We report a case of agenesis of the right inferior lobar branch of the pulmonary artery in the Medical Imaging Department of the Mali Hospital. The patient was a 61-year-old woman residing in Bamako and admitted to the Medical Imaging Department of the Mali Hospital. On admission, she had a history of pulmonary tuberculosis, which had been treated and cured since the age of 25, and had controlled hypertension. Clinical examination revealed a deterioration in general condition, chest pain, respiratory distress, a productive cough, decreased vocal vibrations on palpation, submatousness on percussion, and crackles in both lung fields on auscultation. A standing frontal chest X-ray revealed narrowing of the right intercostal spaces with slight collapse of the ipsilateral lower lobe, elevation of the ipsilateral diaphragmatic hemidome, and a verticalized right lower lobe vascular network. Echocardiography revealed mild dilation of the cardiac chambers. An ECG revealed left ventricular hypertrophy. Based on the echocardiography and ECG findings, a pulmonary CT angiogram was requested, which revealed agenesis of the right lower lobe branch of the pulmonary artery, left hypertrophic cardiomyopathy, hypoplasia of the right lower pulmonary vein, bilateral bronchopulmonary disease, mild hypoplasia of the right lower lobe, and mild dilation of the left arterial branch. Agenesis of the right lower lobe branch of the pulmonary artery is a rare congenital malformation. Pulmonary CT angiography plays a key role in diagnosis and ensures appropriate management.
Objective:To evaluate the short-term efficacy and safety of ultrasound-guided phenol PENG Block for the management of chronic pain of degenerative joint origin at Bouaké University Hospital. Methods:Prospective study conducted over six months (July-December 2024), including patients (>16 years old) suffering from painful degenerative joint diseases (EN > 6/10). Epidemiological, clinical and therapeutic variables were analysed. A statistical analysis using Student's t-test (p < 0.05) assessed pain reduction after phenol PENG Block. Results:Twenty-six patients were included (mean age: 43 years). The majority were women (73.1%), who were overweight (38.5%) or obese (23%). Coxarthrosis was the most common indication (42.4%). Phenol PENG block resulted in a significant reduction in pain, with a decrease in the average EN from 8 to 2 (p = 0.00). No complications were reported. Conclusion:Ultrasound optimises the accuracy and safety of PENG block, making its use essential. The development of cooperation strategies promotes better management of this technique.
Aim:Contributing to the improvement of chest trauma care. Objective:Identifying post-traumatic chest CT lesions. Materials and methods:Retrospective study conducted at the Bouaké Medical Imaging Centre from January 2019 to December 2021, i.e. over a period of three years. It involved 103 patients with chest trauma in Bouaké who underwent CT scans. Epidemiological and clinical parameters and CT scan findings were analysed. Results:The average age of patients was 33 years, with extremes of 2 and 89 years. Males predominated in 78% of cases, with a sex ratio of 3.57. In 76.3% of cases, the patients were victims of road traffic accidents (RTAs). Chest injuries were closed in the majority of cases (94%). Parietal lesions were observed in 87.4% of cases. Rib fractures accounted for 87.4%. These fractures were multiple in 70% of cases. Haemothorax, pulmonary contusion and pneumomediastinum accounted for 25.2%, 28% and 7.7% of chest injuries, respectively. Conclusion:Computed tomography is the appropriate examination for the management of chest trauma, especially in the context of multiple trauma. Rigorous technique and interpretation would ensure a comprehensive study, preventing potential injuries from being overlooked.
Rasmussen encephalitis is a chronic and progressive inflammatory encephalopathy, responsible for unilateral hemispheric damage causing focal epileptic seizures, hemiparesis and cognitive decline. It is an immune-mediated disease, with constant involvement of T lymphocytes. It generally progresses in three phases: a prodromal phase, an acute phase and a residual phase. The diagnostic criteria have been well established since the European consensus of 2005. Early injections of intravenous immunoglobulin and Natalizumab allowed a reduction in the frequency of seizures and cerebral inflammation. We report a case of Rasmussen encephalitis with a review of literature to shed light on this condition suffering from diagnostic delay or even diagnostic error.
Hernia through the Winslow's foramen is rare, with a nonspecific clinical presentation, and its diagnosis can be challenging. It is a form of obstruction due to internal hernia. Internal hernias are a common cause of obstruction, which can present clinically in an acute or progressive manner. This diagnosis should be prioritized in a patient without a history of surgical or inflammatory abdominal conditions. We report two cases of distal ileal hernia through the Winslow's hiatus This uncommon form of internal hernia is difficult to diagnose We highlight the clinical signs and the radiological assessment (abdominal X-ray without contrast) for diagnosing intestinal obstruction, but the computed tomography and the laparoscopy anticipate the location and condition of the loop and provide an overview of treatment.
Introduction:renal damage, often due to impaired glomerular function, is a progressive complication associated with high mortality in sickle cell disease. Few studies report on this complication in the context of organized care in sub-Saharan Africa. Objective:to describe renal damage in sickle-cell patients attending in sickle-cell referral center in sub-Saharan Africa. Patients and Methods:a descriptive and analytical study with retrospective data collection was carried out from March 2010 to March 2017, at the «Centre de Recherche et de Lutte contre la Drépanocytose» of Bamako, Mali. Results:125 sickle cell disease patients, including 70 SS, 43 SC, 10 Sβ+thalassemics and 2 Sβ°thalassemics, distributed between 67 women and 58 men with a mean age of 33.03 ± 15.53 years, were identified. Renal damage was documented by sickle cell nephropathy (84.8%), CKD (10.4%) and hematuria (4.8%); it was significantly associated with a history of hypertension, diabetes or non-steroidal antiinflammatory drugs use (p < 0.05), but was not observed in patients with fœtal hemoglobin > 20%. Five patients (4%) were on chronic kidney dialysis. Conclusion:the precocity and high frequency of renal damage in sickle-cell patients in sub-Saharan Africa call for studies to identify the risk factors for this complication in a cohort of sickle-cell patients followed up from birth.
Introduction:Prostate cancer is a real public health problem. Studies have shown that 95% of deaths secondary to this cancer are due to metastases. The earlier metastases are diagnosed, the better the chances of survival. Objective:Analyze the results and show the contribution of bone scintigraphy in the management of prostate cancer in Niger. Methods:This was a retrospective descriptive and analytical study over a period of 8 years from February 09, 2014 to March 13, 2022 at the Department of Nuclear Medicine of the Institute of Radioisotopes of Niamey of patients who had undergone a bone scan as part of the management of prostate cancer. Results:The frequency of requesting bone scintigraphy concerning the prostate was 7%. The average age of our patients was 67.6 years with extremes ranging from 50 to 90 years. The most represented age group was 60 to 70 years. During the period of our study, bone scintigraphy was indicated in 93% of our patients as part of an initial assessment of prostate cancer. Urologists and oncologists were the main prescribers of this examination in 43.8% and 35.4% respectively. In our study, abnormal PSA > 20 ng/ml was predominant in 69.2%. Bone scintigraphy was abnormal in 72% (n=69) of cases. Bone lesions predominated on the axial + appendicular skeleton in 75.3% (n=52) with the most spinal injuries in 54%. Conclusion:Bone scintigraphy plays a diagnostic, therapeutic and prognostic role in prostatic cancer.
Introduction:Hereditary breast cancer accounts for approximately 5 to 10% of all breast cancer cases. Mutations in the BRCA1 gene, which plays a central role in DNA repair and cell cycle regulation, are the main cause of these familial forms and are strongly associated with aggressive subtypes, particularly triple-negative breast cancer. Methods:A narrative literature review was conducted using biomedical databases (PubMed, Scopus, Web of Science, Google Scholar) between January 2024 and June 2025. Eligible publications addressed the genetic, biological, epidemiological, and clinical aspects of BRCA1 in hereditary breast cancer. Results:BRCA1 ensures genomic stability through its roles in DNA repair, cell cycle checkpoints, and transcriptional regulation. Most mutations are truncating or missense variants, with some reported as founder mutations (e.g., c.68_69delAG, c.5266dupC, 943ins10). Women carrying germline BRCA1 mutations have an estimated lifetime risk of 56-87% of developing breast cancer, with a strong association with aggressive molecular subtypes, especially triple-negative breast cancer. Conclusion:A comprehensive understanding of BRCA1 mutations is crucial to enhance prevention, screening, and personalized management of hereditary breast cancer. In low-resource settings, the integration of genetic testing and counseling remains a major challenge and a public health priority to reduce disparities in cancer care.
We report a case of generalized acute peritonitis following an unsafe abortion complicated by uterine perforation. The patient was a 32-year-old woman admitted for abdominopelvic pain evolving in a febrile context, with an 8-week history of amenorrhea. On admission, clinical examination revealed a picture of generalized acute peritonitis. Abdominopelvic ultrasound and plain abdominal X-ray revealed an intra-abdominal foreign body (a full pencil). Surgical exploration confirmed generalized acute peritonitis secondary to uterine perforation, with approximately 200 ml of purulent fluid and a complete pencil found in the peritoneal cavity. Combined medical and surgical management led to a favorable outcome.
Introduction:Darier-FERRAND dermatofibrosarcoma is a slow-growing fibrous skin tumor with a very high risk of local recurrence but low metastatic potential. Objective:To determine the epidemiological, clinical, and therapeutic characteristics and analyze the treatment outcomes. Methodology:This was a retrospective, cross-sectional study from January 2018 to December 2023, including patients operated on for histologically confirmed Darier-FERRAND dermatofibrosarcoma (DFS). Results:Eight patients with DFS were included. The mean age was 49 years. The sex ratio was 7M/1F. Four were experiencing their first episode, three had undergone surgery once for the same tumor, and one patient was experiencing a second recurrence. The masses were located on the thigh in five cases, two on the trunk, and one on the left arm. The mean tumor size was 12.8 cm. The mean tumor duration was 18.1 months. The treatment decision was based on the presumptive diagnosis. Management was surgical in all patients. The surgical procedure performed in all patients was tumor excision in a healthy area with a 4 cm resection margin. Conclusion:Dermatofibrosarcoma of Darier-Ferrand type is a rare skin tumor. Its progression is very slow, with a very high risk of local recurrence if surgical excision is incomplete, hence the importance of wide surgical excision.
Objective:To study the epidemiological, clinical and evolutionary aspects of chronic kidney disease (CKD) stages 3-5 in women of childbearing age at Saint Jean de Dieu Hospital in Tanguiéta from 2018-2021. Methods:This was a longitudinal study, with data collection from 1 January 2018 to 31 August 2021. All women of childbearing age with a diagnosis of stage 3-5 CKD and who had given their consent were included. The dependent variable was CKD progression. Progression was considered unfavourable after 3 months of follow-up in patients with a GFR <15ml/mn/1.73m2. The significance threshold was p<0.05. Results:Of 7865 women of childbearing age admitted to the hospital, 70 had CKD stages 3-5, representing a hospital frequency of 0.9%. The mean age of the patients was 45±11 years. During the 3 months of follow-up, 26 deaths (37.1%) were recorded. Of the remaining 44 patients, 37 (84.1%) had persistent stage 5 CKD. Self-medication (p=.0232), use of oestroprogestins (p=0.0289) and hypokalaemia (p=0.0043) were significantly associated with an unfavourable outcome. Conclusion:The majority of CKD stages 3-5 in women of childbearing age were unfavourable. Rigorous and early management is needed to improve renal health as much as possible.
Objective:To determine the prevalence, satisfaction of people and factors associated with alternative medicine in eastern Cameroon. Patients and methods:It was a cross-sectional analytical and prospective study in Bertoua and Abong-Mbang in Cameroon. The Chi2 test was used to determine the factors associated with the use of alternative medicine. Results:A total of 448 participants were recruited, including 243 (54.2%) in urban area. The M/F sex ratio was 1.53. The most represented age group was 20 to 35 years old 282 (62.9%). The average age was 34.65±12.63 years. In the study, 197 (44.0%) participants in rural areas and 235 (56.6%) in urban areas had heard of alternative medicine. The participants had heard more about alternative medicine through relatives 110 (53.6%) and 125 (51.4%) in rural and urban areas respectively. The prevalence of use of alternative medicine was 92.6% (415). The study found that 430 (96%) participants were satisfied with alternative medicine. Affordability was associated with alternative medicine (p=0,043). Conclusion:Alternative medicine is frequently used in Cameroon.
Introduction:Gestational trophoblastic tumors (GTT) are heterogeneous tumors characterized by trophoblast involvement with an abnormal increase in human chorionic gonadotropin (HCG). The aim of this study was to describe in our context, the clinical, diagnostic, therapeutic characteristics and poor prognostic factors influencing the survival of these tumors. Patients and methods:This was a descriptive study of 90 patients followed for GTT at the Point G University Hospital between August 2007 and May 2020. Clinical, paraclinical and therapeutic data were collected retrospectively from the medical records of these patients and analyzed by SPSS version 21 software. Results:The mean age of the patients was 31 years ± 10.08 (15-54 years) with a peak frequency between 20-40 years. The clinical picture was frequently dominated by the following symptoms: metrorrhagia (97.8%), anemia (86.7%) and poor Performans Status (PPS) (42.2%). The mean βHCG level was 589,394.15 U/l and choriocarcinoma was the most common histological type -64.9%-. The disease was metastatic in 46.7% with a FIGO 2000 (Fédération Internationale de Gynécologie-Obstétrique) prognostic score of high risk in 57.8%. Regardless of this score, 92.7% underwent polychemotherapy. Only 41.1% of patients were alive at the end of the study. Poor prognostic factors associated with decreased overall survival were WHO PS 2-4, grade 2-4 anemia, high-risk prognostic score, and resistance to chemotherapy, all of which indicate delayed management. Conclusion:Despite their chemosensitivity, GTT may have a poor prognosis if their diagnosis is late and their management is not adapted.
The overall incidence of hypertrophic pyloric stenosis is between 2 and 3 per 1000 live births. Classically, newborns only develop this pathology between 3 weeks and 3 months of life, with a predominance of males at a ratio of 5:1. The diagnosis is clinically evoked by a characteristic pattern of vomiting and progressive malnutrition. Medical imaging, particularly abdominal ultrasound, is used to make the diagnosis, and treatment is surgical.
Vector control is a major public health challenge in reducing the transmission of vector-borne diseases. Bacillus thuringiensis israelensis (Bti), an entomopathogenic bacterium, is primarily known for its larvicidal activity against mosquitoes. However, recent research has explored its use as an oral toxin targeting adult mosquitoes through toxic sugar baits. This review highlights the properties, action mechanism, and efficacy of Bti in this formulation. Its appeal lies in its mosquito specificity, low environmental impact, and potential to overcome insecticide resistance. However, challenges remain regarding the optimization of formulations and the assessment of its long-term efficacy in natural conditions. Should the efficacy of the formulations in open environments be confirmed, this innovative approach could serve as a valuable complement to existing strategies and enhance efforts to control vector-borne diseases.
Aim:The objective of this work was to analyze the epidemiological and medico-legal aspects of pre-hospital deaths (before admission) received at the Treichville University Hospital in order to have current data. Materials and methods:We carried out a retrospective study with a descriptive aim between July 2022 and February 2023, focusing on "deaths before admission" to the emergency room of the Treichville University Hospital. Results:The victims were couples (48.9%), male (61.7%) with an average age of 50.1 years +/- 19.26 and working in the informal sector (52.8%). The patients came from home (83.8%) by taxi (76%) or personal vehicle (12%). The duration of the evacuation was 2 to 3 hours (86.8%). Deaths were recorded on arrival at the hospital between 6 p.m. and 11:59 p.m. (28.5%). These were natural deaths (89.8%) occurring due to complications of a known disease (70.2%) or sudden death (19.6%). Conclusion:Death before admission to hospital remains a major concern for practitioners and constitutes a real public health problem. Prevention involves raising public awareness, bringing health centers closer together and strengthening pre-hospital emergency management structures.
Objective:To evaluate self-esteem in voluntary depigmented patients. Patients and method:We conducted a descriptive cross-sectional study at the Dermatology and Venereology Department of the Treichville University Hospital Centre (CHU) in Abidjan (Côte d'Ivoire) from July 2017 to January 2018 and it included 150 black African patients. The non-probability purposive sampling method was used. To assess self-esteem, we applied the Rosenberg scale. Results:(98%) of those surveyed were female and aged between 15 and 35 (76.70%). One depigmented person in two was single (53.30%). More than half(58.70%) said they had a tanned complexion before using lightening products and were satisfied with their physical appearance in 76% of cases. The main reasons for using depigmenting products were to improve physical appearance(80%) and to repair a physical defect(28%). The results of the Rosenberg global self-esteem scale showed that more than three quarters of the respondents (79.30%) had average to very high self-esteem. Conclusion:Voluntary skin depigmentation in black sub-Saharan Africans does not necessarily reflect a problem with self-esteem, but could be part of a fashionable aesthetic project.
Introduction:Since the confirmation of the first case of SARS-CoV-2 in China in December 2019, all countries in the world have been affected by this pandemic. After one (1) year of the pandemic in Mali, two outbreaks were observed. The objective of this study was to characterize the demographic and clinical variability of cases between the two episodes. Materials and Methods:This was a secondary analysis of data from patients with COVID-19 in Mali during the first and the second outbreaks. The anonymous list of all COVID-19 cases confirmed by RT-PCR was used. Pearson's and Student's Chi-square tests were performed with a significance level of 5%. Results:During the study period, 2567 and 4610 people were confirmed positive for SARS-CoV-2 respectively for the first and second epidemics with a similar average age (40.4 years ±17.6 for the first against 39.9 years ± 17.2 for the second). The male sex had a higher proportion in the two outbreaks but different between the waves (69% for the first outbreak and 60% for the second, p < 0.001). The proportion of symptomatic patients was significantly different between the two waves (6.2% for the first wave versus 13.1% for the second wave, p < 0.001). The proportions of cases by age group were significantly similar between the two waves (0-20 years: 10.1% vs 11.3%; 21-40 years: 46.3% vs 45.7%; 41-60 years: 28.2% vs 29.4%; Over 60: 15.4% vs 13.5%; p = 0.063). Death rate was higher in the first episode compared to the second (5.8% versus 4.3%; p = 0.003). Conclusion:SARS-CoV-2 infection in Mali had a significant variation in symptomatology between the two waves, more highlighted in the second. The proportions of age groups of patients with COVID-19 did not vary between the two outbreaks. Death rate was higher in the first wave.
Aims:To evaluate transfusion practice in the hematology department of Yopougon Teaching Hospital in Abidjan, Côte d'Ivoire. Methods:This was a retrospective descriptive study conducted in the hematology department of the Yopougon University Hospital from January 1, 2017, to December 31, 2017, focusing on the records of patients transfused. Our inclusion criteria were a complete medical record and having a pre-transfusion hemogram. The variables studied were age, sex, reason for hospitalization, diagnosis, blood count data and blood group. Results:A total of 107 patients were included. The sex ratio was 1.01, with a mean age of 25 years [3; 70]. Osteoarticular pain was the main reason for hospitalization (50.4%). Homozygous sickle cell disease accounted for most diagnoses (56.67%). The mean pre-transfusion hemoglobin level was 6.5g/dl, and blood group O+ was the most prescribed (50.5%). The ultimate compatibility test was carried out in all our patients (100%), and no accidents were detected. Conclusion:Blood transfusion is a routine procedure in the clinical hematology department of Yopougon University Hospital. Most patients with sickle cell disease receive blood transfusions.
Context and objective:Perinatal mortality is a worrying reality in maternity wards and exposes mothers to the ordeal of grief. The present study was undertaken to analyze the attitudes of caregivers towards mothers faced with perinatal bereavement. Materials and Methods:This is a mixed study carried out from October 5 to November 16, 2023 at the Anyama maternity hospital and which involved 33 caregivers selected by reasoned choice. These were subjected to a semi-structured interview. Results:The caregivers surveyed were of both sexes with a female predominance (30/33). Their ages ranged from 25 to 50 years with an average age of 36 years. 30 were midwives compared to 3 gynecologists and their seniority in the profession varied from 5 to 15 years. Comfort (05), silence (18), avoidance (05) and escape (05) were their main attitudes adopted towards mothers faced with perinatal bereavement. These attitudes contributed very little to relieving the psychological suffering of these bereaved mothers. Conclusion:These results argue in favor of strengthening the capacities of caregivers in psychological support for mothers faced with perinatal bereavement at the Anyama maternity ward.
