Epidemiology and Management of Heart Failure in the Medicine Department of Tombouctou Hospital

Introduction: Heart failure is a complex syndrome and very frequently observed and secondary to the outcome of many advanced heart diseases. It is made up of a set of symptoms that reflect the tissue and visceral consequences of heart failure. The objective was to determine the hospital prevalence and to describe the management of heart failure in the medical department of Tombouctou hospital in Mali. Methods: This is a descriptive cross-sectional study with retrospective data collection, carried out over 24 months and involving the analysis of 266 records of patients hospitalized for heart failure. Results: The frequency of heart failure was 17.6% with a female predominance. The average age was 48 years with extremes of 16 and 90 years. Cardiovascular risk factors were dominated by high blood pressure with 38%. Global heart failure was the mode of discovery in 72.2% of cases. The etiologies were dominated by hypertensive dilated cardiomyopathy in 36.8% and peripartum cardiomyopathy in 32% of cases. The majority of our patients benefited from diuretic treatment, i.e. 95.9% frequency;with a favorable evolution in 96.2% of cases. We recorded 10 deaths, i.e. a lethality of 3.7%. We report some difficulties encountered during our security study because Tombouctou is a war zone and the lack of a technical platform for biology such as (BNP or NT-proBNP). Conclusion: Heart failure is a real public health problem. Its prevalence is increasing due to the aging of the population and especially the poor management of arterial hypertension in our context.

Case Report: Autoimmune Pancreatitis: About a Case in Hepato-Gastroenterology Department of Mother-Child Hospital in Bamako/Mali

Autoimmune pancreatitis is a distinct form of chronic pancreatitis. It is a chronic pancreatitis distinct from alcohol, genetic or idiopathic impairment and involves possible autoimmune mechanisms. The diagnosis of autoimmune pancreatitis is based on a body of biological, histological and radiological arguments. Also called sclerosing lymphoplasmacytic pancreatitis, it is one of the causes of chronic pancreatitis. The risk factor for the onset of cancer that it represents and its sensitivity to corticosteroids make it a pathology requiring special management. We report a case of autoimmune pancreatitis in a 35-year-old patient.

Practice of Upper Gastrointestinal Endoscopy at the Mother-Child Hospital in Bamako/MALI: About 465 Cases

Introduction: Upper gastrointestinal (GI) endoscopy is an examination that involves exploring the upper part of the digestive tract using an endoscope. Our study was aimed to evaluate the practice of Upper GI endoscopy at the mother-child hospital in Mali. Patients and Methods: This was a descriptive retrospective study on reports of Upper GI endoscopy results in the digestive endoscopy unit at the mother-child hospital in Bamako from January to December 2018. Results: Endoscopy was performed in 465 patients including 231 males and 234 females. The sex ratio was 0.98. Patients were aged 46.69 years old on average with the extremes of 8 and 90 years old. Epigastralgia was the main referral in 50.5%. Endoscopy was normal in 24.7%. The main diagnostics were duodenogastric reflux in 32.5% and gastritis in 14.4%. Conclusion: The practice of Upper GI endoscopy at the mother-child hospital in Mali has allowed the exploration of the upper digestive tract to contribute to the diagnosis of esogastroduodenal lesions.

Cardio-Renal Syndrome: Epidemiological Aspect in the Medicine Department of Tombouctou Hospital

Introduction: Cardio-renal syndrome is a pathophysiological disorder of the heart and kidneys in which chronic or acute dysfunction of one can lead to chronic or acute dysfunction of the other. The objective of this study was to determine the prevalence of cardio-renal syndrome in the Medical Department of the Tombouctou Hospital in Mali. Methods: It is about a descriptive transversal study carried out over 18 months, from January 01st, 2020 to June 30th, 2021 and relating to the analysis of 75 files of patients hospitalized for heart failure and with impaired renal function. Results: The frequency of cardio-renal syndrome was 6.4% with a predominance of men (sex ratio: 2). Hypertension was the most widely described risk factor (50.6%). The history was dominated by chronic heart failure (14.6%) and diabetes (6.6%). The average age was 58 with extremes of 18 and 90. The main aetiologies were dilated cardiomyopathy (46.6%) and ischemic heart disease (20%). Symptoms were dominated by dyspnea (90.6%) and edema of the lower limbs and face (74.6%) accompanied by cough (74.6%). Anemia was noted in 15 patients (20%). The mean clearance (MDRD) was at 32 ml/min. Doppler echocardiography found left ventricular dilation (66.6%), lower left ventricular systolic fraction (64%) and kinetic abnormalities (20%). The kidney ultrasound performed in 9 patients returned to normal in 8 cases and in 1 patient the kidneys were small. Eight deaths (10.6%) were noted. Conclusion: Cardio-renal syndrome is a common feature in which mixed failure is observed in the unfavorable course of heart disease and nephropathy. Its prevalence is unfortunately under evaluated in cardiological settings in Africa and particularly in Mali, hence the interest of a more advanced study.