Background Cancer represents a major global public health challenge and is frequently associated with significant psychological distress. In sub-Saharan Africa, and particularly in Mali, the psychological burden of cancer remains insufficiently documented. From a health psychology perspective, understanding the determinants of anxiety and depression is essential to improve patient-centered care. This study aimed to estimate the prevalence of anxiety and depression and to identify associated factors among cancer patients in Bamako, Mali. Methods A multicenter cross-sectional study with prospective data collection was conducted between January 2024 and April 2025 in four hospitals in Bamako, Mali. Adult patients (≥18 years) with histologically confirmed cancer were included. Data were collected through face-to-face interviews and medical record review. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS). Associations were examined using Chi-square or Fisher’s exact tests, and variables with p < 0.20 were included in multivariable logistic regression models. Results A total of 330 patients were included. The prevalence of anxiety was 72.1%, and 67.6% of participants presented symptoms of depression. In multivariable analysis, illness perception emerged as the strongest factor associated with both anxiety and depression. Patients perceiving their illness as a low threat had significantly lower odds of anxiety (aOR = 0.09; 95% CI: 0.04–0.18) and depression (aOR = 0.05; 95% CI: 0.02–0.11) compared with those perceiving it as a high threat. For anxiety, being no longer in a union was associated with higher odds (aOR = 2.83; 95% CI: 1.35–6.27), while male sex was associated with lower odds (aOR = 0.52; 95% CI: 0.27–0.99). For depression, unemployment (aOR = 2.65; 95% CI: 1.20–5.92) and receiving palliative care (aOR = 3.15; 95% CI: 1.65–6.21) were associated with higher odds. Conclusion Anxiety and depression are highly prevalent among cancer patients in Bamako and are strongly influenced by psychosocial and cognitive factors, particularly illness perception. These findings highlight the importance of integrating routine mental health screening and targeted psychosocial interventions into oncology care, especially in low-resource settings.

The development of a national plan for surgery, obstetrics, and anaesthesia remains a priority for Mali. Our objective was to assess the availability, accessibility, quality, and financing of surgical, obstetric, and anaesthesia care, to provide the scientific basis for developing a national plan. This was a cross-sectional, prospective study conducted from January to June 2023. All regions of Mali, including the district of Bamako, were included. In each region, at least one health district was randomly selected. We selected 25 centres, representing 38% of public facilities. The survey involved district hospitals, health workers and patients. The data were analysed using R software version 4.5.1. Each hospital of the district covered a health area with a population ranging from 7,913 to 818,436. The time to reach the nearest public facility offering safe surgical care was 2 hours for 50% of the population. The total capacity of the facilities was 1,343 beds, or an average of 34 beds per 100,000 inhabitants. All 25 referral health centres had at least one operating room. The basic trio (general surgeon, obstetrician-gynaecologist, anesthesiologist-resuscitator) was available in 14 centres (56%). The average number of annual surgical procedures was 135 per 100,000 inhabitants. Caesarean section, hernia repair, appendectomy, and laparotomy were performed in all centres. Open bone injuries were treated in six centres. Costs for the same procedures varied from one centre to another, and health insurance coverage rates ranged from 1% to 25%. In Mali, surgery is inaccessible to the majority of the population. Limitations include geographic distance, the availability of well-equipped operating rooms and specialists, and low health insurance coverage rates.

The development of a national plan for surgery, obstetrics, and anaesthesia remains a priority for Mali. Our objective was to assess the availability, accessibility, quality, and financing of surgical, obstetric, and anaesthesia care, to provide the scientific basis for developing a national plan. This was a cross-sectional, prospective study conducted from January to June 2023. All regions of Mali, including the district of Bamako, were included. In each region, at least one health district was randomly selected. We selected 25 centres, representing 38% of public facilities. The survey involved district hospitals health workers and patients. The data were analysed using R software version 4.5.1. Each hospital of the district covered a health area with a population ranging from 7,913 to 818,436. The time to reach the nearest public facility offering safe surgical care was 2 hours for 50% of the population. The total capacity of the facilities was 1,343 beds, or an average of 34 beds per 100,000 inhabitants. All 25 referral health centres had at least one operating room. The basic trio (general surgeon, obstetrician-gynaecologist, anesthesiologist-resuscitator) was available in 14 centres (56%). The average number of annual surgical procedures was 135 per 100,000 inhabitants. Caesarean section, hernia repair, appendectomy, and laparotomy were performed in all centres. Open bone injuries were treated in six centres. Costs for the same procedures varied from one centre to another, and health insurance coverage rates ranged from 1% to 25%. In Mali, surgery is inaccessible to the majority of the population. Limitations include geographic distance, the availability of well-equipped operating rooms and specialists, and low health insurance coverage rates.

Fibroadenomas are the most common benign breast disorders. The aim of this study was to identify the clinical and therapeutic aspects of fibroadenoma in the obstetric gynecology department and General Surgery of Teaching hospital Gabriel TOURE in Bamako Mali. PATIENTS AND METHODS:The study was descriptive with retrospective data collection from July 1, 2018 to July 31, 2021. The records of patients treated for fibroadenoma were included in accordance with ethical principles guaranteeing anonymity and confidentiality of data. RESULTS:A total of 112 patients were selected for the study period, representing 15. 9% of all breast pathologies. We recorded 642 cases of breast mass, with fibroadenoma accounting for 16.72% of these breast tumors. Among all 154 benign breast tumors, fibroadenoma accounted for 72%. The mean age was 27 years, with a standard deviation of 14.8 years (13 years and 62 years). The 20-35 age group was the most represented, at 44%. The frequency of fibroadenoma decreased with increasing gestational age and parity. Over 60% of patients were overweight. The main reason for consultation was the presence of breast swelling. Unilateral left breast swelling was predominant in 46% of cases, and location in the upper-outer quadrant accounted for 50%. Surgical excision was the most frequent management modality, accounting for 56,2% of cases. CONCLUSION:fibroadenoma of the breast are a fairly common benign condition. Diagnosis requires surveillance. Surgical treatment should be discussed according to age, size and the presence of risk factors for malignancy.

Introduction: Postpartum is a period of physical and psychological upheaval with the possibility of surgical complications. Objective: To analyze the epidemiological-clinical, therapeutic and prognostic profile of postpartum surgical emergencies. Methods: This was a descriptive, cross-sectional study over 8 months (from August 2022 to March 2023) including all patients admitted to the general surgery service for acute surgical abdomen in the postpartum period. Result: Seven patients were retained with an average age of 28.33 6.89years. We found 4 cases (57.1%) of post-operative peritonitis, 1cas (14.3%) of appendicular abscess and 1 case (14.3%) of strangled white line hernia. Clinical signs were dominated by abdominal pain, conjunctival pallor and fever. Anemia was confirmed in 5 (71.4%) patients and we found leukocytosis in all patients. Laparotomy associated with hysterectomy was performed in 2cas, laparotomy avively of the banks and uterine suture in 2 cases, washing of the peritoneal cavity associated with abdominal drainage in 1 case, hernia cure in 1cas, an appendectomy in 1cas and a sigmoidectomy in 1cas; abdominal drainage was performed in all our patients. Conclusion: The occurrence of an abdominal surgical emergency in postpartum is serious and may involve the obstetric and vital prognosis of the patient. The involvement of all actors (surgeon, obstetrician and anesthesiologist resuscitator) in the management, remains essential to secure the periartum period.

Retroperitoneal soft tissue sarcomas in the retroperitoneal/intra-abdominal regions represent 10% - 15% of all cases of soft tissue sarcoma. Liposarcomas, which are the most common histological type, account for 20% - 45% of retroperitoneal/intra-abdominal sarcoma cases, and 20% of liposarcomas cases are primary retroperitoneal liposarcomas. Surgical resection in case of malignancy remains the treatment of choice for liposarcomas, according to the guidelines of most major international companies. Our goal was to improve the management of retroperitoneal liposarcoma. This was a 65-year-old patient, with no medical or surgical history, who was referred to us for abdominal swelling, in whom clinical and paraclinical examination found retroperitoneal liposarcoma stage IV, and the surgical treatment consisted in making a tumor reduction. Conclusion: Retro-peritoneal liposarcoma is an undervalued malignant tumor, and the diagnosis is often late.

Breast cancer is the leading cancer in Mali. The objective of this study was to evaluate the risk factors of breast cancer associated with reproduction. PATIENTS AND METHODS:We conducted a case-control study (January 2017 - September 2021) at the Gabriel Touré Teaching Hospital. The sample consisted of 200 cases and 400 controls. A multivariable logistic regression model was used to identify reproductive factors associated with breast cancer. Adjusted odds ratios (AOR) were produced with their 95% confidence intervals. RESULTS:The mean age of cases was 46.1 years ± 14.6 vs 33.1 years ± 12.1 for controls. Menopausal women constituted 37.5 % of cases vs only 4% in the controls group. Nulliparity and breastfeeding were negatively associated with breast cancer (p <0,001) while postmenopausal women had a8.09-fold increase in the risk of breast cancer. CONCLUSION:Nulliparity, breastfeeding and menopause were the reproductive factors associated with breast cancer in Mali.

Oncology therapies have repercussions on the quality of life of patients. This quality of life is a cardinal element in the care pathway of patients. We initiated this work to assess the quality of life after mastectomy. MATERIAL AND METHOD:We carried out a descriptive cross-sectional study over a period of 5 years from January 2016 to December 2020 in the General Surgery Department of the Gabriel Touré University Hospital. We included all patients who had undergone surgery for breast cancer with histological evidence and who had undergone a mastectomy and agreed to answer the questionnaire. RESULTS:The QLQC3O questionnaire is a cancer-specific scale used to establish the quality of life score like many others, but with the difference that it is simpler, easier to use and more widely used. We have recorded 79 cases of mastectomy for breast cancer. The prevalence of mastectomy was 5.8%. The median age was 58 years. Patients had at least one child 92.38%. Non-specific ductal carcinoma was the most common histological type with 87.33%. The side effects of mastectomy affect the area of symptoms were the most difficult stage to bear with p value not significant. These situations have seriously affected self-esteem. Among the side effects affecting quality of life (52 cases), digestive disorders (22 cases) were in the first place, followed by dyspnea (7 cases) and financial difficulties (8 cases) which resulted in the sale of goods. CONCLUSION:The place of quality of life remains undeniable in the therapeutic strategy and its evaluation improves the therapeutic choice.

Introduction: The level of knowledge and attitude of health professionals about breast cancer are important determinants. General objective: To study the knowledge, attitude and practice of health professionals of the hospital of the district of the commune IV on breast cancer. Methodology: This was a cross-sectional, prospective, descriptive, qualitative and quantitative study. The study period was from 01 October 2022 to December 2022. Results: In one week of survey, 110 health workers (intern, obstetrician nurse, general practitioners and specialists) received the survey sheet, 80 health workers informed it, a participation rate of 73%. The male sex was most represented at 63.75% with a sex ratio of 1.76. The average age was 39.59 years with extremes of 22 and 61 years. The clinical signs evoked by the participants were: breast nodule (81.25%), followed by breast discharge (48.75%). In relation to risk factors: interns and obstetrician nurses had no good knowledge, 51.72% of general practitioners had good knowledge, 43.48% of specialist doctors had good knowledge, and 5.88% of the wise had good knowledge. Conclusion: Breast cancer is a common pathology around the world, health professionals are at the forefront of the fight against breast cancer, and this fight cannot be effective without trained personnel.

Polythelia also known as supernumerary is an anomaly in the breast development by extra number of nipples. We report a case of polythelia in the Gynecology-Obstetrics department of the CHU Gabriel Touré. This was a 32-year-old woman received for pregnancy monitoring, in whom we accidentally discovered three pairs of nipples located on both breasts. In the postpartum period, five of the six nipples were found to secrete milk.

OBJECTIVES:The aim of this work was to study the prognostic factors of breast cancer and their correlation with survival in women in the General Surgery Department of the Gabriel Touré CHU in Bamako. MATERIALS AND METHODS:This was a cohort study from January 2020 to December 2022, a period of 36 months. RESULTS:A total of 67 patients were registered. The mean age was 47.6 ±13.3 years; the mean time to consultation was 12.7 ±11.6 months. A breast mass was palpable in 82% of cases; its mean size was 7.18 cm±3,97. It was a non-specific infiltrating ductal carcinoma in 95.52% of cases. SBR grade 3 was found in 32.84%. Advanced stages (III and IV) accounted for 77.61% of cancers. The majority of cancers (50.74%) were triple-negative subtypes. Mastectomy with axillary dissection was performed in 95.52% of patients, with significant lymph node involvement in 35.82% of cases. Targeted therapy was performed in 7.46% of cases. Post-operative follow-up was straightforward in 89.09% of cases. Overall survival was 26.30 months with a median survival of 23.86 months. SBR3 grade and triple-negative subtype were the prognostic factors that significantly influenced survival. CONCLUSION:Efficient management of breast cancer requires proper assessment of prognostic factors. Biomolecular factors SBR-EE and triple-negative had a strong correlation with survival.

Introduction: Tuberculosis is an infectious disease that can affect different organs. The spinal disorder is called tuberculous spondylodiscitis (Pott's disease). The objective: Was to elucidate the aspects taken into account by caregivers in the diagnosis of tuberculosis spondylodiscitis in patients referred to the reference health center of commune III of Bamako for anti-tuberculosis treatment. Methodology: This was a descriptive, retrospective study covering all patients referred to CSRef CIII from different health structures with the diagnosis of Pott's disease for treatment during the study period. Results: During the study period, we collected 156 patients. The male sex represented 54% with a sex ratio of 1.18. The average age was 39.3 years with extremes of 12 and 92 years. All patients presented with spinal pain, fever was present in 11.11% of patients and 2.7% had respiratory symptoms. Tuberculin IDR was positive in 95.8% and 2 patients were AFB sputum positive. X-ray (of the lumbar spine) was negative in 18%; there were images of degenerative lesions in 41.6% and only 40.2% of patients had presumptive radiological signs. CT was carried out in all patients revealing 33.33% of sequelae of fractures and degenerative lesions and 55.55% of presumptive signs of tuberculous spondylodiscitis. Only 41.66 of the cases were referred by specialist doctors. Conclusion: In our context, the diagnosis of Pott's disease seems to be based mainly on chronic spinal pain and positive IDR and is not often made by appropriate personnel.

During the dissection of 11 stiffs, we observed the presence of an accessory muscle in the axillary fossa, known as the dorsalis major muscle arch or axillary Carl Langer muscle. This is the main anatomical variation in the walls of the axillary region. This case was reported because of the low frequency of this variation in the axillary region, and the vital importance of incorporating the possible presence of these notions into axillary curage techniques, which may find themselves modified intraoperatively. Ignorance of the dorsalis major muscle arch may be the cause of intra- and postoperative complications during axillary curage or breast reconstruction using a dorsalis major flap.

Breast cancer is the leading cancer in women worldwide. A better understanding of this pathology by women can contribute to significantly reducing its morbidity and mortality. AIM:It was to evaluate women's knowledge about breast cancer in the obstetrics and gynecology department of the district hospital of commune II of Bamako. PATIENTS AND METHODS:We carried out a descriptive and analytical cross-sectional study with prospective collection of data from July 1 to August 31, 2021. It concerned women admitted to gynecological consultation without notion of emergency, who agreed to participate in this study. RESULTS:In 2 months, 390 women agreed to participate in this study, of which almost half of the women (45.1%) had no knowledge of the risk factors, clinical signs and means of screening for breast cancer. breast. Women's knowledge of breast cancer was influenced by age, education level, profession, religion and marital status (p<0.001). CONCLUSION:Breast cancer remains poorly understood by women. Intensifying awareness campaigns can help increase women's understanding of this scourge.

Bowel transit disturbances favored by pregnancy and injuries during childbirth would be triggering or aggravating factors for anal pathologies. The objective of this work was to study the epidemiology, diagnosis, and treatment of anal pathologies during pregnancy and 6 weeks after delivery. We carried out a prospective, multi-centric, and analytical study in 10 obstetric units in Bamako from June 1(st), 2019, to May 31(st), 2020. After informed consent, we enrolled all first-trimester pregnant women admitted to the hospitals and who were followed up through the postpartum. We conducted a rectal examination in each participant and an anoscope in those with an anal symptom. Hemorrhoidal diseases were diagnosed in the case of external hemorrhoids (thrombosis or prolapse) or internal hemorrhoids. During the study period, we followed up 1,422 pregnant women and we found 38.4% (546) with anal pathologies (hemorrhoidal diseases in 13% (192), anal fissure in 10.5% (150) and anal incontinence in 8.6% (123). Risk factors for the hemorrhoidal disease were age of patient >= 30 years old aRR=5.77, 95% CI 4.57-7.34; p=0.000; a existence of chronic constipation aRR=2.61, 95% CI 1.98-3.44; p=0.000; newborn weight >3500 g aRR= 1.61, 95% CI 1.25-2.07; p=0.000 and fetal expulsion time >20 minutes aRR= 6.04, 95% CI 5.07-7.27; p=0.000. The clinical signs observed were constipation, anal pain, bleeding, and pruritus. The treatment was based on counseling on hygiene and diet, the use of laxatives, local topicals, and analgesics along perineal rehabilitation. Anal pathologies were common during pregnancy and 6 weeks after delivery. Pregnant women must be screened systematically for such pathologies. Early diagnostic and appropriate treatment would reduce serious complications.

Introduction: The localization of bone tuberculosis at the level of the olecranon is rare and can pose a problem of differential diagnosis with a tumoral affection.Only the biopsy allows the diagnosis of certainty.The goal was to report our first case to do a review of the literature.Clinical Observation: This was a 64-year-old patient who consulted 2 years after the onset of symptoms for swelling and mechanical pain in the left elbow.On clinical examination there was a firm consistent mass measuring 6/4 cm in diameter, not very painful and hot on the posterior surface of the left elbow, accompanied by paresthesias in the territory of the ulnar nerve associated with partial functional impotence of the left forearm with little altered general condition.The X-rays of the left elbow showed extensive bone lysis of the olecranon with fracture of the base of the olecranon.The CT Scan of the elbow performed showed osteolysis of the olecranon with extensive bone reactions at the distal end of the humerus.The biopsy carried out with histological examination concluded with an aspect of tuberculous osteitis and the culture came back sterile.A curettage was performed associated with anti-tuberculosis treatment for 12 months as well as the placement of a posterior splint.The evolution at 9 months was unsatisfactory with persistence of paresis and stiffness of the elbow.Conclusion: Tuberculous osteitis of the olecranon can simulate a malignant tumor with non-specific signs of bone tuberculosis.Only the anatomopathological examination is definitive for the diagnosis.The treatment is multidisciplinary.Orthopedic evolution is difficult to predict.

Acute appendicitis is the most frequent abdominal surgical emergency in the world. The aim of this study was to analyse the results of surgical management of acute appendicitis. Methodology: This was a prospective study from January 2020 to December 2020 in the reference health centre in Commune I of Bamako. Results: During this period, we operated on 108 patients for acute appendicitis, including 78 men and 30 women, for a sex ratio of 2.5. The mean age was 26.92 years, ranging from 5 to 70 years. Abdominal pain was the main reason for consultation. Physical signs were dominated by a positive Blumberg's sign in 99.1% of cases, right iliac fossa defensiveness in 97.2% of cases, Rovsing's sign in 50% of cases, psoitus (Psoitis) in 18.5% and pain on the right in the cul de sac of Douglas in 69.4%. This physical examination enabled the diagnosis to be made in the majority of cases. In some doubtful cases, we requested an abdominal ultrasound scan. Locoregional anaesthesia was the most commonly used anaesthetic technique (63.9%). Classic Mac Burney appendectomy with burial of the stump was the surgical technique most frequently used. Postoperative recovery was straightforward in 97.2% of cases. However, we recorded one case of death. Conclusion: Acute appendicitis remains the most frequent abdominal surgical emergency in the community. Early diagnosis and rapid management improve prognosis. Treatment is essentially surgical.

Purpose: To analyze the outcomes of the management of open trauma to the abdomen by weapons. Methodology: This was a prospective, descriptive study from February 2019 to January 2020. Results: We performed 418 surgeries with 7.65% (32 cases) of open trauma to the abdomen by weapons. The average age was 31.38 years with extremes of 7 to 54 years. The male sex was the most represented 90% or a ratio of 9. The majority of our patients were injured overnight at home or in nightclubs. The assault was criminal with knives in the majority of cases. Abdominal pain and evisceration were the main reasons for consultation. Physical examination and X-ray of the unprepared abdomen (ASP) made the diagnosis. Laparotomy was performed in all our patients with simple consequences. Conclusion: Since the advent of the socio-political crisis in Mali, the proliferation of weapons has encouraged criminal attacks. Their management is complex often multidisciplinary is still controversial between laparotomy from the outset and non-operative treatment.

The aim is to study acute appendicitis in the surgery department of the Markala Reference Health Center. Patients and Methods: We conducted a retrospective study in the general surgery department of the reference health center which took place over a period of 35 months from October 1, 2019 to October 30, 2021. The retrospective period was from the month of October 2019 in October 2020 then follows the prospective period until October 2021. Inclusion criteria: Were included in our study; all patients with appendicitis or its complicated forms in the general surgery department of the Csréf in Markala. Non-inclusion criteria: Were not included in our study; cases of appendicitis outside the general surgery department of the Csréf. -Appendicitis accounted for 58.2% of hospitalizations or 31% of emergency surgeries performed during the study period. 85.4% of the patients were without medical-surgical ATCD, on the other hand the oldest of our patients was 61 years old; the average age was 29 years old and the youngest was 13 years old. Furthermore, we note that there was no age of onset of appendicitis. The treatment received by all of our patients was appendectomy (93 cases were operated on urgently and the 10 cases were first cooled and then operated on 3 months after the medical treatment). No major complication was noted in our patients, apart from three cases of infection of the surgical site related to the fact that it was an appendicular abscess. Conclusion: Acute appendicitis is one of the most common surgical emergencies in digestive surgery. Its diagnosis is essentially clinical, sometimes made difficult by the absence of anatomo-clinical parallelism linked to the polymorphism of the lesions and the variations in the position of the organ in the abdominal cavity. Untreated, it can progress to serious complications (generalized peritonitis). It is a condition with low morbidity and mortality subject to early diagnosis and surgical treatment.