M Diarra

Cheikh Anta Diop University, Dakar, Dakar, Dakar, Senegal

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Publications (35)18.42 Total impact

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    ABSTRACT: Le diabète et l’infection par le VHC constituent de véritables problèmes de santé publique mondiaux.Le but principal de notre étude était d’étudier la prévalence du VHC dans la population diabétique.Il s’agissait d’une étude observationnelle prospective qui s’est déroulée de juin 2009 à mai 2010 au CHU Gabriel Touré et au Centre de lutte contre le diabète de Bamako. Le dosage des transaminases et la recherche de l’Ac anti VHC ont été effectués chez tous les malades.La recherche des signes d’hypertension portale par l’endoscopie digestive haute, l’échographie abdominale, la PCR quantitative et les autres bilans biologiques de l’hépatite C ont été systématiquement proposés aux patients porteurs des Ac anti VHC.25 patients diabétiques sur 250 (10%) ont été retrouvés porteurs du virus HCV. L’âge moyen des patients était de 49,5 ± 17, 6 ans avec un sex-ratio de 0,38. L’infection par le VHC n’était pas significativement associée au type de diabète (p = 0,54). La majorité des patients avaient un diabète de type 2 mal équilibré, et le génotype 2 était le plus fréquent.Une corrélation positive est observée entre la prévalence du diabète sucré et l’infection par le VHC dans notre région. Cette élévation de prévalence est une donnée importante, permettant un meilleur dépistage et une meilleure prise en charge de ces deux maladies.
    Journal Africain d?Hépato-Gastroentérologie 01/2013; 7(4).
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    ABSTRACT: Le but principal de cette étude était d’évaluer les aspects épidémiologiques et sémiologiques des troubles fonctionnels intestinaux (TFI) dans les centres de santé de référence de Bamako. Il s’agissait d’une étude transversale menée de juin 2006 à novembre 2006. Pendant la période d’étude, 104 patients ont répondu aux critères d’inclusion sur 487 patients, soit une fréquence de 21,35 % de la population examinée. L’âge moyen était de 30,5 ± 11,5 ans, la tranche d’âge de 16–26 ans prédominait avec 45,2 %. Le sex-ratio était de 0,5 en faveur des femmes. Les signes fonctionnels les plus fréquemment retrouvés ont été la douleur abdominale (97,1 %), le météorisme/ballonnement abdominal (51,9 %) et la constipation (45,2 %). Un absentéisme fréquent était rapporté par 65,8 % des patients. Les TFI peuvent être considérés comme un problème de santé publique. Les coûts du traitement et des explorations et les absences fréquentes au travail constituent les véritables problèmes socio-économiques. The main goal of this study was to evaluate epidemiological and clinical aspects of irritable bowel syndrome (IBS) in health districts of Bamako. It was a cross-sectional study conducted from June 2006 to November 2006. During the period of study, 104 of 487 patients, 21.35% of the examined population, met the inclusion criteria. The average age was of 30.5 ± 11.5 years, the age group of 16–26 years predominated with 45.2%. The sex-ratio was 0.5 in favor of women. The signs most frequently found were abdominal pain (97.1%), abdominal distension (51.9%), and constipation (45.2%). A frequent absenteeism was reported by 65.8% of the patients. The IBS can be regarded as a public health problem. Treatment and exploration costs and frequent absences with work constitute true socioeconomic problems. Mots clésTroubles fonctionnels intestinaux–Centre de santé de référence–Bamako KeywordsIrritable bowel syndrom–Health districts–Bamako
    Journal Africain d?Hépato-Gastroentérologie 01/2011; 5(1):39-42.
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    ABSTRACT: The main goal of our study was to evaluate cirrhosis course on one year. The study was prospective and longitudinal from January 2005 to December 2006 in the center of hepatology and gastro-enterology of CHU Gabriel Touré. The patients had one year follow up and examinated every three months. In this study 57 patients were included. Mean age was 41,5 + 15,3 years. Ascite and jaundice were the main clinical signs respectively 70.2% and 54.4%. Ascite or its increase was the most complication in 67.5% of cases (p = 0.002). The global mortality was 82.5% and it was high in the three first months, caused by hepatocellular carcinoma, digestive bleeding and hepatic encephalopathy respectively 33.3%, 27.3% and 15.2%. Abdomen pain, ascite and jaundice have an predictive value for high mortality (p between 3.10-3 et 10-7). Early examination, therapeutic observance and good management of cirrhosis complications could reduce the mortality.
    Le Mali médical 01/2010; 25(1):42-6.
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    ABSTRACT: The SAPHO syndrome is suspected in a 47 years old Senegalese female patient with a swelling of medial quarter of the right clavicle, and a history of palmar pustulosis. The general state of health is preserved, biology shows a nonspecific inflammatory syndrome (elevated erythrocyte rate and C reactive protein level) and an absence of leukocytosis. Histopathological examination found a polymorphic inflammatory granuloma with mononuclear cells and giant cells. The standard radiographs and CT scans did not disclose any lesion while the bone scan displayed a “bull's horn” image of increased uptake on the right sterno-clavicular region suggestive of SAPHO syndrome. The frequent delay in diagnosis, usually related to ignorance of the syndrome and the fear of a bone tumour, is a major source of antibiotic abuse and/or biopsies, invasive or harmful for patients. Bone scintigraphy has a role to play in guiding the diagnosis when it discovers focal increased uptake on clavicle and sternum. May moreover, bone scintigraphy be useful to review and assess the distribution of lesions and their follow-up.
    Medecine Nucleaire-imagerie Fonctionnelle Et Metabolique - MED NUCL. 01/2010; 34.
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    ABSTRACT: Cysticercosis has been reported in Muslim countries in workers coming from endemic regions for Taenia solium. For the first time in Mali, the authors report a case of autochtonous neurocysticercosis where Muslim religion is predominent. The patient was a woman student with fever, arthralgia, headaches, consciousness troubles followed by partial motor epilepsy. Diagnosis was confirmed by clinic, serology ELISA and Western blotting and cephalic tomodensitometry analysis. The medical treatment was successfully based on combination of albendazole and praziquantel. The origin of contamination remains unknown and further investigations are needed, particularly with veterinary research team and the National League against epilepsy recently founded in Mali.
    Bulletin de la Société de pathologie exotique 10/2009; 102(4):211-4.
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    ABSTRACT: The purpose of this study was to describe the epidemiological, clinical, and prognostic profile of tetanus patients managed in the infectious diseases department of the "Hopital du Point G", in Bamako, Mall. This retrospective descriptive study was conducted from July 2001 to August 2004. The following data were collected: age, sex, infection route, clinical features, delay to hospitalization, and outcome. A total of 54 patients hospitalized for tetanus were included. Men accounted for 68.5% of cases. Ages ranged from 15 to 66 years with a mean of 39 years. The most common professional activity was farming: 27.8%. The route of infection was determined in 87% of cases and involved cuts in 46.3% of cases located on the lower limbs in 42.6%. Generalized paroxystic tetanus with opisthotonos was the most prevalent form accounting for 18.5% of cases. Localized tetanus accounted for 12.9% of cases. Outcome was unfavorable with a death rate of 38.9%. All deaths occurred within the first week of hospitalization. Mass vaccination of the population should be a national priority to reduce tetanus-related morbidity and mortality to levels observed in industrialized countries.
    Médecine tropicale: revue du Corps de santé colonial 10/2009; 69(5):485-7.
  • Acta Endoscopica - ACTA ENDOSC. 01/2009; 39(1):72-74.
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    ABSTRACT: We report 3 clinical observations of neuromeningeal cryptococcosis which occurred without any immunodepression related to HIV infection. Our patients were male. They did not present any particular medical history indicating a diagnosis of cryptococcosis. Nevertheless we found a professional exposure to the risk of inhalation of C. neoformans capsules. The diagnosis was based on presence of encapsulated yeast of Cryptococcus in the direct exam by China ink and culture on Sabouraud medium. CD4 lymphocytic count was done in two patients (case 1:899 cells/mm3; case 2:347 cells/mm3). Idiopathic lymphocytopenia was noted in one case. Co-morbidity of 5. pneumoniae meningitis was reported in one patient (case 3). Treatment was based on injectable amphotericin B in monotherapy (case 1), followed by perfusion of fluconazole cure (case 2). Case 3 was treated by perfusion of amphotericin B associated with ceftriaxone (case 2). No secondary prophylactic treatment was administered. Evolution was favorable after follow-up of 5 years (case 1) and of 4 years (case 2). The third patient died during hospitalization.
    Bulletin de la Société de pathologie exotique 11/2008; 101(4):308-10.
  • Journal Africain d?Hépato-Gastroentérologie 11/2007; 1(3):143-145.
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    ABSTRACT: L’évolution naturelle de l’amibiase hépatique se fait dans la grande majorité des cas vers l’augmentation progressive du foyer de nécrose exposant ainsi au risque de rupture dans les organes de voisinage, en particulier le péritoine, la plèvre et les bronches, le péricarde ou un autre viscère creux. La fistulisation cutanée spontanée est rare. Nous rapportons un cas d’amibiase hépatique non traitée, compliquée par une fistulisation à la peau. In most cases, the clinical course of amoebic liver abscesses involves a gradual increase in the area of necrosis as well as the risk of the rupture of neighbouring organs, especially the peritoneum, pleura, bronchi, pericardium, or another hollow viscus. Cutaneous fistulas are rare. We report a case of untreated amoebic liver abscess, complicated by a cutaneous fistula.
    Journal Africain d?Hépato-Gastroentérologie 09/2007; 1(2):98-99.
  • Acta Endoscopica 06/2007; 37(3):321-326. · 0.16 Impact Factor
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    ABSTRACT: RÉSUMÉ Les dosimètres de radon tels que des nitrates de cellulose connaissent souvent une dégradation sous l'action de certains facteurs physiques ou chimiques. Nous avons étudié le comportement du CN-85, détecteur solide de traces nucléaires (DSTN), en atmosphère tropicale très ensoleillée (photo-vieillissement naturel) et dans une enceinte SEPAP 12/24 (photo-vieillissement accéléré artificiel), avant son exposition à une source de particules alpha (Am-241). Les résultats ont montré des modifications chimiques du détecteur, aussi bien en accéléré qu'en naturel, entraînant un changement de coloration. L'étude comparée des deux modes de photo-vieillissement a permis de déterminer un facteur d'accélération du vieillissement de 2,5. L'irradiation aux particules alpha des détecteurs a montré une perte d'efficacité de 98 % après 40 heures d'exposition solaire, ce qui permet de considérer une durée limite d'utilisation du DSTN en atmosphère tropicale ne dépassant guère une semaine. Cette durée d'utilisation pourrait être prolongée à l'intérieur des habitations du fait d'une baisse des températures et de la luminosité. ABSTRACT Influence of ultraviolet radiation (UV) on the physicochemical stability of a radon dosemeter: the CN-85. The radon dosimeters such as cellulose nitrates are often degraded under the action of certain physical or chemical factors. In our research we studied the behavior of the CN-85, solid state nuclear track detector, in very sunny tropical atmosphere (natural photo-ageing) and in enclosure SEPAP 12/24 (artificial accelerated photo-ageing), before its exposure to a source of particles alpha (Am-241). The results showed chemical modifications of the detector, involving a change of coloring in accelerated as well as in natural photo-ageing, yet more in the first mode. The comparative study of the two modes (of photo-ageing) made it possible to determine an ageing acceleration factor of 2.5. The irradiation of the detectors with the particles alpha has shown a 98% loss of effectiveness after 40 hours of solar exposure, which makes it possible to consider the operational limit duration of the detector as hardly exceeding a week, in tropical atmosphere. This utilization period could be prolonged inside the dwellings due to the fall of the temperature and luminosity.
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    ABSTRACT: RÉSUMÉ Les dosimètres de radon tels que des nitrates de cellulose connaissent souvent une dégradation sous l'action de certains facteurs physiques ou chimiques. Nous avons étudié le comportement du CN-85, détecteur solide de traces nucléaires (DSTN), en atmosphère tropicale très ensoleillée (photo-vieillissement naturel) et dans une enceinte SEPAP 12/24 (photo-vieillissement accéléré artificiel), avant son exposition à une source de particules alpha (Am-241). Les résultats ont montré des modifications chimiques du détecteur, aussi bien en accéléré qu'en naturel, entraînant un changement de coloration. L'étude comparée des deux modes de photo-vieillissement a permis de déterminer un facteur d'accélération du vieillissement de 2,5. L'irradiation aux particules alpha des détecteurs a montré une perte d'efficacité de 98 % après 40 heures d'exposition solaire, ce qui permet de considérer une durée limite d'utilisation du DSTN en atmosphère tropicale ne dépassant guère une semaine. Cette durée d'utilisation pourrait être prolongée à l'intérieur des habitations du fait d'une baisse des températures et de la luminosité. ABSTRACT Influence of ultraviolet radiation (UV) on the physicochemical stability of a radon dosemeter: the CN-85. The radon dosimeters such as cellulose nitrates are often degraded under the action of certain physical or chemical factors. In our research we studied the behavior of the CN-85, solid state nuclear track detector, in very sunny tropical atmosphere (natural photo-ageing) and in enclosure SEPAP 12/24 (artificial accelerated photo-ageing), before its exposure to a source of particles alpha (Am-241). The results showed chemical modifications of the detector, involving a change of coloring in accelerated as well as in natural photo-ageing, yet more in the first mode. The comparative study of the two modes (of photo-ageing) made it possible to determine an ageing acceleration factor of 2.5. The irradiation of the detectors with the particles alpha has shown a 98% loss of effectiveness after 40 hours of solar exposure, which makes it possible to consider the operational limit duration of the detector as hardly exceeding a week, in tropical atmosphere. This utilization period could be prolonged inside the dwellings due to the fall of the temperature and luminosity.
    Radioprotection 04/2007; 42(337):42-3. · 0.44 Impact Factor
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    ABSTRACT: We conducted a prospective study in internal medicine and infectious diseases wards of the hospital of Point " G " in Bamako, Mali from January to December 2002. Overall 112 patients HIV positive, thirty-five patients (31,25%) had at least a digestive parasitic disease. We found that the most frequent parasite in stools sample were protozoa (82,85%). The second most frequent parasites were helminthes (20,33%). HIV/AIDS opportunistic parasites represented 40% of all parasites found. These included 25,71% cases of Cryptosporidium sp, 8,57% cases of Isospora belli and 5,71 % for microsporidia. The functional signs of our patients were mostly asthenia and weight loss. The physical signs were conjunctive pallor (71, 42%) and diarrhea (85, 71%). Generalized itching was present in 54, 28% of cases and abdominal pains in 25, 71% of cases. The global lethality was 37, 14% (13/35). The deaths were due to the HIV infection. The parasites appear even frequent at patients infected by HIV/AIDS, in spite of the advent of antiretroviral therapy. The efficient molecule research against the opportunist parasite must constitute one of our priorities in tropical area.
    Le Mali médical 02/2007; 22(1):33-6.
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    ABSTRACT: Oligo-astheno-teratozoospermia being frequently observed (44,1%) in male subjects among hypofertiles couples of the sample population, we studied it at the ultrastuctural level. Our investigations have shown that, in addition to morphological and functional abnormalities, spermatic cells in said persons also presented serious ultrasructural disorders which would cause sterility. However in the absence of specific codified treatment for the majority of abnormalities found in sperms and given the high cost of the utrastructural analysis, we propose to limit our study to precise cases of male sterility through routine sample evaluations.
    Bulletin de la Société médicale d'Afrique noire de langue française 02/2007; 52(1):17-22.
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    ABSTRACT: Le but de notre étude était d’étudier les aspects anatomo-cliniques des gastrites chroniques. Notre étude transversale s’est déroulée dans les centres d’endoscopie de l’hôpital du Point «G» et de la Clinique du Farako. Tous les malades ont subi un examen clinique soigneux. Les biopsies antrales et fundiques fixées dans une solution de formol à 10 % ont été examinées dans le service d’anatomo-pathologie du CHU de Cocody en République de Côte d’Ivoire. Sur 189 patients retenus dans l’étude, le sex-ratio a été de 0,75 en faveur des femmes, l’âge moyen de nos patients était de 38,14±12,4 ans et les mères au foyer étaient les plus représentées (38,10 %). Sur le plan clinique, l’épigastralgie et le borborygme étaient les symptômes prédominants (respectivement 97,88 % et 82,53 %). A l’endoscopie, un aspect congestif de la muqueuse a été le plus fréquemment rapporté (64,5 %). En ce qui concerne l’histologie, la gastrite chronique a été la lésion histologique la plus fréquemment rencontrée (93,1 %). L’infection parHelicobacter pylori (Hp) a été retrouvée chez 89,4 % de nos patients. La gastrite est une lésion fréquente, très souvent associée à l’infection par Hp. Sa relation avec le cancer gastrique nécessite une étroite surveillance. The aim of our study was to appreciate chronic gastritis anatomical and clinical aspects. This transverse study took place in the endoscopy units of the hospital Point «G» and Farako Clinic. All patients underwent a careful clinical examination. The antral and fundic biopsies fixed in 10% formalin have been examined in the pathology unit of Cocody Hospital (Republic of Ivory Coast). Among 189 patients included in the study, the sex ratio of 0.75 was in favour of women, the mean age of our patients was 38.14±12.4 years and the housewives were the more represented social class (38.10%). Epigastralgia and borborygm were the most predominant clinical symptoms (respectively 97.88% and 82.53%). The endoscopic aspect of congestive mucosal membrane was the more frequent (64.5%). Regarding histology, chronic gastritis was the most frequently found histological lesion (93.1%). Helicobacter pylori (Hp) infection was detected in 89.4% of our patients. Gastritis is a frequent lesion, very often associated to Hp infection. Its relationship with gastric cancer requires a close surveillance.
    Acta Endoscopica 01/2007; 37(3):315-320. · 0.16 Impact Factor
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    ABSTRACT: Our main objective was to study gastritis associated to duodeno-gastric reflux. It is about a longitudinal study case/witness, paired according to the sex and the age. It was unrolled from February 2005 to January 2006 in the digestive diseases department of the hospital Gabriél Touré, and endoscopic centers of Promenade des Angevins, and clinique Farako. The patients profited from an upper digestive endoscopy to appreciate endoscopic aspect of gastritis associated to bile in the stomach mucus lake. The gastric biopsies were systematic. This study included 50 patients having gastritis associated to bile in gastric mucus lake compared to 50 patients having gastritis associated to clearly gastric mucus lake. The sex-ratio was 1.26 in favour of men. The average age of the patients was of 41.30 +/- 15.43 years. On the symptomatic hand, fetid breath was significantly met in duodeno-gastric reflux (p = 0.013). Potash consumption in the "tô" (millet cake) was significantly reported in gastritis associated to bile in gastric mucus lake (p = 0.042). The endoscopic aspects were comparable. Histological aspects of nonatrophic chronic gastritis were significantly mint in witnesses as well into the antrum as into the fundus (p = 0.0001 and p = 0.00023). The reactional gastritis aspect was the prerogative of duodenogastric reflux (p ranging between 10(-6) and 3.10 (-6). Helicobacter pylori infection was found comparable in the two groups (p = 0.297). Dysplasia although rare was found only in gastritis associated to duodeno-gastric reflux. Gastritis associated to bile in gastric mucus does not se,nm to have specific clinical, endoscopic and histological presentation. However the presence of dysplasia must have an attentive monitoring.
    Le Mali médical 01/2007; 22(4):47-51.
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    ABSTRACT: The goal of this study was to appreciate principal affections and mortality and in gastroenterology service of Gabriel Touré Hospital. It is about a survey longitudinal that has permit to analyze patients who have been care. During study, 766 patients were unregistered. Mean age of patient was 45.17 years and a sex ratio (M/F) = 1.10. The rate of reference was 13.85%. The morbidity was dominated by HIV infection (29.90%) followed by Hepato-cellular Carcinoma (7.83%) and cirrhosis (4.05%). Mortality (18.41%) was dominated by the VIH infection, HCC and Cirrhosis. The precocious recourse to cares, the improvement of work conditions, the sensitization, the infectious illness prevention is factors that will permit a reduction of morbidity and hospital mortality.
    Le Mali médical 02/2006; 21(3):28-31.
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    ABSTRACT: Le but principal de notre travail était d’étudier les aspects épidémiologiques, cliniques et évolutifs des cancers colorectaux (CCR) en milieu hospitalier. Cette étude transversale cas-témoins, s’est déroulée dans les hôpitaux du point «G» et de Gabriel Touré, et à la clinique Farako de Bamako (MALI). Tous les malades présentant une tumeur maligne histologiquement confirmée ont été colligés. Des patients ayant une endoscopie digestive basse normale ont été comparés aux précédents. Une enquête sur le mode de vie des patients a été réalisée dans les 2 groupes. Pendant la période d’étude, nous avons colligé 19 CCR représentant 0,1% de l’ensemble des endoscopies digestives basses et 19% des cancers du tube digestif. Le sex-ratio était de 0,4 en faveur des femmes. L’âge moyen des cancéreux était de 43,7 ± 16,9 ans. Les couches socioprofessionnelles les plus représentées était les ménagères et, les cultivateurs avec 52,5% (p = 0,001). La consommation fréquente de poissons séchés et fumés, de tô avec potasse, de viande conservée naturellement, de cola et de tabac à fumer, était significativement associée aux CCR (p = 0,001). Les signes cliniques les plus observés étaient la douleur, l’amaigrissement et la rectorragie. L’adénocarcinome représentait 89,5% des aspects histologiques. Le retard diagnostique retrouvé dans la plupart des cas a négativement influencé les attitudes thérapeutiques avec seulement 57,9% de chirurgie à visée palliative et 15,8% de chirurgie à visée curative. La chirurgie, seul espoir thérapeutique des CCR est malheureusement impossible dans la majorité des cas à cause du retard diagnostique. L’amélioration du pronostic passe par un diagnostic et une prise en charge, précoces. The main goal of our work was to study the epidemiological, clinical and prognostic aspects of colorectal cancers in a hospital environment. This casecontrol transversal survey was conducted in the hospitals of the “ G point” and Gabriel Touré, and in Farako clinic of Bamako (Mali). All patients presenting a tumour histologically confirmed have been collected. The patients with normal low digestive endoscopy have been compared to the previous. An investigation about the life habits of the patients has been carried out in both groups. During the period of survey, we collected 19 CCR representing 0.1% of all low digestive endoscopies and 19% of the cancers of the digestive tract. The sexratio of 0.4 was in favour of women. The average age of patients with cancer was of 43.7 ± 16,9 years. The more represented social and professional groups were the housewives and the farmers with 52.5% (p = 0.001). The frequent consumption of dried and smoked fish, tô with potash, of naturally preserved meat, of cola and tobacco smoking was significantly associated to CCR (p = 0.001). The more observed clinical signs were pain, weight loss and rectal bleeding. Adenocarcinoma represented 89.5% of the histological aspects. Diagnostic delay in most cases negatively influenced the therapeutic management with only 57.9% of palliative surgery and 15.8% of curative surgery. Surgery which is the only therapeutic option for the CCR is unfortunately not possible in the majority of the cases because of the delay in diagnosis. The improvement of the prognosis requires an early diagnosis and management.
    Acta Endoscopica 01/2006; 36(2):187-193. · 0.16 Impact Factor
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    ABSTRACT: The main goal of this work was to study the parasitic infections during AIDS diarrhoea. A longitudinal study was carried out from October 2000 to November 2001 in the Hepato-Gastro-Enterology department of Gabriel Toure Hospital and in the Department of Epidemiology and Parasitic infections of Faculty of Medicine, Pharmacy and Odonto-stomatology of Bamako (Mali), concerning HIV positive patients suffering from diarrhoea. Detecting microbes in stools has been done through direct microscopic examination and according to procedures of Henricksen Poblenz Baerman, Kato Katz and the PCR. Among the 70 patients involved, the sex-ratio was 53%, the average age was 35 +/- 8.4 years. Fever weight loss, skin affections and digestive mycosis were often associated. Opportunistic infections have been relatively frequent with Cryptosporidium parvum with 20%, Isospora belli with 8.5% and Microsporidium with 11.5% of cases. Other non-opportunistic microbes were found. Death within the first two weeks seems more important in case of infection by Cryptosporidium parvum. The frequency and the danger of those opportunistic infections require their efficient diagnosis and care management.
    Bulletin de la Société de pathologie exotique 05/2005; 98(1):33-5.