Le Mali medical最新文献

Introduction: Venous thromboembolic disease (MTEV) includes: deep venous thrombosis (DVT) and pulmonary embolism (PE). This work was initiated to identify the female particularities if they exist.

Materials and method: This was a retrospective, descriptive study conductedin the cardiology department of the Kati university hospital over a period from January 01, 2014 to December 31, 2021. Patients hospitalized during the period for venousthromboembolic disease were included. The variables studied were demographic social data, risk factors, clinical and para-clinical parameters, therapeutic and evolutionary aspects.

Results: In total we recorded 68 cases of MTEV of which 40 (58.8%) women. There were 12 (30%) cases of deep vein thrombosis, 25 (62.5%) cases of pulmonary embolism and their association in 3 (7.5%) cases. The majority (82.5%) of patients were housewives. Thepostpartum accounted for 10% of cases. The clinical probability according to the Wells score was high in 93% of deep vein thrombosis, intermediate for cases of pulmonary embolism with 50%. Angio-CT showed that pulmonary embolism was bilateral in 80% of cases. Heparin and anti-vitamin K were the most commonly used. Mortality was 7.5%.

Conclusion: women are more victims of venous thromboembolic diseases than men. Postpartum is a special situation for women. Recurrences are not uncommon.

Breast cancer is the leading cancer in women worldwide. A better understanding of this pathology by women can contribute to significantly reducing its morbidity and mortality.

Aim: It was to evaluate women's knowledge about breast cancer in the obstetrics and gynecology department of the district hospital of commune II of Bamako.

Patients and methods: We carried out a descriptive and analytical cross-sectional study with prospective collection of data from July 1 to August 31, 2021. It concerned women admitted to gynecological consultation without notion of emergency, who agreed to participate in this study.

Results: In 2 months, 390 women agreed to participate in this study, of which almost half of the women (45.1%) had no knowledge of the risk factors, clinical signs and means of screening for breast cancer. breast. Women's knowledge of breast cancer was influenced by age, education level, profession, religion and marital status (p<0.001).

Conclusion: Breast cancer remains poorly understood by women. Intensifying awareness campaigns can help increase women's understanding of this scourge.

Objective: The aim of this study was to investigate adverse events related to the administration of Covishield vaccine from the AstraZeneca laboratory in volunteers vaccinated at the Dermatology Hospital of Bamako.

Methodology: This was a Phase IV clinical trial involving volunteers vaccinated at the Dermatology Hospital of Bamako from April to June 2021. Scientific and ethical aspects were reviewed and addressed. The proposal for this study was approved by the scientific committee of the Hôpital de Dermatologie de Bamako.

Results: A total of 1099 volunteers were included in the study. The median age of participants was 48 years (18-93 years) with a sex ratio of 1.81 (708/391). In all 90.2% of the 1219 adverse events were injection-site pain. Other adverse events were headache, tiredness, and muscle pain, with 3.2% (39/1219), 2.4% (29/1219) and 1.8% (22/1219) respectively. Only one case of diarrhea was reported, 0.08% (1/1219).

Conclusion: Adverse events to this vaccine were mostly moderate and temporary but vary according to the population vaccinated individuals.

Gigantomastia is a rare benign mastopathy of unknown aetiology. It usually occurs in women during puberty or during pregnancy. It is characterized by excessive breast growth, which is psychologically and physically disabling. It is a pathology little studied because of its rarity. In order to describe the epidemiological, clinical, diagnostic and therapeutic aspects, we report the case of four young women. The study was longitudinal over a period of 3 months. We collected data for 6 years from October 1, 2016, to October 31, 2021, at the surgery department B of the "Centre Hospitalier Universitaire du Point G". All patients who consulted for gigantomastia were included. At the end of our study, we found three cases of juvenile gigantomastia and one case of prepubertal gigantomastia. The couple mammography ultrasound performed in two patients, adenofibroma was associated with breast hypertrophy in one patient. The treatment was essentially surgical in our study. Reduction mammoplasty according to the technique of Mc Kissock and modified Mc Kissock was used. We did not note any complication such as nipple-areolar necrosis. All our patients were satisfied with the result.

Background: Few studies have been conducted on breast cancer despite its high burden in our context. Therefore, this study aimed to: (1) specify the sociodemographic and clinical characteristics of breast cancer; and (2) determine the factors associated with breast cancer survival at Gabriel Touré University Hospital (CHU).

Methods: This was a retrospective cohort study conducted at CHU Gabriel Touré between January 1^st2018 and 31^st, December 2022. Histologically confirmed cases of breast cancer were included and divided into three anatomoclinical groups (non-T4 tumor [NT4], locally advanced cancer [LAC] and inflammatory breast cancer [IBC]). We used Pearson's Chi-square or Fisher's Exact tests to compare proportions. The frequency distributions using density plots were constructed for the three breast types. They were compared using the Kruskal Wallis statistic. Kaplan-Meier curves were estimated for the survival analysis and Cox regression was used to identify factors associated with breast cancer survival. Adjusted hazard ratios (AHRs) and their 95% confidence intervals (95% CIs) were computed.

Results: A total of 255 cases of breast cancer were included in this study. The mean age was 46.9 years old. Whatever the anatomoclinical type, the density plot curve peaked before the age 40. NT4 and LAC were more frequently observed on the right breast, while IBC occurred on the left breast (p < 0.001). Comorbidity rates were comparable between the three groups. The median survival time was 9 months, and the overall 5-year survival rate was < 40%. Infertility history and IBC had a significant influence on survival, with AHRs of 1,63 [1,01 - 2,63] and 1,52 [1,04 - 2,22] respectively.

Conclusion: Breast cancer at Gabriel Touré University Hospital is characterized by an early onset and a poor prognosis, suggesting that particular emphasis should be placed on early diagnosis and the quality of management.

Aims: To identify the predictive factors and reduce the mortality of COVID-19 in the Tambacounda region.

Materials and methods: An analytical cross-sectional study was conducted on confirmed COVID-19 individuals. Sampling was exhaustive with 303 cases. Data were collected by literature review, secondary data extraction and interviews. A data extraction form and an Epi Info®7.4.2.0 input mask were used. Medians, numbers, proportions were calculated and odds ratios were estimated. Statistical analysis was performed using Epi Info®7.2.4.0, SAS®9.4 and Excel®2019.

Results: Of the confirmed cases, 58 (19.1%) were deceased. The median age was 59 years (43-69 years). The sex ratio (male to female) was 1.6. Factors independently associated with mortality in COVID-19 were diabetes (ORa=9.34, CI95% [2.15-40.63]); hypertension (ORa=6.51, CI95% [1.85-22.93]); acute respiratory distress (ORa=6.22, CI95% [2.89-13.37]); male sex (ORa=6.44, CI95% [2.22-18.65]) and age ≥ 60 years (ORa=2.62, CI95% [1.14-6.02]).

Conclusion: Prevention strategies targeting diabetics, hypertensives, males, and those at least 60 years old would reduce mortality from COVID-19 in the Tambacounda region.

Aims: The aim of this study was to determine the association between vitamin D deficiency and advanced BC in a Malian women population.

Methods: This is a prospective cross-sectional study, conducted during 4 months, from August 2021 to November 2021. The assays were performed on immunodiagnostic and biochemistry devices in Rodolphe Merieux Laboratory.

Results: We included 77 women diagnosed with advanced breast cancer. The mean age of the study population was 48.51 ± 13.02 years. The mean plasma concentrations of 25(OH)D were 20.65 ± 6.76 ng/ml and 18.89 ± 6.12 ng/ml (p=0.274) in groups III and IV, respectively. Stage III was predominant, comprising 67.5% of the cases, and there were no significant differences between stages III and IV regarding phospho-calcium biological markers. Our results showed a greater deficiency in vitamin D at stage III compared to stage IV, with p=0.782. The logistic regression model demonstrated a significant decrease in the relative risk of advanced breast cancer across the quartiles of vitamin D (p=0.039). There was no association with serum calcium, phosphate, plasma creatinine, and glomerular filtration rate (GFR) (p>0.05).

Conclusions: Our findings show an decrease of the risk of breast cancer about vitamin D levels in our population. These results suggest an association between vitamin D and the risk of advanced breast cancer. Further studies are needed to determine the mechanism of vitamin D deficiency in advanced breast cancer.

Introduction: Inflammatory breast cancer (IBC) is very rare worldwide. The objectives of the present study were to determine the frequency, to describe the socio-demographic and clinical characteristics according to the type of CIS (primary and secondary), and to establish the prognosis.

Method: We conducted a retrospective cohort study in the Gynecology-Obstetrics unit of CHU Gabriel Touré (2015 - 2021). Data were analyzed using descriptive statistics and the Kaplan Meier method was used to produce survival curves.

Results: We identified 100 cases of IBC among 588 breast cancer cases including 23 cases of primary IBC (3.59%) and 77 cases of secondary IBC (13.1%). The two types of IBC appeared in a relatively younger and peaked between 35 and 40 years old. Contrary to primary IBC, secondary IBC exhibited a second peak between 55 and 60 years old (Wilcoxon rank, test p > 0.05). The time between symptom onset to disease progression was significantly shorter in primary IBC cases versus secondary one (p < 0.001). Overall survival and specific survival according to the type of IBC were less than 40% after 60 months of followed up.

Conclusion: The incidence of IBC was high in our setting but dominated by secondary IBC. Whatever the type of IBC, the prognosis was poor.

Aortic dissection (AD) is a medicosurgical emergency whose diagnosis has been considerably facilitated in recent years by the development of reliable and easily available diagnostic methods such as echocardiography, spiral CT angiography, and even magnetic resonance imaging. The prognosis remains serious, particularly when the ascending aorta is involved (type A AD), therefore immediate surgical treatment can considerably reduce its mortality. The prognosis for dissections of the descending thoracic aorta (type B) is the best; treatment is primarily medical in the absence of complications. We report two cases of unexploited Stanford type A aortic dissection respectively in a 38-year-old patient and a 52-year-old patient, both with a fatal outcome, and two case of type B aortic dissection with a favorable outcome. These observations highlight the need to raise awareness among our populations about cardiovascular emergencies and challenge our health policies in order to improve the technical platform concerning the diagnosis and management of these dissections.

Introduction: Fibroma ossificans are usually well-defined tumours, but are rarely encapsulated. The choice of radical or conservative treatment is a challenge for the maxillofacial surgeon. The aim of this case report was to describe the particularities of the management of a case of ossifying fibroma of the mandible.

Case report: The patient was a 17-year-old housewife with a history of caesarean section. She presented with a mandibular swelling that had been evolving for 6 years, with no other functional signs and no change in general condition. Exobuccal examination revealed a voluminous symphyseal swelling, covered by healthy-looking skin, with a bony consistency and forming part of the mandible. On endobuccal examination, there was a vestibular swelling extending from 36 to 45, covered by healthy-looking mucosa, with the absence of teeth 31, 32, 41, 42 and 43 and mobility of teeth 33 and 34. The hypothesis of a benign tumour of the mandible was raised. A maxillofacial CT scan revealed a heterogeneous image with local areas of hyperdensity and blowing of the external cortex. Treatment consisted of an interrupting mandibular resection via the vestibular approach, followed by transitional reconstruction using a stent graft. Histological examination of the surgical specimen revealed an ossifying fibroma. The outcome was favourable, with no recurrence after approximately 2 years.

Conclusion: Treatment of ossifying fibroids can often be mutilating. It is discussed according to the clinical and radiological characteristics of the lesion.