[Extra uterine pregnancy and fertilization in vitro about a case of clinical observation at the maternity of the hospital center (ch) de meaux (France)]. / Grossesse extra uterine et fecondation in vitro a propos d'un cas d'observation clinique a la maternite du centre hospitalier (ch) de meaux (France).

Ectopic pregnancy is the leading cause of maternal morbidity and mortality during the first trimester of pregnancy. There has been a dramatic increase in its incidence since the advent of IVF followed by in vitro Embryo Transfer (IVF-ET). Many risk factors related to IVF techniques and the cause of infertility have been documented. The combination of Endo Vaginal Ultrasonography and Human B Chorionic Gonadotropin (HCG) assays is the most reliable diagnostic tool, sometimes allowing the trunk to be preserved.

Grossesse extra-utérine est la principale cause de morbidité et mortalité maternelles durant le premier trimestre de la grossesse. On note une augmentation spectaculaire de son l'incidence depuis l'avènement de la FIV suivi du Transfert de l'Embryon in vitro (FIV-ET). De nombreux facteurs de risque liés aux techniques de la FIV et la cause de l'infertilité ont été documentés. La combinaison de l'échographie Endo vaginale au dosage des B gonadotrophines chorioniques humaines (HCG) est l'outil de diagnostic le plus fiable, permettant parfois de conserver la trompe.

[Comparative Study of Induced Pregnancies and Spontaneous Pregnancies in a Level II Hospital in Bamako District Mali]. / Etude Comparative Des Grossesses Induites Et Grossesses Spontanees Dans Un Hopital De Niveau II Du District De Bamako Mali.

The aim of this work was to compare the prognosis of induced pregnancies and spontaneous pregnancies received in the service. PATIENTS AND METHODS: We performed a retrospective study of Ca / Witnesses (1 case for 2 controls) with age and parity matching. This study was conducted at the maternity ward of the Reference Health Center of Commune V District Bamako (CSREF CV) over a period of 10 years from January 1, 2007 to December 31, 2016 for all patients meeting our criteria of 'inclusion. We called cases, induced pregnancies, and witnessed spontaneous pregnancies. The data was entered and analyzed on the Epi-Info software version 6.04 according to the formula applicable to the Case / Witness study. RESULTS: We included in this study, (due to a case for two controls), 1611 induced pregnancies (cases), and 3222 spontaneous pregnancies (controls). The average age was 35.4 years (25 years-43 years) with an average parity of 2.7 (1-5). Hypertensive disorders, preterm birth, intrauterine growth retardation (IUGR), caesarean section, poor perinatal prognosis were found with a statistically significant difference (OR> 1) in patients with induced pregnancies. CONCLUSION: Induced singleton pregnancy is a high-risk pregnancy.

L'objectif de ce travail était de comparer le pronostic des grossesses induites et des grossesses spontanées reçues dans le service. PATIENTES ET MÉTHODES: Nous avons réalisé une étude rétrospective Ca/Témoins (1 Cas pour 2 Témoins) avec appariement de l'âge et la parité. Cette étude s'est déroulée la maternité du Centre de Santé de Référence de la Commune V du District de Bamako(CSREF CV) sur une période de 10ans allant du 1er janvier 2007 au 31 Décembre 2016 portant sur toutes les patientes répondant à nos critères d'inclusion. Nous avons appelé Cas, les grossesses induites et témoins les grossesses spontanées. Les données ont été saisies et analysées sur le logiciel Epi-Info version 6.04 conformément à la formule applicable à l'étude Cas/Témoins. RÉSULTATS: Nous avons inclus dans cette étude, (en raison d'un Cas pour deux Témoins), 1611 grossesses induites (Cas), et 3222 grossesses spontanées (Témoins). L'âge moyen était de 35,4 ans (25 ans-43ans) avec une parité moyenne de 2,7 (1-5). Les troubles hypertensifs, l'accouchement prématurité, le retard de croissance intra-utérin(RCIU), la césarienne, le mauvais pronostic périnatal ont été retrouvés avec une différence statistiquement significative (OR>1) chez les patientes avec grossesses induites. CONCLUSION: La grossesse singleton induite est une grossesse à haut risque.

[Study Of Immediate Post-Partum Care Satisfaction (Ssoppi) At The Reference Health Center Of The Community V Of Bamako]. / Étude De La Satisfaction Des Soins Du Post-Partum Immédiat (Ssoppi) Au Centre De Santé De Référence De La Commune V De Bamako.

The objectives of the work were to measure the degree of satisfaction of women in the postpartum period and to determine the stability of the immediate postpartum care satisfaction scale (PASS). MATERIAL AND METHOD: The motherhood of the reference health center of commune V served as a study framework. The study was descriptive for evaluative purposes in postpartum women. It covered the period from 11 July 2014 to 14 January 2015. Two interview questionnaires (SSOPPI1) and (SF12 and SSOPPI2) were used for data collection. The data analysis was done on the software EPI-info version 3.5.3. RESULTS: The study involved a total of 145 women in SSOPPI1 and SSOPPI2. The average age was 25.6 years ± 5.5 years. The level of satisfaction for the two phases of the study (SSOPPI1 and SSOPPI2) was a function of level of study, occupation, mode of initiation of labor, route of delivery, status of newborn at birth. Satisfaction was 98.6% in SSOPPI1 and was 98,5% in SSOPPI2 with a statistically insignificant difference (p = 0.67). CONCLUSION: The degree of overall satisfaction was a function of a number of factors. This satisfaction remained stable during both phases of the study.

Les objectifs du travail étaient de mesurer le degré de satisfaction des femmes dans le post-partum et de déterminer la stabilité de l'échelle de mesure de la satisfaction des soins post-partum immédiat(SSOPPI). MATÉRIEL ET MÉTHODE: La maternité du centre de santé de référence de la commune V a servi de cadre d'étude. L'étude était descriptive à visée évaluative portant sur les femmes en post-partum. Elle a couvert la période allant du 11juillet 2014 au 14 janvier 2015. Deux questionnaires d'entrevue (SSOPPI1) et (SF12 et SSOPPI2) ont été utilisés pour la collecte des données. L'analyse des données a été faite sur le logiciel EPI-info version 3.5.3. RÉSULTATS: L'étude a porté sur un total de 145 femmes en SSOPPI1 et SSOPPI2. L'âge moyen était de 25, 6ans±5,5ans. Le degré de satisfaction pour les deux phases de l'étude (SSOPPI1 et SSOPPI2) était fonction du niveau d'étude, la profession, le mode de déclenchement du travail, la voie d'accouchement, l'état du nouveau-né à la naissance. La satisfaction était de 98,6% en SSOPPI1 et de 98,5% en SSOPPI2 avec une différence statistiquement non significative (p=0,67). CONCLUSION: Le degré de satisfaction globale était fonction d'un certain nombre de facteurs. Cette satisfaction est restée stable pendant les deux phases de l'étude.

Étude de la satisfaction des soins du post-partum immédiat (SSOPPI) au centre de santé de référence de la commune V de Bamako

Les objectifs du travail étaient de mesurer le degré de satisfaction des femmes dans le post-partum et de déterminer la stabilité de l'échelle de mesure de la satisfaction des soins post-partum immédiat(SSOPPI). Matériel et méthode : La maternité du centre de santé de référence de la commune V a servi de cadre d'étude. L'étude était descriptive à visée évaluative portant sur les femmes en post-partum. Elle a couvert la période allant du 11juillet 2014 au 14 janvier 2015. Deux questionnaires d'entrevue (SSOPPI1) et (SF12 et SSOPPI2) ont été utilisés pour la collecte des données. L'analyse des données a été faite sur le logiciel EPI-info version 3.5.3. Résultats : L'étude a porté sur un total de 145 femmes en SSOPPI1 et SSOPPI2. L'âge moyen était de 25, 6ans±5,5ans. Le degré de satisfaction pour les deux phases de l'étude (SSOPPI1 et SSOPPI2) était fonction du niveau d'étude, la profession, le mode de déclenchement du travail, la voie d'accouchement, l'état du nouveau-né à la naissance. La satisfaction était de 98,6% en SSOPPI1 et de 98,5% en SSOPPI2 avec une différence statistiquement non significative (p=0,67). Conclusion : Le degré de satisfaction globale était fonction d'un certain nombre de facteurs. Cette satisfaction est restée stable pendant les deux phases de l'étude

[Knowledge, attitudes and practices of healthcare providers on suspected Ebola cases in Guinea]. / Connaissances, attitudes et pratiques des prestataires de soins de santé de face aux cas suspects d'Ebola en Guinée.

BACKGROUND: Developing a more resilient health system to Ebola Virus Disease (EVD) is a necessity in Guinea. This implies having information on the knowledge and practices that health staffs had during the preceding the EVD outbreak. The objective of this study was to compare the knowledge, attitudes and practices of routine healthcare providers on suspected EVD cases in the affected and non-affected districts in Guinea. METHODS: A cross-sectional analytic study was conducted from December 6th to 30th, 2014 with health staffs and community health workers from 120 health facilities, in four health districts more affected by the EVD and four others less affected. RESULTS: Health staffs who declared being able to identify a suspected EVD case were represented more in the more affected districts (95.2%) than in the less affected districts (78.7%, P<0.01). The main practice towards a suspected case in the more affected districts was referral to the Ebola treatment centre (79.2%, versus 20% in the less affected districts, P<0.05), while in the less affected districts, cases were first tested for malaria prior to treatment or referral (3 cases out of 5). Community health workers who declared being able to identify a suspected EVD case were significantly more represented in the more affected districts (73%) than in the less affected districts (38.1%, P<0.001). CONCLUSION: This study suggests that health system managers should prioritize capacity building of health providers in EVD affected as well as in non-affected districts to ensure better preparation for and response to EVD outbreaks.

The unexpected role of bioaerosols in the Oxidative Potential of PM.

Bioaerosols represent up to 15-25% of PM by mass, but there is currently no assessment of their impact on Oxidative Potential (OP), or capacity of particulate matter (PM) to produce damaging oxidative reactions in the human lungs. Here, the OP of selected bioaerosols (bacteria cells vs fungal spores) was assessed through the cell-free DTT assay. Results show that bioaerosols induce Reactive Oxygen Species (ROS) production, varying along the microorganism type, species, and concentration. Fungal spores show up to 10 times more ROS generation than bacterial cells. At the highest concentrations, fungal spores present as much oxidative reactivity as the most redox-active airborne chemicals (Copper, Naphtoquinone). Moreover, bioaerosols substantially influence OP of ambient PM and that of its chemical constituents: in presence of A. fumigatus spores, the OP of Cu/NQ is increased by a factor of 2 to 5, whereas, 104 and 105 S. epidermidis bacterial cells.mL-1 halves the OP of Cu/NQ. Finally, viable and gamma-rays-killed model bioaerosols present similar oxidative reactivity, suggesting a metabolism-independent cellular mechanism. These results reveal the importance of bioaerosols for PM reactivity. PM toxicity can be modified due to bioaerosols contribution or by their ability to modulate the OP of toxic chemicals present in PM.

[Acute generalized peritonitis in Sominé Dolo's Hospital of Mopti: Epidemiologic and therapeutic aspects]. / Peritonites aiguës Generalisees a l'hopital Somine Dolo de Mopti: Aspects epidemiologique et therapeutique.

Acute generalized peritonitis requires precocious diagnosis and immediate treatment. MATERIALS AND METHODS: The purpose of this study is to determine hospital case frequency, to describe the clinical and therapeutic aspects and to evaluate the operating suites. We conducted a prospective study, lasting 16 months, from January 2005 to April 2006, looking at 40 cases of generalized acute peritonitis operated in several services, including a general surgery department, of the Sominé Dolo's hospital of Mopti. RESULTS: We noted a hospital admittance rate of 3.1% with an average age of 26.3 years old and a 1.66 men to women ratio. Peritonitis at the Sominé Dolo hospital was dominated by intestinal perforation. The diagnosis was essentially made using the clinical approach. The treatment was medico-surgical. Operative mortality was recorded in 7 cases (17.5%) with 7 cases of inner-wall abscesses. The delay of consultations and the Mannheim score were the main factors causing bad prognostics. Excision - sutures associated with a cleansing drainage of the abdominal cavity was the most practised surgical procedure. CONCLUSION: Mortality remains high. The two factors for a bad prognostic are the delay of consultation and the lack of means for reanimation.

INTRODUCTION: La péritonite aiguë généralisée est une urgence qui nécessite un diagnostic précoce et un traitement d'urgence. MATÉRIELS ET MÉTHODES: Nous avons réalisé une étude prospective de seize mois de janvier 2005 à avril 2006 portant sur 40 cas de péritonites aigues généralisées opérés à l'hôpital Sominé Dolo, qui est un hôpital de première référence de la région de Mopti avec plusieurs services dont un service de chirurgie générale. Les objectifs de cette étude étaient de déterminer la fréquence hospitalière, de décrire les aspects cliniques, thérapeutiques et évaluer les suites opératoires. RÉSULTATS: Nous avons eu une fréquence hospitalière de 3,1% avec un âge moyen de 26,3 ans et un sex-ratio de 1,66 pour les hommes. La péritonite à l'hôpital Sominé Dolo de Mopti a été dominée par la perforation intestinale. Le diagnostic a été établi essentiellement sur la clinique. Le traitement a été médico-chirurgical. La mortalité opératoire a été observée dans 7 cas (17,5%) avec 7 cas d'abcès de paroi (17,5%). Le retard de consultation et le score de Mannheim ont été les principaux facteurs de mauvais pronostic. L'excision ­ suture associée à un lavage drainage de la cavité abdominale ont été les gestes chirurgicaux les plus pratiqués. CONCLUSION: La mortalité reste élevée .Les deux facteurs de mauvais pronostic ont été le retard de consultation et le manque de moyens de réanimation.

[Impact of market place activity on the spread of STI/AIDS in Sikasso, Mali]. / Impact des fêtes foraines dans la propagation des IST/sida à Sikasso au Mali.

Since the beginning of the global HIV pandemic, more than 47 million people have been infected and more than 14 millions of people have died with 95% living in developing countries. Mali is located in West Africa that has been relatively less affected. However Mali is a country with a migratory culture. This study was conducted in primary health care centers located on the main road to neighboring countries with higher HIV prevalence. Attention was focused on healthcare services provided around market places in the main cities where diverse populations converge on a weekly basis. Attendance measured at five health centers on market day was compared with attendance on the other days of the week. In addition the level of sexually transmitted infections (STI) diagnosed on market days was determined to compare prevalence in the resident versus non-resident population in function of market activity. Attendance at all the centers was significantly higher on market days. This increase was due mainly to the non-resident population (60.2% vs. 46.5%; p=0.005). Findings also showed that the proportion of STI diagnosed was higher in the non-resident than resident population, but the difference was not statistically significant (15.6% vs. 11.3%; p=0.320). These results indicate that migration has an impact on the spread of STI. This is probably the same for HIV since these pathologies are known to be linked. Control strategies to fight against STI/AIDS could be improved by taking into account market place activity that is common in all localities of Mali and Africa.

[Epidemiologic and therapeutic factors of postoperative incisional hernia at CHU Gabriel Touré]. / Facteurs etiologiques et therapeutiques des eventrations postoperatoires au Chu Gabriel Toure.

INTRODUCTION: The incisional hernia is a frequent complication of the opened abdominal surgery. The objectives of this study were to determine the hospital frequency and the favoritizing factors, to analyze the therapeutic aspects. MATERIALS AND METHODS: We realized a retrospective study from January, 1999 to December, 2005 in the services of general and paediatric surgery of teaching hospital Gabriel Touré. It concerned 45 cases of incisional hernia. The hernias of the abdominal wall, the abdominal and traumatic hernia were not retained. RESULTS: The frequency was 0.52%; the average age of our patients was 37.8 years with a sex ratio of 2 in favour of the woman. The average delay of consultation was of 59 months with extremes going from 2 to 11 months. Favoritizing factors found were the parietal suppuration to 13 (28.8%) patients and the multiple interventions to 8 (17.8%) patients. The average dimension of the hernia was 9.5 cms ± 3.8 with extremes going from 5 to 14 cms. The 45 patients benefited from the cure of the hernia according to Mayo. We didn't lost any patient. 2 parietal suppurations happened post-operatively. CONCLUSION: Incisional hernia treatment consists for Mayo's method or prosthesis. The laparoscopic surgery can reduce complications.

[Omphalocele in general and pediatric surgery in Gabriel Touré]. / Traitement des Omphaloceles Dans les Services de Chirurgie Generale et Pediatrique du Chu Gabriel Toure.

INTRODUCTION: the omphalocèle is an evolution of the extra embryonic coulombs between the 32th and the 72th days of the pregnancy. The treatment depends on his volume. In Mali; few works were published on the omphalocèle and its treatment. MATERIALS AND METHOD: we brought together 111 cases of omphalocèles during 8 years of study with the aim of determining the epidemiological factors and describing the clinical and therapeutic aspects. RESULTS: 49 patients on 111 were of the male and aged between 4,2 days with weight between 2500 - 3500 g. The diameter of the r snare was superior to 8 cms in 29(26,13%) cases and has benefited a conservative treatment according to Grobb. 13 patients had a rupture of the membrane. The liver has been found in 29 time (26,13%) in the sac and 35 case and associated malformation. 20 cases of death have been observed. Antenatal ultrasound found exomphalos in 9 cases. Any mother had a story of teratogenic medications and 67 mothers were multipared. CONCLUSION: Omphaloceles are multidiscipli-nary surgical emergencies. Antenatal echogra-phy is useful for the antenatal diagnosis.

[Influence of the saccule in vestibular tilting reaction in frogs (Rana occipitalis)]. / Influence du saccule sur les réactions vestibulaires à l'inclinaison chez la grenouille (Rana occipitalis)

In blinded frogs we have cut the saccular nerve on both sides. This results in decreasing the amplitude of the tilting reactions (which are elicited by stimulation of the utriculi). The saccular facilitation of tilting reactions is more or less great according to the frogs.