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Hypertension (Htn) among Young People of 18 to 35 Years Old in Cardiology Department of Gabriel Toure University Teaching Hospital  [PDF]
Ichaka Menta, Hamidou O. Ba, Kassoum M. Sanogo
World Journal of Cardiovascular Diseases (WJCD) , 2018, DOI: 10.4236/wjcd.2018.81002
Abstract: Few studies have been conducted on hypertension among youth in Malihence the interest of our study aimed to clarify certain aspects what are not taken account yet in previous studies.?Objective: Determine the clinical and para-clinical characteristics of hypertension among 18 to 35 years old young people.?Methods:?This cross-sectional and retrospective study of 24 months from January 1st, 2009 to December 31st, 2010in the cardiology department of the Gabriel Touré UTH.Results:?We identified 132 cases during the study period out of 2146 cases of hypertension with a prevalence of 6.1%. The female gender represented 81.8%, with a sex ratio of 45.59, 1% of patients had an unknown family history of hypertension. The age group of 31 to 35 years accounted for 43.9%. The circumstances of discovery were dominated by exertional dyspnea (37.9%). Body mass index was normal in 45.5% of patients. The higher BMI was more common in female patients with 39.39% (p?= 0.045). In the sample,53% of patients had a systolic blood pressure between 140and 159 mmHg and 38.6% had diastolic blood pressure ≥ 110 mmHg with no significant difference (p?> 0.5). The high creatinine level was found in 18.18% of our patients. The ECGfound
Surgery of the Goiter in the ENT Department of Chu Gabriel Toure: Problematic and Perspective  [PDF]
Kassim Diarra, N’faly Konaté, Youssouf Sidibé, Tiguida Sissoko, Fatogoma Issa Koné, Boubacary Guindo, Harouna Sanogo, Bagayoko Drissa Kaloga, Siaka Soumaoro, Doumbia Kadidiatou Singare, Samba Karim Timbo, Mohamed Amadou Keita
International Journal of Otolaryngology and Head & Neck Surgery (IJOHNS) , 2019, DOI: 10.4236/ijohns.2019.86026
Abstract: Aims: To describe the diagnostic aspects, surgical indications and post-operative complications of thyroidectomies performed in our department. Materials and method: A descriptive retrospective study that took place in the ENT Department and Cervicofacial Surgery of Gabriel TOURE University Hospital of Bamako. We did a comprehensive sampling of all goiter cases from January 2013 to December 2018. Were included in the study, the records of patients of all ages and genders, admitted into the ward and scheduled for thyroidectomy (partial or total). The exclusion criteria were incomplete hospitalization records. There were a total of 139 files were retained. Results: In 60 months, 139 cases were collected out of 1720 patients hospitalized for surgery, representing a hospital prevalence of 8.08%. The average age was 46.89 years. (123 women and 16 men). The socio-professional categories were dominated by housewives (68.34%). The reported functional signs were tachycardia, asthenia and other signs of dysthyroidism in 59% as well as signs of compression in 24.46%. In 72 cases or 51.80%, the patients consulted between 2 and 10 years of disease progression. Twenty patients or 14.39% had a history of familial goiter and 2 patients had a history of thyroid surgery. On physical examination the swelling was antero-cervical in 56.83% of cases. In 96 cases or 69.06% the glandular diameter was between 5 and 9 cm. In 2 cases or 1.43% we noted cervical adenopathy in the jugulo-carotid chain. Ultrasound, TSHus and fT4 were performed first-line and systematically in all our patients. Ultrasound objectified an appearance of multinodular goiter in 106 cases or 76.26%. In 60.43% of cases the patients were TI classes RADS 3, they were TI RADS 4A in 16 cases or 11.51%. CT scans were performed in 3 patients or 2.15% to specify the loco-regional extension, to look for possible lymph node invasion, and to compress or dipping the goiter. Surgical indication was placed in front of a multinodular goiter (GMN) in 106 cases or 76.26%, a single goiter in 11 cases or 7.9%, a single nodule greater than 3 cm in 17 cases or 12.23%, Basedow disease in 4 cases or 2.88% and a recurrence in one case 0.72%. We performed a lobo-isthmectomy in 56.11%, a total thyroidectomy in 20.14% of cases, subtotal in 20.86% of cases and total thyroidectomy with mediation-recurrent lymph node curage and bilateral jugulo-carotidien in 4 cases or 2.87%. Recurrent nerves were systematically searched and seen in all cases. Replacement therapy was indicated in all
Abdominoperineal Resection in Rectal Cancer in General Surgery Department at Gabriel Toure University Hospital  [PDF]
Amadou Traore, Abdoulaye Diarra, Madiassa Konate, Souleymane Thiam, Soumaila Keita, Tani Kone, Boubacar Karembe, Assitan Kone, Boubacar Sidibe, Amadou Bah, Amadou Ma?ga, Ibrahim Diakite, Bakary Tientigui Dembele, Alhassane Traore, Adegne Togo, Lassana Kante, Moussa Samake, Moustapha Issa Mangane, Thierno Madane Diop, Mamadou Salia Diarra, Adama Diakite, Gangaly Diallo
Surgical Science (SS) , 2019, DOI: 10.4236/ss.2019.101003
Abstract: The objectives: Were to determine the hospital frequency of abdominoperineal resection (APR); to determine mortality and morbidity rates and to assess oncologic outcomes. Method and patients: We performed a retrospective study between 2008 and 2013 in general surgery department at Gabriel Toure University Hospital (UH) which included all patients admitted for rectal cancer confirmed by pathological examination, and having undergone an APR. Results: We have collected 17 cases which accounted for 65.38% of curative resections of rectal cancer. The sex-ratio was 0.89 and the averageage was 49.53 years. The average tumor distance from the anal verge was 4.59 ± 1.7 cm. All patients had adenocarcinoma of the rectum. The histopathologic grade was well in 7 cases, moderate and poor in 5 cases each. According to the pathologic TNM classification, 13 patients were classified T4, 14 patients N+. APR was associated with hysterectomy and partial colpectomy in 4 cases. The average duration of interventions was 202.06 ± 25.68 minutes. The average duration of hospitalization was 18.24 ± 04.89 days. The postoperative mortality and morbidity rates were 5.88% and 29.42%, respectively. Local recurrence was observed in 6 patients and liver metastasis in 2 patients. The overall survival rate was 37.5% at 2 years and 18.75% at 5 years. Conclusion: APR still occupies an important place in our practice. Our results could be improved by the recent introduction of neoadjuvant radio chemotherapy in Mali.
Complications Per and Post Operatory (CPPO) at the Gabriel Toure University Hospital in Bamako  [PDF]
M. Samaké, S. B. Dembélé, S. Konaté, A. Traoré, K. Madiassa, A. Diarra, Z. Saye, B. Tounkara, A. Traoré, I. Abdillahiiltireh, B. T. Dembélé, B. Y. Sidibé, L. Kanté, I. Diakité, Adégné Togo, G. Diallo
Surgical Science (SS) , 2019, DOI: 10.4236/ss.2019.108031
Introduction: Despite the use of less invasive and increasingly effective techniques in order to reduce the morbi-mortality per and post-operative, the CPPO remain an important problem in surgery. Objectives: To determine the rate of per and post-operative complications, to describe the types of complications and to identify their risk factors. Methodology: This was a prospective study carried out from 04 April to 03 June 2016 in the surgical department of CHU-Gabriel TOURE. All patients aged 18 and over operated in the Surgical Department (General Surgery, Gynaecology and Obstetrics, Urology, Traumatology, Otolaryngology, Neurosurgery and Emergency Department), having been hospitalized at least for 24 hours after surgery, were retained. The method of sampling N=P(1-P)Za2/I2 was used; the minimum size necessary was 209 patients. We conducted invitations and the phone call to determine the occurrence of complications and survival of patients up to 30 days after surgery. Results: We counted 262 patients, of whom 142 (54.2%) were women and 120 (45.8%) were men with a sex ratio = 0.85. The average age was 41.48 years, with extremes of 18 and 86 years. We found 71 complications in 61 patients, an early CPPO rate of 23.28%. The various complications encountered were: urinary tract infections (26.76%), surgical site infections (28.17%), pulmonary infections (12.68%) and Deaths (21.13%). The occurrence of complications prolonged the hospital stay by 6 days and increased the average cost of care of 102,700 FCFA. According to Clavien Dindo’s classification, the severe postoperative complication in our series was 9.16% (grade III + IV + V). Factors favoring the occurrence of CPPO were age > 41 years old, ASA > II, the classes of Altemeier 3 and 4, NNISS score 1 and 2, diabetes and hemoglobin rate 8 g/dl. Conclusion: Complications per and post-operative (CPPO) are common in the department of Surgery of CHU-Gabriel TOURE and are dominated by post-operative infection. These complications seem to be favored by multiple factors more related to the patients than to the hospital structure.
Etiological Aspects of the Dilatation of the Upper Urinary Tract at University Hospital of Gabriel Toure  [PDF]
Amadou Kassogué, Mamadou Tidiani Coulibaly, Zanafon Ouattara, Adama Yaflé Diarra, Aly Tembely
Open Journal of Urology (OJU) , 2018, DOI: 10.4236/oju.2018.87022
Abstract: Introduction: The dilatation of the upper urinary tract, signs in the vast majority of cases the presence of a ureteral obstacle. The etiologies are diverse. Mali is a country where urinary schistosomiasis is endemic. Repeated infestation may result in long-term ureteropelastic dilatation secondary to stenotic sequelae. The objective is to study the causes of dilatations of the upper urinary tract. Materials and Methods: This is a prospective study of 12 months, from October 2010 to September 2011, performed in the urology department of Gabriel Toure University Hospital in Bamako. The parameters studied were: age, sex, reason for consultation, medical history, urinary analysis, etiological diagnosis, management, evaluation of renal failure. Result: In 12 months, we collected 50 cases of dilatations of the upper urinary tract representing 0.66% of all consultations. The average age of our patients was 35 years old. The sex ratio was 2.13 in favor of men. A history of urinary schistosomiasis was found in 25 patients or 50%. Low back pain was the most common reason for consultation, 76%. The renal and bladder ultrasonography performed in all 50 patients in our series found bilateral dilatation in 68% of patients and unilateral dilation in 32% of cases. Urinary tract infection with Escherichia coli was found in 53% of cases. Ureterovesical reimplantation was performed in 40% of cases. Conclusion: The dilatation of the upper urinary tract, consequence of an anatomical or functional obstruction, constitutes a rather frequent pathology and constituted 10% of the surgical acts of our service. Etiologies are diverse: congenital and acquired. Open surgery gives good results, but the introduction of innovative minimally invasive surgical technique is necessary.
Blows and Voluntary Wounds of the Emergency Unite in Gabriel Toure Teaching Hospital in Bamako  [PDF]
Mangané Moustapha, Diop Thierno Madane, Almeimoune Abdoul Hamidou, Keita Soumaila, Dembelé Aladji Seydou, Youssouf Sogoba, Konaté Madiassa, Koita Siriman, Traoré Amadou, Issa Amadou, Badimi Siaka, Abdoulaye Kanté, Diallo Sadio, Sangaré Harouna, Dembelé Bakary Tientigui, Togo Adegné, Diango Djibo Mahamane
Surgical Science (SS) , 2018, DOI: 10.4236/ss.2018.99040
Abstract: Introduction: Voluntary assault and injuries are acts that damage the physical and psychological integrity of a human being. WHO in its global report on violence and health estimates that in 2000, 1.6 million people worldwide died as a result of self-harm, interpersonal or collective violence, resulting in an overall rate adjusted by age of 28.8 per 100,000 population. Because of the seriousness of this phenomenon and the heavy socio-economic and health consequences that they generate, it seemed important to us to undertake this study, which aimed to study the deliberate injuries in the emergency unite of the Gabriel Touré Teaching Hospital in Bamako. Material and methods: This was a descriptive and cross-sectional study with a prospective study from September 1st, 2016 to August 31st, 12 months, covering 295 patients, including any patient received for voluntary injury consultation with a workable medical record and/or a full investigation record with or without requisition. Our data were collected on individual survey cards and subsequently analyzed with Word, Excel, IBM SPSS Statistics 22 software. Results: The majority of victims of assault and bodily injury were male with 83.1%; with a sex ratio of 4.9, the 18 to 28 age group was the most concerned with 163 cases of the 295 cases in our study, 55.2%. The extremes were 6 and 100 years old with an ectype at 11.08. The most affected ethnic group was Bambara with 38.6% (n = 114) followed by Fulani with 15.6% (n = 46). Students were the most affected at 24.7% (n = 73), followed by traders at 10%. The victims coming from outside Bamako are the most predominant with 22.4% (n = 66) followed by those of commune IV of Bamako 15.6% (n = 46). In 92.2% of the cases the mechanism was direct with n = 272. Of the lesions recorded in our study, wounds came first with 53.2% of cases. Radiography was the most used imaging at 44.7% (n = 89) followed by computed tomography at 34.7% (n = 69). The hemoperitoneum objectified by abdominal ultrasound represented 29.3% (n = 12). Fractures embarrure associated with bruising-hemorrhagic bruises were the most predominant with 13.4% (n = 10) objectified by brain scan. Conclusion: We note that the phenomenon of violence has reached worrying proportions, especially among young adults, particularly among students and is observed in all so-cio-professional layers. The polymorphism of these injuries caused by the predominant use of knives must draw the attention of our authorities to take measures to reduce these
Management of Kidney Cancers in Urology Department of the Gabriel Toure University Hospital/Bamako  [PDF]
MT Coulibaly, I. Sissoko, A. Berthé, Issa Amadou, B. Traore, M. Ly, Z. Ouattara
Surgical Science (SS) , 2018, DOI: 10.4236/ss.2018.96021

Objective: to report our experience in the management of adult kidney cancer. Patients and Methods: This was a prospective and descriptive study, carried out in the Urology Department of Gabriel Touré University Hospital, during the period from January 1, 2001 to December 31, 2017 for a period of six years, interesting all the medical records of 24 adult patients diagnosed with kidney cancer. Results: During the study period, 24 patients met our inclusion criteria; the mean age was 48.23 ± 8.02 years with extreme ranging from 17 to 82 years. Most of our patients were female (58.3%), and were referred or consulted for lumbar mass in 66.7% of cases. The average tumor size was 13.6 ± 5.8 cm with extremes of 7.8 to 21.1 cm. Management included total nephrectomy in 50% and total nephrectomy expanded in 50% of cases. The histological type found was renal cell carcinoma in 23 patients and papillary carcinoma in one patient. Conclusion: Kidney cancer is rare in our context, its clinical and histological characteristics remain the same for two decades. Its management is largely based on enlarged total nephrectomy.

Appendicular Abscess in the Service of General Surgery at the Teaching Hospital Gabriel Toure, Bamako, Mali  [PDF]
Madiassa Konate, Traore Amadou, Coulibaly Yacaria, Dembele Bakary Tiéntigui, Karembe Boubacar, Keita Soumaila, Amadou Issa, Mangane Moustaphissa, Diop Thierno Madani, Almeimoune Abdoul Hamidou, Togo Adégné Pierre, Kante Lassana, Traore Alhassane, Maiga Amadou, Bah Amadou, Sidibe Boubacaryoro, Diamoutene Kolo, Tolo Maimouna, Samake Moussa, Mounimezié Diarra, Diakite Ibrahim, Diallo Gangaly
Surgical Science (SS) , 2018, DOI: 10.4236/ss.2018.98033
Abstract: Objectives: To determine hospital frequency and to write the diagnostic and therapeutic aspects of appendicular abscess in adults in the General Surgery Department of teaching Hospital Gabriel Touré from 2005 to 2017. Material and Methods: This was a retrospective study conducted from January 1, 2005 to December 31, 2017 in the General Surgery De-partment of Gabriel Touré University Hospital in all patients with appen-dicular abscess. Results: In 13 years, 1420 cases of acute appendicitis have been reported, including 105 cases of appendicular abscess (7.4%). Mean age of the patients was 32 years with extremes of 16 years and 70 years. Abdominal pain and fever were present in all patients. Pain sat in the right iliac fossa in 73.3% and was epigastric in 11.4%. In almost all cases abdominal defense was present (97.1%). There was generalized abdominal contracture in 2.8% of cases. Average duration of evolution was 27 days with extremes of 1 day and 60 days. Ultrasonography was performed in 42.6% of cases and found peri-appendicular effusion in 29 cases (27.6%). 90 incisions were made by incision of Mac Burney, 8 by median umbilical, 7 by midline above and below umbilical. The amount of fluid aspirated was greater than 100 cc in 47 patients. We performed an appendectomy with appendicular stump burying followed by washing plus drainage of the abdominal cavity in 65 patients. Morbidity rate was 14.3%. No deaths were recorded. Average duration of hospitalization was 6.5 days with extremes of 2 days and 26 days.
Management of Urological Lesions Secondary to Obstetrical Gyneco Surgery in the Urology Department of the Gabriel Toure University Hospital Centre  [PDF]
Amadou Berthé, Mamadou Tidiane Coulibaly, Adama Toutou Diallo, Moumine Zié Diarra, Ibrahim Yattara, Zanafon Outtara, Amidou Domegué Ouattara, Thièrno Madane Diop
Surgical Science (SS) , 2018, DOI: 10.4236/ss.2018.97024
Abstract: Summarizes: The objective of this work was to study the clinical, diagnostic, therapeutic and evolutionary aspects of urological lesions secondary to gynaeco-obstetrical surgery in the urology department of the Gabriel Touré University Hospital. Material and method: It was a transversal and retrospective study carried out in the urology department of the Gabriel Touré University Hospital Centre in Bamako over 8 years. It focused on the files of 25 patients operated on for a urological lesion secondary to gynaeco-obstetrical surgery. Sociodemographic, epidemiological, diagnostic, therapeutic and evolutionary parameters were analysed. Results: Urologic lesions secondary to gynaeco-obstetrical surgery were found in 0.72% of urologically operated patients. The mean age of the patients was 39 ± 10.4 years (extremes: 18 and 60 years). The average time to diagnosis was 121, 88 ± 15 days (extremes: 0 and 365 days). Clinical signs were: oligo anuria (16%), urine leakage (52%), lumbar pain (24%). The diagnosis was made by the methylene blue test in 56% of patients, by the uro-scanner (20%) and by intravenous urography (16%). In 8% of patients, the diagnosis was made during surgery. The surgical interventions involved were: hysterectomy (48%), cesarean section (40%), genital prolapse cure (8%), ovarian cystectomy (4%). Lesions were dominated by vaginal vesico fistulas (48%) followed by ureterovaginal fistulas (20%), ureteral ligatures (16%). Treatment consisted of ureterovesical reimplantation according to Lich Gregory with ureteral intubation (36%), fistulography (48%). Healing was achieved in 92% of patients. Conclusion: Hysterectomy for cervical malignancy and cesarean section are the main etiologies of urological lesions secondary to gynaeco-obstetrical surgery. Open surgery is the only alternative for the management of these lesions in our context. Controlling anatomy is the main preventive measure.
Prevalence and Factors Associated with the Anxio-Depressive Symptoms of the Families of Patients in Intensive Care Unit at Gabriel Toure University Hospital, Bamako, Mali  [PDF]
Almeimoune Abdoulhamidou, Mangane Moustapha, Diop Madane Thierno, Démbele Seydou Aladji, Kassogue André, Sogoba Youssouf, Dabo Aminata, Diallo Daouda, Diallo Boubacar, Souleymane Coulibaly, Diallo H. Seybou, Maiga Youssoufa, Diango Djibo Mahamane
Neuroscience & Medicine (NM) , 2018, DOI: 10.4236/nm.2018.93015
Abstract: Introduction: Hospitalization in intensive care is a source of stress and anxiety for close to the patients. Anxio-depressive symptoms appear to be common in intensive care and their prevalence is poorly evaluated. The objective of this study was to evaluate the prevalence of anxio-depressive symptoms in families. Materials and method: Observational prospective study in families of patients hospitalized in the intensive care unit for a period of 5 months. Symptoms of anxiety and depression were measured using Hospital Anxiety and Depression Scale (HADS) during hospitalization. Anxiety and depression were defined by a score greater than 10. Factors associated with the onset of anxious-depressive symptoms were sought. The prevalence of post-traumatic stress disorder in close relatives was measured by the Impact Event Scale-Revised scale (IES-R). Results: A total of 107 patients were admitted to the intensive care unit, of which 49 families agreed to participate in our study. Overall mortality was 32.2% during this period. Fifty-eight (58) patients were not included for the following reasons: death or hospitalization of less than 48 hours, refusal of families, institution, and lack of parents speaking French. Forty-nine (49) relatives completed the HADS questionnaire. Forty-three families completed the IES-R questionnaire, a return rate of 87.7%. The prevalence of anxiety was 61.2% among parents in early hospitalization. The level of anxiety was significantly associated with male parents (p = 0.035) and those with lower education (p = 0.046). The prevalence of depressive symptoms in parents was evaluated 53% at D3. Education level (p = 0.048) and male parents (p = 0.048) appeared to be a significant depression factor. The prevalence of post-traumatic stress disorder was 55.1% among the relatives of the patients. The lack of co-morbidity in admission patients was significantly associated with the occurrence of post-traumatic stress disorder in the family. Conclusion: The prevalence of anxiety and depression symptoms was high in our study. Men were at greater risk of developing these symptoms. The parents of the patients carburized appear as a population with higher risk manifestation of psychological disorders; further research is needed in this group.
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