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Adnexal torsion is a spontaneous rotation of the ovary and sometimes the fallopian tube around its axis which can interfere with arterial supply and lead to ischemia It is a rare complication of an ovarian cyst, which can occur at any age, from the fetal period to adulthood. The mature cystic teratoma accounts for 20% of all ovarian tumors and is seen especially in young girls and therefore is most often benign. It's a surgical emergency. We report here two cases of adnexal torsion operated at the level of the pediatric surgery unit of the Hospital of Mali The two girls are 14 and 13 years old, nulligest and normoregulated with recurrent abdominal pain admitted for acute pelvic pain. On palpation, an abdomino-pelvic mass of a firm and painful consistency is noted. An abdominopelvic ultrasound was performed in both cases and revealed torsion of the left adnexa on the left ovarian cyst in the first and on the right in the second. The surgical procedure performed was manual detorsion and cystectomy in both cases. The anatomopathological examination concluded with a dermoid cyst In the two girls and their postoperative course was simple.

Introduction:Pulmonary embolism is the sudden obliteration (total or partial)of the trunk of the pulmonary artery or one of its branches by a circulating foreign body, most often fibrino-cruoric. Objectives:To study the place of chest CT angiography in the diagnosis of pulmonary embolism Material And Method:This was a descriptive prospective study from February 1, 2020 to January 31, 2021 taking into account all patients referred during this period for clinical suspicion of pulmonary embolism to the medical clinic Marie Curie et les Etoiles. The examinations were performed with a GE 16-bar scanner in helical mode with and without injection of iodinated contrast product by an automatic injector. Results:We diagnosed 43 pulmonary embolisms out of 327 thoracic CT angiography performed by highlighting hypodense gaps inside one or more pulmonary arteries as well as certain branches of division and the sudden interruption of the opacification of certain distal arteries. The prevalence of pulmonary embolism was 13.15%. The female sex predominated with 52% (n=22) and the sex ratio was 1.16. The average age of patients in our series was 45 years with extremes (25 to 85 years). The age group of 41-50 years waspredominant. Dyspnea and chest pain were the most frequent clinical information with44.18% and 18.60% respectively. The seat of the pulmonary embolism concerned the right pulmonary arteries and the seat of the pulmonary embolism concerned the right and left pulmonary arteries in 60.46% and the right side was the most affected. Chronic Obstructive Pulmonary Disease (COPD) Pleurisy and Covid-19 were the lesions most associated with pulmonaryembolism (48.83%, 18.60% and 16.28%) Conclusion:Pulmonary embolism is a serious and life-threatening pathology. Its diagnosis of certainty is made with the thoracic CT angiography, the realization of which must not suffer from any delay. &nbsp

Sacrococcygeal teratoma (TSC) is an embryonic tumor with high potential for congenital malignant transformation. It is rare and therefore considered a neonatal surgical emergency. The authors report a case of sacrococcygeal teratoma whose mother did not follow up during pregnancy and the delivery took place at home and who comes for consultation six months after his birth. It emerges from this case that the delay in diagnosis was due to the lack of financial means in the periphery, the extreme surgery could be performed with simple post-operative follow-ups. The result of the anatomopathological examination of the surgical specimen concluded to a benign teratoma. The patient could not be reassessed in the medium and long term because he is lost of seen.

Summary: Hypertrophic pyloric stenosis is an obstruction of the lumen of the pylorus by muscular hypertrophy of the pyloric sphincter fg [1]. It is a rare disease in Africa: a recent publication in Tanzania reported 102 cases in 5 years [10]. Currently the diagnosis is based on abdominal ultrasound and the treatment is surgical. It affects 2 or 3 children out of 1000 and is more common in boys with a ratio of [4]. It occurs between 3 and 6 weeks of life and rarely after 12 weeks. Materials and methods: We conducted a retrospective study from January 2018 to December 2021 using patient records in the pediatric surgery department of the Fousseyni Daou hospital in Kayes. Results: During the study period we had performed 3260 consultations and we had performed 975 surgical interventions in patients hospitalized in the pediatric surgery department. 8 cases of hypertrophy of the pylorus were operated on, i.e. 0.82% of the operations, including 6 boys and 2 girls. The weight of the patients was between 2kg800 and 3kg500. The age of our patients varied between 05 days and 37 days of life 3 patients had been referred to us by the malnutrition unit of our pediatrics department. The hemoglobin level and the rhesus group had been carried out in all the patients and a moderate anemia had been detected in 3 patients. The ionogram had been performed in only 3 of the patients. Ultrasound confirmed the diagnosis of pyloric hypertrophy in all patients. A pyloromyotomy was performed in all patients with uncomplicated consequences. Conclusion: Pyloric hypertrophy is a rare pathology in our region (Kayes), the diagnosis is ultrasound and the treatment remains surgical.

Gastrochisis is a herniation of the abdominal viscera through a full-thickness hole in the abdominal wall, usually located to the right of the umbilical cord insertion. It is estimated at 1/4000 to 1/10000 births, but there are significant geographical variations, with a high mortality rate in developing countries [1, 3, 4]. We report a case operated on at the Fousseyni Daou hospital in Kayes in 2019. This female child was born at home in septic conditions and was referred to us for care. The aim of this study was to determine the difficulties related to the management of laparochisis, especially with atresia, but also to describe the therapeutic and evolutionary aspects.

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Introduction: Calcaneus fractures are frequent and serious injuries. They represent 65% of tarsal trauma and 2% of all fractures. The thalamic fractures constitute a particular entity by their mechanism of occurrence, by their treatment and by their prognosis much less favorable than the extra-articular fractures.1 Materials and methods: Our series spanning a period of 7 years from January 2011 to November 2018 focused on 12 patients with a thalamic fracture of the calcaneus treated by anatomical plate with bearing, collected in the Orthopedic Trauma Department A of the Hassan II Fez University Hospital. All adult patients with a thalamic calcaneal fracture who had undergone an osteosynthesis using an anatomical plate were included and extra-thalamic fractures and thalamic fractures treated by other therapeutic means or other types of screw plates were excluded. All patients underwent an urgent general systematic examination and a regional examination. On the neurological level, the majority of patients were admitted with a GCS at 15. Results: Our focused on 12 operated patients between the ages of 17 and 53 with an average of 35 years. Our series includes 12 patients including 17 calacneum fractures which are divided into 10 men and 2 women; the male sex represents 83.3%. The preoperative delay was on average 9.25 days with extremes between 03 and 20 days. No thromboembolic complications or algodystrophy were noted in our series. According to Kitaoka's rating, the average score was 73.5%. The functional results were excellent in 47.06% of the cases, good in 23.53% of the cases, average in 23.53% of the cases and poor in 5.88% of the cases. In post-operative the average Bohler angle was 26.5° (15° to 35°) against a pre-operative Bohler angle varying between -7° to 15°. On revision, the average recoil from Bohler's angle finds it to be 21.5°. Conclusion: In the light of all those preceding the surgical treatment of articular fractures of the calcaneus displaced by anatomical plate, despite the risks associated with this technique provides a certain superiority if you are sure you can get a perfect reduction.

Introduction: Breast cancer is the first cancer in woman worldwide. Its prognosis depends on early diagnosis and treatment. CT-scan has an important place in the diagnostic screening and the surveillance of this disease. The goal of this study was to assess the place of CT-scan in extension screening of breast cancer in the Department of Medical Imaging of the Teaching Hospital Mother-Child “Le Luxembourg”. Methods: It is a descriptive study on the retrospective compilation of CT-scan data of patients in the Department of Medical Imaging of the Teaching Hospital Mother-Child “Le Luxembourg” from May 1st to November 30th 2017. Were enrolled all patients, regardless of gender or age, with breast cancer histologically confirmed and who developed at least one secondary lesion found by CT-scan. CT-scan was performed before and after treatment. CT-scan machines were HITACHI® SUPRIA 16 bars and TOSHIBA® 04 bars, without and with Iodine 350mg intravenous injection. Results: Over seven months, 44 patients were enrolled with a mean age of 49 years and females were predominant. A family history of breast cancer was found in 13% of cases and invasive ductal carcinoma represented 95.54%. The main metastases were multi visceral (31.82%), pleural pulmonary (70.75%), ganglionic (63.63%), hepatic (27.27%) and bone (18.18%). Conclusion: Breast cancer is a public health concern with a clear predominance of women. In our context, CT-scan still has an important place in the research of secondary lesion in addition to the surveillance of this disease. Keywords: CT-scan Breast cancer; Metastasis; UHC Luxembourg

Introduction:Breast cancer is the first cancer in woman worldwide. Its prognosis depends on early diagnosis and treatment. CT-scan has an important place in the diagnostic screening and the surveillance of this disease. The goal of this study was to assess the place of CT-scan in extension screening of breast cancer in the Department of Medical Imaging of the Teaching Hospital Mother-Child “Le Luxembourg”. Methods:It is a descriptive study on the retrospective compilation of CT-scan data of patients in the Department of Medical Imaging of the Teaching Hospital Mother-Child “Le Luxembourg” from May 1st to November 30th 2017. Were enrolled all patients, regardless of gender or age, with breast cancer histologically confirmed and who developed at least one secondary lesion found by CT-scan. CT-scan was performed before and after treatment. CT-scan machines were HITACHI® SUPRIA 16 bars and TOSHIBA® 04 bars, without and with Iodine 350mg intravenous injection. Results:Over seven months, 44 patients were enrolled with a mean age of 49 years and females were predominant. A family history of breast cancer was found in 13% of cases and invasive ductal carcinoma represented 95.54%. The main metastases were multi visceral (31.82%), pleural pulmonary (70.75%), ganglionic (63.63%), hepatic (27.27%) and bone (18.18%). Conclusion:Breast cancer is a public health concern with a clear predominance of women. In our context, CT-scan still has an important place in the research of secondary lesion in addition to the surveillance of this disease. Keywords:CT-scan Breast cancer; Metastasis; UHC Luxembourg

Introduction-Objectif: Le diabète et l’hypertension artérielle (HTA) sont des facteurs de risque cardiovasculaire (FRCV) majeurs responsables de morbi-mortalité importante. L’objectif de cette étude était d’identifier les FRCV chez le patient ayant le diabète de type 2 (DT2) nouvellement diagnostiqués avec une HTA.Patients et méthode: Etude transversale, descriptive de 6 mois, concernant tous les patients DT2 nouvellement diagnostiqués et hypertendus. Les paramètres étudiés étaient sociodémographique et clinique.Résultats: 64 patients ont été colligés. Sex ratio était de 0,72. Age moyen était de 58,23 +/-11,81 ans. 30% des patients avaient 3 autres FRCV en plus du DT2 et de l’HTA. Les autres facteurs de risque cardiovasculaire étaient la dyslipidémie (57,8%), la sédentarité (57,7%), le surpoids/obésité (56,3%) et le tabagisme (9,3%). Les Complications macroangiopathiques étaient présentes chez 16 patients (28,2%) dont 10 avaient comme FRCV associé la sédentarité, 5 avaient le surpoids et l’obésité et 1 avait le tabagisme.Conclusion: L’augmentation des facteurs de risque cardiovasculaire en rapport avec la modification des habitudes de vie dans les villes africaines est l’une des causes majeures de la croissance de maladies cardiovasculaires. Leurs identifications avec leur prise en charge permettront d’améliorer le pronostic des patients.Mots clés: Facteurs de risque cardiovasculaire, Hôpital du MaliEnglish Title: Cardiovascular risk factors in newly diagnosed diabetics with high blood pressure in Mali‘s Hospital of BamakoEnglish AbstractIntroduction-aim: diabetes and high blood pressure are major cardiovascular risk factors responsible for significant morbidity and mortality. The aim of this study was to identify cardiovascular risk factors in patients with newly diagnosed type 2 diabetes with high blood pressure.Patients and method: 6 months, descriptive, cross-sectional study of all patients newly diagnosed type 2 diabetes with high blood pressure. The studied parameters were sociodemographic and clinical.Results: 64 patients were collected. Sex ratio was 0.72. Average age was 58.23+/-11.81 years. 30% of patients had 3 other risk factors in addition to diabetes and high blood pressure. Other cardiovascular risk factors were dyslipidemia (57.8%), sedentarity lifestyle (57.7%), overweight/obesity (56.3%) and smoking (9.3%). Macroangiopathic complications were present in 16 patients (28.2%), 10 of whom had sedentarity lifestyle, 5 had overweight/obesity and 1 had smoking.Conclusion: Increase of cardiovascular risk factors related to lifestyle changes in african cities is one of the major causes of cardiovascular disease growth. Their identifications with their care will improve the prognosis of patients.Keywords: cardiovascular risk factors, Mali’s Hospital

Le cancer figure parmi les principales causes de morbidité et de mortalité en Afrique et au Mali.But : étudier le profil épidémiologique et clinique du cancer au centre de radiothérapiede Bamako.Matériels et méthodes : Il s’agissait d’une étude descriptive, rétrospective, de dossiers de patients vus en consultation, pour cancer au Centre de Radiothérapie de Bamako d’avril 2014 à décembre 2016. Les paramètres étudiés étaient : l’âge, le sexe, la provenance du malade, la localisation du cancer, le type histologique, le stade de classification du cancer.Résultats : Nous avons colligé 890 dossiers de patients d’âge moyen de 50±15ans. Le sex-ratio H/F était 0.2. Les cancers gynécologiques et mammaires représentaient 66% de toutes les localisations. Chez l’homme les cancers de la sphère oto-rhino-laryngée et digestif étaient les plus fréquents. Chez la femme, il s’agissait plus des cancers du col de l’utérus et du sein. Le carcinome était retrouvé dans 67% à l’histologie. Soixantequinze pour cent des cancers du col utérin étaient de stade III et 54% des cancers du sein étaient de stade II selon la classification TNM.Conclusion : Le cancer touche le plus les femmes au Mali. Il s’agit le plus souvent de cancers gynécologiques et mammaires. Le diagnostic est fait tardivement, ce qui impose le développement de nouvelles approches pour un diagnostic et une prise en charge précoces.Mots clés : cancer, épidémiologie, clinique, radiothérapie. Epidemiological and clinical features of cancers in the radiotherapy center of BamakoCancer is one of the leading causes of morbidity and mortality in Africa and Mali.Purpose: to study the epidemiological and clinical profile of cancer at the radiotherapy center of Bamako.Materials and methods: through a descriptive and retrospective study, we review patientdata collecting during consultation at the Radiotherapy Center of Hôpital du Mali. The data were collected from April 2014 to December 2016. Results: the mean age of our 890 patients was of 50 ± 15 years and the sex ratio M / F was 0.2. Gynecological and breast cancers accounted for 66% of all locations. The most frequent cancer for man was, the oto-rhino-laryngeal and digestive sphere. In women, it was more cancers of the cervix and breast. Carcinoma was found in 67% histology. Seventy-five percent of cervical cancers were stage III and 54% of breast cancers were stage II according to the TNM classification.Conclusion: Cancer affects mostly women in Mali. And gynecological and breast cancers are the major frequent. The statement is caracterised by a late of diagnosis. So it is important to develop an early diagnosis and management’s approach.Keywords: cancer, epidemiology, clinic, radiotherapy.

Les aliments consommés par les enfants et personnes âgées comprennent les farines composées et des mets précuits tels que l’aliment instantané riz-arachide-lait (RIAL), le Djouka et le couscous à base de riz aux feuilles d’épinard et d’amarante. Lors de leur conservation, ces aliments riches en lipides peuvent être sujets à l’altération de leur qualité nutritionnelle et organoleptique par l’oxydation des lipides, provoquant ainsi le rancissement. L’objectif de la recherche était de déterminer la durée de conservation des farines et des mets précuits et d’assurer leur accessibilité en toute saison. La rancidité des farines et des aliments précuits a été évaluée par la détermination de la teneur en eau et de l’acidité grasse, avant leur mise en conservation et une fois par mois, par échantillonnage pendant 7 mois, pour les farines composées et 12 mois pour les mets précuits. Toutes les farines composées et les mets précuits à base de riz ont été stables au cours de leur conservation. Des différences significatives ont été observées entre l’acidité des aliments à partir du 5è mois de conservation. L’acidité d’aucun met conservé n’a atteint le seuil de rancidité des aliments riches en matières grasses (1g d’acide sulfurique/100g) et celui des farines non conservées (0,4 g d’acide sulfurique).Mots clés : Riz, teneur en eau, acidité, conservation, rancidité

L’aliment de complément de la majorité des enfants maliens est la bouillie des céréales dont la viscosité est très élevée pour les enfants âgés de 6 à 9 mois. Leur densité énergétique inférieure à celle du lait maternelle (70 Kcal/100 ml) variait entre 35 à 45 kcal/100 ml (Bauer et al., 1997). Pour faciliter leur déglutition et améliorer la densité énergétique, la nécessité de les liquéfier par l’utilisation de source d’amylase s’impose (Trèche 1995, Réseau TPA, 1998). Les farines de complément ont été développées à partir du riz NERICA 4 auquel l’arachide, le niébé, le soja, le pain de singe ont été incorporés suivant la formule souhaitée. La farine de riz a été obtenue après mouture du riz NERICA 4 blanchi. Les graines de soja et celles d’arachide ont été torréfiées séparément, dé pelliculées puis réduites en farine. Le niébé a été décortiqué, lavé, séché puis réduit en farine. Le maltage a consisté respectivement à tremper le riz pendant 12 heures et le mil pendant 07 heures dans l’eau tiède. Les grains ont été égouttés séparément et mis en germination dans un panier couvert pendant 3 jours au cours desquels, ils ont été arrosés matin et soir. La germination des grains est interrompue par le séchage. Les grains germés de riz et de mil ont été réduits séparément en farine (malt). Dans chaque formule, 95 % de la farine composée ont été ajoutés à 5 % de malt de mil ou de riz. La viscosité et la densité énergétique des bouillies infantiles ont été déterminées. La viscosité de la bouillie contenant le malt de riz a été plus fluide (13 cm) que celle contenant le malt de mil (11 cm). Les densités énergétiques des bouillies ont varié de 52,19 Kcal à 117 Kcal/100 ml de bouillie. Les bouillies contenant le soja et le malt de riz ou de mil ont présentés des densités énergétiques similaires mais supérieures à celles des autres bouillies. L’objectif de la recherche est de réduire la viscosité des bouillies de complément et d’améliorer leur densité énergétique en vue de lutter contre la malnutrition infantile.Mots clé : Riz, bouillies de complément, malt, viscosité, densité énergétique

In the refrigerated slaughterhouse in Bamako, Mali, bovine tuberculosis remains the most common cause of seizures (bovine tuberculosis in 2010 represents 2.50% of total seizures). This work is a pilot study looking kind conducted from March to October 2011 and to determine the frequency of M. bovis strains isolated from cattle carcasses in refrigerated slaughterhouse Bamako goal. The microbiological examination of 55 samples from cattle carcasses with tuberculosis lesions confirmed the diagnosis of bovine tuberculosis. Isolation and characterization of isolates has highlighted 16 Mycobacterium bovis. The study also helped to establish the 16 samples positive culture of Mycobacterium bovis distribution of M. bovis based on race, sex, age of cattle and make recommendations to better control bovine tuberculosis in Mali.Keywords: Mycobacterium bovis-Cattle-Slaughter-characterization-Mali

This study was conducted in 2003-2007 and involved 22 modern semi-industrial poultry farms (layers) located in the suburban areas of Bamako District and of Sikasso and Segou towns. It was found out that in 1163 layers, the global post- vaccination immunity level was 93.9 % for Newcastle Disease with 89, 6 %, 92.3% and 96.3 % in Segou, Sikasso and Bamako respectively. However, for Gumboro Disease, an overall immunization coverage of 50.5 % was obtained in layers with variations depending on the sites (40.7% in Sikasso, 64.0% in Segou and 49 9% in Bamako). Examination of 89 fecal samples collected in poultry farms in Bamako District peri-urban area showed internal parasites in 23 cases ( 25.8%), and species identified were Ascaridia gallii (EPG values ranging from 50 to 100) and Eimeria spp. (EPG value equal to 50). In addition, analysis of 28 fecal samples collected from farms in Segou identified 5 cases of infection (17.8%) with very high parasite loads for Heterakis with an EPG value of 1600 eggs/g of faeces and Ascaris (1300 eggs/g of feces). Out of 34 fecal samples collected in layer farms in Sikasso, 3 (8.8 %) contained coccidia (50 eggs/g of faeces). The study showed that in semi-industrial poultry farms, layers are inadequately immunized against Gumboro disease and markedly better immunised against Newcastle Disease. It also shows that deworming patterns in most farms are inadequate.Keywords: Poultry farming; Prophylaxis schemes; Diseases; Mali

This study was conducted in 2003-2007 with the aim of identifying prevalent diseases in modern poultry farming in Mali. It covered 22 modern layer farms located in the suburban areas of Bamako District and of Sikasso and Segou towns. Analyses focused on a total of 536 samples, 260 sera, 254 eggs, 149 organ samples, 129 fecal samples and 4 cloacal swabs. Methods used in the study to confirm infectious diseases included histopathology, isolation in culture and biochemical or serological identification. To assess parasite loads, the Modified Mac Master Method was used. To establish a final diagnosis, epidemiological data, results of clinical, lesion and laboratory examinations were taken into account. The main diseases identified were of a viral nature: Gumboro Disease (15 cases), Newcastle Disease (16 cases), Marek Disease (6 cases), Mycoplasma (163 Mycoplasma synoviae positive sera and 49 Mycoplasma gallisepticum positive sera out of 260 screened), bacterial: Pasteurella gallinarum avian cholera (15 confirmed cases), pullorum / gallinarum Salmonella (positive results for 17 organs out of 83 screened ), colibacillosis (positive results for 26 organs of 66 screened), egg infection by Salmonella pullorum / gallinarum (20 positive cases out of 254 screened) and Escherichia coli (14 positive cases out of 254 screened ) and parasitic: infestation by Eimeria (36 cases), Ascaridia gallii (15 cases), Raillietina spp. (5 cases), Heterakis spp. (5 cases) and Argas persicus, including poultry farms in Segou ).Keywords: Diseases; modern poultry farming; Bamako; Sikasso; Ségou