Search

Copyright of Mali Médical is the property of Mali Medical, Faculte de Medecine, de Pharmacie et d'Odonto-stomatologie and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Mali Médical is the property of Mali Medical, Faculte de Medecine, de Pharmacie et d'Odonto-stomatologie and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Granular cell tumors (GCT) are rare ubiquitous site tumors with a predilection for the head and neck localization. In the oral cavity tongue is the preferential localization. They occur at all ages and are most often benign. They are characterized by the proliferation of large cells with abundant, granular and eosinophilic cytoplasm. Immunohistochemistry often helps in diagnosis. The authors report the observation of a 3-year-old child consulting for a right jugal node evolving for about 2 years. Surgical excision was carried out and the histological examination showed anastomosed clusters of large cells, rounded or oval, with granular or xanthelamized cytoplasm, separated by fibro-collagenous partitions and the presence of giant multinucleated cells. The diagnosis of granular cell tumors was retained. The operating suites were simple. The one-year check did not show any recurrence. [ABSTRACT FROM AUTHOR]

Copyright of Mali Médical is the property of Mali Medical, Faculte de Medecine, de Pharmacie et d'Odonto-stomatologie and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Résumé: Introduction: L'offre de soins de santé doit être de qualité et sécurisée pour le patient. La présente recherche a étudié l'incidence et les facteurs de risque de survenue de phlébites liées au cathétérisme veineux périphérique (CVP) lors de la prise en charge des patients dans les services des urgences médicale et chirurgicale du centre hospitalier universitaire Souro Sanou (CHUSS) de Bobo Dioulasso, Burkina Faso. Matériel et méthodes: Il s'est agi d'une étude transversale à visée analytique avec une collecte des données réalisée du 4 juillet au 3 août 2018. Il a été calculé l'incidence de survenue des phlébites liées au CVP et identifié ses facteurs de risque par régression logistique à l'aide du logiciel SPSS version 20 (option entrée) pour un degré de signification de 5 %. Résultats: Des 511 patients inclus dans l'étude, la moyenne d'âge des patients était de 44,7 ans (IC 95 % : 43,1-46,3). La durée moyenne du CVP était de 3,1 jours avec 149 des 511 patients ayant développé une phlébite liée au CVP, soit une incidence de 29,2 % (IC 95 % : 25,0-33,0 %), sans différence statistiquement significative entre les deux services d'urgence. On notait une prédominance des phlébites de deuxième degré (53 %). Les facteurs de risque de survenue de phlébites étaient le sexe féminin, la durée du cathétérisme de plus de trois jours, la petite taille du cathéter, l'absence de friction avec une solution hydroalcoolique des mains du prestataire. Conclusion: Des mesures de prévention doivent être menées. Background: Patients must receive high-quality and safe health care. Peripheral venous catheterization (PVC) exposes patients to complications, mostly phlebitis. This study investigated the incidence of phlebitis and its PVC-related risk factors among patients in the medical and surgical emergency departments of the Souro Sanou University Hospital Center (CHUSS) in Bobo Dioulasso, Burkina Faso. Material and methods: This prospective cross-sectional study took place from July 4 to August 3, 2018. The incidence of PVC-related phlebitis was calculated and its risk factors were identified by logistic regression, with SPSS software version 20 (entry option), with significance set at 5%. Results: The 511 patients included in the study had a mean age of 44.7 (95% CI 43.1-46.3) years. The mean duration of PVC was 3.1 days. Of these patients, 149 developed phlebitis, for an incidence of 29.2% (95% CI 25.0%-33.0%). There was no statistically significant difference between the two emergency (medical and surgical) departments. Second-degree phlebitis accounted for slightly more than half the cases (53%). Risk factors associated with the occurrence of PVC-related phlebitis were female gender, catheterization duration more than 3 days, small size of the catheter, and the healthcare worker's failure to use friction in washing with a hydroalcoholic hand solution. Conclusion: Preventive measures are essential. [ABSTRACT FROM AUTHOR]

Copyright of Revue Africaine de Chirurgie et Spécialités is the property of Faculty of Medicine & Biomedical Sciences, University of Yaounde I, Cameroon and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Mali Médical is the property of Mali Medical, Faculte de Medecine, de Pharmacie et d'Odonto-stomatologie and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Mali Médical is the property of Mali Medical, Faculte de Medecine, de Pharmacie et d'Odonto-stomatologie and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Mali Médical is the property of Mali Medical, Faculte de Medecine, de Pharmacie et d'Odonto-stomatologie and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Mali Médical is the property of Mali Medical, Faculte de Medecine, de Pharmacie et d'Odonto-stomatologie and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

INTRODUCTION: le but de cette étude était d'étudier les infections chez les enfants présentant un syndrome drépanocytaire majeur. METHODES: étude hospitalière monocentrique, rétrospective descriptive sur dix années menée à Ouagadougou, Burkina Faso. Étaient inclus tous les enfants porteurs d'un syndrome drépanocytaire majeur (homozygote SS et double hétérozygote SC, SD sub Punjab sub, Sβ thalassémique, SO Arab et SE) hospitalisés pour une infection bactérienne confirmée à la microbiologie. RESULTATS: cent trente trois patients répondaient à nos critères d'inclusion. Le phénotype SS représentait 63,2 % des cas et le SC 36,8 %. La fréquence des infections était de 21,8 %. Celles-ci touchaient dans 45,9 % des cas les enfants âgés de 0 à 5 ans. Les signes les plus fréquents étaient les douleurs ostéoarticulaires (42,1 %), la toux (25,7 %), les douleurs abdominales (23,3 %), la pâleur (43,6 %). Les broncho-pneumopathies (31,6 %), le paludisme (16,5 %), les ostéomyélites (12,8 %) et les septicémies (10,5 %) étaient les principaux diagnostics trouvés. Les agents pathogènes isolés étaient Streptococcus pneumoniae (35,5 %) et Salmonella sp (33,3 %). Les céphalosporines de 3e génération étaient les antibiotiques les plus fréquemment prescrits. Le taux brut de mortalité était de 7,5 %. CONCLUSION: les infections bactériennes et le paludisme dominent le tableau des infections chez l'enfant drépanocytaire majeur au Centre Hospitalier Universitaire Pédiatrique Charles De Gaulle. Les auteurs recommandent la mise en place d'un programme national de prise en charge de la drépanocytose, ce qui permettrait de prévenir voire réduire la survenue des infections chez les enfants drépanocytaires.

Tracheal intubation using Macintosh blade is the technique of choice for the liberation of airways. It can turn out to be difficult, causing severe complications which can entail the prognosis for survival or the adjournment of the surgical operation. The video-laryngoscope allows a better display of the larynx and a good exposure of the glottis and then making tracheal intubation simpler compared with a conventional laryngoscope. It is little spread in sub-Saharan Africa and more particularly in Burkina Faso because of its high cost. We report our first experiences of use of the video-laryngoscope through two cases of difficult tracheal intubation which had required the adjournment of the interventions. It results that the video-laryngoscope makes tracheal intubation easier even in it's the first use because of the good glottal display which it gives and because its allows apprenticeship easy. Therefore, it is not a luxury to have it in our therapeutic arsenal.

Abstract: The objective of our study was to examine the total psychomotor development of the infants from 1 to 12 months of age in the district of Bamako. We evaluated according to tests'' of Denver 353 old apparently healthy infants from 1 to 12 months seen in consultation of healthy children in mother and infant Health Care Centers. The various tests of the psychomotor development according to the technique of Denver were performed with in the majority of the cases of the rates of success of more than 75%. Despite different lifestyles and environments, this study pinpointed results comparable with the international standards. [Copyright &y& Elsevier]

During the dissection of 11 stiffs, we observed the presence of an accessory muscle in the axillary fossa, known as the dorsalis major muscle arch or axillary Carl Langer muscle. This is the main anatomical variation in the walls of the axillary region. This case was reported because of the low frequency of this variation in the axillary region, and the vital importance of incorporating the possible presence of these notions into axillary curage techniques, which may find themselves modified intraoperatively. Ignorance of the dorsalis major muscle arch may be the cause of intra- and postoperative complications during axillary curage or breast reconstruction using a dorsalis major flap., (Le comité de rédaction se réserve le droit de renvoyer aux auteurs avant toute soumission à l'avis des lecteurs les manuscrits qui ne seraient pas conformes à ces modalités de présentation. En outre il leur conseille de conserver un exemplaire du manuscrit, des figures et des tableaux.)

Gigantomastia is a rare benign mastopathy of unknown aetiology. It usually occurs in women during puberty or during pregnancy. It is characterized by excessive breast growth, which is psychologically and physically disabling. It is a pathology little studied because of its rarity. In order to describe the epidemiological, clinical, diagnostic and therapeutic aspects, we report the case of four young women. The study was longitudinal over a period of 3 months. We collected data for 6 years from October 1, 2016, to October 31, 2021, at the surgery department B of the "Centre Hospitalier Universitaire du Point G". All patients who consulted for gigantomastia were included. At the end of our study, we found three cases of juvenile gigantomastia and one case of prepubertal gigantomastia. The couple mammography ultrasound performed in two patients, adenofibroma was associated with breast hypertrophy in one patient. The treatment was essentially surgical in our study. Reduction mammoplasty according to the technique of Mc Kissock and modified Mc Kissock was used. We did not note any complication such as nipple-areolar necrosis. All our patients were satisfied with the result., (Le comité de rédaction se réserve le droit de renvoyer aux auteurs avant toute soumission à l'avis des lecteurs les manuscrits qui ne seraient pas conformes à ces modalités de présentation. En outre il leur conseille de conserver un exemplaire du manuscrit, des figures et des tableaux.)

Introduction: obstetrical brachial plexus palsy is a relatively rare condition that has not disappeared although important progress has been made in obstetrics. The purpose of this study is to analyze the epidemiological, clinical, therapeutic and evolutionary features of this disorder in our context., Methods: we conducted a retrospective study of the medical records of newborns with obstetrical brachial plexus palsy treated at the Bouaké University Hospital over a period of two years. Children treated after the age of 3 months weren´t included. The variables studied were the epidemiological, therapeutic and evolutionary features., Results: the study included 60 patients, reflecting a rate of 28.5%. There were 31 (52%) girls. The average age of patients was 8 days (D0 and D35]. Multiparous mothers accounted for 94% of cases. Birth took place in a health center in 97% of cases. All children were born at term, 57 (95%) in cephalic presentation. Delivery was normal in 74% of cases. Average birthweight was 3604g [2150g and 4500g]. Forty seven cases (78%) had C5-C5-C6 palsies . Immobilization elbow off body associated with rehabilitation was performed in 51 children (85%). Rehabilitation was performed immediately in 9 children (15%). Functional recovery of the injured limb was complete in 50 children (83%) after a follow-up period of 6 months., Conclusion: obstetrical brachial plexus palsy is a current obstetric disorder. Conservative treatment, that is the only alternative in our context, gives good results., Competing Interests: Les auteurs ne déclarent aucun conflit d´intérêts., (Copyright: Célestin Adoubs Bénié et al.)

Introduction: Ameloblastoma is a locally aggressive and relatively scarce odontogenic benign tumor. Bone swelling is the most common clinical expression. Computed tomography is a considerable diagnostic contribution. This work reports the clinical and computed tomography characteristics of ameloblastomas of the jaws., Patients and Methods: a retrospective analysis of the medical records of patients with histologically confirmed ameloblastoma between January 2014 and December 2018 was carried out., Results: The incidence of ameloblastoma was 3 patients per year. Of the 15 patients, there were 7 men (46.7%) and 8 women (53.3%), giving a sex ratio of 0.87. The age of the patients varied between 9 and 56 years with an average age of 33.7 years. All patients had bone swelling. Mandibular localization predominated with a frequency of 86.7%. Heterogeneity, sharpness of contours and setting of the contrast product were the predominant CT characteristics, each observed in more than 4/5 of the patients., Conclusion: The development of imaging techniques such as CT has significantly changed the diagnostic approach and the management of ameloblastoma., (Le comité de rédaction se réserve le droit de renvoyer aux auteurs avant toute soumission à l'avis des lecteurs les manuscrits qui ne seraient pas conformes à ces modalités de présentation. En outre il leur conseille de conserver un exemplaire du manuscrit, des figures et des tableaux.)

Introduction: Surgical site infections (SSI) are frequent and dangerous in the surgical ward. They represent an obsession for the surgeon. The objectives were to determine the frequency of ISOs and risk factors, to identify the germs and to study their sensitivity to different antibiotics., Materials and Methods: This was a cross-sectional study with prospective data collection, performed at the general surgery department of the Bocar Sidy Sall University Hospital Center (Kati CHU) from January 2015 to December 2018., Results: During this period of study we recorded 55 cases of ISO out of 650 operated patients with a frequency of 8.46%. 450 patients were operated on the cold operating program (69.23%) and 200 patients on emergency (30.77%). The average age was 39, the sex ratio was 2.66. Among the 55 cases of ISO, 60% of these patients were operated in emergency and 40% in the operating program. The most common strains found were Escherichia coli (E. coli) in 38.3% of cases, Staphylococcus aureus in 23.4% and Klebsiella pneumonia in 13.3%. Hemoglobin levels were normal in 70% of cases. 4 of our patients or 7.27% were diabetic. We did not have any cases of obesity. Of the 55 cases of ISO, 66% were of class 3 and 4 of Altemeier, 59% were of ASA score 2 and ASA 3, 55% were of score 2 of NNISS (National Nosocomial Infection Surveillance System), 5.45% were NNISS score 3 or 3 cases and these 3 cases developed ISO. The ISOs were parietal in 49 cases, ie 89%. The recovered germs were 100% sensitive to imipenem. The most informative interventions of the ISOs were peritonitis 25 cases (45.45%), intestinal occlusions 12 cases (21.82%), appendicular abscess 8 cases (14.55%). We had 2 death cases, 3.64%, the average hospital stay was 13 days., Conclusion: Escherichia coli was the common germ found in the ISO in general surgery at Kati BSS Hospital. The usual resistance to antibiotics must provoke effective preventive actions., (Le comité de rédaction se réserve le droit de renvoyer aux auteurs avant toute soumission à l'avis des lecteurs les manuscrits qui ne seraient pas conformes à ces modalités de présentation. En outre il leur conseille de conserver un exemplaire du manuscrit, des figures et des tableaux.)

Radical cystectomy is the standard treatment for bladder tumors infiltrating the bladder muscle, for patients who have tumors without invasion of neighboring organs and without metastasis. After radical cystectomy, the urinary diversion is a challenge for any urologist. Ileal neo bladder is a rare surgery in our country. The ileal neo bladder is recommended in these patients. We report a case of ileal neo bladder in a 42-year-old woman with a bladder tumor. We discuss the clinical, diagnostic and therapeutic aspects., (Le comitée de rédaction se réserve le droit de revoyer aux auteurs avant toute soumission à l'avis des lecteurs les manuscrits qui ne seraient pas conformes à ces modalités de présentation. En outre il leur conseille de sonserver un examplaire du manuscrit, des figures et des tableaux.)

Introduction: This study aims to investigate infections in children with major sickle cell syndrome., Methods: We conducted a monocentric descriptive retrospective hospital study in Ouagadougou, Burkina Faso, over a ten-year period. All children with major sickle cell syndrome (homozygous SS and double heterozygous SC, SD Punjab , Sβ thalassemic, SO Arab and SE) hospitalized for microbiologically confirmed infections were enrolled in the study., Results: One hundred and thirty-three patients met our inclusion criteria. The SS phenotype accounted for 63.2% of cases and SC 36.8%. The frequency of infections was 21.8%. In 45.9% of cases, these affected children aged 0-5 years. The most frequent signs were osteoarticular pain (42.1%), cough (25.7%), abdominal pain (23.3%), pallor (43.6%). The major diagnoses were bronchopneumonia (31.6%), malaria (16.5%), osteomyelitis (12.8%) and septicemia (10.5%). The isolated pathogenic organisms were Streptococcus pneumoniae (35.5%) and Salmonella spp (33.3%). Third generation cephalosporins were the most commonly prescribed antibiotics. Gros mortality rate was 7.5%., Conclusion: Bacterial infections and malaria dominate the clinical picture of infections in children with major sickle cell syndrome at the at the Pediatrics University Hospital Center Charles De-Gaulle. This study highlights the importance of establishing a national program for the management of sickle-cell anemia, which could help prevent or reduce the occurrence of infections in children with sickle cell syndrome., Competing Interests: Les auteurs ne déclarent aucun conflit d’intérêts.

Introduction: Although HIV/AIDS organizations continue to play a major role in the fight against pandemic HIV infections, they are still faced with enormous governance challenges that impair their operations / interventions and their sustainability. The objective of this study was to develop an inventory of the quality of governance within HIV/AIDS organizations in Bobo-Dioulasso., Methods: This qualitative research was conducted in 40 organizations from Bobo-Dioulasso. Qualitative data were collected over a 45-day period using an interview guide. Thematic analysis of the data was performed and the results were reported., Results: Although all 40 organizations had established good governance mechanisms, only fifteen complied with the major rules of democratic functioning and the roles of the various bodies. The majority of these organizations (29/40) ignored many democratic rules. The number of members required for the Executive Board was not met in 29/40 organizations resulting in monopolization of decision-making by a handful of people. Technical and financial reports were not published, resulting in limited access to information on the organization's activities. Gender equality also constituted a weakness., Discussion: Application of good governance principles was limited in these organizations. Organization members, leaders and technical and financial partners must reinforce good governance efforts in order to improve good governance in these organizations.

Introduction: Community Advisory Committees (CAC) have become indicators of good community involvement in health research all over the world. CACs have been developed only recently in several Sub-Saharan African countries. Many countries wonder about how to create and ensure good functioning of a community advisory committee. The objective of this article is to describe the creation of two CACs in Burkina Faso., Methods: This qualitative study comprised a literature review phase, a data collection phase conducted on a sample of 27 subjects (research scientists, representatives of AIDS associations or networks and the local technical and/or financial partners of these associations) and an implementation phase. Study participants were selected on a rational basis, the study complied with the ethical principles of research and data were transcribed and analysed manually., Results: Scientists and/or community workers may initiate the creation of a CAC based on the following main elements: the profile of individuals and/or structures, the dynamism of CAC members, reinforcement of their skills and capacities. The CAC must be independent of research scientists and must be designed to be sustainable., Discussion: The difficulties of sustainability and the poor perception of CACs remain major challenges. Continuing collaboration between CAC members and research scientists improves their knowledge in the field of research ethics, allowing the community to perceive CACs as supporters of research.

Objective: To determine the incidence of postoperative peritonitis, and describe their clinical, paraclinical and therapeutic aspects., Patients and Methods: This was a retrospective study conducted between 1980 and 2010 in the Department of Surgery B of the Point G University Hospital. It focused on all patients who underwent surgical intra-abdominal in the Surgery B department., Results: We collected 25 cases of postoperative peritonitis, 84% were male subjects. The average age of patients was 37.2 years ± 17.0. The clinical picture was dominated by abdominal pain (92%), abdominal defense (92%), and fever (84%). Abdominal ultrasound played an important role in diagnosing 72% of cases. Etiologies were dominated by anastomotic leak (32%), infection of the collection phrenic, iatrogenic perforation (28%). Interventions made at surgery were: suture of the perforation or anastomotic recovery plus peritoneal cleansing and drainage in 36% of cases, peritoneal cleansing and drainage in 36%. There were postoperative complications in five patients. The mortality rate was 4%., Conclusion: Postoperative peritonitis are rare in our service. When they occur their rate of morbidity and mortality are high., (Le comitée de rédaction se réserve le droit de revoyer aux auteurs avant toute soumission à l'avis des lecteurs les manuscrits qui ne seraient pas conformes à ces modalités de présentation. En outre il leur conseille de sonserver un examplaire du manuscrit, des figures et des tableaux.)

Objective: To study the therapeutic aspects and prognosis of volvulus of the sigmoid colon in surgical departments., Patients and Methods: Our study was retrospective from January 2000 to December 2009 (10 years). All patients who underwent sigmoid volvulus in the Point G teaching hospital surgical departments were taken into account., Results: We recorded 96 patients operated for volvulus of sigmoid over 882 cases of bowel obstruction, a rate of 10.9%. The average age was 47.2 years ± 18.9. In per-operative, there was a necrosis of the colon rate of 16.7% (14 cases). Performed surgical treatment modalities were: sigmoidectomy with primary anastomosis in 29.2% of cases (28), sigmoidectomy followed by colostomy and secondary anastomosis in 60.4% of patients (58) and 10.4% rare of simple devolvulation. The immediate postoperative period were marked by a morbidity rate of 7.3% (7 cases) and a mortality rate of 7.3% (7 cases)., Conclusion: In spite of various therapeutic modalities of volvulus of the sigmoid colon, the rates of postoperative morbidity and mortality are rising in the general surgery of the Point G teaching Hospital., (Le comitée de rédaction se réserve le droit de revoyer aux auteurs avant toute soumission à l'avis des lecteurs les manuscrits qui ne seraient pas conformes à ces modalités de présentation. En outre il leur conseille de sonserver un examplaire du manuscrit, des figures et des tableaux.)

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., (Le comitée de rédaction se réserve le droit de revoyer aux auteurs avant toute soumission à l'avis des lecteurs les manuscrits qui ne seraient pas conformes à ces modalités de présentation. En outre il leur conseille de sonserver un examplaire du manuscrit, des figures et des tableaux.)

Aim: To compare paracetamol saving followed by the association of ketamine chlorhydrate - magnesium sulfate to ketamine chlorhydrate and analyze cost after the 2 protocols administration., Material and Methods: We conducted this comparative study from June 2005 to January 2006 in the services of anesthesiology and resuscitation and visceral surgery of the teaching hospital Gabriel Touré, Bamako. 80 patients were split into 2 groups - group A receiving: 0,25mg/kg of ketamine chlorhydrate plus 50mg /kg of magnesium sulfate, group B receiving: 0,25mg/kg of ketamine chlorhydrate., Results: The 2 groups were compared by anthropometrical and clinical data (age, sex, weight) and ASA. The reduction of paracetamol dosage was 57, 50 % of the 4 g actually used per day in A group against 48, 50% in B group., Conclusion: Ketamin chlorhydrate associated to magnesium sulfate insure a post-operative analgesic saving in visceral surgery. Cost of analgesia actually used is reduced., (Le comitée de rédaction se réserve le droit de revoyer aux auteurs avant toute soumission à l'avis des lecteurs les manuscrits qui ne seraient pas conformes à ces modalités de présentation. En outre il leur conseille de sonserver un examplaire du manuscrit, des figures et des tableaux.)

Introduction: The number of HIV trials in Africa is increasing, and they target population groups with high HIV incidence, such as sex workers. Little information, however, is available about the adherence to long-term therapy among such marginalized groups with few economic resources and poor social and family support. A project called "Yerelon" ("know herself" in the Dioula language) began in 1998 in Bobo-Dioulasso to improve the health of women involved in commercial sex through STI/HIV prevention and care adapted to them. This study was conducted before introducing long-term treatment to the population, to assess the effect of communication with those around them on the capacity of these vulnerable women to adhere to drug prescriptions., Methods: The study was based on interviews conducted during the pilot phase of a 3-month trial of vitamins with potential participants. It concerned two groups of women: one group was infected with HIV (N = 22), the other was not (N = 20); all women in both groups were infected by HSV-2, however. For 5 weeks, the two psychologists of the study team in charge of adherence assessment carried out weekly in-depth interviews with the participants. The qualitative data analysis was organised around several themes. The data were related to aspects of communication with family and friends, serologic results, and adherence., Results: According to our definition of communication about treatment, 20 participants communicated with their family and friends; adherence was good for all but three of them. Women who reported that they were married or living with someone (7/42) nearly all spoke about the study treatment (06/07) with him. Of 16 participants living in a family, 10 communicated with them about the treatment. On the other hand, as seems logical, single women who lived alone spoke less often about the treatment with family and friends (04/19). Talking about the treatment did not appear to involve the family or friends in the treatment; no one reminded any participant, whether she lived alone or in a family, to take her medicine. Nor did this discussion seem "helpful" to any of the women. Twenty-two participants hid the study treatment from family and friends; adherence was good for all but two of these. Social management of the treatment was related to HIV serologic status and relationships with family and friends. Concern about gossip about HIV status made it difficult to integrate the treatment into conversation. Those who did not agree to communicate with their family about the treatment did not even take the drug in the sight of the others. Sometimes, refusal to communicate was aimed at avoiding disapproval when the family did not have a favorable perception of prolonged treatment. Hiding the treatment was not an obstacle to good adherence. Adherence was related to perception of the treatment more than to communication about it., Conclusion: Adherence was similar in cases with and without communication. It appeared that these marginalized women, without social networks, were able to adhere correctly to a long-term treatment. To minimize the risks of non-adherence, the support system planned must take into account the factors influencing perceptions of the drug. Specific psychological support centered on the relation with the drug appears necessary during treatment initiation and follow up.

Axillary lymph nodes metastases are an important prognostic factor in patient with breast cancer. Even the diagnosis of metastatic invasion of axilla is perfomed by histologic exam, the preoperative diagnosis on ultrasonography is evoked in literature. The aim of this study was to evaluate through systematic review, the accuracy of ultrasonography in the diagnosis of axillary lymph node invasion in patients with breast cancer. 132 articles were consulted. We included in the study articles in which the invasion of axilla was proved by histology and additionally, studies in which sensibility, specificity and accuracy parameters of ultrasonography can be calculated. The Chi square test was used to evaluate the hetegenicity between studies. Twelve articles with above criteria were included in the study and divided in two groups: group 1: studies on breast cancer with palpable and non palpable axillary lymph node; group 2 : studies on breast cancer in which axillary lymph node biopsy was guided by ultrasonography. In group I, when lymph node size, more than 5 mm was taken as presumption criteria of invasion, sensibility and specificity of ultrasonography varied from 66.1 to 87.1% (p > 0.05) and from 44.1 to 97.9% (p < 0.05) respectively; when the lymph node morphology was the mean criteria of axilla invasion, these parameters varied respectively from 40.5 to 92.3% (p < 0.05) and from 55.6 to 95.2% (p < 0.05). In group II, sensibility and specificity of ultrasonography in diagnosis presumption of axillary lymph node invasion in patient with breast cancer varied respectively from 43.5 to 94.9 (p < 0.05) and from 96.9 to 100% (p > 0.05). In conclusion, according to the sanitary and psychological impact of lymph node invasion in patient with breast cancer, axillary ultrasonography is helpful in the management of this pathology.

Purpose: To determine the incidence of pediatric malformative uropathies and to point out the radiological aspects., Material and Methods: Exploratory studies of 32 cases of malformative uropathies were assessed between January 1998 to June 1999 in the Radiology Departement of Gabriel Touré Hospital of Bamako. Patients aged from 3 days to 15 years underwent sonographic and radiological examinations., Results: The sex ratio was 4 males to 1 female. The main findings were: prune belly syndrome (6 cases), posterior urethral valves (13 cases), bladder exstrophy (3 cases), renal ectopy (6 cases), ureterocele (1 case), hypospadias (1 case), megauretere (1 case) and pyelo-ureteral junction syndrome (1 case). Radiological signs were mainly related to hydronephrosis and bladder lesions., Conclusion: Malformations of the urinary tract are frequent in daily practice. Imaging plays a key role in the assessment and diagnosis.

Objectives : The aims of this study was to describe the clinical, CT scan and prognosis aspects of cranial traumatism in our practice. Material and method : This study was a descriptive and prospective one concerning 324 cases of cranial traumatism. Patients were hospitalized in the emergency unit of Gabriel Touré hospital from January to August 2004. We graded them into 2 groups according to the realization (group 1) or not (groupe 2) of computerized tomography. These 2 groups are equivalent as far as the Glasgow coma scale was concerned. Results : About 324 patients with cranial traumatism,we included 153 (116 males, 37 females) in our study. The mean age was 20.2 years (average 1-69 years). In the group 1 (153 patients) the injury was located in cerebral or pericrebral tissue in 88.2% (cerebral lesion in 58.8%, pericebral in 32,6%, mixed in 8.6%) bone or soft tissue in 24.8%. 6.5% of these patients was operated. 15% of group 1 and 26.3% of group 2 died (X2 : 6.18; p < 2%) In conclusion we believe that computerized tomography allows to improve the prognosis of cranial traumatism.

Urinary bilharziasis is a parasitic infection responsible for vesical, urethral and renal lesions. The authors demonstrate the importance of ambulatory echography on a large scale and describe various echographic lesions. Vesical attacks occurred in 27% of the wall irregularity, 44% of the masses and polyps. Pyelic and urethral abnormalities occurred in 16.6% and 29.9% of cases respectively at the baseline in 1991. These prevalence rates decreased after seven years, in 1998. The authors discuss the utility of chemotherapy with praziquantel and the necessity of a periodical mass treatment in the areas with high bilharziasis endemicity in Mali.

A prospective study of the serological markers of hepatitis B virus (HBV) including hepatitis B virus surface antigen (HBsAg) and hepatitis B surface antibody (anti HBs) was conducted over 5 years in Bamako. The aims of this study were to assess the prevalence of HBsAg in pregnant women and to determine the risk of HBV infection for this population. The study involved 829 pregnant women for whom blood samples were collected after the first quarter of pregnancy. HBsAg and anti HBs were detected in all cases by radioimmunoassay. The prevalence of HBsAg and anti HBs in pregnant women was respectively 15.5% and 16.9%. This prevalence of HBsAg, higher than in the general population, points to the fact that pregnant women are a high risk group for hepatitis B infection. In addition, scarification and tattooing practices increase significantly the risk of infection by hepatitis B virus (OR = 2.03; 1.07 < OR < 3.82; chi 2 = 5.62; p: 1%). Thus, we can presumably conclude that infants and new borns in such conditions are largely exposed to hepatitis B virus infection, even though hepatitis B core antibody and hepatitis B e antigen were not investigated for technical reasons. In conclusion, the authors believe that infants and new borns must be systematically immunised against hepatitis B virus infection in Bamako.

We present three cases with atypical presentation of the Mayer-Rokitansky-Kuster-Hauser syndrome observed by US between August 1994 and December 1997. In two cases we observed complete absence of the uterine. In the last case, an uterus remnant was present. In all cases, both ovaries were normal and the three women reported "normal" sexual activity. An ectopic kidney was present in one patient with complete absence of the uterus. Atypical forms of Mayer-Rokitansky-Kuster-Hauser syndrome with normal vagina can be diagnosed at US. In the cases presented here, US allowed a clear description of the anatomy and provided a comprehensive evaluation of the patients.

Primary non-Hodgkin's lymphoma of the pancreas is a rare disease. Its diagnosis is difficult without histological examination. In fact, clinical and imaging findings are not pathognomonic. Acute pancreatitis associated with pancreatic lymphoma is extremely rare. We have found only 7 case reports in literature. We report herein a new case of pancreatic lymphoma which was revealed by a severe pancreatitis.