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Sacrospinous Fixation in the Gynecology Department of H？pital du Mali  [PDF]
Traoré Alassane, Sissoko Abdoulaye, Coulibaly Mamadou Bakary, Traoré Soumana Oumar, Sima Mahamadou, Bocoum Amadou, Traoré Soumaila, Touré Moustapha, Tegueté Ibrahima, Traoré Youssouf
Open Journal of Obstetrics and Gynecology (OJOG) , 2021, DOI: 10.4236/ojog.2021.111003
Abstract: Sacrospinous fixation (SSF) or Richter’s intervention (RI) aims to treat genital prolapse by securing the posterior vaginal wall to the small sacrospinous ligament. It is performed by low approach and includes a dissection of the pararectal space, visual exposure of the sacrospinous ligament and a needle with strait needle holder with nonabsorbable threads. It is often associated with a more complex corrective procedure, including cystocele cure, vaginal hysterectomy and posterior myorrhaphy. The objective of this study is to report the results of SSF in the gynecology department of Hopital du Mali. A descriptive study was conducted from September 2014 to September 2015 concerning 37 patients operated on for uterine prolapse (UP). All patients with grade III UP were included in our study in whom a unilateral hysterectomy (UH) and sacrospinous fixation (SSF) were performed. All the patients were scheduled. Preoperatively they had benefited from an assessment and a pre-anesthetic consultation. Hospitalization of at least 24 hours prior to the operation was required. Postoperative follow-up was two years with a physical examination at 3 months, 9 months and 15 months, and phone calls between physical consultations. During the study period, we performed 37 RIs. The mean age of the patients was 48 years with extremes of 41 to 73 years. The large multiparity was found out in 35 cases (94.59%), the pauciparous were two with 3 deliveries for each. Long labor of more than 18 hours was found out in 9 patients (24.32%) and home delivery in 13 cases (35.13%). The duration of the occurrence of prolapse was at least two years and 35 patients were going through menopause. The type of anesthesia used for the surgery was spinal anesthesia for all patients. The average duration of the operation was 90 minutes. Complications occurred in three patients or 8.10% of cases, two cases of acute urine retention and one case of hematoma of the para-rectal space. The medium time of hospital stay was 5 days. The anatomical result was satisfactory in all patients. However, two patients presented with grade II rectocele one year after the operation. Sacrospinous fixation is a technique suitable for our patients who present with genital prolapse with extreme laxity of the suspension ligaments. Well done, it brings anatomical satisfaction and its complications are rare and slight.
Role of Laparoscopic Surgery in the Management of Female Infertility at the Department of Gynecology of H？pital du Mali  [PDF]
Mamadou Bakary Coulibaly, Alassane Traoré, Mody Abdoulaye Camara, Bourama Kané, Adama Sangaré, Kalba Tembiné, Ibrahima Tégueté, Youssouf Traoré
Open Journal of Obstetrics and Gynecology (OJOG) , 2020, DOI: 10.4236/ojog.2020.10100131
Abstract: Infertility is a socio-cultural drama in Africa, especially in Mali and remains difficult for couples to overcome. Laparoscopy, also called minimally invasive surgery or keyhole surgery, is an operative technique that permits to explore the pelvis and perform an appropriate therapeutic procedure. The objective of our work was to assess the role of laparoscopic surgery in the treatment of female infertility at Hopital du Mali. It was a retrospective descriptive study that was conducted over a period of 5 years (January 2013 to December 2018). Any patients followed for infertility and who underwent laparoscopic surgery in the gynecology department over a period of two (2) years were included. The outcome of laparoscopic surgery was evaluated in terms of conception of pregnancy. We had collected 103 infertile patients out of 2984, with a frequency of 3.45%. The mean age of our patients was 30.2 years. Housewives and out-of-school women accounted for 68.93% and 54.37% respectively. Nulligravida represented 41.75%. Regarding infertility, it was primary in 41.75% and secondary in 58.25%, with an average duration of 6.2 years. Systematic chlamydial serology was positive in 62.14% of our patients. Hysterosalpingography (HSG) revealed bilateral tubal obstruction in 53.33% of cases. Laparoscopy found tubal adhesions in 97.80% of cases. Adhesiolysis was the main procedure performed with 84.47% bilateral tubal patency achieved in the methylene blue test. Among our patients who had contracted a pregnancy (22.99%), 85% had carried their pregnancies to term. Tubal damage was the main cause of infertility. Adhesiolysis remains the main laparoscopic procedure for treatment.
Artificial Induction of Labor with Misoprostol: Maternal and Fetal Prognosis at the Referral Health Center of Commune I of the District of Bamako  [PDF]
Mamadou Bakary Coulibaly, Alassane Traoré, Mody Abdoulaye Camara, Mamadou Sima, Bourama Kané, Kalba Tembiné, Ibrahima Tégueté, Youssouf Traoré
Open Journal of Obstetrics and Gynecology (OJOG) , 2021, DOI: 10.4236/ojog.2021.112009
Abstract: Artificial induction of labor (AIL) is the set of techniques intended to induce childbirth in order to reduce maternal-fetal mortality. The aim of this paper was to study the maternal and fetal prognosis after the artificial induction of labor with misoprostol. It was a descriptive prospective study conducted from September 1, 2018 to February 28, 2019 at the maternity unit of the Referral Health Center (RHC) in commune I of Bamako. It was about any pregnant woman at term who had received misoprostol as part of the artificial induction of labor. 102 cases of artificial induction with misoprostol 200 μg were collected out of 3641 deliveries, or a frequency of 2.8%. The age group 28 - 32 years accounted for 56.86% with an average age of 28.8 years. Multiparous represented 54.90% of the number. The history of diabetes and hypertension involved 37.25% of the pregnant women. The main indication was premature rupture of membranes (PRM) (40.2%). Induction was performed between the 37th and 41st week of amenorrhea (69.6%). The trigger index according to BISHOP was greater than 7 (50.98%). Induction was done only with 3/4 of misoprostol tablet 200 μg (43.14%). The average labor time was 7 hours (89.22%). The vaginal birth concerned 92.16% of pregnant women. An APGAR10 was noted in 97.85% of newborns after 05 minutes. AIL with misoprostol was practiced at the Center. The main indication was the premature rupture of the membranes. It improves the maternal and fetal prognosis.
Photoionization Study of the 2s22p2 (1D)ns(2D), 2s22p2 (1D)nd(2P), 2s22p2 (1D)nd(2S), 2s22p2 (1S)nd2D, and 2s22p3 (3P)np(2D) Rydberg Series of O+ Ions via the Modified Atomic Orbital Theory  [PDF]
Malick Sow, Fatou Ndoye, Alassane Traoré, Abdou Diouf, Boubacar Sow, Youssou Gning, Papa Amadou Lamine Diagne
Journal of Modern Physics (JMP) , 2021, DOI: 10.4236/jmp.2021.1210086
Abstract: We report in this paper energy positions of the 2P°_2s22p2(1D)nd 2P, 2P°_2s22p2(1D)nd 2S, 2P°_2s22p2(1D)ns 2D, 2P°_2s22p2(1S)nd 2D, and 2P°_2s22p3(3P)np 2D Rydberg series in the photoionization spectra originating from 2P° metastable state of O+ ions. Calculations are performed up to n = 30 using the Modified Orbital Atomic Theory (MAOT). The present results are compared to the experimental data of Aguilar which are the only available values. The accurate data presented in this work may be a useful guideline for future experimental and other theoretical studies.
Study of Cofactors Associated with Precancerous High-Grade Cervical Lesions at the Teaching Hospital Gabriel Touré, 2010 to 2015  [PDF]
Fané Seydou, Bocoum Amadou, Sissoko Abdoulaye, Traoré Soumana Oumar, Sanogo Siaka Amara, Mamadou Sima, Kouma Aminata, Traoré Alassane, Tegueté Ibrahima, Traoré Youssouf, Mounkoro Niani
Surgical Science (SS) , 2019, DOI: 10.4236/ss.2019.109036
Abstract:
Introduction: High grade dysplasia of the cervix has a high incidence and can progress to cervical cancer. The aim was to study cofactors associated with high-grade cervical dysplasia. Methodology: This was a retrospective case-control study without matching. Women with high grade dysplasia were the cases while those with a normal screening test represented the controls. The study took place at the Gabriel Touré University Hospital Center in Bamako. We included 351 cases and 420 controls. The capture and analysis were performed using the SPSS 20 software. A univariate and multivariate logistic regression analysis was performed for the analysis of risk cofactors. The statistical tests used were the odds ratio and its confidence interval and the statistical significance threshold was set at p < 0.05. Results: In univariate analysis, the co-factors statistically significantly associated with the occurrence of high-grade dysplasia were parity 0.6 (0.5 - 0.9), gestational 0.7 (0.5 - 0.9), smoking of the spouse 3.4 (1.1 - 11.3), the non-schooling 1.4 (1.2 - 2.1). In multivariate analysis after adjusting for confounding factors, two co-factors have significantly increased the risk of high-grade dysplasia: lack of schooling 1.4 (1.2 - 2.0) and polygamy 1.5 (1.4 - 2.5). Conclusion: At the end of this study, polygamy and lack of schooling were the main risk factors. The prevention of cervical cancer will go through the education of girls and women as well as communication for behavioral change and social change.
Evaluation of Practice of Prescription of the Corticotherapy in the Department of Internal Medicine of the University Hospital of Point G from 2009 to 2013  [PDF]
Abdel Kader Traoré, Assétou Soukho Kaya, Djibril Sy, Djenebou Traoré, Alassane Doumbia, Ilo Diall, Nangou Tolo, Hadiza Amadou Ka？lou, Karim Dao, Boua Daou Camara, Ganda Soumaré, Mamadou Dembélé, Hamar Alassane Traoré
Open Journal of Internal Medicine (OJIM) , 2019, DOI: 10.4236/ojim.2019.93013
Abstract: Introduction: It is estimated that about 0.2% to 0.5% of French populations received a long-term systemic corticosteroid therapy. In Mali, from March, 2007 to February, 2008, in National Center for Disease Control and Prevention, 19.2% of hospitalized patients (24/125) received long-term corticosteroid therapy. Until now, the department of internal medicine of the university hospital of Point G hasn’t done any research on the corticosteroid therapy specially. Therefore, we initiated this work to evaluate our practice of prescription of corticosteroid. The target of the study was to evaluate practical activity of prescription of corticosteroid of internal medicine. Methods: Based on all hospitalized patient materials of the department of internal medicine of Point G regional university central hospital during January 2009-December 2013, we initiated this retrospective and descriptive study. This study was based on all hospitalized patients receiving corticosteroid in the time of researching, without distinguishing their sex or age. Results: During the period of study, the department of internal medicine of point G regional central hospital had received 2155 patients; 64 were eligible: prevalence of 2.97%. Most patients were female, accounting for 87.5% with a sex-ratio of 0.14. The average age of our patients was 39.11 ± 16.92 years, ranging from 14 to 97 years. Physicians enrolled in the study Specialized Diploma (DES) and Internal represented 79.7% of prescribers. As pretreatment assessment, only 2 patients (3.12%) had carried out all of the standard balance (NFS, electrolytes, calcium, blood glucose and serum protein). The most common glucocorticoide was prednisone. Solid tumors represented 31.25% (20 cases) of the diseases treated, followed by systemic lupus erythematosus with 15.62% (10 cases). In addition, there are two cases of adrenals insufficiency (3.1%). In Point G internal medicine, pre-therapy evaluation and methods about corticosteroids therapy were insufficient and different.
Perinatal Deaths in Rural a Health Area, Case of the Health District of Kadiolo, Mali  [PDF]
Seydou Fané, Amadou Bocoum, Youssouf Traoré, Abdoulaye Sissoko, Ibrahima Tegueté, Mamadou Sima, Mamadou Salia Traoré, Tiounkani Augustin Thera, Yaya Sylla, Alassane Traoré, Soumana Oumar Traoré, Aminata Kouma, Niani Mounkoro
Surgical Science (SS) , 2019, DOI: 10.4236/ss.2019.1011043
Abstract: The perinatal mortality is a public health issue in developing countries. In fact, the perinatal death rate seems the highest in a Malian rural area. The objective of this work was to study the perinatal mortality in a rural area of Mali (Kadiolo). Methodology: It was a cross-sectional descriptive study conducted in Kadiolo over 12 months. The study took place from April 1, 2016 to March 31, 2017. We have included in our study all dead fetuses in gestational age ≥ 28 weeks of amenorrhea (WA) or weight ≥ 500 grams (g) and infants died during the first week of life. Mothers who have experienced a perinatal death were included. Results: During the 12 months of study period, we have recorded a total of 2212 births out of which we have collected 205 perinatal deaths, a perinatal mortality rate of 205/2212 with 93 per 1000. The stillbirth rate was 152/2212 with 69‰ and the early neonatal mortality rate was 53/2212 with 24‰. The sociodemographic characteristic of the patients was: patient who has been evacuated 71.70%, unschooled 77.1%, coming out of the city Kadiolo 76%, young women 65% and patient who did not receive antenatal care 35%.
Maternal-Fetal Prognosis of the Prophylactic Cesaarian versus Emergency Cesaarian at the Reference Health Center of Commune V of Bamako District, Mali  [PDF]
Cheickna Sylla, Soumano Oumar Traoré, Alassane Traoré, Alou Samaké, Saleck Doumbia, Saoudatou Tall, Belco Tamboura, Sitapha Dembélé, Seydou Z. Dao, Ibrahima Teguété, Youssouf Traoré, Niani Mounkoro, Mamadou Traoré, Amadou Ingré Dolo
Surgical Science (SS) , 2020, DOI: 10.4236/ss.2020.1110034
Abstract: Objectives: The goal was to assess the risk factors for emergency cesarean section versus prophylactic caesarean section. Materials and Methods: This was a descriptive analytical cross-sectional study of the Type Cas/Witnesses at the Reference Health Centre of Commune V of the District of Bamako in Mali. The sample consisted of 100 cases for 200 controls (1 case for 2 controls) with retrospective collection of data for the period from January 1 to July 11, 2011 (6 months and 11 days). Results: During the study period, out of a total of 3559 deliveries, we recorded 2,794 vaginal deliveries, 78.50% and 765 caesarean sections or 21.50%. Of the 765ceras, we performed 353 emergency caesarean sections or 46.15% and 412 prophylactic caesarean sections 53.85%. We have selected 100 prophylactic caesarean section files and 200 emergency caesarean section files. The average age of the patients was 27.41 years-5.84 with extreme ages of 14 to 40 years. 100% of our patients (Cas) had performed at least one antenatal consultation compared to 83.5% of the parturients evacuated (Witnesses). The most frequently cited reasons for evacuation were: acute fetal suffering, non-cephalic presentation and excessive uterine height with 30%, 17.5% and 12% respectively. The bulk of the caesarean section indications were dominated by dystocies with 90% in cases compared to 65% in Witnesses, followed by acute fetal suffering with 30% in Witnesses. We recorded 30% perinatal deaths among Witnesses compared to 1% in Cases. We recorded 16 uterine ruptures in the Witnesses among which 2 hysterectomies and 14 hystererraphia. Conclusion: Prophylactic caesarean section improves maternal and perinatal prognosis more than emergency caesarean section.
Lipid Profile among the Diabetic and Non-Diabetic Obese Patients  [PDF]
Djénèbou Traoré, Aminata Hamar Traoré, Djeneba Sylla Sow, Massama Konaté, Amadou Koné, Hadiaratou Doumbia N’Diaye, Modibo Mariko, Ibrahim Amadou Dembélé, Moctar Bah, Bah Traoré, Djibril Sy, Ichaka Menta, Hamidou Oumar Ba, Nongoba Sawadogo, Abdramane Traoré, Assa Traoré Sidibé, Assétou Soukho Kaya, Abdel Kader Traoré, Mamadou Dembélé, Hamar Alassane Traoré
Open Journal of Internal Medicine (OJIM) , 2018, DOI: 10.4236/ojim.2018.81010
Abstract: Objective: To study the lipid profile among the diabetic and non-diabetic obese patients. Methods: It was a descriptive and prospective study carried out over a period of 9 months from March to December 2010. It concerned all the patients who came for consultation in endocrinology at the internal medicine of Point G University Hospital Center and at the National Center for Diabetes Research. All the patients were included without any gender or age difference, voluntary and with a BMI ≥ 30 kg/m2. Results: Out of the 1543 patients received in consultation, we had identified 178 obese people that is to say 11, 53% of the cases. Among these cases 60 abided by our criteria with 30 diabetic patients and 30 non-diabetic ones. The average age was 45.83 ± 14.68 years old; 73.3% were more than 40 years old. The sex ratio was 0.07. Two third (66.7%) of our patients limited their eating diet to the three main meals/day and 61.7% were sedentary. The notion of family obesity was found in 93.4% of the cases, of family diabetes in 58.3% of the cases, of past personal medical history of hypertension in 43.3% of the cases. It was about an android obesity in 91% and Gynoid in 9% of the cases. The BMI was 55% of the cases comprised between 30 - 34.9 kg/m2. The lipid profile noticed was: A hypertriglyceridemia: 33% of diabetic patients and 10% of non-diabetic patients, a high LDL cholesterol: 37% of diabetic patients and 30% of our diabetic patients, a HDL hypocholesterolemia: 40% of the diabetic patients and 20% of the non-diabetic patients, a total hypercholesterolemia: 37% of the diabetic patients and 23% of non-diabetic patients. A hyperglycemia was noticed in 13.3% of non-diabetic patients. Conclusion: The frequency of metabolic troubles were higher in obese diabetic patients comparedto non-diabetic obese patients mainly the hypertriglyceridemia.
Anemia in the Elderly: Frequency and Etiologies at University Hospital Center of Point G  [PDF]
Sy Djibril, Traoré Abdel Kader, Kaya Assétou Soukho, Traoré Djenebou, Gozo Jean-Jonathan Cocou, Ke？ta Zakaria, Dembelé Ibrahima Amadou, Cissoko Mamadou, Ke？ta Kaly, Sangaré Barry Boubacar, Mallé Mamadou, Sy Seydou, Dembélé Mamadou, Traoré Hamar Alassane
Open Journal of Clinical Diagnostics (OJCD) , 2019, DOI: 10.4236/ojcd.2019.94008
Abstract:

Introduction: Older people are exposed to particular health problems that must be taken into account, including anemia defined by the World Health Organization (WHO) in people aged 65 and over hemoglobin < 13 g/dl in men and < 12 g/dl in women. Objectives: To determine the frequency of anemia, to describe its clinical and paraclinical aspects, and to determine the etiologies. Material and Methods: We conducted a cross-sectional study with prospective data collection that took place in the Department of Internal Medicine of the Point G CHU in Mali from January 1st, 2018 to August 31st, 2018, covering all elderly patients. At least 65 years old hospitalized and/or having consulted and presenting with anemia. Anemia was defined as Hb < 13 g/dl in men and < 12 g/dl in women (WHO definition). Biological markers were collected at admission. Results: Anemia was observed in 42 patients in 160 elderly patients, a prevalence of 26%, the age of our patients ranged from 65 to 90 years. The sex ratio was 1.33. Fifty percent (50%) of the patients had high blood pressure as antecedents. Weight loss was found in 69% of cases; 47.6% of patients had dyspnea on admission. Tachycardia was the physical sign associated with anemia present in 85.7% of them. The mean hemoglobin level was 9.2 g/dl ± 2.03: thus 50% of the subjects had microcytic and or hypochromic anemia. The etiologies found were infectious in 31.0% of cases, inflammatory in 31.0% of cases, renal in 14.2% of cases. Chronic hemorrhage, acute haemorrhage, hemolysis accounted for 2.4% each. We observed 9.5% of unexplained causes. Conclusion: The frequency of anemia is high. Nearly half of the geriatric population has anemia. The lack of means and the nonperformance of the technical platform

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