[Neurological complications of chronic alcoholism: study of 42 observations in Guinea]. / Complications neurologiques de l'alcoolisme chronique : étude de quarante-deux observations en Guinée.

Neurologic disorders related to chronic alcoholism in traditional areas of Guinea are frequent, but reports about them are rare. We conducted the first study in Guinea on this subject and retrospectively collected 42 cases of neurologic manifestations related to alcoholism over a 7-year period. The standard findings of the literature were confirmed in our population: peak frequency after the age of 40 years (82.8%) and clear male overrepresentation (M/F sex ratio: 13/1). All the standard signs and symptoms are reported, with a clear predominance of alcoholic polyneuropathy and hepatic encephalopathy. The study of nutritional status by both body mass index (BMI) and the Detsky criteria showed that these patients were severely malnourished. The brain MRI was a crucial contribution for diagnosing the standard central nervous system complications of alcoholism: Gayet Wernicke encephalopathy, Marchiafava-Bignami disease, Korsakoff syndrome, central pontine myelinolysis, and cerebellar degeneration.

Etude des oesophagites a Bamako : a propos de 228 cas

Les auteurs de cet article ont eu comme principal objectif d'etudier la prevalence des oesophagites au moyen de l'endoscopie digestive haute. En 12 mois ils ont collige 228 cas d'oesophagite dans 63;59 pour cent des cas chez l'homme adulte jeune. L'oesophagite peptique a ete plus frequente et ses aspects congestifs ont ete plus courants. La principale indication de l'endoscopie chez les malades atteints d'oesophagite a ete les epigastralgies

[Anatomo-clinical study of chronic gastritis in Mali]. / Etude anatomo-clinique des gastrites chroniques au Mali.

The aim of our study was to evaluate the frequency of chronic gastritis and its anatomoclinical aspects in Mali. Within thirteen months of prospective study, we have recorded seventy four chronic gastritis histologically confirmed which represented 3.28% of the total oesogastroduodenal pathologies registered during the same period (2256 cases). Chronic gastritis has been most observed between 31 to 40 years (24.3%) and women were affected (sex ratio = 0.6). Households and civil servants were predominant. The precocious burning epigastralgy just after the meal was the main motive of the examination and chronic gastritis has been a fortuitous discovery. The basic alimentation included smoked or dried fish, peanuts, "tô" and salt. The most frequent endoscopic aspect was the congestive one. The duodenogastric reflux was not negligible. The diffuse form and antral localisation were more frequent. Five displasiae and four intestinal metaplasiae have been found.

[Esophagitis in Bamako. Apropos of 228 cases]. / Etude des oesophagites A bamako. A propos de 228 cas.

Our main objective has been to study the prevalence of oesophagitis by upper digestive endoscopy. Within 12 months, we have registered 228 cases of oesophagitis out of 612 oesophagean anomalies (37.25%) during 3019 fibroscopies. Oesophagitis has been found to 63.59% in cases in young adult men. Peptic oesophagitis has been most frequent and its congestive aspects most current. The main indication of endoscopy in patients suffering of oesophagitis has been epigastralgies.

[Incidence of malaria and S hemoglobinopathy in the pediatric hospital milieu in Bamako, Mali]. / Incidence du paludisme et hémoglobinose S en milieu hospitalier pédiatrique bamakois au Mali.

A study on the incidence and gravity of malaria among children suffering of sickle cell anemia was carried out in the pediatric hospital of Bamako-Mali. On the 236 cases of fever studied, 54.2% were malaria infected and 21.2% were carriers of the sicklemic trait. There was a significant difference between malaria affecting AA children and HbS children, specially concerning parasites load.

Contribution endoscopique a l'etude de la pathologie recto-colique en milieu tropical : a propos de 80 colonoscopies realisees a l'hopital national du point G de Bamako

Cette etude perspective; qui a porte sur 80 colonoscopies de janvier 1989 a fevrier 1990; interessant 53 hommes et 27 femmes a l'hopital national du point G de Bamako; a permis d'abord de preciser les indications qui sont les douleurs abdominales; les rectorragies et les diarrhees. Elle montre aussi que les lesions siegent le plus souvent au niveau du rectum et du sigmoide dans 69;81 pour cent des cas et puis repertorie les principales etiologies representees par les colites non specifiques; la rectocolite hemorragique et les cancers colorectaux. Cette etude permet enfin de proposer un suivi des colites non specifiques qui est d'un interet majeur pour la recherche etiologique

Cancer in Mali, 1987-1988.

Results from the population cancer registry in Bamako, Mali, for the years 1987 and 1988, are presented. The age-standardized incidence for all cancers is high compared with rates reported elsewhere in West Africa (119.6 per 10(5) in males and 88.3 per 10(5) in females), but the leading cancers in each sex are the same (liver cancer in males, cervix cancer in females). The incidence of stomach cancer is the highest recorded in Africa, while rates for lung cancer, although low, exceed those in earlier series from registries in the region.

[Sinus histiocytosis with extensive adenopathy in a Mali child]. / Histiocytose sinusale avec adénopathies massives chez un enfant malien.

Destombes, Rosai and Dorfman's sinus histiocytosis (HS) is a rare disease. Many cases have been reported in Africans, particularly in children. Case reported here is the second malian clinical report. Its particularities are difficulties for the histological diagnosis with confusion with Hodgkin's disease, a temporary decrease of adenopathies after vincristine therapy, an eosinophilic infiltrate of lymph nodes and a long evolution during at least 4 years. The pathological physiology of HS remains uncertain. The benign natural course of the disease does not justify employment of chemotherapy.

[African histoplasmosis in Mali]. / L'histoplasmose africaine au Mali.

Twenty-four cases of histoplasmosis have been diagnosed since 1945 in native Malians (20 cases) or Europeans living in Mali (4 cases). Seventeen cases have already been published and 7 other cases diagnosed recently in Bamako or Marseille are reported here. Mali is within the African histoplasmosis zone and the Kayes district may be a particularly endemic zone. The disease affected the skin (62 p. 100), lymph nodes (46 p. 100), bones (21 p. 100), gastrointestinal tract (26 p. 100) and lungs (4 p. 100). A rare lesion of the uvula is also reported. Direct fungal and histopathological techniques are the easiest and the most effective diagnostic investigations. All cases were due to Histoplasma duboisii. Amphotericin B was used in over 60 p. 100 of cases for an average period of 3 months. The total recovery rate was 66 p. 100.

[Major eosinophilia in bronchial cancer in an African man]. / Hyperèosinophilie majeure au cours d'un cancer bronchique chez un Africain.

Paraneoplasic syndromes an unusual cause of eosinophilia in tropical countries. We report a case of major eosinophilia in a black Malian's bronchopulmonary cancer. A decrease of eosinophilia under antineoplastic chemotherapy is noted. Several physiopathologic hypothesis have been propounded in the literature, particularly the secretion by the tumour of a stimulating hormone for the production of eosinophil cells by the bone marrow.

[Estimation of the impact of the principal diseases in rural Mali]. / Estimation de l'impact des principales maladies en zone rurale malienne.

The authors assess the health impact of major diseases in the circles of Kita, Bafoulabé and Kenieba (Western Mali) by measuring, for each of them, the number of healthy days of life lost through illness, disability and death. Malaria, birth diseases, infant gastro-enteritis and pneumopathies, measles, malnutrition and hemoglobinopathies account for 58.1% of healthy life lost due to all studied diseases. Parasitic diseases (except malaria), tuberculosis, leprosy are less important than usually said; on the contrary, the impact of hepatic, cardiovascular, and eyes diseases is great. In developing countries assessing the number of healthy days lost by the community due to different diseases is usefull to choose the health priorities and to compare the cost/effectiveness ratio of different health programs.

[Importance of proctological examination in tropical environment. Apropos of 1000 rectoscopies performed at the Hospital of Bamako]. / Intérêt de l'examen proctologique en milieu tropical. A propos de 1,000 rectoscopies effectuées à l'Hôpital de Bamako.

Analysing the results of 1,000 procto-sigmoidoscopies done in Bamako (Mali), the authors asses the major indications of this examination in Africa: rectal biopsy is quite efficient for the diagnosis of schistosomiasis; hemorroides and proctitis are frequent while tumors seem rare.

[Cytodiagnosis of hepatoma. Apropos of 100 fine needle punctures of primary cancers of the liver]. / Cytodiagnostic des hépatomes. A propos de 100 ponctions à l'aiguille fine de cancers primitifs du foie.

The authors report the results of 100 liver biopsies with fine needle aspiration performed in patients with primary hepatocellular carcinoma (P.H.C.). The method is simple, quick, without danger and reliable: cytodiagnosis on aspirated material shows typical P.H.C. in 69 p. 100 of cases and probable P.H.C. in an additional 21 p. 100 of cases. Peritoneoscopic or ultrasonic guidance gives even better results.

[Hemoglobin C in a hospital milieu in Bamako (Mali)]. / L'hémoglobinose C en milieu hospitalier bamakois (Mali).

An hospital survey, performed in Bamako (Mali, West Africa) showed 7.5% haemoglobin AC, 0.4% haemoglobin CC, 1.6% haemoglobin SC and 0.2% haemoglobin CA (haemoglobin C-beta+thalassaemia). Haemoglobin C was mostly prevalent among Bobo, Mossi, Senoufo, Minianka and Dogon coming from the Southern border of Mali. Haemoglobin SC and to a lesser extent haemoglobins CC and CA often induce haemolysis and vasoocclusion. Microcytosis is common, even in the absence of anaemia.

[Epidemiology and pathologic results of chronic carriers state of hepatitis B in Mali]. / Epidémiologie et conséquences pathologiques du portage chronique du virus de l'hépatite B au Mali.

The HB antigen of the hepatitis B (HB) virus, studied by counter immunoelectrophoresis shows a prevalence of 8.7% in 1,860 rural Malians and 11.3% in 764 blood donors from Bamako. Amongst 1,350 hospitalised patients, no correlation could be established between the HBs antigen chronic carriers state and other infectious diseases, malnutrition or genetic deficiencies. On the other hand, the prevalence of HBs antigen is particularly high in hepatic infections: acute and chronic hepatitis (53.5%), cirrhosis (31.5%) and hepatomas (25.3%). The study of the prevalence of hepatitis B by radioimmunoassay of the HBV seric markers was carried out in: --176 "healthy" town dwellers of which 97.2% were carriers of at least one marker--HBs Ag: 16.5%; anti-HBc alone: 34.1%; anti-HBs: 46.6%--. --30 subjects with cirrhosis--HBs Ag: 66.7%; anti-HBc alone: 10.0%; anti-HBs: 23.3%--. --42 subjects with PHC--HBs Ag: 47.6%; anti-HBc alone: 23.8%; anti-HBs: 28.6%--. The difference in HBs Ag carrier state between patients (cirrhosis and PHC) and controls, cross-matched for sex and age, is highly significative--p = 0,0001--.