Emergency C-Section on Multi-Scar Uterus: Maternal and Fetal Prognosis at the Nianankoro Fomba Hospital in Segou, Mali

Background: Multi-scar uterus is a uterus with two or more scars due to surgery or trauma. Objective: The aim was to compare the maternal and fetal prognosis of emergency C-sections of bi-scar uteruses to those of uteruses with at least 3 scars at the Nianankoro Fomba Hospital in Segou. Materials and Methods: It was a descriptive and analytical cross-sectional study with prospective data collection over a 24-month period from March 20, 2018, to March 20, 2020. Results: In 2 years, we collected 103 emergency C-sections for multi-scar uterus out of 1198 C-sections with a frequency of 8.6%. The age group of 20 to 35 years was the most represented with 86.4%. The bi-scar uteruses were the most frequent with 77.7%. In 71.8% of cases, the C-section was performed during the latent phase of labor. The C-section was performed under loco-regional anesthesia in 89.3% of cases. Difficulties in hemostasis and bladder injury were the most frequent intraoperative accidents. Surgical site infection was the main postoperative complication. No maternal deaths were recorded. The perinatal prognosis was marked by 4.3% fresh stillbirths in bi-scar uterus against 3.7% in three or more scar uteruses and including 2 fresh stillbirths and 1 macerated. We did not record any early neonatal deaths after C-section. Conclusion: The frequency of emergency C-sections in patients with a multi-scar uterus remains very high in our hospital. A better awareness of the patients, their spouses and all the actors involved in the management of pregnancies and childbirth, can contribute to curb this trend.

Evaluation of Pesticide Toxicity and Chemical Compounds Revealed in Soils of Sikasso and Segou (Mali)

The contaminants of the ground are potentially harmful agents and when they are released in this medium, their persistence becomes an important concern. Because of the expressed interest, a certain number of pesticides and important chemicals and their toxicity are described in this article. The studies went on the determination of the concentration, the lethal amount of the organochlorinated compounds, chemical organophosphates, carbamates and compounds. One summer recorded 3 pesticides in 5 samples of the grounds of Sikasso and Segou (Mali). Their concentration varies from 20 (atrazine) with 45 g/kg of ground. The lethal amounts of the revealed poisons variable from 338 for phtalates to 28.710 mg/kg for hexane (alkane) thus evaluate their impact on the food chain. Organophosphates and the carbamates (insecticidal) involve a reduction of 34.2% of the number of Cyprinus carpio of fresh water. The atrazine contaminates drinking water, but the diuron modifies the behavior and the reproduction of fish by deteriorating their system of olfactive perception of natural substances. Important mortalities of birds are noted around the corn fields of Bougouni treated by the carbofuran. The pesticides involve at the man a reduction in fruitfulness, an increase in the risk of miscarriage of premature birth, congenital malformations and cancers.

Management of Trauma to the External Genitalia at the Nianankoro-Fomba Hospital in Segou Mali

Trauma to the male genitalia is not very common and mainly affects a young population. There is probably a particular instinct in men to defend their external genitalia;indeed, in the flaccid state, the penis is little exposed, and fairly well protected and its mobility allows it to move with the impact of trauma and thus reduce the vulnating force. Open trauma is rare, as is testicular dislocation, the most common being closed trauma. Testicular trauma is an uncommon accident that affects young people. Trauma is most often caused by road and traffic accidents. Animal bites are rare, as is genital self-mutilation related to a psychiatric disorder. Surgical exploration is the rule except in cases of moderate testicular trauma. Our objective was to report our experience in an emergency context where treatment is poorly codified and to review the literature. We recorded four patients with external genitalia trauma managed in the urology department from April 2013 to March 2022. Our patients were children with open genitalia trauma following a traffic accident, scrotal injuries were encountered in three patients, and additional penile injuries in one patient. All patients were treated surgically. The follow-up was straightforward.

Geomechanical Characterization of Sandstones Cliffs of Segou (Senegal, West Africa) in the Madina Kouta Basin

This work presents the behavior of Segou sandstones in the laboratory and in the field conditions. Four types of sandstone are collected in the northern part of the Madina Kouta basin (eastern Senegal). These types of specimens are the white sandstones, the red sandstones, the purple sandstones and the sandstones with intercalation of pelites. Uniaxial tests are carried out on these specimens of sandstones. The Young Moduli (E) and the Uniaxial Compression Strengths (Rc) are higher for the white sandstone. Values of the mechanical parameters decrease slightly for red sandstones due to an increase of the amount of pelites in the composition of the rock. Decrease of mechanical parameters is more important for the purple facies due to an important network of fractures. The facies with weaker characteristics corresponds to the sandstones with intercalation of pelites. This is due to the soft nature of the pelites. The slope stability of the Cliff sides depends also on to these characteristics.

Epidemiological Clinical Aspects and Medical Management of Sexual Assault in the Region of Ségou in Mali

Introduction: Sexual assault is an act of a sexual nature perpetrated on another person without their consent. Goal: To describe the epidemio-clinical aspects and the medical management of sexual assault in the Segou region. Methodology: This was a retro-prospective descriptive study from September 2010 to September 2018 on the alleged female victims of sexual assault registered in the Gynecology and Obstetrics departments of the hospital and the sanitary quarters of Ségou. Results: We recorded 107 cases of sexual assault out of 47,729 gynecological consultations, representing a hospital prevalence of 0.22%. The victims were between 10 and 15 years old in 48.59% of the cases. Students were the most represented with 53.27% (57/107) of cases. Genito-genital contact was recorded in 90.65% (97/107) of cases. Vulvo-perineal lesions were present in 44.86% (48/107) of survivors. Hymenial deflowering was the most frequent traumatic genital lesion accounting for 43.70% (21/48) of old cases and 27.00% (13/48) of recent cases. Sexual assault was committed by a single individual in 60.75% (65/107) of cases and by a friend of the victim in 21.5% (23/107) of cases. The survivors had consulted within 24 hours of the sexual assault in 53.27% (57/107) of the cases, the treatment was medical in 68.22% (73/107) and medical-surgical in 4.7% (5/107), post-exposure prophylaxis to the Human Immunodeficiency Virus (HIV) was performed in only 26.16% (28/107) of survivors. Conclusion: Sexual assault remains a concern although its frequency is low. This scourge mainly affects children and adolescents, and the lesions are mainly genitals.