Introduction: Seizures are the most common neurological emergency in paediatrics and are often the subject of heated debate in terms of their aetiology, diagnosis and treatment. There are numerous causes of seizures, including infectious, metabolic, toxic and traumatic conditions. Aim: The study aimed to investigate the causes of seizures in the paediatric emergency department at Gabriel Touré University Hospital. Materials and Methods: This is a prospective, cross-sectional, descriptive and analytical study conducted between 1 November 2023 to 31 October 2024 in children aged 1 month to 15 years admitted for convulsions. Data were collected on an individual survey form and gathered from interviews with parents, physical examinations of patients and hospital records. The chi-square test was used to compare qualitative variables. A p-value of <0.05 was considered statistically significant. Results: The frequency was 4.2%. The 13-59 month age group was the most represented (39.1%). The sex ratio was 1.7. The frequent reasons for consultation included convulsions + fever (31.8%), respiratory distress (20.9%), and altered consciousness + fever (10.6%). The convulsions were generalised tonic-clonic (73.5%), lasting less than 5 minutes (59.3%), and simple (67.9%), with post-critical coma in 77.8% of cases. Additional tests to confirm the aetiology included Rapid Diagnostic Test (RDT) and Gastroenteritis (GE) (47.7%), Cerebrospinal Fluid (CSF) Complete Blood Count (CBC) (29.9%), and EEG (6.6%). The main causes were neuropaludism (40.7%), acute dehydration (14.9%), meningitis (12.3%) and epilepsy (6%). The anticonvulsants used were: diazepam (93.4%), clonazepam (35.4%) and phenobarbital (4.3%). The case fatality rate was 24.2%. Conclusion: The main causes of convulsions are infections and acute dehydration. Malaria prevention and vaccination will help reduce the high mortality rate.

Introduction: Acute pneumonia is defined as inflammation of the alveoli and interstitial lung tissue, with respiratory signs and symptoms.1 The term community-acquired pneumonia is used when it develops outside the hospital setting. The aim of our study was to investigate acute community-acquired pneumonia in children aged 1 month to 15 years in the Gabriel Touré teaching hospital pediatric ward. Patients and methods : This was a prospective descriptive and analytical study conducted from April 1, 2022 to March 31, 2023, including all children aged 1 month to 15 years hospitalized for acute bacterial community-acquired pneumonia. Results: We collected 211 patients out of a total of 6639 hospitalizations, or a frequency of 3.17%. The age range from 1 month to 12 months was the most represented (58.3%), the mean age was 18.08± 22.7 months with extremes of 1 and 180 months; the equal sex ratio was 1.13. Fathers were blue-collar workers in 33% of cases, and had unfavorable socioeconomic conditions in 62.6%. Respiratory distress was the most frequent reason for consultation (53.1%). Vaccination was correct in 78% of patients. Most patients (49.3%) consulted within the first week of onset of symptoms. Cough (47.9%) and dyspnoea (30.8%) were the main functional signs. The main signs of respiratory struggle were chest indrawing (43.8%) and nasal flaring (23.1%). Crackling rales (45.13%) were the most common physical sign, while severe acute malnutrition accounted for 27.5%. Hyperleukocytosis, predominantly neutrophilic, was found in 60.8% of patients, anemia in 92% and elevated CRP in 64.9%. HIV serology was positive in 7.1% of patients, and Acid-fast bacilli test were positive in sputum in 3.8%. Chest X-rays showed opacity in both lung fields in 28.4% of patients. Pneumonia was the main diagnosis (87.7%). Malnutrition (34.1%) and cardiac malformation (16.6%) were the pathologies most frequently associated with pneumonia. The antibiotic combination amoxicillin + clavulanic acid was the most widely used (82.9%). Hospitalization lasted from 4 to 9 days in 48.34% of cases. Pleurisy was the most frequent complication (4.74%). The mortality rate was high (18.4%), more than half of which occurred between 1 and 12 months of age (53.8%). Conclusion: Community-acquired pneumonia is common in the pediatric ward of Gabriel Toure teaching hospital. Despite the introduction of pneumococcal vaccine in routine vaccination.

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: Birth trauma in newborns is the result of difficult deliveries. Despite improvements in pregnancy monitoring and the standardization of delivery care, injuries in neonates during delivery remain a major concern in neonatology. Methodology: Study conducted from January 1, 2014 to December 31, 2018, was a retrospective, cross-sectional, analytical study. The purpose was to determine the frequency of obstetric trauma in newborns at CHU Gabriel TOURE, to analyze the different types of injuries observed and to assess risk factors. All newborns admitted to neonatology for injuries were included. Results: Thirty-nine neonates were included (n=39). The sex ratio was 1.29 (M= 22; F=17). Hospital frequency was 1.9 ‰. The majority of patients were admitted within the first 24h (n=35; 90%). The majority of mothers were aged between 20 and 34, (i.e.76.8 %). Multiparous women represented 38% of the mothers. No pregnancy follow-up had been carried out in 23.1% of mothers. Deliveries by vaginal route accounted for 82.1%. Caesarean section accounted for 18%. Transverse fetal presentation was the most frequent reason for Caesarean section, representing 57%. Instrumental delivery was performed in 23.1% of deliveries. Cupping was utilized in 18%. Perinatal anoxia accounted for 59% of newborns. Trauma in newborns was as follows: Serosanguineous bump (n= 6; 15%), Skull skin injury (n=5; 13%), Brachial plexus nerve palsy (n=13; 33%), Femur fracture (n=12; 31%). Trauma to the skull and face accounted for 25.6%. Twelve patients (31%) received treatment with a posterior splint. Twenty percent of neonates had polytraumatism. Instrumental birth was a significant factor in neonatal craniofacial trauma (p = 0.0001). Macrosomia was a risk factor for brachial plexus palsy (p= 0.03). Breech positioning was a factor in the occurrence of lower leg fractures (p=0.001). The mortality rate was 33.3% (n=13). Perinatal asphyxia was the main cause of death (n= 23; 59%). Conclusion: Newborn birth trauma remains a major concern in neonatology in our country. Enhanced monitoring of pregnancy and delivery will reduce the morbidity and mortality associated with this disorder.

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.

Summary: Human immunodeficiency virus (HIV) is an infection that attacks the body's immune system. The most advanced stage of HIV infection is acquired immunodeficiency syndrome (AIDS). HIV is spread through the body fluids of an infected person, including blood, breast milk, semen, and vaginal fluids. Observation: These were 2 patients who had been consulted for a transfusion during which routine screening was carried out. Faced with divergent results, the hypothesis of a serodiscordance was raised. Series of tests carried out came back sometimes Negative and sometimes positive. It was the result of the PCR which made it possible to conclude that it was negative for HIV infection. These results had an impact on the psychological state of donors and could contribute to raising questions on the quality, specificity and/or sensitivity of current tests? On the interaction of one or more viral markers of another unknown viral pathology? And on the other hand on a possible genetic predisposition of these blood donors? Conclusion: HIV is a preventable disease. Awareness campaigns and promotion of early detection are effective ways to reduce transmission.

AIMS:Malaria remains a health problem. The objective was to study cerebral malaria (CM) epidemiology before and after the implementation of seasonal malaria chemoprevention (SMC). MATERIALS AND METHODS:This was a retrospective cross-sectional study carried out from January 01, 2014 to December 31, 2018 in children aged 0 to 15 years hospitalized for CM at the paediatrics' department of CHU Gabriel Touré. RESULTS:We recorded 1336 cases of CM, 803 boys and 533 girls with a sex ratio of 1.5. CM accounted for 92.1% and 83.5% respectively two years before and three years after the SMC implementation (p = 0.013). The overall lethality was 9.2% varying according to the years of follow up (p = 0.001) The SMC led to decrease of CM frequency of 8.6%. CONCLUSION:SMC could have an impact on the expression of severe malaria phenotypes, with an increase of frequency of CM and CM associated with pulmonary oedema, a decrease of the frequency of CM associated with severe anaemia. Prospective studies will enable to understand the increasing case lethality rate observed during SMC period.

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: The aim of this study was to describe the epidemiological and clinical aspects of low-lying ARF in children aged 1 month to 14 years seen in the emergency department of the Nianankoro Fomba Ségou Hospital. Methodology: We included for this prospective descriptive study all children aged 1 month to 14 years of both sexes, seen in consultation at the pediatric emergency department, presenting with low-onset ARF, from January to December 2020. Results: The frequency of low ARF was 6.5%. More than half the patients were aged between 3 months and 2 years. Males predominated. The most frequent reason for consultation was fever. The most common diagnosis was bronchitis (63.23%). 78.6% of patients had moderate anemia and hyperleukocytosis. An opacity was found in 66.67 of the radiographs taken. Amoxicillin was the antibiotic of choice. Hospital mortality was 3.59%. Conclusion: ARIs are frequent in emergency consultations.

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.

Tuberculosis is a tropical pathology caused by Mycobacterium Tuberculosis. Public heath problem in developing countries with a polymorphous clinical picture. OBSERVATION: It was a 67-day-old infant, weighing 3350 g, admitted for fever, whining, hacking cough, prostration for which traditional treatment based on chest massage and medical treatment at home was unsuccessful. The clinical examination revealed conjunctival pallor, dry skin, a temperature of 38°3c, and a bulging anterior fontanelle. The blood count returned to 11000/Fields. Faced with this picture, a neonatal infection or meningitis was mentioned. An initial treatment based on dual antibiotics (Ampicillin, Gentamicin) was administered without success. The evolution was marked by the persistence of the cough, respiratory distress and the lumbar puncture suggesting neonatal tuberculosis placed under protocol 2 RHZ(E) /10RE. After 22 days, the infant died.

GOAL:To assess knowledges and practices on iron prescription in pediatric ward in CHU Gabriel Touré of Bamako, Mali. TOOLS AND METHODS:It was a prospective and transversal study canied out. We submitted questionnaire and analyzed the case history of to the children aged 1-60 months old who received iron during the study period from 1rst to 30 July 2012. The prescriptators' consent were solicited and obtained at first of all. RESULTS:Fifty prestators were interviewed among them 10 pediatricians (20%), 31 pediatrics' resident (62 %), 2 generalists physicians (4%), 7 medical student (14%). One hundred 100 were analyzed medical records. More than half of the prestators known the need of iron in children. Thirty percent have received iron at 8 to 10mg/kg. The medication duration wasn't indicating in 92% of patients. In our context prestators well know about meaning and the needs of iron in children bout they're limited on iron food sources and iron storage. CONCLUSION:The well theorical knowledge on indications and prescription roules on iron in children didn't escape from miss practices in its prescription. Moreover works should analyze the reasons of discrepancies.

was statistically significant (p=0.047).Conclusion: Pneumonia remains the most common complication of measles.The major challenge is to reach the WHO target of 95% immunization coverage.

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.

AIMS:To describe the clinical and evolutionary aspects of the primary closure of exstrophy at the CHU Gabriel Touré.MATERIALS AND METHODS:This was a retrospective and prospective study carried out from January 2014 to December 2019 in all the children admitted and operated on for bladder exstrophy at the CHU Gabriel Touré.RESULTS:We collected 35 cases of exstrophy, ie25 boys and 10 girls. The mean age at diagnosis was 4.8 months. The bladder plate was both normal and budded, ie 28.6% of cases. Plaque infection was found in 45.7%. A malformation was associated in 34.3% of cases. Primary plaque closure was achieved in all of our patients. Postoperative morbidity was 28.6% of cases and mortality 11.4% of cases.CONCLUSION:Bladder exstrophy is a rare malformation of the urogenital sphere, its management is complex and its mortality is not null.

Summary: Introduction: Knowledge of the birth cycle is important in the organization of reproductive health services in a facility. The main objective was to study the determinants of the birth cycle at the Kalaban-Coro health center. However, it seems that there are other determinants of the birth cycle, hence the relevance of this study. Material and methods: This was a cross-sectional analytical study from October 1 to December 31, 2020. Results: The study included 977 parturients who gave birth in the department. It recorded more night deliveries (59.1%) than day deliveries (40.9%). The average age of the women was 25 years. Non-educated births were the most represented with 39% of cases. Nocturnal admissions were predominant (58.8%); 59% of parturients had a history of nocturnal delivery and 40% preferred to give birth at night, while 30% had no preference. At admission, 57.91% of parturients were in the active phase during the night, compared to 42.59% during the day; 52.6% of parturients had a nocturnal onset of labor, compared to 47.4% during the day. Conclusion: The study showed that childbirth is more frequent at night than during the day. It highlighted the admission nycthemer, the previous nycthemer of deliveries and the preference of the parturient as other determinants of the nycthemer of the delivery.

https://doi.org/10.30574/gscbps.2022.18.1.0021 Abstract Background : β-lactams and carbapenems. are the major antibiotics used to treat gram-negative bacteria and non-fermenting bacilli. However, the increasing production of β-lactamase and carbapenemase limits the therapeutic options. Our study aims to determine the resistant phenotypes of these bacteria while describing their epidemiological aspect. Material and Methods : This was a cross-sectional study by consecutive enrollment from January 2018 to December 2019 at Sominé DOLO Hospital of Mopti, Mali. We performed manual method for bacteria culture, identification and antibiotics sensitivity testing. The antibiotics sensitivity testing was accessed by the diffusion method according to CA-SFM/EUCAST (“Comité de l’Antibiogramme de la Société Française de Microbiologie” / European Committee on Antimicrobial Susceptibility Testing) recommendations V1.0 february 2018 and V2.0 may 2019 2019 V.2.0. May recommendation released in 2019. Data were analyzed by software R 4.0.3 GUI 1.73 Catalina build (7892). Results : At all 904 samples were included in this study. Out of the 904 cultures, 297 sample (32.85%) were positive. The rates of enzymes production were as follow: Extended-spectrum ß-lactamase (ESBL) 56.42% (101/179), cepholosporinase hyperproduction (HCASE) 15.64% (28/179), cephalosporinase production (CASE) 6.14% (11/179), penicillinase hyperproduction (HP) 5.58% (10/179), carbapenemase production (CP) 6.14% (11/179) and savage strains 10.05% (18/179). Conclusion : Our data showed a high prevalence of resistance to β-lactamins ß-talactamins and carbapenemes in gram-negative bacteria and non-fermenting bacillus bacilli. The A high level of β-lactamase and carbapenemase production by gram negative bacillus were also reported by others authors calls for the rational use of antibiotic in hospital

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.

https://doi.org/10.30574/gscbps.2022.18.1.0021 Abstract Background : β-lactams and carbapenems are the major antibiotics used to treat gram-negative bacteria and non-fermenting bacilli. However, the increasing production of β-lactamase and carbapenemase limits the therapeutic options. Our study aims to determine the resistant phenotypes of these bacteria while describing their epidemiological aspect. Material and Methods : This was a cross-sectional study by consecutive enrollment from January 2018 to December 2019 at Sominé DOLO Hospital of Mopti, Mali. We performed manual method for bacteria culture, identification and antibiotics sensitivity testing. The antibiotics sensitivity testing was accessed by the diffusion method according to CA-SFM/EUCAST (“Comité de l’Antibiogramme de la Société Française de Microbiologie” / European Committee on Antimicrobial Susceptibility Testing) recommendations V1.0 february 2018 and V2.0 may 2019 2019 V.2.0. May recommendation released in 2019. Data were analyzed by software R 4.0.3 GUI 1.73 Catalina build (7892). Results : At all 904 samples were included in this study. Out of the 904 cultures, 297 sample (32.85%) were positive. The rates of enzymes production were as follow: Extended-spectrum ß-lactamase (ESBL) 56.42% (101/179), cepholosporinase hyperproduction (HCASE) 15.64% (28/179), cephalosporinase production (CASE) 6.14% (11/179), penicillinase hyperproduction (HP) 5.58% (10/179), carbapenemase production (CP) 6.14% (11/179) and savage strains 10.05% (18/179). Conclusion : Our data showed a high prevalence of resistance to β-lactamins and carbapenemes in gram-negative bacteria and non-fermenting bacilli. The A high level of β-lactamase and carbapenemase production by gram negative bacilli were also reported by others authors calls for the rational use of antibiotic in hospital