Prevalence of Refractive Errors among School Children Aged 5 to 15 Years Old at CHU-IOTA

Introduction: Undetected refractive errors constitute a health problem among school children who cannot take advantage of educational opportunities. The authors studied the prevalence of refractive errors in school children aged 5 to 15 at CHU-IOTA. Patients and Method: This is a prospective, descriptive cross-sectional study carried out in the ophthalmic-pediatrics department of CHU-IOTA, from October to November 2023. Results: We received 340 school children aged 5 to 15, among whom 111 presented ametropia, i.e. a prevalence of 32.65%. The average age was 11.42 ± 2.75 years and a sex ratio of 0.59. The average visual acuity was 4/10 (range 1/10 and 10/10). We found refractive defects: astigmatism 73.87%, hyperopia 23.87% of cases and myopia 2.25%. The decline in distance visual acuity was the most common functional sign. Ocular abnormalities associated with ametropia were dominated by allergic conjunctivitis (26.13%) and papillary excavation (6.31%) in astigmatics;allergic conjunctivitis (9.01%) and papillary excavation (7.20%) in hyperopic patients;turbid vitreous (0.90%), myopic choroidosis (0.45%) and allergic conjunctivitis (0.45%) in myopes. Conclusion: Refractive errors constitute a reality and a major public health problem among school children.

Prevalence of Ocular Trauma at the Reference Health Center (CSREF) of Kati

Introduction: The authors wanted to study the prevalence of ocular trauma in the ophthalmology unit of the CSREF of Kati. Patients and method: This is a retrospective study, covering the period from January to December 2015, carried out in the ophthalmology unit of the CSREF in Kati. Results: The sample consisted of 568 patients, or 6.82% of ophthalmological consultations. Children aged 0 to 14 years accounted for 154 (27.11%) of the trauma cases. Bruises constitute the main circumstance (58.1%) of eye trauma, followed by domestic accidents (15.6%). Closed globe ocular trauma was the main type of trauma (61.6%), followed by ocular adnexal trauma (30.1%) and open globe trauma (8.3%) in which the penetrating wound was the lesion, the least common (2.6%) but the most serious. Medical treatment was the most used therapeutic modality in 82.4% of cases, followed by surgery with 17.6% of cases. The evolution of the lesions after treatment was favorable in 85.6% of cases and unfavorable in 14.4% of cases. Complications were observed in 5.8% of cases and sequelae in 8.6% of cases. Conclusion: Ocular trauma constitutes an important reason for ophthalmological consultation at the CSREF of Kati. The severity of some of these lesions requires frequent recourse to surgery. The complexity of the treatment should encourage us to favor preventive measures.

Giant Tuberculomas Suggesting a Malignant Brain Tumor: About Two Cases

Tuberculoma is a common condition in developing countries. In some cases, it may mimic a glial lesion, making differential diagnosis challenging. The authors report two cases of giant tuberculoma in young patients aged 14 and 16. A literature review was conducted on these cases. Both patients underwent partial excision. Histology concluded tuberculoma. Anti-tubercular treatment was implemented. The evolution one year later was marked by the persistence of neurological disorders, although they had improved.

Cervical Meningocele about 2 Operated Cases

Cervical meningoceles are the least common forms of spina bifida, representing between 4% to 8% of all spinal dysraphisms. They are not accompanied by neurological deficit in childhood but attached cord syndrome can occur with growth. Surgical treatment, in addition to avoiding rupture and correcting the aesthetic damage, will preserve neurological functions. We report 2 cases that we took care of. They are a 5-month-old infant and a 3-year-old girl. The first presented a 7 cm rounded meningocele pedunculated through the C1 lamina defect. The second presented an 8.6 cm polylobed meningocele pedunculated through the C2 lamina defect. They both underwent surgery with good progress.

Angiographic Features of Intracranial Aneurisms in Mali: A Preliminary Study of 105 Patients

Introduction: Rupture of intracranial aneurisms leads to severe morbidity and mortality. There are two modalities of treatment surgery and endovascular treatment. The diagnosis is made by angiography (DSA, CTA, RMA). The angiographic features used to assess the risk of the complications and choose the treatment modality are size, location and aneurism morphology. Materials and Methods: We reviewed and analyzed the computed tomographic angiography and magnetic resonance angiography of all patients admitted to the hospital of Mali with IAs from 2015 to 2021 either 7 years. Patients who were less than 18 years old, those with non-aneurysmal SAH, patients who request a discharge and those with an incomplete angiographic description of the IAs were excluded from the analysis. Results: We have collected 105 patients with 109 aneurysms. The sex ratio was 2/1 in favor of females. The mean age was 44.51 years with the range from 18 to 70 years. The presentation mode was subarachnoid hemorrhage (SAH) in 97% of cases. 76.19% had confirmed high blood pressure before the bleeding. 19.04% were diabetics. 98% of our patients have made a CT angiography and 2% have made MR angiography for the aneurysm diagnosis. 97.24% of aneurisms were located in the anterior part of the Willis circle. 39.44% of these aneurisms were the anterior communicating complex aneurysm. 27.52% of aneurysm had a small size, 42.20% had a medium size, 20.18% large size against 5.50% of the giant (Figure 3) and the middle cerebral artery was the most involved in the least. 95.41% of cases were saccular aneurysms against 4.59% fusiform. Conclusion: The angiographic feature of an intracranial aneurism in the Malian population may differ from other populations of the sub-region. The anterior communicating complex aneurysm is more common and the aneurism of the posterior part of the Willis circle is less common. We found the aneurism size ≥ 6 mm, ACA, MCA and Pcom more frequent.

Basedowian Orbitopathy Without Thyreotoxicosis : A Case Report from Sikasso Hospital

Basedowian orbitopathy is an autoimmune disease representing the most frequent extra-thyroidal manifestation. Its pathophysiology is imperfectly elucidated and is the result of cross-reactivity between thyroid antigens and orbital tissue. It is most frequently seen in the context of hyperthyroidism (basedow’s disease or Graves’ disease), sometimes hypothyroidism (Hashimoto’s thyroiditis), or euthyroidism. Diagnosis is often straightforward, but management remains difficult. The introduction of simple medical treatment exposes the patient to the risk of recurrence. In Sikasso, there have been few studies of Graves’ disease. The aim of this study was to describe the clinical, therapeutic and evolutionary features of Graves’ disease in Sikasso Hospital. The patient was a 35-year-old woman with no previous history of Graves’ disease and no history of alcohol or tobacco intoxication, consulting for bilateral exophthalmos with moderate pain for 1 year. Endocrine tests were normal (euthyroidism), as was orbital-cerebral MRI, which revealed stage II exophthalmos with no sellar or supra-saltar abnormalities. The main complication was exposure to keratitis. Our patient was treated with corticosteroids. The evolution was favorable under treatment, with no recurrence after one year’s follow-up. Graves’ disease is the most common cause of hyperthyroidism, but this should not obscure the diagnosis of euthyroidism, as demonstrated in this case report. Exophthalmos remains the main ophthalmological clinical manifestation.

Basedowian Orbitopathy Without Thyreotoxicosis : A Case Report from Sikasso Hospital

Basedowian orbitopathy is an autoimmune disease representing the most frequent extra-thyroidal manifestation. Its pathophysiology is imperfectly elucidated and is the result of cross-reactivity between thyroid antigens and orbital tissue. It is most frequently seen in the context of hyperthyroidism (basedow’s disease or Graves’ disease), sometimes hypothyroidism (Hashimoto’s thyroiditis), or euthyroidism. Diagnosis is often straightforward, but management remains difficult. The introduction of simple medical treatment exposes the patient to the risk of recurrence. In Sikasso, there have been few studies of Graves’ disease. The aim of this study was to describe the clinical, therapeutic and evolutionary features of Graves’ disease in Sikasso Hospital. The patient was a 35-year-old woman with no previous history of Graves’ disease and no history of alcohol or tobacco intoxication, consulting for bilateral exophthalmos with moderate pain for 1 year. Endocrine tests were normal (euthyroidism), as was orbital-cerebral MRI, which revealed stage II exophthalmos with no sellar or supra-saltar abnormalities. The main complication was exposure to keratitis. Our patient was treated with corticosteroids. The evolution was favorable under treatment, with no recurrence after one year’s follow-up. Graves’ disease is the most common cause of hyperthyroidism, but this should not obscure the diagnosis of euthyroidism, as demonstrated in this case report. Exophthalmos remains the main ophthalmological clinical manifestation.

Meningioma of the Optical Nerves in a Case at the Hospitalier Center of Saint Denis in Ile de France

Summary: Optic nerve tumors are rare tumors, representing 3% - 5% of intracranial tumors developing mainly along the optic nerve and/or the chiasm. Optic nerve meningiomas are histologically benign tumors whose severity is linked to diagnostic and especially therapeutic difficulties. The Optic nerve meningioma is the second leading cause of optic nerve tumor after glioma. Observation: We report the case of a 49-year-old woman from South Asia, who consults an ophthalmology department for progressive visual loss in her right eye for about a year with her glasses and would like to renew her optical correction. Having no particular medical history apart from left unilateral blindness is known for approximately 15 years. Magnetic Resonance Imaging (IRM) cerebral found a tissue mass with a clear outline and polylobules on the left temporo-peduncular. Through this case, we describe the circumstances of discovery of the disease, the clinical characteristics, as well as our diagnostic approach. Conclusion: In the majority of cases, these are benign tumours, the circumstances of which are discovered in multiple ways. A mostly unilateral and non-improvable loss of visual acuity must attract our attention. Renewing glasses may be the reason for discovering the disease. Today Magnetic Resonance Imaging (IRM) remains an important and capital examination for the diagnosis and monitoring of this pathology.

Corneal Blindness Caused by Accidental Ocular Use of Chlorhexidine (Hexz) Gel in Two Newborn Born in the Health District of Kati in Mali

Introduction: Corneal opacities in children are relatively common. In children, it is urgent because of the risk of irreversible amblyopia. The causes of these blindnesses vary considerably according to the regions of the world. Chlorhexidine digluconate is a broad-spectrum antiseptic directed against gram-positive and gram-negative bacteria. It has been used as an antiseptic for more than 50 years, both in humans and in animals. However, despite these benefits, it can cause serious damage if applied to the eyes. Incidents of eye damage with 7.1% chlorhexidine have been reported to WHO across Africa. Observation: We report and write two cases of bilateral corneal blindness caused by accidental ocular use of chlorhexidine (HEXZ) GEL 7.1% in two newborns in the health district of Kati in MALI. The ophthalmological examination had revealed corneal opacity, conjunctival hyperaemia and limbic ischemia greater than 50% in 1 eye out of 4, corresponding to stage IV of the ROPPER HALL classification;2 eyes out of 4 were at stage III and 1 eye out of 4 was at stage I of the same classification. Conclusion: It is essential to ensure correct use of chlorhexidine digluconate gel 7%. It is an antiseptic which should not be used on the ocular and auditory mucous membranes, at the risk of most often permanent burns.

Bilateral Central Serous Chorioretinopathy (CRSC) in Pregnancy Complicated with Retroplacental Hematoma: About a Case

Introduction: Central serous chorioretinopathy (CSCR) is associated with serous sensorineural retinal detachment in the macular region. The condition that affects the male gender more than their female counterpart results from focal leakage disturbance of retinal pigment epithelial cells and choroidal abnormalities. The corticosteroid is highlighted as one of the major factors that promote the occurrence of CSCR. Stress and pregnancy, especially in the third trimester, have also been reported by some authors. Central serous chorioretinopathy associated with pregnancy complicated by retroplacental hematoma is a rare event. Observation: We report the case of a pregnant woman at approximately 34 weeks of amenorrhea who presented a sudden and severe drop in visual acuity on a pregnancy complicated by retroplacental hematoma and delivered by cesarean section. The diagnosis was based on clinical arguments associated with photos of the retina made by the MII Ret Cam device (Made In India, Retinoscope Camera) highlighting the lifting of the macular region. Ophthalmological monitoring without medical or physical treatment was instituted. At two months of progression without treatment, bilateral visual acuity was 10/10. Conclusion: Central serous chorioretinopathy and pregnancy is not unusual;however, its bilateral and brutal form in a context of pregnancy complicated by retroplacental hematoma is rare. Despite this favorable evolution, monitoring remains necessary in order to prevent recurrences and complications.

Palpebral Reconstruction in a Secondary Ophthalmology Center in Mali: About a Case

Introduction: Significant trauma to the periocular region can seriously damage ocular structures and their adnexa. The eyelids can be damaged during these traumas. The most frequent lesions are lacerations, the surgical treatment of which is generally simple. In some cases, there are complex traumas where there is a loss of tissue, which is difficult to treat. We report the case of a 26-year-old young man, farmer with no medical and surgical history, referred by the odontostomatology and maxillofacial surgery department for burns to the left hemi face by the exhaust pipe of his motorbike which occurred following a public road accident (AVP). Observation: A 26-year-old young man with no medical-surgical history, visual acuity was 5/10 with good mobility of the globe. In collaboration with the maxillofacial surgeon, a graft of the hemi face was performed using a flap from the inner side of the thigh first. In the second time we carried out a recovery by a flap which consisted in taking a supra-superciliary flap and suturing it at the level of the palpebral edges which, in spite of a fragile vitality of the tissues. Conclusion: The reconstruction of the eyelid is a real problem in our service because of the technical platform and the availability of consumables, which limits us in the choice of the operating technique.

Development of an Intelligent Queue Manager That Takes Account of the Social and Health Context

Virus prevention has been considered central to the fight against the COVID- 19 coronavirus pandemic. To limit the spread of the virus in public places, several measures have been taken, in particular respect for barrier gestures. This work is part of this dynamic and sets up a new wireless version of an electronic and nominative queue manager using artificial intelligence for more equity, inclusion and solidarity. This system, named Gifa is developed in our laboratory. The first prototype, whose connections are largely provided by a wired system with an artisanal acquisition module, is difficult to deploy for general public use, especially in buildings already built. This article deals with an artificial intelligence queue management system, presenting more functionalities, whose access to the service is ensured in very large part by wireless exchanges with a modern acquisition module realized by 3D printing. The flexible and autonomous design of this device makes it particularly easy to deploy on premises open to the public without having to modify the existing installation for commissioning. The manager is equipped with a configuration terminal, and at the counters the call is made by a cashier also equipped with a tablet connected to the wifi network. Its display screen shows certain information relating to the identity of the customer such as his face, his order number, his first name and last name. This reduces the authentication time of the person at the checkout, queue bypasses for more fairness and less stress. This work has resulted in the improvement of queue management systems by giving them more flexibility to make them more adaptable in several types of environments and other contexts.

Intracranial Calcified Extradural Hematoma about a Case

Introduction: Extradural hematoma is a common pathology in our department. The natural history of small-volume hematoma is usually towards resorption. In rare cases, the hematoma calcifies and compresses the brain. We report an extradural hematoma in a 15-year-old boy who had a road traffic accident on February 2011. The brain CT-scan performed the following day revealed a small right frontal extradural hematoma. During hospitalization, he had a fever of 40 degrees with convulsions and the blood culture isolated the coagulase-negative staphylococci and Group D streptococci. When his conscience was restored, hemiparesis and dysarthria were observed. The control brain CT-scan performed 2 weeks after the trauma showed early resorption of the hematoma. Two months after the trauma, the brain CT-scan showed calcification of the hematoma. He underwent surgery in April 2011 to remove the calcification. The sequels were hemiparesis and posttraumatic epilepsy. Conclusion: The evolution of a small non-operated extradural hematoma can be done towards calcification thus requiring surgery.

Stand-Alone Patient Reception and Referral System with Health Data Management

The COVID-19 pandemic has exposed vulnerabilities within our healthcare structures. Healthcare facilities are often faced with staff shortages and work overloads, which can have an impact on the collection of health data and constants essential for early diagnosis. In order to minimize the risk of error and optimize data collection, we have developed a robot incorporating artificial intelligence. This robot has been designed to automate and collect health data and constants in a contactless way, while at the same time verifying the conditions for correct measurements, such as the absence of hats and shoes. Furthermore, this health information needs to be transmitted to services for processing. Thus, this article addresses the aspect of reception and collection of health data and constants through various modules: for taking height, temperature and weight, as well as the module for entering patient identification data. The article also deals with orientation, presenting a module for selecting the patient’s destination department. This data is then routed via a wireless network and an application integrated into the doctors’ tablets. This application will enable efficient queue management by classifying patients according to their order of arrival. The system’s infrastructure is easily deployable, taking advantage of the healthcare facility’s local wireless network, and includes encryption mechanisms to reinforce the security of data circulating over the network. In short, this innovative system will offer an autonomous, contactless method for collecting vital constants such as size, mass, and temperature. What’s more, it will facilitate the flow of data, including identification information, across a network, simplifying the implementation of this solution within healthcare facilities.

Improving the Stability of the Inflatable Soil of Diamniadio by Using Typha Australis in Order to Value It in Partitioning Wall

The construction industry in Senegal is experiencing an upsurge in the development of residential housing units and administrative buildings within the new Diamniadio municipality, an area located just about 35 km from the capital city of Dakar. Laboratory oedometer or expansive-index tests, however, show poor density and compromised shear strength in the soil samples within the area -posing serious construction problems due to significant volume changes (swellings) that occur when subjected to moisture, thus, bringing into question the structural performance integrity of the soil, and the financial implications of substitute soil types used to compensate for its poor tensile strength. By way, the companies collect the soil of this location (Diamniadio) and throw it to make pile or micro-pile (pious) for their structures. This article demonstrates how we can value the soil of Diamniadio and the Typha Australis in residential building with a reasonable cost. Typha Australis is a plant generally luxuriant within the northern and central belts of Senegal but also known for its negative ecological impacts on the agricultural production of rice. The valorisation of the soil of Diamniadio will pass by the ability to increase its stability or to decrease its shrinkage/swelling rate. When we achieve it, the soil associate with Typha Australis will be used for small bricks which can be useful for partition wall and so the soil will not be ever thrown as a non-useful material. Tests results of soil specimens extracted from the site show a shrinkage rate of 29.19% with estimated cracking depths of 3.5 cm. But by adding gradually Typha Australis, the shrinkage rate will pass from 29.19% to 5.13% with the material treats with 10% by mass of Typha Australis. Moreover, the crackings in the cylindrical specimen disappear. That shows the increase of the stability;thus the composition will be used for building bricks. However, the densities will also be affected by the presence of Typha Australis. The density is decreased from 2032.28 Kg/m3 for the soil without Typha Australis to 937 Kg/m3 for the one with 10% of Typha Australis.

Thermophysical Characterization of Typha’s Concrete for Its Integration into Construction

Energy consumption in the building sector is constantly increasing and represents more than 44% in the residential and tertiary sectors in many countries [1]. Thus, the building represents a real possibility of energy saving and is the subject of several studies particularly in actual context of experimentation with materials based on plant fibers (hemp, flax, millet wastage, etc.). These biobased materials such as typha have shown real interest in the buildings construction due to their light and porous nature. It’s in this context that we were interested in typha australis mixed with classic aggregates (cement, sand, gravel 3/8) to make typha’s concrete. On this concrete, we carried out experimental measurements in order to better understand its contributions in the building. The interesting results obtained show that typha australis, which is an invasive and harmful grass, can be valued and integrated among local building materials in the form of typha’s concrete in order to improve the energy efficiency of buildings.

Infracallosal Aneurysm Rupture Revealed by Chronic Subdural Hematoma: A Case Report

Chronic subdural hematoma (CSDH) is one of the most common entities seen in neurosurgery. We report a case of infracallosal aneurysm revealed by CSDH in a 52 years old woman. She presented 3 days alteration of consciousness in 2019 and repeated in September 2020 a severe headache and dizziness. There was no history of others symptoms, nor head trauma. Routine blood examination and coagulation profile were normal. Emergency computed tomography (TC) showed a left temporoparietal-occipital CSDH. Cerebral Angio CT found a bilobated of A2 aneurysm. The precallosal interhemispheric approach was made and clipping the aneurysm after evacuation of CSDH without complication. CSDH is one of the revealed features of intracerebral aneurysm rupture.

Improving the Thermal Comfort of a Building by Adding a Layer of Straw over the High Floor

This document deals with the thermal characterization of a building with a layer of straw above the high floor. In the current environmental context, in Senegal, buildings are the biggest consumers of energy. This is due to the construction materials used. Almost of buildings in Senegal used concrete (cement + aggregates) as based material construction. Due to this, the buildings require air conditioning or artificial ventilation to ensure minimum comfort. In face of this situation, it becomes useful to propose methods for reducing this high energy consumption. In this work, we propose to add a layer of straw above the high floor of a building in Matam city (North Senegal). In this case, we designed and modeled one building of single room in which the walls are in briks and a concrete slab. A bale of straw is layered on this slab in order to determine its influence on the energy consumption of the building. This study shows that the straw has a strong influence on the energy consumption of a building and the slab + straw building is more energy efficient than the bare slab building.

Management of Epidermoid Carcinoma of the Conjunctiva in a Melanoderma Subject in a Secondary Ophtalmology Centre: About a Case

We report a case of a unilateral conjunctival neoformation in a 44-year-old female melanoderma subject. It was a conjunctival squamous cell carcinoma (CSC). The risk factor was exposure to sunlight and dust. No HIV or HPV infection was found. The treatment consisted of simple removal of the tumour with a healthy margin of 3 to 4 mm. After a postoperative follow-up of 18 months, there was no recurrence. As CSC is the most common conjunctival malignancy and given the rate of recurrence with the possibility of associated local invasion, early diagnosis with long-term follow-up is necessary.

Staphylococcus xylosus Isolation of Conjunctival Secretions in an 8-Year-Old Child at Sikasso Hospital (Mali): About a Case

Staphylococcus xylosus is a species of bacteria belonging to the genus Staphylococcus. This genus currently includes several species and subspecies. We distinguish between 2 groups: the group of coagulase-positive staphylococci (CoPS) and coagulase-negative staphylococci (CoNS), a larger group that includes more than forty species and subspecies. Among the CoNS, Staphylococcus xylosus occupies a special place because it is frequently isolated from meats, dairy products, and agricultural environments. It is commonly used in fermentation due to its primary role in the flavor and color development of fermented products. It is a commensal bacterium of the skin of small mammals and farm animals, where it constitutes the majority of flora. In this species, there are a large number of strains, including phenotypes and genotypes. Although S. xylosus is actually a recognized non-pathogenic species, a few strains can be potentially dangerous. They can thus be responsible for mastitis and dermatitis in cattle. With the multiplicity of breeding farms, the consumption of livestock products and the increasingly frequent contact of humans with animals a few rare cases of human opportunistic infections have also been reported in the literature. These include pyelonephritis, endocarditis, urinary, lymphatic, and lymph node infections, contamination of orthopedic materials and catheters. Thereby, we report the case of a lingering and chronic infection of the lacrimal tract by Staphylococcus xylosus in an 8-year-old child in the Ophthalmology Department of Sikasso hospital in Mali.