Evaluation de la qualité de vie après mastectomie pour cancer du sein au CHU Gabriel Touré / Evaluation of the quality of life after mastectomy for breast cancer at the Gabriel Touré university hospital

Les thérapeutiques oncologiques entraînent des répercussions sur la qualité de vie des patientes. Cette qualité de vie constitue un élément cardinal dans le parcours de soins de malades. Nous avons initié ce travail pour évaluer la qualité de vie après mastectomie. Matériel et méthode : Nous avons réalisé une étude transversale descriptive sur une période de 5ans allant de janvier 2016 à décembre 2020 au service de chirurgie générale au CHU Gabriel Touré. Nous avons inclus tous les patients opérés pour cancer du sein avec preuve histologique et ayant subi une mastectomie et acceptant de répondre au questionnaire. Résultat : Le questionnaire QLQC3O est une échelle spécifique au cancer utilisée pour établir le score sur la qualité de vie comme beaucoup d'autres mais à la différence d'être plus simple, facile d'utilisation et plus utilisé. Nous avons enregistré 79 cas de mastectomie pour cancer du sein. La prévalence de la mastectomie était de 5,8%. L'âge médian était de 58 ans. Les patientes avaient au moins un enfant dans 92,38%. Le carcinome canalaire de type non spécifique était le type histologique le plus fréquent avec 87,33%.Les effets secondaires de la mastectomie affectent le domaine des symptômes ont constitué l'étape la plus difficile à supporter avec p value non significatif. Ces situations ont sérieusement affecté l'estime de soi. Parmi les effets secondaires affectant la qualité de vie (52 cas), les troubles digestifs (22 cas) étaient au 1er plan suivis de dyspnée (7 cas) et des difficultés financières (8 cas) qui ont abouti à la vente de biens. Conclusion : La place de la qualité de vie reste incontestable dans la stratégie thérapeutique et son évaluation améliore quant au choix thérapeutique.

Oncology therapies have repercussions on the quality of life of patients. This quality of life is a cardinal element in the care pathway of patients. We initiated this work to assess the quality of life after mastectomy. Material and method: We carried out a descriptive cross-sectional study over a period of 5 years from January 2016 to December 2020 in the General Surgery Department of the Gabriel Touré University Hospital. We included all patients who had undergone surgery for breast cancer with histological evidence and who had undergone a mastectomy and agreed to answer the questionnaire. Results: The QLQC3O questionnaire is a cancer-specific scale used to establish the quality of life score like many others, but with the difference that it is simpler, easier to use and more widely used. We have recorded 79 cases of mastectomy for breast cancer. The prevalence of mastectomy was 5.8%. The median age was 58 years. Patients had at least one child 92.38%. Non-specific ductal carcinoma was the most common histological type with 87.33%.The side effects of mastectomy affect the area of symptoms were the most difficult stage to bear with p value not significant. These situations have seriously affected self-esteem. Among the side effects affecting quality of life (52 cases), digestive disorders (22 cases) were in the first place, followed by dyspnea (7 cases) and financial difficulties (8 cases) which resulted in the sale of goods. Conclusion: The place of quality of life remains undeniable in the therapeutic strategy and its evaluation improves the therapeutic choice

[Materno-Fetal Prognosis Of Anemia In Bougouni]. / Pronostic Materno-Fœtal De L'Anemie A Bougouni.

GOAL: The goal was to assess the maternal-fetal prognosis of anemia in pregnant women in the Bougouni reference health center. METHODS: We carried out a prospective descriptive and analytical cross-sectional study from January 1 to December 31, 2013 at the Bougouni reference health center. It covered all pregnant women with a hemoglobin level below 11g/dl regardless of the outcome of the pregnancy. RESULTS: The prevalence of anemia in pregnant women was 33.2%. They were women married to peasants in 88.6% of cases, unschooled in 93.2% of cases, having not done antenal care in 56.8% of cases. Malaria was the most common etiology in 75% of cases. Anemia was severe in 61.4% of cases. The maternal-fetal prognosis was dominated by 3.3% of maternal death, 12.5% of abortion, 7.6% of prematurity and 6.8% of fetal death in utero. CONCLUSION: Anemia in pregnant women is the source of many maternal-fetal complications.

BUT: Le but était d'évaluer le pronostic materno-fœtal de l'anémie chez la femme enceinte dans le centre de santé de référence de Bougouni. MÉTHODES: Nous avons réalisé une étude transversale prospective descriptive et analytique du 1er janvier au 31 décembre 2013 au centre de santé de référence de Bougouni. Elle a porté sur toutes les femmes enceintes ayant un taux d'hémoglobine inférieur à 11g/dl quelle que soit l'issue de la grossesse. RÉSULTATS: La prévalence de l'anémie chez les femmes enceintes a été de 33,2%. Il s'agissait de femmes mariées à des paysans dans 88,6% des cas, analphabètes dans 93,2% des cas, n'ayant pas fait de consultations prénatales dans 56,8% des cas. Le paludisme a été l'étiologie la plus fréquente dans 75% des cas. L'anémie était sévère dans 61,4% des cas. Le pronostic materno-fœtal a été dominé par 3,3% de décès maternel, 12,5% d'avortement, 7,6% de prématurité et 6,8% de mort fœtale in utéro. CONCLUSION: L'anémie chez la femme enceinte est pourvoyeuse de nombreuses complications materno-fœtales.

[Infectious etiology of diarrheal morbidity in a Senegalese region of high exposure to Schistosoma mansoni]. / Etiologie infectieuse de la morbidité diarrheique dans un foyer sénégalais fortement exposé à Schistosoma mansoni.

Endemic schistosomiasis due to Schistosoma mansoni has been observed in Richard-Toll (The Senegal River basin) in Senegal since 1990. Because of its high prevalence, schistosomiasis is assumed to be the cause of most cases of diarrhea observed in the region. The purpose of the present study carried out within the framework of the ESPOIR program for control of bilharziasis in the Senegal River region was to confirm the exact etiology of diarrhea in the region. A total of 109 subjects presenting diarrhea including 57 children under the age of 5 years were included in the study. In all cases, stool examination using appropriate techniques was performed to detect bacterial, viral, and parasitic agents. Schistosoma mansoni was identified in 47 cases (43.1%). Stool cultures were positive in 28 cases (25.6%) for Escherichia coli (n = 9), Shigella spp. (n = 18), and Salmonella spp. (n = 1). With regard to Shigella, a predominance of the Shigella dysenteriae type I stereotype (10/18) and a high incidence of co-infection involving Shigella spp. and Schistosoma was noted. Rotavirus infection was observed in 6 cases involving subjects under the age of 5 years. The relative incidence of the different infectious agents varied widely in function of age. This study in an endemic area of bilharziasis in Senegal demonstrates that Schistosoma mansoni should not be assumed to account for all cases of diarrhea occurring in the area.

Etude epidemiologique des affections oeso-gastro-duodenales au Mali au moyen de la fibroscopie digestive haute

L'objectif principal a ete d'evaluer au moyen de la fibroscopie digestive haute la frequence des affections oeso-gastro-duodenales au Mali. Sur 2864 examens pratiques; 1963 (68;54 pour cent) ont permis la decouverte de 2386 lesions (associations frequentes de differentes lesions). L'estomac a ete le plus frequemment touche (54;27 pour cent). Les gastrites ont domine la pathologie (46;19 pour cent). L'homme jeune de 21 a 40 ans a ete le plus affecte. Le symptome le plus frequent a ete l'epigastralgie. Il n'a ete constate aucune particularite quant a l'ncidence des anomalies constatees; selon la profession; la residence et l'ethnie

Management of STDs and cost of treatment in primary health care centres in Pikine, Senegal.

We studied the current management of STD-related syndromes by urban health facilities in Pikine (Senegal) in 252 consecutive patients presenting with STD-related complaints, to assess the cost and effectiveness of services and to estimate the potential benefit by introducing management protocols. Most common presenting complaints for women were vaginal discharge and low abdominal pain, reported for 122 (82.9%) and 22 (15.0%) of 147 female patients. Urethral discharge and genital ulceration were reported for 80 (76.2%) and for 17 (16.2%) of 105 male patients. The average cost was 4.01 ECU (1 European Currency Unit = 1.2 US$ = 334 Franc CFA) for male patients (ranging from 0.57 to 25.70 ECU) and 12.75 ECU for female patients (ranging from 0.57 to 37.60 ECU). Only 20 of 80 patients with urethral discharge (25%) received effective treatment. Effectiveness was not related to cost of therapy or qualification of staff. Utilization of management protocols improves the quality and accessibility of care for STD, by potentially doubling effectiveness and reducing the costs for patients to 12% of the current level.

Simultaneous injection of hepatitis B vaccine with BCG and killed poliovirus vaccine.

In most developing countries, hepatitis B virus is endemic and prevention has to be carried out early in life and on a mass scale. In these regions, simultaneous administration of multiple antigens is normal practice. We have therefore investigated the interaction of hepatitis B vaccine with BCG and inactivated polio vaccine. The serological antibody response to poliovirus and HBsAg as well as the cellular immune response to tuberculin post BCG immunization were assessed. The immune responses to HBsAg, BCG and polio vaccines injected simultaneously were comparable to those observed after separate administration of each vaccine. Moreover, no increase of adverse reactions was noted. Results confirmed that HB vaccine could be introduced into the WHO expanded programmes on immunization without impairing the expected protective efficacy against the targeted vaccine-preventable diseases.

Comparative immunogenicity in children of mammalian cell-derived recombinant hepatitis B vaccine and plasma-derived hepatitis B vaccine.

Three doses of hepatitis B vaccine were given at 2, 4 and 9 months of age to 220 Senegalese infants living in the Dakar area of Senegal. Half of the infants received 5 micrograms plasma-derived hepatitis B vaccine (Hevac B) and the remainder 20 micrograms mammalian cell-derived recombinant hepatitis B vaccine (GenHevac B). Both vaccines contain S and pre-S2 encoded proteins; however, the recombinant vaccine had a much higher pre-S2 content than the plasma-derived vaccine. Adverse reactions to both vaccines were limited to mild and transient soreness at the injection site. Fever was reported in 14-21% of the infants and was likely to be related to DTP-polio vaccine which was given simultaneously. After the two first doses, seroconversion rates and geometric mean titres of anti-HBs were higher in infants receiving the recombinant vaccine than in infants receiving the plasma-derived vaccine. After completion of vaccination, all infants in both groups had protective levels of anti-HBs antibodies. The recombinant vaccine induced more rapidly antibodies directed against S and pre-S2 epitopes. Anti-pre-S2 antibodies were detected after the first injection of GenHevac B and only after the third injection of Hevac B. From the data, GenHevac B vaccine is expected to be as effective as Hevac B vaccine for controlling hepatitis B infection.

[Sexually transmitted diseases in the female population of Pikine, Senegal]. / Maladies sexuellement transmissibles dans la population féminine à Pikine, Sénégal.

The prevalence of some sexually transmitted disease is determined in 250 gynaecology patients and in 200 pregnant women seen in primary health centers in Pikine, Senegal. The main reason for consultation at gynaecology is infertility. Gonorrhoea and Chlamydia trachomatis infection are present respectively in 1.5% and 7% of pregnant women and in 4.4% and 7.6% of gynaecology patients. Human papillomavirus infection, determined by DNA extraction and hybridization technique, is seen in 4% of obstetric and in 1.2% of gynecology patients. Cytological anomalies is found in 5.5% of pregnant women and in 4.8% of gynecology patients.

[Some exceptional evolution of the abdominal pregnancy (author's transl)]. / Evolutions exceptionnelles de la grossesse abdominale.

The authors have reported 5 exceptional cases of abdominal pregnancy observed at the clinic of obstetrics and gynecology of the university of Dakar. This pathology remains important and shows various clinical aspects in these counties presenting insufficient medical development. In a review of the literature the authors have studied the frequency and the etiopathogenic aspects of this "dystocical" pregnancies.