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Search Results: 1 - 10 of 208530 matches for " Bakary Tientigui Dembélé "
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The Polytraumatized in the Emergency Hosting Service and the Service of Resuscitation Gabriel Touré Mali  [PDF]
Diop Thierno Madane, Magane Moustapha Issa, Almeimoune Abdoulhamidou, Dembélé AlajiSeidou, Dabo Aminata, Ouattara Kassoum, Dembélé Bakary Tientigui, Traoré Alhassane, Togo Adegné, Diango Mahamane Djibo
Surgical Science (SS) , 2018, DOI: 10.4236/ss.2018.94018
Abstract: Summary: Polytrauma is the leading cause of death in the under-40 population. They are accompanied by major morbidity with severe sequelae. The polytraumatized is defined as a serious trauma with several bodily injuries, at least one of which is life-threatening in the very short term. The initial hospital care must not barely delay and directly affect the prognosis. In developing countries, the absence of pre-hospital medicine means that mortality is still very high, which leads us to initiate this work, which aims to study the epidemiological and clinical aspects of polytrauma in emergency and in resuscitation of Gabriel Toure University Hospital. Material and Methods: This was a retrospective study that took place over a period of ten (10) months from February to November 2016. We included all patients received for polytrauma emergency hosting service. The data were collected using a surveycard. Results: During our study period, we collected a total of 200 polytraumatized cases out of a total of 16,141 patients admitted to the emergency hosting service, a prevalence of 1.3%. The age group of 20 - 29 years was the most represented with average age of 32.39 years. The male sex was predominant with 65% with a sex ratio of 1.9. The students were the most represented with 24%. The trauma occurred at 22.5% between 8:00 and 12:00 am, the public road was the main place of the trauma with 57.5% of the cases. Two-wheeled vehicles were involved in the accident in 68.9% of cases. The delay between trauma and admission was minus 6 hours in 70.5% of cases, 15.5% had a Glasgow lessthan 8% and 44.5% PAS < 90 mmHg. The polytrauma associated with a cranial + limb and cranial + abdominal were the most represented with respectively 37.5% and 25%. The damage control suegery was performed in 79% of patients. The mortality was 31% and hemorrhagic shock was the most common etiology of these deaths with 51.6%. Conclusion: The polytrauma is clinical situation putting the patients vital prognosis at stake. The haemorrhage is the origin of the student mortality. The installation of rigorous diagnostic system and a pre-hospital medicine will reduce the morbi-mortality.
Post-Operative Peritonitis: Diagnostic Problems, Morbidity and Mortality in Developing Countries  [PDF]
Alhassane Traoré, Bakary Tientigui Dembélé, Adégné Togo, Lassana Kanté, Madiassa Konaté, Ibrahima Diakité, Simo Notue Fabienne Laurence, Boubacar Karembé, Abdoulaye Diarra, Amadou Traoré, Mahamane Djibo Diango, Gangaly Diallo
Surgical Science (SS) , 2014, DOI: 10.4236/ss.2014.58059
Abstract:

Goal: To study the diagnostic difficulties and post-operative morbidity and mortality of peritonitis. Patients and Methods: Retrospective study about the records of adult patients operated on between 1999 and 2013 whose diagnosis of post-operative peritonitis was made. Results: We achieved 23,573 lanterns and recorded 148 cases of postoperative peritonitis or 0.62%. The medium age was 37.1 ± 17.7 years and the sex ratio was 1.2. The delay between the initial intervention and reoperation was less than 5 days. Factors occurrence of postoperative peritonitis were those related to the initial surgery: septic context 70.8%, emergency surgery 81.1% under the seat mesocolic 25% and 20.3% initial surgical technique. The diagnosis was made preoperatively in 62.2% (n = 92). Ultrasound has found an effusion in 29.7% (n = 44). Cytobactériologic review identified germs in 85.1% (n = 126) and sterile in 12.9% of patients (n = 22). The most frequent etiologies were: 22.9% anastigmatic leak (n = 34), the phoenix abscess in 17.6% (n = 26), iatrogenic perforation 13.5% (n = 20) and digestive fistula 25% (n = 37). Other causes were the stoical necrosis 12.2% (n = 18) and evisceration 8.8% (n = 13). We performed a digestive stoma in 61% (n = 89), a closure of the abdomen bolsters in 8.8% (n = 13), a suture in iatrogenic perforation in 13.5% (n = 20) and washing with drainage in patients with phoenix abscess in 17.6% (n = 26). Morbidity was 22.3% and 53.4% mortality. Conclusion: The diagnosis of post-operative peritonitis is difficult in a developing country. Morbidity and mortality is high. Improved diagnostic tools are needed.

Operating Site Infections at General Surgery Department of Gabriel Toure Training Hospital  [PDF]
Bakary Tientigui Dembélé, Alhassane Traoré, Adégné Togo, Lassana Kanté, Ibrahim Diakité, Bourama Diarra, Amadou Traoré, Madiassa Konaté, Boubacar Karembé, Yacaria Coulibaly, Mamby Keita, Souleymane Diallo, Souleymane Diallo, Gangaly Diallo
Surgical Science (SS) , 2015, DOI: 10.4236/ss.2015.62010
Abstract:
The operating site infections constitute the major postoperative issue in surgery. Our objectives were to determine the hospital frequency, the risk factors, the involved germs as well as the cost generated by the operating site infections. Method: Our three months prospective survey run from September the 1st to November the 30th 2013 has included all department patients being operated on and hospitalized. The criteria have been set by CDC d’Atlanta. Results: 374 files were involved, among them 229 (61.2%) were emergencies and 145 (38.8%) were scheduled. The average age was 41 (extremes 7 and 95 standard deviation 17.46), the sex ratio 1.67. The infective risk according to Altmeier has found 17.5% type 1, 25.1% type 2, 11.2% type 3 and 46.3% type 4; according to NNISS, 96 (25.7) were NNISS 0; 94 (51.9%) NNISS 1; 80 (21.4%) NNISS 2; and 4 (1.1%) NNISS. In the Altmeier class I have not got antibiotic before infection signs appearances. Our overall rate of operating site infections was 7.9% (29 cases), with 24 (82.8%) emergency cases. According to Altmeier’s class of infective risk, the rate of operating site infections was 1.54% making 1 out of 65 type I patients; 4.3% making 4 out of 93 type II patients; 11.9% making 5 out of 42 type III patients; 10.9% making 19 out of 174 type IV patients. According to NNISS, the infective risk has been assessed and was 2.08% for score 0, we have got 8.25% score 1, and 12.5% for score 2, and 25% for score 3. The bacteriology has been dominated by Escherichia colii(51.7), Proteus mirabilisi(13.8), and
Antibioprophylaxy by the Surgery Staff in the Teaching Hospital Gabriel Touré in Mali  [PDF]
Bakary Tientigui Dembélé, Alhassane Traoré, Adégné Togo, Lassana Kanté, Ibrahim Diakité, Amadou Traoré, Bourama Emmanuel Cissoko, Madiassa Konaté, Boubacar Karembé, Yacaria Coulibaly, Soumeila Keita, Mamby Keita, Souleymane Diallo, Gangaly Diallo
Surgical Science (SS) , 2015, DOI: 10.4236/ss.2015.63022
Abstract:

This prospective survey was conducted from February to December 2014 about the use ceftriaxone (ceftriaz) for antibioprophylaxy concerning 300 patients by the surgery staff in the Gabriel Touré Teaching Hospital in Mali. The quantity of drug used was based on the weight of the patient. One dose was administrated in intravenous at the anesthesiology induction time. For more than 2 hours of intervention time, 4 (1.3%) patients received a second dose. The majority of cases (189, 63%) were out of emergency (emergency cases—111, 37%). The mean age was 41.6 years (range: 3 - 95 years). The patients were classed Altmeir II 203 (67.7%) and Altmeir I 97 (32.3%). The NNISS score 0 concerned 101 (33.6%) and NNISS 1 in 180 (60%) patients. The factors of risky were anemia (38; 12.7%), diabetes (6; 2%), and HIV (3; 1%). The mean of intervention duration was 56.8?±?27.5 minutes. Four cases of intervention site infection were encountered caused by?Pseudomonas?aeruginosa?in 2 patients;?Escherichia coli?(1 case), and?Staphylococcus aureus?(1 case). Conclusion: Antibioprohylaxy is not the only way to prevent infections but it stays necessary. The respect of hygien and aseptic measures should be used to reduce the rate of intervention site infection.

Treatment of Operative Pain in Visceral Cancer Surgery at CHU Gabriel Toure  [PDF]
Dembélé Bakary Tientigui, Traoré Alhassane, Togo Adégné, Kante Lassana, Diakité Ibrahim, Konate Madiassa, Traore Amadou, Diakité Boubacar, Bah Amadou, Sidibé Yoro, Koné Tany, Diop Thiorno Madani, Django Djibo, Diallo Gangaly
Surgical Science (SS) , 2017, DOI: 10.4236/ss.2017.81006
Abstract: The objectives were to determine the frequency of pain in cancer patients and its intensity in cancer pathologies and to evaluate the evolution of pain intensity after analgesic treatment; the effectiveness of its management study involved 121 cases of operated gastrointestinal cancers, which accounted for 85.82% (141) of operated cancers and 16.78% (721) of all operated patients; the average age of our patients was 49.93 years with extremes 17 and 78 years. Standard deviation: 15.75; with a sex ratio of 1.46. The majority of our patients had WHO III (54/121) or 44.6%; 46.3% (56/121) of patients were in stage IV of the TNM classification. The main digestive cancers were cancer of the esophagus 4 cases (3.3%); of the stomach 61 cases (50.4%); of the pancreas 7 cases (5.8%); of the liver 4 cases (3.3%); gall bladder 2 cases (1.6%); colon 33 cases (27.3%); rectum 6 cases (4.9%) and hail 4 cases (3.3%). The average pain intensities were 3 to 6 hour; 2 to 24 hour; 1.6 to 48 hour; and 1.2 to 72 hour. The majority of our patients had a treatment protocol involving nefopam, and paracetamol was 58%. The pain was exacerbated especially during exercise. Vomiting and vein burning were the main side effects encountered.
Traumatic Perforation of the Small Intestine in General Surgery of the CHU Gabriel Touré  [PDF]
Alhassane Traoré, Bakary Tientigui Dembélé, Ibrahima Diakité, Adégné Togo, Lassana Kanté, Amadou Traoré, Madiassa Konaté, Boubacar Karembé, Abdoulaye Diarra, Amadou Bah, Boubacar Sidibé, Tany Koné, Astan Koné, Nouténé Koné, Djibo Mahamane Diango, Gangaly Diallo
Surgical Science (SS) , 2017, DOI: 10.4236/ss.2017.89045
Abstract: Goal: To determine hospital frequency, to describe the clinical and therapeutic aspects and to determine the prognosis. Patients and Methods: This was a retrospective and prospective study carried out in the General Surgery Department from 1 January 1999 to 31 December 2015. Inclusion criteria: 1) open or closed trauma of the abdomen with perforation of the small bowel; 2) clinical examination (abdominal pain, vomiting, fever, abdominal contracture, evisceration, intraoperative findings); 3) paraclinical examinations: pneumoperitoneum on the abdominal X-ray without preparation (ASP) and CT scan. Exclusion Criteria: Abdominal trauma without perforation of the small bowel. We selected 128 patients operated for traumatic perforation of the small bowel. The data was entered and analyzed using Word, Excel 2007 and Statistical Package and Social Science Windows 16.0. The statistical analysis consisted in the calculation of the different frequencies of the variables studied. We used the Khi2 test with significance level P < 0.05. Results: We recorded 119 men versus 9 women and the sex ratio was 13.22. The mean age was 25 years with extremes varying between 15 and 70 years. The majority of patients 57.7% (74 cases) came from the capital, 46.1% (59 cases) were workers, 26.6% (34 cases) of the students. The average time to admission was 29 hours. The main etiologies were road traffic accidents 36.7% (47 cases), stabbing 21.9% (28 cases), firearm 14.8% (19 cases), and sports accidents 10.1% (13 cases). The main clinical signs were abdominal pain 48.44% (62 cases), abdominal contracture 60% (76 cases), disappearance of pre-liver dullness 66.36% (84 cases), and Douglas painful 74.4% (94 cases). The abdominal X-ray without preparation (A.S.P) allowed to objectify a pneumoperitoneum in 45.31% and the scanner a liquid effusion in 45.31% with the associated lesions in 37.5% (48 cases). The surgical treatment consisted of 60.15% suture excision (77 cases), 25% anastomosis resection (32 cases) and a 15% stoma (19 cases). The average length of hospital stay was 9 days with extremes of 1 to 60 days. The morbidity was 10.15% at the site of surgical site (OS) infection 17.4% (8 cases), postoperative peritonitis 3.1% (4 cases) and evisceration 0.8% (1 case). Mortality was 17.18% due to septic shock and multivisceral failure. Conclusion: Traumatic perforation of the small bowel is an emergency. Young people are more victims. The prognosis depends on the speed of diagnosis and management. Emphasis should be
Evisceration of the Small Bowel in the Vagina Following Endo-Uterine Maneuvers for Clandestine Abortion (APC) at CHU Gabriel Touré, Bamako, Mali  [PDF]
Dabo Aminata, Diop Thierno Madane, Dembélé Bakary Tientigui, Coulibaly Mahamadoun, Doumbia Arouna, Manganémoustapha Issa, Abdoul Hamidou Almeimoune, Traoré Alhassane, Togo Adégné, Téguété Ibrahima, Django Djibo Mahamane, Diallo Gangaly
Surgical Science (SS) , 2018, DOI: 10.4236/ss.2018.94016
Abstract: Intra-uterine manual aspiration is the recommended maneuver for abortive endo-uterine evacuation. It must be performed in a medical setting for therapeutic purposes, while respecting its contraindications and asepsis rules essential for its implementation. The ignorance of anatomical structures by the authors of clandestine abortions is marked by the presence of utero-adnexal lesions, digestive lesions and vesical lesions or evisceration by the vagina. Vaginal evisceration of the small bowel is a rare and serious complication of manual intrauterine aspirations and induced abortions. Their late diagnosis and clandestine practice are responsible for unpredictable severe secondary complications and remain an important cause of morbidity and mortality. The development of a policy of continuous training of agents on the technique of manual intrauterine aspiration, broad information on contraceptive methods and a multidisciplinary, rapid and adequate management of complications will provide minimum morbidity and mortality. Conclusion: Abortion is a serious source of life-threatening complications.
Diverticular Fistula of the Female Urethra on Lithiasis at the District Health Center (CSREF) in Communeii, Bamako, Mali  [PDF]
Tounkara Idrissa, Diarra Abdoulaye, Traoré Amadou, Coulibaly B. Bakary, Kanté Abdoulaye, Dembélé Dabéré Ives, Thiam Souleymane, Ouattara Kassoum, Kanté Lassana, Konate Madiassa, Koné Assitan, Ongoiba Oumar, Sangaré Modibo, Dembélé Bakary Tiètiki, Diakité Ibrahim, Sidibé Yoro, Bah Amadou, Coulibaly Yakaria, Togo Adégné, Diallo Gangaly
Surgical Science (SS) , 2019, DOI: 10.4236/ss.2019.103011
Abstract:
The diverticulum of the female urethra or sub-urethral pouch is in the form of a cul-de-sac lined with mucous membrane through the muscular layer of the urethra. Thus, it is a site of stasis, urinary infection, formation of calculus or even malignant tumor. The diverticula of the urethra or sub-urethral pouches in women have a prevalence of 0.5% to 6% depending on the series. We report the case of a 61-year-old patient operated for a diverticulum on fistulized urethra complicated lithiasis. Our patient had five pregnancies and five births when she consulted for dysuria, urinary burns evolving since a year. The urogenital examination revealed a partially stenotic urethral meatus and a 3-cm large fistulized intravaginal peri-urethral mass allowing urine leak. The mass was painful and hard at palpation. We performed transvaginal diverticulectomy. The follow-up was simple and the probe was removed two weeks after the surgery. An atomo-pathological examination of the resected diverticulum concluded an aspect compatible with lithiasis urethritis.
Primitive Umbilical Endometriosis in a Young Woman at the District Health Center (CSREF) in Commune II in Bamako  [PDF]
Tounkara Idrissa, Diarra Abdoulaye, Traoré Amadou, Coulibaly B. Bakary, Kanté Abdoulaye, Dembélé Dabéré Ives, Thiam Souleymane, Ouattara Kassoum, Kanté Lassana, Konate Madiassa, Koné Assitan, Ongoiba Oumar, Sangaré Modibo, Dembélé Bakary Tiètiki, Diakité Ibrahim, Sidibé Yoro, Bah Amadou, Coulibaly Yakaria, Togo Adégné, Diallo Gangaly
Surgical Science (SS) , 2019, DOI: 10.4236/ss.2019.103012
Abstract:
Umbilical endometriosis, also called Villar’s nodule, has rarely been described in the literature. It represents only 0.5% to 1% of all cases of endometriosis. We report a case in a 28-year-old nulligest, nulliparous woman who consulted at the CSREF CII in Bamako. The diagnosis was suspected with the presence of umbilical swelling with cyclic, painful, dark hemorrhage of firm consistency. We performed an omphalectomy with an uncomplicated postoperative course. She was released from the hospital three days post-surgery. Anatomo-pathological examination of the resected specimen confirmed the diagnosis of umbilical endometriosis.
A Flexible Microarray Data Simulation Model
Doulaye Dembélé
Microarrays , 2013, DOI: 10.3390/microarrays2020115
Abstract: Microarray technology allows monitoring of gene expression profiling at the genome level. This is useful in order to search for genes involved in a disease. The performances of the methods used to select interesting genes are most often judged after other analyzes (qPCR validation, search in databases...), which are also subject to error. A good evaluation of gene selection methods is possible with data whose characteristics are known, that is to say, synthetic data. We propose a model to simulate microarray data with similar characteristics to the data commonly produced by current platforms. The parameters used in this model are described to allow the user to generate data with varying characteristics. In order to show the flexibility of the proposed model, a commented example is given and illustrated. An R package is available for immediate use.
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