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Introduction: The involvement of the endothelial dysfunction (ED) in arterial hypotension (AHPT) post of spinal anesthesia (SA) has not been established. Objective: To determine if there is a relationship between ED and AHPT observed during the 1st 15 minutes after SA. Population and Methods: The study concerned 40 people who were to benefit from a programmed herniorrhaphy under SA and 40 controls (SA-). The correlations between mean plasma concentrations of endothelin-1 (CmET-1, pg/ml) and Vascular Cell Adhesion Molecule-1 (CmVCAM-1, pg/ml) taken from SA+ one hour before (H0), then 15 minutes after the SA (H15) and the mean arterial pression (AMP, mmHg) with heart rate (bpm) were analyzed (p - were 1.07 and 3.34, respectively, compared to 1.12 (p = 0.735) and 3.57 (p = 0.862) in SA+ at H0 and H15. In SA+, at H15, CmET-1 was 1.13 (p = 0.823) and CmVCAM-1 was 3.57 (p = 0.257). In SA-, a negative correlation existed between CmET-1 and CmVCAM-1 (r = -0.438; p = 0.005). Conversely, in SA+, whether at H0 (r = -0.31; p = 0.051) or at H15 (r = 0.024; p = 0.883), no correlation existed between CmET-1 and CmVCAM-1, nor between MAP and ED markers (r = 0.111; p = 0.325). Conclusion: These results show that there is no relationship between the AHPT which occurs during the first fifteen minutes post SA, CmVCAM-1 and CmET-1. Moreover, these data suggest that ED is not involved in AHPT post SA.

Introduction: Upper gastrointestinal (GI) endoscopy is an examination that involves exploring the upper part of the digestive tract using an endoscope. Our study was aimed to evaluate the practice of Upper GI endoscopy at the mother-child hospital in Mali. Patients and Methods: This was a descriptive retrospective study on reports of Upper GI endoscopy results in the digestive endoscopy unit at the mother-child hospital in Bamako from January to December 2018. Results: Endoscopy was performed in 465 patients including 231 males and 234 females. The sex ratio was 0.98. Patients were aged 46.69 years old on average with the extremes of 8 and 90 years old. Epigastralgia was the main referral in 50.5%. Endoscopy was normal in 24.7%. The main diagnostics were duodenogastric reflux in 32.5% and gastritis in 14.4%. Conclusion: The practice of Upper GI endoscopy at the mother-child hospital in Mali has allowed the exploration of the upper digestive tract to contribute to the diagnosis of esogastroduodenal lesions.

Autoimmune pancreatitis is a distinct form of chronic pancreatitis. It is a chronic pancreatitis distinct from alcohol, genetic or idiopathic impairment and involves possible autoimmune mechanisms. The diagnosis of autoimmune pancreatitis is based on a body of biological, histological and radiological arguments. Also called sclerosing lymphoplasmacytic pancreatitis, it is one of the causes of chronic pancreatitis. The risk factor for the onset of cancer that it represents and its sensitivity to corticosteroids make it a pathology requiring special management. We report a case of autoimmune pancreatitis in a 35-year-old patient.

Tenofovir reduces viral load during viral cirrhosis B and improves prognosis. The aim of this study was to evaluate the effectiveness and safety of Tenofovir during the treatment of viral B cirrhosis. The study was retrospective and prospective on patients with viral B cirrhosis treated with Tenofovir in the Hepato-Gastroenterology Department of University Hospital Gabriel Toure in Bamako (Mali) and evaluated between three and six months after the start of treatment. We included 89 patients. The mean age was 44.5 ± 16 years with extremes of 18 and 90 years. The sex ratio was 1.2. At inclusion all patients had a detectable viral load with an average of 2651.96 ± 1495.85 IU/ml. Follow-up viral load was undetectable in 84.3% with patients between 3 and 6 months of treatment. The average detectable viral load was only 27.04 ± 21.05 IU/ml. There was also an improvement in hepatocellular function and few side effects. Conclusion: This study shows the interest of Tenofovir in the treatment of viral cirrhosis B with very few adverse effects.

Background: The Ebola Virus Epidemic epidemic in Guinea was marked by its rapid spread in the capital, forcing the authorities to build several Ebola treatment centers including Wonkifong (Coyah), Conakry. Objective: To evaluate the case fatality rate of Ebola Virus Disease in this center and to identify associated factors. Patients and Method: There is a prospective study at wonkifong Ebola treatment center from January 1st, 2014 to April 30th, 2015. All patients diagnosed with an Ebola Virus Disease from January 1st, 2014 to April 30th, 2015 were enrolled in this study. Kaplan-Meier curves and multivariate regression model were used to analyze factors associated with death. Results: 216 patients were included, the mean age was 30.52 ± 17 years and 53.2% were female. The average time between admission to the Ebola treatment center and the onset of signs was 5.13 ± 3.8 days. The average period of stay in the Ebola Treatment Center was 12.64 ± 11.31 days and duration median of death after admission in Wonkifong ETC was 11 days. According to the source, more than half of the patients were from Forecariah, i.e. 60.2% (n = 134). The case fatality rate was 64.4%. This rate was 72.0% in Dubreka, 65.1% in Coyah and 64.6% in Forecariah. The factors independently associated with Ebola Virus Disease death were signs of diarrhea [OR = 2.22 (1.17 - 4.20)], anorexia [OR= 0.40 (0.19 - 0.81)] and period of patients stay in ETC [OR = 0.96 (0.93 - 0.99)]. Conclusion: These results show that the fatality rate linked to the Ebola virus disease remains high. The factors independently associated with death were Diarrhea, anorexia and period between beginning of illness and date of latest news. Biological monitoring and resuscitation seem interesting for the reduction of this mortality.