Le Mali medical最新文献

Introduction: One of the main goals of routine antenatal care is to identify mal developing fetuses and fetal ultrasound biometry parameters are used for this purpose. The objective of this study was to establish the norms of umbilical cord diameter (UCD) and to investigate its relationship with estimated fetal weight (EFW) and other fetal biometry parameters.

Populations and methods: This was a descriptive and analytical cross-sectional study with prospective data collection conducted in the radiology and medical imaging and gynaecological-obstetrics departments of Sokodé regional hospital. All pregnancies with a single fetus that appeared normal from the 11th week of pregnancy were included. Excel and R-4.2.2 software was used. A significance level of 5% was established for the statistical tests.

Results: A total of 256 pregnant women were recorded. The mean UCD in the 1st, 2nd and 3rd trimester was 4.07±0.99 mm; 9.69±2.65 mm and 15.36±2.08 mm respectively. There was a strong positive linear correlation between UCD and gestational age (r=0.87; p<0.00001) and between UCD and EFW (r=0.80; p<0.00001). The linear relationship between UCD and gestational age (GA) is expressed by the equation: GA= 1.605*UCD+ 6.235. Similarly, the linear relationship between UCD and EFW is expressed by the equation EFW= 207.854*UCD-1382.382. Fetal biometry parameters were strongly correlated with UCD (r≥0.81; p<0.00001).

Conclusion: Ultrasound measurement of umbilical cord diameter is a relatively simple technique to estimate gestational age and assess fetal growth.

Introduction: Smoking, a major preventable cause of morbidity and mortality is a real public health problem in the world.

The objective: was to establish the epidemiological profile of smoking among soldiers at Camp Almamy Samory Touré.

Method: This was a descriptive cross-sectional study lasting 6 months in 2018 at Camp Almamy Samory Touré in Conakry including all serving soldiers, without distinction of age, sex, residence and who accepted freely to participate.

Results: We investigated 384 soldiers, including 287 smokers, a prevalence of 75% and 97 non-smokers, 25%. The most represented age group was 31-40 years 25.5% with an average age of 38.95 ± 9.36 years. They were all male (100%) and the majority resided in Conakry 96.61%. The level of education was secondary followed by higher and primary respectively: 38.54%; 24.48% and 23.70%. Married people were more numerous 39.58% followed by single people 34.11%. The average age of onset of smoking among our soldiers was 18.86 ± 3.42 years. Leisure places 26.48% were the main place of initiation to tobacco smoking. The 38.46% of the military smoke 11-20 wicks of cigarettes per day. During the study, 55.93% of soldiers wanted to quit smoking now.

Conclusion: The prevalence of smoking among soldiers at Camp Almamy Samory Touré in Conakry remains very high with a young and male predominance. Nearly ¾ of the soldiers surveyed had smoked in the past and places of leisure were the main place of initiation to tobacco smoking. However, more than half of the soldiers now wanted to quit smoking after a good knowledge of the toxic effects of this practice.

Background and objectives: Cesarean section is an increasingly common life-saving procedure in obstetrics. The objectives of this study were to identify the factors associated with the decision to perform a cesarean section in the labor room and to determine the therapeutic and obstetric practices that can increase the probability of giving birth by high way.

Methods: This was a case-control study conducted in the gynecology-obstetrics department of the General Hospital of Bonzola (HGR) in Mbujimayi from May 1, 2020 to April 30, 2021. The target population consisted of all low-risk parturients. The logistic regression model on epi-info 7.2.0 software was used to determine the predictive factors for the indication of caesarean section among parturients.

Results: Indications for cesarean section were dominated by stationary dilatation with 56.2% of cases and ARCF with16.7% of cases; an Apgar≤ 3 and a birth weight ≥ 4000g were retained as essential neonatal characteristics for cesarean section in labor. After multivariate analysis by logistic regression, a Bishop score < 6 with unfavorable cervix,dilatation < 3 cm on admission, and therapy done with oxytocin, artificial rupture of membranes, and G10% during labor were identified as risk factors for cesarean section in labor.

Conclusion: Certain factors predict the risk of cesarean section in parturients at low obstetrical risk. Knowledge of these risk factors may allow practitioners to prevent it or to better prepare patients for this procedure.

Aim: The aim of this work was to describe the deaths by mechanical as phyxiation that occurred in Abidjan in order to contribute to their prevention.

Material and methods: This was a retrospective and descriptive study carried out over a period of 19 years (2002-2020) and relating to deaths by mechanical asphyxia treated by Forensic Medicine.

Results: Deaths by mechanical asphyxiation represented 1.23% (756/60,984), concerned men (85%), from the informal sector (39.7%) or pupils/students (34.1%), single people (75%). These deaths occurred on Wednesdays (16.7%), in the afternoon (47.9%), during the month of June (15.2%), by drowning (72.2%), during swimming (56%). The hanging (15.1%) was discovered at the victim's home (95.6%) and the contexts that occurred were financial problems (26%) and depression (25%). Choking (11.4%) followed landslides (79%). Strangulation (1.3%) was criminal (100%) and occurred in the context of settling scores (60%) and crimes of passion (40%). The circumstances of occurrence of drowning and suffocation were accidental respectively in 71.8% and 82.6% of cases while hanging was suicidal (85%).

Conclusion: Deaths by mechanical asphyxiation although minimal, constitute a social drama. Their prevention requires the implementation of preventive measures against drowning.

Objectives: To identify the factors of poor prognosis of ventilator-associated lung disease (VAP) in order to improve their management.

Patients and method: Prospective, descriptive and analytical study of patients admitted to intensive care at the Angré University Hospital from November 1, 2019 to July 31, 2021 and having presented VAP.

Results: We collected 43 patients out of 625 admissions, i.e. 6.88%. The average age was 49.06 years. The sex ratio was 0.38. The main reason for admission was coma with 88.37%. Hypertension and diabetes were the main antecedents. Early VAP accounted for 53.49%. Klebsiella pneumoniae was the main germ. Patients intubated on admission accounted for 79.07%. The average duration of ventilation was 26.95 days and the average duration of hospitalization was 30.8140 days. Probabilistic antibiotic therapy was performed in 75.76% of patients. Mortality was 76.74%. The mortality factors were duration of mechanical ventilation greater than 15 days and age greater than 50 years.

Conclusion: Secondary mortality from VAP remains high. The identification of the two prognostic factors should improve the subsequent management of all new cases.

Introduction: Few data exist on the issue of visual impairment (VI) in people living with HIV (PLHIV).

Objective: To identify the causes of visual impairment among people living with HIV (PLHIV) at the University Hospital of Libreville.

Population and methods: This was an observational study of 737 people living with HIV (PLHIV). The parameters studied were age (year), gender, CD4 count, age of infection, use of antiretroviral therapy as well as visual acuity from far and near (CMI-11) and cause of VI.

Results: Out of a population of 737 PLHIV, 75 (101 eyes) had VI, representing a hospital prevalence of 10.2% (n = 75/737). VI was bilateral for 34.7% (n = 26/75) of them. The main aetiology were refractive disorders (47.5%). Uveitis affected 16.8% of the number of eyes, of which 12.9% were of toxoplasmic origin. Other causes were cataracts (11.9%) and cytomegalovirus retinitis (10.9%). Two patients experienced early macular degeneration and two others with macular ischemia. Bilateral macular hemorrhage and occlusion of the central artery of the retina were also observed.

Conclusion: One in 10 PLHIV is visually impaired. In half of the cases, the pathologies that provide this handicap, are opportunistic disease with ocular toxoplasmosis in the foreground. Routine screening may improve visual prognosis.

Purpose: To study the diagnostic and therapeutic aspects of hemangioma of the tongue.

Observation: A 65 year old man admitted to ENT for a swelling of the tongue that appeared two years ago and progressively increased in volume leading to permanent protrusion. The swelling took up the entire anterior third of the tongue. It had a reddish appearance. On palpation, it was a rounded, firm, well-limited, slightly sensitive mass, measuring 5 cm in diameter. The rest of the ENT examination was unremarkable. Lingual CT scan revealed a very limited mass with hyperechogenic content that did not increase in size after injection of the contrast agent. Surgical excision was performed and the postoperative follow-up was simple. Histology concluded that there was a hemangioma of the tongue.

Conclusion: Hemangioma of the tongue is a rare pathology. It must be considered in front of any lingual mass in adults. Its positive diagnosis is clinical and histological.

Introduction: Several authors have suggested an association between the ABO system (ABOS) and the risk of SARS CoV-2 infection. The objective of the present study was to identify the susceptibility of ABOS blood groups to COVID-19 at the National Institute of Public Health (INSP) of Mali.

Material and methods: This was an unpaired case-control study. The cases (402) were COVID-19 patients, and the controls (5438) were Muslim pilgrims, all of whom had undergone ABO blood grouping at the INSP. Logistic regression was performed to identify factors associated with SARS-CoV-2 infection status using SPSS version25 software.

Results: Blood types had the following frequencies: O(34%), B(30%), A(28%), AB(8%) for cases and O(42%), B(27%), A(25%), AB(6%) for controls. COVID-19 positive status was not significantly associated with blood groups A(oR=1.17; CI95%[0.93-1.47]), B(OR=1.11; CI95%[0.89-1.39]) and AB(OR=1.41; CI95%[0.97-2.06]). However, blood group O subjects were 28 times less likely to have COVID-19 than non-O(OR=0.72; CI95%[0.58-0.89).

Conclusion: The results show that blood group O individuals were less likely to have SARS CoV-2 infection than non-O individuals. This should not affect the use of barrier measures in ABOS groups.

Objective: To evaluate the knowledge of digestive surgeons and anesthesiologists about péri-operative under nutrition.

Methodology: this was a cross-sectional investigation in the anesthesia resuscitation and digestive surgery departments of the CHU Yopougon, Cocody, Treichville and Bouaké. We counted digestive surgeons, anesthesiologists survey period (August 2018).

Results: Out of 50 questionnaires given to the doctors included in the survey, 34 returned the completed questionnaires. We had 52.9% of surgeons and 47.1% of intensive care anesthetists. 88.2% of the respondents gave an "approximately correct" answer to the definition of under nutrition. 14.7% gave "approximately correct" answers on the important items for the diagnosis of under nutrition. 52.9% knew exactly the ideal time to assess under nutrition. 58.8% knew the ideal time for the management of under nutrition. 14.7 gave approximately correct answers about the average of managing under nutrition.

Conclusion: Digestive surgeons and anesthetists at the University Hospitals of Cocody, Treichville, Yopougon and Bouaké have generally insufficient knowledge and practices in relation to malnutrition and need training in this area.

Inguinal hernia is one of the most frequent pathologies in surgery and is defined by the passage of abdominal or pelvic contents through the inguinal orifice [1]. However, an inguinal hernia is said to be of the bladder when the contents involve the bladder [2]. It is rare and most often discovered intraoperatively [3]. We report a case of left inguinal bladder hernia diagnosed by ultrasound. This was a 74-year-old patient who consulted for dysuria associated with bilateral inguino-scrotal swelling. A vesico-prostatic ultrasound was performed using a Samsung ultrasound scanner equipped with high and low frequency probes and a pulsed and color Doppler mode. At the end of this examination, the diagnosis of a left inguinal hernia of the bladder was made.