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Introduction: Cataract is the leading cause of curable blindness in the world. Its treatment is surgical. The aim was to evaluate the functional results of cataract surgery in a second referral centre in Mali (Nianankoro FOMBA Hospital in Ségou) with reference to the quality standards of the World Health Organisation. Patients and methods: Prospective descriptive study conducted between October 2018 and September 2019 in the ophthalmology department of the Nianankoro FOMBA hospital in Ségou, in patients aged 40 years and over with cataract. Results: During the study, 954 eyes were operated on, of which 522 (54.7%) were female. The average age was 64.28 years. The occupation of housewife was 52.7%. The main reason for consultation was the decrease in visual acuity with 96.1%. Hypertension and diabetes were 20.1% and 5.7% respectively. The initial uncorrected distance visual acuity was less than 1/10 in 94.2% of cases. At 30 days postoperatively, the good, average and poor results were respectively 82.92%, 12.01% and 5.06% without optical correction, decreasing to 92.56%, 4.51% and 2.93% respectively after optical correction. Discussion: These results met the World Health Organization standards which recommend a value greater than or equal to 80% without correction and greater than 90% with correction for good results and a value of less than 5% for poor results with correction. Conclusion: Cataract surgery with Phaco A is a simple solution that gives good results and is well adapted to our socio-economic context.

Le district de Bamako capitale du Mali, connaît depuis une vingtaine d’années des taux de croissance démographique spectaculaires. Malheureusement, cette croissance a aussi été accompagnée d’une très forte dégradation de l’environnement et a placé le District de Bamako parmi les capitales les plus polluées du monde, notamment au niveau de son atmosphère. Ainsi, ce souci majeur, conduit à poser la question de savoir : quels sont les comportements socio-professionnels susceptibles de dégrader la santé publique dans le District de Bamako ? L’objectif opérationnel de cette étude est d’identifier les activités économiques et sociales susceptibles de dégrader la ville de Bamako, et analyser son effet sur la santé publique. Pour atteindre cet objectif, une méthodologie de recherche a été adoptée, basée sur les données épidémiologiques, les observations et les enquête de terrain. L’étude a montré que la croissance démographique et spatiale n’a pas été accompagnée de plan d’urbanisation adéquat et que les activités économiques et sociales que mènent les populations ont des externalités négatives sur la santé publique, si la gestion rationnelle des déchets qu’elles produisent n’est pas garantie. La gestion inadéquate des déchets a conduit à des conditions bioécologiques favorables au développement d’agents pathogènes (virus, bactéries, parasites) responsables de nombreuses maladies telles que, le paludisme, la diarrhée, le rhume, la fièvre typhoïde et le choléra qui sévissent dans nos quartiers et au sein de la population du District de Bamako. Il ressort également de cette analyse que, le coût de prise en charge de ces maladies est trop par rapport aux revenus des populations les plus concernées par ces épidémies. Cependant, les populations du District de Bamako souffrent de pollutions de toutes formes, dues aux activités incontrôlées et aux comportements inadaptés des populations.

Context: Cerebellar syndrome caused by disturbances of balance and coordination is not an uncommon neurological disorder. It has varied etiologies usually caused by tumor processes or suppurative collections. Vascular causes remain very rare, especially when it is a giant aneurysm of PICA representing 1% of intracranial aneurysms. Treating giant PICA aneurysms is a very difficult task for neurosurgeons because the surgical dissection can lead to severe damage due to the intimate relationship of PICA with the brainstem or nerve structures. We report a case of giant PICA aneurysm responsible for cerebellar syndrome successfully treated with surgery. The objective of this work is to draw the attention of practitioners to this unusual cause which can lead to diagnosis wandering and a lack of planning at the time of management. Case report: A 65 years old hypertensive patient was seen for a progressive disturbance of balance and walking disorder, but worsened in the last three months with no notion of fever. On admission, the patient was lucid, oriented in time and space and presented with static and kinetic cerebellar syndrome. Brain CT-scan without and with contrast revealed a tissular mass in the posterior fossa suggesting a tumor process, however, CT angiography showed a giant aneurysm of the PICA after reconstruction. A careful microdissection by a sub-occipital approach was decided. Opening the large cistern made it possible to visualize the aneurysm sack surrounded by a yellowish gliosis. The reclining and microdissection revealed the neck of the aneurysm, which was clipped to exclude the giant aneurysm in block. Postoperative follow-up was simple with progressive improvement in the cerebellar syndrome and walking over three months. Conclusion: Giant aneurysm of the PICA is rare. The localization in the posterior cerebral fossa can be confusing. Microsurgery gives a good result.

Pleomorphic xanthoastrocytoma (PXA) generally occurs in children and young adults and is classified as a low-grade astrocytic tumor with a potential favorable prognosis. But these data must be interpreted with much caution, because of some rapid progression or malignant transformation during the postoperative follow-up. We report herein a rare case of a cerebellar PXA manifested as a benign lesion at first time in a 39 year-old woman, but with malignant transformation two years later. In this paper, we discuss the clinical signs, radiological findings and the therapeutic data on the subject according to literature review.