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1.
Bull. méd. Owendo (En ligne) ; 20(51): 64-68, 2022.
Article in French | AIM (Africa) | ID: biblio-1378393

ABSTRACT

Introduction : La Neurochirurgie au Mali reste une discipline relativement jeune par rapport aux autres spécialités chirurgicales. Le but de ce travail est de décrire le parcours des urgences neurochirurgicales admises au SAU de l'hôpital du Mali.Patient et méthodes : C'est une étude prospective transversale analytique qui s'est déroulée au SAU de l'hôpital du Mali sur une durée de 02 mois. Sont inclus dans cette étude, tous les patients admis au SAU et dont on a eu recours à un avis neurochirurgical. Nous avons recensé et analysé les données épidémiologiques, cliniques, paracliniques et thérapeutiques chez 82 patients. Résultats : Sur un total de 152 patients admis au SAU, il y'avait 82 cas pour lesquels un avis neurochirurgical a été demandé soit 53, 95 % des admissions. Parmi ces 82 patients, il y avait 50 cas de traumatismes crâniens, 20 cas de traumatismes du rachis, 08 cas d'accident vasculaire cérébral hémorragique (AVCH), 03 cas de suppurations intracrâniennes et 01 cas de tumeur cérébrale. Nous avons opéré 41 patients (50%) et mis en observation 32 patients (39,02%). Malgré nos efforts, 09 patients sont sortis contre avis médical ou par faute de moyens. Nous avons noté 03 cas de décès. Conclusion : La qualité des soins et l'accès aux soins sont très souvent considérés par les patients comme les éléments essentiels de la performance d'un système de santé. En tant que Etablissement Public Hospitalier (EPH) de niveau 3, il doit bénéficier d'un plateau technique adéquat et d'un personnel médical et paramédical suffisant afin d'assurer une prise en charge correcte des patients


Introduction : Neurosurgery in Mali remains a relatively young discipline compared to other surgical specialties.The aim of this study is to describe the course of neurosurgical emergencies in "Hôpital du Mali". Patients and methods: This is a prospective cross-sectional analytical study that took place at the emergency department of "hôpital du Mali" over a period of 02 months. Are included in this study, all the patients admitted in emergency for whom neurosurgical advice was sought. We identified and analyzed epidemiological, clinical, paraclinical and therapeutic data in 82 patients.Results: Out of a total of 152 patients admitted to our emergency unit, there were 82 cases for which a neurosurgical opinion was requested, ie 53.95% of admissions. Among these 82 patients, there were 50 cases of head trauma, 20 cases of spinal trauma, 08 cases of brain stroke, 03 cases of intracranial suppurations and 01 case of brain tumor. We operated on 41 patients (50%) and observed 32 patients (39.02%). Despite our efforts, 09 patients were released against medical advice or for lack of funds. We noted 03 cases of death. Conclusion: The quality of care and access to care are very often seen by patients as essential elements of the performance of a health system. As a level 3 public hospital, it must have an adequate technical platform and sufficient medical and paramedical staff to ensure correct patient care


Subject(s)
Humans , Male , Female , Food Quality , Chief Executive Officers, Hospital , Purchasing, Hospital , Neurosurgical Procedures , Management Audit
2.
Mali Med ; 30(3): 42-45, 2015.
Article in French | MEDLINE | ID: mdl-29927167

ABSTRACT

The aim of this study was to identify factors influencing the clinical outcomes of surgery of obstetric urogenital genital fistula. This was a cross sectional study, which focused on factors influencing results in the treatment of urogenital fistula, from January 2011 to January 2012 at the urology department of the Point-G University Hospital. This study involved 115 patients suffering from urogenital fistula. Cure of urogenital fistula accounted for 17% of the bloc's activities. Closure of the fistula was achieved in 68.7% of cases. This result was influenced by certain factors. Including factors related to condition of the tissue peri-fistula (good trophic tissue, or fibrosis peri-fistula). Fistulas operated primarily peri-sinus tissue remodeling were closed in 71.42% of cases. Factors related to the patient and care: those carried out for the first time have a success rate of 68.42%, only 47.62% of success in patients who presented after five years. Factors related to clinicopathological seat: fistula vesicovaginal septum and cervical-vaginal urethrovaginal reported a success rate of 76.92%. Care-related factors include: the experience of the surgeon, surgeons of the urology service have a 76.19% success rate against 25% from other surgeons. The incision fistula was related to the clinicopathological seat, so the trigonal-vaginal fistulas and uretero addressed by the upper route have been successful in 85%. In addition to these factors the postoperative follow-up, the instruments, the suture thread, the operating table, and the lighting in the room have also improved the results.


Le but de cette étude était d'identifier les facteurs influençant les résultats cliniques de la chirurgie de la fistule uro- génitale obstétricale. Il s'agissait d'une étude transversale, qui a porté sur les facteurs influençant les résultats dans la prise en charge de fistule uro-génitale, allant du janvier 2011 au janvier 2012 au service d'urologie du CHU du Point-G. Cette étude a concerné 115 patientes souffrantes de fistule uro-génitale. La cure de la fistule uro-génitale a représenté 17 % des activités du bloc. La fermeture de la fistule a été obtenue dans 68,7% des cas. Ce résultat a été influencé par certains facteurs, dont les facteurs liés à l'état du tissu péri-fistuleux (bonne trophicité du tissu, ou fibrose péri-fistuleux). Les fistules opérées avant tout remaniement tissulaire péri-fistuleux ont été fermées dans 71,42 % des cas. Les facteurs liés à la patiente et aux soins : celles opérées pour la première fois ont un taux de réussite de 68,42 %, seulement 47,62 % de succès chez les patientes qui se sont présentées après cinq ans. Les facteurs liés au siège anatomo-clinique : les fistules de la cloison vésico-vaginale et cervico-urétro-vaginale ont occupé un taux de succès de 76,92 %. Les facteurs liés aux soins regroupent : l'expérience du chirurgien, les chirurgiens du service d'urologie contrairement aux autres chirurgiens ont 76,19 % de réussite contre 25%. La voie d'abord de la fistule était en rapport avec le siège anatomo-clinique, ainsi les fistules trigonales et urétéro-vaginales abordées par la voie haute ont été réussies dans 85 %. En plus de ces facteurs le suivi post-opératoire, les instruments, les fils de suture, la table opératoire, l'éclairage de la salle ont améliorée aussi les résultats.

3.
Mali méd. (En ligne) ; 30(3): 42-45, 2015.
Article in French | AIM (Africa) | ID: biblio-1265694

ABSTRACT

Le but de cette etude etait d'identifier les facteurs influencant les resultats cliniques de la chirurgie de la fistule uro- genitale obstetricale. Il s'agissait d'une etude transversale; qui a porte sur les facteurs influencant les resultats dans la prise en charge de fistule uro-genitale; allant du janvier 2011 au janvier 2012 au service d'urologie du CHU du Point-G. Cette etude a concerne 115 patientes souffrantes de fistule uro-genitale. La cure de la fistule uro-genitale a represente 17 % des activites du bloc. La fermeture de la fistule a ete obtenue dans 68;7% des cas. Ce resultat a ete influence par certains facteurs; dont les facteurs lies a l'etat du tissu peri-fistuleux (bonne trophicite du tissu; ou fibrose peri-fistuleux). Les fistules operees avant tout remaniement tissulaire peri-fistuleux ont ete fermees dans 71;42 % des cas. Les facteurs lies a la patiente et aux soins : celles operees pour la premiere fois ont un taux de reussite de 68;42 %; seulement 47;62 % de succes chez les patientes qui se sont presentees apres cinq ans. Les facteurs lies au siege anatomo-clinique : les fistules de la cloison vesico-vaginale et cervico-uretro-vaginale ont occupe un taux de succes de 76;92 %. Les facteurs lies aux soins regroupent : l'experience du chirurgien; les chirurgiens du service d'urologie contrairement aux autres chirurgiens ont 76;19 % de reussite contre 25%. La voie d'abord de la fistule etait en rapport avec le siege anatomo-clinique; ainsi les fistules trigonales et uretero-vaginales abordees par la voie haute ont ete reussies dans 85 %. En plus de ces facteurs le suivi post-operatoire; les instruments; les fils de suture; la table operatoire; l'eclairage de la salle ont amelioree aussi les resultats


Subject(s)
Academic Medical Centers , Postoperative Period , Treatment Outcome , Vesicovaginal Fistula
4.
Med Sante Trop ; 24(4): 438-40, 2014.
Article in French | MEDLINE | ID: mdl-25295691

ABSTRACT

OBJECTIVE: Severe acute colitis (SAC) is one of the major complications of inflammatory bowel disease (IBD), especially ulcerative colitis, and it is life-threatening. Although IBD is considered rare in sub-Saharan Africa, we report 2 fatal cases of SAC in Senegalese patients with ulcerative colitis in Dakar. CASES: One patient was a 73-year-old man and the other a 35-year-old woman. In both cases, the diagnosis was preceded by a chronic dysenteric syndrome (febrile in the woman). Despite antibiotic treatment for potential infectious colitis, both patients' condition worsened. Second-line treatment of parenteral corticosteroids did not prevent the occurrence of intestinal perforation for the man, who developed multiorgan failure. The woman developed toxic megacolon during antibiotic treatment, and it was fatal despite bolus corticosteroids: cardiovascular collapse with shock (case 2) occurred before emergency surgery could begin. Conclusion: in subtropical zones where infectious colitis predominates, it is important to consider the diagnosis of SAC in patients with ulcerative colitis and to begin appropriate treatment despite the fear of infection and the difficulty of accessibility to endoscopic exploration.


Subject(s)
Colitis, Ulcerative , Acute Disease , Adult , Aged , Colitis, Ulcerative/diagnosis , Colitis, Ulcerative/therapy , Fatal Outcome , Female , Humans , Male , Senegal , Severity of Illness Index
5.
Mali Med ; 26(1): 23-5, 2011.
Article in French | MEDLINE | ID: mdl-22953334

ABSTRACT

The cystic lymphangioma is a relatively frequent affection. The scrotum is the least common sites. It is a benign tumor discovered during an examination or in a fortuitous way. The diagnosis is done with ultrasonography and the treatment of the limited and circumscribed cases, is a surgical excision. We reported the case of a child of 2 years old which was presented to the surgery emergency for the scrotum traumatism. The clinical and paraclinical exams founded a cystic mass. After mass excision, histopathology founded a cystic lymphangioma.


Subject(s)
Genital Neoplasms, Male/diagnosis , Lymphangioma, Cystic/diagnosis , Scrotum/pathology , Child, Preschool , Genital Neoplasms, Male/surgery , Humans , Lymphangioma, Cystic/surgery , Male , Scrotum/surgery
6.
Mali Med ; 25(3): 49-52, 2010.
Article in French | MEDLINE | ID: mdl-21441092

ABSTRACT

The bladder rhabdomyosarcoma in children is a rare tumor. We report a case of bladder rhabdomyosarcoma in a child 3 years, who consulted for more dysuria hematuria. The aim of this work is to remind the symptomatology and clinical aspects of para-clinical examinations of this disease in children after a review of the literature of this disease and discuss treatment options. The rhabdomyosarcoma should be discussed before any symptoms of dysuria associated with hematuria in children. His diagnosis is suspected by medical imaging and confirmed by pathology. Our attitude has been resection of the tumor, then chemotherapy.


Subject(s)
Rhabdomyosarcoma, Embryonal/pathology , Urinary Bladder Neoplasms/pathology , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Child, Preschool , Combined Modality Therapy , Cyclophosphamide/administration & dosage , Cystostomy , Dactinomycin/administration & dosage , Dysuria/etiology , Hematuria/etiology , Humans , Male , Rhabdomyosarcoma, Embryonal/diagnosis , Rhabdomyosarcoma, Embryonal/drug therapy , Rhabdomyosarcoma, Embryonal/surgery , Urinary Bladder Neoplasms/diagnosis , Urinary Bladder Neoplasms/drug therapy , Urinary Bladder Neoplasms/surgery , Vincristine/administration & dosage
7.
Mali Med ; 24(2): 50-2, 2009.
Article in French | MEDLINE | ID: mdl-19666370

ABSTRACT

UNLABELLED: Our study was made with the C.H.U of the hospital of the Point G in the Service of Urology in Bamako in Mali. It is about a retrospective study in a service which has a dosage unit in load of F.V.V.O on average two hundred patients per annum. We included in our study all the F.V.V.O examined in the service which had an organic assessment. This assessment noted the aspect of the vagina and the topographic situation of the dent. Sometimes the examination of certain patients required a loco-regional anaesthesia and tests with the methylene blue to individualize the dent. CONCLUSION: The classification proposed is the result of an experiment on the ground. It is a tool for learning thus enabling him to distinguish from the types of dent with their forecast and from the technical epic to realize.


Subject(s)
Pregnancy Complications/classification , Vesicovaginal Fistula/classification , Female , Humans , Pregnancy , Retrospective Studies
8.
Mali méd. (En ligne) ; 24(2): 50-52, 2009.
Article in French | AIM (Africa) | ID: biblio-1265584

ABSTRACT

Notre etude a ete faite au C.H.U de l'hopital du Point G. dans le Service d'Urologie a Bamako au Mali. Il s'agit d'une etude retrospective dans un service qui possede une unite de prise en charge de F.V.V.O en moyenne deux cent patients par an. Nous avons inclus dans notre etude toutes les F.V.V.O examinees dans le service qui ont eu un bilan lesionnel. Ce bilan a note l'aspect du vagin et la situation topographique de la fistule. L'examen de certaines patientes a necessite parfois une anesthesie loco-regionale et des tests au bleu de methylene pour individualiser la fistule. Conclusion : la classification proposee est le resultat d'une experience sur le terrain. Elle est un outil pour l'apprenant lui permettant ainsi de distinguer des types de fistule avec leur pronostic et des gestes techniques a realiser


Subject(s)
Urinary Bladder Fistula
9.
Mali Med ; 23(4): 5-10, 2008.
Article in French | MEDLINE | ID: mdl-19617168

ABSTRACT

OBJECTIVE: To specify the aspects clinical, para-private clinics and therapeutic of the diverticulum of the female urethra in the services of Urology of the CHU of the Point G. PATIENTS AND METHODS: Il acts of a retrospective study relating to ten patients having been hospitalized with the diagnosis of urethral diverticulum in the service of urology of the hospital of the Point G. The clinical examination of our patients, the examinations Para biological private clinics and of medical imagery made it possible to pose the operational indication. RESULTS: The majority of our patients were a secretary of office. The average age was 32 years with extremes of 28, 65 years. In antecedents gyneco- obstetrician 80% had normal childbirth and 20% were the nulliparous ones. All patients are without surgical antecedents. The urinary infection with repetition was found in all our patients in spite of the catch of antibiotics. The symptomatology of the low urinary tract was expressed by our patients (pollakiurie, of mictionnelles burns, dysurie). et the dyspareunie by some. The vaginal examination finds a tumefaction under urethral in all our patients. Echography endo-vaginale showed the mass under urethral contained liquid evocative of a diverticulum under urethral or a cyst under urethral in all the cases. The assumption of responsibility of all our patients was surgical E (gynaecological position, even procedure: the diverticulectomie transvaginale. The histology did not announce any case of process neoplastic. The immediate continuations post operational were simple. No patient announced a urinary symptomatology after six months. CONCLUSION: The diverticulum of the urethra of the woman is an ignored affection her treatment is surgical.


Subject(s)
Diverticulum , Urethral Diseases , Adult , Aged , Cysts/diagnosis , Diagnosis, Differential , Diagnostic Imaging , Diverticulum/complications , Diverticulum/diagnosis , Diverticulum/pathology , Diverticulum/surgery , Female , Humans , Retrospective Studies , Urethra/injuries , Urethral Diseases/complications , Urethral Diseases/diagnosis , Urethral Diseases/pathology , Urethral Diseases/surgery , Urinary Tract Infections/etiology
10.
Mali méd. (En ligne) ; 23(4): 1-10, 2008.
Article in French | AIM (Africa) | ID: biblio-1265555

ABSTRACT

Objectif : Preciser les aspects cliniques; para-cliniques et therapeutiques du diverticule de l'uretre feminin dans le services d'Urologie du CHU du Point G . Patients et methodes : Il s'agit d'une etude retrospective portant sur dix patientes ayant ete hospitalisees avec le diagnostic de diverticule uretral dans le service d'urologie de l'hopital du Point G. L'examen clinique de nos patientes; les examens para cliniques biologiques et d'imagerie medicale ont permis de poser l'indication operatoire. Resultats : La majorite de nos patientes etaient secretaire de bureau. L'age moyen etait de 32 ans avec des extremes de 28; 65 ans. Dans les antecedents gyneco obstetricaux 80ont eu des accouchements normaux et 20etaient des nullipares. Toutes les patientes sont sans antecedents chirurgicaux. L'infection urinaire a repetition se retrouvait chez toutes nos patientes malgre la prise des antibiotiques. La symptomatologie du bas appareil urinaire a ete exprimee par nos patientes (pollakiurie; brulures mictionnelles; dysurie).et la dyspareunie par certaines. Le toucher vaginal retrouve une tumefaction sous uretral chez toutes nos patientes. L'echographie endo-vavinale a montre la masse sous uretrale a contenu liquidien evocatrice d'un diverticule sous uretral ou d'un kyste sous uretral dans tous les cas. La prise en charge de toutes nos patientes a ete chirurgicale (position gynecologique; meme technique operatoire : la Diverticulectomie transvaginale. L'histologie n'a signale aucun cas de processus neoplasique. Les suites immediates post operatoires ont ete simples. Aucune patiente n'a signale une symptomatologie urinaire apres six mois. Conclusion : le diverticule de l'uretre de la femme est une affection rare; souvent meconnue; son traitement est chirurgical


Subject(s)
Diverticulum , Diverticulum/diagnosis , Urethra , Women
11.
Gen Comp Endocrinol ; 89(2): 195-205, 1993 Feb.
Article in English | MEDLINE | ID: mdl-8454164

ABSTRACT

Recently hatched chickens were fed a vitamin D and calcium deficient diet for 4 weeks. Calcitonin (CT) biosynthesis in the ultimobranchial glands (UBG) was studied during the treatment by means of in situ hybridization of specific CT mRNAs and immunocytochemical detection of the CT intracellular stores. Circulating CT levels were measured by radioimmunoassay. Within 1 week of the start of treatment, the deficient animals had significantly lowered plasma calcium concentrations and a dramatic fall of plasma CT levels, but the UBGs were not much affected. From week 2 to week 4, the UBG underwent a gradual atrophy. The tissue became lacunar due to the presence of an abnormally developed cystic component. Although calcemia returned to normal at week 4, the cellular endocrine cords were dramatically reduced, corresponding to the undetectable circulating CT levels. However, the UB glands always contained persistent CT-secreting cells, mainly at the periphery of the tissue or in contact with enlarged parathyroid tissue inclusions. These endocrine UB cells contained large amounts of hybridizable CT mRNA and immunodetectable stores of the mature hormone, and their ultrastructural features were quite unaffected compared to normal ones. Thus, we conclude that, in the chicken, severe calcium malnutrition led to a striking reduction of CT biosynthesis in the UB glands by decreasing the number of secretory cells and not by triggering modifications of the biosynthetic activity of the UB endocrine cells.


Subject(s)
Calcitonin/biosynthesis , Calcium/deficiency , Gene Expression Regulation/physiology , Vitamin D Deficiency/metabolism , Animals , Atrophy , Calcitonin/blood , Calcium/blood , Chickens , DNA Probes , Diet , Immunohistochemistry , In Situ Hybridization , Microscopy, Electron , Radioimmunoassay , Thyroid Gland/physiology
12.
Odonto-stomatol. trop ; 16(2): 18-22, 1993.
Article in French | AIM (Africa) | ID: biblio-1268175

ABSTRACT

Dans la société traditionnelle ivoirienne et africaine en général, la cavite buccale et les dents en particulier sont l'objet des tabous réligieux, et figurent en bonne partie les canons de beauté. Le changement du mode de vie suscite par le modernisme n'a en rien altere l'interet esthetique porte aux dents anterieures, lequel figure parmi les plus fréquents de consultation. Cette etude tente de repondre à cette attente en se penchant sur la restauration des dents présentant des anomalies et des teintes frequentes dans nos regions


Subject(s)
Anthropology, Cultural , Cote d'Ivoire , Dental Enamel Hypoplasia , Esthetics, Dental
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