Malaria is a serious and potentially fatal parasitic infectious disease caused by several species of parasite belonging to the Plasmodium genus. The female Anopheles injects the parasite into humans in the form of a "sporozoite". This rapidly migrates via the bloodstream to the liver. Transmission can occur through mother-to-child transmission and transfusion of infected blood products. Objective: To study the prevalence of malaria among newborn babies in the paediatric ward of the CSRéf in Markala. Methodology: Cross-sectional, retrospective, descriptive study from 1st January to 30th December 2023. Results: The mean age at admission was 03 to 07 days and 08 to 14 days of life. The sex ratio was in favour of males (51%). The overall result for the prevalence of malaria according to the means of biological diagnosisused was 0.62% for the RDT compared with 56.52% for the GE. The weight range where the RDT was positive was weights over 3.5kg. The results for congenital malaria were 0% for RDT and 60% for GE. The sex-ratio was in favour of males (51%). The age range at admission was 3 to14 days. The highest number of cases was observed in the month of May. The overall prevalence of congenital malaria including the total number of babies with cord blood parasitaemia and peripheral blood parasitaemia was 18.6% and 56.8% respectively using microscopy and real-time PCR. The frequency of cases of submicroscopic congenital malaria (negative on thick blood smear and positive on PCR) was 12.2%). Theaverageadmissionweightofnewbornswas2.9kg+/-0.9andtheaveragebirthweightwas2,319g(160.03)and 83 (81.4%). Conclusion: Congenital and neonatal malaria is a public health problem in a malaria-endemic country such as Mali. We note a difference in diagnosis according to the different biological means of diagnosis (RDT and EW). Newborns showing signs of suspected sepsis should be screened and treated early.

The odontostomatology consultation is a medical visit which, according to Hippocrates, involves the following four stages: observation, palpation, percussion and auscultation. The aim was to study the reasons for consultation in Odontostomatology. Methodology: Retrospective and descriptive over three months from 1er January to 31 March 2022. Results: The age group 15 to 44 years was the most represented, i.e. 72% of cases. The female sex constituted 59%; the household profession was the most represented, i.e. 43% of cases, and the marital status was married (70%) of cases. Dental pain was the most frequent cause of consultation (98%), followed by dental mobility (2%), and self-medication was used by 37% of our patients. Dental caries was the most common diagnosis, accounting for 77.87% of cases. Conclusion: Early consultation and appropriate management can prevent the most serious complications of oral diseases.

DEMONS-MEIGS syndrome is defined by a pathological triad associating ascites, hydrothorax (Both can sometimes be associated) and an ovarian tumor, most often solid and benign but possibly cystic. Objective: To describe a case of Demons-Meigs syndrome observed at the Health Center of Reference of Markala. Clinical observation: We report the medical file of a 64-year-old postmenopausal lady, G11P7V6A0D1, IIG=2 years old without surgical history but poorly monitored hypertension. She was conducted in our department on 08/25/2020 in a picture of paroxysmal abdominal-pelvic pain with gravity type associated with an alteration of the general condition. It is associated with a productive cough with dyspnea of effort and previous chest pains. After the physical examination, there was a voluminous rounded pelvic mass going from the epigastric region to the pubic hair, the ultrasound examination having objectified an ascites of medium abundance and a voluminous left pelvic mass of 191mm / 120 mm then the chest X-ray from the front showing a right basal pleural effusion, the diagnosis of Demons-Meigs syndrome was evoked. After a preoperative assessment and a pre-anesthetic consultation, an exploratory laparotomy was performed. At the celiotomy, a serohematic ascites of 1.5 l is discovered, a large ovoid and pediculated ovarian tumor of the left ovary, not bumpy, overhanging the uterus, not twisted and not adhered but easily mobilizable. Conclusion: The Demons-Meigs syndrome which essentially comprises a benign ovarian tumor, ascites and a recurrent pleural effusion, characterized by healing without sequelae with drying of the effusions (Ascites and pleurisy) after removal of the ovarian tumor still retains a rather obscure etiology and pathophysiology.

Our work is a prospective study of 73 caesarean section cases (from 10 October to 10 December 2022), i.e. a period of 2 months at the Csréf in Markala. Our caesarean section success rate was 65.17%. The 20 to 40 age group was the most represented, with 73.97%, ranging from 16 to 42. In 83.56% of cases, caesarean sections were performed urgently. The indications for caesarean section were dominated by scar uterus (28.77%) and acute foetal distress (19.18%). General anaesthesia was the anaesthetic technique used in 89.04% of cases. Ketamine was the only narcotic used for induction and maintenance. Vomiting (8.22% of parturients) was the most common post-operative complication in the immediate post-partum period. Post-operative pain was managed with a combination of Paracetamol and Nefopam.

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.

Necrotizing fasciitis is an infection of the skin and deep subcutaneous tissues, spreading along the fasciae and adipose tissue, mainly caused by Group A streptococcus (Streptococcus pyogenes) but also by other bacteria such as Vibrio vulnificus, Clostridium perfringens or Bacteroides fragilis. Objective: To report a case of Necrotizing Fasciitis received at the Markala Reference Health Center. Clinical observation: It was a 45-year-old rice farmer with no known medical-surgical history received for an extensive wound on the right upper limb evolving for three months with impaired general condition and consciousness. The onset of the symptomatology dates back to about 3 months marked by a paronychia of the pulp of the right thumb extended secondarily to the right forearm. The physical examination finds an extensive necrotic wound of the right upper limb presenting voluminous blisters of brown color with a black background filled with purulent and smelly serosities. The diagnosis of Necrotizing Fasciitis was strongly suspected due to the presence of Pyogenic Streptococcus (Sensitive to gentamycin and Amoxicillin) in the pus sample. The patient was therefore put on antibiotic therapy combining Clavulanic acid at a rate of 2g x 3 per day and gentamicin at a rate of 160 mg per day with wide excision of necrotic tissues under general anesthesia in the operating room followed by a daily dressing with 30V hydrogen peroxide and Polyvidone iodine. The evolution was very favorable with a directed healing on D16. Conclusion: Necrotizing fasciitis is distinguished by its increasingly increasing and worrying frequency, its clinical severity and its detrimental character from a functional and vital point of view, which is why its management must be early.

This was a retrospective study conducted at the Markala referral health centre from 2019 to 2022. The general objective was to study caesarean section at CS Réf in Markala. During our study period from 2019 to 2022, we recorded 1244 caesarean sections, i.e. a frequency of 28.29% of all deliveries. Parturients were evacuated in 51.6% of cases. Only 14.23% of our parturients were well monitored. The most frequent indication for caesarean section was SFA in 30.1%, i.e. 375 cases. The surgical procedure most frequently associated with caesarean section was LRT. Maternal mortality was 0.3%, mainly due to haemorrhage and pregnancy-related maternal pathologies. Maternal morbidity was dominated by infections, severe anaemia and haemorrhage. Fetal mortality was 11.9%, mainly due to severe fetal distress. Resuscitation was required for 23.5% of our caesarean section babies. Improving these results requires the support of all sectors of society.

A cross-sectional study with two collection techniques, a retrospective collection involving 347 files and a cross-sectional collection by face-to-face mode interview of the mothers of the 9 children who died during the collection period and part of the nursing staff. It aimed to assess mortality among malnourished children aged 6-59 months and to contribute to the improvement of their health status. The mortality rate among the malnourished is relatively low 3.69%. Malaria was frequently associated with malnutrition: 53.65%. Hypovolaemic and septic shock were the most common causes of death with 46.15 and 38.46%. In view of these results, emphasis should be placed on early referral of children with complications and also on vaccination campaigns, awareness-raising on exclusive breastfeeding and dietary diversification. In Mali in general and in Fana in particular, malnutrition remains a huge health problem in children aged 6-59 months.

The aim was to carry out an epidemioclinical and therapeutic study of fractures of the penis at the Csréf in Markala. Patients and methods: This is a retrospective prospective descriptive study of 13 cases of fracture of the penis during four years at the Csréf of Markala from 01 January 2019 to 01 January 2023. All patients who had a treated penis fracture were included in our study. All patients who had other forms of trauma to the penis other than a penis fracture were excluded. Results: The frequency of fracture of the penis was 14.8% compared to other urological injuries. The average age of our patients was 36.30 years with extremes ranging from 25 to 54 years. 53.8% of our patients were single. The average consultation time was 14.8 hours, with extremes ranging from 3 hours to 47 hours. The approach was longitudinal in some cases and in other cases a circumferential incision or at the level of the balano preputial fold. The most frequent complications were penis bending, with 15.5% (2 patients), urethral fistula was observed in one patient (7.7%), and we also noted cases of fibrosis of the erectile bodies (23.1%). Conclusion: The fracture of the penis is a real uro-andrological emergency, and the treatment must be rapid and effective in order to avoid irreversible after-effects, which may even lead to erectile dysfunction or urethral stricture in these patients. The approach must be appropriate in order to prevent short, medium and late complications.

The aim of this study was to evalute the performance of the referral system for evacuation of obstetric emergencies between the CSCom and the CS Réf in Markala from 1 January 2021 to 31 December 2021. This study enabled us to identify:  The performance of the evacuation reference system between the CSCom and the CS Réf in Markala; • The effectiveness of maternal death audits ; • Holding staff meetings; • The mother's condition.  The problems related to : • The functionality of the management committee; • The child's condition; • Payment of co-payments. At the end of the work, it was concluded that the evacuation reference system between the CSCom and the CS Réf in Markala was not performing well with regard to the criteria set by the evaluation team.

The level of use of MCMs remains low in our country. The objective of this study was to analyze the factors associated with the low use of modern contraceptive methods in the Diamarabougou health area. It was a cross-sectional study with an analytical focus conducted among 150 PAFs selected through random sampling. The study established the following: -Modern contraceptive prevalence was 35%. -The majority of women knew about family planning (99%). -The main source of information was health personnel (34.7%). -The reasons for the low use of MCM were The low level of education of the woman and/or her spouse, the desire to have many children and the unfavorable opinion of the spouse. -Both men and women believe that lack of control over the menstrual cycle, jealousy, and lack of distraction are the reasons for many unplanned pregnancies; - The main disadvantage of contraception is infertility. -The main disadvantage of contraception is sterility. For the ATRs, contraception is an effective way to fight against maternal and infant mortality. They also believe that the use of contraception and the choice of a smaller family are also accompanied by significant economic and material advantages, as expenses related to health, education and family maintenance are reduced. Conclusion : The use of modern contraceptive methods remains low in the Diamarabougou health area. The correct information to women and the identification of associated factors: the low level of education of the woman and her spouse, the desire to have many children, insufficient discussion with the spouse and the lack of involvement of traditional birth attendants in family planning programs.

Trauma of the external genitalia is defined as a set of local lesions, involving tissues and organs, caused by an external agent following various mechanisms. The objective of our work was to write the management of two cases of trauma of the external genitalia at the Csréf of Markala.

Scrotal elephantiasis (scrotal lymphoedema) is defined as an increase in scrotal volume that can reach a very large size. It has functional (burying of the penis), aesthetic and psychological repercussions. This is an extreme feature of lymphatic filariasis, which is mainly seen in endemic filarial areas. Outside these areas, this condition is rare and is usually idiopathic, rarely congenital. We report a case of scrotal elephantiasis treated by wide excision of the pathological scrotal wall and scrotal plasty, with a good functional and aesthetic result.

Described since the 15th century by Ambroise Paré, adult hydrocele is an abnormal collection of serous fluid in the space between the parietal and visceral layers of the tunica vaginalis It is generally a lesion acquired by attack of the integrity of the vagina, unlike the hydrocele of the child due to the persistence of the peritoneal-vaginal canal. Purpose: To study the epidemiological, clinical and therapeutic aspects of hydrocele in the reference health center of Fana. Methodology: A descriptive prospective study, conducted from January 1, 2020 to December 31, 2020 of the CSRéf of Fana. Results: We collected 66 cases of hydroceles be 16.8% of surgical activities. The average age of disease was 49.27 ± 4 years. The age of 60 to 74 was the most represented with a frequency of 39.4%; Harming during physical activities has been the most common reason for consultation and accounted for 51%. The hydrocele was idiopathic in the majority of our patients in our study, or 65%. The nature of the vaginal fluid was yellow citrin in the majority of patients or 90.9%. Hernie was the most frequently associated pathology with the hydrocele (11 out of 26) or 42%. The Bergman technique was used in 77% of patients and closing the peritoneo-vaginal canal in 23%. Morbidity was 4.5% (3 cases) with hematoma type and 1.5% (1 case) with type of infection. The mortality rate has been zero. Conclusion: Vaginal hydrocele is a pathology that remains frequent in tropical regions. Surgical treatment by total vaginal resection with hemostatic overlock gives good results. Its morbidity is low, dominated by intrascrotal hematoma and infection of the surgical site which are generally well controlled by rigorous care.

Road traffic accidents are the second cause of mortality between 30 and 40 years worldwide. They are 1,2 million injured or disabled person. It was a prospective and descriptive study of 223 cases of road accidents, occurring from 01 January to 31 December 2020 and consulted at the CSREF of FANA, of which. Objective was to study the trauma caused by the public road accidents at the FANA reference health center. Results: During our study period we have completed 13471 Curative consultations, 6130 Emergency Home Consultations, 45.5% of which 223 AVP cases are 3.64%. The frequency of road accidents in the FANA CSREF is 3.64%. The average age observed in our sample was 27.51 ± 15.57 with extremes ranging from 4 to 70 years. A male predominance, 72.6% and a 2.65 ratio sex. The most represented socioprofessional layer is students and students with 34.5% case. The wound lesion is the most observed 63.2%. Cases of type ski-type accident accounted for 36, 8% of the cases. Conclusion: traffic accidents nowadays constitute a growing threat of precious losses in human life and disabilities for our populations, which constitutes a potential waste human resources and economic growth.

The aim was to assess maternal and neonatal deaths. Materials and Methods: This was a cross-sectional retro-prospective study on the evolution of the trend of maternal and neonatal deaths in the fana health district from 01 January 2018 to 31 December 2022. Results: We recorded the following assisted delivery rates: 69.19% in 2018; 74.44% in 2019; 73.35% in 2020; 80.47% in 2021 and 79.13% in 2022. The maternal death rates in the fana health district from 2018 to 2022 are 0.20, 0.26, 0.44, 0.43 and 0.47 per 1000 live births, respectively. Theneonatal death rate in the Fana Health District from 2018 to 2022 is 1.9; 1.7; 1.1; 1.4 and 1.0 per 1,000 live births. Maternal death rates in the Koulikoro region and Mali from 2018 to 2022 evolved as follows: 0.28; 0.26; 0.32; 0.32 and 0.32 costs 0.48; 0.43; 0.48; 0.49 and 0.42 per 1000 live births, respectively. Neonatal death rates in the Koulikoro region and Mali from 2018 to 2022 evolved as follows: 1.8, 1.6, 1.6; 2.2 and 2.4 co n tre 2.4; 2.3; 2.2; 2.3 and 2.2 per 1000 live births, respectively. Conclusion: Maternal and neonatal mortality rates remain a priority problem in developing countries, including ours, but we believe that the creation of the SO NUB and SONUC structures and the recruitment of qualified personnel could really reduce the rates obtained.

This is a 20-year-old man admitted for abdominal pain, proctalgia and rectorrhagia of medium abundance that occurred 48 HOURS after voluntary introduction into the rectum of a bottle of Tetracycline 10% for therapeutic purposes. On rectal examination, we noted the lower end of a bottle-type object about 5cm from the anal margin. The ASP did not objectify signs of perforation, on the other hand, she highlighted a bottle-type object of about 6 cm at the level of the upper rectum. A laparotomy was performed to extract it by pushing it back towards the anus without opening the colorectal lumen. Conclusion: The introduction of a foreign body rectally is a rare phenomenon nowadays, especially in developing countries. There is no gender specificity, nor age range. Easy clinical diagnosis, its early management makes it possible to avoid serious complications.

Vaccination is one of the most efficient public health interventions in developing countries with epidemiological facies dominated by communicable diseases. Objective: To evaluate the efficiency of the logistical management of routine EPI vaccines and consumables in the Fana health district from 01 December 2018 to 30 November 2019. Results: The efficiency of the health areas in monitoring the storage temperature of vaccines (+2°c to +8°c) was 94.54%. The district obtained a rate of 100% in the management of stocks of vaccines and consumables. As for the quality of the cold chain equipment, the average rate obtained by the health district was 96.81%. The rate obtained by the district was 100% in relation to the maintenance of the cold chain equipment. In stock management, the average rate recorded in the district was 97.27%. The district obtained a rate of 100% in the efficiency of the vaccine management system. The average rate obtained by the district was 96.59% in the correct use of diluents. In the implementation of the Policy on opened vials (PFE), the rate obtained by the district was 90.81%. During the period, the management is 89.18% for the control of vaccine losses. Conclusion: All the cold chain equipment used for vaccine storage (Churchill solar fridges and vaccine carriers) comply with World Health Organization standards.

This is a prospective cross-sectional study which took place at Segou Hospital from 15 January 2019 to 15 January 2022 on the management of female infertility by tubal obstruction in laparoscopic surgery at Segou Hospital on 14 cases. 42.9% were between 31 and 35 years of age. The mean age was 20.3 years, with extremes ranging from 20 to 41 years. Civil servants were the most represented, with 42.9% in our series, followed by shopkeepers with 21.4%. All our patients were married. 78.6% had primary infertility, 21.4% had secondary infertility. The average duration of infertility was 1.9 years, with extremes of 2 and 10 years. Obstetrical outcome after catheterisation was favourable in four (4) of our patients, i.e. 28.6% had a pregnancy after recanalisation compared with 71.4% without pregnancy. Conclusion: The advent of laparoscopic surgery in our country has made it possible to improve care for women suffering from female infertility.

Caesarean section is a procedure allowing the extraction of the fetus and its appendages after surgical opening of the uterus by transabdominal rarely vaginally. Objective: To study the practice of caesarean section in a context of free education in the Fana health district. Methodology: This is a cross-sectional retro-prospective study on the evolution of the caesarean section trend in a context of free in the health district of fana from 01 January 2020 to 31 December 2022. Results: We recorded: 1303 caesarean sections distributed as suites: 363 in 2020 (2.26%); 481 in 2021 (2.93%) and 459 in 2022 (2.72%). 10,686 assisted deliveries in 2020 or 73.35%; 12,779 assisted deliveries in 2021 or 80.47% against 11,348 assisted deliveries in 2022 or 79.13%. The 20-2-9 age group was the most represented, i.e. 4-2.90% with extremesof 14 a n s and 45 a ns. 81.43% of patient nosinthe fana health district. The majority of our patients are married women, i.e. 93.48%. 85.42% of caesarized women are housewives. Caesarean section completion rates evolved as follows from 2020 to 2022: 2.26%; 2.93% and 2.72%. At the same time the Koulikoro region obtained rates of 2.25%; 2.33% and 2.46% against 3.06%; 3.48% and 3.29% as national rates respectively in 2020; 2021 and 2022. Conclusion: Free caesarean section has led to anupward trend in the number of caesarean sections even if the objective national is not reached.