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The management of patients with diabetes is done with a focus on the "biological" component in relation to other determinants of health, namely the psychosocial aspect. This work aimed to study the contribution of therapeutic education to the psychological level of patients.a cross-sectional study, carried out in the medical department of the Mali Hospital during the first half of 2018, which concerned all 115 patients hospitalized during this period.Among these patients, 52.20% were over 50 years old, with 52.2% female versus 47.8% male. Depression was found in 64.31% of patients, patients who never received a Therapeutic Education constituted 67.83%, the correlation was significant between the psychological level of the patient and his participation in a therapeutic education with a correlation coefficient r = 0.518 and a level p0.001.Educating a patient can help him cope with and manage his illness. However, this education is complex because it is a real training leading to a transfer of skills from the caregiver to the care.la prise en charge des malades atteints de diabète se fait en mettant l'accent prioritairement sur la composante « biologique » par rapport aux autres déterminants de la santé à savoir l'aspect psychosocial. Ce travail avait pour objectif d'étudier l'apport de l'éducation thérapeutique sur le niveau psychologique des patients.une étude transversale, réalisée dans le service de médecine de l'Hôpital du Mali durant le premier semestre 2018 et qui a concernée tous les 115 malades hospitalisés pendant cette période.parmi ces malades, 52,20% avaient plus de 50 ans, avec 52,2 % de sexe féminin contre 47,8% pour le sexe masculin. La dépression a été constatée chez 64,31% des patients, les patients qui n'ont jamais reçu d'Education Thérapeutique constituaient 67,83%, la corrélation était significative entre le niveau psychologique du patient et sa participation à une éducation thérapeutique avec un coefficient de corrélation r= 0,518 et un niveau p0,001.éduquer un patient permet de l'aider à supporter sa maladie et à bien la gérer. Cependant, cette éducation est complexe parce qu'il s'agit d'une véritable formation devant aboutir à un transfert de compétences du soignant vers le soigné.

In discussions on inequality in Africa, Mali often appears as an exception, being the country with the lowest level of inequality in the West African sub-region. In this paper, we analyse the dynamics of inequality in the country and try to understand the role played by the different sources of income. To do so, we use the LIS harmonized version of the 3 waves of the Modular and Permanent Household Survey (MPHS) and our results show an increase in inequality in 2019. Furthermore, we find that income inequalities are mainly due to the duality of the labour market, which then reinforces spatial inequalities. Given the prevalence of the informal sector and the very limited existence of social safety nets, social protection does not play its role in reducing inequalities.

Purpose: To show the interest of the serum-ascites concentration gradient in albumin (SAAG) in the etiological diagnosis of ascites in African black. Materiel and Methods: This was a monocentric observational and analytical study performed on patients over 15 years old and hospitalized in the Hepato-Gastroenterology department of Cocody from January 1st, 2010 to March 31st, 2017 for ascites. The cytology and chemistry of the ascites fluid and the protidogram were performed. The main outcome measure was the prediction of portal hypertension (PHT) or non-portal hypertension related causes of ascites from SAAG. Results: The hospital prevalence of ascites was 11%. There were 82 women (46.9%) and 93 men (53.1%) with a sex ratio (M/F) of 1.1. SAAG was low in 68.6% of cases and high in 31.4% of cases. The most common etiologies were post-viral cirrhosis (74%), HCC (16.60%) and peritoneal tuberculosis (13.7%) respectively. In the case of high SAAG, 91% of ascites related to PHT were observed, but also 77.5% of a low SAAG corresponded to ascites related to PHT (p = 0.024) with Se = 35% Sp = 84% and accuracy = 44%. All patients with peritoneal tuberculosis had a SAAG low of less than 1.1 g/dl significantly (p = 0.002). SAAG had a diagnostic performance of 89% in peritoneal tuberculosis at the cutoff value of ?1.24 g/dl (AUROC = 0.91, Se = 96%, Sp = 86%) while in post viral hepatitis cirrhosis at a threshold of 0.58 g/dl the diagnostic performance was 60% (AUROC = 0.69, Se = 53%, Sp = 79%). Conclusion: The simple technical SAAG, allowing to distinguish the ascites linked to the PHT and the ascites not bound to the PHT, can be used like a method of diagnosis of the etiologies of the ascites especially in the peritoneal tuberculosis in the African countries low income.

Purpose: To evaluate the serological status of hepatitis B and C and to identify the risk factors for viral B and C infection in health workers at the university hospital. Material and Method: Mono-centric cross-sectional study carried out at Bouake University Hospital from March 2nd to May 16th, 2016, concerning the health staff of the Bouake University Hospital. Cross-sectional study mono-centric concerning the serological status of viral hepatitis B and C from the period from March 2nd to May 16th, 2016 of the health staff of the University Hospital of Bouake. It has benefited from data from PNLHVi (national program against viral hepatitis) as part of its awareness campaign. The data were analyzed by SPSS software version 20.0. Results: Of the 1107 health workers, 632 had been included, representing a participation rate of 57.1%. The average age of the staff was 37.8 years with extremes ranging from 18 to 66 years. The sex ratio (H/F) was 0.8. Accidents with blood exposure were noted in 52.4% of cases. The maximum vaccine coverage was 16.1%. The prevalence of HBsAg was 8.4%. Contact with HBV was present in 3/4 of the staff. Anti HCV Ab was positive in 1.4% of the staff. Males, age over 50 and over 20 years of seniority were associated with HBV. Also, HBV infection was significantly higher in boys and girls (81.7%), nurses (78.3%) and nursing aides (73.8%), (p = 0.022). HCV infection was significantly correlated with emergency services. Conclusion: Age, gender, seniority, paramedic qualification, and high risk of exposure to body fluids were correlated with viral B infection while emergency department membership was a factor risk of HCV infection.

Intracardiac metastases from hepatocellular carcinoma (HCC) are rare and have a poor prognosis. We report an observation in a West African university hospital in a 39-year-old black patient admitted with upper gastrointestinal bleeding. Clinical examination noted signs of cirrhosis, namely hepatocellular failure, portal hypertension, melena and signs of right heart failure against a background of deterioration in general condition (WHO-3). The CT scan showed a focal hepatic lesion with arterial enhancement and portal lavage compatible with HCC and a right intracardiac mass taking contrast. Doppler echocardiography confirmed the presence of a large heterogeneous mass occupying almost the entire right atrium. Palliative and symptomatic treatment was instituted in the patient improving his clinical condition. His death occurred two months after his release. The intracardiac localization of HCC, although rare, is not exceptional and of appalling prognosis. It should be sought in the assessment of the extension of HCC, especially in the presence of signs of cardiac involvement.

The stone circles of Senegambia are impressive remains that have for long puzzled the visitors who have examined them. Stone circles of many types are found in Europe and Africa, though nowhere there is such a large concentration of megaliths as it is found on the north bank of the River Gambia.What therefore makes the Stone Circles of The Gambia and Senegal unique in respect to other megalithic monuments worldwide is the sheernumber of such monuments. While the individual stones are not as large as those at Stonehenge, in the Senegambia, thousands of stones are skilfully dressed and placed in the form of Circles and other alignments.; Les cercles de mégalithiques de Sénégambie sont d’impressionnants vestiges qui depuis longtemps ont étonné les visiteurs qui les ont examinés. Les cercles de pierres sont relativement courants en Europe et en Afrique, mais nulle part nous ne trouvons une concentration de mégalithes comparable à celle de la rive nord du Fleuve Gambie. Ce qui rend donc uniques les cercles de mégalithes de Gambie et du Sénégal, en comparaison aux autres sites dans le monde, c’est leur abondance. En Sénégambie, bien que les pierres n’aient pas la monumentalité de Stonehenge, des milliers d’entre elles ont été savamment taillées et érigées sous forme de cercles ou autres alignements.

The stone circles of Senegambia are impressive remains that have for long puzzled the visitors who have examined them. Stone circles of many types are found in Europe and Africa, though nowhere there is such a large concentration of megaliths as it is found on the north bank of the River Gambia.What therefore makes the Stone Circles of The Gambia and Senegal unique in respect to other megalithic monuments worldwide is the sheernumber of such monuments. While the individual stones are not as large as those at Stonehenge, in the Senegambia, thousands of stones are skilfully dressed and placed in the form of Circles and other alignments.; Les cercles de mégalithiques de Sénégambie sont d’impressionnants vestiges qui depuis longtemps ont étonné les visiteurs qui les ont examinés. Les cercles de pierres sont relativement courants en Europe et en Afrique, mais nulle part nous ne trouvons une concentration de mégalithes comparable à celle de la rive nord du Fleuve Gambie. Ce qui rend donc uniques les cercles de mégalithes de Gambie et du Sénégal, en comparaison aux autres sites dans le monde, c’est leur abondance. En Sénégambie, bien que les pierres n’aient pas la monumentalité de Stonehenge, des milliers d’entre elles ont été savamment taillées et érigées sous forme de cercles ou autres alignements.