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Introduction : Les infections respiratoires aiguës (IRA) constituent l’une des principales causes de morbidité et de mortalité infantile au Mali. L’objectif de ce travail était de décrire les aspects épidémiologiques, cliniques et thérapeutiques de la bronchiolite aiguë du nourrisson au service de pédiatrie du CHU Gabriel Touré. Méthodologie: Il s’agit d’une étude rétrospective portant sur 112 nourrissons âgés de 1 à 24 mois hospitalisés dans le service de pédiatrie générale pour bronchiolite aiguë. L’étude s’étalait sur une période d’un an (du 1er janvier au 31 décembre 2012). Résultats: Les nourrissons âgés de 1 à 6 mois étaient majoritaires (69%). L’âge moyen des patients était de 6 mois avec des extrêmes de 1 et 24 mois. Le sexe masculin était prédominant (63%) avec un sex-ratio de 1,73. Le principal motif de consultation était la difficulté respiratoire (87%). Le pic d’hospitalisation était au mois de novembre (33%). Les principaux signes cliniques en plus des sibilants étaient la toux, la rhinorrhée et la détresse respiratoire (97%). La fièvre était présente dans 38% des cas et la cyanose chez 4% des patients. La saturation en oxygène était inférieure à 94% chez 50% des patients. La kinésithérapie respiratoire a été faite chez un tiers des malades. Tous les malades avaient reçu une corticothérapie et une nébulisation avec du salbutamol et sérum physiologique. Une antibiothérapie a été faite chez 85% des patients. La durée moyenne d’hospitalisation était de 6 jours avec des extrêmes de 1 et 30 jours. Le taux de guérison était de 98 %. Conclusion : La bronchiolite est une pathologie bénigne et fréquente chez le nourrisson de 1 à 6 mois qui évolue favorablement dans la majorité des cas.

Introduction : Les détresses respiratoires sont une cause majeure de morbidité et de mortalité en pédiatrie ; l’objectif de notre étude était d’étudier les aspects épidemiocliniques des détresses respiratoires chez les enfants âgés de 1 à 59 mois dans le service de pédiatrie de CHU. Gabriel Toure. Méthodologie : Il s’agit d’une étude transversale descriptive sur douze mois du 1er au 31 décembre 2012 au service de pédiatrie du CHU Gabriel Touré Bamako Mali. Tous les enfants de 1 à 59 mois présentant une détresse respiratoire ont été inclus. Résultats : Ainsi 678 dossiers d’enfants en détresse respiratoire sur un total de 2241 hospitalisés en pédiatrie ont été analysés soit un taux d’admission de 30,25%. 64,75% des enfants avaient un âge compris entre 1 et 11 mois. Le sex-ratio était de 1,38 en faveur des garçons; les signes de lutte respiratoire (battement des ailes du nez, tirage intercostal et le geignement) étaient présents dans 96,22%. La pathologie pulmonaire la plus fréquente était la pneumonie (68,36%) celle extra-pulmonaire était le paludisme grave (11,80%). Le taux de mortalité était de 20,65%. Conclusion : les détresses respiratoires restent une importante cause de mortalité du nourrisson dans notre contexte avec des problèmes majeurs de prise en charge

We report two observations of portal cavernoma diagnosed successively in Bamako and Dakar. The first is a 6-year-old male admitted to the service for ascites and abdominal pain. At admission the clinical parameters (weight, height, temperature, cranial perimeter and temperature) were within the norms for age. The clinical examination noted a moderate skin-mucosal pallor, asthenia. The biological assessment returned to moderate normochrome anemia with impaired pancreatic function while renal and hepatic functions were maintained. The abdominal scan performed after two low-contribution abdominal ultrasounds, objected signs in favor of a portal cavernoma with perisplenic and gastric varicose veins. The second is an 8-year-old male child born from an unborn marriage and from a followed pregnancy with premature delivery. His pathological history includes a notion of prematurity that required a stay in neonatology with umbilical catheterization and repeated abdominal pain. He had an acute abdominal episode in March 2015 justifying a surgical hospitalization for suspicion of appendicitis. At admission the clinical parameters (weight, height, temperature, cranial perimeter and temperature) were within the norms for age. The abdominal ultrasound prescribed for this was suggestive of portal cavernoma, later confirmed by abdominal computed tomography. [ABSTRACT FROM AUTHOR]

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Introduction: Household accidental child poisonings are frequent pediatric medical emergencies in developing countries. Objective: To study the epidemiological, etiological, clinical and therapeutic aspects of acute accidental domestic poisoning in children aged 0 to 15 years admitted to the pediatric emergency department of Gabriel Toure. METHOD: This was a prospective, descriptive study that ran from January 1, 2014 to December 31, 2014. All patients aged 0 to 15 years admitted to pediatric emergencies for acute intoxication were included. Results: A hundred cases of acute accidental poisoning were collected. Children under five accounted for 94%. The majority of mothers was housewives and had custody of children (83%). Forty-nine percent of the mothers were unschooled. The place of storage of the product was indoor in 96% of cases. The product was taken by the child himself (88%). A gesture at the scene of the accident was reported in 68% of cases, the ingestion of milk (72%) and water (10%) were the first acts used. The hospital was the first resort (72%). The time between taking the product and admission to hospital was 1 to 5 hours in 58% of cases. Vomiting (37 cases), agitation (17 cases) and respiratory distress (16 cases) were the most common symptoms. Domestic products (48%) followed by drugs (33%) ranked first among the families of poisons. Caustic soda (18%) and bleach (17%) were the most commonly found intoxication products. The evolution was good with a cure without sequelae (93%). Conclusion: Accidental acute intoxications to household products are common in Mali. The hospital admission deadline is still long; the actions taken by patients at the accident site often aggravate their states but are largely done by the parents before the use of health care. [ABSTRACT FROM AUTHOR]

Résumé: Objectif: L'objectif principal était d'étudier les circonstances du diagnostic et la répartition des tumeurs cérébrales chez l'enfant. Méthodologie: Il s'agissait d'une étude rétrospective descriptive réalisée chez les enfants de 0 à 15 ans hospitalisés pour tumeur cérébrale au CHU Gabriel Touré à Bamako, Mali, du 31 janvier 2007 au 3 décembre 2012. Résultats: Pendant la période d'étude, 41 enfants d'âge moyen de 5,5 ans (extrêmes : 1-12 ans) étaient admis pour une tumeur cérébrale. Le sexe masculin était prédominant (53,7 %). Le délai moyen d'admission était de 205,6 jours (extrêmes : 30-455). L'hypertension intracrânienne était le mode de révélation le plus fréquent des tumeurs primitives (26,8 %). La localisation sous-tentorielle représentait 83 % des cas. Le gliome était le diagnostic le plus souvent évoqué à la tomodensitométrie (TDM) (29,3 %). Seulement cinq malades avaient bénéficié d'une chirurgie dont deux cas d'énucléation, deux cas de dérivation et un cas de dérivation avec exérèse tumorale. Conclusion: Cette étude nous a permis de connaître la topographie des tumeurs cérébrales et la difficulté de leur diagnostic et de leur prise en charge liée au retard diagnostique. Objective: to assess epidemiologic and clinical aspects of childhood brain tumors in Mali. Methods: a retrospective, descriptive study of children aged 0-15 years with brain tumors, conducted in the pediatrics department of the Gabriel Touré University Hospital Center in Bamako, Mali, from January 31, 2007 to December 3, 2012. Results: In all, 41 cases of brain tumors were recorded during this period (mean: 5.5 years old; range: 1-12 years). Brain tumors were most frequent in the children aged 2-5 years (53.7%) and among boys (53.7%). Late stage at presentation was relatively frequent (34.1%) with a mean time to diagnosis of 10 months. Features of elevated intracranial pressure were the most frequent mode of revelation of primary tumors (26.8%). Supratentorial tumors accounted for 83% of the cases, and gliomas were most frequently (29.3%) identified on computed tomography. Only five patients underwent surgical tumor removal. Conclusion: A broader study including the other hospitals in Bamako could help to assess more accurately the epidemiology of pediatric brain tumors in Mali. [ABSTRACT FROM AUTHOR]

In Mali, malaria is a major public health problem. The region of Sikasso is classified according to the geo-climatic facies as a zone with a long seasonal transmission of malaria greater than 6 months. Objective: To describe the epidemiological, clinical and therapeutic characteristics of children aged 0-5 years hospitalized for severe malaria in the pediatric ward of the Sikasso hospital. Variables analyzed were epidemiological, clinical, paraclinical, therapeutic and evolutionary. Patients and Methods: This is a retrospective, 12-month (January-December 2014) cross-sectional study of all 0-5-year-olds hospitalized for severe malaria at the Sikasso Regional Hospital. Results: The hospital frequency of severe malaria was 55.82%. The age group of 12-35 months was the most concerned (45.3%). The peak frequency was in August (21.2%). Anemic, mixed (anemia and neurological) and neurological forms were the most frequent. Artéméther and quinine were the antimalarials used. The use of a blood transfusion was frequent (82.8%). The lethality was 10% and the mixed form (anemia and neurology) was the most lethal ((P<10-6). Conclusion: Malaria remains a national concern in Mali. Improving the quality of care and prevention must be a priority to reduce the lethality that remains high. [ABSTRACT FROM AUTHOR]

We report two observations of portal cavernoma diagnosed successively in Bamako and Dakar. The first is a 6-year-old male admitted to the service for ascites and abdominal pain. At admission the clinical parameters (weight, height, temperature, cranial perimeter and temperature) were within the norms for age. The clinical examination noted a moderate skin-mucosal pallor, asthenia. The biological assessment returned to moderate normochrome anemia with impaired pancreatic function while renal and hepatic functions were maintained. The abdominal scan performed after two low-contribution abdominal ultrasounds, objected signs in favor of a portal cavernoma with perisplenic and gastric varicose veins. The second is an 8-year-old male child born from an unborn marriage and from a followed pregnancy with premature delivery. His pathological history includes a notion of prematurity that required a stay in neonatology with umbilical catheterization and repeated abdominal pain. He had an acute abdominal episode in March 2015 justifying a surgical hospitalization for suspicion of appendicitis. At admission the clinical parameters (weight, height, temperature, cranial perimeter and temperature) were within the norms for age. The abdominal ultrasound prescribed for this was suggestive of portal cavernoma, later confirmed by abdominal computed tomography., (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: Early neonatal bacterial infection (ENBI) is a major concern in neonatology. In Mali, no study had addressed this aspect, hence the initiation of this work to study the epidemiological-clinical, biological and bacteriological profile of ENBI., Materials and Methods: This was a descriptive longitudinal study that took place from june 27 to september 3, 2016 involving newborns aged ≤ 72 hours hospitalized for ENBI confirmed by blood culture in the neonatology service of the pediatrics department of the Center Hospitalier et Universitaire (CHU) Gabriel Toure in Bamako. The parameters studied were the socio-demographic and obstetrical characteristics of the mothers, the clinical, biological and bacteriological characteristics of newborns infected early., Results: Of the 324 blood cultures performed, 52 were positive, i.e. an ENBI frequency of 11.04%. The sex ratio was 1.3 with 73.1% low birth weight. On admission, 90.4% of newborns had less than 24 hours of life and 86.5% were births outside the CHU Gabriel Toure. The main clinical signs were hyperthermia or hypothermia and respiratory distress. The main bacteria isolated in blood culture were Staphylococcus aureus (55.8%), Klebsiella pneumoniae (13.5%) and Escherichia coli (07.7%). Sensitivity to first-line biantibiotic therapy (ceftriaxone + gentamicin) was low (63.6%) and that of amikacin was better (100%). Half of the newborns infected early died and 19.2% of exeat without medical agreement was recorded., Conclusion: Early neonatal bacterial infection is a major cause of neonatal morbidity and mortality. In our context, amikacin could be a better therapeutic alternative., (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.)

Malnutrition among children under five is a major public health problem in low-income countries, and contributes significantly to mortality in this age group. The purpose of this work was to evaluate the epidemiological and clinical profile of malnourished children at the Nara hospital in north of Mali., Method: It was a retrospective and descriptive study, from 01/01/2016 to 31/12/2016. Children aged 6 months to 59 months admitted for acute malnutrition were included., Results: Four hundred and sixty-one children had malnutrition, representing 15% of consultations and 50% of hospitalizations. The median age was 26 months (2 months-93 months). The sex ratio was 0.92 (M = 222, F = 239). Nineteen percent of the patients had progressive weaning (n = 90), and it was brutal in 371 patients (80%). The distribution of patients according to the Z-score was as follows: Z-score <-1 (n = 15, 3%), Z-score <-2 (n = 46, 10%), Z-score <-3 (n = 400, 87%). Mean MUAC was 105 mm (99mm-124mm). Hypoglycemia was noted in 45% (n = 204). The marasmus cases accounted for 80% (n = 367) kwashiorkor 10% (n = 48). The mixed form of malnutrition accounted for 10% (n = 46). The disease associated with malnutrition were pneumonia (n = 219, 47%), malaria (n = 115, 25%) and gastroenteritis (n = 68, 15%). The F75 milk was administered predominantly for 3 months in 93% of cases. For phase 2 of treatment, Plumpy Nut and F100 milk were respectively administered in 88% and 12%. The nutritional recovery rate was 95% (n = 435). Five percent of the patients died (n = 26). Pneumonia was the cause of death in 85% of cases. The cure rate for marasmus and kwashiorkor cases was respectively 94% and 93%., Conclusion: Acute malnutrition remains frequent in the Sahelian environment. Better knowledge of mothers about weaning and dietary diversification will improve the nutritional status of children., (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.)

to assess epidemiologic and clinical aspects of childhood brain tumors in Mali. a retrospective, descriptive study of children aged 0-15 years with brain tumors, conducted in the pediatrics department of the Gabriel Touré University Hospital Center in Bamako, Mali, from January 31, 2007 to December 3, 2012. In all, 41 cases of brain tumors were recorded during this period (mean: 5.5 years old; range: 1-12 years). Brain tumors were most frequent in the children aged 2-5 years (53.7%) and among boys (53.7%). Late stage at presentation was relatively frequent (34.1%) with a mean time to diagnosis of 10 months. Features of elevated intracranial pressure were the most frequent mode of revelation of primary tumors (26.8%). Supratentorial tumors accounted for 83% of the cases, and gliomas were most frequently (29.3%) identified on computed tomography. Only five patients underwent surgical tumor removal. A broader study including the other hospitals in Bamako could help to assess more accurately the epidemiology of pediatric brain tumors in Mali.

This study aimed to evaluate the anti-cancer effect of a combination therapy of miRNA-29b and genistein loaded in mucin-1 (MUC 1)-aptamer functionalized hybrid nanoparticles in non-small cell lung cancer (NSCLC) A549 cell line. Genistein-miRNA-29b-loaded hybrid nanoparticles (GMLHN) was prepared and characterized. Particle size and zeta potential were measured using photon correlation spectroscopy (PCS). Encapsulation efficiency and loading efficiency were determined using HPLC. Preferential internalization of MUC 1-aptamer functionalized GMLHN by A549 cells was evaluated and compared to normal MRC-5 cells. The ability of GMLHN to downregulate targeted oncoproteins Phosphorylated protein kinase, strain AK, Thymoma (Phosphorylated protein kinase B) (pAKT), Phosphorylated phosphoinositide 3-kinase (p-PI3K), DNA (cytosine-5-)-methyltransferase 3 beta (DNMT3B) and Myeloid Cell Leukemia Sequence 1 (MCL 1) was evaluated using western blot, while antiproliferative effect and ability to initiate apoptosis was also assessed in A549 cells. MUC 1-aptamer functionalized GMLHN nanoparticles were prepared. These nanoparticles were preferentially internalized by A549 cells but less so, in MRC-5 cells. pAKT, p-PI3K, DNMT3B and MCL 1 were efficiently downregulated by these nanoparticles without affecting the levels of AKT and PI3K in A549 cells. GMLHN demonstrated a superior antiproliferative effect compared to individual genistein and miRNA-29b-loaded nanoparticles. Results generated were able to demonstrate that genistein-miRNA-29b-loaded hybrid nanoparticles (GMLHN) could be a potential treatment modality for NSCLC because of the ability of the payloads to attack multiple targets.

In Mali, malaria is a major public health problem. The region of Sikasso is classified according to the geo-climatic facies as a zone with a long seasonal transmission of malaria greater than 6 months., Objective: To describe the epidemiological, clinical and therapeutic characteristics of children aged 0- 5 years hospitalized for severe malaria in the pediatric ward of the Sikasso hospital. Variables analyzed were epidemiological, clinical, paraclinical, therapeutic and evolutionary., Patients and Methods: This is a retrospective, 12-month (January-December 2014) cross-sectional study of all 0-5-year-olds hospitalized for severe malaria at the Sikasso Regional Hospital., Results: The hospital frequency of severe malaria was 55.82%. The age group of 12-35 months was the most concerned (45.3%). The peak frequency was in August (21.2%). Anemic, mixed (anemia and neurological) and neurological forms were the most frequent. Artemether and quinine were the antimalarials used. The use of a blood transfusion was frequent (82.8%). The lethality was 10% and the mixed form (anemia and neurology) was the most lethal ((P<10 -6 )., Conclusion: Malaria remains a national concern in Mali. Improving the quality of care and prevention must be a priority to reduce the lethality that remains 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.)

Introduction: Household accidental child poisonings are frequent pediatric medical emergencies in developing countries., Objective: To study the epidemiological, etiological, clinical and therapeutic aspects of acute accidental domestic poisoning in children aged 0 to 15 years admitted to the pediatric emergency department of Gabriel Toure., Method: This was a prospective, descriptive study that ran from January 1, 2014 to December 31, 2014. All patients aged 0 to 15 years admitted to pediatric emergencies for acute intoxication were included., Results: A hundred cases of acute accidental poisoning were collected. Children under five accounted for 94%. The majority of mothers was housewives and had custody of children (83%). Forty-nine percent of the mothers were unschooled. The place of storage of the product was indoor in 96% of cases. The product was taken by the child himself (88%). A gesture at the scene of the accident was reported in 68% of cases, the ingestion of milk (72%) and water (10%) were the first acts used. The hospital was the first resort (72%). The time between taking the product and admission to hospital was 1 to 5 hours in 58% of cases. Vomiting (37 cases), agitation (17 cases) and respiratory distress (16 cases) were the most common symptoms. Domestic products (48%) followed by drugs (33%) ranked first among the families of poisons. Caustic soda (18%) and bleach (17%) were the most commonly found intoxication products. The evolution was good with a cure without sequelae (93%)., Conclusion: Accidental acute intoxications to household products are common in Mali. The hospital admission deadline is still long; the actions taken by patients at the accident site often aggravate their states but are largely done by the parents before the use of health care., (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.)

The objective of this study was to evaluate the therapeutic efficacy and pharmacokinetic study of mucin1-aptamer functionalized miRNA-29b-loaded hybrid nanoparticles (MAFMILHNs) in lung tumor-bearing SCID mice. MAFMILHNs were manufactured using an isoelectric point based nanotechnology. They were then fully characterized for particle size, loading capacity, zeta potential, and encapsulation efficiency. The ability of MAFMILHNs to downregulate oncoprotein DNMT3B both at the cellular level and in vivo was monitored using Western blot, while the effect of the downregulation of DNMT3B on tumor growth was assessed using bioluminescence. Results indicate that the presence of MUC1-aptamer conjugated to the surface of the nanoparticles enhanced the selective delivery of miRNA-29b to tumor cells and tissues. Further, the downregulation of DNMT3B by MAFMILHNs resulted in the inhibition of tumor growth in mouse models.