Perception and Management of Hemorroid Disease at the CSREF of the Commune Bamako Mali

This work was a prospective transversal study over 6 (six) months from May 2 to December 31, 2017 at the Reference Health Center of Commune I and the Chérif la Confessional Health Center in Bamako. The aim was to study the knowledge, attitudes and behavioral practices linked to hemorrhoids in Commune I of the Bamako district, to evaluate the frequency of hemorrhoidal disease, to determine the knowledge, attitudes and behavioral practices linked to hemorrhoids among patients, their companions and traditional therapists in Commune I of the district of Bamako and the factors which influence the motivations and decisions to resort to medical-surgical care and traditional medicine in patients suffering from hemorrhoids in order to analyze the results of the management of hemorrhoidal disease at Cs Ref CI. We collected 36 patients with hemorrhoidal disease, 25 caregivers and 15 traditional hemorrhoidal disease therapists. The sex ratio was 1.25 for patients;6.5 for traditional therapists and 1.5 for accompanying people. The average age of the patients was 32.75 years;49 years for traditional therapists and 28.76 years for those accompanying them. 55.6% of patients claim to know about hemorrhoidal disease;100% of traditional therapists and 80% of accompanying people. The dietary factor of hemorrhoidal disease was mentioned by 90% of patients;66.7% of traditional therapists and 100% of caregivers. Most patients initially resorted to traditional treatment out of fear of surgery and its after-effects. The patients were treated medically and surgically.

Clinical and Therapeutic Aspects of Inguinal Hernia in Children in the General Surgery Department of Reference Health Center in Commune I of Bamako Mali

Inguinal hernia in children is a congenital pathology in children linked to the persistence of the peritoneo-vaginal canal in children and the NüCK canal in girls;persisting into adulthood. This work aimed to study inguinal hernia in children in the general surgery department of the Reference Health Center of Commune I of the Bamako District;to determine the frequency of inguinal hernia;describe the epidemiological, clinical and therapeutic aspects of inguinal hernias and in order to evaluate the cost of treatment. This was a prospective study from April 2017 to March 2018 during which 60 children with an inguinal hernia were collected. Inguinal hernias in children represented 9.23% of patients operated on in the department. The average age was 59.23 months with extremes of one month and 180 months and a standard deviation of 49.23 years. The male sex was dominant with a sex ratio equal to 9:1. The notion of prematurity was found in 11.7% and was associated with a testicle not in place in 1.7% of cases. 41.7% of our patients were referred by a doctor and 66.7% of patients presented with painless, intermittent inguino-scrotal swelling (83.3% of cases). The hernia was discovered before one week of life in 50% of cases. Inguinal swelling was absent in 11.7% but observed intraoperatively. The inguinal hernia was unilateral in 91.7% of cases and 70% of hernias were discovered by the parents during pushing efforts. The inguinal hernia was located on the right in 61.7% of cases. The hernia swelling was soft, painless, impulsive and reducible in 78.3% of cases. The swelling was inguino-scrotal in 58.3% of cases. The hernia was simple in 95% of patients and hernial strangulation was observed in 3 cases or 5% of cases. 98.3% of patients were ASA I. The treatment was carried out openly in all our patients including closure of the vaginal peritoneal canal in 95% of cases under general anesthesia in 98.3% of cases. The morbidity rate was 8.4% (surgical site infection: 6.7% of cases and hematoma: 1.7%). The immediate consequences were simple in 96.6% of cases. No cases of recurrence occurred during the 6 months after the intervention. The average cost of care was estimated at 69,743 FCFA.

Acute Intestinal Occlusions at the Cs Ref of Commune I of Bamako

Acute intestinal obstructions are defined as a complete and persistent cessation of materials and gases in a segment of the digestive tract. They constitute a medical-surgical emergency. Our work aimed to study acute intestinal obstructions, to determine the hospital frequency, to describe the aspects (epidemiological, clinical and therapeutic), to analyze the surgical consequences and to evaluate the cost of the management of obstructions. acute intestinal infections in the general surgery department of the reference health center of commune I of Bamako in Mali. Our retrospective, longitudinal and descriptive study took place from January 1, 2015 to December 31, 2019 in the general surgery department of the reference health center in commune I of Bamako. The average age was 47.72 years with extremes of 15 and 78 years and a standard deviation of 16.07. Our sex ratio (56 men/15 women) was 3.38. The clinical signs were dominated by abdominal pain (100%), vomiting (52.9%), cessation of materials and gases (25.4%) and meteorism (35.3%). The main etiologies found intraoperatively were strangulated hernia (54.9%), bands and/or adhesions (21.1%), sigmoid volvulus (12.7%), colorectal tumor (7%), small bowel volvulus (2.8%) and acute intestinal intussusception (1.4%). Hernia repair was the most performed surgical procedure, i.e. 54.9%. The overall mortality rate was 1.4%.