[Prevalence and risk factors of hepatitis C virus infection in chronic hemodialysis patients at the University Hospital of Point G, Bamako, Mali]. / Prevalence et facteurs associes au portage du virus de l'hepatite virale C chez les hemodialyses chroniques au CHU du Point G, Bamako, Mali.

The objective of this prospective study conducted in November 2008, was to determine the prevalence and the factors associated with Hepatitis C Virus (HCV) infection in chronic hemodialysis patients. The study was carried out in the hemodialysis unit of the university teaching hospital of Point G. Serum samples were tested for anti-HCV antibody, anti-HIV antibody and HBs Ag using enzyme immunoassay methods (ELISA) at the laboratory of immunology of the National Blood Transfusion Service of Bamako. The following parameters were assessed: initial nephropathy, duration of the dialysis, history of blood transfusion, number of blood units transfused since the beginning of the dialysis, history of nosocomial exposure. A total of 66 patients were enrolled. The mean age of the patients was 42,27±14, 8 years, with a male to female sex-ratio of 1,44. Anti-HCV antibodies were found in 13 chronic hemodialysis patients, leading to a prevalence of 19,7%. A significant association was found between the bearing of HCV and the duration of the dialysis. These results indicate that hepatitis C is frequent in the chronic hemodialysis patients of the university teaching hospital of Point G, and that the duration of dialysis constitutes the main factor associated with the contamination by the HCV.

[Frequency of red blood cell alloimmunization in polytransfused patients at the university teaching hospital of Point G, Bamako, Mali]. / Fréquence de l'allo-immunisation érythrocytaire chez les malades polytransfusés au centre hospitalo-universitaire du Point G, Bamako, Mali.

This prospective study conducted within 9 months period aimed to determine the frequency of red cell alloimmunization among polytransfused patients of the medical Hematology and oncology ward, and the unit of hemodialysis of the Nephrology ward at the Point-G hospital. Irregular red blood cell antibody screening and identification were performed by gel-filtration method using indirect antiglobulin test and enzymatic treated cells. We did not use saline medium. A total of 78 patients were included in this study. The mean age of the patients was 36.78±14.73 years (range: 11 and 77 years). The sex ratio was of 1.11 in favour of the women. The mean blood units transfused were 12.21±9.99 units (range: 4 and 45 units). The Rhesus phenotypes Dccee, DccEe and DCcee were most predominant, with the respective frequencies of 67.9, 15.4 and 10.3%. Kell antigen was found at a frequency of 1.28%. The total rate of red cell alloimmunization was 10.3%. There was no significant difference between the two wards. All the screened agglutinins were warm antibodies belonging to the Rhesus system: anti-E (7.7%), anti-C (1.3%) and anti-D (1.3%). Only Anti-E was present among hematologic patients. We did not find a significant link between the sex, the age, the number of blood units transfused and the positivity of the antibody screening. We conclude that the frequency of post-transfusional alloimmunization is high among polytransfused patients in Mali. A systematic antibody screening among these patients and the selection of red cells with known Rhesus/Kell phenotypes would allow an optimal blood transfusion safety.

[Assessment of the use of partogram at the district maternity hospital of commune II in Bamako area]. / Evaluation de L'Utilisation du Partogramme a la Maternite du Centre de Sante de Reference de la Commune V du Distict de Bamako.

OBJECTIVE: To estimate the use of the partogram at the district hospital of commune II in Bamako area; to identify the risk factors by pregnant women and her newborn babies ; to appreciate the filling quality of the partogram; to determine the sensibility, the specificity and the predictive worth of the alert line. METHOD: Our study has been conducted at the district hospital of commune II in Bamako area because of his high examination rate. The study was retrospective, analytic and transversal, conducted during 12 months (from first January 2005 to 31 st December 2005). Were considered in this study, partograms of all pregnant women, who have been admitted to delivery in the hospital during the study period and whom labor was monitored with partogram from latence phase or active phase. Were excluded, partograms of women, who has delivered at home, the one who have suffered prophylactic cesarean and the one who have been admitted with a cervix dilatation ≥8 cm. RESULTS: 287 partograms ( 18,85%) were correctly filled; 64% of the deliveries were performed left of the alert line; 31,3% right of the alert line; 4,7% right of the action line. 83,04% of the pregnant women performed at least one prenatal examination, the age bracket of 15 to 19 years shows a little predominance with 27% of cases; 46,71% among them have delivered right of the alert line. The primigravidas represent 32% of the sample; among them, 38% got over the alert line and 7,93% the action line. Women smaller than 150 cm represent 1,05% ( 16 cases). In this bracket 68,75% ( 11 cases) suffered caesarean, 31,25% (5 cases) delivered normal. The caesarean has been performed again by 61,45% of the pregnant women, who had a previous cesarean, 29,52% have delivered normal. Concerning the newborn babies, 1,24% coming from the 84,95% deliveries whom labor time was lower than 10 hours, 51,98% those coming from the 13,27% deliveries whom labor time was between 11 and 24 hours, 100% of those coming from the 1,77% deliveries whom labor time was over 24 hours, had a low Apgar score at birth. 65,06% of the newborn babies delivered from the 5,45% women with greenish amniotic liquid have a low Apgar score against 3,32% of those from 73,32% with clear amniotic liquid.

[Assessment of the use of partogram at the district maternity hospital of commune II in Bamako area]. / Evaluation de L'utilisation du Partogramme a la Maternite du Centre de Sante de Reference de la Commune V du Distict de Bamako.

OBJECTIVE: To estimate the use of the partogram at the district hospital of commune II in Bamako area; to identify the risk factors by pregnant women and her newborn babies; to appreciate the filling quality of the partogram; to determine the sensibility, the specificity and the predictive worth of the alert line. METHODOLOGY: Our study has been conducted at the district hospital of commune II in Bamako area because of his high examination rate. The study was retrospective, analytic and transversal, conducted during 12 months (from first January 2005 to 31 st December 2005). Were considered in this study, partograms of all pregnant women, who have been admitted to delivery in the hospital during the study period and whom labor was monitored with partogram from latence phase or active phase. Were excluded, partograms of women, who has delivered at home, the one who have suffered prophylactic cesarean and the one who have been admitted with a cervix dilatation ≥ 8 cm. RESULTS: 287 partograms (18.85%) were correctly filled; 64% of the deliveries were performed left of the alert line; 31.3%right of the alert line; 4.7% right of the action line. 83.04% of the pregnant women performed at least one prenatal examination, the age bracket of 15 to 19 years shows a little predominance with 27% of cases; 46.71% among them have delivered right of the alert line. The primigravidas represent 32% of the sample; among them, 38% got over the alert line and 7.93% the action line. Women smaller than 150 cm represent 1.05% ( 16 cases). In this bracket 68.75% (11 cases) suffered caesarean, 31.25% (5 cases) delivered normal. The caesarean has been performed again by 61.45% of the pregnant women,who had a previous cesarean, 29.52% have delivered normal. Concerning the newborn babies, 1.24% coming from the 84.95% deliveries whom labor time was lower than 10 hours, 51.98% those coming from the 13.27% deliveries whom labor time was between 11 and 24 hours, 100% of those coming from the 1.77% deliveries whom labor time was over 24 hours, had a low Apgar score at birth. 65.06% of the newborn babies delivered from the 5.45% women with greenish amniotic liquid have a low Apgar score again 3.32% of those from 73.32% with clear amniotic liquid.

[Kidney sicknesses associated with gene of the drepanocytose in the Department of Nephrology and Haemodialysis of the CHU of Point G]. / Atteintes Renales Associees au Gene de la Drepanocytose Dans le Service de Nephrologie et D'hemodialyse du Chu du Point G.

PURPOSE: To assess renal features joint to gene of the drepanocytose. PATIENTS AND METHODS: It concerned a descriptive transversal study from June 1995 to January 2004. Were included drepanocytose patients admitted hospital or seeing for consulting having one of the features: haematuria, proteinuria, leucocyturia, positive aeroculture, urea increasing and/ or of blood creatinine. The analysis and data capture were conducted on SPSS 11.0. The statistic text was the Khi square with a threshold of signification p<0.05. RESULTS: The folders of 30 patients (18 m and 12 w) were collected. The average age was of 3104 years (5 and 64 years). The most hospitalization reasons encountered were the oedema syndrome (26.7%) and the overall haematuria (20%). The majority of the patients were heterozygote 93.33%. The kidney sicknesses encountered were: acute renal deficiency 40%, the macroscopic haematuria 20%, the nephritic syndrome 20%, chronic renal deficiency 13.4%, urinary infection 3.3% and microscopic haematuria 33%. CONCLUSION: The sicklaneny's gene in Mali is associated to a renal morbidity. The increased frequency of drepanocytaria feature bearers must be confirmed by other studies in order to establish a strategic of treatment of this pathology.

[Clinical and biological evolution of nephrotic syndrome patients and corticotherapy]. / Evolution clinique et biologique sous corticotherapie au cours du syndrome nephrotique a propos de 50 cas au service de nephrologie point G.

AIMS: This study was aimed to follow clinical and biological data of patients presenting a nephrotic syndrom apparently primitiv, devided in two groups. PATIENTS AND METHODS: The study was prospectiv including 50 patients hospitalized from January 1999 to January 2001. The first group received prednison tablets according to their body weight, and the second group received firstly a bolus of methyl prednisone to the cumulative dose of 20mg/kg divided on 3 days; relayed by the 20mg/day of prednison tablets. The Chi2 test was estimated (p

[Neurologic disorders in pregnancy and post-partum period at the neurology service of Chu du Point-G and the referral center of the Commune V of Bamako]. / Troubles neurologiques au cours de la grossesse et du post-partum dans le service de neurologie du Chu du Point-G et du Centre de Reference de la Commune V de Bamako.

The objective of the study was to describe epidemiological and clinical characteristic of acute vascular accidents, epilepsies and eclampsy, observed during the periods of pregnancy and post delivery. The study was prospective, conducted during 19 mouths from August 2005 to February 2007. Women aged from 15 to 45 years were considered, presenting neurological disorders. Among 6914 consulted patients, 37 were recruited and presenting required criteria of neurological disorders (3.02%). Most of the case (48.7%) were between the ages of 15 to 25 years. Epilepsy was detected in 51.40% of this group, acute vascular accidents 37.83% and eclampsy 13.51% of the cases. The evolution of the pregnancy was favorable eutopic delivery was frequent, only 1 caesarean has been registered.

[Dysmenorrhea in adolescents: epidemio-clinical study at the referral health center, Bamako District. Report of 300 cases]. / La dysmenorhee chez l'adolescente : etude epidemio-clinique au centre de santede reference de la commune II du District de Bamako a propos de 300 cas.

This clinical epidemiological study has been conducted at the district hospital of Commune II in Bamako area.Dysmenorrhea has become a very common feature during out patients consultation. It affects almost one adolescent out of 3 examined during this study which represent 42, 8% of the studied population ranged from 10 to 19 years, with a men age of 16 years. Most of them were household women (50%),never pregnant (60%) and never delivery (64%). Most of them have been mainly claiming about contraction pain (33%) and discomfort (17,3%). The pain has been followed by asthenia (86,7%), and irritability (87,7%).Dysmenorrhea was a major cause of absenteism (48,3%). The factors influencing this type of dysmenorhea was the age and psychological stress.

Troubles neurologiques au cours de la grossesse et du post-partum dans le service de neurologie du CHU du Point-G et du centre et du centre de référence de la commune v de Bamako

Objectifs :Decrire les caracteristiques epidemiologiques; et cliniques des AVC; de l'epilepsie et de l'eclampsie. Observes au cours de la grossesse et du post-partum. Methode : il s'agit d'une etude de prospective sur 19 mois allant d'Aout a 2005 a Fevrier 2007; qui s'est deroulee dans le service de neurologie du CHU du Point-G et dans le centre de sante de reference de la commune V du district de Bamako. Etaient concernees par ce travail toutes les femmes en age de procreer ( 15 a 45 ans) consentantes; ayant ete examinees et/ou hospitalisees pour troubles neurologiques apparus pendant la grossesse et /ou les six mois suivant l'accouchement; dans nos differents site d'etude. Resultat : Au cours de notre etude nous avons recrute 20 patientes en consultation externe (sur 629 ) et 17 patientes en hospitalisation ( sur 629 ); soit au total 37 malades ( sur 6914) qui repondaient a nos criteres. La frequence globale des troubles neurologiques associes a la grossesse et au postpartum etait de 3;02. La tranche d'age la plus representee etait celle de15 a 25 ans avec 48;70des cas. Le diagnostic d'epilepsie a ete retenu chez 51;40de nos patientes ; l'AVC et l'eclampsie ont occupe les deuxieme et troisieme rangs avec les taux respectifs de 37;80et 10;80. L'evolution de la grossesse etait en generale favorable ; les accouchements ont ete dans la plupart des cas; eutociques; nous avons enregistre 1 seul cas de cesarienne

Atteintes rénales associées au gène de la drépanocytose dans le service de néphrologie et d'hémodialyse du CHU Point G

But : identifier les manifestations rénales associées au gène de la drépanocytose. Patients et méthodes : il s'agissait d'une étude transversale descriptive allant de juin 1995 à janvier 2004. Ont été inclus les patients drépanocytaires vus en consultation ou hospitalisés présentant une des manifestations rénales: hématurie, protéinurie, leucocyturie, uroculture positive, augmentation de l'urée et/ou de la créatinine sanguines. L'analyse et la saisie des données ont été effectuées sur SPSS 11.0. Le test statistique a été le Khi carré avec un seuil de signification p≤0,05. Résultats : les dossiers de 30 patients (18 H et 12 F) ont été colligés. L'âge moyen était de 31,4 ans (5 et 64 ans). Les motifs d'hospitalisation les plus rencontrés étaient le syndrome œdémateux (26,7%) et l'hématurie totale (20%). La majorité des patients étaient hétérozygote 93,33%. Les atteintes rénales rencontrées étaient : l'IRA 40%, l'hématurie macroscopique 20%, le syndrome néphrotique 20%, l'IRC 13,4%, l'infection urinaire 3,3% et l'hématurie microscopique 3,3%. Conclusion : le gène drépanocytaire au Mali est associé à une morbidité rénale. La fréquence élevée des porteurs du trait drépanocytaire doit être confirmée par d'autres études afin d'élaborer une stratégie de prise en charge de cette pathologie

67Gallium kinetics in the blood of patients with malignant tumors.

67Gallium was injected into 60 patients with malignant tumors and into 42 patients in whom malignant tumors had been excluded by clinical investigation. 67Ga kinetics in blood were evaluated by non-linear least square regression computer analysis according to an open 2-compartment model where elimination proceeds from the peripheral compartment. Parameters of 67Ga kinetics in tumor patients showed a bimodal distribution, as was also the case in patients without tumors. No difference could be demonstrated between kinetic parameters of tumor patients and patients without tumors. In 4 patients, 67Ga kinetics could be evaluated before and after treatment of their malignant tumors, but a decrease in the volume of distribution was the single alteration of kinetic parameters occurring after treatment. This decrease may be explained by a smaller peripheral compartment resulting from the loss of tumor mass after treatment. Nevertheless, we conclude that the evaluation of 67Ga kinetics in blood will provide only limited information about the presence, size and growth rate of malignant tumors in man.

Influence of prostaglandins A1, E1, E2, and F2 alpha on renal blood flow and plasma renin activity. Investigations in chronically instrumented conscious dogs.

The effects of different prostaglandins (PG) on serial determination of renal blood flow (RBF), mean arterial blood pressure (MABP), renal vascular resistance (RVR) and renin release were investigated in the conscious, chronically instrumented dog. 2 months after right-sided nephrectomy, female beagle dogs (n = 6) were implanted with an electromagnetic flow probe and an inflatable pneumatic cuff around the left renal artery, and a catheter was inserted into the aorta above the renal artery. In repeated experiments, different prostaglandins (PGA1, E1, E2 and F2 alpha) were infused above the renal artery at increasing doses (infusion time 15 min, doses 0.03--1.0 micrograms min-1 kg-1). Lower and medium doses induced an increase of RBF, which returned to or were slightly below control levels with higher doses. PGA1 appeared to be the most potent vasodilator with a significant hypotensive activity and the greatest augmentation of RBF. Simultaneously, renin release was most pronounced by PGA1.