal.

Methodology: Our study is of transverse, descriptive concerned the public sanitary, the wholesalers, the private pharmacies, The population of study concerns the old children at least of 5ans. The methods used were the interviews by means of questionnaire.

Results: The group of antibiotics, acid anti, antidotes, vitamins, diuretics, antiemetic's, and psychotropic were not available. As regards generic medicines, relatively low availability of 30,4 %, 23,8 % and 16,7 % is respectively observed in the public, private and denominational sectors. The availability of generic medicines in Dakar was from 81 % in the public sector and from 113 % in the private sector.

Conclusion: The findings make it imperative for all other relevant medicine drugs in order to reduce the mortality rate.

Introduction: The pure digestive form of COVID-19 is possible and initially considered rare. Our objectives were to determine the frequency of COVID-19 in patients treated in general surgery, identify the circumstances of COVID-19 discoveries in surgery, describe the post-operative complications in patients operated on COVID-1919 and describe the reorganization of post-operative COVID-19 diagnosis management.

Materials and methods: We conducted a prospective descriptive study from March 2020 to August 2021 (18 months). All patients who have been operated on, hospitalized or consulted in the department, the Emergency Department (ERS) or other CHU-GT departments for surgical pathology with COVID-19 or infected with COVID-19 while hospitalized were included in the study.

Results: 23 cases collected, representing 8.91% (23/258) of COVID-19 cases identified, a frequency of 1.27/month. The age group 66-75 was the most affected, the average age was 49.13 18.75 years, the predominance was male (sex ratio of 1.3). More than 34.78% were recruited at the SAU, 16 patients (69.56%) consulted in emergency, and digestive signs of COVID-19 were: Abdominal pain 20 cases (89.96%), anorexia 19 cases (82.61%), vomiting 8 cases (34.78%) and diarrhea 3 cases (13.04%). The pulmonary signs of COVID-19 were: Cough 18 cases (78.26%), chest pain 15 cases (65.22%), and dyspnea 9 cases (39.13%). Manifestations of COVID-19 were: pulmonary 9 cases, digestive 9 cases, associated 3 cases, incidental discovery 2 cases. The diagnostic mean was Thoracic CT (100%), Test-PCR 14 cases (60.86%) with a positive PCR test in 50% of cases. Surgical pathologies were surgical emergencies in 7 cases (30.43%), cancers in 6 cases (26.09%), COVID-19 digestive event (30.43%) and other 3 cases (13.04%). More than half of patients were operated on 12 cases (52.17%). The overall mortality was 60.87% and the mortality of surgical patients was 41.67%.

Conclusion: The infectious risk of COVID-19 during hospitalization, during or after digestive surgery is a real and potentially serious risk for the patient and caregivers.

Purpose: Report the epidemiological and lesion aspects of hand bone fractures in children.

Patients and method: We did a retrospective and descriptive study over a 10-year period. This study involved 222 childre nunder the age of 16 with 261 fracture cases. The parameters studied were frequency, age, sex, mechanism, circumstances of fracture, consultation time, data from standard physical examination and x-ray of the hand, and associated lesions.

Results: Hand bone fractures accounted for 6.4% of all fractures in children in our service. The average age of the children was 8.5 years with a standard deviation of 4. There was a male predominance with a sex ratio of 2. Domestic accidents led the way with 44.3% of cases. They were followed by playful accidents with 33.94% of cases. Receiving heavy objects and fallingwith hand reception were the most common mechanisms. 62.8% of patients consulted within the first 24 hours. All fractures were in the metacarpals and phalanxes with 31% and 69% of cases, respectively. Head and diaphysis fractures each accounted for 28.1% of cases followed by cervical fractures with 27.8%. Non-displaced fractures accounted for 65% of cases. Associated lesions were found in 10 patients.

Conclusion: Hand bone fractures are quite common. They often interest the bigchild in the decoy of a domestic or playful accident, by crushing the hand or falling with reception on the hand. Fractures of the phalanxes are the most common while those of carp are absent.