Le Mali medical最新文献

Purpose: The purpose of this study was to describe the nature and reasons for the fall, the injuries caused and their prognosis.

Patients and methods: This was a descriptive cross-sectional study over a period of 9 years. Patients admitted for abdominal trauma from a fall from a height during the study period were included. Ultrasound and CT scan allowed diagnosis of the lesion. Patients in shock who do not respond to resuscitation are considered to have unstable hemodynamics.

Results: fifty-three cases of abdominal trauma by falling from a height, including 11 adults and 42 children, were collected. They were 46 men and 7 women. The average age was 11.6 years. In 86.8% (n=46) of the cases it was a fall from the top of a tree. There were 83% (n=44) abdominal contusion and 17% (n=9) open trauma. Other lesions were associated in 28.3% (n=15) of cases. There were 26 splenic lesions (49%), 14 liver (22.6%) and 6 hollow organs (11.3%). Non-operative treatment was applied in 79.2% (n=42) of cases. Morbidity was 9.4% (n=5) and mortality 5.7% (n=3).

Conclusion: Abdominal trauma from a fall from a height was dominated by falls from the top of fruit trees, and occurred in young male subjects.

Objective: Early detection of sickle cell disease significantly reduces sickle cell mortality, but it is not practiced in Burkina Faso where the disease is responsible for significant early mortality. The objective of the study was to analyze the relationship between this finding and the knowledge and attitudes of pregnant women with hemoglobinopathy and health workers.

Materials and methods: the study was cross-sectional and conducted in three health districts of Ouagadougou, Burkina Faso, from June 17 to July 31, 2019. Data were collected using a structured individual interview guide.

Results: 200 pregnant women with hemoglobinopathy and 50 active health workers had participated in the study. Most women defined sickle cell disease as a bone disease, did not know its transmission mode or the hemoglobin type of their child (ren); 95,4% had never heard of neonatal screening for sickle cell disease. Health workers had limited knowledge of sickle cell disease (16-87%), and only 30% offered neonatal screening to pregnant women with hemoglobinopathy.

Conclusion: the awareness of the population and training health workers on sickle cell disease, supported by a policy of good access to screening tests, would improve the prognosis of sickle cell disease in Burkina Faso.

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.

Introduction: Musculoskeletal disorders are the most common occupational disease in the world. They constitute a major health problem.

Methods: A cross-sectional study was carried out over a period of three months involving the secretaries of the Yopougon University Hospital. The data were collected using a questionnaire inspired by the National Research and Security Institute (INRS) questionnaire.

Results: The study found an exclusively female population with an average age of 40.6 years ± 8.6, mostly overweight or obese (71%). Almost half of the secretaries had more than ten years of seniority in the post (44.7%) and the absence of an ergonomic chair was noted in 84% of cases. In this population of 38 secretaries, the prevalence of MSDs was 89.5% with pain as the main symptom (89.5%). The preferred locations for MSDs were the dorsolumbar spine (78.9%) and the cervical spine (57.9%). The study showed a predominance of MSDs in the following populations: overweight secretaries (63.1%); more than ten years in the post (39.6%); poor working posture (68.4%); the use of a non-ergonomic seat (81.6%).

Conclusion: Musculoskeletal disorders are common among secretaries. They are associated with many factors. It is imperative to implement preventive measures to reduce their risk of occurrence.

Behçet's disease is an autoinflammatory systemic vasculitis of unknown etiology. The literature on this pathology in the black subject is rare. We report the case of a 53-year-old subject with mucocutaneous and ocular manifestation. He met the diagnostic criteria and progressed well on colchicine and prednisone.

Introduction: Hip prosthetic surgery is a commonly performed procedure in orthopedic trauma. It has changed the prognosis of traumatic, degenerative and inflammatory hip diseases.

Objective: The aim of this work was to evaluate the functional and anatomical results of a series of total hip replacements in our department in the short and medium term and to compare them with the literature.

Patients and methods: This was a retrospective descriptive and analytical study of a series of 96 total hip replacements performed at the University Hospital of Kati, from January 2019 to December 2021. Functional discomfort was assessed in all patients before and after surgery. The prostheses used were of the Aston, AK, Surgival, Evolutus and Sharma types. The anatomical results were assessed by radiological criteria and the functional results by Postel Merle d'Aubigné criteria.

Results: In our study, 96 hips were operated on by total prosthesis in 91 patients, including five bilateral cases. The patients were 49 men and 42 women. The average age was 46.9 years. Coxarthrosis associated with necrosis of the femoral head was the most frequent indication for arthroplasty (n=51), followed by femoral neck fracture (n=26). The inclination of the cup was anatomical in 73.3% of cases. The mean femoral offset was 44.1 mm with extremes of 26 and 59 mm. Cup anteversion was normal in 79.4% of cases. The mean preoperative PMA score increased from 5.2 (0 and 15) to 16.9 (4 and 18) late postoperatively. Our results were satisfactory in 89% of cases.

Conclusion: Total hip arthroplasty allows, in the vast majority of cases, to recover indolence and perfect functionality of the hip.

Aims: To describe the clinical and evolutionary aspects of the primary closure of exstrophy at the CHU Gabriel Touré.

Materials and methods: This was a retrospective and prospective study carried out from January 2014 to December 2019 in all the children admitted and operated on for bladder exstrophy at the CHU Gabriel Touré.

Results: We collected 35 cases of exstrophy, ie25 boys and 10 girls. The mean age at diagnosis was 4.8 months. The bladder plate was both normal and budded, ie 28.6% of cases. Plaque infection was found in 45.7%. A malformation was associated in 34.3% of cases. Primary plaque closure was achieved in all of our patients. Postoperative morbidity was 28.6% of cases and mortality 11.4% of cases.

Conclusion: Bladder exstrophy is a rare malformation of the urogenital sphere, its management is complex and its mortality is not null.

Introduction: Parietal hernias were the first pathology after appendicitis at the Chad-China Friendship Hospital.

Objective: The aim of this study was to specify the epidemiological, clinical, diagnostic and therapeutic aspects of parietal hernias.

Patients and method: This was a retrospective descriptive cross-sectional and analytical study of adult patients operated for parietal hernias between June 2015 and July 2020.

Results: Of the 386 cases, there were 281 men (72.8%) and 105 women (27.2%). The sex ratio was 2.68. The mean age of the patients was 43.14 years with extremes of 20 and 79 years. In 7.5% of the cases, it was the strangulated hernias received in emergency (n=29). Inguinal hernia (n=268) was the most frequent variety with 69.4% of cases, followed bylinea alba hernia (78=20.2%) and umbilical hernia (40=10.4%). The main surgical technique used was the Bassini technique. Postoperative complications were 2 cases of hemorrhage (0.5%), 4 cases of hematoma (1%), 7 cases of urinary retention (1.8%) and 10 cases of parietal suppuration (2.6%).

Conclusion: Parietal hernias are dominated by inguinal hernias. Raphy was the only technique performed. Early consultations could prevent complications.

Objective: To study the epidemiological, clinical and evolutionary characteristics of autoimmune dysthyroidism in the endocrinology-diabetes department of the CNHU-HKM.

Material and method: This was a descriptive and analytical cross-sectional study of patients seen for thyroid pathology in the endocrinology diabetology department over a 10-year period. Patients with at least one abnormal TSH and positive anti-thyroid antibodies were included.

Results: Over the study period, we recorded 2883 consultants, 347 of them having thyroid diseases, including 69 cases of autoimmune dysthyroidism divided into 54 cases of Graves' disease and 15 cases of Hashimoto's disease. Autoimmune dysthyroidism represented 2.39% of consultations and 19.89% of thyroid disorders. Graves' disease and Hashimoto's disease accounted for 1.87% (54 cases) and 0.52% (15 cases) of consultations respectively. Autoimmune dysthyroidism was more frequent in the 30-40 and 40-50 age groups. The most frequent symptoms of Graves' disease were asthenia (94.4%), weight loss (87.0%) and tachycardia (85.2%). In Hashimoto's disease, the main symptoms were asthenia (86.66%), goiter (66.6%) and weight gain (60%). High initial R-TSH antibody levels and iatrogenic hypothyroidism were found to be factors associated with extended follow-up of Graves' disease beyond 18 months.

Conclusion: Autoimmune dysthyroidism is a frequent condition, with Graves' disease predominating. Their evolution under therapy is influenced by clinical, biological and ultrasonographic factors.

The psoas major muscle is one of the three muscle chiefs of the ilio-psoas muscle. The pathological processes concerning it are dominated by tumor lesions which are mostly malignant. The diagnostic approach is based on the clinic and the abdomino-pelvic scanner. If necessary, it will make it possible to direct a puncture and / or a biopsy. We report the observation of a 33-year-old patient admitted to the Bouaké University Hospital presenting with a mass in the left iliac fossa and an intermittent claudication of chronic evolution in whom the diagnosis of a psoas tumor was diagnosedthrough the abdomino-pelvic scanner and the pathology concluded to an angiomyolipoma.