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Sexual ambiguities are due to varied congenital or hormonal causes. A retrospective study carried out from January 1995 to December 2000 and followed by a prospective study from January 2001 to September 2002 sought to describe the clinical aspects of sexual ambiguities in Internal Medicine in a tertiary hospital Mali. Among 12 patients out of 2223 consultants identified (0.54 percent), 10 of them were phenotypically feminine and 2 phenotypically masculine. The average age of the patients was 14.3+- 8.9 years. Clinically, 3 out of the 10 phenotypically feminine patients presented an anomaly of the external genital organs; 5 out of the 10 had low axillary and pubic hair growth; 4 out of the 10 had delayed puberty; 6 out of the 10 had primary amenorrhoea; 7 out of 10 had hypoplasia of the mammary glands; and3 out of 10 had an inguinal mass. For the the 2 phenotypically masculine patients, one had a bilateral gynecomastia, a macroskelia of 2m04, a low axillary and pubic hair growth and the other had an anomaly of the external genital organs.

Pulmonary tuberculosis among diabetic patients in internal medicine at Point G Hospital, Bamako - Mali.

The depression of cellular immunity among diabetic patients exposes them to tuberculosis considered as one of the major diseases of immune-depressive people. The purpose of our study was to evaluate the frequency, gravity, treatment and evolution of pulmonary tuberculosis among our patients affected with diabetes. For that purpose, two descriptive retrospective and prospective studies were undertaken from January 1982 to December 1992 in the Internal Medicine (Internal medicine) department of Hospital of Point G, the national hospital. Thus, 54 diabetics patients hospitalised out of 1 365 had tuberculosis at a frequency rate of 3,95%. The average age of our patients was 49 years + 12 and the sex ratio was 2,18 in favour of men. The infection was also more frequent in diabetes type 1 (51,9%) then in type 2 (48,1%), and concerned mainly men (68.51%) who were more than 37 years old (57.41%). Clinically, the common signs to both affections were prevalent namely asthenia: 85,2%, anorexia: 53,7%, weight loss: 66,7%, associated to cough: 81,5% and to dyspnea: 29,6%. However, for a third of the patients (22,2%), tuberculosis was discovered during a systematic check up. All the patients had a glycemia higher than 8mmol/l, with extremes up to 8mmol/l and32mmol/l, 63% of patient had a febricula. The intradermo cutaneous reaction to tuberculosis (IDR) was negative in 44,4%. The bacilloscopy during direct testing or through the liquid obtained by casing was positive in 64,82%. Tubercular lesions were localised at the top: 91,8%, with an equal attack of the two lungs. During the treatment six products were mainly used comprising Rifampicine (R) isoniazid (INH or H), Streptomycine (S), Ethambutol (E), Thiacetazone (T), and Pyrazinamide (Z). Insulin treatment was done on all patients until tuberculosis was cured. The evolution was favourable after 2 to 3 months of treatment for 48 patients (88,88%) among whom 4: (8,33%) fell sick again. Six patients out of 54 died, i.e. 11,12%.

Pulmonary tuberculosis among diabetic patients in internal medicine at point g hospital, bamako - mali.

Summary The depression of cellular immunity among diabetic patients exposes them to tuberculosis considered as one of the major diseases of immune-depressive people. The purpose of our study was to evaluate the frequency, gravity, treatment and evolution of pulmonary tuberculosis among our patients affected with diabetes. For that purpose, two descriptive retrospective and prospective studies were undertaken from January 1982 to December 1992 in the Internal Medicine (Internal medicine) department of Hospital of Point G, the national hospital. Thus, 54 diabetics patients hospitalised out of 1 365 had tuberculosis at a frequency rate of 3,95%. The average age of our patients was 49 years +/- 12 and the sex ratio was 2,18 in favour of men. The infection was also more frequent in diabetes type 1 (51,9%) then in type 2 (48,1%), and concerned mainly men (68.51%) who were more than 37 years old (57.41%). Clinically, the common signs to both affections were prevalent namely asthenia: 85,2%, anorexia: 53,7%, weight loss: 66,7%, associated to cough: 81,5% and to dyspnea: 29,6%. However, for a third of the patients (22,2%), tuberculosis was discovered during a systematic check up. All the patients had a glycemia higher than 8mmol/l, with extremes up to 8mmol/l and 32mmol/l, 63% of patient had a febricula. The intradermo cutaneous reaction to tuberculosis (IDR) was negative in 44,4%. The bacilloscopy during direct testing or through the liquid obtained by casing was positive in 64,82%. Tubercular lesions were localised at the top: 91,8%, with an equal attack of the two lungs. During the treatment six products were mainly used comprising Rifampicine (R) isoniazid (INH or H), Streptomycine (S), Ethambutol (E), Thiacetazone (T), and Pyrazinamide (Z). Insulin treatment was done on all patients until tuberculosis was cured. The evolution was favourable after 2 to 3 months of treatment for 48 patients (88,88%) among whom 4: (8,33%) fell sick again. Six patients out of 54 died, i.e. 11,12%.

Updated epidemiology of haematological malignancies in the haematology & oncology and the internal medicine wards of the hospital of Point G, Bamako, Mali.

Summary This is a retrospective study on epidemiologic aspects of hematological malignancies from 1996 to 2003 in the Hospital of Point G, Bamako, Mali, in which we looked at files of all patients who visited the center during that period. During the study, 264 cases were diagnosed for hematological malignancies corresponding to an annual mean of 33 cases. Hematological malignancies were mostly lymphoid types (76.51%), among which NHL were predominant. For non lymphoid malignancies, CML was the most frequent (70.96 %). The prevalence of hematological malignancies was multiplied by 2.18 for lymphomas, 2.16 for leukemia, and 1.87 for multiple myeloma; whereas it was stable for other cases. The sex ratio was in favor of men with regard to all hematological malignancies except for CML that is more frequent un female (p=0,002). The case frequency repartition according to age showed a bimodal distribution with one peak for the 10-19 years old and another peak for the 40-49 years old. Among 44 patients tested for HIV, 11.4 % were positive. We couldn't establish a relationship with other classic risk factors. There were some particularities in the distribution of cases with regard to patient's provenances and the time spent before the hospital visits. The hospital-based mortality rate was 10.4 per 1000 and, lethality was high, probably because of case management difficulties and particular popular representation of the disease. More prospective studies with emphasis on risk factors in relation with hematological malignancies in Mali will help to better understand these observed epidemiologic particularities and to elaborate prevention and treatment strategies.

Schistomiasis morbidity to hospital ward of hospital of point g in Bamako - Mali.

Summary Aims The coinfection of the VIH and the schistosomiasis is affections brought back in schistosomiasis endemic area. We valued the level of morbidity partner to the schistosomiasis in hospital yard to patients hospitalized without distinction of immunological statute of patients. Patients and Methods Our study was retrospective and prospective. We included all patients hospitalized to internal Medicine and infectious diseases carriers of schistosomiasis to the mucous rectal biopsy and parasitologic exam of stools and urines between January 1998 and July 2005. Results Twenty-four patients were included in the survey of which 15 of masculine sex (62,50%) and 9 of feminine sex (37,50%). The sex ratio (H/F) = 1,66. The most tainted professions were pupils, peasants and housewives. Ten patients had benefited from the VIH tracking (41,66%) and 6 patients were seropositive for the VIH (25%). Sixty fifteen percent of patients accommodated Schistosoma haematobium (18 cases), 20,83% Schistosoma mansoni (5 cases) and 1 patient had a mixed infection. It doesn't exist a statistically difference between the frequency of species met (p = 0,061) . The main motives of hospitalization were the fever (12,50%), the hepatomegaly and splenomegaly, the ascite, the abdominal pain associated to the diarrhea and the diarrhea associated to an anemic syndrome with 8,20% for each of these motives. The most frequent clinical symptomatology was diarrhea (12,50%). The underlying pathologies more associated were the opportunist infections of the VIH (8,30%) the cirrhosis (12,50%), a syndrome amoebic dysentery syndrome (8,30%), a hepatic granuloma (8,30%). In the group of patients HIV positive the symptomatology was made of chronic and /or of glair - bloody diarrhea. One alone patient with a rate of CD4 = 279/mm3 presented prurigos in bouquet on the right flank. All patients without immunological statute distinction answered favorably to the treatment by the praziquantel. Conclusion The schistosomiasis stays even frequent in hospital yard of Bamako. The best understanding of the interaction between HIV and schistosomiasis is a pledge of the success of struggle programs in endemic area of schistosomiasis and of VIH.