Hydrogeophysical and Structural Investigations Using VES: A Case Study of Dosso Region in the Southwestern Part of the Meso-Cenozoic Iullemmeden Basin (Southwestern Niger)

A regional study connecting geolelectrical surveys with geology and hydrogeology was carried out in the western part of the Iullemmeden basin, precisely in the Dosso region in Niger. One hundred and four (104) vertical electrical sounds have been realized, among them nineteen representative were thus be used as parametric surveys. The local resistivity values of the geological formations of Quaternary range from 100 Ω⋅m to 1000 Ω⋅m (sands and lateritic sandstones). The Oligo-Miocene formation of the Continental terminal (Ct) shows resistivity values ranging from 1 to 5 Ω⋅m (brackish groundwaters) to 1500 Ω⋅m (clay sandstones) while the Upper Cretaceous formation of the Continental “hamadien” (Ch) indicates values ranging from 20 Ω⋅m (sandy clay) to 5000 Ω⋅m (clayey sandstones). The geological formations of Paleocene have values from 2 Ω⋅m (marls) to 60 Ω⋅m (calcareous marl), while the Precambrian basement exhibits values of granite around 300 Ω⋅m to 60,000 Ω⋅m. The update of the structural settings reveals many faults in the study area which explain both the shape of the basin and the geometry of the aquifers. Tectonics is also consistent with the hydraulic characteristics of aquifers. In addition, brackish groundwaters were identified as perched aquifer groundwaters in different depths in Dosso region. They probably come from the marine brines during the regression of the Paleocene Sea.

Satisfaction of Patients Operated on and Hospitalized in the Surgery Department of the Referral Health Center of Commune I in the District of Bamako (Resource-Limited Health District)

Introduction: Evaluating the quality of care offered is a reliable indicator of the effectiveness of a health system. Developing countries are still lagging behind in implementing these principles. This work aims to evaluate the satisfaction of patients operated on and hospitalized in the surgery department at the municipality’s reference health center over a period of 6 months (June 2020 to December 2020). Materials and Methods: This is a quantitative, qualitative, transversal and evaluative study over a period of 6 months based on a self-administered questionnaire to patients who underwent surgery and were hospitalized in the surgery department of the reference health center of commune I upon leaving their hospitalization. The questions are structured around welcome, respect and privacy, care, accommodation conditions as well as overall satisfaction. Results: The survey included 260 patients, 60.8% of whom were male. The 31 - 40 year old age group was in the majority and the majority had completed primary education (42.3%). Married patients were the majority, i.e. 60.4% of cases. Patients were not insured in 66.5% of cases. Almost all of the patients surveyed found that the welcome, care, waiting time, respect and privacy were satisfactory. On the other hand, patients found the rooms and beds uncomfortable. Conclusion: The satisfaction survey reveals worrying data regarding the comfort of patients who must challenge caregivers in healthcare structures. Decision-makers should find useful information there to improve the quality of care.

Maternal Fetal Prognosis: Pregnancy and Delivery in Women of 40 Years Old and Over in a Second Reference Hospital in Bamako

Introduction: Late pregnancies are considered a public health problem linked to maternal mortality due to their complications. These risks, which worsen with maternal age, should be better known and taken into account in monitoring these pregnancies. Objective: To evaluate the impact of age on the prevalence of obstetric and neonatal complications among parturients of 40 years old and over. Methodology: This was an 11-year retrospective analytical case control study from January 1, 2007 to December 31, 2017. The study population was female patients of 40 years old or older for cases and female patients younger than 40 years of control case. Results: In total, we collected 640 cases of parturients of 40 years old and over out of a total of 84,234 deliveries during the study period;i.e. a frequency of 0.76%. Spontaneous abortion increased in patients of 40 and over with 8.28%. Hypertension and diabetes were higher of women of 40 and over, 52.65%. Concerning the method of admission: 55% of parturients of 40 and over were referrals. Incidents occurring among women of 40 and over were more pronounced than in control cases. Complications during vaginal delivery, cervical tear, perineal tear, uterine dehiscence and uterine rupture are high in our cases, i.e. 11.88%;3.59%;2.19%;2.66. During our study, depending on the type of delivery, the cesarean rate was much higher among women of 40 and over than among control cases, i.e. 54.22% versus 12.24%. Hemorrhages in the 3rd trimester were the main indications for cesarean section. Hemorrhages in the 3rd trimester were more frequent with women of 40 and over, i.e. 10.47%;5.94% versus 1.74% and 0.42%. As for the different types of malformations in parturients, women under 40 years old fetal malformations were absent in 92.29%, on the other hand they were more frequent in patients with 40 years and over, i.e. a normal frequency of 36.72%. Conclusion: Pregnancy at a late age exposes the elderly patient and the newborn to several risks. During this study, an increase in maternal-fetal morbidity was observed with aged women.

Maternal and Perinatal Prognosis of Arterial Hypertension and Pregnancy in a Peripheral Health Center in Mali

Introduction: Maternal mortality constitutes a public health problem and its rate is an indicator of a country’s development. Among the causes of maternal and perinatal death, high blood pressure associated with pregnancy occupies a significant part. It represents 5% of direct maternal deaths. Objective: to study the maternal and perinatal prognosis of high blood pressure during pregnancy in the Tenenkou reference health center in Mali. Methodology: This was a descriptive, analytical and retrospective cross-sectional study over a period of twelve months from January 1, 2021 to December 31, 2021 and involving 144 cases of high blood pressure associated with pregnancy. Results: We obtained a frequency of 11.75%. The majority of patients 70.9% were aged between 20 - 35 years. The important risk factor found was young age. During our study, 46.5% of patients had performed at least one CPN and only 13.9% performed 04 CPN. Pre-eclampsia was the most common type of high blood pressure during pregnancy, i.e. 61.1%. Eclampsia and retroplacental hematoma were the most common maternal complications, respectively 27.8% and 11.1%. The most common fetal complications were premature births and fetal distress with 20.9% and 17.4% respectively. Conclusion: Hypertension associated with pregnancy still remains a major cause of maternal-fetal morbidity and mortality in our context where diagnosis is often late. The main clinical form was preeclampsia. Eclampsia and retroplacental hematoma were the most frequent maternal complications. Fetal complications were mainly prematurity and fetal distress.

Breast Cancer in Young Women about 87 Cases in the General Surgery Department CHU Gabriel Touré

Our objectives were to determine the frequency of breast cancer in young women, to determine the risk factors for breast cancer in young women, to detail the diagnostic process of the disease, to determine the different therapeutic strategies. This was a retrospective and descriptive study going from January 2005 to December 2021, a period of 17 years. The study involved 87 women with an average age of 33.2 years. Patients consulted 66 times or 75.9% for breast mass. The size of the tumor was greater than or equal to 5 cm in 62 patients;it was localized in the supero external quadrant 41 times or 47.1%. Molecular classification revealed the following results: Luminal A 21.4%;receptive (HER2) positive 28.6%, and triple negative 42.9%. Stage II was the most represented with 47.4%. Histology found infiltrating carcinoma of non-specific type in 76 patients. The treatment was mastectomy axillary dissection in 66 patients, quadrantectomy + axillary dissection in 6 cases (6.9%) associated with radiotherapy in 6 patients, chemotherapy was performed in 79 of our patients and hormone therapy in 10 patients. Conclusion: Breast cancer is frequent in our country. Patients generally consult us at a late stage. The possibility of determining certain receptors and carrying out certain non-surgical treatments on site would improve the prognosis.

Diagnosis and Therapeutic Aspects of the Ileo-Sigmoidian Node in the General Surgery Department of Gabriel Toure Chu

Introduction: Emergency medico-surgical ileosigmoid node is a rare cause of intestinal obstruction. Diagnosis and treatment must be prompt. Objective: To determine the frequency of NIS, to describe the diagnostic aspects, therapeutic aspects and to analyze the postoperative effects. Methodology: Retrospective and prospective study from January 2006 to December 2020 including all patients operated on for ileosigmoid node confirmed by the intraoperative diagnosis at the CHU Gabriel Touré. Results: From January 2006 to December 2020 (15 years), 30 cases of ileo-sigmoid node were recorded in the service. During this period NIS accounted for 0.19% of surgeries. Abdominal pain was present in (100%) of cases, vomiting was present in 80% and cessation of materials and gas (57%). All of our patients underwent ASP and CT (1 case). All of our patients were operated on, and exploration revealed intestinal necrosis in 97%. The surgical procedures performed were colostomy according to HARTMANN (63%), anastomosis resection (16%), devolvulation (10%). Restoration of continuity was achieved in (73%). The postoperative consequences were straightforward in (80%). Morbidity was 17% including infection of the lining. Mortality was 3% (1 case). Conclusion: NIS is an emergency, the diagnosis and the management must be fast and precise.

Isolated Congestive Reactional Non-Specific Retro-Peritoneal Adenitis Mimicking a Choledocal Cyst in a Case at the “Luxembourg” Hospital Center in Bamako

The aim of our work was to establish the diagnostic difficulty of isolated nonspecific retroperitoneal congestive adenitis on medical imaging. Patient: This is a 27-year-old patient from a district located 660 km from Bamako with no known medical history or notion of travel. The onset of the disease dates back to 3 years marked by pain in the right hypochondrium and the epigastrium radiating to the back in the form of torsion, of medium intensity associated with periodic vomiting and jaundice. She was referred to the medical imaging department for pain in the right hypochondrium and cholestatic jaundice. The abdominal CT scan with and without contrast injection showed an oval retroperitoneal mass, with regular contours sitting behind the head of the pancreas and in front of the right kidney with its hypo-dense center of density equal to 23 HU measuring 44 × 28 mm, with a thick wall enhanced after injection of contrast product. It was associated with a distended gallbladder with a thin wall and hypo-dense content and a moderate dilation of the intrahepatic bile ducts. Following these examinations, the diagnostic hypothesis of cystic dilation of the common bile duct was retained. Surgery made it possible to cure the retroperitoneal lesion, discectomy of the gallbladder and biopsy of the lesions. The histological examination made it possible to make the diagnosis of isolated nonspecific reactive congestive adenitis. Conclusion: Isolated nonspecific congestive retropancreatic adenitis with a necrotic center poses a diagnostic problem for imaging in our environment because of its similarity to the bile duct cyst. This study, which is a very illustrative case, showed us a diagnostic discrepancy between the result of cross-sectional imaging and that of surgery and pathology.

Volvulus of Colon Sigmoide in the General Surgery Department of Chu Gabriel Toure

Introduction: Sigmoid colon volvulus is a medico-surgical emergency which represents a common cause of colonic occlusion, it is characterized by strangulation of the sigmoid loop around its meso colic axis producing low mechanical occlusion [1]. Apart from this form conventionally described, the volvulus of the sigmoid colon can occur along an organoaxial axis. This form has been highlighted in the literature thanks to the diagnostic contribution of multi-detector scanners [2]. Objective: To determine the hospital frequency of sigmoid colon volvulus;to write the clinical and para-clinical aspects of sigmoid colon volvulus;write down the different treatments used for the management of sigmoid colon volvulus. Material and methods: This was a retrospective and prospective study that took place from January 2008 to December 2020 in the General Surgery Department of Gabriel Touré. The retrospective phase ran from January 2008 to December 2019 and the prospective phase from January 2020 to December 2020. Results: From January 2008 to December 2020, we collected 320 cases of patients operated on for sigmoid colon volvulus out of 7989 surgical emergencies over a 12-year period, or 3.64%. In our study, the most represented age group was between 16 and 60 years old, i.e. 81.88%. The mean age was 42.6 ± 17.4 years with extremities of 16 and 90 years. The male sex was the most represented, 89% with a sex ratio of 8.41. The surgical history was found in 13.75% of our patients. The clinic was dominated by abdominal pain (100%), meteorism (100%), and gas and matter arrest (91.3%). The most common radiological image found in the ASP was the double jamb, i.e. 74.69% of cases. We found sigmoid necrosis in 18.13% of cases. We found an absence of necrosis in the majority of cases, i.e. 91.56%. The most performed operative procedure in our patients was the RACR, i.e. 75.63% of cases. The reoperation was performed in only 5.94% of our patients. Complications were grade V in 42.55% according to the Clavin Dindo classification.