Introduction: Abnormalities of sexual differentiation are conditions due to various congenital or hormonal etiologies. The aim of our study was to describe the clinical aspects of sexual differentiation abnormalities in the department of medicine and endocrinology. Methodology: Our study was retro-prospective and descriptive ranging from September 2011 to July 2021 (i.e. 10 years), carried out in the Medicine and Endocrinology department of the Mali Hospital. Results: Ten patients out of 8213 consultants were collected, representing a hospital frequency of 0.12%. Six (6) of them were of female phenotype, and 2 of male phenotype. The average age was 21.71 years with extremes ranging from 17 days to 46 years. Clinically, patients with a female phenotype presented an anomaly of the external genitalia (5/10), axillary and pubic hypopilosity (6/10), delayed puberty (5/10), primary amenorrhea (5/10), and the presence of a bilateral inguinal mass (2/10). For patients with a male phenotype (2/10); bilateral gynecomastia (2/10), macroskelia (1/10) with wingspan of 197cm, axillary and pubic hypopilosity (1/10), an anomaly of the external genitalia (2/10). Conclusion: anomalies of sexual differentiation, although relatively rare, exist in Mali and throughout the world.

Introduction: Glycated haemoglobin is considered an objective element in monitoring glycaemic control in diabetic patients. High-performance liquid chromatography (HPLC) is the reference method for measuring HbA1c. However, even this method can be affected by certain conditions such as anemia. Purpose: To study the impact of anaemia on the measurement of glycated haemoglobin levels by HPLC in diabetic patients. Methodology: We conducted a prospective, descriptive and comprehensive study from November 2022 to April 2023, on 06 months at the Mali Hospital, measuring glycated haemoglobin, blood glucose and haematological parameters (CBC). Results: We included 71 diabetic patients, 42.3% were men and 57.7% women. In our study population, 33.8% were anaemic, among them 16.9% were women and 16.9% men. The age group [50-80] years constituted the majority (n = 14) of anaemic patients. The most common type of anaemia in our diabetic patients was normocytic anaemia. HbA1c >7% was found in 91.6% (n=22) of our anaemic patients. The mean haemoglobin level was not statistically significantly different from the HbA1c level (P = 0.0595). There was a statistically significant difference between MCHC and HbA1c (P = 0.04). To our knowledge, we did not observe any significant impact of anaemia on the measurement of HbA1c by the HPLC method. Conclusion: Our study showed a high frequency of normocytic anaemia in diabetic patients. We also noted that the reliability of HPLC in measuring HbA1c was not affected by a minor decrease in total haemoglobin levels.

Introduction: Diabetes is a group of metabolic diseases characterized by chronic hyperglycemia of variable degree resulting from a defect in insulin secretion and/or its action. Diabetic nephropathy is a common complication of diabetes, which in the early stage is characterized by a slight increase in urinary albumin excretion. Objective: To study micro albuminuria in type 2 diabetics in the diabetology-endocrinology unit of the Reference Health Center of Commune VI of Bamako. Methodology: We carried out a retrospective and prospective analytical study for one year from November 2021 to October 2022. This study described the sociodemographic and clinical variables. It focused on the prevalence of micro albuminuria in diabetics apart from urinary infection in the diabetology-endocrinology service unit of the Reference Health Center of Commune VI of Bamako. All type 2 diabetic patients with micro albuminuria less than 300 mg/24 hours apart from any urinary infection with or without hypertension were included in this study. Result: During the study period, 100 type 2 diabetic patients, whether hypertensive or not, were recruited, among whom 38 presented micro albuminuria with a hospital frequency of 38%. The sex ratio was 0.61, the average age was 56.79 years with extremes of 40 and 79 years. In our study, 40% of patients were overweight, more than half were at the stage of diabetic nephropathy. HyperLDLdemia was (17%). Hypertension was the most common associated risk factor and affected 55% of patients. Smoking was present in 20%. Retinopathy was present in 18%. Neurological complications represent 67%. Cardiomyopathy was the most represented cardiovascular complication with 17%. Conclusion: Micro albuminuria can appear at any age of development of diabetes. Whether or not it is associated with other risk factors remains decisive; it is the first paraclinical sign of diabetic nephropathy.

Introduction: Pubertal delay is defined by the absence of development of secondary sexual characteristics beyond the age of 13 in girls or 14 years in boys. In children of puberty age, delayed puberty is common in long-standing, untreated hypothyroidism. We report a case of delayed puberty revealed by Hashimoto's disease in the hypothyroid phase diagnosed in the Internal Medicine department of the Gabriel Touré University Hospital in Bamako, Mali. Observation: This was a female patient, aged 20 years old, without any particular medico-surgical ATCD or notion of taking medication, who had consulted at the end of 2021, in the Internal Medicine department of the University Hospital Gabriel Touré from Bamako for primary amenorrhea and delayed puberty. At the end of the clinical and paraclinical examination, a hypometabolism syndrome and pubertal delay were noted. On an evolutionary level, development of secondary sexual characteristics (From T1 to T3, and appearance of menstruation) after one year of treatment. Conclusion: Delayed puberty may be the consequence of hypothyroidism. Opotherapy with L Thyroxine helps restore normal pubertal development.

This retrospective study was conducted from 01 January 2011 to 31 December 2016, in purpose to study the link between neurological disorders and HIV infection at internal medicine department of Point “G” Hospital. Were included all HIV patients, seen in outpatient and/or hospitalization, naive or not of antiretroviral treatment; whose HIV was discovered through neurological disorders and/or whose neurological disorders appeared during HIV disease. We collected 344 cases, 169 of which were included, corresponding to a hospital frequency of 49.12%. The patients were mainly married women with a mean age of 41 years. The sex ratio was 0.7 in the women's favour, and the age group (36-45) accounted for 32.5% of cases. Clinically, confusion and headache were the most frequent complaints, at 10.06% and 5.92% respectively. The most frequent neurological manifestations were encephalitis and ischaemic stroke, with 26.56 and 25% respectively. They occurred in less than 6 months in the majority of our patients (55.62% of cases). Topographically, central nervous system damage was the most represented with 56.25% of cases. The occurrence of these neurological manifestations was correlated with the WHO clinical stage. HIV1 was the most represented type with 90.53% of cases. The occurrence of neurological pathologies related to HIV was correlated to the level of detectable viral load and to a low CD4 count. From a therapeutic and evolutionary aspect, the first line scheme represented 60.95% of cases. Despite the efficacy of this multiple anti-retroviral therapy, the prognosis was unfavourable in more than half of our patients (52.66%).

Introduction: Anaemia is a condition that is often underestimated and insufficiently treated in the elderly. It is the most common haematological problem in this age group, with 30% of aetiologies remaining unexplained. In our context, few patients benefit from investigation, hence this study to assess the state of anaemia. Methods: We conducted a retrospective study from January 2011 to December 2012 in the internal medicine department of the Point "G" University Hospital. All hospitalised patients aged 65 and over with anaemia according to the WHO definition were included. Results: Among 199 elderly subjects hospitalised during our study period, 95 (47.73%) presented with anemia. The sex ratio was 1.71. The mean age of the patients was 73.39 ± 6.65 years. Weight loss (82.1%), polypnea (56.5%) and dyspnea (21.1%) were the predominant clinical manifestations. The mean haemoglobin level was 8.93 g/dl, with extremes of 3.1 and 12.5 g/dl. Aregenerative normochromic anemia (37.9%) was the most common. Inflammatory anemia was the main cause of anemia in the elderly (58.6%), followed by multifactorial anemia (20.7%), renal failure (6.9%) and unknown causes (6.9%). Conclusion: Anemia is a frequent condition in elderly patients in internal medicine, dominated by inflammatory causes.

Osgood-Schlatter disease is a painful inflammation of the bone and cartilage of the tibial tuberosity. It is caused by excessive stress on the leg. We conducted a retrospective descriptive cross-sectional study at the rheumatology unit of the Army Medical and Surgical Centre of Bamako. The study population consisted of patients followed at the rheumatology unit from January 2021 to 31 December 2022. Patients with a confirmed diagnosis of Osgood-Schlatter disease were included. During our study period, we enrolled 27 patients, 25 of whom were male (92.60%). The mean age of our patients was 13.5 + 2.4 years. All cases in our series were unilateral (100%) and 85.2% of our patients had practised sport. Painful manifestations of the anterior face of the knee were noted in all patients (100%) and were associated with swelling in 55.55% of cases. Soft tissue tumefaction constituted 92.5% of radiographic abnormalities. This is the most common osteoarticular disease in adolescent males, with a generally favourable outcome.

Introduction: Road traffic accidents (RTAs) are nowadays a real worldwide scourge because of the high number of victims. In Mali, we have little data related to the characteristics of deaths related to MVAs, hence the interest of this study which aimed to determine the sociodemographic, clinical and paraclinical characteristics of deaths involving a motorcycle received in our forensic medicine unit. Materials and method: This was a prospective, monocentric, cross-sectional study conducted from January 1, 2016 to December 31, 2016 in the forensic medicine unit of the CHU GT. Were included, all deaths involving a motorcycle received in our unit and accompanied by a requisition. Results: Of 458 MVA deaths, we identified 147 motorcycle deaths, a prevalence of 32.1%. The mean age was 36.5 years with extremes of 1 to 72 years and a sex ratio of 7.65. Students were the most represented, 90 cases (25.18%). The motorcycle mechanism was more frequent 90 cases (61.9%). The month of May and the hours from 19:00 to 05:00 were the most frequent times of occurrence of accidents respectively 37 cases (25.2%) and 76 cases (51.7%). Polytraumatic lesions were found on 83 bodies, i.e. 56.46%. Death was noted on arrival in 80% of cases and none of our bodies had undergone autopsy. Conclusion: Motorcycle accidents on public roads remain a major public health problem in our country.

Introduction: Acquired immunodeficiency syndrome (AIDS) linked to HIV infection is accompanied by auto-immune phenomena. Autoimmune diseases can develop in people living with HIV, most in a context of good immunological control (vasculitis, anti-phospholipid syndrome). Since the advent of antiretroviral therapy, an increasing number of autoimmune connective tissue diseases such as systemic lupus erythematosus, dermatomyositis, and syndromes of Sj?gren and scleroderma have been reported. Purpose: To describe this association’s not very common scleroderma and HIV infection. Observation: We report the case of a 56-year-old lady admitted into the service for functional impotence that would have been evolving for a week. Prior to her hospitalization, she presented edemas of the lower limbs associated with anesthesia of the lower limbs for 5 months. The painting is accompanied by a productive cough and an intermittent fever. At the physical examination a weight loss (BMI = 13.74 Kg/m2), fever (38.7°C): Oral candidiasis, lower lip ulceration, perlicking, undernutrition folds, sclerodactyly and homogeneous hepatomegaly was noted. The diagnosis of immunosuppression to HIV Stage 3 with TB co-morbidity and positive hepatitis B Serology was retained while diffuse Scleroderma was selected from the ACR/EULAR criteria of 2012 with a score of 10 (sclerodactyly = 4 point; Raynaud’s phenomenon = 3 point and Ac Anti Scl 70 positive = 3 point). Conclusion: These associations of chronic pathology must be described to improve the future treatment of our patients.