The aim of our work was to study the epidemiological and clinical aspects of acute thoracic syndrome in children with sickle cell disease hospitalized in the paediatric department of the Gabriel Touré University. Materials and methods: We conducted a retrospective study over six (06) years, from January 1, 2017 to October 31, 2022, based on the records of children under 16 years of age with sickle cell disease confirmed by haemoglobin electrophoresis and hospitalized for acute thoracic syndrome in the paediatric department of the UH-GT. Results: The frequency of hospitalization was 5.46%, the average age was 6.2 years, with a male predominance (sex ratio: 4.6). Nearly half of (studie subject?) (47.8%) had a history of vaso-occlusive crises. Chest pain was the main reason of consultation (61.5%). Hyperthermia, tachypnoea and hypoxia were present in 43.6%, 4.4% and 76.9% respectively. Pulmonary signs were dominated by respiratory distress (92.3%), with the homozygous form (SS) being the most common (92.3%). Bilateral basal opacities were found on frontal chest X-ray in 46.2% of patients. All patients were rehydrated. The mean duration of treatment was 9.1 days, with extremes of 2 and 31 days. Mortality rate was 2.6%, related to the degree of hypoxia (P= 0.001). Conclusion: Acute thoracic syndrome is a frequent and serious acute complication of sickle cell disease. Any chest pain associated with respiratory signs and poor oxygen saturation should call for the diagnosis Acute thoracic syndrome.

INTRODUCTION:Constipation is a symptom that corresponds to an anomaly of the stools or their elimination: they are too bulky or too hard, too rare, or their elimination is painful, even incomplete. OBJECTIVE:was to determine the frequency, the contributing factors, the signs and the therapeutic methods of constipation in children in the pediatric department of the CHU Gabriel Touré. PATIENTS AND METHOD:This was a descriptive cross-sectional study with prospective collection from April 1, 2019 to January 31, 2020. All patients aged 0 to 15 who consulted in the pediatric department for constipation and responding to the Rome IV criteria. RESULT:We registered 75 patients. The hospital frequency of 0.23%. The age group from one month to two years represented 61.3% of the patients, the average age was 27.7 +/- 43 months. The male gender predominated with 58.7%. Constipation alone was the most common reason for consultation with 62.6%. One stool per week was found in 77.3% of patients. Pain on defecation was found in 65.3% of patients. Constipation was functional in 69.3% of patients. Hirschsprung disease was the cause of organic constipation in 65.2% of patients. Laxatives were prescribed in 64% of patients at the consultation. CONCLUSION:Constipation is a frequent pathology that affects children at all ages. It is of functional origin in most case.

INTRODUCTION:Asthma is the most common chronic disease of children. It is a leading cause of emergency room visits, hospitalization and school absenteeism. Asthma is a real public health problem. The prevalence of this disease is increasing worldwide. PATIENTS AND METHOD:We had conducted a prospective study, among children with asthma over a period of one year, from January 2018 to December 2018. RESULTS:We counted 105 asthmatic patients for a total of 14344 consultations, or a frequency of 0,73%. The sex ratio was 1,9, the age group 2-5 years was the most frequent, (52%), the age of the first attack was generally between 1 and 2 years, ( 75,24%). We observed that almost 22% of the attacks occurred in December (21,90%). Smoke and humidity were the main triggers. All the patients had benefited from nebulization with B 2 mimetics. CONCLUSION:Education of asthmatic children, their families and the establishment of standard management protocols could significantly reduce asthma-related morbidity in our countries.

When access to peripheral veins is delayed or impossible, intraosseous access must be rapidly considered. The aim of our study was to determine the epidemiological, clinical and therapeutic characteristics of children who have benefited from intraosseous access, as well as the practical details of its implementation. Materials and methods: It was a prospective study, on the assessment of aspects of intraosseous access in the management of pediatric emergencies. Children under 15 years of age who received this procedure were included. The study was performed over a 14-month period from March 2018 to April 2019 at the pediatric emergencies of Gabriel Touré hospital. Results: Twenty-two patients were included. The sex ratio was 2.14. The mean age was 9 months (2 months-36 months). Dehydration complicated by shock represented 45.5% of treated diseases. All intraosseous access points were placed in the proximal tibia. Manual insertion was used in all cases. The most frequent early complication was deperfusion (13.6%). Difficulty with peripheral venous access was the main indication (77.3%). The procedure was performed by a physician in 91% of cases, with a success rate of 86.4%. Vascular filling was the most common treatment used by this route, accounting for 82% of cases. Conclusion: Intraosseous device insertion has saved children in life-threatening emergencies. The main factors limiting the insertion of the intraosseous device in our study were high cost of devices and lack of appropriate training about veins access in case of pediatric emergencies.

Hospitalization of newborns leads to tricky psychological concerns. Creating a therapeutic alliance between parents and caregivers is necessary for a optimal care. Objectives: To assess the psychological impact on mothers of newborns hospitalized in the neonatology department of the Gabriel Touré University Hospital. Materials and Methods: We performed a prospective study conducted over a six-month period (from January 1, 2020, to June 30, 2020). The questionnaire was completed by interviewing mothers of newborns hospitalized in neonatology. Data were collected and analyzed on SPSS. Results: The age range of 15-25 years was most represented in our survey with 62%. Ninety-six (96%) of the mothers used to be married and 58% attended school. The welcoming at admittance was acceptable in 62% of cases. All the mothers had consented to the hospitalisation of their newborns. Unfortunately, sadness, fear and anxiety were the most common complaints of the mothers (36%, 28% and 20% respectively). Organization of the department was rated as poor by 96% of mothers, and 58% of those mothers could not identify the function of the healthcare staff during their hospital stay. Access to caregivers was considered unsatisfactory in 54% of respondents. The diagnosis was explained in 72% of cases and 76% of mothers were involved in caring for their child. Sleep disturbances were noted in 32% of the interviewees. The majority of them had a negative opinion of the hospital stay (74%). Conclusion: Parental support during hospitalization and throughout medical care is crucial to the well-being of the newly born child. The enhancement of communication with the parents of newborns is required for an effective as well as efficient care.

The practice of excision in girls poses a significant risk to their health. The objective of this study was to determine the immediate acute complications associated with this practice.PATIENTS AND METHODS:This was a retrospective descriptive study over a period of 15 months including all girls aged 0-15 years hospitalized for acute complications related to excision within 7 days of the practice in the pediatric department of the University Hospital Gabriel Toure.RESULTS:We collected 17 patient files. The median consultation time was 43 h. The main reason for consultation was post-excision bleeding in 76.4% of the cases. Pallor associated with respiratory distress was found in almost all cases. On admission, four girls (23.5%) were comatose and five girls (29.4%) showed signs of shock. The reasons for hospitalization were hemorrhage associated with post-excisional sepsis (52.9%), complicated shock anemia (23.5%), and severe post-excision anemia (23.5%). The average hemoglobin level was 5.5 g/dL; there was severe anemia in 94.1% of the girls (Hb <7g/dl). All the girls received blood transfusions with red blood cell concentrate. The other treatments received were local care (100%), administration of analgesics (100%), antibiotic therapy (82.4%), and oxygen therapy (41.2%). The outcome was unfavorable in two patients (11.8% deaths).CONCLUSION:This study shows the seriousness of the immediate complications associated with the practice of excision.

INTRODUCTION:The objective of this work was to determine the frequency of mental disorders among female inmates of the C.S.D.R.F "Bollé".METHOD:This was a descriptive, cross-cutting, prospective study that took place from August to September 2016 at (C.S.D.R.F) "Bollé" in Bamako. It concerned all female inmates present during the study period. The data were collected from pre-established fact sheets, the administration of the Mental Health Screening Questionnaire (MSQ) and clinical variables according to ICD10 criteria.RESULTS:In total, 85 of inmates, or 74% (N-115) agreed to participate in the study. The 14-24 age group accounted for 61.0%. Singles accounted for 56.5% and 95.3% of female inmates had no previous prison history. Seventy-four percent were in pre-trial detention 12.6% had psychotic disorders. Personality disorders were observed in 11.8%. An inmate was on the committee. Thyme disorders were present in 4.7% of female inmates. Drug abuse was observed in 2.4% of female inmates.CONCLUSION:Detention can trigger, promote or aggravate a mental disorder.

Introduction: According to Mali’s National Immunization Center, the Haemophilus influenzae b (Hib) vaccine coverage rate was 90% in 2015. Our work aimed to study invasive bacterial infections due to Haemophilus influenzae type b in children aged 0 - 15 years hospitalized in the pediatrics department of the UH-GT. Method: We carried out a retrospective descriptive study from January 2017 to December 2018 (i.e. 2 years) among children aged 0 - 15 years and hospitalized for Haemophilus influenzae type b infection confirmed by culture (blood culture, Cerebro-spinal Fluid, and pleural and skin fluid). Results: Thirty-three cases of Hib infections were collected giving a frequency of 0.2% and the age group 3 months to 3 years was the most affected (72.73%). Children who received no vaccine accounted for 21.21%. The Cerebro-spinal Fluid culture and other samples (pleural and skin) identified the bacterium in 100% of cases, against 72.72% in the blood culture Meningitis was the most frequent pathology (78.79%) and the lethality was high (21.21%). Conclusion: Despite the introduction of the Hib vaccine in the routine immunization program in Mali, Hib infections remain with a high lethality linked to meningitis.

INTRODUCTION:Mental health is a state of equilibrium and well-being, any alteration of which leads to the appearance of a state of distress and/or mental disorder.OBJECTIVE:The objective of this work was to study familial and environmental factors associated with mental disorders.MATERIALS AND METHODS:A cross-sectional study was conducted in the Psychiatry Department of the Point G University Hospital Center from April 1, 2016 to March 31, 2017 among outpatients with a psychiatric disorder in whom factors associated with psychiatric disorders were studied.RESULTS:We included 288 patients. The median age was 33.0 years. The sex ratio was 1.88 in favor of males. Married patients accounted for 45.5%. First born uterine siblings accounted for 26.7%. Patients born of an inbreeding alliance accounted for 25.7%. Cases with a family history of a psychiatric disorder represented 59.0% and those who spent their childhood with their parents accounted for 64.2%. Cases of psychoactive substance use prior to the onset of the mental disorder accounted for 42.7%. The main psychosocial stress factors that preceded the onset of the mental disorder were grief (46.2%) and family conflict (22.6%). Psychotic disorders accounted for 77.8%.CONCLUSION:Our results show an association of mental disorders with family history of psychiatric disorder among patients followed in psychiatry. Further studies, such as genetic association may prove useful.

Pneumomediastinum is sometimes observed in adult patients but its occurrence in pediatric patients (especially infants) is very rare. We here report a 14-month-old male infant who had subcutaneous emphysema, pneumomediastinum, and importantly, pneumopericardium. He had no particular past histories. He abruptly had cough, fever, and eruption on the abdomen. Computed tomography and echocardiography revealed pneumomediastinum and pneumopericardium. Antibiotics, rest, and supportive therapy ameliorated the condition. We must be aware that pneumomediastinum, and importantly pneumopericardium, can be present in a pediatric patient with subcutaneous emphysema. The infant’s symptoms disappeared under strict monitoring of respiratory status, nasal oxygen therapy and antibiotic therapy.

RESUME Introduction. Au Mali, la seroprevalence au VIH est de 1,1% dans la population adulte. Chez les femmes, elle est de 1,3%, plus elevee que celle estimee chez les hommes a 0,8 %. Au-dela de cette disparite epidemiologique, peu d’etudes ont porte sur l’etat de sante mentale de cette population feminine au Mali d’ou l’interet de la presente etude dont l’objectif etait de determiner la tendance et la nature des troubles psychiatriques chez les femmes seropositives au VIH suivies au CHU Point G. Materiel et methodes. Il s’agissait d’une etude transversale et descriptive de tous les cas de troubles psychiatriques chez les femmes seropositives au VIH durant la periode du 1er aout 2011 au 31 juillet 2012. Resultats. Au cours de cette etude, 222 patientes ont ete enquetees, 95 presentaient des troubles psychiatriques soit 42,8%. Parmi elles, 92 etaient VIH1 soit 96,8%. L’indice de Karnofsky etait compris entre 60 et 100% dans 95,8% des cas. Le diagnostic psychiatrique etait les troubles anxiodepressifs dans 86,3% des cas. La tranche d’âge 38 – 47 ans comptait 37,8% de cas de trouble anxiodepressif. Les patientes mariees ont represente 53,7% des cas dont 54,9% presentaient un trouble anxiodepressif. Les non scolarisees correspondaient a 61,1% des cas. Les menageres ont represente 60,0% des cas, et dont 58,5% etaient un trouble anxiodepressif. Conclusion. Les resultats de notre etude montrent que la prevalence des troubles psychiatriques reste elevee chez les femmes vivant avec le VIH, et qu’il s’agit surtout de troubles anxiodepressifs. Par consequent, la prise en charge psychotherapeutique est indiquee dans le suivi de cette population. ABSTRACT Introduction. In Mali, HIV seroprevalence is 1.1% in the adult population. For women, it is 1.3%, higher than that estimated for men at 0.8%. Beyond this epidemiological disparity, few studies have focused on the state of mental health of this female population in Mali, hence the interest of the present study. Its objective was to determine the trend and nature of psychiatric disorders in HIV-positive women at the University Hospital of Point G. Methods. This was a cross-sectional and descriptive study of all cases of psychiatric disorders among HIV-positive women during the period from 1 August 2011 to 31 July 2012. Results. In this study, 222 patients were surveyed, 95 had psychiatric disorders, or 42.8%. Of these, 92 were HIV1 or 96.8%. The Karnofsky Index was between 60 and 100% in 95.8% of cases. The psychiatric diagnosis was anxio-depressive disorders in 86.3% of cases. The 38-47 age group accounted for 37.8% of cases of anxio-depressive disorder. Married patients accounted for 53.7% of cases, of which 54.9% had anxio-depressive disorder. Unschooled patients accounted for 61.1% of the cases. Housewives accounted for 60.0% of cases, of which 58.5% were anxio-depressive disorder. Conclusion: The results of our study show that the prevalence of psychiatric disorders remains high among women living with HIV, and that these are mainly anode-depressive disorders. Therefore, psychotherapeutic management should be indicated in the follow-up of this population.

RESUME Introduction. L’emigration, surtout clandestine, est un facteur hautement stressant et generateur de troubles psychiatriques selon plusieurs etudes en Afrique et dans le monde. Mais au Mali, tres peu d’etudes y ont ete dediees. Objectif. Exposer les troubles psychiatriques chez les emigres de retour au pays. Materiels et methodes. Il s’agissait d’une etude transversale descriptive retrospective effectuee de janvier a Decembre 2008, ayant exploite les donnees concernant 3105 patients hospitalises dans le service de psychiatrie du CHU du « Point G » de Janvier 1998 a Decembre 2007. Dans notre etude, nous nous sommes limites aux cas dont le retour etait du a l’eclosion des troubles dans le pays d’accueil. Resultats. 359 migrants ont ete colliges (11,5% des patients hospitalises). Il s’agissait generalement de patients de sexe masculin (90.2%), âges de 27 a 35 ans, celibataires, non scolarises et d’ethnie Soninke. Les facteurs ayant favorise la decompensation etaient les difficultes d’insertion, les expulsions et les incarcerations. Les psychoses aigues (bouffee delirante’ aigue, confusion mentale, psychoses reactionnelles et psychoses puerperales) avec 42% et la schizophrenie (28%) ont domine les pathologies psychiatriques. La recherche d’une prise en charge traditionnelle a ete le motif de retour chez environ 59% des patients. Conclusion. Des etudes plus approfondies permettraient de mieux preciser le lien entre sante mentale et emigration. ABSTRACT Introduction. Emigration, especially when clandestine, is a highly stressful factor generating psychiatric disorders according to several studies in Africa and in the world. But in Mali, very few studies have been dedicated to it. Goal. To report psychiatric disorders among returning Malian emigrants at the University Teaching Hospital Point G. Patients and Methods. This was a cross sectional descriptive retrospective study from January to December 2008, which collected data of 3105 patients hospitalized in the psychiatric ward from January 1998 to December 2007. The main inclusion criterion was the outbreak of unrest in the host country. Results. 359 returning migrants (11.5% of inpatients) were studied. They were generally male (90.2%), aged between 26 and 35, single, out of school and of Soninke ethnic group. Factors favoring decompensation were insertion difficulties, expulsions and incarcerations. The main psychiatric pathologies were acute psychoses (acute psychosis, mental confusion, reactive psychoses and puerperal psychoses)(42%) and schizophrenia (28%). Desire of traditional care was the reason for returning home for 59% of patients. Conclusion. More in-depth studies are necessary to clarify the link between migration and mental pathologies.

AIMS:Autism is a global and early developmental disorder that appears before the age 3 years old. It is characterized by a triad of symptoms affecting the following domains: social interaction, verbal and non-verbal communication, imagination and behaviors. This work aimed to determine the frequency of autism and to identify its risk factors in Malians aged 0-17 years old.METHOD:In a cross sectional and prospective study, we reviewed clinical data in 2068 medical charts dating from 1992 to 2012 from all the mental health care centers in Bamako.RESULTS:We found a frequency of 7.8% (162/2068). The age range 0-5 years old was the most represented. The sex ratio was 1.7. The autistic child was issued from a consanguineous marriage in 25.4% (41/162) of the cases. To have parents in divorce, being the first child, and male gender were associated with autism with statistical significance. Our data suggest an elevated number of autism cases in Mali. We plan to carry out a larger prospective study to determine other autism risk factors and importantly to identify autistic families for a molecular genetic study.