Le Mali medical最新文献

Aim: The aim of this study was to establish the spermiological profile of patients treated for infertility at Sikasso Hospital.

Material and methods: This was a prospective descriptive cross-sectional study, which took place from January to December 2022 at Sikasso Hospital. Interpretation of spermiological parameters was based on standards established by the World Health Organization in 2010.

Results: We enrolled 41 patients, 51.22% of whom had disturbed spermiological parameters. The abnormalities were azoospermia (21.92%), asthenooligozoospermia (12.20%), asthenozoospermia (7.32%), oligozoospermia (7.32%) and asthenonecrozoospermia (2.44%). These anomalies were mainly observed in the 34-44 age group (47.62%).

Conclusion: This study revealed significant disturbances in spermiological parameters, with azoospermia being the most frequent abnormality.

Introduction: Ultrasound is the first-line examination in the morphological exploration of the thyroid. It is an excellent diagnostic and prognostic tool in nodular thyropathy.

Objective: to determine the profile of thyroid nodules on ultrasound according to the EU-TIRADS classification.

Material and methods: descriptive cross-sectional study carried out in the radiology department of the University Hospital of Bouaké during one year. We included all thyroid ultrasound reports of patients with thyroid nodules. Data were analysed using Epi Info 7 software.

Results: A total of 60 patients had nodules out of 97 referred for thyropathy (60.8%). The mean age was 45.6 years [13-82 years]. Females predominated with 82.7%. Anterior cervical swelling was the main indication in 72%. Thyroid volume was increased in 63% of patients with a mean volume of 71 cm3. Solitary nodules were present in 46.55%. Spongiform nodules were predominant in 32%. The nodules were solid in 29.8% and mixed in 16.5%. Hypoechogenicity was found in 44.8% of solid nodules. Lesions were classified as EU-TIRADS 2 in 58.8%, EU-TIRADS 3 in 23.5%, EU-TIRADS 4 in 14.7% and EU-TIRADS 5 in 2.9%.

Conclusion: The characterisation and classification of thyroid nodules is an important step in the management of patients. In our study, these nodules are essentially benign (EU-TIRADS 2 and 3) with a female predominance. A decision tree taking into account the clinical and cytopathological elements would be more useful for possible surgery.

Introduction: Pneumothorax are frequent reasons for hospitalization in African pneumological settings. The objective of this work was to describe the epidemiological-clinical, etiological, therapeutic and evolutionary aspects of pneumothorax at the Center Hospitalier Universitaire d'Abéché (CHU-A) in Chad.

Materials and methods: This was a prospective and descriptive study conducted in the internal medicine department, from January 1, 2020 to December 31, 2021 concerning cases of pneumothorax.

Results: A total of 40 cases of pneumothorax were collected, representing a hospital frequency of 2.38%. The most affected age group was that of 26-45 years (40%) with a male predominance (M/F ratio=2.33). The main contributing factors were smoking (32.5%) and being underweight (55.5%). Acute bacterial pneumonia (57.5%) and tuberculosis (27.5%) were the main etiologies of secondary pneumothorax. Pleural drainage (62.5%), combined with non-specific antibiotic therapy (57.5%) or antituberculous treatment (27.5%) were the main means of management. The evolution was favorable at 90%. We had recorded a hospital mortality of 7.5%.

Conclusion: Pneumothorax remains frequent in our hospital settings. The dominant etiologies were acute bacterial pneumonia and tuberculosis. The evolution is sometimes interspersed with complications such as residual pneumothorax or pachypleuritis.

Objective: The general objective of this work was to evaluate the quality of medical prescriptions at the CHU Bocar SALL of Kati before the introduction of a therapeutic form.

Methods: This was a cross-sectional study with prospective collection covering one year (April 2021-March 2022). A simple random sampling was carried out from the prescriptions (n=1283) of the patients coming for outpatient consultations and the files (n=847) of the hospitalized patients.

Results: Prescriptions were made mainly by medical specialists, including 468 prescriptions and 612 patient files. The average number of drugs per prescription was 2.66. As for hospitalized patients, they received an average of 5.75 drugs. The "Prescription quality score" obtained an average of 5.19 out of 8 points. A little more than half of the prescriptions were made on the basis of the national list of essential drugs with a rate of 53.31%.The treatments given to the patients were consistent with the diagnoses, with a score of 4.14 out of 5 points.

Conclusion: Compliance with the rules of good practice for medical prescriptions not only guarantees the quality of care offered to users, but also allows good planning and control of the establishment's future public health actions.

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: Facial fractures are rare in the pediatric population compared to adults. They represent 1 to 15% of maxilla-facial trauma. The objective of this study was to describe the epidemiological, clinical and therapeutic characteristics of mandible fractures in children in a developing country.

Material and methods: This was a retrospective descriptive cross-sectional study - from January 1, 2016 to June 31, 2020 involving 17 cases. It took place in the Department of Odonto-Stomatology and Maxillofacial Surgery of the Hospital and University Center (CHU) of Bouaké.

Results: There were 14 boys (82.35%) and 3 girls (17.65%) i.e. a sex ratio of 4.66. Road traffic accidents were the main cause with 64.72% (n=11). Unifocal fractures were found in 14 patients (82.35%). The seat was parasymphyseal in 29.41% (n=5). Bifocal fractures were found in 3 patients (17.65%). The site was condylar and symphyseal in 2 patients (75%). It involved the symphysis and the horizontal branch in 1 patient (25%). Orthopedic treatment was performed in all patients (100%). The evolution was favorable in all patients, i.e. 100% of cases.

Conclusion: The fracture of the mandible in children is a traumatological entity which is an epidemiological and therapeutic particularity.

Aims: The aim was to describe the diagnostic and therapeutic aspects of biliary peritonitis.

Patients and methods: This was a descriptive cross-sectional study with retrospective collection over a period of 10 years including patients operated on for biliary peritonitis.

Results: We collected 10 cases of biliary peritonitis with an average age of 38 years with a sex ratio of 2.3. Two patients presented with an abdominal contusion following a road traffic accident. Maximum abdominal pain in the right hypochondrium was present in three patients, signs of peritoneal irritation in all patients, positive Widal and Felix serodiagnosis in eight patients. At midline laparotomy, the gallbladder was perforated in three patients, gangrenous in five, phlegmonous in one, sclero-atrophic in one. Cholecystectomy was performed in all patients. Biliary peritonitis was of traumatic origin in two patients, and typhoid in eight. Postoperatively, there were four cases of sepsis and three cases of parietal suppuration. Three patients died.

Conclusion: Biliary peritonitis discovered during laparotomies for peritonitis, was secondary to typhoid cholecystitis, and had a high morbidity and mortality.

The causes of death are of great importance in assessing the health status of the population and care'squality. Their study could guide health policies aimed at increasing life expectancy.

Objectives: It was to determine the causes of death; to study the socio-demographic characteristics of deceased.

Materials and methods: This was a retrospective and descriptive study of all deaths that occurred in the Medical Department of Sikasso Hospital from January 2018 to December 2020.

Results: Among 265 deaths recorded, the mean age was 45.12 ± 17.5 years. The sex ratio was 1.59. They were mostly city dwellers and 51.64% lived in Sikasso city. The mean length of hospitalization was 7.09 ± 6.38 days. Kidney failure was the first reason for hospitalization. HIV infection was the leading cause of death (29.8%), followed by renal failure (24.2%). The male sex was predominant in all causes of death except HIV infection and anemia. Deaths linked to kidney failure have increased fivefold from 2018 to 2020.

Conclusion: Deaths related to HIV/AIDS remain in the lead despite their strong reduction; those related to kidney failure have increased fivefold.

Aim: To evaluate the initial results of our different treatments of open humeral shaft fractures.

Method: This was a retrospective study conductecd in Abidjan (Ivory Coast) over a period of 10 years, involving 16 open humeral shaft fractures. It included 10 men and six women with a mean age of 32.8 years (Extremes: 21 and 61). The skin opening was classified according to Cauchoix and Duparc. Fractures were either treated by trimming followed by a brachial-ante-brachial cast, or treated with a screwed plate or external fixator. Patients were followed according to a strict protocol. Overall results were assessed by Stewart and hundley functional scoring.

Results: At a minimum follow-up of 24 months, all patients had consolidated. There was one case of local infection, three cases of elbow stiffness and four reversible cases of radial nerve palsy. The functional results according to the Stewart and Hundley score were very good in 11 cases, good in four cases and fair in one case, with no poor result.

Conclusion: Depending on the therapeutic indications, the initial results are satisfactory both clinically and functionally.

Introduction: Autosomal recessive cerebellar ataxias (ARCA) are a group of rare and heterogynous neurodegenerative diseases mainly characterized by unbalance and walking difficulty and movement incoordination.

Objectives: To clinically and paraclinically characterize ARCA in the department of Neurology at the Teaching Hospital of Point G and identify the underlying genetic defect.

Patients and method: We have conducted a longitudinal and prospective study from January 2018 to December 2020. Patients with ARCA phenotype seen in the Department of Neurology at the Teaching Hospital of Point "G" were enrolled.

Results: We have enrolled 7 families totaling 13 patients after giving an informed verbal and written consent. The sex ratio was 2.2 in favor of males, Kayes region and Fulani ethnic group were respectively the most represented region and ethnic group.Walking difficulty represented the major symptom followed by loss of vibration and joint sense, nystagmus, dysarthria and skeletal deformities. Alpha-foetoprotein level was high in one patient. Genetic testing confirmed Friedreich ataxia in one family and was not conclusive in 4 families.

Conclusion: This study showed that ARCA are not uncommon in Mali and genetic testing is crucial to confirm the diagnosis.