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Introduction: Magnetic Resonance Imaging is one of the non-invasive or irradiating medical imaging techniques. MRI explores with precision the organs and soft tissues, in the different planes of space (2 to 3 Dimensions). In patients with neurological signs suggestive of cervical spinal cord compression, MRI is the reference examination, even normal CT and X-rays. Objective: To highlight the technique of performing MRI of the cervical spine in patients admitted to the Medical Imaging department of the Mali hospital. Method: This was a prospective and descriptive study that took place from October to December 2018. The MRI device used is low field (0.35T) and open. This study included 23 patients who had undergone MRI of the cervical spine. Results: These different methodologies enabled us to obtain the results of 23 patients. The male sex was more represented with 60.87% against the female sex or 39.13%. Among the most common reasons, paralysis is 52.17% of our examinations carried out. The average age was 47 years with extremes ranging from 16 to 75 years. The most represented age group in our series was 46 to 55 years or 30.43%. These results confirm the relationship between cervical pathologies and professional activities, men being the most active in Mali. MRI examinations of the cervical spine were 23, out of 165, or 07%. Conclusion: MRI has revolutionized the imaging of the cervical spine as this technique proves to be complete and efficient for the study of all the anatomical structures of the spine, of which it allows the most precise diagnostic assessment. Despite the low capacity of the installation and the lack of people trained in its implementation, the technique meets the standards of implementation and produces quality diagnoses with the assistance of radiologists.

Introduction:Diarrheal diseases and meningitis are among the first causes of death in the world. Objective:The aim of this study was to evaluate the follow-up of the epidemiological surveillance of diseases with epidemic potential at the laboratories of the National Hospital of Donka (LHND), the National Hospital of Ignace Deen (LHNID) and the National Institute of Public Health (LINSP). Material and Methods: This was a four years retrospective study, from May 1st, 2009 to May 1st, 2013. Data collection was made from the registers. Results:Only the LHND had notified cases of cholera (17 cases =100%). The frequency of proven cases by gender was respectively 52.94% men for 47.06% women. The most affected age groups were those of 21-40 years (41.18%) and 41-60 years (29.41%). The mean age was 21.59 ± 4.71 years. During this survey period, the LINSP notified more cases of meningitis (60%), followed by the LHND (21.88%) and the LHNID (18.12%). The age group from 0 to 5 years was the most affected by meningitis with 84.29% for LHND and 77.59% for LHNID. The mean age was 2.87 ± 0.63 year. TheHemophilus influenzaeb was the most encountered with 55.73% at the LINSP, 47.15% at the LHND and 27.59% at the LHNID. Five of twenty suspected samples for red diarrhea were positive forShigella dysenteriae. Conclusion: The epidemiological surveillance of diseases with epidemic potential is useful and necessary for the control, prevention and fight against these infectious bacterial diseases.

International audience; We present a reconstruction of human demography and shell fishing activity in the Sine-Saloum mangrove Delta (Senegal) in the past 6000 years using the summed probability density (SPD) of radiocarbon dates in archaeological shell middens. We explore how this local history relates to the climatic and political history of West Africa. We find that traces of human presence were scarce from 6000 to 2000 yr BP, partly because the geomorphology of the estuary was less favorable to human settlements at that time. A specialized shell fishing population migrated massively to the Sine-Saloum around 2000 yr BP, at the end of the aridification trend that followed the African humid period. This population, likely coming from the northern coast in search of land and resources, fleeing from aridity and the subsequent warfare, found refuge in the coastal mangroves and reached a maximum activity at about 1700 yr BP. This period corresponds to the beginning of trans-Saharan trade, and to a political complexification that would give rise to the Ghana empire. The incoming migration may have occurred in two waves as suggested by two peaks in the SPD curve at 200–400 CE and 600–800 CE and by cultural differences within the Delta. Most sites in the Sine-Saloum islands were abandoned in the early 15th century, before the arrival of Europeans, possibly because intensive shell fishing was not sustainable anymore, or because of the regional political destabilization associated to the fall of the Ghana empire and the beginning of the Mali empire. Shortly after, in agreement with oral traditions, a new population lead by the Manding Guelwars, moved to the Sine Saloum after a military defeat and founded the modern towns. They had a reduced shellfishing activity compared to previous inhabitants, possibly because activities were more oriented to the new trade with Europeans or to a prosperous agriculture in more humid climatic conditions that prevailed from 1500 to 1800 CE

The sub-mitral annular aneurysm is a rare cardiac pathology. The etiologies are diverse, ranging from the congenital form to the idiopathic form, including the acquired form. The clinical case we report is that of a 27-year-old young man, with no particular history, admitted with a picture of global heart failure. A cardiac ultrasound diagnosed a ruptured mitral sub-annular aneurysm in the pericardium. The difficulty lies in the surgical management of this condition, due to the lack of an adequate cardiac surgery service in most of the countries in Africa south of the Sahara.

Introduction: Intracranial suppurations are neoformed purulent collections including, in decreasing order, cerebral abscesses, subdural empyemas and extradural empyemas. Otorhinolaryngologic infections are one of the main causes, especially in older children and adolescents. We report 3 clinical cases of endocranial suppurations treated at the Mali Hospital. Clinical Cases: 1) Observation 1. IK was a 14-year-old boy, who was hospitalized in our department for fever, headache and left hemiplegia. The emergency brain scan showed a right frontal and interhemispheric subdural empyema associated with multifocal sinusitis. Surgical drainage associated with ceftriaxone: 100 mg/Kg/d in direct intravenous (DI), metronidazole: 10 mg/Kgs/12hours in slow intravenous (SI) for 15 days, gentamycin: 3 mg/Kgs/d in SI for 3 days, paracetamol 15 mg/Kgs/6hours in SI, 10% glucose serum: 100 ml/Kg/d were given. The bacteriological analysis of the pus came back sterile. The postoperative period was calm. 2) Observation 2. This was a 14-year-old boy with a history of headaches who was admitted to our department for left hemiplegia. An emergency brain scan showed a right pre-suppurative encephalitis associated with a right fronto-ethmoidal and maxillary sinusitis. He was put on ceftriaxone 100 mg/kg/d in DI for 21 days, gentamycin: 3 mg/Kg/d in SI for 3 days; metronidazole: 10 mg/kg/12hours in SI for 21 days, paracetamol: 15 mg/kg/6hours in SI. After 3 weeks of medical treatment, a follow-up brain scan revealed an interhemispheric and right subdural empyema. Surgical drainage was associated with the triple antibiotic therapy initially instituted. The bacteriological analysis of the pus was sterile. The postoperative course was calm. 3) Observation 3. N.M was an 11-year-old boy, who was admitted with fever and left hemiplegia. An emergency brain scan revealed a right hemispheric subdural empyema associated with an intracerebral abscess and pansinusitis. Surgical drainage associated with ceftriaxone 100 mg/kg/d in DI for 15 days, gentamycin; 3 mg/kg/d in SI for 3 days, metronidazole: 10 mg/kg/12hours in SI for 15 days and paracetamol: 15 mg/kg/6hours in SI were instituted. Staphylococcus aureus was isolated in the pus of the abscess. The postoperative course was calm. Conclusion: Endocranial suppurations of sinus origin are serious and frequent infections in children in developing countries. Its diagnosis must be evoked in front of any hemiplegia associated with a fever or headache and confirmed by a cerebral scanner.

Artificial induction of labor (AIL) is the set of techniques intended to induce childbirth in order to reduce maternal-fetal mortality. The aim of this paper was to study the maternal and fetal prognosis after the artificial induction of labor with misoprostol. It was a descriptive prospective study conducted from September 1, 2018 to February 28, 2019 at the maternity unit of the Referral Health Center (RHC) in commune I of Bamako. It was about any pregnant woman at term who had received misoprostol as part of the artificial induction of labor. 102 cases of artificial induction with misoprostol 200 μg were collected out of 3641 deliveries, or a frequency of 2.8%. The age group 28 - 32 years accounted for 56.86% with an average age of 28.8 years. Multiparous represented 54.90% of the number. The history of diabetes and hypertension involved 37.25% of the pregnant women. The main indication was premature rupture of membranes (PRM) (40.2%). Induction was performed between the 37th and 41st week of amenorrhea (69.6%). The trigger index according to BISHOP was greater than 7 (50.98%). Induction was done only with 3/4 of misoprostol tablet 200 μg (43.14%). The average labor time was 7 hours (89.22%). The vaginal birth concerned 92.16% of pregnant women. An APGAR10 was noted in 97.85% of newborns after 05 minutes. AIL with misoprostol was practiced at the Center. The main indication was the premature rupture of the membranes. It improves the maternal and fetal prognosis.

Summary: A malignant tumour that develops from the bronchial epithelium and then invades the lungs. It ranks third after colorectal and breast cancer. In Mali, computed tomography (CT) is the main imaging tool used at all stages of treatment. We had initiated this study with the objective of specifying the place of CT in the diagnosis of primary bronchopulmonary cancer at the hospital of Mali. Method: This is a prospective and descriptive study conducted by the Medical Imaging and Thoracic Surgery departments at Mali Hospital from March 2014 to February 2015. All the patients who have benefited from a CT scan and presenting at least one histologically confirmed bronchopulmonary tumor were included. Results: We were recruiting 60 patients with bronchopulmonary cancers out of 500 referred for a thoracic CT scan performed, a frequency of 12%. There was one male patient with a sex ratio of 4H/1F. The average age was 60 years. The history of smoking was 85%. The symptoms were dominated by general condition (63.33%), cough (25%) and haemoptysis (58.33%). CT scans were performed in all patients. The lesions were located more in the lower lobes (71%). The tumours were: heterogeneous tissue density (70%), spiculated contours (80%), and the histology was more non-small cell carcinoma. Conclusion: The incidence of bronchopulmonary cancer is very high and its prognosis is poor at an advanced stage. The evaluative role of CT and biopsy guidance has given it a place of choice in its management. The diagnosis of certainty remains histology.

Uterine leiomyomas (myomas) are the most common benign tumors of the female genital tract. They affect 20% to 25% of women of childbearing age and are 3 to 9 times more common in black women. We initiated this study in order to report the socio-demographic aspects and the indications for leiomyomas surgery at Hopital du Mali. This was a retro-prospective descriptive study, conducted in the gynecology department of Hopital du Mali from January 1, 2015 to December 31, 2019. Any patients, regardless of their age, in whom a leiomyomas had been detected and surgically treated were included. We had collected 180 cases of surgery for leiomyomas out of 950 surgical procedures, with a frequency of 18.94%. The 36 - 45 age group represented 45% of our patients with an average age of 35 years. Nulligravida accounted for 48.9% and nulliparous (60%). The main reason for consultation was the desire to become pregnant (53.33%). A history of myomectomy was found out in 15.55% of patients. Pelvic ultrasound figured out 64.44% interstitial myomas. Myomectomy was performed in 88.88% of cases and hysterectomy in 11.12% of cases. Among our patients 39.37% had become pregnant. Operative complications were dominated by anemia 14.44%. Leiomyoma was the histological tissue found in all cases of myomectomy. The average duration of hospitalization was 3 days. Conclusion: Leiomyomas surgery is the first scheduled gynecological surgical activity. Laparotomy remains the primary route of entry. The indications are dominated by the desire for pregnancy.

The fibroids affect 20% to 25% of women of reproductive age and are 3 to 9 times more common in black women. We’ll talk about giant fibroids (GFs) when uterine height reaches or exceeds the navel. We have initiated this study in order to report the epidemioclinical and therapeutic aspects of giant fibroids at the Hopital du Mali. A descriptive retro-prospective study, conducted in the service of gynecology of the Hopital du Mali from November 2017 to December 2018 were included in this study, any patients, regardless of their age, having developed a fibroid, the uterin e height of the patient reaching or exceeding the umbilicus on physical examination and who were on surgical treatment. We had collected 30 cases of GFs out of the 92 patients who had undergone myomectomies, with a frequency of 32.60%. The age group 25 - 29 years accounted for 46.6% with an average age of 35 years. Housewives represented 50% and nulligravida made up 33% of our patients. Desire to become pregnant was the main reason for consultation in 34.4% of cases. The uterine height was between 25 and 29 cm on physical examination in 46.66% of cases. Myomectomy was performed in 76.64% and hysterectomy in 23.3% of cases. The size of the nuclei after surgery was over 25 cm in 48.66% of our patients. Conclusion: The giant fibroid (GF) is a common cause of myomectomy. The treatment is either hysterectomy or myomectomy and depends on the indications.

Slow spinal compressions are due to the development of an expansive process in the spinal canal. It is a very common pathology, the diagnosis of which is mainly clinical. However, magnetic resonance imaging occupies an essential place in the site diagnosis and etiological research in the management. Non-traumatic spinal cord compression is a diagnostic and therapeutic emergency, requiring early and appropriate management. MRI is the benchmark imaging examination for this pathology. No similar previous MRI study in Mali. We undertook this work with the aim to determine the place of MRI in the diagnosis of spinal cord compressions in Mali hospital. Method and Patients: This was a descriptive retrospective study, carried out at the hospital’s medical imaging department from January 1, 2017 to December 31, 2018 (02 years). It involved all patients, regardless of sex and age, sent for an MRI examination of the spine, and in whom spinal cord compression was diagnosed. We used a 0.35T low-field MRI machine with solid-state antennas. Results: We collected 179 cases of spinal cord compression MRI out of 585 spinal MRI performed, (frequency of 30.59%). The average age was 53.5 years with a male predominance (sex ratio 3.7). Motor disorders were the most common reason for examination (41%). We used the T1 T2 sagittal and T2 axial sequences. IV injection of gadolinium was performed in 48% of patients. The topographic lesions were: cervical (54.7%), thoracic (31.3%) and several segments (9.5%). The lesions concerned the compartments: extradural (79.3%), intradural (4.5%), and intramedullary (16.2%). The processes were degenerative (57.5%). tumorous (29.6%), infectious (12.3%) and vascular (0.6%). Conclusion: MRI is the benchmark imaging test for the management of non-traumatic spinal cord injury. Myelo-CT can be an alternative in the absence or in case of MRI contraindication.

Introduction: Deep vein thrombosis is a frequent disease, its origin is most often multifactorial. Venous thromboembolic disease (MVTE) and cancer are two frequently entangled pathologies. Here we report the diagnosis of deep vein thrombosis that discovered prostate cancer in an 88-year-old Guinean man. On clinical examination, there was a painful and hot swelling of the right leg, an absence of sloshing of the calf, a positive sign of Homans. The digital rectal examination revealed an enlarged prostate with an irregular surface. Cardiopulmonary auscultation was normal. The electrocardiogram showed a regular sinus rhythm at 65 cycles/min, with no sign of enlarged cavities or conduction disturbance. Venous Doppler ultrasound of the lower limbs showed the presence of an extensive acute deep venous thrombosis of the right sural vein extended to the popliteal and to the homolateral deep femoral. The reino-vesico-prostatic ultrasound concluded in a heterogeneous prostatic hypertrophy with projection of a median lobe associated with a bladder of fight with an important post voiding residue evaluated at 170 ml; the rate of specific antigen of the prostate PSA was at 84.87 ng/ml. The pathology analysis made after a prostate biopsy puncture concluded with an adenocarcinoma with a Gleason score of 3. Conclusion: The association of venous thromboembolic disease (MVTE) and neoplasia is frequent. The existence of active cancer in a patient is a known risk factor for MVTE and, conversely, the discovery of a first episode of deep vein thrombosis (DVT) or pulmonary embolism (PE) may be the mode of revelation of cancer.

Infertility is a socio-cultural drama in Africa, especially in Mali and remains difficult for couples to overcome. Laparoscopy, also called minimally invasive surgery or keyhole surgery, is an operative technique that permits to explore the pelvis and perform an appropriate therapeutic procedure. The objective of our work was to assess the role of laparoscopic surgery in the treatment of female infertility at Hopital du Mali. It was a retrospective descriptive study that was conducted over a period of 5 years (January 2013 to December 2018). Any patients followed for infertility and who underwent laparoscopic surgery in the gynecology department over a period of two (2) years were included. The outcome of laparoscopic surgery was evaluated in terms of conception of pregnancy. We had collected 103 infertile patients out of 2984, with a frequency of 3.45%. The mean age of our patients was 30.2 years. Housewives and out-of-school women accounted for 68.93% and 54.37% respectively. Nulligravida represented 41.75%. Regarding infertility, it was primary in 41.75% and secondary in 58.25%, with an average duration of 6.2 years. Systematic chlamydial serology was positive in 62.14% of our patients. Hysterosalpingography (HSG) revealed bilateral tubal obstruction in 53.33% of cases. Laparoscopy found tubal adhesions in 97.80% of cases. Adhesiolysis was the main procedure performed with 84.47% bilateral tubal patency achieved in the methylene blue test. Among our patients who had contracted a pregnancy (22.99%), 85% had carried their pregnancies to term. Tubal damage was the main cause of infertility. Adhesiolysis remains the main laparoscopic procedure for treatment.

Introduction: Pulmonary agenesis is a rare congenital abnormality defined by the absence of parenchyma, bronchi and pulmonary vessels, frequently associated with other malformations. We describe a case of isolated right pulmonary agenesis diagnosed in the pediatric ward of the Mali Hospital. Clinical case: He was a month-old baby boy, born at term by cesarean section of a well-followed pregnancy. He was not resuscitated. He developed dyspnea after a cold. An emergency chest X-ray revealed a right opaque lung. He was referred to the hospital for the exploration of this opacity. At the entrance, it weighed 3910 g, size: 54 cm and the temperature was 36.9°C. He had a polypnea, an intercostal print. The sounds of the heart were diverted to the right. The rest of the clinical examination was without much particularity. The chest CT scan confirmed the right pulmonary agenesis. Abdominal and cardiac ultrasound was normal. A healing includes oxygenotherapy, serum glucose 10% minding 100 ml/ Kg/day and amoxicillin minding 100 mg/ Kg/day at 3 times by oral way. After 24 hours of treatment, we observed an improvement in dyspnea. On D2, he was weaned off oxygen and resumed feeding. Conclusion: Pulmonary agenesis is a rare congenital anomaly that is frequently associated with other malformations, thus making its prognosis poor. The search for malformative abnormalities should be systematic in right pulmonary agenesis.

Fibroids affect 20% to 25% of reproductive-age women, and black women are 3 to 9 times more likely to develop them. When uterine height approaches or exceeds the navel, we're talking about giant fibroids. This research was started at the Hôpital du Mali to report on the epidemioclinical and therapeutic aspects of giant fibroids. A descriptive retro-prospective study, conducted in the service of gynecology of the Hôpital du Mali from November 2017 to December 2018 were included in this study, any patients, regardless of their age, having developed a fibroid, the uterine height of the patient reaching or exceeding the umbilicus on physical examination and who were on surgical treatment. We had collected 30 cases of GFs out of the 92 patients who had undergone myomectomies, with a frequency of 32.60%. The age group 25 - 29 years accounted for 46.6% with an average age of 35 years. Housewives represented 50% and nulligravida made up 33% of our patients. Desire to become pregnant was the main reason for consultation in 34.4% of cases. On physical inspection, 46.66 % of the time, the uterine height was between 25 and 29 cm. In 76.64 percent of cases, myomectomy was performed, while hysterectomy was performed in 23.3 %. The size of the nuclei after surgery was over 25 cm in 48.66% of our patients. Conclusion: The giant fibroid (GF) is a common cause of myomectomy. The treatment is either hysterectomy or myomectomy and depends on the indications. Hysterectomy should be reserved for the etiologies: excessive volume of fibroids, postmenopausal women and multiple gravida.

IntroductionThe 2018–2020 Ebola outbreak in the Democratic Republic of the Congo (DRC) took place in the highly complex protracted crisis regions of North Kivu and Ituri. The Red Cross developed a community feedback (CF) data collection process through the work of hundreds of Red Cross personnel, who gathered unprompted feedback in order to inform the response coordination mechanism and decision-making.AimTo understand how a new CF system was used to make operational and strategic decisions by Ebola response leadership.MethodsQualitative data collection in November 2019 in Goma and Beni (DRC), including document review, observation of meetings and CF activities, key informant interviews and focus group discussions.FindingsThe credibility and use of different evidence types was affected by the experiential and academic backgrounds of the consumers of that evidence. Ebola response decision-makers were often medics or epidemiologists who tended to view quantitative evidence as having more rigour than qualitative evidence. The process of taking in and using evidence in the Ebola response was affected by decision-makers’ bandwidth to parse large volumes of data coming from a range of different sources. The operationalisation of those data into decisions was hampered by the size of the response and an associated reduction in agility to new evidence.ConclusionCF data collection has both instrumental and intrinsic value for outbreak response and should be normalised as a critical data stream; however, a failure to act on those data can further frustrate communities.

The Red Cross community feedback system enabled rapid collection and analysis of extensive verbal feedback during an Ebola outbreak in eastern DRC. Using this information, Ebola response leaders adapted strategies to address community concerns. In an epidemic, community feedback is critical to ensure that response strategies are accepted and appropriate., Key Findings Ebola-affected communities in the eastern Democratic Republic of the Congo had questions about the outbreak, doubts about the reality of Ebola, and concerns about health care and the Ebola vaccination program.In peak outbreak areas, beliefs that Ebola response teams were stealing organs and bodies declined after burial teams introduced transparent body bags. Similarly, calls for making vaccination “more fair” declined after Ebola vaccination eligibility was expanded. Key Implications The model for recording community feedback provided rapid, ongoing comments from neighborhoods and villages where Ebola response activities were underway, allowing people to share perceptions, questions, and concerns in their own words. Local volunteers were central to the model's success because they were involved in the rapid collection, coding, and interpretation of feedback and applying it to response activities.Collecting continuous community feedback throughout an emergency response enables response teams to answer questions, consider suggestions, and adapt interventions to better meet community needs and preferences. Local health departments everywhere could employ this approach to enhance community engagement., Background: Efforts to contain the spread of Ebola in the eastern Democratic Republic of the Congo (DRC) during the 2018–2020 epidemic faced challenges in gaining community trust and participation. This affected implementation of community alerts, early isolation, contact tracing, vaccination, and safe and dignified burials. To quickly understand community perspectives and improve community engagement, collaborators from the DRC Red Cross, the International Federation of the Red Cross, and the U.S. Centers for Disease Control and Prevention explored a new method of collecting, coding, and quickly analyzing community feedback. Methods: Over 800 DRC Red Cross local volunteers recorded unstructured, free-text questions and comments from community members during community Ebola awareness activities. Comments were coded and analyzed using a text-coding system developed by the collaborators. Coded comments were then aggregated and qualitatively grouped into major themes, and time trends were examined. Results: Communities reported a lack of information about the outbreak and the response, as well as concerns about the Ebola vaccination program and health care quality. Some doubted that Ebola was real. The response used the feedback to revise some community engagement approaches. For example, 2 procedural changes that were followed by drops in negative community responses were: using transparent body bags, which allayed fears that bodies or organs were being stolen, and widening the eligibility criteria for Ebola vaccination, which addressed concerns that selectively vaccinating individuals within Ebola-affected communities was unfair. Discussion: This system is unique in that unstructured feedback collected by local volunteers in the course of their work was rapidly coded, analyzed, and given to health authorities for use in making course corrections throughout the response. It provides a platform for local voices to be heard throughout an emergency response and provides a mechanism for assessing the effects of program adjustments on community sentiments.

L´agenesie pulmonaire est une anomalie congenitale rare definie par l´absence totale de parenchyme, des bronches et des vaisseaux. Elle est souvent associee aux malformations. Nous rapportons 2 cas d´agenesie pulmonaire droite diagnostiques dans le Service de Pediatrie de l´Hopital du Mali. Le premier patient etait un nourrisson de 2 mois, de sexe masculin, ne a terme par cesarienne. Il n´a pas ete reanime a la naissance. Il a ete hospitalise pour detresse respiratoire aigue. Le diagnostic d´agenesie pulmonaire droite a ete confirme par le scanner thoracique. Il n´ y avait pas d´autres malformations associees. Le second patient etait un nourrisson de 3 mois, de sexe feminin, ne a terme par voie basse avec une bonne adaptation. Il est admis pour dyspnee aigue. Le diagnostic a ete confirme par le scanner thoracique. L´agenesie pulmonaire droite etait associee aux anomalies squelettiques. L´agenesie pulmonaire unilaterale une cause rare de la detresse respiratoire. Le scanner thoracique est essentiel pour son diagnostic. Son traitement consiste a traiter et a prevenir les infections broncho-pulmonaires du poumon controlateral.

Cervical cancer remains a major public health problem in Africa, particularly in Mali. The goal of this work was to investigate the epidemiological and clinical aspects of cervix cancer seen at the radiation therapy center. This was a descriptive study on the retrospective collection of data on patients found in the Radiation Therapy Centre of Bamako, for invasive cervical cancer be-tween April 2014 and April 2017. The average age of our population was 52 ± 12.5 years with extremes ranges from 18 to 95 years. The most represented age group was [50 - 65 years] with 44.2%. The predominant histological type was squamous carcinoma (CE) with 94.2%. Bleeding were found in almost all patients, most often associated with foul smelling hydrorrhea; 80.3% of our patients were stage III and 12.9% of stage IV according to the IFGO classifi-cation. Cervix cancer remains a major public health problem in Mali. The di-agnosis is often late, therefore, resulting in late care and unfavorable progno-sis. Sensitization, vulgarization of vaccination and systematization of screen-ing could be helpful in the fight against this cancer.

Breast cancer is a major public health problem because of its incidence and mortality. Purpose: To establish the epidemiological and clinical characteristics of breast cancer seen at the radiotherapy center at the Mali Hospital of Bamako. Patients and methods: It was a retrospective, descriptive study of data from patients seen for breast cancer at the Center of Radiotherapy of Mali Hospital between April 2014 and December 2016. The parameters studied were: age, sex, family history of breast cancer, menopausal status, parity, breast tumor location, histological type, histological grade, cancer classification stage. Results: 134 cases of breast cancer were collected, with a frequency of 15%. The sex ratio (H/F) of 0.007. The patient’s mean age was 47 ± 11 years old. The most represented age groups were 33 - 47 years old with 45.5% and 48 - 62 years old with 39%. Three percent (3%) of patients had a family history of breast cancer. Fifty (50%) of the patients were menopausal. The main clinical signs found were : mammary nodules (98%), mastodynia (65%), nodes (67%). Invasive ductal carcinomas were found in 94% of patients, followed by infiltrating lobular carcinomas with 3.7% and metaplastic carcinomas with 1.7%. SBR Grades II and III were mostly found with 37% and 23%. The average tumor size was 87 mm ± 43. Stage III was predominantly represented with 72%, followed by Stage II with 24% and Stages I and IV with 2% each. Conclusion: Breast cancer is common and reaches both before and after 50 years; the diagnosis is usually late; hence it is the importance of raising awareness and screening before the age of 50 and popularizing some complementary tests to better understand the prognosis of this disease and promote more targeted and conservative treatments that will improve survival.

Observation: This patient was a 40-year-old housewife with dysphonia, physical asthenia, palpitations, fever and cervical tumefaction that had been going on for 2 months, no known cardiovascular risk factor, such as medical history, ischemic stroke. Heart sounds were regular at 110 bpm, blood pressure = 120/80 mmhg, to the lungs there are sibilant rattles. Elsewhere, there is a painful left lateral cervical tumefaction febrile to the touch. Temperature = 38°C. The rest of the exam is peculiar. Conclusion: Jugular vein thrombosis is a rare variety of unusual localization of venous thromboembolism. It must be suspected in the presence of a painful cervical swelling and confirmed by magnetic resonance imaging or to scan with contrast or ultrasound. Anticoagulant therapy should be instituted as soon as possible to avoid the formidable complication of pulmonary embolism.

The objective of this study was to describe Thrombotic manifestations and therapeutic management during HIV infection and tuberculosis in a 19-year-old male student. The objective of this study was to describe Thrombotic manifestations and therapeutic management during HIV infection and tuberculosis in a 19-year-old student. Observation: It is Mr. S. C., aged 19, admitted for pain and swelling of the right lower limb, physical asthenia and notion of fever. Evolution 5 days, with no particular history of cardiovascular disease, anti-retroviral treatment for 1 year and anti-tuberculosis treatment for 3 months. On clinical examination heart sounds are irregular with a heart rate at 115 bpm, blood pressure at 110/70 mmhg. A febrile red painful swelling at right lower limb with positive Homans sign. 0°C (Temperature 37.7°C), Weight at 58 Kg. The rest of the clinical examination is without particularity. Venous Doppler echo of the lower limbs: shows the presence of acute deep vein thrombosis of the right lateral vein. Mr. S. C. to benefit the following Medical Treatment: lovenox 0.6 UI subcutaneously morning and evening, Sintrom 4 mg 1 comprimed at night, Tramadol 50 mg morning and evening; with a good clinical evolution. CONCLUSION: TB and HIV are chronic infections that result in widespread inflammation predisposing patients to a MTVE (Venous thromboembolic disease) table as well as rifampicin and anti-proteases.

As climate model uncertainties remain very large for future rainfall in the Sahel, a multi-centennial perspective is required to assess the situation of current Sahel climate in the context of global warming. We present here the first record of hydroclimatic variability over the past 1600 years in Senegal, obtained from stable oxygen isotope analyses (δ 18 O) in archaeological shell middens from the Saloum Delta. During the preindustrial period, the region was relatively humid, with maximum humidity reached during the period from AD 1500 to AD 1800, referred to as the Little Ice Age. A significant negative link is observed at the centennial scale between global temperature and humidity in the Sahel that is at odds with the expected effects of latitudinal shifts of the intertropical convergence zone during the last millennium. In the context of the past 1600 years, the Western Sahel appears to be experiencing today unprecedented drought conditions. The rapid aridification that started ca. AD 1800 and the recent emergence of Sahel drought from the natural variability point to an anthropogenic forcing of Sahel drying trend. This new long-term perspective suggests that the recovery of Sahel rainfall in the last decade may only result from short-term internal variability, and supports climate models that predict an increase of Sahel drought under future greenhouse climate.

Objective: To report the experience of Gynecology Department of the University Hospital of Treichville in the management of the inflammatory breast cancers. Methodology: We conducted a retrospective and descriptive study on cases of the inflammatory breast cancers managed in the Gynecology Department of the University Hospital of Treichville, from January 2011 to December 2015. Results: We collected 44 cases of inflammatory breast cancer representing 17.9% of all breast cancers. The average age of patients was 46.5 years (32 - 70 years) and among them, the majority had inadequate socioeconomic level (90.9%). The risk factor for cancer found in the majority of patients was the age of first menstrual periods before the age of 12 years (52.3%). The average consultation time was long (10 months) and several patients had extensive inflammatory signs (38.6%), with lymph node involvement (84.1%) and metastases (36.4%). At the histological analysis, the most common type was invasive ductal carcinoma (81.8%), SBR grade III (54.5%). Regarding treatment, mastectomy according to Patey associated with a chemotherapy was performed in 22.7% cases. The evolution has been marked by an overall 5-year survival of 20%. Conclusion: The management of inflammatory breast cancers was late and incomplete in our service making poor prognosis.

Les etudes menees le long de la Faleme, affluent du Senegal, dans le secteur Sansande‑Missira, permettent de se faire une idee assez precise de la stratigraphie des formations sedimentaires qui se devoilent a la faveur de l’incision recente du cours d’eau. Les datations par le radiocarbone et par luminescence optiquement stimulee calent l’essentiel de ces depots du dernier cycle climatique, avec une tres bonne representation de la periode 45-5 ka pour les sediments fins deposes lors des crues regulieres. Dans ces depots, la recurrence des sites archeologiques montre qu’il y avait, meme pendant la phase du dernier maximum aride, un ecoulement sud-nord suffisant pour attirer les populations.

This paper aims to study the impact of financial development and the institutional environment on economic growth in the countries of the WAEMU (West Africa Economic and Monetary Union) zone. We used a standard growth model like Eggoh (2010) with a cointegration technique on panel data. We used the 2017 World Bank database (World Bank data, 2017). The results showed that money supply to GDP (M2/GDP), domestic bank credit to GDP (CB/GDP) and regulatory quality (QR) have a positive and significant impact on long-term economic growth. However, the positive effect of respect for law and order is not significant.